Cheri Mah: Thirty extra sleep minutes change NBA careers

1. 0:00 – 1:59

   Intro

   1. CMDr Cheri Mah0:00

      I was 86% correct on accurately predicting when an NBA team will be at highest risk of losing, strictly based on their sleep.

   2. SBSteven Bartlett0:07

      Oh, gosh.

   3. CMDr Cheri Mah0:08

      Yes. And just 15 or 30 minutes can make a difference. So let's dive into just some very practical strategies to get the best sleep possible.

   4. NANarrator0:17

      Dr. Sherine Ma is a renowned sleep doctor and performance expert, whose sleep optimization research has enhanced the careers of CEOs, as well as athletes in the NFL, MLB, and Formula 1, and has provided life-changing expertise to companies like Nike, Under Armour, and Google.

   5. CMDr Cheri Mah0:31

      For my elite athletes that I work with, sufficient sleep, it's a game-changer. For example, we saw a 12% faster reaction time, a 9% improvement in free throws, and a 4% increase in faster sprint time. And when you experience what it feels like to be well-rested, you never wanna go back to getting insufficient sleep. And it doesn't have to be these big jumps.

   6. SBSteven Bartlett0:52

      I'd love to dig into that.

   7. CMDr Cheri Mah0:53

      Okay.

   8. SBSteven Bartlett0:53

      So I have a shower, then I get straight into bed after. Is that good or bad?

   9. CMDr Cheri Mah0:57

      Tweak the timing of your shower and your hot bath to just an hour or two before bed. It's hard to grasp how much of a difference this can make in your life.

   10. SBSteven Bartlett1:06

       What about sex? Does it have an impact on your sleep?

   11. CMDr Cheri Mah1:08

       Ooh. Okay, so-

   12. SBSteven Bartlett1:10

       Is there anything that I can eat before bed that won't disrupt my sleep, but will get rid of the hunger?

   13. CMDr Cheri Mah1:14

       There's a pre-sleep meal. For example, cereal and milk.

   14. SBSteven Bartlett1:17

       Cereal?

   15. CMDr Cheri Mah1:18

       And the reason why is because-

   16. SBSteven Bartlett1:19

       And then I read this fascinating word, nappuccino.

   17. CMDr Cheri Mah1:22

       Yes (laughs) . This is a useful tool if you're a working professional and y- you need a little boost in alertness and performance. What you do is ...

   18. SBSteven Bartlett1:31

       The Diary of a CEO raffle is about to close. Anyone that subscribes to The Diary of a CEO before we hit seven million subscribers, which is probably gonna be in a couple of days' time, you will be included in the raffle. And on the day we hit seven million subscribers, we are giving away a lot of money-can't-buy prizes to all of you. So hit the subscribe button, get in before seven million, and I'll announce the prizes and the winners in the comments below when we hit seven million subscribers.

2. 1:59 – 4:22

   What do you do and why do you do it?

   1. SBSteven Bartlett2:00

      Dr. Ma, what is it you do, and why is it so important, in your mind, that you do it?

   2. CMDr Cheri Mah2:10

      Great question. So I am a sleep physician, um, but I spend a lot of my time and career trying to educate and, and advocate for people to prioritize sleep, right, this fascinating process that each of us does every single night, and arguably is about a third of our lives, but many individuals don't do this very well, or they, you know, sacrifice it and overlook this area. I very much believe if you don't sleep your best, you will not be your best. Or counter to that is if you, your s- if your sleep is best, you will be at your best. And what that means, if I unpack that a little bit more, is we often are sacrificing our sleep. We're under-slept. We often don't have good-quality sleep. It ... We're very reactive to our sleep at nighttime, and it's the last thing that we think of at the end of the day when we wrap everything up. Um, and that's arguably not gonna put ourselves up to be the best we can be in the following day, right? And for my elite athletes that I work with, when you actually get sufficient sleep, you have practices that you plan into your day, and you actually are more proactive with that, it can be a game-changer. And for them, when it comes to performance on the field, that can be the difference of a 9% improvement in free throw shots. It can mean reacting 12% faster. And so until you experience that, it sometimes is hard to grasp how much of a difference this can make in your life, but it is one of the foundations that are, will impact everything about how you function, your mood, how you feel, and ultimately perform the following day. If I could offer you, or y- yes, you specifically, Stephen, if I could offer you something that's free and healthy and safe that's going to help you think more clearly, make better decisions, be in a better mood, be more productive and efficient, would you want it?

   3. SBSteven Bartlett4:06

      Of course. How much?

   4. CMDr Cheri Mah4:08

      Exactly.

   5. SBSteven Bartlett4:08

      (laughs)

   6. CMDr Cheri Mah4:09

      And so it's really a decision of whether you want to invest, uh, your time to be able to be more proactive with this particular area of your life to get the benefits that come down the road with it.

   7. SBSteven Bartlett4:21

      Who do you work with?

3. 4:22 – 7:06

   Who do you work with?

   1. SBSteven Bartlett4:22

      Give me a sort of broad spectrum of the individuals, organizations that you've worked with on sleep, and why have they come to you?

   2. CMDr Cheri Mah4:31

      I have had an opportunity to work with a number of professional sports teams and athletes, as well as organizations over the years to try and apply the science into practice to help them improve their sleep, their scheduling, and their travel. So for example, I've been with the San Francisco Giants in Major League Baseball. I've worked with, um, NBA teams like the Golden State Warriors, uh, NFL teams like the Philadelphia Eagles, I won a Super Bowl ring in 2017 with them, to, um, other sports organizations like Nike and Under Armour and ESPN to try and show how you can predict when NBA teams will lose strictly based on the schedule and insufficient sleep opportunities, um, to individual athletes who recognize, you know, "Hey, this is an area that I am not optimizing, and I know this can be such a valuable asset to extend my career, p- to prevent injuries down the road, and to help me be at my best."

   3. SBSteven Bartlett5:28

      Do you ever work with CEOs?

   4. CMDr Cheri Mah5:29

      I do. I do work, uh, with executives and C-suite, um, uh, executives to try and help them be their best, because they too, are high performers, right? Their performance outcomes are maybe a little bit different than pro athletes, where we're quantifying on-field performance and looking at their swim times and what they're doing when it comes to the, you know, on-court or on-field, um, performance outcomes. But for these executives, they arguably are also making incredibly important decisions. They have to still react when they're under pressure, and they have to make good judgment calls. And so many of the things that I coach and, and try to recommend to my elite athletes are very much applicable to the C-suite executive, or even just the working professional.

   5. SBSteven Bartlett6:14

      That's really what, what I found so fascinating about your research and your work, is that...Although there's a focus on athletes, as someone who is also traveling, is also very, very busy, also, um, struggles with sleep sometimes because I'm- I have to perform late at night, whether that's on stage or with meetings, whatever it might be, I resonated with so much of it, and I also train in the gym pretty much every day, if I can. Um, and I've also noticed a correlation between things like injury in the gym based on how I'm sleeping and my, quote-unquote, sleep debt. But I, but I, I wanna confront two things. The first thing I wanna confront is the misconceptions around sleep that you encounter over and over again. What are the, like, big, overarching misconceptions that stand in the way of people believing in and/or implementing the advice that you give them?

   6. CMDr Cheri Mah7:03

      I'll start with just this badge of honor that I really

4. 7:06 – 10:46

   What are the misconceptions about sleep?

   1. CMDr Cheri Mah7:06

      believe still persists in society where you should get only four or five hours of sleep and should be able to perform at your best, and I think the tides are turning, and I do think that that is changing over the last several years where there are more vocal advocates of, um, you know, elite athletes, like the Tom Bradys who, you know, say everything is around performance enhancement. "I'm go- need to go to bed early so that I can wake up early and to be ready to go for the day," to, you know, the Simone Biles who says, "I need to get eight hours of sleep." And so I think that that is a badge of honor that is now shifting, and now it's going to become, well, if you're not getting your eight, nine, 10 hours of sleep, right, then you're actually at a decrement to yourself, and you're actually not gonna set yourself up to be the best that you could possibly be, whether you're on the field as a pro athlete or whether you're leading an organization or trying to go after whatever it is that matters to you, right?

   2. SBSteven Bartlett8:01

      Mm-hmm.

   3. CMDr Cheri Mah8:01

      And, and I think that's going to continue to shift, but I'm excited about it because that's one thing. Until you experience that, that difference and that life transformation of what it feels like to be well-rested, then it can be a game-changer, and you never wanna go back to it again when you're getting insufficient sleep.

   4. SBSteven Bartlett8:19

      Are there any misconceptions around how to sleep and sleep hygiene, and, um, I don't know, the quantities of sleep we need that also seem to stand in people's way of them getting a great night's sleep?

   5. CMDr Cheri Mah8:32

      Yeah, so I think that there is a misconception that everyone needs a certain amount of sleep. There's individual variability. So the, the recommendation from the American Academy of Sleep Medicine and the Sleep Research Society, so two of our national organizations here in the US, recommend minimally seven hours of sleep, but that's the lower threshold. You might actually need eight hours or nine hours or more to feel well-rested, right? I, I personally feel terrible on seven hours, and I much more need the eight to nine hours, and there's those in- that individual differences. So you need to find what you feel well-rested, you're able to function well at a high level during the day, and that will then be your individual requirement. So I think there's this misperception that everyone needs a certain amount, but you need to find what works for you, and it's all about small changes. So if you're not at seven hours, I think you shared sometimes you're, you're, you're under that.

   6. SBSteven Bartlett9:23

      Oh, yeah, sometimes, yeah.

   7. CMDr Cheri Mah9:25

      (laughs) You know, it's about f- 15 or 30 minutes more can make a difference. So if you're getting six hours, then I'm gonna recommend getting 15 minutes or 30 minutes more every day for this one week, and then get 15 or 30 minutes more next week so that you're building from, say, six hours of sleep to six and a half hours, and you may not think that that's that much, but we can all do 15 minutes more, right? We're less scrolling.

   8. SBSteven Bartlett9:48

      Mm-hmm.

   9. CMDr Cheri Mah9:48

      We're doing what we're... wrapping up our day, but those 15 minutes add up where that's a difference of, like, an A student to a B student, or 11 minutes more sleep is the difference-

   10. SBSteven Bartlett9:58

       It's actually?

   11. CMDr Cheri Mah9:58

       ... of a B student to a C student in one of these studies.

   12. SBSteven Bartlett10:01

       Really?

