Dr. Michael Breus on How to Get the Perfect Amount of Sleep

• Hi, everyone, and welcome back to The WellBe Show and Podcast. I am thrilled to have Dr. Michael Breus today with me. He is a Clinical Psychologist and a Diplomat of the American Board of Sleep Medicine, and a Fellow of the American Academy of Sleep Medicine. As you can probably guess, we are going to be talking all about sleep today, and I am so excited. I have so many questions for you. Dr. Breus, welcome. - Thank you for having me. I’m excited to be here. Fire away, I’m ready for your questions! - Okay, great. So, sleep is one of those things that is, in some ways, boring to talk about, and also fascinating, fascinating if you’re a bit of a health nerd like me.

00:41 - But there’s a lot of, I think, myths about sleep. There’s a lot of assumptions, and there is an, across the board, failure to understand just how related a lack of either hours of sleep or quality of sleep affects your chronic disease risk and your everyday mental and physical health, and so many other things. So I think you’ll be able to share a lot more on that. But I did want to talk about this topic with you and really make sure that my community understands all of the nuts and bolts of it, because it is the fastest, cheapest way, I think, to begin to restore your health if you have some symptoms, or some sort of a chronic health issue, and also just feel better instantly. So, can you just give us a brief overview- - Sure.

- Of why sleep is so important 01:34 - as I said, but you can tell us more on a biological level. - Yep. - And specifically, what’s happening internally while we are sleeping? And inversely, what’s happening internally with our health, i.e. any chronic conditions that affect our sleep? - Sure, sure. So look, here’s the bottom line. Everything you do, you do better with a good night’s sleep. Sleep affects every organ system, every disease state.

02:01 - I mean, literally everything that you can do, you can do better with a good night’s rest. And so, when you start to break that down and start to understand like, “Okay, Michael, well that’s a broad statement. “Help us understand some of the specifics “about how something like this works.” It’s actually very interesting. So when we look at sleep, what does it really affect? It affects us emotionally, so it affects whether or not we get depressed. It affects our anxiety, it affects our moods, it affects everything.

02:26 - It affects our physicality, right? So we know that lack of sleep, or what we call sleep deprivation, which by the way, is different for everybody, right? So if you’ve got five hours of sleep last night, you might be sleep deprived. But for somebody who normally gets five hours of sleep, that could be their normal routine. I am not suggesting, by the way, that people should be getting five hours of sleep. But if some people are, and then that’s not a deprived situation for them acutely. One of the things we have to understand is the idea that, “Okay, I’m not getting enough sleep.

02:57 - “Is it quantity, or is it quality of sleep?” ‘Cause that’s one of the things that a lot of people don’t think about. They say, “Oh, am I getting my eight hours?” You know, that kind of thing? What I tell people all the time is you don’t need a set amount of sleep. Everybody’s sleep need is individual, okay? So that’s number one. So everybody’s sleep deprivation is gonna be individual. So once you know how much sleep you need, if you don’t get that, that’s when the bad stuff happens.

03:24 - So, that’s when we see cognitive problems, so our memories fail That’s when we see physical problems, like reaction time slowing down. That’s when we see emotional problems, like we get angrier at things. I mean, the list literally goes on and on. We see pain perception increases. Believe it or not, exercise feels like it hurts more the more sleep deprived we are. So that’s like a deterrent for us to be moving, and exercising, and things like that.

03:48 - So, it’s pretty impressive, but I would argue that sleep is one of three human, what I call denominators, right? So, there are three things that every human must do in a particular way. They’ve gotta breathe air, they gotta drink water, and they gotta sleep. Now, don’t get me wrong. I know people have to eat, but there’s a million different ways that you can do that. There’s pretty much only one way to sleep, one way to drink water, and one way to breathe air. - I’m gonna skip to a question I had for later. - Sure.

- But since you touched on it, 04:15 - how do you know how much sleep you need? From the research I’ve done, it seems that there’s this seven to nine number. Is that also what you’ve seen? - So, here’s the deal. People came up with a seven to nine number, it’s total crap, alright? I’m gonna tell you exactly how to figure out how much sleep that you need. So, there’s two specific ways. One is a general way, and then one is to get very specific to you as a human. Generally speaking, we know that the average sleep cycle, that’s when your brain goes from wake to stage one, to stage two, stage three, four, back to stage two, and into REM sleep.

04:47 - That little dance maneuver takes approximately 90 minutes, okay? The average human has five of those cycles, right? So five 90 minute cycles throughout the night. If you multiply that out, 5x90 is 450 minutes, or what we know as seven and a half hours. Okay, so first of all, the math doesn’t even work on eight hours, right? I mean, we just did the, we just did the math. We just said you got enough sleep cycles and it doesn’t seem to make sense. So, number one, eight hours is a myth. But number two, use this seven and a half number to your advantage.

05:20 - So most people have what we call a socially determined wake up time. What does that mean? What time do you have to get up to either make breakfast for the kids, let your dogs out, or get ready for work, right? We take that time and we count backwards seven and a half hours. And then, we do this for 10 days in a row. If you can wake up before your alarm clock, you figured out exactly how much sleep you need. If you wake up an hour before it happens, then you can stay up an hour later.

