The ten percent happier. Podcast Dan harris hello. My fellow. Offering beings. We are talking sleep today with a dude who is anything but sleepy, doktor, don posner as a proud, bronx native and is quite correct. in a good way. In my opinion, and in this interview he got me thinking about the issue of sleep in a whole new way. First thing: that he normalizes the sleep problems that many of us have, if in poorly right now he said, don't freak out about it. It's natural and normal and and fixable and he has a whole bunch of tips for how to deal with insomnia, some of which I had I never heard before As I said, his name is don posner he's one of the leaders in the field of cognitive behind you're a therapy for insomnia or c b t I his title

are founder and president of sleep well consultants and adjunct clinical associate professor in the deep men of psychiatry and behavioral sciences at stanford, university, school of medicine, not the dawn patiently answer my many many questions in this interview, but we also played him some listener voice, males to get some answers to your questions. here, just a quick preview of what we talked about the difference between chronic and acute insomnia. How we adapt to the commission up our sleep like roma work. What sub chronic sleep conditions are what to do it experiencing acute insomnia, so that doesn't become chronic insomnia. The importance of structure when it comes to goods then: how do we achieve some structure? What social jet lag. Is he's taken having why waked it is so important when it comes to good sleep and why we should not try to compensate for a bad night's sleep. This support

You have a series were running this week on sleep if you missed my conversation with the journalist, Diane Maceda, who wrote a book about her own sleep travails filled with evidence based advice, go check out that episode also to say this episode with on posner originally aired at the hall The pandemic, but, of course, advice on sleep is very much evergreen. Don't miss out on the enjoy everyday walking meditation pack over on the ten percent happier app it's available for free until august twenty If you haven't tried walking meditation on the app before I highly recommend, you check it out here is what one use your head to say: I'm quoting here, I'm in my six the year with ten percent. I start and end my day with it. I like their walking meditations to use when I'm out exercising or walking the dog the long I use it. The more I learn the nuances and subtleties and refinements of the process is life. Changing that's awesome to hear

although the ten percent happier after day wherever you get your apps and get started for free this. Oh a sponsored by better help someone in life were faced. A tough choices in the path forward is not always clear what he guilty era say when you come to a fork in the road taken, not very useful, although I guess kind of funny, but yeah we don't always know what the right way to go is, and I find myself and many forks in the road or places in the road where it does more than fork, and it can be really helpful to have expert advice, better decisions, whether you're dealing with decisions around your career, your relationships or anything else, therapy help you stay connected to what you actually want. While you do your life, so you can move forward some confidence and maybe even some excitement. Trusting to make this Is that a line with your values like anything else and life, the more you practice it the easier it gets

in quite a bit of time, going over big decisions with my therapist ten? I found him to be massively massively helpful. if you're thinking about starting therapy, give better help, try its entirely online, designed to be convenient, flexible and suited to your schedule. Let therapy be your map with better help visit better health. Calm, slash happier today to get ten percent off your first month. That's better help, h e dot com, slash happier. Maybe you stayed in an air b and be before and thought yourself. This actually pretty doable. Maybe my place could be an air be envy the could be as simple as starting with a spare room or your old place when you're a way you could be sitting on an air b and be gold mine and not even know if I stay air. Being these every once in a while, I really enjoyed taxpayer terrific alternative to hotels,

especially when I go on beach vacations with my family. We love to be able to have a house more space cook for ourselves, so big fan and it really is something that many of us it would take advantage of as an economic opportunity, for example, if there's a big music festival or tournament come into your city. That's a perfect opportune to get out of town and avoid the traffic you can air. Can be your home and make a little extra money, whether you could use a little extra money to cover some bills or something a little bit more fun. Your home might be worth more than you think, find out much more at air being be dot com, slash host great to meet you in thanks for doing this. I appreciate a sure thing good to be here. You gave a talk recently that got some attention deservedly hopefully or get now more attention. Another other were putting you on the show about acute insomnia. Now. Can you tell us what that

means and why you're worried about it right now, especially, let me clarify a couple of things. Let me maybe work backward. The best way to define a cute insomnia is to define chronic or long term insomnia, which we in the field called sound the disorder and the way we define that is that a person is having trouble initiating sleep to begin with or they wake up in the middle of the night and can get back to sleep or they wake up sort of. end of their night and never get back to sleep, and so those are really three labors of insomnia. If you will beginning middle and end what we like to say, chocolate, vanilla strawberry and then there's neapolitan, which is a mixed bag right. So that's insomnia. If that is happening, and we say what's a problem with getting to sleep or staying asleep its if you take longer than thirty minutes to get to sleep on average, if you

who are awake for some combination of thirty minutes in the middle of the night or you wake more than thirty minutes earlier than your desired time. If that's happening three, more nights a week for long, and three months and you have associated daytime symptoms, that's in some disorder- and I want to underscore that last piece, which is it really a twenty four hour disorder it it has to have impact on your day for us to say that this is really in some sort of problem. You have to have something like fatigue, sleepiness concentration, problems, performance problems and so forth, so chronic insomnia is those symptoms more than three months. So now, going back to your question about acute insomnia, acute insomnia is all of that less than three months. When I give talks and when I asked the audience how many people here have ever had a bad night sleep. I know I'm gonna get a laugh and a hundred per cent of the hands go up. We ve all had that experience

and all of that is normal and nothing to concern ourselves about, and we don't even talk about. Anything is diagnostic as acute insomnia until we get to at least three days, but then anywhere between three days and three months is considered acute in salmon. And that means that you're having those problems either initiating or maintaining sleep. and you may or may not have daytime symptoms yet, and it's usually due to some stress her and we anything from the bio psychosocial spectrum. I now say too: I trainees, you could probably opened the dictionary. Put your finger down in a word and find something that causes insomnia, whether it's an illness, a physical pain a change in your environment, a psychological stress like stress it work, tax time, those sorts of things, and I also hasten to add that the violence of that does not have to be negative right.

Change is stressful, so getting married and getting a new bed partner in your bed can change your sleep patterns having a child is a good precipitous cute insomnia until you can get that kind of straightened away. The thought process is absolutely very much that's a normal reaction distress, maybe even a good one, because if we go back evolution narrowly speaking, sleep is a dangerous activity right if you're asleep your vulnerable. It must be important for that reason, because every species does it and so on must provide a very important function, but it's dangerous. So we always say that sleep is deferred. When the lion walks into the mouth of the cave, and therefore we could say that acute insomnia is adaptive

you understand so, even now in our culture, its adaptive in the sense that you're making changes you're trying to deal with whatever is coming down the pike. But we always expect that if you then adapt appropriately or the problem itself goes away or you can on some medication or the stress or itself remit, then we expect the acute insomnia to remit, and so all of that we consider to be normal and it is for a smaller subset, but yet epidemic numbers that sort of gravitate into this chronic insomnia realm, which is where people like myself and my colleagues coming in terms of helping people to treat that if I've heard you correctly chronic insomnia is a big issue. You ve dedicated you're your life's work to addressing in acute in sound

Yeah makes sense, given what we're all living through right now and in some people it will escalate to chronic and that's the source of your big concern right now, and one hundred per cent correct yeah so I could be causing a lot. You no more acute insomnia. Now then, in normal times, well, were more all more under stress. We're under stress for a lot of reasons were under stress because of the disease and everything it goes along with that. What goes along with that worries about our own Health worry about our children's health. Worry about our elders. Health worry about ourselves getting that the disease, but we are also concerned about the mitigation attempts were making at least some places were doing it. Well, we are concerned with you no loss of job loss of revenue, loss of our business. I can imagine the person whose sleeping well through that so again, I say and will come back to this later, but

The first thing with regard to acute insomnia is don't panic, its normal came. There are lines in the cave so to speak there and in the cave is exactly right. So we should not be surprised. That said, in addition, not only we have. Are we faced with a tremendous increase in the amount of stress to a vast swathes of the population? We really say this is now worldwide is also the case that the mitigation attempts threaten potentially threaten our sleep, and let me come back to potentially at some point but potentially threatens our sleeping As of the changes we make in our day, as we go more into this and talk more about this today, then I would hope people will learn that one of the major things that keeps your sleep healthiest structure, okay and we are sort of most of us.

