1 00:00:00,022 --> 00:00:02,062 Everything is worse at three in the morning. 2 00:00:02,092 --> 00:00:06,622 There's that to-do list piling up or that early clinic you've got to make, 3 00:00:06,622 --> 00:00:10,192 or that thing you said to your colleague that you just can't stop thinking about. 4 00:00:10,449 --> 00:00:14,019 These worries just pile up at night and that's on top of that cheeky glass 5 00:00:14,019 --> 00:00:17,829 of wine late at night or that piece of cheese or that doom scrolling when all 6 00:00:17,829 --> 00:00:19,509 you meant to do was set your alarm. 7 00:00:19,855 --> 00:00:23,185 And we are constantly told how important getting a good night's sleep is, 8 00:00:23,185 --> 00:00:25,015 particularly in a high stakes job. 9 00:00:25,225 --> 00:00:27,835 But it's easier said than done, and it does feel like something 10 00:00:27,835 --> 00:00:29,095 we don't have much control over. 11 00:00:29,622 --> 00:00:33,492 So this week in our summer wellbeing series, I'm joined by Dr. Steve Smith. 12 00:00:33,552 --> 00:00:38,399 He's a GP and a self-certified insomniac, and he's developed some training to 13 00:00:38,399 --> 00:00:40,546 help people get a good night's sleep. 14 00:00:40,936 --> 00:00:44,056 Now Steve has worked extensively in the field of substance abuse, and he's 15 00:00:44,056 --> 00:00:47,417 previously been on the podcast talking about the importance of forgiveness, 16 00:00:47,597 --> 00:00:52,054 particularly as a mental health strategy, and he's found some unexpected connections 17 00:00:52,054 --> 00:00:56,404 between substance abuse and sleep, and he's sharing some of his tried and 18 00:00:56,404 --> 00:01:00,544 tested strategies as well as some new and surprising ways to improve both the 19 00:01:00,544 --> 00:01:03,514 quality and the quantity of your sleep. 20 00:01:03,874 --> 00:01:07,024 Spoiler alert is not just about REM sleep. 21 00:01:07,374 --> 00:01:11,244 So grab yourself a hot, milky drink, preferably without any caffeine 22 00:01:11,244 --> 00:01:14,234 if it's after midday, and enjoy this conversation with Steve. 23 00:01:14,284 --> 00:01:17,364 And if you want to start putting his advice into practice, stay tuned 24 00:01:17,454 --> 00:01:20,874 for an exclusive discount on his course, especially for Frog listeners. 25 00:01:23,169 --> 00:01:27,219 If you're in a high stress, high stakes, still blank medicine, and you're feeling 26 00:01:27,219 --> 00:01:32,675 stressed or overwhelmed, burning out or getting out are not your only options. 27 00:01:32,905 --> 00:01:36,835 I'm Dr. Rachel Morris, and welcome to You Are Not a Frog. 28 00:01:40,286 --> 00:01:41,996 Well, hello, I'm Dr. Steve Smith. 29 00:01:41,996 --> 00:01:48,506 I am a GP and for two or three decades I've been working as a GP specialist 30 00:01:48,506 --> 00:01:50,426 in substance misuse in addiction. 31 00:01:50,606 --> 00:01:54,689 but in more recent years I have been working, on the subjects of sleep 32 00:01:54,719 --> 00:01:55,889 and have a great interest in sleep. 33 00:01:55,889 --> 00:01:59,639 And I'm currently working in a clinic in North London where a big part of our 34 00:01:59,639 --> 00:02:02,009 work is helping people with sleep issues. 35 00:02:02,202 --> 00:02:04,272 great to have you back on the podcast, Steve, 'cause you've been here 36 00:02:04,272 --> 00:02:05,952 before talking about forgiveness. 37 00:02:06,055 --> 00:02:06,955 Coming up to a year ago. 38 00:02:07,455 --> 00:02:07,905 Gosh. 39 00:02:08,115 --> 00:02:12,045 And I, it is interesting 'cause that was a big part of your work with, 40 00:02:12,105 --> 00:02:14,355 um, people with addiction as well. 41 00:02:14,355 --> 00:02:18,195 You found forgiveness was a real, a real thing that people needed to 42 00:02:18,195 --> 00:02:19,335 sort of get to the bottom of it. 43 00:02:19,335 --> 00:02:22,815 Is that the same reason why you got into sleep and stuff like that? 44 00:02:23,357 --> 00:02:29,237 I think sleep, sleep is very much a big part of why people 45 00:02:29,417 --> 00:02:31,097 are addicted to substances. 46 00:02:31,397 --> 00:02:36,977 But one of the, my main interests in sleep is my own personal journey with insomnia. 47 00:02:36,977 --> 00:02:41,777 So I've, I've described myself as having been a certified insomniac. 48 00:02:42,617 --> 00:02:47,117 So, um, that's, that's been a big motivator to, to, to study it more, 49 00:02:47,117 --> 00:02:50,295 to look into it and, you know, done a lot of reading, attended 50 00:02:50,625 --> 00:02:52,825 seminars, uh, and and so on. 51 00:02:52,825 --> 00:02:55,975 So that's, that's, um, so it's been, been professional and 52 00:02:55,975 --> 00:02:57,535 personal interest in sleep. 53 00:02:57,745 --> 00:03:01,095 how long have you been a, a certified professional insomniac for? 54 00:03:01,095 --> 00:03:03,779 So when, when did your issues with Sleeping first start? 55 00:03:04,015 --> 00:03:07,555 I, I was actually thinking about that 'cause I was, I and I, I've, I've 56 00:03:07,555 --> 00:03:08,905 thought about it a, a number of times. 57 00:03:08,905 --> 00:03:12,685 I really cannot remember having any sleep issues as a child. 58 00:03:13,075 --> 00:03:17,575 But what I really, really remember having, when I really ha remember having 59 00:03:17,575 --> 00:03:19,735 sleep problems was as a junior doctor. 60 00:03:19,854 --> 00:03:23,184 We, I know as you, as you know, we used to work sometimes 61 00:03:23,184 --> 00:03:25,164 these ridiculously long shifts. 62 00:03:25,450 --> 00:03:29,080 I remember starting on a Saturday morning when I did a one in four weekend and 63 00:03:29,080 --> 00:03:30,730 I was always on call on Monday nights. 64 00:03:31,039 --> 00:03:34,999 Um, so I would, I would start on Saturday morning doing a busy surgical job 65 00:03:34,999 --> 00:03:38,299 where there were always things going on during the night or very often. 66 00:03:38,629 --> 00:03:44,067 And then I would go home on Tuesday, five o'clock crash and would you believe it? 67 00:03:44,067 --> 00:03:45,627 I was on call Mondays and Wednesdays. 68 00:03:45,627 --> 00:03:47,697 And so then, then I would have, then I would work from Wednesday 69 00:03:47,697 --> 00:03:48,777 morning till Thursday evening. 70 00:03:49,107 --> 00:03:51,627 So it was just an exhausting job. 71 00:03:51,901 --> 00:03:55,081 And, and then when there were opportunities to sleep, whether it 72 00:03:55,081 --> 00:03:59,071 was between cases in the middle of the night or when I got home, I was just 73 00:03:59,071 --> 00:04:02,861 so often obsessed with, I've gotta sleep, gotta sleep, that I absolutely 74 00:04:02,861 --> 00:04:04,751 had good doses of sleep anxiety. 75 00:04:05,116 --> 00:04:07,846 So yeah, uh, it's been on and off over the years. 76 00:04:08,026 --> 00:04:12,226 but I, I really understand the issue of sleep anxiety, which, which is one 77 00:04:12,226 --> 00:04:14,056 of the major causes of, of insomnia. 78 00:04:14,484 --> 00:04:17,214 Because you don't often hear much about that, do you? 79 00:04:17,214 --> 00:04:20,994 When when people talk about sleep, they talk about sleep hygiene, yeah, yeah, 80 00:04:20,994 --> 00:04:22,554 we all pretty much know what to do. 81 00:04:22,554 --> 00:04:24,654 But the sleep anxiety and it exists. 82 00:04:24,654 --> 00:04:27,504 I'm literally thinking about three times in the last month where I've 83 00:04:27,504 --> 00:04:31,944 had exactly that where my daughter hap had an operation on her foot, so we're 84 00:04:31,944 --> 00:04:35,064 having to get up really early to get her to the mini bus to get to school. 85 00:04:35,484 --> 00:04:38,034 I'm not sleeping so well 'cause I'm waking up and checking my clock. 86 00:04:38,124 --> 00:04:40,044 I was doing a keynote talk in Edinburgh. 87 00:04:40,314 --> 00:04:41,754 It started at 8 45. 88 00:04:41,754 --> 00:04:43,074 I had a really nice hotel. 89 00:04:43,074 --> 00:04:44,124 It was really comfortable. 90 00:04:44,424 --> 00:04:46,824 I hardly slept a wink that night because I was so worried about missing 91 00:04:46,824 --> 00:04:48,489 my alarm to get up to to do it. 92 00:04:49,194 --> 00:04:50,964 It was just a bit mad really. 93 00:04:50,964 --> 00:04:55,674 So it sleep anxiety, something that happens to everybody or just a few 94 00:04:55,674 --> 00:04:58,764 people, or It happens to most people occasionally, but there are some 95 00:04:58,944 --> 00:05:00,444 few people that get it really bad? 96 00:05:00,601 --> 00:05:04,471 What I would say is it's a major cause of anxiety and it is totally, 97 00:05:04,531 --> 00:05:08,491 ugh, not totally, but it's largely overlooked and poorly understood. 98 00:05:08,521 --> 00:05:11,911 And I think also by medical professionals, by healthcare professionals. 99 00:05:12,211 --> 00:05:15,301 And I, I was at St. George's Hospital in the 1980s, actually 100 00:05:15,301 --> 00:05:16,651 the seventies, let's be honest. 101 00:05:16,959 --> 00:05:20,947 where I was at medical school and it was a particular medical school where sleep was 102 00:05:20,947 --> 00:05:22,867 taught probably better than other places. 103 00:05:22,867 --> 00:05:25,417 But we didn't have very much about sleep at all. 104 00:05:25,597 --> 00:05:29,255 And the only lesson, the only lecture I can remember on sleep. 105 00:05:29,291 --> 00:05:30,101 Sleep hygiene. 106 00:05:30,161 --> 00:05:30,911 That's all we were told. 107 00:05:30,911 --> 00:05:34,211 Yeah, tell them, you know, not to drink too much coffee and maybe, 108 00:05:34,271 --> 00:05:37,871 maybe have a milky drink and exercise here and there and all those things 109 00:05:37,871 --> 00:05:38,891 that maybe we can talk about. 110 00:05:38,921 --> 00:05:40,331 'Cause they're, they are important. 111 00:05:40,571 --> 00:05:45,876 I mean, they, they, they are part of, what people need to tackle, but it's 112 00:05:45,906 --> 00:05:48,546 not, it's not the most important thing. 113 00:05:48,546 --> 00:05:54,006 It's, it is, it's, the way I look at how to help people is, is, is there's 114 00:05:54,006 --> 00:05:56,346 various steps in, in how I help people. 115 00:05:56,586 --> 00:06:01,146 And one, one of them is sleep hygiene, which needs to be looked at early on. 116 00:06:01,656 --> 00:06:05,316 But, but absolutely is the anxiety of not sleeping that is 117 00:06:05,316 --> 00:06:06,546 what really keeps people awake. 