Peter Attia: Understanding Sleep and How to Improve it

Released Date:9/4/2022

Podcast Duration: 01:37:03

3 Key Takeaways

1. Increase your sleep regularity

   1. Wake up and go to bed at the same time every day

2. Do not nap during the day if you struggle to fall asleep at night

3. Room temperature of 65-67 degrees is the most optimal to promote sleep

Topics Covered

1. Why do we sleep?

2. Stages of sleep

3. Sleep chronotypes

4. Tips to improve total sleep and efficiency

5. Pros and cons of napping

6. Effects of blue light and caffeine on sleep

7. Dangers of sleeping pills

   1. Useful alternatives to help sleep disorders

Evolutionary reasons to sleep

1. Data shows within the span of 70 years society has decreased total sleep time by almost 20 to 25%.

   1. Reducing sleep means reducing the oxygen saturation in our blood

   2. Eight hours of sleep is the greatest life support system from mother nature

   3. Sleep is the foundation of good health when compared to diet and activity

2. The record of survival without food was 382 days (a lean person maybe 30 days)

   1. Deprivation of sleep causes the quickest reduction of health

   2. Guinness has banned trying to set a record for sleep deprivation (record might have been up to 24 days) because it’s so dangerous (cancer, mental health, CVD, metabolic syndrome, suicidal tendencies)

Stages of sleep, sleep cycles, and brainwaves

1. Human beings, and in fact, all mammals will experience two different stages of sleep

   1. Non REM (rapid eye movement)

   2. REM

2. Non REM sleep has been further subdivided into four separate stages, which are called stages one through four

   1. Stages 1-2

      1. Lightest stages of sleep

   2. Stages 3-4

      1. Really deep restorative

3. REM sleep

   1. Involves bizarre rapid horizontal shuttling eye movements

4. Standard cycling architecture of sleep is a 90 minute sleep cycle which fluctuates between REM and Non-REM stages of sleep

Brainwaves Under the Wakeful Condition

1. When you're awake, your brain shows a series of frenetic, high frequency electrical activity

2. The size of that brainwave is not very big, but the frequency is high (50-60 wavelengths) per second.

   1. As you start to fall asleep the back of the brain begins to settle down, it goes into what is called alpha rhythm

   2. Once you start to actually transition through the bridge from the world of wakefulness to sleep, your eyeballs start to roll in their sockets

      1. This is called slow rolling eye movements

3. Then you start to go down into the light stages of non REM sleep

   1. Stages one and two

   2. After about 20 minutes, you will fall into stages three and four

Understanding Sleep Chronotypes and why Knowing Yours can Help

1. There are genetic tests that can give you a stronger sense of chronotype

   1. Chronotype in simple terms means:

      1. Are you most productive in the morning?

      2. Do you function better at night?

      3. Do you operate best in the afternoon?

   2. 25 to 30% of the population are morning types

   3. 25 to 30% are evening types

   4. The rest of us are somewhere in between

2. Chronotype is under strong genetic control for two reasons

   1. There is a significant degree of heritability (passed on from previous generations)

   2. A collection of genes will determine, to a degree what your chronotype is

   3. Environmental factors also dictate chronotype

3. There is a pencil and paper method that sleep scientists have developed called the MEQ test

   1. MEQ test is given in the morning and evening

      1. Questionnaire test

      2. Your score implies your Chronotype

Defining Sleep Efficiency and how to improve it

1. Healthy adults usually have a sleep efficiency of around 90%

   1. Eight hours of sleep is 480 minutes, if you experience a 10% loss of efficiency you're down to 7:12

   2. Devices like the aura ring and smart watches are very helpful because they can differentiate time in bed vs actual time spent sleeping

      1. Based on respiration and heart rate

2. If you have sleep inefficiency then you need to extend your time in bed to overcome that slight inefficiency

   1. 7-8 hours for adults is optimal

Correcting Insomnia: a Counterintuitive Approach

1. The only situation in which to avoid spending a longer time in bed is if you're someone who is struggling with insomnia and you're laying in bed awake

