#77 – AMA #2 with sleep expert, Matthew Walker, Ph.D.: short sleep mutants, optimal sleep environment, sleep apnea, & rapid fire questions
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Summary
In this episode, Dr. Peter Atiyah discusses why we don't run ads on this podcast, and why instead we rely entirely on listener support to sustain it. He also interviews Dr. Matt Walker, who is a professor of neuroscience and psychology at UC Berkeley and the Director of the Center for the Human Sciences and Psychology at the First Time Institute.
Transcript
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Hey everyone, welcome to the Peter Atiyah Drive. I'm your host, Peter Atiyah.
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The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
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along with a few other obsessions along the way. I've spent the last several years working with
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some of the most successful top performing individuals in the world. And this podcast
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is my attempt to synthesize what I've learned along the way to help you live a higher quality,
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more fulfilling life. If you enjoy this podcast, you can find more information on today's episode
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Hey everyone, I'd like to take a couple of minutes to talk about why we don't run ads on this podcast
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and why instead we've chosen to rely entirely on listener support. If you're listening to this,
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you probably already know, but the two things I care most about professionally are how to live
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longer and how to live better. I have a complete fascination and obsession with this topic.
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I practice it professionally and I've seen firsthand how access to information is basically
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all people need to make better decisions and improve the quality of their lives.
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Curating and sharing this knowledge is not easy. And even before starting the podcast,
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that became clear to me. The sheer volume of material published in this space is overwhelming.
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I'm fortunate to have a great team that helps me continue learning and sharing this information
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with you. To take one example, our show notes are in a league of their own. In fact, we now have a
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full-time person that is dedicated to producing those and their feedback has mirrored this. So all of
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this raises a natural question. How will we continue to fund the work necessary to support this? As you
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probably know, the tried and true way to do this is to sell ads. But after a lot of contemplation,
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that model just doesn't feel right to me for a few reasons. Now, the first and most important of these
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is trust. I'm not sure how you could trust me if I'm telling you about something when you know I'm
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being paid by the company that makes it to tell you about it. Another reason selling ads doesn't
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feel right to me is because I just know myself. I have a really hard time advocating for something
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that I'm not absolutely nuts for. So if I don't feel that way about something, I don't know how I
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can talk about it enthusiastically. So instead of selling ads, I've chosen to do what a handful of
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others have proved can work over time. And that is to create a subscriber support model for my
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audience. This keeps my relationship with you both simple and honest. If you value what I'm doing,
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you can become a member and support us at whatever level works for you. In exchange, you'll get the
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benefits above and beyond what's available for free. It's that simple. It's my goal to ensure that
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So for example, members will receive full access to the exclusive show notes, including other things
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that we plan to build upon, such as the downloadable transcripts for each episode. These are useful
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asking questions directly into the AMA portal and also getting to hear these podcasts when they come
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out. Lastly, and this is something I'm really excited about. I want my supporters to get the best
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deals possible on the products that I love. And as I said, we're not taking ad dollars from anyone,
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but instead what I'd like to do is work with companies who make the products that I already love and would
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already talk about for free and have them pass savings on to you. Again, the podcast will remain
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I want to thank you for taking a moment to listen to this. If you learn from and find value in the
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My guest this week is Matt Walker. Many of you are familiar with Matt because in April of this year,
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we released a three-part series on sleep that was probably one of the most listened to series we ever
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released. These have been really popular podcasts and it's reflected in the fact that many of you have
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requested a specific AMA with Matt, which we did. And we are now back for a second version of that.
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And for those of you perhaps listening to Matt for the first time, Matt's a professor of neuroscience
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and psychology at UC Berkeley and the founder and director of the Center for Human Sleep Sciences.
