Dr. Michael Breus

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O: Hello Dr. Breus and welcome to the show.

M: Thank you. I’m excited to be here.

O: I am so excited to be talking to you and honored. You’ve been everywhere, you’ve been on Oprah and Dr. Oz. People love you and love your stuff.

M: Well, you’re very kind to say so. Sleep is one of those topics where everybody’s got to do it. I don’t think I’d be nearly as famous if I was a cardiologist. It’s so funny because when my wife and I go to a party she’ll say, “Don’t tell anybody what you do, Michael.” Because the second I do she just kind of rolls her eyes and walks to the bar because she knows I’m going to get hit with sleep questions, or chronotype questions, or things like that. We have a lot of fun with it though.

O: Yeah. Let’s start by you sharing a little bit about yourself.

M: Of course. I’m an actively practicing sleep specialist. I’ve been in practice for about 17 years. I have a PhD in Clinical Psychology. I’m board certified in clinical sleep disorders. What that means is I took the Medical Specialty Board without going to medical school and passed. They said, “I guess you’re a sleep doctor now.” I’ve been in practice for 17 years. I treat everything from sleep apnea to narcolepsy but my specialty is insomnia. As we were talking about before we started the show, I have a new book out called The Power of When.

O: Right. We’re going to talk all about the book. Before that, why sleep? Why was it interesting?

M: Yeah, it was kind of serendipitous. I didn’t grow up saying, “Hey, I want to be a sleep specialist.” It wasn’t because I had sleep problems, people always ask me that. When I was doing my residency, there were rotations that you could take. It was my first rotation and nobody had taken the sleep rotation. I thought, “That sounds kind of cool, who knows what that might entail?” I didn’t know anything about sleep apnea or narcolepsy. I knew a little bit about insomnia. I said, “I think I’ll give it a shot.” It turned out by the third day, I absolutely fell in love with clinical sleep medicine. I’m very fortunate, I can literally help people like that. In 48 hours, I can change a person’s life. That’s a very unique gift to be given, I respect it a lot. If I can identify a sleep disorder in somebody and get them treated fairly quickly, you change somebody’s sleep, you change their life.

O: Yeah. Not too many doctors could say that. They can change someone’s life like that. The confidence behind that is amazing.

M:Oh yeah. It happens all the time. It gets to the point where when I’m walking into a room with a patient they’re like, “Doc, I got to tell you something.” I’m like, “Yeah, yeah, I know. I changed your life.”

O: You’re doing good in the world. You wrote this book to help many other people. It’s called The Power of When. It’s a beautiful, well written, really, really interesting book.

M: Thank you.

O: I haven’t read all of it. I read just a little bit and I loved what I saw. I took the quiz and you’re dividing people into chronotypes. What you’re saying is you don’t have to be an early bird. It’s okay to sleep late because you’re different, you can be different than other people.

M: Exactly. It’s interesting because when you start to look out there at things like the Miracle Morning. I like Hal Elrod, as a matter of fact he interviewed me for his movie. I was kind of the opposite side of the coin because I was talking about how people can be successful without waking up at [5:30] in the morning and without putting themselves in that spot because everything that I do is based on science. This is all about your genetics. As a matter of fact, I’m going to be starting to talk with several companies that do genetic testing. They want to be able to talk more to people about chronotypes and what does that mean. There’s data that now show that I just got to study actually today from a doctor at Stanford. He showed me that if people don’t follow their chronotypes, specifically women, the incidents of breast cancer is significantly higher in women who do not follow their chronotype than in women who do follow their chronotype.

O: Wow.

M: Yeah, I know. This is hard core serious stuff. That’s part of what got me interested in this was I started to learn a little bit about the literature on chemotherapy and chronotypes. We now know that if we deliver chemotherapy to somebody at very particular times in their 24 hour cycle, it’s actually more effective and we use less chemotherapy which is even better for the body. Because remember, chemotherapy is basically poison that’s going into the body that kill the cancer cells. We’re learning a lot more about chronotherapy. If you really want to know what kind of the bleeding edge of medicine is, it’s chronobiotics and it’s chronotherapy.

O: How did you come up with this book, The Power of When?

M: I tell you, it’s interesting. Thank you.

O: I like it.

M: Thanks. You like it? Good. What was fascinating was I had a patient and she wasn’t doing very well. Usually my patients do very well. She had insomnia and all the things I tried didn’t work. I tried different techniques, we tried nutraceuticals, we even tried pharmaceuticals and it wasn’t working for her. I brought her back in and I said, “Sit down and let’s learn more about what’s going on with you.” She said, “It’s not that I can’t fall asleep and it’s not that I can’t stay asleep.” She said, “I sleep at the wrong time.” I said, “You sleep at the wrong time?” I said I had heard of shift workers, people who work at night and sleep during the day. I have two kids, a 14 year old son and a 13 year old daughter. Let me tell you something, if it’s up to them, they stay up until [2:00]AM, and they sleep until [12:00] the next day. I said, “Is it kind of like that?” She said, “It’s exactly like that.” I thought, okay. Usually you don’t find that in a lot of people, at least walking into a sleep center. I said, “I want to delve a little bit more deeply into this.” She said, “You need to do it quick because my boss told me that I’m going to get fired if I don’t show up at work on time and stop falling asleep in meetings, and be more productive.” I took that as an opportunity. I said, “Can I call your boss?” She said, “Sure.” I called her boss and I said, “I want to try an experiment with her. Can we have her show up to work two hours later than she normally would and stay two hours later than she normally would just to see what would happen because I have a feeling her levels of productivity would change significantly.” He said, “Let me tell you something, I’m going to fire her in a week so whatever you want to try, give it a shot.” He said, “I really like her but I can’t keep her here. She actually sleeps at meetings and it’s a problem.” I called him back about a week later and he said, “I don’t know what you did but it’s amazing, big change for her.” He said, “She shows up at work at the new time, she’s productive, she doesn’t fall asleep in meetings, her work product has improved 1000%.” He’s like, “This is fantastic.” I went to call her to tell her the news and her husband answer the phone. I said, “How do you think she’s doing?” Just being curious. He said, “I like my wife more now.”

