Hey, everyone, welcome to the Peter Attea drive. I'm your host, Peter, into you. Theo Drive is a result of my hunger for optimizing performance, health longevity, critical thinking, along with a few other obsessions along the way. I have spent the last several years working with some of the most successful top performing individuals in the world, and this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at Peter tia MD dot com. Everybody welcome to this week's episode of the drive. I'd like to take a couple of minutes to talk about why we don't run ads on this podcast and why.

Instead, we've chosen to rely entirely on listener support. If you're listening this, you probably already know. But the two things I care most about professionally are how to live longer and how to live better have a complete fascination and obsession with this topic. I practice it professionally, and I've seen firsthand how access to information is basically all people need to make better decisions and improve the quality of their lives curating and sharing this knowledge is not easy. And even before starting the podcast, that became clear to me. The sheer volume of material published in this base is overwhelming. I'm fortunate to have a great team that helps me continue learning and sharing this information with you. To take one example, our show notes are in a league of their own. In fact, we now have a full time person that is dedicated to producing those. And the feedback has mirrored this.

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And as I said, we're not taking ad dollars from anyone. But instead, what I'd like to do is work with companies who make the products that I already love and would already talk about for free and have them past savings on to you again. The podcast will remain free to all. But my hope is that many of you will find enough value in one the podcast itself and to the additional content exclusive for members to support us at a level that makes sense for you. I want to thank you for taking a moment to listen to this. If you learn from and find value in the content I produce, please consider supporting us directly by signing up for a monthly subscription. Welcome back to the final installment, part three of three of the Matthew Walker Siris on sleep. If for some reason you haven't yet listen to the 1st 2 episodes at Recommend going back and listening to those prior to listening to this one. My guest this week is Matthew Walker, professor of neuroscience and psychology at the University, California, Berkeley,

and the founder and director of the Center for Human Sleep Science. Math. You earned his undergraduate degree and PhD in neurophysiology in London and subsequently became a professor of psychiatry at Harvard Medical School before moving to Berkeley. His research examines the impact of sleep on human brain function in healthy and disease populations. Today he has published over 100 scientific studies. He has received numerous funding awards from the National Science Foundation, National Institutes of Health, and he's a fellow of the National Academy of Sciences. He's the author of the international bestseller Why We Sleep, which also happens to be the favorite book of my not yet two year old son. He holds many patents covering various consumer base sleep recordings, sleep tracking and sleep simulation. He's asleep scientist it Google, where he helps the scientific exploration of sleep in health and disease. He is also an enormous fan of Formula One and my hero, Ireton Santa.

In the final part of this series, we discuss the role of sleep and my weight gain, presumably that of others. Sleep and blood sugar sleeps. Effect on jeans sleeps effect on the food you eat the effective sleep on people's productivity, the relationship between alcohol, caffeine, th see CBD and sleep. And that's not all combined, of course, what Matthew is doing today at Berkeley at the Center for Human Sleep Science and other startup projects he's working on, and we close this out with a discussion of Formula One, our mutual favorite thing driving and sleep as a reminder at the end of this series, we're going to take questions for a follow up a m A, with Matthew asking questions on the A. M A forum and listening to the A.

M. A podcast with Matthew along with all I am is will only be available to subscribers. So if you haven't signed up yet, you can do so now. At Peter tia MD dot com forward slash Subscribe. So, without further delay, here is the finale with Professor Matthew Walker ee wantto talk about it. Another several topics on here, but I want to go back to something that you and I have spoken about before. But I think it's so important. I want to make sure we've got it for all the listeners, one of the most compelling things I ever read. I mean, I think there were several moments in my journey in the sort of world of sleep that really shook me. One of them was reading this paper out of the University of Chicago,

and I believe it was even Carter. But it might not have been. It took a group of subjects, and it was a very small study, but it was so well controlled because they sleep deprived these and, well, they did. You guys seem it clamps on, you know, date zero. So for the listener, that's ah, really rigorous test where you inject glucose and insulin into the patient and you keep the glucose level steady by tight trading, the insulin level. And this is an elegant way to measure one of the most important features of metabolism, which is how well you dispose of glucose primarily into the muscle. And I believe the subjects were restricted to four hours of sleep a night for two weeks,

so you know about its being replicated for 45 and six hours for one week.

Okay, At the end of that period of time, they repeated the you glaze seem it clamp again. The gold standard for measuring insulin resistance in these patients suffered a 50% reduction in their ability to put glucose into their muscle, which again would certainly rank among the five most important physiologic things to do again. To put this in perspective and normal blood sugar might be 100 milligrams per desa leader or roughly five mil imola. For a normal sized individual that represents five grams of glucose, let the siren go by here.

Yeah, it may actually be immigration. Coming to get me finally ends in deporting me right in the United Kingdom. But sorry.

So So you've got five grams of glucose in the blood stream, which is one table teaspoon frank. Diabetes would be 200 milligrams per desolate er 10 to 11 miller, two teaspoons of sugar. So the amount of glucose you have in your bloodstream is trivial compared to what's in the muscles and in the liver. So imagine losing the ability to put that away by 50%. And as I look back at how metabolically deranged I was at the end of my residency. I can't help but realize something that I think eluded me for a great number of years, which is their role that sleep deprivation played in my weight gain my insulin resistance. My hyper gonad is, um I know you and I have joked about it, but I think at the end of residency, my testosterone was about 200 to 220 nanograms per desa leader on a scale where two standard deviations below the mean is about 3 50 So, you know, about twice that of, ah, of a female in terms of testosterone,

I now realize that was the sleep deprivation that wasn't just the cafeteria food. And by the way, it certainly wasn't a lack of exercise. Amazingly, throughout residency, I still managed to figure out a way to exercise

like crazy. And you know, the point there is despite all of that exercise, despite the power that that should have had on your metabolic system. My guess is that if we'd done that same glucose tolerance test, it would have bean way down. And when you think about, you know, that's essentially taking healthy individuals who show no signs of diabetes, limiting them to an anemic diet of sleep. You know, 45 hours for one week. Now we've seen and you can get them into a state. Was someone like you if you just read their readings at the end of the week and, you know, think about the experiment, you would probably argue that they may be in a pre diabetic state

of that state. Sure, you're writing the right for the metformin prescription? How is this happening, Matt? What is the mechanism by which something so profound, so fundamental and important to our survival is going so awry in such a short period of time?

We know the evidence. We we've unpacked this mechanism now. So the way that you regulate your glucose the way that you sort of have glucose home your Stasis is that there are at least two major parts of this equation. The first is that cells in your pancreas school beater cells need to sense the spike in blood sugar, and then they need to release insulin. And then when that insulin is released, it actually tells the cells of the body to reach out and absorb the blood glucose, the blood sugar, and that prevents you from another wise, dangerous spike in blood sugar. So these two things need to happen. Your beater cells in your pancreas need to release insulin, and then the cells of the body need to be sensitive to that insulin to be then instructed toe. Essentially, you suck in that. That blood glucose from the blood stream. Now,

what can happen is that if you have a deficit in one and you know, I think you know, pregnancy, maybe a good demonstration of this worse. Sometimes, you know, the cells of the body become less sensitive to that insulin. But what's nice is that the beater cells in the pancreas they understand that the cells aren't sucking in the glucose that they need. So they just released some more insulin and your insulin home. Your Stasis remains imbalance. So this is what we call the disposition index. How goody you at disposing of glucose. And you know, can you manage that disposition index? So what happens with insufficient sleep is unfortunately bad on both sides of those equations. So,

firstly, we know that when you are under slept the beater cells of your pancreas become insensitive to the spike in blood sugar glucose. In other words, your body stops releasing enough insulin to deal with the food that you've just eaten. So you're down on insulin. You haven't released enough insulin. That's a bad thing. But maybe it wouldn't be so bad if the cells of the body were just really sensitive to what little insulin is left. And you could still at least clear some of that blood glucose. Unfortunately, that doesn't happen, because what's worse is that the cells of the body actually become insensitive to the signal of insulin. And so the cells of the body stops sucking in as much glucose as much sugar from the bloodstream. So on both sides, off wth igloo coz, homie Oh,

Stasis balance, your kind of a little bit screwed. That insufficient sleep means that you don't release enough insulin, so you don't have enough of that signal to begin with. What little has Bean released, unfortunately, is not listened to and heard by the cells of your body. So those cells actually don't end up dragging in the blood glucose, the gushing kind of monsoon of glucose that's now in your bloodstream after a meal, which means that you end up having an inability on both sides of the glucose equation to clear that blood glucose. That's why you have that type of glucose intolerance problems with glucose absorption and to get down to even the causal mechanism in humans some great cities where you can actually say, Why are the cells so mute to the signal of insulin? Why are your cells not listening to insulin correctly and not responding by bringing that blood sugar into them to drop your blood sugar levels? And the answer is this. What they did was they took a group of again healthy people, no signs of diabetes.

They took a biopsy of cells from around the belly button from the number like, um, and then you can actually measure how those cells are behaving inside of those cells themselves. You can kind of like poke around inside and figure out what's happening. They took the biopsy in those same subjects after they being limited to just four or five hours of sleep, and then they repeated the biopsy when those participants had been sleeping eight hours. So this is again, one of those beautifully carefully controlled studies. Same individuals, same

person. Are they looking at out of post site or

so it's at a post site. So this is fat cells,

right? So this. I would expect something different in the adipose site from the muscle,

so I don't think the experiment is being done with the muscle cell yet, but it has been done with the Adipose site, and then they essentially got these. Now these cells outside of the body and you can play around You can essentially sort of, you know, drip insulin onto those cells, and you can ask what's going to happen to those cells in terms of the instruction that they receive from the insulin? One of the critical things that happens when insulin binds to the receptor of the cells is the phosphor relation of something called a Katie on Dhe. When a Katie is phosphor related, it essentially help something called the glue four transporter inside of the cell to essentially go to the surface of the cell, and it's almost like the metaphorical straw that gets stuck out of the cell on it's bringing glucose and to simplify it. What you find is that when that cell has bean under conditions of insufficient sleep, the amount off insulin required to phosphor relate that a. Katie. To get those cells to start absorbing glucose, you need almost twice the amount of insulin you need. Double the amount of insulin to get those cells to do the same thing, which

that's counterintuitive. Actually, you'd think that the Adipose site would be even more sensitive to insulin as the body works harder to undergo a stare ification and put fat away, given that the muscle becomes more resistant to insulin. So that's interesting. So of course, this speaks to why many hormones are necessary, too. Dr the Metabolic derangement, because also the court assault level would maybe even opposed that. But in isolation, What you just described would actually oppose Reace terrifically ation of fatty acid.