118 00:06:06,936 --> 00:06:10,326 And people, time and time again, especially when I'm, when I'm 119 00:06:10,326 --> 00:06:13,386 working in an addiction clinic, people just don't get that. 120 00:06:13,476 --> 00:06:14,826 'cause they, they've learned. 121 00:06:15,113 --> 00:06:18,143 They've taught themselves that it's substances that they 122 00:06:18,143 --> 00:06:19,973 need to, to get through life. 123 00:06:19,973 --> 00:06:23,363 And, and of course it's not, not, that's, that's true for so many people, 124 00:06:23,363 --> 00:06:24,773 whether or not they go to a drug clinic. 125 00:06:25,262 --> 00:06:28,291 And they've learned that, yeah, if I take this, I sleep well. 126 00:06:28,291 --> 00:06:30,481 And if I don't take it, I don't, I don't sleep. 127 00:06:30,603 --> 00:06:35,013 Um, and so this, they take a lot of persuading that anxiety is an issue and 128 00:06:35,013 --> 00:06:36,303 I'm, that's the clinic I'm working in now. 129 00:06:36,303 --> 00:06:40,335 I'm working in a clinic now where we're helping people manage, 130 00:06:40,335 --> 00:06:44,235 prescribed benzos that's a and another and opiates and z drugs. 131 00:06:44,890 --> 00:06:49,120 And it's, it's a big lesson to, for them to learn that it's sleep anxiety. 132 00:06:49,455 --> 00:06:51,940 'Cause, 'cause so often when people have been taking a substance. 133 00:06:52,172 --> 00:06:56,158 whether it's prescribed or it's illicit or whatever, the, the substance has 134 00:06:56,158 --> 00:06:57,898 actually stopped working a long time ago. 135 00:06:58,918 --> 00:07:03,268 It's, it's, it's lost its benefit, but it's, it's the reason why they don't 136 00:07:03,268 --> 00:07:08,529 sleep when they don't take their, whatever it is, they have their, their 137 00:07:08,529 --> 00:07:12,933 cannabis, alcohol, promethazine, whatever it is, the reason why sleep is poor 138 00:07:12,933 --> 00:07:16,203 is, is because they're thinking, oh no, I haven't had my sleeping tablet. 139 00:07:16,203 --> 00:07:17,193 I'm not gonna sleep well. 140 00:07:17,359 --> 00:07:20,329 like most things in life, the, the root is all up here, isn't it? 141 00:07:20,329 --> 00:07:24,169 It's the way we think about everything and, and, and what's going for us, and 142 00:07:24,169 --> 00:07:26,659 those underlying concerns and worries. 143 00:07:26,937 --> 00:07:28,077 Absolutely. 144 00:07:28,167 --> 00:07:31,437 I mean, I've heard you talking about things at different times, um, in 145 00:07:31,437 --> 00:07:33,837 relation to stress management and so on. 146 00:07:33,867 --> 00:07:38,418 the whole Chimp Paradox, you know, the limbic system, it's a 147 00:07:38,568 --> 00:07:40,788 big part of, of sleep management 148 00:07:40,788 --> 00:07:43,053 And it's really interesting 'cause I must say, yeah, I haven't 149 00:07:43,053 --> 00:07:44,643 really heard about it before. 150 00:07:44,973 --> 00:07:49,323 So obviously there's a, a great book, Matthew Walker, why We Sleep, you 151 00:07:49,323 --> 00:07:54,333 know, fantastic and recommend everybody to, I think every single healthcare 152 00:07:54,333 --> 00:07:57,093 professional should read that, not just for themselves, but so they 153 00:07:57,093 --> 00:07:58,983 can advise their patients about it. 154 00:07:58,983 --> 00:08:01,156 So, um, quick, quick summary. 155 00:08:01,156 --> 00:08:03,976 Let's just give it like a one minute summary, um, Steve, 156 00:08:03,976 --> 00:08:05,086 of why we need to sleep. 157 00:08:05,086 --> 00:08:08,386 So I wanna go on and talk more about sleep anxiety, but let's get out of the way, 158 00:08:08,386 --> 00:08:10,186 first of all, why sleep is important. 159 00:08:10,186 --> 00:08:13,850 And number two, quick, you know, 32nd summary of sleep hygiene. 160 00:08:13,850 --> 00:08:16,580 'cause I think, you know, we, we just need to know it. 161 00:08:16,640 --> 00:08:20,450 And then it's, let's look at the thing that actually really makes a difference. 162 00:08:20,450 --> 00:08:21,500 So why sleep? 163 00:08:21,500 --> 00:08:22,310 Important quick 164 00:08:22,400 --> 00:08:22,850 my goodness. 165 00:08:22,850 --> 00:08:24,410 That, that's such a big subject. 166 00:08:24,530 --> 00:08:25,280 Okay. 167 00:08:25,280 --> 00:08:29,360 It's so important for, for our life, for our health, for 168 00:08:29,360 --> 00:08:31,220 our wellbeing, for creativity. 169 00:08:31,220 --> 00:08:34,040 So just quickly for our life, you did, did you know that if you 170 00:08:34,250 --> 00:08:37,480 consistently sleep less than five hours at night, Your, your risk of 171 00:08:37,480 --> 00:08:40,189 death from all causes is 15% greater. 172 00:08:40,459 --> 00:08:44,478 If you sleep less consistently, sleep less than six hours, at night, you, 173 00:08:44,483 --> 00:08:48,220 you have a 30% increased risk of cardiovascular disease and diabetes. 174 00:08:48,493 --> 00:08:52,903 One is 55% more likely to be obese if you're sleeping less than seven 175 00:08:52,903 --> 00:08:56,053 hours actually compared to somebody who sleeps more than seven hours. 176 00:08:56,343 --> 00:08:57,513 One really big deal. 177 00:08:57,513 --> 00:09:00,513 I mean, this is really big, a really big deal for healthcare professionals who 178 00:09:00,513 --> 00:09:02,673 are managing people in general practice. 179 00:09:02,673 --> 00:09:05,853 It's, I really like to stress that mental health and insomnia 180 00:09:05,853 --> 00:09:07,893 are a two-way street because. 181 00:09:08,569 --> 00:09:10,969 We were all taught in medical school that somebody's come, somebody 182 00:09:10,969 --> 00:09:15,469 presents with insomnia, oh, they must be depressed, probably depressed. 183 00:09:15,859 --> 00:09:17,989 And, and that was certainly how I used to think. 184 00:09:17,989 --> 00:09:22,369 I mean, that's how I, I, I understood most GPs thinking that they're not sleeping. 185 00:09:22,369 --> 00:09:23,359 Well, why are they depressed? 186 00:09:23,359 --> 00:09:24,619 Let's put 'em on antidepressants. 187 00:09:25,129 --> 00:09:29,239 And what's really interesting is how many people are anxious or depressed, 188 00:09:29,239 --> 00:09:31,369 primarily because they've got insomnia. 189 00:09:31,466 --> 00:09:31,706 Gosh. 190 00:09:31,939 --> 00:09:35,509 And it is, it's, and that's so overlooked, um, by so many. 191 00:09:35,509 --> 00:09:36,229 And they are depressed. 192 00:09:36,229 --> 00:09:38,869 They are depressed, but, and so the antidepressants will probably help. 193 00:09:39,079 --> 00:09:42,409 But, but the, but the primary issue is, is, is the insomnia. 194 00:09:42,799 --> 00:09:43,699 Memory. 195 00:09:43,965 --> 00:09:44,825 uh, dementia. 196 00:09:45,230 --> 00:09:53,180 So we detox, our brains are busy detoxing, uh, ourselves of beta amyloid, you the 197 00:09:53,180 --> 00:09:57,260 protein that's, uh, associated with Alzheimer's in the brain during the night. 198 00:09:57,539 --> 00:10:01,559 And there are so many stories of, of people just not sleeping 199 00:10:01,559 --> 00:10:04,739 and, and obviously dementia's common anyway, but it's very like, 200 00:10:04,739 --> 00:10:06,441 closely linked with, poor sleep. 201 00:10:06,521 --> 00:10:09,806 I mean, I remember in the 1980s, uh, I don't, you know, there might be 202 00:10:09,806 --> 00:10:13,129 others listening to this, remembering about the power of, of power naps. 203 00:10:13,429 --> 00:10:15,979 You know, you could sleep, you could, you could rest for 10 minutes and have 204 00:10:15,979 --> 00:10:18,409 the equivalent of two hours sleep. 205 00:10:18,409 --> 00:10:19,849 And that just seemed amazing. 206 00:10:19,849 --> 00:10:22,194 And I think that's how people like Margaret Thatcher got by, 207 00:10:22,219 --> 00:10:25,750 just by, working all night, having these little power nap and, and 208 00:10:25,750 --> 00:10:30,280 functioning, but massive correlation with, with memory loss and dementia. 209 00:10:30,310 --> 00:10:32,350 So that, that, are those a few good reasons, 210 00:10:32,500 --> 00:10:34,495 Gosh, that that's good enough for me. 211 00:10:34,495 --> 00:10:34,765 Yeah. 212 00:10:34,847 --> 00:10:35,177 yeah. 213 00:10:35,177 --> 00:10:39,504 And, and just productivity, creativity, um, um, they're massive as well. 214 00:10:39,766 --> 00:10:42,819 It's just the, it's the laying down of memories and the solving of problems 215 00:10:42,819 --> 00:10:45,639 and things that particularly happens in your REM sleep, doesn't it? 216 00:10:45,639 --> 00:10:49,509 And I think for me, yes, let's, let's get rid of all the AM amyloid. 217 00:10:49,509 --> 00:10:52,659 But actually, if you wanna have an impact, if you want to solve 218 00:10:52,659 --> 00:10:56,589 problems and, and feel better, you need a good night's sleep. 219 00:10:56,589 --> 00:10:58,646 So there's stuff we can do. 220 00:10:58,856 --> 00:11:04,196 And if I was to list sleep hygiene as a, if I remember back to my GP days, 221 00:11:04,196 --> 00:11:06,026 it's make, make the bedroom really dark. 222 00:11:06,596 --> 00:11:10,706 Make it cold-ish, you know, not too well, not too cold, but not too hot either. 223 00:11:11,036 --> 00:11:13,796 Um, don't have any caffeine from midday. 224 00:11:13,826 --> 00:11:16,196 'cause the half, the half life of caffeine is six hours. 225 00:11:16,196 --> 00:11:18,236 So you'll still have aquar, quarter of the strong cup of 226 00:11:18,461 --> 00:11:19,031 I thought it was eight 227 00:11:19,136 --> 00:11:19,796 system, or 228 00:11:19,871 --> 00:11:20,231 Yeah. 229 00:11:20,231 --> 00:11:21,671 Or well, whatever. 230 00:11:21,671 --> 00:11:21,971 Yeah, it's, 231 00:11:22,046 --> 00:11:22,496 yeah. 232 00:11:22,736 --> 00:11:25,856 So avoid caffeine and, and chocolate and stuff like that before bed. 233 00:11:25,886 --> 00:11:28,286 Um, sound, you know, go somewhere quiet. 234 00:11:28,316 --> 00:11:30,056 Um, go to bed at the same time. 235 00:11:30,056 --> 00:11:32,156 Get up at the, get up at the same time. 236 00:11:32,239 --> 00:11:33,199 Absolutely. 237 00:11:33,199 --> 00:11:33,679 Yes. 238 00:11:33,715 --> 00:11:38,474 we are really conditionable creatures, you know, we all know Pavlov's, 239 00:11:38,714 --> 00:11:43,334 Pavlov's dogs and, and, and we can do so much to condition ourselves 240 00:11:43,664 --> 00:11:45,794 to, to sleep, to sleep well. 241 00:11:46,244 --> 00:11:50,684 Um, and so you, you mentioned things about the bedroom, have the bedroom cool, dark, 242 00:11:51,134 --> 00:11:55,174 um, have a good sleeping environment, but, but, but have the bed bedroom. 