O: Wow.

M: I thought, “Wow.” That’s a powerful statement to say. I said, “How did the kids feel about her?” He said, “She’s getting along better with the children, we’re not fighting as much in the family.” He’s like, “I think it was all that she was just exhausted all of the time. We had to find the right spot for her.” I said, “Okay, sounds like we did.” When I was interviewing her again, she said to me, “One of the other things I notice now that I’m going to work at a certain time and leaving at a certain time is throughout the day there are time periods where I find I could do things better. Sometimes I can read things better, or sometimes I can write things better.” We were trying to find these zones for her. I said, “She can’t be the only person this happens to.” I’m a sleep specialist and I’m doing all the stuff. I got to figure this out so I dove into the research pretty hard and happy. I found almost 400 studies looking at chronotypes and what are they, and how do they work. It wasn’t just earlybird and night owl. When I use the word chronotype sometimes people think, “Oh, he’s talking about early birds and night owls again.” It’s not just that. It’s that, but it’s not just that. It turns out that there are actually four different types. There wasn’t a way to assess them. There wasn’t a questionnaire, or a quiz, or even a medical device that I could use to test them so I made up my own. That’s the quiz. If people are interested, they can go to thepowerofwhenquiz.com. I’m sure you’ll put that in the show notes for people to check out. You can go there for free and I don’t ask you for anything. Go check it out. Take the quiz and see what you are.  Once you fall into one of these four distinct buckets or these chronotypes, I’ll tell you what they are in just a second, then I know what your hormone distribution is for 24 hours cycle. When I know when your cortisol is high, your melatonin is low, your adrenaline is high, your serotonin is low, I can actually use that information to tell me what time of day you should do certain activities. I figured out the best time to have sex, eat a cheeseburger, run a mile, ask your boss for a raise, you name it. I figured out the timing for it and that’s what the book is all about. Most books tell you what to do or how to do it but they don’t tell you when to do it so it’s called The Power of When.

O: Yeah. That’s brilliant. I love it.

M: Thanks.

O: Let’s go into the chronotypes. You have all kinds of interesting animals that are in your book.

M: Yeah. Did you take the quiz?

O: I did. I will talk to you about my quiz later. Let’s go into the chronotypes. I have a lot of questions.

M: You’re allowed to have as many questions as you want. There are four different chronotypes. I didn’t like the idea of being a bird. I’m a mammal and I wanted to choose animals that actually represented the chronotypes. Early birds turn into lions. We know that lions, their first kill is early in the morning, we know that they can get lazy by the middle of the afternoon. It fit well with them. Lions make up approximately 15% of the population. My lions are oftentimes my leaders. These are my COOs of a company. They’re very organized people, they’re good managers, they have a tendency to make a list at the beginning of the day and then go from step one to step two to step three. They don’t like to derivate very much. They’re kind of type A personalities that have a plan and like to work their plan. The problem with being a lion however is they get up at [5:30] in the morning so by [8:30] at night they’re done. They want to be in bed at [9:00] and they miss out socially on a lot of things that might occur. Sometimes my lions can be on the lonely side, or they’re going to bed, they’re missing out on all the fun, they feel like they’re missing something on the social scene. The next one is somebody that’s in the middle. Not a lion but also not what I call a wolf but what I call a bear. Bears make up 55% of the population. These are my extroverted, fun loving people. These are the folks that work really hard but they also play really hard. If you go out to dinner with them, they’re telling the funny stories, they’re goofing off, they’re buying the drinks, they’re doing all than kind of fun and more social related stuff. I always enjoy spending time with bears. Most of society is built around the bear’s schedule because there’s so many of them, I mean one in two people is a bear. The next group are what I fall into which is the wolf category. I’m a wolf, I’m a late night person. I rarely get in bed before midnight. If I had my druthers, I would sleep late if I possibly could. Wolves have a tendency to be more introverted but we’re also very, very creative. We’re the actors, the authors, the musicians, and the creative types of people. We have a tendency to not trust people too much at first but once we get to know them, you really can’t shut us up. We’re very loyal friends and we enjoy people’s company. The world wasn’t meant for people who are wolfish like myself because not a lot of stuff is open late at night. The stuff that is open isn’t necessarily very good for you, like fast food places or things like that. The world isn’t really ready for wolves as it would be right now. Again, wolves can be very successful entrepreneurs. A lot of my entrepreneurs actually are wolves. A lot of my computer coders are wolves, oddly enough. It’s kind of interesting. The final category are the dolphins. My dolphins are my problem sleepers. These are the people that I do see walking into my office fairly regularly. They’re highly intelligent but they have this perfectionistic quality to them. They’re a little bit on the obsessive compulsive side, a little bit neurotic, and sometimes that perfectionism gets in the way of them actually being productive. They’re always type A personalities but not type A in a good way. Type A in way that kind of stops them from being able to get to where they want to go. Those are the four different chronotypes but I will tell you that there are hybrids out there. I’ve got some people who are a bear, who lean more in the lion direction, or lean more in the wolf direction. I’ve got people who have hybrids of all the different ones out there. It’s actually pretty interesting.

