WEBVTT - Working to Sleep and Sleeping at Work 0:00:05.519 --> 0:00:07.880 I think sleep has uh certainly come a long way. 0:00:08.280 --> 0:00:11.720 Particularly is very many luminaries in the field have gone 0:00:11.720 --> 0:00:14.400 from the basic mechanisms of what's going on in the brain, 0:00:14.480 --> 0:00:17.960 what circuits and what neurotransmitters are being released and at 0:00:17.960 --> 0:00:20.759 what times all the way up to well, how is 0:00:20.800 --> 0:00:23.280 sleep actually affecting us? How does it affect our mood 0:00:23.440 --> 0:00:25.439 or decisions to what we eat during the day, how 0:00:25.480 --> 0:00:29.760 does it affect our metabolism. Logan Schneider is a medical 0:00:29.840 --> 0:00:33.360 doctor and board certified clinician who specializes in the treatment 0:00:33.360 --> 0:00:38.520 of sleep disorders that includes things like sleep apnea and ourcolepsy, insomnia, 0:00:38.760 --> 0:00:43.360 restless leg syndrome, sleepwalking, and ram sleep behavior disorder. He's 0:00:43.360 --> 0:00:46.360 earned awards and honors from the American Academies of Sleep 0:00:46.400 --> 0:00:49.640 Medicine and Neurology. I sat down with Logan to get 0:00:49.680 --> 0:00:52.960 a better idea of exactly how sleep research is done 0:00:53.440 --> 0:00:56.360 and it's real impact on patients who struggle with sleep. 0:00:57.440 --> 0:01:00.240 The nice part about being a sleep specialist is you 0:01:00.280 --> 0:01:03.040 get to benefit from a community of all these different 0:01:03.040 --> 0:01:05.680 types of clinicians that are interested in sleep. I went 0:01:05.760 --> 0:01:08.480 by path of the neurology residency training, but you can 0:01:08.520 --> 0:01:13.240 come through internal medicine, pediatrics, family medicine, and athesiology. Then 0:01:13.560 --> 0:01:16.720 once you've done your primary training in residency, you then 0:01:16.880 --> 0:01:19.520 typically do a year or maybe two years sleep in 0:01:19.560 --> 0:01:23.520 research or just sleep clinical sleep fellowship that specializes you 0:01:23.640 --> 0:01:26.520 by learning everything there is to know really about sleep 0:01:26.560 --> 0:01:29.119 in that one year, and then go and take your 0:01:29.120 --> 0:01:33.240 examinations and get certified, and then you start practicing sleep hopefully. 0:01:33.720 --> 0:01:36.360 I also reached out to Chris Winter. He's a medical 0:01:36.400 --> 0:01:39.000 doctor with years of experience in the field. He's a 0:01:39.000 --> 0:01:42.280 neurologist and a sleep specialist who authored two books, The 0:01:42.280 --> 0:01:45.440 Sleep Solution and The Rested Child. He gave us some 0:01:45.480 --> 0:01:48.720 additional insight into this field and how it continues to evolve. 0:01:49.880 --> 0:01:52.680 One of the nice things about the changes in technology 0:01:52.760 --> 0:01:56.920 is that has taken different shape as time has passed. 0:01:57.000 --> 0:02:00.360 So the original sleep studies we did. That mean, if 0:02:00.400 --> 0:02:02.520 you talk to all the people who were sort of 0:02:02.560 --> 0:02:06.080 the first generation sleep doctors, and we're not that far 0:02:06.200 --> 0:02:10.480 removed from them, those sleep studies were very primitive. I 0:02:10.520 --> 0:02:14.000 mean they were sort of experimenting with this. They were 0:02:14.000 --> 0:02:17.200 trying to figure out where they're ways to capture information 0:02:17.240 --> 0:02:19.880 about sleep. And that's changed to the point where a 0:02:19.919 --> 0:02:22.840 lot of the sleep assessments that we do in individuals 0:02:23.520 --> 0:02:28.440 happens in a person's own bed. We've had an interesting 0:02:28.480 --> 0:02:32.040 journey so far talking extensively about the science of sleep 0:02:32.440 --> 0:02:36.519 and showcasing examples of people with very unique sleeping patterns 0:02:36.560 --> 0:02:40.640 and challenges. Today, we're going right to the source, to 0:02:40.840 --> 0:02:43.760 the sleep researcher. We'll find out what it's like being 0:02:43.800 --> 0:02:46.440 at the forefront of one of the newest and most 0:02:46.480 --> 0:02:55.760 interesting fields and healthcare. Hi, I'm on a hut O'Connor 0:02:56.000 --> 0:02:59.560 and this is Chasing Sleep and I heart radio production 0:02:59.800 --> 0:03:09.960 and partnership with Mattress Firm. About a year ago, I 0:03:10.000 --> 0:03:13.080 decided I was going to visit a Mattress firm in 0:03:13.120 --> 0:03:18.680 every state of the Union. I'm really interested in the 0:03:18.760 --> 0:03:23.400 perspective on the ground. Mattress Firm sleep experts. They see 0:03:23.440 --> 0:03:26.040 it all and you never know what new nuggets of 0:03:26.040 --> 0:03:28.680 sleep you'll learn about. In fact, that a great conversation 0:03:28.680 --> 0:03:31.000 with the manager from one of their locations in Texas. 