Adventures in health

Body Rx Show Transcripts: #26 – Midnight
Smacks – Metabolic Consequences of Short
Sleep Duration
{George's Note: I have not edited this program in any way. I make no claims as to the authorship of this transcriptor the information contained within, all information belongs to Body Rx Radio and I make no guarantees about theinformation you will find here, I have transcribed this for information purposes only. With that in mind, enjoy! I suredid.} Body Rx Show Transcripts: #26
Midnight Smacks
Metabolic Consequences of Short Sleep Duration
{The original mp3 file can be found on this page The following paid program does not necessarily reflect the views or opinions of the staff and management ofTriceptor Productions or the Super Human Channel. Triceptor Productions and the Super Human Channel are notresponsible for any claims, warranties or guarantees made during this program. You’re listening to the Body RXShow with Dr. Scott Connelly.
Carl: Welcome back to Body RX. I’m Carl Lanore and we’re joined today by Vince Andrich and of course Dr.
Connelly. Later in the show, we’ll have Dr. Layne Norton and of course the Paleolithic nutrition expert, Robb
Wolf. How are you doing Dr. Connelly?
Dr. Connelly: I’m here Carl.
Carl: Okay. Sorry about that. Okay. That will be an edit point right there. Anyway, okay, so what are we talking
about tonight Dr. Connelly?
Dr. Connelly: Well, we left off last time talking about the summary points that we’ve been trying to emphasize
since we started this show several months ago and that is that of all of the variables that have been empathically
reiterated over and over again about how to approach mitigating the worldwide increase in prevalence of obesity
that the standard variables of increased caloric intake and decreased physical activity continue to dominate the
conversation which basically means that once again the calorie theory of body composition modulation has
remained preeminent in all of the mother goose discussions that dominate the mainstream media. We’ve been
trying to essentially overturn that prejudice by demonstrating through legitimate science in both cross sectional
and prospective studies in human beings that calorie issues have in fact very little to do with the persistence and
increase in this problem worldwide. We had discussed some of the attributes of different dietary constituents that
provide powerful metabolic signals that can skew the relative proportion of the oxidation and storage which is
what we call partitioning. Partitioning is like, you can visualize it as a seesaw over the fulcrum being in the centre
and oxidation and storage on either end of the seesaw. Obviously, the prevalence and incidence increases
worldwide in obesity indicate that the partitioning of fat balance that is the difference between fat storage and fat
oxidation has been grossly prejudice to the side of the storage. We’ve constantly reiterated this from the context
of people talking about weight control. This has nothing to do with body weight control. This has to do with the
amount of dietary or other energy stored as fat. Obesity is a disorder of fat balance which essentially speaks to
the dynamic of fat storage versus fat oxidation. We’ve discussed the intersection of several metabolic loops that
have to do with the monitoring and the disposal of ingested nutrients. We spent a lot of time talking about amino
acids as primary drivers. We’ve spent some time in the last few weeks talking about fatty acids and their
signalling power in this particular continuum. We ended last week with sort of emphasizing the paradox that one
of the variables that has been identified as a very powerful predictor of weight gain in both cross sectional andprospective studies in humans that would predict essentially untoward gain of body fat overtime has nothingwhatsoever to do with calories. So, these are variables that are, in one sense, have no a priority calorie value onor their face have no calorie value that can be assigned to them. One of the most dramatic demonstrations of thisphenomenon is sleep duration. Obviously, sleep duration has received a lot of sort of airtime in the public media.
In fact, just last week, there was an article in U.S. News and World Report, the title of which was six ways lack ofsleep is costing you a fortune and this was an article out of their finance section. Essentially, the article wasskewed towards the demonstration of the impact of shortened sleep duration on your financial health but it alsoincluded a mention of the topic we’re going to talk about today and that is sleep duration and obesity. But for kindof starting off this show with the evidence that sleep duration has been truncated pretty dramatically since the1960’s to the present day with the 1960 numbers from the National Sleep Foundation being somewhere in thevicinity of average of 9 hours down to less than 7 hours. Now, in 2010, the most recent publication of their data, alot of different groups have sort of written or studied aspects of this truncation in sleep duration on impact ofhuman behaviour and quality of life. The article in U.S. News and World Report had this sort of six features ofshortened sleep durations for purposes of our talk today will set a limit at truncated sleep duration as anythingunder 7 hours in duration for consistency purposes. So, with that in mind, they identified that you’re essentiallymore accident prone and they used some statistics that showed that 30 to 40% of all heavy truck accidents areindeed caused by fatigue and if you basically try to correlate the fatigue of a truck driver with their sleep duration,you get a pretty consistent positive relationship. They also noticed that they, people who don’t get enough sleepare more likely to have, overall all kinds of different health issues. So, one of their focused areas was if you don’tget enough sleep, you’re bound to incur a lot of increased medical expenses. From investor perspective, theyalso had an article, a bullet point that had to do with making bad financial decisions if you don’t sleep enough.