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I will gloss over the remainder of his bio because you can find it everywhere else,
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but needless to say, it has all of these ridiculous accolades and he's just kind of an all-around total
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stud. He's also the author of an international bestseller, Why We Sleep. And very recently in 2019,
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this year that is, he gave a TED talk that was incredibly well received. We linked to that
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previously and we will do so again. Now in this AMA, which again, as a reminder, these are for
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subscribers only. So if you're not a subscriber, you're going to be able to hear a little bit of
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this. If you are a subscriber, you're going to want to activate your RSS feed so that you can hear
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this entire thing in an uninterrupted fashion. And by the way, that also means you will hear all
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podcasts in an uninterrupted fashion without any of the other sort of housekeeping stuff that is
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not necessarily intended for you at this point. So what do we talk about? We talk about a bunch
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of things. We talk about the deck two mutants. These are folks who actually don't need to sleep
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that much. We talk about a whole bunch of environmental factors that you've asked about
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as they pertain to sleep, you know, position, temperature, other tools and tricks that may or
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may not help us sleep, elevation, all these sorts of things. We then kind of go into a, what we call
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I did or took an am this sort of thing. And is it hurting or helping? So getting into caffeine,
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getting into sex, talking about the role of parents with young kids and things like that.
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We get into a little bit of sleep apnea before rounding out a speed round where we go through
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a bunch of, you know, kind of a potpourri of questions that are all over the place. I thought,
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just personally, I thought this AMA brought up a lot of questions that I had. So I was really
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happy to see that. And I think we actually got through every single question on the AMA. It took
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a little while, but we did. And I'm not going to put Matt on the spot, but I suspect he'd probably
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be willing to do a third round of this in some period of time. Oh, he's giving me the thumbs up
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because I'm doing this intro while he's getting ready to go for a run. So with nothing else to say
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on the topic, please enjoy our follow-up AMA with Professor Matt Walker.
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All right, everyone coming to you from warm Bakersfield, California this evening. Matt,
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thank you so much for agreeing to sit down again to do an AMA and no less on a day when the two of
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us are probably about as exhausted as we could be. I mean, I got to be honest with you. If you had
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said to me, Peter, I don't have it in me to do this. I just want to go to bed right now. I would
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have seconded that motion 10 minutes ago. Well, firstly, it is a delight and a privilege to be back
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on. And thank you so much for having me. And thank you for the experience that we've just had here.
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I would say I am ecstatically exhausted. Yeah, we were sort of joking about it after that last
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session today that I can understand why there are probably people who have never been involved in
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motorsport and don't follow it and don't care about it that sort of look at it and think, well,
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that's not really a sport, is it? I mean, people driving a car fast is not really a sport, but
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certainly anybody who's done it would disagree with that. Hemingway, there's a great Hemingway
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quote, which I'm sort of paraphrasing, but the gist of it is there are only three sports,
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bullfighting, motor racing, and mountaineering. The rest are all games.
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And I understand that now so much. I mean, I think we were coming out of the car,
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the temperatures were over a hundred degrees. We were coming out of the car at the end of our
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sessions looking visibly thinner as a consequence. And we were probably only in the car for like 20,
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30, 40 minutes. Incredible. I think I will go home firstly, looking like I slept with a coat hanger
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in my mouth. And the second is that after the first day I made the decision that I need to sit
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down. I need to understand what is the minimum I can spend on food, sort of salad, rice, beans.
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What is the need for me to put a roof above my head? And then everything else in terms of income
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is motorsport. This was a great couple of days and we had a great crew and a great coach and a great
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track and amazing conditions. And I mean, I guess I know people, I think get the sense how much we
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both love this, but we talked about this idea of there's a feeling when you're out there, when
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everything is in this sort of groove and it's hard to imagine you could be so pulled back from
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anything else and everything else that's happening. So, you know, people talk about this flow state and
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you can find this in so many different areas, but I've never experienced it to a greater extent than in
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a car. You're so right. You are present in that moment and there is nothing else. There's nothing
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else behind you in terms of recollection. There's no prospection forward in terms of thinking about
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the future. And I think I would almost liken it to bring it back to sleep because that's of course
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what I do. But when you first wake up in the morning, there's just that one or two slivers of
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seconds of time where you remember nothing about yesterday, none of your troubles, difficulties.