05:47 - If after 10 days, you still need an alarm clock, then maybe you need to go to bed a little bit earlier. And so, that’s how I help, I tell people is just take this seven and a half hours, socially determined wake up time, and count backward. If you wanna get super duper precise, then you wanna learn about something called your chronotype. So, your chronotype is a genetically predetermined sleep schedule that all of us have. You might not have heard of the term before, but you’ve probably heard of the idea.

06:13 - Being an early bird or a night owl, those are chronotypes. It turns out that there’s four. If you wanna get really precise, once you know your chronotype, you can sleep in that schedule and that’s the best. - Okay, so how do you figure out your chronotype? - It’s super easy. You go to chronoquiz.com. So I created a quiz online where you can take it. It’s like 30 questions. It’s completely free, it doesn’t cost you a dime.

06:36 - If you happen to have done one of the DNA, like 23andMe or ancestry.com, they actually have reports in those that you can look at and determine if you’re an early bird or a night owl. But what’s nice about the ChronoQuiz is it’s super simple. It literally takes you three minutes to fill it out. And then, you fall into one of these three categories, and then it teaches you how to sleep. But it also teaches you when to wake up, a pre-bed routine, some really fun, interesting stuff. When to drink coffee, when to drink alcohol, stuff like that. - Yeah. Now, there’s so many things that determine whether or not you are going to bed quite late, or getting up early, or feel rested when you wake up, that don’t just have to do, I think, with your natural chronotype, right? - Sure. - Like a thyroid disorder, or Lyme Disease, or like all these other things. - Sure. - You know, my community, I’m a Holistic Patient Advocate, so there’s a lot of people that have, you know, nagging symptoms or are just interested in reversing chronic health issues naturally so that they can just, you know, not have them any more, and get to the root cause.

07:37 - So what do you suggest for people that are maybe, that take the quiz, or are, you know- - It’s simple. - Go back seven and a half hours, and are like, “I’m still exhausted after 11 hours. “Like, I couldn’t possibly need that.” Like, how do you figure out- - Sure. - If it’s really your sleep pattern or something else? - So, the very first thing that you should do no matter what is you should look at what are your symptoms, right? And so, as an example, if you do sleep nine hours, 10 hours, 11 hours, and you’re still tired, there’s something seriously wrong, right? So anybody that sleeps over nine hours in a given night, unless they have a genetic condition called long sleeper, then we worry about things like narcolepsy, depression, or an undiagnosed sleep disorder, like sleep apnea, things like that, right? Because what’s happening is you’re getting really bad quality sleep, and it’s forcing your sleep to extend in order to just get the sleep that it’s looking for, because the sleep that it’s currently getting is really not that great. So that’s the first thing. But if you, let’s say you’re sleeping seven and a half hours, right? And you just, you wake up and you feel like crap.

08:41 - You’re like, “What the heck is going on?” The very first thing I talked about with people is consistency. Most people don’t think about the consistency of their sleep, but it turns out that that’s the most important factor. In fact, if all of your viewers and listeners took one thing for me today, it would be wake up at the same time every day, including the weekends, every day. Now, I know people are like, “Michael, that sucks. “I don’t wanna do that.” Okay, well, I don’t care! It’s how your body works the best.

09:12 - So, I wake up at between 6:12 and 6:14 literally every day, whether I want to or not. My body is literally that fine tuned. I go to bed at midnight, that’s when I wake up. Notice something, everybody, The Sleep Doctor, that would be me, goes to bed at midnight and I wake up at 6:13. I get six hours and 13 minutes of sleep. I’ve had no coffee today. I have total energy. I’ve been up since, well, since 6:13. So I mean, like, at the end of the day, looking at the amount of sleep that you need, it’s individual. So if you get that amount of sleep and you don’t feel good, get a little bit more.

09:47 - If you still don’t, then it’s probably time to talk with a doctor, right? Because that could be a quality issue. Like you said, what if somebody is having a difficult time teasing out the difference between, let’s say, fibromyalgia fatigue and daytime sleepiness. That’s not an easy thing to figure out. So, if you’re doing all the stuff that you need to do for sleep, and you still feel fatigued, or you still feel tired, that’s the time to talk to a physician. - Great. And then there’s so many other things I’m just thinking about. Like, if you drank too much, for example. - So if we look at alcohol, that’s a whole different story.

10:20 - So, it turns out alcohol is the number one sleep aid in the world. More people drink themselves to sleep than anything else. - Wow. - There’s a really big difference between going to sleep and passing out, right? So, we don’t want people to do that, but I like beer and scotch, and those things, and wine. So, I have a rule that actually works very well for people if they wanna drink alcohol, but not have it affect their sleep. I’m like the only sleep doctor that seems to like to have a glass of wine every once in a while.