Yep, But in my mind, I think what's striking, though it it starts to tell you that individual cell types need sleep. What, you know what

I was just gonna say, What do you think is the communication vehicle? What is telling that phosphor related sign? Do less of it be less effective? How is that communicated

that right now, I think we at least I don't know of what interest cellular mechanisms have transpired to decrease the amount off all the capacity for the phosphor relation of a Katie to bring glucose into the cell. There clearly some kind of signaling mechanisms that are coming extra Celia Lee on dhe telling intracellular e things to do that are either maladaptive or just much less efficient inside of the cell. But to me, that just blows my mind that, you know, we often think of the impact of a lack of sleep on things like behavior like driving or, you know, making food choices. We've done some of this stuff with brain scanning, and but your question is so beautifully nuanced because it's actually asking there was something about a lack of sleep that will get even into cells themselves on altar interest, cellular functioning. So if you can get a single factor sleep, that can have its impact all the way from complex cognitive issues like decision making, all the way down to something like interest cellular function. My goodness, you need to look out if you're depriving yourself of that one function and I'll go a step further because there was a great paper published in something called The Proceedings of the National Academy of Science. Very prestigious

journal. We like to call it peanuts around,

right? Yep. Penis the acronym with my students. I'll say p and s on try to get navigate around that unfortunate acronym.

That is hilarious. Because, like, I'm so you know, far removed that it was just Penis like it was. We never even thought you would have to be politically correct and call it p and s.

Yeah, I just published, You know, my biggest death of research and Penis. Well done. That sounds like your parents must be swelling with pride right now. Could you imagine? And I actually have We have published a bunch of stuff in Penis. But this this

thing, I just got a pause for a moment. Why is it here's another evolutionary question. Why is it that any two guys can be hanging out like you could have? The press is gonna say the president of states. Bad example. Any two male heads of state and put them in the U. N. On the floor trying to negotiate a resolution and like a Penis joke just makes everybody laugh.

Can I just say that within? I think people can tell me the time of this. In the comments, I think within the space of about 180 seconds, we went from intracellular cascade mechanisms, from phosphor relation of a Katie to Penis jokes. And it's all my fault eyes. Now I want to go

back to this because what you said is it actually scares me more. Here's why. I think that at the surface everything you opened our discussion with with respect to Alzheimer's disease I mean, you lead with the best punch right to me, that is, you could stop there if sleep disturbance didn't impair your driving didn't increase your risk of cardiovascular mortality, didn't trash your immune system and double your risk of cancer didn't give you diabetes. If you took every one of those things away, just driving your risk of dementia is that's full stop. Reason enough didn't impair your learning.

Take everything. When you guys get disease, depression against studio,

I'll take it all. But but paradoxically, most of those things because at least we see what the mechanism in that the mechanism of action is. And even when we don't like in Alzheimer's disease, I don't think we know exactly the mechanism of action. But there's a plausible theme. But it's this last one that you're bringing up that in many ways scares me the most because it speaks to the ubiquity and the spread and the breath of that impact, like there are other cellular fact like this is so central that it's impacting and regulating the phosphor relation of a series of enzymes that drive something so seemingly unrelated as a glute four transporter to trans locate the surface of us selling. Why in the world would that happen at a single cell

level that you cannot serve the impact off a process, be it you know, diet or exercise of food. You know, at that level the fact that it can transcend almost every biological level off slice that you conduce to biology and to me, I think that the final image comes back to the Penis. The PN s paper takes the final step for me. What they did was they took a group of again healthy adults and they limited them to six hours of sleep for one week.

So they basically made them average

Americans. Average Americans. Yeah. And then they essentially looked at the change in the gene activity profile. This is from

blood. You're not going to tell me there was epi genetic change?

Well, relative to when those same individuals were getting eight hours of sleep and there were two critical findings. First, what they found is exactly your fear. They found that a sizable and nontrivial 711 genes were distorted in their activity caused by the insufficient sleep, which, by the way again, six hours of sleep, you know, may even sound luxury to some people. But this is very common. So this is not one of those experiments where you say, Oh, they limited them to two hours of sleep or that it total deprivation. And that's not ecologically relevant. This is an ecologically relevant manipulation. This is six hours of sleep.

It's very common in society. And it distorts, you know, well over 700 genes relative to when those same individuals at getting eight hours of. Let's

just put this in context. There's only about 20,000 genes in the human genome. It's not like you said seven jeans or it's not like you said 700 in the presence of two billion jeans. This is 3% right. You have an epi genetic change in 3% of your

Gino, and this is with epi genetic change within seven days at a moderate dose off sleep restriction. What was also interesting was the direction that about half of those genes were actually up regulated. The other half were actually down regulated those genes that were imported in their activity when numerous genes associated with the immune system. Those genes that were actually up regulated were genes that were associated with tumor promotion, genes that were associated with long term chronic inflammation within the body and genes that were associated with stress and, as a consequence, cardiovascular disease. And I find that impressive because many people in society right now feel uncomfortable about the idea of something like genetically modified embryos or genetically modified food, for example,

or crisper right Chris.

But especially here as we are in Buckley, it's relevant. But to me, I think that if you feel that way, if you feel uncomfortable, but about sort of GM owes just commodified food or genetically modified embryos. But you're choosing to get insufficient sleep in here was talking about six hours of sleep. Then I think you must accept then that you are performing firstly a similar genetic modifying experiment on yourself by reducing your sleep amount. And secondly, if you don't let your Children get the sleep that they need, you may be inflicting inadvertently a genetic manipulation on them as well.

Did that Penis sorry? I see to me, I can say Penis without thinking Penis. But, um, now I can't now that did that paper show the reverse? In other words, once you restored sleep, could you undo any of that genetic damage? Didn't look at it because because I'm gonna take thesaurus of contrarian view here, which is we're all host because there's not a single person that hasn't been restricted to six hours a night. So it's almost like we should throw up our hands and ways in which I don't think is the answer.

No, I don't think it is the the answer. And I think his why. Firstly, you know, coming back to this argument that sleep is not like the bank, you cannot accumulated debt and then hope to pay it off at a later point in time. That's why that binging at the weekend doesn't work. So once you've gone without sleep, whatever has happened during that time, when you are under slept doesn't seem to be reversible. However, that doesn't mean that from this point forward, it's a waste of time to to start sleeping better, and I have evidence for that. We and others have bean looking at cognitive decline in older adults, as we mentioned before now,

once the deed looked at a group of individuals who were in mid toe later life on, they had sleep apnea snoring, which, by the way, is a devastating condition. If you snore or your partner tells you to snow, please go and see your doctor get a sleep test and get on sleep apnea treatment. But the point was this. They gave them the C Pap treatment, which is the sort of face mask to push the airway open so that you don't snore and you don't go without oxygen and by way of an experiment of nature. About half of those individuals were compliant with the treatment. About half of them weren't those individuals who complied to the treatment and started sleeping better because they had their sleep apnea treated ended up staving off the onslaught of Alzheimer's disease by about 10 years. So, in other words, this is a causal demonstration that if you course correct sleep, you can actually modify your dementia probability risk.

And it tells me in some ways, a message of hope, which is that perhaps it's never too late to start sleeping better, because if I've got evidence that in moderate in mid to late life that when you start course correcting bad sleep here, it's a sleep disorder with a particular treatment that can have an observable benefit in terms of reducing your cognitive decline rate. And

although it's hard to know right, because the people who are compliant with CPAP presumably are doing so for reasons that might also make them more compliant with other inputs. Such a CZ you know

that's radiation, and it could even be, you know, that that sleep is not actually so maybe the sleep is the influencing factor. But sleep is not the route through which the benefit comes. It's because you're sleeping that you start to eat better and we can speak about that relationship between sleep and food choices and caloric intake. And when you are under slept, you are far less likely to be active and motivated to be physically active. When you are physically active, the amount of force pressure that you congenital rate the amount of aerobic output that you can generate, the amount that you can resist. Physical exhaustion when you're sleeping Well, all of those things are improved to your polling

all. It's about a 30% roughly. I mean, it's not. It's a non trivial reduction and performance with sleep

deprivation. Yeah, I take someone healthy person who's physically active, and I limit them to six hours of sleep. You get about a 30% decrease in your time to physical exhaustion. So the idea would be, let's say that you're training for a 10 K on DDE in the days before. For whatever reason, you're down to six hours of sleep and you've trained to maintain your point of physical exhaustion. You know, to the 10 K level. Well, now, just with six hours of sleep, I'm going to see you fail. It's at seven K because I've had a 30% reduction in your time to physical exhaustion. But I think your point again is a very good one,

which is. Maybe it's not the sleep directly. It's the sleep transacting its benefits that we know also play into decrease risk for cognitive decline, such that you start making better food choices. The amount of caloric intake that you have is loa. The amount of calories that you expend is higher your motivations to be physically active. And when you are active, you work out more intensely and harder. All of those things we know come by way of a benefit of sleep. So maybe sleep is, you know, the root cause. But it's not ultimately the thing that maybe transacting it now. I think knowing the relationship between sleep loss and Alzheimer's protein pathology that we described, maybe it is playing a part I don't think we know. But to your point,

which is a good one, don't feel as though if you're someone listening to this and you've bean on a diet off five or six hours of sleep for most of your adult life, that all is lost, and you should just cash in your chips and say, Well, basically, my fate is now sealed. It's not. I don't think it's ever too late to start sleeping better. I honestly don't.

