How To Finally Fix Your Sleep, Wake Up Rested & Transform Your Life with Dr Michael Breus #672
Dr. Michael Breus, a clinical psychologist and sleep specialist, reveals five common sleep traps and offers practical advice. He debunks myths like needing eight hours and the harm of weekend lie-ins, explains 3 AM awakenings, discusses sleep apnea, and provides a five-step plan for better sleep.
Deep Dive Analysis
23 Topic Outline
Common Sleep Mistakes and Circadian Rhythms
The 'Freaking Out' Sleep Trap
Modernity's Impact on Sleep and Basic Principles
Sleep Disrupting Habits and Avoiding Sleep Disorders
Understanding and Diagnosing Sleep Apnea
Dr. Breus's Personal Sleep Apnea Journey
Waking Up Between 1 and 3 AM: Causes and Solutions
The 'Power Down Hour' and Pre-Bed Routines
First Night Effect and Travel Sleep Hacks
Impact of Food and Blood Sugar on Sleep
Accuracy of Sleep Trackers and Wearables
Optimal Deep and REM Sleep and Aging
Sleep Challenges in Menopause
Addressing Sleep Issues for Carers and Shift Workers
Medication and Sleep (SSRIs)
Supplements for Sleep (Magnesium, Valerian Root)
Techniques for a Busy Mind
Frequent Night Wake-ups and Environmental Factors
Sleep During Pregnancy
Helping Children with ADHD Sleep
Restless Leg Syndrome Solutions
Dr. Breus's Five-Step Sleep Plan
Personal Sleep Environment and Thermoregulation
10 Key Concepts
Melanopsin Cell
A specialized cell in the eye that detects sunlight and sends a signal to the brain to turn off melatonin production, initiating a 14-hour timer for its re-release.
Melatonin Phase Response Curve
This describes the direct relationship between your wake-up time and when your body's internal sleep hormone, melatonin, begins to be released in the evening.
Social Jet Lag
A disruption of the body's circadian rhythm that occurs when sleep-wake times vary significantly between weekdays and weekends, making it difficult to adjust to the weekday schedule.
Monkey Mind
A colloquial term referring to the uncontrolled, often anxious, stream of thoughts about various topics (e.g., chores, work, personal issues) that can prevent someone from falling or staying asleep.
Sleep Apnea
A serious sleep disorder where breathing repeatedly stops and starts during sleep, most commonly due to the back of the tongue touching the back of the throat and obstructing the airway.
Bradycardia/Tachycardia
A pattern seen in sleep apnea where the heart rate first slows down (bradycardia) due to lack of oxygen, then speeds up (tachycardia) as the brain signals to resume breathing.
First Night Effect
The phenomenon where sleep quality is often poor on the first night in a new or unfamiliar environment because the brain is not accustomed to the different sensory inputs like noises and light.
Glymphatic System
A system in the brain that becomes highly active during deep sleep (stage 3/4), responsible for clearing out metabolic waste products and proteins, essentially 'washing' the brain.
REM Sleep
The stage of sleep primarily associated with mental restoration, where information is transferred from short-term to long-term memory, and the brain organizes and processes data.
Non-Sleep Deep Rest (NSDR)
A state of deep relaxation, also known as Yoga Nidra, where one lies in a relaxed pose without sleeping. An hour of NSDR can provide rejuvenative benefits equivalent to about 20 minutes of sleep.
12 Questions Answered
Everyone naturally wakes up between 1 and 3 AM because this is when the core body temperature reaches its lowest point. Most people roll over and go back to sleep, but 10-20% of the population has difficulty falling back asleep at this time.
You can partially catch up on sleep, but it's recommended to limit sleeping in to 30-45 minutes. Sleeping in for longer periods can disrupt your circadian rhythm and lead to 'social jet lag,' making Mondays difficult.
Signs include snoring, waking up with a headache, daytime tiredness, hitting the snooze button multiple times, mood disruption, difficulty focusing, and consistently feeling like you had a terrible night's sleep.