O: Alright. Good because that really bothered me. I was like, wait a minute as I took the two quizzes in the book, one was a lion and one was a bear. I got two different answers.

M: Oh, that’s good.

O: When I took the one online, I was a bear but I really see myself as a lioness actually.

M: Yeah. Of course you do.

O: I was like, “Can I be a libear, like a liger?

M: You could. You absolutely could be a libear. What’s really interesting is within the bears, because they make up so many people, they have a tendency to move towards one side of bear or the other. A lot of my bears are more lion and a lot of my bears more are wolfish.  Remember, bears are the glue that keeps society together. You guys are the workforce, you get stuff done but you’re also very congenial and social creatures. If you’re a lion, If I had to guess, your lioness tendencies would be that you have probably a good drive in terms of wanting to get stuff done. You probably like to make lists if you will, and you probably like to follow those. But you’re probably not too worried if you don’t follow lists exactly in the right order, but you like to make the list because that gives you a guide post from which to work. Does that make sense to you?

O: Yes, it makes sense to me. Thank you. I feel so relieved because sometimes I put myself in one box and sometimes I do like to stay up late at night, what does that all mean?

M: Again, it’s a continuum. It’s like anything else, it’s not that you’re always going be in one thing but the majority of your time you spend you’re probably more on the bearish side than anything else. But you’ve got some of those good lion qualities, don’t you worry.

O: Thank you so much. I’m so relieved. Now I can be a very successful entrepreneur, conquer the world, and just world domination with pride and joy.

M: There you go. I think you can do it.

O: Thank you. Let’s talk about the when of the lions, bears, and wolves.

M: Sure. Do you have questions in specific or do you want me to go into a couple of things that I know people out there might be thinking about?

O: Yes.

M: Okay. One of the first questions that people ask me about is coffee. I don’t know if you’re a coffee drinker or not. Do you drink any coffee?

O: This is very interesting. I stopped drinking coffee because I’ve been told it’s really bad for me. I know that when I take at least green tea, I function better. I did a speck scan at the Amiens Clinic, my brain is overactive but they said that I have some lower activity and caffeine might be really good for me. At the end of the day, I feel good with caffeine.

M: Let me tell you when you should be drinking you’re caffeine. When we wake up the morning, there are two hormones that help us wake up, one is cortisol and the other is adrenaline. Those actually bring us out of the state of unconsciousness. We have to have a lot of them in our system to wake up. That’s not always the easiest thing to do. Many, many people tell me that the very first thing that they drink in the morning is coffee. That’s not a good idea and I’m going to tell you two reasons why. Number one is when you’re asleep and you breathe, just the humidity in your breath, you actually breathe out almost a full liter of water each night.

O: Really?

M: Yeah so you wake up dehydrated. You may find that your lips are getting chapped, or things like that. You need to keep water by the bedside. Again, that’s because you’re dehydrated from breathing out all this water. Caffeine is a diuretic, it makes you pee. The last thing that you want to do is be slugging down a cup of coffee because in fact all it’s going to do is it’s going to make you more dehydrated. Very first thing I like people to do when they wake up in the morning is grab an eight to twelve ounce bottle of water and drink the whole thing. That’s got to be one of the best things you can possibly do. The second thing that you have to do is get in front of a window and get some direct sunlight, either by walking outside or going in front of the window because sunlight hits your eye and there’s special cells in your eyes called melanopsin cell. These cells send the trigger to your brain to turn off the melatonin faucet. Melatonin is the key that starts the engine for sleep. Light actually pulls that out of there so it’s very, very good to get in front of sun in the early morning. What you don’t want is to get in front of sunlight or blue light in the evenings because that doesn’t allow your body to produce that melatonin. Coffee is not a great idea early in the morning. However, these levels of adrenaline and these levels of cortisol that wake you up, they start to fade about maybe two, two and a half hours after you wake up. That’s the perfect time for a cup of coffee because it will help bring that energy level right back up. What time do you wake up in the mornings if I may ask?

O: I guess [7:00] now. It was [8:00] or [7:00].

M: Let’s say [7:00]. If you woke up at [7:00], then I’d want you having a cup of coffee around [9:30] to [10:00]. That will again lift that energy level back up, or green tea with caffeine, whatever is your pleasure. That will actually help raise that back up there. It all depends upon when did you wake up and what your chronotype is, because you’re a bear and that’s exactly the perfect time by the way for bears to wake up is between [7:00] and [8:00]. You’re right on the money there. It will allow that again that boost of energy that you’re looking for. If you’re a lion, a true lion, you’re waking up at [5:30] in the morning. If you’re waking up at [5:30] then you can have your first cup of coffee around [8:30] or [8:00]. About two, two and a half hours after you wake up, that’s when you want to have your first cup of coffee.