   13. CMDr Cheri Mah10:02

       Exactly, and then over the course of a week, 15 minutes will be almost two hours more sleep than if you didn't.

   14. SBSteven Bartlett10:09

       What was the study?

   15. CMDr Cheri Mah10:10

       So this was a study done, um, in high school students but looking at the difference of how much they're sleeping versus their correlation to, to grades. And so that 15-minute difference was shown to be that A to B student, 11 minutes from that B to C student.

   16. SBSteven Bartlett10:26

       Oh, gosh.

   17. CMDr Cheri Mah10:26

       Yes. So it doesn't have to be these big jumps, but small changes over time will, will add up.

   18. SBSteven Bartlett10:33

       The, the study I have in front of me here, which I printed out, um, also highlights the importance of sleep for everybody but also specifically in this case for athletes. Can you walk me through this study and what you found

5. 10:46 – 14:11

   Study that increases performance by 12%

   1. SBSteven Bartlett10:46

      in this particular study on the adult male basketball players?

   2. CMDr Cheri Mah10:49

      Yes.

   3. SBSteven Bartlett10:50

      And how you conducted the study?

   4. CMDr Cheri Mah10:51

      So in this study, we looked at the men's basketball team and th- we really tried to examine if we extended their sleep over five to seven weeks, encouraging them to get nine or 10 hours of sleep every single night to ba- pay back what we call an accumulated sleep debt, would we see any impact on performance outcome? Specifically, would we see an impact on reaction time, their fatigue levels, and would we see an impact on their on-court performance, specifically free throw shots, three-point shots, sprint time? And these are measures that we would do after every regular practice, and over the course of those five to seven weeks, we demonstrated that we saw a 9% improvement in free throws, a 9% improvement in three-point shots. We saw a 12% faster reaction time and a 4% increase in, uh, faster sprint time. And so these were the quantification which was novel at the time was what was quite fascinating because it wasn't that 1% that I think many elite athletes are trying to find every small way to adjust their training to get that 1% better because in elite sport, that 1% can be the difference, right-

   5. SBSteven Bartlett12:03

      Yeah.

   6. CMDr Cheri Mah12:03

      ... of being at the top versus not. But this was arguably 9% or even double digits for reaction time depending on the outcome, and so we've expanded that looking at other sports as well, but this was one of the first ones to show that it really potentially could have a significant impact on performance outcome for these athletes.

   7. SBSteven Bartlett12:21

      How much did they sleep more per night to get those results?

   8. CMDr Cheri Mah12:24

      Yeah, so they did s- we did quantify objectively through a, um, what's called actigraphy. It looks like a wearable nowadays, um, and then compared that also with what they thought they were getting, and so we did extend their sleep, um, uh, substantially over, I believe, an hour and a half, uh, compared to what they were getting prior to the study.

   9. SBSteven Bartlett12:45

      Because getting 9% more...... free throws or three-point shots or 12% better reaction time is, quite frankly, for some teams, the difference between, like, winning a championship and not.

   10. CMDr Cheri Mah12:56

       Yeah.

   11. SBSteven Bartlett12:57

       'Cause I think about the Premier League often, which is, uh, it's, uh, soccer, I guess, football. Um, oftent- uh, there's been leagues within my lifetime, there's been years in my lifetime where both teams have, um, tied with the same amount of points and one has won just on the amount of goals they've scored. They've just scored a couple more goals, so after 38 games, they both have the exact same points and the winner is just the person that's scored, like, a couple more goals.

   12. CMDr Cheri Mah13:19

       Mm-hmm.

   13. SBSteven Bartlett13:20

       But even you think of reaction times, you think of goalkeepers in, in soccer, their whole game is reaction time, so if you can increase your reaction time by 12%, it's really, really staggering. It is-

   14. CMDr Cheri Mah13:30

       It can be a game changer, and I think that's what has been so fascinating with some of the athletes or organizations and teams I've worked with who have made it to the most important games and those championships, because th- the hope is that you've invested not just the night before that championship game, but you've invested an entire season, even starting in the off season, on cultivating better habits to give yourself that foundation and be able to leverage these strategies that the other team has not. Because we know that it significantly can impact not just the individual level on performance outcome, but organizations as a whole. And I think one example of that is, um, I partnered with ESPN

6. 14:11 – 17:03

   NBA players losing based on schedule

   1. CMDr Cheri Mah14:11

      to do what was called the NBA Schedule Alert project, where they ask, "Can you predict, Dr. Ma, when NBA teams are gonna be at risk of losing games strictly based on the schedule?" So not factoring in strength of team, but based simply on their schedule, where they're traveling to, how many timezones they're crossing, these various factors, does it affect organizations as a whole and teams and their game outcomes, as you mentioned? And over three seasons, I was 76 to 86% correct on accurately predicting when an NBA team will be at highest risk of losing strictly based on the schedule. So in the spirit of the project, we didn't factor in strength of team, but to me, that was staggering because there's many other factors that maybe are not always considered to be as clearly important about s- you know, this travel schedule upfront, but hey, maybe these factors really do play and influence, um, game outcomes in this way. And that's not the only thing that has obviously shown that organizations and teams as a- as a whole will have differences in performance outcome. There's other studies like the Monday Night Football study that showed if you simply bet on a West Coast team when they play an East Coast/West Coast matchup during night games, over 25 seasons, you'd beat the Las Vegas point spread 68% of the time. And so if you're able to predict with- with greater accuracy, then obviously there is potentially some g- gambling outcomes that-

   2. SBSteven Bartlett15:39

      Yeah.

   3. CMDr Cheri Mah15:39

      ... could work in your favor here. But really being able to show that you would be able to benefit and predict better than what the spread will be between the- the two teams over time.

   4. SBSteven Bartlett15:50

      Sorry, is that because the West... Sorry, the West Coast team has gone... Which- wh- who's- who's traveled?

   5. CMDr Cheri Mah15:55

      It doesn't matter. It simply matters that the West Coast team is playing the East Coast team during night games. So this can happen on the West Coast, it can happen on the East Coast.

   6. SBSteven Bartlett16:03

      Oh, okay.

   7. CMDr Cheri Mah16:03

      The reason why is because performance is enhanced in the late afternoon to evening, around 4:00 to 8:00. In both scenarios, the body clock of the West Coast team, because they typically go out just the day before the game, it feels like they're on the West Coast.

   8. SBSteven Bartlett16:20

      Okay.

   9. CMDr Cheri Mah16:21

      Right? So when you're a West Coast team and you stay there and the East Coast team comes out, the East Coast is three hours later, so what is a 7:00 game on a West Coast feels like a 10:00 game for a East Coast team.

   10. SBSteven Bartlett16:34

       Got you.

   11. CMDr Cheri Mah16:36

       S- same thing applies when the West Coast team goes East Coast. Even if it's a 7:00 game there-

   12. SBSteven Bartlett16:41

       Ah, yeah.

   13. CMDr Cheri Mah16:41

       ... the West Coast feels like it's a 4:00 body clock.

   14. SBSteven Bartlett16:45

       Yes.

   15. CMDr Cheri Mah16:45

       And so that special window around 4:00 to 8:00 PM when world records are broken and performance in a 24-hour day is- is optimal, and that is leveraged then over those 25 seasons that the West Coast will have more favorable outcome overall.

   16. SBSteven Bartlett17:01

       Got you. So

7. 17:03 – 18:49

   Players who slept more sprinted faster

   1. SBSteven Bartlett17:03

      in this study you did in 2011, it was published in 2011-

   2. CMDr Cheri Mah17:06

      Yeah.

   3. SBSteven Bartlett17:06

      ... one of the things I read as well is that players who had slept more in your study sprinted faster. I mean, quite- quite dramatically faster as well, I- I think. From 16.2 seconds at the start of the study versus 15.5 seconds at the end.

   4. CMDr Cheri Mah17:22

      Yes.

   5. SBSteven Bartlett17:23

      Over what distance was that?

   6. CMDr Cheri Mah17:24

      Yes. So that was from the baseline to half court to baseline to full court and back.

   7. SBSteven Bartlett17:28

      Okay.

   8. CMDr Cheri Mah17:29

      So we chose a very standardized sprinting, uh, sprinting drill that they are familiar with that we could replicate after every regular practice. As you imagine, not everyone on the team was participating on- in this study, and so they did this after every regular practice and that ended up being a 4% difference in sprint time.

   9. SBSteven Bartlett17:47

      That is pretty crazy. Do- do- do professional teams know this? Do athletes know this? Are they aware of this or is this something that's fairly new?

   10. CMDr Cheri Mah17:55

       Some are aware, and I think the momentum is shifting towards more athletes, more teams recognizing that this is an untapped competitive advantage, that this is an area that they may or may not have implemented specific strategies or education or sh- or planning for when they travel, but I think the more forward-thinking organizations, teams, and athletes are starting to pick this up and starting to recognize that they can use this as a weapon, right?

   11. SBSteven Bartlett18:26

       Mm-hmm.

   12. CMDr Cheri Mah18:26

       As a performance-enhancing drug, if you may, because it is safe, it's healthy, it's effective, and we know that it'll be one of the only things that can give you these performance benefits, um, and- and those are the ones that are trying to leverage the science into application for optimizing, yeah, their sleep at nighttime.

   13. SBSteven Bartlett18:46

       Have you seen athletes, individual athletes-...

8. 18:49 – 22:05

   Athletes who have changed their careers by focusing on sleep

   1. SBSteven Bartlett18:49

      change and save their careers? When I say change, I mean change the trajectory of their career-

   2. CMDr Cheri Mah18:54

      Yeah.

   3. SBSteven Bartlett18:54

      ... or save their careers because they focused on their sleep? And can you give me some examples of that as well?

