WEBVTT - Working to Sleep and Sleeping at Work 0:00:05.559 --> 0:00:08.719 I think sleep has certainly come a long way, particularly 0:00:08.800 --> 0:00:11.920 as very many luminaries in the field have gone from 0:00:11.960 --> 0:00:14.400 the basic mechanisms of what's going on in the brain, 0:00:14.520 --> 0:00:18.000 what circuits and what neurotransmitters are being released and at 0:00:18.000 --> 0:00:20.800 what times all the way up to well, how is 0:00:20.840 --> 0:00:23.279 sleep actually affecting us? How does it affect our mood 0:00:23.440 --> 0:00:25.479 or decisions to what we eat during the day, How 0:00:25.480 --> 0:00:28.240 does it affect our metabolism. 0:00:28.400 --> 0:00:31.760 Logan Schneider is a medical doctor and board certified clinician 0:00:31.960 --> 0:00:35.159 who specializes in the treatment of sleep disorders that includes 0:00:35.200 --> 0:00:40.839 things like sleep apnea, narcolepsy, insomnia, restless leg syndrome, sleepwalking, 0:00:41.200 --> 0:00:44.920 and ramsleep behavior disorder. He's earned awards and honors from 0:00:44.960 --> 0:00:48.320 the American Academies of Sleep Medicine and Neurology. I sat 0:00:48.360 --> 0:00:51.199 down with Logan to get a better idea of exactly 0:00:51.440 --> 0:00:54.800 how sleep research is done and its real impact on 0:00:54.880 --> 0:00:56.440 patients who struggle with sleep. 0:00:57.480 --> 0:00:59.880 The nice part about being a sleep specialist is that 0:01:00.160 --> 0:01:02.760 you get to benefit from a community of all these 0:01:02.760 --> 0:01:05.440 different types of clinicians that are interested in sleep. I 0:01:05.520 --> 0:01:08.360 went by path of the neurology residency training, but you 0:01:08.400 --> 0:01:12.800 can come through internal medicine, pediatrics, family medicine, and a sociology. 0:01:13.080 --> 0:01:16.520 Then once you've done your primary training in residency, you 0:01:16.560 --> 0:01:19.440 then typically do a year or maybe two year sleep 0:01:19.480 --> 0:01:23.400 in research or just sleep clinical sleep fellowship that specializes 0:01:23.440 --> 0:01:26.280 you by learning everything there is to know really about 0:01:26.280 --> 0:01:28.920 sleep in that one year, and then go and take 0:01:28.959 --> 0:01:32.040 your examinations and get certified, and then you start practicing 0:01:32.080 --> 0:01:32.720 sleep hopefully. 0:01:33.760 --> 0:01:36.400 I also reached out to Chris Winter. He's a medical 0:01:36.400 --> 0:01:39.040 doctor with years of experience in the field. He's a 0:01:39.040 --> 0:01:42.280 neurologist and a sleep specialist who authored two books, The 0:01:42.319 --> 0:01:45.399 Sleep Solution and The Rested Child. He gave us some 0:01:45.560 --> 0:01:48.760 additional insight into this field and how it continues to evolve. 0:01:49.880 --> 0:01:52.720 One of the nice things about the changes in technology 0:01:52.800 --> 0:01:57.000 is that has taken different shape as time has passed. 0:01:57.040 --> 0:02:00.400 So the original sleep studies we did, I mean, if 0:02:00.400 --> 0:02:02.520 you talk to all the people who were sort of 0:02:02.560 --> 0:02:06.160 the first generation sleep doctors, and we're not that far 0:02:06.240 --> 0:02:10.520 removed from them, those sleep studies were very primitive. I 0:02:10.520 --> 0:02:13.959 mean they were sort of experimenting with this. They were 0:02:14.080 --> 0:02:16.440 trying to figure out where there are ways to capture 0:02:16.600 --> 0:02:19.800 information about sleep. And that's changed to the point where 0:02:19.840 --> 0:02:22.040 a lot of the sleep assessments that we do in 0:02:22.040 --> 0:02:26.080 individuals happens in a person's own bed. 0:02:27.400 --> 0:02:31.080 We've had an interesting journey so far talking extensively about 0:02:31.120 --> 0:02:34.800 the science of sleep and showcasing examples of people with 0:02:35.040 --> 0:02:39.520 very unique sleeping patterns and challenges. Today, we're going right 0:02:39.560 --> 0:02:43.000 to the source, to the sleep researcher. We'll find out 0:02:43.040 --> 0:02:45.440 what it's like being at the forefront of one of 0:02:45.440 --> 0:02:47.959 the newest and most interesting fields in healthcare. 