O: It’s very interesting because when I was in my 20s, I used to wake up earlier. Now I feel the need to wake up a little later.

M: Yeah. What happens is the thing called chrono-longevity. As we age, our chronotypes can have a tendency to shift. I’m 48 years old and I used to stay up until [2:00], [3:00] in the morning, and then I would sleep until [10:00], [11:00]. I don’t do that nearly as much anymore. I still don’t go to bed before [12:00] but I get up around [6:30], [7:00]. I’m a person who only needs six and a half hours of sleep. Let’s get this out there to all of your crowd, eight hours is a myth. Not everybody needs eight hours of sleep. Everybody has an individual sleep need. Mine happens to be six and a half to seven hours. Other people can figure out what theirs are, because most people know the amount that they need but people feel guilty all the time. They come to me and they say, “Dr. Breus, I only get six and a half hours of sleep, am I going to die?” “No, you’re not going to die, you’re fine. It’s just that’s what you need is that six and half hours of sleep.” I don’t want people to think that they need more than they really do.

O: Right. In the book you were talking about the fact that babies are wolves, toddlers are, can you talk a little bit about that?

M: Yeah, of course. What’s interesting is just like as we get older, we have a tendency to see people getting up earlier and earlier. At certain ages, we know that certain ages are very chronotypical. Infants, ittybitty babies and toddlers, they’re lions. They’re up at [5:30], they’re ready to go, they’re doing their thing. You look at school aged children, school age children are more like bears, they wake up with society and got to sleep with society. When you get to teenagers, like what I have in my house, let me tell you something, it’s like wolf city over here. I’ll tell you a funny example. When I pick up my daughter from school, she’s 13. I say “Hey, Carson, how is school today?” She’ll say, “Fine.” I’ll say, “Do you have any homework?” And she’ll say, “No.” And then I’ll say, “Did you learn anything new?” And she’ll say, “Yes.” It’s very straightforward one word answers.  If I walk into her room at [10:30] at night and I say, “Hey Carson, how’s school today?” I’ll get 45 minutes of every single thing that happened throughout the day.

O: Wow.

M: Just by changing the timing of when I speak to her, I catch her at a time where she’s got more energy, she’s more interested, and she’s more engaging. I think for parents all over, that’s an important section. I’ve got a section in the book called When to Talk to Your Kids. It has a lot to do with knowing and understanding what their chronotypes are as opposed to yours and you trying to enforce upon them what you want to have done. As we all know when we try to enforce things on kids, it doesn’t really work very well.

O: Do you and your wife have the same chronotype?

M: It’s funny that you ask that, we do. She’s a wolf and I’m a wolf. We didn’t really think about it but when we were dating, I would say, “What time do you want me to pick you up?” She’d say, “I don’t know, [8:30].” I picked her up at [8:30], we get to the restaurant by [9:00], we’d have dinner until [10:00], we then go to a movie from [10:00] to midnight, and then we’d go out for a drink or for dessert afterwards. We never really thought much about it because we both said, “Oh, I guess we’re just night people.” It’s funny when you see people lining up. I’ve always thought that I should go to like match.com or eHarmony and tell them, you need to test people on their chronotypes because once people are in the same rhythm together, they’re going to get along better for sure.

O: Right. I’m a libear and I’m with a wolf.

M: You’re on opposite sides of the spectrum almost.

O: Right, yeah.

M: One of the big questions I always get asked is about sex. How is this kind of thing going to work? Because if you’re a more of a morning, average day morning person and they’re more of an evening person, how do those things coincide?

O: I have an answer for that.

M: Fire away.

O: In that case you do what the woman wants.

M: Yes. The good news is men like to have sex whenever offered.

O: Exactly.

M: It’s all good for us but if you’re really trying to time that, one of the things we know is that most sexual activity occurs at night, around [11:00] at night. It’s mostly out of convenience, it’s not mostly out of desire. The person is there, the other person is there, hey why not, let’s go, that’s what happens. What we now understand is when you look at your hormones, specifically estrogen, progesterone, testosterone, cortisol, and adrenaline, you want all of those to be high in order to have a really good sexual experience. You want your melatonin to be low to have a very good sexual experience. At [11:00] at night, your melatonin is high and all of those other things are low.

O: That’s exactly when my wolf wants to have sex.

M: Exactly.

O: Nah-ah, scheduled.

M: Right. What you want to do then is what about Saturday morning? Saturday mornings work out really, really well because they’re going to be more awake. The testosterone is going to be actually firing at all guns because a lot men wake up with an erection. That’s like Mother Nature’s way of saying now is the time that we’re supposed to be having sex. What a lot of guys are willing to do is try to have sex on Saturday mornings because their lion or libear partners are going to be actually much easier to have sex, be more satisfied with the sexual experience just by trying that in the morning. I know kids might fall into the play where you got activities or things like that but most people can get pretty creative.

O: What if I want to have sex every day?

M: There’s nothing wrong with that. Then what you would do is there are early evening times for sex. I actually created a matrix in the book. You saw in the book.

O: You have this beautiful clock. I haven’t got into everything in the book. I need to still read a lot of it.