2. To treat insomnia, its best to constrain or reduce total sleep time

   1. Do not try to sleep until drowsiness occurs

   2. Meditation and breath work can help slow the mind

   3. Over the counter drugs and supplements can help induce sleep

      1. Example:

         1. Melatonin

         2. Valerian root

         3. Magnesium

Pros and Cons of Napping

1. Naps really are a "double edged sword"

   1. Even short duration naps of 17 minutes can improve learning and memory benefits

   2. May improve cardiovascular health as well

2. The downside of naps is that it can take away sleep structure and cycle

   1. If you are struggling with sleep at night, avoid naps during the day

3. If you are not struggling with your sleep, you can nap regularly during the day without producing any negative responses

Sleep Hygiene, Wind-down Routine, and Tips for Better Sleep

1. Regularity

   1. Go to bed at the same time every night

   2. Wake up at the same time every morning

2. Get a lot of darkness at night

   1. Avoid bright lights in the evening

3. You need low body temperature to initiate sleep

4. Avoid alcohol in the evenings

5. Avoid caffeine in the afternoon

6. Give yourself some wind down opportunity time and build it into your routine

   1. Meditation

   2. Reading

7. If you are struggling with sleep, remove all clock faces from your bedroom

8. Try to keep all of your technology outside of the bedroom

   1. If you're going to have your phone in your bedroom, the rule is that you can only use it if you're standing up

The Optimal Room Temperature and Body Temperature for the Best Sleep

1. Data shows from hunter gatherer tribes, that they sleep less in the summer or when there is a hotter environment

   1. Tribe members take summer naps to compensate for this

   2. During winter, when they get cooler, they sleep longer at night

   3. Frequency of daytime naps actually decreases

2. The data shows that somewhere around 65 to 67 degrees is optimal to promote sleep in most people

3. You need to cool down your extremities (arms and legs) to fall asleep

   1. The body needs to remain cool to stay asleep (relative to environmental temperatures)

   2. The body temperature will then rise as you begin to wake up

4. Keep the room cool and warm yourself up a little inside of bed

   1. This will create comfortable radiating

      1. Improves latency (you fall asleep faster)

Understanding Blue Light

1. Peter Attia explained that he has recently down-regulated his belief in the effectiveness of blue light

   1. He developed a new mental framework regarding the effects of the invasion of technology in our evening lives and in the bedroom

2. The idea is that they are mentally stimulating which is disruptive to sleep

   1. Light emitting is not as impacting as brain stimulation

3. The reason that screens were blamed is because they are LED based

   1. Enriched in the lower visible light spectrum, the shorter wavelength, in other words, the cool blues

Understanding Caffeine and Sleep

1. If you look at Coffee drinkers, they reliably decrease risk in regards to a whole constellation of diseases

2. Some specialists believe caffeine consumption should not only be tolerated but maybe encouraged as well

3. Caffeine consumption later in the day is correlated with health detriment

4. For many Americans who don't get a balanced diet, coffee in the morning may be one of the only primary sources of antioxidant consumption

   1. Decaffeinated coffee, which carries the same antioxidant load, but without the caffeine has many health benefits associated with it

5. It's fine and considered healthy to be drinking a couple of cups of coffee in the morning

   1. Maximum daily dose should not exceed 500mg

The Dangers of Sleeping pills, Useful Alternatives and Cognitive Behavioral Therapy for Insomnia

1. The FDA has recently upped mortality risk for the use of Ambien, Lunesta and other drugs in this family

   1. These drugs have been shown to dramatically decrease immune system function

   2. Try to use them as a very last resort in the smallest dose possible

2. Sleeping pills must no longer be the first line recommendation for insomnia, it should be something else called cognitive behavioral therapy for insomnia or CBTI

3. Research found that anywhere between three to 18 pills per year, carried a statistically significant increase in mortality risk