0:02:54.000 --> 0:02:54.160 Hi. 0:02:54.720 --> 0:02:59.040 I'm Anahad O'Connor, and this is Chasing Sleep and iHeartRadio 0:02:59.120 --> 0:03:08.640 production and partnership with Mattress Firm. 0:03:08.760 --> 0:03:11.480 About a year ago, I decided I was going to 0:03:11.560 --> 0:03:14.680 visit a Mattress firm in every state of the Union. 0:03:17.360 --> 0:03:21.560 I'm really interested in the perspective on the ground. Mattress 0:03:21.600 --> 0:03:24.799 Firm sleep experts. They see it all and you never 0:03:24.880 --> 0:03:27.680 know what new nuggets of sleep you'll learn about. In fact, 0:03:27.680 --> 0:03:29.760 that a great conversation with the manager from one of 0:03:29.760 --> 0:03:31.040 their locations in Texas. 0:03:33.520 --> 0:03:36.320 My name is Raoul Davila. I'm a senior store manager 0:03:36.360 --> 0:03:40.200 for Mattress Firm out of Houston, Texas. It's interesting because 0:03:40.240 --> 0:03:43.840 throughout the years, right you start to see all walks 0:03:43.880 --> 0:03:46.920 of life and all the different issues that are out there. 0:03:47.160 --> 0:03:51.680 So actually seeing guests come in with those issues saying 0:03:51.680 --> 0:03:54.280 that they're not sleeping at night, that they're not getting 0:03:54.680 --> 0:03:58.640 the recommended amount of hours of sleep, that they're being 0:03:58.760 --> 0:04:03.080 impacted at their jobs firsthand. Hearing those stories from my 0:04:03.240 --> 0:04:08.040 guests really puts it in perspective. People are not sleeping well, 0:04:08.520 --> 0:04:11.160 and it all starts with what you're sleeping on. I 0:04:11.240 --> 0:04:14.000 mean that has a huge advantage on getting the sleep 0:04:14.040 --> 0:04:15.080 that we all need. 0:04:15.960 --> 0:04:19.440 So I find it really interesting to talk to the 0:04:19.480 --> 0:04:22.520 sleep experts about and what do they see, What kinds 0:04:22.560 --> 0:04:28.159 of problems have they been confronted with. These individuals are 0:04:28.360 --> 0:04:32.680 using their pretty profound expertise. I mean, they get hundreds 0:04:32.720 --> 0:04:36.080 of hours of sleep training to do more than just 0:04:36.120 --> 0:04:39.760 sell a mattress. They're really trying to help people solve 0:04:39.880 --> 0:04:41.559 sleep problems. 0:04:42.120 --> 0:04:45.800 Whether your sleeping habits are common or uncommon. We have 0:04:46.080 --> 0:04:50.200 the curious researchers to thank for blowing this relatively new 0:04:50.279 --> 0:04:54.120 science completely open. When I sat down with Logan, he 0:04:54.360 --> 0:04:57.640 was enthusiastic about his work and eager to tell me 0:04:57.680 --> 0:05:01.800 all about it. So put us in your clinic, I'd 0:05:01.839 --> 0:05:02.719 love to know what it's like. 0:05:05.320 --> 0:05:08.200 Yeah, well it's a mostly outpatient clinical practice, which is 0:05:08.240 --> 0:05:11.560 really nice about sleep medicine, Like, there are virtually no 0:05:11.640 --> 0:05:13.800 sleep emergencies that I can think of and certainly don't 0:05:13.800 --> 0:05:15.839 get called in. The nice part about sleep is you 0:05:15.880 --> 0:05:17.320 get to I feel that you get to spend a 0:05:17.360 --> 0:05:20.760 lot of time talking to people about their history because 0:05:20.760 --> 0:05:24.520 that's a significant portion of the evaluation of sleep disorders. Right. 0:05:24.560 --> 0:05:26.520 There isn't much of an examination that you can do 0:05:26.600 --> 0:05:29.039 for sleep other than the actual in lab or home 0:05:29.040 --> 0:05:31.839 sleep study or some other diary or other measures. So 0:05:32.160 --> 0:05:35.200 it's really gathering a story getting to understand people's experiences. 