First into a structure by our work in school day lives. I now that's gone for many people, so if you get to work from home, that's terrific, but it also gives you the possible opportunity to throw structure out the window. One of the places we often see what we call a recipient of acute insomnia and eventually chronic and semi is retirement, sort of the same thing, we ve all been forced into this. Well, you know no need for that clock in the morning anymore. That in and of itself can potentially eight acute insomnia. So we have all of these reasons. For that and again, none of that is of concern, because, especially the stress itself, I think we've kind of seeing it happen where we're adapting as best as we can it's a little bit of a moving target, but people who have now been-

working from home, I know at one point I tried to get a monitor from my computer at the store and I couldn't find any cause. They were all gone. Everybody's got manner is now everybody's learned to kind of create their home office there adapting better and better and better, and it might be for those that kind of say, gee. This is kind of working. Ok, it's not what I prefer, but it working okay. We can imagine where they automatically are just on their own start to sleep better. But there is this possibility that those that of thrown away a lot of what we would call good sleep. Health inadvertently are at more risk for chronic insomnia and those that are for anybody who get an acute insomnia, those that begin to make a shift and while I say acute and sammy as up to three months, my one of my colleagues would start to say that even one a month or so to three months starts to get into what we might call a sub chronic condition where we're starting to see this transition

nor this shift, where not only is the stress her the problem, distress or do jure is what you are concerned with, but you also are now starting to shift your attention to the sleep problem itself. If you understand what I'm saying- and that creates the potential for a vicious cycle and changes in behaviour that serve only to make sleep worse and more chronic, and so that was the line that when I was giving that talk, I was kind of saying let it least think about a key.

Insomnia and what we might do in that phase of acute insomnia to prevent the epidemic of chronic insomnia that might follow the pandemic. So what could we do to prevent this epidemic was on the list without getting to science about it. Lets understand that, as I said, there is an important to structure and if I was gonna start that conversation the place, I always start is the single most point of important structure. There is an that wake time, and so we all understand most of us know that we have this internal biological, circadian rhythm, and there are a number of bodily functions that fluctuate and a twenty four hour basis like hormones, secretions and body temperature and so forth. But for the sake of our conversation, what we're looking at four a muster circadian point of view is sleep. Wake rhythms and that rhythm is held in check is what we call in trained the waiter.

about it is. How do we get that clock to be well set to chime when I wanted to chime and not to chime when I dont want to china The single most important point of data of input into that clock is wake time, which is also a proxy for my first exposure to day, and light exposure and so getting up at the same time at least most days a week is important kay, If you are someone who has now thrown the clock out and some day you are getting up at six and some days you're getting up at seven in some days, you're getting up at eight and nine. That is what we call social jet lag. So imagine if you I'll. Just anybody listening has to just think what would happen and I'm based in the east coast right now shall take an east coast reference. But what would happen if you flew from the east coast to the mid west to say from now

to chicago and state overnight for one night and flew back to new york and then stayed one night, but the very next day flew to denver, and then stay there, one night and then flew back to new york and then the very next night flew to LOS angeles and stay there for a night and flew back to new york. How would you feel then I'd feel like a working journalists, because that's what I used to do all the time, but it feels crappy. It feels crappy as it is the perfect word. It feels crappy and that, of course, jet lag, but what I want people to and is that you can feel that it's same what we'll call social jet lag by varying your times in the morning, just as much so, if your I had already having trouble sleeping. You dont have to be heavy handed about it. When I'm working with patience and trying to write their sleep, I talk about getting up at the same time. Seven days a week,

fix the clock, but I will always tell them is a well oiled clock if you will doesn't require quite the same amount of consistency as a broken clock to fix it, so the well oiled clock we will usually say requires what we ve seen in most people, which is five days a week. Most of us get up around the same time I am every day five days a week and a couple of days, usually on weekends. We do it a little differently and that doesn't throw anybody into a tizzy and so, if you're already not having problems sleeping, all I can recommend is get up at the same time, five days a week and largely go to bed at the same time or after, if you're not sleepy five days a week, because that will help maintain good, sir

eighty and entertainment and good circadian rhythm now add to that any other regularity and our lives can add to that circadian, entertainment, so regular meal times, as opposed to grazing on you know, random schedule, regular exercise times going back to some structure and your life take a walk at the same. I'm every day, do things like that at the same time every day maintain your activities during the day tat? to get out and be active activity, helps sleep and nothing begets lethargy, like lethargy oh sitting around and doing. Nothing is not a great idea either. We are, diurnal animals, which means we're not raccoons, we dont forged for food at night. We do our foraging in our work during the day, so most of us should be on a daytime schedule

We should be eating our meals during the day. Our activity and work should be during the day and as we transition into night, we should make that transition into lower levels of light. We don't have to be in the dark but lower those of night and also transition are activities, we probably should not be working right up until bedtime. We should not be letting are difficult child who lives on the other The country call us at eleven o clock at night with their problems. We should set a limit for that and true. Position into quieter. More relaxing times at stir an hour or two before bedtime. Those are just some good. Health tips for people who are already sleeping well staying away for the moment from the typical sleep, hygiene joint things, bedroom environment. Those are always in place and should be in place, and we can talk about those later. But in terms of right now,

what do you really need to focus on if your home and not working and don't have that structure imposed upon you? I can say that you know we probably for most of us. Now you might be able to nap a little bit and napping is not bad. The problem with now Is this a right way to nap in a wrong waiting up? If you feel like you, build napping in you can, and we can do it the right way. If, however, you foresee that soon you're gonna go be going back to work, keep in mind that when you nap when you take a siesta during the day as many cultures do, that you are reinforcing your internal clock for wanting that nap. At that time of the day,

if you think in, like even a month, you're going back to work and can't nap you're, probably best off trying to avoid that nap during the day. If you can at all help it. If you do nap whether because you want to now just build that into your life as many for instance, retired people might do or you just can't help it because you're having a problem with sleep at night, trying to compensate as little as possible. So if you are going to nap the ideal time now, but we all know we have this little dip after lunch, this post prendick circadian dip in red and that's a normal function? That's as it is expected to be it biological it programmed in it's a time when our drive to sleep has already been built up somewhat by half of our days activities. and yet our circadian rhythm is going into a little bit of a low, so that's the best time and that that is

something like seventy nine hours after the you wake up in the morning or habitual wake time and a short nap, the minutes and set an alarm to wake yourself up is much more preferable to so called power nap to sleeping for an hour or two that's going to rob you again of more sleep. The next night and it is going to leave you feeling a lot of sleep inertia when you wake up you're, going to feel worse when you awaken from that nap than you did going to sleep, a good short nap will carve off just enough. penis, and then your circadian rhythms, alerting signals are kicking back in any way that it's gonna give you a nice stepping stone for the day. I think I got all of those notions that you just listed. There is one thing

