79. The Sleep Expert | Get to sleep and stay asleep
May 31, 2022
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Sleep expert Mike Stone, MD discusses various strategies for getting a good night's sleep, including the impact of caffeine and alcohol, the effects of artificial light on sleep, and the risks and benefits of melatonin. He also addresses the challenges doctors face with night shifts and offers tips for improving sleep quality.
Night shifts have negative long-term effects on mental health, cardiovascular disease, all-cause mortality, and dementia, but strategies such as light exposure, caffeine timing, and creating a supportive environment can help mitigate the impact.
Deep sleep (slow wave sleep) is essential for memory, cognition, and restfulness, while REM sleep is crucial for new memory formation and learning, and taking magnesium supplements and using sleep trackers can improve sleep quality.
Light exposure plays a significant role in regulating sleep, with sunlight early in the day setting the circadian rhythm, avoiding bright lights and screens in the evening signaling wind down, and establishing a consistent routine for night shift workers to overcome challenges.
Deep dives
Night Shift Scheduling and its Challenges
Night shifts, especially rotating shifts, have negative long-term effects on mental health, cardiovascular disease, all-cause mortality, and dementia. While there is no perfect solution, there are some strategies to mitigate the impact. Light exposure is important, so getting sunlight early in the day and wearing sunglasses after a night shift can help regulate the circadian rhythm. Careful caffeine timing is also necessary, balancing the need for alertness during the shift with avoiding sleep disruption afterwards. Creating a supportive environment at home, with a cool, dark, and quiet bedroom, is crucial. Avoiding eating during overnight shifts and maintaining regular eating times can also help improve sleep quality. Overall, night shift work is challenging and can have significant consequences, so finding ways to prioritize sleep and recovery is essential.
Understanding Sleep Stages and their Importance
Deep sleep (slow wave sleep) and REM sleep are the two most important phases of sleep. Slow wave sleep is essential for memory, cognition, and restfulness, while REM sleep is crucial for new memory formation, synaptic connections, and learning. The sleep cycle typically progresses from light sleep to deep sleep to REM sleep over the course of the night. Alcohol consumption before bed disrupts REM sleep, while drinking earlier in the evening may affect slow wave sleep. Magnesium supplements may improve sleep quality, and using sleep trackers can help identify patterns and adjust behaviors to improve sleep.
Managing the Impact of Light Exposure and Alcohol on Sleep
Light exposure plays a significant role in regulating sleep. Getting sunlight early in the day helps set the circadian rhythm, while avoiding bright lights and screens in the evening signals that it's time to wind down. Alcohol disrupts sleep, especially REM sleep, and the timing and quantity can influence its impact. Having an optimal sleep environment, including a lack of noise and light disturbances, is crucial. Night shift workers face unique challenges, and establishing a consistent routine can help them navigate the difficulties associated with working against their natural sleep-wake cycle.
Caffeine's Effect on Sleep
Caffeine blocks adenosine receptors, which reduces sleepiness and increases alertness. The impact of caffeine on sleep architecture is opposite to that of alcohol, with caffeine primarily affecting deep sleep. Caffeine has a half-life of 4-6 hours on average, and its effects can persist for up to 12 hours in slow metabolizers. It is generally advised to avoid caffeine consumption at least 6 hours before bedtime to minimize sleep disturbances.
Temperature and Sleep
Maintaining a cold room temperature between 64-68 degrees Fahrenheit can improve sleep quality. Cold environments promote easier transition into sleep. Personal preferences for room temperature may vary slightly within this range. Tools such as cooling pads or cold weighted blankets can further enhance the sleep environment. Experimenting with temperature modifications, such as taking a hot shower before bed and entering a cold room, can help identify optimal conditions for individual sleep comfort.
Sleep expert Mike Stone, MD joins us for a conversation about how to sleep well (and strategies to do it poorly!) We cover: how sleep cleans your brain, alcohol, caffeine, a pragmatic approach to wearables, light exposure, the villainy of devices before bed, cannabinoids, heat, room temp, and night shifts.
Guest Bio: Dr. Mike Stone has been in medical practice for almost 20 years, and currently serves as the Chief Education Officer at Wild Health. Dr. Stone has held academic appointments at Harvard Medical School and UCSF, and has received multiple national awards for education, innovation, and leadership in medicine. He has spent the bulk of his career focusing on educating students, trainees, and colleagues. Mike is obsessed with optimal health and peak performance, with a deep interest in the effects of lifestyle interventions to improve longevity and cognitive function. He is currently focused on knowledge translation for healthcare practitioners, striving to empower practitioners with practical techniques to competently construct strategies and tactics for their patients' health optimization.
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