Chris Winter, Clint Murphy
Clint Murphy 00:15
Welcome to the growth guide podcast. I’m your host Clint Murphy. Every week I talk to authors, subject matter experts and millionaire mentors to share the lessons that will help you and me be better, achieve more and become financially free.
Clint Murphy 00:37
Today, I had the pleasure of talking with Chris Winter, a sleep expert and neurologist who has helped more than 10,000 patients rest better at night, including countless professional athletes. Chris is the author of The Sleep Solution, Why Your Sleep is Broken, and How to Fix It, which is an exciting journey of sleep self discovery to help you understand how sleep works, what helps or hurts the sleep process, and how to achieve your best sleep. This is something I need a lot more of in my life. And I know that a lot of you out there also need to sleep better. Enjoy the conversation.
Clint Murphy 01:25
Chris, welcome to the growth guide podcast, we are going to dive deep into your book, The Sleep Solution, Why Your Sleep is Broken and How to Fix it. Before we do would love if you can share with our listeners a bit about yourself so that they know who you are as we dive into this conversation.
Chris Winter 01:44
Sure. And now thanks for having me, Clint, really appreciate it. I’m a neurologist and sleep specialist from Charlottesville, Virginia. I’ve been in the field of sleep research or sleep medicine for 30 years. And currently, clinically see adults and children who have sleep disorders, write about sleep, help athletes who struggle with their sleep and do a podcast called Sleep Unplugged about various sleep topics that we talk about once a week.
Clint Murphy 02:14
And correct me if I’m wrong, but even as early as elementary school, you thought someday I want to be a doctor. Why were you thinking that when you were already very young? And when did you make the flip to I want to study sleep?
Chris Winter 02:32
I think it was. I always say third grade, but I really liked science. I thought the human body was fascinating. I made this little model of the heart when I was little. And I was fascinated by the way the blood flowed into the heart and to the lungs back to the heart and out through the body and memorize Latin names of muscles. The short answer is I thought it was interesting. I didn’t really know what it meant to be a doctor. And I don’t think a lot of people who go into medicine know what it means to be a doctor until late in the process. But so the flip to sleep happened, I started doing sleep medicine when I was an undergraduate. I started with sleep research, I should say I should be more clear about that.
Clint Murphy 03:31
Right so early on in the book, you point out something that seems so obvious when it comes to sleep and yet, a lot of us mess up all three of the things you talk about, which are nutrition, exercise, and sleep. The things that we can exert some control over, can you share how that has such a downside effect on our health? And some of the simple things we should be thinking about in those areas?
Chris Winter 04:03
Yeah, I think that one of the things that is nice about the way we think about sleep now and maybe not back when I got started in the 90s or even you know well before that is that I think in the past we’ve looked at sleep as a trait. So he’s tall or short, they’re fast or they’re slow, they’re a good sleeper, they’re a bad sleeper, and wherever you sort of sort out your lot in life is where you stay. And one of the great things about the way we think about sleep now is that this is a modifiable variable. There are things that you can do in your life that will make you sleep better or can make you sleep worse. And so I think that’s very empowering for people. And I think you can put it there with what you were saying fitness, nutrition. You know if you decide, okay, I’ve lived an unhealthy life and I want to stop doing that and change things. This think that you can put sleep in that category. You know, my father was a football player and a football coach. And he would often say things like, you can’t coach big. And what he meant by that was if you’re a small person like I am, you can play football, and I can coach you in a certain way. But I can’t coach your size to be bigger than what it really is. So that’s static but sleep’s not. And so I think when people start to look at it that way, it feels a lot more freeing than thinking about, well, I’m a bad sleeper, and there’s nothing that can be done about that.
Clint Murphy 05:34
And so one of the areas that I’m really interested that I read about was the glymphatic system, I believe you called it in the impact on Alzheimer’s, and I’ll share a little backstory is a personal interest to this one. It’s always been something that worries me, my DNA testing indicated, potential early onset for Alzheimer’s. Growing up, I had a lot of concussions. So I’ve always worried that someday my brain is going to deteriorate quicker than the average person. And I shouldn’t say I’m not a good sleeper, I don’t sleep enough. And so the combination of that I’m learning more and more can actually exacerbate the Alzheimer’s, can you fill in people in on what we’re talking about? And what we’ve learned about Alzheimer’s and how sleep actually can help us, maybe not stop it, but delay it?
Chris Winter 06:29
Yeah, that’s a great line of thinking. The glymphatic system that you mentioned early on, is a part of the human anatomy that was actually discovered relatively recently. When I was in medical school, we were taught that the lymphatic system was a sort of drainage system in our body for everything except our brain. I remember that lecture distinctly when they said that the brain doesn’t have a lymphatic system. I remember thinking it’s so fascinating, the most important organ in our body, the organ everything is serving within our viscera doesn’t have a way to remove waste. Well, it did. It was just very difficult to sort of dissect out and see and this woman, her last name is Nedergaard discovered it and she named it the glymphatic system. So the glymphatic system is essentially a passive drainage system for waste products in the brain and central nervous system. And when you look at the components of what it’s removing, the vast majority is beta amyloid, which is the building block of Alzheimer’s plaque. So what’s interesting about the glymphatic system is not so much that it’s removing this, but the fact that it’s actually about 10 times more active removing brain waste products when we’re sleeping than when we’re awake. So we’ve known for many years that individuals who were inadequate sleepers tended to develop dementia and Alzheimer’s disease at a higher rate than individuals who weren’t. So this discovery sort of gave a mechanism for that. And we’re back to that empowering sort of situation of, I don’t sleep enough, and I’ve got Alzheimer’s disease in my family. Well, that’s something that you can control, you can’t control the ABO gene that you might have found on a test. But there’s actually research that came out of Asia that basically said, individuals who possess the genetic tendency for Alzheimer’s can dramatically influence their tendency to develop it, if they’re good sleepers. And it’s, I remember, there was a great 60 minutes if you watch that show, where they actually sort of interviewed older individuals, people who are approaching the age of 100, and sort of followed them trying to kind of work backwards, how do they get to that point of living so long, and then when they unfortunately, pass away, they actually donate a lot of them donate their bodies to this project. And, you know, some of the people in the project to, you know, live to be 103. And were ballroom dancing right up till the end. And, you know, quick as a whip cognitively, when they looked at their brains, post mortem, showed all kinds of evidence of dementia and white matter changes and atrophy that you would see an individual who had Alzheimer’s disease, yet never developed the the symptoms of it. So I find that to be really empowering that we think about genetic testing as being absolute, but we’re really learning is that our behaviors can influence the expression or non expression of certain genes and our development of Alzheimer’s disease may fall into that category.
Clint Murphy 09:48
And when you think Alzheimer’s or dementia and the impact sleep has, we often talk about the fact that if we’re not sleeping enough for a consistently for long period of time we get that impact, it’s essentially as if we’re drunk – brain fog, fogginess. How does that tie into this or is there linkages between the two? Or is something else at play when we get that absolute brain fog, where we might back our truck up into our retaining wall in our driveway, which our wives may catch on video. But digressions.