Oh, that you set up there with what you lead with that. I'm still little curious about, which is you said, wake time is the sort of apex predator of the lever. Is you can pull them, mixing metaphor horribly here, but anyway I wake up. I'm is super important. Let's just put more colloquially, I'm having a hard time disentangled net from bedtime. Wouldn't that the more important input? No really is wake time with regard to what do without daylight exposure. and bedtime and when you feel ready for bed is determined by when you first get that light exposure in the morning. So you should sudden alarm figure out? What are you body normally wants to wake up and then ensure that your waking up at that. I am regularly with an alarm if need be, and then back timing, your bed time to that

yeah. When you say back timing, that's an interesting story, because the question is how many hours of sleep do you need? Okay, and I don't think most of us in this country know how much we need that is each individual. But if you think you're good at knowing what you need- and you are going to do that- yes, exactly what you said is what I would do- What time do either need to wake up in the morning or now want to wake up in the morning and then backtrack from that for the amount of ours you think you need. So if I'm having trouble sleeping and by the way, I definitely followed me chronic insomnia category so just to say that, and I know you can't and shouldn't be giving clinical Vice here, some of them either chronic or acute insomnia, and I want to work this first piece of advice that you gave about wake time the operational that I would think about what the wisest waked time and then set an alarm to get myself up yes and then impose some day

the plan on the front end around dead time, so that of getting enough sleep. Yes to hit that. Ok, yes, and the bed time is also then not occur. I'm not saying you must then go to bed at that our or else what were we saying about bedtime, is if, in a twenty four hour day, you think you need seven hours and your waking up it Evan then bedtimes roughly around midnight and you shouldn't go to bed before that and again you started to make. Transition I hadn't yet made, but is reasonable to do at this point, which is first, we have people who are already sleeping well. Should they maintain some of this structure to me, contain that wellness. Yes, if you are starting to have a problem now. You should absolutely be doing those things to kind of get yourself back on track and the second rule I would put on wake time being structured and bedtime being structured is don't compensate for a bad night.

It goes along with rule number one. If waked time is wake time, if seven o clock, it should be seven o clock the fact that I was awake for two hours in the middle and I doesn't mean I should now sleep till nine. It will just make it more likely that I'm gonna more trouble down the road k, so the rule is always whatever your sleep needed, get that amount to sleep most days or less, never go for more, and certainly don't go more when you are trying to compensate for a bad night of sleep. So it's that person whose neither get up any later should not go to bed any earlier and should not nap during the day to compensate for that law. Sleep we have an internal mechanism of sleep regulation between what we call sleep drive and circadian rhythm, that will right itself if we allow it by not doing those things. I just mentioned

me up. Doktor posner tackles the controversy around. Much sleep. We actually need every night when you should go, see Asleep expert and when and how sleep medications should be used. Tad blocking is on the rise and audiences are getting harder to reach so to cut through both brands, throw. if you see out the window and ramp up online tracking, but rave There's a new approach: one we're privacy and performance come together. Brave users choose when and where they see brave adds the result in three leading add engaged with brave, you can drive, traffic sales and product awareness. Without lady use your privacy and each new audiences while you're at it to get started with a new way of advertising online. Go to brave dot com forward, slash ads

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dot amazon dot com slash happier to get started? How do we? oh, how much sleep we need. How do I know how much sleep I need? Well, so that's why I say most people, I think dont know because unfortunately, my tribe, my brethren, the sleep people in the world have now gotten this message out there that we all need eight hours and nothing could be further from the truth. now the truth is. I do see more and more over the last say, five years or ten years that the message is now you need to get between, seven and nine or else, and even that the data is, is not so clear on that that the range of what people need within

be a standard deviation or so of the normal mean is somewhere between about six and nine hours. So that's about where I would put it that said, understood and the average is actually not eight in this country, the average in the mode is closer to seven and a half there's at least gonna be a stir or deviation on either side of that meaning. Yes, some people are going to need seven, and some people are gonna need six and a half simply brutal guaranteed eight and some people are gonna need eight and a half, and the question is how You know you're getting the right amount of sleep, because when you get that amount asleep, you feel fine during the day now again, I caution? What I mean by that is when you're getting that amount every day. The fact that you don't get you know: do you get two hours to nine three then, for the next and then get your right sleet need for one night. You may not feel perfect and by the way, if you compensate and then all of a sudden crashing

we can get eight and a half hours or nine hours and say gee. I feel great. That doesn't mean that's what you need. That's just! U compensating for the bound gender of going up and down and up and down and up and down, but if you're, a seven or seven and a half hours sleeper, and you get that every day, if you're getting something every day and you say yeah, I don't feel tired for most of the day, all of us have a little bit of sleep inertia when we wake up in the morning a little bit of transition to wipe the cobwebs out of our eyes and transition to wakefulness so don't use. That is your gauge. We all have that little bit a dip in the afternoon and we all it stands to reason should be starting to feel more tired and sleepy as we approach bedtime. So I asked people to gauge how their function at all other times of the day, that's when I want to know how you doing. Are you tired sleepy? No, are you concentrating? Well, yes,

Are you active in creative and feel good? Yes, you are probably getting what you need. So this issue of what the message your brethren are putting out is Can we get coming into the conversation I wanted to get to this? We had a sleep expert on the show, and this expert said all the data he had looked at suggested if your falling below seven hours a night, you are in danger. I was just reading something about that and I am telling you that the data not clear on that? It's probably a little bit more likely that if you fall below five hours a night, that's a little bit more true But you understand that a lot of these epidemiological studies do this. By doing cut points and the cut points when they look at seven and below seven is they'll say something is below seven and including below

seven every body whose below seven so understand there are people who are sleeping for hours and five hours and four and a half hours and five? half hours there are included in that number and when you do a fight grained analysis of the data it looks like going below. Five makes a difference, but people who are its six six and a half. If you just separate out them from everybody else. That's below six, not so much danger. Okay, so I got quite exercised when I heard this junction, this exhortation to make sure you're getting seven plus a night and started to get from quite fixated.

