Supercharge Your VO2 Max & Protect Your Heart - Dr Andy Galpin

1. 0:00 – 4:01

   Most Important Health Metrics

   1. CWChris Williamson0:00

      Talk to me about the metrics that matter most for health, in your opinion. We've got an unlimited amount of data that we can access from wearables and beds and, and breath work and CO2 tolerance tests and everything else. What are the ones that you think are most important?

   2. AGDr Andy Galpin0:18

      Yeah, sure. I think the easiest way to start this is go over a very large picture and then to stop us from being very general the entire time, which is sometimes a bit boring, I'll let you pick whichever one you want to go hardest into, uh, there. So when we start looking at things, uh, from the perspective of how long you're going to live and how well you're going to live, most people are pretty keen on that idea now and those things are different and it's not just about living a long time and you want to live well. So what's that mean? Well, we actually can pull from multiple datasets here in the sense that it's everything from your sense of connection to the world, your sense of purpose, uh, social belongings. Those things are incredibly important and depending on the papers you, you pull from, some could argue those are the top predictors of how long. Now, mental health and such is not my expertise, so I, I will hopefully not spend all of our time on that. But we have to acknowledge those... The way you asked the question, that is a, a true and honest answer. It is the things that go into making you feel like a sense of purpose and belonging. That's great. Independent of that, in terms of your physical health, now we can just really run through the gamut of, what does your body have to do to survive and perform well, right? Well, it has to have some functionality of cardiorespiratory fitness. Easy metric we talk about here very often and people are, are really keen to this fact now which makes me smile because for 25 years when I've been screaming this and no one cared and, and like the Podcastistan universe took over about three years ago and I'm like, "Well great." (laughs) Now it's out there. So VO2 max is a, a very strong predictor of how long you're going to live, uh, from the, from that perspective. Other research, uh, is gonna look at things like physical strength, both your grip strength and your leg strength. Also very, very important. Backing down from that, now you have things like muscle quality, overall muscle size. Of course you have negative regulators. So what I mean by that are these are things you don't want to have. So as I've been going through this, I realize, realize I've been giving you things that you want to make sure are high, and you have a whole subset of things you want to stay away from. Obesity, you don't wanna have metabolic disease, you don't wanna have sleep disorders, you don't wanna have that. So I tend to leave that stuff. I, I always forget to mention that. But yeah, like don't have any of those, and then be fit, be strong and maintain a sense of, of proprioception. And so if you look at the research on things like brain aging, what's critically clear is you don't wanna lose your sense of smell. You don't wanna lose your sense of vision or your hearing because those are all tied into the global idea of proprioception, and that is a fancy way of saying your body's ability to understand where it is in space. This is translated often into things like balance. Okay, so if you were to, to look at the research on fall prevention, it's very clear you do not wanna fall and have an accident after the age of 60. That's... And I don't mean to be a bit dramatic here but it's, it's quite literally almost a death sentence, uh, if you fall and break a hip or something like that after the age of 60. Well, what causes that? Pure accidents. But then outside of that, it is things like loss of balance. Then once you lose the balance you have a lack of foot speed or hand speed to get your hand in the right position to brace yourself from a fall, and then if you do do that, it's the lack of eccentric strength to stop yourself from hitting the ground and collapsing and smashing a bone. And so I just sprayed you with a whole bunch of stuff to answer your question but from just the physical side of the equation, those are generally the things we're looking at in terms of an exercise scientist's perspective. I don't really spend much time in my career honestly on medical stuff. I'm not a medical doctor. Go talk to Peter Attia or Gabrielle Lyon if you wanna know about ApoB4. Like I don't care about those things at all. Uh, I, I look at the human performance side of the perspective on that question.

2. 4:01 – 11:19

   Why People Are Prioritising VO2 Max

   1. CWChris Williamson4:01

      Where has this recent pivot to prioritizing VO2 max come from? Is this just that m- I was a normie and totally didn't know what was going on in the literature? 'Cause it felt to me like up until maybe three years ago, maybe even less, it was all go slow to go fast, it's all zone two, we must accumulate a d- a very, very high amount of, uh, aggressive walking per week. What's happened with this VO2 max revolution?

   2. AGDr Andy Galpin4:29

      Okay, that's a really nice question. We have known this answer since the late 1980s. There's a very classic... And he just passed away actually, an exercise scientist named Stephen Blair out of South Carolina and he published these data 1989, 1990, '91. We have million people databases on this. I actually remember as a graduate student in 2005 sitting in a lecture from Jonathan Myers at Stanford presenting incredibly clear evidence of VO2 max out predicting diabetes, out predicting blood pressure, out predicting cholesterol, out predicting heart disease, out predicting heart surgeries. And we- we've known this stuff for now well over 20 years.

   3. CWChris Williamson5:10

      What... Do you mean out predicting all of those things for longevity?

   4. AGDr Andy Galpin5:16

      For all cause mortality, dying for any reason.

   5. CWChris Williamson5:19

      Right. Yep.

   6. AGDr Andy Galpin5:19

      You wanna call it longevity, fine. Scientifically we'd say mortality.

   7. CWChris Williamson5:22

      All cause mortality.

   8. AGDr Andy Galpin5:23

      So yes, thank you. So the point being as an exercise scientist in the community, again we've, we've known this answer for an extremely long time. There was research in 2004 and 1999 in JAMA as well showing that leg strength, uh, in a handful of studies out predicted even VO2 max in terms of, again, predicting all cause mortality, clinical prognosis, how long you're going to live, who's gonna fare best post-surgery. Anyone who randomly shows up to the hospital, if you give them a leg press test, or a leg extension test rather, that will be the most significant predict- without knowing any other information of what's gonna... Like how, how serious the problem is gonna be.

   9. CWChris Williamson5:59

      Yeah.

   10. AGDr Andy Galpin5:59

       Right? Like wh- uh, again this is...... in JAMA, not in, like, the journal of dudes who like to lift weights. (laughs)

   11. CWChris Williamson6:07

       Ah. (laughs)

   12. AGDr Andy Galpin6:07

       (laughs) Like... that, that... Mike Sertelle and I started that journal, by the way. That's-

   13. CWChris Williamson6:11

       Good.

   14. AGDr Andy Galpin6:11

       ... that's our... Yeah. Um, so okay, we've, we've known this for a very long time. So, your question, why did it get so popular? Well, a handful of things. I think we screamed from the rafters about this stuff for, for forever, and the medical community never cared or didn't listen or whatever the case was. Why they started turning the attention, I think at some point, the, the tsunami of data just starts to overwhelm me, and then when these data started getting published in medical journals, and then really, I believe the true key was this, and I'm being quite arrogant here, but I think it is my generation of scientists. Because you had, when I was a graduate student, everyone who was a scientist in this field was from the 1970s, 1980s generation. This is your steady state, long, slow cycling, swimming, jogging. That's what they do for exercise. Those are the sports they followed. That's the research we did. And then you had Arnold come along, and strength training became this thing, and you have this whole generation of kids from the 1980s who liked science but then also liked lifting weights, and going, started going like, "Why is there none of this stuff in the science?" This stuff was not exercise science. And so we went on to become students, we went on to go to graduate schools, and then we started doing, opened up our own laboratories and started doing research on these types of things. That, that's a 30-year window, right? (laughs) Takes a long time. And then those data finally started coming out, and so last 20 years, you've seen this just enormous increase in strength training and higher intensity stuff. Now, the last couple of years, I think that's just kind of the wave of science, right? Where it takes a long time of like 10 years of data to accumulate, people getting awards, becoming big names in the field where they are respectable, coming out of the big labs, from the big, you know... Oh, okay, like, I guess there's, there's something here going on. Why that took off in the pop culture, uh, I don't know per se, but I, I think it probably has to do with the idea of going, hey, one of the biggest barriers to exercise that we're aware of is people's, uh, uh, time, right? They say, "I don't have the time for it." And so then when Marty Gibala's research started coming out, and he started saying, "Hey, we can get the same cardiovascular benefits in four total minutes of accumulated work throughout a week as four hours," and he, again, and, and not one study, it's, it's dozens of studies now coming out in different areas and populations, that grabbed a lot of media attention, and that's when high-intensity interval training really took off media-wise, and I think that's, that's what landed us in this position. I think it's probably gone too far in that direction. But nonetheless, if I had to guess, this is why things got to where they are now.

