Steven Bartlett: What are the most popular questions people come to you with as a sleep doctor?

Dr. Michael Bruce: There's three biggies. Number one is, "What do I do if I fall asleep, okay, and I wake up in the middle of the night and I can't fall back asleep?"

Steven Bartlett: And you can help people with that.

Dr. Michael Bruce: Absolutely. The second question is, "What pillow should I buy?" And I'm going to walk you through which pillows make sense for which people. And then another one that people ask me all the time is, "What's the best time to have sex?"

Steven Bartlett: That's a strange thing for somebody of your profession to be

Dr. Michael Bruce: about. Well, let me explain why. So, I've been an actively practicing sleep specialist for 26 years. I take care of people's sleep problems like apnea, insomnia, and I'm really interested in the things that you might be doing right now that are messing up your sleep that are easy to fix. So, for example, most people don't know that they have a genetic sleep code inside them called their chronoype, which decides when your brain releases things like melatonin, cortisol, adrenaline, and dopamine. And so I can show you based on your chronotype when it's bedtime, but also the perfect time of day to do almost any activity, including the perfect time to have coffee and alcohol. Crazy. There's even data to show that your ability to understand complicated concepts improves when you're more in line with your chronoype. Now, there are three known chronotypes, but what I'm famous for is discovering a fourth one, which I think might be you. So, we're going to talk a lot about that. We're also going to talk about dreams because dreams can tell you things about yourself that you may not want to know. And then there's how to fix jet lag, whether you should sleep with a TV on, the truth about melatonin supplementation, and my favorite way to get magnesium.

Steven Bartlett: Before we get into all of that, shall we go and look at the best possible sleep position?

Dr. Michael Bruce: Yeah, let's check it out.

Steven Bartlett: Dr. Bruce, yes. What is it you do? Why does it matter so much now? And what perspective do you take on what you do that is atypical versus other people I might have spoken to about this subject?

Dr. Michael Bruce: I'm a sleep doctor. I take care of people's sleep problems like apnea, narcolepsy, insomnia, things like that. I've dedicated a good portion of my career not just to understanding how to treat those disorders which are sleep disorders, but what I also I call disordered sleep. I'm really interested in behavioral habits. What's going on? what are the things that you might be doing right now that are kind of messing up your sleep that are easy to fix and be able to maybe change how things are going forward? You know, I I didn't start out thinking I was going to become a sleep doctor if I'm going to be honest with you. Like that that was not on the on the path. I was actually going in a completely different direction. And one of the things I really discovered was when you change someone's sleep, dude, you change their life. Like it is fundamental to who they are. And it's important for me to be a sleep educator in a way, shape, and form that's practical so that people can actually get something from what I'm talking about and apply it right then and there.

Steven Bartlett: And there's probably a couple of million people that have clicked onto this conversation to listen.

Dr. Michael Bruce: Yeah.

Steven Bartlett: Who is this conversation for?

Dr. Michael Bruce: I think it's for anybody out there who's either curious about sleep or wants to try to improve their sleep or maybe suspicious that they could have a problem with their sleep. I think any one of those three types of people would find tremendous value here. And what are we going to be able to do for those people today specifically?

Dr. Michael Bruce: So, I'm going to give people several different like plans, if you will, maybe even a five-step plan of things that they can absolutely learn how to do. They're also going to learn about a genetic sleep code that they have inside them called their chronoype. A lot of people don't even know that they have a chronoype or maybe they've heard of the of the idea, but they haven't ever heard of the term. We're going to learn a lot about that. We're also going to talk about dreams a little bit. I'm excited to have the opportunity to do that. I've spent the last year and a half learning more about how to use dreams in my clinical work as a psychologist, which is very interesting stuff. So, I'm excited to share some of that. So, I think people are going to learn a whole bunch.

Steven Bartlett: And dreams matter.

Dr. Michael Bruce: Oh, yeah. They absolutely matter. I'm I call dreams emotional metabolism, right? And so, when you're dreaming, what is you what is the function? What is the purpose? What are you doing? You're actually working through your emotional states that you had during the daytime. this is why we have nightmares, right? And so in a nightmare, it's a scary scene and all a sudden it gets so emotional, you wake up. That is officially called a nightmare. That awakening, but you stop processing. And when you go back to sleep, you go back to the dream and you get to that scary point, you wake up again and you get caught in this loop, right? And so dreams matter because they can be incredibly disruptive. Also, they can tell you things about yourself that you may not want to know or may not have in the front of your mind at all times. Right? Sometimes people have very interesting dreams like dreams of being chased or dreams of their teeth falling out or all these different things and they can mean a whole host of different things. But I want to be super clear. There's no guide book that says, "Hey, you know, if you're if you're dreaming of that you're in water, you hate your mother." Like, it doesn't really work that way. Dreams mean something to the dreamer. And so the goal is to understand the context within that. So who is the dreamer? What is the dream? And then how do those two work together?

Steven Bartlett: And what is the experience that you're drawing from academically but also professionally? Give me a view of how many people you've worked with and the range of things people come to you with.

Dr. Michael Bruce: Yeah. So I've been an actively practicing sleep specialist for 26 years. So I work in offices with medical doctors cuz I'm not a medical doctor. I have a PhD and I work with them on their patients. lot of insomnia patients but also the apneas, the restless legs, the narcolepsies of the world because I have kind of a unique distinction in that I'm one of 168 people in the world who took the medical boards without going to medical school and passed. So I can work within that framework and really understand a lot of what's going on. I don't prescribe medication, but if I'm honest with you, most people don't need sleep medication as far as I'm concerned. I can get them to sleep usually without any medication at all.

Steven Bartlett: And you're a psychologist as well?

Dr. Michael Bruce: I am. I'm a clinical psychologist.

Steven Bartlett: And how does those two worlds make 1 plus 1 equal three?

Dr. Michael Bruce: Sure. So when you talk about sleep, psychology is all over the place. I would argue 75% of the reason people don't sleep is anxiety or fear. That really falls well within the range of psychology for sure. Um, and it's different kinds of fears. It's fears that you know about that are right in your face, like something that's going on in your daytime, but it could be other fears. It could be fears of your relationship. It could be financial fears. It could be a whole host of different things. So, I think there's a lot of psychology that gets to be played in all of this kind of thing.

Steven Bartlett: I got two more questions before we really get into the details and specifics and start really helping the audience with whatever they're dealing with. The first is we have lots of props here.

Dr. Michael Bruce: Yes.

Steven Bartlett: Give me a a topline view of the types of things you're going to show me and why you've brought all of these wonderful props.

Dr. Michael Bruce: Absolutely. So, I get asked a lot of questions as you might imagine and um one of the big questions that I get asked is what bed and pillow should I buy? So, sitting next to you is a large stack of pillows, all different types, actually. And I want to be able to show some of your viewers how you look at pillows and which pillows make sense for which people. Believe it or not, there's like a fitting process. We're going to go through that. This device right here is a sleep test, believe it or not. So, it used to be we'd have to send you to the hospital. Yeah, you can unwind it. Uh, you have to send you to the hospital. We'd put 27 electrodes all over your body, respiratory belts across your chest. We'd have cameras zoomed in on you. And then, by the way, you're supposed to be able to go to sleep, right? And we're supposed to be able to monitor you. Now, historically, we were able to do that pretty well. But once COVID hit, nobody wanted to sleep in the same bed that somebody else had been sleeping in the day before. So, now we have what are called HSTS or home sleep tests.

Steven Bartlett: Wow.

Dr. Michael Bruce: Yeah. We'll talk about how to use it and and what it can tell you.

Steven Bartlett: My last question before we get into the details is what are the most popular questions that people come to you with as a sleep doctor?

Dr. Michael Bruce: Yeah. So, I'd say there's probably three biggies, right? Number one is, "Hey, Dr. Bruce, I fall asleep just fine, but I wake up somewhere between 1 and 3:00 in the morning, and it either takes me 20 minutes or 3 hours to fall back asleep. What the heck is going on there?"

Steven Bartlett: And you can help people with that.

Dr. Michael Bruce: Absolutely. I'm going to give everybody a exactly what I do in clinic. Like, I'm going to explain to everybody exactly what I say to my patients and how to go about getting through that particular problem because it's it's so flagrant. Everybody needs to know how to how to work with that. The second question would be um what bed should I buy or what pillow should I buy? I think we're going to address that over here. Um and then another one that people ask me all the time is, you know, is there some kind of timing? Is there some like I feel like my body is off. They say this all the time. They're like, if I just lived in a different time zone, I feel like everything would work out well. So the very basics of sleep.

Steven Bartlett: Uhhuh.

Steven Bartlett: What do I need to know about what sleep is, the role it solves for us to even understand the context of the things we're going to talk about today?

Dr. Michael Bruce: Yep. There's only a few things that are truly important to understand about sleep. One is how does sleep work in the brain. It turns out that there's two separate systems in the brain. One is called your sleep drive. The other is called your sleep rhythm. And they both work uh in an interesting way. They're both a little bit like hunger, right? So sleep drive is like hunger because right I'm hungry. I'm hungry. I'm hungry. I eat something. that hunger begins to dissipate. Same holds true with sleep. The longer you stay awake, the more the more sleepy that you get. When you look at it from a biology standpoint, it's kind of interesting. So, when a cell eats a piece of glucose, something comes out the back end. One of those things is called a denisonin. It works its way through your system and goes to a very specific receptor area, as a denisonin accumulates, you get sleepier and sleepier and sleepier. Now, why am I going into so much detail? Turns out when you look at a denisonin and you look at caffeine, they're off by one molecule. So, here's a little tip or trick early in the pod for everyone. I call it the nappa latte. So, what you do is you take a cup of drip black coffee, just throw in a couple of ice cubes, right? Merely to cool it down, drink it as fast as you can, and immediately take a 25minute nap. The adenosin that's built up in your brain will burn through while you're napping. Caffeine, since it's so close in molecular structure, can fit into that receptor site. It blocks any new adenosin. You're good for four hours, guaranteed. I use it with every CEO that I work with. So, let's say you only got three hours of sleep the other night and you've got a big presentation to do or an awards ceremony or something like that. You can do a nappa latte for about 25 minutes or so and you will feel much better. That's sleep drive.

Steven Bartlett: Let me just

Dr. Michael Bruce: Sure.

Steven Bartlett: I want to make sure I really understand this. Can you explain this to me again as if I'm a 16-year-old? by having a coffee and then taking a nap would make me feel energetic because one would think that having a coffee and taking a nap are like

Dr. Michael Bruce: would be almost impossible, right? So, number one, the caffeine doesn't kick in before the end of the nap. So, a lot of people think when I drink coffee, boom, it just kind of spins up and all a sudden I'm able to, you know, I get a lot of energy from it. That's really not actually how caffeine works. It has to go down, has to get absorbed, has to be digested. And so while all that's going on, which takes approximately 25 to 30 minutes, you're actually taking a nap to lower the amount of adenosin that has built up in your brain. Let's say it's 2 o'clock in the afternoon and you only slept for 4 hours and you are dragging, right? All that adenosine that's built up when you take that 25minute nap, you'll burn through a lot of it and then caffeine fits in and blocks any additional adenosin from coming in. So that way you're actually adding caffeine to the situation and boom, your energy goes straight. Okay. So adenosine is makes me tired when it's docked in my brain.

Steven Bartlett: Exactly.

Steven Bartlett: So I have 4 hours sleep which means there's lots of adenosine and sleep get clears the adenosine.

Dr. Michael Bruce: Correct. And then caffeine comes in because it fits so perfectly into that receptor site

Steven Bartlett: and off you go. That's sleep drive. Sleep rhythm has to do with your circadian rhythm. Right. And so lots of lots of information about that. But basically your circadian rhythm is also a lot like hunger. Right? You ever notice you're hungry around breakfast time, around lunchtime, around dinner time, right? That's your circadian rhythm for hunger. For sleep, most people, at least here in North America, have a tendency to fall asleep somewhere between 10:30 and 11:00, 11:30 at night. So, that's kind of the circadian rhythm there. So, when your circadian rhythm is high and your drive is high, you sleep. But if either one of them is off, that's when you have a sleep disorder or disordered sleep.