My sleep. I got one of those aura rings that tells you how much you're sleeping and that turned into a mess for me, and we got some white passionate people love the episode by and large, but we got a few really gloriously, negative reviews from people who said I've never had a slight problem until I listen to this interview and they went down the same rabbit hole that I went down, which is a vague got fixated on sleep and then started to second guess themselves, etc, etc. Show any thoughts on the foregoing, yeah yours my my song. So this is why I mean I mean I love my field and look. I mean you I understand the data that this person, whoever they were said they looked at its out there. I can show it to you but what I'm telling you is, when you do this finer grain analysis,

There are a number of papers that are now saying well well, well, well, and it in some ways it doesn't matter. So let me say a few things about that, so I will stick with this idea that under six is more the cut point, so give me six to nine that even between five and six is may be an issue, but not egregious, and again it's about this way in which we do this fine grin. You have to think about how the questions and asked, and the question sometimes have been asked and cut points have been made with regard to these on the hour cut points. So what eventually some people did was to look at data below seven hours when you start to look at between seven and eight, that's a slice, and when you look at between eight and nine, that's a slice. When you look between seven and nine, that's a slice that smaller

then below seven k below seven is everything: that's below seven, that's a much wider margin, and so I tell you There are people in that margin that they looked at. Who are sleeping five hours and four hours and therefore their being included and there swaying the numbers. So if you look under seven, yes there's an indication that some of them are more prone to certain kinds. Of morbidity and mortality. We say, but that may be because that now is overwhelmingly being swayed by the people who are getting much less sleep than that. Going back to your comment, which I love The other thing they're not doing when they do these studies is there never looking at the people I just talked about, which is their just saying, how much sleep d get and not? How do you feel? Ok, so suppose you took a cohort of people who are getting six hours a night,

and felt great, and you found ten thousand of those people, that's not what they're doing came there just lump it, everybody in so some people get six hours a night, because not sleeping well, and they could get more? They should get more and some people are getting. You know being forced into that by work schedules, but some people get six hours because that's what they need and if you get six hours- and you feel great- and you get that every day, if you try to sleep for seven or eight hours, you're going to get insomnia you're going to expand your sleep opportunity beyond what your body can give you. You will occasionally sleep for sex, for eight hours and put yourself into deficit so that you now no longer need as much sleep the next night and have a night of insomnia, and this is what starts to happen, and then people get freaked out, and so I've been saying,

for a long time, my brethren or well- meaning we should definitely takes they're out. There also think we should take sleep much more seriously. Yes, we should be attentive to what our sleet needs are and fight like the dickens to get yes, but to start seeing everybody needs between these numbers and you should get. It is absolutely makes business for me. I people with insomnia all the time we're coming in saying, but so and so said, they said and I go day again. Ok, let's debunk that, so you see, if you're getting overly fixated on your sleep, because somebody told you that sleep is important. You're gonna undermine the whole machine if you're getting overly fixated on sleep for any reason, you're going to undermine the whole machine sleep. That's one of the big issues here and one of the advice pieces of advice I give to everybody, but also especially those people are having trouble sleeping. You cannot make yourselves sleep

You cannot sleep is such an autonomic automatic process. It is think of it like heart rate, digestion, perspiration respiration, and I say to my patients: you don't ever find yourself after your last meal thinking, let me see if I can digest a little bit faster here. Okay and they'll say: oh no. I never do that and I'll say. Why? Don't you do that and I'll say, because I don't have any ability to do that now say exactly the same with sleep. If you get into bed- and you start trying to make yourself sleep, you are done in. I asked these questions in my audiences. I always ask for somebody when I'm I'm usually training other therapists, how to do this work, and I always ask for somebody who has a good sleep in the audience- and I asked them to raise their hands. I say: ok, forget any other behaviors you have in terms of rights,

in bed or not reading in bed watching tv in bed, whatever your habits are at some point. Most of us close the book do all of that sort of stuff and put our heads down on the pillow, and I ask that person who's. A good sleeper. Tell me what it is that you do at that point to get to sleep and one hundred percent of the time I get either a one of the shoulders a quizzical look. The answer I dont know the answer. I'm not sure what your question is because exact, that's exactly the right answer. Good sleepers! Do nothing when you ask them what happened last night, when you got into bed, they say I got into bed and then I don't remember, that's what it should feel like Dan. When you start getting into bed. In saying I don't know I my close to my getting there Not your way beyond already where you should be in terms of trying too hard, and, of course s

buddy and their brother has a remedy, and when you start becoming fixated on your sleep, it is one of the worst. We call perpetuating factors that keeps insomnia chronic, okay. Well, you just described my life sounds like I need to come, see somebody like you, and so that actually is because we're going to start taking some questions now from the audience, but before we do that, I want to give you a chance to say something that you said to me before we started recording which is you're going to give general. I sorry, my son is opening the door to this closet. Okay, hi buddy. He has his pajamas on. That's awesome, alexander, I'm recording a podcast. So, can you go away. Yeah, ok club be quietly. All of my meetings are like this, so he is five and and

made a million appearances on this by gas during the pandemic. Big, that's awesome! That's just yes! He's coming in here to pet our cap. Ok, so your point is you'll give general. I hesitate to use this term but advice, but it is not the same as going in to see a doctor and having the doctor or the sleep expert, diagnose what your particular issues are right exactly so let me go back again. How do we transition? from acute insomnia, some chronic insomnia, and we talk about. We call perpetuating factors and those perpetuating factors by and large have to do with the things we ve talked about here today. I start to alter my sleep schedule as a way to compensate for my poor sleep and therefore I throw myself further off. I will

begin to work harder at something that I never had to work out before in my life and by doing so exert more energy and tense up. Would you can imagine is not conducive to a good night's sleep, and this is we haven't mentioned yet, and it's a tip I can give if you are in the middle of the night awake, and I don't care whether you're just thinking random thoughts or all the way up to worry. It's not a good idea to stay there. and the people who are staying there are engaged in what I just talked about, which is sleep effort for one thing right there hold not do that just for dear life, hoping that sleep we'll come back, but the other thing they're doing night after night week after week, month after month, is associating their bed with a place of worry and thinking and ruminating about stuff. So imagine that you can start to get so be while you're on your sofa watching television

go into bed and like pavlov's dogs, boy, your wide awake, because your bed is now a trigger for being awake. So my commendation to people who are not sleeping well is that if their awake now be in bed when you're awake go somewhere else. Do something fun, wait until your sleepy again and try again and if it doesn't happen, night. It doesn't happen tonight again. Acute insomnia is normal, don't panic, and if you don't compensate, if you don't stay in bed, if you don't over, think it if you don't work too hard at it it's going to rectify itself. As I said, and usually within a few nights,. So yeah you might lose two or three nights and then right. The ship and you'll be fine, but people got get at it right away and they cause themselves more problems of the other thing. Of course people do. Is they start to worry about this,

my god, I'm not getting enough sleep. What is this going to do to me? Imagine what that thought does to your sleep. So going back to your question There are a number of different perpetuating factors and any given individual, whose not sleeping well might be exhibiting some or all or others of those factors, and what it requires to get well is a really good assessment, a good evaluation of that process by somebody who knows what they're doing and then knows how to fix those things because fixing a bug right now I can tell somebody look, don't stay in bed and you won't develop a problem once you've done that for six years you ought to see a professional to help you get beyond that, because just getting out of bed for one night isn't going to do it.