10:48 - I don’t know why all these other guys and gals are like, “No, you can never have alcohol.” I don’t believe in that, I mean, personally. So, here’s what you do. It takes the average human one hour to digest one alcoholic beverage. So, if you have one alcoholic beverage, drink one glass of water, wait one hour. If you have to have two, have two waters, wait two hours. Once you get past two alcoholic beverages in a night, weird stuff starts to happen. So, what we notice is that your energy increases, not decreases, and for men, they can become aggressive. So, now is arguably the most stressful time in our lives. I don’t think it makes sense for anybody to be getting drunk at home every night to try to make themselves fall asleep. So, if you can limit it to two glasses of whatever with two glasses of water in two hours, you’re gonna be in a much better place.

11:39 - The truth of the matter is is the biggest offender, right now in particular, is caffeine. So, caffeine is leveling up. More people are using caffeine now than ever before. And I think it has a lot to do with just being at home, right? Like, you’re not in the office. And so, what happens is you make a pot of coffee in the morning, and then you just keep warming up your cup all day long, and before you know it, you’ve had four cups of coffee and you’re jittering off the walls, right? So what I recommend for my patients is that they stop caffeine by 2:00 p.m. So what that does is because caffeine has a half-life of six to eight hours, and so when you have that long of a half-life, what’s nice about that is if you stop it 2:00, by about 10:00, at least half of it’s out of your system.

12:21 - And that seems to be the amount that’s gonna allow you to at least fall asleep. To be clear, it would be great if you had no caffeine in your system. But the bottom line here is very few people have no caffeine in their system, number one. And number two, if you’re listening to this and you decide, “Hey, I wanna make sure “that I can stop caffeine,” do not go cold turkey. Do not. You must taper your caffeine. I’ve had two patients end up in the emergency room because they stopped, uh-huh, stopped caffeine cold turkey. One of them had a seizure, okay, that…

I know! 12:56 - I get it, right? I’m trying to tell everybody. And the other one got so, so anxious that they had to actually give them a sedative, because of the withdrawal. It was a mess, right? So once again, if you’re thinking about understanding caffeine, you really need to be observant and say to yourself, “Okay, I’m gonna stop caffeine by 2:00 p.m., “and I’m gonna stop alcohol roughly three hours before bed, “and have one wake up time.” So you notice I’m coming up with a stepped plan here, right? So step number one, one wake up time. Step number two, stop caffeine by 2:00 p.m.

13:29 - Step number three, stop alcohol three hours before bed. And the next question that people always ask me about is, “Well, what can I do to improve my sleep? “I mean, you’re telling me all this stuff “I gotta take away, Michael, and I have to slow down. “I mean, what can I do to make it better?” So exercise is the best, best way to improve sleep quality. But here’s the problem, is people aren’t quarantined. We’re all stuck in these small places and not getting to move very much.

13:51 - And that’s having a dramatic, dramatic affect on our sleep. So, my recommendation for improving sleep quality is 20 minutes of cardio every day at a minimum. And I’m not talking about like, going to run in a marathon. You can just walk your dog or whatever. But if you wanna put in the miles and you wanna really get something out of it, there’s nothing better for sleep than exercise. But here’s the key. You don’t want to exercise too close to bedtime, because it increases your core body temperature, and that makes it hard to fall asleep.

14:20 - So step number four is to stop exercise four hours before bed, but to exercise everyday. - Yeah, so four hours before bed, like if you’re turning the light out at 10:30, that’s 6:30. A lot of people, you know, may not even stop working or something ‘til 6:00. - Sure. - So that makes you realize you got to get it in earlier in the day. I was gonna ask, you know, you mentioned obviously caffeine, and then alcohol.

14:43 - But are there any other major sleep disruptors that you’re seeing with your patients, and just people in general? - Yeah. - Maybe screens, or I don’t know? - There’s a ton of stuff that’s messing up people’s sleep. I mean, you wanna talk about blue light? Absolutely. So, I mean, but look, here’s the thing. I fall asleep with the television on every night, and I’m The Sleep Doc. I know, right? I’m like making you shocked all the time. I love it, right? - Yeah.

15:08 - - So I’m The Sleep Doctor that falls asleep with the TV on every night, okay? And you wanna know what? There’s nothing wrong with it, okay? It’s a distraction technique. So many people say, “Oh my gosh, “I can’t fall asleep with the TV on “because I’m gonna get the blue light.” Newsflash, your eyes are closed, okay? So, here’s the thing. Don’t worry so much about this. Should you wear blue light blocking glasses at night? Yeah, you probably should. Do I wear them? Yes, I do. Do both of my children wear them? Yes, they do.

15:36 - About 90 minutes before bed, I throw on a pair of blue light blocking glasses. I can still read, I can use my E-reader, like my Kindle, if I want to, or I can watch TV, or I can even watch a movie on my laptop. As long as I got those glasses on, I’m not getting the damaging blue light, which would make it hard for me to fall asleep. So again, timer inside the television, 99% of TVs have timers built into the software. So, if you’re so worried about it, just turn on the software, let it go, and then, it will turn off automatically. You have to remember something.