0:05:35.240 --> 0:05:37.360 And the things that we do in our sleep are 0:05:37.520 --> 0:05:41.200 really astounding, eating tubes of toothpaste or driving cars, all 0:05:41.240 --> 0:05:43.520 sorts of crazy stuff. So it's really interesting to hear 0:05:43.960 --> 0:05:47.520 people's experiences with sleep that we never thought possible. We 0:05:47.520 --> 0:05:49.560 all experience sleep a lot of it, and so we 0:05:49.560 --> 0:05:51.680 think we're quite expert at it, but every day I 0:05:51.720 --> 0:05:52.359 get a surprise. 0:05:53.760 --> 0:05:57.039 Very interesting to think about how important the story behind 0:05:57.080 --> 0:06:01.440 each sleeping problem is, which makes sense considering how specific 0:06:01.760 --> 0:06:05.839 and unique each person sleeping circumstances are. Chris found the 0:06:05.839 --> 0:06:07.760 same thing to be true in his own practice. 0:06:09.520 --> 0:06:11.719 Getting the patients side of the story is one of 0:06:11.760 --> 0:06:14.320 the most important techniques for finding out what's going on 0:06:14.360 --> 0:06:17.040 with their sleep. It won't give us the whole picture, 0:06:17.120 --> 0:06:20.920 of course, but if it just rules things out, it's useful. 0:06:21.279 --> 0:06:24.240 We do this from a medical standpoint. But Roll told 0:06:24.279 --> 0:06:26.719 me how sleep experts at mattress firm use the same 0:06:26.800 --> 0:06:29.200 methods with customers as we do with patients. 0:06:31.560 --> 0:06:33.560 When I have a guess that comes in and they're 0:06:33.600 --> 0:06:35.599 looking for me to solve a problem, I mean it 0:06:35.640 --> 0:06:39.320 almost comes down to the support or lack thereof. For 0:06:39.360 --> 0:06:43.320 some reason, they are not happy with the current sleeping situation. 0:06:44.080 --> 0:06:46.839 So it's my job to really ask those questions to 0:06:46.920 --> 0:06:49.920 make sure that we're going to find the right mattress. 0:06:50.040 --> 0:06:53.279 If I'm not asking the right questions, I'm really not 0:06:53.560 --> 0:06:57.040 solving the right problem. When you go see a doctor, 0:06:57.520 --> 0:07:00.360 they're asking questions to try to diagnose something the just 0:07:00.880 --> 0:07:03.560 randomly throwing darts out aboard. They're going to ask the 0:07:03.600 --> 0:07:06.400 right questions to make sure that they can make the 0:07:06.480 --> 0:07:09.720 right recommendation. It's just listening to the guests and really 0:07:09.720 --> 0:07:10.800 hearing them out. 0:07:12.160 --> 0:07:15.880 When you are studying patients, in their sleep. What are 0:07:15.880 --> 0:07:18.880 you typically looking for? What tools are you using? 0:07:19.560 --> 0:07:21.400 Yeah, there are all sorts of tools that we have 0:07:21.440 --> 0:07:24.920 at our disposal. Some of them are pretty rudimentary. The 0:07:24.960 --> 0:07:27.200 classic sleep diary where people print out the sheet of 0:07:27.200 --> 0:07:30.080 paper and fill out their sleep diary. Maybe that could 0:07:30.080 --> 0:07:34.960 be supplanted by some helpful objective monitoring through various technologies, 0:07:35.080 --> 0:07:37.680 things like an actigraph which is a watch almost like 0:07:37.720 --> 0:07:41.800 a standard sports or sleep fitness tracker, where it tracks 0:07:41.960 --> 0:07:46.240 movement and light. Sometimes that helps us understand patterns over 0:07:46.280 --> 0:07:49.440 time that can complement a sleep diary. But then the 0:07:49.520 --> 0:07:52.680 major diagnostic tools we have are those things like a 0:07:52.680 --> 0:07:56.120 sleep study, and the sleep study in lab requires a 0:07:56.120 --> 0:07:58.800 specialized technician. Those are the people who are there overnight 0:07:58.840 --> 0:08:00.720 to help make sure that things are going well because 0:08:00.760 --> 0:08:02.600 there are a lot of wires, a lot of tubes, 0:08:02.640 --> 0:08:05.720 a lot of things to monitor various body signals, from 0:08:05.800 --> 0:08:08.760 brain wave activity to eye movements, to muscle activity in 0:08:08.800 --> 0:08:12.000 the face and muscles of the legs, to looking at 0:08:12.160 --> 0:08:16.320 heartbeat and oxygenation and pulse and breathing effort. So that 0:08:16.360 --> 0:08:19.320 we're really gathering a very rich data set to understand 0:08:19.400 --> 0:08:21.000 all of the different things that could be going on 0:08:21.040 --> 0:08:21.440 in sleep. 