WEBVTT - What's the deal with sleep? 0:00:00.680 --> 0:00:04.920 Emily. Back when I was a resident in internal medicine 0:00:04.920 --> 0:00:07.280 at the Hospital University of Pennsylvania, we used to do 0:00:07.360 --> 0:00:11.320 these thirty hour call shifts. So you'd get there at 0:00:11.400 --> 0:00:15.280 like six in the morning and you'd stay, you know, 0:00:15.560 --> 0:00:17.520 all the way through the night, and then you'd leave 0:00:17.560 --> 0:00:19.600 at one pm the next day. 0:00:19.920 --> 0:00:22.200 It's no good, that's not good. That's not a good doctor. 0:00:22.320 --> 0:00:24.119 I do not want to see you at noon on 0:00:24.200 --> 0:00:25.240 that day, that's for sure. 0:00:25.680 --> 0:00:30.160 Well, that's this. This episode on Sleep had me reflecting 0:00:30.200 --> 0:00:34.120 back with mild PTSD on like the state I was 0:00:34.159 --> 0:00:36.600 in at one pm driving home. By the way, I 0:00:36.600 --> 0:00:39.279 had a very good friend in this situation who got 0:00:39.280 --> 0:00:42.040 in a car accident and lacerated her spleen and it 0:00:42.120 --> 0:00:44.519 had to be removed, and like, this is a this 0:00:44.640 --> 0:00:47.360 is a real problem. They limit the hours doctors can 0:00:47.400 --> 0:00:51.080 work to shorter than thirty now, thank goodness. But one 0:00:51.080 --> 0:00:54.600 of the experiences we all had after being awake for 0:00:54.640 --> 0:00:57.480 thirty hours and going home is something we labeled post 0:00:57.520 --> 0:01:02.160 call temperature dysregulation, which I have never seen officially studied, 0:01:02.360 --> 0:01:05.360 but it was this phenomenon where you would just be 0:01:05.600 --> 0:01:10.800 like shaking with cold, like you could no longer something 0:01:10.920 --> 0:01:11.280 was fun. 0:01:11.319 --> 0:01:12.800 It was like that was like we got to give 0:01:12.880 --> 0:01:14.200 up on temperature regulation. 0:01:14.480 --> 0:01:17.080 Yeah, it was just it was like something was fundamentally broken. 0:01:17.240 --> 0:01:20.399 And you know, I would drive home and I would stop, 0:01:20.440 --> 0:01:23.360 this is horrible. I would stop at this amazing little 0:01:23.360 --> 0:01:26.800 bodega and get like a chicken cheese steak because I 0:01:26.840 --> 0:01:29.800 was so hungry and cold and shaking, and I would 0:01:29.800 --> 0:01:32.000 sit on my couch and I would like eat the 0:01:32.040 --> 0:01:35.520 whole cheese steak, you know, still in my scrubs, and 0:01:35.520 --> 0:01:38.200 then I would like lie on the couch and fall 0:01:38.560 --> 0:01:42.280 fall into the like unhealthiest coma and then wake up, 0:01:42.280 --> 0:01:43.840 you know, at nine pm, and be up for a 0:01:43.840 --> 0:01:45.440 couple hours and then sleeping and then go in the 0:01:45.440 --> 0:01:49.120 next day. It was. It was crazy. And it's just 0:01:49.240 --> 0:01:53.280 one of many examples of how much we take sleep 0:01:53.320 --> 0:01:56.320 for granted, because when you don't get it, you are 0:01:57.000 --> 0:01:57.560 in trouble. 0:01:57.880 --> 0:02:00.800 And we're going to talk about that today and also 0:02:00.840 --> 0:02:03.840 why it makes you eat too much cheese steak and 0:02:05.280 --> 0:02:06.000 be really cold. 0:02:06.200 --> 0:02:07.200 So let's do it. 0:02:09.919 --> 0:02:13.000 I'm Emily ast I'm an economist and a data expert. 0:02:13.080 --> 0:02:16.160 And I'm Perry Wilson. I'm a medical doctor. It's Thursday, 0:02:16.240 --> 0:02:19.560 June eighteenth, twenty twenty six. And this is wellness actually, 0:02:20.200 --> 0:02:23.639 because you're getting a staggering amount of health and wellness 0:02:23.680 --> 0:02:27.519 information nowadays from every source imaginable, and some of it 0:02:27.560 --> 0:02:29.079 is awesome and some. 0:02:29.040 --> 0:02:34.240 Of it is well actually both Fortunately we are both 0:02:34.280 --> 0:02:36.840 people who know how to read studies, how to parse 0:02:36.880 --> 0:02:39.560 the data, and can tell you what's worth thinking about 0:02:39.600 --> 0:02:41.360 and what you can safely ignore. 