If you’re anything like me, you probably have a love/hate relationship with sleep. You love the way it makes you feel, but you hate that it seems to waste so much time, or maybe it just doesn’t come easily to you.
As someone who has struggled with and ultimately conquered severe sleep onset insomnia, here are the lessons I’ve learned. Dr. Jubbal, MedSchoolInsiders.com.
New research has illustrated just how important sleep is, this is the part where you moan in annoyance as you’ve been told this time and time again. I won’t belabor the point, but I do want to leave you with three facts about the importance of sleep that are too interesting to omit. First, drowsy driving accounts for more accidents than drunk driving or driving under the influence of other substances combined. Second, you can function well without food for several weeks, without water for several days, but you experience the most rapid decline in function without sleep. And third, despite millions of years of evolution, we still spend one-third of our lives asleep despite it being extremely costly. Think about it, it must be necessary if evolution hasn’t prioritized finding food, or finding a mate, or simply not being vulnerable to predation. For more interesting sleep facts, check out the
Peter Attia The Drive episode with Dr. Matthew Walker. Link in the description. Now, let’s address your difficulty with getting good quality sleep or getting enough sleep, and don’t tell me you are too busy to prioritize your sleep.
As someone who is actively growing two YouTube channels, and growing three separate businesses while still getting seven to eight hours of sleep, I’ll be the first to say that it’s less about you being busy and more about you being inefficient with your time. A lot of viewers have asked me how I’m so productive and I’ll be releasing a video about my strategies on the Kevin Jubbal, M.D. YouTube channel. Make sure you’re subscribed, so you don’t miss it. The discussion on sleep optimization has recently focused heavily on one’s chronotype. As humans, or rather organisms on planet earth, we run on a circadian rhythm. This 24-hour internal clock coordinates various physiologic functions related to sleep and wakefulness from hormone levels to body temperature and much more. Approximately 40% of people have an advanced sleep chronotype, meaning that they are morning people or early risers. Approximately 30 percent of the population has a delayed sleep chronotype, meaning they are night owls. The other 30% falls somewhere in the middle. As Dr. Walker writes in his book Why We Sleep, night owls are not owls by choice. They are bound to a delayed schedule by unavoidable DNA hardwiring. It is not their conscious fault, but rather their genetic fate.
Chronotypes actually change over the course of your life. Infants are predisposed to early chronotypes, teenagers are delayed chronotypes, and once you pass the age of 50 or 60, you trend towards early again. Your chronotype in adulthood is set in your early 20’s and generally stays constant. Greater understanding of chronotypes is awesome, but it comes with good and bad news. The good news is that it’s backed by science and we understand that being a night owl doesn’t mean you’re lazy, It just means you have a delayed sleep chronotype. If you have a delayed sleep chronotype, there are even data suggesting your prefrontal cortex, which is the part most important for your higher-level cognition won’t function optimally when you’re forced to wake up early. But here’s the bad news, the world doesn’t care about your chronotype. I don’t consider myself an early bird, but I still had to wake up at 3:30 a.m hundreds of days in a row while doing plastic surgery.
The hospital and operating room didn’t slow down just because I’m not a morning person. That being said, all hope is not lost.
In my first video about sleep optimization, which now has over five million views, I explained how I grew to love waking up early despite not being a morning person. And in this video, I’ll teach you the techniques to sleep like a pro regardless of your chronotype. When we speak about optimizing sleep, we don’t simply mean getting more shut-eye. Surely, you’ve experienced nights where you slept for eight hours and felt great in the morning, and other nights where you slept eight hours but somehow felt terrible. The reason is that there are four pillars of sleep and sleep duration is only one of them. The four pillars are: First, Sleep Depth and Quality. This is reflected in the quality of a sleep waves, meaning alpha, beta, delta, theta waves, sleep spindles, k complexes, etc. These are measured on an EEG.