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You remember none of the anxiety that's coming up in the next day. It's just you in that moment
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and it lasts so briefly. But when you get into motorsports and into a car and on a track,
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it's that perpetually lap after lap with a lot more G-force. But other than that, that state of
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being present and pure, there is something incredibly, there's an authenticity of consciousness
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that you get. And that sounds pompous and I really don't mean it to, but it is an elegant
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condition. One that leaves you with a neck that is so sore the next morning because of the G-forces
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that you're pulling. That's the only reason that you remember how difficult it was, but what an
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What was the highlight for you these couple of days here?
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I think, I mean, this is really the first time that I've been on track and to understand the
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limits of a car. Now we had a car that was, it wasn't just your typical street car. It was a notch
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above that. But to truly understand the limits of a car in a way that you should never, and you must
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never test on a street and to see how far beyond what I thought it was capable of. And it was so beyond
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my skill level too. And we got in with this incredible instructor and he took it to the limit,
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but to feel the limit of a mechanical object designed for purely one purpose and one purpose
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alone. Oh, that is a very special thing. And to even feel 50% of it or 20% of it is something that
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Well, the good news is one, you're going to do it a heck of a lot more because now I've got my hooks
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in you so you're not going back. But we haven't discussed this actually. So I know that some
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people, I promise we're going to talk about sleep. Matt and I will stop talking about cars, but I knew
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when we got to the track that Thomas always wants to shake the car down first. And I was so happy for
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you to get in the car that first time to see it. And I also knew it was going to have this weird
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outcome, which is you're going to come out of that car. And in, in one way, it's going to excite you
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beyond belief, but another way you're going to be like, there's no way that car can move that
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quickly. Like I'll never be able to make it go that fast. And of course the answer is,
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of course you won't. Neither of us will. We would spend the rest of our lives and we probably could
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never get a car to go that fast, but you still got a glimpse of what's possible.
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And I think one of the difficult things with driving is everyone drives, but not everyone plays
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different professional sports. So if you see a pitcher throwing a ball and you think that is a
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remarkable skill. Yeah. We all throw a ball every now and again, but almost every day,
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most people, or perhaps not every day, but people are driving all of the time.
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So I think that fools people into thinking, well, how much more skill is required to be not just a
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driver, but a race car driver. And it turns out it is just as large as you sitting, watching your
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television and seeing David Beckham bend a ball into the net. By the way, my Liverpool supporter,
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it's a bad example considering as Manchester United history, but you get the idea, which is,
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I think we get fooled into thinking that it really isn't that much more difficult. How much more do
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you have to train and how much more skilled do you have to become? And the answer, as I've learned
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by turning the car backwards a few times over the past two days is a great deal, but gosh.
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But that's part of its joy. I think is, I was talking about this on another podcast once, which was
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the beauty of something like car racing. And I feel the same way about archery is they are really
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easy to do at some level. In other words, anybody can drive a car and anybody could shoot a bow,
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maybe not well or not far or whatever, but they're very difficult to do well. Whereas tennis is kind
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of hard to do. If you took someone who's not remotely athletic and you handed them a tennis racket and
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made them go and play against somebody, they might not even be able to return a single serve,
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but everybody can drive. Yeah. The bandwidth of opportunity is great. So it's not too hard to
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get on the bottom rung. Yeah. Well, we're going to work on our curriculum and we'll build that a
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curriculum over the next few years with the goal of you owning a race car one day. And I just want
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to be able to put one sticker on it and you know what that sticker is going to say. I do. And I'm not
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going to repeat it here, but an inbound sticker for my Mazda Miata MX-5.