16:05 - People who fall asleep with the television on, almost none of them actually watch it. They listen, right? So their eyes get heavy, they start to relax, and they close their eyes, and they just kind of let the content flow over them. And before you know it, you’re out cold, right? If you just set the timer for three hours later and it turns off, you’re fine. - I am so alert to anything that’s going on, I would stay up and watch it all night. Like, I don’t, I don’t have that capacity.

- So, right, 16:33 - so it doesn’t do for you what it might do for other people, right? So you might be one of these people that’s like, “I want the cone of silence. “I want it dark and cold and quiet.” And you know, all of these other things. That’s awesome for you. But if there are other people out there, I just don’t want everybody out there to think that’s the only way to sleep, because it’s not. People sleep in different environments all the time. - That’s another question I had for you. How much does the temperature, and the light, and the sound affect your sleep? I know that, for me, you know, any light outside my window, even if I have the shades drawn, is affecting me and you know, living so many years in Manhattan with a lot of sirens and stuff, that affected me a lot, as well. And then, I think actually more than both of those things, I find that when I’m hot, I can’t sleep.

17:18 - Let me know what you have to say about those three. - So, light turns out to be the thing that affects sleep the most, right? And so, when blue light hits our eyes, it turns off the melatonin faucet in our brain. And remember, we want to, melatonin is kind of like that key that starts the engine for sleep. So, we always want the melatonin to be flowing. So, when we’re looking at a bedroom environment, the number one thing I look for is light, and that’s why I wear those blue light blocking glasses.

17:44 - The second thing I look at is temperature, right? And so, the bottom line is people have a hard time sleeping in the heat. There was a great study that came out just this year from NASA looking at not only the ambient temperature in the room, which they suggest should be somewhere around 65 to 75 degrees, but the humidity turns out to be an important factor. You should have a relative humidity of about 40%, and that appears to help with the sleep process. When they change the humidity along with the temperature, they found that this combination of this 60 to 75 degrees in the ambient room temperature, and then about a 40% humidity seemed to work the best in terms of environmental cues for sleep. Now, you also mentioned hearing things, right? So let’s talk about sound, as well.

18:32 - And so, what’s interesting about sound is that the more quiet it is, the more acute your hearing becomes. So you hear more the quieter it is. So, for somebody who tells me, like you just said, “Oh, Michael, I’ve gotta have it all these different ways.” I would actually say you might want to consider a white noise machine, or a sound machine, or something like that, because it’s a known sound that you would be comfortable with over time. And then, you wouldn’t hear something that might be outside, or what have you, that really has no relevance, you know, generally speaking one way or another. The most interesting aspect about sound and sleep that I recently learned, ‘cause I was working with some sound engineers, is it’s not the actual decibel level of the sound itself that wakes you up.

19:13 - It’s the change in decibel from one time period to the next. So when you go from silence to 30 decibels, it’s tremendous. But if you fell asleep in something that was 30 decibels loud, and it went from 30 to 35, you’d never know the difference. - That’s very interesting. - But if you went from zero to 35, you would wake up almost immediately. - We have a dryer that, you know, it continues to run- - There you go! - The drying cycle downstairs, and that woke me up the other night, because it like turned back on.

19:43 - And so, it was the silence to that. - Right, it was refluffing or whatever. - But you’re right, I do sleep with a fan, and that doesn’t seem to bother me, of course, at all, because it’s like, it’s almost like a white noise machine, and it’s stable right, all night. But it is interesting how, like you said, it’s so individual. Certain people are impacted by these different things, and certain people are not. - I have, yeah, I have some patients that I call them the princess and the pea, you know? Remember that old story? Well, you’re too young to know this.

20:10 - But back in the day, there was this story about this princess who wanted all, had all these mattresses and somebody placed a pea under the bottom mattress, and she could always feel it, right? And so, I’ve got some people who are just more sensitive to their environment. Well, that makes sense to me. One of the things that I’ve learned recently, and I don’t know if you’re, if you’ve discussed this with your audience before, but it’s called EMFs, so electronic magnetic fields, right? So electromagnetic fields. So, I’ve been doing this for 23 years, okay? I didn’t believe in them at all, And I’ve had two patients come to me and they’re like, “Dr. Breus, I think I’m EMF sensitive.” And I was like, “Okay, let’s figure this out.” And so, we actually removed every, like we created what’s called a Faraday Cage.

20:54 - There’s special paint that you can actually paint on your walls that will take all the EMFs out. Honestly, they sleep like a stone in this thing, right? And when they went to a hotel, completely opposite. Even in a different part of the house, same house, but without the paint, completely out. And we were monitoring their sleep and the whole thing. So, do I believe that there is such a thing as EMF sensitivity? I do now, I didn’t before. - That’s so interesting. - Do I know what to do about it? Yeah. - Yeah.

21:21 - - I can’t say that I know 100% what to do about it, but what I can tell you, I can tell you my experiences with these two patients and what happened with them. One of them, we got them this thing called a grounding pad. So, it’s just a pad that goes like under a sheet, and then a wire comes out and it goes out your window and you literally bury the wire in the ground. And so, you become grounded. It’s kind of like the idea, I think it’s called earthing. You know, where people are walking around outside with their bare feet? I think it’s kind of like that idea.