   15. CWChris Williamson8:51

       Can you tell me about that study or the, the, uh, protocol that was followed by a sequence of studies, the four minutes thing?

   16. AGDr Andy Galpin8:58

       Oh, there's, there's been dozens and dozens of them. You could... This is everything from, uh, 20 seconds of work and 20 seconds of rest repeated, you know, four to 12 times. I'm summarizing a bunch of different papers and protocols. Uh, higher ones, up to one minute on, one minute off. Like all, all the classic, again, what me- most people would call high-intensity interval training. This is, this is actually a good way to get yourself confused on the internet, because back in my day, HIT training, it was H-I-T training. This was an old Mike Mentzer bodybuilding, very, very, very, very slow repetition stuff, right? And then when HIT came along, the second HIT, there's an extra I in there. It's high-intensity interval training. So people have a, like, we always, I see people all the time fighting about this stuff and always laughing. I'm like, "Man, you guys don't even know you're not even saying the same thing." (laughs) Like, this is not... This is two different things okay? But yeah, tons and tons of protocols. Some of them have longer rest intervals. So for example, one minute as hard as you possibly can, recover for four or five minutes. Repeat that four times in a day. These are typically on things like a bike, so you're cycling almost always they're there. But some of them are shorter rest intervals. And, and TABADA came on board, meaning... And that actually, those studies came out over 25 years ago. But again, people just, like, got wind of them a few years ago, so that got big. But the way I'm saying is, I want you people to be really clear here. There is absolutely no magic protocol there. None at all. There's no magic duration, there's no magic rest interval, and there's no magic number of times you have to do it. 'Cause there have been, again, countless studies over a, a, a huge range of all those variables, and almost all of them still show benefit, with, with one key. If you truly take those intervals at a max effort, it'll work, right? Now, if you're doing 30 on 30 off, and you're just kind of going like 80, 85% through that 30 seconds of work, then you're not going to see the same results. So the one key, and Marty would say this too, is with, if you're trying to, to get tons of benefits, cardiovascular benefits especially, from a very, very short amount of work, that amount of work has to be, like, you got to get it done. You really, really... You, you can't just be like, "Well, I went way shorter and I kind of worked a little harder." Like, nope, nope. You, you got to do the work one way or the other. You got to do the work over time, or you got to do the work and it'll hurt.

   17. CWChris Williamson11:18

       What

3. 11:19 – 20:52

   Favourite Protocols to Improve VO2 Max

   1. CWChris Williamson11:19

      are your favorite protocols that you either suggest to friends, clients, or that you use yourself, um, for improving VO2 max? Rhonda Patrick was on. She extolled the virtues of the Norwegian four-by-four. I've been doing that. Uh, I thought that was fun. But I am, I'm, I'm non-monogamous, man. I'm a, I'm a whore for this. I'll take... You give me something that you think is sexier, I'll slip into that negligee and I'll get on it.

   2. AGDr Andy Galpin11:44

      Yeah, this is, uh, like, I, I apologize for, like, r- rolling my eyes (laughs) when you said that. Uh, Norwegian. Sure. That's great. Like Peter and Rhonda talk about it. Awesome. It's just one group of scientists put one protocol out. (laughs) There's nothing magical about it.

   3. CWChris Williamson11:59

      Mm-hmm.

   4. AGDr Andy Galpin12:00

      And the same thing happened with TABADA 20 years ago. Everyone's like, "Oh, it's TABADA, you have..." Like, okay, fine. If you want to do the Norwegian, that's just excellent. Um-... I'll do those things. Honestly, that's the old school run a mile, walk a mile. (laughs) That's really all it is for the most part, right? So, um, it is a similar thing of there was an old protocol called Fartlek, right? You can do a Fartlek thing, that's, uh, f- t- at least 30 years old, if not longer. There is the, you know, sprint the straightaway, walk the corners sort of thing, re- get a mile of work done. Those are awesome. You asked which ones I use! I use all of them. I use the ones I just talked about. I will do personally, as well as in my coaching practice with our athletes, as well as with our executive non-athletes. We will use all of these. Um, I will do very commonly, very short max effort, 20 seconds or so, with even up to 60 seconds of rest. Lot of recovery, and in those 20 seconds, like you have to get after it. And we're typically going to do somewhere between eight to 12 rounds-

   5. CWChris Williamson13:02

      Mm-hmm.

   6. AGDr Andy Galpin13:02

      ... of that work, right?

   7. CWChris Williamson13:04

      I would, just from a, a motivation standpoint, I think there's something about the 30 seconds to one minute sort of mark... Like, if I was just doing 20 seconds, I, I, it's gonna be, I'm gonna have to motivate myself to get back on the horse so many times, eight rounds, 12 rounds. By round seven, I'm like, "Oh god, go fuck yourself. I, I don't want, I don't wanna do this again." I have to say, from a psychological standpoint, the Norwegian 4x4, to me, is actually quite enjoyable. Uh, reason being that there's fewer rounds. Yes, you've got to hold and yes, you're actually probably not hitting peak as much. Um, is d- t- to actually ask a question on that, 'cause I'll, I guess, maybe a good few people on the show, that listen to the show, will have started doing that 'cause of what Rhonda and Peter have been talking about. What is the upper bound for the work duration in order to improve VO2 max beyond which you're no longer hitting the peak that you need to... Like, presumably if I said, "Oh, it's 15 minutes on, 15 minutes off," well, what are we doing here? Like that, that can't be the case. Four minutes to me seems like it's probably close to the upper bound of a work i- interval, no?

   8. AGDr Andy Galpin14:14

      No, no, much higher. Much higher. You, you can extend that. So if you... L- let's take a quick step back. What is VO2 max? So in... uh, essentially what we're looking at is the max amount of oxygen you can bring in and utilize. And that has two s- two components, a central and peripheral component. Peripheral meaning it is your lungs and heart. Okay, so it is how much air can you bring in to your lungs? How much of that can you get from your lungs to your heart, right? Then you gotta pump that out of your heart into your blood. That's, that's the s- uh, the central side of it. The peripheral side of it, you gotta get that to your working tissue. Your ability to extract that oxygen from your blood into your tissue is the, the AVO2 max side of the equation. So there's g- arterial, venous difference, so it's the difference in oxygen concentration going into your muscle versus out, which tells you how much your muscle's extracting. Okay, a typical way to test VO2 max is on a treadmill or a bike, on a metabolic cart, so you have your face hooked up to a machine and we collect every s- you know, milliliter, literally, of air you breathe in or out. Okay? Those protocols, those tests take somewhere between eight to 15 minutes to complete. It is hard to get up to your VO2 max in a time shorter than that. Such as to say, this law of specificity tells us, it's called SAID, S-A-I-D, specific adaptation to imposed demand. What that says is the best way to ever improve a physiological marker is to do exactly the challenge. Right? So, the best way to improve your VO2 max is to run a VO2 max test, or equivalent, period. Right? Like that's, that's specificity. It's not practical. It's not realistic. But it is like, by the... If we were robots, I'd say that is your number right there. Eight to 12 minutes long of progressively getting harder. Okay, now, if you're super fit, sometimes that takes longer, 15 to 20. If you're unfit, that can certainly happen much lower. But typically if you're hitting a peak and much lower than that, it's often not a true VO2 max because you're failing for other reasons, like muscular endurance, like, uh, you s- your quads blew up, your calves blew up before you could truly get there, whatever the case may be. So, I'm not indicating you can't get to a VO2 max in four minutes, you can. And certainly, and the data are clear, the Norwegian protocol will absolutely work. Okay? So, it's w- we have to make sure we're going after the right thing though, right? And so if we understand eight to 12 minutes is a, uh, eight to 15 is a very typical one, this is your one mile repeat. Run a mile. Most people, that's gonna take eight to 10 minutes, again, as little as four minutes and maybe higher. Rest, do it again. Do that every single day. That would be your most specific and direct protocol. That said, when we understand the physiological limitations, the way that I will always teach this is, in the place of adaptation is the place of limitation. Whatever limited you in your performance is the thing that will adapt to that training. So if you and I both went out and did the Norwegian protocol-

   9. CWChris Williamson17:10

      Mm-hmm. Mm-hmm.