Wearables are generally good at detecting when you fall asleep and wake up, but they are not accurate for measuring the depth of sleep (deep and REM stages) because they approximate these from non-brainwave data. It's best to look at trends over a week rather than daily numbers.
Roughly 25% of REM sleep and 23% of deep sleep are general targets, but individual needs vary. As people age, they naturally get less deep sleep, and sleep architecture changes, requiring different scoring criteria in sleep medicine for those over 55.
Magnesium helps with sleep if you have a magnesium deficiency, which is common. If you do not have a deficiency, its effects are not as significant.
Frequent wake-ups can be caused by too much fluid or eating too close to bedtime, having emotional discussions before sleep, or underlying sleep disorders like sleep apnea.
Night shift workers should try to maintain their 'night' schedule as much as possible, even on days off, create a dark, cool, and quiet 'cave' for daytime sleep, and consider strategic short naps.
During pregnancy, prioritize getting as much sleep as possible in the second trimester, as the third trimester often brings discomfort. Relax and don't try to do too much, and ask for help when needed.
Work closely with their doctor on medication timing, as some ADHD medications can disrupt sleep. Educate the child on how good sleep can help their ADHD symptoms to encourage their cooperation with sleep routines.
First, check ferritin levels (a type of iron) through blood work, as levels below 60 can cause restless leg symptoms. If not ferritin-related, distraction techniques like crossword puzzles or certain medications may be used.
Some SSRIs can be alerting or affect sleep architecture (e.g., decreasing REM sleep). It's recommended to discuss medication timing with your doctor or explore alternative sleep-friendly SSRIs.
18 Actionable Insights
1. Maintain Consistent Wake-Up Time
Wake up at the same time every day, seven days a week, as your wake-up time directly determines when your internal sleep hormone, melatonin, turns on, impacting your circadian rhythm.
2. Limit Weekend Sleep-Ins
If you need to catch up on sleep, limit sleeping in on weekends to no more than 30 to 45 minutes past your usual wake-up time to avoid disrupting your circadian rhythm and causing ‘social jet lag’.
3. Avoid Freaking Out About Sleep
Do not get upset or anxious about sleep problems, especially when waking in the middle of the night, as anxiety increases heart rate and body temperature, making it harder to fall asleep. Approach sleep like love: the less you look for it, the more it shows up.
4. Implement a ‘Power Down Hour’
Dedicate the hour before bed to a structured routine: 20 minutes for necessary tasks, 20 minutes for hygiene, and 20 minutes for relaxing activities like reading a book, meditation, or prayer, to gradually prepare your body for sleep.
5. Stop Food and Alcohol Before Bed
Cease all food intake three to four hours before bed, and alcohol three hours before bed, as digestion and alcohol consumption raise heart rate and body temperature, disrupting sleep quality.
6. Stop Water Intake Before Bed
Stop drinking water at least two hours before bed and ensure you go to the bathroom once before lying down to reduce nighttime awakenings for urination.
7. Address Potential Sleep Apnea
If you experience symptoms like snoring, morning headaches, daytime tiredness, mood disruption, or difficulty focusing, consult a doctor for a sleep study, as these could indicate undiagnosed sleep apnea.
8. Use Breathing to Lower Anxiety
Practice 4-7-8 breathing (inhale for 4, hold for 7, exhale for 8) to lower heart rate and anxiety, which are crucial for falling asleep. Modify the counts if needed and use fingers to track cycles to avoid mental counting.
9. Distract a Busy Mind
If your mind is racing, try mentally counting backwards from 300 by threes or using cognitive shuffling (picking a word and finding five words for each letter) to distract your ‘monkey mind’ and allow natural sleep to take over.
10. Manage Travel Sleep Environment
When traveling, bring your own pillow for trips longer than three days, use an eye mask, earplugs, and drape clips to control light and noise. Check alarm clocks in hotel rooms and request quiet areas to minimize stress.