   4. CMDr Cheri Mah18:59

      Yes. Golden State Warriors' Andre Iguodala, he's someone who I worked closely with. He came to the Warriors back in around 2014. He was already an All Star. He was 28 at the time, knew that his career was going to probably be sunsetting at some future time, but wanted to extend it as long as possible, but he knew he wasn't doing sleep best as possible. He was very open about sharing how he would stay up till the wee hours of the morning playing video games, would sleep for a few hours, go to practice, play for a few hours, come home and take a two to three hour power nap, and that was his routine for- for 10 years. Um, and he said, you know, "How do I improve how I approach my sleep? I know that this is important as an athlete to- who wants to play in the league as long as possible." So I had the opportunity to work with him over several months to help him re-craft how he approached his sleep, including a wind-down routine, thought about some of his nutritional choices, tried to shorten his naps, time them closer to game time to give him the boost in alertness and performance, be able to manage a racing mind, and being able to have just a more proactive approach to his sleep. In a really neat way, the following season, the Warriors went to the championship for the first time in many years. They won. He came back with the Finals MVP. He subsequently has won three more championships with them, so four in total, and extended his career for 10 years. When we made these changes, there was a quantification of the performance enhancement. So a third-party quantified as he went from under seven to seven and a half to more than eight hours, he had a twofold increase in his three-point percentage. He had a 8.9% increase in his free throw shots, which very interestingly is the exact same 9% that I showed in my men's basketball study that had the same 9% improvement in free throws. He had a 29% improvement in his points per minute, a 45% decrease in his fouls-

   5. SBSteven Bartlett21:02

      Hmm.

   6. CMDr Cheri Mah21:03

      ... and so, you know, these numbers are pretty staggering, again, for someone who's already at the highest level as an All Star. And it's not to take anything away from Andre, but he has been very vocal about the difference this made as he changed these habits. It ... He says it changed everything for him, and I think that that's, you know, a very inspiring story of what it can mean to extend your career and be able to almost pr- tap into this additional performance capacity that I think even he was surprised about, that he, for the first time, was able to improve beyond what he already thought was his best. And I think that's what's so inspiring, because this is something that's accessible to all of us to be able to tap into that little bit more.

   7. SBSteven Bartlett21:46

      So not only did he win the Most Valuable Player award, but his three-point conversion went up 218%.

   8. CMDr Cheri Mah21:54

      Yes. So during the time that I had worked with him, his three-point percentage went up twofold during that time.

   9. SBSteven Bartlett22:00

      It begs the question, what did you do to him?

   10. CMDr Cheri Mah22:03

       (laughs)

   11. SBSteven Bartlett22:04

       And, you know, you named a

9. 22:05 – 23:18

   Where to start getting better sleep?

   1. SBSteven Bartlett22:05

      couple of things there, but I'd love to dig into some of those key points-

   2. CMDr Cheri Mah22:08

      Sure.

   3. SBSteven Bartlett22:08

      ... um, where you started with him, the specific sort of implementa- things that you implemented into his, um, sleep hygiene, and ... So that if I am him, the day that you met him, when he was taking those naps and staying up late, which I often do, to be fair-

   4. CMDr Cheri Mah22:24

      Yes.

   5. SBSteven Bartlett22:24

      ... um, where would you start with me, and where did you start with him?

   6. CMDr Cheri Mah22:26

      Okay. So let's dive into just some very practical strategies that I started to challenge him with, which was, we'll start with his sleep environment. We wanna make your sleep environment like a cave, really dark, quiet, cool, and comfortable. Dark cave, so dark, blackout curtains, eye mask are some of the easiest tools that you can grab, but are incredibly helpful and great investment to be able to use that both at home and then when you travel, so that if you're in a non-ideal environment like a hotel room, you have, for example, an eye mask that can help dampen out the- the light. Uh, making it quiet, so earplugs, uh, also a white noise machine. I'm a huge fan of even a small travel white noise so that you can actually mask over external noises that you may or not be able to control.

   7. SBSteven Bartlett23:15

      I'm someone that tells myself that I sleep with something playing.

10. 23:18 – 24:39

    Does sound/music hurt sleep quality?

    1. SBSteven Bartlett23:18

       For s- I- I grew up with a radio in my room, so when I'm ... as an adult now, I'm always looking to play something-

    2. CMDr Cheri Mah23:23

       Mm-hmm.

    3. SBSteven Bartlett23:23

       ... as I fall asleep.

    4. CMDr Cheri Mah23:24

       Mm-hmm.

    5. SBSteven Bartlett23:24

       Is that gonna hurt my sleep quality?

    6. CMDr Cheri Mah23:26

       I would say if you're accustomed to this, I would say that's fine to continue to do so.

    7. SBSteven Bartlett23:30

       Okay.

    8. CMDr Cheri Mah23:30

       I am not a fan of having the TV on and having the bright light exposed, um, to you in that hour before bedtime, because it also can just be very psychologically stimulating. But if, like you said, it's a radio or it's a podcast that you feel is helping you relax, then I'm a fan of it.

    9. SBSteven Bartlett23:46

       Do you think Dioversio will help people relax?

    10. CMDr Cheri Mah23:48

        It might. (laughs)

    11. SBSteven Bartlett23:49

        (laughs)

    12. CMDr Cheri Mah23:50

        It might help you at least think about your sleep a bit more and challenge you to do maybe one- one change tonight. Uh ...

    13. SBSteven Bartlett23:56

        We consider that to be a scientific endorsement of the podcast.

    14. CMDr Cheri Mah23:59

        (laughs)

    15. SBSteven Bartlett23:59

        Um, okay, so I've got sound down. You are a fan of the white- white noise machines.

    16. CMDr Cheri Mah24:05

        I am, because sometimes there's external noises like a garbage truck or construction that you're not always able to control. So if you can at least mask over it temporarily, that can sometimes be helpful to keep individuals more asleep during the nighttime, and there's even some now that are adaptive, so if the door slams, then the volume temporarily increases and then will decrease. So there's almost these smart white noise machines that are- that are coming out on the market. So that's from a noise standpoint, and earplugs are gonna be helpful if you're traveling. When you're at home, you can obviously use those to dampen down any external noise.

11. 24:39 – 26:44

    Does temperature matter?

    1. CMDr Cheri Mah24:39

       From a- from a temperature standpoint, you want it to be cool. I think this is an area that a lot of people can benefit from, because they often sleep in much warmer temperatures than what we know is probably more conducive to sleep, which is cooler.

    2. SBSteven Bartlett24:51

       Mm-hmm.

    3. CMDr Cheri Mah24:52

       60 to 67 degrees has been shown to help individuals stay asleep and fall asleep. That may be frigidly cold for some, but you have to find the temperature that's right for you. I would say-... decrease your temperature by, say, one degree or two degrees every couple of days, and then you can find the temperature that works well for you. And there's even technology now where there's mattress covers that can help you regulate temperature from much cooler to warmer. So, if there's differences in bed partners, that's a way that you can actually accommodate both of their preferences.

    4. SBSteven Bartlett25:24

       So, that's about 16 to 20 degrees Celsius. What about when I shower or I bath? Because often, I go and have a shower, then I get straight into bed after.

    5. CMDr Cheri Mah25:35

       Yes.

    6. SBSteven Bartlett25:35

       Is that good or bad?

    7. CMDr Cheri Mah25:37

       I would encourage you to shift that timing a little bit earlier into the night. So, an hour and a half before you are planning to go to bed, I would shift your shower. Because when you are taking a hot bath or hot shower, it increases your core temperature, but when you fall asleep, your core temperature drops.

    8. SBSteven Bartlett25:55

       Right.

    9. CMDr Cheri Mah25:55

       So, you don't want that competing signal to be right before bedtime. But if you back that shower up an hour and a half, that should be sufficient time that we think potentially there's an augmentation of helping that drop in temperature. And some smaller studies have shown that that can help decrease the time to fall asleep and also enhance deep sleep, which has implications for muscle recovery, regeneration. And you get more of that in the earlier part of your night. So, it's an easy fix, uh, just to tweak the timing of your shower and your hot bath to be just an hour or two before bedtime, not right before bed. So, it's a strategy too if you have difficulties winding down and relaxing, to implement that hot shower or hot bath earlier in the evening.

    10. SBSteven Bartlett26:41

        One of the problems I also have when I sleep sometimes is

12. 26:44 – 29:09

    Food timing for better sleep

    1. SBSteven Bartlett26:44

       I- I hear people say you gotta- you can't eat, like, three or four hours before bed. However, I sometimes, you know ... I sometimes get home at 10:00 PM and I get home hungry as hell at 10:00 PM.

    2. CMDr Cheri Mah26:56

       Yeah.

    3. SBSteven Bartlett26:56

       And then sometimes if I order food, for example, it might come at, like, 11:00.

    4. CMDr Cheri Mah26:59

       Okay.

    5. SBSteven Bartlett27:00

       Which means that I end up eating at 11:00, and then I really see it in my sleep scores. Um ... I think, as well, that I'm someone that tends to fall asleep later. Again, this might just be me telling BS to myself, but that's what tends to happen. And I know I'm not supposed to eat before bed, but I'm so hungry. So, is there anything that I can eat before bed that won't disrupt my sleep, but will get rid of the hunger?

    6. CMDr Cheri Mah27:22

       Yes, the preference is not to have a huge meal right before bed that's fried, fatty, uh, you know, really heavy sitting in your stomach that hour right before bedtime. Um, so if you're able to time that and be strategic, then that's obviously the preference. But I'm okay with you having a pre-sleep snack. A lot of times for my athletes, that means we'll go for something like 50% of a complex carb and, like, 50% of a lean protein. So, for example, cereal and milk is an easy one.

    7. SBSteven Bartlett27:50

       Cereal?

    8. CMDr Cheri Mah27:50

       Yes, cereal and milk. Of course, we want something that's whole grain, uh, and not, you know, necessarily a sugary, you know, cereal, but cereal and milk is an easy one that many people have access to, or cottage cheese and fruit, or 100% whole wheat crackers and peanut butter. And the reason why is because I don't want you waking up in the middle of the night being hungry, or even trying to fall asleep and you feel like you're hungry. But we want something that's slow digesting through the night, because ideally, you're gonna be sleeping seven, eight, nine hours during the night. Uh, and we want it to be able to get you to the morning time, and then you will fuel when you wake up. So, a pre-sleep snack can be a great strategy if you're coming home late and you want to obviously be able to fuel before bed, or if you have a really early dinner and you're hungry before bedtime.

    9. SBSteven Bartlett28:36

       Yeah, that happens sometimes as well.

    10. CMDr Cheri Mah28:38

        Mm-hmm. Yeah.

    11. SBSteven Bartlett28:38

        Sometimes I'll eat dinner at about 5:00 PM.

    12. CMDr Cheri Mah28:40

        Yep.

    13. SBSteven Bartlett28:40

        And then I get to about 10:00, 11:00 PM, and I'm still awake and I'm starving.

    14. CMDr Cheri Mah28:44

        Okay, so what's a pre-sleep snack that you think you can grab for ...

    15. SBSteven Bartlett28:47

        Some nuts?

    16. CMDr Cheri Mah28:48

        Okay, yeah.