0:03:33.480 --> 0:03:36.240 My name is Raoul Davila. I'm a senior store manager 0:03:36.360 --> 0:03:40.160 for Mattress Firm out of Houston, Texas. It's interesting because 0:03:40.200 --> 0:03:43.360 throughout the years right you you start to see all 0:03:43.440 --> 0:03:46.400 walks of life and all the different issues that are 0:03:46.400 --> 0:03:50.760 out there. So actually seeing guests come in with those 0:03:50.800 --> 0:03:53.560 issues saying that they're not sleeping at night, that they're 0:03:53.600 --> 0:03:58.080 not getting the recommended amount of hours of sleep, that 0:03:58.200 --> 0:04:02.720 they're being impacted at their jobs firsthand, hearing those stories 0:04:02.800 --> 0:04:06.320 from my guests really puts it in perspective. People are 0:04:06.360 --> 0:04:10.440 not sleeping well, and it all starts with what you're 0:04:10.480 --> 0:04:13.120 sleeping on. I mean that has a huge advantage on 0:04:13.280 --> 0:04:16.440 getting the sleep that we all need. So I find 0:04:16.440 --> 0:04:20.559 it really interesting to talk to the sleep experts about 0:04:20.600 --> 0:04:24.359 and what do they see, What kinds of problems have 0:04:24.480 --> 0:04:29.960 they been confronted with. These individuals are using their pretty 0:04:30.000 --> 0:04:33.279 profound expertise. I mean, they get hundreds of hours of 0:04:33.320 --> 0:04:36.880 sleep training to do more than just sell a mattress. 0:04:36.920 --> 0:04:42.359 They're really trying to help people solve sleep problems, whether 0:04:42.400 --> 0:04:46.080 you're sleeping habits are common or uncommon. We have the 0:04:46.240 --> 0:04:50.680 curious researchers to thank for blowing this relatively new science 0:04:50.839 --> 0:04:54.400 completely open. When I sat down with Logan, he was 0:04:54.600 --> 0:04:57.800 enthusiastic about his work and eager to tell me all 0:04:57.839 --> 0:05:01.920 about it. So put us in your clinic. I'd love 0:05:01.960 --> 0:05:06.400 to know what it's like. Yeah, well it's a mostly 0:05:06.440 --> 0:05:09.839 outpatient clinical practice, which is really nice about sleep medicine, 0:05:09.920 --> 0:05:12.840 Like there are virtually no sleep emergencies that I can 0:05:12.880 --> 0:05:14.880 think of and certainly don't get called in. The nice 0:05:14.880 --> 0:05:16.640 part about sleep is you get to I feel that 0:05:16.680 --> 0:05:18.760 you get to spend a lot of time talking to 0:05:18.839 --> 0:05:22.480 people about their history because that's a significant portion of 0:05:22.600 --> 0:05:25.160 the evaluation of sleep disorders. Right There isn't much of 0:05:25.200 --> 0:05:27.320 an examination that you can do for sleep other than 0:05:27.360 --> 0:05:29.839 the actual in lab or home sleep study or some 0:05:29.920 --> 0:05:33.359 other diarrhy or other measures. So it's really gathering a story, 0:05:33.400 --> 0:05:36.520 getting to understand people's experiences. And the things that we 0:05:36.560 --> 0:05:38.719 do on our sleep are really astounding, eating two as 0:05:38.760 --> 0:05:42.240 a toothpaste or driving cars, all sorts of crazy stuff. 0:05:42.240 --> 0:05:45.480 So it's really interesting to hear people's experiences with sleep 0:05:45.520 --> 0:05:48.440 that we never thought possible. We all experienced sleep a 0:05:48.440 --> 0:05:50.560 lot of it, and so we think we're quite expert 0:05:50.600 --> 0:05:53.880 at it, but every day I get a surprise. Very 0:05:53.960 --> 0:05:57.280 interesting to think about how important the story behind each 0:05:57.320 --> 0:06:01.800 sleeping problem is, which makes sense considering how specific and 0:06:01.920 --> 0:06:06.039 unique each person sleeping circumstances are. Chris found the same 0:06:06.080 --> 0:06:09.880 thing to be true in his own practice. Getting the 0:06:09.920 --> 0:06:12.120 patient's side of the story is one of the most 0:06:12.120 --> 0:06:14.919 important techniques for finding out what's going on with their sleep. 