M: Yeah. Look at the section on sex because there’s a chart there. What you can do is you put in your chronotype across the top and his chronotype across the side, and it will actually tell you exactly what times you guys can try. It gives an early evening time and an early morning time to give it a shot.

O: How long did you work on this? It’s so detailed and so well thought.

M: Oh, thank you.

O: Yeah. It’s just a really good book.

M: It took a little while. It wasn’t super long. It was funny was because once I started working with that patient, she opened my eyes to this literature. I was just so intrigued by all the studies and all the interesting stuff there that I was like, “Wow, this is really cool stuff. I’m going to dive right into it.” It took about two month to get all the research together and it took about three months to write the book. I just pounded it out, pounded it out.

O: Every night?

M: I actually found that there were certain times that I wrote better than others. There were certain times a day that I did my research and there were certain times a day that I wrote.

O: Wow.

M: Yeah.

O: What do you think about naps? When I take a nap, regardless of when, it’s hard for me to fall asleep at night.

M: Okay. That’s a big factor. For a lot of people out there, I don’t recommend napping if you have insomnia or if napping prevents you from falling asleep at night. For those people, napping is not a good idea. As an example for my lions, my pure lions who are up at [5:30], sometimes them taking a nap at [2:30] for about 20 minutes can actually help them be able to stay up until [9:30], [10:00] at night. In those cases, that actually can make a lot of sense to be able to take a nap. My bears love to nap, they love it. Weekends, they love to take naps. But you got to be careful because I don’t know if you’ve ever had this experience. Have you ever gone to take a nap and felt worse when you woke up than when you started?

O: Yeah.

M: That’s one of the things you have to be careful. That means you napped for too long. People need to nap for somewhere between 15 and 25 minutes. It’s the maximum amount of time that you want to nap. You don’t want to nap any longer than that otherwise your body gets into deep sleep and then it’s really hard to pull your brain out of deep sleep. Make your naps 25 minutes or less. Generally speaking, napping is best to occur somewhere between [1:00] and [3:00] in the afternoon. For my lions, they’re napping around [1:00], my bears are napping around [2:00], my wolves are napping around [3:00] or [4:00], and dolphins should never nap because dolphins are my problems sleepers. If they nap during the day, oftentimes they can have problem sleeping at night.

O: Right. How do you deal with dolphins? What do you do to help with insomnia?

M: The very first thing I do with dolphins is we try to figure out what’s the appropriate sleep schedule for them because many of my dolphins do some of the cardinal sins. If you have a problem sleeping at night, a lot of times what you’ll do is you’ll go to bed an hour or two early in the hopes that you’re going to be able to catch up on your sleep. It doesn’t work that way. First thing I do with my dolphins is I actually create a bedtime schedule for them. I don’t let them sleep for very long. Dolphins actually work really well if they sleep for about six and a half to seven hours. If they have to wake up let’s say at [6:00]AM, then I have my dolphins not go to bed until [11:00]. A lot of my dolphins freak out when I tell them that because they think it’s so counter intuitive. It’s like, “I have a hard time sleeping, why are you telling me to go to bed later, not earlier?” I’m doing that because I want your sleep deprivation to rise. I want you to be more and more tired because bearably what ends up happening is they go to bed at [9:00] and they sit there and they lie look at the ceiling, they look over at the clock, and they instantly do the mental math. They look at the clock and they say, “Alright, it’s [11:00] now, I haven’t fallen asleep yet.” They’re going to try to sleep and sleep and sleep. That doesn’t work and then they look at the clock and it’s [12:00] and they do the same thing, it’s [1:00] they do the same thing. They just get pissed off. They just get angry and that causes autonomic arousal. That level of arousal continues, what we find is it’s even more difficult for them to go to sleep. With my dolphins, the first thing I do is I set up a sleep schedule somewhere between six and a half and seven hours. I have them follow that for seven to ten days. After that, things seem to get a little bit easier and sometimes I do what’s called cognitive behavioral therapy. Actually my website, in a week I think, we’re going to be launching a new program specifically for dolphins in helping them to sleep better.

O: Oh wow, that sounds amazing. The cognitive behaviour therapy, from my understanding it’s a therapy that is to do with asking questions?

M: It is, it is. We ask questions about how do people think about sleep. Cognitive meaning thinking, behavioural changing bed times, we combine those two areas to help them out. We first do the bedtime thing like I told you before, the six and a half to seven hours, then I start asking them questions about, “What do you think about sleep?” “Do you like it? Do you not like it?” Because you’ll be surprised, a lot of people who don’t sleep well they hate sleep because they can’t ever get it. Sleep becomes the enemy for them. We try to disassociate that and make them think more positively about sleep. You’ll be surprised how much easier it is for them to sleep.

O: They get so obsessed about sleep that they can’t sleep because they’re obsessed about it.

M:Exactly. I tell people, I tell all my dolphins that sleep is a lot like love. The less you look for it, the more it shows up.

O: Oh, interesting, interesting. What do you think about sleep hypnosis?

M: There’s been at least three studies to show that certain people who are hypnotizable do very, very well with hypnotherapy for sleep. You have to be one of those people that’s hypnotizable. That’s a sparely small percentage of the population but if you’re hypnotizable, it can actually be quite effective.