11. Check for Nutrient Deficiencies
Before taking sleep supplements, get blood work to check for deficiencies in magnesium, vitamin D, and iron, as correcting these can significantly improve sleep quality.
12. Adjust Stimulant Intake with Age
As you age or go through hormonal changes like menopause, your body’s tolerance to caffeine and alcohol may decrease. Consider stopping caffeine by 2 PM and alcohol three hours before bed, or even earlier if sensitive.
13. Prioritize Sleep as a Carer
If you are a full-time carer getting only 3-4 hours of sleep, prioritize extending your sleep to 4-5 hours, take short strategic naps (around 25 minutes), or incorporate non-sleep deep rest periods to mitigate negative effects.
14. Create a Morning Wake-Up Routine
Start your day with ’the three 15s’: 15 deep breaths, 15 ounces of water, and 15 minutes of sunlight exposure to hydrate, clear brain fog, and set your circadian rhythm.
15. Use a Rolled Towel for Neck Support
If you don’t travel with your own pillow, roll a hand towel from the hotel bathroom and place it along the horizon of the pillow to provide extra neck support, mimicking a supportive home pillow.
16. Avoid Emotional Discussions Before Bed
Refrain from having big, emotional discussions or making major decisions in the evening, as these can increase anxiety and heart rate, making it difficult to fall asleep.
17. Model Good Sleep Habits for Children
Create a consistent evening routine for children by dimming lights and lowering your voice, which prepares them for sleep and models healthy sleep habits they can adopt.
18. Consider Continuous Glucose Monitor
Use a continuous glucose monitor (CGM) to identify which foods cause blood sugar spikes or drops, especially in the evening, and adjust your diet to maintain stable glucose levels overnight and prevent awakenings.
5 Key Quotes
Sleep is a lot like love: the less you look for it, the more it shows up.
Dr. Michael Breus
We all used to know how to sleep until we grew up, and then life seemed to get in the way.
Dr. Michael Breus
In the history of time, nobody has ever forced themselves to sleep without anesthesia.
Dr. Michael Breus
I think that we are our best doctors. I think when we wake up in the morning, we know if we've slept well or we haven't slept well.
Dr. Michael Breus
It's all about the sleep that you got for the two weeks before the test. It's almost nothing to do with what happened the night before the test.
Dr. Michael Breus
3 Protocols
Getting Back to Sleep Protocol
Dr. Michael Breus- Don't go pee unless absolutely necessary, to avoid raising heart rate and temperature.
- Don't look at the clock or your phone to prevent anxiety about the time.
- Practice 4-7-8 breathing: slowly breathe in through the nose for a count of four, hold for a count of seven, then gently push out through the mouth for a count of eight. (Modify counts if needed, e.g., 4-5-6, and use fingers to track 20 cycles).
- If breathing doesn't work, try non-sleep deep rest (yoga nidra) by lying in a corpse pose on your bed in a quiet, relaxed, cool, dark room.
- Stay positive: acknowledge negative thoughts about being awake, but immediately counter with a reassuring thought (e.g., 'I've been here before, I'll be fine') to lower anxiety.
The Power Down Hour
Dr. Michael Breus- Dedicate the first 20 minutes to 'stuff you got to do' like last-minute emails or preparing for the next day.
- Spend the next 20 minutes on hygiene, such as brushing teeth, washing your face, or taking an evening bath/shower.
- Use the final 20 minutes for relaxation, engaging in activities like reading a book, meditation, prayer, or watching a non-engaging show.
Dr. Breus's Five-Step Sleep Plan
Dr. Michael Breus- Wake up at the same time, seven days a week.
- Stop caffeine by 2 PM.
- Stop alcohol three hours before bed (limit to two drinks if consumed).
- Stop exercise four hours before bed.
- Implement a morning wake-up routine: take 15 deep breaths, drink 15 ounces of water, and get 15 minutes of sunlight.