   10. AGDr Andy Galpin17:10

       ... you and I might adapt differently, because what we're failing in those four minutes might be different. You might be failing 2020

   11. NANarrator17:16

       Yeah, my lungs might have blown up, but your, your legs might have blown up.

   12. AGDr Andy Galpin17:20

       Bingo. I always... I, I run, I don't even know how many now, know how many VO2 maxes I've run, but I will always ask people afterwards, "Why'd you stop?" Right? And they're always like... I'm like, "Why'd you quit?" And it is either, "My legs," boom, "Couldn't take another step," or it is, "Felt like my heart's gonna blow out of my chest," something like that. Okay, I'm asking that because now I'm, that's leading my coaching decision. Like what is our limitation? What did we fail? Was this stroke volume? Was this heart rate? Was this position? Was this fatigue? Was this technique breakdown? Maybe this is respiratory muscular failure. Like where is actually driving the problem? This is where I'm gonna go with my coaching then. And so this could... And our clients will see this all the time. Some of them will get a lot of long duration, lower intensity stuff. Some of them will get the opposite. Some of them will get a combination of both. Some of them will get like maybe some kettlebell, uh, intervals, anaerobic stuff with weights. Some of them will get strictly...... you know, rowing, walking, stuff like that. Because you can improve VO2 max in all of those cases, if that's the place that's being limited. You see what I'm saying? Like that is my-

   13. CWChris Williamson18:27

       Mm-hmm.

   14. AGDr Andy Galpin18:27

       ... like, I- I- I- I'd like to try to give more direct answers. But my honest answer (laughs) because I do coach people at this point, is w- we do all of that depending on what their actual specific problem is. If you don't know your problem, my recommendation would be to do some, one to twice per week, of some lower intensity movement stuff. I, do not care what zone you're in at all. (laughs) We never test, like hardly ever pay attention to that. I'm sorry, Nigul, like, the fact (laughs) I just don't care about those things. Something low, okay? Whatever that can be, something that's going to be insanely high and so this is almost always less than two minutes duration. The problem with four minutes is it's very hard for people to really get work done in four minutes. Most people who in, like, like y- yourself I could... I mean, I know you've been up to the top of the mountain with a rock on your shoulder.

   15. CWChris Williamson19:17

       (laughs)

   16. AGDr Andy Galpin19:17

       Like, I know you probably have the ability to, to really get after it for those four minutes, but most people in our experience struggle with those four minutes to do anything besides kind of just coast.

   17. CWChris Williamson19:28

       Hmm.

   18. AGDr Andy Galpin19:28

       So that's not really doing enough work. So the four-minute one is a little bit dangerous for me 'cause it's just way too easy for people to kind of just cruise, right?

   19. CWChris Williamson19:36

       Mm-hmm.

   20. AGDr Andy Galpin19:36

       So the highest, the hard stuff, I want it truly hard. Now we're still gonna coach people. If you tell me, "Hey, literally, psychologically I'm at..." Okay, great. I'm, I'm not gonna force you to go do a 30-second thing for- 'cause you're like, "Oh." Well, we'll pick something different for you and another person who's like, "Yo, I just cannot get myself to work that hard for four straight minutes." Fine, let's cut it down to 45 seconds and let's do a repeat of 45 seconds, whatever we're gonna have to do, right? But that's component two, some real true high-intensity thing. Component three then is more of that middle ground. Give me 4 to 15 minutes of continuous work by the end we're going to peg, and we might do one round of that. Like that might be it, like the whole protocol today, which we've used a lot in our professional athletes and our non-athletes, nice good solid warmup, probably a 10 to 15 up to 20 minute, like good warmup, and we're gonna do one round and that might be a one-mile m- max. You're gonna run a mile as fast as you can. If you can't run, we'll do, we'll do something in the equivalent of an 6 to 15 minute max effort by the end, that's it, and we're probably shutting it down. Doesn't mean we're doing all three of those in the week-

   21. CWChris Williamson20:40

       Mm-hmm.

   22. AGDr Andy Galpin20:40

       ... but over the course of the month we're gonna understand like where are we getting an A, B and C, and how does that fit into this person's protocol and plan? That's, that's the most honest answer I can give you on how we actually do it.

   23. CWChris Williamson20:50

       That's great. That's a nice protocol.

4. 20:52 – 31:25

   Integrating VO2 Max in a Normal Week

   1. CWChris Williamson20:52

      Uh, for the people who want to integrate VO2 max work into their weekly routine, I'm imagining most people will be on some form of push-pull leg splits, some kind of body part split. But maybe they're realizing that, "Ugh, I should pay attention to my heart. And I do sometimes get out of breath doing up a set of stairs, and I look good, but, uh, you know, I probably should do a little bit more fitness stuff." Um, what are just a couple of protocols, uh, Norwegian, 4x4 is something that we've spoken about, uh, on versus off with rounds and then, uh, frequency per week? What's a couple of, uh, common favorites that you might suggest that people try?

   2. AGDr Andy Galpin21:27

      Uh, can you ask that again? I'm not sure how I was tracking exactly what you're saying. Like the whole week-

   3. CWChris Williamson21:31

      What would...

   4. AGDr Andy Galpin21:31

      ... with all the training or...

   5. CWChris Williamson21:33

      No, so, so what would be a couple of different VO2 max optimizing workouts that people could do in terms of the intervals of work and rest, and then what would the frequency per week be?

   6. AGDr Andy Galpin21:44

      Oh, okay. All right, let's just maybe sketch out a week if... and that'll be like a theoretical week, which would be a little bit easier. Okay, great. So let's just say you're gonna start on Monday, and I always like to d- to do the hardest thing training-wise on Mondays. It's (laughs) just like, "Get out of the way," right? So maybe Monday is your day where we're gonna do that one-mile test. Okay, great. It's a 40-minute workout total because for 20 minutes you're gonna be laying there in agony, right? That's... so we got to allow for 40, but we're gonna do a solid 10-minute warmup, very, very good one, and then we're gonna run an eight-minute test. You're out of there, it's done. Pick machine, pick the rower, pick the assault bike, pick the whatever you wanna do. If you don't have a mile, fine, set it for eight minutes. Great, let's just do something as hard as we can and this is... you're not progressing, you're not backing down, you're just pegging it for eight minutes. Right? You can kind of use minute one or two to kind of ramp up a little bit-

   7. CWChris Williamson22:40

      Mm-hmm.

   8. AGDr Andy Galpin22:40

      ... but then you're just gonna enter death and see how long you can play in death. That, that's

   9. CWChris Williamson22:43

      You'd be happy for somebody to use an assault bike, a rower?

   10. AGDr Andy Galpin22:47

       Oh yeah, yeah. A ski erg, walk, run, swim.

   11. CWChris Williamson22:51

       Fuck a ski erg. No one's doing a ski erg, that's insane. But yeah, the (laughs) the assault bike or the, (laughs) or the rower maybe.

   12. AGDr Andy Galpin22:57

       I almost always do it on the assault bike.

   13. CWChris Williamson23:00

       It's, it's by far for, for the top end stuff, it's, it's by far my favorite. I think, uh, one of the problems that I encounter, uh, a lot of the time is getting my heart rate up sufficiently high without blowing my legs out doing something.

   14. AGDr Andy Galpin23:16

       Mm-hmm.

   15. CWChris Williamson23:16

       And the challenge that I often face is if I'm doing it on just a static bike, my legs are f- like if I try to do it on a bike erg, my legs are absolutely smoked. If I try to do it on a TrueForm, uh, my hamstrings-

   16. AGDr Andy Galpin23:30

       Mm-hmm.

   17. CWChris Williamson23:30

       ... feel like they're gonna fall off. Uh, I just can't get my heart rate up sufficiently high, uh, without feeling, without not feeling that sort of muscular fatigue. Uh, and then also if you're doing intervals-

   18. AGDr Andy Galpin23:41

       Okay, that's, that's solvable by the way. That's very easy to fix.

   19. CWChris Williamson23:43

       Okay. Teach me.