O: Is it true that the time before your sleep, your subconscious is more open to suggestions and so that might a good thing whether you’re not you’re able to be hypnotized or not?

M: I think that whether or not you’re able to hypnotizable is a trait, an inborn trait. What I think is that there are certain times of day where you’re more suggestible. That happens when you’re tired, that happens later in the evening, yeah. I would agree with that comment.

O: What about sleep supplements?

M: People ask me all the time about sleep supplement. Let me tell you, the big one that people ask me about is melatonin. Remember, melatonin is a hormone, it’s not a mineral, it’s not an herb, it’s not a plant or anything like that, it’s a hormone. We have to be very, very careful with hormones because we don’t just go out to the local store and buy testosterone or estrogen. Melatonin is something that’s kind of similar. We want to think through that idea of do we want to take a hormone, number one. Number two is most melatonin is sold in an over dosage format. The appropriate dose is between a half and one milligram. Most of it is sold in three, five, or even ten milligram dosages. You need to be careful because if you take too much melatonin, it can interact with other medications or it can cause things like nightmares, night sweats, things like that. The third thing that’s important to realize is melatonin takes approximately 90 minutes to reach plasma concentration levels for it to be effective. Melatonin is not a sleep initiator, it’s a sleep regulator. What I mean by that is melatonin doesn’t make you fall asleep, it helps you stay asleep. By taking it about an hour and a half before you want to go to bed, it can be much more effective that way. The biggest thing you have to worry about with melatonin is quality because since there’s no FDA regulations on it, anybody can make it in any specific ways. You really want to look for companies that create melatonin that are going to be helpful for people, and that are going to of high quality for people.

O: Do you have any recommendations?

M: I do. There’s two companies that I’ve found that I used for my patients. One is called Usana. The other one believe it or not is Trader Joe’s.

O: Wow, really?

M: I know. I was kind of surprised. Trader Joe’s, they’re one of the only people that make the melatonin in the right milligram dosage, 500, what I called micrograms, which is the half of milligram. Their quality is actually very good. I don’t mind if people use Trader Joe’s or Usana products. I think I know because I actually visited the Usana plant. I went and did a tour to understand what are their purity standards. Let me tell you something, those guys take their quality very seriously. I was pretty okay with that. The other thing that people don’t know is that melatonin is by prescription only in Europe. You have to actually get a prescription for melatonin in Europe. At very high dosages, it’s a contraceptive, which is not so good. You should not be giving melatonin to children, specifically young girls. At very high dosages melatonin is a contraceptive. I can’t think of anything worse for a young female developing body than to be introducing a contraceptive at age eight, nine, ten. I can tell you right now, my daughter will never take melatonin.

O: Wow. That’s an eye opener. I never knew like melatonin for me was just like taking vitamin B.

M: Nope, it’s not. I promise.

O: Definitely not. I experimented with melatonin and it didn’t work for me. Probably the dosages were not right for me.

M: Yeah. My guess is did you take it right before bed or did you take it early?

O: Right before bed.

M: Yeah, that’s why.

O: Right. What about sleeping pills?

M: There are lot of sleeping pills on the market. Sleeping pills can be used effectively and safely but that’s not my first line of defense ever. There’s actually data to now show that cognitive behavioural therapy, what we were talking about before is actually equally effective, if not more effective than sleeping pills, number one. Number two, the American College of Physicians is now saying that the first line of defense should be cognitive behavioural therapy long before you even start to look at sleeping pills. Don’t get me wrong, there are certain instances where sleeping pills can be very, very effective. I would also tell you that 90% of my patients show up to my office already on a sleeping pill. Most people don’t like it, most people want to get off the sleeping pills, they’re kind of fearful of them, they feel they become addicted to the sleeping pills. I’ll tell you this, it takes a long time to get people off their sleeping pills. In some cases, six to nine months to come off those sleeping pills.

O: Wow, very addictive. Let me tell you a story, I took a sleeping pill only once in my life. It was on a flight between Japan and Israel, it’s a 12 or 13 hour flight, long flight. What happened to me is that I remember after couple of hours I was sitting on my chair and my body was really numb but my brain was completely awake. I had to go to the bathroom and I couldn’t.

M: Oh no.

O: That was terrible. Since then, never ever again, I am not touching those pills. I did though took and I take sometimes Ashwagandha, an Ayurvedic powder. What do you think about Ashwagandha?

M: There’s some great studies on Ashwagandha. I like Ashwagandha for a lot of reasons. One, it helps relax people, it helps with stress. There’s at least two different studies that I’ve seen that showed that it can be effective for helping people fall asleep.

O: Yeah. I guess it’s just a relaxation. Sometimes we get so stressed so a little moment to relax. Whether through cognitive behavioral therapy or some natural herb that help can you go to sleep.

M: Yeah.

O: Yeah. Before we go to sleep, is it better to have a cool shower or a hot shower?

M: It’s better to have a hot shower before bed because when we raise our core body temperature, then it drops. When it drops, it’s a signal to the brain to release melatonin. That’s one of the ways for my dolphins. A lot of times I actually tell them, actually, you’re going to like this, I don’t tell to them to take a hot shower, I tell them to take a hot bubble bath.

O: Oh, I totally love that.