Steven Bartlett: My circadian rhythm is high.

Dr. Michael Bruce: When your circadian rhythm is on point, high is probably not the right word. On point. So meaning you are abiding by your circadian rhythm. Now another question you might say to me is well how do I know what my circadian rhythm is? And we're going to talk a lot about chronotypes cuz that's what your circadian rhythm is.

Steven Bartlett: Okay. So let's do chronotypes then. You've got some cards in front of you.

Dr. Michael Bruce: I do. I kind of like these cards. So when we talk about chronotypes, a lot of people may have heard of the idea but not actually heard the term chronoype before. So if anybody out there has ever been called an early bird or a night owl, those are chronoypes. So, we've got early birds. These are people who, by the way, this is genetic. You don't you don't actually get to choose this. There's a special area on your genome called the PER3 area. And when you have something called a single nucleotide polymorphism or a snip. If it's flipped one way, you're an early bird. If it's flipped another way, you're a night owl. If it's not flipped, you're in the middle. Okay? So, so far, I haven't told anybody anything new. Like, this is this is all stuff that we've already learned. The new part is this irregularity that seems to happen for people during for their sleep schedule. Specifically, an irregularity in their melatonin and cortisol production. So, all of this is predicated on when does your body make melatonin. So, if you're an early bird, your body makes melatonin earlier in the night starting at around 8:00 in the evening. Makes you want to go to bed around 9:30. You have a question.

Steven Bartlett: So, melatonin is a hormone

Dr. Michael Bruce: it is

Steven Bartlett: that

Dr. Michael Bruce: you produce inside of your body that actually helps you sleep. It guides, it tells your body when it's bedtime, which is a little bit different than the adenosine, which makes you feel sleepy.

Steven Bartlett: I guess people listening now would be asking themselves, why does it matter to know my chronotype? Like, as it relates to my productivity, the way I live my life, my relationships, whatever matters to me, why does it matter?

Dr. Michael Bruce: Because I can show you based on your chronoype the perfect time of day to do almost any activity. So if you f if you know when your body is doing certain things, when it has melatonin or when it has cortisol or adrenaline or all these other things, if you know the schedule, you can actually just change your activity to when your body is naturally producing the hormone and then you do the hormone better.

Steven Bartlett: Okay,

Dr. Michael Bruce: so let's talk about the easy one, which is sex, right? So a lot of people want to know, "Hey, Michael, what's the best time to have sex?" By the way, I think that might be the third question that I get asked most um often other than uh the insomnia one and the mattress one I think is what's the best time for sex might be the the other question that I get asked more than anything.

Steven Bartlett: Must be tricky if you the time you want to have sex and the time your partner wants to have sex are off.

Dr. Michael Bruce: Well, think about it like this. What if your partner's an early bird and you're a night owl?

Steven Bartlett: Yeah, I think that's me.

Dr. Michael Bruce: Don't worry, we're we're going to be able to fix you. So, first of all, there's a couple of different answers to this question. So, number one is you want to have a time. So, first of all, most people are intimate between 10:30 and 11:30 at night. That's just a survey that we did. So, it makes kind of a lot of sense. But here's what's interesting is your hormone profile doesn't look too good at 11:30 at night for having sex. In order to have successful sex, you want to have estrogen, testosterone, progesterone, adrenaline, and cortisol all to be high and melatonin to be low. What do you think your hormone profile looks like at 10:30 at night?

Steven Bartlett: It's literally the opposite, right? Melatonin is high and all those other things are low. That's hint number one as to when would probably be the best time to have sex. Hint number two, if you happen to be having sex with somebody who was born biologically male, what do most men wake up with in the morning? An erection. If that's not mother nature telling you when to use that thing, I don't know what is. Right? So, when you start to look at it, and we actually did the surveys, we discovered that people actually have greater connection and greater performance in their sex when they have sex in the morning time. Now, do you have to brush your teeth and throw in a little mouthwash first? Yes, of course you do. Like, let's be fair to your partner here. But you end up learning quite a bit. Again, your body is telling you this is actually the perfect time to do something like this. Did you know there's like a perfect time to have coffee?

Dr. Michael Bruce: I didn't.

Steven Bartlett: Yeah, there's absolutely a perfect time based on your chronoype, too. One of the first things that I ask people all the time, I'll ask you, um, is the first liquid that crosses over your lips in the morning caffeinated?

Dr. Michael Bruce: Yes. So, let's talk about why that's probably not the best idea. So, most people don't know, sorry, most people don't know, but uh sleep in and of itself is a dehydrative event. You lose almost a full liter of water just from the humidity in your breath by by breathing all night long. Caffeine is a diuretic, which mean it makes you have to go pee. So, when you're already lost a liter, now you add a couple of cups of caffeine, which makes you have to pee, you're going to turn into a raisin before this whole thing is through. Okay? So, we need to get some water inside of you. And so, one of the big recommendations that I give all of my patients is don't have caffeine for the first 90 minutes you're awake. Now, you're going to sit here and say, "9 minutes? That's a Michael? That's a long time not to have any caffeine." Like, how am I going to do that? Like, I've got my morning routine. I can smell the coffee in the morning. It smells so good. Everything's going. How's how's this going to work? Let me explain the biology. In order to exit a state of unconsciousness, you need two hormones, and you need a lot of them. You need adrenaline and cortisol and they both wake you up. When you have a brain that's full of adrenaline and cortisol and you add caffeine to it, it's like it's like adding weak tea to somebody who's taking cocaine. Okay? It's not a very powerful stimulant compared to the hormones that are in your brain that are a powerful stimulant. But if you just wait 90 minutes, cortisol and adrenaline naturally drop. If you have your caffeine, then it actually boosts the cortisol and gives you a bigger bang for your buck. M

Steven Bartlett: so you hydrate before you caffeinate and about the amount somewhere between 15 and 20 ounces of water if you can get that down in the first hour and a half that you're awake.

Dr. Michael Bruce: What's that in English terms?

Steven Bartlett: Oh, I don't know what that we'll have to look it up.

Dr. Michael Bruce: Is it one cup? Is it two cups?

Steven Bartlett: Oh, I would say it's probably 3 to four cups of water.

Dr. Michael Bruce: Okay. Well, that's a lot.

Steven Bartlett: Well, don't forget you've lost a lot of water while you're sleeping and you might have lost it the previous day because let's say you worked out or things like that.

Steven Bartlett: So, let's get into these chronotypes then.

Dr. Michael Bruce: Yeah. So, let's start off with the lion. So, lions are my early birds. Um, you know you've got a lion in your midst when you get an email at 6:00 a.m., right? That's somebody who's been up for a while and who's got their brain kind of cooking. Um, lions like to make a list and go from step one to step two to step three every single day. They get a lot of confidence and they get a lot of pleasure following uh this list. But, if I'm honest with you, being a lion isn't all it's cracked up to be because dinner and a movie is out for a line. They've been up since like 4:30, 5 o'clock in the morning, right? They don't want to go see a concert late at night. They want to go to bed at like 8:30, nine o'clock. So, when you're looking at lions or what I early birds, what I call lions, they've got some very interesting characteristics. They make up between 10 and 15% of the population from a biological characteristic standpoint, their melatonin stops early and their cortisol starts early. So, their melatonin stops at about 4:30, 5:00 in the morning, and that's when cortisol starts. And that's the reason why they wake up so early.

Steven Bartlett: What sort of window do the lions wake up in?

Dr. Michael Bruce: So, it's interesting because I've got some lions who are kind of extreme, like they're getting up at 4:30 in the morning, which is not really probably the best idea. But generally speaking, my lions get up right around 5 5:15 up until about 6:00 6:30, but they are definitely my early risers. They have a small breakfast. They don't like to eat a lot of food early in the in the morning time because a lot of these people like to go work out fairly quickly after they've uh after they've woken up. um which is very different than some of my other chronotypes. My night owls don't like to work out in the morning. They don't like to do anything in the morning. So, my lions like to work out early in the morning. A light breakfast. And also, their best work window is usually somewhere between like 9:30 and 11:30. Like, that's when all the good stuff gets done. Like when they have if they have to get details or if they have to do brainstorming or things like that, that's really kind of where a lot of the magic happens for them. By about two o'clock in the afternoon, there's not a lot of stuff left inside the lion to be able to do do a lot of good things. That's when I have lions do more physical activities that don't require a lot of cognition. So maybe you go for an afternoon walk or maybe you have uh you know you're you're meeting with your folks that may not be really detail oriented but more processoriented in the afternoon

Steven Bartlett: admin and stuff.

Dr. Michael Bruce: Yeah, absolutely. I actually had one uh fellow chronotype his entire company and then move meetings based on who was going to be in the meeting. Like it like he had all the early birds and he had meeting at 8:00 in the morning and then all the night owls he had a meeting at 4:00 in the afternoon. He said it was amazing. He said it worked out really really well.

Steven Bartlett: Wow. What's the next one?

Dr. Michael Bruce: So the next one is the bear. So bears are representative of people that are in between early birds and night owls, right? So bears are the best. Honestly, dude, I wish I was a bear because the whole schedule of life works on a bear schedule. 9 to5 is perfect for a bear. And they make up between 50 and 55% of the population. So, literally one out of two people is a bear.

Steven Bartlett: And when's their peak work time?

Dr. Michael Bruce: So, their peak work time has a tendency to be sort of in the noon to 2:00 range. Um, they're a little bit later than what you would see the line. Some of them, I think, can actually be better at 11. It's kind of interesting. And we've had almost 3 million people take the quiz and we've discovered that inside of bears, there appear to be early bears and later bears. So there are people who fall into that category but like to get up a little bit early. So for them their productivity window is probably 10:30, 11. But for the later bears, it's more like 11:30, 12, and then it's about a 2hour window after that.

Steven Bartlett: For the people listening, um on screen at the moment is a grid showing you the different chronotypes, the weight times, the peak work window, and the sort of afternoon slump time. What's the next chronotype?

Dr. Michael Bruce: So, the next chronotype is me, the wolf.

Steven Bartlett: I think I'm a wolf.

Dr. Michael Bruce: You might be a wolf.

Steven Bartlett: I love lions. I get it. I get a wolf.

Dr. Michael Bruce: Well, you might be. Hey, look, join me. It'd be great. So, wolves represent the night owls, right? And so, wolves are my artists, my actors, my creatives. If you know a creative, when do they get their biggest idea? It's not 2 o'clock in the afternoon, it's 2 o'clock in the morning. Wolves are my highest risktakers. I know that that probably you fall into that category as well. Wolves are the folks that show up at the party at 11 o'clock at night, but they stay till 2 o'clock in the morning and they help you clean up and they hate mornings more than anything.

Steven Bartlett: So, should we talk about dolphins?

Dr. Michael Bruce: What's the next one? Yeah,

Steven Bartlett: dolphins. This is the category that you fell into. So, let's talk about who are the dolphins and and what does this actually represent? So, dolphins are usually highly intelligent. They're usually people who are fast-talking, well- read. These are people who are a lot like a lion in terms of they like to get up. They crave longer bouts of sleep, but unfortunately their body just doesn't have a long sleep drive and so they get really frustrated a lot of times. Um, also I think they have just a teeny bit of anxiety behind them. So a lot of them, for example, the details really matter to a dolphin, right? Versus other people where details might not matter nearly as much. I think a lot of my dolphins have got just a little bit of obsessivecompulsive disorder. So they're kind of focused in on the on the different things. Like if I ask a dolphin to do a project, generally speaking, they're never finished with it until I say, "Can you just give me the project back now because they're always working on a little detail here or working on a detail there." Um, but dolphins are my favorite. They're the people that I actually wrote the book for. Um, they're the ones that I I enjoy working with the most. Um, because they're actually the easiest to work with because we can once I explain to them how their hormones can be up and down and sideways, it can it starts to make a lot more sense for them. And for anyone trying to figure out which one of these they are, where do they go to do the test and how long does it take?