0:08:24.760 --> 0:08:28.120 These sophisticated ways to measure our bodies and our brains 0:08:28.120 --> 0:08:32.920 while we sleep clearly require equally sophisticated training, but it 0:08:32.920 --> 0:08:35.400 seems like there are also multiple ways to dive into 0:08:35.400 --> 0:08:38.160 this field. I mean, I personally have learned a whole 0:08:38.200 --> 0:08:41.079 lot about the science of sleep just by doing research 0:08:41.120 --> 0:08:44.320 as a journalist and by interviewing experts like yourself. 0:08:45.040 --> 0:08:49.479 Absolutely, they're obviously doctors like Logan and myself who specialize 0:08:49.520 --> 0:08:52.600 in the medical realm of sleep. But the beautiful thing 0:08:52.640 --> 0:08:56.000 about this science is there are multiple avenues to approach 0:08:56.040 --> 0:08:59.160 it from a journalistic approach, as you mentioned in a 0:08:59.240 --> 0:09:02.400 number of other ways. In my conversation with Roll, he 0:09:02.440 --> 0:09:04.920 told me how he and other in store sleep experts 0:09:04.960 --> 0:09:10.960 complete over two hundred hours of training. Can you tell 0:09:11.000 --> 0:09:14.520 us more about your training as a mattress firm sleep 0:09:14.559 --> 0:09:16.319 expert and what it involves. 0:09:16.960 --> 0:09:20.760 Yeah. Absolutely, so. When we use the term sleep expert, 0:09:20.760 --> 0:09:23.160 we don't use it lightly at all. There's hundreds of 0:09:23.240 --> 0:09:28.000 hours of hands on training that we do here in 0:09:28.040 --> 0:09:30.400 the store, and we talk about the quality of sleep, 0:09:30.480 --> 0:09:33.240 we talk about the type of mattresses we have, how 0:09:33.400 --> 0:09:36.520 we can connect the two, how a mattress can help 0:09:36.559 --> 0:09:39.560 increase the quality of sleep. We're the only ones that 0:09:39.640 --> 0:09:43.680 are really diving in to learn about sleep, and you 0:09:43.720 --> 0:09:46.439 know how that can benefit you and what can happen 0:09:46.440 --> 0:09:48.600 if you don't get the right amount of sleep. There's 0:09:48.640 --> 0:09:51.280 so much out there on sleep that we still don't 0:09:51.280 --> 0:09:56.840 know about. But if we can pair what's happening with 0:09:57.120 --> 0:10:00.640 my guests to a certain mattress and a cert and feature, 0:10:00.800 --> 0:10:03.720 I think that's when we get that aha moment where 0:10:03.800 --> 0:10:06.640 you know, that's exactly what's happening to me and this 0:10:06.800 --> 0:10:08.199 is exactly what I need. 0:10:11.240 --> 0:10:13.160 We'll be right back after a brief message from our 0:10:13.160 --> 0:10:23.760 partners at Mattress Firm, and now back to chasing sleep. 0:10:27.960 --> 0:10:31.319 Doctor Logan Schnyder broke down the different types of sleeping disorders. 0:10:32.360 --> 0:10:35.440 We have a set of about six disorder categorizations that 0:10:35.480 --> 0:10:38.280 we can then subdivide into. You have a breathing disorder. 0:10:38.360 --> 0:10:40.320 Is it a breathing disorder because of a blockage like 0:10:40.320 --> 0:10:43.120 obstructive seatp apnea? Is it central meaning that your brain 0:10:43.160 --> 0:10:45.559 is not triggered to breathe, maybe because of a medication 0:10:45.640 --> 0:10:48.840 you're taking. We have all of these different signals that 0:10:49.040 --> 0:10:51.160 different chunks of them can tell us different things about 0:10:51.200 --> 0:10:53.680 your sleep. If we don't need all of that, we're 0:10:53.679 --> 0:10:55.760 not looking for a more complicated disorder, but something more 0:10:55.840 --> 0:10:57.880 run of the mill. Sometimes we can farm that out 0:10:57.880 --> 0:11:00.040 to like a home based diagnostic study where we just 0:11:00.080 --> 0:11:04.240 look for breathing effort problems and oxygen problems where the 0:11:04.240 --> 0:11:06.800 blood is not getting enough oxygen because the breathing is impaired, 0:11:06.840 --> 0:11:09.000 to something like for just substructive sleep apnea, a little 0:11:09.000 --> 0:11:11.000 bit easier to descend to the