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Ep. 1424: Where we say Good Night to you404 all-star Dr. Michael Breus is back on the show today to talk about his new insomnia app, Good Night, and to answer questions about our listener's freakish sleep oddities.
-Hey everyone, it's Tuesday, February 11, 2014. This is The 404 Show on CNET. I'm Jeff Bakalar. -I'm Ariel Nunez. -Justin Yu is feeling under the weather so he's sick, that usually means it's time for Dr. Michael Breus, the sleep doctor to come back on the show. Welcome sir. -Thank you. Did you know tomorrow is my birthday? -No! -Yes, it is. -30 years old. -Wouldn't that be nice? 46. -Really? -I would not have guessed that. -46 tomorrow. -Be honest, Ariel. I'm not sitting next to a 46-year-old. -No way. He's lying to us, man. -It's like Ariel, you can get like the same thing going on like you'd never-- like Ariel has got this baby face thing going on even with that 35. 35, would you believe? -I would not guess you as 35. -Right? -All right. -For sure. -Because I get some good sleep. -Is it? 9 -Yeah. -For sure. -And it's clearly beauty sleep. -Really? -Welcome back to the show, man. -Thank you. -It's been a very long time. -Not really, but it always feels like it's long when you're not here. -Right. Thank you, sir. -What have you been on to, man? I know a lot of things are coming down the road for you. -You know, we've been doing quite a lot of interesting things lately. I've been very fortunate. I was just on the Dr. Oz Show. -You and Oz, you guys are like home boys. -You know what? He's a great guy, gives good information. -Yeah. -So, we've had a lot of fun doing that. -But be honest, after you tape, you go out and just get waisted. -No, I do not. -Wouldn't you wanna drink with Dr. Oz? -You know, I had to be honest with you, I'm not-- I don't think he drinks. -Really? -I don't really know. -The reason I say this and not just for the sake of getting drunk with, but like I wanna get to a point with a doctor like him as opposed to-- we have a doctor like you and then just started asking him like crazy stuff, maybe his inhibitions or a little loser when he's intoxicated and starts telling you awesome stuff. -I got to tell I have no earthly idea. -Really? -None. -Interesting. -None. -All right. So, how was the session you just taped, right? -Yeah, it was great. We were actually talking about prescription sleeping pill use. -Okay. -There's a new study that just came out that shows that believe it or not prescription sleeping pill use is up in America. -Right. -Big surprise. -Yeah, I was gonna say I definitely believe doing that. -150% in the last 10 years increase. -That's shocking. Yeah. -And what's-- we're learning is that people are using this prescription sleeping pills with other sedatives and with alcohol more and more, which is really bad news. We had somebody on who actually had what we call an Ambien incident. She actually took her Ambien and woke up in the back of a police car. -Wow! -Yeah. -At least she was okay. -Yeah. I mean and thank God she didn't hurt anybody else, but I mean there are plenty of times where people are taking, you know, sleep aids in an inappropriate way whether they take it and they're waiting for the effect to occur, -Yeah. -where they take it with a glass of wine or something along those lines and, you know, these are powerful medications. -Sure. -A lot of people-- You know, some patients will take a medication and said that they're waiting for it to take effect. -Yeah. -Bad idea. -Right. -Right. You should take it and turn off the light. -Exactly. That's how you take those meds. -Yeah. And this definitely leads me to a conversation that I wanted to bring up with you for a while and we talked about it briefly-- -Fire away. -in the pre-show and this is something that I think the skeptical side of me was sort of urging me along. -Uh huh. -There was a show I watched that did a little bit of research with doctors and scientists and they were talking about the true effectiveness of sleeping pills. -Sure. -And they were on the side of saying that most of them are BS that they really don't work the way we want them to work. -So, it's really interesting when you start to look at this as an industry. -Right. -So, what I-- what we were talking about and I think it's important for everybody out there to know and understand is this is a pill that makes you do something that you're gonna do anyway, right? -Sure. -So, we all know that you're gonna fall asleep no matter what eventually and this is a pill that either makes that process occur more quickly or occur at a particular time that you may want it to occur. But eventually, your body is going to sleep. -Uh huh. -What's interesting is when you look at the compounds themselves they can prevent certain types of sleep. So, old school sleep aids like Valium and Xanax and Restoril, they actually keep you out of the deeper stages of sleep. They may knock you out, but there's a big difference between being knocked out and true natural sleep. -It's fake sleep. -Right. Well, natural sleep is healing. Right. Natural sleep is when your body is not only recharging, but it's-- it's you know-- it's rehabbing if you will from the insults and injuries during the day. Different things that have gone on in your body, the healing process that needs to occur will occur at night. -Sure. -And that's a big deal. Sometimes that's not going to occur with the sleeping pill, then you get into the newer line medications and what we're learning from the newer line medications is it's not that you're changing the sleep architecture, the sleep staging is much, but you're still not getting into some of that deeper stage of sleep that you're really looking for. -Sure. There's a new drug that's coming out called Suvorexant, which is pretty cool. This drug actually instead of affecting the sleep center-- -Yeah. -it actually turns off the wake center. -Oh my God. That's-- No, I want to wake up, but it's interesting because if you think about it, for example the number one complaint that I hear is I can turn off my brain. -Yeah. -That's why people can't fall asleep. -Yeah. -So, this is a medication we think that could help with that. -We think-- -Really important-- While we think, we're not sure. It's just the lawyer like covering your ass telling you I was-- -No, no, no. From the research, -Yeah. -that's what-- that's what the research would indicate. -Sure. -What's really interesting though is for example if you take veterans, like veterans are a really interesting group of people who have insomnia. -Yeah. -Because if you've ever been inactive [unk] and somebody shot a gun at you, you don't sleep well ever again. -No. No. That will traumatize-- -Right. Because the hypervigilance that you need in order to keep you alert and save your life, once that switches on, it's almost impossible to turn it off. -Sure. -And so that medication might be something that can help those people in particular turn that off. So, it's kind of an exciting time in sleeping pill research, but at the end of the