I think the argument that it's it's too late almost fails on first principles. When you just consider virtually every other intervention, right, if you take someone who has diabetes, type two diabetes and you know you dramatically change the way they eat and exercise, it's quite clear what you can do if you take someone who smokes. I mean, smoking might even be a better example because we have such longitudinal data on risk reduction as time of non smoking increases after a period of smoking. I mean those air that's actuarially mapped up the wazoo, and that's a simple enough intervention that you can attribute it to. It's actually very similar intervention, right, because you would argue that in the individuals who stop smoking, they're more likely to make more positive health decisions for the simple reason that if I'm not going to smoke, what else am I gonna take seriously in my health and in the end, for the purest? Who says I need a randomized prospective trial to demonstrate this one? I don't think you're ever going to get it. And I think the reason is we're really at the point where it's going to become unethical to do draconian studies of sleep deprivation. Or I don't even think it would be ethical to take to do a longitudinal study of depriving people with apnea of See

Pat. I think the evidence is so overwhelming that yet you're ethically going to be unable to do those things, you know. And it's the same way with kids in school that I think the only option that we're going to have in terms of proving the importance of sleep for school start times and just health in general for kids is going to be, you know, elongating their sleep. If you look over the past 50 years, what we found is that kids across all ages are sleeping about two hours less now than they did 50 years ago, two hours less now to put that in context, if I went to my ethics committee and said, Look, I'd like to take a group off seven year olds six year olds and I'd liketo lop off two hours of their sleep and I'd like to impose that on them for the next month and study it. Is that okay? I probably be, you know, put on academic probation for even suggesting that, let alone they would never let me do that.

But that's what's happened in society. So I think your point is, is a great one to witches. We are probably not going to be able to do the sleep restrictions that is increasingly anymore. We're going to have to do you know, the sleep intervention and the sleep extension cities and even some of the sleep interventions that is ethically. You may not be able to do it because it's already so clear that you need to be treating the sleep disorder. And, you know, sleep apnea is a good example there to that when you treat sleep apnea and you typically see far higher rates of diabetes in people who have untreated sleep apnea on when you treat them, you see it. They're diabetic. Profile improved markedly. But you also see that they start eating. Less choices of food are better. They are far more likely to be physically active once again.

So again, I think it's unclear whether it's that direct benefit of sleeping better on things like the pancreas, releasing the right amounts of insulin or the cells in the body being instructed by the insulin to suck in the glucose more. Or if it's just higher order things such as your sleeping better. So you make better food choices. You are not as hungry anymore. You know, we and others, have done these cities where you look at sleeping appetite, regulation and there, I think, the date the data is Justus causal and powerful as it is for glucose regulation. You know what we find is that when you start short sleeping people 456 hours a night for one week, the appetite hormones that regulate exactly you know that food intake, the court lepton and grilling. They go in opposite directions in ways that you wish they didn't.

So leptin is the hormone that, essentially is the satiety signal. It tells your brain that you are full. You don't need to eat anymore. You're satisfied with your food. Stop eating. Essentially, it's that satiety sort of red flag. Ghrelin is the opposite, whole mon. It essentially says no, you're not satisfied with your food. You want to eat Maur its hunger signal essentially. So what you find is that when you are under slept, the leptin, which is saying you're full,

don't eat anymore. That signal gets turned down, so it's not particularly volume us anymore, so your brain loses the signal of I'm full, I'm satisfied on. Instead, growling is actually ramped up, so you start to feel unsatisfied by your food and you will eat Maur. And so on both sides of that hormonal appetite equation, you essentially downgrade this red flag off satiety and you upgrade the signal off hunger, which then leads to what we've now demonstrated, which is an increasing your caloric intake. People sleeping six hours a night during the week. They will typically eat about 300 extra calories during the day, which may not sound very much. But when you add it up week after week, year after year comes to about 70,000 calories. If you look at the actual numbers and I think it's

even more pronounced than that because you know the caloric arithmetic is complicated because of the compensatory components. But I think anybody I mean I do this natural experiment of doing too much flying across the country and the east to west, which is a very long day. And it's a sleep deprived, A cause you're used, at least for me. I always want the earliest flight out to have the most time back. That is unquestionably one of the worst eating days of my life. If I let it be so one of the tricks I've learned for that day, which I now do very well. But I had to be very deliberate about it was so, you know, fly out of JFK at 6 a.m. Which means you're waking up in about four. And you didn't go to bed at eight. Right? So that sucks. I go to the airport and I get a really good breakfast,

a proper breakfast. Like I eat, You know exactly what I would want to eat. I don't eat a single thing on the plane despite all of the dumb snacks that keep coming your way. And I also managed to exert enough self discipline to get on the plane without buying trail mix, which is my absolute airport kryptonite. But here's the thing, then you know you land in California. It's like 10 o'clock, and what I do is basically have a tiny snack that is also like, well, scripted, like I know exactly what it's gonna be. It's like sort of avocado and macadamia nut, highly satiating. And then I don't eat again until dinner,

and then I go to bed really early. So super early Dinner 5 p.m. Super early. Bedtime. Eight. And if I do that, it's It's awesome. But it, like that, requires a lot of work. It just requires a lot of planning and and momentary moments of discipline. But if you don't, if you just do that on autopilot, which is basically what you would be doing if you were living that way every day I mean, I'm amazed at the food choices I want to make. Like I I have literally If I look back, there are moments when I caught myself eating a pizza in the airport for breakfast,

like under no circumstance, would you would you do that regularly? And yet like the cravings you get for the craziest things under the sleep deprived, I mean, any college, any college kid will know this right? You're pulling the all night

or like you want to You? Yeah, right. And so you imagine someone like you who has the knowledge that they have about sleep and then has this maniacal discipline to be able to fast for long periods of time and even you, with that arsenal of benefit in place, can struggle under the weight of sleep deprivation. No wonder the majority of you know a CZ non Demi gods of control will will implode so quickly

to see what Jocko would do under sleep deprived conditions with respective

food, right? And a gentleman who, by the way, I have such incredible respect for in many areas on I would love to have a conversation in just an honest, frank conversation about sleep with him. But it's someone who you know, I just My goodness, what an incredible human being. But to come back to your point about food choices, it's not just that you over eat when you are under slept, which you do. And if you pull the all nighter, you'll typically eat probably about 450 more calories than when you're well rested. It's also the profile off food that you eat. What I mean by that is if you give people in these of the studies that have bean done essentially an AB Gleb food buffet were at the end of the sleep deprivation period or sleep restriction, where you kind of limit them to 45 hours of sleep for the week.

And at the end of that, you give them this food buffet in you, say eat whatever you want, it's up to you. And there's everything from kind of leafy greens. Thio, you know, avocados and macadamia nuts all the way down to Oreos, ice cream and pizza. What you find is that not only do you eat more, but you eat more of the things that you should not eat. So people will actually eat more from the heavy hitting carbohydrates that starchy carbohydrates together with simple sugars. So they'll be going after pizza cookies, ice cream and they stay away from things like protein as well as you know, leafy greens. So,

in other words, it's not just that you eat Maur, but what you're eating in terms of both micro and macro groups of food is actually also distorted in the wrong direction that you want. So we understand at the hormonal level. What's causing these changes? We understand that it leads you to overeat in the excess of probably about 70,000 calories each year, which is about £10 of additional obese mass that you would put on each year, which for some people, maybe painfully familiar. But we also know what happens in your brain, and we did a study where we took a group of people. We limited them. We restricted their sleep on dhe. Then we gave him a full eight hours of sleep, put them in a brain scanner, showed them a whole bunch of different food images,

desirable foods, non desirable foods. What you find is that when you are under slept, the centers of the brain that keep your hedonic desires in check, and it's a part of the brain that we call the prefrontal cortex. That part of the brain was actually taken offline by sleep deprivation, and that led to the more primitive areas of the brain regions such as thehe, Mick Taylor, for example, that just erupted in terms of its hedonic response to desirable foods. So you can see that essentially, you're losing impulse control networks

within the brain, which, by the way, brings us right back to the five year old. It's so obvious when we see the kid that missed his or her nap, especially his nap, it seems, and look as adults. Maybe we're not going to throw temper tantrums in the grocery store. But you know what? We're probably a hell of a lot more likely to buy Pringles,

right, and you can scale it up. We've just described the litany of causal evidence, from circulating hormones to food choices to changes in network brain activity. This idea of sleep leading you on a path towards obesity and diabetes is very clear import regulation equation of energy balance That, I think is it's just unquestionable. But your point is a good one about impulsivity. You think about other sectors were impulsivity is probably not great. Yet sleep deprivation is rife. Military aviation, stock markets. I was speaking to, uh, another author who lives here in Berkeley, called Michael Lewis was written some fantastic books, and he was describing how rife sleep deprivation is, You know,

down on Wall Street in terms of trading and money markets, I can only imagine the types of poor decisions and deficits that come by way off your brain, shifting into impulsivity when you are under slept. And we're starting to do some work in those financial market sectors as well. With choice and decision had lived to at some point do a survey of sleep in Mackenzie and see exactly what the efficacy of insufficient see piers. And there's already work out there. We've done some. The studies in response has done some of these studies in Washington. If you look at employees who are sleeping six hours or less, the impact is probably fivefold. Firstly, those employees who are under slept will select less challenging problems. So you give them the experiment where you give him a range of problems, and they just typically will choose listening to voice messages or doing email rather than digging into hard project work. Secondly, off the problems that they do select,

they end up producing fewer creative solutions to those problems. And that's an issue because it's supposed to be creativity and ingenuity that's driving businesses forward. But you lose that with a lack of sleep. The third thing that we found is that when under slept, employees are actually working in groups working in teams. They just slack off, and they just let other people work. It's riding the coattails of other people's hard work. It's called social loafing Doesn't breed good atmosphere. The fourth thing that they found was that the lesson less sleep at an employee has had the more and more deviant and unethical he became, which comes back to impulsivity and deep emotional sort of eruption uncontrolled. So, for example, they starts to falsify data and spreadsheets. They starts to claim the work of other people, even falsify reimbursement claims,

and then the final study, which we didn't do. But it's a great study miss from Christopher Bonds. They looked at the sleep off a business leader, and then they asked their employees how charismatic and inspiring was that business leader from one day to the next. And what they found is that the less sleep that that CEO had had from one night to the next, the less inspiring and charismatic their employees rated that business leader from one day to the next. Even though they knew nothing about the sleep off that leader, it was evidential in their behavior. So here again, you know we've gone from intra cellular networks and the impact we've gone from jeans out to changes in food consumption, energy consumption, food choices, changes in brain networks all the way back up to, you know, the workforce.