Dr. Michael Bruce: Yeah, you can go to my website. It's called chronoquiz.com. Uh, and uh, it takes about 3 4 minutes. It's not very long at all. It's going to ask you a bunch of questions about your sleep, about timing, things like that.

Steven Bartlett: Okay, I'll put that in the description. So, after you finish listening, you can all go take it and let me know your thoughts in the comments section as well. So, once you figure out what your chronosype is, come back to the episode and and let me know below,

Dr. Michael Bruce: please.

Steven Bartlett: And does my sleep change with age, Michael? It does. Absolutely.

Dr. Michael Bruce: So, do my do my chronotypes change with age?

Steven Bartlett: They do, actually. So, believe it or not, you've gone through all the chronotypes already. When you're an itty bitty baby, you're a lion. You go to bed really early. You wake up really early, right? Then you're a toddler, right? And in in like grammar school, you're a bear. You're going to bed around 7:30. You're waking up around 7:30. Then adolescence hits, right? What do you want to do? Stay up until midnight and sleep until 2, right? You become a wolf. Then at about 23 24 your chronotype has a tendency to set into one of those three or four things and then you stay there for an extended period of time like 25 30 years until you hit my age. So I'm going to be 58 soon and right when you hit in the mid-50s what we see is melatonin production can either slow down or get earlier. So as an example if your parents are still alive and you said hey mom dad I want to go for dinner. What time would they want to go for dinner?

Dr. Michael Bruce: Early.

Steven Bartlett: Right? four o'clock in the afternoon, 4:30 in the afternoon, you're like, "What is wrong with you, mom? What's going on?" That's her chronoype is going backwards and your sleep changes over the course of time. To be clear, at once you hit like age probably 50, 45 or 50, we start to see a slowdown in production of melatonin. We also see an increase in what are called EEG arousals. So things that break up your sleep and make it so it's not so continuous. That can be problematic as well. So there's a lot of things that can happen as you age.

Steven Bartlett: So do I start sleeping less as I get older?

Dr. Michael Bruce: You start sleeping poorer quality. I'm not convinced that it's always less.

Steven Bartlett: And is that going to make me grumpy?

Dr. Michael Bruce: Yes, it is.

Steven Bartlett: Really?

Dr. Michael Bruce: Absolutely. Poor quality sleep is, I would argue, is much worse than poor quantity sleep. I I would rather I've got somebody who got 5 hours of really great sleep versus seven hours of really light crappy sleep every time.

Steven Bartlett: Does that mean that as I get older, I'm going to be more grumpy?

Dr. Michael Bruce: It depends on the quality of your sleep. So, what I can teach you is how to not get poor quality sleep as you age. Perfect example, a lot of folks who are a little bit on the older side are used to drinking coffee late in the day. Well, if you change that habit, then you don't have as many sleep problems.

Steven Bartlett: And I shouldn't I shouldn't be having coffee late in the day at all.

Dr. Michael Bruce: Probably you want to stop by about 2 p.m., right? So, if you stop around 2 p.m., the halfife of caffeine is between 6 and 8 hours. So, 8 hours later is roughly 10, which is roughly when people are kind of wanting to go to sleep. So, I would say that that would probably be the the time to do it. I think about my siblings and us all being woken up for school and I think about my performance in school

Steven Bartlett: and of all my siblings, there's four of us. I was the one that always struggled with being woken up in the morning in part because I'd gone to bed later. But then I was also the one that struggled with school the most.

Dr. Michael Bruce: Yeah. That characteristic of a wolf characteristic of this night person. If I'm honest with you, dude, like most kids should not be waking up at the time they're waking up to go to school, right? I mean so many kids are waking up at real like you know 5:30 6:00 in the morning they have an hourong bus ride then they get there and if you're an adolescent I don't think anything could be worse

Steven Bartlett: right

Dr. Michael Bruce: so we have to really start to try to be a little bit more thoughtful and look at like what are some of the activities that kids are doing how can we get them to maybe take naps during the day if they need them um athletic performance can depend on sleep academic performance can depend on sleep it's it's unbelievable all the different things yes

Steven Bartlett: has there ever been any research done there has on different chronotypes academic performance.

Dr. Michael Bruce: There has been actually they haven't they labeled it directly as chronotypes but they've looked at it based on age range and we know that for example here in the United States there's a big push for to change school start times so that way high schoolers aren't starting at 7:00 in the morning because high schools shouldn't be starting at 7 o'clock in the morning. Preschoolers should be starting at 7 o'clock in the morning because their body naturally wakes up at that time. So, we've actually seen there was a great study um that was done at the University of Minnesota that discovered that um when they just had people come in 1 hour later from their first period, they improved by one full letter grade, meaning they went from being C students to being B students or from B students to A students merely by changing the timing of their first class. So that should give you pretty good insight as to sort of these big area like and and all children are vulnerable to this. Like this is not like I'm not telling you anything that's new. This is these are studies that have been going on for quite a while. And there's actually a whole movement trying to get school start times to to slow down now.

Steven Bartlett: Looking at some of the research here, it says research consistently shows that morning types, which is the

Dr. Michael Bruce: lion,

Steven Bartlett: the lion, earn higher grades not due to higher IQ, but because exams are scheduled during their peak alertness windows. You got it.

Dr. Michael Bruce: That's crazy.

Steven Bartlett: Sometimes wolves turn out to be much smarter, but because they're they can't perform at those early times, nobody knows. Remember, wolves are my creatives. Like, where do you think some of these create great creative innovations and ideas come from in the tech world, right? Like, these are the wolves that are out there that are up late at night coding and trying to figure out what's going on.

Dr. Michael Bruce: It's pretty cool when you think about it. And I just there's this thing called the synchronous synchrony effect from a study in 2020 where nearly 800 students found a clear synchrony effect. Students performed significantly better when their class schedule matched their chronotype.

Steven Bartlett: Exactly.

Dr. Michael Bruce: Those morning people dominated in morning classes and and the owls um or the wolves often caught up and outperformed the morning people when tested in the afternoon or evening.

Steven Bartlett: Exactly.

Dr. Michael Bruce: It's pretty fascinating. Now think about it like this. Could you imagine a school system where if we identified children's chronotypes during their particular age range and then we changed the testing so that they got tested when they're at their peak hours?

Steven Bartlett: Yeah.

Dr. Michael Bruce: They'd actually do better.

Steven Bartlett: People don't know this, but I never do p podcasts in the morning.

Dr. Michael Bruce: I don't blame you ever.

Steven Bartlett: You shouldn't. Yeah.

Dr. Michael Bruce: It's it's not your time. Yeah.

Steven Bartlett: Right. Like you have a very specific subscribed time that I think works well for you. So I think you should abide by that.

Steven Bartlett: Duration of sleep. There's lots of conversation around how long you're supposed to sleep for. What what's the truth? Yeah.

Dr. Michael Bruce: 8 hours is a myth. Let's be fair. Like we came up with that from like the 30s. There was a great study at Stanford that came up with 8 hours and 13 minutes plus or minus. And that's kind of where we came up with that as an idea. The truth of the matter is somewhere between 7 and 9 hours really is kind of the amount that people should be looking for. But some people don't have that luxury. Some people don't have that much time that they can put towards sleep and so they get a little bit less sleep. But for the lower level limit, I don't like anybody getting less than 6 hours. When somebody gets less than 6 hours sleep, their driving is off. And so you can't operate machinery. So if you're driving to work or god forbid, carpooling your kids to school and you're only you only got, you know, less than 6 hours of sleep on on board, it's probably not going to go well.

Steven Bartlett: We we do have to stop here and talk about parents because listen, you're either a parent now, you might be someday. Absolutely.

Dr. Michael Bruce: Maybe you won't be. But for those I've just got a huge amount of respect for parents because you know I've gone I'm not a parent yet. I hope I will become one. But when I see what my brother who has three kids under the age of what seven now um how much sleep has he lost?

Steven Bartlett: A lot and and and his wife as well. But um you must get parents coming to you all the time being like what the hell do I do? Like I've got the I've got to wake up when the kids wake up and but I'm it's destroying my my relationship, my marriage, my sex, whatever it might be.

Dr. Michael Bruce: Yeah. So parenting children and sleep are difficult to coexist, but they're not impossible. It really has to do with discipline and kind of thinking through some ideas for yourself. When my So I have a 23-year-old son and a 22-year-old daughter, so I'm a little bit out of the the realm of having to deal with them every day. Um, but I was, like I said before, I was in charge of mornings uh at our house waking them up. And it's a lot, right? And so the very first thing that I try to explain to parents, especially if they have a child who has an irregular sleep pattern and is really causing chaos for the rest, like one child who won't go to sleep and it's keeping every the whole house up. First thing you want to do, educate the kid, right? A lot of kids don't know what they're doing is causing a lot of problems. They they're just kids. They're just hanging out having fun. You know, they're they've got energy. They want to be awake. So that you want to educate them and say, "Hey, now is a particular time to wind down. This is where your body recovers. this is how you get to do sports the next day or theater the next day or ac whatever your computers whatever your thing is you can tie it to sleep and performance pretty easily and so getting them to understand that becomes very very critical number two is have some guidelines right have bedtimes have wake up times and follow them as quick as closely as you can for parents oftentimes what I try to tell them to do is like look after your child goes to bed if you've got a child that has problems for sleeping take turns. Do what I call the on call method. So, as a doctor, sometimes, you know, you get a call in the middle of the night because you you're covering patients at the hospital for your buddy or something like that. You're on call. So, when you've got two people who are managing one child, one person handles Monday night, Wednesday night, Friday night, the other one handles Tuesday, Thursday, Saturday. You flip a coin for Sunday. So, if the kid wakes up at 2 o'clock in the morning, both parents aren't awake. One parent has that responsibility. the other one can keep their eyes closed and go to sleep. Interesting study was done looking at men and women in bed when a child cries. So women take care of the child whereas men lie there and fake sleeping in order to be able to stay asleep, right? That's problematic. Um in a lot of

Steven Bartlett: they know in the study that they were fake sleeping

Dr. Michael Bruce: because they asked the men afterwards what were you doing and they all said they woke up and they were faking it. It's pretty crazy when you think about it. But this is a big this is a big deal for parents, right? A lot of parents turn to me and they're like, "This is killing our marriage." Like, "We haven't had sex in, you know, three years because we've got a child who maybe the child has special needs or maybe the child doesn't have special needs, but has other things going on or maybe it's just normal development and and you know, they're worried about it." And so, what I like to sit down with parents and do is number one, let's figure out when your kid needs to sleep and let's set some guidelines and rules. But number two, let's do the same for you.

Steven Bartlett: Right? A lot of parents when they're super stressed out, one of the first things they do, grab a glass of wine, right? Wine's about the worst thing you could possibly do for sleep to be fair. Now, I'm going to teach people how you can still have a glass or two of alcohol and not completely destroy your sleep. But I want to be very clear about something. If you're using alcohol as a stress relief tool at night before bed, it's messing up your sleep probably pretty bad.

Dr. Michael Bruce: You might be asleep, but the quality of your sleep is

Steven Bartlett: is [ __ ] It's awful, right? And interestingly enough, during the one stage of sleep that alcohol knocks out, which is stage three and four sleep, what's the most interesting is that dur during that particular stage of sleep, there's something called the glimpmphatic system that comes in and scoops out these proteins that have a tendency to accumulate in your brain. And when proteins accumulate in your brain, they wrap around the nerves and that's called Alzheimer's disease.

Dr. Michael Bruce: So stage four sleep is imperative to avoid Alzheimer's disease. And when you drink alcohol, you destroy stage four sleep. H.