day I believe that less medicine is better, right? -Sure. -I believe that what we're trying to do is we're trying to get people away from sleeping pills. We're trying to get people towards a more natural sleep and, again, that's what the body does anyway is get you there. -Right. -And that's really what we're trying to do. -So, 150% increase in 10 years-- -Yup. -that's staggering. -It is. It's huge. -We're clearly not headed in the direction you think we should be headed in. -No, I don't think so. -So, you know, I mean, what do we do? And obviously, this isn't something that can be solved overnight, so what do we do? -Yeah. -Well, I think there's a couple of different things that we have to do. Number one is we have to be responsible for our own behavior, right? -Uh huh. -And so one of the things that people have to remember is sleep is not just an on and off switch, right? You don't just walk into that room, you know, and say, "Okay, boom! I'm gonna sleep right now." You really have to give yourself that opportunity to do so. What I tell people all the time is sleep is more like pulling your foot off the gas and putting your foot on the break. There's a process that has to occur, right. -Uh huh. -If you don't understand that you give your body the time to perform that process, you're really gonna have a hard time falling asleep. -Yeah. -So, one of the things is understanding how the sleep work, allowing your body to do that is gonna be really important and I created an app that does that. -Perfect segway. So, tell us about the app. What's it called? Where can we get it? How much is it? -Sure. -Yeah. -The app is called Good Night and it's produced with the company called Mental Workout. And so Mental Workout approached to me and they're really interesting company. What they do is they find experts in an area and then they help pull all that expertise out of the brain and put it into an application that can be used on their platform. What their platform does that's kind of unique is they use text messaging, they use video, they use regular content in a whole bunch of different ways to be able to get that information to the user or to the consumer in a way that's very effective. -Uh huh. -So, I created a 10-day program and it can be used anywhere so like the very first part of the app asks people from an assessment standpoint like, where are you, are you in a hotel, are you at a friend's house, are you at home? Where are you? In order to us to understand what could be the influences. Once we know that, then we start to look at what your schedule like, what are you eating, how are you exercising, what are the influences on your sleep and we actually go through a full 10-day program. And so each day, they have different things that they're supposed to do. And as they go through those things, we identify different myths, so things like what people say, I got to get 8 hours every night or I'm not gonna wake up and be able to perform my best. Well, the truth of the matter is that's probably not true. -Yeah. -Right. And so we challenge some of those thoughts along the way-- -Sure. -and we get people to say, "Okay, well, here's what you need to do on day 1 and let's challenge some of those thoughts and let's-- let you realize that it's okay." We do not have perfect sleep every night, but some sleep is better than no sleep. -Exactly. -And getting people to that point is gonna be critical. But I took all of the information from my first book and I put it into an app. -Right. So, basically, that's what it is. It's like the first book appitude if you will. -Exactly. Exactly. -It's available for iPhone, Android, Mac and PC. -Yup. -And the pricing-- Well, first thing before we've talked about the price, it's the thing I like about it is that it's not just a one-way street, the way a lot of things work. It's like up to you. This sort of has a back and forth interactivity, -It does. -which can definitely, you know, lead to a better result. -And it's more effective that way. -Yeah. -What we're finding is is you're getting actually information from me and it's personalized. So what happens is when you say I go to bed at this time and I wake up at this time, then the app actually has an algorithm and it then helps you understand what's good about that, what's not good about that and helps you change that for yourself. -Sure. -And then there's videos from me that say, "Hey, let me explain to you personally why we're doing this as opposed to you're just kind of reading the content along and plugging in the numbers and hoping that it's gonna work for you." -And then of course, if all else fails, there's the mode where you just read lullaby's to people and just-- -In my melodious voice. -Right. In your super baritone. You get real, nice and heavy. -My melodious voice. Well, we actually have-- -Puts your eye to bed. -Believe it or not, we have meditation and relaxation on there. -Right. -And that's actually showing to be quite helpful-- -Yeah. -with best special music that we use and what's new about Mental Workout is they actually also have one of the top apps for meditation with Stephan Bodian so we've actually used some of his work. We've got special music that's been shown-- clinically shown to help people fall asleep. So, we've got some really interesting pieces in there. -That's good. -And then we hit people with text messages during the day and we're like, "Hey, did you remember to do this, did you remember to do that?" -Right. -I like that. -Because we wanna catch people at different times of the day to be able to remind them, "Hey, this could be affecting your sleep or that could be, things like that." -Very cool. So, how much are we talking here? -$17.99. -Okay. Soon, I would-- I'm looking at those and here it says, $17.99 for one year, so that's like a subscription. -Right. So, it's a yearlong subscription-- -Okay. -and so-- and there's a couple of different, you know, aspects to it. So, it's not just this one shot deal. I run it for 10 days and it's over. You can go back to it. You can use it again and again. You can do a lot of different things with it. So, yeah, it's got a little bit steeper price tag to it. -Sure. -But at the end of the day, there's a reason for that. It's worth a lot. -Right. -I mean we spent a lot of time, there's a lot of research behind it. -[unk] therapy. -Exactly. This is a lot like if you were in some type of a therapy. Now, don't get me wrong, it's not therapy. -Right. -Okay. This is not in place of going to a psychologist or going to a sleep specialist. -Sure. -But at the same time, this is a lot more than I gonna read a couple articles and hopefully sleep better. -Right. -This is much more interactive. -Excellent. All right, very good. And for people who were able to send in their questions or at least the people we get to today-- -Yup. -they're gonna get a free copy. -You got it. We're give them-- We're gonna give a free one of Good Night-- -Oh, the app. -by the Sleep Doctor. -So, what was the naming process? -Good Night? -Yeah. It was quite-- -That was the name