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Nice. So moving on to the AMA, which is why we're here, Matt, this is a first time when we've had a
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repeat AMA on the exact same topic. And I think it speaks to two things. The first is how much people
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want to understand sleep. And I think that's such a credit to the way you've been able to articulate
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it and the attention you have brought to this subject. And then the second point is really also that
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it's that you are very proficient at talking about it. And the breadth of questions we get on
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this is incredible. I mean, we're going to lead off with kind of some technical stuff. And then
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there's some great questions. I looked through this list recently and it's really fun because
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people think of better questions than I can think of. Yeah. And if anyone's starting to lose
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a little bit of attention or will to live at this moment, I promise you masturbation is coming up.
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So stay tuned. Yes. All right. So let's start by talking about,
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this is actually kind of a question from me because this question feeds out of an email
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exchange you and I had several months ago about the DEC2s. So these are a genetic mutation that
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produces a short sleeping phenotype. Can you tell us a little bit more about people with this mutation
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and what it does? Yeah. So these are the acclaimed short sleepers that people have started to become
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aware of. I mean, it got a lot of media attention and the gene is called DEC2, DEC number two.
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And they are the short sleepers that we found. They are a genetic mutant that seems to,
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which sounds a little bit X-Men by the way. These are individuals who have a gene that,
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and that gene seems to mean that they don't sleep as much as most people or as much as most people
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should be sleeping. So their sleep need is lower than we have typically seen before.
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And I think there are several important things to point out to the public. Firstly,
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when I describe the short sleeping gene phenotype, most people start to think, well, that's probably
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me. I think I'm one of those who can get away with five hours of sleep. Firstly, the probability that
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you are a DEC2 carrier is very low. It's a fraction of a percent of the population right now.
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So you're far more likely to be struck by lightning in your lifetime, it turns out statistically,
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than to have this gene, just to sort of frame that context and expectation in people's mind.
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The second, I think, interesting part of this is, well, how much do they sleep? And we've got all
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of these sort of chest beating heads of state like Thatcher and Reagan, and more recently,
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Donald Trump, espousing five hours or four hours. Is this the realm of the DEC2 individual?
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And the answer is no. So if we bring these individuals into the lab and we just take
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away their phone, no clocks in sight, and we just let them sleep what we call the habitual amount.
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So you put them to bed, you let them fall asleep when they want, and you let them wake up and you
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let them sleep as much as they typically would want, or even physiologically can. And where they come
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out is at about 6.25 hours of sleep. In other words, six and a quarter hours of sleep.
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So this is not your five hours or four hours. And this is the genetic mutant that is the short
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sleeper, and they are getting six and a quarter hours. And the reason that kind of concerns me is
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if you look at America right now, the average American adult is sleeping about six hours and
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31 minutes during the week. So genetic mutant only needs a few minutes less than what the average of
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the population is getting. Now, by the way, that's the average, which must mean that there's a large
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tail of the distribution that is sleeping considerably less than six and a half hours.
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A vast proportion of them do not have the DEC2 mutant gene.
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And just to refresh everybody's memory, when you do that same type of a sleep study on the majority
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of the population, the rest of us have an equilibration at how many hours is the optimal?
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Yeah, it's somewhere between about seven and a half to nine and a half hours.
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It is an enormous range. And some of that has to do with age, because as we get older, even though we may
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need as much sleep as we did when we were younger, physiologically, we just can't generate that sleep that we need,
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which may actually be pulling that number down because those numbers are generated.
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It actually may be that we generate even more adenosine as we get older, but there are a number
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of reasons why. Firstly, the parts of the brain that deteriorate with aging, your brain doesn't
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deteriorate homogeneously as you get older. Some parts of the brain deteriorate what we call atrophy
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more quickly than others. Unfortunately, those areas are the sleep generating areas, particularly the deep
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sleep generating areas, especially a region that we call the prefrontal cortex and the middle part
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of that. So take your thumb, stick it between your eyes, raise it up about an inch or an inch and a
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half, and you're right there. That's your medial prefrontal cortex. That's a deep sleep generating
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region. It's one of the epicenters for the generation of cortical deep sleep. That part of the brain
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atrophies quickly, it also accumulates beta amyloid most significantly and early on.