    17. SBSteven Bartlett28:49

        Does that work?

    18. CMDr Cheri Mah28:50

        Yeah, yeah. Nuts have protein in them. Um ... Yeah, you can grab a- a good nut mix, maybe you can partner that also with, like, some yogurt too.

    19. SBSteven Bartlett28:58

        Raspberries.

    20. CMDr Cheri Mah28:59

        Raspberries, yeah. Fruit.

    21. SBSteven Bartlett29:00

        Blackberries.

    22. CMDr Cheri Mah29:00

        Yeah, and some ... Yes, a- a protein and carb in there, and those are good p- good pre-sleep snacks.

    23. SBSteven Bartlett29:08

        What's the ... If I wanted

13. 29:09 – 34:03

    The food to eat before bed that will destroy your sleep

    1. SBSteven Bartlett29:09

       to destroy my sleep, what would you recommend I eat right before bed? What would you recommend I- I, yeah, consume right before bed? It could be-

    2. CMDr Cheri Mah29:17

       If you just wanna destroy your sleep entirely.

    3. SBSteven Bartlett29:19

       I wanna destroy my sleep.

    4. CMDr Cheri Mah29:19

       Okay, so we're gonna have the- the nightcap of having a couple of drinks right before bed.

    5. SBSteven Bartlett29:25

       Okay, so some alcohol.

    6. CMDr Cheri Mah29:26

       Yeah, we'll have some alcohol on board. We'll- we'll throw in some caffeine too to-

    7. SBSteven Bartlett29:31

       Mm-hmm.

    8. CMDr Cheri Mah29:31

       ... to really get you to stay awake in the next couple of hours. We'll add a really heavy meal that's fried, tomato-based, um, fatty, sitting in your stomach right before bed and ...

    9. SBSteven Bartlett29:44

       Did you say tomato-based?

    10. CMDr Cheri Mah29:45

        Yeah, sometimes individuals will have acid reflux with tomato-based products. And so if that's something that is ch- is ... Yeah, if that's something that you experience, then you generally want to avoid some of the tomato-based products that can aggravate some of the acid reflux.

    11. SBSteven Bartlett30:00

        So, some fried food with some ketchup?

    12. CMDr Cheri Mah30:05

        Yes.

    13. SBSteven Bartlett30:06

        Okay, so alcohol, caffeine, and some fried food with some ketchup.

    14. CMDr Cheri Mah30:09

        I think that would really work to your disadvantage during the nighttime.

    15. SBSteven Bartlett30:14

        Any sugar?

    16. CMDr Cheri Mah30:15

        Yes, sugary carbs are tends to be some of the preferences when you're particularly also sleep-deprived.

    17. SBSteven Bartlett30:21

        Mm-hmm.

    18. CMDr Cheri Mah30:21

        So, people will choose more carb-heavy foods and foods that have, um, less fiber and more- more sugar.

    19. SBSteven Bartlett30:30

        Why-

    20. CMDr Cheri Mah30:30

        Fats.

    21. SBSteven Bartlett30:31

        ... is it that if I eat those foods before bed, it impacts my sleep? What- what- what's going on?

    22. CMDr Cheri Mah30:37

        I don't think we have a great understanding of that. I think the field of sleep and nutrition is definitely growing, and I think down the road in the next 5 or 10 years, we hopefully will have more answers to that. But it's a fascinating area that we do start to understand what we eat can affect our sleep. So, for example, the stages of our sleep-

    23. SBSteven Bartlett30:54

        Mm-hmm.

    24. CMDr Cheri Mah30:54

        ... or how we sleep during the nighttime. Some of the smaller studies have shown what you eat can then affect having more awakenings during the nighttime, um, and affecting the quality of your sleep, but I think many of them are still at the infancy.

    25. SBSteven Bartlett31:08

        'Cause that's certainly something I can attest to. I- I talked about one time many months ago, I think it was last year actually, when I ... I was staying in a hotel here in LA and I had a cookie before bed 'cause it was- 'cause I'm bloody ... You know, I blame the hotel. I don't really blame the hotel, I take full responsibility. It was in the minibar.And I hadn't eaten all day. I came back, I'd been working all day and when I'm, when I'm, when I've been working a lot, I'm much more likely to reach for something bad. And I had this cookie, and honestly, I woke up the next morning, eight hours later, feeling like I hadn't slept at all. I just felt so tired and I know it was that bloody cookie 'cause I looked at my, um, my Whoop, hashtag ad, hashtag investor, and I could see that my heart rate throughout the night was really high.

    26. CMDr Cheri Mah31:49

        Mm-hmm.

    27. SBSteven Bartlett31:49

        Like, atypically high. My heart rate throughout the night will usually just be this nice flat, I don't know, 50, 55 beats per minute.

    28. CMDr Cheri Mah31:56

        Mm-hmm.

    29. SBSteven Bartlett31:56

        And when I'd had that cookie, it started and pretty much stayed for the first three or four hours at about 75 beats.

    30. CMDr Cheri Mah32:01

        Mm-hmm.
14. 34:03 – 35:34

    What to do for a racing mind?

    1. SBSteven Bartlett34:03

       this managing a racing mind, athletes, um, performers, creatives. Um, so if, I've got a racing mind I think as well. I think I tend to feel like I have my best ideas just before I'm about to get in bed. What would you recommend someone do if they have a racing mind?

    2. CMDr Cheri Mah34:20

       Again, incredibly common to have racing thoughts, thinking through the day, needing to process your thoughts about how to prepare for tomorrow. So what I'd recommend is spending 10 minutes processing your thoughts outside of bed in dim light every single night. So that can mean I would recommend you could do stretching, uh, you could do deep breathing exercises to activate your parasympathetic system and dampen down your sympathetic system. That's what I recommend for a lot of my athletes. If that's not your thing, I recommend journaling. Getting your thoughts down onto paper, uh, or writing a to-do list. Those are easy ones that all of us can do for, even if you start with five minutes today.

    3. SBSteven Bartlett35:03

       So I'm gonna stretch.

    4. CMDr Cheri Mah35:05

       Okay.

    5. SBSteven Bartlett35:05

       Um, I read so-, I read something, I think it was Whoop's data they released at the end of the year where they, 'cause th- there's an activity log in Whoop-

    6. CMDr Cheri Mah35:11

       Yeah.

    7. SBSteven Bartlett35:11

       ... where you basically say what you're doing. And I, I'm gonna butcher this, but I think the stats said that reading before bed improved your sleep by about 5% across everyone that was using Whoop.

    8. CMDr Cheri Mah35:23

       Mm-hmm.

    9. SBSteven Bartlett35:23

       Which makes sense, because you're gonna be away from light-

    10. CMDr Cheri Mah35:27

        Mm-hmm.

    11. SBSteven Bartlett35:27

        ... I guess, and you're also gonna be calming your, you called it your parasympathetic nervous system.

    12. CMDr Cheri Mah35:31

        Yes. Yes.

    13. SBSteven Bartlett35:32

        The parasympathetic nervous system, what do I need

15. 35:34 – 39:40

    What is the parasympathetic nervous system?

    1. SBSteven Bartlett35:34

       to know about that in the context of sleep?

    2. CMDr Cheri Mah35:35

       That's just the system that helps you relax and wind down. The, it is in balance with the sympathetic system, which you may have heard is the fight or flight system that gets you going, that's where your heart rate, heartbeat will be much more rapid, your breathing can be much more rapid when you need to go.

    3. SBSteven Bartlett35:52

       That's when I'm overthinking.

    4. CMDr Cheri Mah35:53

       Yes. But you want to dampen that down and you want to get your parasympathetic system activated so you can help actually relax physiologically your body and also your brain so that you're in a better state to sleep at night, right? It's easier to slowly pump your brakes and then try to sleep versus if you were going 60 miles an hour on a freeway and then suddenly slamming on the brakes and just jumping into bed. So you actually have a process to slow yourself down, your brain and body. It will help prepare you to actually get better sleep during the nighttime.

    5. SBSteven Bartlett36:27

       Just wanna close off on Andre then. Is there anything else you did with him to-

    6. CMDr Cheri Mah36:30

       Yes. There's-

    7. SBSteven Bartlett36:31

       Please do give me more.

    8. CMDr Cheri Mah36:32

       There's more that we've done with Andre, but this is to give you some highlights. So, you know, approaches to s- his sleep were having that way to process his thoughts, being able to wind down before bed and relax.... improving his sleep environment so that it was, as I mentioned, dark and cool. I believe his was around 67 degrees. It was quiet. Um, we tried to... We took out technology from his bedroom so he didn't have that exposure prior to bed. We looked at cutting down some of his power naps that were several hours long, to shorten them to 20 to 30 minutes and time it much closer to game time, so he would get that boost as you would go into evening games. Um, and we looked at some of his nutritional choices. But this is the highlight of, of some of the ways that we were strategic about his approach to sleep, and while we were also extending his sleep from that under seven to seven and a half to eight hours, because we knew he had an accumulated sleep debt that had been built from not getting sufficient sleep, probably for many months to years prior to this. And so as we've shared, some of the performance outcomes were astonishing, and he's been very vocal about sharing his sleep story, and he's not the only one. Um, if I could share another story about another athlete where you've asked what has saved someone's career. So with Andre, I think he saw this performance enhancement that he could tap into, that was, that was, um, previously he didn't know almost existed, right? But then there's other athletes where I think having sleep as a foundation almost saved their career. One example is Ryan Jensen. So Ryan Jensen was cut from the Ravens and put on the practice squad, and during this time, as the story goes, his father said, you know, "What's happening? You're not yourself. You, like, made your mom cry the other day. You know, there's, there's something that's going on." And he eventually was tested for sleep apnea, which is a very, very common sleep disorder where your airway has some partial or full collapse during the air... during the night, and so it can have very fragmented sleep through the night. And he was eventually tested, diagnosed, and then put on treatment through what's called a CPAP, or continuous positive airway pressure. So it's a, it's a mask that provides air to keep the airway open, so then you actually can have consolidated sleep during the nighttime. And in a very neat way, four years later, Ryan Jensen comes back, signs a $42 million contract as one of the highest paid centers in the NFL, and then three years later, in 2021, wins the Super Bowl with Tom Brady, uh, on the Bucs. I see this as the success story of saving his career, and he's been vocal about how much of a difference it made from literally almost the end of his career happening to now being able to succeed at the highest level. And also, of course, being healthier and being able to have, um, more success on the field than he probably imagined for himself.

