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AMA #16: Sleep, Vertigo, TBI, OCD, Tips for Travelers, Gut-Brain Axis & More

Feb 29, 2024 56m 48s 37 insights
Welcome to a special edition of the 16th Ask Me Anything (AMA) episode, part of Huberman Lab Premium, recorded in Sydney, Australia. This episode is a recording of a live stream AMA, originally exclusive to our Premium members. We've decided to make the full-length version available to everyone, including non-members of Huberman Lab Premium. Huberman Lab Premium was launched for two main reasons. First, it was launched in order to raise support for the main Huberman Lab podcast — which will continue to come out every Monday at zero-cost. Second, it was launched as a means to raise funds for important scientific research. A significant portion of proceeds from the Huberman Lab Premium subscription will fund human research (not animal models) selected by Dr. Huberman, with a dollar-for-dollar match from the Tiny Foundation. If you're not yet a member but enjoyed this full-length livestream AMA, we invite you to join Huberman Lab Premium. By subscribing, you'll gain access to exclusive benefits including our regular monthly full-length AMA episodes, AMA transcripts, podcast episode transcripts, early access to live events and more. Additionally, a significant portion of your membership proceeds contributes to advancing human scientific research. You can learn more about the research we were able to support in our Annual Letter 2023. If you're a Huberman Lab Premium member, you can access the transcript for this AMA episode here.
Actionable Insights

1. Daily Non-Sleep Deep Rest (NSDR)

Incorporate a daily non-sleep deep rest (NSDR) or yoga nidra protocol for 10-30 minutes to reduce stress, replenish dopamine, and enhance mental and physical vigor, either in the morning or later in the day.

2. Omega-3 (EPA) Supplementation

Supplement with 1-3 grams of EPA (eicosapentaenoic acid) per day, checking product labels for actual EPA content, to support brain and body health, provide building blocks for nerve cells, and potentially achieve a mild to moderate antidepressant effect. Choose high-quality fish oil tested for contaminants like mercury.

3. Morning Sunlight Exposure

Get morning sunlight as often as possible, even on overcast days, to help shift circadian rhythm and amplify morning cortisol/catecholamine release for improved mood, focus, and alertness.

4. Evening Red Light Use

Use a red light bulb unit or red party lights in the evening, switching off regular overhead lights, to quickly lower cortisol levels and make it easier to fall asleep.

5. Comprehensive Oral Hygiene

Brush and floss your teeth daily, with brushing before sleep being especially critical for remineralization, and avoid antiseptic alcohol-based mouthwashes.

6. Gentle Tongue Brushing

Gently brush your tongue with a separate soft toothbrush (different from your teeth brush) to remove bad bacteria and promote healthy bacterial turnover. Replace the tongue brush every few weeks to months.

7. Adequate Fiber Intake

Ensure you consume enough prebiotic and probiotic fibers from fruits and vegetables for gut motility and to offset gut cancers.

8. Probiotic-Rich Diet

Ingest 1-4 servings of low-sugar fermented foods daily (e.g., sauerkraut, kimchi, natto, kefir) to support gut health.

9. Limit Antiseptic Overuse

Avoid overusing antiseptics such as mouthwashes and hand rinses to maintain a healthy and diverse microbiome.

10. Increase Microbiome Diversity

Encourage microbiome diversity through safe environmental interactions, such as allowing children to play outside and eat with slightly dirty hands (in a safe environment), or owning pets.

11. Optimize Workout Intensity/Duration

If you feel excessively sleepy after morning workouts, reduce intensity or duration, aiming for 80-90% of your maximum output to maintain energy and vigor throughout the day, rather than pushing to failure and causing depletion.

12. Prioritize Injury Prevention

The most crucial aspect of fitness is to avoid injury, as getting hurt prevents you from training altogether.

13. Sustainable Workload Management

Determine your consistent daily workload capacity (e.g., 4-8 hours with weekend breaks) that allows you to maintain sleep, mental, and physical health, as this sustainable approach leads to greater long-term productivity than overworking.

14. Focus on Present Health Improvements

Do not dwell on past dietary or lifestyle mistakes, as biological systems are robust, and you can always improve your health, health span, and lifespan by making positive changes now.

15. Avoid Trans Fats

Eliminate trans fats from your diet, as there is universal agreement on their detrimental health effects.

16. Regular Hormone Level Monitoring

Get hormone levels checked once in late teens, mid-20s, and 30s for baseline, then annually after age 40, to monitor key markers like IGF-1, testosterone (total and free), estrogen (estradiol), DHT, cortisol (fasted morning), creatinine, LDL, ApoB, SHBG, and for women, progesterone and prolactin, always considering ratios and consistency in timing for women’s cycles.