Essentially, one of the things that they looked at was the cost of insomnia from a standpoint of employees whocost employers money because they don’t get enough sleep and they had an interesting statistic that, I think itwas employees that were reported to suffer from insomnia cost their employers $3200 more than employers whodo get enough sleep just because they essentially make bad decisions. Obviously, one of the points they hadbrought up in this article which wasn’t the focus, the article was more on sort of the economic impact of poorsleep habits but they did mention that you’re more likely to suffer from obesity. That’s a trend that has beenpicked up in the literature and discussed in ever increasingly detail and focus for the past decade really. This isnot a topic that has just surfaced. This has been researched by a number of different groups across the worldusing as I said both cross sectional studies that is studying people as they exist and prospective studies, taking agroup and then following them forward in time trying to ascertain how the correlates of different aspects ofphysiology and body composition change overtime and if they in fact are related in any mathematical consistentway with sleep duration. From the standpoint of looking at this from an aerial view, you would expect that a lot ofimpact would be felt throughout the body by disturbing a sleep pattern. Remember that a sleep cycle is regulatedby the same what we call clock genes that regulate all sorts of physiologic phenomenon that are ultimately tied tothe day, the light dark cycle of organism’s existence. These light dark cycles’ circadian rhythms can beextremely powerful in controlling metabolic regulation and skewing portioning influences for all of themacronutrients in a dramatic way. Sleep deprivation which is volitional in most cases in modern humans isessentially a powerful dysregulator of these circadian physiologic loops. It wouldn’t be unexpected to think that achronic disturbance of sleep duration that exist because of the preponderance of artificial light sources and thetendency for modern humans to work longer hours, recreate longer hours and thus extend their activity patternway beyond the natural dark period of the day that that would have a profound effect on a lot of differentphysiologic systems. In fact, when you look at a number of different physiologic variables that have beenscrutinized with respect to this aspect that it’s very clear that reducing the total numbers of hours of sleep canlead to a lot of very bad problems for almost any body organ system that you want to take a look at and just sortof just a review of some of the things that have been studied and documented on average overall immunity asmeasured by several different biomarkers for example inflammatory markers such as the release profilecirculating of the interleukins, interleukin 1, interleukins 6 and the tumour necrosis factor. Alpha compounds sleepdeprivation is linked to increased daytime levels of all of those things and there’s a significant interaction betweensleep duration and the overall functioning of the immune system with respect to its ability to respond throughacute stressors which would activate an immune reaction. So, starting kind of at that gross level and proceedingon, you can have data that clearly shows that sleep for five subjects, again those people who have less than 7hours per night of sleep are a higher risk for developing high blood pressure, Dyslipidemia from the standpoint ofblood lipids, type 2 diabetes is now recognized as being very particularly related to short sleep duration. But also, other aspects of Neurocognitive function and disorders of Neurocognitive function including depression and moreserious psychiatric disorders are all apparently impacted by shortened sleep duration overall mortality is impactedin a negative way. There’s a bunch of study which show that behavioural sleep deprivation leads to alterations insubstrate metabolism including profound changes in glucose metabolism and regulation and some of thehormones that are known to affect peripheral peripherally mediated and secreted messengers that signal appetiteand energy expenditure. We know that there are different components of sleep, slow-wave sleep, REM slate, etc.