in the first book. -That was the name of the first book. So, you just do this-- you're plagiarizing yourself. -I'm plagiarizing myself as it were. -The only way to win. All right. this is my favorite part. Let's get to the questions. -With Rock 'n Roll. -We have a lot to get to including some from Justin who wanted the help-- -From his sick bed. -from his sick bed. He messengered over a bunch of questions. We'll get to those. -I think it's kind of ironic that Justin is asking questions from bed to the sleep doctor. -Yeah. -I wanna know-- -I don't wanna see him in bed, but I don't mind getting his questions from bed. It's an amazing-- Technology is an amazing thing. -Isn't it, right? -Absolutely. All right. So, he sent in like three questions, but will bring up maybe what I feel is the most compelling. He says and this is from our very own Justin Yu. How do I stop tossing and turning in my sleep. I wanna be one of those people that fall asleep and wake up in the exact, same position. -Really? I mean we can't have everything in life. But I've tried cutting caffeine intake several hours before bed, changing pillows, and even melatonin, but I still move around a lot from lying on my back to my side, putting my hands underneath the pillow, etc. So what's deal? Do I have to restrain myself? -Interesting choice of words. -Yeah. -So, here's what I would tell you is the only way that you could prevent yourself from moving in your sleep is to lose so much weight that you weigh approximately 39 pounds. And here's why-- is because any more than 39 pounds on the skeletal frame when you-- when you lie on a mattress is to push down on the capillaries-- -Yeah. and it will crush those capillaries. So, remember, we've talked on the show before about what we call capillary crush, right? -Right. -So, when you lie down, even if you're lying on your back where weight is mostly distributed across your skeletal frame, more than 39 pounds of pressure crushes those capillaries. When it does so, it restricts blood flow and eventually your brain says, "Oh, restricting blood flow, -Move around. -move around." -Yeah. -So, you're supposed to move in your sleep. So, Justin you know better than they ask this question. This was a bad question. -It was just a bad question. -You do not get a free Good Night app, Justin. -I mean, yeah. No. Of course, that goes without saying. You know-- All right. So, there's one-- other one that I don't think we've really tackled. You know, you've been here a bunch of times. We've really covered the gamete. He says, "How do people train themselves to stop the habits they developed in their sleep?" That's-- I think that's a good question. -That's a fair question. -Things like teeth grinding, jaw clicking, sleeptalking. Is it even possible and do you believe in hypnotism for it? -Okay. So, there are two separate questions. -Sure. -So, some of it is possible. Some of it is not. So, teeth grinding oftentimes is related to stress. -Yeah. -But it can also be due to certain medications. Believe it or not, the SSRIs or anti-depressant medications can increase the likelihood of teeth grinding. Also people who have TMJ, so-- -Yup. -the transmandibular joint issues can have a pretty major affecting cause, a clenching or a grinding of the teeth not an uncommon scenario. So, one of the things to do is to relax before bed, meditation, relaxation, yoga, hot bath, things of that nature. Anything to distress you before bed will actually help with the teeth grinding. There are also mouthguards that people can purchase, that can be very effective. But be careful because some of those mouthguards can make your TMJ worse. -Right. -Not better. -Yeah. -So, it's always best to talk with your dentist about something like that. -Okay. -When you're talking about sleepwalking, sleeptalking, things like that, those are all usually a product of sleep deprivation. So, the easiest way to get rid of those is to get more sleep. -Uh huh. -Avoid things like alcohol late at night, avoid caffeine after 2:00 p.m., all things that could cause more-- -After 2:00-- 2:00 p.m. is the cut off? -2:00 p.m. is probably the best cut off and here's why. Because we know that caffeine has a half-life between 8 and 10 hours. -Right. -And so if you want all of it out of your system, cut it at 2:00, you're going to bed at 10:00. It's probably all out of your system at that point. Now, different people do have different caffeine sensitivities. -Sure. -What we've now learned is that, for example, you may not be affected by caffeine nearly as much as I am, but your brain is still affected about the same. So, you may turn to me and you may say, "Well, Michael, I can have a cup of coffee or cappuccino at dinner and I can still go straight to sleep. You may be able to fall asleep, but it's still a stimulant and it's still having an effect on your brain. So, again, you'll stay out of the deeper stages of sleep, which is gonna have overall effect on your sleep quality, which is gonna cause problems with sleepwalking, sleeptalking, things like that. -Right. -Here's the good news. You're not gonna let loose any major secrets in your sleep while on your sleeptalking. -Because it's usually all nonsense. -It's usually all gibberish or it's, you know, whatever your dream is about or something like that. -Right. -You know, James Bond didn't release any of the top secrets, -Right. -you know, for the secret service in his sleep. -Right. -It just doesn't work that way. -Right. -That would be a whole new kind of questioning. -Exactly. -All right. Jason writes in and he goes, "When you wake up and feel all sore for no reason-- -Yup. -what is that about? Why is that happening? What is the cause and how do you prevent it? And I have a separate followup to that once you tackle that. -Okay. So, a lot of times morning stiffness or soreness can have a lot to do with the mattress. So, if you're sleeping on a bed that isn't supportive-- -Yeah. -a lot of times that can have a lot to do with it. So, the older the mattress oftentimes, the more likely you are to wake stiff and sore and that can be causing a lot of your overall pain. Sometimes, it can have to do with your exercise regimen, so if you've worked out really hard the day before, you can have what's called delayed-onset muscle soreness. Do you ever notice you're not really sore the day after you work out? -It's like two days some-- -But two days or three days later, you know, you can't get the fork to the mouth type of scenario. -Right. -Sometimes, that can have something to do with it. Sometimes, it can have to do with inflammation. Inflammation-- What we're learning now is inflammation is a tremendous problem in all kinds of different areas and so looking at things that are causing inflammation like certain foods, certain diet, certain things like that, so you got to be kind of be careful at what is your eating, what is your doing. So, looking at nutrition, looking at exercise, and then looking at your mattress are all areas that can have a pretty major effect on waking up and feeling-- -Kinda seems like