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So for that sort of sweet spot for the general public, we can do those washout studies where we
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bring them into the lab, or you can do another great study. People just took them up hiking in
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the Rocky Mountains, dislocated them from all of modernity, no electricity, no phones, not even
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matches a candlelight. And firstly, what you find is that they sleep long. They slept sort of almost
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close to, on average, about nine hours. Now, these were pretty young, healthy folks. Probably the
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more striking part of that data to me, however, was when they were sleeping. If you look at what
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they were saying their habitual bedtime was, it was 11 midnight, and they were actually going to bed
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around sort of 9, 9.30 in the evening. And it always strikes me when you think about this term
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midnight and what it actually means. Midnight actually means middle of the night. And it is
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when you let yourself sleep in harmony with the natural edict. But for most of us, that's the time
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when we think, well, yeah, I should just send my last tweet or check my email. That's midnight for us.
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But so for the deck twos, they definitely seem to sleep less, but it's nowhere near the proclaimed
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sort of media hype that is just four or five hours. They need still considerably more.
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And do we know if there are any health consequences to people that have a deck two mutation? Is it
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acquired or are there any twin studies that could compare or at least sibling studies?
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There are, there've been some twin studies that they've looked at too. One twin has the gene,
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one does not. And you actually get some interesting findings from that, which I'll come on to in a
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second that may explain why they could be a short sleeper. The answer to your question though,
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the health consequences is that we just don't know. And we don't know for two reasons.
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Firstly, we haven't known about this genetic mutation for very long. So we haven't been able
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to actually pick up these people and then track them longitudinally across the lifespan and see
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as they move with age, are they filled with more disease, less disease, or no difference in terms of
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their risk ratio for these typical things that we know are causally related to a lack of sleep?
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Are they living more with sort of disease right now at whatever age they are? There's just too
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few of them for us to make any statistically meaningful sense of that equation. So I think
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right now the answer is going to come much later for humans. I think the answer could come more
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quickly. However, if we look at genetic mouse models, where we create that same mutant and you
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can fast track those questions. But in terms of humans right now, I think we just don't know.
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And do we know if they disproportionately suffer one stage loss versus another?
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Yes, they seem to under certain conditions. So one way that we can try to assess what your sleep need
00:22:12.300
is paradoxically is to bring you into the lab, deprive you of a night of sleep, and then look at how
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hard you rebound in terms of your sleep appetite on the following recovery night. And that's almost a
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way for us to sense or get a measure of how sort of healthy and virulent is that sleep system. And
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that's what they've done with these individuals. Firstly, what you see is that when they sleep,
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when they have their sleep recovery and their rebound, they rebound much harder in terms of deep sleep.
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They actually have a lot more deep, non-rapid eye movement sleep. So that's dreamless sleep,
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and especially the deeper stages of deep sleep. It's even more evident if you look at the electrical
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quality of that deep sleep, not just quantity minutes, but the actual power and depth of those
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deep sleep brainwaves. So at that level, I started to actually get quite bullish on the idea that this
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genetic phenotype may actually truly be capable of surviving on six and a quarter hours a night
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without any harm, because just the sheer raw turbocharged quality of their deep sleep is so high
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that essentially they can accomplish what we can in six and a quarter hours that would normally take
00:23:26.780
someone like me eight hours and 10 minutes or so. However, if you looked into that data a little bit
00:23:32.900
more, there is a more troubling sign. So actually, just to come back to that, what would be the
00:23:37.220
analogy? It's almost like glucose clearance. If someone is really healthy in terms of their metabolic
00:23:42.900
profile, their ability to clear glucose and get it out of the system is just ultra efficient.