M: Yeah, see. I knew just by looking at you you’d like that. It has to be a bubble bath and here is why. The bubbles form a layer of insulation across the water and it keeps the water hotter longer. When you get in there, really get up to your neck with all the bubbles, and then allow your body to really heat up so you can get a nice sweat going. When you get out, dry off. When you get into bed, your core body temperature drops. Again, that’s a signal to the brain to go to sleep and release melatonin.

O: Right. Where I live, we have a Jacuzzi there, we share with our neighbours.

M: Oh, great.

O: Sometimes I do that before going to bed and just feel it, it feels so good.

M: Yeah. No, absolutely it’s fantastic. I’m a big fan of hot tubs and jacuzzis. That’s a great way to go to sleep for sure.

O: Yeah. Can you recommend some sleeping hacks?

M: Sure, sure. The first one we talked about a little bit already is temperature. The cooler that you can make your surroundings, the easier it’s going to be to fall asleep. By elevating your core body temperature, then allowing it to drop, that’s going to certainly be one that’s got to be quite helpful. As far as scheduling, one of the other things again, I said this a little bit before but I think it holds true for everybody, not just for dolphins is don’t go to bed too early. That’s something that I have a lot of people do. They get in bed because they’re tired, or they just want to relax for the day. No, no, no, no, wait to get into bed until what would be your good bed time, whether that’s [10:30], [11:30], even [12:30]. Don’t go to bed too early because that can certainly have a big problem for you.

O: Right. How can we deal with jetlag?

M: That’s a little bit more complicated. Jetlag is difficult because it depends upon the direction of travel. East is least and West is best. When you travel west, it’s easier because I’m just asking you to stay up later. But if you travel east, I’m asking you to go to bed earlier and that doesn’t always work so well. I have a patient who’s an Arabian princess, actually an Arabian princess believe it or not.

O: How cool is that?

M: I know, it’s super cool. She comes over from Saudi Arabia, I live in Los Angeles. She comes over to Los Angeles every once in awhile. She was having terrible jet lag, it would last for three, four, even five days. What we did was we timed her naps on her flights along with caffeine and light therapy, very specific lights that I have. We got rid of her jetlag almost completely just by doing that. It was really funny because I said to her, “Tell me what time your flights are so that I can figure out exactly when you should nap, and take your caffeine, and use your light therapy.” She said to me, “What time would you like my flights to be, just talk to my pilot.” She had her own 747 plane. That didn’t even dawn on me that she would have her own jet plane that takes off from Saudi Arabia to the United States. She’s a princess, of course she does.

O: Of course she does. That’s just ordinary.

M: Yeah.

O: For somebody who is not your patient, what could be good tips for us? Because I’m flying to Israel a lot from Los Angeles. Last time I was there, I had the worst jet lag. It just seems like it’s getting worst and worst and worst, it’s not getting easier.

M: There’s a couple of different things. First of all if you’re in Los Angeles, you and I should talk after the show and I can help develop a schedule for you. I’ve got lots of contacts in Israel, I’ve got people who go over there all the time, number one. Number two is what I tell people to do, one of the easiest things you can do is slowly start to eat your meals on the time of where you’re going.

O: Okay.

M: Okay. Because what happens is your stomach is your second brain. It controls a lot of different hormones and different hormonal functions. What’s the time difference between Los Angeles and Israel, do you know what that is?

O: 10 hours.

M: Okay, it’s 10 hours.

O: They’re 10 hours ahead.

M: They’re 10 hours ahead, okay. What I would do is I would start moving your meal times by like one or two hours for a day or two, and one or two hours for a day two. You’re not going to get to the same time that they’re on but what you’ll do is you’ll start the process. By the time you get there, you’re already be a little bit ahead of the game. I would use light therapy for you right when you got there. A little bit of melatonin on the flight over and we’d probably get you just right.

O: What’s light therapy?

M: Light therapy, these are commercially available light boxes. You can go on to Amazon. If you just type in light therapy, there’s a box, it’s about this big, it costs about $150, and it’s a bank of lights. You don’t have to put it right here, you put it next to you while you’re having your breakfast in the morning. It’ll actually helps shift that circadian rhythm. Remember, light turns off the melatonin faucet. That’s part of what’s going on.

O: Right. Lovely, thank you.

M: Sure.

O: Can you share some of your success stories or your most interesting stories?

M: Sure. One of them was this woman who I helped with this chronotherapy and that started me along the way here. I’ll tell you one story that was really kind of fascinating, kind of warmed my heart is I had a gentleman come in and he was wearing a gun in the office. I assumed that he was with law enforcement and it turns out that he was. This was back when I was living in Atlanta, Georgia. He told me that he was a member of the GBI, which is the George of Bureau of Investigation, that’s like the FBI but at the state level. He said that he had been put at the desk job because he kept falling asleep at stake outs, he was snoring really loud, he was very disruptive, he didn’t feel like he had his energy anymore, he was cranky at home, and it really just wasn’t fun for him anymore. I took a look in his throat and I discovered that he had really huge tonsils and he was a big guy. I suspected that he had sleep apnea which is where your throat collapses in the middle of the night. We brought him into the sleep lab. Sure enough, he had terrible apnea, I think he stopped breathing in his sleep like 80 something times an hour. It was pretty, pretty bad. I got him on a treatment which is called the CPAP machine which is a little air compressor that blows air into a tube in his nose, that then keeps his airway open. I saw him for follow up about a month later. When I walked in the room, his wife was with him. She was not a small person either, she was kind of a big lady. She came running up to me and she gave me this huge hug, she was crying.