Chris Winter 10:26
Yeah, I guess what I would say before I answer that question is, and it’s really important is to differentiate when people say they’re not sleeping enough, I would define that as somebody who goes to bed at midnight and is up at 4am to go to the gym. They have the ability to sleep longer if if the alarm didn’t go off at 4am. If they accidentally set the alarm for 4pm, they would wake up at eight and be like, oh, no, I’ve overslept. You know, because I set the alarm wrong. So we have to be careful about that. That’s sleep deprivation, somebody’s trying to operate their life on four and a half hours of sleep, versus an insomnia patient. Yeah, and we get into a lot of trouble with that, where the individual with insomnia gets into bed at 10 o’clock, and it takes them three hours to fall asleep. So they’ve got the opportunity to sleep, their brain’s not that interested in doing it, thinking, oh, my God, it took me three hours to fall asleep. This doesn’t get fixed, I’m going to develop Alzheimer’s disease. I mean, generally speaking, sleep deprivation does not manifest as it takes me three hours to fall asleep. Sleep deprivation manifests as I’m working two jobs and driving an Uber in between to make some money. And I’m nodding off at every stoplight I stop at so just if you’re somebody who gets into bed, and you’re giving yourself the time to sleep, but it takes you a while to fall asleep. We’re not really talking about you, you’re talking to the trauma resident who only gets three hours of sleep every other night, because they’re on call like you got to listen up. So you know, in terms of what you’re describing, when you think about sleep deprivation, it is something that we can control. You know, it’s something that we can sort of provide a measure of intervention to fix. And so you know, when somebody’s like you said, backs their truck into a retaining wall, what is happening there, or there can be a lot of things happening. For somebody who’s truly sleep deprived, you pulled an all nighter to get some work done, or the boss has you in at the office, because the big project and presentations due in 24 hours. And it’s going to be a long night because we’re behind trying to get this stuff done. So you just burn the candle at night, and you order some pizzas, and you try to put this presentation together and you watch the sunrise from your office window. So when that individual walks out, gets in their car and backs into a retaining wall. What’s happening? Well, one, they’re excessively sleepy, they’re nodding off. So you could easily have had a little micro sleep as you’re backing up, you just kind of fell asleep very quickly. And that’s the reason why you went into the wall. And most accidents, when you talk to a lot of patients who are excessively sleepy, they always happen somewhere in the neighborhood. Like they make the two hour journey home from seeing their grandparents up in New Jersey and they’re, they’re so sleepy, and they’re like, oh my gosh, seven more miles, and they finally pull into the neighborhood. And they fall asleep and drive their car into the ditch next to their driveway. It’s amazing how many people, it’s sort of like they let up right there at the end because they’re almost home and then they sort of fall asleep. Sleep deprivation does other things, it creates poor decision making. So maybe when you were backing the truck up or the car up, you thought it’s gonna be close, but I know I can swing it around and not clip the edge of the wall and you miscalculate and you hit it. So maybe it was just sort of a bad, bad calculation, bad decision, or we know that we’re less risk averse when we’re excessively sleepy. So maybe you did think I’m not gonna make it, but screw it, I’m gonna see what happened. Like you just take the risks and for no reason, you know? So, there’s all kinds of different sort of things that happen. You know, I deal a lot with athletes. So I always think, you know, what does it take to catch a basketball dribbling down a court, you know, make a pass or make a shot, you know, or you’re a baseball player to hit a ball that’s coming at you at 100 miles an hour. There’s so many things that have to be working perfectly for that to happen, that sleep can interfere, you know, make each one of those things 5% worse. And that’s really all it takes to really destroy somebody’s performance. So when you think about brain fog, that’s a poorly defined term. We talk about it a lot. You know, what is it when somebody says, gosh, Chris, I just have so much brain fog. I don’t really know. But it’s probably a combination of, you know, fatigue, excessive sleepiness, concentration issues, there can be mood issues at play with that. So it’s a shared experience that we have a very hard time defining
Clint Murphy 14:54
And the interesting part. And I was gonna bring this one up later, but we can dive into it now. hours I don’t know if you’ve seen with your patients and the people that you work with, is when we look at COVID. And some of the outcomes of it, one of the things that I saw was my sleep was much less strong. And we’ll talk about this when we get into the cycles later. I wasn’t hitting more than, say, 45 minutes of deep sleep in any night. And I noticed that after a few days, I went into I was brain fog for about a month. And then at the end of that month, my sleep readjusted up, I was hitting deep sleep, and the brain fog went away. And so are you seeing with any of your clients or are you hearing, and maybe it’s because our breathing is affected, that we’re not sleeping as well, that leads to brain fog after a period of time, and some call it long COVID. After a period of time, our sleep readjusts and we come out of the brain fog. Are you seeing any of that?
Chris Winter 16:10
Yeah, I mean, if you’re a neurologist or a sleep specialist, you see a lot of individuals who struggle with that sort of melting pot of symptoms and your brain fog, fatigue, depression, you know, what would, you know, we certainly don’t really understand what long COVID is, but I suspect it causes a lot of issues related to both fatigue and sleep. So the answer is, yes, we see it. What it is, and what’s causing it is probably a little less clear. You know, deep sleep is sort of the restorative sleep, I guess, questions I would have, you’re saying 45 minutes of deep sleep, I’m assuming that’s coming from some sort of tracker that you where, which are infinitely problematic, and I’m a huge supporter of them. So I find that we have to be a little bit careful about it. But the only thing that can really differentiate light and deep sleep is a whole bunch of wires glued to your head. So I mean, these things are not without merit in use. But sometimes those can be a little bit misleading. And the other thing too is a great night asleep for an adult is probably an hour and a half or 90 minutes of deep sleep. A lot of individuals, 45 minutes of deep sleep is what they get when we do sleep studies, you know, we often see people getting 45 minutes of deep sleep. So you might feel a little something from that, it’s a difficult thing to sort of put together. I mean, you got somebody saying, well, I get 90 minutes of deep sleep, I’m great. If I get 45 minutes, I’ve got you know, horrible brain fog yet, you know, there’s some young woman who’s taking somebody’s spleen out in a hospital, who’s like I didn’t sleep at all last night, because I was in the emergency room all night long dealing with traumas. So it’s kind of hard to reconcile, well, how is she able to function at such a high level and granted, I don’t really want her taking my spleen out when she’s been up all night. But she can do it, when somebody has had sort of a less than adequate amount, you know, perfect night, you know, 80% and they’re debilitated by it, you know, that’s a very, those are difficult sort of situations to kind of wrap our minds around sometimes, like somebody saying, I ate all my potatoes, half my green beans and half my turkey. So I’m not gonna be able to go to work tomorrow. Well, why like, because you only ate half your dinner, that’s not how dinner works. So it becomes problematic and kind of relates to a lot of research that often says, how we feel about our sleep impacts our performance the next day, much more than the way we actually sleep, which is fascinating, actually. So in other words, if you blind somebody to a study, and we do this all the time, kind of accidentally, when somebody comes back from a sleep study, our first question is always how did you do? And it’s interesting to see what people’s perceptions are of what happened during a study versus what was actually recorded during a sleep study. I’ve been doing this for 30 years, I’d never find that not to be infinitely fascinating.
Clint Murphy 19:08
The human brain is more powerful at confusing itself, then what’s actually happening. And it’s in so many areas and one of the things that I noticed was a lot of people always focus on, hey, here’s all the positives about sleep and why we should do it. You went a bit of the other way. You’re like, hey, if you’re not sleeping, weight gain, cancer, depression, and just sort of threw all the bad stuff that’s going to happen at us. Can you share with the listeners, some of the bigger downsides that you see coming out of people, whether it’s through the insomnia or sleep deprivation? What are some of the worst health outcomes that we should be aware of as a result of it?
Clint Murphy 19:54
Of a heart attack?
Chris Winter 19:54
Yeah. And everybody at the funeral gonna be like, gosh, Jason was so healthy, what in the world, like, it’s so crazy. If it can happen to him, it can happen to everybody. But the people who know Jason knows he was pushing it too hard. And just because you can do it. You know, all you medical students and residents and law clerks and military people, just because you can operate on three hours asleep, does not mean you should. And there’s some people who can, they’re not escaping the negative health consequences of it. They just hold it together better than people who don’t possess those genes. So if you’re one of those people is like I’m good on three, Chris, I hear what you’re saying. As long as I get my three, I’m good. You’re not good. And that’s the person who needs to read the first part of my book or read Matt Walker’s book, Matt Walker’s book is a treatise on why sleep is important. Now if you’re somebody who’s like, oh, I believe it. I’m in bed by nine o’clock. I try to get 12 hours every night. It takes me a while to fall asleep. Don’t read Matt Walker’s book cause it’ll scare you to death and but that really doesn’t apply to the insomnia patient. But we don’t do a very good job of separating. And we think of insomnia is a person who can’t sleep or is not getting enough sleep. And that’s really not what’s going on there.
Chris Winter 19:54
Yeah, and that’s a constant point of confusion for people. I mean, if you look look through all the terrible reviews of my book, all the one star reviews. It often is a narrative that says, why would he start a book telling us all the terrible things that happen when we don’t sleep. But yet on page whatever he says, it doesn’t matter if we fall asleep fast. And again, there’s so much confusion about insomnia and sleep deprivation, and it’s everywhere. So what you’re referring to is problems related to sleep deprivation. So and I lived it for many years, when I was in my medical training, I was not sleeping enough. And if somebody had offered me an opportunity to get more sleep, I would have taken it. In fact, one of my medical school buddies fell asleep into a patient, we were you know, when you’re a little peon medical student, or whatever, you sit there and hold the retractor for the almighty trauma surgeon that’s, you know, sitting there doing his or her thing, and you just hold the retractor and say nothing for hours, you know, he might let you put a stitch in or something like that, but it’s infinitely you know, you’re there at four in the morning, whenever the surgeries get going, or whatever. And you just stand there all day, I was watching my friend kind of sit there and kind of wobbly, can only see his eyes because he was covered with a little hairnet and a mask and everything. And we weren’t allowed to talk. So I couldn’t say, man, wake up, wake up, come on, rally here a little bit. And all of a sudden, he just fell asleep and went right into the patient. So that is the face of sleep deprivation, it is a runaway freight train, that even though you’re standing next to the guy who is going to write you that recommendation that will change your life and get you into the trauma surgery residency you want, it doesn’t matter. You have to sleep, you’re going to sleep. And if you’re not going to lie down, your brain is going to take matters into its own hands. Insomnia is a completely different thing. And it’s so complicated, that it’s so difficult to sort of encapsulate but insomnia is essentially a fear of not sleeping, it’s an individual who gets into bed and an hour later, they’re still awake, and they’re really upset by that situation. And they’re often upset by the situation because they think that that is sleep deprivation and that’s putting them at risk for Alzheimer’s disease, heart attack, stroke, weight, gain, diabetes, you name it. That’s, that’s their interpretation. And the media loves to talk about these kinds of things. I mean, I looked at like a thousand articles one time, about deep and about 900 were tips for falling asleep fast or getting back to sleep if you wake up during the middle of the night. And so the point of my book is who cares? It’s like a tip for I got halfway through my sandwich, and I haven’t finished it for lunch, getting ten surprising tips for ways I can finish my sandwich. I would say do you need to? Sounds like you’re full. Maybe wrap it up and eat it later. I don’t know. But I don’t really care. I’ve never experienced somebody calling their doctor. Hey, you gotta help me. I’m halfway through this pastrami club and I just no way I can finish it. And my god, I think I’m going to starve to death. So I need an appetite stimulant immediately. You know, we’re so poorly educated about sleep in this country, and that includes doctors too that are taking care of you that everything becomes how fast can we get people to sleep and how sedated can we keep them through the night. It’s not the way sleep works. So when we’re talking about all those health risks that I talked about the beginning of the book, these are people it’s like the investment banker or somebody I called ginny trauma surgeon, investment banker is up until midnight, and he is you know, goes to bed, wakes up at 4am when the stock markets open in some place in the world, he’s training for a triathlon everything. Everybody thinks he’s the greatest guy in the world, super smart, rich. He’s so healthy because gosh, he’s done 20 triathlons. Yeah, but he’s only getting four hours asleep. And when you talk to him, he’s like, yeah, as long as I get my four hours, I’m good. But his wife is saying, well, no, every time you sit down to do something with the kids, you fall asleep, right? Because the brain is looking for more sleep. But he’s fighting and fighting, and he’s gonna die when he’s 54 years old.