home. But if you 0:11:11.040 --> 0:11:15.319 need a more in depth diagnosis looking for more complicated 0:11:15.559 --> 0:11:17.880 sleep disorders, then we want all of those signals, and 0:11:18.080 --> 0:11:19.880 we have video to accompany it to make sure we 0:11:19.920 --> 0:11:22.320 know what's going on. Like when people sleepwalk, you can 0:11:22.360 --> 0:11:24.960 actually see their behaviors and try and differentiate was that 0:11:25.040 --> 0:11:28.199 actual sleepwalking from non dreaming sleep or was this guy 0:11:28.360 --> 0:11:31.080 of a dream based sleep disorder. It's important to know 0:11:31.120 --> 0:11:33.440 what stage of sleep you're in to know what's going on. 0:11:33.960 --> 0:11:36.760 So there are different types of sleepwalking based on the 0:11:36.760 --> 0:11:38.080 stage of sleep that they're in. 0:11:38.360 --> 0:11:40.520 Exactly, and it could even not be standard run of 0:11:40.559 --> 0:11:44.920 the mill sleepwalking, which is a relatively benign disorder unless 0:11:44.960 --> 0:11:47.360 it causes problems like somebody driving a car. We all sleep, 0:11:47.679 --> 0:11:49.760 but then we are trying to differentiate what's going on 0:11:49.800 --> 0:11:51.600 in your sleep. Right, people come to us and say, hey, 0:11:51.920 --> 0:11:54.240 I'm doing this weird thing, and we don't know. We 0:11:54.280 --> 0:11:56.520 can't know unless we're actually looking at what your brain 0:11:56.559 --> 0:11:58.199 is doing. And that's really worth capturing it on a 0:11:58.280 --> 0:12:00.960 video and also looking at all these bios all at 0:12:00.960 --> 0:12:02.320 once can help us differentiate that. 0:12:02.960 --> 0:12:06.760 And with insomnia, for example, what are some of the 0:12:06.800 --> 0:12:09.240 sort of common things that you see causing that. Is 0:12:09.240 --> 0:12:12.000 it going to be a person's you know, their sleep environment, 0:12:12.320 --> 0:12:15.319 or is it typically stress or anxiety or their job, 0:12:15.600 --> 0:12:20.160 or do you see common sort of themes underlying people's insomnia. 0:12:20.360 --> 0:12:23.400 Yeah, there are a lot of commonalities in general and sleep, 0:12:23.720 --> 0:12:27.520 and particularly for insomnia. There are various constructs, various groups 0:12:27.520 --> 0:12:30.840 described to different ways of thinking about this, but one 0:12:30.880 --> 0:12:33.760 common model is called a three P model, where somebody 0:12:33.840 --> 0:12:37.360 might be predisposed. It might be your genetics that predisposes 0:12:37.400 --> 0:12:40.280 you to having sleepwalking similar type of thing here, So 0:12:40.280 --> 0:12:43.800 that's the predisposition, and then you have a precipitating factor. 0:12:43.800 --> 0:12:46.360 Often one big precipitating factor for a lot of people 0:12:46.400 --> 0:12:49.080 actually happen to be the pandemic. Was it the stress 0:12:49.120 --> 0:12:51.600 of the pandemic? Was it the change in your schedule, 0:12:51.720 --> 0:12:55.000 even the opportunity to sleep more that actually cause you 0:12:55.040 --> 0:12:58.560 to develop an insomnia. So then there's that precipitating event 0:12:58.640 --> 0:13:02.120 that causes the insomnia happen. And then after that, when 0:13:02.120 --> 0:13:05.040 we see insomnia eventually come to us in the sleep clinic, 0:13:05.120 --> 0:13:07.880 often because that's an acute in Zombia, 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, it lasts 0:13:11.920 --> 0:13:13.439 for a long period of time, and that's where we 0:13:13.520 --> 0:13:15.680 have to worry about these factors that perpetuate it. That's 0:13:15.679 --> 0:13:19.320 the third p Things that people are doing in response 0:13:19.360 --> 0:13:21.679 to their insomnia that then keep it going on. So 0:13:21.720 --> 0:13:24.840 some people will stay in bed a lot longer hoping 0:13:24.880 --> 0:13:28.319 that sleep will come, and unfortunately that inherently induces in insomnia. 