243 00:11:55,338 --> 00:12:01,878 Only associated in your mind with, with sleep and intimacy and nothing else. 244 00:12:02,208 --> 00:12:02,388 No. 245 00:12:02,388 --> 00:12:04,818 Scrolling through your, and, and get, keep, get your 246 00:12:04,818 --> 00:12:06,018 phone away from your bedroom. 247 00:12:06,228 --> 00:12:07,218 Uh, oh my goodness. 248 00:12:07,378 --> 00:12:11,638 But, um, you know, when, when people are watching TV, even reading, studying, 249 00:12:11,658 --> 00:12:15,498 working, scrolling through Instagram, whatever it may be in the bedroom, 250 00:12:15,566 --> 00:12:17,366 we condition ourselves to be awake. 251 00:12:17,636 --> 00:12:20,936 And that's not even taking into account the blue light, which maybe, 252 00:12:21,026 --> 00:12:23,137 um, is also not insignificant. 253 00:12:23,467 --> 00:12:26,737 So, so all those things that we've discussed, really important. 254 00:12:26,737 --> 00:12:31,749 You've mentioned rhythm, and I think I, I, I like to con consider 255 00:12:31,749 --> 00:12:36,404 rhythm as such a massive subject in itself that it, that it warrants. 256 00:12:36,464 --> 00:12:40,064 A whole, whole discussion, a whole course, a whole, um, 257 00:12:40,304 --> 00:12:41,714 session because it's so important. 258 00:12:41,984 --> 00:12:42,284 Yes. 259 00:12:42,284 --> 00:12:45,824 Get, let's get up, let's get up consistently, get up in a good time in the 260 00:12:45,824 --> 00:12:47,594 morning and go to bed at the same time. 261 00:12:47,594 --> 00:12:51,412 'Cause 'cause then we're, I mean, do we wanna talk about the, the sleep drive? 262 00:12:51,412 --> 00:12:54,832 But the, there's two, two things that are important for sleep drive and one of them 263 00:12:54,832 --> 00:12:57,442 is circadian rhythm and that's massive. 264 00:12:57,892 --> 00:13:00,502 And so if we, if we can be consistent in when we are getting 265 00:13:00,502 --> 00:13:02,182 up, that will really help. 266 00:13:02,212 --> 00:13:04,042 And then conversely when we go to bed. 267 00:13:04,582 --> 00:13:09,082 But also resting, you know, re that, that's, um, I like to say the fight 268 00:13:09,082 --> 00:13:13,342 for the night is fought in the day and, and, and, and so we need to have 269 00:13:13,342 --> 00:13:17,962 a rhythm of rest during the day as well as during the night and during the week. 270 00:13:18,022 --> 00:13:21,112 You know, I've heard you talking about rest and, and to rest during 271 00:13:21,112 --> 00:13:24,895 the day, to rest during the week, have a day off during the week to have. 272 00:13:24,937 --> 00:13:26,857 vacation to have a holiday during the year. 273 00:13:26,887 --> 00:13:30,497 I mean, I think people who don't have a holiday, uh, they have 274 00:13:30,497 --> 00:13:33,437 the same increased cardiovascular risk as people who sleep badly. 275 00:13:33,442 --> 00:13:35,057 And, and there's probably a massive overlap. 276 00:13:35,062 --> 00:13:38,847 You, you, you are, you are 30% more likely to have a cardiovascular 277 00:13:38,847 --> 00:13:42,057 event if you, if you're somebody who doesn't have a holiday. 278 00:13:42,346 --> 00:13:45,116 Well, if you're somebody who doesn't have a holiday, there's probably a 279 00:13:45,116 --> 00:13:47,906 per, you're probably a personality type that's not gonna sleep. 280 00:13:47,906 --> 00:13:49,916 So there's probably different factors that play there. 281 00:13:50,280 --> 00:13:54,350 But, but yeah, lot, lots, lots of things under, under the heading of sleep hygiene. 282 00:13:54,350 --> 00:13:56,150 But, but they're all important. 283 00:13:56,420 --> 00:13:59,510 But, but I think rhythm is massive 284 00:14:00,234 --> 00:14:01,194 Gosh, there's a lot. 285 00:14:01,194 --> 00:14:03,384 There's a lot there that I'm quite interested in actually. 286 00:14:03,384 --> 00:14:07,246 Well, first of all, if I, I'm quite knackered, if I had a few late nights. 287 00:14:07,276 --> 00:14:09,796 Are you saying that actually it would be better for me to get up 288 00:14:09,796 --> 00:14:12,496 at 7 o'clock on a Saturday morning than to stay in bed for those two 289 00:14:12,496 --> 00:14:14,356 extra hours if I can till 9 o'clock? 290 00:14:14,710 --> 00:14:18,903 Well, there's something called, social jet lag, and I can't remember 291 00:14:18,903 --> 00:14:19,838 the name of the psychologist. 292 00:14:19,838 --> 00:14:22,148 It's a German psychologist who coined that phrase. 293 00:14:22,148 --> 00:14:24,710 Now, if, if, if it is, you know, one off. 294 00:14:24,965 --> 00:14:25,895 Yeah, then yeah, sure. 295 00:14:25,895 --> 00:14:26,945 That's, that's fine. 296 00:14:26,945 --> 00:14:31,265 You had a late night and yeah, we'll sleep in, if it's a regular pattern, which is 297 00:14:31,265 --> 00:14:34,175 for a lot of people, it's, it's, it's a massive problem for a lot of people, 298 00:14:34,175 --> 00:14:35,825 they work really hard during the week. 299 00:14:35,825 --> 00:14:37,565 They get up at five in the morning, four in the morning, 300 00:14:37,565 --> 00:14:38,945 whatever time it is, go to work. 301 00:14:39,209 --> 00:14:41,609 And then, then it's tg. 302 00:14:41,609 --> 00:14:45,419 IF thank God it's Friday party, Friday late nights watching movies. 303 00:14:45,689 --> 00:14:46,829 Same again Saturday. 304 00:14:47,117 --> 00:14:48,587 and you've just shifted your body clock. 305 00:14:48,587 --> 00:14:51,017 You might as well have flown to mo to Greece or somewhere, you know, you've, 306 00:14:51,077 --> 00:14:54,902 you've gone forward, you put your, your, um, clock forward three hours or whatever. 307 00:14:55,312 --> 00:14:59,846 and then suddenly you wanna go to bed early on Sunday and then get up early on 308 00:14:59,846 --> 00:15:02,486 Monday and it, and it's, it doesn't work. 309 00:15:02,620 --> 00:15:05,470 So, so if you're doing, if you're doing what you described on a 310 00:15:05,470 --> 00:15:10,090 regular basis and you are sleeping badly, then that's something that 311 00:15:10,090 --> 00:15:11,800 absolutely needs to be addressed. 312 00:15:11,890 --> 00:15:13,600 And, and there's a phrase for it as, as I say, 313 00:15:13,855 --> 00:15:16,825 Social jet like that, that makes a lot of sense to me. 314 00:15:16,855 --> 00:15:17,575 Okay, thank you. 315 00:15:17,575 --> 00:15:18,205 That's useful. 316 00:15:18,385 --> 00:15:19,915 One question students. 317 00:15:19,915 --> 00:15:21,295 Yeah, gosh. 318 00:15:21,500 --> 00:15:23,270 The other thing I wanted to ask you about was rest. 319 00:15:23,270 --> 00:15:26,540 So are you saying that if you are totally knackered, you've really not had any 320 00:15:26,540 --> 00:15:30,721 time to rest in the week, I would've thought, well, you're gonna sleep almost 321 00:15:30,721 --> 00:15:32,071 better 'cause you're so knackered. 322 00:15:32,071 --> 00:15:34,591 Are you saying that actually if you've not been taking the time to rest, 323 00:15:35,041 --> 00:15:36,691 the quality of your sleep is worse? 324 00:15:36,691 --> 00:15:39,661 Or you don't get to sleep as easily or you're gonna wake 325 00:15:39,661 --> 00:15:40,801 up earlier in the morning? 326 00:15:41,260 --> 00:15:43,155 Yeah, it's, it's a, it is a complex answer. 327 00:15:43,646 --> 00:15:48,925 Helping people to sleep better can involve deliberate sleep deprivation. 328 00:15:48,925 --> 00:15:52,885 So one of the most common ways of treating people, and I don't think 329 00:15:52,885 --> 00:15:57,203 it's necessarily the be all and end all is, is, is sleep restriction. 330 00:15:57,203 --> 00:15:58,343 Actually, that's, that's the phrase. 331 00:15:58,823 --> 00:16:03,773 So, so we can improve the quality or, or the technical term is the term is the 332 00:16:03,773 --> 00:16:07,703 efficiency of our sleep by restricting our sleep and then we sleep better. 333 00:16:08,344 --> 00:16:11,014 So, so to a degree that we can use that. 334 00:16:11,104 --> 00:16:15,754 But, but what is, what is bad is, is when, is when we vary 335 00:16:15,754 --> 00:16:17,314 enormously vary what we do. 336 00:16:18,004 --> 00:16:20,494 For example, during the week as compared to the weekend. 337 00:16:20,884 --> 00:16:23,944 If that's a regular pattern, that's not good. 338 00:16:24,334 --> 00:16:28,114 There, there are, there are various myths at play out there. 339 00:16:28,264 --> 00:16:31,024 I've mentioned one, one that I bought into is that, you know, 340 00:16:31,024 --> 00:16:32,194 you can have these power naps. 341 00:16:32,474 --> 00:16:36,614 Another myth is that you can catch up with lost sleep at the weekend 342 00:16:36,914 --> 00:16:40,874 and maybe to a degree you can, but you, you once sleep's lost, it's 343 00:16:40,874 --> 00:16:43,074 lost and you pay a price for it. 344 00:16:43,698 --> 00:16:46,548 So yeah, you know, if you, you get yourself exhausted during the week, 345 00:16:46,548 --> 00:16:49,368 well yes, you probably will sleep well. 346 00:16:49,368 --> 00:16:52,278 There's, we, we have rebound REM. 347 00:16:52,278 --> 00:16:57,678 you know, we, we are programmed if you like to get a certain amount of REM sleep. 348 00:16:57,678 --> 00:17:02,748 And if we deprive ourselves of sleep, then we sort of catch up with it. 349 00:17:02,838 --> 00:17:05,721 So there's a degree of catching up, which is an interesting subject. 350 00:17:05,784 --> 00:17:08,454 Because a lot of people, it's really important for people to understand 351 00:17:08,454 --> 00:17:10,824 that whole concept of REM rebound. 352 00:17:10,824 --> 00:17:15,832 A lot of people take substances to, to sleep well, or so they think 353 00:17:16,003 --> 00:17:17,683 they actually to sedate themselves. 354 00:17:17,683 --> 00:17:19,393 And I like to point out that there's a big difference 355 00:17:19,393 --> 00:17:21,133 between sedation and good sleep. 356 00:17:21,553 --> 00:17:26,678 And when they're, when they're sedated with substances, cannabis, alcohol, 357 00:17:26,958 --> 00:17:30,913 whatever it may be, they're not getting the REM sleep that, that, that they need. 358 00:17:31,243 --> 00:17:34,903 And then, so when they stop taking the alcohol cannabis, they, they 359 00:17:34,903 --> 00:17:38,923 have a, a REM rebound, and then they have these vivid dreams, and then 360 00:17:38,923 --> 00:17:41,503 they have these nightmares and, and then, and then they'll think, oh my 361 00:17:41,503 --> 00:17:43,153 goodness, I need, I need the cannabis. 