Clint Murphy 25:10
And so everybody has a different number. And I appreciated that you put a range on it and didn’t confine it to this whole, you have to sleep eight hours every night, because I’ve never found eight to be a good number. But what’s a minimum, like for the average person, take out these outliers. Like if I do six and a half every night, I feel fine. Maybe every month, I’ll have a day or two where I’m tired, and I go to sleep earlier. But when I’m sub six, sub five and a half for an extended period of time, it really starts to lead to that fatigue. And your point about, you know, I’m sitting down and I’m falling asleep in a meeting. Yeah, what’s the right number?
Chris Winter 25:53
Right. So that depends on several things, genes from your parents. So a lot of times, you know, if I’m talking to somebody who doesn’t seem, I just met a guy when I was doing some filming out in LA, and he was like a producer type. And he said, I’ve never slept eight hours in my life. He said, I can’t imagine that. He said, I don’t think that I could. And I asked him, what are your parents do? He said, my mother is a nurse in the ER, my father’s a trauma surgeon. Well, there you go. You know, when you look at trauma surgeons, they’re very smart people. And they’re lovely people, and thank God, they exist in the world. But what I found when I was in medical school wasn’t an auditorium of exceptional brilliance, what I saw was an auditorium full of people who are really good at sleep deprivation, like they had that ability to do it. So to me, you know, when you think about an adult, and we got to qualify that, because if you’re thinking about a child, like a baby who’s just been born, the minimum is probably 11 hours. And that’s fascinating to me because if you’ve got a newborn, you know, some under three months old, the range of normal is probably somewhere 11 to 19 hours, which is fascinating, because I just talked to somebody at a lecture the other day, and she said, I’ve got three kids, two are great sleepers, one’s not. And my first thought is, right, because your first two are 17 hours and your newest ones a 13 hour. Because if we don’t adapt to the range, we’re going to have significant problems, not only when we’re little, because that range is massive, you know, two parents sitting there with their two month old, they’re sleep could vary by literally eight hours, an entire night of adult sleep. So if you’re, you know, I was joking, you know, if you’re paying attention to Ryan Reynolds and his wife, and you know, their parenting tips on Instagram, it’s great if your kid requires what their kid required. So you always have to be sort of open to the idea that your kid is a great sleeper, he just doesn’t need nearly as much as your first kid did. Because he inherited that from your husband and not from you whatever. So for an adult, you know, it’s probably somewhere between five to 10. And this is really interesting research that a guy named Tom Roth that up in Detroit, he kind of looked at his entire career, not for individuals who could get by on a smaller amount. But truly can we find people who are sleeping less than five hours because that’s what they need, meaning that if you gave them six hours asleep, they would wake up after five, you put them in bed at 11, they just naturally wake up at four o’clock, and don’t really want to sleep again until 11. He really felt that five hours and 45 minutes of sleep. He has a famous quotation, that’s something like the number of people who need less than five hours asleep, rounded to the nearest whole number is zero, meaning that they may exist, but I can’t find them. And again, that’s different from I mean, there are a lot of people my residency and neurology fellowships and stuff that, you know, if we got two hours on call, we could go the whole next day, or if we didn’t get any sleep at all, I was really good at all nighters, you know. That’s why in fact, I’ve kept a couple of evaluations from medical school and one of them basically said he’s not particularly good at obstetrics. But man, that guy was available at all hours of the night like anytime something was going on. All the other medical students were gone. And Chris was just sitting there like wide awake talking to somebody like oh, you want to see a breech birth? Sure. Let’s go. I’m awake. Let’s do it. So it was sort of like he’s available. He was always available.
Clint Murphy 29:50
Which, which gets you ahead?
Chris Winter 29:52
Well, that’s the danger,call it horsepower. And I’ve got a daughter who has it and I’m telling you what, it is a double edged sword, you can crush people, you crush your competition, you rise to the ranks because you’re the person who’s doing all the research, you can get it all done. You can be a star at the meeting the next day, you can work all through the night, you outwork everybody else. And so yeah, you get promoted, move up very quickly. But at some point, you’ve got to get to a point where you’re in charge, you’re the boss. And now you’ve got to take your foot off that gas pedal, and get the sleep you need. I had that come to Jesus moment at one point in my life. And I think it’s happened soon after I just kept running out of time each weekend to paint my basement. And you know, I masked it, put all the tape up. I just never had the time to do it. And it was annoying me, it was annoying my wife because there was tape everywhere. And I was like, you know, I’m just gonna stay up all night and do it. So just stayed up all night, painted the basement. By the time I was putting the cans away and washing the brushes, kids were getting up, woke up, had breakfast with them, took them to come school and went to work. No problem. And I was tired. But I don’t think anybody that day would have said, oh, what’s wrong with Chris? He’s really a mess today. No, I cruise right through it, you know, went to sleep the next day, it was fine. But that’s terrible. You know, at some point, you’ve got to save yourself just because you can do it doesn’t mean you should. So that’s the kind of stuff that you know, I think kills people early. I mean, your body’s doing all kinds of negative things to make up for the fact that it’s lost a night asleep. Your cortisol is through the roof. I’m sure my blood pressure was terrible. You know, it’s your mood’s not great. making bad decisions on the freeway and all that good stuff.
Clint Murphy 31:35
Yeah, emotional regulation with your family. And yeah, absolutely being snappy with your kids, for sure.
Chris Winter 31:42
So I would say five to 9, 8 and a half is the middle of the bell curve. So I think you’re exactly right, that if you’re like, look, I don’t know how much I need. Pick a number that I could start working from. There’s nothing wrong with eight. But if you’re like, I’ve been trying to get eight, go to bed at 11, get up at seven. But it always takes me an hour to fall asleep. Okay, well, maybe you’re a seven person, you know, so there’s nothing wrong with starting with 8. It’s kind of like, I don’t know how much to eat, I’m an adult man and I’m, you know, 30? Well, maybe 2300 calories. I’m making that up. I have no idea what I’m talking about. You know, and we’ll check in in a month, and in a month, your like, Chris I lost 17 pounds. Okay, whoo. Wow. The 2300 was not nearly enough, you know, what’s going on? Well, I’m a professional swimmer. Okay, well, that probably would have been nice to know that before I said, 2300. Okay, let’s do 3300 or maybe even 4000 given this dramatic amount of caloric exercise. So you kind of pick a spot and and kind of work from it and sleep’s no different.
Clint Murphy 32:37
And something that jumped out at me, because you were talking about the sleep trackers, you know, not necessarily being fully accurate, but probably better than not tracking at all. And when you were saying people want to fall asleep fast, one of the interesting things about the Oura ring is it tells you that if you’re falling asleep too quickly, and they call that your latency and mind is almost always red now. Because it’s like, hey, your head hits the pillow and two minutes, like I’m out cold is. So why is that an issue? Is that a sign that we’re potentially sleep deprived because our brain is saying, I need sleep, your heads on a pillow, we’re going under?