And that last one, by the way, is to me one of the most interesting. Which is when you consider what that message is right, because that's a great blinding in the sense that the employees I have no idea how much sleep they might not even recognize what the purpose of the experiment was. I'm sure that if the was directly they were blinding isn't even the reason. That's right. If something so socially important, because that goes beyond just being the CEO and being the person that works for the CEO, right, that that speaks to a much broader network of communication and interpersonal skill. You know, you think about that from the standpoint of dating, mating, like all of these other things, parenting like I think about God. What what kind of a horrible parent am I when I'm sleep deprived? Because, I mean, I just I can't imagine that I'm doing the same job

and what's interesting. You know they're about sort of dating, mating and parenting. It brings me on to sort of that similar control, one of the interesting things, and this really actually does impact reproductive fitness and reproductive health. That's a great city from Sweden, a colleague of mine there, and they took some individuals, and they gave them a full night of sleep. They sleep, deprived them. Then they took essentially a portrait shot beauty picture under both conditions. And then they took a group of independent judges who knew nothing about the sleep that those individuals had got or had not obtained. And they just simply asked them to rate those pictures essentially like a beauty contest. How attractive does this person look? How sickly does this person look on?

How sleepy does this person look? So these. It's the same individual just under two different experimental conditions, and the judges in this beauty contest have no idea what those two images are. They just see the two images. Despite being blind to the experimental manipulation, you are consistently rated as looking more sickly looking sleepier, but especially looking less attractive when you have not slept. So there is scientific proof off this thing called beauty sleep. But you know, in truth, it's it's a really issue regarding, you know, attractiveness. If you're trying to find a maze or if you've got a mate and you're trying to get intimacy and move towards reproduction, you're not going to be looking your best when you are under slept in that regard.

So I think you you know these things consistently keep playing out under very carefully controlled experimental conditions you just conquered around it. You know, sleep is it is a life support system, and I often think of sleepers, the Swiss Army, knife of health. Whatever ailment you face, it's more than likely that it's got a tool in its box that's going to help out. And this decimation of sleep throughout industrialized nations, I think, is having a really demonstrably I mean that, as in literally a demonstrator ball impact on our health, our productivity off safety on the roads, on the education of our Children. You know there is. There's truly no aspect off a human being's wellness that we've bean able to discover that isn't eroded by a lack of sleep, lack of sleep. It's almost like a broken water pipe in your home in the sense that it will leak down into every nook and cranny of your physiology.

That is actually an elegant way to state what I've been struggling to wrap my mind around over the past few hours. Taking a step back, we've gone through so many aspects of the pathology of sleep deprivation. From what I would consider, we started it a somewhat macro level, which is big, chronic diseases that are multifaceted. We went really, really, really micro into something for which we can't even elucidate the mechanism of a Katie's phosphor relation, then brought it out to arguably the most macro, which is suitability for leadership and appearance. I mean, you can't get more macro, and a great analogy is water. I mean, is anyone who's ever had a leaky roof has known,

and I had a leaky roof in residency that tormented me for two years. Water will always find a way, and that's a sort of picture. Sleep as if you interrupt this system. It is always going to track into something negative, and sometimes it will be water gushing through the ceiling, and sometimes it'll be a slow drip that streaks your wall and you barely know where it's coming from.

Yeah, that just It's very It's been very hard to find something that is resistant. There are a few things in your biology or your psychology that can retreat at the sign of sleep deprivation and get away unscathed.

I think it goes back to the point you made earlier, Matt, which is it is such a ridiculous proposition to sleep that the fact that it is here, the fact that we spend probably when you consider, you know, our origins at the very beginning you call it half a 1,000,000,000 years. Keeping this strange thing around that on the surface makes no sense and and we've had no pressure to get rid of it. I mean that we haven't already resisted, right, meaning, like all the pressure that would get rid of it, that we discussed, You know, the inability to get food while you're sleeping. The inability to find a mate inability to protect yourself, the inability to care for your Children. We resisted all of those things,

but it's only in the last 152 150 years and really in the last 40 years that a totally new pressure has come on board that we didn't really prepare for, that it could be so devastating. Whereas starvation, excess food, we've had lots of time to prepare for that and again, even though the excess food we have today doesn't look anything like the binging that we would have done years ago. And and Rick Johnson has written very eloquently about some of the genetic changes in fructose metabolism that really saved us and enabled us to fatten up in the fall when the fruit were sweeter. At least that prepared us a little bit of you know what we would do with excess nutrients in this modern era. At least we had a relatively safe place to store excess energy, and we certainly have a safe way to handle not having energy. I mean ketosis, starvation ketosis. If not for that ability, our species wouldn't exist. So we've got that one pretty covered. We just I asleep. We just didn't have

the chase. It's just there's just nothing there. And I think you know, part of this now comes to the bleed out of what's happening, which is where people are either. So stressed, or the diet exercise substance intake is such that they are finding all manner of sleep AIDS. Now we know for a fact that 10 million American adults in the past month have swallowed some kind of a sleep aid 10 million.

I'm actually surprised it's

not hire, which will, and that's all that we can get people to admit to, and we know off. You know, I think that's probably a lot of over the counter things that are

Yeah, that wouldn't include necessarily someone taking Benadryl for sleep,

right? Exactly. Tylenol PM, whatever. And so, you know, I think this is where we're starting to see, and people have a very, I think, complex misunderstanding about what sleep aids actually are. Alcohol is probably the most misunderstood of all of those sleep aids, and it comes back to our discussion about sleeping pills a little bit, too, that what I often hear from people are saying, you know, I'm pretty stressed in the evening account. Fall asleep when I get into bed,

um, to awake, perhaps because they're not getting enough darkness or perhaps because of use of caffeine too much or because of the anxiety one of the problems with alcohol is that well, it does three things to your sleep. First, the alcohol is we sort of mentioned before is also a drug that is a sedative. So it works on the same class of receptors that sleeping pills actually does. And when you have a nightcap, what you're doing is again just sedating your brain. You're just knocking yourself out. So that's the first thing you think you fall asleep fast that you don't. You're just losing consciousness quicker. You're not falling asleep quicker. The second thing is that alcohol will fragment your sleep so you wake up many more times throughout the night. Now, typically,

they're so brief that you don't remember them. But they have a measurable impact on your sleep physiology and, as a consequence, your own wellness biology. The final thing that we've discovered is that alcohol is actually very good at blocking your dream. Sleep your rapid eye movement, sleep. And so what happens is that you end up waking up the next morning feeling un refreshed and unrestored by your sleep and some of the times you may think, Well, I don't remember waking up with the alcohol so maybe it wasn't the alcohol. I don't know what's going on, but now you start to feel lousy. The next morning, you start to feel that you have this, like, kind of sleep inertia where sleep is still with you and you won't let go of you. So now you start abusing caffeine

or by its more technical name, a dentist Sing, reducing substance.

Correct A dentist scene Muting substance. If you're taking caffeine, you know, before midday I think it good questions to ask why? Because that naturally should be your peak level of alertness around 11 or 12. You know, I often used to look before on planes Now where you can now use your phones on takeoff. You know, five years ago you couldn't do that, and it was a great experiment for me cause I get on a flight a 10 o'clock when everyone on that plane, for the most part, depending on their prototype, they should be getting into the nice, sweet spot of their alertness. They should be wide awake. And when finally people could not do anything, they weren't allowed to use the phones.

They could just have to sit with the boredom of taking off boredom unmasked the state of chronic sleep deprivation, and I would look around on half of the plane was fast asleep. So what then happens with you know, Al calls that you start using caffeine and caffeine is a problem, because everyone knows caffeine, you know, makes you awake on the way that caffeine works, comes back to our discussion of a dentist sing, which is that a dentist seeing builds up. It's a sleepiness signal. It's telling your brain. Get to sleep, get to sleep along them or that you have caffeine rushes into the brain and it latches on it hijacks those a Dennis seen receptors, and itjust blocks them. So essentially it acts like a remote control for your TV, and it just hits the mute button on the sleepiness signal so your brain thinks,

oh, haven't been awake for 16 hours. Maybe I've only been awake for eight hours because I just slammed an espresso after dinner. But then the problem with caffeine is that it had actually has 1/2 life of about six hours. It has 1/4 life of 12 hours. So in other words, if you have a cup of coffee at midday. Ah, quarter of that caffeine is still in your brain at midnight. So the equivalent would be, you know, getting into bed. And before you go to sleep, before you turn the light out, you swig 1/4 of a cup of Starbucks and you hope for a good night of sleep. It's not going to happen for some people.

Other people will tell me. Well, you know, I'm one of those people with caffeine. I can have an espresso after dinner and I fall asleep and I stay asleep. So no harm, no foul, presumably. Isn't that okay? And the danger there. We've done the studies to where if you give someone a standard 200 milligram dose of caffeine in the evening and then you measure their sleep architecture, what you see is about a 20% reduction in deep sleep as a consequence of that caffeine being in the system. To put that in context, to drop your deep sleep by about 20% at half, to artificially age you by about 20 to 30 years to get that type of reduction of love is this Is

this independent of the caffeine metabolism, snip differences that exist is everybody equally like I've always felt like caffeine doesn't do anything to me. I mean, I love coffee, so I make most days. I'll make a coffee in the morning as a French press more. Maura's the ritual, and I just love the taste in the aroma. But when I'm tired, caffeine does not wake me up, and it just seems to have zero impact on me in any way positive or negative.