I want to prevent people from getting there, but if you're there, you should go, seek professional help, as I always say, for other disorders. We understand that the doctor wants an x ray before they cast your leg. They want blood work before they give you a medication, and likewise here, I'm not gonna, give anybody specific ideas about what to do other than what we have already talked about, and what I would advise anybody who has tried a couple of these things and it's not working to do is go, get it properly, assessed by professional who is a behavioral sleep, medicine special. I like myself so just to put a fine point on this: the tips or advice that you're a general guidelines that you are going to share in the course of this and you've already shared in the course of this interview are basic sleep hygiene that we should all be sort of endeavoring to,

who operationalize eyes and our lives, but for finding ourselves with chronic or sub chronic insomnia. That's the time to actually go get an individual assessment, yet look even sub chronic. If you do some of these things, it might work. But if you ve gone beyond three months and more often than not by the time for somebody comes to see me, they have had their insomnia for three years and thirty years. So once you cross that three month mark, you tend not to get better without some targeted treatment and I'm talking about non farm logical treatment, not medication, the number one I should get this out there, the second largest medical organization in the country, the american college of physicians. Has now done a guideline paper on insomnia and is basically made the statement that the treatment of choice for insomnia disorder is cognitive, behavioral therapy for insomnia, which is a non married

patient therapy for insomnia, which goes after all these things we ve talked about and that you know if it were possible. Unfortunately, it is not enough of me out there, but if it were possible that somebody ought to almost fail this before they go onto a medication, because medications are rate for short term insomnia, but they were never really intended for the long term problem. Is it safe to go, see us doctor. I now I mean I I had been under the impression that, in order to really get the most out of us, sleep, doktor asleep expert, do you need a sleep study I don't really feel like going into a hospital in the era of covert, is fine. Just as you know you a series of consult over of resume and gecko in that way, I'm so glad you asked that question. First of all, when I say I practice behavioral sleep medicine that encompasses a lot of different sleep disorders and insomnia,

one of those and beyond what I do. Behaviorally there are medical sleep disorders and medical things that we do. The most common of those would be obstructive. Sleep app and many of you listeners may know about that and the most common they treatment of choice, for that is see, pap or continuous, positive airway pressure in order to get diagnosed with sleep acne appropriately. You have to have asleep study, as you have noted, and yes often that entails going into a sleep, lab and sleeping there, but more and more frequently, even those labs are now doing. Homes, studies and certainly in the era of covert, I'm sure they're, almost entirely doing home studies and diagnosing you for those kinds of disorders they're coming back Two insomnia insomnia is disordered. That does not, unless you suspect, other occult sleep disorders does not require asleep study whatsoever for the diagnosis, and so somebody like myself, could diagnose you online like this, and we

right now in an age when tell a health is flourishing and law, State laws are allowing people to do more, tell a health rather than bringing people in the office so for the particular type of work we're talking about. With regard to treating insomnia with cognitive behavioral therapy for insomnia, it can be done exclusively on line through tell health. How's that I love it figuring this out- is now number one on my to do list coming up done. Talks about why the pandemic may have ushered in better sleep for a certain subset of people how to break the cycle of waking up in the middle of the night and his advice on using devices in bed. Audible. do you enjoy all your audio entertainment in one arab will always find the best of what you love ford, something new to discover you'll discovered thousands of protests from popular favorite to exclusive new series guy

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special financing for a limited time, only add sleep number stores. with number dot. Com see store for details before we dive into that. Some of these questions that we got from listeners who called him and left us voice males. Is there anything else? Any other points. You want a macro points. Micro points. Anything you want to say before we start getting into these kind of specific issues here this one that we haven't touched on, which he is one of the interesting things. Look, there's no questions. Everything we ve talked about, I think, is true and by the way, there's people all over the world right now doing research studies and getting grants uncovered and sleep and looking at all of those issues, So we don't have all the data right now, but we will eventually but anecdotally, no question. Some people are becoming more stressed and therefore at risk for acute insomnia and at risk. Therefore chronic insomnia

and some people may be altering their schedules in ways that are making them at risk for acute and chronic insomnia. That said, one of the things that I'm definitely hearing within my field is that at least some subset of people our sleeping better now than they ever did interesting and I wanted to get that out there, because I can only speculate as to why that is, but I think it has to do with things that we ve been talking about, but I did talk about this idea that we all have sort of a proper sleep. Number, if you. sleep need having nothing to do with asleep number mattress. We all have asleep number. I'm gonna use the number seven I hate using number. Eight. Everybody somehow thinks all my patients come into me and they're locked into an eight hour timeframe, I'm going to use the number seven suppose you're a seven hour sleeper The other thing that we all genetically have is a preferred sleep phase, meaning when, in the twenty four hour day and my best able to get me

seven hours and we all have an intuitive sense of this. This is the effect that we have when we think Somebody is being a night owl or somebody being a morning person. So when I say, if somebody needs seven hours, they can probably get seven in a fair range of sleep, but it may be that they can get their best sleep between tend to five and not between one two, eight and somebody else is gonna, get their best, seven hours between one, two, eight and so on and so forth. What I think may be happening during covered for people who are working home is that if, in fact, they are getting up with some structure in their lives, their doing so but- a different set of phases than they did when they were forced to work when you have to get up in the morning at five thirty in order to get showered and dressed, and shaved or make up and then in the car and commute for an hour and then get to work on time you

had to do any of that anymore and now maybe you can afford to get up at seven o clock instead of five o clock or five thirty, and it may be that just that slight shift of an hour an hour and a half allowed you to sleep a little bit better because its closer to your preferred phase. It also may be the people of feeling better, because their not being shortly again, I'm not saying anybody can sleep any number of hours. I'm saying if your sleep me to seven, you should try to get seven and if you're getting six you're going to feel a little shorted, and it may be that our work schedules for many people are forcing than the burn the candle at both ends and not getting enough sleep. That's

as such my brethren have out there that they are right about. We should try to get. What we need is the way I'd like to frame the message and covert may be allowing some people to get what they need in the proper phase, and so, if you're, finding yourself sleeping better. I think that may be the reason. That's so interesting. I know I said want to get to the voicemails, but there's one other point I want to let you make because you kind of made a nod in this direction, but when we were talking about the importance of wakeup time, you then talked about exposure to daylight or sunlight, and I actually think

and I know in your talk- you expand on this. What does that look like? Should we be if we can getting outside first thing in the morning? Why is that important if we can't get outside should be sitting by a window? Why is this an emphasis for you again light is what in trains the circadian rhythm, it is essential to that pacemaker in the brain, and so the timing of that light is essential to keep us in trained into a twenty four hour schedule a controlling when your exp. to that light is a good idea, which means two things. It means that when you get up in the morning, you should open up the curtains and get as much light exposures you can, if you're not having a particular problem with sleep shore sitting by an open window is good enough. Try not to sit in the basement. If you put it all help to do it. If you are a very dark place, you can get out for a little while that's a good idea that will help to strengthen again if you're, already sleeping well, I'm not telling people boy you're better, do this or else, but if you're not sleep,

Well, definitely you want to get light at the same time every day and try to get either by a window or get outside if you're not getting exposure. That light and frankly, the other thing that should be doing is controlling the light in their bedroom before that we don't want to get too much light exposure before our destined time to wake up or that can predispose you two waking up earlier or resetting circadian patterns and waking you early so asleep mask is a good thing. If you can afford it room darkening shades and putting shades on tracks I always like to say that the rest of the world has gotten a memo and we missed it. We seem to MR, in a lot of things now with the rest of the world, got this memo, and I'm always we were born in caves and we should have stayed there. If you go into latin god they have what we called. They call percy ana. They have metal sheets on tracks that come down and I feel fairly certain. You could survive a nuclear last behind that thing, but for sure you're, not in any light exposure. If you go to europe you're going to see the shutters that they

clothes and you kind have a slightly comes down and close them off, and there is no I coming in in the morning we have window treatments. We have blinds and drake that led a lot a light in the morning, relatively speaking. And so I always tell people it's much better to keep your bedroom as close to really dark as possible that what I'd like to be able to develop film in your bedroom in the morning before you wake up. Ok, this is all about incredibly helpful. So let's somebody other than me ask some questions here. We got a lot of along the same lines there is war in a really big theme that I want to hit first you've already kind of hit it it's going to require some repetition, but I think it's worth it because I think this is a big issue that a lot of people are dealing with witches, the middle of the night. Wake up so samuel our producers just going to