00:23:48.840
That's kind of how they are. And it's almost as though they're clearing adenosine, which is this
00:23:53.280
wake chemical that builds up. And at night, we must sleep in part to clear out that adenosine,
00:23:58.720
that sleepiness. And they just do it in greater efficiency. So it's sort of, they are the true
00:24:04.660
glucose heroes in the sleep world, as it were. But when you look at that data, something else emerges,
00:24:10.920
they actually suffer from getting less rapid eye movement sleep. And this is what started to make
00:24:17.280
me more concerned about the phenotype. Why am I more concerned if they're getting more deep sleep? A lot
00:24:22.860
of people say, it's the deep sleep that I need. Well, firstly, you need all stages of sleep.
00:24:27.960
It's such a fragile, idiotic state to be in this thing called sleep, that if there was any stage
00:24:34.000
of it that could have been weeded out in the course of evolution, Mother Nature would have done away
00:24:38.460
with it hundreds of thousands, if not millions of years ago. We know that they all have a function.
00:24:44.720
So why am I concerned so much about REM sleep? Studies done back in the 1980s with rats that will
00:24:50.560
probably never be done again for ethical reasons. They took them and they split them up into three
00:24:55.540
different groups and they deprive them of sleep and they deprive them until they died. The three
00:25:00.920
groups were the following total sleep deprivation, selective deep sleep deprivation, selective deep
00:25:07.160
non-REM sleep deprivation, and selective REM sleep deprivation. The first finding was that the rats in
00:25:13.560
the total sleep deprivation group died after about nine to 11 days of total sleep deprivation.
00:25:18.880
How much were they being deprived? Total. They had almost no sleep at all. So these were people
00:25:24.420
monitoring them around the clock, no sleep day after day after day. And those rats died essentially
00:25:31.960
as quickly from a lack of sleep as they did from a lack of food. If you want to sort of put things
00:25:36.920
head to head, sleep is just as essential as food in terms of life support. What was more interesting,
00:25:42.260
however, was that when you looked at the two groups that were selectively deprived,
00:25:46.360
the group that was deprived of deep non-REM sleep was still able to get all of the REM sleep that they
00:25:52.820
wanted and vice versa, the group that was deprived of REM sleep got all of the deep sleep that they
00:25:57.920
wanted. The rats that were deprived of rapid eye movement sleep, what we typically think of as dream
00:26:03.260
sleep, they died almost as quickly as the total sleep deprivation group. The deep sleep deprivation
00:26:11.340
group, it took them almost twice as long in terms of deprivation before they died. So in terms of a
00:26:18.900
life support system, which stage of sleep is more important? On the basis of these mortalities data,
00:26:26.320
you would argue that REM sleep is the more life essential ingredient. Now they all are, but which
00:26:32.140
one is more life sustaining? That data would argue REM sleep, which brings me back to the deck twos.
00:26:37.820
If they're suffering from a lack of REM sleep, does that mean that their mortality risk is actually
00:26:43.320
higher? We just don't know, but that's the only countervalence force to the first part where I was
00:26:48.920
quite bullish. The next set of questions, Matt, are, we've kind of organized them as sort of environmental.
00:26:56.900
So we've got a lot of questions about sleep position. So starting with one, does your sleep
00:27:03.780
position matter specifically on your back, on your side, head propped up with a pillow on your stomach?
00:27:11.340
Is there any evidence that one of these positions is better or worse than others? I'll exclude or I'll
00:27:19.240
create a caveat, which says notwithstanding the mechanical issues associated with it. So presumably
00:27:24.520
for someone with apnea, we would assume that laying on your back would be a worse position than laying on
00:27:31.220
your side. Feel free to address that of course, but I'm assuming the person who asked this question
00:27:35.420
is looking for more than just that mechanical issue. You can find all of this information and
00:27:42.140
more at peteratiamd.com forward slash podcast. There you'll find the show notes, readings, and links
00:27:48.080
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00:27:54.400
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00:27:59.460
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00:28:04.960
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00:28:16.220
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00:28:20.920
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