And I think that's where we, you know, we don't know. We know that people have different genes that are associated with the enzyme that decomposes caffeine, and that's why some people are very caffeine, sensitive or less way

actually run this on most of our patients. If you do it, they've done a 23 and you can you can run it into Prometheus and see that. And truthfully, though, Matt, you know the association isn't as as clear as I experience it clinically with people I've always kind of been jealous of. Those people who can use caffeine is a true performance enhancer, but on the flip doesn't have that effect. It has no effect on me whatsoever. What

we don't know is those people who have those particular gene profiles that may have the ability to more quickly decomposed caffeine. All they the same people who also don't suffer the same type of. I don't think we know. We don't know

Andre gets to something interesting, right? So, you know, going back to the alcohol point, I would add two points. The first is there are a handful of things that my wearing the or a ring for the past three years has has has done for me, and I want to disclose that I'm an investor to an adviser to Aura. So please understand that it's important, you know that so that you can take what I'm saying with a grain of salt. But but what I'm about to say every single one of my patients has said, and we buy this ring for every single one of our patients. There is no greater behavioral tool to show you the dill it eeriest effects of alcohol than this ring. I mean, you see the effect and for most people it is somewhere between zero and two drinks. So in other words, for me,

it appears that a single drink 4 to 5 hours before bed doesn't appear to have a difference that I can discern anything beyond that, meaning one drink closer to bed or two drinks even six hours before bed. My sleep is shot. My resting heart rate will be 6 to 8 beats. High high heart rate variability is compressed by a 20%. Yet my respiratory rate is higher by probably two breaths per minute, 1 to 2 breast per minute. My temperature is up by 0.32 point 6 F. It is a kick in the groin

on every one of those levels. You know, that's that's exactly what we see in the scientific evidence. You need heart rate to drop your heart rate. Variability is, you know, usually for hire with sleep, especially good sleep the same mystery for the next morning. If you've been getting good sleep, temperature and respiration are critical. A CZ Well, we know that you need to drop your core body temperature by about 2 to 3 F to initiate sleep, and that's the reason that you will always find it easier to fall asleep in a room that's too cold than to heart because the cold is at least taking you in the right temperature direction for good sleep. Yet alcohol with this thermo genic profile starts to increase your poor core body temperature, which is Theo exact opposite of what has to happen for good sleep. So you're going to get more fragmented sleep. You get more awakenings,

you disrupt RAM sleep. It fits exactly the profile of a scientific data. So you know, people can take your comment if they want with a grain of salt, Should that, you know, investor thing sort of lead it. But I can tell you, here's a sleep scientist that what you're describing is exactly what you see in the scientific

literature. And the reality is, I think, every one of my patients who at least wears their ring. Some of them won't wear the ring for reasons I don't know. But any patient who wears the ring reports the same thing, and it's this deal reported on the same four metrics. Second thing I want to point out, which is alcohol inhibits vasopressin. And so anybody who's who's who's had something to drink knows you tend to pee a little bit more and some people might think, Well, you know the reason you're peeing Maura's, you're just drinking more, but the reality of it, that's not true. You're peeing disproportionate to the volume you're consuming because ethanol inhibits ah hormone called anti diuretic hormones. Who,

if you inhibit the anti diuretic hormone, it has a pro diuretic effect. And so if it if everything you just said weren't bad enough now imagine taking a diary tick before bed. I mean, do you really want to make your sleep any worse? I mean, and by the way, I used to be so dumb that I if I drank before bed, I would actually take vasopressin. I would take 0.2 milligrams of A's a precedent to at least not, like make me get up. Which, of course, is I mean, talk about the most backwards logic history. Yeah,

or you could just rage a bit a little bit more sensible with the alcohol. Yeah, yeah, yeah, it's it's incredible. The thing I've noticed is a very high carbohydrate meal and especially a crap carbohydrate meal. So, you know, like high quality carbohydrate something to do this. But I mean and I had fun. I'm admitting all the horrible things I do. But it's good. I think people need to know just how much

of a failure I am. It's just you and me here. It's,

um, at least once every few months, like I just cave in and I just an hour before bed. I just been ish, Eat something. Stew stupid is beyond like a bowl of cereal that, like I just can't resist or something. It basically produces the exact same architecture as that drink. As those two drinks, I want to go to another compound that I get asked about a lot. And truthfully, I just don't know the data, and that is what we'll start with th see and we'll move to CBD, and then the T H C touches. I guess you could think about it through two lenses, right, which is the developing brain versus the quote unquote developed brain.

So let's start with the ladder, since I think it's more clear in the former that the developing brain probably is not benefiting from th see, so it's probably not even worth asking. The question is th see a good sleep aid in a teenager. I think the answer would be clearly, No, but you and I is th see a pro sleep compound.

No, I don't think I'd feel comfortable in suggesting that it's a pro sleep

compound. And would you say that? Independent of strains. I mean, you know, the anybody who's experimented, these things will tell you, you know well, city, Va. Maybe not, but indicate

yes, I mean, firstly, I don't think we have enough data to, you know, pinwheel out the different strains and sort of Parametric Lee sliced the strain pie as it were, and ask that. But what I do know from the evidence, firstly, I should say that you know, acute use of th see typically has a quote unquote beneficial effect such that it will decrease the amount of time it takes you to fall asleep. What's called your sleep late and see That's

the only thing that impacts

is Leighton. See, So it reduces the Leighton see, and it makes it feel is though well,

and you are essentially a view your duration.

So yeah, so you're falling asleep faster. Total duration, not so much. But what is happening, however unfortunately, is that that th see just like alcohol has been shown to be a very robust blocker of your dream sleep of your M sleep. Add that to the fact that with chronic use of th see you build up a tolerance to the benefit on falling asleep faster so that now you actually have to start using Maur off the compound to get the same reduction in sleep on set time means that that tolerance independency. I don't think it's necessarily a good thing when you then cease. The use of th see what you find in the studies is a pretty horrific insomnia rebound, where people then actually have miserable sleep, and it usually typically leads to then falling off the bandwagon of abstinence. If that's their goal on people, then to suck, having to use again to gain back that crutch that you may not necessarily have needed otherwise. So I think the the evidence right now, especially with the Rams three blocking effect of T H C and the importance of REM sleep that we know off.

I don't feel comfortable in thinking that th see itself is really the sleep aid of the future and that there is more evidence on the th seaside CBD is starting to gain more research traction. I don't think there's enough studies done. I think part of the reason with CBD is and T h. C. It's just it's hard to do these studies because they're hard to get funded because of still some of the moral. And now I am not again. I'm not puritanical about this. I'm not casting any judgment at all. And I've often thought, well, you know, what would it take? Maybe, you know, I should do. Yeah, like Kickstarter and trying crowd source enough money to do the appropriate CBD studies because I think CVD it is more promising on the data right now. The data for CBD is that you get that benefit of fooling asleep fast. Either

way, would you just interject for a second? Would you be able to get an Irby approval to do a real world study where a bunch of people were just using wearables and he could homogenize in uniform the wearable and the CBD and things like that, but without having to do it as an in house sleep study? Do you think the wearables air good enough that I could get enough data in the community,

I would probably do a hybrid.

I mean, you know,

that makes its irony of its of th CNC FM being used. His hybrids is not lost on me, but I would probably do a hybrid where I would do some tracking of sleep ecologically in the in the home setting as it were, and then have a couple of nights where they would actually come in. And we would measure their high grades, the quality, Because the trackers out there right now, you know, they're just not quite accurate. They're not clinical grade enough for me to understand the quality and the stages of your sleep. I think trackers are not bad right

now. And But even those metrics, you'd get a clue, right?

Like even with the f someone of a clue. Yet you can see it. I think you know, people often ask me what's the best sleep tracker on? I would say it's the sleep tracker that you wear every night. You know, I think most of them are much of a muchness in terms of that current inaccuracy. So I would do a hybrid city, probably where I have do some tracking outside with things like wristwatches or rings. And then I would do some in laboratory studies. But I think the CBD things are actually looking more promising. CBD does give you that same benefit. You fall asleep faster. You don't seem to get the hit on REM sleep now. I don't think there's enough studies for me to yet feel comfortable in saying definitively you don't But for this small handful of non placebo controlled trials, for whatever it's worth and we are talking about hands up here, everyone,

no recommendations, no promise, Oriole notes. This is just very early. Tentative. Preliminary evidence suggests that you may not get the Rams the deficit, which is good. The other thing is that you typically don't see the dependency issues, nor do you get the insomnia rebound when you stop using CBD. And the final thing I think that's interesting with CBD is that it may actually have some benefits in certain sleep disorders. There's some of the little bit of evidence that it may reduce the severity of sleep out near, but I think that that's just, you know, one or two studies with some benefit that's happening in PTSD with CBD treatment to help with PTSD. Sleep problems and sleep problems are really problematic issues with PTSD patients. So I think anything there that could be of help as long as it's medically safe on doesn't compromise your sleep.

Unlike th see, would be a good thing, too. Probably two caveats or least one caveat. It does seem to be somewhat dose dependent. I don't think it's very clear right now what the optimal dose is. There have been some times where people have actually suggested that the use of CBD at a certain doses actually wake promoting rather than sleep promoting. So I think that may actually be this U shaped function when it comes to CBD that what or some kind of a function. I don't know what the function is going to be, but there's going to be perhaps a sweet spot of a dose concentration that is optimal for C BDs benefit on sleep. And there may be other doses that are actually detrimental to sleep, and we need toe stay away from them. How is C B D? Doing that and having that kind of benefit of sleep? There was actually even some evidence that it may actually increase the amount of deep sleep, which was interesting.

And that was just one single study. Small study again. I'm not believing it. I'm not going to go out there and start telling people to take CBD on the basis of that single city. I am saying that I think it's got promise right now, but we don't know how could it be doing that? Well, one of the interesting things could actually be thermo regulation. In some of those studies, they were actually finding that the core body temperature decreased with CBD administration, and we were just describing that when you drop core body temperature, you sleep better. When you increase core body temperature by way of something, fama genic like alcohol. Or it's just a hot room or a big meal that increasing core body temperature is worse for sleep. So C B D may actually be having its mechanistic benefit through the thermo regulatory system is one of my hypotheses.