it's almost unavoidable completely. -It depends on your lifestyle. -Yeah. -Right. So, I mean, if you go out and you party pretty hard, you're gonna wake up with the hangover, right? -Right. -But if you go out and you drink responsibly, you're probably not. -Uh huh. -So from the avoidance perspective, yeah, you can probably avoid waking up and feeling stiff and sore. -Uh huh. -You just got to do the right stuff. So, what is that mean? Go to bed at roughly the same time each night, try to, you know, limit yourself to two drinks and I would have those at least two hours before lights out. -Sure. -Try to limit caffeine to around 2:00 o'clock and try to exercise about three to four hours before lights out. -Right. Okay. -What is your followup? -And this is like a personal sort of add-on to Jason's question. I think people need to learn more about the big warning signs of symptoms when you wake up. -Okay. -There are a lot of things that we've talked about when you've been on in the past where I think some people might have experienced the symptoms and sort of ignore them or wait for them to go away. Can you name like three to five symptoms that if it's happening to you chronically on a regular basis, you got a good help. -Sure. So, if you wake up in the morning with a headache, that is a clear sign of oxygen deprivation at night and you could have sleep apnea. -So was that-- So now, are you talking four out of seven days? Are you talking once a week? -Okay. For a headache, I would say if you're waking up with a headache more than twice a week, then you absolutely should talk with your doctor and let him know that, because that's a clear sign of potentially having sleep apnea. If you're waking up with a dry mouth more than two times a week or sore throat, that's a likely candidate that you're sleeping with your mouth open, which means you're probably have congestion. -Right. -And that congestion is forcing your mouth to go open, which is making your mouth dry, again, affecting your ability to get good quality sleep. If you're waking up in the morning and you're stiff and sore, one of the first things I talk to people about is how old is your pillow, how old is your mattress, look at that. If it's more than about six or seven years old for a mattress and more than two years old for a pillow, it's probably time to get a new one and see if that has an effect. Because, you know, as we've talked about on the show before, sleep is a performance activity, right? -Uh huh. -If you got the right gear, you're gonna perform better, right? -Yeah. -So, if you're gonna run a race, you can run it in flip-flops with cut-offs and a torn T-shirt and a boombox on your arm. -Right. -Right. -And you're still gonna go for start to finish, but your time isn't gonna be too good. -Right. Yeah. -But if you got your, you know, your running shoes and your dry footwear and your iPad, you're gonna perform better, same holds true with sleep. If you've got a good pillow, good mattress, and you're in a good environment for sleep, you're gonna perform better. -Excellent. -That's what I told people a lot of times. -Okay. So, those are the good symptoms to keep your eye out for. -Absolutely. -Andre writes in "My wife is a pharmaceutical sales rep. She does a lot of traveling, racking up a lot of air miles. Can you give some recommendations on getting a good night of sleep in a strange place? -Sure. -For example, a hotel room. She's also a very light sleeper who complains about not being able to switch off at night and very rare-- rarely sleeps through the entire night resulting in her being tired during the day, -Okay. -when she's gonna be behind the wheel. -Okay. So-- -So that's a bomber. -So, that's definitely could be scary, yeah. So very common the road warrior, traveler who's out there and trying to get a good night's rest in a different environment. So, the first thing that I tell my road warriors and I kinda have I'm a little bit of a road warrior myself, because I'm traveling quite a bit. -Yeah, you are. Yeah. -I actually have my own little sleep kit that I bring with me. Okay. And because every hotel is a little different, -Sure. -and sometimes you stay in a really nice hotel. Sometimes, you think you're staying in a nice hotel and it turns out they're not be so great. -Right. -So, what I keep is I keep eye shades, like an eye mask, earplugs. I have a meditation relaxation audio CD that I keep with me, that I rip to my audio players so I can listen to it that is relaxing. And as a matter of fact, if you want, we can put it on your website-- -Oh yeah. -so we can let people download it for free. -That will be awesome. -It can be cool. -Yeah. -Excellent. -It's actually part of the app. -Okay. -So, if people wanted to check it out from the app, they can have as well. -Yeah, for sure. -But I have those types of things. There's a little sleep kit for me also. When I check in to the hotel, one of the first things I ask them for is, you know, can I get a room that faces west, not east because the sun rises in the east? -The sun. -So, I don't wanna be facing the sun in the morning. -Right. -I wanna be facing away from the sun. Also, I wanna know is there a club or a restaurant, because I wanna be on the other side of the hotel from that. -Yeah. -I wanna be as high as I can be so I'm away from, you know, street noise, things like that. -So, you're the guy that the hotel desk clerk just-- just hates. -You know what's funny is when I walk in and-- -Here he comes. -Well, they all know me, right, -Yeah. -because I'm used this thing in similar places, but a lot of times their-- when I start to ask the questions, I only get through like one or two questions. They're like, "I know exactly which room I wanna put you in." -They know. -Like they really know. If you ask the hotel desk, they really know like what's the quietest room in the hotel, what's the room that you're gonna get the best night's rest in. And if you ask them and you're cool about it, like don't walk out to him, give him a hard time-- -Sure. Sure. -I'm just be like, seriously, I'm exhausted. I need a really good night's rest. -Right. -What-- Where in the hotel-- -Where's the quiet room-- -Exactly, where is the quiet room in this hotel. -I'm gonna start doing that. -And I'm telling you, these folks know their staff. -Yeah. -They know exactly what's going on. They can tell you, "Okay, you wanna be on the fourth floor, you wanna be in room such and such, because that's the last room that housekeeping gets too." -Right. Less traffic. -It's far enough away from the elevator. You know, I just spoke to a whole group of, you know, 20 kids on the other side of the hotel. -Right. -Like that kind of stuff, it's really important. -Now, for sure. -And then also when she's home, she's probably so used to traveling that she's got to catch up on her sleep. So maintaining a solid sleep schedule is gonna be a really big factor for going to bed, waking up at the exact same time, even the weekends is big. Don't try to catch up on sleep on the weekends. Lots of us try to do it. It's a