← The Peter Attia Drive

#221 ‒ Understanding sleep and how to improve it

Sep 5, 2022 1h 37m 22 insights
<p><a href="https://peterattiamd.com/understanding-sleep/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220905-pod-understanding-sleep&amp;utm_content=220905-pod-understanding-sleep-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220905-pod-understanding-sleep&amp;utm_content=220905-pod-understanding-sleep-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220905-pod-understanding-sleep&amp;utm_content=220905-pod-understanding-sleep-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this special episode of The Drive, we have pulled together a variety of clips from previous podcasts with sleep expert Dr. Matthew Walker to help listeners understand this topic more deeply, as well as to identify which previous episodes featuring Matt may be of interest. In this episode, Matt gives an overview of why we sleep, the stages of sleep, and sleep chronotypes, and he provides tips to those looking to improve their total sleep and sleep efficiency. Additionally, Matt discusses the pros and cons of napping, and gives his current thinking on the effects of blue light and caffeine on sleep. Finally, Matt explains the dangers of sleeping pills and reveals what he believes are the most useful alternatives for someone struggling with sleep, such as those with insomnia.</p> <p>We discuss:</p> <ul> <li>Evolutionary reasons to sleep [2:15];</li> <li>Stages of sleep, sleep cycles, and brainwaves [10:00];</li> <li>Understanding sleep chronotypes and how knowing yours could help you [25:45];</li> <li>Defining sleep efficiency and how to improve it [36:15];</li> <li>Correcting insomnia: a counterintuitive approach [38:45];</li> <li>Pros and cons of napping, and insights from the sleep habits of hunter-gatherer tribes [41:30];</li> <li>Sleep hygiene, wind-down routine, and tips for better sleep [50:15];</li> <li>The optimal room temperature and body temperature for the best sleep [59:30];</li> <li>Blue light: how Matt shifted his thinking [1:08:30];</li> <li>Caffeine: how Matt has adjusted his hypothesis [1:14:45];</li> <li>The dangers of sleeping pills, useful alternatives, and cognitive behavioral therapy for insomnia [1:19:45];</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights

1. Prioritize Sleep as Health Foundation

Recognize sleep as the fundamental pillar of good health, even more critical than diet or exercise, as its deprivation leads to the quickest reduction in overall health.

2. Understand Sleep Efficiency & Opportunity

Aim for 8 to 9 hours of ‘sleep opportunity’ (time in bed) to achieve 7 to 8 hours of actual sleep, accounting for typical inefficiencies where 10-15% of time in bed is spent awake. Utilize sleep trackers to monitor total sleep time and efficiency, not just time in bed.

3. Establish Sleep Regularity

Maintain a consistent sleep schedule by going to bed and waking up at the same time every day, as regularity is crucial for optimal sleep.

4. Optimize Bedroom Temperature

Keep your bedroom cool, ideally between 65-67 degrees Fahrenheit, as a cooler environment facilitates falling asleep and maintaining deep sleep throughout the night.

5. Implement a Wind Down Routine

Create a consistent 15-30 minute pre-sleep routine involving relaxing activities like light stretches or meditation, and put away all phones and gadgets to allow your brain to gradually transition into sleep.

6. Avoid Staying in Bed Awake

If you find yourself awake for more than 20 minutes, get out of bed and engage in a non-stimulating activity, returning to bed only when you feel sleepy, to prevent your brain from associating the bed with wakefulness.

7. Manage Napping Wisely

If you struggle with sleep at night, avoid daytime naps to build sufficient ‘sleep pressure’ for deeper nighttime sleep. However, if you sleep well at night, short naps (e.g., 17 minutes) can be beneficial.

8. Limit Evening Alcohol & Caffeine

Avoid alcohol and caffeine, especially in the afternoon and evening, as they can significantly disrupt sleep architecture and quality.

9. Ensure Darkness & Daylight Exposure

Maximize darkness in your sleeping environment at night and ensure you get ample daylight exposure during the first half of the day to properly regulate your circadian rhythm.

10. Keep Technology Out of Bedroom

Store all technological devices outside the bedroom to prevent mental stimulation, ‘sleep procrastination,’ and the anticipatory anxiety associated with checking them.

11. Delay Morning Phone Check

Avoid checking your phone immediately upon waking to prevent a ’tsunami’ of anxiety and information overload, which can lighten sleep throughout the night due to anticipatory stress. Start with a 5-10 minute delay and gradually increase.

12. Remove Bedroom Clocks

If you struggle with sleep, remove all visible clocks from your bedroom to reduce anxiety about the time and the inability to fall asleep.

13. Understand Your Sleep Chronotype

Determine your innate chronotype (morning, evening, or in-between) using tools like the MEQ test to understand your natural sleep-wake timing, which can explain struggles and help align your schedule with your biology.

14. Seek Professional Help for Sleep Disorders

If sleep hygiene tips are ineffective, consult a doctor to rule out and treat underlying sleep disorders like insomnia or sleep apnea, as these conditions require specific medical intervention.

15. Prioritize CBTI for Insomnia

For insomnia, pursue Cognitive Behavioral Therapy for Insomnia (CBTI) as the first-line treatment, as it is a non-pharmacological, psychological method that is as efficacious as sleeping pills in the short term and offers lasting benefits.

16. Avoid Sedative Hypnotic Sleeping Pills

Strongly avoid sedative-hypnotic sleeping pills (e.g., Ambien, Lunesta) due to significant health risks, including increased mortality, weakened immune function, and nominal benefits over placebo. Use only as a very last resort under strict medical guidance.

17. Avoid Benadryl/OTC Sleep Aids

Shy away from using over-the-counter sleep aids like Benadryl or Advil PM, as they carry statistically significant risks similar to prescription sleeping pills.

18. Re-evaluate Blue Light’s Primary Impact

Recognize that the detrimental effect of technology on sleep is primarily due to its mentally stimulating and activating nature, rather than solely the blue light emitted from screens.

19. Moderate Morning Caffeine Consumption

Moderate caffeine consumption (1-2 cups) in the morning is generally acceptable and may offer health benefits, possibly due to the antioxidant content of coffee beans, but be mindful of individual sensitivity and timing.

20. Consider Decaffeinated Coffee for Antioxidants

If concerned about caffeine’s impact on sleep, opt for decaffeinated coffee, which still provides beneficial antioxidants without the stimulating effects.

21. Benzodiazepines for Extreme Jet Lag (Last Resort)

For extreme jet lag (e.g., 12-hour time zone difference), benzodiazepines (like Valium) can be considered as a very infrequent, last-resort measure to induce sleep, but be aware that even infrequent use carries a statistically significant increase in mortality risk.

22. Do Not Use Xyrem/GHB for Sleep Optimization

Avoid using Xyrem or GHB to optimize sleep, as it does not produce naturalistic sleep and can decrease critical sleep spindle activity essential for learning and memory, making it suitable only for specific medical conditions like narcolepsy.