0:06:15.600 --> 0:06:18.120 It won't give us the whole picture, of course, but 0:06:18.160 --> 0:06:21.520 if it just rules things out, it's useful. We do 0:06:21.600 --> 0:06:24.520 this from a medical standpoint, But Roold told me how 0:06:24.520 --> 0:06:28.040 sleepexperts it. Mattress firm used the same methods with customers 0:06:28.080 --> 0:06:32.240 as we do with patients. When I have a guess 0:06:32.279 --> 0:06:34.120 that comes in and and they're looking for me to 0:06:34.160 --> 0:06:36.480 solve a problem, I mean, it's it almost comes down 0:06:36.520 --> 0:06:40.120 to the support or lack thereof. For some reason, they 0:06:40.160 --> 0:06:44.440 are not happy with the current sleeping situation. So it's 0:06:44.480 --> 0:06:47.320 my job to really ask those questions to make sure 0:06:47.440 --> 0:06:50.320 that we're going to find the right mattress. If I'm 0:06:50.360 --> 0:06:54.080 not asking the right questions, I'm really not solving the 0:06:54.760 --> 0:06:58.040 right problem. When you go see a doctor, they're asking 0:06:58.120 --> 0:07:01.359 questions to try to diagnose something. They're not just randomly 0:07:01.440 --> 0:07:04.160 throwing darts out aboard. They're gonna ask the right questions 0:07:04.160 --> 0:07:07.400 to make sure that they can make the right recommendation. 0:07:07.839 --> 0:07:09.920 Is just listening to the guests and and really hearing 0:07:09.920 --> 0:07:15.440 them out. When you are studying a patients in their sleep, 0:07:15.560 --> 0:07:19.720 what are you typically looking for? What tools are you using? Yeah, 0:07:19.800 --> 0:07:21.560 there are all sorts of tools that we have at 0:07:21.560 --> 0:07:25.320 our disposal. Some of them are pretty rudimentary. The classic 0:07:25.360 --> 0:07:27.480 sleep diary where people print out the sheet of paper 0:07:27.520 --> 0:07:30.080 and fill out their sleep diary. Maybe that can be 0:07:30.120 --> 0:07:35.280 supplanted by some helpful objective monitoring through various technologies, things 0:07:35.320 --> 0:07:37.800 like an actograph, which is a watch almost like a 0:07:37.920 --> 0:07:42.360 standard sports or sleep fitness tracker, where it tracks movement 0:07:42.640 --> 0:07:46.480 and light. Sometimes that helps us understand patterns over time 0:07:46.840 --> 0:07:50.080 that can complement a sleep diary. But then the major 0:07:50.360 --> 0:07:53.240 diagnostic tools we have are those things like a sleep study, 0:07:53.320 --> 0:07:57.160 and the sleep study in lab requires a specialized technician. 0:07:57.280 --> 0:07:59.160 Those are the people who were there overnight to help 0:07:59.280 --> 0:08:00.960 make sure that things going well because there are a 0:08:00.960 --> 0:08:02.960 lot of wires, a lot of tubes, a lot of 0:08:03.000 --> 0:08:06.880 things to monitor various body signals, from brainwave activity to 0:08:07.000 --> 0:08:10.440 eye movements, to muscle activity in the face and muscles 0:08:10.440 --> 0:08:13.960 of the legs, to looking at heartbeat and oxygenation and 0:08:14.040 --> 0:08:17.080 pulse and breathing effort. So that we're really gathering a 0:08:17.280 --> 0:08:20.120 very rich data set to understand all of the different 0:08:20.120 --> 0:08:25.960 things that could be going on in sleep. These sophisticated 0:08:26.000 --> 0:08:28.440 ways to measure our bodies and our brains while we 0:08:28.480 --> 0:08:33.280 sleep clearly require equally sophisticated training, but it seems like 0:08:33.280 --> 0:08:35.880 there are also multiple ways to dive into this field. 