I've got a sick kid that I'm on the way to take to the doctor. So I'm sitting on the back seat so
sorry to hear that. You know what's going on? With or
I think hey,
I am assuming that he probably has the flu. He has asthma really bad so he always kind of makes me a little extra nervous.
Yeah, yeah,
we we my husband and I are supposed to fly out to Las Vegas in the morning for a wedding. So we're trying to if he's got the flu then we got a lot of stuff to switch around.
Yeah, wow. Well, I hope it's not RSV. That's the other thing going around, right.
I did. I forgot about that. Yeah. We he plays on a traveling soccer team and they said that for the kids had the flu this week, so I I'm probably about 95% Sure. That's what we're about to
Yeah. Sorry to hear that. Oh, boy.
How are you feeling?
I'm feeling much better. Thank you. My wife still has 24 ast she still has some residual symptoms respiratory but I'm good
goodness Yeah, it's a hard time of year.
So I got my flu shot. And I had just gotten my updated COVID shot right before I got COVID So we're gonna do
my goodness. Yeah. I think can never be easy, can it?
Currently no. We're learning.
Learning I'm gonna go ahead real quick and make you co host
okay there we go.
Excellent.
So also be here in the background listening. I'll probably keep my camera off the majority of the time if you're okay with it. If you need me just let me know but sure.
Should be able to handle things I think if I remember how to do things. Is Is he not around tonight?
I'm not sure I messaged him all right. In just a minute ago. Let me see if I don't I think he's been kind of exhausted. Yeah.
He's been to he talked to the teacher this past weekend was it
it was Halloween weekend so we can before last weekend before last?
Yeah, yeah. Yeah, I just realized I had to just cut back and start taking it easy for a bit yeah. Okay, I don't see you take care more portly
know quite a bit of questions that came in. Did you get the email I sent?
Yeah. I probably won't get to more. I try. I got to I got some from end of October. I think that we never got to. Oh, that's right. So I got a couple from there from Barry and the ones up until the last one from Nighthawk today I think I'm not going to get to that one. Okay.
No signal. See here, hold on.
But yeah, I got a bunch of questions that I could see
that Cinzia
we try to get my heart wire in here let's see where are we now? Looking for the calendar
otter yeah
give him a couple more minutes
yep, I can see him trickling in now. You
want to make sure this sometimes it likes to add itself sometimes it doesn't.
Just about ready sorry. Not as easy as you think it would be.
I know you can't see all that you usually see right
hey, what's up there's Andrew. Let me get him in here real quick. Okay.
There is. Yeah, I've
been trying to get on.
Yeah, sorry. We were trying to get the transcript to work.
Oh, okay. What are you talking out of a Halloween pumpkin or what?
I was just telling Dr. Adam actually on the way my my son is ridiculously sick, so I'm taking him to the doctor. Sorry. So I'm here. I will be here. I just just kind of look like um
do what you need to do. Thanks for coming on. I hope he's hope he's okay.
Thank you. I appreciate it.
Crazy times. How are you doing, Andrew?
I'm good. I'm good. I'm about to head off to SLN to do a 5g event with a bunch of Stanford folks, which will Yeah, yeah. Cool. Looking for. I mean, I haven't been there in years. And I got I got three events out there in the next year or so. It's going to be kind of fun. And I love it out there.
Yeah, you are. You are I guess country hopping but also probably busy.
Yeah. busy but I can't complain. Life is okay. How about you? You feel it okay.
recovered? Yeah, yeah, love better, all better. Actually. I was just telling Listen, my my wife still has some symptoms. She still has respiratory. Yeah. She didn't get the PAC slogan. I did. So I think that made a difference. Yeah.
You guys are all boosted up. You had the third and fourth boosters in the whole shebang. And
I got boosted Monday night but it was after I'd already been exposed unfortunately. So now I'm good to go. You can't bring it on. I got my flu shot. I mean, I'm good to go. Yeah, me too. But I'm still just taking it slow. You know, I can't I can't keep your schedule. No, there's no way right now.
Yeah, that's one of my challenges is keeping it keeping it in tap. But hey, the floor is yours. Alyssa let their gang in and I don't need to intros and whatnot. You just I'm gonna turn my camera off and you are good to roll, man. All right.
Sounds good. Right. Okay.
Let me start this recording real quick.
Okay. Okay,
here we go. Here they all come.
Here then come Come on in. Right.
Good. We have some live ones. Karen.
varies in space as per usual
All right, I only made
10 How are you?
Guys miss me? I missed you all
right, I'm all back and healthy ready to go.