0:13:28.360 --> 0:13:29.880 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 --> 0:13:35.559 have two hours. So people will do different behaviors or 0:13:35.600 --> 0:13:38.320 even have thought patterns. Even the bed alone will make 0:13:38.360 --> 0:13:40.880 them anxious about going to bed, and so they're terrified. Oh, 0:13:40.920 --> 0:13:42.439 oh man, am I going to be able to sleep tonight? 0:13:42.679 --> 0:13:44.920 So it's these thought patterns and behaviors that keep it 0:13:45.240 --> 0:13:46.360 kind of rolling on. 0:13:46.720 --> 0:13:48.680 That sounds like Pavlovian conditioning. 0:13:49.040 --> 0:13:50.120 I was just want to say that, I was gonna 0:13:50.120 --> 0:13:52.240 say one of the most common things that's referencing poun 0:13:52.280 --> 0:13:55.760 Love's dog is people create this association with bed that 0:13:55.880 --> 0:14:01.360 is actually both physically activating as well as cognitive emotionally activating, 0:14:01.400 --> 0:14:04.000 so they actually just even being in bed. Stimulus control 0:14:04.040 --> 0:14:05.240 is one of the things that we use is to 0:14:05.280 --> 0:14:08.319 separate the stimulus of the bed from the sense of wakefulness. 0:14:08.320 --> 0:14:10.680 And if we can effectively do that, people then start 0:14:10.720 --> 0:14:12.520 to get used to, oh, the bed is for sleep again. 0:14:12.559 --> 0:14:15.000 So yeah, it's exactly Pavlovas dog. You got it. 0:14:15.280 --> 0:14:18.560 So you have to retrain their brains to view their 0:14:18.559 --> 0:14:21.600 bed as not a place of stress and anxiety and insomnia, 0:14:21.680 --> 0:14:26.120 but a sanctuary of sleep. A sanctuary of sleep is 0:14:26.160 --> 0:14:29.280 definitely my new favorite term for my bedroom, and it 0:14:29.320 --> 0:14:33.800 really highlights just how important being physically and mentally comfortable 0:14:33.880 --> 0:14:36.800 is to our health. Throughout this series, one of the 0:14:36.800 --> 0:14:40.240 most fascinating aspects of sleep science that we've looked at 0:14:40.680 --> 0:14:43.120 is the amount of power that our brains have to 0:14:43.200 --> 0:14:47.040 perform certain functions completely on their own. And one of 0:14:47.040 --> 0:14:51.120 the best examples of how overwhelmingly strong our mental capacities 0:14:51.160 --> 0:14:54.880 can be, even on autopilot is the disorder that many 0:14:54.880 --> 0:15:00.520 people suffer from known as sleepwalking. You know, what are 0:15:00.520 --> 0:15:02.000 some of the common things that you see when people 0:15:02.080 --> 0:15:06.560 are sleepwalking? And what is the cause of sleepwalking? Generally speaking? 0:15:07.040 --> 0:15:10.600 Yeah, well, we don't know what the underlying cause of 0:15:10.640 --> 0:15:13.200 sleepwalking is. It just is that some people have a 0:15:13.360 --> 0:15:16.120 tendency to do it and others don't, which would suggest 0:15:16.120 --> 0:15:21.280 that maybe there's a underlying genetic predisposition. It might be 0:15:21.360 --> 0:15:24.400 that their body doesn't do a good job of suppressing 0:15:24.480 --> 0:15:27.520 motor activity or doesn't do a good job of waking 0:15:27.600 --> 0:15:30.880 up fully when it starts to do motor activity, for example. Right, 0:15:30.920 --> 0:15:33.240 So it could be something in that kind of pathway, 0:15:33.280 --> 0:15:36.920 because to sleep, you have to maintain sleep while you 0:15:37.000 --> 0:15:40.360 might actually have brain activity that would suggest wake for example. 0:15:41.040 --> 0:15:44.240 But what can trigger sleepwalking typically or the things that 0:15:44.280 --> 0:15:47.520 you might see like I had in residency, So excessive 0:15:47.560 --> 0:15:51.040 amounts of deep slow wave sleep that can come from 0:15:51.280 --> 0:15:55.040 chronic sleep deprivation, sometimes drinking alcohol can be a trigger 0:15:55.080 --> 0:15:57.160 for it. Another thing that makes it more likely to 0:15:57.160 --> 0:15:59.960 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 0:16:02.240 --> 0:16:05.000 so probability would be if you have more of the 0:16:05.000 --> 0:16:08.880 slow wave sleep and your brain hasn't matured enough to 0:16:08.880 --> 0:16:11.800 have all of these systems