we got through. He messages along these lines is just gonna play them for you in and then you can all our ok. Thank you for taking any sleep strength minding elsewhere, how to break the cycle of wake up in the middle of the night and not being able to get, to sleep. If there's anything that can be done to break that cycle, would be interested to hear what the tips or suggestions might be. Thank you, I do if my anxiety is waking up in the middle of the night. This is the question regarding flee. Cathy calling from palm springs a foreign, yes and no trouble getting the slave. I'm usually tired and sleepy before I'd like to be, but inevitably where between thirty. Four, I wake up start ruminating and wonder

start ruminating, forget it and you know no matter what I do and I can't pull my mind out of that constant, I'm trying to figure out this thing or that thing or whatever anyway any any help on that would be appreciated. Thank you, okay suspect your hearing a lot of this during the pandemic. Guess I've heard out do this. For thirty years I mean you know you, don't you dont require a pandemic to wake up in the middle of the night ruminating, so I may look a couple of things. Let's go back and reiterate some things I said one is that if you are having trouble sleeping in the middle of the night, the first thing to do is not lay there in bed and ruminate, if you're, gonna, ruminate, ruminate somewhere else at the very least, take it somewhere else, but a better. I! four ruminating is do something fun if you occupy your mom and it's less prone to rumination. Then it

You know an idle mind- is the devil's playground, as they say, and it's very hard to flip a switch on our minds and just turn them off and frankly, the more we try to turn our minds off. That's like that sleep effort. We talked about the more we try to turn our minds off. The more energy we're expecting to do that. So it's a it's! A vicious do loop, where we can't get out of that, as people are sort of noticing so give that up get out of bed and do something fun and wait for sleepiness return. If this has been a long term problem, though my senses that that alone is not going to do the trick. That there's other is What's going on here with regard to why somebody's awake in the middle of the night- and they really ought to get it properly assessed- and I know I gave you links to that people can kind of find somebody to help them with Another thing that I wanted to say is: we have now talked a lot about how people get this message when they're looking for problems when they're looking for answers to their sleep problems where they start to hear they need to sleep a certain number of hours.

One of the things that can wake you up in the middle of the night is being in bed for too many hours if you're a six hours, sleepers, seven hours, sleep or a new start being in bed. were eight hours, because somebody on podcast told you, you know, the in bed for eight hours, you're, gonna, open a whole somewhere and eventually reaffirmed that and so you're just open this hole in the middle of the night. It might be that your getting the proper amount asleep. You're just got a hole in the middle of the night, because you don't need all that sleep, but I can't say to any particular person who just asked the question whether that their particular problem can you say that you did? These are ways in which those holes can open up the holes. Will open up, remember ass! We get older, there's lots of things that cause us to wake up in the middle of the night, first of all, we can, in the middle of the night, is not unusual. The average sleeper weeks, fifteen twenty times a night if we were studied them in a lab, it's just that their each of those wake

These are so short that you're not you're amnesty for them. You don't remember them. Now, ass, we get older. We start to remember a couple of those awakenings because they get a little bit longer, maybe once or twice or even three, a night and if you can roll over and go right back to sleep, that's really not of concern that waking up ass. We get older. I can't make it through the night now without waking up and needing to use the restroom. It's not happening. So the question is not did I wake? The question is: can I re initiate sleep and that's what people with a chronic insomnia problem need to learn to do and again there's many things that they need to do to do that, but many people will hesitate to go, get the kind of help I'm talking about, because they will a tribute. The reason their awaken. The middle of the night is to some medical problem. Is it true that a hot flash from menopause Will wake you in the middle of the night. Yes, is it true that a full blown

or a urinary retention problem will wake you in the middle of the night? Yes, is it true that a a prostate, problem will wake you in the middle of the night? Yes, is it true, the chronic pain wake you in the middle of the night, yes, but most people who have those problems. Will you whether their voting in the bathroom and then coming back to bed there now done their bladders, not keeping them awake for forty minutes at that point or an hour? Something else is, and they can get help with that. So you have a hot flash if it doesn't last all night long and you get cooler, but then you still can't go back to sleep, that's something else, and you can get help with that, and it may be the difference between waking three times a night for twenty minutes, total or waking three nights at three times a night for ninety minutes total and that's the way to think about that. One less thing about waking in the middle of the night or early morning. The thing we haven't touched on it all is what I'd call general sleep hygiene. This is the kind of stuff where people are told owed

link less caffeine. You know what is it I do about exercise. What should I do about alcohol? Perhaps the biggest one on that list is alcohol, alcohols and interesting substance, because it will first cause you to be more drowsy and sleepy and in some ways, therefore, might help you to get to sleep, but it is a bit sleep aid, because it last very short and wears off in the middle of the night and can produce fragmentation and cause you to wake. I'm not talking about substance abuse issue. Now, I'm not talking about alcoholism or any of that for some people, and I dont know who they are, for some people just having a glass of wine or an alcoholic beverage near bedtime, might make you both first of all, sleepier than you wanna, be before bedtime. So you're fallen asleep inadvertently on the couch earlier than you should, which will wait, you up in the middle of the night, and alcohol wearing off itself in the middle of the night? We ll wake you.

in the middle of the night and If anybody out there has a doctor that says- or maybe a glass of wine before bed would be a good idea, don't listen to that it's really a bad idea to use alcohol to help you to sleep right now, and I now said that do any of the people they called in is it alcohol is causing their problem almost certainly not. But it's a good jumping off point four worth talking about that. Let me ask you a question on this. Waking up in the middle and night thing, this place of the very first thing you said, which is it going on for a while you get out of bed, do something fun, one thing that might be fun for some people that I would imagine you would say we shouldn't do, is play video games on your phone or do anything on your phone, because then you're bombarding yourself with the kind of blue light that might make it harder to fall back to sleep. Is that correct?

So yes- and no I mean remember yeah, we don't want to get a lot of light exposure in the middle of the night, but please for those of you out there who are taking this to heart, put out night lights and things like that, don't bump into walls, don't fall and break your hip. Don't do any of those things it's. Ok to get low level light. It's ok to watch television if you're watching television, that's all about the light! You need right. If you're reading a book, you want a booklet lighter you want. You know a source of light from behind you to light the book. That's fine! So then we come to devices like pads and phones, and things like that and what I will say there is. You touched on the idea that it's not light per se, but the spectrum of blue light that has the most effect on the circadian rhythm and most us now, almost all of our devices, have a blue light filter so download the blue light filter you can set to say I want no blue light between ten p m and eight a m and your screen. What

take on a little bit more of an orange tint and that should do better. There are blue light filters that you can download off the internet if you don't have it built into your machine, so that would make it better It depends on the person. There are people who have what I would call real circadian rhythm disorders. That's different from insomnia. You can have people who have significant circadian rhythm disorders, which is beyond the scope of of today's talk for those people. They need to be much more careful and sensitive about light, and I wouldn't be advising those folks to stay away from handheld devices with light sources close to the eye, but for the average person who is does not have a significant circadian rhythm disorder. They can probably get away with it. But if their concerned again yeah do something fun, but do it at a distance from your eyes. Do the television in a plug the computer with some device into your mouth monitors

green. So you can sit farther away from it and download a blue light filter and you should be fine great. So the next batch of questions actually to in this case agree that we're in a play for you. But I think this is quite a common question has to do with sleep aids How do you know about my question is ready to sleep, not sleeping pills, but that does not mean that those three things the castle, which are you then he early days, the pandemics pretty religiously the means really an equal and I didn't know safe. Those actually were. I I'm not using them as often now, because I'm Jim tobacco, but I'm able to exercise and that kinda tires me out and helps me sleep better. But I still do use on one occasion and I know they're they're supposed an addictive, but I suspect using them. canada is a cry tonight for wireless, less unhealthy