Chris Winter 33:24
You’re absolutely right. That’s one of the things I like about the Oura ring. It’s sort of, it’s working to dispel that myth of I’m asleep before my heads hits the pillow so I’m an awesome sleeper. You know, to me, it’s sort of like, I eat food out of a trash can. So I’m a great eater. No, you’re starving. That’s what’s happening. And when you look at people, I mean, look at my own father, I think that when you say Dad, I’m worried about your sleep and your breathing and you snore and the response is always a good sleeper. I can sleep anywhere. Right, that’s the point. That’s the problem that when you sit down to watch the ballgame, you fall asleep, go to church on Christmas Eve, you fall asleep, you know, all these situations, you’re falling asleep. When you get into bed, you’re immediately asleep. So I think that we often think about that as being great. That’s the goal. And I have partners tell me that all the time. Oh, Chris, if only I could fall asleep like this guy. What do you mean? Well, I mean, he’s in bed and he’s asleep before his head hits the pillow. I’m up 20, 30 minutes. You know what I think you’re in the normal there. I’m actually worried about him. And again, we’re back to that. I always call it speed of unconsciousness. Like that’s the goal and in our current culture is speed of unconsciousness. We’ve got to get there quick. God forbid we get in bed and 20 minutes later, we’re still awake. Like it’s sort of like waiting until you’re starving to eat a meal. You know, we were waiting and he was opening up salt packets and ketchup packets and eating them, oh, wow, he must be really hungry, you might have wanted to, you know, eat a little bit before. So I think that we want that kind of sweet spot like I don’t want to sit there for two hours to fall asleep, but you know, 15, 20 minutes is fine. And if somebody says I routinely takes me two hours to fall asleep, then let’s have a conversation about your bedtime and how it was chosen. You know, so, you know, again, middle of the road here, not immediately falling asleep, not two hours to fall asleep. But if it takes an hour or two, every now and then it’s not the end of the world.
Clint Murphy 35:34
Yeah, it’s that on average, what is it? You know, I know I need to sleep more and more might not be the right word, but I need better sleep. And it’s a potential sign of it. The interesting part, you talked about that, when we aren’t getting enough sleep, our body takes action. And what jumped out at me was you talked about this idea of the drive reduction theory. Can you share that with our listeners? And what are some of the drives were going for? Including sleep and how the body basically says no, no, like, I’m going to shut you down because you need to sleep.
Chris Winter 36:13
Yeah, and this is a really important thing for individuals to reflect on who kind of struggle with their sleep, they often refer to, you know, your sleep as a primary drive, meaning that my drive for good television on HBO is a drive. But if you took away the White Lotus and The Last of Us and Game of Thrones, I don’t die. My drive for air or fluid intake or food or sleep is different than my drive for House of the Dragon. Because if you take any of those four things away from me, eventually you die. These are things that are not negotiable, which is why I really dislike the phrase, I can’t sleep because it’s never true. That doesn’t exist in nature. And somebody said, well, there’s this guy in the Philippines who hasn’t slept in 50 years, which is not true either. Thai Ngoc, I think is his name. But anyway. So it’s nice and to me uplifting when you think about that if somebody’s struggling with their sleep, the idea that you can take all those sleeping pills that your doctor gave you, but they’re not influencing a fundamental theory of nature that you’re going to sleep, whether you take that pill or those pills or not, and there’s nothing you can do about it. And so that’s really where sort of the beginning of the education start to but and when you start to sort of think about primary drives. Imagine a person who’s been deprived of water for a period of time or deprived of food, what do they look like? What are their behaviors like? I was just lecturing the other day and said, you know, imagine walking into the woods on a little trail, and you just get turned around and you get lost. And you’re in the woods for you know, somebody’s out there for seven days or 12 days, and they don’t really have the skills to do it and search and rescue comes and you finally find them. Just imagine what they would look like and how they would respond when you pull a sandwich out of your pocket and a bottle of water and hand it to them. What if they said no, what I’m actually good. I’ve gained a lot of weight out here. And I’m really trying to cut back, you know, that would make no sense. You’ve been out here in the woods for seven days, and you’ve gained weight and you’re not hungry for the sandwich that I’ve got, you know, that’s not how starvation works. So when somebody says I can’t sleep, I’m lucky if I get an hour a night and I have been that way for 20 years. And you ask them what do you do a nap they ever fall asleep in church, on a long car ride? Would you ever nod off and they’re saying no. Just from a completely scientific perspective does that make sense to you? That the lack of sleep would create inability to sleep. No no no, the lack of sleep creates falling into a open viscera during an operation like my medical school buddy. That’s what it looks like. And that’s what I always say your brain at some point, unlike hunger and thirst where your brain can’t technically make you eat, your brain can make you sleep. At some point, you will fall asleep. You just hope it’s not when you’re driving down the road. So this is not something we have that much control over. And it’s funny because I was talking to somebody one time and they said, you know they didn’t sleep and I’m like, well, when’s the last time you slept? They said it was 11 days ago. I said that’s funny. I said you know what the world record for sleep is? It’s it’s 11 days and said you’ve broken it. And she looked fine. She looked great actually. You know, I said do you think you look like somebody hasn’t slept in 11 days and she said I don’t know what that looks like. And when you think about Randy Gardner who’s the guy who has the record for 11 days of sleep deprivation and you talk to this fantastic sleep researcher whose passed away and you ask him about it, I remember hearing him say it was a sham. It’s not real. He didn’t go 11 days without sleeping. He may have gone 11 days without a continuous monophasic period of sleep in the bed like we think about. But this guy was falling asleep playing pinball, we could not stop him from falling asleep. He kind of like micro sleeps that everybody’s had driving down the road. And all of a sudden you’re like, oh my gosh, yeah, I was not there for a minute. I was somewhere else. I have no idea how much time passed. I think it was just a few seconds. But your heart’s kind of racing. And that’s when you pull over and get some chips and soft drink or something because it’s terrifying. And he didn’t even know it was it was coming and it came and happened. You always think that person whoever developed his little rumble strip on the side of the road?
Chris Winter 36:13
Oh genius. I mean.
Chris Winter 40:43
Nobel winning genius.
Clint Murphy 40:46
Saved a lot of lives.
Chris Winter 40:47
Oh, more than penicillin. I’m sure of it. Anyway, yeah,
Clint Murphy 40:51
Fully aligned. So as we think of that, how and why of sleep. This one’s a little bit more sciency for some of the listeners, but you talk about two different phenomena. And then two chemicals that tie to it. So you talk about homeostasis, and our circadian rhythm. And then you talk about adenosine, and melatonin, can you share how these all work together on our sleep? And the interesting one on the adenosine is how caffeine interacts with it as well.
Chris Winter 41:26
Yeah, your listeners have this for sure. If I can understand it, anybody can understand it. So when you say So if you start with the homeostatic drive to sleep, what that’s saying is, the longer you go without something, the more likely you want it. Longer you go without drinking some water, the more thirsty become, longer you go without food, the more you want to eat food, this is sort of just fundamental to an organism, any organism. So the longer you go without sleep, the more you want it. And again, it might ebb and flow a little bit, meaning that wow, I was so sleepy at 11 o’clock. But when noon rolled around, I kind of got a second wind. Sure, so it’s not a perfectly linear relationship, it might ebb and flow a little bit. But in general, the longer you go without sleep, the more you really want to sleep. And that’s facilitated by a chemical called adenosine, which, if you studied the cell, like all my kids had to study the cell at some point, like you know, sixth grade was when you studied the plant cell and the animal cell and one had a membrane and one had a cell wall in the nucleus and the ribosomes. Well, if you remember the mitochondria, mitochondria are actually the little organelles in our in our body cells that take food energy, and convert it into the energy we use to run a race and lead our lives. And that was that energy currency is often called ATP. Adenosine trinucleotide phosphate. So ATP is the energy we’re getting from food. And it’s converted into that energy in the mitochondria. Well, one of the byproducts of that reaction is adenosine. So adenosine is sort of the cast off product from that energy release. And it accumulates in our brain and has the tendency to make us want to sleep. When we sleep, we sort of magically clear out the adenomine and start all over the next day. So right now you and I, and everybody listening to this podcast is accumulating adenosine in your brain. And it’s having the effect of making us want to sleep. So the longer we keep accumulating, the more you want to sleep, and like you said, we can block it temporarily, we don’t make it go away. Well, we can block that effect with caffeine. Caffeine prevents the adenosine from sort of having that effect. So if you think about the organism, and only the homeostatic mechanism, and we’ve already talked about people need different amounts of sleep. So if you’re a six hour guy, and I’m an eight hour guy, and the listeners is, you know, somewhere in the middle, if we only had adenosine and we kept checking in with each other, you know, in a week or two, I’d be going to bed at midnight and getting up at 8am, you might be going to bed at 3am and getting up at 6am. And the listener might be going to bed. And so each week as we keep checking in with each other, our schedules are just going to keep becoming more and more random. It’s like we all have watches, but mine’s a 22 hour watch. There’s a 24 hour watch, somebody else has a 23. So there would be no sort of rhythm to us. We’d be getting our six hours asleep, just all over the clock. And so we need another system to help sort of align ourselves. And this is a fundamental, again, sort of philosophy of life that we want organisms to you know, the flower opens up to get to the sun during the day and closes up to protect itself at night. Raccoons are in your garbage can at night but they sleep during the day. So we align ourselves with this circadian rhythm which we talk a lot about when it comes to sleep, but it’s really a timing for everything that our bodies do. You know, as a neurologists often say, there’s nothing our brains or bodies do accidentally, everything’s got some sort of timing a master schedule. And so melatonin is the neurotransmitter of that schedule. So what melatonin is essentially doing is starting us all off at the same time every day. So when the sun comes up, you and me, and the listener all wake up, now I’m going to sleep for eight, you’re going to sleep for six, they’ll sleep for seven. But we’re going to start off our rhythm at roughly the same time every day because of that light. And that rhythm is sort of intrinsic to us. So the combination of adenosine and melatonin creates not only a need and a pattern for getting a certain amount of sleep, but also roughly timing that sleep. So it’s always happening at the same point every 24 hours.