So
ng Do you want to say anything or
no, just just welcome everybody. You know what we do here? Big bow gratitude ad for taking his time to prep all this stuff and really help us out with the scientific and medical end of the whole sleep and dream thing. So thank you. Dr. Edie. The table is the show is yours
before. Thank you. Alright, so yep, feeling much better. Everyone. So let me jump right in. We obviously had a lot of questions with questions that came in. Even back from my last back from, I think October so I went back and grabbed a couple of questions. And whatever came in, what I thought I'd do is I'd start though with the basics once again because you know, even the questions that we get are really important, but I think one of the issues with the with a lot of the answers have to do with action here have to do with our
So just as a reminder,
most everything that we take for sleep, and that's where the first question is going to we're going to start with some of those questions. Sleep age for for sleep, most of what we take for sleep, really are anti anxiety agents for the most part. So most of the herbs, the supplements, even the some of the sedatives we take for sleep some of the prescription meds a lot of them work on reducing anxiety, okay, increasing relaxation, however you want to look at it. And so, you know, we have these three major factors, right, we have being awake long enough to generate sleep pressure. So our brain needs to put us to sleep. We have an offsetting alerting signal, a waking pressure, a circadian rhythm that drives us awake and offsets the sleepiness that builds up by being awake during the day and unless someone wants to ask us a question about it, I won't go into those byproducts of thinking that creates sleepiness, but we like to get these allied and then if everything else is equal, we'll get the sleep. But I think one of the ones we miss mostly is this. And you know, I've said it, it's an old refrain, and I just keep saying it living in 21st century Western society is a pressurized stress pressure issue. Just getting through our days getting through the dealing with the world. I haven't even looked at any of the data coming in on Election Day here in the States. I just can't go there because you drive me crazy and so I know how to stay off that but nevertheless, you know, just living life and making sure we make ends meet you know, we get the kids where it gets have to go to school and to get to work. We have our schedules we have to deal with we have families, we have holidays coming. So we have to find ways to offload the stressors that just build up during the day doesn't mean they're bad. They could be good stressors. You know, we we have projects, we're doing it work we really enjoy but we can overdo it. So we need to find ways to reduce this stress, pressure that builds up during the day so that we can get to sleep and I I'd like to suggest that we do our meditation but we don't do it just in the morning. We do it again in the afternoon or even in the evening before the night starts. Okay? Because that will acutely drop the level of stress we're carrying. And even though we're going back into the same stressful world we're just at this lower level, you know, it's more manageable, and if we can interrupt it twice during the day, then we're really dropping it and so that it doesn't become an issue and preventing us from either falling asleep. Remember, if we have a strong enough sleep system, we can override high stress at bedtime. But then we wake up in the middle of the night and we're awake for a couple of hours and maybe sometimes all the way till morning. Okay and that's also a result of not dealing with the physiological arousal associated with stress. And the more we do that, and there are tools out there, you know, I've said it before there's that a lot of biofeedback tools, there's Neurofeedback and there's good deep meditation right the more we do meditation, what happens is, we begin dropping our reactivity to the world. So there's less stress, that kind of gloms onto us that kind of climbs onto our back that we have to carry as we're moving through our days and if we don't offload we carry it to bed, right. And then finally, if we combine these two, we just really become long term meditators and we really we do it every day and we do it for an extended period of time. Then we're going to be Zen masters when it comes to bedtime. Okay, so I wanted to preface answering questions tonight with this basic sort of the basic factors that cause us to be going to have difficulties sleeping. Okay. Any questions about that popping up? Okay. No, nothing yet. Okay. All right. So, so this question came in. Barry Barry, we have a couple of questions that came in late October from my last one that I had to cancel so I'm gonna get to those next. But this one actually came in, I think, even before before your state so I'm going to answer this one first. Because this is a pretty big question and I get a lot of comments. A lot of recommendations come in around what do we take when we need something to get to sleep so somebody asked what are the best herbs and supplements for getting a good night of sleep? And then if there are prescription strength ones, which ones should we use and avoid? So first of all, the basic herbs and we say herbs that generally flowers or root or leaves, and these are found in teas. I have valerian root, highlighted here bolded because there's been there have been there have been studies on all of these but valerian root has been shown to actually increase deep sleep. So there are some really strong data for valerian. Okay, that one really changes the quality of sleep, but also hops, lemon balm, chamomile, passion flower, and lavender is great. All of these act mostly by relaxing the nervous system. Okay, that physiologic stress that builds up during the day living lives, okay, living in this world today. So we need to manage our nervous system we need to manage our relaxation levels. Now there are others that come with a variety of names as kava, there's maca from Peru. So there are a lot of other ones indigenous to other lands but these are mostly available here. And they do work and they do work by calming the nervous system. Now the more stressed you are the more flat out having a difficult time or the more you have some situation that you're dealing with, you know, your your there's a major emotional issue that's in your life that may be acutely happening. You might need more than this. Okay, dealing with the typical stresses of life most of these will help you relax and have a having a couple of cups of tea or have some of this later in your day. Not too close to bedtime so you're not getting up to pee all night. But you know having it like with right after dinner, having a cup of tea any of these will help you begin winding down for the night. Now, in addition, there are tons of supplements out there. And again, melatonin is the one that's most common many people are using. I always I recommend that it's always the liquid or supplemental tabs that go under the tongue and they dissolve under the tongue. Three milligram should be the maximum amount anybody ever needs to use the melatonin for sleep, okay. I you know half a milligram a milligram should be plenty, especially if you're taking it in this form, because it bypasses the digestive system, which when you're taking tablets, or other versions of it capsules. By the time it gets through your digestive system, it takes 45 minutes to get to the brain. Plus you lose a lot that gets metabolized away or digested away when it moves through your system. And only so much of it makes it to the brain. So if you're taking liquid or supplemental you should start feeling it within 15 minutes or so. And and you'll get the majority of it so you need low dose. In addition, there's five HT that five hydroxy tryptamine, which is just the name for something that's a precursor. It's a precursor both to serotonin and melatonin. Serotonin is one of the neurotransmitters that supports sleep. But it's also a precursor to melatonin if you're a little bit low on that. l theanine is something found in like green tea, actually. It's also one that kind of quiets the nervous system and finally, magnesium. A number of studies have looked at