Steven Bartlett: So, it would be great if nobody drank alcohol, but I'm not so stupid as to think that. Plus, I like bourbon. I like whiskey. I enjoy a glass of champagne every once in a while. So, how can you successfully still drink alcohol and still get a decent night's sleep? I'm going to give you a quick one, right? Let's say you're having dinner at 6:30, have your first glass of wine, then have a glass of water, right? Then your second glass of wine starts at, let's say, almost 7:00, right? Then you have your second glass of water. Then you stop everything by 7:30. You wait 3 hours, which would be 10:30, and then you can go to bed.

Dr. Michael Bruce: Why the water? Why the weight?

Steven Bartlett: So, the water helps wash it through the system. Also fills your stomach up so you don't have too much. So, you you've got more fluid in there so that way you don't drink extra wine. Um, and it makes you have to pee, which flushes the system out as well. The 3 hours.

Dr. Michael Bruce: And it hydrates you.

Steven Bartlett: It does. Okay.

Dr. Michael Bruce: Absolutely. Because remember, wine pulls uh both magnesium and uh most water out of your system because it makes you have to go pee.

Steven Bartlett: Helps with the hangover. So, there's a couple of different things that I would say. Number one, this definitely helps with the hangover because you've got water going in. For a lot of my patients, what I tell them is the very last thing that you could do is have a little bit of coconut water. So, coconut water is loaded with zinc, magnesium, and vitamin B. And those are some of the things that get pulled out of your system uh when you're drinking. By the way, did you know that there are happy hours specific to your chronoype?

Dr. Michael Bruce: Didn't know that. No.

Steven Bartlett: Yeah. So, it's kind of interesting. So here's what's cool about it is your body produces something called alcohol dehydrogenase which is how you metabolize alcohol but it does it at a particular time and the time is different for each chronotype.

Dr. Michael Bruce: So your body is most efficient at drinking between basically the hours of 4 and 8 happy hour as a lot of people know it.

Steven Bartlett: And how do you think about what time you eat at night time?

Dr. Michael Bruce: Such a great question. So 3 hours before bed, you want to stop fluids including alcohol um and food. You want to just stop it all 3 hours before bed. So it takes your body about that level of time to number one digest, clear all the food, and then have all the mechanisms that are working towards digestion now be able to be refocused onto the recovery process of sleep. However, I I will tell you that there's this uh I've seen a couple people and there are people out there that are claiming that if they stop eating at 11:00 in the morning that it helps their sleep dramatically at night. And it turns out it has to do with your heart rate. So, one of the big metrics that is very important that all of our viewers and listeners want to know is you need a heart rate of 60 or below in order to enter into a state of unconsciousness. And when you've got food in your stomach,

Steven Bartlett: your heart rate is up.

Dr. Michael Bruce: That's right.

Steven Bartlett: So, right. So if the longer you can wait, the lower your heart rate is, the easier it gets into sleep. And so when we're talking about So a great example, let's get back to parents for a second, right? You feed your kids at an earlier time and then what do you do? Oh, then you go back and have dinner with your spouse, right? Maybe that's not the best idea because you're having dinner so late. Maybe you should have dinner with your kids, right? And and enjoy that time with them and eat earlier because that gives you more space later on to be able to relax and go to bed. I said that tracks because I remember I've told this story once or twice before. I remember when I was doing some podcasts over here in LA, we had Seth Rogan on.

Dr. Michael Bruce: Sure.

Steven Bartlett: And the day before in the hotel before I lived here, I had a cookie from the mini bar. I'm going to admit it. I had the cookie and then I went to bed pretty quickly.

Dr. Michael Bruce: they're so good.

Steven Bartlett: It was And then I went to bed pretty quickly. Oh god, we were just terrible. And I was looking at my whoop the next day ad and it my heart rate was like 75 or 80 for the first 2 to 3 hours after I got into bed.

Dr. Michael Bruce: Isn't that crazy?

Steven Bartlett: And I woke up feeling like hell.

Dr. Michael Bruce: Yep.

Steven Bartlett: Terrible day the next day. I was terrible during the conversation and I looked at my go, "Oh my god, it was that cookie. It put my heart rate high."

Dr. Michael Bruce: So also on top of that is sugar.

Steven Bartlett: Yeah. I mean, [ __ ] me. Yeah.

Dr. Michael Bruce: Right. So sugar turn so sugar actually slows production of melatonin. Remember melatonin is kind of the key that starts the Yeah. The key that starts the engine for sleep.

Steven Bartlett: So is there anything else that I can do to make sure my heart rate is low as I get into bed?

Dr. Michael Bruce: Absolutely. Meditate.

Steven Bartlett: Okay.

Dr. Michael Bruce: Breath work. All kinds of brings my heart rate down.

Dr. Michael Bruce: Yeah. Absolutely. So what a lot of people don't realize is just because we're breathing doesn't mean we're actually breathing in a way, shape, and form that can be helpful for us for sleep. So, in my most recent book, Sleep, Drink, Breathe, I talk a lot about breath work and what is it and how does it work for you. But I'd love to teach you my favorite form of breath work and meditation. Um, that I think you'll you'll get a lot out of. So,

Steven Bartlett: and I do this before bed.

Dr. Michael Bruce: Exactly.

Steven Bartlett: Okay.

Dr. Michael Bruce: And you can, by the way, you can do it in the middle of the night if you wake up as well. Right. So, let's talk about how to get how to fall asleep and do some relaxation exercises for that. And then I'm gonna give you some different ones for in the middle of the night. So, let's talk beginning of the night. So, number one, you need runway to land the plane. Okay? So many people think they're just waiting for their head to be bobbing in front of the TV and then they go brush their teeth and they get in bed and then all of a sudden they're wide awake and they don't know what's going on, right? So, you need time for your system to shut down. It's not an onoff switch. It's more like slowly pulling your foot off the gas and slowly putting your foot on the brake. There's a process. It should take you about 12 to 15 minutes to actually fall asleep. Okay? So number one, what I ask people to do is take the last hour before bed and chop it up into three 20 minute segments, right? So let's say you're going to bed at 11, starting at 10:00. And by the way, set an alarm on your phone to to tell you that it's 10:00 because it's really easy to slide by your bedtime and then all of a sudden it's like all bets are off. So set the alarm 20 minutes for [ __ ] you just got to do. So, in our house, it used to be getting backpacks together for school for our kids, finding sports equipment, maybe laying out my stuff for work the next day or getting last emails sent, something like that. 20 minutes for hygiene, right? Brush your teeth, wash your face, maybe take a shower, something along those lines. And then 20 minutes for some form of meditation, relaxation, prayer. I don't care what you do, but it has to be something that's calming to get you there. Okay? So, my one of my favorite techniques to do is meditation. Now, I'm going to be honest with you. I'm a terrible meditator. I have never been able to do it. I've actually gotten kicked out of meditation retreats because I'm the guy that's like, "What's going on?" Like, am I doing it right? You know, I'm kind of that that person. And so, I was I was told about this tool called a Muse headband. We have one right here. So, this is my personal Muse. I actually brought it from home. And um you'll notice on the inside there are sensors here. And there are sensors along the earpiece here. And so what happens is is you wear it on your head, right? And it's measuring your brain waves. And so when we're Yeah. Check it out. And so when we're when we're doing it and we're measuring brain waves. Yep. Exactly. And that goes on the back part. Yeah. There you go. So what's cool about this is it's attached to an app. And then while it's measuring your brain waves, you're listening to a particular music. It could be a guided meditation. It could be any of those things. And while you're doing this, the volume gets lower. And then you know you're getting closer to a meditative state.

Steven Bartlett: The volume comes down when

Dr. Michael Bruce: on the app when your brain wave starts to relax.

Steven Bartlett: Oh, okay.

Dr. Michael Bruce: So, you're immediately getting feedback. We can try it if you want. Um, but it's pretty interesting. And then when you get to the alpha state, little birds start chirping.

Steven Bartlett: The alpha state.

Dr. Michael Bruce: Yeah. The alpha state is when your eyes are closed and you're at the most relaxed state of your brain waves. It's called the alpha state. And that's really what people are trying to get to for meditation.

Steven Bartlett: And are you affiliated with this company in any way?

Dr. Michael Bruce: I am not.

Steven Bartlett: And how much does it cost? I think it's around $275

Dr. Michael Bruce: I think is the headband.

Steven Bartlett: Okay. Interesting.

Dr. Michael Bruce: It's pretty fascinating. Um I I've been pretty impressed with them.

Steven Bartlett: So that's meditation. You talked about breath work as well before.

Dr. Michael Bruce: Yeah. Let's talk about it. So one of the other things that I do is I do something Well, this isn't breath work. This is called progressive muscle relaxation. So this is where you tense and relax muscles starting from your feet and going all the way up your body. And as you tense and relax the muscles, you feel that relaxation from releasing that tension and it helps you fall asleep. Um, actually, you know what I can do is I can send you a an audio file that has me walking through progressive muscle relaxation that we can make available for everybody if you want. We for free. It's no big deal.

Steven Bartlett: Amazing. I'll put that in the description below as well.

Dr. Michael Bruce: Yeah. Yeah. People will really dig it. I think they'll really enjoy it. So, that's another thing that we do. But now, let's talk about the middle of the night, right? So, by the way, do you have this as an issue? Have this has this happened to you before?

Steven Bartlett: It it happens sometimes and it's typically when like my sleep is somewhat disordered or disruptive or when there's really something on my mind.

Dr. Michael Bruce: Yes. So that that precipitatory anxiety like before a flight like if I have an 8:00 in the morning flight like I sleep like [ __ ] the night before because I'm constantly worried about that. Right. But a lot of times what people do normally is they just wake up in the middle of the night and they can't return to sleep and they're really not sure why. So number one there's biology involved. So your core body temperature rises rises rises and when it hits a peak it drops. That drop is then a signal to your brain to release melatonin. Right? Again, the key that starts the engine for sleep. However, your core body temperature continues to drop, drop, drop. By the way, this is the reason why we tell people you want to sleep in the cool, not the warm environment. Because again, your core body temperature is dropping. If it's too hot, your core body temperature can't go down and you can't get to sleep,

Steven Bartlett: which tracks with evolution.

Dr. Michael Bruce: Exactly. So, here's where it gets interesting is it keeps going, going, going, and then at some point in time, your body has to heat up. And if it doesn't heat up, you go hypothermic. Guess what time that is? Between 1 and 3 o'clock in the morning.

Steven Bartlett: Oh, your body starts heating up at 1 1 and 3.

Dr. Michael Bruce: Every single person's body on Earth does this. Everybody on Earth wakes up between 1 and 3:00 in the morning. However, most people burp, roll over, get comfortable, and fall back asleep in 30 seconds. However, there's a select group of people who end up being my patients who don't have that. And there here in lies the problem. So, here are the steps you want to take in the middle of the night to be able to solve this issue. So number one, don't go pee. I know, I know, I know people like, "What? What are you talking about, Michael?" So here's what ends up happening is when people wake up in the middle of the night, they say to themselves, "Well, I'm up. I might as well go pee." Right? Here's the problem. Remember I told you the big metric was in order to enter into a state of unconsciousness, you need a heart rate of 60 or below. Right? What do you think happens to your heart rate when you go from a lying position to a seated position to a standing position? You walk across the room, your heart rate goes straight up. So what we want to do is keep your heart rate down. So, if you don't really have to go to the bathroom, don't go to the bathroom. 75% of people sleep on their sides and they kind of squunch up, which means they're putting pressure on their bladder. So, my guess is is that most of those people, if all you did was when you woke up is lie and get on your back for about 25 seconds and see if you still need to pee. If you don't need to pee, stay in bed and keep your heart rate down. If you need to pee, please go pee. Right? If you're going to go to the bathroom, have a strategically placed nightlight along the way so you don't have to flip on the light in the water closet because if you do that, you just told your brain it's morning and it stops producing melatonin. But let's say you don't have to pee. The second thing, don't look at your phone. Now, this turns out to be very difficult for 99% of the people out there because the first thing they do is they grab their phone and they head to the bathroom, right? and they're either checking emails, looking at Facebook or Twitter or whatever social media they're on,

Steven Bartlett: or we're just trying to figure out what time it is

Dr. Michael Bruce: or and that's where the problem is is as soon as you see the time, you instantly do the mental math and now you're pissed off, right? It's 3:30 in the morning. I got to get up at 6:00. Sleep, sleep, sleep. And you try to force your brain to sleep. Dude, in the history of time, nobody has been able to force their brain to sleep, okay? Because your heart rate's going in the wrong way, right? It needs to be coming down. So, if you can, don't look at the clock. All right, so you haven't peed, you haven't looked at the clock, but you're still awake and nothing's going on. Here's where the breathing technique comes in. It's called 478 breathing. I did not develop this technique. It was developed by Dr. Andrew Wild, Harvard trained natural doctor, super smart dude. Um, and uh, he did it for the military to teach them how to lower their heart rate during stressful situations. We use it because it helps lower our heart rate past 60. And it's super simple. I'm going to get you to try it. So, go ahead and sit up straight. Okay. And so all you're going to do is breathe in for a count of four. You're going to hold for a count of seven. And you're going to breathe out for a count of eight. And I'm going to walk you through it. I want you to have your eyes closed. And what I also want you to do, you're going to go in through the nose, out through the mouth. And then what I also want you to do is picture the number in your head. So when I say breathe in two, three, four, you should picture the two, the three, the four in your mind's eye. Okay?