Clint Murphy 45:52
Okay. And so if we look at that caffeine you talked about, a lot of people think it wakes them up. But what you’re suggesting is no, no, it’s not waking you up, it’s just shutting down the chemical that makes you think you’re tired. And then what happens when the caffeine wears off?
Chris Winter 46:11
Right, so it’s a great question. And it’s a very intelligent way of looking at it. It’s, it’s not waking you up, it’s protecting you, or it’s shielding you from the effects of something that makes you want to fall asleep. There’s a nuance there. So and the nuance comes in the question that you just asked, which is, well, what happens when the caffeine is metabolized? Well, the adenosine hasn’t gone anywhere, it’s not getting rid of it in adenosine. It’s just sort of blocking its effect. So this is completely made up. If there’s some sort of units of adenosine, we have 30 units of adenosine in our brain at 10 o’clock, and we have a latte. And now it’s 11 o’clock, the latte is kind of wearing off, we now have 35 units of adenosine. So the only way to kind of keep yourself going is to consume more caffeine, because you’re still adding that adenosine. So it becomes kind of an arms race, you know, the first, you know, coffee you drink during your night shift was very helpful. But maybe that second cup is not nearly as helpful at 3am, when our drive to sleep is really high and we’ve accumulated more adenosine, that’s when you’re double shotting it or chasing it with a Red Bull or something like that. So at some point, caffeine becomes outmatched.
Clint Murphy 47:31
And then so that’s at some point during that day, but you you also have the phenomenon that over time, the amount of caffeine I need to consume to feel awake keeps going up. You know I started with a tall, then I’m on a grande, then I’m on a venti, then I’m on a venti Americano with replaced the hot water with coffee, they call that their Red Bull, or their more their red eye. Is that because the adenosine is building up a tolerance to the caffeine? And so what, what the amount of caffeine that would normally block the adenosine, it’s not strong enough anymore? What’s happening there?
Chris Winter 48:14
Yeah my guess is, and that’s an interesting question. You know, when you look at high consumers of caffeine, I’m not sure anybody beats the military, they have just such a reputation for consuming vast quantities of it. And I’ve got some some experience with individuals in various branches of the service. And you know, some of their schedules are just inhuman, you know, in terms of you’re watching on a naval ship, three hour shifts and things like that. So, to answer your question, I think what’s often happening there is imagine somebody who needs eight hours sleep consistently gets six. So they needed eight on Monday night, they got six, so they have a two hour sleep debt leading into Tuesday night. So Tuesday night, they get their six hours, they wake up and they move on to Wednesday. Now they have a four hour sleep debt. So my guess is for a lot of people who have that sort of ratcheting, or rising caffeine use, I think it’s probably parallel to rising sleep debt. In other words, if an individual needed eight hours and always got eight hours, I don’t know necessarily that they would feel that need to really ratchet up the caffeine. But that’s a really good question. I mean, there is tolerance to certain medications. But I think what would really drive that tolerance would be a debt that’s not being paid. It’s sort of I’m not an economics person. But you know, as debts continued to, you know, deficit spending, well we’ll just print more money. Yeah, but at some point, like if the debt is rising faster than you’re going to you create all kinds of problems out way. So my guess is that for those individuals that you’re like, wow, I mean, how many Red Bulls have you had today, this is your fifth by my account, that individual is not getting an adequate amount of sleep and is sort of compounding a debt most likely.
Clint Murphy 50:13
And so when we think of the sleep debt, that’s an interesting topic to go into, because for the listeners, and throughout the years, you always hear this conflicting information about sleep debt. And can you wait till Friday and Saturday night and make up for a bad week? And people say, well, no, you can’t make up a sleep debt. Some people say you can. What is the science show and how important is it to make it up? You talked about making it up quickly. And when you make it up, like can you make it up in a couple big hits? Or do you need to make it up in a sustained fashion? Thanks for listening. If you enjoy what you’re hearing so far, and want me to be able to get your favorite guests on this show, please do me a quick favor, subscribe to the show. And leave me a rating. The 30 seconds of your time will mean a ton to me.
Chris Winter 51:12
Yes, so I think you’re right to call this confusing and maybe controversial. I think that if you were to poll 100 sleep experts, I think the majority would say what I’m about to say I don’t think what I’m saying is particularly controversial. I think that for long term sleep debts, you probably can’t make them up meaning I did things in medical school and residency 20 years ago that I can’t fix now. To me, it’s almost like, I don’t smoke. But you know, for the period of between 2007 I was a heavy smoker. So then I quit. Great that you quit. And we always heard that. Well, if you were to look at that person’s lungs a few years later, there’s no evidence of the smoking. But my guess is there was some damage done that you can’t undo. You did it. You smoked heavily, but you stopped. That’s great. But there’s been some mathematical calculation of risk that has occurred versus the person who never smoked for the seven years. So when you think about sleep debt to me, it’s not about can you pay it off or not? I think he can. It’s what is the time period. And there was a really compelling study that looked at individuals who slept, you know, eight hours every night, and slept eight hours every night very well, versus individuals who averaged eight hours, meaning that instead of thinking about it as eight hours a night, let’s talk about people getting 56 hours a week. And so as long as they got 56 hours in that seven day period, they lived just as long. And were just as healthy as the people who got the perfectly consistent eight hours every night from 11 to seven. And I just have trouble believing that as an evolved organism, we can’t absorb some degree of sleep difficulty, confusion, you know, chaos or whatever. There’s this idea that we’re such fragile organisms, that if something somebody calls us at three o’clock in the morning with some distressing news, we’re hurt by that. I don’t buy that any more than I’m going to try to eat breakfast, lunch and dinner every day. Sometimes I might miss meals, I might miss a couple of meals. If I’m not hungry, I’m not going to eat it, you know, or I’m on a flight and they don’t serve food on the flight and they didn’t bring anything to eat. So it might be a while before I find some food or so I think we have the ability to deviate from perfect. And so what I always tell people is think about your sleep as a credit card. Chris is giving you a seven day sleep credit card. And what that means is you can charge up any sleep that you want, as long as you pay it off in seven days, no interest charge, no fees, no finance problems. It’s all forgiven. And so again, think about whatever you need seven hours, eight hours multiplied by seven, that’s the week that you need to have. And it’s a moving average, obviously, Monday to Monday, Wednesday to Wednesday. So at any point, the seven days that you’re looking at should always equal that 56 hours if you’re somebody who needs eight and so to answer your question, I think it’s perfectly fine to make it up with a nap, falling asleep a little bit early, sleeping a little bit late on the weekend. Maybe you know a couple of things. You sleep in an extra hour on Saturday, take a two hour nap in the middle of the afternoon because Wednesday night, you’re a police officer and you got called out and you had to deal with an emergency or something like that, or you’re a trauma surgeon or your kid was just sick and you were up with them because they were throwing up and you had to deal with all that fun stuff. And so you didn’t get sleep or a flight was canceled and you’re trying to rebook and you’re stuck in Cleveland trying to get somewhere you know, whatever the reason, there’s no value judgment here. You just have to say, oh, rough flight back from Cleveland, weather cancelled it. I was stuck in this hotel. But I didn’t even get to the hotel three in the morning, I have to be back at the airport at six to catch my flight. So I got three hours that night, should have gotten seven. So you’re four hours in debt. Where can you find four hours in the next seven days? I think that’s a great way to look at it. You know, it’s just kind of freeing, kind of frees people up from this idea that every night has to be perfect. That’s an impossible pressure.
Clint Murphy 55:23
You can sleep for 4 hours on a plane.
Chris Winter 55:26
Yeah, of course, you’re a baseball player. Like if you’re getting a hit three out of 10 times you’re the bat, you’re doing your job. I like that, you know, versus you know, nobody has this kind of gotta hit the ball every time I get up there. So I think you set the stage for good sleep as much as you can. And then yeah, you just figure it out when it goes a little sideways.
Clint Murphy 55:45
Now, interesting to that, because the you said pretty emphatically that the number one thing you give people advice when they say, What is one piece of advice I should take for my sleep, you say wake up at the same time every day. So as we adjust the hours, it feels like we’re adjusting the starting point. And we’re trying to be as strict as possible at when we wake up. Why is that the number one advice you give?