I just want to know what your ashworth had to say about these not addictive sweet solutions. Are you hello? This is air in kind from portland Oregon. I have a question for these sleep experts I'm wondering what's their thoughts are on using marijuana to help you sleep, especially if you're in, the position of trying to avoid taking pharmaceutical drugs to try and help your sleep? Ah, thank you very much. I love that we'd question came from. Lend the maize and in his personal much and it's it's the is it our eye from you to take drugs to avoid taking pharmaceutical drugs question so. There is the weed question and then the anti his demeanor sort of without collar was calling sort of non addictive sleep aid, so

take it in whatever order you would like with the order you had it in, let's start with anti histamines and over the counter sleep aids, most of them are anti histamine medications which have as a side effect. Drowsiness, not nessus, early sleep and there's no good data, although not. A lot of data whatsoever I mean they haven't been studied, is the basic answer, but what little there has been done suggests that they are not as a class of medications. All that useful or helpful, that doesn't mean that any individual might not derive benefit from taking over the counter sleep aid. But again I would argue that all sleep aids are designed to be for short term problems and especially if you can define the problem. So, as I said a night or two of bad sleep is now

anything to think about what you might think well yeah, but I always get my night or to a bad sleep before I have a big test per hour always have by night or to a bad sleep before the big papers, whatever it is, there's a place for medications for sleep, whatever we're talking about. I would prefer, if you're, going to use medications for sleep, that you do use prescription medications. They were designed for this and that you have a I cut off point. You say guy will use this for the next two nights I will use this when I go to europe and I ve a little jet lag, and I want to get myself to sleep at the proper time for a few days and then I'm done, but when you have a chronic insomnia, the idea of haven't you, those things for years and years and years is really not what was intended and ultimately can provoke more problems than otherwise now over. The counter medications is not my big would not paid by big thrust.

Again, if somebody having severe problem even right now, really anxious really troubled and they need just need to get some sleep for a few days again under an adviser rose or or physicians guidance may be. Taking some medication in those circumstances. To get themselves back on track would be a good idea, but that's in the acute phase in the chronic phase. When you take those medications, they can work, they can work very well, but they dont tend to fix those underlying perpetuating factors that I've now talked about so much today, and so the problem is when you try to come off those medications. Those problems are still there. The worries are still there. The conditioning is still there, and so the insomnia often comes back, which is why we say look the better way to do. This is to start the right way and and and knock it. I'm medications for chronic insomnia for short term insomnia. They were made for this. Also

there's this sense of dependency. There are certain classes of medications that our physiological lee habit forming, and certainly some of them are sleep medications but understand. I had said to you that there is a system for our sleep which why costly regulation between sleep drive and circadian rhythm, and that will, if you let it and not compensate for poor sleep, will regulate your sleep and get you back on track eventually, and we done summary and there is a bit of a rhythm of insomnia and the river of insomnia goes something like this. Nobody has insomnia every night, almost no insomniac we say to you seven nights a week: that's why we, find it s three or more nights a week, but the really of insomnia is bad, bad, bad, good, bad, bad, bad, good, bad, bad, bad good, which means after every third or fourth night,

bound a pop off a reasonable night of sleep. I'm just gonna happen. Now it won't stay. That way if you're doing everything wrong, which is why I don't want people to develop chronic insomnia, but if you're, just in an acute phase- and you just wait, it out you're bound to have a good night eventually. Now, if you start taking things on an intermittent base, psych. I want to take this medication, but I don't want to get addicted, so I'm only take it every three or four nights, You can see what happens it's much more easy at that point to become at least psychologically dependent on those medications, and it may be that they didn't do much for you to begin with. A lot of my patients come back to me. I'll, say well did that over the counter medication work did thing that you tried work, did the doing whatever you do in bed work and what I

here inevitably is well yeah, sometimes. and I can say that about everything you know it works for insomnia, sometimes everything- including magic, pajamas. Ok, if on your third fourth night you where the magic pajamas you're gonna sleep. You know why not because of the magic pajamas so? Do you understand what I'm saying I do understand and I want to get to the weed for a second. But let me just ask a question about sleep medications, this sleep act bert that we had on previously strenuously argue that there is a big difference between sleep and sedation so that, if your using something benzodiazepines or and some these sleep meds are that family, I understand so like. What's the famous one ambient ambien there have been so I believe it is not. However,

was related to valley emperor caught up in a no. No, the newer class of medications like self it in which his ambien sonata lou nesta. Those medications are what we call benda diet. Bein, receptor agonists and they are much more specifically targeted to sleep and non sedation, and They are, while again anybody can develop dependency on these medication, psychological, Imagine you take it every night and it works for you and then you stop taking it tonight. What do you think's gonna happen you're gonna get into bed and start thinking. Oh my god. I wonder if I'm gonna be able to sleep without x Y and see what do you think that does to your sleep? So, basically anything can do that, but those newark The medications are not benzodiazepines. I would hasten to say that I would definitely agree with a better idea, though, that there is a difference between sedation and

sleep and so again, I'm not, I don't know whether is advocating medications for sleep. I do. I was not here this evening or to term not a long term solution. I don't think, there's a good, long term solution and I think people should work to get off of them where are you and weed, you got some where am I on we'd? What we know marijuana is that it works a lot like ambient. That is, it will in the initial phases. It will work to put you to sleep a little fast sure it may wake you more in the middle of the night but yeah. But if you wake you'll, get back to sleep, faster and so like ambien. It will do both of those things, but there is a tendency, a possibility like with ambien and will mess than any of those medications to become more tolerant of the medication, which means that over time, it's having less effect

If that happens, you then may find that it taking longer to get to sleep in your longer awaken the middle of night. If you use we'd for. You know a long time and then decide. I don't want to do this anymore. You again might have some significant problem trying to get to sleep and get back to sleep. Now. I'm not saying at that point that can be fixed. Just like everybody else's insomnia just talked about it can be fixed. If you're using marijuana again, I would think Like any other sleeping pills, I wouldn't use it for a long term fix. I would use it if you wanted for short term fix now. The other thing to kind of there is some people are using it for other things. We need to remember that some people on various kinds of medications that might not be great for their sleep, but they needed for other reasons. Then that is a struggle to then get to a person like me to say