    9. SBSteven Bartlett39:37

       And better relationships. Um, presumably he's not made his mother cry.

16. 39:40 – 41:44

    Emotional link to better sleep

    1. SBSteven Bartlett39:40

       I'm quite curious about that. Why is it that when we haven't slept, we're more likely to make people cry?

    2. CMDr Cheri Mah39:46

       Because we are... Our emotions are not regulated well when we're short on sleep. We are more irritable. We are more grouchy. We respond more with our emotions than being able to-

    3. SBSteven Bartlett39:59

       Why?

    4. CMDr Cheri Mah39:59

       Um, why we respond with our emotions?

    5. SBSteven Bartlett40:01

       Yeah, what's going on in the body? Is it, like, a different part of my brain? Is it my hormones? Is it something else?

    6. CMDr Cheri Mah40:06

       It's probably a combination of both, right? We know that, um, our emotional regulation is not the same if we're well-rested versus if we're sleep-deprived, and so we rely more on our innate response, which may not necessarily be that which is strategic for what we should be responding with if we were tempered and had a better rest under our belt. Um, so yes, cognitively there's a, an implication of which part of your brain you're gonna be using, but then also you are just not in a state in which you are going to be able to respond in the way that you would otherwise.

    7. SBSteven Bartlett40:41

       Is it the amygdala that's the emotional center?

    8. CMDr Cheri Mah40:43

       That is one. That's where, like, fear is very much, um, and emotions and, and, um... Yeah, the amygdala is where, like, fear and emotions are, are often centered.

    9. SBSteven Bartlett40:52

       'Cause I started... When I started learning more about sleep and the impact it has on my emotions, I could see a huge variance in how, um, how I make my decisions, but also how, like, short I can be-

    10. CMDr Cheri Mah41:04

        Yeah.

    11. SBSteven Bartlett41:05

        ... if I haven't slept.

    12. CMDr Cheri Mah41:06

        Yeah.

    13. SBSteven Bartlett41:07

        And so on the days now where I haven't slept, I literally have a conversation with myself and tell myself that I'm gonna be in my amygdala, amygdala today, so to try not to make any decisions, try not to talk to many people. (laughs)

    14. CMDr Cheri Mah41:18

        (laughs)

    15. SBSteven Bartlett41:18

        Because there's a risk that I might just be... I might be too short in how I consider things and how I respond, and I really wanna stay away from that. But I've seen such a huge-

    16. CMDr Cheri Mah41:27

        Yeah.

    17. SBSteven Bartlett41:27

        ... huge variance, and I've also heard of other, like, famous CEOs and stuff like that talk about how they, they focus so much on their sleep. I, I can't... I was reading something the other day and it was... I think it was... It was Jeff Bezos.

    18. CMDr Cheri Mah41:39

        Mm-hmm.

    19. SBSteven Bartlett41:40

        Do you know what I'm gonna say?

    20. CMDr Cheri Mah41:41

        I don't, but Jeff Bezos is someone who has been

17. 41:44 – 44:01

    Perception change on the importance of sleep

    1. CMDr Cheri Mah41:44

       an advocate about sleep-

    2. SBSteven Bartlett41:45

       Yeah.

    3. CMDr Cheri Mah41:45

       ... and vocal that he needs eight hours every night.

    4. SBSteven Bartlett41:48

       Yes. The quote that I heard him say, or someone told me that he said, was... I think it might have been Arianna Huffington, actually. He said that his job as a CEO is to make decisions, and he says he doesn't have to make that many decisions a year. He only makes a couple of big decisions a year. Uh, every day he's probably just making two or three big decisions. So if his job is to make decisions, then his job is also to sleep, because the variance I see in even my own decision-making when I'm slept and under-slept is just unbelievably staggering. As someone that sits here for seven, eight hours a day sometimes having conversations, you wouldn't believe the difference when my brain and my mouth are, like, connected because I've slept. It's like a different human being. It's a different podcast host. Um, have you got data to support this, this impact on cognitive performance?

    5. CMDr Cheri Mah42:37

       Yes. So you definitely make better decisions when you're well-rested. You're less likely to make cognitive errors. You have better judgment when you're well-rested, and you're gonna react faster. So in the situations where you need to make big decisions, whether it's on the field and you need to react because you're running a pass, whether you are Jeff Bezos and you're running a company and you need to make critical decisions, um, under, under sometimes, you know, acute stressors, or you are someone who just is trying to be your best, we know that the cognitive domain very much is influenced by getting sufficient sleep. And some of the, I would say, you know, large, um, very, very public disasters have happened as a result of what we know is sleep loss, um, where people have made poor decisions or decisions that have led to unfortunate disasters. So for example, the Challenger disaster-

    6. SBSteven Bartlett43:35

       What was that?

    7. CMDr Cheri Mah43:35

       ... with the space shuttle that exploded.

    8. SBSteven Bartlett43:37

       Right.

    9. CMDr Cheri Mah43:38

       Um, and as a result, there's investigations of why did this happen, and the final report does suggest that insufficient sleep for some of those key decision-makers around being able to launch or not was attributed to fatigue and insufficient sleep. So being able to make good game-time decisions had this disastrous effect, ultimately, on the Challenger explosion. Or-

    10. SBSteven Bartlett44:00

        Are, are you

18. 44:01 – 47:49

    Cognitive performance and sleep

    1. SBSteven Bartlett44:01

       aware of any studies that have measured cognitive performance on, and sleep?

    2. CMDr Cheri Mah44:07

       Yes. So my studies, as well as many of my other colleagues', particularly look at reaction time, because we know reaction time is, um, very finely or is very sensitive to sleep loss, and I'm starting to find it also is sensitive to extension of sleep, so the other half of this story. When you pay back sleep lo- sleep debt, we see that benefit on, on, uh, reaction time. But, uh, reaction time and looking at aspects of, you know, how quickly you're able to respond, or if you're having errors when you're responding and you're not supposed to be responding, cognitively those aren't, um, tests that are typically used in a lot of sleep studies because we know it's quite sensitive.

    3. SBSteven Bartlett44:47

       Can you give me an example of a study that will convince me that, um, if I sleep more, my cognitive performance will improve?

    4. CMDr Cheri Mah44:55

       One of the studies I mentioned before, even 15 minutes more sleep was that difference of that A student to the B student.

    5. SBSteven Bartlett45:01

       Oh, yeah.

    6. CMDr Cheri Mah45:01

       There's another study I often cite where if you look at the difference of someone who gets nine hours of sleep for a full week, the reaction time stays very consistent. Great. You wanna react appropriately. You wanna not make cognitive errors or lapses in judgment, and that will be consistent over the week. If you're someone who's getting seven hours of sleep, you see a slowing of that reaction time and then a leveling off. If you are getting five hours of sleep, you see even, even sharper decline in being able to react fast, and then you see a leveling off. If you're getting three hours of sleep every night, you're just gonna tank that reaction time and be slower. At the same time, you have more lapses in judgment and not able to respond appropriately. But the, the thing about the study that I find so fascinating is when we know that there's this deficit when you're gonna react slower, in the seven and the five-hour group, there's this leveling off. So people say, "Oh, can I get used to getting insufficient sleep?" In some sense, there was the stabilizing of it, but the reality is you're not at your best, right? We know what your reaction could be if you were getting that nine hours, and if we even gave you three nights of what we call recovery sleep, so we said, "Okay, now we get, let's say, eight hours in bed for the next three days," you're gonna feel better and you'll probably feel more refreshed, but those reaction times for the seven hours and the five hours and the three-hour group didn't go back to the baseline. So it takes more than one night or one weekend of that recovery sleep to get you back to your baseline. And so that's the bottom line that I try to show my athletes, is that you can pay back sleep debt, but it often can take more than just one day or one weekend of-

    7. SBSteven Bartlett46:43

       How long-

    8. CMDr Cheri Mah46:43

       ... quality sleep.

    9. SBSteven Bartlett46:44

       How long does it take?

    10. CMDr Cheri Mah46:45

        So my studies have suggested multiple weeks, uh, will really be beneficial to paying back more of your sleep debt than just a night or two nights of sleep. The biggest bang for your buck tends to be in the first week or two, but obviously this depends on how much more you're actually getting, how you're timing that in your night, but the bottom line is that if you can invest maybe a week or maybe if you have a vacation coming up and you do two weeks, that's going to be, uh, the biggest impact on paying back your sleep debt. And if you say, "Hey, that sounds like a long time, Dr. Ma," well, even potentially, like, five days, as one of my preliminary studies had suggested in professional baseball players, even if it's five days of getting one additional hour of sleep, that was shown to potential- that was shown to improve cognitive reaction time and also processing speed in the athletes that actually got one additional hour. So if you got six hours, you went to seven. If you got seven hours, you went to eight hours, versus the athletes that just continued to get their normal sleep.

    11. SBSteven Bartlett47:46

        Interesting. I g- I guess I've gotta understand what this

19. 47:49 – 52:22

    Sleep debt and how it works

    1. SBSteven Bartlett47:49

       concept or this idea of sleep debt is, because I, I wanna make sure I'm super clear on what it is and isn't. 'Cause when you say the word debt, I assume it's kind of like I, I owe the sleep bank manager a couple of hours.

    2. CMDr Cheri Mah48:00

       (laughs) Yes.

    3. SBSteven Bartlett48:00

       Um, but I, but I, I've kind of gone back and forward on this idea of sleep debt. I think some people have told me that it's real, some people have told me that it's not real, um, and I don't know where, where I should stand on it.

    4. CMDr Cheri Mah48:11

       Yes.

    5. SBSteven Bartlett48:11

       If, so if I, if I haven't ... So for example, I flew into LA, the first couple of nights, my sleep wasn't great. Am I still ... But I had good sleep last night, am I still paying for it now?

    6. CMDr Cheri Mah48:21

       The way I explain the concept of sleep debt is that your body requires a certain amount every single night. Again, we talked about individual variability, but let's just say you need eight hours every night, and conceptually, if you don't meet that eight hours, then you build up a debt. So if you're only getting six hours a night, you now have two hours of debt built up. If you go Monday to Friday, that's five days, now you have 10 hours built up.Right? Two hours-

    7. SBSteven Bartlett48:44

       Yeah.

    8. CMDr Cheri Mah48:44

       ... every night-

    9. SBSteven Bartlett48:44

       Yeah.