17. Creatine for Brain Function

Consider taking 5-10 grams of creatine monohydrate per day (depending on body weight) to enhance creatine phosphate metabolism in the forebrain and improve brain function, especially under conditions of high altitude or TBI. Monitor for increased DHT if you experience hair thinning and stop use if concerned.

18. TBI Recovery Protocols

For traumatic brain injury (TBI) recovery, prioritize adequate sleep for glymphatic outflow, consider transcranial magnetic stimulation, hyperbaric chambers, or hyperoxygenation treatments if accessible, and elevate your feet 5-15 degrees during sleep to increase glymphatic flow and debris clearance. Avoid sleeping upright in a chair.

19. Cautious Turmeric/Curcumin Use

Be cautious with high-dose turmeric or curcumin supplementation due to potential negative effects (e.g., limiting DHT production) and lead contamination; check sourcing carefully, and cooking with it is generally fine.

20. OCD Treatment Strategy

Treat OCD by working with a psychiatrist for appropriate medication (e.g., SSRIs) to create a neurochemical environment conducive to plasticity, combined with behavioral interventions like exposure and response prevention (resisting compulsions with therapist support) or replacement behaviors, possibly augmented by transcranial magnetic stimulation.

21. Circadian Rhythm Shift Quadfecta

To quickly shift your circadian rhythm in a new place or become an early riser, combine morning sunlight, movement, social engagement, and caffeine (or breakfast if preferred).

22. Align with Local Meal Schedule

To quickly shift your circadian rhythm to a local schedule, try to align your meal times with the local schedule.

23. Pre-Travel Circadian Shift

When traveling east across time zones (e.g., San Francisco to New York), gradually shift your wake-up time earlier by an hour two days before, then another hour the day before, completing the shift upon arrival.

24. Light Exposure for Circadian Shift

To shift your circadian rhythm earlier for eastbound travel, identify your temperature minimum (approx. 2 hours before normal wake-up) and expose yourself to bright light for 5-10 minutes between this minimum and your normal wake-up time for a few days before travel, even if you go back to sleep. Avoid bright light before your temperature minimum.

25. “Brute Force” Jet Lag Adjustment

Alternatively, for eastbound travel, fly to your destination and immediately force yourself to wake up early, using caffeine, exercise, and social engagement to align with the local rhythm, but be prepared for late morning fatigue which can be mitigated by a 30-90 minute nap.

26. Distinguish Dizziness/Vertigo

If feeling dizzy, stop and sit (or stand bracing yourself) and close your eyes, then determine if you feel like falling straight down (lightheadedness) or spinning and falling (vertigo) to aid diagnosis.

27. Vertigo/Nausea Visual Fixation

To address vertigo or nausea, fixate your gaze on a point 3-4 feet away and move closer, or look at your finger held out and slowly move it towards your nose, then back out, to anchor the visual part of the vestibulo-ocular reflex.

28. Outdoor Fixation for Motion Sickness

If feeling nauseous, seasick, or generally unwell after being in a closed environment, get outside and look at a distant fixation point to help re-calibrate your visual system.

29. General Wellbeing Visual Anchoring

When feeling unwell (without fever), go outside and fixate on the furthest possible point, walking towards it if safe, or perform the finger-to-nose exercise to anchor the vestibular-ocular reflex.

30. Assess Sleep Needs by Daytime Function

If you feel reasonably good and aren’t falling asleep during the day, your 5-6 hours of sleep might be sufficient, possibly supplemented by a brief 10-30 minute afternoon nap.

31. Don’t Obsess Over Sleep Quantity

Do not obsess over specific sleep quantity (e.g., 7-8 hours) if you feel good, as individual sleep needs vary and less sleep doesn’t automatically lead to severe health issues like dementia.

32. Evaluate Sleep with QQRT Framework

When assessing your sleep, consider the QQRT framework: Quality (consistent sleep, slow-wave & REM), Quantity (how much you get), Regularity (consistent sleep/wake times), and Timing (sleep aligned with your chronotype).

33. Limit Nighttime Awakenings

One trip to the restroom at night is considered normal, but multiple awakenings or trips should be addressed to improve sleep quality.

34. Gauge REM Sleep by Emotional State

Assess if you feel emotionally rested upon waking as an indicator of whether you are getting sufficient rapid eye movement (REM) sleep, which is crucial for emotional recovery.

35. Delay Checking Sleep Tracker Scores

Wait until halfway through your day to check sleep tracker scores (e.g., Oura, Whoop) to avoid the ‘belief effect’ where a poor score can negatively impact performance regardless of actual sleep quality.

36. Consistent Sleep Timing

Ensure the timing of your sleep within the 24-hour cycle is correct for your chronotype and fairly consistent (regularity) for optimal benefit.

37. Oil Pulling (Optional)

Oil pulling is not strongly recommended by dentists due to lack of clear evidence for benefit, but it’s not considered particularly harmful if you enjoy it.