0:02:41.720 --> 0:02:43.959 But before we dig in, a note that this podcast 0:02:44.080 --> 0:02:46.639 is for educational purposes and should not be construed as 0:02:46.639 --> 0:02:49.880 medical advice. We don't know your unique situation, so talk 0:02:49.880 --> 0:02:54.239 to your doctor for personal health decisions. This week we're 0:02:54.280 --> 0:02:57.600 asking what's the deal with sleep? Emily and I will 0:02:57.600 --> 0:03:00.600 give the official smash or pass, and then we'll get 0:03:00.600 --> 0:03:02.960 to your question of the week. But first let's do 0:03:03.160 --> 0:03:18.080 the health news roundup. After the break and we're back 0:03:18.160 --> 0:03:20.920 with the health news of the week. This is a 0:03:21.040 --> 0:03:25.040 special health news because my intrepid co host Emily is 0:03:25.080 --> 0:03:29.240 on vacation, so you get a solo Parry set of 0:03:29.280 --> 0:03:32.320 health news. But don't worry, Emily will be joining us 0:03:32.480 --> 0:03:34.760 when we ask what's the deal with sleep very shortly, 0:03:35.400 --> 0:03:38.120 so buckle in, folks, it's just me today. And we're 0:03:38.160 --> 0:03:42.080 going to start with screwworm. I've been getting a lot 0:03:42.080 --> 0:03:45.880 of questions about screw worm and the screw worm response lately, 0:03:45.960 --> 0:03:51.120 So what's going on with this invasive species. A couple 0:03:51.160 --> 0:03:53.839 of things that people need to know about screwworm. Number One, 0:03:54.360 --> 0:03:57.840 they're not worms. Screwworms are the larva of a species 0:03:57.880 --> 0:04:04.240 of blowfly, and unlike most fly larvae, they eat living 0:04:04.360 --> 0:04:09.320 flesh instead of dead or decaying tissue. That is fairly unique. 0:04:09.400 --> 0:04:13.120 And so these flies will come and lay hundreds of 0:04:13.200 --> 0:04:18.000 eggs near an open wound or another insect bite, or 0:04:18.680 --> 0:04:21.440 near a sensitive part typically of cattle, like around the 0:04:21.480 --> 0:04:26.400 eyes or nose, and when the magattatch, they start eating 0:04:26.400 --> 0:04:29.480 the living tissue, which can lead to secondary infection and 0:04:29.600 --> 0:04:34.840 death blow. The screwworm was eradicated in the US in 0:04:35.000 --> 0:04:38.680 nineteen eighty two, and over the following decade was pushed 0:04:38.760 --> 0:04:42.480 all the way south through Central America and past Panama, 0:04:43.600 --> 0:04:47.200 and that had been the state of play until twenty 0:04:47.279 --> 0:04:53.080 twenty four, when it re emerged in Mexico. June third, 0:04:53.240 --> 0:04:56.040 twenty twenty six, just a couple of weeks ago, there 0:04:56.120 --> 0:04:59.960 was the first case in the US, which was in tech. 0:05:00.640 --> 0:05:02.800 I think it's worth noting how we got rid of 0:05:02.800 --> 0:05:05.279 screwworm in the first place. We used something called the 0:05:05.320 --> 0:05:11.200 steril insect technique. So the screw worm flies, the women 0:05:11.360 --> 0:05:14.680 only mate once in their lifetime. The women, the females 0:05:15.120 --> 0:05:20.800 only mate once in their lifetime, and they store that 0:05:20.920 --> 0:05:26.839 sperm and lay multiple clutches of eggs over you over 0:05:26.960 --> 0:05:29.280 the next months and things like that. But they only 0:05:29.320 --> 0:05:33.000 mate that one time. And so what the USDA had 0:05:33.040 --> 0:05:37.080 been doing is breeding these sterile male flies and releasing 0:05:37.120 --> 0:05:39.160 them into the wild. They would mate with the female 0:05:39.160 --> 0:05:42.159 and then that's it. The female will never mate again. 0:05:42.560 --> 0:05:47.200 And that was a highly effective technique to push them 0:05:47.240 --> 0:05:52.359 back south. The problem is that there's only one steril 0:05:52.400 --> 0:05:56.160 fly manufacturing facility operating right now. It is in Panamon. 