    10. CMDr Cheri Mah48:44

        ... becomes ten hours, and if you then sleep in on a Saturday and you get, let's just say, ten hours of sleep, you've paid back two of those hours, but you still have eight hours left to go.

    11. SBSteven Bartlett48:55

        And my, and my body knows?

    12. CMDr Cheri Mah48:57

        Yes. So conceptually, that's the idea of accumulating sleep debt. I do stand in the camp that believes that that does accumulate over time. We do think that you can a- pay back some of that debt on the short term, right? So what you lost, like you said, this past day or this past week, maybe this past month, you should pay that back with getting extra sleep, or we call sleep extension. We don't think that you can surplus and bank more and that you can pull from that in the future, but we recognize that if you've got insufficient sleep, that if you extend it over a couple of days, maybe a couple weeks, then you will see benefits in your reaction time, in your fatigue levels, in your performance outcomes. And so we do recommend that as a tool, especially if you know that you're going to have a day where you're gonna have sleep loss. So it's a strategy, for example, if you know, okay, in a week, I'm going to have a project and I'm not gonna be getting enough sleep that night. Then what you can do in the days leading up to it is getting sufficient sleep, but arguably even more so that we know when it gets to that project, the decrements that you'll experience tend to be less robust than if you went into it with just, say, those five hours.

    13. SBSteven Bartlett50:13

        So what evidence do you have that sleep debt is a real thing? What's the first thing that comes to mind?

    14. CMDr Cheri Mah50:18

        So my, my... What I've dedicated my career to is trying to understand how to pay back sleep debt with sleep extension interventions. So what that means is typically I'm working with a number of collegiate athletes where many of them are not getting what they need because when we start these studies, many of them have high fatigue levels, they are reacting slowly. We often see lapses in their, um, their judgment and their ability to ultimately perform and function, which is what they consider their baseline. But then when we actually challenge them by paying back some of that debt by getting additional hours, when we monitor the, the differences that can make over multiple weeks, that's where we see there's improvement in the reaction time. Their fatigue levels drop. Their performance on the field improves. And so we recognize what has changed in this is trying to pay back some of that accumulated debt when the rest of their training has been held consistent-

    15. SBSteven Bartlett51:20

        So... Ah, okay.

    16. CMDr Cheri Mah51:20

        ... where we've been trying to maintain the rest of their, their training.

    17. SBSteven Bartlett51:23

        That... Which is key.

    18. CMDr Cheri Mah51:24

        Yeah.

    19. SBSteven Bartlett51:24

        Which is the key point because in my mind, I go, well, maybe if you've got the athlete to sleep well on that first night, then when they've showed up to training, they've trained a little bit harder.

    20. CMDr Cheri Mah51:34

        Mm-hmm.

    21. SBSteven Bartlett51:34

        They've built their muscles a little bit more. They've had better r- recovery in their muscles. So then the next day, the h- same thing happens because they've slept. So it's actually just that they're training better-

    22. CMDr Cheri Mah51:44

        Mm-hmm.

    23. SBSteven Bartlett51:45

        ... which is causing them to improve test scores.

    24. CMDr Cheri Mah51:46

        Mm-hmm. That's fair. We, we've tried to hold their training to be consistent and choosing periods where their training isn't going to vary significantly, as well as you can almost make the argument too that sometimes as the season goes on, athletes get more fatigued, more tired and that can be actually a decrement to how they'll perform. So when we see the benefits come down the road as the season potentially gets even longer, that at least is some suggestion that the intervention of sleep, while we also have the measures of how much more they were getting, actually were at least associated with these performance outcomes.

    25. SBSteven Bartlett52:20

        Because REM s- th- one of the

20. 52:22 – 54:35

    Muscle memory and its connection to sleep

    1. SBSteven Bartlett52:22

       key things about REM sleep, which is the sort of final stage of sleep, is that it helps with muscle recovery?

    2. CMDr Cheri Mah52:27

       Uh, deep sleep is actually-

    3. SBSteven Bartlett52:28

       Deep sleep is... Oh, okay.

    4. CMDr Cheri Mah52:29

       Deep sleep is where we, um... Deep sleep is where it's implied that there's more rus- muscle recovery regeneration because there's the biggest pulse of growth hormone during your deep sleep. So to back up a bit, you have light stages of sleep, then you have deep stages of sleep, and then you have that rapid eye movement sleep or when you dream. That is, tends to be more associated with consolidation of learning and memory-

    5. SBSteven Bartlett52:52

       Mm-hmm.

    6. CMDr Cheri Mah52:52

       ... and skill consolidation. So you go through these cycles during the nighttime, about 90 to 120 minutes, but the proportion changes through the night. The beginning of the night, you get more of that deep sleep, and then in the early morning hours is when you get more of that REM sleep. So you might have woken up in the earlier morning and had the recall of these vivid dreams. It's because you often will be waking up from the, that REM sleep.

    7. SBSteven Bartlett53:17

       Yes. That happened last night actually-

    8. CMDr Cheri Mah53:18

       Yeah.

    9. SBSteven Bartlett53:18

       ... 'cause I woke up suspiciously early for me. So I woke up at a- about five or six o'clock, and I was just kinda dipping in and out of dreams.

    10. CMDr Cheri Mah53:25

        Mm-hmm.

    11. SBSteven Bartlett53:26

        And they were very vivid dreams that I can still remember now.

    12. CMDr Cheri Mah53:28

        Yeah.

    13. SBSteven Bartlett53:29

        Um, so the muscle memory element of all of this, what is muscle memory and how is that sort of implicated with sleep?

    14. CMDr Cheri Mah53:37

        So muscle memory, there's different types of memory, and you need sleep... Think of sleep as hitting that save button, right?

    15. SBSteven Bartlett53:44

        Mm-hmm.

    16. CMDr Cheri Mah53:44

        You need to sleep after you have learned new information, learned a new skill so that you can consolidate those, those, uh, those memories and be able to retrieve it later. So I always use an analogy of hitting that save button. After you learn new material or learn a new skill set, you need to go home and sleep so that it goes into long-term storage and that you can retrieve that the following day and subsequently. Without that sleep, we know that that groundwork for that new skill or that new memory is not gonna be as strong. And so in the context of students who are trying to study for a test or an athlete that's trying to remember the playbook, you want to space those intervals that you're learning that material and have sleep that follows so that you strengthen those connections.

21. 54:35 – 56:05

    What's a nappucino?

    1. CMDr Cheri Mah54:35

    2. SBSteven Bartlett54:35

       And also, you mentioned when you were talking about one of your athletes, encouraging them to nap before a game.

    3. CMDr Cheri Mah54:41

       Yes.

    4. SBSteven Bartlett54:42

       Um, I, I read this f- fascinating word in the research that I was doing on your work. I think it's nappuccino.

    5. CMDr Cheri Mah54:48

       Yes. (laughs)

    6. SBSteven Bartlett54:49

       What's a nappuccino?

    7. CMDr Cheri Mah54:50

       (laughs) The nappuccino. So this is a useful tool if you're trying to have a temporary boost in alertness and performance. So the nappuccino, you go and take your favorite caffeinated beverage.

    8. SBSteven Bartlett55:02

       Yeah.

    9. CMDr Cheri Mah55:02

       The caffeine will start to kick in in about 15 minutes, and you go and then take your 20 to 30 minute power nap. So if you're able to fall asleep within that five to 10 minutes while the caffeine will start to come on board, then when you wake up after 20 to 30 minutes, then bam, both the caffeine will have kicked in and the power nap will have kicked in. And there's research to show that that's more effective for alertness and performance improvement for a couple of hours than if you only did the caffeine alone or only did the power nap alone. So the nappuccino is, is a useful tool for some who, who utilize caffeine, and you can partner that together with a short 20 to 30 minute nap.

    10. SBSteven Bartlett55:42

        So if I wanted to take a nap now, I have an espresso and then go and have my nap.

    11. CMDr Cheri Mah55:49

        Exactly, yes. The caveat is you do need to fall asleep within about 10 minutes or else the caffeine will start to come on board, but if you do this in the late morning or early afternoon, it can be a helpful tool so that you have a boost in your alertness for a couple of hours.

    12. SBSteven Bartlett56:04

        And

22. 56:05 – 57:39

    Do naps work?

    1. SBSteven Bartlett56:05

       I grew up thinking that naps didn't work because the minute I learned about sleep and these sleep cycles and that it takes, I don't know, 45, 60 minutes, whatever it is to get into late stage sleep like the REM sleep, the deep s- sleep, I thought what's the point in taking a 15, 20 minute nap if I'm not gonna get into deep or REM sleep?

    2. CMDr Cheri Mah56:21

       So there is benefit of just that 15 minute nap you mentioned. You wanna stay in lighter stages of sleep 'cause there's benefits of lighter stages of sleep, and that can give you that alertness and performance boost even when you're in lighter stages of sleep. You actually don't wanna go into deeper stages of sleep because when you take the longer naps, as I think you, you might have shared, you've, you've taken the two hour nap, the three hour power nap, you wake up and you're much more sluggish, much more groggy. That's not a good state for you to go out and then do, you know, work after that or it's not the state that you wanna be if you're a pl- a basketball player and have to go and play a game. But those deeper stages, you come out of what we call sleep inertia with that sluggishness, and so it can also affect your sleep at night and make it harder to sleep subsequently. So you actually wanna stay in those lighter stages of sleep and keep those naps very short.

    3. SBSteven Bartlett57:12

       So what's the maximum length that a nap should be?

    4. CMDr Cheri Mah57:15

       I like 30 minutes.

    5. SBSteven Bartlett57:16

       Okay.

    6. CMDr Cheri Mah57:17

       Yes. So you can time that by setting an alarm. If it takes you five or 10 minutes to fall asleep, you can plan for that as well, and then setting an alarm to wake yourself up 30 minutes later. I think it's a great strategy when, again, you don't get sufficient sleep at night or you had poor sleep leading into that night and you need a little bit of a boost later in the day.

    7. SBSteven Bartlett57:37

       What do you think of the snooze button?

23. 57:39 – 1:00:10

    Is the snooze button bad?

    1. SBSteven Bartlett57:39

    2. CMDr Cheri Mah57:39

       The snooze button. (laughs)

    3. SBSteven Bartlett57:41

       Are you a fan?

    4. CMDr Cheri Mah57:41

       I'm not a huge fan of the snooze. (laughs)

    5. SBSteven Bartlett57:43

       Right.