so if you're low, if your level of magnesium intake is low supplements work like a charm, okay. And in general that's what most of the studies have found. And I have some data I'm going to show you in just a minute from about magnesium. I think Barry was one of your questions too. So we're gonna get to that in a little more detail. But we want to make sure our minerals are up to speed as well. Calcium but these are the main ones. Now, in addition, there's a whole class of substances agents that actually work in a different way. And they're call adaptogens. And these you may be hearing a lot more about you may have heard about you may not have heard about yet but they're basically substances and usually they come from the herbals they're some kind of plant material that exert no specific biological effects do not putting you to sleep, but they tend to normalize or otherwise bring the body into a state of homeostasis. A lot of them work on the HPA Axis hypothalamic pituitary adrenal axis. And the way they generally work is by bringing you up if you're not making enough of the stuff that keeps you awake, or bringing you down if you're too stressed and you're carrying too much anxiety, too much cortisol and so forth. Jen saying Rhodiola Luthra Oh caucus, astrologist root stragglers food ashwagandha just sonda Shandra there you know you can look them up. There's a link I have on this particular page has a great explanation about adaptogens in general, and about each of these in particular, and they maybe think they had a couple more there too. So adaptogens can help by normalizing your ability to manage stress during the day, so you're not carrying a lot you're staying more balanced throughout your day. Therefore you have less to deal with when comes bedtime. Okay. Question in the box. I'm going to hold off on the chat questions till we get a little further along. And certainly type your questions into the chat in case we don't get to them all tonight. I'm going to do there were a lot of questions. So we we may not get to everybody's tonight. Okay. So here's that second part of that question is what about a prescription strength? sleep aid? What would I recommend? What would I avoid? Well, and each of course you would talk about with your primary care provider who's ever prescribing new medications. One of the best ones out there is Lunesta. And it's as Apple clone is the pharmaceutical name but Lunesta is the brand name. There are several dosages they last about six hours. So it kind of takes care of falling asleep issues and maintaining sleep throughout the night. And it's gone by morning so there's no hangover I really important for people needing all my medication and it's over the counter. I mean at the counter, it's prescribed, but it's prescribed specifically for sleep issues. So it is a hypnotic for sleep. It's not something used off label. It's not something designed for anything else. It's been tested specifically for sleep. And if you look at the sleep structure of people who take Lunesta, it's pretty close to normal so you get your non REM stages, and you get your REM sleep, so you're really getting close to good sleep with Lunesta. Now there's also Sanada which is a much shorter acting medication. Generally it's half life is an hour and so it's gone in a couple hours. So if you have trouble just falling asleep, it's great for that. But it's also if you're in the middle of the night, and you wake up and you still need sleep for whatever reason. Then it's a medication you can take in the middle of the night, because it will be gone by morning. Okay, so you won't, you won't have much in the way of side effects or hangover. Okay. And that's one of the dangers of taking a medication in the middle of the night is if it's not metabolized away by morning. You could be a danger on the roads or whatever else you need to do. Okay. So, so not is for something you need to take in the middle of the night and you need to have it gone by morning. Now Trazodone is not a sleep aid per se that is something that used off label for sleep. You've probably heard a lot about it. Some people it does not agree with them at all. But in low doses, it can be sedating, and it's non addictive. Okay? It's not a benzodiazepine like medication. So it's, it's typically non addictive. You can get away with taking it for a long period of time. If you're going through a chronic issue. And it's just a better medication than any of the benzodiazepines. I don't put any benzodiazepines on something that we typically recommend. Primary Care Doc's will prescribe these but you know, they can get you into more trouble down the road than they're worth because things like Klonopin, even Ativan can be hard to get off once you've been on it for a while. What I'm mentioning here, they're not hard to DC to get rid of when you need to taper and all of that, but you need to have this conversation with your doctor. Okay, there's not something you'd get on the side. And you need to have had some significant insomnia or returns or you know, it's more than just the first time and it's just for a couple of nights. It's something that's ongoing. And so what you want to do when you take prescription medication for sleep is prevent it developing into a chronic insomnia. Okay, so these are four. It's more than one night has been more than a few nights. It's been, you know, a few nights for several times, several weeks of a month, and it's been lasting for one to three months. Now, if you're having that kind of insomnia. You really don't want it to extend beyond that because then it becomes a real chronic issue and it it almost like recruits other systems that begin having further events further effects down the road. So we want to prevent having a long lasting insomnia by taking something if nothing else is working. What to avoid so like I said, the benzodiazepines just in general, but Ambien, you know Ambien like, I mean, it can really knock people out. It generally increases deep sleep. In that respect it can be very helpful. On the other hand, it has a lot of potential side by side effects. So people have reports sleepwalking disorientation, if they wake up after they've taken it falls in the elderly very important to avoid other dangerous disorders of arousal. They're asleep driving, sleep, eating, sleep, sex. All of these activities are part of the brain wakes up. Part of the brain is still in deep sleep. And so road behaviors can be carried out you know, people have been driven their cars. And the problem is everything is fine until there's a red light or a stop sign. Or you're supposed to turn there's a curve in the road. Okay, that becomes difficult to manage if you still have asleep. And so these can this can be very dangerous. And people do this without being without full awareness. And so, you have to be really careful with Ambien, especially in the elderly.