0:08:36.160 --> 0:08:39.000 I mean, I personally have learned a whole lot about 0:08:39.000 --> 0:08:41.280 the science of sleep just by doing research as a 0:08:41.360 --> 0:08:46.880 journalist and by interviewing experts like yourself. Absolutely, they're obviously 0:08:46.920 --> 0:08:50.000 doctors like Logan and myself who specialized in the medical 0:08:50.000 --> 0:08:53.600 realm of sleep. But the beautiful thing about this science 0:08:53.720 --> 0:08:56.959 is there are multiple avenues to approach it from a 0:08:57.040 --> 0:09:00.200 journalistic approach, as you mentioned in a number of other ways. 0:09:00.960 --> 0:09:03.200 In my conversation with Role, he told me how he 0:09:03.280 --> 0:09:07.040 and other instore sleep experts complete over two hundred hours 0:09:07.080 --> 0:09:13.120 of training. Can you tell us more about your training 0:09:13.200 --> 0:09:17.160 as a mattress firm sleep expert and what it involves. Yeah, 0:09:17.200 --> 0:09:20.680 absolutely so. When we when we use the term sleep expert, 0:09:20.760 --> 0:09:23.120 we don't use it lightly at all. There's hundreds of 0:09:23.160 --> 0:09:27.959 hours of hands on training that we do here in 0:09:28.000 --> 0:09:30.360 the store, and we talk about the quality of sleep, 0:09:30.440 --> 0:09:33.200 we talk about the type of mattresses we have, how 0:09:33.360 --> 0:09:36.440 we can connect it to how a mattress can help 0:09:36.559 --> 0:09:39.520 increase the quality of sleep. We're the only ones that 0:09:39.559 --> 0:09:43.680 are really diving in to learn about sleep, and you 0:09:43.720 --> 0:09:46.400 know how that can benefit you and what can happen 0:09:46.440 --> 0:09:48.560 if you don't get the right amount of sleep. There's 0:09:48.600 --> 0:09:51.240 so much out there on sleep that we still don't 0:09:51.240 --> 0:09:56.960 know about. But if we can pair what's happening with 0:09:57.080 --> 0:10:00.640 my guests to a certain mattress in a certain and feature, 0:10:00.760 --> 0:10:03.760 I think that's when we get that aha moment where 0:10:03.800 --> 0:10:06.679 you know, that's exactly what's happening to me, and this 0:10:06.760 --> 0:10:12.160 is exactly what I need. We'll be right back after 0:10:12.160 --> 0:10:22.480 a brief message from our partners at Mattress Firm, and 0:10:22.520 --> 0:10:29.439 now back to chasing sleep. Dr Logan Schnyder broke down 0:10:29.520 --> 0:10:33.080 the different types of sleeping disorders. We have a set 0:10:33.080 --> 0:10:37.200 of about six disorder categorizations that we can then subdivide into. 0:10:37.240 --> 0:10:39.280 You have a breathing disorder. Is it a breathing disorder 0:10:39.360 --> 0:10:41.679 because of a blockage like obstructive sleep apnia? Is it 0:10:41.880 --> 0:10:44.480 central meaning that your brain is not triggered to breathe, 0:10:44.480 --> 0:10:47.360 Maybe because of a medication you're taking. We have all 0:10:47.360 --> 0:10:50.080 of these different signals that different chunks of them can 0:10:50.120 --> 0:10:52.640 tell us different things about your sleep. If we don't 0:10:52.640 --> 0:10:54.320 need all of that, we're not looking for a more 0:10:54.360 --> 0:10:57.000 complicated disorder, but something more run of the mill. Sometimes 0:10:57.080 --> 0:10:58.679 we can form that out to like a home based 0:10:58.679 --> 0:11:02.600 diagnostic study where we just look for breathing effort problems 0:11:02.640 --> 0:11:05.120 and oxygen problems where the blood is not getting into 0:11:05.160 --> 0:11:07.520 oxygen because the breathing is impaired, to something like for 0:11:07.559 --> 0:11:09.840 just substructive sleep APNA a little bit easier to descend 0:11:09.840 --> 0:11:12.200 to the home. But if you need a more in 0:11:12.280 --> 0:11:16.640 depth diagnosis looking for more complicated sleep disorders, than we 0:11:16.640 --> 0:11:18.800 want all of those signals and we have video to 0:11:18.840 --> 0:11:20.600 accompany it to make sure we know what's going on. 0:11:20.800 --> 0:11:23.360 Like when people sleepwalk, you can actually see their behaviors 0:11:23.400 --> 0:11:26.719 and try and differentiate was that actual sleep walking from 0:11:26.880 --> 0:11:29.120 non dreaming sleep? Was this guy and a dream based 0:11:29.360 --> 0:11:31.800 sleep disorder. It's important to know what stage of sleep 0:11:31.800 --> 0:11:34.600 you're in to know what's going on. So there are 0:11:34.679 --> 0:11:37.439 different types of sleepwalking