0:05:56.200 --> 0:05:58.520 It can produce about one hundred million flies per week. 0:05:59.680 --> 0:06:02.320 Estimate suggests we need about five hundred million flies per 0:06:02.360 --> 0:06:07.719 week to put down this spreading epidemic of blowfly. Texas 0:06:07.800 --> 0:06:13.440 broke round on a new blowfly screwworm sterile fly facility 0:06:13.480 --> 0:06:16.240 in April, but apparently it won't be ready till next year. 0:06:17.080 --> 0:06:19.880 The state of infections right now, or that there are 0:06:19.920 --> 0:06:24.320 twelve animals with documented infections, mostly cattle, but also a goat, sheep, 0:06:24.440 --> 0:06:29.919 and dog. The FDA has given an emergency authorization for 0:06:30.000 --> 0:06:32.360 a drug called ten per am, which is an over 0:06:32.400 --> 0:06:37.000 the counter drug for animals who are infected. But the 0:06:37.040 --> 0:06:39.279 experts that have been talking about this suspect that there's 0:06:39.360 --> 0:06:42.760 many more infections than have been currently diagnosed, and this 0:06:42.800 --> 0:06:46.640 can spread pretty quickly and threaten the cattle industry, so 0:06:47.880 --> 0:06:50.800 we're keeping a close eye on that. There is, of course, 0:06:50.800 --> 0:06:56.760 some politics here. It's worth noting that the USDA is 0:06:56.800 --> 0:07:00.880 the agency responsible for fighting this, and between January of 0:07:00.920 --> 0:07:04.320 twenty twenty five and January twenty twenty six, twenty thousand 0:07:04.400 --> 0:07:08.080 employees were lost from the USDA, both through layoffs and 0:07:08.120 --> 0:07:15.080 incentive retirement programs. The specific service responsible for screwworm response, 0:07:15.160 --> 0:07:18.680 the Animal Plant and Health Inspection Service, lost twenty five 0:07:18.720 --> 0:07:22.600 percent of its staff. The administration says those losses are 0:07:22.800 --> 0:07:27.640 not a problem, and they have the spread of screwworm 0:07:28.200 --> 0:07:33.240 well in hand. I hope that is the case. Moving on, 0:07:34.160 --> 0:07:38.200 let's talk about ozempic butt or ozempic face and a 0:07:38.240 --> 0:07:42.800 new drug that might prevent it. At least that's how 0:07:42.920 --> 0:07:46.679 the headlines are reporting this. Emily and I have talked 0:07:46.720 --> 0:07:52.160 before about this idea that the GLP one drugs lead 0:07:52.200 --> 0:07:56.920 to significant muscle loss in addition to total body weight loss, 0:07:56.920 --> 0:07:58.800 and how that can give an appearance of sort of 0:07:58.840 --> 0:08:01.960 a gaunt face, which has been labeled ozembic face. If 0:08:01.960 --> 0:08:04.280 you go back to our GLP one episode, you'll see 0:08:04.280 --> 0:08:07.720 that we point out that this muscle loss does happen, 0:08:07.880 --> 0:08:12.040 but happens in any situation where there is significant weight loss, 0:08:12.080 --> 0:08:16.760 including you know, gastric banding, gastric bypass. Anything that's going 0:08:16.840 --> 0:08:18.800 to get you to lose fifteen to twenty percent of 0:08:18.800 --> 0:08:21.440 your body weight in a year is going to result 0:08:21.520 --> 0:08:25.400 in some muscle loss because practically speaking, you're just not 0:08:25.520 --> 0:08:28.200 carrying as much weight around. You've got, you know, twenty 0:08:28.240 --> 0:08:30.480 thirty pounds that every time you take a step you're 0:08:30.520 --> 0:08:32.959 carrying around, and you'll lose muscle in your legs and 0:08:33.000 --> 0:08:37.280 your quadriceps in particular. So it's not unique to GLP ones, 0:08:37.320 --> 0:08:40.240 but it does happen. But we now have a new 0:08:40.280 --> 0:08:45.199 study appearing in Nature Medicine examining a drug called atpeitigra 0:08:45.360 --> 0:08:52.160 mab and Apatigra mab is an interesting. It's an antibody injection. 