362 00:17:43,153 --> 00:17:47,053 I need the alcohol to stop, stop these terrible nightmares, which 363 00:17:47,053 --> 00:17:51,433 is what I have certainly seen repeatedly, um, in the clinics. 364 00:17:51,523 --> 00:17:55,908 So sleep restriction has its place, but it's not something that that's, that's 365 00:17:55,908 --> 00:17:58,289 good when it's uneven, as it were. 366 00:17:58,502 --> 00:18:03,168 So are we saying then that REM sleep is literally the holy grail of sleeping? 367 00:18:03,168 --> 00:18:06,275 That's what we're really trying to get as much of as possible. 368 00:18:06,478 --> 00:18:06,698 No, 369 00:18:06,993 --> 00:18:08,013 Oh, okay. 370 00:18:08,283 --> 00:18:09,783 I always, I always believed that. 371 00:18:09,783 --> 00:18:12,393 'cause when I had some sleep tracker on, I was like, it was pretty 372 00:18:12,393 --> 00:18:15,453 low on REM, but, you know, high on the other things, but, okay. 373 00:18:15,723 --> 00:18:18,093 What type of sleep are we aiming for then? 374 00:18:18,210 --> 00:18:20,100 We, what we want is a nice good cycle. 375 00:18:20,130 --> 00:18:20,910 We want a good cycle. 376 00:18:20,910 --> 00:18:24,120 We want, we want the, the different, the four phases of sleep. 377 00:18:24,120 --> 00:18:25,500 We want, we want light sleep. 378 00:18:25,740 --> 00:18:30,787 We want deep sleep and, and we wanna come outta deep sleep with REM sleep. 379 00:18:31,078 --> 00:18:35,668 And you, you referenced creativity and, and the benefits 380 00:18:35,728 --> 00:18:38,808 to our emotional wellbeing. 381 00:18:38,954 --> 00:18:41,084 During REM sleep, that's massive. 382 00:18:41,384 --> 00:18:43,979 But during deep sleep where we're out of it. 383 00:18:44,353 --> 00:18:47,743 there's a lot of restoration going, a lot of muscle rebuilding. 384 00:18:47,758 --> 00:18:51,853 I, I think I'm right in saying that there's a surge in, um, growth 385 00:18:51,853 --> 00:18:55,118 hormone during, during sleep in general, but during deep sleep, a 386 00:18:55,118 --> 00:18:57,218 lot of muscle repair takes place. 387 00:18:57,218 --> 00:19:01,718 A lot of, you know, just mentioned the benefits of sleep, muscle repair. 388 00:19:01,958 --> 00:19:05,918 Athletes are much more likely to have accidents, to have, to have injuries, 389 00:19:05,918 --> 00:19:08,138 sorry if, if they don't sleep. 390 00:19:08,168 --> 00:19:10,898 So, um, and that, and there's, you know, various things there. 391 00:19:10,898 --> 00:19:13,538 There's muscle repair, there's coordination. 392 00:19:13,949 --> 00:19:16,439 Talking of, um, being poorly coordinated. 393 00:19:16,439 --> 00:19:23,489 When we're sleep deprived, we might as well be intoxicated with alcohol, and 394 00:19:23,489 --> 00:19:27,359 that, and that's something to, to re remember when you've got doctors that have 395 00:19:27,359 --> 00:19:33,479 been working really long shifts in mental, mental ability and, and coordination 396 00:19:33,779 --> 00:19:38,159 is impaired by poor sleep, just in the same way as it is with alcohol. 397 00:19:38,519 --> 00:19:39,029 But no. 398 00:19:39,029 --> 00:19:41,819 So yeah, we want, we want rem sleep, we want deep sleep and, 399 00:19:41,819 --> 00:19:43,139 and we want the light sleep. 400 00:19:43,504 --> 00:19:48,509 And, and actually understanding what light sleep is, is, has been for me and 401 00:19:48,509 --> 00:19:50,249 for many people, a game changer as well. 402 00:19:50,609 --> 00:19:54,327 Recognizing that light sleep is on the edge of consciousness. 403 00:19:54,872 --> 00:19:58,664 ' Cause a lot of people are in, are in light sleep and they're cognizant, they're 404 00:19:58,664 --> 00:20:02,794 thinking things and that what they can be thinking is, oh no, I'm not sleeping, 405 00:20:02,969 --> 00:20:04,259 when actually they're in light sleep. 406 00:20:04,334 --> 00:20:07,484 so when you've, when all night you think, I just haven't slept a wink all 407 00:20:07,484 --> 00:20:11,924 night, you probably, you know, without being like, thing I'm, I'm awake. 408 00:20:11,954 --> 00:20:16,053 But actually it's likely that for quite a lot of that, if you haven't 409 00:20:16,053 --> 00:20:18,963 been like, just looking around and thinking, should I get up or not? 410 00:20:19,413 --> 00:20:21,903 But you, you've just been conscious, you've been thinking all night. 411 00:20:22,233 --> 00:20:24,543 That might be because you've been in light sleep, not because 412 00:20:24,543 --> 00:20:25,683 you've actually been awake. 413 00:20:25,846 --> 00:20:26,416 Yes. 414 00:20:26,506 --> 00:20:29,746 There there's two conditions that are worth thinking about in relation to 415 00:20:29,746 --> 00:20:32,596 insomnia, and you've mentioned sleep tracking and, and then we could bring 416 00:20:32,596 --> 00:20:34,216 sleep tracking into the, into this. 417 00:20:34,966 --> 00:20:38,416 There's ortho insomnia and paradoxical insomnia. 418 00:20:38,712 --> 00:20:42,942 Now I absolutely remember, see, I can think of one particular case of 419 00:20:43,122 --> 00:20:46,512 what we call paradoxical insomnia, where somebody believes themselves 420 00:20:46,902 --> 00:20:51,740 to have slept badly and they have in fact slept a whole lot better. 421 00:20:51,740 --> 00:20:53,390 I just remember being on the ward. 422 00:20:53,480 --> 00:20:55,970 I was a, I was, it's my very first house job. 423 00:20:56,630 --> 00:20:59,840 Um, and just, I remember somebody snoring heavily on the ward. 424 00:21:00,020 --> 00:21:03,110 I was working during the night and then on the ward round in the morning, 425 00:21:03,110 --> 00:21:04,790 he just told me how badly he'd slept. 426 00:21:04,790 --> 00:21:05,810 And I thought, no, you didn't. 427 00:21:07,310 --> 00:21:10,310 And, and yeah, we don't remember how well we sleep. 428 00:21:10,790 --> 00:21:15,590 And that's, that's one thing, but also a lot of sleep is light sleep. 429 00:21:15,830 --> 00:21:21,440 And so if we, if we're anxious about not sleeping, we can be remembering 430 00:21:21,440 --> 00:21:24,784 when we were in light sleep thinking we were not sleeping and, and 431 00:21:24,784 --> 00:21:26,404 then counting that as poor sleep. 432 00:21:26,529 --> 00:21:29,019 So that's one of the bene there, there's pros and cons of where 433 00:21:29,019 --> 00:21:31,359 of, of, of, um, sleep trackers. 434 00:21:31,409 --> 00:21:32,879 So I've mentioned paradoxical insomnia. 435 00:21:32,879 --> 00:21:38,819 The, the value of a sleep tracker can be, and I, and I've really benefited from this 436 00:21:38,819 --> 00:21:43,816 myself in the past, is whether it's on a phone or a watch, one of the benefits is, 437 00:21:43,816 --> 00:21:45,586 looking back and thinking, oh my goodness. 438 00:21:45,765 --> 00:21:47,775 the night wasn't half as bad as I thought it was. 439 00:21:47,916 --> 00:21:49,176 And that happens so often. 440 00:21:49,440 --> 00:21:53,790 So that's so, so it is good to track your sleep, but when you start looking 441 00:21:53,790 --> 00:21:56,220 at it every, when you, well, when, when you wake up in the morning, think, 442 00:21:56,220 --> 00:21:57,270 oh no, I didn't have enough sleep. 443 00:21:57,270 --> 00:22:00,340 I didn't have enough REM, I had too much this, too little of that, then the 444 00:22:00,340 --> 00:22:04,240 whole obsession with sleep, which is what a lot of people get, particularly 445 00:22:04,240 --> 00:22:09,236 with sleep trackers, is, is in itself a cause of sleep, anxiety and insomnia. 446 00:22:09,686 --> 00:22:13,957 So I've, I've heard a number of people, uh, one person in particular in a sleep, 447 00:22:14,186 --> 00:22:18,746 sleep therapist saying, no, no to sleep trackers, but they have their place. 448 00:22:19,046 --> 00:22:20,426 But, but use them with care. 449 00:22:20,846 --> 00:22:22,946 I mean, it's, I think the same goes with blood pressure monitors. 450 00:22:22,946 --> 00:22:25,437 People start getting really anxious about their blood pressures when they're 451 00:22:25,437 --> 00:22:26,457 checking their blood pressure and 452 00:22:26,778 --> 00:22:28,128 well, any sort of monitoring, right? 453 00:22:28,128 --> 00:22:30,738 It makes you more obsessed with the figures and then you end up treating the 454 00:22:30,738 --> 00:22:34,938 figures and not, not the thing that's going on and that, that, that makes sense. 455 00:22:34,938 --> 00:22:38,898 So not a good idea to use sleep trackers unless you're sort of really needing 456 00:22:38,928 --> 00:22:40,818 it for a certain thing, perhaps. 457 00:22:40,818 --> 00:22:42,858 Or if you're the sort of person that's gonna get a bit obsessed 458 00:22:42,858 --> 00:22:44,343 by it and get worried by it, 459 00:22:44,868 --> 00:22:49,338 Yeah, I, I would say I, I'd say it's, it is often got a place, actually, 460 00:22:49,368 --> 00:22:52,458 'cause I think there's a lot of people who can be reassured by it. 461 00:22:52,518 --> 00:22:54,228 But what you've gotta do, you've just gotta do it. 462 00:22:54,228 --> 00:22:55,128 Use it with care. 463 00:22:55,198 --> 00:22:56,608 And it gives you good data, doesn't it? 464 00:22:56,608 --> 00:23:00,748 Because you can see how alcohol would affect your REM sleep or things like that. 465 00:23:00,748 --> 00:23:04,378 And that, that was one of my big disappointing discoveries is just 466 00:23:04,378 --> 00:23:06,478 the effect of alcohol in your sleep. 467 00:23:06,478 --> 00:23:09,628 And that's the one thing that's maybe cut right down, because even 468 00:23:09,628 --> 00:23:13,348 just after one unit, two units, your sleep is really disrupted, 469 00:23:13,348 --> 00:23:14,728 which is so depressing, isn't it 470 00:23:14,948 --> 00:23:14,949 is. 471 00:23:15,945 --> 00:23:19,725 but, um, and of course there are people who will use the alcohol to get to 472 00:23:19,725 --> 00:23:23,835 sleep, but even people who don't have an issue with alcohol, as you say, have 473 00:23:23,835 --> 00:23:27,133 got to be aware that they're not gonna, they're gonna knock their rem yeah, 474 00:23:27,133 --> 00:23:28,483 as you say, even with a small amount. 475 00:23:28,663 --> 00:23:30,883 Well there's, that's another reason for eating early. 