based on the stage of sleep 0:11:37.480 --> 0:11:39.640 that they're in exactly, and it could even not be 0:11:39.880 --> 0:11:42.360 standard run of the mill sleepwalking which is a relatively 0:11:43.000 --> 0:11:46.600 benign disorder unless it causes problems like somebody driving a 0:11:46.600 --> 0:11:49.240 car while sleep. But then we are trying to differentiate 0:11:49.280 --> 0:11:50.920 what's going on in your sleep, right, people come to 0:11:50.960 --> 0:11:53.120 us and say, hey, I'm doing this weird thing, and 0:11:53.120 --> 0:11:55.600 we're we don't know. We can't know unless we're actually 0:11:55.640 --> 0:11:57.240 looking at what your brain is doing, and that's really 0:11:57.280 --> 0:11:59.360 we're capturing it on a video and also looking at 0:11:59.360 --> 0:12:01.600 all these bios signals all at once can help us 0:12:01.640 --> 0:12:06.480 differentiate that. And with insomnia, for example, what are some 0:12:06.559 --> 0:12:08.960 of the sort of common things that you see causing that? 0:12:09.120 --> 0:12:11.960 Is it could be a person's you know, their sleep environment, 0:12:12.320 --> 0:12:15.240 or is it typically stress or anxiety or their job 0:12:15.559 --> 0:12:20.520 or do you see common sort of themes underlying people's insomnia. Yeah, 0:12:20.559 --> 0:12:23.320 there are a lot of commonalities in general and sleep 0:12:23.679 --> 0:12:27.480 and particularly for insomnia. There are various constructs, various groups 0:12:27.480 --> 0:12:30.800 described to different ways of thinking about this, but one 0:12:30.840 --> 0:12:33.760 common model is called the three P model, where somebody 0:12:33.800 --> 0:12:37.320 might be predisposed. It might be your genetics that predisposes 0:12:37.360 --> 0:12:40.240 you to having sleepwalking similar type of thing here, So 0:12:40.280 --> 0:12:43.720 that's the predisposition, and then you have a precipitating factor. 0:12:43.800 --> 0:12:46.319 Often one big precipitating factor for a lot of people 0:12:46.360 --> 0:12:49.040 actually happen to be the pandemic. Was it the stress 0:12:49.080 --> 0:12:51.520 of the pandemic? Was it the change in your schedule, 0:12:51.679 --> 0:12:54.960 even the opportunity to sleep more that actually cause you 0:12:55.000 --> 0:12:58.480 to develop in insomnia. So then there's that precipitating event 0:12:58.600 --> 0:13:02.079 that causes the insomnia happen. And then after that, when 0:13:02.120 --> 0:13:05.000 we see insomnia eventually come to us in the sleep clinic, 0:13:05.080 --> 0:13:07.839 often because that's an acute and zomnia, something triggered it. 0:13:07.920 --> 0:13:09.520 You had a bad night. Everybody has a bad night 0:13:09.559 --> 0:13:11.880 here and there. But when it becomes chronic and lasts 0:13:11.880 --> 0:13:13.440 for a long period of time, and that's where we 0:13:13.480 --> 0:13:15.640 have to worry about these factors that perpetuate it. That's 0:13:15.640 --> 0:13:19.280 the third p Things that people are doing in response 0:13:19.320 --> 0:13:21.640 to their insomnia that then keep it going on. So 0:13:21.679 --> 0:13:24.800 some people will stay in bed a lot longer hoping 0:13:24.840 --> 0:13:28.280 that sleep will come, and unfortunately that inherently induces it insomnia. 0:13:28.320 --> 0:13:29.840 If you need six hours of sleep and you're in 0:13:29.880 --> 0:13:31.720 bed for eight hours, we'll guess how much insomnia you 0:13:31.760 --> 0:13:35.560 have two hours. So people will do different behaviors or 0:13:35.559 --> 0:13:38.160 even have thought patterns. Right, even the bed alone will 0:13:38.160 --> 0:13:40.679 make them anxious about going to bed, and so they're terrified, 0:13:40.720 --> 0:13:42.400 I'll come, man, am I gonna be able to sleep tonight? 