There are other medications like Lunesta and Sanada that I would try first before you ever go to Ambien. And again, the other benzodiazepines like I mentioned, they're very addictive. and difficult to taper when you need to. Now if you need something and nothing else is working, and you've tried these, you work with your doc, you know, and you say, you know, look, okay, I appreciate it. We try the Lunesta, it's not working. It's not it's not working for me and I need to I need something that's really going to knock me out. And then if you do need Ambien, and your doctor prescribes it, you want to make sure you get the kind that's useful for the complaint. So if your complaint is I fall asleep just fine, but I wake up in the middle of the night, you don't want to take a cute acting Ambien. Okay, there's quick acting Ambien that knocks you right out. And that's generally for people who have trouble falling asleep. If you have trouble falling asleep, and middle of the night wake ups and or just middle of the night wake ups. You could take sustain release Ambien, okay because then it will have a longer effect and keep you asleep during the middle of the night. If you have a middle of the night waking issue when you take Ambien that's a cute acting, it will deepen your asleep and then actually rebound you awake in the middle of the night which is your problem in the first place. You don't need anything that's gonna support being awake and more anxious in the middle of the night. Plus, there's also the potential for daytime rebound anxiety from people who've been taking Ambien for a while. So there are a lot of reasons to not take it but you work it out with your doctor. Make sure you get the right prescription for the complaint, the sleep issue your reporting, okay. And then finally, the cannabinoids there are so many I know I've said this before I'm gonna say it again. You know, my colleague says to me, the more I read about cannabis, the less I seem to know. And unfortunately, there's so much anecdotal data. There's very little hard data to support its impact on sleep. However many people are reporting using it for sleep and having pretty good success with it. So my recommendation generally to my patients are, try it and see if it works for you. But if you're gonna try it, well then there's a couple of things you could keep in mind. One is you always start low. Okay, because once it's in your system, it's really hard to to eliminate you want full spectrum and that which usually has a little bit of THC, so THC tetrahydrocannabinol cannabinol. That is the business end of marijuana. Okay, that's the high part. But it seems to be necessary for activation the full activation of CBD. So you want full spectrum. You want a little bit of THC in there but not too much. And if even a little bit of THC starts giving you you know too much of a head trip going on hallucinations and or whatever else comes along with it. Then there is an antidote, and that's that you want several whole peppercorns, which seemed to enzymatically shut down the process. You know, it's interesting because, like for instance with Tumeric in order to take Tumeric they have its effects and it's one of those adaptogens as well. You need to take pepper along with it, because that helps it that the enzyme that that stimulates, helps bring it to to use in the body so peppercorns if the THC gets to your head and it doesn't feel good and you know like it okay. And then lastly, the last thing to consider when you're looking at cannabinoids is that there are two major strains. Of of cannabis. What is sativa which is mostly responsible for the high experience, you know, for the higher cognitive activity that happens with the high and there's indica, which is mostly responsible for the body relaxation, pain reduction most of those reports and that body relaxation is really what you need to knock down some of the cortisol and other associated arousal producing substances. Okay, so those are these are the general recommendations for and against certain sleep aids.
Now, any questions about I use esta instead. Estelle Snazzle am
yeah, Richard, I don't know what's going on. Is everybody anyone else having any trouble? It might be just yours. I think mine's been working fine. Let's see anyone else reporting anything that might be yours.
Okay. So I don't see any questions. Beyond that. Let's move on a little bit.