O: She was fair, just kidding.

M: Yes, she was fair. She gave me this huge hug and she said, “Thank you for giving me my husband back.” She said, “I don’t know what I was going to do.” As they were walking out, she handed me the stack of papers and she said, “I don’t think I’m going to need these anymore.” I opened them up and they were divorce papers.

O: Really?

M: Really.

O: Wow.

M: Hair is standing on my arm.

O: I know me too.

M: I know it’s crazy.

O: Wow.

M: I know. She was like, “I don’t need this anymore.” That one of the interesting stories that I’ve had.

O: Wow. More, more, more.

M: Let’s see. I’ll give you one more interesting one. I had a woman who came to me and she wasn’t a good sleeper, and she didn’t know what was going on so we brought her to the sleep lab. By the way, I don’t bring all my patients to the sleep lab, only the ones where we either can’t figure it out, or think that they got sleep apnea, or narcolepsy, or something like that. We brought her to the lab and the technologist called me up and said, “I need you to come down to the lab. She’s exhibiting some strange behavior.” I said, “Okay, let’s see what this is all about.” I walked in and she have the covers. She would pull the covers up to her eyes like this, then she would him down, she would go like this.  She pull the covers up and she’d bring him down just like this. She was eating something. I walked in there and I said, “Alright, what have you got in there that you’re eating?” I pulled out a six pound Hershey bar, six pound chocolate bar that she kept with her while she slept. She would just chew on it all night long. She couldn’t figure out why she couldn’t sleep.

O: Okay, that’s really weird.

M: Believe me, you’d be surprised in some other things I see. I get some pretty interesting characters in the sleep lab but it’s all could fun and fortunately we’re able to help them out and make them feel better so that’s part is nice.

O: Yeah, wow. Thank you so much for doing that.

M: Oh yeah.

O: I clench a lot when I sleep. I know that when you clench, when I was at the Amiens Clinic and I clench, I saw what it does to my brain. It’s just like the brain waves go crazy when you clench your jaws.

M: Oh yeah, for sure.

O: I bet it’s very disruptive. I think that started I did in [0:47:52].0]. Since then I’ve been clenching a lot, never like that before. How can I get rid of that so I can sleep better?

M: Clenching can be due to medication, it can be due to stress, or it can be due to tooth alignment. It could be any one of those three that could be going on. There’s not much that you can do other than get a bite guard that you would use and put into your mouth that you would prevent you from clenching. I actually know, since you’re here in Los Angeles, I know of a dentist who specializes in sleep medicine for dental issues which sounds like what you have. I can certainly put you in touch with them. But generally speaking when we see clenching or teeth grinding, it’s because of stress.

O: Oh, stress. What are other ways to reduce stress?

M: We talked about a couple of them but the easiest way to reduce stress and improve sleep is daily exercise. About 20, 25 minutes of some type of cardiovascular exercise, whether it’s walking, or running, something along those lines. It doesn’t have to be something big, you don’t have to do some crazy amount of excersice but just a little bit of exercise on a daily basis. Check with your doctor first. You’ll find that it’ll help your sleep quite a bit and reduce your stress.

O: Right. How does your nutrition affect your sleep?

M: Nutrition can affect sleep in a lot of different ways. We know that there are certain foods that are not such a great idea to eat before bed, high spice food are not good, very large meals, a lot of carbohydrates, especially the high fat, high carb meals can actually make you feel sleepy. It’s not good because you’ll have the tendency to put on pounds. My second book was called the Sleep Doctor’s Diet Plan: Lose Weight Through Better Sleep, it discusses that whole relationship between sleep and the metabolic rate and things like that.

O: Oh wow, I need to read that. It’s interesting.

M: Yeah.

O: Yeah. One thing I’ve noticed for me is that if I take vitamin B6 at night, I tend to have nightmares.

M: The B vitamins are actually very good for sleep but they’re not good to take at night. They’re much better to take in the morning because they have a tendency to give people too much energy. One of the things I’m telling people a lot is to take your Bs in the morning and you can take your other vitamins at night.

O: Yeah. I saw some sleeping pills that contain B6. It didn’t make sense to me.

M: Yup.

O: Alright. Thank you so much for all this incredible knowledge.

M: Sure.

O: I just wanted to ask you, what are your three major tips to live with this to their life?

M: Okay. Number one, figure out what your chronotype is. Check out The Power of When and figure out what your chronotype is, and try to live your life within your type. Number two, you should do something for your mind, your body, and your soul every day. Whatever that happens to be that make that works for you. Number three, make sure that you get sunlight every morning because that is one of the easiest ways to maintain a healthy lifestyle.

O: Wow, that’s amazing. Where can people find you?

M: If people want to learn more about me, my website is thepowerofwhen.com or thesleepdoctor.com.

O: Or?

M: By the book.

O: By the book, The Power of When, just incredible book and can change your life forever.

M: Thank you.

O: Thank you so much. I really appreciate you and I appreciate your time.

M: You’re very welcome. My pleasure to be here.

O: Yeah. Thank you all for watching and listening, and we’ll see you next time.

M: Alright. Take care.

O: Take care, bye.

M: Bye.