really bad idea. If you sleep any longer than 30 minutes extra on the weekends, your entire biological clock wants to shift to that time and then you end up with insomnia on Sunday night. -I think I have been able to do it, man. -Being able to do what? -You know like sometime-- I've been able to just not-- I'm not trying to catch up on sleep 'cause I still get my six and a half to seven, my sweet spot. -Right. -But on the weekend for whatever reason-- -Uh huh. -you know, we just keep sleeping and it's not-- 'cause we don't set an alarm. -Right. -And a lot of people say like, "How you not just automatically wake up?" We just don't. We just keep sleeping until the dog is like, all right, he's got his got his tail between his legs and he's like, "Let's go." -Right. He's like ready to roll. -Yeah. Well, for some people, they can do that. -Yeah. -But here's what ends up happening. As long as you don't get what we call Sunday night insomnia. So on Sunday nights, can you fall asleep at your normal-- -Pretty much, yeah. -Then you're fine. What happens with a lot of people is they basically they sleep-in Saturday. Well, they stay up late Friday night, sleep-in Saturday, stay up late Saturday nights, sleep-in Sunday and then by the time Sunday night rolls around, their body is still used to staying up late that they can't fall asleep. -Right. -That's where the problem lies. If you don't have a problem with it, I'm okay with it. -Right. Right. Yeah, that's just like college for me. It was just like, man, I didn't even have classes on Friday, so I had like three days of that. -Right. Well, that was well planned. -Well, yeah. For four years, I didn't have one Friday class. -That's amazing. -It's amazing. -Did you ever have an 8:00 o'clock class? -I had once. My freshman year was like a Thursday. -Right. You'll never do that again. -And I never-- But I never went to it. -Right. -Well, plus I'll never go to college again. So, but yeah, that was what I remember when it was a problem. -Right. -Because I would sleep like 3:00 o'clock on a Sunday. -Wow. -I'm telling you man, you need to start going to college campuses. Have you done that at all? -We have actually. There's been some decent research that's been done in college. I mean-- and, you know, kind of college all bets are off because there's so much-- -Oh my God. It's such a different environment. -Sure. -Then what like normal people do-- -Right. -in terms of going to work and things like that 'cause in college campuses, people are always staying up late. They're always partying, -Distractions. -distractions, noise. You have roommates literally in the room with you, so it's just a very different environment. I feel like none enough people respect sleep. They just don't-- They write it off. It's like just something that got to do. -Yeah. Well, I mean, you know, the saying is, "I'll sleep when I'm dead is very common." -Sure. -And I think a lot of people feel that way because they're just like, "Well, I go in there. It's dark. I do something for six, seven, maybe eight hours and I walked out." Do I feel okay? I feel fine. I'll grab a couple of cups of coffee. I'll be good. -Yeah. -And people will do that for years and years and years. And at the end of the whole scenario, here's what we see happening is we see people contracting sleep apnea, insomnia and that will have a major effect on your health overall. I mean, there's-- the data is extremely clear. -Yeah. -Over the course of time if you're not sleeping well, you will get sick. -Uh huh. Unbelievable. That's scary. -Absolutely. -So, I'm telling you man, we'll book you up at colleges across the nation. -I'm ready to do it. -It makes so much sense 'cause if I had someone like you in college that came to me and said, "Look, you're sleeping like garbage. You look terrible." -Right. -Even if that wasn't true, just tell me I look terrible and I will-- I'd be like, man, that makes sense. It's like an insurance policy. It's like preventative medicine. -There's no question-- Well, I would also be willing to argue that the freshman 15, at least half of that has to do with sleep, -Absolutely. -you know, because you're staying up. You're eating stuff that you shouldn't be eating. -And then you go right to bed. -And then you go right bed, so it basically turns straight to fat. -Yeah. For sure. A lot of people wrote in about sleeping on planes. -Okay. -Do you have any good advice for falling asleep on a plane? -I do. -And this-- I'm included in that because I suck it that. -All right. So, first of all, it is a skill set to be able to sleep on an airplane. So, there's a couple of things to think about. So, number one, I personally find that sleeping-- picking your seat is gonna be pretty important so you want a window seat versus an aisle seat, because then you can kind of lean up against the window and get that. I tell people all the time to bring their own pillows because nowadays you have to buy a pillow, you know. The airlines aren't given away pillows anymore. -No. -It's actually better to sleep in the middle of the plane, then towards the ends because there's less turbulence, because the way the fuselage is built, the sturdiest part is actually over the wing. -Right. Okay. -So, you'll get less bounce there. -Really? That's interesting. -So, kind of staying in and around that area is usually good. But be careful with the exit row seats. A lot of people are always saying, "Oh, I want an exit row." I never sit in an exit row. -Because they don't lean back, right? -Number one, they don't lean back, but number two the padding on the rear end of the seat is not nearly as good because they're designed so that those whole seats can actually be removed in case of an emergency. -Oh, wow. -So, they're-- they're just-- -Interesting. -they don't have as much as cushion. -Sure. -And of course, they don't lean back as much as I like the seats right behind the exit row or two rows in front that's still lean back and forth and they're still pretty sturdy against the window. If you can hit first class, great. -Right. -It's always gonna be better, but not everybody kinda has that luxury. -Sure. -I like those cervical pillows as well. -Right. The horseshoe. -Yeah, the horseshoe things. Those actually worked pretty well. I also go for the earplugs. There's a brand of earplugs that I really like called Ear Planes. -Okay. -Believe it or not, they are cone shaped. -Yeah. -And they actually go into the ear canal and they don't hurt. I found that a lot of those foam-based one, once they get-- once you get them in there after a while, they start to bother my ear canal and they sort to hurt. -Yeah. They irritate. Yeah. -And so that's something to be aware of and with an eye shade. So, kinda like the sleep kit that I was talking about that you'd have in your hotel room, a lot of times people will bring that on to the airplane with them and it can be pretty effective-- -Right. -to help you be able to sleep. And then you know, or-- you know, have your earbuds in and listening to, again, some type of meditation/relaxation type of