working together to promote stages 0:16:11.840 --> 0:16:14.760 of sleep or states of sleep, then there's a higher 0:16:14.840 --> 0:16:17.680 chance that they might actually have an event where they sleepwalk. Right, Like, 0:16:17.960 --> 0:16:21.320 the trigger could be in them a bladder feeling full 0:16:21.440 --> 0:16:22.800 and they have to go to the bathroom, but it 0:16:22.800 --> 0:16:25.120 happens to be right in the middle of the deepest 0:16:25.120 --> 0:16:27.120 part of sleep where they're the most inactive. Well, that 0:16:27.160 --> 0:16:31.960 triggers them enough to become awake but not conscious. You 0:16:32.040 --> 0:16:33.280 have to be in the right state. So if you 0:16:33.320 --> 0:16:35.800 have more of that state, the deep sleep, then you're 0:16:35.800 --> 0:16:37.320 more likely to have an event. And if you have 0:16:37.440 --> 0:16:39.640 a trigger in that state, well, then it's more likely 0:16:39.680 --> 0:16:41.920 that you're going to precipitate an event. About ten percent 0:16:41.920 --> 0:16:44.120 of people that will have a sleepwalking event about once 0:16:44.120 --> 0:16:44.600 a year or so. 0:16:45.120 --> 0:16:49.800 Oh wow, and does it usually the person themselves who's 0:16:50.120 --> 0:16:52.760 becomes aware of it or is it sort of like 0:16:53.160 --> 0:16:55.880 sleep happneing like with myself, where it's a partner or 0:16:56.400 --> 0:16:59.800 you know, bed mate who brings it to the person's attention. 0:17:00.280 --> 0:17:03.840 Yeah, it's about a mix. If somebody has something very 0:17:03.880 --> 0:17:07.000 clearly out of place or out of order, that might 0:17:07.040 --> 0:17:10.119 be a good indication. For example, with the sleep eating, 0:17:10.920 --> 0:17:13.240 some people come into 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 0:17:16.080 --> 0:17:19.720 up and unusual contents like crumbs are in their bed 0:17:19.920 --> 0:17:22.160 and they're like, hey, I don't know how these got here. 0:17:22.359 --> 0:17:24.400 I think that's a good indication to people that something 0:17:24.440 --> 0:17:26.280 happened at night and it doesn't make sense. They'll check 0:17:26.280 --> 0:17:28.080 their locks and think that they're going crazy. It's a 0:17:28.080 --> 0:17:30.879 great build up for a sci fi thriller, right, and 0:17:30.920 --> 0:17:33.359 then we now get this bed partner who is somebody 0:17:33.359 --> 0:17:36.480 who can finally observe our sleep for us again, And 0:17:36.520 --> 0:17:39.359 that's when typically these things come to people's awareness, is 0:17:39.400 --> 0:17:41.240 that they have somebody who's like, hey, you did this 0:17:41.680 --> 0:17:43.879 crazy thing last night, or hey you punched me in 0:17:43.920 --> 0:17:46.600 your sleep as everything okay, it sounded like you were 0:17:46.640 --> 0:17:50.520 fighting off like a wolf or something. So it oftentimes 0:17:50.640 --> 0:17:52.919 most of our sleep disorders are recognized when people are 0:17:52.920 --> 0:17:55.359 sleeping in context. That's when you know, even if you're 0:17:55.400 --> 0:17:57.640 sleeping alone, you might catch it on these intermittent cases. 0:17:57.680 --> 0:18:01.360 But oftentimes it's things that are reported that are completely 0:18:01.359 --> 0:18:03.520 out of whack and people think is something wrong with them, 0:18:03.520 --> 0:18:05.160 but they're not likely to report it, like I don't 0:18:05.200 --> 0:18:07.960 know what's going on. Normally it's a bad partner who's like, hey, 0:18:07.960 --> 0:18:09.280 that's weird, go check that out. 0:18:10.240 --> 0:18:13.000 The more we learn about sleep science, the more interesting 0:18:13.040 --> 0:18:17.399 it becomes. Now, Chris, I'm curious as a medical doctor, 0:18:17.480 --> 0:18:20.080 what do you look for and what are your goals 0:18:20.080 --> 0:18:21.840 when it comes to getting good quality sleep? 