0:13:42.679 --> 0:13:45.400 So it's these thought patterns behaviors that keep it kind 0:13:45.400 --> 0:13:49.160 of rolling on. It sounds like Pavlovian conditioning. I was 0:13:49.200 --> 0:13:51.000 just I was gonna say. One of the most common 0:13:51.040 --> 0:13:54.560 things's referencing Pound Love's Dog is people create this association 0:13:54.679 --> 0:13:59.319 with bed that is actually both physically activating as well 0:13:59.320 --> 0:14:02.880 as cognitive emotionally activating, so they actually just even being 0:14:02.880 --> 0:14:04.640 in bed. Stimulus control is one of the things that 0:14:04.640 --> 0:14:06.680 we use is to separate the stimulus of the bed 0:14:07.040 --> 0:14:09.359 from the sense of wakefulness. And if we can effectively 0:14:09.360 --> 0:14:11.439 do that, people then start to get used to, oh, 0:14:11.520 --> 0:14:13.720 the bed is for sleep again. So yeah, it's exactly 0:14:13.760 --> 0:14:15.720 pow Love's Dog. You got it. So you have to 0:14:15.760 --> 0:14:19.040 retrain their brains to view their their bed as not 0:14:19.120 --> 0:14:21.840 a place of stress and anxiety and insomnia, but a 0:14:22.320 --> 0:14:26.760 sanctuary of sleep. A sanctuary of sleep is definitely my 0:14:26.840 --> 0:14:30.239 new favorite term from my bedroom, and it really highlights 0:14:30.320 --> 0:14:34.040 just how important being physically and mentally comfortable is to 0:14:34.080 --> 0:14:37.800 our health. Throughout this series, one of the most fascinating 0:14:37.840 --> 0:14:40.960 aspects of sleep science that we've looked at is the 0:14:41.000 --> 0:14:43.920 amount of power that our brains have to perform certain 0:14:43.920 --> 0:14:47.400 functions completely on their own. And one of the best 0:14:47.400 --> 0:14:51.360 examples of how overwhelmingly strong our mental capacities can be, 0:14:51.880 --> 0:14:55.760 even on autopilot is the disorder that many people suffer from, 0:14:55.960 --> 0:15:00.760 known as sleepwalking. You know, what are some of the 0:15:00.800 --> 0:15:03.520 common things that you see when people are are sleepwalking 0:15:03.560 --> 0:15:07.880 and what is the cause of sleepwalking? Generally speaking? Yeah, well, 0:15:08.160 --> 0:15:11.400 we don't know what the underlying cause of sleepwalking is. 0:15:11.440 --> 0:15:13.920 It just is that some people have a tendency to 0:15:13.960 --> 0:15:16.440 do it and others don't, which would suggest that maybe 0:15:16.440 --> 0:15:22.120 there's a underlying genetic predisposition. It might be that their 0:15:22.160 --> 0:15:25.640 body doesn't do a good job of suppressing motor activity 0:15:25.960 --> 0:15:28.040 or doesn't do a good job of waking up fully 0:15:28.080 --> 0:15:30.880 when it starts to do motor activity, for example, Right, 0:15:30.880 --> 0:15:33.200 So it could be something in that kind of pathway, 0:15:33.240 --> 0:15:36.920 because to sleep, you have to maintain sleep while you 0:15:37.000 --> 0:15:40.320 might actually have brain activity that would suggest wake for example. 0:15:41.000 --> 0:15:44.240 But what can trigger sleepwalking typically are the things that 0:15:44.280 --> 0:15:47.480 you might see like I had in residency, So excessive 0:15:47.520 --> 0:15:51.040 amounts of deep, slow wave sleep that can come from 0:15:51.240 --> 0:15:55.000 chronic sleep deprivation. Sometimes drinking alcohol can be a trigger 0:15:55.040 --> 0:15:57.120 for it. Another thing that makes it more likely to 0:15:57.160 --> 0:15:59.920 have a sleepwalking event, for example, is being a kid. 0:16:00.320 --> 0:16:02.200 They have an awful lot of slow wave sleep, and 0:16:02.200 --> 0:16:04.960 so probability would be if you have more of the 0:16:05.000 --> 0:16:08.720 slow wave of sleep and your brain hasn't matured enough 0:16:08.760 --> 0:16:11.280 to have all of these systems working together to promote 0:16:11.360 --> 0:16:14.440 stages of sleep or states of sleep, then there's a 0:16:14.520 --> 0:16:16.600 higher chance that they might actually have an event where 0:16:16.600 --> 0:16:18.800 they sleep walk. Right, Like, the trigger could be in 0:16:18.840 --> 0:16:21.960 them a bladder feeling full and they have to go 0:16:22.000 --> 0:16:23.720 to the bathroom, but it happens to be right in 0:16:23.760 --> 0:16:25.960 the middle of the deepest part of sleep where they're 0:16:25.960 --> 0:16:29.280 the most inactive. Well, that triggers them enough to become 0:16:29.880 --> 0:16:32.400 awake but not conscious. You have to be in the 0:16:32.480 --> 0:16:34.160 right state. So if you have more of that state, 0:16:34.360 --> 0:16:36.800 the deep sleep, then you're more likely to have an event. 