Okay, so Barry, you had a couple of questions in there that we didn't get to. Actually, yeah, let me let me see you asked about heart rate variability as measured, usually between 12 and 16. Is that good or bad? What can you do to make it better? So, yeah, we'll talk about that first. That's fine. So here's a graph that actually comes from the ring people themselves and it's generally you know, it basically holds up this is what we see with with HRV. So, so the first thing is HRV with a ring. Ring is measured during sleep. Okay, and one reason why that's a great place to measure it is because the body is quiet. Okay, except for REM period. And when you look at HRV for the night, you have a lot of times you'll see some peaks, and that's generally mapping to your REM cycles because HRV goes up. Heart Rate Variability goes up during REM because the body is more active, the mind is more active, less so the body, but there's more activity going on. And so your heart rate will vary. There's more variation in your heart rate. There's more variation in your breathing patterns, and your level of activation. So HRV will go up during those 90 minute every sort of 90 minute cycle when you're in REM sleep, but for the most part, it's a more stable physiologic state sleep is than being an awake when you're awake. There's all kinds of activity, there's no activity. There are medications, there are foods, there are all kinds of things going on during the day. Hence your variability itself. will vary during the day. So this will measure during sleep and come up with a nice range. But you can see that it's a huge range. Now as we get older, that range begins to drop because generally there's less activity overall. Generally, there's hopefully not too much insomnia, but there may be some, but you can see the numbers really level out the variability of range drops as we get older. Okay, now, in general, okay, in general, and again, heart rate variability is unique to an individual, okay? That's why there is such a huge range. Okay. So there are two reasons. One is it's specific to the individual and it varies by activity. So of course, our activity levels can vary from person to person as well.
Okay, so
what generally causes a low HRV is stress. There's that word again. Okay. And stress may be coming from any number of sources. Okay. It could be if you are not sleeping, well, that's a stressor on the body on the physiology. Okay. You're not metabolizing as well as if as when you sleep well, but it can also be related to the medications, you're taking medications that quiet the body, beta blockers and such can reduce heart rate variability too. And so you may not be able to shift it much the way you want to use it with this ring and just like I say about any of the other devices that we use to monitor our activity levels and are asleep is that see what makes it change? If anything, both in the short term over days, maybe you know, on the weekend, you have a couple of football games you play or you go out and play some basketball with the guys, the girls, what you do some more activity than you typically do on the weekend than you do during the week. See if that makes a change. You retired you're not doing as much activity Your days are fairly consistent. Maybe your numbers are gonna stay relatively low and you're not very stressed and you're sleeping reasonably well and your medications aren't changing, then you probably won't see much variability in your HRV measure. Okay, so the best way to test that is to do something different so you need to become more active or less active. reduce your stress if your stress levels are high. Get on a regular sleep wake schedule if you're not and see if that makes a difference that can increase the heart rate variability we see during sleep. So those are some of the recommendations around HRV any if you have any questions come on or shoot me a note in the chat.
Oh, by the way, healing is two, we'll knock it down. Okay. All right. So that's HRV question. And now the magnesium question. Oh, there's a hand raised Karen. Karen has a hand raised is so his heart rate variability.
Good or bad? Or do we want it or what? Go go? One step. Okay.
That's a reasonable question. So, heart rate variability so we don't want a heart rate. That doesn't move. Because if it does, if it's as steady as a rock, then it can't respond to activity when it you need it to go up. So you need to have a certain range of variability. When it's really low. I mean, not what Barry was talking about doing sick what he's seeing, but it's somebody who has ventricular tachycardia, which precedes a heart attack. There's no variability, and that ain't a good thing. That's a really bad thing. The heart is its beats are coming really close together, but and there's no variability. It's just happening one after the other one. After the other. And for other reasons, that's not a great state to be in. But in general, we want to have some variability. So when we need to stand up even our heart rate will pump more blood more quickly. So it doesn't, we don't faint because we don't push it up fast enough to the to the brain we're going to faint so we need to have some variability. But again, I would look, if you're measuring it if you're monitoring if you have a device that's keeping track of it, I would look and see what changes you know when you're ill when you're not ill when you're sleeping when we're not sleeping well and so forth. And then that will give you an idea what your range should be. And what you want to get back to if you've been ill if you haven't been sleeping well. Okay.