The other is that it in direct through its fangs e elliptic benefits, I think probably the greatest strongest evidence right there out there right now for C BDs clinical efficacy is for anxiety, and I actually think I have tried to read as much of that dangerous I can. I think it's actually pretty interesting. I think one of the major causes of insufficient sleep and poor sleep right now is that everyone is just cranked in terms of anxiety. On that they wake up or, you know, we are constantly on reception in this modern day of life on the only time that our brain goes from reception to reflection is when our head hits the pillow. And that's the last time that you need to be ruminating and catastrophe izing on having that roll index of anxiety. So I think if C B team is efficacious for lowering anxiety on anxiety is one of the causes of poor sleep in society. Then part of that benefit may not be fueled a direct mechanism on sleep regulating centers, but instead a secondary benefit off lowering anxiety, which perhaps lowers that sympathetic fight or flight branch of the nervous system, which means that you shift into a more parasympathetic state and or it drops core body temperature. Both of those roots, I think,

are in my mind the tenable hypotheses that in, you know, a crowd source study that I would want to do. And I don't know if people want to do that sitting, you know, comments in wherever

comments can be. But I would also wonder myself, I would love to see that study because anecdotally not so much in myself. But I also think I'm I sleep reasonably well. But in people who don't sleep that well, I have anecdotally scene some pretty impressive results with CBD. Another times I've seen nothing, and what's interesting is in some of the people in whom I've seen impressive results. It's people who have been largely recalcitrant to other big guns again, I think whenever you can sleep without pharmacology, you're doing a good thing. But I agree when you look at things like Trash did own Thorazine with their anti ruminative properties, and you see patients who even a 25 and 50 milligrams it doesn't matter. That's right, you know doesn't sleep and yet, you

know, see, being does having Yeah,

and at that point you start to think well, it's less likely to be the placebo effect because you've tried all of these other things that didn't work why would this silly little oil work? And you know, I'll share a sort of unrelated story that speaks to this role of anxiety because this kind of brings it back to this idea of mental health. I I think it's such an important part of longevity. I have a patient who's sleep has really eroded in ways that I can't even imagine. And it's been quite devastating. Tow watch. And this is an individual who has done everything that you would ask someone to do, right? This means we you control the room temperature, you control the light, you control the nutrients you control, You eliminate the alcohol, you eliminate the caffeine an hour of meditation. And I mean this is everything. But you know,

this person is in the midst of a very difficult personal struggle. And that's so by the time you're it, you know, 50 milligrams of Thorazine to just try to shut off the ruminative properties, and you would get some intermittent benefit, but not long term. So in the end, what he was able to do was enter into a clinical setting under which he was able to therapeutically utilize M d m. A to deal with some of the issues that were predisposing and again. I want to be very clear what I'm saying here. I'm not saying he went to a party and did ecstasy right to the listener. This is a clinical administration with a therapist of M D M A. To address the underlying trauma and anxiety and depression of the situation the next day and for months to follow. And we're still at that standpoint. His sleep is fixed now. I think that is an outlier situation.

But sometimes these outlier situations provide an insight into a mechanism. And I think in this person's individual, because we had already fixed all of the sleep hygiene metrics. I mean, we had literally done everything in our tool kit, and that's a tool kit that has about 10 tools in it. To see this one thing, this one intervention work and, you know, the patient would describe this as a transformational life experience was just another example of the power of the mind and how the mind can sort of get in its own way at times

and the power of the mind in terms off it. Essentially deconstructing this thing called. Ah, full night of sleep is, I think so. Critical and more and more. Now we are seeing that the causes of sleep difficulties and sleep problems are shifting from, you know, typical biological problems to increasingly psychological problems. I think that rise in anxiety has walked in lockstep with the rise in insomnia. I I think we've got enough evidence to suggest that those two you're probably not coincidental but are significantly interrelated is probably the strongest thing I could say right now. So it doesn't surprise me that if you have something that essentially is, you know, a mental health reset on your WiFi router, any the monster, you know in a marked way that could lead to essentially the same type of reset in that physiological thing called sleep. It doesn't surprise me,

You know, whether or not you know that is that the treatment for everyone you know is, and you're very clear about that and I enjoy that. But it doesn't surprise me that if you fix mental health, you fix on. We've seen this by direction. We do a lot of work on sleeper mental health, and it's very clear that I can take people who don't have any problems with mental health, depression, poor mood anxiety, suicide ality on When you sleep deprived them, you can instigate many of those conditions. In fact, I can. Within one single night of sleep loss, I can put someone who is non clinically anxious to a level of anxiety where they would have a clinical anxiety disorder diagnosis.

That's how quickly it can happen. So yes, sleep can impact your mental health. And what's interesting is that psychiatry In the past 25 years, I have not been able to discover a single psychiatric condition in which sleep is normal, which to me was quite profound when we added it up that I can manipulate sleep in mentally well people and then produced by way of the excising of sleep. Mental ill health tells me that there is a causal direction from insufficient sleep, too poor mental health that sleep is essentially emotional. First aid in that regard, however, don't mistake that for the fact that it's a two way street as well, and I think what you're describing here is a state off mental ill health and when you course correct, that mental ill health. You then correct the sleep. And so I think the relationship between sleep and mental health is bi directional. I think is it's a two way street.

Is the traffic flowing more in one direction than the other? Perhaps on perhaps, psychiatry has had it wrong for the past 50 years. They used to think that the poor sleep in their patients that they knew about long before we published. You know, scientific data that was a symptom of the disorder rather than considering it, a potential predisposing cause off the disorder. So I think psychiatry is under starting to undergo a revolution when it comes to sleep. On understanding how fundamental sleep is to the maintenance of good mental health. I think it's I think it's the bedrock of it. You can stack up the different physiological body systems and the different operations of the mind. But I would put mental health pretty high up there in terms of one of the things that falls apart quickest. And the reason I can say that is because essentially we start with the sleep deprivation studies and we can just keep sampling the organism, which is the patient. The individual you know, every hour on we can just look to see the further you go into sleep deprivation.

What is the trajectory of impairment in brain and body systems? And some, you know, Come on tap later in the sleep, deprivation others very, very quickly. Essentially, what we're trying to ask is, what is the recycle rate of a human being? And after about 16 hours of wakefulness, things start to go wrong on the things that start to go wrong, soonest. And perhaps most severely, one of those things certainly is your mental health anxiety being one of the mood being the other depression.

It's interesting, right? How long it can take for certain things to ravage the brain neurodegenerative disease that manifest clinically in dementia. And yet how quickly certain elements of the brain will demonstrate the limitation. Memory, consolidation and anxiety has two examples. You're in your sabbatical year, correct. I am. I'm finishing it up right now. I am. So what else are you doing with your time besides being incredibly generous and sitting here with me?

So I still even though I don't teach, I still I'm here at the Sleep Center. I'm the director of the Center for Human Sleep Science here at Berkeley on Dhe. We continue to do all of our research time. Still, you know, directing the center writing grants. I've been doing a lot of public advocacy of being doing a lot of public speaking. Now that the book has come out and doing sort of television media. I've also got a couple of start up companies that are emerging. One of them has just gone public. It's a brain stimulation company. This comes from work that's out there in the literature, showing that if you can try to essentially electrically singing time with deep sleep brain waves, you can boost the amplitude in the size of those deep sleep. Brainwaves were hoping to try and transfer that same technology into older adults and those with dementia. Can we salvage some aspects of the landing and memory by way of boosting back the deep sleep? That's one of those.

Can you say how the device works? Is it a device that sits in the room?

No, it's actually device that you placed on your head, actually measuring the waves. It both measures the waves a minute, inserts electrical voltage into the brain. And essentially what we're trying to do is measure when you're having those sleeping brain waves and almost act like a choir to a flagging lead vocalist that you're trying to sing in time with the electrical stimulation of the deep sleep of older adults, which is diminished by 50 to 80%. But giving them an electrical sort of, you know, stimulation to try. And every time they have, ah, deep, slow wave, boost the size of that slow wave. And in doing so, try to almost double the amount of memory benefit that you get from sleep,

because that's what we've already been able to demonstrate in young, healthy adults. So that's one of the companies. What's that company called? It's called Stem Science, And that's together with a set of co founders that we just recently got seat funding for from Coastal Adventures. Then I'm starting to think about writing a second book on dhe, unclear exactly what it will be. A king was probably three candidates right now. The other thing that we're trying to do as well, though, is raise funds for the sleep center. We've just moved to this beautiful new building that we're in with the new sleep center. So we're trying to raise philanthropic funds because, you know, and I think you've done this,

you know wonderfully. And you've done work with Gary Tubs trying to create this this vision for how you can fund science in ways that typical funding mechanisms will never do. That's what we needed at my sleep centers that we need philanthropic support on there is now currently through the university. They've granted the ability to name the Sleep Center for philanthropic donation. So I'm now just trying to move that work out. So I guess this is a shameless plug that should anyone out there wish tohave a legacy name to name the center that is there, but just to give you a sense of some of these, you know, studies. One of the's adversities that I'm fascinated by in our elderly cohorts is not just the deficit in deep sleep that happens as you age, which it does. There is also this strange cluster of outliers of people in their seventies and eighties that when I put their data of sleep and deep sleep plotted against all of the young, healthy adults that we've studied. Some of those older adults seem to be incredibly resistant. Toe age related sleep decline. Why?

No one is willing to kind of give me the money to do the studies, which is the inverse. You know, it's easier to get money toe explore when things go wrong, but you can get insights into those critical questions by looking at also when things go anomalous. Lee, right? And a good example of this is the blue zones. You know, this work that was done starting by National Geographic, where they looked at longevity, and they found that there were these pockets throughout the world where people seem to live longer. Now I think some of the cut the data there is controversial, but it was a good idea that you could look. Is there something about their social fabric? Is there something about their diet,

Their exercise that no one in terms of thes blue zones has asked the fundamental question about sleep? Why, you know that's gonna be fiendishly difficult for me to get funding for. So one of the things that I'm trying to do right now is raise money for the sleep center to do what would be otherwise impossible fundamental research to make critical discoveries on the flip side of where I think we can make riel inroads into understanding sleep, which are usually typically very difficult to get funded of these kind of more blue sky research questions, but could make real impacts. But sorry. Enter Where does sleep

reside within N I. H. Which of the 17

it resides in most of those branches, you know. It resides in the National Institute of Aging. It's therefore neurology. It's there for cardiovascular disease. It's therefore metabolism glucose, and it's therefore Nayda, which is the Institute for Drug Abuse. So it's prevalent in all of them. But I would say

that, but paradoxically, it doesn't have its own institute. Alright doesn't which it seems like it ought to. Well,

if you were to think that exercise, nutrition and sleep are the three fundamental ingredients, that, as best we can tell from the science that we've done as a human species, keeps us alive on longer living and living longer well

and yet those things all spread across the entities as opposed to stand in their own, which there's benefit to that, you would argue they shouldn't be siloed. They should be studied. But of course you could almost argue for a matrix That's right, pose to

show. Yet what you really want is horizontal tze and verticals And when you put those together we create the matrix that you've just described. So I would say, you know, I think n I h has done has definitely supported a you know, a huge amount of sleep research. And they support Cem, the research or some of the research that we do here at the Sleep Center. And I'm incredibly grateful and very fortunate to have those grants. They're very hard to come by, but there's also I keep running into these fundamental questions that when I write these grounds that difficult to get money for Andi. I understand why, because you've got government policies, you've got particular institutional mandates that you have to fill. They're just not going to fund thes these research programs. So that's another thing that I'm doing is trying to raise money for the sleep center, then with the start up companies and then also just doing our fundamental basic science.