    6. CMDr Cheri Mah57:43

       Um, I fully understand why people love to hit the snooze and then go back to bed, uh, and if you're someone who does that, m- one of my suggestions is just to cut down so that you only hit the snooze once, five minutes later start your day. The reason why is because it helps to maximize your REM or your dreaming sleep in those early morning hours if you can actually sleep consolidated all the way until the time you have to wake up. So for example, if you're someone who hits the snooze button five times, every five minutes for a half hour, it means that you're having very interrupted sleep for the last half hour of your night versus if you just let yourself sleep consolidated all the way through and then maybe hit the snooze button just one time and then got yourself up to start your day, it means you would have given yourself another 25 minutes of consolidated sleep, likely that dreaming REM sleep that's so important for learning and memory. And so that is one just easy adjustment that you can make in terms of your morning approach to maximizing what you get during the night.

    7. SBSteven Bartlett58:46

       So, so what's the, what's the value in consolidating it versus just...

    8. CMDr Cheri Mah58:49

       Having fragmented sleep?

    9. SBSteven Bartlett58:51

       Yeah.

    10. CMDr Cheri Mah58:51

        So then if you're getting a lot of that REM sleep in those early morning hours and you're snoozing, you're going to be waking up and coming out of that REM sleep.

    11. SBSteven Bartlett58:59

        Yeah.

    12. CMDr Cheri Mah58:59

        So you likely are changing the stages of sleep you would be getting in those early hours, so you would then be awake and then probably going into lighter stages of sleep, awake, lighter stages of sleep, than necessarily having a solid REM period all the way until you wake up.

    13. SBSteven Bartlett59:15

        And what's the cost of that?

    14. CMDr Cheri Mah59:16

        So learning and memory and s- consolidation is definitely one area that we recognize is associated with that REM sleep, and so you want, as we talked about it changes through the night, you wanna have as much as possible but you p- part have to have just the duration. So when you get the most of it in the morning hours, if you cut that short and either wake up earlier or you're snoozing and you're interrupting it, you're not gonna maximize the value you get of the hours in REM.

    15. SBSteven Bartlett59:43

        Okay, so I just wanna make sure that I, those 25 minutes, I give them to REM sleep-

    16. CMDr Cheri Mah59:50

        Exactly.

    17. SBSteven Bartlett59:50

        ... versus just giving them to little fragmented light sleep.

    18. CMDr Cheri Mah59:53

        Exactly.

    19. SBSteven Bartlett59:53

        So I'd r- I'm, I'm better off just putting my alarm to the time that I actually have to get out of bed-

    20. CMDr Cheri Mah59:58

        Exactly.

    21. SBSteven Bartlett59:59

        ... just to maximize the amount of REM sleep that I get-

    22. CMDr Cheri Mah1:00:00

        Yeah.

    23. SBSteven Bartlett1:00:01

        ... to consolidate my m- my memories.

    24. CMDr Cheri Mah1:00:02

        Are you a snoozer?

    25. SBSteven Bartlett1:00:03

        No, not really.

    26. CMDr Cheri Mah1:00:04

        Okay. (laughs)

    27. SBSteven Bartlett1:00:05

        Well, I mean, we all have our, our moments, but not really. I can't remember the

24. 1:00:10 – 1:02:46

    Are there different chronotypes?

    1. SBSteven Bartlett1:00:10

       last time I pressed a s- pressed the snooze button. But the thing that I do, and I'm not sure if this is a good idea or not, is because I have told myself, and I say told myself 'cause I'm quite conscious of the BS that I believe about myself, but um, I've told myself that I'm like an owl chronotype or something, which by the way I don't even know if it's true and I don't know if chrono- chronotypes are true, um, and I typically work quite late and I love working late, I get better ideas late, I r- do my writing pretty late at night as well, and so what I've done in my life is I've basically made sure that I don't have any meetings or any engagements before 11:00. So even like this podcast today started at 11:00.

    2. CMDr Cheri Mah1:00:46

       Yes.

    3. SBSteven Bartlett1:00:46

       Um, n- basically nothing in my life starts til 11:00.... for that very reason, just to ... Because if I do end up staying up a little bit late, I wanna be able to kinda sleep through without having to set an alarm-

    4. CMDr Cheri Mah1:00:57

       Yeah.

    5. SBSteven Bartlett1:00:57

       ... and just wake up naturally. What do you think of that? Is that suboptimal?

    6. CMDr Cheri Mah1:01:01

       No, I think it's a great strategy. So there are chronotypes where you've mentioned you're more of an evening owl. You go to bed later, you like to wake up later as a natural predilection.

    7. SBSteven Bartlett1:01:11

       Is, is that real? Or have I just told myself this-

    8. CMDr Cheri Mah1:01:13

       This is real. This is real. (laughs)

    9. SBSteven Bartlett1:01:13

       ... just to find myself, so.

    10. CMDr Cheri Mah1:01:15

        No, there is a natural tendency for some to feel like they're evening owls, and there's others who feel like they do much better in the morning, so they go to bed earlier, they wake up earlier, they're more productive in the morning. Those are our, our morning larks. And then there is a group that's somewhere in the middle that don't strongly lean one way or another, but really what you're doing is you're, you're making your sleep work to your, your chronotype and to your advantage, where you do feel like you're more productive in the evenings, and then you want to be able to maximize your sleep, waking up without an alarm and starting your day later. I think that's, like, a great strategy, because a lot of people aren't able to have that flexibility, and so society often will force particularly the night owls onto an earlier schedule where you have to wake up whether to go to work-

    11. SBSteven Bartlett1:01:58

        Yeah.

    12. CMDr Cheri Mah1:01:58

        ... or other obligations or kids-

    13. SBSteven Bartlett1:02:01

        And then we fail at school.

    14. CMDr Cheri Mah1:02:01

        ... at a earlier point, yeah. (laughs) Yeah.

    15. SBSteven Bartlett1:02:03

        Mm-hmm.

    16. CMDr Cheri Mah1:02:04

        And, and then you're cutting your sleep short, like you mentioned, like, with school, and then we're getting these, um ... And then you're on a schedule that doesn't work synergistically with what your chronotype is, so.

    17. SBSteven Bartlett1:02:16

        They should do some studies on kids in school and, like, disobedience and ability to pay attention and do your homework and grades, because honestly, I was so useless in school, and I really, I really think a lot of it ... Now, I'm not entirely sure here because I got diagnosed with ADHD when I was, like, 30 years old, so part of me thinks I've just got like a very active brain. And part, part of having an active brain meant that late at night I was finding ways to stimulate it by playing video games, et cetera, so that might just be the reason. But the other reason might be that I'm an owl chronotype, and I found it really hard to get up at like 7:30

25. 1:02:46 – 1:04:32

    Does school start too early for kids?

    1. SBSteven Bartlett1:02:46

       to get, to go to school-

    2. CMDr Cheri Mah1:02:47

       Mm-hmm.

    3. SBSteven Bartlett1:02:48

       ... by sort of 8:30-ish.

    4. CMDr Cheri Mah1:02:49

       Mm-hmm.

    5. SBSteven Bartlett1:02:50

       And so I would miss school, I would show up knackered, I would sleep in lessons, um, and I feel like s- school just starts way too early for kids.

    6. CMDr Cheri Mah1:02:59

       It, it is a ongoing, uh, it's an ongoing problem, and actually in a very interesting way. There has been a change to school start times, particularly in California. Um, this, this year was the first year that school scar- start times for high schools and for middle schools was shifted much later, because there are studies to show that our, when our students are better rested, they have higher attendance rates, their GPA and grades are much higher, there's less mental health issues, um, there's less car accidents. And so this, these studies have, um, been over the last decade and longer in which they have built evidence to help make deci- decisions to start school time later. Um, and that is in California been enacted this year and some other states are starting to follow suit. But to your point, what makes it challenging is that at the age of high school, many of those body clocks are shifted, and so students want to in adolescence go to bed later and wake up later naturally. That's just how our sleep changes through the life cycle. But when they stay up late and then we cut their sleep short by forcing them to get up really early for school, now they have insufficient sleep, and that builds like a sleep debt, and so they're not setting, uh, themselves up for success in school for learning and memory. So that's where, again, there's more evidence of if we can shift the school start time, get these students to have a little bit more sleep, they ultimately are better prepared for school, come to school, have less, uh, car accidents, and are just healthier students.

    7. SBSteven Bartlett1:04:31

       Do you think there's anything parents

26. 1:04:32 – 1:07:47

    What parents should know

    1. SBSteven Bartlett1:04:32

       need to know about sleep when it, as it relates to their children and sleep hygiene with their children?

    2. CMDr Cheri Mah1:04:38

       I think it's important for parents to start at the early, early years of instilling good sleep habits-

    3. SBSteven Bartlett1:04:44

       Yeah.

    4. CMDr Cheri Mah1:04:45

       ... a good sleep routine, and giving theirs, their children the s- tools and skills to be able to make sure that it's a priority as they go through early childhood into adolescence, and hopefully then sets themselves up for making sure it's a priority for their adult life. Um, I'm a young parent myself. I just had, uh, my first son, and so, um, I recognize and can empathize with the tr- the struggles of getting sufficient sleep when they're very young, but then trying to instill how they can approach their sleep from early age I think would be incredibly helpful, to also just change culturally how we think about sleep, because so many of us now have never heard, learned about sleep before or what we should do until you're an adult. But if we can make that change earlier on, I think we're gonna have healthier kids, better families, um, who are better rested and, and also just this generation where we recognize this is so important that we shouldn't sacrifice it, 'cause we're doing ourselves a disservice to letting us be the best that we can possibly be.

    5. SBSteven Bartlett1:05:46

       How old is your son?

    6. CMDr Cheri Mah1:05:47

       11 months.

    7. SBSteven Bartlett1:05:48

       11 months. So how are you sleeping?

    8. CMDr Cheri Mah1:05:50

       Oh, I transparently am quite tired. (laughs)

    9. SBSteven Bartlett1:05:53

       I do. Yeah.

    10. CMDr Cheri Mah1:05:54

        I, I as a, yeah, new young mom also, um, I don't have the ideal sleep that I know I would love. Um, and it's just for a short time, but I'm trying to be strategic of the things that I can do with some of the tools that we've talked about, trying to leverage power naps, um, when, for example, I do have to still wake up during the nighttime to tend to him. Um, and, you know, the early morning starts are not always consistent, so my sl- sleep schedule is not always consistent. So, you know, going back to those three buckets we talked about earlier, like, if I don't get the full duration that I want, then how do I maximize the quality, right? I've optimized my sleep environment. I try to have a process to wind down at nighttime, um, or the timing, you know, is, uh, and the sleep schedule is another area that you can still work on when, for example, you may not be getting the duration. Um, so these are strategies that I try to employ when I know that I, um, also am a work in progress in trying to get the best sleep possible.