0:08:52.840 --> 0:08:57.160 It is an antibody to a protein called myostatin. The 0:08:57.200 --> 0:09:00.240 bodybuilders will know about myostatin. This is sort of in 0:09:00.320 --> 0:09:06.640 the wellness space. Muscles produce myostatin, and myostatin inhibits muscle growth, 0:09:06.800 --> 0:09:11.040 and so there is this sort of cycle where larger 0:09:11.120 --> 0:09:14.760 muscles produce more myostatin, which limits further muscle growth so 0:09:14.800 --> 0:09:17.520 that you don't become kind of too muscly. If you 0:09:17.559 --> 0:09:19.679 want to have some fun googling, you can look at 0:09:19.720 --> 0:09:23.800 some animals that are myostatin knockouts, including the Belgian blue cattle, 0:09:24.040 --> 0:09:26.720 which are like the most jacked cows you'll ever see 0:09:26.760 --> 0:09:29.520 in your life. I think there's also a whippet dog 0:09:29.559 --> 0:09:34.960 that is a myostatin knockout that is like super ripped, 0:09:35.200 --> 0:09:37.320 and so of course people are very interested in this 0:09:37.520 --> 0:09:41.839 kind of thing. For humans, aptagra mab was originally developed 0:09:41.960 --> 0:09:45.480 for people with some genetic muscle wasting conditions. But in 0:09:45.480 --> 0:09:48.400 this study they randomized one hundred people. Half of them 0:09:48.400 --> 0:09:52.400 got munjaro and aptagram mab and half just got munjaro 0:09:52.679 --> 0:09:55.280 for a twenty four week period. Both groups lost a 0:09:55.320 --> 0:09:57.800 significant amount of weight. As you might expect, twenty five 0:09:57.880 --> 0:10:00.360 pounds in the combo group twenty eight pounds, and the 0:10:00.400 --> 0:10:04.320 Manjaro alone group. Those weren't different statistically, but when they 0:10:04.360 --> 0:10:08.880 looked at lean body mass so muscle loss, the group 0:10:08.880 --> 0:10:12.319 that got the combo lost three point five pounds compared 0:10:12.320 --> 0:10:15.600 to seven point seven pounds in the group that only 0:10:15.640 --> 0:10:20.400 got Munjaro. So that was a finding that suggested that 0:10:20.440 --> 0:10:24.760 indeed this combination, when given with GLP one therapy, might 0:10:24.840 --> 0:10:28.720 reduce some of the muscle loss. We see. Bad news, folks. 0:10:28.880 --> 0:10:31.640 Not FDA approved for any indication. You cannot get your 0:10:31.679 --> 0:10:35.680 hands on it quite yet. And of course, because it 0:10:35.800 --> 0:10:39.600 is a myostatin inhibitor, it will be banned by all 0:10:39.720 --> 0:10:42.960 the anti doping agencies, which is, you know, as Emily 0:10:43.040 --> 0:10:45.319 likes to say, you know, it must work if it's 0:10:45.360 --> 0:10:48.800 going to be banned. I will say one other caveat though, 0:10:48.840 --> 0:10:51.560 these people had a bit more muscle functional metrics like 0:10:51.600 --> 0:10:54.360 grip strength and chair stands and things like that that 0:10:54.440 --> 0:10:56.720 test sort of how well your muscles work. Didn't show 0:10:56.800 --> 0:10:59.720 much difference, But you know, this might have been too 0:10:59.760 --> 0:11:03.719 small a study to look in detail at those things. 0:11:04.760 --> 0:11:07.440 Last one in our health News of the week is 0:11:07.800 --> 0:11:13.679 hard Seltzer causing a brand new kidney disorder. Hard Seltzer's, 0:11:13.840 --> 0:11:19.960 like Trullian high noons, are becoming incredibly popular. I will 0:11:20.000 --> 0:11:22.360 say that I may have one or more of these 0:11:22.480 --> 0:11:25.080 in my local drink fridge at home. And so I 0:11:25.080 --> 0:11:29.000 was a little concerned when I saw a headline about 0:11:29.040 --> 0:11:35.680 a new kidney syndrome called mehandru Vatchara Johnny syndrome. That's 0:11:35.679 --> 0:11:40.760 a tough one associated with these Seltzers. What this is 0:11:40.760 --> 0:11:43.680 is a series of cases of people who drank so 0:11:43.760 --> 0:11:47.600 much hard Seltzer that the sodium level in their blood 0:11:47.640 --> 0:11:53.160 got dangerously low, a condition we call hypononatremia the kidneys. 0:11:53.360 --> 0:11:56.280 This is an interesting The way this works. When you 0:11:56.360 --> 0:11:58.920 drink water, your kidneys sense that and they make you 0:11:59.040 --> 0:12:03.200 pee more water. So you know, if you drink some more, 0:12:03.280 --> 0:12:05.760 you piece some more, and the kidney's job is to 0:12:05.840 --> 0:12:08.840 keep you in balance. If they fail to excrete the 0:12:08.880 --> 0:12:12.760 water you drink, that dilutes the solutes in your blood 0:12:12.840 --> 0:12:15.120 like sodium and things like that, which are really important. 