   20. AGDr Andy Galpin23:45

       That's super easy. Uh, one, you're not warming up appropriately, I promise. And then you're not progressing into it heart rate wise. You fi- you do that and that problem will go away almost immediately.

   21. CWChris Williamson23:56

       Hmm. Okay. Okay. So...

   22. AGDr Andy Galpin23:59

       Am I right?

   23. CWChris Williamson24:01

       Uh, five minutes at like a moderate pace, that's a warmup.

   24. AGDr Andy Galpin24:04

       Yeah, yeah.

   25. CWChris Williamson24:05

       Isn't it?

   26. AGDr Andy Galpin24:05

       That, no, that's not a warmup.

   27. CWChris Williamson24:07

       I'm pretty sure that's a warmup.

   28. AGDr Andy Galpin24:09

       Not for, not for max effort it's not. (laughs)

   29. CWChris Williamson24:13

       (laughs) Okay.

   30. AGDr Andy Galpin24:13

       I mean, that's a laboratory... we use that protocol all the time in the lab, like five minutes of low level aerobic exercise, and then you jump in and do a max effort. Like, well, why do you think you're... oh, think about it this way, uh, do you think that's the protocol I would use prior to somebody walking into the octagon to fight for a UFC title?Let's just-
5. 31:25 – 43:26

   Motivation to Train VO2 Max

   1. CWChris Williamson31:25

      the things that you mentioned there was motivation to do this. I would imagine that for a lot of people, one of the biggest hurdles to doing top end VO2 max work is fear of the difficulty. It's the trepidation that you have as you walk into the gym knowing I, if I'm going to do this properly, it's really gonna hurt and that means my heart rate's gonna be high, and that's kind of scary and I get anxious thinking about that, and that sucks. From a motivation sustaining, um, will to train over time, intra-session or intra-workout VO2 max motivation, what have you come to learn as levers and ways that people can kind of really sink in?

   2. AGDr Andy Galpin32:10

      Yeah, that's a really great question because you have people that go into one of two big camps on this one. Camp one is, we'll call this CrossFit camp, which is if I'm not throwing up at the end of the workout, it didn't count, right? And it's not, it's not... I'm not taking a shot at all, but these are people that do not have the problem you just described. This is actually the opposite. I feel like I didn't do anything if I don't peg myself all the way to the end every day. That, that's a problem. And then you have the other group, which is more what you described, which is going, "Hey, I just worked all these hours, had this going on, and like now my whole workout. Fuck." Like, no, like I wanna work out today. I can get it done, but I can't do that. Like there's just no way. That happens to me all the time. I have 27 jobs and a kid. Like sometimes I'm just like, oh God, I have 30 minutes, I can get a workout in, but (laughs) that's not gonna happen and I just know, right? All right, great. So I personally, and the way we often coach is I... This is why I don't like having set workouts on set days of the week. Example I gave you was like Monday's the hard day. I never do that. I just have the workouts in order and I just do the next one in order regardless, right? And so if something came up on Monday and I couldn't train, I'm not doing Tuesday's workout on a Tuesday. I'm doing Monday's workout. So there are no Monday workouts. It is just, this is the order we do them in, and I try to get 20 in in 30 days. Sometimes that's seven in a row, sometimes that's, you know, one, one off. Sometimes it's 14 days in a row 'cause I got a break and lined up that way. I never take a day off unless I'm forced to, because my schedule forces me to do it often enough anyways it works out, right? So that, that's how I end up doing it. Um, that said, this gives you the ability to when that flight got delayed and you landed in, and the other thing happened, your kid was sick all night and you're like, "Yes, today's supposed to be that max effort one mile. Not doing it. Today I'm just gonna slide in that lower intensity one." And there's a game you're gonna play here, right? Because if you do that often enough, you end up just putting a 30 minute kind of easy one every day when you didn't have to, right? At the same time there's also, I, I'd rather people do that than choose nothing, right? If the option is okay then I don't have time to do that perfect workout at that intensity, and therefore Dr. Andy said if I don't do it at all the way up to max, it doesn't do any benefit. So therefore I'm just not gonna do it.

   3. CWChris Williamson34:36

      Mm.

   4. AGDr Andy Galpin34:37

      That's not the case. Still working at 80% still has benefit. Working out 40% still has benefit over 0%. There is never a case in which exercise is doing nothing. That does not happen. It's not the optimal benefit potentially, but it's never zero. And so I always want to make people, especially people that are like struggling, if exercise is new to them, if it's just even not new, but it's not a huge passion like it is ours, I want, I still want to win. I want to win as many times as we can. And if we see it sliding into that spot where it's like, all right, it's been three weeks, we haven't done anything hard, then I, then it's, it's time to reassess what we're doing. But often is the case, as you know this, once you get in there and get moving, you're like, "All right, I can do this." (laughs) And then you end up going and doing the hard thing anyways. But if you never show up in the gym, that answer is gonna be zero every time. So I just, I just don't want people not training. It is the primary thing I'm worried about.

   5. CWChris Williamson35:39

      Yeah. This is one of the... I guess VO2 max training is the cardio equivalent of one RMs. And well, like one RM days are, they're scary and you know-

   6. AGDr Andy Galpin35:50

      Yeah.

   7. CWChris Williamson35:50

      ... it's the one, it's the one that you're tempted to miss. So yeah, the, the hurdle to doing it is like embedded in the difficulty and the difficulty is precisely the signal for the outcome that you're trying to get. So it's this sort of very vicious cycle of the thing that you want to do being the thing that discourages you from doing the thing. So I, yeah, I mean, you know, I'm, I'm speaking to myself here as someone who's trying to improve my cardiovascular fitness after, uh, many years of just lifting heavy things.

   8. AGDr Andy Galpin36:15

      Yeah, yeah. I mean, we're the same here friend. (laughs) You know, that's us.

   9. CWChris Williamson36:19

      I see.

   10. AGDr Andy Galpin36:20

       One thing I will often describe is think about the month. All right? So I, I got this from a friend of mine, Kenny Kane, many years ago, actually started one of the first CrossFit gyms, top 10 or something like that, CrossFitting like for many, many years. And he realized this problem of, hey, you can't just go red line every single day. So he set up a structure where he says 70% of our training...... however many trainings that is, 70% of them are going to be practice. What he means by that is you're still gonna work, you're still gonna get sweaty, it's gonna be hard, but the goal is to get better at something. Get better at technique, get better at holding your rib cage when you get tired, get, you're getting better at something. Much like if you were to go to play sports and you go to practice every day, you're not thinking, you're trying to win that practice. You're, you're intentionally doing a drill where someone's holding their arm behind you or there's six basketball players against your... Uh, you, you're setting odds against you on purpose. You know you're not going to win, but you're trying to specifically get better at something. 70% of a basketball practice, or whatever it is, practice-related, right? Great. That leaves you then 20% or so of the time where we're gonna practice competing. Okay, so we're gonna scrimmage. We're gonna actually try to get the best score possible. So here, here's our 20-minute test, Chris. Let's see how, you know, can, can you get the highest amount of mileage? Whatever the thing is we can be, right? We're going to compete, and this is, we're going to pace ourself. We're not gonna go as hard as we can... We're gonna try to win, right? We're gonna try to beat the person, the leaderboard, whatever the case may be, right? We're going to change our technique and our position. We wanna get the highest score on the bench, right? In terms of a weight up there. That's 20%. That leaves us 10% of the time where we're gonna touch death, right? We're gonna touch death, which means we might do that same 20-minute workout and I want you sprinting step number one. I know you're gonna blow up in three minutes. I know. The point is you're gonna get a worse score. You will do way better if you pace yourself, but I, I don't want a good score here.

   11. CWChris Williamson38:18

       Mm.

   12. AGDr Andy Galpin38:18

       I want this to, I want this to be how, how horrible can you feel, can you put the rock... I, I saw your, your Borat hat, and I just got back from camp, so I'm using this analogy, but-

   13. CWChris Williamson38:28

       Oh, wow. He made you do the thing?

   14. AGDr Andy Galpin38:31

       Of course (laughs) . He, he... I begged him. I'm like, "Come on, dude. We had to reschedule." He's like, "Oh, we'll just skip it." I'm like, "No, no."

   15. CWChris Williamson38:36

       Oh, no.