music-- -Sure. -'cause that definitely gonna help. Stay away from alcohol on airplanes. One drink in the air is worth two on the ground. -Right. -Because of the oxygen content in the airplane is significantly less. -Yeah. -So, what ends up happening is as you think you're getting sleep, but what you're doing is you're passing out. -Oh, man. -You get dehydrated. You hit the head, then you go to the bathroom. Now, you're dehydrated. You're not getting good sleep and you're making bad decisions. -Oh, forget it. There's just nothing good can come out-- I don't-- It blows my mind that they even offer alcohol on plane. -Yeah. -I really don't get it, because I had such a terrible experience three years ago going out to Vegas. -Do tell. -Oh my God. Do you remember this Ariel? -No, I heard about it. -You're going for-- You've gone up for CES? -We're going up for CES. So, no, this isn't the Xanax one. -Oh. -So-- Okay. I'll tell you that too. So, we're going out like three years ago, I was still in my anxiety-ridden flying, you know, behavior that I used to have. Now, I'm all good with flying. -Uh huh. -And I was-- I was watching a hockey game before I got on the plane and I was drinking whiskey. I was just straight up drinking whiskey. -Even better. -I wasn't even like mixing it with anything. I was just drinking whiskey watching hockey at the airport-- -Right. -having a lot of fun all the couple others there. -Sure. -Get on the plane and I get one more drink, which-- -Uh huh. -and was just a beer. -Right. -We're about 40 minutes away from landing and all of a sudden I could tell like my-- I knew I was green, like I knew my face was green. And you know, I was surprised 'cause I was like, man, it took, you know, a five-hour flight for it to like kick in and it started happening and I didn't know what to do and I just like, I got up, I was in the window seat, I got up and climb, literally climbed over the two people next to me. -Right. -I ran to the bag of the plane. -Bag of the plane. -I didn't even go to the bathroom 'cause I wasn't gonna throw up. -You just-- -I just went to-- and I was like, "Somebody help me." -Right. -I'm like I don't know what's happening. -Right. -And they sat me down in the area and they were like, "Man, you look terrible." -Terrible. Yeah. -They gave me all this orange juice. -Yeah. -They like, "Oh, this happens once a flight one of you idiots gets drunk and like to do the-- -Right. And it's usually a drop-in sugar. -Yeah. It was bad. -And you become dehydrated really quickly. -I'm scared, super scared. -And that's part of the problem is is your in a controlled environment that you cannot get out of and especially if you're going from New York to Vegas. I mean, was that a five-hour flight? -It's about-- Yeah. -So, you're stuck. -Yeah. -And you know, don't get drunk in a place that you're stuck, you know. -No. -You can't get any fresh air. It doesn't work that way in an airplane. -You can't open the window. -Right, it's not-- you know, you're not gonna hang out on the wing and smoke a cigarette, right? -No. -It doesn't work that way. -Simply not happening. -So, at the end of the day, again, it's just not a great environment to do those types of things. -Right. -So, you want to avoid alcohol. I also told people you wanna avoid carbonated drinks. A lot of people are drinking sodas on the airplane. -You must not. -Try to avoid caffeine. Well, it ends up giving you gas-- -Yeah. -number one, but it also upsets your stomach because, again, you're in a pressurized cabin. -Sure. -What I told people do is stick to water. -Yeah. -And what you wanna-- If you're gonna eat something, eat something that's gonna be more on the carbohydrate side, so crackers, cookies, and stuff like that are fine. A sandwich is fine. Don't sit at the airport and, you know, eat, you know, one of those pizzas. -Oh, yeah. -Because first of all, you're sitting in, you know, your seat for five hours and sitting like a stone in your stomach. -Right. -You're gonna get an upset stomach. You're gonna have gas. It's not gonna be good for the people sitting next to you. -Yeah. -You're gonna hit the restroom. You're gonna feel-- and in those restrooms-- I mean, they're this big so, you know, even if you're not a big-- I mean, I'm not a big guy, but still you're in those restrooms. There's nothing comfortable about that. -Sucks. Yeah. -So, again, you just-- you really wanna be smart about-- The other big thing I told people do wear loose-fitting clothing. Take your shoes off, because your feet will swell. -I do that. -So, take your shoes off or loosen the laces on your shoes. Again, the goal of the game here is to be as comfortable-- -Sure. -as you can be. -Right. -Sometimes, people will take off their watch if you're wearing a wedding ring something like that. You can take it off, put in your pocket, things like that. Just really wanted anything that's constrictive, you want to avoid. -Uh huh. Good advice. And then the other story had to do with drugs. I'm not gonna get too much into that. But Clemente wrote in and he's got a question regarding a specific drug and his girlfriend. -Okay. -He says his girlfriend can't sleep at night. -Okay. -This has been going on for the past year. I'm losing my mind from hearing her complained about it. She swears that it's not because of stress or over thinking at night. -Okay. -She went to the doctor, had blood work done, they didn't find any issues. The doctor prescribed Xanax. -Okay. -He wrote in parenthesis, which I think is dumb and it's still didn't help. She's taking nearly every over-the-counter sleep aid and supplement that is available. They barely work. And if they do, she only gets three hours of sleep. -Okay. -She's in the process of changing her diet to see if that helps. Do you have any other suggestions? It seems like they're kind of-- at the end of the line-- -Okay. So, she gets the app. -She gets the app for sure. There's no doubt about that. -All right. No doubt about that, she gets the app. -Yeah. -And she's actually a great candidate for the app or something like that. -Sure. -So, number one, Xanax falls into the category like we're talking about before, the benzodiazepines. -Yeah. -So, it's really an anti-anxiety medication, not necessarily a sleep medication. Unfortunately, that category of medication is highly addictive. -Uh huh. -So, it's good that she's not-- that she's getting off of it. It sounds like she's gotten off of it. It's not a category of medications that I recommend for sleep aids initially. -Plus, you wake in-- I used to take it and you would wake up and you're like, "Where am I? What's going on?" -You're fussy. You're in a fussy state. It's not something that a lot of people like. Don't get me wrong, they're plenty of people who have anxiety and it's a highly effective drug. -They need it. Sure. -And they need it. I'm not suggesting-- You know, I am clearly not telling people to not take their medication. -Right. -What I am saying is if you have sleeplessness, there are a lot of different things that you can do. Over-the-counter medications, they