0:12:15.120 --> 0:12:17.080 And if your sodium gets too low, your brain stops 0:12:17.120 --> 0:12:19.000 functioning and you go into a coma and you die. 0:12:20.200 --> 0:12:24.160 And that's not great. What is going on with these 0:12:24.200 --> 0:12:26.960 hard seltzers, at least in the cases that they're reporting, 0:12:26.960 --> 0:12:31.000 are people who are drinking, you know, a dozen or 0:12:31.000 --> 0:12:33.520 more of these per day, and it sounds like to 0:12:33.559 --> 0:12:37.640 the exclusion of everything else. So, as a kidney doctor, 0:12:38.000 --> 0:12:40.280 one of the cool things or interesting things about the 0:12:40.360 --> 0:12:43.320 kidneys is that they can excrete a lot of water, 0:12:43.640 --> 0:12:47.400 about twenty liters of water per day. In someone who's 0:12:47.440 --> 0:12:50.080 kidneys work normally, that's you'd be drinking an awful lot 0:12:50.600 --> 0:12:52.560 four and a half gallons of water a day to 0:12:52.679 --> 0:12:55.160 outpace their ability to excrete it, although you'd be run 0:12:55.120 --> 0:12:57.120 into the bathroom a lot. But there is a caveat. 0:12:57.840 --> 0:13:03.160 They need either salt or urea, which is a protein 0:13:03.240 --> 0:13:06.600 byproduct to excrete that water. They don't need both, but 0:13:06.679 --> 0:13:09.719 they need one or the other otherwise they can't get 0:13:09.760 --> 0:13:12.520 the water out. That's just the way the physiology works. 0:13:12.840 --> 0:13:16.160 And so the problem with seltzers like these is that 0:13:16.200 --> 0:13:18.880 they don't have any protein and they don't have any salt. 0:13:19.080 --> 0:13:23.080 Right all they are basically are carbohydrates and water. If 0:13:23.160 --> 0:13:26.040 people are getting protein or salt from other sources, usually 0:13:26.040 --> 0:13:29.240 they won't run into these problems. Although obviously drinking twelve 0:13:29.280 --> 0:13:32.760 hard seltzers a day can cause multiple other problems, including 0:13:33.280 --> 0:13:36.520 with your liver. Doctors listening to this will recognize that 0:13:36.559 --> 0:13:39.520 this syndrome, despite getting a new name, is not really new. 0:13:39.679 --> 0:13:44.760 We've known about this for hundreds of years. Potentially this 0:13:44.840 --> 0:13:51.239 is beer potomania with a different, different name. Beer potomania 0:13:51.360 --> 0:13:54.280 was a syndrome where people drinking a ton of beer 0:13:54.760 --> 0:13:58.520 got this hyponatremia low sodium levels, and it's the same mechanism, 0:13:58.880 --> 0:14:01.000 you know, drinking a bunch of water, not taking in 0:14:01.040 --> 0:14:03.960 any protein, not taking in any salt. And if you 0:14:04.000 --> 0:14:06.760 want a sort of less of vice filled version, some 0:14:06.920 --> 0:14:09.720 little old ladies will get what's called tea and toast hypo, 0:14:09.800 --> 0:14:12.640 a trimia where if they're only surviving on tea and toast, 0:14:13.000 --> 0:14:16.040 they're not getting enough salt, they're not getting any protein 0:14:16.120 --> 0:14:19.040 because toast and jam and stuff is Jess carbohydrates. They 0:14:19.040 --> 0:14:22.880 can also get hyponatremia, so don't drink too much, but 0:14:23.200 --> 0:14:25.280 if you do, make sure you're getting some salt and 0:14:25.320 --> 0:14:30.080 protein in as well. That is it for the health 0:14:30.120 --> 0:14:33.680 news of the week. After the break, what's the deal 0:14:34.280 --> 0:14:42.320 with sleep? And we're back today. We're going to talk 0:14:42.360 --> 0:14:46.960 about what's the deal with sleep? And to get us started, Emily, 0:14:47.120 --> 0:14:50.480 I'm going to play quick clip for you from one 0:14:50.520 --> 0:14:52.280 of the greatest TV shows of all time. 0:14:52.960 --> 0:14:57.960 Truthfully, Shambo, I've been entirely preoccupied by the most frightening 0:14:58.000 --> 0:15:03.440 experience of my own. A couple of hours ago, I 0:15:03.520 --> 0:15:06.640 realized that my body was no longer functioning properly. I 0:15:06.680 --> 0:15:10.760 felt weak, I could no longer stand. The life was 0:15:10.760 --> 0:15:14.480 oozing out of me. I lost consciousness. You fell asleep? 