etc. There’s a bunch of more nuance studies which I’ve looked at specific and dislocations of different phases ofsleep with respect to specific changes in hormones and other cytokines that have been released. Now, what’sinteresting is that there is now literature in what I consider to be abundance that points to the fact that theseparticular aberrant consequences of shortened sleep duration are more profoundly felt in children. There’s beena number of studies and literature in the paediatric area of medicine which recently have come to the forefront thatsuggest that our kids in particular are very, very susceptible to these adverse effects including the more profoundmetabolic disturbances which lead to the elaboration of the metabolic syndrome, biomarker proliferation and alsothe change in body fat accumulation leading to childhood and adolescent obesity. So, this is an area of researchthat has received a lot of focus in the last decade and it continues to produce a plethora of interesting researchwhich looks at not only the overall mathematical relationship on an epidemiologic scale with respect to all of thesedifferent problems and metabolic interleukin and immune sequelae of shortened sleep durations. But morerecently, studies have begun to look at the more mechanistic aspects of why this might be the case. There was arecent study that was circulated through our band of merry men last week that came out in the American Journalof Clinical Nutrition, it was done by the group out of the Netherlands, couple of authors that are very, very prolificin that field of metabolic regulation and evaluation. They had looked at specifically the effects of disrupting sleepvia procedure of frequently waking people up during the night with an alarm clock type methodology so that theirsleep was really kind of disrupted on a fragmentation type basis. What they wanted to do is to look at the effectsof this sort of staccato interruption of their sleep pattern on their energy expenditure, their substrate oxidation,physical activity and their perceived levels of exhaustion as measured in a metabolic chamber. This group in theNetherlands is renowned for publishing studies that have to do with observations accrued in their metabolicchambers which were essentially little apartments that have the requisite oxygen and CO2 sensors to essentiallydo indirect Calorimetry measurements on people who are extensively free living. Although living up until little tinymetabolic compartment is not exactly replicative of free living existence. It’s better than the older antiquatedmethods of the hood Calorimetry. So, these studies have, at their core, some inherent limitations because of thesomewhat obvious departure from your life existence but they don’t suffer from the same limitations andrestrictions that earlier studies that used this more antiquated hood methods of measuring metabolic rate areprone to and couple of the interesting observations that came out of that study was that in contrast to what youmight intuitively expect by interrupting somebody’s sleep periodically throughout the night that they would be atrain wreck the next day and be somewhat less active.
Dr. Connelly: In contrast to what you might intuitively expect by interrupting somebody’s sleep periodicallythroughout the night that they would be a train wreck the next day and be somewhat less active. They actuallyfound that the activity associated energy expenditure in these truncated sleep subjects was actually higher. Again,we talked about this last week from the standpoint of a conceptual paroxysm that is why would short sleepduration which allows you to be more active during the day and essentially expend more energy and activity beassociated with a higher chance of becoming obese over time. This group actually documented that their controlsubjects anyway, the activity energy expenditure portion of total 24 hour energy expenditure was actually slightlyincreased above their control subjects. But what they found which was pretty interesting and consistent with astudy that we’ll talk about after our guest, Robb Wolf, comes on is the fact that when they looked at total energyexpenditure that is on a 24 hour basis between the control subjects and the sleep disrupted subjects, they reallydidn’t find any significant difference. And other studies that have looked at this from the standpoint of the amountof “Kilocalorie” expenditure that would accrue when you reduce somebody’s sleep I say less than 7 hours anight amounts to less than 200 kilocalories on average of activity related energy expenditure. So, that would notbe expected to have a monumental effect on someone’s average 24 hour energy expenditure under anycircumstances. But it’s interesting in this case the total energy expenditure as measured by their equipment wasnot different between the two groups and yet the changes that were profound were that the fragmented sleepgroup experienced a marked increase in their respiratory quotient which is associated with an increase incarbohydrate oxidation at the expense of fat oxidation. And that was one of the most interesting aspects of thestudy was that in essence although total energy expenditure was not affected in a substantive way the percentage of fat oxidation was reduced quite considerably. And this is interesting from several respects because it speaks tothe issue of the duality of the influence of some of the hormones that have been postulated to control appetite andenergy expenditure