maybe helpful for occasional sleeplessness, right? So, if you're having a hard time sleeping one or two nights a week for a couple of three weeks that's fine. But if it's going on longer than that, you need to talk to a sleep specialist. -Uh huh. -You need to seek out a qualified sleep board-certified sleep specialist and figure out what's kind of going on there. Like we were saying before, this is a natural process. It's going to occur for you. -Yeah. -You just got to know and understand the right rules and regulations to get you there. -Sure. -Most people have taught themselves how to not sleep. It's just a matter of re-teaching yourself how to sleep. -You think she could benefit from going to one of those sleep testing centers? -Here's what's interesting about having a sleep test. It's great for sleep apnea, narcolepsy, or restless leg syndrome. It's not particularly good for insomnia and here's why. If you can't fall asleep regularly-- -They're not gonna test-- -and I put 27 electrodes on you, you're really not gonna be able to fall asleep. We reserve sleep testing in people with insomnia only in really extreme cases when we suspect things like seizure disorders or we just really have not earthly idea what's going on and we're just going exploratory. -Gotcha. All right, here's one question I wanted to say for the end here. Is this-- -The end? What are you talking about? -We're getting close to the end. -All right. -I know. -Time flies, you know. -It does. It moves quick-- -Why is that? I don't know. -Because we're having such a-- It's interesting. -I'm talking about sleep and sleep happens quick, right? All right, here we go. Get ready. -I'm ready. -This one's [unk] -It always is. -Question for the sleep doctor. This comes from Scott. Why you would attach your real name because I'm not sure? Nevertheless, I have a problem. -All right Scotty. -where I will grope my wife sexually in my sleep. -Okay. -This happens rarely, maybe once every couple of months. My wife can tell I'm asleep because I will only do it for a little bit. Forgive me my chocolate. Then just not off like nothing ever happened. -Uh huh. -I don't know that I did anything until I wake up the next day and she tells me what I did. It's really weird knowing that I'm doing something at night that I have no control over. I don't do anything else in my sleep. I don't sleepwalk. I don't talk, just this groping thing. -Right. -Luckily, the only person who's ever experienced me do it is my wife who doesn't really mind except for the fact that I'm waking her up. -Right. -Is this something I should be worried about? Can I do anything to prevent this from happening in the future? I worried that one day I might end up sleeping close to someone that will not be so forgiving. So, I think that goes without saying just never sleep with anyone else in a bed. -So number one, don't sleep with anyone else. -Yeah. -Number two, so this is not-- this is an uncommon scenario, but it's not something that I've never seen or dealt with before. So, there is a disorder believe it or not called sexsomnia. -Wow! -And there are people who actually have full on intercourse completely asleep. Most of the time, it's Ambien-induced or some type of medication induced. It's almost exclusively in men-- -Uh huh. -and we have found that in a lot of cases, it has to do with sleepwalking. What we know is that in terms of sleep deprivation usually people are pretty sleep deprived, so my-- if I had to guess for this gentleman, it's probably on times where he hasn't gotten a good night's rest for two or three nights in a row beforehand and that's when the behavior is occurring, so the easiest way to prevent the behavior is to get more rest-- -Right. -and to get good quality rest. You know, a lot of times when we talk on the show we're only talking about getting more sleep in terms of number of minutes, but sometimes as you and I have talked many times, it's not just about number of minutes, but about the quality of those minutes. And so for this gentleman, we may say things like, "Look at your caffeine intake. Are you making sure that you're stopping caffeine by 2:00 p.m.? Look at your daily exercise 'cause that's a great way to improve the quality of your sleep and extend the number of minutes of sleep that you're getting. My guess is is if you wrote down, for example time you went to bed, time you woke up, amount of caffeine, amount of alcohol and amount of exercise for a month and then look-- you know, do that everyday for a month, and then you look at a number of times that you-- -Right. -this incident occurred. It would be probably occurring on the times where you weren't getting enough or weren't following the good sleep hygiene rules-- -Right. -and then you'll have your answer, which is follow those rules. -So, in frequency that's leading, you don't believe that that's probably it was not-- -That would be my guess, yeah. -Gotcha. -The good news is is it doesn't mean that there's anything major going on especially because it's fairly infrequent. If he said to me this is happening every night or multiple times a week, then we would start to look at different things 'cause there are some very rare disorder or certain seizure disorders or things like that that we would wanna take into account, but I really don't think that's what's going on here. -Gotcha. Okay, Scott good luck with that. [unk]. Oh, man. What a perv [unk]. Here's something I experienced personally, a situation where I cannot get a regular length night of sleep and it's just gonna happen. -Uh huh. -I've been going on a bunch of ski trips and the way that schedule works is you drive up every month on Friday night. -Right. Uh huh. -You don't get-- You know, it takes four, five hours to get there. You don't get there 12:30, 1:30 a.m. You got to get up and hit the first lift on the mountain, which is 8:00 a.m. -Right. -We're only gonna get four to five hours tops and then you had to really spend a lot of energy. -Yeah. -You're screwed with that situation, how do you make the best of it? -It's tough. -Yeah. -You've got-- One of the things that I tell people is you've got to be really careful. The bad news here is you can't bank sleep. -Uh huh. -But you can make sure that you're not sleep deprived before you start that scenario. So the week before you go on your ski trip, you don't need to be up late. You don't need-- You need to really make sure that you're getting to bed on time for that whole week prior to going. -Right. -Also, while you're on the slopes, be careful. Don't load up with energy drinks. Don't be drinking there your Monsters and your AMP and your this and your that or, you know-- -It's gonna send you out of way. -Right. You know, because what will happen is you're gonna be so exhausted on your way home that you're gonna have the sleep deprivation plus all the residual effects of the coming off of the caffeines and the guaranas and things like that, that it's gonna make you that much more tired. Here's the biggest problem is the more sleepy you get, the more your brain tells you