Steven Bartlett: With my eyes closed.

Dr. Michael Bruce: With your eyes closed. You ready?

Steven Bartlett: Yep. Breathe in. 2 3 4. Hold. 2 3 4 5 6 7. Push. 2 3 4 5 6 7 8. Good. You want to get through about 20 cycles of that. It's incredibly relaxing. I actually did it before I came out here to do the pod because it helps lower my heart rate and gets me centered.

Steven Bartlett: H. It's pretty remarkable. Now, there's some problems with the technique. Number one, sometimes it's hard to hold for seven, and sometimes it's really hard to push for eight. So, I tell people you can do this four, five, six, 4, 6, 7, or 478. So, just work your way up to it, right? If if it's too hard to hold your breath for 7 seconds or it's too too hard to push your breath for eight, you can do a little bit less just while you're getting used to it. And then the other big thing is it's hard to figure out where the 20 cycles is because you need to get to 20 cycles of this. So, what I have people do is take their hands and make light fists while they're doing this. And when they do one cycle, they put out a finger. Another cycle, put out a finger. And before you know it, you got 10. And when you bring it back, you've done 20 cycles.

Dr. Michael Bruce: It's funny. I just did two and I start yawning.

Steven Bartlett: I know. I just saw that. I'm telling you, dude, this thing works, right? And so, I have people do this technique. Here's the best part is it avoids monkey mind, right? So, what is monkey mind? Monkey mind is I'm thinking about stuff that I have no business thinking about in the middle of the night for absolutely no reason. Like what's on the grocery list or what did I say to my spouse or did that podcast go okay or any of the things that might be floating through your head? You cannot count and worry at the same time.

Dr. Michael Bruce: And why does it work? What's going on in my physiology? Uh-huh. You're distracting the brain from the thing that's stressing you out and it's lowering your heart rate and then the natural sleep process comes in after it. So, all these are are distraction techniques to be clear. Now, there's there's several of them out there. One of the other ones I use for some of my patients is I tell them, "Hey, count backwards from 300 by threes. It's mathematically so complicated you can't think of anything else and it's so damn boring. You're out like a light." On that point of distractions, a lot of people go to bed listening to podcasts or movies. Jack was just saying that, you know, he he needs to listen to something to fall asleep. I'm the same. I listen to like serial killer stuff,

Steven Bartlett: which is, you know, that's interesting.

Dr. Michael Bruce: Don't don't judge me.

Steven Bartlett: Wait till we get to the dreams part of the podcast. I can't wait to hear what you dream about. I

Dr. Michael Bruce: I don't I think I always try and figure out why it is. And I My sister's the same, my sister Amanda, and she she listens to serial killer stuff to fall asleep. I think it's because this is just hypothesis. My mom would always ask me to put on forensic files, which was this like serial murder documentary thing when we were younger cuz she couldn't use the remote. So my mom would say she'd pass me the remote, say, "Put on forensic files." And I'd like put on the number for her, right?

Steven Bartlett: And so that was always playing in our house at night time. And we all had TVs in our bedroom that just mirrored what was ever what was playing downstairs, course.

Dr. Michael Bruce: So when I got into bed, I'd watch fall asleep.

Steven Bartlett: This explains a lot about you.

Dr. Michael Bruce: I know, right? You say that to people, they think you're yours. Yeah.

Steven Bartlett: So, let me tell you what it's like in my house. And actually, you and I have a commonality. So, in my house, we have a big screen TV. It's on all night long.

Dr. Michael Bruce: Where? In which room?

Steven Bartlett: In my bedroom.

Dr. Michael Bruce: Okay.

Steven Bartlett: Okay. When I met my wife, she said to me, "Michael, if you ever happen to spend the night, I want to let you know that I sleep with the television on." I said, "Don't worry about that, Lauren. I'm gonna be a sleep doctor. I'm gonna fix that." We we met when I was uh 30, so uh known her for quite a while. And uh you ever tried to change something in your bed partner? Yeah, good luck.

Dr. Michael Bruce: Yeah, good luck. So I took the TV out. She said, "If you ever want to come back in here again, I suggest you put the I put the TV back in." And then I studied her to learn what was going on. And it turns out that she's listening to it out of what I call the corner of her ear. Her eyes aren't even open. And half the time it's a episode of Seinfeld or something like that. My wife actually likes murder mysteries and so it's usually forensic files or something along those lines that's going on. But for her, it's a perfect distraction technique. Now, there's a second thing that's important uh in our bedroom that happens uh is we have two dogs. They sleep in the bed with us. I'm the freaking sleep doctor, dude. Like, it's insane. But the point here is sleep is flexible. Okay? Just because it works for you doesn't mean it works for your bed partner. And and vice versa is also true, right? Like just because some people can't sleep with the TV on doesn't mean that it's going to mess up your sleep forever to have the television on cuz it's not. And by the way, 99% of TVs have timers built into them. Like if you don't know what it is, ask your kid. I had to ask my son. He showed me how to use it. We turned it off. It wasn't a problem, right? So creating a sleep environment that is conducive to sleep for you and your bed partner can have a lot of variation to it. And I don't think people there's no hard and fast rule that says, "Hey, nobody should ever sleep with the TV on." I mean, there are people out there who say that, but quite frankly, everybody sleeps with the TV on.

Steven Bartlett: Well, a lot of people do. I I I wouldn't put the TV on in our bedroom. I mean, we've done it once or twice or whatever, cuz we're watching something and we slip off to sleep and I wake up and I realize it's on and I turn it off.

Dr. Michael Bruce: But I I also really think it's an important point to say that people will listen to podcasts like this. They'll listen to the like biohackers of the world and then they'll get so militant about how they fall asleep that it will cause friction because one partner is different.

Steven Bartlett: Don't do that. And I had this problem in my relationship which was

Dr. Michael Bruce: my girlfriend sleeps in silence and is has like just such a glorious routine to everything she does.

Steven Bartlett: And I am completely the opposite

Dr. Michael Bruce: and the opposite like I need to like I want to listen to a murder. I could be on my phone. It's like when I look at my Whoop scores

Steven Bartlett: works for me.

Dr. Michael Bruce: Yeah.

Steven Bartlett: It's like I am getting I have I get great sleep even if I'm listening to a serial killer documentary.

Dr. Michael Bruce: So

Steven Bartlett: but not if you eat a cookie before bed.

Dr. Michael Bruce: Not if I eat a cookie. That's that's gone. But I so what I do is I put one AirPod in in my right ear. So whichever ear is not going to be on the pillow

Steven Bartlett: and it means I can listen to her if she says something.

Dr. Michael Bruce: But when it's silence, all I hear is the thing that I'm listening to.

Steven Bartlett: So I've got a trick for you.

Dr. Michael Bruce: And I wake up in the morning and dig the AirPod out of the bed where it ended up.

Steven Bartlett: Right. So now I'm going to help you with the digging of the AirPod. So first of all, they now make these things called pillow speakers.

Dr. Michael Bruce: Oh, interesting.

Steven Bartlett: Right. So it's a it's a it's a Bluetooth speaker that will attach to your phone that you can just slide and it's just under your pillow so only you can hear it. So, that's number one. You might want to consider that. And they're pretty inexpensive. Number two, they now make specifically earbuds designed to be slept in.

Dr. Michael Bruce: Oh, nice.

Steven Bartlett: So, there's a a new company out called Next Sense. Um, and they have developed an earbud that actually measures your brain waves while you are sleeping. And when you move into a lighter stage of sleep, it sends in a frequency signal to help you go back to sleep or to stay in that depth of sleep. Brand new company. Next sense. I have nothing to do with them. I mean, it's a friend of mine who owns the company, but I'm not on their own.

Dr. Michael Bruce: I would like something to do with them

Steven Bartlett: if we'll figure that out.

Dr. Michael Bruce: So, does it allow you to play your music as well or your or your podcast or whatever?

Steven Bartlett: I can listen to Diary of a CEO every single night while I fall asleep and it will make sure that I don't wake up from any dreams.

Dr. Michael Bruce: And you can still like and subscribe and stuff.

Steven Bartlett: Even through the earbuds, of course. I think everybody should like and subscribe.

Dr. Michael Bruce: That's a good feature like an AI agent that helps you subscribe. Okay, so that's that's you woke up in the middle of the night. You don't pee. You don't check your phone. You're doing these breathing exercises. You don't give yourself a hard time.

Steven Bartlett: And then what happens? It doesn't work. What do you do? Yeah. Right. So, there's the new research on something called non-sleep deep rest. We call it yoga nidra. Okay? It's been around for thousands of years. When you lie relaxed in like a corpse pose like this, you're actually doing something that's valuable for your sleep. Now, I want to be clear. It's not the same as sleep, but if you lie there for an hour, it's like 20 minutes worth of sleep. So everybody should know that even lying relaxed and calm is very very helpful right but if you start to get anxious and your heart rate starts to tick up you need to get yourself out of bed because that's when because all you're doing then is thinking hey this bed is this place where I get anxious and pissed off. This is not a place to sleep. So as long as you stay nice and quiet the non-sleep deep rest absolutely the thing to do. The other big thing that I do and by the way this happens to me on occasion too like I'm not immune to it just because I'm a sleep doctor. You have to stay positive. And what I what do I mean by that is everybody when they wake up in the middle of the night, your brain is set to negativity. There's no reason you should be up at 3:00 in the morning that something good is going on, right? Nobody's coming in wishing you happy birthday at 3:00 in the morning. Something terrible has happened. And your brain has gotten accustomed to that. So when it wakes up, it immediately goes to the negative and you start thinking about bad things. You can't stop your first thought, but you can stop your second thought, right? Right? And so when you wake up and you think negative, what I want you to replace that with is, "Okay, Michael, for some reason, your body has decided to wake up at 3:00 in the morning, it's not the game that I wanted to be playing tonight. However, I think I'm going to be okay. I'm just going to lie here and relax and let the natural sleep process take over. If I feel my heart rate increasing, I'm going to go to another room in the house where I've already got a book and a light set up so I can do a little bit of light reading and then come back to sleep." And I just tell myself that I give myself permission to just chill, just relax. And then you know what happens? The natural sleep process comes over. As soon as your heart rate starts to go down, your body wants to get back to sleep. And so it really has a lot to do with heart rate.

Steven Bartlett: I love having these conversations on the diio because I have a huge amount of sympathy and concern for people that don't get sufficient sleep. And I know there's a lot of people that don't. And I actually think it's to some degree it's somewhat increasing because of the way we live our lives. I was looking at some of the stats around the increase and there's a study done in 2025 and early 2026 that revealed we're in a global sleep crisis.

Dr. Michael Bruce: Oh yes, we are.