476 00:23:30,943 --> 00:23:31,153 Okay. 477 00:23:31,363 --> 00:23:35,473 We, we, we mentioned mentioned, um, sleep hygiene, go backtrack to sleep hygiene. 478 00:23:35,893 --> 00:23:38,143 Eating suppresses melatonin. 479 00:23:38,143 --> 00:23:41,743 So if we're eating a big meal late in the evening and having a drink with 480 00:23:41,743 --> 00:23:45,804 it, then let's not expect to have the best night's sleep, let alone 481 00:23:45,804 --> 00:23:47,244 the dyspepsia we might be having. 482 00:23:47,408 --> 00:23:49,598 it did make me laugh when I read, um, Matthew Walker's book about 483 00:23:49,628 --> 00:23:53,078 why we sleep, the, the one piece of advice they gave about alcohol. 484 00:23:53,078 --> 00:23:56,618 They said, well, you know, we can't in any good conscience say that it's 485 00:23:56,618 --> 00:24:00,278 okay to drink alcohol for sleep, but we can say that if you get drink 486 00:24:00,278 --> 00:24:02,738 alcohol, drink it at nine o'clock in the morning because it'll be out 487 00:24:02,738 --> 00:24:04,658 your system by the night, I'm, yeah, 488 00:24:04,708 --> 00:24:08,261 So, okay, so we've got these different types of, insomnia. 489 00:24:08,291 --> 00:24:11,861 We've talked a little bit about, about sleep hygiene. 490 00:24:12,521 --> 00:24:16,936 One of the reasons I think people get difficulty sleeping or that the reason 491 00:24:16,936 --> 00:24:20,566 I find difficult sleeping is when you're suddenly waking up worrying about stuff. 492 00:24:20,826 --> 00:24:23,526 and that does interfere with my sleep sometimes. 493 00:24:23,761 --> 00:24:25,891 But now you've mentioned the sleep anxiety. 494 00:24:25,891 --> 00:24:26,926 I'm wondering whether it all sort of. 495 00:24:27,616 --> 00:24:29,566 Interacts and in and intermingles. 496 00:24:29,566 --> 00:24:33,886 So what do you think actual anxiety is a more common sleep 497 00:24:33,886 --> 00:24:35,866 blocker than sleep anxiety? 498 00:24:35,866 --> 00:24:39,256 Or do you think sleep anxiety has a, has an even bigger role than we thought? 499 00:24:39,795 --> 00:24:41,385 Well, they're all interrelated. 500 00:24:41,455 --> 00:24:46,768 One thing I would say is that, you know, recovery from sleep, and I use that word 501 00:24:46,768 --> 00:24:50,278 recovery 'cause I, I liken it almost to drug and alcohol recovery is, it's 502 00:24:50,278 --> 00:24:53,428 a journey and it's not a quick fix. 503 00:24:53,938 --> 00:24:58,498 Um, I've heard you talking, I heard you talking once about the fact that 504 00:24:58,498 --> 00:25:04,378 you are a, you help people manage stress, but you, there was a time when 505 00:25:04,378 --> 00:25:07,558 you were talking about how you were drifting into, into stress yourself, 506 00:25:07,558 --> 00:25:13,438 and, and we can know all the answers, uh, but I, it, it happens to us all. 507 00:25:13,688 --> 00:25:18,218 And I, for the me routine is a really big deal when I've lost my routine and 508 00:25:18,218 --> 00:25:21,908 then life is frantic, i've got lots of things on my mind, they may not, they may 509 00:25:21,908 --> 00:25:24,038 not necessarily be bad things, actually. 510 00:25:24,038 --> 00:25:25,358 They may just be busy things. 511 00:25:25,868 --> 00:25:27,428 A lot of things I'm thinking about planning. 512 00:25:27,701 --> 00:25:30,131 when my, when my head is, when I'm frantic, I'd say it's being 513 00:25:30,131 --> 00:25:32,771 frantic is, is a massive issue. 514 00:25:33,251 --> 00:25:35,591 Whether or not it's things you're actually anxious about. 515 00:25:35,861 --> 00:25:37,751 But yes, it's, it's a big, it's an interplay. 516 00:25:37,751 --> 00:25:41,531 So you could be anxious about, you can be anxious about whatever it is, your health, 517 00:25:41,531 --> 00:25:46,241 your, your, your, your relationships, finances, whatever it may be. 518 00:25:46,691 --> 00:25:49,691 And so of course that that's gonna be a big deal. 519 00:25:49,691 --> 00:25:52,631 So, so that's why I like to say the fight for the night is sports in the 520 00:25:52,631 --> 00:25:58,364 day, let's, let's, let's make time in the day to manage our anxieties so that 521 00:25:58,364 --> 00:26:02,415 when we wake up in the night, we can think, yeah, I've, I've parked that one. 522 00:26:02,415 --> 00:26:07,641 And, I'll tell you one massive game changer for me and this, this isn't, 523 00:26:07,641 --> 00:26:11,511 I haven't, I, I, I came across it and I hadn't a while back, and I've not 524 00:26:11,511 --> 00:26:15,612 heard anybody else say, this is during the night when you are asleep, your 525 00:26:15,672 --> 00:26:18,462 prefrontal cortex activity is suppressed. 526 00:26:18,981 --> 00:26:22,029 And I thought, wow, isn't that, that's such a big deal. 527 00:26:22,569 --> 00:26:27,009 'Cause, 'cause again, you've, you talk about chimp brain and human brain. 528 00:26:27,489 --> 00:26:33,639 Well, our human brain goes to sleep before our chimp brain does. 529 00:26:33,869 --> 00:26:36,209 And, do I, do we, do we need to talk about what that means? 530 00:26:36,209 --> 00:26:38,894 I think probably a lot of people know that, but you know, our, our, our, 531 00:26:39,329 --> 00:26:43,679 our limbic system, our amygdalas are, are, are, are much busier than our, 532 00:26:43,889 --> 00:26:45,719 our thinking brains during the night. 533 00:26:45,864 --> 00:26:48,686 So that's just say, that's our threat detection system. 534 00:26:48,686 --> 00:26:51,746 So the thing that's gonna, uh, make you feel anxious and worried and 535 00:26:51,746 --> 00:26:53,096 detect threats all over the place. 536 00:26:53,096 --> 00:26:55,226 So they, that, that's what you're talking about when talking about 537 00:26:55,226 --> 00:26:58,076 the chimp brain, the, the amygdala versus the prefrontal cortex, which 538 00:26:58,076 --> 00:26:59,666 is the rational side of things. 539 00:26:59,666 --> 00:27:03,986 So, so, and, and again, you know, when, when you, when you're lying awake and you 540 00:27:03,986 --> 00:27:07,277 can rationalize, when you can, when you, when you've got enough, consciousness to 541 00:27:07,277 --> 00:27:12,280 think, right, I'm anxious, I'm thinking about this stuff, but it's, I, I can 542 00:27:12,280 --> 00:27:15,190 actually, I can actually, I, I've done this now and it really helps, is I, I 543 00:27:15,190 --> 00:27:18,362 think, right, I don't, I don't, I can't, I'm not in a good place to think about 544 00:27:18,362 --> 00:27:20,972 what might, what, whatever it might be, this, this meeting that's coming 545 00:27:20,972 --> 00:27:24,932 up because I'm not using my prefrontal cortex, and I've been able to do that in 546 00:27:24,932 --> 00:27:28,982 light sleep and, and, and think, right, I'm gonna park it, leave it for tomorrow. 547 00:27:29,372 --> 00:27:30,482 Takes a lot of practice. 548 00:27:30,572 --> 00:27:33,692 That's where learning to be mindful comes in, I believe. 549 00:27:33,873 --> 00:27:38,643 But, but, but a big, a massive interplay between anxiety, sleep 550 00:27:38,643 --> 00:27:42,033 anxiety, and again, it's, it goes back to what I was saying earlier. 551 00:27:42,333 --> 00:27:44,133 There's a, it's a two-way street. 552 00:27:44,133 --> 00:27:48,273 Men, good mental health, poor mental health, and insomnia are a two-way street. 553 00:27:48,273 --> 00:27:50,043 One causes the other both directions. 554 00:27:50,253 --> 00:27:52,743 So I mentioned it in relation to depression earlier on, but of course, 555 00:27:52,743 --> 00:27:54,573 exactly the same applies to anxiety. 556 00:27:54,912 --> 00:27:59,504 I was in India and I saw this man with a t-shirt It, it just said in 557 00:27:59,504 --> 00:28:04,516 the daytime, I don't believe in ghosts at nighttime, I'm more open-minded. 558 00:28:04,810 --> 00:28:07,720 I thought, yes, that's, that's, that, that's exactly it. 559 00:28:07,810 --> 00:28:08,410 Um, 560 00:28:08,707 --> 00:28:12,277 Or we start just completely catastrophizing and worrying 561 00:28:12,277 --> 00:28:16,057 about stuff that, and I think sometimes your brain just even 562 00:28:16,057 --> 00:28:17,797 looks around things to worry about. 563 00:28:17,977 --> 00:28:19,657 Um, which is quite uncanny, isn't it? 564 00:28:19,657 --> 00:28:22,037 That's why useful to keep like a piece of paper by your bed. 565 00:28:22,037 --> 00:28:25,247 So I was thinking, well, I'm just gonna write it down and I'll make 566 00:28:25,247 --> 00:28:26,657 sure I worry about that tomorrow. 567 00:28:26,657 --> 00:28:30,058 So don't worry in a chimp or amygdala, I'll worry about that 568 00:28:30,088 --> 00:28:32,668 tomorrow and then tomorrow I'm like, oh, that's, that's not important. 569 00:28:32,668 --> 00:28:36,748 But I think that's, that's useful because we worry then we worry about 570 00:28:36,748 --> 00:28:39,868 the worry and then we worry about not sleeping and then we get ourselves 571 00:28:40,078 --> 00:28:41,738 mixed up in the right old muddle. 572 00:28:41,758 --> 00:28:44,668 And I guess that's, that's part of the problem with sleep anxiety. 573 00:28:44,668 --> 00:28:47,548 So we worry about not sleeping and then we worry about worrying about not sleeping. 574 00:28:47,548 --> 00:28:50,249 Before you know it, you've got a million worries all over the fact 575 00:28:50,249 --> 00:28:53,300 that, yeah, you might not have enough sleep for tomorrow or you might miss 576 00:28:53,300 --> 00:28:54,800 your alarm or, or something like that. 577 00:28:54,810 --> 00:28:58,710 What can we do if, like, if, like me, you've gotta suddenly get up really early 578 00:28:58,710 --> 00:29:01,860 because you've got keynote talk or you're gonna miss a plane, or you know, so you've 579 00:29:01,860 --> 00:29:06,193 got less than normal, you've got a early deadline and you lie awake all night. 580 00:29:06,522 --> 00:29:09,972 Or the second one, I guess is for somebody that has had a lot of trouble 581 00:29:09,972 --> 00:29:12,672 sleeping in their lives, and then it just becomes a chronic, oh gosh, am I 582 00:29:12,672 --> 00:29:14,382 going to, am I gonna get sleep tonight? 583 00:29:14,382 --> 00:29:15,192 How am I sleeping? 584 00:29:15,192 --> 00:29:15,942 All that sort of stuff. 