   16. AGDr Andy Galpin38:36

       "Like, I will come back up later. We are going up that mountain." (laughs)

   17. CWChris Williamson38:39

       Yeah. Yeah.

   18. AGDr Andy Galpin38:40

       Right? Like, we're gonna put this 70-pound mount- rock on your shoulder and we're going to sprint. And yeah, that means we're gonna triple our time. It's gonna take us two and a half hours to get up that mountain.

   19. CWChris Williamson38:49

       (laughs)

   20. AGDr Andy Galpin38:50

       But this is today's point, right? That's 10%. And so mentally, if the athlete and the client knows that, "Hey, I just need you to get there mentally 10% of the time," think of the average person working out four times per week, okay? Over the months, that's 16 workouts. 10% means twice. "Twice a month, can you give me that? Can you give me that max one mile twice this month?" "Uh, I'm not feeling it this week." "Not feeling it today, this..." "Okay, cool, cool, cool." 70% is still gonna be practice. 70, 70%'s still gonna be, or 20% still gonna be compete. We're gonna pace... twice though. It's only between once and twice I need you to get there. And now we have that like, okay, you have the breathing room, but then we also have a context of going, uh, "I don't know the last time I really went hard." Who knows? 'Cause we have a set schedule.

   21. CWChris Williamson39:42

       Yeah.

   22. AGDr Andy Galpin39:43

       Yeah.

   23. CWChris Williamson39:43

       That's nice. I like, uh... I was talking to Mike Israetel about fat loss a couple of weeks ago, and he was saying that he treats his step count across the week the same way as he treats his calorie intake across the week.

   24. AGDr Andy Galpin39:56

       Yeah.

   25. CWChris Williamson39:56

       That if he has one day where he only hits 5K, then tomorrow he maybe tries to do 13, and the day after that he tries to do 13, and then he's like, "Oh, no, we're back. We're back to where we're supposed to be." And, um, yeah, I like the idea of not being so dogmatic with a week, which is just an arbitrary measure in any case, but taking a slightly broader window, and then within that it gives you, it allows you to kind of play around with things a bit more.

   26. AGDr Andy Galpin40:19

       Yeah. And this is actually a really important thing. I know you've had Mike on... Uh, I don't even probably know. I feel like I see you guys posting clips from your show three times a week for the last year and a half. So he must have been-

   27. CWChris Williamson40:31

       He-

   28. AGDr Andy Galpin40:31

       ... on your show 20 times.

   29. CWChris Williamson40:32

       He is, he is, um, my biggest fan. And-

   30. AGDr Andy Galpin40:36

       I believe that.
6. 43:26 – 49:13

   Common VO2 Max & Cardio Errors

   1. CWChris Williamson43:26

      about VO2 max? Any other common assumptions, errors that people make, any unclosed loops that you think that you need to, uh, dial in?

   2. AGDr Andy Galpin43:37

      One thing, uh, uh, part of the reason I push back so hard on the, the protocol thing is because I really want people to not see those as limitations. And what I mean by that is, they're thinking, "Oh, because I didn't do the four-by-four perfectly, therefore I can't train or I'm not gonna get better." And, and I've made that before, but I like being ... Or that point earlier, but I like being very direct in that you have unlimited options with VO2 max. It is really equivalent, in my opinion, to bodybuilding training, where I almost call it idiot proof, in the sense that the training is hard for sure and the programming at the highest levels gets complicated, but at the entry point, mid-point, moderate point, if there's any part of a protocol you heard on a program that you feel like you can't do, "Oh, I'd love to do that but I, my knee. I'd love to do that but I can't, I don't have access to ..." You're okay. You're totally fine. You can still get whatever needs to be done regardless of the exercise equipment you have, regardless of the time limitations you have, regardless of the weather outside. There are still lots of options that work. So if you get inspired by Rhonda doing her awesome stuff, or Pete, or, or whatever, and you hear the exact protocol and you go, "I can't do that, therefore it's not gonna work," I, I wanna make sure you know that that is not the case. You can modify these things in a ton of ways and still get all of the benefits, if not more.

   3. CWChris Williamson45:02

      What else, or what, what do you wish that more people knew about cardiovascular fitness? It seems to me that with, uh, in, in part of this VO2 max revolution that we're seeing at the moment, massive proliferation of heart disease, big concerns that people have over protecting their heart over the long term. What do you wish that more people knew about cardiovascular fitness?

   4. AGDr Andy Galpin45:25

      You would be stunned how little effort it takes to see benefit. Like, really quite stunned how little exercise has to happen for you to see big results, especially if you are in those bottom 20 or 25% of fitness. So if you are really in a bad spot, it takes nothing. As little, I'm talking about as 20 seconds. So there's a handful of studies out of Canada that have been done on things like exercise snacks. So these are literally 20-second bursts, one to three times per day, in office related settings. So imagine you're in your suit and your tie and all that, you get up from your desk, you sprint 20 seconds up a step and you go right back to work. Those have been shown in multiple studies from multiple labs to enhance VO2 max. Now it's not gonna do it if you're a highly trained athlete. I'm not saying, "Oh, don't do any other workouts. All you have to do is this 20-second sprint once." What I'm, what I'm going all the way down to the bottom is, that's how little you're, uh, stimulus you need for your body to actually pay attention. Now, the benefits of VO2 max for a protocol like that are small. You're talking a few percentage points. But look at the power of that, right? It can certainly maintain where you're at. And so if you are in a situation where, whatever, you can't have access, can't afford a gym membership or who ... Well, now I, I told Andrew Hebermann about this a couple years ago, and still to this day, like, I'll see him in the studio just, like, sprinting around the studio like full getup. I'm like, "Oh, badonk."

   5. CWChris Williamson46:58

      That's him running away from his demons. He's not doing VO2 max work.

   6. AGDr Andy Galpin47:02

      Oh, of course. Yeah. Uh, or running away from his cellphone, or-

   7. CWChris Williamson47:06

      (laughs)

   8. AGDr Andy Galpin47:07

      ... (laughs) or what- whatever else.

   9. CWChris Williamson47:08

      Yeah.

   10. AGDr Andy Galpin47:08

       Uh, so yeah. Uh, these, these things can really, really help. So y- if you, uh, if, if you just do the bare minimum, that will matter. And it will matter for about as many physiological variables as one can think. Sure, your longevity. Sure, your heart disease. Yes, of course. But blood sugar regulation. Energy throughout the day. Um, in fact, in the studies I'm mentioning, not only did they look at VO2 max, but they also looked at executive function, decision-making and word recall. All that improved. So, I mean, you really can enhance your life in whatever metric matters to you. Some people-

   11. CWChris Williamson47:46

       Mm-hmm.

   12. AGDr Andy Galpin47:46

       ... like you and I, to be honest, like death-related stuff doesn't do much for me. Like, all right, I'm, I'm young, I'm pretty he- I'm okay. But man, improving my word recall by 20%, that's, that's fantastic. Make better decisions, I don't have to redo my work. That, that would be nice. Um, there's data on money. People make more money. Like y- you, you-

   13. CWChris Williamson48:08

       You're kidding me.

   14. AGDr Andy Galpin48:08

       Finances are high. No, no, for sure. Like you see this with sleep all the time too. I think the number with sleep is actually like, in America most recent estimate was poor sleep, uh, i- is, causes a $400 billion loss in America alone. On average, people lose something like six working days because of slightly ... Not, not like massive bad sleep, just slightly worse sleep causes a total throughout the year of about six equivalent working days. We actually have a client-

   15. CWChris Williamson48:34

       And what's that? Is that, is that productivity, loss in productivity, errors, car crashes, full works?

   16. AGDr Andy Galpin48:39

       All of it. Got sick more.

   17. CWChris Williamson48:41

       Yep.

   18. AGDr Andy Galpin48:41

       Just, you know, kind of checked out that 10 minutes early today and went home because I was a little tired today. It was the redid my work faster, all those things. We have a client in my, uh, in my sleep company who, he's a financial trader.... and he, he tracks. We have his sleep data tracked for a long time with his financial trades, and it is a very statistically significant correlation.

   19. CWChris Williamson49:01

       (laughs)

   20. AGDr Andy Galpin49:03

       So he keeps, he keeps re-upping. He keeps repaying 'cause he's like, "No matter what I pay you guys, I make more money." Just like sleeping (laughs) better. We're like, "Great." So-

   21. CWChris Williamson49:12

       Wow.