0:15:16.120 --> 0:15:19.800 Oh, terrifying what you were hearing. There is the Great 0:15:19.920 --> 0:15:24.160 John Delancy as the omnipotent being who transcends time and 0:15:24.280 --> 0:15:27.080 space known as Q in Star Trek the Next Generation. 0:15:27.560 --> 0:15:31.960 He has temporarily been rendered fully human and has the 0:15:32.240 --> 0:15:36.000 experience for the first time in his immortal life of 0:15:36.160 --> 0:15:39.720 falling asleep. And you know of churs. Patrick Stewart as 0:15:39.880 --> 0:15:44.880 Jean Luke Picard is wonderfully dismissive of him. But as 0:15:45.040 --> 0:15:49.400 I was researching for this episode, this kept coming back 0:15:49.440 --> 0:15:55.120 to me, this scene because sleep is weird. It's maybe 0:15:55.160 --> 0:15:58.240 the weirdest thing that humans do. 0:15:59.160 --> 0:16:01.160 It's not just a weird thing that humans do, so 0:16:01.320 --> 0:16:07.360 basically every animal has sleep or a sleep like resting state. 0:16:07.520 --> 0:16:10.880 So like dolphins sleep half their. 0:16:10.720 --> 0:16:13.560 Brain at a time so they can like keep one 0:16:13.600 --> 0:16:15.600 side of their brain awake and like remember to breathe 0:16:15.640 --> 0:16:17.520 in the water and then they sleep the other the 0:16:17.560 --> 0:16:20.320 other side of the brain. And if you think about it, 0:16:20.560 --> 0:16:25.000 like it must be so important to sleep because it's 0:16:25.080 --> 0:16:30.720 so stupid, right, like think about the idea like early Evolutionarily, 0:16:30.760 --> 0:16:34.080 this is the dumbest idea, Like we're going to evolve 0:16:34.400 --> 0:16:38.600 to like lay around for eight hours in a row 0:16:39.120 --> 0:16:41.040 totally exposed to sabertoo tigers. 0:16:41.080 --> 0:16:42.560 They could eat us at any time. 0:16:42.920 --> 0:16:45.120 You would think you would select for the people who 0:16:45.160 --> 0:16:47.120 like didn't sleep, right, I mean that's how evolution works, 0:16:47.200 --> 0:16:50.000 natural selection eventually, so must be we're getting something out 0:16:50.000 --> 0:16:52.080 of sleep, and it must be all animals are. And 0:16:52.160 --> 0:16:56.160 yet this is actually, I think, still not super well understood. 0:16:56.200 --> 0:16:58.080 So we can't unlike with food, where you can be like, 0:16:58.120 --> 0:17:00.560 here's why you need food, It powers the cell if 0:17:00.560 --> 0:17:04.160 you don't have glucos, the sleep, we're just like, nah, 0:17:04.920 --> 0:17:05.760 it seems. 0:17:05.400 --> 0:17:10.439 Important, clearly, and you know the horrible experiments on animals 0:17:10.480 --> 0:17:14.240 where they keep them awake they die. We still aren't 0:17:14.359 --> 0:17:17.400 entirely sure why you pointed out dolphins sleep half their brain. 0:17:17.480 --> 0:17:21.239 I mean it's not just mammals. Jellyfish sleep like with 0:17:21.280 --> 0:17:24.160 a with a distributed nervous system. They go through these 0:17:24.160 --> 0:17:26.840 phases where they're like less responsive to stimuli and then 0:17:26.960 --> 0:17:29.080 and and it goes with the day night cycle. It's 0:17:29.240 --> 0:17:35.760 it is crazy. They're even single celled organisms that functionally sleep. 0:17:36.280 --> 0:17:39.600 I was trying to figure out, like what's the you know, 0:17:40.040 --> 0:17:42.680 how would this thing even get started? And you can 0:17:42.720 --> 0:17:44.760 go back when we talk about evolution, you can go 0:17:44.840 --> 0:17:48.840 back into our very very very distant evolutionary past, like 0:17:48.920 --> 0:17:55.080 before animals even existed. There's essentially sleep because plants will 0:17:56.040 --> 0:18:02.200 photosynthesize with oxygen but then also thi nitrogen, and those 0:18:02.200 --> 0:18:04.520 two things are incompatible. They can't happen in the same 0:18:04.560 --> 0:18:07.320 cell at the same time. Like those chemical reactions just 0:18:07.600 --> 0:18:09.640 like won't work if you're doing both at the same time. 0:18:09.720 --> 0:18:12.680 So from the very first plants, they had to evolve 0:18:12.720 --> 0:18:15.680 this ability to like turn on the oxygen like the 0:18:15.680 --> 0:18:18.040 photosynthesis thing, and then shut that down and then turn 0:18:18.080 --> 0:18:20.000 on the nitrogen fixation thing. And so it would do 0:18:20.040 --> 0:18:22.800 like photosynthesis during the day and nitrogen fixation at night. 