0:16:36.840 --> 0:16:38.920 And if you have a trigger in that state, well, 0:16:38.920 --> 0:16:40.960 then it's more likely that you're going to precipitate an event. 0:16:41.160 --> 0:16:43.360 About ten percent of people that will have a sleepwalking 0:16:43.400 --> 0:16:46.680 event about once a year or so. Wow, and does 0:16:46.720 --> 0:16:50.960 it usually the person themselves who's becomes aware of it, 0:16:51.120 --> 0:16:53.680 or is it you know, sort of like sleep happening 0:16:53.880 --> 0:16:56.520 like with myself, where it's a partner or you know, 0:16:56.640 --> 0:17:00.480 bed mate who brings it to the person's attention. Yeah, 0:17:00.520 --> 0:17:03.800 it's it's about a mix. If somebody has something very 0:17:03.840 --> 0:17:07.000 clearly out of place or out of order, that might 0:17:07.000 --> 0:17:10.119 be a good indication. For example, with a sleep eating 0:17:10.920 --> 0:17:13.240 some people come to their kitchen they're like, who cooked 0:17:13.240 --> 0:17:15.960 this meal in my house last night? Or they wake 0:17:16.040 --> 0:17:19.680 up an unusual contents like crumbs are in their bed 0:17:19.920 --> 0:17:22.120 and they're like, hey, I don't know how these got here. 0:17:22.359 --> 0:17:24.359 I think that's a good indication to people that something 0:17:24.400 --> 0:17:26.240 happened at night and it doesn't make sense. They'll check 0:17:26.280 --> 0:17:28.040 their locks and think that they're going crazy. It's a 0:17:28.040 --> 0:17:30.840 great build up for a sci fi thriller, right, and 0:17:30.880 --> 0:17:32.920 then we now get this bed partner who is that 0:17:33.080 --> 0:17:35.560 somebody who can finally observe our sleep for us again? 0:17:36.240 --> 0:17:39.240 And that's when typically these things come to people's awareness, 0:17:39.240 --> 0:17:41.000 is that they have somebody who's like, hey, you did 0:17:41.040 --> 0:17:43.720 this crazy thing last night, or hey, you punched me 0:17:43.760 --> 0:17:46.439 in your sleep? Is everything okay? It sounded like you 0:17:46.480 --> 0:17:49.680 were fighting off like a wolf or something. So it 0:17:49.800 --> 0:17:52.800 oftentimes most of our sleep disorders are recognized when people 0:17:52.800 --> 0:17:55.199 are sleeping in context. That's when you know, even if 0:17:55.200 --> 0:17:57.640 you're sleeping alone, you might catch it on these intermittent cases. 0:17:57.680 --> 0:18:00.880 But um oftentimes it's things that are reported that are 0:18:00.920 --> 0:18:03.040 completely out of whack and people think that there's something 0:18:03.080 --> 0:18:04.639 wrong with them, but they're not likely to report it, 0:18:04.680 --> 0:18:06.960 like I don't know what's going on. Normally it's a 0:18:06.960 --> 0:18:09.200 bad partner who's like, hey, that's weird, go check that out. 0:18:10.200 --> 0:18:12.960 The more we learn about sleep science, the more interesting 0:18:13.000 --> 0:18:17.359 it becomes. Now, Chris, I'm curious as a medical doctor, 0:18:17.440 --> 0:18:20.040 what do you look for and what are your goals 0:18:20.040 --> 0:18:23.040 when it comes to getting good quality sleep. Yeah, I 0:18:23.119 --> 0:18:26.760 love the idea of sleep metrics. I think the best 0:18:26.800 --> 0:18:29.560 way for people to really assess their sleep is are 0:18:29.600 --> 0:18:32.639 you still awake listening to this podcast, meaning that do 0:18:32.720 --> 0:18:36.760 you struggle with excessive sleepiness during the day? So to me, 0:18:37.119 --> 0:18:40.600 looking at fatigue and sleepiness levels during the day, I 0:18:40.640 --> 0:18:42.680 think it's probably the best way to determine whether or 0:18:42.680 --> 0:18:45.200 not somebody's a good sleeper. Somebody says to me, I'm 0:18:45.280 --> 0:18:48.600 so unsleepy that I can't nap. I've never taken a 0:18:48.720 --> 0:18:50.560 nap in my life. It's hard to paint them as 0:18:50.560 --> 0:18:54.000 a bad sleeper. It's kind of like I want a sandwich, Nope, 0:18:54.359 --> 0:18:57.240 want a strawberry, nope, I want a cookie, nope. Well, 0:18:57.520 --> 0:19:00.680 you're probably not hungry, so hard to hate that person 0:19:00.680 --> 0:19:03.359 to somebody who's starving