7. 49:13 – 57:55

   Andy’s Sleep Company

   1. CWChris Williamson49:13

   2. AGDr Andy Galpin49:13

      ... um-

   3. CWChris Williamson49:13

      What's your s- what's your sleep company?

   4. AGDr Andy Galpin49:15

      It's called Absolute Rest.

   5. CWChris Williamson49:17

      Okay. Um, is that sleep coaching? Is that a product?

   6. AGDr Andy Galpin49:20

      Yeah.

   7. CWChris Williamson49:20

      What is it?

   8. AGDr Andy Galpin49:21

      I- i- it's both of it. So at the height... We have two things actually. One of 'em we just released like a month ago, is a more consumer grade version. But for the first handful of years, where it started is this elite program where we come in and we can actually build full sleep labs in people's houses. So you can get a full clinical grade FDA approved sleep study done every single night in your house, or work... Take it with you. Take it wherever you want. So we have full... It's all wireless too. Like you've ever seen people in the sleep clinics that have the wires like all over... Like all that stuff's gone. You don't need any of those things. So we can run all that from your house but we... In addition to that, now we've got the highest fidelity understanding of how you sleep, right? We're not missing data and making assumptions. And because of that, we now want to go, "Well, why are you sleeping that way?" And so we're not just stopping and being like, "Well, your sleep's shitty." And people are like, "Great. I got a sleep study done, they told me to have an app." (laughs) Like that didn't help at all. Why are you sleeping that way? Well, number one then, we're gonna start off by looking at your environment. So we have a full environmental scanner that sits next to your bed and it's scanning your room at all times for CO2 concentrations, uh, humidity, uh, particulates, volatile organics, uh, dander, mold, pollen, allergens. All those things are being continuously scanned in your room to make sure it's not environmentally related. We're doing blood work specific to sleep related physiology. Uh, we have a psychological evaluation. One of our co-founders is a Harvard psychiatry, uh, psychologist of sleep. Um, and then we have any pathology screen, of course, and so we have an understanding of exactly why you're sleeping that... It's all positionally done too, so if the problem was on your left side or right side, or whatever the thing is happening. So all those data come back to our scientists who are the most, uh, published scientists in the world in sleep, folks that handle the astronauts and the space station and all that. They go over all those data, give you your results back there, and then put you on a, a several month long coaching program where you get to check in and, and see, and, and we fix sleep very successfully because of that. So we have been doing that for a very long time. And then just about a month ago, we released what's called Sleep Lens, which is a fingertip version of, of our sleep program. And so now we can do this at about a 10th of the price, and so we can run a full FDA approved equivalent to being in a sleep lab from your fingertip. It's not a wearable, it's not a tracker. You're not gonna like check your sleep score.

   9. CWChris Williamson51:49

      Mm-hmm.

   10. AGDr Andy Galpin51:49

       You, you... We can medically diagnose sleep disorders, uh, on this thing, and we can look at hundreds of measures per second as opposed to like one measure per five minutes.

   11. CWChris Williamson52:00

       Wow. So sleep is, you know, between VO2 max... Uh, I think it's 11, episode 1109 or 1159 was, uh, Matthew Walker on Rogan, and that was the day that I got red pilled about my sleep because-

   12. AGDr Andy Galpin52:16

       Oh, you-

   13. CWChris Williamson52:16

       ... I'd been a club promoter-

   14. AGDr Andy Galpin52:17

       Oh, were you not a good sleeper? Uh-oh.

   15. CWChris Williamson52:19

       I'm not-

   16. AGDr Andy Galpin52:20

       Are you struggling?

   17. CWChris Williamson52:20

       I'm not a good sleeper. I was, I was a club promoter for so long, and baked into my weekly routine from the age of 18 until the age of 32 or 33 when COVID came along was, I was awake until at least 3:00 or 4:00 in the morning running a nightclub, and the beautiful thing about being a club promoter is that the very final task you have to do is the most cognitively demanding one. So you have to count the till, make sure that-

   18. AGDr Andy Galpin52:45

       Oh, I love that shit.

   19. CWChris Williamson52:45

       ... all of the money is where you say it is, enter it into a spreadsheet so you're looking at a beautiful bright screen for a little while, drive home, put it in the... or drive to the office, put it in the safe, make sure that everything's okay. And then within 20 minutes go, "Right, okay, brain, I know that you just did all that mental arithmetic. Best of luck getting yourself to sleep." And I did that, and that was just life. That was life for me. You know, there was other times when we'd be driving... We ran events in Manchester, which is about two and a half hours from where we were based, and, um, I would do that drive every other week for half a decade, uh-

   20. AGDr Andy Galpin53:14

       Yeah.

   21. CWChris Williamson53:14

       ... and I'd get back at f- I'd get back at 5:00 AM. There was some times where I'd hit rush hour leaving Newcastle going to Manchester-

   22. AGDr Andy Galpin53:21

       Totally.

   23. CWChris Williamson53:21

       ... at 5:00 PM and then I would hit rush hour getting back home, uh, the next day, which felt particularly unfair. But yeah, I, um, I think that that was a big turning point for me. I don't think that I'd really considered sleep. It sounds so stupid in retrospect. It makes me sound like a total idiot. But I just hadn't considered how important sleep was for cognition, for performance, for mood, all of this stuff. And, um, I think, yeah, between VO2 max and sleep, that's been probably two of the biggest red pill changes that I've seen in terms of prioritization over the last five years.

   24. AGDr Andy Galpin53:57

       Yeah. I mean, we coach ba- Major League Baseball players. I coach NBA players. I coached Travis Barker, the drummer for, you know, Blink-182. I was just at, with Travis last weekend. So we had a 5K in the morning. So, uh, let's see. We were probably there 7:00 AM getting warmed up and all that stuff. Travis ran, uh, 20, just under 22 minutes for a 5K. It's pretty good, right? And then-

   25. CWChris Williamson54:24

       Better than me.

   26. AGDr Andy Galpin54:25

       (laughs) We were in a staple set or KIA for- form whatever, uh, SOFI Stadium in front of 70,000 people until, I don't know, I left at midnight I think, something like that, and then who knows when he, like, got home, got to sleep and all that, right? So I, I'm dealing... (laughs) He's on tour right now. He's in Salt Lake today. Like okay, play in front of 70,000 people, be a fucking drummer in front of-

   27. CWChris Williamson54:48

       Right.

   28. AGDr Andy Galpin54:48

       ... 70,000 people on stage, and then go to bed. Good luck, right? Like-

   29. CWChris Williamson54:53

       Not me.

   30. AGDr Andy Galpin54:54

       ... absolutely good luck. And he is a maniac with his health.... he's, he's dialed, he runs every day, and he's up super early. But it's the same problems. Like by the time we get off stage, we get wound down, all that stuff, it's 5:00 in the morning. Like-
8. 57:55 – 1:01:53

   What Most People Don’t Know About Sleep

   1. CWChris Williamson57:55

      Assume that most of the people listening have been red-pilled on most of Matthew Walker's stuff, that-

   2. AGDr Andy Galpin58:02

      Yeah.

   3. CWChris Williamson58:02

      ... look, I know that I should be aiming to get eight hours a night, I know that eight hours of sleep is not derived from eight hours in bed because sleep efficiency is a thing.

   4. AGDr Andy Galpin58:13

      Yep.

   5. CWChris Williamson58:13

      That being consistent, cool dark room, et cetera, et cetera. You've mentioned there's this entire other world of enhancement. What are, what are the big movers there that most people don't know about?

   6. AGDr Andy Galpin58:25

      Right. I love the way you say that because I feel like every time sleep comes up people tune out because they're like, "Yes, cool, dark, quiet." And that's like all true.

   7. CWChris Williamson58:32

      Correct.

   8. AGDr Andy Galpin58:33

      What else can we do? Okay, well let's go backwards. Why don't people sleep well to begin with, right? That, that's actually causing most of your problem. So we're gonna look at this in different parts. Sleep duration is one thing. Honestly, it's the variable we probably pay the least amount of attention to.

   9. CWChris Williamson58:48

      Really?