And now are you formally involved with Google in some way as well. I've seen some of your talks there, but a Did you work with verily doers?

Yes. Oh, I do. So right now, I'm also a scientific advisor for verily, which is formally known as Google Life Sciences. So I do help fairly to try and help shape their mission of sleep on dhe. You know, I've also being a consultant for many of the other large tech companies out there and many of the fitness trackers as well. But right now, yeah, I do also do some time it, verily, to try and help with many of their exciting visions regarding how you could use the resource is of a big technology company like alphabet to try and do things differently than the way that the government does health. I think we'll need both of those forces, and both first forces will be for good, but it's a wonderful place to be.

You've got incredible people there on dhe. The way in which they see problems is different. The time course over which they want to solve those problems is different. And the solutions and the expertise that they bring to those health problems are different. So when I got the chance to work at Google Life Sciences there or essentially be an adviser there jumped at the chance. It was It was great

to try and help shape that mission. You know, Matt, I I had a list of, ah, five pages worth of things that I wanted to discuss with you, and we covered many of them. But I would say we covered half of them truthfully, and I think the only the only solution is we probably have to sit down again sooner rather than later. And amazingly, we were pretty good about not getting into cars, which is, I mean, like, we could have spent this entire time talking about Formula One.

Maybe that's thesent half of the second conversation. Should people not generally lose the will to live when they hear my voice for, you know, several hours, which is what most people do, unfortunately, But I would be so thrilled to come back at any time. You would wish Mi Teoh and same for the audience. And if that second time did involve a little discussion of all things cars on dhe car racing, including Formula One, it is one of the few things you know, I I've never been a big fan of alcohol, not because I'm down or against it. It's never really liked the taste, so I typically don't drink. I'm caffeine free Justcause. I'm one of those people who's sensitive to caffeine,

but with one vice that I have, My biggest weakness is cars. Car racing are it's, it's a It's a wonderfully terrible affliction. I adore

all things automotive. The next time we do this, let's do it in San Diego so we can sit in the simulator and I don't know, maybe just do 100 laps of code or something like that. Yeah, it's,

uh, that would be such a gift. That really would be,

Well, thank you all the minute that you know, it's possible that by the time this comes out, we'll already know the answer to this question. But given where we are right now, which is in late February, what is your take on this year's season? I mean, early testing looks really good for Ferrari. Looks like that front wing is giving Mercedes a little bit of difficulty and they still got me. If if you had to predict 12 and three this year in both constructor and driver. How would you handicap it now on these air? Impossible questions to be no need to be

clear. Yeah, I don't know about driver. I think I'm gonna put Ferrari one and three Mercedes to Andi. I think

floors with a huge question then is Vettel LeClair? I mean, where you going?

Okay, if you're gonna push it, I would say a battle won, I think, Hamilton,

you know? Yeah,

it's gonna be probably the number to the ladies. That's my suggestion. Or I would at least say that that's gonna be the first half of the season. You know, Mercedes as a team, technologically, they are fantastic to on dhe. I think that they could rebound. You know, if this first or all the data I've seen, it's just the one set of testing data that, you know, you and I have both seen here now in February, and it looks like Mercedes has got a rip roaringly hot car on their hands. But I think Mercedeses

came Ferrari sorry for Are you sorry? Sorry. Sorry.

Ferrari. I think Mercedes is capable technically though, of coming back in the second half of the season to make sure that that car performs. So they've got a good chance and Hamilton, with skill that he has, I think, may be ableto hang in there until that technology and the engineers come good. I would also just love as a British man to see McClaren do a little bit better. I love tha Mazza car brand. I've never had the opportunity to be in one of their cars. I've only had the chance to look at them. And usually that means that I become a even Maur incoherent human being. And then I dribble. Andi want toe typically tend to like the car. Just to be honest,

uh, if you had to have a za daily driver, so cost doesn't matter, But it's gotta be the car you drive. You take a 7 20 or a P one.

I think the p one just the rattle alone that that happens on that carbon mon A cock with driving around would probably prevent it from being a daily driver for sure. Would I like to have the uptown problem of having a P one? Is my driver? Absolutely, I would, but I think 7 20 s I could live with every day. You know, I look I could go with any one of the models, you know, put me in any one of the five Siri's that they've come out. I would adore to. That may actually be a more relaxing car, but I'd love to see Well, firstly, I'd live to see myself in a McLaren.

But what I

was about to say was, I'd live to see McClaren doing a little bit better. And I've got a soft spot for Bruce McLaren and what he did for the automotive

industry and just lost the remarkable era of driving. And he died relatively soon after Clark, right? I mean, it is unfortunately you're Jim Clark died. Yep, that's right. I mean, that was the That was the era where the exception and not the rule that you

retired. Yeah. And you know, it's It's that And then plus my similar obsession that you have with my Insana Andi the history that he had with McClaren too, of course, even transition to Williams later. But there was something special about that that time where he was with McClaren. That makes me just want to see McClaren do better, too. If you look at McClaren's rise in just road cars and what they've done, they have scaled more quickly in terms off incredible technology and competing with the likes of Ferrari and Porsche within such a short time period. And I think Ron Dennis, who is the mastermind behind McClaren in that regard, is just a man of genius. And so you know, they came out with the 12 C and there was a lot of discussion that it was it didn't have the heart of a Ferrari

on Drea de three

GT three. You know, it didn't have the the emotional temperament that would excite you that it was perhaps somewhat of a clinical car. I think they've bean battered, increasingly increasing the emotionality into the cause, but I also think that part of them is resistant to that idea of necessarily the emotionality. But just the precision and performance that you can get from those cars on the the doing, emotionality better. But in terms of precision and performance, I don't know if anyone touches

them right now, and it's not like the revolution. I have not driven a McLaren that I've never driven one, and I have friends who have them. And they've said, You know, you're welcome to come in but I just haven't I don't know, I haven't done it But I've driven lots of Ferraris have driven lots of Porsche's. I've driven lots of these other cars, and it's everything you say has been reiterated to me by the McLaren drivers who themselves have driven all of these other cars. So just my curiosity is equally peaked, and I'm a bit ashamed to say, I don't know why I haven't just taken someone up on the offer to do

this. Please do. And then can you write me a long email so that I can live vicariously through the gift that was

given to me well for her, the way we'll figure a way to do it together now. So So So one more question before we figure out something else to do. The 1988 McClaren versus the 1993 Williams, which again you don't compare them. Kartik, are totally different technology, but you could make an argument. Those were the two most dominant cars in Formula One. I'm guessing your heart is with the MP 44 But what do you think about that 93? Williams? I mean, that's a car that doesn't get as much attention as I think it deserves. I mean, it was so technologically advanced. It was some. Some have argued. It is to this day the most technologically advanced Formula One car.

If you look at some of the shots where you know they've got different Tink, you know computers plugged into it. You know, I'm always making musical symphonies with the engine and the suspension, the chassis dynamics of damping. It was just next level. It was kind of almost this step function that we've been going along with race cars on. We've been having beautiful evolution, and then all of a sudden revolution came along with that car so I would actually go for the Williams, you know, And again, this probably goes against myself of my McClaren bent. But it was just such an exercise in engineering passion that lent itself to this clear night and day almost next day benefit and

obviously post one that year was Hill, the

other driver. Hey, I believe you want Yeah. So because MENSA was driving

at that time? Well, yeah. Mansell was with Williams the year before he won in 92. Okay, in there, will

you? Yeah, yeah, yeah. It's just such an amazing and great here. I mean, I love watching now, and they're, you know, they're still competition that's relevant there. And this still, you know, I think there's lots of good, colorful characters, but I just can't help thinking that there was thes eras during Formula One. You know, even back in the days of,

you know, James Hunt, for example, who I just adored that kind of just fly by the CT of pants, You know,

he was. So when I'm acquiring,

also in the McClaren, too. And then, you know, there was this lovely kind of passing of that chalice from him Thio Iron Center. And I think it was happening when he was commenting. Maybe it was with Murray Walker when Senna was finishing up his last race in the season when he was with the jump layer car. You know, that beautiful kind of black and gold, A load of sort of the low two years or the lows this year. With that on dhe. You know, you could just hear the excitement in Hunt's voice as to what this young potential prospect called Iron Center could possibly be. And for me, it was just this lovely kind of, you know, generational shift from one driver to the next is a driver who knew how to spot talent and to see that you know,

talent. And you could hear in the emotionality of James Hunt's voice that type of affirmation that you will next be one off the great and I read all of that. You know, I think it's probably nonsense, but for me, that was beautiful, too. But this being great eras hunted men and center, and now it's just different. But I still watch. I still love it

and the wheels it's it's sort of funny, like I mean, truthfully, we can all sit here and pooh pooh the sound of the engines today and stuff, but the reality of it is when you hear them, it doesn't matter. It's still Pavlovian. I mean, it's you just can't stop drooling. There's such beautiful machines.

Yeah, and if you just hear them full chat coming down a straight and it goes past you and you've got any small modicum of gasoline that runs in your veins. There, has on your back of the neck will stand up, you know, and you'll say, Yeah, I was wrong about it'll going away in this modern era. Truly not.