21:50 - We did that with one person, and then the other person, we had the paint on the walls, and then we had the, we turned off the routers, and there was a way that we could take the electrical plugs and turn them off, as well, and that’s what we did with them. Both of them worked for those people in particular. I was pretty amazed to be honest with you. I didn’t, I thought it was all nonsense, to be quite fair, but they taught me something for sure. - Yeah, I haven’t actually talked about this too much with my audience, but I’m glad that you brought it up, because I do follow the California state guidelines actually, for minimizing, well, they say wifi disruptor, but EMF disruptors.

22:28 - And part of their recommendations are that everybody should have a timer to turn off their routers in the evening, which is like a $10-15 timer I have. - Right, yeah. It’s pretty simple. - And once you set it, it’s you just set it and forget it. So I think that’s very, very interesting. And then, similarly, you know, not having that router close to you all day, like trying to distance yourself from it, ‘cause it is, you know, exposure over time, and certain limits, and things like that. - Yeah, well let’s also talk about one of the biggest offenders, these guys, your telephone, right? How many people that are watching or listening to us sleep with the telephone near their head, right? Lots of people. - Oh, that was another one of their recommendations, yep.

- I know, right? 23:07 - It’s a problem, right? My phone gets charged in my office downstairs every night. And here’s the thing, phones leak radiation, period, okay? There’s no discussion about this. We know for a fact that phones leak radiation. Why do you wanna have a leaking radiation activity right next to your head every night? I mean, really, right? Like, that doesn’t make sense to me. And then, people always, I love this answer, “But my alarm is in my phone, Dr. Breus, “and that’s how I’m gonna wake up.

” 23:37 - Are you kidding me? Like, if you go to Kmart or Target, do you know how much an analog clock costs? It’s like $6, right? - Yeah. - I’ll buy you the clock, how about that, right? - Yeah. - Just for two weeks, don’t sleep with your phone next to your head, and you might be pleasantly surprised at how much better your sleep is, not just because you’re not getting the radiation. It’s ‘cause you’re not picking it up in the middle of the night. So many people, when they wake up in the middle of the night, you know what they do? They grab their phone like, “Oh, what’s going on on Facebook?” That’s the stupidest idea I’ve ever heard.

Why? 24:08 - Blue light is one, but it’s the engagement, right? - Right. - Scrolling, doing all that stuff. You don’t need to be doing that at 3:00 in the morning. You need to relax! - Well that, and also, I think for me and my husband, I am decently good about, I keep it about, probably 15 feet from my bed- - Mm-hm, yeah, that’s fine. - And turn off the wifi at night, which- - Oh, that’s great. - Airplane mode, actually, now that we have a landline, I’m doing airplane mode. But before, that’s what we did.

24:32 - But he is like, an offender of the, you know, behind, next to your head. And I think the main thing is that people stay up too late, because there’s just endless articles, and social media to consume. - Yes, endless. - And so, like you said, you have that time that you have to get up, and you need seven and a half hours per se, but you just keep, you know, being entertained by the device. - Yep, oh, I get it. - So you get six and a half, and then, you’re just constantly tired, so I do see that quite a bit. Or you start your day off in a suboptimal way because you’re on your phone in bed in the morning endlessly scrolling and whatever, which is something- - Oh, that’s a whole ‘nother, that’s a, yeah. So, let’s talk about it.

25:09 - So, you know, when we wake up, it’s like, it’s the only time of day our brains are fresh, right? Like, it’s blank. Like, you can put in whatever you want, and you’re gonna go through Facebook? Who needs that crap? Like, meditate, you know? Like, get in touch with yourself. Like, be, have that be your spiritual time. I’ll tell you what I do in the mornings. When I wake up in the morning, I have 18 ounces of water that I drink. I go over to my window, and I get direct sunlight, because sunlight turns off that melatonin faucet.

25:38 - You know, most people don’t know that sleep in and of itself is a dehydrative event. Meaning that the humidity in your breath, you actually lose almost a full liter of water every single day, every single night rather, when you fall asleep. So when you wake up, you’re dehydrated. So, the first thing you have to do is drink water, not coffee. Coffee dehydrates you. 90 minutes of water first. After 90 minutes, then you can have your coffee, okay? But get that direct sunlight. And you know what the other thing is I do? I have no science behind this one, by the way, but I just do it ‘cause it feels good.

26:08 - I walk outside with my dog, and I take my shoes off, and I put my feet on the earth. I don’t know why, it just makes me feel good. It’s that whole earthing idea thing, I guess, but that’s my morning routine. - Yeah, I was like there’s quite a lot of research around this. It’s not crazy, yeah. - I really like it. - Earthing, and also, it’s called forest bathing- - It feels good. - In Japan, I believe. - Forest what? - Forest bathing in Japan. - Oh! - They have done more clinical research on this topic in Japan for some reason than the US. - Yeah, it makes sense. - But yes, it’s, it’s a thing. It’s very, it’s very true. - Absolutely. So having a good morning routine really sets your whole day. And a lot of people come to me like, “Michael, I got morning fog.” This sunlight and water thing, honestly, I know it sounds crazy.