You want enough variability but too much would be like not good eat
too much weed right would be over stressing the whole system right? If it were just all over the place. It wouldn't pump when you needed to hit it would be pumping it when you don't need it. So your body would quickly get out of balance and that would not be a good thing either. Yeah. There's definitely a range. You're quite welcome. Okay. Okay, there's a couple of questions popping in here, but I'm going to just power on a little bit further and then we'll see if we can get to some time for questions before we finish off this. Okay. So Barry second question about magnesium. He quoted this great paper that was published that looked at magnesium supplementation in the elderly for actually in the LD elderly Insomniac complaints, patients with insomnia. Okay, and so I just took this table from that paper for a couple of reasons. So we can kind of march on through this. So in the first place. They also talk about the amount of magnesium and almost all of the elderly and our average age of 65. Almost all of the elderly had their serum, magnesium measured, they measured that pre and post and they were all on the lower end to start with. So if you already are eating lots of leafy greens and nuts and seeds, you're getting enough magnesium, that may not be your issue, or you could always try to supplement it and see but these are all people who generally have lower than normal magnesium. So that's one thing. And you know, and they really looked into this deeply like some of the issues are you know, it used to be that we didn't have great dentists out there and people would lose their choppers as they get older they lose teeth or they'd get get into getting what do you call those things? You get mouth? dentures. And so it'd be hard to crack nuts in with your teeth and you know, chew things as well as when you were younger. And so that could be a reason you don't you start losing those foods and the ability to process or chew those foods that would give you that same level of magnesium so there are reasons why it can increase in the elderly, but in any in any event. magnesium supplementation definitely helped. Okay. But not as dramatically as they would have liked to have seen and there were a couple of issues. So so we're going to work through the so the insomnia Severity Index, okay. Any number above 12 is generally considered significant insomnia. And so their numbers before and after they're definitely in the insomnia range, but they're still in the insomnia range even after taking their magnesium. So the numbers are dropping from 16 to 14, still well above 12, which is really where we like to get people below to say they don't have insomnia anymore. So even though there's a statistical significantly significant difference. It's not as powerful as we'd like it to be. On the other hand, if you look at the placebo people were given before and after their numbers don't change all that much. So magnesium is doing something and I would contend that it's replacing what they're not getting from their diet. Okay, so you want to make sure you're getting enough of the foods that carry magnesium and if you're not you may need supplementation or you may need to add some leafy greens and nuts and seeds to your to your diet. Now, this was a, this is a real mistake, and they call this total sleep time and it's really funny. They say, Well, your total sleep time does not change at all. This is an hours. So before and after that we're getting 7.8 hours and 7.9 hours. And then they have another measure here called Sleep time. Also when hours, which is much less so let's break this down. And this is why really being able to read the papers. Helps because it's not always so clear and this was done by a number of Iranian we researchers and so there was some translation issues in the paper but that's so total sleep time what they really mean here is total time spent in bed. Okay, total time spent center because if they're getting eight hours of night of sleep a night, they're not insomniac. That's just not a definition of insomnia. So this is really time in bed so so they're spending eight hours in bed some point at some point. They're spending that enough time in bed now these guys are having a little less, but whatever we're not gonna we're not going to argue about that. But if you think about it, well, we're not gonna get into it. This is per hour, right? So they're asleep time and sleep time is measured from sleep onset to when they get up in the morning. Okay, so the numbers are still a little funky here because they're sleep onset latency. That's when they have the first moment of sleep. Okay? They're taking an hour and a third an hour and 20 minutes to fall asleep. That's insomnia. But after the intervention, they're taking an hour and 12 minutes to fall asleep. Six minutes an hour in six minutes. Now, for someone who has insomnia on average, if you look at a bunch of people and they're going down, you know, roughly 15 minutes it's taking them 15 minutes less to fall asleep. That will be a noticeable difference. But it's still pretty significant. That take it over an hour to fall asleep. So this is not an insomnia cure per se. Okay, but it is having an impact because it's helping people get more sleep. Now they're asleep time increases, point six hours. All right. So it's a little more than half an hour of total sleep that they're getting each night which isn't a lot. It's still something okay, it's still something point six hours is still an increase. You know, I tell people if you need eight hours a night and you're getting seven and a half by the end of the week, you owe the bank two and a half hours. Well, they're getting a half an hour and I better so that that can add up that can be useful. Again, very statistically significant, but you know, we're talking about not a lot of sleep here. And again, not a lot of not a lot quicker falling asleep. They still wake up just as much at night, even though there's a significant difference. Now, you know, literally those numbers are just not dramatic, but they're asleep efficiency. Now, you know, it's hard to tell what this all means. But if you really know what these values are, you can say well some of that makes a difference. So this makes a pretty big difference. There's sleep efficiency is how much sleep you're getting. divided by how much time you have to sleep. So it's really the ratio of these two numbers, your sleep time. Now it's how many hours you're actually sleeping and your time in bed, your opportunity to sleep. And so you can see the numbers are pretty low, but it goes up you know, a significant amount here. So, you know, their sleep, sleep efficiency goes up 10 points. That's pretty good. In the elderly in normal, people who aren't complaining of sleep issues, that number should be around 90.9 or 90%. Okay, so 90% of the time you spend in bed should be sleep. And if it's not, you're getting closer to insomnia in the elderly that numbers allowed to be 85%. So again, they're no they're not. They still have a ways to go before they get to 85% Sleep efficiency, but they did report feeling better. So is magnesium and magnesium supplementation? A cure for insomnia? No. Can IT Assist Candidate A and people who are who have low levels of magnesium? Yes. Okay, so that's, that's the magnesium story. Got it. Barry. Okay. Now, let's go to some more questions. You people have been great about questions. So let's see what else we have. Richard has a couple of questions. Um
Let's see. I think
in the time we have, you know, Richard, I'm going to get to a couple of your questions there. But I'm gonna answer Amanda's first because she's gonna be traveling. And not only that, she has good news because she's been following my recommendations. And she's been getting great natural sleep. But she wants to keep it that way. When she flies from the UK to California, is that what we're doing flying from UK to California. Okay.