Steven Bartlett: Both the CDC and Stanford Medicine report said that one in three adults and nearly 80% of teenagers are now chronically sleepdeprived.

Dr. Michael Bruce: Correct. A 2026 survey by the American Academy of Sleep Medicine found that 93% of Gen Z admit to regularly losing sleep due to social media usage. And 71% of employed respondents globally have said that they sometimes call in sick at least once or twice due to poor sleep.

Steven Bartlett: Just to sleep. Yeah. When I was down in Australia doing some work down there, a lot of Australians they take holiday and they just sleep.

Dr. Michael Bruce: Yeah.

Steven Bartlett: Just to catch up. Like it's it's pretty remarkable. We're in a very sleep-d deprived society and I think there's a couple of different reasons why that is. Number one, have you seen what's going on outside in the world today? It's pretty crazy out there. Well, I can understand why people are getting a little anxious.

Dr. Michael Bruce: I think one could argue it's been crazier through history, but we never knew about it,

Dr. Michael Bruce: right? Well, I mean, the media getting it to getting us this information so quickly, I think, is definitely what I would agree with you. It was much crazier during like World War II, you know, and stuff like that. Now we're getting information so quickly and people are getting so ratcheted up about it. I think that has something to do with it. But if I I think the bigger culprit is people being overweight. You know, when you look here in the United States and you look at the obesity epidemic and you look at people being overweight, it's something close to like 70s something percent of people in America are overweight. When you're overweight, that puts you in line for potentially having something called sleep apnea. Now, I want to be clear, not everybody with sleep apnea is overweight, but a a large percentage of the people with sleep apnnea are bigger people. And so, when you look at a society that's getting bigger and all the unhealthy food that we've got going on, like all this highly processed food, things of that nature, that isn't helping anybody, it's adding the pounds. And specifically, like for men, we gain weight through our necks. Like I I don't know if you've ever noticed it, but like if you ever were heavy and you lose weight, the first thing somebody says is, "Oh, it looks like you lost weight cuz I can tell from your face, right?" and they're like, "Oh, your neck looks, you know, different now." And so, we see a lot of what's going on in the world from a weight perspective and a food perspective could be driving some of the sleep problems. Then there's the anxiety perspective that I spoke of earlier that I think comes in. And again, I I agree with you. I don't think we have more crazy stuff going on. I think we know about more crazy stuff that's going on,

Steven Bartlett: but also work is now largely digital. And I imagine for my great-grandfather, he would go to, I don't know, the factory or wherever he works. His work would finish at 6.

Dr. Michael Bruce: Yes. Your work doesn't finish at 6 now. It finishes when you're awake.

Steven Bartlett: Yeah. Absolutely. It finishes when you go to sleep.

Dr. Michael Bruce: Yeah. Exactly.

Steven Bartlett: Yeah. And and that becomes problematic, right? Because a lot of times also, by the way, you need to have dividers in your home. Like let's say you live in a studio apartment and your bed is your couch is your kitchen, right? You have no designated spot for sleep. Your body needs to know, hey, this is the spot where I can chill out and finally get some rest. And I think a lot of times our environments just aren't that way.

Steven Bartlett: Which sleep disorder should we start with?

Dr. Michael Bruce: Sleep apnea and insomnia. Sleep apnea, for folks out there who may not know what it is, is when you are snoring at night. Almost everybody who has sleep apnea snores. Not everybody, but almost everybody. And when you're sucking air in, you pull your tongue to the back of your throat and you cut off your air. And you literally stop breathing, right, for a few seconds. And then all a sudden you and you make all this kind of grunting, groaning noises. and then you wake up. This can happen hundreds of times a night and it can be very problematic because of course it wakes you up every single time that you have one of these events, right? And so as an example, we measure the events per hour. So as an example, somebody with sleep apnnea could have between five and 15 times per hour that they stop breathing and that's mild.

Steven Bartlett: So how are they going to get into the deep sleep that clears out their brain?

Dr. Michael Bruce: That's the problem, right? And so apnea prevents them from getting into a lot of that deep sleep. And so their brain doesn't clear out and then they got they're they're kind of screwed. So at the end of the day, the the goal here is to get as many people to number one identify if they have a sleep disorder and then be able to try to figure out what to do about it. And the percentage of people in the US that have undiagnosed sleep apnea is pretty big. It's like somewhere between I think like 18 to 20%.

Steven Bartlett: This is crazy. I was just looking at the stats. It says according to 2026 data approximately 936 million people to 1 billion adults worldwide have obstructive sleep apnnea which is what one in seven

Dr. Michael Bruce: yeah that's about right

Steven Bartlett: making it as common as diabetes. One in seven people listening have sleep apnnea.

Dr. Michael Bruce: Yes.

Steven Bartlett: Wow.

Dr. Michael Bruce: As popular as diabetes. Let that sink in for like half a second. Everybody knows what diabetes is. Almost nobody knows what sleep disorders are. Specifically sleep apnnea. And it says 80 to 90% of those people remain undiagnosed. That is correct.

Steven Bartlett: So there's people listening right there's actually a huge percentage of people listening right now

Dr. Michael Bruce: that have sleep apnea and have no idea that they have it.

Steven Bartlett: Exactly. Right.

Steven Bartlett: How would they know?

Dr. Michael Bruce: Do the sleep test.

Steven Bartlett: This thing here.

Dr. Michael Bruce: Yeah.

Steven Bartlett: And what would this show?

Dr. Michael Bruce: So this would this actually collects what is your oxygen levels throughout the night? What is your heart rate throughout the night? How many times do you actually stop breathing? And also the depth of your sleep, which stages of sleep you get when you fall asleep, things like that. And what would this So, you know, because people are going to be like, "How do I know if I need to do the test?"

Steven Bartlett: So, great question. So, you want to think about the symptoms that you might have. So, do you snore? Do you wake up gasping for air? Has anybody told you that your snoring stops for brief periods of time or that they've heard you gasping for air? Do you wake up with a headache in the morning? Do you find your moods are up and down? All of those are signs and symptoms of sleep apnnea.

Dr. Michael Bruce: And this test, are you affiliated with this company at all?

Steven Bartlett: I am not. But um we do have that test on my website. We sell it to people so that way we can test them.

Dr. Michael Bruce: And how much does it cost?

Steven Bartlett: $189.

Dr. Michael Bruce: Okay. So it's not

Steven Bartlett: it's not exorbitantly expensive. And it also is covered by insurance.

Dr. Michael Bruce: And it connects to an app.

Steven Bartlett: Uh-huh. Absolutely. So you'd put it through your sleeve.

Dr. Michael Bruce: So I' I'd put that there and like this.

Steven Bartlett: Yeah. Exactly. And that's it. You go to bed, wake up, then the information ports over to your phone and then tells us exactly what's going on. Now, here's where it gets even better. I know, right?

Dr. Michael Bruce: Can you imagine me getting in bed with my fiance and being like, "Come on, babe. Let's

Steven Bartlett: We're recording all kinds of good stuff. Who knows what she might like?

Dr. Michael Bruce: Is this going to help my sex life?"

Steven Bartlett: It's absolutely it will because getting into bed and knowing how well you sleep and knowing if you have sleep apnea or not will definitely affect your sex life. Also, by the way, I've saved more marriages as a sleep doctor than I ever would have as a marital therapist dealing with snoring in the middle of the night and things like that. So, you'd be you'd be surprised. But what's nice about this is it's one night. You don't have to do it multiple nights. It's super easy. Um, and again, believe it or not, that's disposable. You can actually throw that whole thing away after it's all said and done.

Dr. Michael Bruce: And on that point, before we just go a little bit further into sleep apnnea, should should we be sleeping in bed with our partners? And I know that's an interesting thing.

Steven Bartlett: Great question. Great question. The strength of your relationship has nothing to do with where you sleep. Okay? So, lots of people are like, "I got to sleep with my partner otherwise my relationship's going to go to [ __ ] and everything's going to go terrible and we're never going to have sex and we're not true." Okay. So, a lot of times for people that I have, so for example, I've got people who um have sleep apnnea and they use a a machine to help them sleep called a CPAP machine, right? And um that noise for some people can be disruptive and so they sleep, let's say, in a different room, right? So, is that is that detrimental to your marriage? No, it's not. Because here's what you do is you vacation on the weekends in your bedroom, right? I can't count the number of people who sleep separately during the week and then together on the weekends. And it turns out that they get much better sleep during the week. And then guess what? Intimacy shows up much faster on the weekends because they're not so tired. Used to be, you know, not tonight I have a headache. It was really not tonight I'm exhausted. When you allow your partner to get good sleep during the week, there's a reasonably good shot that you're going to be able to be intimate over the weekend if they got good sleep. So, wearing that to bed might not be the sexiest thing in the universe, but it's better than having sleep apnnea and eventually ending up dead.

Dr. Michael Bruce: Are the symptoms of sleep apnnea different for men and women?

Steven Bartlett: They are. Great question. So, it turns out that men and women are quite different, but we've historically been scoring them the same. So women don't have a tendency to have as much snoring as men do. Um women have a tendency to have more arousals where they wake up constantly. Women have a tendency to report headaches in the morning more so than men do. So it's actually different types of symptoms for women versus men when it comes to sleep apnea to the point where we're now considering using different testing devices. So this testing device um would not necessarily measure EEG and in women EEG might be important. That's what we're learning. So, as an example, our company is finding a device specifically to send to women so that way we can more accurately measure sleep apnea in women. Now, there's a lot of questions about treatment for sleep apnea. And the biggest reason why nobody gets sleep tested is because they're afraid that they're going to end up sleeping with a CPAP machine on their face at night. And so, let me describe to your audience what that is. Also, full disclosure, I have sleep apnea. I don't look like somebody who has sleep apnea. I stop breathing in my sleep. I think it's 26 times an hour. I know, right? Kind of crazy. And I wear a CPAT machine and it helps me sleep every single night. Let me explain what it is. So, when your throat closes here, CPAT machine is a little air compressor with a tube and a mask that sits on your nose, pushes a just thin stream of just air, and when it hits that blockage, it ever so slightly opens it up, shoots air straight down to your lungs. Now, you might be saying to yourself, "That sounds barbaric. That is insane. That's a haird dryer blowing up my nose all night long. Here's what I can tell you is when you have a severe case of sleep apnea, this can be a lifesaver. This can be one of the biggest, most important things that you possibly do. Now, a lot of people say, "Oh, I don't think I could sleep with a mask on my face." Well, that's not the only treatment. There are other treatments called oral appliances. This is like a a mouthguard like you see the footballers wear, but it's an upper and a lower. and the lower slowly brings your jaw forward which opens up your posterior airway space. The same way that air pushes things aside, the oral appliance structurally moves your jaw slightly forward thereby opening up your airway. So that works well and there's no mask on your face. There's a third device that you can wear on your tongue that vibrates that shrinks your tongue by a couple of millimeters which opens up this posterior airway space and allows you to breathe better.

Dr. Michael Bruce: Have you tried all of them?

Steven Bartlett: I have as a matter of fact. And why did you choose the apnea machine?

Dr. Michael Bruce: So for me, the apnea machine worked the best and made the most sense for me right now. But I'll be honest with you, I will probably get the uh mouthguard for when I travel. There's a lot that can be done out there. And by the way, there's also surgeries and surgeries are a little bit more permanent fix. Um, but in many cases, those surgeries can be quite effective. Also, by the way, they're working on a pill for sleep apnnea now. And that's just apnea. We haven't even talked about insomnia yet.

Steven Bartlett: I was just reading about the FDA approving a drug. Yeah, it's it's quite remarkable. And there's actually two I think there's actually three different companies that are working on different drugs right now for sleep apnea. And I mean to be clear, when that happens, I think it's pretty much game over for sleep apnea, right? I mean once we can get it in a pill form, which means compliance increases dramatically, we can help a lot of people with sleep apnea, which I think would be pretty amazing.

Dr. Michael Bruce: And women are heavily undiagnosed, right? Because we heavily

Steven Bartlett: we think of it as I mean I've heard it being referred to as a sort of an old man's disease.