26:50 - How could it be so simple? Trust me on this one. 15 minutes of sunlight within 15 minutes of getting up, 18 ounces of water every morning. If you do that for 10 days, and you wake up at the same time every day, you’re done. I promise you your sleep will improve. - Yeah, no, I think, I do some of those things, but you’re reminding me to make sure that I do do all of them. You mentioned that, you know, we’re all in a very stressful time here.

27:16 - And I wanted to say that, or ask you, what are some effective ways to still get quality sleep, even if you are feeling really stressed and anxious when you turn the light out, and you can feel yourself just, you know, thoughts racing, heart pounding, all that? - Of course. So, here’s the thing. Like, we can go down that path if you want. So, let’s be clear, melatonin is a hormone, and I don’t recommend it. Melatonin should be used for jet lag and jet lag only. It is not a sleep supplement, okay? So many, many people use melatonin, unfortunately inappropriately. Now, there are some people you could use melatonin to get your sleep cycle in line, and that could be helpful. But melatonin is not an insomnia supplement by any stretch of the imagination. So, the way sleep works in the brain is there’s two systems. One is called your sleep drive. The other is called your sleep rhythm. Your drive is your homeostatic drive for sleep. So kind of like hunger, you know? I’m hungry, I’m hungry, I’m hungry.

28:09 - I eat something, and that hunger dissipates. Same holds true with sleep. There’s a second side, and that’s your circadian rhythm. That kind of tells your brain, a little bit like hunger, if it’s breakfast time, if it’s lunchtime, or if it’s dinner time, right? It’ll tell you if it’s bedtime. So one gives you sleep drive, which makes you feel sleepy. One tells you that it’s bedtime. Melatonin only affects the bedtime. It does almost nothing for your sleep drive.

28:33 - So, when somebody turns to me and they say, “Oh, Dr. Breus, I can’t fall asleep at night. “I’m gonna take some melatonin.” And I’m like, “Why are you doing that? “Like, that doesn’t make any sense to me.” I would rather see you take valerian. I would rather see you take magnesium. I would other see you take vitamin D. Like, there are a whole host of things that can be very helpful for sleep, but melatonin affects the circadian rhythm, not the drive of sleep. And that’s 90% of the time what most people are worried about is, “I can’t fall asleep,” type of thing. Now, if you turn to me and you said, “I can’t stay asleep,” melatonin could be appropriate, but you really need to talk with your doctor about it, number one.

29:05 - And number two, 95% of people have plenty of melatonin in their brains, so why are people taking it? I get it if you’re deficient in magnesium, I want you to have more magnesium. If you’re deficient in vitamin D, I want you to have more vitamin D, because both of those have effects on the sleep cycle. But again, 95% of people out there have plenty of melatonin wandering around their brains. What they need to do is go to bed at the same time, stop drinking caffeine, stop drinking alcohol, get some exercise, and all of this goes away, right? I get it. If you don’t have enough magnesium in your system, that’s probably a good thing to fix.

29:43 - You don’t have enough vitamin D, especially during COVID, there’s a lot of information now coming out about vitamin D and COVID, everybody out there should be on about 5,000 units, International Units, of vitamin D3 every single morning. But again, you shouldn’t need- - I was just about to ask you that. - A supplement. - So you mentioned every morning, because it was only a couple of months ago that someone informed me that vitamin D and melatonin have an inverse relationship, right? - That’s correct. - Sometimes, I would forget to take my supplements, and vitamin D is, I take 5,000 IUs a day actually. - Oh, and you were taking it at night? - I was taking it after dinner.

30:17 - And I didn’t know, because I just forgot at breakfast, and I just didn’t want to miss it. - Right. - And somebody said, “Whoa, no, no, no, no, no.” - You don’t wanna do that. - “You don’t wanna do that.” So I just wanted to say it on this, because it is something that people should remember, you know, not to do. - Yes, so I take my vitamin D in the morning, and I’ll take my magnesium in the evening, and people seem to like that timetable for those two things, and it’s a can be very, very helpful. - Okay, great. We haven’t talked about this at all, but I know that food is a component of sleep, or impacts, you know, maybe sleep quality.

30:53 - What are your recommendations on, you know, food as it relates to sleep, but also the time at which you eat and how much you eat? - Yep, so look, at the end of the day, your body was not meant to digest food lying down, okay? So you shouldn’t be having these massive meals before bed. However, you shouldn’t go to bed hungry either. Because if you go to bed hungry, you’re not gonna be able to fall asleep. So, what a lot of times I’m telling people is if you have a normal dinner at let’s say 6:30, 7:00, 7:30 at night, let’s say you’re going to bed at 11, right? You may want a snack before bed, right? So what would be a good snack before bed is the question, right? So, one thing is you wanna have a snack that’s about 75% carbohydrates and about 25% protein, and it should be about 250 calories. What are you talking about, Dr. Breus? Why on earth would I eat carbohydrates right before bed? This is what you’re thinking, ‘cause I can see you’re looking at me like I’m crazy, right? So I’m gonna tell you why. Carbohydrates increases serotonin. Serotonin is the calming hormone.