to death. So you know, to me, 0:19:04.000 --> 0:19:06.880 I think it's really about explaining sleep studies are awesome, 0:19:07.400 --> 0:19:11.600 but it all starts with communicating with Dr Schneider and 0:19:11.680 --> 0:19:15.720 sitting down and having questions for him and exploring the 0:19:15.800 --> 0:19:18.400 things that are concerning you about your sleep and how 0:19:18.440 --> 0:19:21.679 sleep interconnects to other parts of your health. And you know, 0:19:21.720 --> 0:19:24.880 sleep studies are often very appropriate, but not always, so 0:19:25.440 --> 0:19:27.879 I don't think everybody should have a sleep study. I 0:19:27.880 --> 0:19:30.199 think the secret to good sleep, and my secret is 0:19:30.680 --> 0:19:34.040 I don't worry about it because I've learned enough about 0:19:34.119 --> 0:19:37.520 sleep to know that it's impossible not to. That won't 0:19:37.560 --> 0:19:41.080 be perfect all the time. We will have sleepless nights, 0:19:41.160 --> 0:19:44.040 but sleepless nights are a normal variant that that's what 0:19:44.160 --> 0:19:46.960 happens to people. It only becomes insomnia when you're scared 0:19:47.040 --> 0:19:51.040 of it. So understanding that I'm going to set aside 0:19:51.240 --> 0:19:54.200 a proper amount of time to sleep. I'm gonna use 0:19:54.240 --> 0:19:57.359 it tonight or I won't. But that's not something that 0:19:57.400 --> 0:20:00.680 I can really control. And you know, always tell people 0:20:00.680 --> 0:20:02.960 the secret to great sleep is feeling is happy and 0:20:03.040 --> 0:20:05.320 bed awake as you are asleep. So I think that 0:20:05.359 --> 0:20:08.040 when you release fear from the process of sleep, it's 0:20:08.080 --> 0:20:11.480 incredibly empowering. So after you've done that, you create a 0:20:11.480 --> 0:20:14.800 schedule that gives you an ample opportunity to sleep, start 0:20:14.800 --> 0:20:17.000 your time off every day. At the same time, you've 0:20:17.000 --> 0:20:20.520 got to exercise, you gotta eat right. Mindfulness is not 0:20:20.680 --> 0:20:23.760 something the younger sleep doctor Winter would have told you 0:20:23.880 --> 0:20:26.720 was that important, but the older sleep doctor thinks it's everything. 0:20:27.920 --> 0:20:32.040 So between sleep studies, communication and sleep metrics, it sounds 0:20:32.080 --> 0:20:34.359 like you have a lot of different techniques at your disposal, 0:20:35.200 --> 0:20:38.560 a lot of tools, and the techniques are constantly evolving. 0:20:39.240 --> 0:20:42.000 The take of sleep study has become very popular versus 0:20:42.040 --> 0:20:45.280 strictly in lab studies, and the culture of sleep has 0:20:45.400 --> 0:20:48.280 changed a lot too, And I get a first row 0:20:48.359 --> 0:20:50.840 seat to that when I talk to sleep experts in 0:20:50.920 --> 0:20:57.280 my work with Mattress Firm. I think throughout the years 0:20:58.359 --> 0:21:00.719 the only thing that's really changed is that we are 0:21:00.880 --> 0:21:04.880 We're now what we used to joke about, we're we're 0:21:04.880 --> 0:21:07.200 no longer joking about it, right. So we used to 0:21:07.280 --> 0:21:12.000 joke about and almost brag about how little sleep we 0:21:12.080 --> 0:21:15.919 need to function right, And now I feel like, instead 0:21:15.960 --> 0:21:19.280 of joking about that, we're taking it more seriously than 0:21:19.359 --> 0:21:21.640 than we have in the past. It's it's still there, 0:21:21.680 --> 0:21:23.800 We're still saying the same thing, but instead of being 0:21:23.840 --> 0:21:27.040 proud that only got three hours of sleep, now it's 0:21:27.119 --> 0:21:29.520 I only got three hours of sleep, and it's not 0:21:29.560 --> 0:21:31.720 like you can make that up. It's it's lost, right. 0:21:32.200 --> 0:21:34.359 So I think making it more of a focus taking 0:21:34.359 --> 0:21:40.800 it serious. I think that's the big difference. Besides the 0:21:40.840 --> 0:21:44.080 tools we talked about, both doctors had interesting ways to 0:21:44.119 --> 0:21:47.040 bring that extra bit of care to their practices. Logan 0:21:47.080 --> 0:21:50.480 explained that when doctors undergo sleep studies themselves, it helps 0:21:50.520 --> 0:21:53.840