    11. SBSteven Bartlett1:06:52

        Once upon a time, if you had a business idea, it was exceptionally difficult to get going. But now, in the age of Shopify, it is exceptionally easy. As many of you will know, Shopify are a sponsor of this podcast. If you don't know Shopify, it's an exceptionally simple web platform for anybody that's got an idea that wants to transact on a global scale. So things like these conversation cards which we sell, we sold using Shopify, and it only took us a couple of clicks to get going. So why did we choose Shopify? For a number of reasons, but I think one of the big ones which goes unappreciated is their checkout system converts 36% better compared to other platforms. And here's what I'm gonna do to remove the cost for you. If you go to shopify.com/bartlett, you'll be able to try Shopify for $1 a month. I've seen Shopify completely change people's lives. And for many of you, I think it could change yours.

27. 1:07:47 – 1:12:13

    Sleeping travel tips

    1. SBSteven Bartlett1:07:47

       What are the other examples of sort of case studies that you're, you're most proud of, or that were most pivotal in ch- shaping your thinking about sleep?

    2. CMDr Cheri Mah1:07:55

       Uh, I mentioned the Philadelphia Eagles back in 2017 and tried to help them educate their players about sleep, how to have a more strategic approach to their wind-down routine, to thinking about how they're integrating sleep into their training practices, and thinking about ultimately how they travel and, and having, for example, strategies to minimize jet lag when you're crossing time zones and having to play in different locations than the home.

    3. SBSteven Bartlett1:08:22

       Gimme some of those then. So some, the tips you'd give me as someone that travels a lot-

    4. CMDr Cheri Mah1:08:26

       Yeah.

    5. SBSteven Bartlett1:08:27

       ... um, pre, during, and post-travel.

    6. CMDr Cheri Mah1:08:29

       Yeah.

    7. SBSteven Bartlett1:08:29

       What should I be thinking about before I travel, while I'm traveling, and after I, I land?

    8. CMDr Cheri Mah1:08:33

       Yeah. So have a, a game plan for every trip. I think most people have no strategies in place when they travel. They just get onto an airplane, get to a new location, and try to adjust when they get there. That is not really a great strategy. You wanna have at least a pre-flight strategy, in-flight strategy, and post-flight strategies because that will set yourself up better to minimize jet lag, also travel fatigue, and ultimately then be able to acclimate faster if you're crossing multiple time zones. Before pre-flight, try not to panic-pack. I know all of us do (laughs) -

    9. SBSteven Bartlett1:09:05

       Right.

    10. CMDr Cheri Mah1:09:05

        ... do panic-packing right before bed, right before we're getting on a flight.

    11. SBSteven Bartlett1:09:08

        Right.

    12. CMDr Cheri Mah1:09:08

        Um, so you wanna try and be strategic and pack early. You wanna get at least-

    13. SBSteven Bartlett1:09:13

        Why do I wanna not panic-pack?

    14. CMDr Cheri Mah1:09:14

        Because most people will panic-pack the night before they, they have a flight, and then they'll cut their sleep short. So they'll get only, say, five hours of sleep because they're staying up late-

    15. SBSteven Bartlett1:09:22

        Ah.

    16. CMDr Cheri Mah1:09:22

        ... trying to pack everything and get ready for that early morning flight or for the next day.

    17. SBSteven Bartlett1:09:27

        Ah, yeah. Well, I, I pack the morning of travel, so-

    18. CMDr Cheri Mah1:09:29

        Okay (laughs) .

    19. SBSteven Bartlett1:09:30

        But I, I'm out here in LA for, I'm out here for two weeks, and I packed a carry-on ba- carry-on suitcase.

    20. CMDr Cheri Mah1:09:36

        Okay.

    21. SBSteven Bartlett1:09:36

        'Cause I o- so look at what I'm wearing. I wear just the same outfit every day, so I have, like, the same outfit. Um, but I pack literally an hour before I go to the airport. (laughs)

    22. CMDr Cheri Mah1:09:44

        Okay, okay, so-

    23. SBSteven Bartlett1:09:45

        But you're right. It does cut my sleep because I could've been in bed.

    24. CMDr Cheri Mah1:09:48

        Whether it's beginning of the day or the end of the day, if it's affecting then the duration of your sleep, I would recommend trying to be a little more strategic and do it a day before, two days before.

    25. SBSteven Bartlett1:09:59

        Don't panic-pack.

    26. CMDr Cheri Mah1:10:00

        Number two, try to get at least those seven hours, if not your, your amount of sleep that makes you feel like you're functioning and performing well, um, at least a day if not two days. If you get insufficient sleep before you get onto an airplane, jet lag will be worse, and that travel fatigue can feel much more robust.

    27. SBSteven Bartlett1:10:19

        And you're more likely to have a croissant in the airport-

    28. CMDr Cheri Mah1:10:22

        Exactly.

    29. SBSteven Bartlett1:10:22

        ... which is gonna destroy the whole thing for, for you.

    30. CMDr Cheri Mah1:10:24

        (laughs)
28. 1:12:13 – 1:16:01

    Sleeping drugs

    1. CMDr Cheri Mah1:12:13

       to make-

    2. SBSteven Bartlett1:12:13

       Sleeping drugs?

    3. CMDr Cheri Mah1:12:14

       S- Uh, sorry?

    4. SBSteven Bartlett1:12:15

       Sleeping medication?

    5. CMDr Cheri Mah1:12:16

       (laughs) Okay. So some, uh, medications can be helpful, like melatonin, particularly if you're trying to advance your clock, has, um, evidence that it can help shift that a little bit more quickly when you're trying to advance your clock earlier.

    6. SBSteven Bartlett1:12:30

       Would you recommend it to athletes?

    7. CMDr Cheri Mah1:12:31

       Um, it c- I would say if it's something that you've used before and you know that you don't experience some of the side effects, it could be a useful tool. So melatonin, while it's one of the most commonly used supplements and sleep aids, there are still side effects I'd be wary of. So specifically for athletes, too, you can feel more groggy and sluggish when you wake up from it. Um, it's not regulated by the, the FDA here in the US, and so you don't always know what's actually in those supplements. So for my elite athletes, they use what's called NSF Sport Certified versions. Um, they're just, there's more, um, regulation around them, but in for the, for the, you know, everyday person, you know, there's a study where they looked at the amount of melatonin that was actually in a variety of these supplements, and it was a wide range from over 400% of what was on the label to obviously sub, you know, you know, uh, under 100% of what they actually indicated. So there's a wide range of what's actually gonna be in the supplement, but it can help.... particularly when you're on travel with, um, reacclimating.

    8. SBSteven Bartlett1:13:35

       My team here, we, most of them use, uh, a certain app when we travel, and it just tells you basically, you say where you're going and then it'll tell you what time to eat, what time not to eat, et cetera.

    9. CMDr Cheri Mah1:13:45

       Mm-hmm.

    10. SBSteven Bartlett1:13:45

        So you can get aligned with that, with your destination's, like, circadian rhythm, I guess.

    11. CMDr Cheri Mah1:13:50

        Mm-hmm.

    12. SBSteven Bartlett1:13:51

        So we'll link below one of the apps that our team use. We're not affiliated with them in any way, but when we were flying out here, I know Will in my team sent me a screenshot and said, "Steve, this is what time you need to be eating and everything 'cause we're going to LA." So it's s- been super helpful for all of us. I'll, I'll link that below 'cause I know some people are gonna be wondering what apps they should be using. So we're in the flight, we've got our post-travel flight kit with the eye masks and all those kinds of things in, we've got our app. Is... We're hydrated, um, k- noise-canceling headphones. Is there anything else we need to be thinking about while we're traveling?

    13. CMDr Cheri Mah1:14:21

        When you're traveling, so-

    14. SBSteven Bartlett1:14:22

        Yeah, on a plane.

    15. CMDr Cheri Mah1:14:23

        On a plane. So we talked about hydration.

    16. SBSteven Bartlett1:14:25

        Yeah.

    17. CMDr Cheri Mah1:14:25

        Minimizing alcohol and caffeine or eliminating entirely is going to be a great strategy-

    18. SBSteven Bartlett1:14:31

        Mm-hmm.

    19. CMDr Cheri Mah1:14:31

        ... instead of, um, having some on board because that can also potentially worsen, um, jet lag and/or make it more difficult to sleep when you're actually trying to when you arrive. And again, seeking light, that is the most powerful signal to your brain to help shift your body clock. Also, bringing sunglasses so that you actually avoid sunlight at certain times because your body can respond differently depending on, again, on your home location and how many time zones you cross. So there are certain times that these apps can be helpful that will likely tell you you don't want to get sunlight during these hours. And so you wanna be strategic about that and just make sure you have sunglasses so that you can still go about your day, but try to minimize that sun exposure. Um, getting well-rested and getting sufficient sleep, even if it might be a little bit more fragmented than usual. Just giving yourself at least a day to acclimate so that I would recommend not scheduling your most important meetings right when you get in or in that first day. For athletes, they don't want to do maximal exercise because there's a risk that that jet lag could increase injury in that acute period, so you want your body clock to be able to readjust. And then using caffeine and power naps strategically. So for example, our afternoon, one to four o'clock is typically when we have this dip in our alertness. Now, when you get to a new time zone, that can occur at a different time point in the day. But strategically, then you can use caffeine and, and, uh, power naps to be able to help you through those lulls when you're in that new time zone.

29. 1:16:01 – 1:17:34

    Does sex before sleep hurt quality of sleep?

    1. CMDr Cheri Mah1:16:01

    2. SBSteven Bartlett1:16:01

       What about sex?

    3. CMDr Cheri Mah1:16:03

       Sleep and sex in bed, and that is it, because I think so many people actually make the mistake of being in bed and being on their computer, on their phone, doing other work while they're awake, and that actually helps strengthen that connection that when you're in bed, you're awake and your brain will start to associate that. So sleep and sex are all that you want in bed. Everything else should be outside. So when we talked about that wind-down routine or that racing mind, all that should happen outside of bed because you wanna actually tease apart that association that your brain is making of being awake in bed, and that will be one small adjustment that's helpful to, to get better rest at night.

Episode duration: 1:36:19