Dr. Michael Bruce: Yeah. And oh, absolutely. And here's the thing. Many women have a tendency to report insomnia types of symptoms over sleep apnea types of symptoms when in fact they actually have under undiagnosed sleep apnnea, which we can catch.

Steven Bartlett: We talked a little bit earlier, but um from many of the conversations I've had on the show about Alzheimer's,

Dr. Michael Bruce: yes,

Steven Bartlett: your chance of um getting Alzheimer's, I imagine, is going to increase, right? Because absolutely you have sleep apnnea.

Dr. Michael Bruce: Yeah. Well, because when you have sleep apnnea, it keeps you out of the deeper stages of sleep. the deeper stages of sleep is where that lymphatic system comes in and scoops out those proteins and that's really probably one of those big causes for it. So that's one of the things that we always want people to understand. But there's also something else that I think is important to maybe talk about which is on the other side not sleep apnnea side but on the insomnia side which is there's a lot of people who go and they go to the drugstore and they buy an over-the-counter sleep aid. Right now I'm not talking about supplementation yet. We can get into supplements in a minute if you want to, but I'm talking about things like the PM medications, right? You know, they so here in America, we have them where there's like there's like an analesic plus a PM. So there's Tylenol PM, Advil PM, and what it is is it's a pain reliever, but they add something called dyenhydramine and it makes you feel sleepy and it makes you fall asleep. Dyenhydramine is actually an antihistamine, right? So it's used for congestion and things like that. But there's now data to suggest that daily use of the PM part of this, not the pain relieving part, but the PM part can lead almost directly to Alzheimer's.

Steven Bartlett: Oh, wow.

Dr. Michael Bruce: Right. So, if people can just go to bed and follow a couple simple rules and go to bed naturally, you'd be shocked at how much better your world is going to be. The Queensland Brain Institute um at the University of Queensland found that people with untreated apnea have a 45% higher risk of developing Alzheimer's disease.

Steven Bartlett: Like I said,

Dr. Michael Bruce: which is crazy.

Steven Bartlett: Soant here's the thing is we've got all these people who are watching your show right now. They need to start thinking in their head like maybe I have sleep apnea, maybe I don't, but maybe I should take a look at what are some of the symptoms and see if that's something that could be going on for me. Because again, testing is available. And to be clear, it's not like I'm the only guy out there testing people. I mean, there are sleep doctors all over the world that are testing people. My encouragement to people is, hey, figure it out. If if you can't figure it out, you know, shoot us an email. We'll find a sleep center for you to go to. But if you think there's something going on, it's definitely worth checking out because, by the way, you can stay with undiagnosed sleep apnnea for your entire life. And it all it does is basically break down everything that's going on inside. And that's not what you want. Like remember sleep is recovery, right? This is how your body still functions. Like if you want to lead a nice prosperous life, you want to sleep.

Dr. Michael Bruce: Insomnia has become a bit of a word that people throw around

Steven Bartlett: for sure,

Dr. Michael Bruce: right? They they kind of self diagnose themselves. We kind of think of it as this one specific thing. I think people say, "I have insomnia when they just don't sleep well."

Steven Bartlett: Right.

Dr. Michael Bruce: What is insomnia and what's the big myth around it?

Steven Bartlett: Yeah. So, number one, there's a couple of different flavors of insomnia. There's the I can't fall asleep. There's the I can't stay asleep, which we talked about quite a bit. There's the I wake up too early, and then there's just the I wake up from unrefreshing sleep. So, we really think that there are four sort of types of insomnia, right? And um when people I would say some of the biggest myths that a lot of people have surrounding insomnia is or like the biggest problem that they do is when somebody has a really crappy night then what they try to do is the next evening go to bed early and try to catch up on some of that sleep that they missed. So to be clear this is a terrible idea because your circadian rhythm isn't ready to go to bed early. So you lie in bed and you're exhausted but you can't fall asleep. you're what I call wired and tired, right? And so what we want people to do is if you do have a bout of insomnia where you have difficulty falling asleep or difficulty staying asleep, number one, don't overcaffeinate during the daytime. So many people are like, "Oh, I'm dragging. I got to get a coffee," you know, and and they and they caffeinate, caffeinate, caffeinate, and then they caffeinate so late into the day that they have shitty sleep that night, and now we're in the washing machine cycle going over and over and over. It sounds like you might be relating to this uh a little bit maybe yourself. And then so we want to avoid that. The other thing we want to avoid is over stimulation at night, right? So a lot of pimps people get that nervous energy and so they're just doing doing. Again, you need runway to land the plane. So give yourself some kind of that space. Um and then just make sure that you've got some level of regularity. I would argue for my insomnia patients, but quite honestly for anybody who's watching this, the number one sleep tip that I can give people is to wake up at the same time seven days a week. Not go to bed. I don't actually care when you go to bed that much. I know there's a lot of sleep specialists out there who are like, you got to go to bed at the same time and wake up at the same time. I'm not of that ilk. I don't really care that much about the going to bed time. I really only care about the wake up time. Let me explain why. When you wake up in the morning, sunlight hits your eye and you have a special cell in your eye called the melanopsin cell which sends a signal to your brain to turn off the melatonin faucet in your head. But it sets a timer for exactly 14 hours later. It's called the melatonin phase response curve. So if you're waking up at 6, melatonin turns off until about 8:00 p.m. Then it takes about a couple hours for it to get up and in. So then you start to get sleep around 9:30 and you go to bed. But if you did that and now it's Saturday and you sleep in until 8, melatonin doesn't kick off until 10:00 Saturday night. So what I'm saying is the time that you wake up directly determines when your internal melatonin kicks into gear. So if everybody woke up at the exact same time every single day, seven days a week, automatically you would get tired at the right time and you would start going to sleep.

Dr. Michael Bruce: And is there two different types of insomnia? Sometimes I hear primary, secondary insomnia. I think you have that on your YouTube channel.

Steven Bartlett: So when you look at primary insomnia versus secondary insomnia, the way we categorize that, secondary insomnia is usually due to something else that's going on in your life. So

Dr. Michael Bruce: psychology,

Steven Bartlett: so maybe caffeine abuse.

Dr. Michael Bruce: Okay?

Steven Bartlett: Right? Um maybe something along those lines. Whereas primary insomnia is there's nothing else. You the only thing you've got going on is sleep disorder. Another example of of something where insomnia might be secondary would be pain.

Dr. Michael Bruce: Right? So if you have a pain syndrome, if you have fibromyalgia or low back pain, that could prevent you from sleeping. That would be secondary insomnia, secondary to pain.

Steven Bartlett: And I hear that the most common treatment for insomnia is CBT therapy.

Dr. Michael Bruce: So yes and no.

Steven Bartlett: Okay.

Dr. Michael Bruce: So I would say that the most common therapy for insomnia is alcohol.

Steven Bartlett: More people drink themselves to sleep than any other single thing out there.

Dr. Michael Bruce: Um and then you start to get into the pharmacy of it all. And there's a lot of pharmaceutical drugs out there that people utilize for for sleep. And I want to make a point if I can is there's nothing wrong with needing a pill to sleep. Okay? I want to be very clear about this. There are people out there who need pills, right? All kinds of different ones. Thank you. There's a whole host of reasons why you and your doctor may have come to the conclusion that a sleeping tablet is good for you. The problem comes when those sleeping tablets are overprescribed. So insomnia is in the in the sleep world, we call it a door handle diagnosis because when the doctor has their hand on the door and they're just about to leave, that's when the patient says, "Oh, and by the way, I'm not sleeping."

Steven Bartlett: And then the doctor usually pulls out the prescription pad and says, you know, ambient or trazadone or something like that, writes it up, says, "Here, come back in 30 days." Well, you haven't really done anything for this person. You've handed them a pill. And by the way, now they're probably either psychologically or physiologically addicted to said pill right now. Once again, if you've got a major mental health issue, I don't think I care. I think it's okay for you to have your AMVN and be fine. And

Dr. Michael Bruce: and a lot of people that do have insomnia have depression.

Steven Bartlett: Oh, I think it's one of the biggest things that we see. But I would argue anxiety might be a little bit more than depression. But yes, anxiety and depression, I would argue, make up 75% of insomnia at any given time. Right? I work with people and I do something called cognitive behavioral therapy for insomnia which you correctly identified as CBTI, right? And so I work with patients all the time. Um, and that's exactly what we do is we reschedule them. So that's the behavioral part. And then the cognitive part is we talk to them about how do you think about sleep? Because a lot of people think about sleep in disastrous ways. They're like, if I don't get eight hours, my old day is screwed and everything's going to happen. It rarely happens that way. Like it's called catastrophizing. You just make it worse and worse and worse. And so we look at those cognitive distortions and we help fix them in therapy by really kind of what I call doing the math. And so I say, "Well, have you ever had four hours of sleep?" "Yes." "Did you do something terrible the next day?" "No." "So where's your evidence?" Right? And you start to get people to challenge themselves and all of a sudden they kind of they can kind of get there. There's also another area of that a lot of people go to somewhere in between the pills and therapy, and that's supplementation. So there's a lot of people out there who like to use supplements and try to understand how to fix quote their insomnia with supplementation. So if we can let's talk a little bit about supplements and sort of what's good and what's bad.

Dr. Michael Bruce: What is the difference between a supplement and a pill or is it you talking about the same thing here?

Steven Bartlett: So under the context of this conversation, a supplement is a non FDA regulated thing that you can purchase at any drugstore and a pill is a by prescription only from a doctor.

Dr. Michael Bruce: Okay,

Steven Bartlett: that's how we're going to make the distinction for this particular conversation.

Dr. Michael Bruce: Okay, so those pills that are in front of you there,

Steven Bartlett: so right in front of me, these are most these are actually all supplements. So these are different. So these are not pharmaceuticals. These are different things. So, we've got

Dr. Michael Bruce: I mean, in different countries, it's different, right?

Steven Bartlett: Great point. So, let's talk about melatonin since that's kind of the biggie that a lot of people like to know about. So, number one, melatonin is by prescription only almost everywhere other than the United States, right? So, in England, in Australia, in Europe, you can't just walk into the drugstore and buy melatonin. And there's a reason. A lot of people don't realize it, but melatonin is a hormone. There's a reason you can't go to the CVS and get testosterone and estrogen, right? Because hormones affect the entire system. They affect all three almost 300 different things in your body. So what you don't want to do is have somebody just willy-nilly grabbing a hormone and starting to pop it without somebody understanding what's going on with them. More importantly, melatonin in particular, and the point I wanted to make earlier about depression, melatonin interacts with all SSRI medication. An SSRI is a serotonin specific reuptake inhibitor, an anti-depressant. So things like Prozac, Zoloft, um, Selelexa, all of those are medications that will be affected by melatonin ingestion and nobody knows that it is. In addition, melatonin affects birth control. Yes, you heard it here, birth control. It affects blood pressure medication and it affects diabetes medication. So, one of the problems is that people go into the local drugstore and they're like, "Oh, I'm going to grab some melatonin and I'm going to make my sleep better because I'm sleeping poorly." So, first of all, that's not what melatonin does. Melatonin is a sleep regulator, not a sleep initiator. Melatonin doesn't affect sleep drive. Melatonin affects sleep rhythm. So, remember in the beginning of our conversation, we're talking about the two systems. Melatonin only affects your brain telling it when it's time to go to bed. It does not make you sleepy. That's a denisonin. We already talked about adenosin and caffeine and how similar their molecular structures are. So when you look at something like melatonin, you need to really be thoughtful about using it. Number two, melatonin is not to be used in children. Okay? So a lot of people are like, "Michael, I've got pediatricians all over the country telling my telling me to give my children melatonin." I'm going to say it right here in front of everybody. That is the dumbest idea I have heard in a long time because you just taught your child that they need a pill to sleep. Normally, no child needs pills to sleep. And by the way, most children make almost four times the amount of melatonin that their brain even needs. So, giving them extra melatonin doesn't do you any good. There is, however, one group of children where melatonin does work well, and that's in kids on the autism spectrum. um we don't know exactly why but um or at least I don't but there is data to suggest that at five six seven milligrams that that can be very helpful for them. Dosage also is a problem like if you go to the drugstore you can you almost can't find it in the appropriate dose. The appropriate dose is anywhere from about half a milligram to one and a half milligrams. Maybe top out at three but that's about as high as you want to go. But when you go to CVS you find a gummies in 10 and 20 milligrams. And people tell me all the time, "Oh, I can't take melatonin. It gives me crazy dreams." Number one side effect of overdosing on melatonin is crazy dreams.