0:18:23.400 --> 0:18:26.080 And it's everywhere. 0:18:26.400 --> 0:18:27.119 It's everywhere. 0:18:28.200 --> 0:18:32.000 We are sort of slowly, I think, understanding a bit better, 0:18:32.160 --> 0:18:34.280 Like what are we getting out of sleep? 0:18:34.320 --> 0:18:37.600 There's a sort of general idea. 0:18:37.359 --> 0:18:39.160 That people will say, which is like, well, the brain 0:18:39.240 --> 0:18:41.760 cleans itself out, like it's like your opportunity to clean 0:18:41.800 --> 0:18:43.359 things out of your brain. 0:18:43.720 --> 0:18:45.040 That's not very specific. 0:18:45.080 --> 0:18:48.720 There's actually some new evidence on mice from a couple 0:18:48.680 --> 0:18:51.400 of years ago where they looked at sort of the 0:18:51.520 --> 0:18:55.000 patterns of brain waves and basically found that like during 0:18:55.160 --> 0:18:58.359 the night, the brain waves lined up in a way 0:18:58.400 --> 0:18:59.560 that we're moving like. 0:19:00.640 --> 0:19:02.760 Debris effectively out of the brain. 0:19:02.920 --> 0:19:05.919 And so their idea was you needed this period of 0:19:05.960 --> 0:19:08.040 sleep where the brain waves lined up in this way 0:19:08.119 --> 0:19:13.160 to like flush the byproducts of being a functional thing 0:19:13.600 --> 0:19:15.439 out of your brain, and otherwise they just build up 0:19:15.440 --> 0:19:17.679 and build up and build up and then you die. 0:19:18.040 --> 0:19:20.760 Yeah, these are you can actually visualize. This is a 0:19:20.920 --> 0:19:25.399 very cool set of studies. Like the cerebrospinal fluid, like 0:19:25.640 --> 0:19:27.919 the fluid that the brain sits in, this you know, 0:19:28.200 --> 0:19:31.720 sort of salty clear fluid that protects it somewhat. Yeah, 0:19:31.760 --> 0:19:35.640 just kind of like washing over the brain at night. That's, 0:19:35.680 --> 0:19:38.800 of course not the only thing that's happening to your 0:19:38.840 --> 0:19:40.679 brain at night. Like, lots of stuff is going on. 0:19:40.720 --> 0:19:44.240 We'll need to get into some more detail as people 0:19:44.480 --> 0:19:47.040 start thinking about like what's happening during sleep. But you know, 0:19:47.080 --> 0:19:52.720 certainly for humans, it appears that memory consolidation between short 0:19:52.800 --> 0:19:57.359 term and long term memory is happening, probably primarily during sleep. 0:19:57.560 --> 0:20:00.600 I learned that from inside out. Did you see inside out? Oh? 0:20:00.680 --> 0:20:02.560 I have seen inside out, but I don't I don't remember. 0:20:02.720 --> 0:20:05.680 Yeah, they like remember like when she's the balls, they're 0:20:05.720 --> 0:20:08.199 like moving the balls from like the short term memory 0:20:08.240 --> 0:20:10.080 like to the memory storage area. 0:20:10.160 --> 0:20:11.560 That seems to happen at night. 0:20:12.160 --> 0:20:14.920 I learned that it's important to feel my feelings. 0:20:15.240 --> 0:20:17.399 Yeah, no, that's also true. I cried so much at 0:20:17.400 --> 0:20:19.439 that movie. Oh my gosh, that's a great that's really good. 0:20:19.560 --> 0:20:20.600 Should watch that really good? 0:20:20.640 --> 0:20:23.160 Okay, uh, back to sleep. 0:20:23.640 --> 0:20:28.879 Okay, So people sleep, big picture, everybody sleeps, including potentially 0:20:29.160 --> 0:20:32.360 plants and certainly all all you know living. 0:20:32.560 --> 0:20:35.440 All of the animal like and animal organisms. 