Well, we'll see. We'll see what happens this year, but I think you're right. I think it's going to be really competitive. I think despite the challenges Mercedes have had, you can't count them out. They're just so damn good and dominant. Yeah, and of course, Lewis is incredible. So and I'm not actually huge Ferrari fan as the team, But I like Vettel a lot. Yeah, I think the culture of Ferrari is broken. I think that's actually become quite public in the past year. I think it's a lot of people have have made that pretty clear that it's sort of a toxic culture,

and it's a stark difference to see how those two garages operate just as a fan, if you're there and you can sort of see what's happening, it za stark difference. So anyway, it should be fun. Talk about another sport where, like all sports, sleep really matters. I mean, I can't I can't imagine any athlete that's under Maur difficult sleep conditions than a Formula One driver. Because you know, it's one thing. If you play in the n b A, you're gonna fly a lot. But you have a three hour time zone max. And based on how the conferences work and how the schedules work,

it's not like you're going plus three minus three plus three minus three plus three minus three. When you look at Formula One first Falls a 10 month season. Basically, I mean, it's, you know, when you include pre season testing and it's truly a global sport and it's not even like it's structured perfectly well. It's not like they comb through Europe, then go over to Asia and then, you know, hit a little Australian Melbourne on the way over to North America and then hit South America. It's not even done in the logical way that you would do it if you were optimizing for Continental jump, right,

it's black and leave horrific and there in that sport, if you're talking about margin of error and reaction time, we don't currently have essentially a Breathalyzer for sleep deprivation, which we should, and I think you know there's ways that we can think about that, too. But if there is one gold standard measure off insufficient sleep, it's not only just your response time your basic reaction time, but it's the number of times that you miss a response. What we call a lapse or an error of omission you omitted. A response that should have been happening is so obvious that insufficient sleep impacts your basic reaction time and you're missing of choice response times. And in Formula One, or in any vehicle racing at high speeds, you no response times and reaction times. You're talking about margins of error here that a 10.0 x, you know, and six hours of sleep for one week Condone. Drop your reaction time by up to 3 to 400 milliseconds. Now 3 to 400 million. Almost half a second in terms of slowed response times in Formula One could make the difference between you being first and you being somewhat basically Noah.

Yeah, the other thing I've noticed. And this is one of the things I enjoy about having a simulator is I get to test stuff out. I mean, I've figured out that even after one drink, I drive worse in a simulator, even though I am not legally drunk, right, I probably have a blood alcohol of point. 03 point. Oh, I mean, a very low blood alcohol after one drink and someone my size who metabolizes things so quickly. But I don't drive well, and I know this is clear is, you know, as clear as day because when I drive with my coach,

you know, we drive virtually inside of I racing together. So he's in the cockpit with me, seeing my telemetry, seeing the drive, the whole thing. And it's just a different game. And it's not actually just reaction time. The other thing I've noticed is there something about my spatial coordination that goes down. So I actually think that that's a bigger problem than the reaction time. I think the bigger issue is you're just you're never quite hitting the right apex. You're never quite finding the right grip in the track, and this is even when you know the track like the back of your hand, you're just off. So

it's a facial. Attention is one of the things that we consider the we do it with brain scanners very quick. I think that's it was going to sleep deprivation. Yep, that I think together with also just specific choices. You know, if you're racing, you know you can. If you're by yourself and you're on the clock, that's one thing to worry about. A soon as you put other cars on the track, you make it strategic. When you make it a strategic, you make it about decision choices. Do you dive into that apex when you know that you've got someone on your flank, do you not? When is the time to break?

Do I want to break later? Do I have the downforce? Where am I? With my tires, you can go through a whole litany of decision making that has to happen within split seconds of time. Decision making again, you know, sleep critical components of unjust judgement.

I mean, I think that's been having a microscopic miscue on your judgment. And as you said, it's hard enough when you were on a track by yourself, just trying to bang out best lap times the moment someone else is there. And it's incredible how much your judgment could be impaired even subtly to do something stupid for me. You know what it is? It's impatience. I am much more impatient under that situation. Impulsivity? Yeah, Very impulsive flights. The child in the supermarket? Yeah, Yeah, just much more likely to, You know,

for example, you think about it. Let's say you have 10 laps to go and there's one car you need to pass. You know, you think about that for a moment. You've got all the time in the world to figure this out. You wanna wait until it's perfect and yet I can see it in myself. There's this belief would like, Well, I just gotta do it now. It's got to be on this lap. It's this lap or never that I totally irrational thinking. And I have to wonder because it's not. We do see these guys who are gods. I mean, you've you've driven race cars.

I've driven race cars so we can watch that sport and appreciate it may be more than the casual observer like we know how good they are, just like someone who plays soccer and watches. Messi can appreciate him more than I can, right or someone who plays tennis can look at Federer and actually explain why he's so great. That's what we can do with these Formula One guys, and yet sometimes you see them do things that really don't make sense. In the light of this conversation, it's hard toe. Wonder how much of that could be due to impaired sleep, given the again grueling schedule that they have to keep and the enormous time zones they're constantly skipping with very little recovery. I mean, it's impossible, actually, because on many occasions they won't show up in a new city until Monday or Tuesday. And if you've hopped eight hours in a time

zone, a great demonstration of this is just simply your. You know, driving a race car is physical, a swell. It requires physical fitness on nontrivial physical fitness. And a good example of this is that when you're trying to miss match your physical performance relative to your natural circadian rhythm, which is what happens when you're jet lagged. You are not going to be performing at your optimal sweet spot, and I can tell you that because if you look at the number of world records that are broken in the Olympics, they are statistically far more likely to occur. World record breaking efforts at the peak of most human beings. Circadian rhythm, which is around about 1 to 2 PM in the afternoon. Farm or world records broken in the Olympics at that moment on the circadian phase. And if you look earlier in the morning or later in the day, that probability curve actually decreases down,

and it's common across all sports. So that shows you that when you are in harmony when with your circadian rhythm, your ability to perform physically according to atleast world records, is optimized and maximized. So I can only imagine that when it comes to race car driving, if you're shifting between time zones so dramatically and you're not finding ways to optimize your circadian rhythm biology nor your sleep, you are losing a competitive advantage. And you, as a team, could spend 10 million on trying to shave off 100.1 of a second in a car, which would be heroic as an engineering accomplishment. Yet you could be shaving off, you know, 0.4 point five by way of human era by way of this thing called insufficient sleep or mismatch, Circadian rhythm So, as with many things that we're finding now with technology,

were starting to get to the saturation maximum off engineering and technology accomplishments. What we're finding is that the greatest week, the weakest link, the lowest hanging fruit may no longer be. Technology may no longer be tire, compound or downforce. It may be the human being themselves. And if you look at that constellation of things that are taken care off in race car drivers, any most high performance athletes diet, nutrition, mental health, those three things are well on the radar map of most of them. Sleep, usually not.

Yeah, and as you know, because you've driven and I've driven when I think about what separates people like us, who are enthusiasts from people who are professionals, it's really this ability to be consistently exceptional. I mean, I've probably had individual laps, you know that we're really, really good where, like, you could squeak like if you only saw me do that one lap, you'd think that guy's good, but I don't think I've ever strung together three laps that you could look at and say, Wow, that guy is really good. And, you know,

that's sort of the in many ways the challenge for even the best in the world. Which is you can't make a mistake on 70 laps. That's two plus hours sometimes, and I think to your earlier point about the reaction times and the speed with which the world is coming at you when you're driving a Formula One car. This this need to be incredibly focused, have a level of concentration that, you know, if you think about there's no other sport I can think of that requires that level of focus and concentration for that long. You know, most sports, you have brakes. And you could say, Well, sure, if you're on a straightaway, maybe you have a bit more of a break,

but I don't know, I don't know about you, but even when I'm on the straightaway is going flat out, I'm already going. Okay, break so like like yeah, there's there's really no moment where I'm not focusing right

in cognitive neuroscience. We call that essentially a time on task effect, which is that the longer that you're doing it does your performance changes a function of time, and firstly, the answer is yes, that your sustained attentional ability starts to wane, the longer that you perform just about any cognitive task, it turns out what's interesting with sleep deprivation is that the effects, the unmasking of insufficient sleep grows, the longer that you apply the brain to a task. So maybe for the 1st 30 seconds they may be performing, you know, 10 seconds at the level of someone who sleep arrested or their own level when their sleep rested. But you've got to go into a kind of minute, four minute five before you really start to see the lines deviate from one another. And that's what we call a time on task effect. And that is most prevalent in what we call sustained attention and sustained spatial attention, which comes right back to exactly what you were discussing. So certainly, I think if it's a missing ingredient in a racing team, it would be a cost savings to you on a point scoring benefit that you may want to look into.

Well, Matt, until next time this has been, I mean, really, really insightful. And when I think about how much I probably know about sleep to begin with and how much I have learned even from this discussion and certainly from reading your work. I'm incredibly grateful. And I do think that this is probably the single biggest deficit within the tool kit of most physicians. And I'm you know, a few people are more critical of the absolute dearth of rigor in the nutrition field. But I think this is worse, and it's not the dearth in the quality of the research. It's the dearth in the translation of that research to clinical application. And I think I think the research in nutrition is the worst research of all things. Just and again. It's not to be critical of the people doing it.

It's the difficulty and studying it. But at least there's a greater effort to translate what is known into practice. But here, this is the biggest chasm that said, I think your work has had a greater impact here than anything I'm aware of, and I wish you all the continued success. I think you could argue part of our humanity depends on it.

Thank you for giving me, firstly that information because I am on a mission to try to reunite humanity with. I think the sleep that it is so desperately bereft off and having this type of forum where you can disseminate that knowledge. You mean what you described there Is that the researchers not being translated to the clinical practice? You're absolutely right. And that's part of the work that I do with trying to be asleep advocate. But another part of that is just the transmission off that sleep knowledge to the general public as well. And I think people, you know, I'm not. I can't speak for any of my colleagues, but early on in my career, I don't think I did a very good job. But communicating science, the importance of sleep to the public through the science. And that's what I've been desperately trying to course correct with the book and then just trying to be out there and having this type of forum, this type of opportunity,

a long form discussion with, you know, just a fascinating, intelligent mind like yourself who has an incredible listener ship be given That platform is such a privilege. And so I have an immense amount of gratitude this time that you've bean providing me with. Thank you. Thank

you. Thank you. You can find all of this information and more. Peter Tia MD dot com forward slash podcast. There, you'll find the show notes, readings and links related to this episode. You can also find my blogged at peter tia MD dot com. Maybe the simplest thing to do is to sign up for my subjectively non lame once a week email where I'll update you on what I've been up to. The most interesting papers I've read and all things related to longevity. Science, performance, sleep, etcetera on social. You confined me on Twitter, Instagram and Facebook, all with the I D Peter A T f M d.

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