Number two, Sleep Duration. How long are you sleeping? For most adults, this should be between seven to nine hours. Number three, Continuity. Is your sleep continuous or interrupted, and number four, Regularity. Falling asleep and waking up at the same time each day. Falling short in any one of these four pillars will result in sub-optimal sleep and negative effects on your restfulness and overall health. For example, say you have two scenarios where you sleep eight hours each night, on one night, you sleep eight hours continuously without interruption. On the other night, you sleep the same amount of time but over a longer nine hours with multiple small interruptions. The continuous sleep will result in far better restfulness. Keep these four pillars in mind as we work through the five steps in optimizing your sleep. There is no one single magic bullet and only you can decide how much you are willing to prioritize your sleep. Some of these changes will come easier than others. That being said, if you follow these instructions, you should experience a drastic improvement in how rested you feel. First, determine what time you have to wake up in order to get to work or school on time, work backwards from there, accounting for how long it takes to commute and get ready in the morning. You should plan for seven to nine hours of sleep each night. By doing this exercise, you will set up your target bed and wake times. This may not be optimized for your chronotype, but setting these times will still be highly beneficial in improving the quality of your sleep. As tempting as it is, do not deprive your sleep during the week only to binge and catch up on the weekends. This behavior throws off your circadian rhythm, resulting in reduced sleep pressure, meaning it’s harder for you to fall asleep and stick to your schedule come Monday. There’s a reason this is Step 1. This is arguably the most difficult step to implement, but I have personally found it the most powerful. If there are days that you can go into work or school later, I still suggest you sleep and wake up at your scheduled times. Use that extra time in the morning to get studying or work done. This benefits your sleep schedule and you might as well start the day off with a win. It’s not uncommon to stay up late on Fridays and Saturdays for social events throwing off your sleep schedule, I’ve done that too from time to time. However, during particularly stressful periods, like when I was doing plastic surgery, plus growing Med School Insiders, plus building and running a biomedical incubator, I prioritized sleep over social events. I wasn’t writing off socializing and partying forever, I simply was in a season in my life where I need it to grind hard. What season are you in. Step 2. Bedroom Optimization. If you’re serious about not feeling tired all the time, optimizing your bedroom should not be taken lightly. Let’s talk about lighting, sound, and temperature. In terms of lighting, you want your bedroom as dark as possible at night. I bought blackout curtains in college mostly because my apartment was poorly insulated but I soon realized the benefits of sleeping in complete darkness. This also means turning off any lights from electronics that illuminate your room. I placed electrical tape on various battery chargers and electronics in my bedroom that gave off even dim light. The results were surprisingly drastic. For temperature, understand that your hypothalamus reduces your core body temperature by approximately 2 degrees Fahrenheit for sleep. Ever notice how it’s terribly difficult to fall asleep in a hot room? To help your body get into a more conducive state for sleep, it helps to keep the room cool with most experts agreeing that the mid-60s are a good temperature to aim for. Or you can do what I do, which is wear very little when going to sleep and use light bedding. This means I can keep the room in the low 70s and still sleep like a baby. With regards to noise, most people don’t realize that noises that don’t wake them up consciously still affect their sleep quality. Remember continuity and depth from the four pillars? I like to use a fan as white noise in my room, but you can also buy a white noise generator which is what my housemate does. If it’s still noisy, I recommend using earplugs. Some people complain that earplugs poke them in the ears if they lay on their sides but that’s usually due to them not inserting the earplugs deep enough. If earplugs still bother you, Tim Ferriss has recommended putty earplugs instead. There are links to all of these items down in the description below. Step 3, Pre-bedtime Routine. If your mind is racing while you lay in bed trying to sleep, I feel you. I found pre-bedtime routines to be the most effective antidote. A good routine not only relaxes you and activates your parasympathetic nervous system, preparing you for rest, but it also acts as a classical conditioning stimulus to signal to your subconscious that it’s time to sleep. Substitute Pavlov ringing the bell and the dog salivating with you doing your bedtime routine and getting sleepy. My personal bedtime routine is to set my bedroom lights to a dim red color, take a warm shower, and practice mindfulness meditation for 10 minutes. Meditation has been demonstrated in clinical studies to reduce sleep latency, meaning how long it takes for you to fall asleep and also improve the continuity of sleep. I also keep a notebook and pen by my bedside so I can write down any lingering thoughts that may come up. I find that by writing them down and trapping them on paper, It’s easier