   10. AGDr Andy Galpin58:50

       Yeah, I mean it's fine but like either people sleep, you know, five hours and it's like, "Hey, do you, do you want to spend 10 grand?" 'Cause I can also just tell you, go, like, "You have to sleep more." (laughs) Like, like, like I could do that but there'd be a problem. What's more interesting is the like, "I'm in bed for eight hours, uh," here's the problem starts, right? You're falling asleep problems, like, "I get up a lot." Um, it is often things that are benign, that people think benign but are not. "Oh, I sleep, I snore a ton." "Oh, really? Interesting. That's not normal. Doesn't necessarily mean you have a sleep disorder, but it's very generally likely that something bad is happening." "Oh, okay, I wake up two or three times to go pee every night." Oh, that's not normal either. Like, should not be happening. That, that number should be basically zero, right? That, that... "Oh, I'm just getting old." Nope, nope, nope, nope, those are not answers either. Shouldn't be happening. We see a lot of, "Oh, I feel terrible all day. Energy's low, libido's low, focus is low, brain fog's low. I think I have COVID-related, long COVID, something like that." Okay, all, all possible, right? Sure. "How's your sleep?" "Oh, I sleep pretty well." Really? Take a look at it. Uh, this happened actually with one of our professional athletes. Used a wearable, we'll say, and had like a 90 plus percent score on the wearable consistently. We run him through stuff, immediately clinically diagnosable sleep disorder. Like, this is not, this is not a test, um, we get this-

   11. CWChris Williamson1:00:17

       What was the, what was the sleep disorder that was missed so obviously by the wearable?

   12. AGDr Andy Galpin1:00:22

       Well, wearables can't diagnose any sleep disorders.

   13. CWChris Williamson1:00:24

       Of course, but I would, I would have pred- I would have guessed that if you have a disorder it would show up somehow in some of those markers.

   14. AGDr Andy Galpin1:00:31

       No, it won't because the vast majority of cheap consumer wearables are going to be looking at so low resolution that any... Uh, it's an X-ray. So imagine you fell off the mountain today as you're running and your knee is destroyed, you got helevaced down and they took you down there. And they're like, "Oh man, his knee is torn up and it, we'll take an X-ray." Then the doctor comes back and goes, "Hm, no broken bones, you're fine." Like, well okay, but your MCL's torn, ACL's torn, his kneecap's dislocated. ... it is an X-ray. It can only look at a few things and it's looking at it at very, very low resolution. Typically, wearables are gonna take a measurement once every five minutes. So if you had any event that happened not within that very small time window-

   15. CWChris Williamson1:01:13

       Yeah.

   16. AGDr Andy Galpin1:01:13

       ... it all gets missed.

   17. CWChris Williamson1:01:14

       That's something. I remember I had a... Fuck. Who's elite HRV? Joel Jameson?

   18. AGDr Andy Galpin1:01:23

       Oh, yeah, with Morpheus?

   19. CWChris Williamson1:01:25

       Yes. Um, I remember speaking to him and he was telling me about how HRV, uh, when you do it in those bracket windows like that, uh, if you're laid on your front versus if you're laid on your side, if you're at a particular s- stage of sleep, and you can kind of do this odd dance routine during sleep that gives a really, um, skewed, uh, set of data, uh, which I, I found particularly interesting. All right, so I, I, I know that I'm branching off, but I, I promise I'll bring you back.

9. 1:01:53 – 1:12:56

   Key Metrics for Understanding Your Sleep

   1. CWChris Williamson1:01:53

      What are the metrics that you guys, when you do your sleep studies are-

   2. AGDr Andy Galpin1:01:59

      Yeah.

   3. CWChris Williamson1:01:59

      ... looking at which are being missed? What are the things that pick up these sleep disorders?

   4. AGDr Andy Galpin1:02:04

      Okay. So, you wanna think about this this way. When most people are... Uh, this is cool. I'm having fun. Um, when most people think about sleep, right, we're thinking about duration and their sleep score on your wearables and I could go on, but I think you get the point that those are not a good way. One of the main reasons why is what people tend to be s- concerned about is how long did I sleep and how much time did I spend in various stages. Deep, REM, things like that. Throw all that out of the way. It's completely garbage. Not only from like a technology perspective, but what I simply mean is the construct, the idea of sleep stages is almost nonsensical for everybody. The amount of time you spend in a sleep stage I'm not gonna say is totally irrelevant, but it's way less important than most people think because of a handful of things. Your brain is going to engineer what we call the architect. So, the, how, uh, the architecture of your sleep based upon the demands of what it needs. And so, you are not going through the same physical or cognitive demands every single day. Thus, you don't need the same sleep staging every single day. When your brain is doing something with your sleep staging, it's doing it for a reason. And then you're going in there and listening to Andrew Huberman and taking a supplement to hack that sleep stage, and th- now you're going against what your brain is trying to do. You're causing problems. The sleep staging is not accurately depicted, they also change, for the record. Like, they, they are changed arbitrarily. "Uh, this is now deep sleep, this is now not deep sleep." So, so we see people consistently over time like, "Oh my God, my deep sleep's gone way down." I'm like, "What? Uh, what do you mean?" Oh, no, no, no. One, an algorithm could have been just changed in the background. (laughs) Now like your two years of data is gone, and that happens all the time. But I mean even medically. The medical side of the equation can change their definition of these things and has happened many times. So, we don't also even know at all how much sleep staging y- you should be in for any given sort of purpose. It would be the equivalent of saying you should do this exact type of training every single day of the rest of your life. Why? Well, because that's the average type of training the average person does. Well, that's fucking unhelpful. (laughs) That's about as unhelpful as it could possibly get. And so tha- that's not going to provide you any insight into what's going on. More importantly than the time you spend... Let's just throw all that away. Let's say you could accurately measure your sleep stages. It's not the time you spend in those stages, it's the depth in those stages that matter. I'm not aware of any tracker or wearable that can actually measure any of that. And so if you and I both spent an hour in deep sleep, whatever that means, but your amplitude within that is five times higher than mine, you're gonna have much more restorative sleep than I. And this is your classic, "My scores are okay, I'm in the right time, but I'm still feeling lethargic, I'm still feeling whatever other thing or issue." And, and we see, have seen this a ton from TRT clinics. So people that have gone on testosterone because energy is low, you know, you fill in the blanks there. Fine, like not against that at all. When we come back we're like, "Why did you think you, you needed testosterone?" When we take a look at your sleep we're like, "If you're tired, the first place we should look is sleep." Like, (laughs) th- this is pretty obvious, right? Like what's energy intake look like? Food, nutrition. And what's sleep look like? Th- those are the... That's our mountain, right? We don't need to think we're in some weird spot. A- and so, again, testosterone's fine. Let's... Don't wanna take us off track here. Th- that was not the point. But the point is going like, "Whoa, we have to really pay attention to how sleep actually works." So when I say like duration, like it is what it is. I am more looking at things like what is the amplitude, uh, within these sleep stages? So what's the quality of that? What's the consistency of your sleep/wake cycles and rhythms? What is the actual, um, next day feelings? What's your symptomatology, right? How's that actually doing? And we're gonna measure that cognitively. So I'm not just gonna like ask you, "How do you feel?" We're gonna measure cognitive speed, processing speed, reaction time, things like that.

   5. CWChris Williamson1:06:04

      What do you... I was gonna say, what are the tests that you do for that?

   6. AGDr Andy Galpin1:06:07

      Yeah, we have, we, we have, we... We don't do anything without testing for the most part. Like we're gonna, we're gonna track metrics on... This is, this is technology and performance. This is our game, right? So we're not messing around with an- any of that stuff. So, we're gonna test all of those. Um, we're gonna look at things like respiratory rate, right? We're gonna look at HRV. And now since we can do this in such high variability I can differentiate and tell you, oh, this was a problem of you're unfit, right? So I, I can... I can give you that example maybe. I... Okay. I can, we can very easily triangulate and say, all right, you're resting... I take a look at you and I say, all right, um, symptomatology is there. We're not feeling refreshed. We think something's going on with sleep. All right. Awesome. Now we look and you don't have any clinical insomnia, right? We're not having these obvious signs of that. But just because you don't have clinical apnea or whatever, doesn't mean you don't have sub.... clinical. So, maybe we see a little bit of subclinical apnea. Okay. Well, you're kind of a bigger guy, mm, body mass tends to go up. That tends to start happening. All right. Now, why are you having that apnea? Hmm. Interesting. Well, apnea could be done for h- could be anatomical. So, we're gonna actually run a, a scan of your face and we're gonna be able to see is there any anatomical things going on. It's a nasal cavity thing. It could be a tongue-related issue. And so there are tongue... believe it or not, there are tongue-strengthening exercises we can do that'll stop your tongue from flopping back in your neck.