Can we make you the best sleeper? You need to be on marijuana because you're using it for glaucoma or on marijuana, because you're using it for pain or on marijuana because you're using it for cancer, and we do that all the time. So why dont want people to run away from. Here is saying that. Did I better start, my rwanda, that I'm using for other things, but as a soul, sleep bade, I, think of it like any of the other sleeping pills, it wouldn't be my first choice for long term management of its army. Okay, so I think we have time for one more little set of questions here. These both have to do, something that I was psychology that I see at play in my own mind about bedtimes, me from connecticut and my question is about the sting staying super late. In my normal life, I'm an eight hour and I speak myself- go to bed around eleven

but now that I have no reason to like get up early anymore, I find myself being up till about two. Sometimes just He and even then I don't even want to fall asleep, I'm just wide awake. So how can I bring it back to eleven? How can I get sleepy again? How can I retrain my body to not want to party all night thanks bye on the subject of sleep on screaming? I struggle with not so much with the falling asleep or staying asleep, but I find myself every night. whether it be dooms rolling on twitter or watching tv too late at night? I can. I just wanna, keep it going into small, allow myself to go free at reasonable hour, and even though I always wake up in the morning feeling very exhausted and not well rested and point that I should go.

earlier and ever more com. My time routine, I forget, got those I'm like comes around and I just wanna watch networks. well on twitter, so wondering if you are, the experts have any advice on outer cash kind. That our wisdom and are now better freak, whatever a big impact on my life accident, he added My people lists ten o clock at night in my way for local should we watch another episode of whatever shall watching, and you know it's like rebellion time. So how would you say yeah, that's another thing that do you should keep in mind is As I said, marriage is a time when insomnia starts because people of different preferred sleep phases in the people of the same sleep phased tend not to marry each other and so there's always this argument over. You know I wanna go to bed earlier and I want to go to bed later and so he's gonna lose that argument and that can precipitate insomnia going back to the collar. There's a general

question here, as I want to address it in a general way again, not necessarily to her problem but there's a whole class of people. What we're talking about here is preferred Is she used the term nite owl all People are night hours, and all that saying is my preferred internal phase, the best time for me to get my good sleep number is later than the average bear, there's a whole class of people that ten the fall in that category. There are always exceptions but tend to fall in that category and we call them teenagers. Think all of us go from childhood into adolescence and into young adulthood, and children sleep long. They need more hours than than adults and they sleep early an eight year old, a seven year old, is tending to awake at five or six in the morning. and waking their parents to their utter consternation. And then, like my son,

turned into an adolescent and it took dynamite to wake him up in the morning. Ok, that's a natural change in in preferred face. Your sleep number doesn't change that much once you get to adulthood, but your preferred phase changes a lot during the course of the lifespan and in younger age. The tendency is for it. What we called the laid sleep face for life. and that has nothing to do with all the activities that kids are doing. If they had none of those. If they were live, in a mennonite colony. How all we're living of pious life with no parties and no late night. You know carriers and any of that stuff. They would still want to go to bed later it just an adult natural shift that takes place genetically. I had already mentioned to you that some people are sleeping better because there are being allowed to sleep in their natural state.

and I think that's no we're going to be more true than with our teenagers and young adults that they are going to be finding that they're going to bed later and their sleeping in later, because they can and because they're doing it they're getting more sleep. We are doing a terrible disservice to our teenagers by making them got up earlier than the young kids to go to school. Crazy, ok, absolutely crazy, for the human animal. So, with regard to the question that I get a lot which is well, should I allow my person to do that should allow my team to do that again sleeping well and waking up in the morning and they feel like they're doing great. The answer is, I don't see why not it's more their preferred phase and if they right now have an opportunity to get that they're gonna. Should better and more efficiently in the hours that they have awake when they do that. What we still want to see away from in that class is irregular hours. I still don't want that teen getting up some days at nine some days at ten

some days at eleven, some days at twelve and so forth. If their natural phases like from you know two in the morning to nine in the morning or ten in the morning, then do that five days a week now the question was also about transitioning back. The question is: how soon do you have to transit, back, as you start approaching a time when you're gonna have to get up earlier in the morning again yeah, you may want to start transitioning. How do I look? the fall asleep earlier was the question. Again I go back to you set that with wake time. If you keep getting but ten o clock you're not going to be ready to fall asleep at eleven? But if you start not early earlier and earlier you'll start to become more and more prone to be ready to sleep at eleven unless again you're so delayed. Your clock is so off kilter that that becomes problem in all of that can be fixed with a with a specialist speaking of specialists. You reference this earlier, but it bears repeating ye. We have links that you provided to us

we will put in the show notes that will allow people to find specialists should they need one rights are one of them is a site that science education, education cited answered by the american academy of sleep medicine, and it has a bar in there. You can put in your zip code and it will give you your nearest accredited sleep centres, but that's for other kinds of sleep problems. If things are good, strange and bump in the night, like your your sleep walking and you got night terrors, and you got you think: I've have sleep, apnea or other kinds of problems like that. That's what you really want to sleep centre for, if there's nobody else close to you asleep centre, might also be able to direct you to a behavioral, sleep, medicine specialist, like myself, but if you haven't zambia and you want to get first to a baby- sleep medicine specialists decide. I would Who is the other one, which is the society of behavioral sleep, medicine and when you go there there's a place that says provider search, and give you a map of the united states and you can click on your state give you a listing of all the providers in your state that either do this

actually or are frankly certified or have diplomates status to do this kind of work down. This been a real pleasure. Really. I love a salty guy from the bronx has been really fun, we didn't get your other question guy. I dont know. If you wanted to go back to that one, but we don't have to the doom sky, going on twitter and the netflix thing yeah I'd. Actually the answer is I'm a little bit more flip about that? I mean you know. This is a guy who's. Basically saying I know I should be going to bed earlier, but I don't and to which I have. The answer is that you know there's an old joke that says the guy goes into the doctrine says doctor it hurts when I go like this, and the answer is don't do that anymore? You know more seriously. There are some people with various kinds of problems like attention, deficit disorders and obsessive, compulsive disorders that really do struggle in a way that it makes- it difficult for them to just choose to do it on again I'd say they need to get professional help and get that assessed. If it's not that, then I simple trick you can try. If you conduct

pass. The time you wanted to go to bed is. Sudden alarm on your phone and have a go for the time you want to get ready for bed and then do so and see if that works, but the same advice you gave to the female collar of set an alarm in the morning and you'll be paying the price for that twitter late night, dooms growing on twitter that might strongly disincentive eyes you from doing it the next night. Absolutely that actually right. So I must have done a good job here cause I taught you the right stuff. You definitely did a good job here. I'll tell you some bad advice. When I was a little kid, I would go to my father, who is a joke, stir and I'd, say daddy, I can fall asleep and I would say, bend over and run as fast as you can into the wall. Yeah yeah, I know those treatments. Listen I've seen it all really seen it all, including magic pajamas. Yes, gonna, buy em and invest in some magic pajamas. Just remember they work sometimes done

you again really appreciate it yeah my pleasure thanks for having me this was a blast thing, and doktor posner. That was very helpful conversation for me personally, thanks to for listening and thanks, most importantly to everybody who worked so hard on the show ten percent happier. by Gabriel's ackerman, Justine, gavi, Lauren smith and terry Anderson dj kashmir as our senior producer research lighterman? Is our Your editor and can be regular. Is our executive producer scoring mixing by Peter bonaventure of ultraviolet audio, and we get our theme music from nick thorburn of the great envy rock band islands was back here on Monday for a brand new episode of talking to. I was actually quite nervous for this because I so admire this person talking to a legend you're, a hero of mine, Jennifer egan, the novelist great conversation, even though I was.

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