0:20:36.080 --> 0:20:38.520 Probably it has something to do with cleaning something out, 0:20:38.560 --> 0:20:41.560 and your brain is doing something we don't completely understand it. 0:20:42.119 --> 0:20:45.280 People talk a lot about the idea of circadian uh 0:20:45.480 --> 0:20:50.120 biology here, So do you want to And I hesitate 0:20:50.160 --> 0:20:52.520 to ask this because of some earlier episodes where you 0:20:52.600 --> 0:20:55.240 got to involved, but do you want to do a 0:20:55.280 --> 0:20:58.480 little of the biology, Doctor Perry. 0:20:58.680 --> 0:21:01.400 I think that people want to hear about the biology. 0:21:01.600 --> 0:21:06.440 People do people do? Okay, do it briefly? 0:21:06.680 --> 0:21:06.720 No. 0:21:06.840 --> 0:21:10.000 Circadian biology is really cool, so circa around the end 0:21:10.119 --> 0:21:12.560 the day. So these this is the day night cycle, 0:21:12.800 --> 0:21:17.320 which everyone on the planet Earth has, I say, everyone, 0:21:17.320 --> 0:21:19.960 including the plants and everything like that. We live on 0:21:20.000 --> 0:21:21.960 a planet that has a daytime and a night time, 0:21:22.040 --> 0:21:24.840 and it's no wonder that biology has sort of adapted 0:21:24.920 --> 0:21:27.360 to these uh to the these different things. The way 0:21:27.359 --> 0:21:31.080 it works in humans is pretty cool. There's a specific 0:21:31.160 --> 0:21:34.720 part of your brain called the super chismatic nucleus which 0:21:34.920 --> 0:21:37.919 is the clock. Like to the point that if people 0:21:38.000 --> 0:21:41.439 have a stroke or a tumor and that part of 0:21:41.480 --> 0:21:45.479 the brain needs to get removed, they no longer follow 0:21:45.560 --> 0:21:49.480 day night cycles. They just like free run through their 0:21:49.600 --> 0:21:53.320 circadian rhythm. The super chismatic nucleus is the clock in 0:21:53.359 --> 0:21:55.520 your brain, and it doesn't only only tell you when 0:21:55.520 --> 0:21:58.320 you're tired and when to go to sleep, but all 0:21:58.359 --> 0:22:00.440 the other things that vary throughout the day, like your 0:22:00.440 --> 0:22:03.960 basal body temperature and your cortisol levels that spike in 0:22:04.000 --> 0:22:06.000 the morning, and all of those things are determined by 0:22:06.000 --> 0:22:09.800 the superch nucleus. That part of the brain has a 0:22:09.880 --> 0:22:14.840 direct neural pathway to your retinas and on planet Earth, 0:22:15.119 --> 0:22:19.199 if you're human, the way the super chismatic nucleus stays 0:22:19.280 --> 0:22:23.560 in sync with day and night is through light. It's 0:22:24.080 --> 0:22:27.320 very simple, and that's probably how you would design it anyway, right, Like, 0:22:28.320 --> 0:22:31.240 it turns out that if you put someone in an 0:22:31.280 --> 0:22:35.520 isolated room, right just like a no exposure to outside 0:22:35.600 --> 0:22:38.120 light whatsoever, you know, the lights on all the time 0:22:38.200 --> 0:22:41.480 or the lights off all the time, they have an 0:22:41.520 --> 0:22:47.320 inherent pace that their super chismatic nucleus will follow. Some 0:22:47.359 --> 0:22:50.080 people have a slightly longer day than twenty four hours, 0:22:50.160 --> 0:22:52.719 maybe twenty five, maybe even twenty six. And so if 0:22:52.720 --> 0:22:55.440 you just let them go and they've done these experiments 0:22:55.480 --> 0:22:58.080 where they keep these poor you know, graduate students in 0:22:58.880 --> 0:23:01.240 like a lab for weeks at a time while they 0:23:01.440 --> 0:23:03.240 you know, write their THESS or whatever they pay them, 0:23:03.240 --> 0:23:05.639 but you know, and they'll basically like go to sleep 0:23:05.640 --> 0:23:07.800 two hours later every night, and they'll just you know, 0:23:07.840 --> 0:23:10.040 buy seven days later there're all of a sudden twelve 0:23:10.080 --> 0:23:13.000 hours off. Some people have a shorter cycle twenty three 0:23:13.080 --> 0:23:15.399 twenty two hours, and the reverse happens. Right. They just 0:23:15.480 --> 0:23:17.840 kind of like every night they go to bed a 0:23:17.880 --> 0:23:20.000