   7. CWChris Williamson1:07:30

      Fucking flaccid tongue. I knew I had a flaccid tongue.

   8. AGDr Andy Galpin1:07:32

      I mean, I didn't want to say it, but-

   9. CWChris Williamson1:07:34

      Yeah.

   10. AGDr Andy Galpin1:07:34

       ... if it never gets used, it...

   11. CWChris Williamson1:07:36

       It's pretty obvious, man. It's pretty obvious.

   12. AGDr Andy Galpin1:07:40

       Right? So, we just need to firm you up a little bit.

   13. CWChris Williamson1:07:43

       Mm-hmm, mm-hmm.

   14. AGDr Andy Galpin1:07:43

       It is, you know-

   15. CWChris Williamson1:07:44

       Turgid, nice turgid tongue.

   16. AGDr Andy Galpin1:07:47

       (laughs) Turgid tongue. It could be as simple as that, right? It could be as simple as positional. So, maybe the... and all of your apneas are happening when you're laying on your right shoulder. Now all we have to do is get you to stop laying on your right shoulder, and all of a sudden your sleep changes instantaneously. And we've had this... I, I can't even count how many times things like that have happened. It could also be, uh, things like environmental. So, one of the things I've talked about a lot in the past is the fact that when you take a breath in, you inhale oxygen. When you take a breath out, you exhale CO₂. Okay? Now in a normal situation, that's fine. As you're sleeping, you're not exhaling very hard, so that breath, if you're watching the video here, is coming just kind of like seeping out of your mouth. That stays right in front of your face and forms what's called a CO₂ cloud. And you take your next breath and you re-breathe back in some of that CO₂. Most people, that's not a big deal. However, if you're highly sensitive to CO₂, or if the CO₂ concentrations in your room start getting really high. Why? Because all your doors and windows are shut. Because you have a sleeping partner. Because you have an animal in there as well, your kid is in there too. More bodies in a room, poor ventilation. When that number crosses 900 parts per million, you will see consistent research showing poor sleep onset, wakeful events, next day restfulness, next day concentration, next day cognitive function, all when CO₂ levels start to rise above 900. So, it could be simply that. It has nothing to do with anything else going on besides the fact that you're choking yourself on CO₂. CO₂ levels rise in your body, that's one of your primary levers that kicks you from autonomic to parasympathetic nervous system. This is fight or flight-

   17. CWChris Williamson1:09:28

       Huberman-

   18. AGDr Andy Galpin1:09:28

       ... to rest and digest.

   19. CWChris Williamson1:09:28

       Huberman taught me about, uh, this test that they do where they get people to take a single breath in from some mask that's got a really high concentration of carbon dioxide, and it's able to reliably bring on a panic attack. A single breath is able to-

   20. AGDr Andy Galpin1:09:42

       Oh, there's-

   21. CWChris Williamson1:09:42

       ... reliably-

   22. AGDr Andy Galpin1:09:43

       There's been many, many decades of research in psychiatry that uses CO₂ to induce panic. That, that's like one of the most standard models for anxiety and panic disorder research, is inhaling CO₂.

   23. CWChris Williamson1:09:55

       Wow. Yeah. And you're-

   24. AGDr Andy Galpin1:09:56

       Yeah. It's been around for a very long time.

   25. CWChris Williamson1:09:57

       ... doing it, a lower level version of that when you have poor ventilation and high amounts of CO₂ in your, in your room?

   26. AGDr Andy Galpin1:10:04

       Yep. Or if none of that's happening and you're simply intolerant to CO₂, you're hypersensitive to it, your concentrations in your bedroom could be very, very low, but it's still kicking off that entire sympathetic cascade because you're overly triggered to your CO₂. Right? So, I can see that because I can see your HRV, I can see your heart rate, and I can see your oxygenation. So, I will very quickly be able to be like, "This is the problem. To hell with your tongue exercises, to hell with your supplementation and all those other things, or whatever. In your particular case, this is simply about you developing better CO₂ tolerance." We see this one really routinely. The opposite could be the other... the case. We see that those things are fine, heart rate is actually... So, the way I can triangulate this is 'cause... because we can look at HRV, we can look at CO₂, and we can look at O₂ concentration, and I can look at your VO₂ max. Now I can identify, oh, if your resting heart rate's really, really high but your HRV is also high, that means you're nice and downregulated, and your respiratory rate is low, you're not over-breathing, right? And then I look at your VO₂ max, and your VO₂ max is shit, and go, "Oh. Okay, you're unfit. You're just unfit." We have got to get... That's our problem. You're not over-brereathing, it's not an O₂ issue, it's not an environmental, it's not a tongue thing. You're just unfit to a position where you're having a... any deviation, that small of apnea you have, that small amount of apnea you have, rather, is causing such a big effect because you don't have any breathing room. The VO₂ you need to have just to sleep is just barely (laughs) below your threshold when you're awake. And so slight deviations cause you to choke, O₂ gets low, and now you're having this response. Or the opposite. And that's the last one I'll give you. But we could be super fit, very low resting heart rate, HRV is high, and/or respiratory rate is high. You're not downregulated. You're exhausted-

   27. CWChris Williamson1:11:56

       Mm-hmm.

   28. AGDr Andy Galpin1:11:57

       ... so your sleep onset is really, really short, you're falling asleep immediately, but you wake up often. When you wake up, you have a hard time going back to sleep. And/or when you even sleep through the night, you still feel very fatigued the next day. And when we look, respiratory rate's overly high, you're dumping CO₂, you're getting rid of it too much. This causes respiratory alkalosis. And I can confirm this by looking at your hydration status because in response to respiratory alkalosis, your kidneys will put you into metabolic acidosis, which means it's very, very hard to retain electrolytes. And all of a sudden you're waking up and peeing con- a ton, often, but there's not a lot of volume in it, it's not super clear, you're not overly hydrated. We're consistently seeing signs and symptoms of dehydration in your lab work, in your blood. And now we know, bada bing, bada boom, this is all simply coming down to the fact that you're overly sympathetically driven, you're over-breathing. We correct that, sleep problems go away.

   29. CWChris Williamson1:12:48

       Wow. Dude, this... I love the 360 view of all of this. It's very impressive-

   30. AGDr Andy Galpin1:12:53

       This is how we play, man.
10. 1:12:56 – 1:23:58

    Important Tips for Sleep Enhancement

    1. CWChris Williamson1:12:56

       Okay. Getting back into sleep enhancements not for newbs. Sleep enhancements-

    2. AGDr Andy Galpin1:13:02

       Mm-hmm.

    3. CWChris Williamson1:13:02

       ... not for newbs.

    4. AGDr Andy Galpin1:13:04

       Yeah. So, this is where it comes down to going, okay-... we're sleeping okay, you're falling asleep fine, and you're maybe waking up a couple of times and we'll just, we'll just call your sleep, you know, kind of like the way I call your podcast. It's okay. It's not great, but it's just like, it's okay. Right? Like, it's all right. If I have to, I'm gonna watch it, but then, you know, not gonna go out of my way, right? (laughs) So what we're looking at there could be duration, could be timing, could be consistency, could be any of those things. And we're just gonna go there and polish it all the way up. Right? And so this is making sure... We want to change the rhetoric here. This is not about you getting the most sleep. This is not about you, um, having to have a 90-minute routine to get to bed every night. I want to actually develop the most resilient sleepers possible. That is our goal. We always shy away from optimization. That's like the most anti-science word you could ever develop but, like, sometimes you just use it. We would rather be resilient. What's that mean? Even when you do have a slightly crummy night or a suboptimal night, we're still performing at the highest level possible the next day.

Episode duration: 2:12:03