Chris Winter 56:12
Yeah, I mean, I think that again, this is sort of in a relatively perfect situation where like, I got a job, I got a couple of kids, I can sleep when I want to, things don’t really mess up my sleep too much. What’s the best piece of information you could give me? I would say if you’re trying to make changes, creating consistency in your wakeup time is a good one. Just because if you think about what’s happening when you wake up, there’s a lot going on, you are going from a dark environment to a lit environment, you are going from a relatively cool bedroom, to a warm kitchen or outside, you are going from relatively immobile to moving your body, maybe going into the gym to work out. You’re socially isolated, you’re socially around other people, you’re fasting. And now you’re fed with a you know, bagel and a coffee from dunkin donuts or whatever. So there’s a lot of very significant sensory triggers that are happening, that your brain uses to sort of mark oh, this is that time when everything changes. So it’s a really strong marker for the beginning of our circadian rhythm. So if somebody says, look, you know, I’ll do whatever you want me to do, Chris, I’m cleaning your hands. I would say, hey, on the night where you had a difficult situation, why don’t you go ahead and get up at the time most people do anyway, everybody says, you know, wake up on Saturday, when I can sleep in, I still wake up at 630. But then I kind of roll over and go back to bed and wake up at nine or you know, whatever. So why don’t you wake up at 630 have a little something to eat, take the dog for a walk, check the mail, take a look at your phone if you want to, you know, read it. And then if you’re feeling like yeah, I didn’t have a great night, Thursday night, take a nap. And this way you you supplement your sleep with your nap. But you’ve kept that morning sort of routine in place. That’s a hard thing to convince people to do. I mean, you tell that to a 18 year old college student to laugh in your face, like no, I’m going to wake up at noon on Saturday and two o’clock on Sunday. And then I’m going to try to go back to bed you know, six hours later, you know, that sort of social jetlag, but, you know, trying to keep that wake time consistent if you can, I think is good. And the other piece of advice I always give people is if you really want the secret to good sleep it’s probably being equally happy in bed awake as you are asleep. So we’re all going to go to bed at some point tonight. Some of us we’ll go right to sleep, others won’t. And what’s your plan if you don’t? My plan is I’m just gonna sit there and think about stuff, I like being in bed awake. It doesn’t scare me if you’re scared of it and hate it and it’s a living nightmare as somebody told me. I think it’s a good thing to talk to yourself and ask why. And I can tell you some of my living nightmares being abducted and stuck in a hole naked in somebody’s basement, nobody knows where I’m at like, like that silence of the lamb scene, that’s kind of a living nightmare. I would hate to be in that situation if you’re trying to convince me being in my bed awake next to the person that I love with some food the pantry at 67 degrees and my pillow is really comfortable. That’s a living nightmare. No, I’m curious how you’ve gotten to a place in your life where you feel that way. It’s just you’re just in bed comfortable, why relaxed in bed so have a plan for what you’re going to do when you get to that place because if you can embrace it, if you can run towards it, it’s completely liberating. Yeah, I made the analogy one time I saw this great video of some little you know, two year old girl or something on YouTube that was obsessed with like a slasher like Mike Myers and the Halloween movies. She loved him, like she had his poster and you know, all these books about you know, whatever, which is kind of weird because he’s like this, you know, psychopathic killer. So the parents were like, I don’t know what to do with this. But you know, whatever, she’s two years old. She has a birthday party. Somebody dresses up like Mike Myers with the terrifying mask and you know, whatever, and shows up at the party. already and the kids like, freak out except for her, she goes running towards them and hugs him. That is the key to insomnia right there. Like, if you’re looking at the situation as being Mike Myers, and you’re scared of it, it’s really sort of a self fulfilling prophecy. Like it’s creating anxiety and performance problems. And but if you’re like, oh, what if I, you know, get in bed at night, and I don’t fall asleep right away, that’ll give me a chance to plan out my vacation, read this book I’m reading, think about what to get my partner for Valentine’s Day, you know, whatever you like to think about. Like, if you’re running towards the situation, your body kind of loses that angst. And it all just kind of disappeared.
Clint Murphy 1:00:39
And Chris, while you’re while you’re sharing that you were talking about some of the things you love about your bedroom, which brings up the idea of sleep hygiene. So you say sleep hygiene is the act of controlling your sleep behaviors and environments in an effort to optimize your sleep. Basically, it’s doing what you can to set yourself up to sleep successfully controlling what you can control. So the first couple of things that really jumped out at me were this idea of creating our hibernation lair. For our listeners, what is their hibernation layer? Like you had a temperature in there, you had like, black out the room – what are some of the things the listener really wants to do to optimize their hibernation lair?
Chris Winter 1:01:25
Yeah, man, I think that there should be a degree of excitement to go to your bedroom. I think it starts with making it neat. You know, I think people should make their beds, you know, it just feels nice to get into a bed that has been made and looks really tidy. Like when you go to a hotel, it’s just all perfect and tidy. And as much as we can do that, I know we’re busy, we gotta get out the door and get to work, get the kids lunches packed and stuff like that. But you know, you take the time to make the bed does feel so much nicer and ritualistic then sliding into the unmade bed that just something that’s it’s like a present. You ever really give it a present, like, here’s some cufflinks. I didn’t wrap them up. But here they are, like in there. There’s just like in your hand like yeah, are they new? Are they recycling them? Or your grandfather? Okay. Yeah, thanks. Appreciate versus like the wrapping in the tissue paper. Like, it’s just such a nice thing. So you know, and for people who have you know, laundry that accumulates in places or your bills and weird stuff, you know everybody’s getting their tax bills now, it just, that’s fine, it’s going to accumulate somewhere just somewhere other than your bedroom. That bedroom should be like a little sanctuary, little zen moment when you walk in there. And you know, I’m a big fan of showering before you go to bed because I don’t want to get into the bed dirty, you know, you can the shower in the morning, if you want to and there’s lots of good things about that. But I love showering at night and being clean and getting into that bed. So you know, the sheets that feel good to you. It’s amazing how many patients I asked, what kind of pillow Do you sleep on? They have no idea, can’t tell you anything about it. It’s like the pillow they were using in high school. And it just came with them to college. And then they met a girl and then they got moved in together, it just got dragged along and nobody knows anything about it. And God knows what’s inside. Yeah, there you go. So actually putting some thought into the pillow, you know that it fits you, fits the position you sleep in, the weight is right, the temperature’s right. So I think when you kind of put all those things together, it becomes kind of an experience that you hopefully look forward to. And I think that, you know, there might be sort of a privilege here that if you’re listening to like, to me and like look, I’m living in my buddy’s apartment because you know, my house burned down, I couldn’t make a mortgage payment because I lost my job. I apologize, you know, but everybody can do the best they can to kind of create, if you sleep on your buddy’s couch, get some $5 pillow spray or something and every night before you go to bed you spray a little lavender spray on your pillow. And it just kind of elevates it a little bit. Or you know getting a nice blanket that really feels comfortable to you, anything like that, that you can sort of create that sort of ritual and schedule with I think really makes it a nice experience and then creating as much darkness as you can is good if you can’t because you’re like look I’m in somebody’s living room and they don’t have great shades, then you get a little cheap eyemask and have that be part of your ritual. So whatever situation you’re in, you can sort of elevate that sleeping experience and I think it elevates our sleep in general.
Clint Murphy 1:04:26
And then for the room itself any desired temperature any ideal temperatures for sleep.
Chris Winter 1:04:31
Most people say 65-67 degrees. I get dirty, dirty kind of mean emails from people in Florida and Arizona are like sure I’ll do that if you want to pay for my electrical bill you know kind of thing so there are some cheap ways you can create a lot of you know, a lower temperature in your bed there’s some products, one’s called chilly pad or it’s a company called chilly or sleep me if you remember the, the company’s name has changed but they make something called chilly pad and ooler and dark pro where you can put it on whatever bed you’ve got. And it circulates water through little coils. So even if your room’s kind of hot and humid, the bed can be super cool and it’s dual zone. So one of the things that upsets a lot of people is that, you know, I like a very, very cold bedroom, but my, my wife, not so much, not not quite as cold as I would like it. So if you’re somebody who likes it kind of warm and toasty, and your partner likes it frigid. And then with the window open in the wintertime, you can create that situation with that device. And they’re kind of pricey, but I think they’ve got a pretty liberal return policy. And I’ve met people said, my God, it’s worth every penny because I’ve got hot flashes or I sleep really hot, and I sweat a lot at night. And if I get it cool enough that it bothers my partner, and then I have to sleep without covers on which makes me feel bad. So you can sleep with the covers on all you want. Because the bed is frigid if you want it to be.
Clint Murphy 1:05:59
Yeah, like that idea. Different points. As I’ve gotten older, I’ll just wake up drenched in sweat. So the idea of that would be powerful. Now what about these weighted blankets that we’re seeing now? Pros Cons, what are your thoughts on them?
Chris Winter 1:06:15
I would say there’s the pros probably outweigh the cons. I mean, the cons are probably, you know, for a very small child, or an adult with mobility issues, Parkinson’s patients sometimes kind of get stiff at night and have trouble moving, it might be kind of suffocating. Another con is probably not a lot of great research behind it. So I’m not going to sell you on a weighted blanket based upon the placebo blinded controlled studies that show they do things but you know, what I always tell patients is when you go to the dentist, they put the lead apron on your body and do the dental X rays. What is your immediate response when they put that heavy, you know, apron on if it’s a kind of like that feel it’s like this generalized pressure on my body, then you might like it. You know, to me, it doesn’t have to be scientifically, rigorously proven for somebody to say I like it, it makes me sleep better. I’ve got a few because every now and then I have Restless Leg Syndrome, it’s pretty uncommon. But when it happens is this is incredibly uneasy feeling in my legs, it’s hard to explain, you just want to get up and walk around, you don’t want to be still. So when I feel it, I just leave the bedroom, go to the guest bedroom, I’ve got a weighted blanket in there and I get underneath it and it’s heavy, like heavy to the point where it’s kind of hard to flip from your back to your front or your front to back when it’s on you ,but I really liked that weight on me it kind of quells that feeling. So it’s one of those things where outside of losing the money for the weighted blanket that you might spend, and maybe you could send it back or regift it to your friend, you know, wrap it up really nicely and give it to him. I don’t think there’s a lot of risk involved with it. And for some people, they really resonate. For other people. I mean, like my wife hates them, she doesn’t feel anything positive with that. It’s like cleaning your ears. Like there’s something about when I clean my ears with a cute tip like that feels really, really good to me. And my wife is like, I don’t feel what you’re feeling like, it just feels like you’re just rubbing a Q tip on my forehead. Whereas I mean, I can’t even describe the feeling the thoughts.