for me to let go of that thought. If you’re wondering why I set my bedroom to red, it isn’t for the sex dungeon vibes although that is a welcome. secondary effect. Blue light stimulates photoreceptors in your eyes that inhibit the release of melatonin from your pineal gland. In short, using screens like your smartphone tablet computer or TV makes it harder for you to fall asleep. You can adjust the color temperature on your screens. On Apple devices, this is called nightshift, analogous to night mode on android devices, or flux on your computer. These work by turning your screen more yellow to warmer colors thus reducing the amount of blue light emitted in the evening. While they are helpful, a recent study has demonstrated that screens with night shift still suppress melatonin. The best way around this is to simply stop using devices at least 60 minutes, but ideally 120 minutes before bed. I know that is a long shot, so the next best thing to do is wear blue light blocking glasses which make everything appear super orange. These are the ones I wear and they aren’t just super sexy, but they work great too. Link Below. Be sure to also reduce the brightness on your devices as bright screens regardless of light color will also suppress that sweet, sweet melatonin. I take this part so seriously that I auto-scheduled “Do Not Disturb” mode on my phone every night after 9 p.m, that means no notifications, messages or phone calls. I also charge my phone far away from my bed, so I’m never tempted to pick it up. I don’t even set my alarm by looking at my phone, I always do it hands-free by activating Siri or Alexa through voice activation alone. That way, I don’t have to look at any screen. You may be wondering whether or not you should read in bed, here are the guidelines: If you have sleep-onset insomnia, meaning you have difficulty falling asleep then avoid reading in bed. You want to associate your bed only with sleep and sex. If you read in bed, you’ll begin to associate it with wakefulness. If you don’t have sleep-onset insomnia, or if you have issues with sleep maintenance insomnia, then you should be fine to read. That being said, remember to use a dim light and definitely do not read on an iPad or other backlit screen, Kindles are okay. Now for the fun part, setting your wake routine. I’ve used spin alarm clock which forces you to get up and spin in circles to turn the alarm off and sleep cycle in the past. But nowadays, I just use my regular built-in alarm function of my phone with two big caveats. First, I put my phone across the room, so I’m forced to get up to turn it off. Simple and effective. Second, I have Philips Hue smart lights integrated across my room, and actually across my entire apartment. Thirty minutes prior to waking up, my lights gradually increase in brightness, simulating a sunrise. This results in a much softer and less violently jolting way of waking up. Dare I say that waking up is even … pleasant. If you don’t want to go all out with smart lights, or if you’re on a tighter budget, you can also go with a wake-up light which is essentially a standalone alarm clock that gradually illuminates your whole room. Step 5. Daily habits to improve sleep. This is gonna be your least favorite part, but probably the most important for you to hear. You need sleep pressure or sleep debt to fall asleep at night. Adenosine is a compound that builds up in your brain during the day and it’s cleared at night. It’s one of the factors responsible for why we feel tired or sleepy as the day progresses. For this reason, if you struggle with sleep onset insomnia, avoid taking naps particularly later in the day as this clears adenosine and reduces sleep pressure. Caffeine, which blocks adenosine from acting on brain receptors should also be used carefully. Caffeine has a half-life of about 6 to 8 hours. We know you can sleep fine with blood concentrations of approximately half of your caffeine intake of the day, otherwise, your sleep will be disrupted. Therefore, stop drinking any coffee or tea eight hours prior to bedtime. If you sleep at 10:00 p.m, that means stop at 2 p.m. Caffeine should not be a crutch you rely on but rather a tool you use when necessary. I got through medical school and was in surgical residency drinking coffee only a couple times per year. So, yes, you can do it too. Alcohol and sleep don’t mix. While it may reduce sleep latency, the quality of your sleep is highly compromised. Remember the pillars? Alcohol inhibits REM sleep and also increases your body temperature, which is the opposite of what we want. Is marijuana the wonder sleep drug that we’ve always wanted? Not quite. THC decreases sleep latency, but it also inhibits REM sleep. There’s also a dependency component regarding the latency, meaning that when you stop using marijuana, you’ll have rebound insomnia. CBD, on the other hand, decreases latency without inhibiting REM. It also helps to reduce body temperature and may contribute to restfulness through its anxiolytic, meaning anxiety-reducing, effects. That being said, more research is required before we can provide guidelines on whether CBD use is beneficial or not with regards to sleep. If you found this video helpful, please let us know with a thumbs up as that keeps the YouTube gods happy. There are links to all the items discussed in this video down in the description. If you purchased using those links, we get a small kickback at no cost to you. Thank you guys for your support. Let me know what you want me to cover in the next video. Much love to you all and I will see you guys in that next one.