585 00:29:15,942 --> 00:29:18,642 So do you manage those in two completely different ways? 586 00:29:18,642 --> 00:29:20,742 Or is it the same sort of thing either way? 587 00:29:20,889 --> 00:29:21,159 Yeah. 588 00:29:21,159 --> 00:29:25,731 I, I think you, you, you, you manage things together and I think you've, 589 00:29:25,791 --> 00:29:30,272 we've gotta talk about people who have chronic insomnia versus people whom 590 00:29:30,272 --> 00:29:31,652 it's just an intermittent problem. 591 00:29:32,192 --> 00:29:35,642 One thing that's really helpful to recognize is that actually it's 592 00:29:35,642 --> 00:29:38,729 not the end of the day, if you really sleep particularly well. 593 00:29:38,729 --> 00:29:39,869 You know, we can function. 594 00:29:40,139 --> 00:29:43,439 I mean, I remember one of my worst nights, actually, this is before I 595 00:29:43,439 --> 00:29:46,452 was working as a junior doctor, so maybe, this was a medical student. 596 00:29:46,452 --> 00:29:48,822 I remember the day before my pediatrics exam. 597 00:29:48,822 --> 00:29:52,922 And I, I just had this sudden thought at 8:00 PM that I, I, I 598 00:29:52,922 --> 00:29:54,662 dunno anything about pediatrics. 599 00:29:54,692 --> 00:29:56,852 And I literally stayed awake all night. 600 00:29:56,942 --> 00:30:00,359 Re I was up, I was up reading pediatrics textbook. 601 00:30:00,809 --> 00:30:01,469 Stupid. 602 00:30:01,559 --> 00:30:04,679 I mean, it just, you know, but I, I thought I've got to go through it and, 603 00:30:04,679 --> 00:30:11,039 um, and, um, but yeah, the exam went fine and it, the point being that we, 604 00:30:11,039 --> 00:30:15,569 we c if it is an occasional bad meeting, occasional meeting, and we're thinking, 605 00:30:15,929 --> 00:30:18,929 um, oh, I've gotta go to sleep well for, for that meeting tomorrow, we can also 606 00:30:18,929 --> 00:30:22,139 tell ourselves, well, even if I don't, it's not gonna be the end of the world. 607 00:30:22,469 --> 00:30:26,699 But that, so that, that's for, for, for, for the occasional. 608 00:30:27,074 --> 00:30:28,574 Um, bout of insomnia. 609 00:30:29,174 --> 00:30:32,264 For the, for the chronic in insomniac, it's, it's, it's different. 610 00:30:32,324 --> 00:30:36,314 We, we need to be more, you know, we need to be more purposeful in managing 611 00:30:36,314 --> 00:30:38,444 that on a, on a daily basis, I'd say. 612 00:30:38,885 --> 00:30:41,162 So what sort of techniques would you be recommending to people 613 00:30:41,162 --> 00:30:42,750 for, for that sort of thing? 614 00:30:43,316 --> 00:30:46,971 I, I, I have a, a, a four step approach. 615 00:30:46,971 --> 00:30:49,821 I, we, we've talked a bit about the sleep science and I, I think 616 00:30:49,821 --> 00:30:51,201 understanding sleep science is important. 617 00:30:51,201 --> 00:30:53,241 We've talked about sleep hygiene and that and that, and I would, 618 00:30:53,391 --> 00:30:54,501 that's another key thing. 619 00:30:54,501 --> 00:30:58,060 And then rhythm and then, and then what, what we massively need to 620 00:30:58,060 --> 00:31:01,780 do, having done the other things, arguably, arguably first, is to work 621 00:31:01,780 --> 00:31:04,510 on what I call having a sleep mindset. 622 00:31:04,799 --> 00:31:10,709 What I think is massive, absolute game changer. 623 00:31:11,035 --> 00:31:14,652 Is something called a, it's a more modern therapy. 624 00:31:14,652 --> 00:31:17,172 It's called Accept Acceptance and commitment therapy. 625 00:31:17,802 --> 00:31:22,082 And when we spoke, I think, I think it was May last year, so it was coming up 626 00:31:22,082 --> 00:31:27,092 to a year ago, we talked a bit about accepting the things that we can't 627 00:31:27,092 --> 00:31:32,645 control, having the courage to change the things that we can, and that's such 628 00:31:32,975 --> 00:31:38,435 a massive, massive part of my journey, and, and, and those that I have, I've 629 00:31:38,435 --> 00:31:43,355 helped to, to come to, to, um, a better place with in terms of life in general. 630 00:31:43,685 --> 00:31:46,925 But, um, in terms of bed sleeping better in particular. 631 00:31:47,375 --> 00:31:53,645 Learning to relax about the things that, that I don't have any control over. 632 00:31:53,825 --> 00:31:57,395 I don't have, nor do you, nor does anybody listening to this, generally speaking, 633 00:31:57,395 --> 00:32:01,265 we do not have the ability to say, right, I'm gonna lie down now and go to 634 00:32:01,265 --> 00:32:02,750 sleep unless you're totally exhausted. 635 00:32:03,077 --> 00:32:07,067 You can't choose to go to sleep at, I'm gonna go to sleep at 10:30 PM tonight. 636 00:32:07,493 --> 00:32:09,233 It's not within my skillset. 637 00:32:09,274 --> 00:32:14,382 And so if I learn to accept that and don't fight against that desire to 638 00:32:14,382 --> 00:32:17,142 go to sleep, I've gotta, I've gotta fall asleep, I've gotta fall asleep. 639 00:32:17,142 --> 00:32:17,832 I've don't fall asleep. 640 00:32:18,072 --> 00:32:21,942 I'm gonna be so tired if I learn to accept that, I can't control that, but 641 00:32:21,942 --> 00:32:28,376 what I can do is I can control the things that are within my skillset are what 642 00:32:28,376 --> 00:32:31,916 we talked about in terms of, our sleep environment and how much caffeine we 643 00:32:31,916 --> 00:32:35,735 drink and so on, and my, and then I can control what I choose to think about, 644 00:32:36,095 --> 00:32:41,697 and I can control how much rest I take then, then sleep probably will follow 645 00:32:41,829 --> 00:32:44,559 And so is there any other way that ACT therapy helps? 646 00:32:44,559 --> 00:32:48,009 Because I think I, I love ACT therapy and when, when I've sort of heard 647 00:32:48,009 --> 00:32:51,189 about it before, I think I've read a couple of books about it, one of the 648 00:32:51,189 --> 00:32:55,749 things that has been really powerful for me is being able to choose 649 00:32:56,109 --> 00:32:57,549 the thoughts that you latch onto. 650 00:32:58,089 --> 00:33:02,379 So sort of accepting the thoughts that's there and either just, and, and 651 00:33:02,379 --> 00:33:06,009 trying to detach yourself from, oh, I, I'm noticing I'm having the thought, 652 00:33:06,009 --> 00:33:09,789 or I am thinking rather than, or I am stressed, or I'm thinking I'm stressed. 653 00:33:09,789 --> 00:33:11,379 I'm noticing I'm having the thought, I'm stressed. 654 00:33:11,379 --> 00:33:13,809 Therefore, that you're sort of distancing yourself each time. 655 00:33:14,026 --> 00:33:14,701 absolutely. 656 00:33:14,806 --> 00:33:19,276 What particular distancing things have you found have helped you 657 00:33:19,276 --> 00:33:20,266 when it comes to the sleep? 658 00:33:20,266 --> 00:33:21,376 An anxiety. 659 00:33:21,376 --> 00:33:23,806 What's the sort of changing in the thinking that's helped? 660 00:33:23,978 --> 00:33:26,498 there are a couple of things, and the first thing you've just, first 661 00:33:26,498 --> 00:33:28,358 thing you've mentioned is, is massive. 662 00:33:28,823 --> 00:33:33,345 Is, is, is, you know, as soon as we say to ourselves, oh, I'm having a, an 663 00:33:33,345 --> 00:33:38,055 anxious thought, ooh, I can feel my heart beating, I can feel the tension in my 664 00:33:38,175 --> 00:33:42,819 neck, or whatever it is, as soon as we describe our, describe what's going on, 665 00:33:42,819 --> 00:33:45,399 we have distanced ourself to some degree. 666 00:33:46,044 --> 00:33:52,194 So, and, and, um, the phrase that I love is, um, not being at 667 00:33:52,194 --> 00:33:54,144 the mercy of, of that thought. 668 00:33:54,676 --> 00:33:58,756 So, so choosing, choosing to notice it rather than be at the mercy of it. 669 00:33:59,446 --> 00:34:03,016 Um, so that's one part of, of, that's a big part of acceptance 670 00:34:03,016 --> 00:34:03,916 and commitment therapy. 671 00:34:04,276 --> 00:34:07,096 For those that are not familiar with it, it's, it's, it's, it's a therapy 672 00:34:07,096 --> 00:34:12,466 that came, was devised by somebody called Steven Hayes in the 1980s. 673 00:34:12,466 --> 00:34:15,796 So it's really relatively, um, recent. 674 00:34:15,826 --> 00:34:21,016 I mean, I feel it's based on ancient wisdom, but big part of it is just 675 00:34:21,076 --> 00:34:24,826 learning to, to be mindful, be observant. 676 00:34:25,426 --> 00:34:30,196 And the other thing is, is what, what Stephen Hayes is and, and his and his 677 00:34:30,196 --> 00:34:36,486 successors have really helped us to do is to, is to recognize that the things 678 00:34:36,486 --> 00:34:40,066 that we worry about don't actually have the power that we think they do. 679 00:34:40,424 --> 00:34:46,484 So what ACT therapists do is they encourage, encourage us to see 680 00:34:46,484 --> 00:34:51,410 our anxieties as monsters, sleep monsters, whatever it is, you know? 681 00:34:51,470 --> 00:34:54,435 And, and, and that, that has, that has been really helpful. 682 00:34:54,885 --> 00:34:58,069 So see it as a monster that, that can't actually hurt you. 683 00:34:58,489 --> 00:35:00,529 It's like, it's like a dog that's barking. 684 00:35:00,529 --> 00:35:04,279 It's really a really scary bark dog, but it's on a lead, it's chained. 685 00:35:04,549 --> 00:35:07,355 And so it can, it can bark really loudly, but it can't actually, 686 00:35:07,390 --> 00:35:08,855 you, you know, it can't bite you. 687 00:35:08,855 --> 00:35:13,746 And if you start thinking, yeah, that dog or that monster, um, it's, that's, it's 688 00:35:13,746 --> 00:35:15,756 keeping me awake, but it can't hurt me. 689 00:35:16,046 --> 00:35:20,366 And if I, if I, if I focus on it, if I bark back at the dog or the monster, 690 00:35:20,426 --> 00:35:24,806 it'll bark back even louder and it'll, and it'll, and then I'm on a downward spiral. 691 00:35:25,166 --> 00:35:30,026 And some people will say, recognize that okay, I'll thank my amygdala 692 00:35:30,476 --> 00:35:31,321 'cause it's trying to help me. 693 00:35:31,880 --> 00:35:34,610 You know, we, our amygdalas are lifesavers, aren't they 694 00:35:34,610 --> 00:35:35,930 in the right circumstances? 695 00:35:35,990 --> 00:35:39,800 And you're crossing a field and a bull's chasing you, thank, thank God for a, 696 00:35:40,040 --> 00:35:43,670 for the amygdala, which gives you then releases the adrenaline, which causes 697 00:35:43,670 --> 00:35:46,760 the adrenaline to come up, which means you escape from the t from the bull. 698 00:35:47,060 --> 00:35:50,300 But we don't want, we don't, we don't want its help at nighttime. 