Clint Murphy 1:08:28
Pure bliss, you and I are wired to like because I actually do sleep with a heavy blanket as well. And I love when I use my Q tips. My wife says I have a specific cute tip face that I make that doesn’t look very flattering, you know, because you got it right in there and you’re carrying it and she says your Q-tip face, I gotta film it. But probably have the weighted blanket, gosh, it must like I’ll put it on and I’ll sleep with it at every night. And then every once in a while that it’ll fall off, I might not put it back on for a night or two. It’s to your point. It’s like the dentist, that lead blankets. It’s just grounding and relaxing. And it just feels like whether it’s the anxiety or the ADHD, it just melts away. And it’s like, okay, I’m in bed.
Chris Winter 1:09:11
Think about you know, what do you do for a crying baby and remember that
Clint Murphy 1:09:16
Yeah, you swaddled them. You rock them. You hold them.
Clint Murphy 1:09:18
Oh my gosh
Chris Winter 1:09:18
Remember was in the hospital the first time the nurse showed me with my first child, I remember thinking, hoo that looks a little tight there, like, are they able to breathe and they just loved it. And you know, what do you do with an adult who looks pretty down like your buddy and you walk away crying, oh, my what’s going on? Come here, come here. And if you read an instruction manual, put your arms around your crying friend and squeeze, not to the point of pain but to the point like it’s such a we have little receptors in our nerves that respond to pressure. And so it’s interesting that that’s comforting to us. And it’s funny because I’ve talked to patients over the years, who said really the great thing about sleep is it’s like one when one step removed from sex, like when you’re talking about sleep, it’s a pretty intimate kind of discussion. I’ve had patients say like, I had one woman say I dream about lying down on the boxspring. And then my husband putting the mattress on top of me, and I’m sleeping kind of Oreoed, between those two things like that just really feels good to me. Or, you know, people want their legs wedged underneath their partner when they sleep. And they like that feeling of like you said, grounding, it’s a great word or anchoring. It’s like, kind of wedged in there. You’re sitting there’s little, there’s, there’s really nice massage chairs.
Chris Winter 1:09:26
Fit into the groove. Yeah. Arm and the leg is the best part of it. It just kind of seals up your arm and your needs and does all that stuff. But that pressure? You know, for some people, it’s just the best thing in the world.
Clint Murphy 1:10:51
Yeah, I’m with you on that. In the book, you referenced the one company and I tried to find there, it was almost like an adult sleepsack like a online but I couldn’t find it. I don’t know if they went out of business, or..
Chris Winter 1:11:05
They did. Okay, there is a new one. I think it’s called sleepsack. sleepsack. Okay, pretty. Yeah, it’s a pretty lightweight fabric. So I don’t know how much it’s pushing on you. So I mean, the weighted blanket, you know, is very heavy. I don’t think it’s like the degree of like a compression sock, or like women who wear like tights or leggings. You know, it looks a little lighter than that. But it’s yeah, it’s like you’re sleeping in this sock that really does kind of it looks like really stretchy material. So I’ve never tried one. But it might be kind of a nice thing as well, too. They kind of feel a little just a little bit of pressure. My wife said something funny the other day. She’s like, leggings feel great, until they don’t. I thought… Yeah, yeah. them off. You know, and yeah, it’s funny you mentioned that the weighted blanket. Sometimes it does fall on the ground. And like, I’m like, oh, it’s on the ground. I’m not picking that thing up tonight. Like it’s like pulling a body.
Clint Murphy 1:11:28
Chris Winter 1:11:43
Right on the ground. It’s lost until the morning. But it does sometimes feel good when you’re when you get out from under it even though you so can you can like it both ways, like the pressure then when the pressure is gone. It does feel kind of…
Clint Murphy 1:12:10
Yeah, you’re almost it’s almost light for a night or two. And so one more question on the book, before I throw a final four fun ones that you is, it’s around routines, because like we’ve mentioned babies throughout here, and kids and like, a lot of parents don’t do this. And then they tell you, their kids aren’t good sleepers, but the whole idea of like, hey, every the first thing my sister taught me when I had my kids, she’s like, hey, look like do the bath this time, then do this, then read a book, then do this. And then they’re in bed. And she’s like, do that every night forever. And as soon as you go to the bath, they’re like, it’s bedtime. Let’s start getting ready. (A) Why don’t adults do that and (B) what would a healthy daily routine from the time we wake up till we go to bed? What are some of the things we should be thinking about on that journey to have a good routine?
Chris Winter 1:13:06
I think adults should do that. I think your point is a very good one. And again, it’s sometimes kind of an interesting space you find yourself in in terms of as a physician, I want you as the parent to do what you think is right for your child, I’m not here to tell you that, you know, if your child sleeps, whenever she wants to sleep, my guttural rule, we can sleep, whatever we want to day or night, that’s up to you, as long as you’re okay with sort of the consequences of that, you know, if somebody’s saying, look, I need help trying to establish his schedule, that’s usually the more typical visit. But I don’t know why as adults, we lose it. But I think that we should have it. So to me, it would really be starting your day off at the same time, like we talked about, and whether or not you’re really hungry for breakfast, trying to eat a little something right off the bat, even if it’s just half a banana and some water or something like that. Just trying to sort of engage your eating or your digestive system at the same time every day. And so with that, I’d like to see people try to eat about the same time every day. And so if lunch rolls around, and your lunchtime is noon to one and you don’t feel hungry, you don’t have to eat but maybe if you kept like a bar or something and had a little bite of a bar more just to let your brain know, I’m not going to eat much today. But this is the eating time. I’m just not going to have my typical lunch because I’m not that hungry. I think exercise at the same time every day. Really trying to shut down electronics and light in the evening is really important. And I think you know, the older I get the more I think about mindfulness and meditation and just trying to have a time at some point in the evening where you’re away from the phone, away from the television. I think that’s a great time for prayer, meditation, breathing exercises, just something you know, that you do during the day. I try to get all my athletes that I work with, to have 15 minutes at some point every day to rest. Not not necessarily sleep, although sleep happens, that’s fine. But so you’ve got to find a quiet place every day at two o’clock. I always did it right before my lunch break ended. So my lunch was, you know, one to two or whatever, always had a later lunch. And so from 145 to two was always that quiet time. So before I saw the two o’clock patient at 145, I just tried to put everything away and just close my eyes and do some breathing exercises or meditate or add little games, I would play in my head or whatever, if you use meditation device. I have this little thing called a Muse. Sometimes I would pull it out, do a little session with the Muse and then two o’clock start your day. And if you fell asleep at 145, I had an office manager, you’d come in wake me up, you know, if I drifted off, and so, but that was never the goal to sleep, it was always really just to shut my mind down. And it’s a great thing to kind of practice with children calling it rest time instead of naptime. So they’re not under like a subtle pressure to sleep.
Clint Murphy 1:16:06
And then one thing I thought interesting was this idea of our temperature regulation. So whether it’s a hot bath, you do a hot shower, sometimes I find if I do my steam shower, then when I go to bed, it’s like yeah, I’m a little bit sweaty, but I’m just like, ah, melt into the bed. What is it about raising our temperature, that makes the sleep easier.
Chris Winter 1:16:32
So when you look at I did a podcast episode on that. So when you look at temperature, temperature sort of peaks around four in the afternoon, and starts to slowly start to drop after that. And about the time we’re going to bed is sort of the steepest drop of our temperature. So preparing for bed, it’s usually a time where people want to be warm, you know, a blanket, when you watch TV, warm socks. If you look at dogs, they kind of cuddle up with each other in the evening, they usually don’t do that during the day. So they’re kind of that sort of a nesting behavior they do before they get ready to sleep. And then you know, as we sleep, we’re trying to kind of create a safe place where we can be more cool. So I think that, you know, sleeping in lighter clothing and things of that nature in a cooler environment, it can really help to facilitate sleep. But a lot of people like the I like a really hot bath or a hot shower, about 30 minutes to an hour before I go to bed. So I heat up, gonna hop out of the shower, put your shorts and a T shirt on, it sort of encourages that cooling phenomenon that really kind of leads us to help us sleep.
Clint Murphy 1:17:34
So we heat ourselves up, which causes the body to say I’ve got to cool you down, then we go into a cool room. And just the combo of all of that is a little cocktail to go to sleep because the last thing you know you talk about you’re not a fan of and most sleep experts, I see say the same thing. Alcohol and sleeping pills are not a sleep aid. They’re a sedative that basically just knocks you out, which isn’t sleep so we want to avoid those?