Dr. Michael Bruce: On this point of going to a supermarket and picking some melatonin off the shelf,

Steven Bartlett: FDA approval and the lack of FDA approval in melatonin means that there's less clarity on what's actually in there. Right.

Dr. Michael Bruce: That's exactly right. I was reading about a study in 2024 um where they looked at different melatonins that were found on the shelf

Steven Bartlett: and they found very different things inside the bottle.

Dr. Michael Bruce: Very very different things. They looked at an analysis of melatonin gummies marketed for children and found that the actual amount of melatonin ranged from 0% to 667% of what was listed on the label.

Steven Bartlett: right

Dr. Michael Bruce: Yep. See it all the time. And in the same study, melatonin gummies, some melatonin gummies contained absolutely no melatonin, while others contained hazardous contaminants like CBD that were not disclosed on the label.

Steven Bartlett: Yep.

Dr. Michael Bruce: Because melatonin is sold as a supplement in the US and not a drug, the FDA does not test it for safety or accuracy before it hits the shelf.

Steven Bartlett: You are 100% correct. And that's a huge problem. Just think about that for a second. I mean, the market for melatonin is tremendous. It's huge in the supplement world. Yet, there's no regulation. whatsoever. Nobody knows about these interaction effects which are big, big, big. And by the way, most people are using it wrong. There's really only three maybe four different instances when melatonin would be useful. I would use melatonin for jet lag, and we should talk about jet lag. Um I I would use uh melatonin for shift workers, right? So for people who work, you know, night shift who have to sleep during the daytime, they would be excellent people to use melatonin. people with a melatonin deficiency. A lot of people don't think about that, but right around age 50 is when if you're going to have a melatonin deficiency, we start to see that happening for people is it their the ability to produce melatonin begins to decline. So, I think those three situations absolutely would be on board for melatonin. Believe it or not, there's some data to show that in ADD and ADHD there's uh some use for melatonin and then also for a very specific sleeping disorder called REM behavior disorder.

Dr. Michael Bruce: We're going melatonin crazy as a society, aren't we?

Steven Bartlett: Absolutely. We don't need it. It's completely unnecessary.

Dr. Michael Bruce: I was looking at the data. In 1999, 0.4% of Americans said they used melatonin. Today, it's almost 30%. So, 70 million Americans up, dude. That is problematic. And again, they have no idea what it's doing to them, right? And they're giving it to their kids. Like, I can't think of anything worse for a young female developing body than to add a contraceptive when it's not necessary. Like, it just doesn't make sense to me. The rise in children overdosing on sleep gummies is the fastest growing trend in poison control data.

Steven Bartlett: Yeah, I think it's like almost 600% increase or something crazy like that for kids who have uh gotten uh who've overdosed on melatonin like within there was a study that came out maybe a year ago, year and a half ago showed like almost 600% of uh increase in uh overdoses for kids. Like that's pretty messed up when you start to think about it. And here's the thing, kids know how to sleep, right? You just got to stop. You just got to let them sleep, right? You got to give them some parameters. Here's when you go to bed. Here's when you wake up. Don't get out of bed. You know, don't come in and ask for 12 glasses of water. You know, all the all the stuff that goes on there. I mean, it it this isn't hard.

Dr. Michael Bruce: So, when and how So, I used melatonin once in my life.

Steven Bartlett: Okay.

Dr. Michael Bruce: And I got to be honest, it [ __ ] worked.

Steven Bartlett: Yeah. Oh, if you use it right, it works, bro.

Dr. Michael Bruce: And it was it was actually about a week ago because I'd been struggling with lots of jet lag. I'd flown from the UK to the LA to UK to LA to Cape Town to Middle East to wherever and I was getting to bed every night at like 4:00 or 5 a.m. and still waking up at, you know, having to wake up at about 10:00.

Steven Bartlett: So, I thought, I need to correct this. It's been going for two weeks and I need to correct this.

Dr. Michael Bruce: Absolutely.

Steven Bartlett: So, I thought, [ __ ] it, I'm going to cave. I g I took the melatonin and corrected it.

Dr. Michael Bruce: Yes, it does. So, let's talk about jet lag. So, it's a bit of a story, but I got involved with a company that um has got an app, which is very interesting. Okay. Um I don't have any like I'm not invested in the company, just to be clear, but it's one of my close friends who developed this. So, I'm kind of a space nerd.

Steven Bartlett: It's not Time Shifter.

Dr. Michael Bruce: It is Time Shifter.

Steven Bartlett: Oh, really?

Dr. Michael Bruce: It is.

Steven Bartlett: I also like an affiliation with Time Shifter

Dr. Michael Bruce: because I used to Yeah, I will get you that. So, here's what's fascinating is the way the whole time shifter started was um so aren't you kind of a space guy? Like, aren't you

Steven Bartlett: I'm an investor in SpaceX and

Dr. Michael Bruce: Okay. So, I'm a space nerd myself, right? So, you know, the the ISS is moving around at 17,500 miles an hour around the Earth. It's cooking.

Steven Bartlett: ISS meaning the International Space Station. It's whipping around, right?

Dr. Michael Bruce: Can you imagine how many sunrises and sunsets they get in a given day?

Steven Bartlett: Oh, no. How many?

Dr. Michael Bruce: Every two hours. So, they basically get 12.

Steven Bartlett: Wow. Think about how messed up their circadian rhythms would be from seeing the sunrise and seeing it go and see it gets really messed up, right? And by the way, you don't want to make big mistakes in the space station. Like you don't leave the air lock open, you know, or [ __ ] like that. Like that's when things get really really bad. So they called down to NASA and they were like, "Hey, we got a problem up here. Everybody wants to use the lab at the same time like people seeing the sun. Like what's going on?" So they called a buddy of mine named Steven Lachley over at Harvard. Stephen is arguably the one of the best circadian researchers in the world. um super smart dude and he was like, "Well, let's send up a lighting kit and let's create ships on the space station."

Dr. Michael Bruce: Mhm.

Steven Bartlett: Right. So that's exactly what they did. So they sent up a lighting kit. I think it was on the Colombia um shuttle before it got decommissioned. And they set up lighting and then they set up timing for lighting. And so there was a morning shift, a midshift, and a night shift for the astronauts. Once they got the algorithm working, they brought it down terrestrially and they put it into the Mercedes-Benz uh Formula 1 race car team. So they gave it to Lewis Hamilton.

Dr. Michael Bruce: Mhm.

Steven Bartlett: Right. Because when you think about it, think about what he has to do, right? He's on or off the podium on hundreds of a second, right? And he's in a different country every 3 weeks,

Dr. Michael Bruce: right? So this guy's got jet lag like you wouldn't believe. And so once we were able to get it going there, then we created the time shifter app. And so it's an app you can get it on your phone. And what you do is you put in your flight number and it automatically pulls up the flight and knows where you are. This is why I think that jet lag is a math problem. Let me explain. We learned about 20 years ago that when you take a certain frequency and intensity of light and you shine it in somebody's eyes, you can move their circadian rhythm by about eight hours if you want to.

Steven Bartlett: That circadian rhythm again being

Dr. Michael Bruce: being that internal biological clock, the time when your body wants to go to bed and wants to wake up. We can actually move that by about 8 hours with about 10,000 lux, which is the brightness level of blue light, particular frequency of light. Okay? So when you hit that, if you start in LA and you're going to Manchester, right, and there's a big time difference and you know what time it is in LA and you know what time it is in Manchester, it's a math problem of when do you get the light.

Steven Bartlett: So that's what time shifter is, is it determines when do you need that light and then on the times when you don't need light, it has you use caffeine, right? Or to keep you awake or if it's time to sleep, then you use a little bit of melatonin. That's when melatonin becomes so valuable.

Dr. Michael Bruce: It also tells you when to eat.

Steven Bartlett: It does. It tells you all of these different things. And it's kind of nice because it kind of shows up on your phone. It's like, "Hey, do this then. Do this then." And it works really, really well. But yeah, Time Shifter is one of my favorites. Uh I've been uh using it literally for 15 years.

Dr. Michael Bruce: Wow.

Steven Bartlett: And it solves jet lag, bro. Like we're going to fix that for you. No, no question.

Dr. Michael Bruce: How often should someone be having melatonin? Is there like too often? Because some people literally have it every day. Yeah, I would argue it's a bad idea. So, if you have a melatonin deficiency, sure, have it every day. But, um, or if you're a shift worker, probably. But I I use it only for jet lag myself. Otherwise, I'm not using it on the regular.

Steven Bartlett: And what's the risk there of having it every day? Is it?

Dr. Michael Bruce: Uh, it's a good question. So, when you start to look at melatonin overdose and you start to look at melatonin on board for long periods of time, there's been some conflict in the in the research. Um, there's a group of people that say if you stay on melatonin for extended periods of time, your body stops producing it. There's another group of people that have looked at research and have said actually that's not the case. So, right now we have we have studies that lead out to about a year or so on melatonin. And when you stop their melatonin production after they've been taking it for a year, their body seems to start back up no problem. It's different than testosterone, right? So with testosterone, we know that when men start taking testosterone, their body actually stops producing it. With melatonin, that does not appear to be the case, but we don't have studies that go out past, you know, that yearong. And so if somebody's been taking melatonin every day for 5 10 years, you know, you you kind of start to wonder uh what's going to happen. Also, don't forget that that melatonin is different than the melatonin that's actually produced in your head. I think it was Andrew Huberman who I was speaking to a couple of weeks ago that was was saying about not giving kids an overdose of melatonin. And I think afterwards I I was doing some research on it and I read something that said it has an impact on puberty potentially.

Steven Bartlett: So in high dosages melatonin is a contraceptive.

Dr. Michael Bruce: So that would pause puberty.

Steven Bartlett: Exactly. Or change it

Dr. Michael Bruce: and ways we may or may not know. So, I agree with Andrew on that point that again, melatonin is not something that kids need unless you've got kids on the spectrum, which is again where I find it to be helpful and I've treated kids with that before, but generally speaking, I don't put melatonin on anybody under the age of 18.

Steven Bartlett: Am I more likely to have nightmares if I'm having lots of melatonin?

Dr. Michael Bruce: If you're overdosing, you are. So, the number one side effect of a high dose of melatonin is super vivid dreams and then eventually nightmares.

Steven Bartlett: Why? I'm not really sure. If I was garnering a guess, then what I would say is that part of the reason why that you have crazy vivid dreams from melatonin is because it probably does put you into REM sleep a little bit quicker than you normally would and might keep you there a little bit longer. I don't have any data to support that. So, I want to be clear. Um, this is more of a hypothesis on my end, but that might make intuitive sense to me.

Dr. Michael Bruce: Just on a quick search, um, Sure. You're right. It says it keep keeps you in REM sleep a little bit longer and more intensely.

Steven Bartlett: There you go.

Dr. Michael Bruce: This leads to vivid highly vivid dreams or night terrors which paradoxically makes you wake up feeling more exhausted.

Steven Bartlett: Right. I can't count the number of people who tell me

Dr. Michael Bruce: I need to go back to sleep because I'm so exhausted from my dreams.

Steven Bartlett: Oh wow.

Dr. Michael Bruce: Right.

Steven Bartlett: So let's finish off on these supplements then.

Dr. Michael Bruce: Yeah. Absolutely. So we talked a little bit about melatonin which like