31:54 - When people are awake, it’s ‘cause their cortisol levels are high. The easiest thing to dampen cortisol is serotonin, right? The easiest way to get serotonin is to eat a Snickers. It literally happens like that. So when you eat high fat, high carbohydrate foods, it branches out for serotonin which calms the brain. Now, I’m not suggesting that you eat a Snickers before bed. I’m just explaining how that part works. You want a healthy snack before bed, again, 250 calories, about 75% carbs, about 25% protein.

32:27 - So what would that be? That might be something like an apple with some nut butter on it, right? That could be a non-sugar cereal with non-dairy milk, like with almond milk or something like that. - Is it more advisable though to just eat dinner two to three hours before bed for optimal digestion, rather than having a snack right before bed, if you can help it? - So, it depends on your chronotype. So for different, so like as an example, if I’ve got somebody who’s an early bird chronotype, then they’re gonna have to eat early, because that’s how their system is set up. I’m a night owl, so I eat very late anyway. Like, I usually don’t have dinner until 8:00 anyway, so me having a snack right before bed, usually I don’t need one.

33:06 - We just have to be careful for the earlier people who have their dinners at like, 6:00, 6:30, and then aren’t going to bed until 11:30, 12:00. That’s a pretty big timeframe to not have any fuel in the system. - Oh, yeah. The people I know with the early bird chronotype are like, you know, completely passed out by 10:00. - Right. - So hopefully, they have that going for them. Are there any particular foods though that really make it more challenging to fall asleep? Like, is there something- - Sugar.

33:32 - - That’s very hard to digest, that you would say, “Try not to eat too much of that in the evening?” - I would argue that sugar is really the biggest offender that we meet. I mean, other than caffeine and alcohol, people should really be thinking about sugar. I wrote a blog about the four ways that sugar wrecks your sleep on thesleepdoctor.com. So, if people wanna look at that. I’ve also got blogs on foods that can be helpful for sleep, and foods that can be harmful for sleep. Obviously, all the foods that are high in processed sugars are gonna be the ones that are gonna actually be so detrimental for sleep in general. - Okay.

- But I mean, 34:06 - there are some spicy foods that can cause indigestion, so that’s something that people kind of have to look out for. You know, slow down on the hot sauce, you know, before bed-type of thing. But generally speaking, most people’s diets shouldn’t have a dramatic, dramatic effect on their ability to sleep. - Okay, and what are your thoughts on naps? Because I love taking inspiration from the Blue Zones, which is, you know, the pockets of longevity. And it seems that almost all of the Blue Zone Centenarians nap, and yet, I cannot nap at all. I find it very challenging.

34:39 - So, I’m just curious if you recommend naps or don’t recommend naps? - So, I love naps as a tool to make up for lost sleep, but I hate naps for insomniacs. So, for people out there who have insomnia, napping is about the worst possible thing you could do. And the reason is is because you lower that sleep drive. So, your sleep drive builds throughout the day. And if you take a nap in the middle of the day, you lower it. And then, if you’re an insomniac and you already have low sleep drive at night, it’s gonna suck when you get in bed at night if you’ve taken a nap. But if you only got five hours because you had to catch a plane or whatever, and you’re on vacation, and you wanna take a 20 minute nap, go for it. The big issue I always tell people is 25 minutes or less, or 90 minutes or more. If you take a nap somewhere between 25 and 90 minutes, you wake up and feel like crap. And the reason is is ‘cause your body gets into deep, deep sleep, and it’s just hard to pull your brain out of it.

35:36 - So, a 25-minute power nap works really well. My favorite thing actually to do is use a little coffee, and I have coffee before my nap. I take a 25 minute nap, I lower my stage one, my stage two sleep that I needed to get. The coffee kicks in. You’re good for four hours. I call it a Nap-a-latte. - (laughs) That’s funny. Going back to, you know, a good night’s sleep, ‘cause I know people are really so concerned about that these days. I mean, as they should be. But what are some of the common reasons that people wake up in the middle of the night? Is it, you know, neurological? Is it hormonal? Because I know that, you know, it can be linked to things like menopause and all of that.

36:15 - - So there’s a gazillion reasons why people wake up in the middle of night. The first question becomes male or female, right? So, for women, a lot of times we look at ideas like menopause. For men, we look at ideas like enlarged prostate. It all depends upon like, if guys are getting up to go to the bathroom all night long, that’s one of the things that we start to look at there. But this food idea turns out to be something that I think is important, as well.