Chris Winter 1:18:05
100%. I mean, you don’t have to avoid alcohol. If you can’t imagine eating a hamburger without a beer, then choose the beer but you’re choosing the beer because you liked the taste. You really liked the way it pairs with the hamburger. Just don’t choose it because you think it’s improving your sleep or you’re somebody who says well, I hear what you’re saying, Chris, but I just it just helps me relax a little bit better. Well, that’s not the point. Like we shouldn’t be using alcohol to relax or sedate ourselves at night, we should be able to do that ourselves. And the sleep that we’re getting when we’re consuming alcohol is not good. I mean, you don’t meet a lot of people who drink a six pack every night and say I feel great. And you certainly don’t find a lot of people who when they come off of it when you convince them, look, you can do better than this, just go without it for a while. I don’t think I’ve ever had come to me come back and say yeah I did your way for a few months of not drinking alcohol and I think I’m gonna go back like it never happens. Yeah, I understand people have stressful jobs and stressful lives and they want something just to kind of blank the screen like, but we can’t rely on craft beers to do that.
Clint Murphy 1:19:14
Chris, you have a couple minutes for a quick final four questions?
Chris Winter 1:19:16
Clint Murphy 1:19:19
What is a book that’s had a major impact on your life?
Chris Winter 1:19:22
House of God by Samuel Shem.
Clint Murphy 1:19:25
House of God, okay.
Chris Winter 1:19:27
It’s the book that’s St. Elsewhere, an old TV show is loosely based on it’s sort of the lives of medical residents and it’s pretty close to the way it really happens. Grey’s Anatomy is total fiction. I don’t know what world they’re living in. But this is a great and I read it when I was young, like when I was in high school. And I read it while I was in the thick of residency and I’ve read it many years later and it’s written by Samuel Shem and it’s pretty honest and could may be off putting to some people. But he had these rules of the House of God. And there and they talk about him at the end of the book, there’s a little appendices, and they have these 12 rules of the House of God, and one of my favorites was, you can’t find a fever if you don’t take a temperature. Which I’ve always thought was hilarious. And so in my new book, The Rested Child, I had at the end of the book, rules of the house of sleep, which was a shameless ripoff of Samuel Shem. But it was really more of a tribute. But there’s certain rules that we have in the clinic, like you can’t fall asleep hanging sheet rock. What I mean by that is a lot of people who are very active, busy lives, they don’t nod off like they would if they had a job where you sat at a computer all day. And so these people often hurt themselves driving home because it’s the first time they sat down all day. So we have these little saying we say at the clinic so I put them all together and made the rules of the house of leep at the end of that. So that would be the book.
Clint Murphy 1:20:58
Oh, it’s beautiful. What’s on the bookshelf right now? What are you reading today?
Chris Winter 1:21:02
Right now I’m reading a David Bowie biography. And I am trying to finish up the book Catch 22. And then I got another book that I’m just getting started, but I’m blanking on the title right now.
Clint Murphy 1:21:15
I love it. Multi-books on the go. I tried that for a couple of years. It was beautiful.
Chris Winter 1:21:21
I don’t like I don’t mean to do that. But yeah, that I am doing that.
Clint Murphy 1:21:24
What is something under $1,000 in the last year or 18 months that Chris has bought that you’ve said, Wow, I wish I had got this earlier.
Chris Winter 1:21:35
Barista mini espresso coffee maker. That’s probably like $700. I love to start my day off with a latte. I love coffee. I like the ritual of it. If you said, look, Chris, you can never have coffee again. I don’t lean on it to get through my day. I just love making it and the science behind it and the taste. And so I sip on this one latte all day long. But I did some calculations, I think for Men’s Health magazine, and figured out that if you bought well, if you’re somebody who gets a Starbucks latte every day, just the plain latte, that I think you’ll make this money that you spend back within, you know, nine months or something like that. Then after that every latte, you drink, you’re making money. So it’s fun. It allows you to experiment with coffee making and different kinds of coffee beans, and it will in this time of trying to save money, it’ll it’ll definitely make you save money
Clint Murphy 1:22:26
And what was the brand of it?
Chris Winter 1:22:27
It’s Breville Mini. It’s like the barista Mini Express or the mini barista Express or something like that. But it’s there. It’s like the main one that they sell. And it was on sale there for a little while like it, you know, Williams Sonoma and on Amazon, so yeah, give it a shot. It’s fun. I really enjoy enjoyed that.
Clint Murphy 1:22:48
Yeah,, I’ve only got one of the Keurig ones at home. And that just that’s just not and then my wife buys like the cheap K cups.
Chris Winter 1:22:54
This allows you to get get rid of that cake up waste.
Clint Murphy 1:22:58
Yes, yes. I’m gonna convince her it’s a good idea. And I’ll work on that. So the last one, what is one mindset shift, habit change or behavior change that you made in your life at some point that had an oversized impact on your life.
Chris Winter 1:23:17
I stopped viewing exercise as optional and viewed it exactly the way I view brushing my teeth. I don’t you know, it’s tough. You know, as a doctor, you’re working towards helping people move in a certain direction with their health and I get it people are busy. I have three kids. There were times in my life where exercise was just not happening. But I think if you can boil it down to 15 minutes a day, you’ve got a treadmill or you bought a peloton and you’re not using it. Can I convince you that when you’re watching the news, when the first break for commercials comes on, and the psoriasis commercial is happening, can you get up, go sit on the peloton, don’t even start a class and just pedal until David Muir comes back on so it’s talking about you know, Chinese balloon floating over Montana or whatever. So, to me, exercise, there’s a lot of components. One is just establishing the rhythm. So what I would say to you know, somebody who’s not exercising right now is you devote two minutes every day to brushing your teeth minimum, I’m guessing, can you give me 13 minutes of your day to exercise. And what I often tell patients is you’re not allowed to do more, like you’re not allowed to exercise longer than the commercials of the ABC nightly news. So every time the commercial comes on, you go over there and pedal the bike, the commercial ends, you get back on and that’s all you’re, even if you want to exercise more you’re not allowed to. At the end of two weeks, you can extend that if you want to, and if you want to keep doing it just during the commercials, that’s fine with me too. I think the hardest part of exercise or anything like that is the establishment of the habit. And yeah, I think people jump into it too hard. I think people look at it. Oh, I only have 13 minutes to exercise because my kids going to need to be picked up in a few minutes so I’m not going to do it. Because I only have 10 minutes, then exercise for 10 minutes, you know, and if you can get to a place where you like wow, for the last 21 days, I have exercised every one of those 21 days. We love a streak, video games and cell phones have proven out over and over again. So you can get your streak set at 21 days of exercise. I don’t care what kind of exercise you’ve done. That’s great. You kind of build from there if you want to, and never get to the place which I think a lot of us do where you feel like well, I’ve only got X amount of time to exercise. That’s not enough. You know, for the more seasoned exercise or runner or weightlifter, I run every day after my clinic with my two dogs, no amount of time is too little. And then we have this sort of escalation. I did a mini triathlon, now I’m doing an Olympic triathlon. And I remember when I was training for triathlons, I got into a phase doing them where if I didn’t have three hours to bike, I just didn’t do it. So that was kind of crazy. Like that’s, I felt like that was really getting unhealthy. Like I’m not going to win any awards. We’re not what am I doing here? I’m missing Sunday breakfast pancakes and my kids. Because I have to do a three hour bike ride. No I don’t a 20 minute bike ride is fine and have pancakes. So I would say just start with establishing a rhythm or a habit even if it’s just five or 10 minutes. And you can’t say no, because you have the two minutes to brush your teeth. So everybody’s got that time. And if you don’t believe me, look at your phone and go to the place where it shows your cell phone usage over the last week, you had time to look at the YouTube videos and the Tik Tok videos and social media and compare yourself to your friends. You’ve got time to walk or do some leg lifts or some stomach crunches.
Clint Murphy 1:26:42
And so we went pretty far and wide on the book. Is there anything we missed that you want to leave the listeners with?
Chris Winter 1:26:49
I don’t think so, I’m gonna guess that they’ve had had enough of me for one Listen, so but yeah, if people want more they can find my podcast or find my books pretty easy.
Clint Murphy 1:26:59
Perfect. And where can our listeners find you? We’ll get that in the show notes.
Chris Winter 1:27:02
Yeah, so Twitter and Instagram. It’s DrChrisWinter. I’ve got a TikTok but the best video on that one is when the power went out and I got really upset about so I happen to be filming myself doing something the power went out which it always goes out at my house and so that my best tiktok has nothing to do with sleep, just an angry tirade about why the power always goes out in our neighborhood but nowhere else in the city of Charlottesville. So those two places are good. I’ve got a YouTube channel it’s called Sleep Unplugged and my podcast is called Sleep Unplugged. You can find that anywhere and then Sleep Solution and The Rested Child.
Clint Murphy 1:27:37
Perfect. We will get all of that in the show notes. Thank you for joining me today. It was a pleasure chatting
Chris Winter 1:27:42
it probably you have good day bud.
Clint Murphy 1:27:44
You too. Bye
Clint Murphy 1:27:51
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