0:18:22.600 --> 0:18:26.360 Yeah, I love the idea of sleep metrics. I think 0:18:26.359 --> 0:18:29.159 the best way for people to really assess their sleep 0:18:29.280 --> 0:18:31.960 is are you still awake listening to this podcast? Meaning 0:18:32.000 --> 0:18:35.639 that do you struggle with excessive sleepiness during the day? 0:18:36.200 --> 0:18:40.120 So to me, looking at fatigue and sleepiness levels during 0:18:40.119 --> 0:18:41.960 the day, I think is probably the best way to 0:18:42.000 --> 0:18:44.240 determine whether or not somebody's a good sleeper. Somebody says 0:18:44.240 --> 0:18:48.040 to me, I'm so unsleepy that I can't nap. I've 0:18:48.080 --> 0:18:50.040 never taken a nap in my life. It's hard to 0:18:50.040 --> 0:18:52.040 paint them as a bad sleeper. It's kind of like 0:18:52.760 --> 0:18:56.080 want a sandwich, Nope, want a strawberry nope? I want 0:18:56.080 --> 0:18:59.840 a cookie nope. Well, you're probably not hungry, so hard 0:18:59.840 --> 0:19:02.240 to paint that person to somebody who's starving to death. So, 0:19:02.840 --> 0:19:05.639 you know, to me, I think it's really about exploring. 0:19:05.680 --> 0:19:09.440 Sleep studies are awesome, but it all starts with communicating 0:19:09.480 --> 0:19:13.399 with doctor Schneider and sitting down and having questions for 0:19:13.520 --> 0:19:17.280 him and exploring the things that are concerning you about 0:19:17.280 --> 0:19:20.240 your sleep and how sleep interconnects to other parts of 0:19:20.280 --> 0:19:23.639 your health. And you know, sleep studies are often very appropriate, 0:19:23.680 --> 0:19:26.800 but not always, so I don't think everybody should have 0:19:26.800 --> 0:19:29.240 a sleep study. I think the secret to good sleep 0:19:29.280 --> 0:19:32.640 and my secret is I don't worry about it because 0:19:32.880 --> 0:19:35.920 I've learned enough about sleep to know that it's impossible 0:19:36.000 --> 0:19:39.600 not to. It won't be perfect all the time. We 0:19:39.680 --> 0:19:43.600 will have sleepless nights, but sleepless nights are a normal variant. 0:19:43.600 --> 0:19:46.520 That's what happens to people. It only becomes insomnia when 0:19:46.520 --> 0:19:50.359 you're scared of it. So understanding that I'm going to 0:19:50.440 --> 0:19:53.720 set aside a proper amount of time to sleep, I'm 0:19:53.720 --> 0:19:56.639 going to use it tonight or I won't. But that's 0:19:56.680 --> 0:19:59.879 not something that I can really control. And you know, 0:20:00.000 --> 0:20:02.240 always tell people the secret to grade sleep is feeling 0:20:02.280 --> 0:20:04.840 as happy in bed awake as you are asleep. So 0:20:04.920 --> 0:20:07.400 I think that when you release fear from the process 0:20:07.440 --> 0:20:10.920 of sleep, it's incredibly empowering. So after you've done that, 0:20:10.960 --> 0:20:13.480 you create a schedule that gives you an ample opportunity 0:20:13.520 --> 0:20:16.240 to sleep. Start your time off every day at the 0:20:16.280 --> 0:20:19.159 same time you gotta exercise, you got to eat, write. 0:20:19.640 --> 0:20:23.360 Mindfulness is not something the younger sleep doctor Winter would 0:20:23.400 --> 0:20:25.480 have told you was that important, but the older sleep 0:20:25.520 --> 0:20:26.760 doctor thinks it's everything. 0:20:27.920 --> 0:20:32.119 So between sleep studies, communication and sleep metrics, it sounds 0:20:32.119 --> 0:20:35.440 like you have a lot of different techniques at your disposal, a. 0:20:35.400 --> 0:20:39.359 Lot of tools, and the techniques are constantly evolving. The 0:20:39.440 --> 0:20:42.440 take of sleep study has become very popular versus strictly 0:20:42.480 --> 0:20:45.880 in lab studies, and the culture of sleep has changed 0:20:45.880 --> 0:20:48.680 a lot too, and I get a first row seat 0:20:48.720 --> 0:20:51.000 to that when I talk to sleep experts in my 0:20:51.119 --> 0:20:55.120 work with Mattress Firm. 0:20:55.240 --> 0:20:59.359 I think throughout the years, the only thing that's really 0:20:59.440 --> 0:21:04.120 changed that we're now what we used to joke about. 0:21:04.720 --> 0:21:07.159 We're no longer joking about it, right. So we used 0:21:07.160 --> 0:21:11.639 to joke about and almost brag about how little sleep 0:21:11.840 --> 0:21:15.480