699 00:35:50,660 --> 00:35:54,590 And so we can thank the amygdala if we want to, um, and, and then 700 00:35:54,590 --> 00:35:58,580 just sort of diffuse the, the power of that sleep monster. 701 00:35:58,730 --> 00:36:01,850 So I think, I think, um, the, it, it's a, it's a silly picture, 702 00:36:01,850 --> 00:36:03,140 but I, I don't mean it silly. 703 00:36:03,140 --> 00:36:06,920 It's, you know, it, it sounds, sounds a bit inane, but it actually 704 00:36:06,920 --> 00:36:10,370 works to to see your anxiety as a monster that can't actually hurt you. 705 00:36:10,554 --> 00:36:14,184 And the fact that if you engage with that dog, the anxiety or the 706 00:36:14,184 --> 00:36:16,884 monster, that actually just, it just gets louder and louder and louder. 707 00:36:17,184 --> 00:36:18,504 You've just gotta ignore it. 708 00:36:19,074 --> 00:36:22,104 It's fascinating this, this sleep mindset stuff. 709 00:36:22,134 --> 00:36:26,604 If there have been any sort of quick hacks that have really helped you, any 710 00:36:26,604 --> 00:36:32,034 sort of mantras or quick shifts that have helped you with the, that sleep mindset 711 00:36:32,034 --> 00:36:34,044 and to get rid of your sleep anxiety? 712 00:36:34,632 --> 00:36:38,832 I, I mean there are some quick fixes and one is to believe that you can do it. 713 00:36:39,402 --> 00:36:42,822 I mean, what I say to people, I say any to anybody who. 714 00:36:43,065 --> 00:36:43,995 has insomnia. 715 00:36:44,325 --> 00:36:48,375 I'll say there probably was a day when you slept like a baby. 716 00:36:49,005 --> 00:36:52,785 Nobody had to teach you how to sleep when you were a baby so you can sleep. 717 00:36:52,785 --> 00:36:55,515 So, so many people, I've heard so many people tell me, I can't sleep. 718 00:36:55,515 --> 00:36:57,555 I'm deficient in something. 719 00:36:57,555 --> 00:36:59,625 I don't, my brain doesn't produce melatonin. 720 00:36:59,625 --> 00:37:00,825 I'm, whatever it may be. 721 00:37:01,185 --> 00:37:03,825 I think they've got a lot of people truly believe they've got a 722 00:37:03,825 --> 00:37:05,745 physical cause for their insomnia. 723 00:37:06,135 --> 00:37:09,285 And you say, no, you know, you, you've got what you need and 724 00:37:09,285 --> 00:37:10,485 you once slept like a baby. 725 00:37:10,485 --> 00:37:15,705 And to, to learn to believe that you can sleep like a baby again, that's maybe 726 00:37:15,705 --> 00:37:17,505 sometimes we can have breakthroughs. 727 00:37:17,505 --> 00:37:20,895 Absolutely we can have breakthroughs and we learn how to manage certain issues. 728 00:37:21,375 --> 00:37:25,785 But I thi I think what my, what I would encourage people who've got chronic 729 00:37:25,785 --> 00:37:28,515 insomnia and when we say chronic insomnia, we mean insomnia that's 730 00:37:28,515 --> 00:37:32,475 persisted for more than three days a week for more than three months. 731 00:37:33,045 --> 00:37:34,935 Um, I'd say well see it as a journey. 732 00:37:35,299 --> 00:37:39,264 And um, another little metaphor is, which I think is really helpful. 733 00:37:39,879 --> 00:37:44,979 is somebody paddling on a boat in a, on a, on a river where everything's 734 00:37:44,979 --> 00:37:47,889 lovely and the gr trees are green and the sky is blue, the bird 735 00:37:47,889 --> 00:37:49,419 singing, it's all very ni nice. 736 00:37:49,419 --> 00:37:53,524 You're in this paddle boat and behind you is a waterfall, and if 737 00:37:53,524 --> 00:37:57,454 you stop paddling, you'll be slowly dragged back into the waterfall. 738 00:37:57,754 --> 00:38:04,204 So for me and for people that I've, um, helped, I encourage 739 00:38:04,444 --> 00:38:05,914 just to see it as a journey. 740 00:38:06,154 --> 00:38:10,444 You're gonna keep paddling and it's very similar to people maybe who've had, who 741 00:38:10,444 --> 00:38:15,917 have got tendency towards an addictive behavior or or substance, whatever. 742 00:38:16,247 --> 00:38:19,217 It's, it's not there, there aren't many quick fixes. 743 00:38:19,532 --> 00:38:22,802 So how many people do actually have a medical condition 744 00:38:22,802 --> 00:38:23,942 that means they can't sleep? 745 00:38:23,942 --> 00:38:27,812 You know, what percentage of, of everyone with insomnia will find out that there is 746 00:38:27,812 --> 00:38:30,812 a sort of physical medical reason for it? 747 00:38:30,812 --> 00:38:33,362 Is it just tiny, tiny tiny percentage? 748 00:38:33,412 --> 00:38:38,332 Yeah, it's, it's, it's relatively small there, but there are a bunch of, um, 749 00:38:38,392 --> 00:38:43,912 sleep disorders and, and there will probably be people listening to this who 750 00:38:43,912 --> 00:38:46,102 have got, who've got physical issues. 751 00:38:46,102 --> 00:38:47,662 Now there's obstructive sleep apnea. 752 00:38:48,144 --> 00:38:51,204 and that's a physical issue, which is, which is really, it's really 753 00:38:51,204 --> 00:38:55,364 significant and it is often, it's badly, it's often not diagnosed. 754 00:38:55,805 --> 00:39:01,720 Is it 2% of women, 4% of males and, and, and increased with people with obesity. 755 00:39:02,170 --> 00:39:05,170 So there's not an insignificant number of people have. 756 00:39:05,170 --> 00:39:07,900 And, and there, there is a physical cause there's, there's intermittent, 757 00:39:08,350 --> 00:39:13,878 um, sort of partial collapsing of, of the airways, which causes intermittent 758 00:39:13,968 --> 00:39:17,449 choking and snoring, having snoring, which then wakes the person up. 759 00:39:17,569 --> 00:39:20,089 Sometimes they don't really realize that they've woken up 760 00:39:20,089 --> 00:39:21,439 and then they fall asleep again. 761 00:39:21,439 --> 00:39:24,829 But they've had significant impairment of, of the normal sleep rhythm. 762 00:39:25,202 --> 00:39:28,712 Um, there's restless leg syndrome, whether that's truly a physical issue, 763 00:39:28,862 --> 00:39:30,452 you know, the sleep movement disorders. 764 00:39:30,785 --> 00:39:32,225 And that affects a lot of people. 765 00:39:32,305 --> 00:39:34,165 And that's up to 10% of people actually. 766 00:39:34,555 --> 00:39:38,125 Um, sometimes, sometimes for them there's iron deficiency, which is a factor. 767 00:39:38,385 --> 00:39:41,535 And then, and then, yeah, there, there, there are circadian rhythm disorders, 768 00:39:41,748 --> 00:39:46,368 whether that's, uh, a physical cause, but, but it's, but it's a recognized issue. 769 00:39:46,368 --> 00:39:49,308 There's narcolepsy, there's, there's, there's various other 770 00:39:49,548 --> 00:39:53,568 sleep disorders, but, but, but the biggest problem with sleep that 771 00:39:53,568 --> 00:39:56,058 causes so much distress is insomnia. 772 00:39:56,388 --> 00:40:00,648 And the one, perhaps the most single, most important factor is sleep anxiety. 773 00:40:01,134 --> 00:40:02,604 Um, I guess that's good news, isn't it? 774 00:40:02,604 --> 00:40:05,214 Because that means that we can overcome it. 775 00:40:05,214 --> 00:40:06,744 That means it can get better. 776 00:40:06,744 --> 00:40:07,614 It's a journey. 777 00:40:07,614 --> 00:40:10,284 Just because you don't see it well now doesn't mean you are never going to 778 00:40:10,284 --> 00:40:14,544 be able to, but it's gonna take, gonna take a bit of time, gonna take a bit of 779 00:40:14,544 --> 00:40:16,224 effort, and I guess it's like everything. 780 00:40:16,597 --> 00:40:19,867 Wouldn't it be great if there was just pill you could take and totally cure it? 781 00:40:19,867 --> 00:40:24,007 Unfortunately, with sleeping, we, the pills often make it worse, don't they? 782 00:40:24,007 --> 00:40:26,497 Or, yeah, they cause they cause extra problems. 783 00:40:26,497 --> 00:40:28,717 But like you said, it's a journey. 784 00:40:28,777 --> 00:40:29,917 It takes work. 785 00:40:29,947 --> 00:40:32,591 But the great news is you're in control of it. 786 00:40:32,591 --> 00:40:35,651 If it's to do with the way we are thinking and what's in our mind, 787 00:40:35,651 --> 00:40:37,361 then there are things we can do. 788 00:40:37,527 --> 00:40:40,167 Yeah, and actually you, you asked about physical causes of insomnia. 789 00:40:40,167 --> 00:40:43,178 What I didn't think to say is, yeah, there's a lot of people 790 00:40:43,178 --> 00:40:45,368 who've got secondary insomnia. 791 00:40:45,368 --> 00:40:48,158 So insomnia is, there's different ways of categorizing it. 792 00:40:48,428 --> 00:40:50,618 And one way is primary versus secondary. 793 00:40:50,888 --> 00:40:56,348 And secondary is secondary to what may be a physical or, or a secondary, uh, 794 00:40:56,378 --> 00:40:58,028 physical or a mental primary cause. 795 00:40:58,028 --> 00:41:02,648 So, you know, we've talked a lot about the mental health issues that may be 796 00:41:02,648 --> 00:41:05,738 the underlying cause for insomnia, but of course there's a lot of people who 797 00:41:05,738 --> 00:41:08,136 can't sleep 'cause of pain, genuine pain. 798 00:41:08,589 --> 00:41:12,589 And, and so the clinic I am, working in at the moment in London is, is for people 799 00:41:12,589 --> 00:41:19,399 who are, have ended up on high doses of prescribed opiates and benzodiazepines. 800 00:41:19,810 --> 00:41:23,800 And so they, they will attribute their poor sleep to their backache, 801 00:41:23,800 --> 00:41:27,040 their sciatica, their postoperative pain, whatever it may be. 802 00:41:27,040 --> 00:41:29,710 And that probably is a factor, but actually. 803 00:41:29,909 --> 00:41:34,799 It always invariably becomes compounded and it becomes a mixed picture. 804 00:41:34,799 --> 00:41:39,619 And, and so the anxiety aggravates the pain and, and, and, and very 805 00:41:39,619 --> 00:41:42,889 often, even though there may be some genuine underlying pain that's 806 00:41:42,979 --> 00:41:48,049 coming into play, if we can deal with the, the mindset, then we can make 807 00:41:48,049 --> 00:41:49,219 things a whole lot more tolerable. 808 00:41:49,219 --> 00:41:53,764 And of course, a, a big part of pain management is, is the mindset as well. 809 00:41:53,975 --> 00:41:56,855 I know you've sort of mentioned mindfulness earlier on, but you know, 810 00:41:56,855 --> 00:42:00,215 that's a huge part of pain management as well, and I can imagine it's part of sleep 811 00:42:00,215 --> 00:42:01,535 management and, and everything like that. 812 00:42:01,535 --> 00:42:07,496 So just yet another reason why meditation, that sort of thing can be really helpful. 