you're not sleepy. -Uh huh. -There's a mechanism inside your brain that basically tells you, "Don't worry, you're fine, you're fine." -Keep going. Keep going. -Exactly and that's a problem. -Yeah. -Because you don't realize you're not fine. -Yeah. -This is not good and you need to be very careful. -How come you feel your brain is playing for the wrong team sometime? -Well, it's a survival instinct, right? -Yeah. -So, basically, what your brain is saying is that there must be a reason why you're staying awake, so I don't wanna tell you go to sleep, -Right. -because you must need to survive. -Yeah. -So, I'm gonna just tell you stay awake, keep sharp, look around and that you're okay even though quite honestly you're not. -Stupid brain. Finally and we'll end on this and I almost forgot and my buddy would absolutely destroy me. Speaking of the skiing trip, I saw friend of mine I haven't seen in about two years, he follows the show and he found out you're coming on and he said, "You have to ask Dr. Breus this question." -Fire away. -This is very serious to him. We'll call him Kevin. -Okay. -Kevin believes truly that he is addicted to a sleeping after-- he can only sleep by smoking marijuana. -Okay. -He is 100%. I saw it happened where it was like everyone is gonna to bed. He's like, "Well, I'm not high. I can't go to bed." -Sure. -What do you do for something like that? Is it worst thing in the world? What do you think? -Okay. So, this is a fair question. -He truly thinks he's like-- it's a real issue. -So now, we have I think it's 14 states where medical marijuana is legal, right? -Right. -As it stands right now, it's not legal for insomnia-- -Uh huh. -as a medical-- -Even in California? -Even in California. -Okay. -Now, we know in Colorado recreationally it's legal. -Sure. -So, that could be an area where people might be using it in that way. We also know that as the research is starting to bear out, there are two different strains of marijuana. There's what's called sativa and there's what's called indica. -Yeah. Right. -Indica has a more sedative quality to it. Sativa has a more energy quality to it. And what I have-- So, I have patients in my pain center 'cause one day a week-- or one day every two weeks, I work in pain center 'cause people in pain don't sleep. -Uh huh. -The large number of those people actually smoked marijuana to help them with their pain because in the State of Arizona where I practice that's legal. -Uh huh. -So, I have that as part of the practice because I have to understand how that mechanism works. -Right. So, you have this-- -Right. Well, I have to understand how that works because I have to be able to treat those people and understand can they take sleeping pills, can they not? How does that whole thing kind of work? So, what's interesting about that is here's what we know is that the data is very consistent. Yes, you can smoke marijuana and it will make you sleepy, but what does that do to the actual sleep itself. Very similar to alcohol, it can keep you out of the deep stages of sleep. So, a lot of times it's a balancing act. So, do I get no sleep or do I get some sleep that's not as good as sleep. I can tell you that most people at least in my experience who are using marijuana and they're not using it for pain, they're not using it for seizure, they're just using it as a sleep aid, number one it's probably not an appropriate use for medical marijuana at least legally. We know that it's not an appropriate use. -Uh huh. -But number two, it's probably not giving them the quality of sleep that's necessary. I can tell you that 99% of these people if we work with them, we can teach them how to sleep without medical marijuana or marijuana period and they can sleep just fine. -Right. -So, is it necessary? No. Does he like it? Sure. So-- -And he claims like 6 out of 7 nights, he has to do it. -Well, see that and in of itself is interesting. So, 1 out of 7 nights, he doesn't. -I don't know the specific reasoning why I think he just too tired that it's just happening naturally. -And so that-- And so that even, you know, supplements my argument more, which is to say because he's getting bad sleep from using the marijuana, 6 out of 7 nights, by the 7th night, he's so exhausted because of the poor quality sleep that he's probably getting. It's leading him to sleep naturally on his own. So, again, is he doing himself any favors? Probably not. -I mean, I'll be honest he didn't look sleep deprived. -He might not. -He looked-- He had a lot of energy. He's able to stay up to how long we were up. -Yeah. -But yeah, he is really-- It wasn't something where he was like, "Man, this is it for me." But he was genuinely concerned. -Yeah. Well, I can tell you that my patients with pain-- -Yeah. -a lot of them, they would rather smoke at night. -Sure. -Because it does help them sleep. -Right. -Again, how are we understanding this legally? I'm personally not making an endorsement for marijuana for sleep. But what I can tell you is that the research that's out there is definitely starting to get bigger and bigger and we're trying to learn more and more about this. In the years to come, here's what I would tell you is probably going to occur. We're gonna start to learn that there are more diagnoses out there that something like the cannabinoids that are inside medical marijuana that will be helpful for inflammation, for pain. Who knows that they'll be available for sleep or not, but it's something that we need to learn about because it's gonna be there. -Right. -And as physicians and people who are understanding the world of sleep, it's something that we need to learn. -Very good. All right. I think that's where we gonna end it. -It sounds like a plan. -Thank you so much. The app is Good Night. Check it out. It's on iPhone, Android, Mac, and PC. We're gonna give away five copies of the app to our listeners who wrote in and had their questions answered. -Absolutely. -Then check out the sleepdoctor.com for all the latest from Dr. Michael Breus in the world and your little insomnia universe. -Indeed. -And then make sure you follow him on Twitter @thesleepdoctor. And there you have it. -And if people wanna sign it from my newsletter, they can do that as well. That's it my website, @thesleepdoctor.com. -Thanks so much, man. Always a pleasure having you here. -Thank you Jeff. -That will do it for us, the number 866-404-CNET. Email us firstname.lastname@example.org. We'll be back here tomorrow, hopefully with Justin depending on how he's feeling. -Just feel better Justin. -Right. -What do you think he's-- -I think he's avoiding me. -I mean, look, you know, once was-- -Twice in a row. -Now, it's a pattern. -It clearly. -Right. Follow us on Reddit, Twitter, Instagram, Facebook and all that good stuff. We're back here tomorrow. Until then, I'm Jeff Bakalar. -I'm Ariel Nunez. -Thanks again to Dr. Michael Breus. -Thank you. -He'll be back a couple of months or something like that. -I'll be back as soon as you'll have me. -Rock 'n Roll. We'll see you guys tomorrow. Have a good one. -Sweet dreams.