36:37 - So for a lot of people who eat earlier in the evening, what I would argue, like most people call me up and they’re like, “Michael, I wake up at 2:37 every night.” They always have a particular time it seems to happen every single night. I don’t know why that is. But they’re always like, “Michael, this is the problem.” I’m like, “Okay, when was your last meal?” Nine times out of 10, they tell me that they, you know, they finished their dinner at 6:30 at night, and it’s 2:30 in the morning. So I’m like 6:30 to 12:00, that’s six hours. 2:30, that’s another two hours. They haven’t had any fuel in eight hours.

37:06 - So, I think it’s a blood sugar issue, right? So, when your brain doesn’t have enough blood sugar in it, it sends a signal out to increase cortisol to go find food. Cortisol does not mix well with sleep. And so, that’s what happens in the middle of the night is we see these spikes somewhere between 2:00-3:00 in the evening. Now, the other thing is right at that period of time, your core body temperature starts to rise, because your body has to have enough time to get it to the point to wake up. So there’s two things that are happening here. We have a low blood sugar and we have the temperature rise, and those two things combine many times to make people wake up in the middle of the night.

37:41 - “Okay, great, how do I fix that?” Well, number one is you’ve gotta have enough food on board to make sure your blood sugar doesn’t go crazy. My favorite trick for that is this stuff, I don’t know if you can see it. It’s called guava leaf tea. I don’t know if you can see it on my thing here. Probably not. Not guava fruit and not guava juice, but guava leaf tea. I think it’s like $10 on Amazon. There’s at least two studies to show that if you have a cup of this before bed, it keeps your blood sugar stable all night long. Just (whooshes). - That’s great, yeah. - I know it’s great.

38:15 - It’s a little medicinal tasting, but I really like it. And in about 30% of my cases of people waking up at night, I literally asked them to try the tea first, and then I never hear from them again because it worked. - Wow. - Like one out of three of my patients who’s waking in the middle of the night can use this tea, and it’s just awesome. - That’s so great. I love that tea is the solution, because that’s so much easier than some sort of contraption or you know, whatever else. - Yeah, or pharmaceutical, or whatever, yeah. - Right, totally.

38:42 - Alright, so I know we’re coming to the end of our time together. Thank you so much for all of this great information so far. You’ve touched on it a little bit already, but of course, I have to ask you not only, you know, what is your sleep routine from bedtime to morning routine. - Sure. - But specifically, how do you #getwellbe? Because you know, that’s our website, all of our social platforms. And it’s really the idea that, you know, good health doesn’t just happen.

39:11 - You really have to do things every day to make sure that you’re staying well and getting well. - I #getwellbe by going to bed at the same time, but more importantly, waking up at the same time every single morning, ‘cause I really do that. Number two is I really do stop caffeine by 2:00 p.m. I really do stop alcohol three hours before bed. I really do exercise daily, but stop my exercise four hours before bed.

39:37 - And I really do drink water in the mornings, get some sunlight and grounding, you said earthing? I do that, too. So, if you really wanna have a plan, and you wanna have a WellBe lifestyle, that’s the way to do it for sleep. - Alright, thank you so much! I do some of those, but not all of them. - Start. - And you’ve inspired me to get on it and make sure that those become part of my routine. Mostly the getting up every single day at the same time.

40:01 - I’m pretty good about the weekdays, but definitely not the weekends. - Yep, that’s the key. - And I think it’s one of those things that it’s gonna hurt for maybe the first weekend or two, but once it actually is going, it will help so much, and will make, you know, just waking up in general, weekday and weekend, probably less painful for me (laughs). - It’s so much easier. Like, once I made the cross, and to be fair, it sucked, okay? Like, there was nothing fun about it at all. It took me about three weeks, like about three weekends to be able to do it. But now, it’s great, because like I wake up at 6:15 on Saturday morning, I have the whole house to myself. I can do whatever I want.

40:39 - So, I spend time either doing some like spiritual reading if that’s something that I’m interested in, I learn new meditations. I do some of my journaling. Like, it’s a really great time to have in the morning for myself that I never realized that I could have before. So, it’s kind of like a little, it’s a gift, I guess, to yourself by waking up at the same time every day. - Yes. As my best friend from growing up’s mom used to say to us when we were teenagers, “Nothing good happens “after midnight.” So- - Right. - If you’re someone that, you know, even if you have a chronotype of a night owl- - Right.

- Staying up 41:09 - much past midnight, generally you’re scrolling social media, you’re watching weird stuff, you’re drinking too much or, you know, whatever it is. So, I try to keep that in mind, and I think that will help me to, you know, get to bed on time- - Absolutely. - Get up on time, and keep this virtuous cycle going. - Yeah! - So, thank you so much again for all of your insight, and sharing it with this community. How can everybody find you? - So I’m super easy to find. It’s just thesleepdoctor.com.

41:37 - If you wanna learn about your chronotype, head on over to chronoquiz.com. And then, I also have a podcast. It’s called Sleep Success. So if people wanna learn more about how to sleep better, check it out, Sleep Success. It’s available on Apple, Spotify, all of the places that podcasts are available. - Okay, thank you so much again! - Absolutely, thank you. Sweet dreams! - Bye. .