So,
we're going to talk about jetlag for a few minutes, and then we'll see where we're left. Okay, so the two questions is I don't want to lose that I want to be able to continue sleeping. Well. What do we do when we fly through time zones? And then I know it's the return which causes more jetlag. That's not entirely true. It depends on which direction you're flying in. That causes the most jetlag. Okay. My brain appreciates. More asleep, yes, like all brains do. And is that a result of the glymphatic process that happens during the night? Thanks. And the short answer to that is, no, it's not necessarily a result of that. But that's one of the functions of or that happens during sleep. And maybe it's some, maybe to some extent, there is that process because that process is clearing the adenosine that builds up during the day that creates sleepiness. So to some extent, that's why you feel better when you sleep more because you're clearing that out. But there are also a lot of other like the toxins of the beta amyloid protein and tau protein. Those are cleared out as well. There are other reasons other things that the compact process, which essentially is washing the brain, washing all the junk that's accumulated during the day washing it out during sleep, because there's no time to clear it all during the day, in a brain that's functioning at top speed. Okay, so let's take a look at my favorite graphic. We remember these three major factors that we talked about stress and finding a way to do stress, right, if we can reduce stress, we're definitely going to be able to sleep better. But also we need to align our circadian rhythm, right, that's what's going to be affected by jetlag. And the reason that is, is because it's regulated by light exposure okay? So the cells in the retina, your visual cells, right, that respond to size, shape, color, movement, all the things that give us good vision, okay? But there are also a subset of cells that only respond to the presence or absence of light. And they carry that light information back to the master biological clock in the hypothalamus called the Super cosmetic nucleus. And it's the Yes, see, and for sure, okay. Now the Sen takes that information, and it's helping to regulate all kinds of rhythms, but the most important one for sleep is it shoots back to the pineal gland, which is the home of melatonin production. Okay, that's what's key about light exposure and sleep because it regulates melatonin. So everyone on the call right now, had our melatonin rhythm set this morning, when we got up and got exposed to light. And that's why light exposure first thing in the morning is so important, because that tells our brains number one, it's morning, turn off melatonin. Number two. When metals melatonin is turned off in the morning, a timer is set for it to come back on 16 hours later, so your brain prepares for sleep at night. And now in that 16 hour period, if we get exposed to light at night like we all are now looking at our devices, unless of course I saw that in one of the chats unless of course we are wearing our blue blocker sunglasses and looking like we're cool dudes from the 60s. Okay, the blue blocker sunglasses, they're amber colored see the amber color in here. Mind fit over my glasses. that I wear. You can buy them that fit directly even if you don't have glasses, but the idea is that they're orangey they're not. They're not clear. Okay, now these are blue blocker. Glasses. These are sun, daytime glasses, computer glasses that have a coating that knock out about 20% of the blue light. So when we're staring at screens all day, you know what I'm reading and all the things that I'm doing and I'm getting all that light in my eyes get tired these help reduce that eyestrain, but they will not block the light we get exposed to after hours. We really need those blue blocker sunglasses. Okay. So, that's all being said that how light interacts with our rhythm. Now, when we fly, East, that's the problem West is best. East is least. Okay. So when we're flying back even from California to New York, it's only three time zones. Right, Amanda? You've got another six time zones. To go. We'll get to that in a second. But when you're when you've been in California for at least a weekend, three days, four days, your brain has now adapted to their light. So in the morning in California now your circadian alerting system is turning on California morning. Okay. And now it's not turning off until California time. Okay, that's what's been shift to. So when you fly back to New York, it's not turning off until the middle of the night. And that's why we have trouble falling asleep when we fly east, from California to New York, or from California to the UK. Oh, it's much worse because it's nine time zones. But when you're flying West, okay, when you're flying West, your clock is is ready and willing to turn off well before you get to your new location. Okay, so I don't know if it's five hours from here to UK right now. Because you know, we're all shifting from Daylight Savings Time to Standard Time. So we just shifted this past weekend. We shifted in a good way this past weekend. Everybody gets an extra hour asleep. Okay. In the spring, hopefully by the way that may never happen again in the US. It may become permanent, standard time should become permanent. So in the spring, we will not shift to daylight savings time. That time. We're always forcing ourselves to lose an hour of sleep when we spring forward. And so instead of being able to sleep till seven, now that seven becomes becomes eight o'clock. And so we're actually getting up now an hour earlier. And that's really problematic. There are statistical increases in accidents and work accidents, car accidents, illnesses, you name it. So that's that's why it's going to become permanently the other way but nevertheless, so either you're flying nine or eight or maybe 10. I don't know if England shifts or what the scoop is there. If you want to come on and say something that'd be great. Yeah, yeah, I'm going to probably delay the rest of them. But this is really important. So what's going to happen is when you fly to California, your circadian clock is going to want to turn off pretty early, probably around lunchtime, maybe around two or three in the afternoon, because your circadian clock is much earlier in in the UK. Now you're flying west, so you can force yourself to stay up later. You might take a little nap on the plane. Force yourself to stay up later, which you can do you can force yourself to get sleepier, even though your clock is turning off earlier. You can force yourself to stay awake. And then when you get up the next day, you're going to get up on California time and get exposed to strong light California time. You're also going to get exposed to California light because your clock is going to be really ready to turn it off probably around. You know if you normally go to bed at 10 and you're flying nine timezones, your clock is ready to put you to sleep at 1pm When you get to California. So if you force yourself to stay awake or just get a short nap in and then get awake again, while it's still laid out, you're already helping your brain begin to shift and adapt to California time. And it'll be easier for you to go when you fly to California. So in your case, yeah, with the return trip will be more difficult and the only way you can start dealing with that is if you if you start
let's see sleeping in much later. Okay, and so right I think if you sleep in later when you're in California, your clock when you get up later California time, you'll start pushing your clock later, you'll start pushing your clock later out here. So it'll start turning off later and later. If you get up later in California, so that when you fly back to the UK, it'll be a little bit easier. And the other thing you could do is start taking melatonin when you get back. And when you get back to the UK it may help you realign your rhythm
Okay, so I think that's what I had prepared someone to stop that share.