813 00:42:08,156 --> 00:42:10,937 Steve, there, there's so much we could talk about with this. 814 00:42:10,997 --> 00:42:14,357 Um, and in a minute, I know you've got a, a course that you've done. 815 00:42:14,357 --> 00:42:17,778 So anybody who wants to dig in deeper to this will be able to, do this 816 00:42:17,778 --> 00:42:22,038 course and that find out more and, and really hear some of your tips and 817 00:42:22,038 --> 00:42:24,228 techniques in, in much greater detail. 818 00:42:24,595 --> 00:42:27,355 Could you just share what was your top three things? 819 00:42:27,355 --> 00:42:29,605 You know, if, if someone came to you and they said, right, 820 00:42:29,845 --> 00:42:30,775 well, I'm, I'm struggling. 821 00:42:30,775 --> 00:42:32,455 I can't really find a cause. 822 00:42:32,455 --> 00:42:34,975 I'm not really, um, in, in any pain. 823 00:42:34,975 --> 00:42:37,705 I don't think I've got a physical thing, but it's just, just getting worse. 824 00:42:37,705 --> 00:42:41,785 What was your, what would the basics we would say, okay, these three things, just 825 00:42:41,785 --> 00:42:43,735 go and do, go and have a look at now? 826 00:42:44,115 --> 00:42:50,073 The number one and two is to pray whether or not you believe anybody's 827 00:42:50,073 --> 00:42:52,773 listening, still pray the serenity prayer. 828 00:42:53,013 --> 00:42:57,153 God give me the grant, me the serenity, and we talked about this, 829 00:42:57,213 --> 00:42:59,073 to accept the things I cannot control. 830 00:42:59,283 --> 00:42:59,883 That's number one. 831 00:42:59,883 --> 00:43:01,353 Accept the things I cannot control. 832 00:43:01,353 --> 00:43:02,733 I cannot control my insomnia. 833 00:43:03,063 --> 00:43:04,533 Accept it, don't fight it. 834 00:43:05,139 --> 00:43:10,153 Number two, courage to change the things I can and again, that's massive. 835 00:43:10,153 --> 00:43:13,813 And, and I guess what I was gonna say for number three really comes onto 836 00:43:13,813 --> 00:43:20,293 number two, but I'm gonna say anyway, is, is really work on a healthy routine. 837 00:43:20,783 --> 00:43:21,623 I love this expression. 838 00:43:21,623 --> 00:43:23,543 Somebody said, put your phone to bed. 839 00:43:23,691 --> 00:43:24,561 Parent your phone. 840 00:43:24,681 --> 00:43:28,251 You know, we, we, those of us that have had kids, we like to put our beds, our 841 00:43:28,251 --> 00:43:32,189 kids to bed at an early, an early time so that we can then enjoy the rest of the 842 00:43:32,189 --> 00:43:33,629 evening without whilst they're asleep. 843 00:43:33,869 --> 00:43:36,909 We'll, put your bed, put your phone to sleep, leave it in another room. 844 00:43:37,453 --> 00:43:39,553 I mean that is my number one sleep tip. 845 00:43:39,553 --> 00:43:42,913 Whenever we do any training, it's like, yeah, 'cause uh, you check 846 00:43:42,913 --> 00:43:47,083 your phone or, and the main problem is, is everyone uses their phone. 847 00:43:47,083 --> 00:43:48,103 It's an alarm clock. 848 00:43:48,463 --> 00:43:51,373 And this is probably part of the reason why I can't sleep when I go away, because 849 00:43:51,373 --> 00:43:52,783 of course I don't take my alarm clock. 850 00:43:52,783 --> 00:43:53,593 So I use my phone. 851 00:43:53,593 --> 00:43:56,743 But then what you did before, the minute you just about to go to sleep, 852 00:43:56,743 --> 00:43:59,511 you check that you've set your alarm on your phone and while you're there, 853 00:43:59,511 --> 00:44:02,301 you check your texts, you check your messages and you think, well, 854 00:44:02,301 --> 00:44:03,411 while I'm here just check my emails. 855 00:44:03,411 --> 00:44:04,281 And what am I doing tomorrow? 856 00:44:04,281 --> 00:44:07,101 Check your diary and before you know it, you've done half an hour more of work. 857 00:44:07,581 --> 00:44:08,781 So forget the blue light. 858 00:44:08,781 --> 00:44:09,201 Forget anything. 859 00:44:09,231 --> 00:44:14,421 It just intrudes in, it makes work and everything else that you get obsessed 860 00:44:14,421 --> 00:44:17,631 with and distracted by, intrude into everything and so no wonder can't 861 00:44:17,631 --> 00:44:18,921 sleep because your brain is going. 862 00:44:18,921 --> 00:44:23,391 And even at home, when I find, when I've maybe got my phone next to my 863 00:44:23,391 --> 00:44:25,851 bed, 'cause maybe one of my teenagers out really late and I think, well, 864 00:44:25,851 --> 00:44:29,121 I can't put my phone down, so I need to be able to hear it if they're in 865 00:44:29,121 --> 00:44:33,894 trouble, I find myself scrolling on it, even when I know it is just stupid. 866 00:44:34,193 --> 00:44:35,243 It's so annoying. 867 00:44:35,273 --> 00:44:38,423 So I think number one tip, and honestly I have bought myself an 868 00:44:38,423 --> 00:44:42,653 alarm clock, and it's a digital one because I hate ticking, from Amazon. 869 00:44:42,653 --> 00:44:44,063 It costs like 20 quid. 870 00:44:44,063 --> 00:44:47,108 It's honestly the best buy ever, and it's really reliable. 871 00:44:47,108 --> 00:44:50,378 It never, it never alarm, never doesn't go off and all that. 872 00:44:50,378 --> 00:44:54,608 So it's, you know, honestly, top tip, I think Steve, that's absolutely 873 00:44:54,749 --> 00:44:57,149 I just make add to that actually, there, there I, I have 874 00:44:57,149 --> 00:44:58,919 what I call a Sabbath phone. 875 00:44:59,083 --> 00:45:01,783 ' Cause because it's, you know, Sabbath is not, is not, doesn't 876 00:45:01,783 --> 00:45:02,653 have to be anything religious. 877 00:45:02,653 --> 00:45:04,903 It's about just means having a rest, have a rest once a 878 00:45:04,903 --> 00:45:06,313 week, have a digital Sabbath. 879 00:45:06,463 --> 00:45:09,883 But we, we, goodness me, you know, I, I, I like listening to music. 880 00:45:09,883 --> 00:45:13,813 So my, I've used my, I need, I need my phone for Spotify and then 881 00:45:13,813 --> 00:45:17,083 I, I like to do meditations and I use the me the phone for that. 882 00:45:17,263 --> 00:45:21,753 Well have a phone that doesn't have your email, your Facebook and everything else. 883 00:45:21,753 --> 00:45:24,649 A separate phone that you use when you are off duty. 884 00:45:24,859 --> 00:45:25,463 Even better. 885 00:45:25,463 --> 00:45:26,573 I'm looking around my desk. 886 00:45:27,113 --> 00:45:27,953 Oh, it's over there. 887 00:45:28,013 --> 00:45:30,503 I've got a thing called a brick, which I haven't used yet. 888 00:45:30,683 --> 00:45:31,675 Have you heard about the brick? 889 00:45:31,675 --> 00:45:33,355 Well, I've heard of people referring to their 890 00:45:33,505 --> 00:45:34,015 No. 891 00:45:34,075 --> 00:45:36,595 This is an actual brick and, hang on, I'm just gonna get it. 892 00:45:36,595 --> 00:45:41,032 Wait a sec. Can I just say, I have no financial interest in the brick company, 893 00:45:41,032 --> 00:45:42,232 but my friends told me about this. 894 00:45:42,471 --> 00:45:44,121 And it comes in a little box. 895 00:45:44,181 --> 00:45:45,411 You stick it on your fridge. 896 00:45:45,741 --> 00:45:50,301 And what the brick does, you download the app onto your phone and the it turns your 897 00:45:50,301 --> 00:45:52,431 phone into a brick phone, into a no phone. 898 00:45:52,461 --> 00:45:56,151 Or you can choose what apps you want it to access and what it blocks. 899 00:45:56,151 --> 00:46:00,261 But if you want to unlock it, you literally have to go and tap your 900 00:46:00,261 --> 00:46:01,491 phone on the brick to unlock it. 901 00:46:02,031 --> 00:46:05,811 So it turns your smartphone into a brick or, or, or whatever you want. 902 00:46:05,811 --> 00:46:08,151 So you could leave Spotify on it, for example. 903 00:46:08,631 --> 00:46:10,131 Um, and everything that you need. 904 00:46:10,194 --> 00:46:13,629 you can, then you can choose, you don't have to have everything 905 00:46:13,629 --> 00:46:16,149 off your phone, but I thought that was absolute genius idea. 906 00:46:16,149 --> 00:46:17,679 So yeah, I have to set that up. 907 00:46:17,709 --> 00:46:19,565 Anyway, steve, it's been wonderful to have you with us. 908 00:46:19,565 --> 00:46:22,175 If people wanna find more about you and more about your sleep 909 00:46:22,175 --> 00:46:24,545 course and everything else that you do, where can they find you? 910 00:46:24,545 --> 00:46:25,375 Where's the best place to go? 911 00:46:25,520 --> 00:46:31,855 so I, I've set up a website, it's called fightforthenight.com, and I've 912 00:46:31,855 --> 00:46:35,965 got a sleep course on there, which is, um, expanding really all the 913 00:46:35,965 --> 00:46:37,375 things that we've been talking about. 914 00:46:37,634 --> 00:46:43,004 And, um, I'm delighted to be able to offer, I think it's really, really 915 00:46:43,004 --> 00:46:48,048 very well priced anyway, but for anybody who follows your podcast, 916 00:46:48,138 --> 00:46:54,838 we've got a, a code, which is FROG20, which gives you a 20% discount. 917 00:46:55,136 --> 00:46:56,546 So do, do, check that out. 918 00:46:56,546 --> 00:46:58,016 Use that code as a discount. 919 00:46:58,016 --> 00:47:01,826 I think, you know, if you struggle with sleep, then get on and do this course. 920 00:47:01,826 --> 00:47:06,026 It's part of their like courage to change the things that you can get yourself. 921 00:47:06,026 --> 00:47:07,136 Get yourself educated. 922 00:47:07,136 --> 00:47:08,666 Get a book, read the Matthew Walker. 923 00:47:08,666 --> 00:47:11,756 Why we, why We sleep book and all that sort of stuff. 924 00:47:11,926 --> 00:47:14,656 Steve, thank you so much for being here and, uh, be good to 925 00:47:14,656 --> 00:47:15,946 chat again soon at some point. 926 00:47:15,946 --> 00:47:16,546 Thank you. 927 00:47:16,546 --> 00:47:17,116 My pleasure. 928 00:47:17,116 --> 00:47:17,986 Thank you for having me. 929 00:47:19,200 --> 00:47:20,130 Thanks for listening. 930 00:47:20,230 --> 00:47:24,690 Don't forget, you can get extra bonus episodes and audio courses along with 931 00:47:24,780 --> 00:47:29,610 unlimited access to our library of videos and CPD workbooks by joining 932 00:47:29,690 --> 00:47:34,150 FrogXtra and FrogXtra Gold, our memberships to help busy professionals 933 00:47:34,150 --> 00:47:37,120 like you beat burnout and work happier. 934 00:47:37,493 --> 00:47:41,013 Find out more at youarenotafrog.com/members.