Oh, yeah, right. We were sorry. I forgot.
There was one of Richard's questions.
I think I can answer okay.
Go back
okay, let's, let's look at it
Okay, so let me do it. Now. Okay,
so, the one question I will well actually I could probably, I could probably deal with this mostly. So is it useful to use EFT tapping for insomnia? What EFT everybody know what EFT is? Emotional. Freedom Technique. It's, you know, you tap yourself there are different places you tap and you tap them at different rhythms or, you know, here or you can tap your wrist or different, different points. To tap on, that can improve your ability to fall asleep. What it's doing is it's not directly working for insomnia and veterans. It's reducing their PTSD. Again, it reducing stress so that they can sleep better. Okay. There's very little evidence, you know, it can help you relax. It can help you relax. And so, helping you to helping to relax and overstressed nervous system is the mechanism by which it can help sleep okay? But again, it's finding ways to reduce levels of stress. And in this case, is working for PTSD. And then the chronic insomnia can be considered trauma. No, it's not necessarily. Trauma is generally a strong emotional event. I mean, it may be a somewhat ongoing event like you keep getting re traumatized. But it's something that's dramatically changing your response to the environment. And then that gets encoded in the body. And that becomes really hard to change without certain therapies without certain approaches. Trauma is basically stored in the amygdala in the brain. It's where we hold our fear. Okay. And now, yeah, to some extent, insomnia can be a fear of sleep, but it's more considered a learned insomnia. And that can be unlearned, trauma cannot be unlearned. You have to find ways of dealing with it. And in some respects, it looks like it's unlearning, but it's not really. It's finding a different way for the brain and the nervous system to respond when traumatic triggers are present. Okay. So I would say no, you really can't consider chronic insomnia or trauma. chronic insomnia can be can result from a trauma, a trauma, and until the trauma is dealt with, you may not be able to get rid of the chronic insomnia, but it's not a trauma itself. Okay.
I'm gonna say
then that last one about testosterone. We'll talk about that next time. Oh, good, Tim, I'm glad you saw my presentation. At the conference. Okay. Yeah, I'm gonna save that one on testosterone.
Save the changes in the brain with aging too. Because that's a testosterone thing to maybe I'll do a whole thing on aging. What are the aging changes we see in both neurotransmitters, the hormones and actual sleep stages. Yeah, we will do that. Next time on the accuracy of the goobers, ring rings, heart rate. Yeah, high 90s 96 98%. The oximeter I'm not as well versed in I think it's reasonable. They're not you know, the FDA. Is not allowing me over ring to or the Fitbit or the whoop to say, these hypoxemia markers or accurate markers of of hypoxemia during sleep, but they are allowing them to say that they can note that there were some changes and that's about all I can say. Okay. I see Andrew popping back on let's see if there's anything else I can do quickly and take the zoo. The blue blocker glasses warranted Yes. They asked that question. The answer is yes. After hours. If you have to work on a computer, you set your computer's settings to pull out the blue lights but that's still not enough. Really. Yeah, I'm probably done talking. I think I'm about to lose. Excuse me. Yeah, so we'll we'll include so two issues for next time will be blue light and blue light exposure and aging changes. How about that. We'll deal with all that.
Okay. I'm done. Yeah, I think that's a terrific information. And I think it's a great idea because the material is wonderfully concentrated. And so in order to really wrap our minds around it, especially the question on aging and when there's so much to talk about that one. Really
changes. Yeah. And you know, there's so much data coming out, you know, like day in and day out what's coming out, is that so much of what we thought was associated with aging was really having to do with sleep disorders on diagnose this on diagnose that. So,
next, and also on the other end, kids who aren't getting enough sleep are being misdiagnosed with ADHD ADHD, so it works on both ends. It just shows you that extraordinary undiagnosed issues around just having poor sleep habits. So yeah, so cool.
All right, everyone. Well, I'm glad to be back. I think ya know, it's always a pleasure. I love talking about sleep. So you know, I can just keep going on and on. As long as my voice lasts, I can do that. So next month, yeah. Well, we'll talk about I think I have to be a half an hour earlier late for the next one for some reason. I know. But I'm good on that date. So we'll, we'll call it. Okay.
Thanks for that. It's really super helpful stuff every time I was learning a lot. So Muchas Gracias, amigo.