and Greylan being a good example which we discussed on the previous show. Greylanobviously has discernable effects on appetite promotion but it also has effects independent of appetite stimulationthat effect energy expenditure from the standpoint of the efficiency of fat oxidation which has nothing to do withthe energy content of the food but the ease with which your body takes those ingested nutrients and partitionsthem into fat stores. So their demonstration in this study that there was little or no effect on total energyexpenditure but a qualitative shift in the oxidation of substrate towards carbohydrate away from fat isdemonstrative of the concept that we’ve been trying to drill down on for several weeks on this show that theabsolute determination of a final body composition is a representation of a balance between what has beenreferred to as the respiratory quotient which is simply a mathematical representation of the relative contribution ofcarbohydrate, fat and protein to total energy consumption or oxidative phosphor relation and what’s called thefood quotient which is the body’s ability to store or to oxidize each one of the macronutrients with relative ease orrelative difficulty. People who are prone to become obese have a dislocation of the RQ/FQ continuum. They mayin fact have an unfavourable RQ which favours carbohydrate over fat oxidation and coupled with that due todifferences primarily in body fat mass, a dramatically different ability to oxidize fat. If you combine those two thingsovertime, you have human beings who will experience under the influence of a carbohydrate rich diet andincrease propensity to gain fat irrespective of the fact that they really don’t eat in terms of number of calories perday a larger amount of dietary energy. So, with that in mind, I’m going to turn this over, well maybe we could takea quick break here, music break as usual and when we come back we’ll have one of our favourite guess, RobbWolf has graciously agreed to join us again today to talk about this subject with respect to his perspective and hisadvice that he gives to his clients. And so, with that in mind, we’ll take a quick break and we’ll be right back.
Carl: Welcome back to Body RX. Vince you want to intro our guest this hour.
Vince: Absolutely! He’s Robb Wolf and as Dr. Connelly mention, one of our favourite guests and he’s an expertin Palaeolithic nutrition, author of the Paleo Solution the original human diet, and he’s got a lot to talk about withrespect to sleep and we’re glad to have him. Want to give his evolutionary perspective on the topic as we moveforward. So, Robb are you there? Vince: Good to have you again. Thanks.
Robb: Thanks for having me guys. Good to know that the last show didn’t completely ruin your listenership.
Vince: No way. I know that you have, you’ve written in your books on the topic of sleep and last, I think on ourlast show you mentioned something that’s stuck out of my mind is getting to sleep in a pitch black room. Whydon’t you start with maybe how we got to where we are from an evolutionary perspective, what were our ancestors doing with regards to sleep before the invention of the light bulb.
Robb: Well, we can tackle this thing both from a little bit of anthropological perspective which is interesting but notsuper solid from a scientific perspective. We can look at this from the big picture macro level and get someinsights from this kind of evolutionary biology caveman kind of gig but we can also, we are now with a levelspecification with this stuff where we can explain all this stuff from a mechanistic standpoint forward. So I’ll try tolike weave both of those things together but in pretty simple terms we like every other creature on this planet arewoven into some sort of a Circadian Rhythmicity some sort of wake-sleep patterning. It’s pretty interesting. Weusually folks associate our perception of light just with our eyes but the forefront proteins in our red blood cellsactually can absorb blue wavelengths of light and communicate that to the brain. Folks who are blind have anormal Circadian Rhythmicity just like the other folks around them because this information is communicated tothe brain. So we have some fairly complex biophysical mechanisms could tell us when to go to bed, when to wakeup. It’s very much tied in to food procurement, reproduction, you name it [indiscernible] DNA and a lot what we[indiscernible], this interface between the endo-bium, the creatures that our intestinal [indiscernible] are hopefullybeneficial creatures and kind of a dynamic tension between those things and our immune system. And typicallythrough the day we see an overgrowth of bacterial activity. At night, we actually see a proliferation of our immunecells and [indiscernible] it’s kind of a dynamic equilibrium there if everything is working well and we tend tomaintain insulin sensitivity, we have restoration of neurological function. The process of sleep is still very, veryblack box. It’s kind of like opening the astrodome and hanging a microphone into the astrodome and trying tofigure out what’s going on during a football game or a baseball game or something which we hear a bunch ofnoise but we really don’t know what exactly is going on and our understanding of what exactly sleep is, what itdoes, how it benefits us is still at that very impure goal kind of 30,000 foot level but we know for a fact that it’svery, very tightly tied into blood sugar regulation, androgen levels, its systemic inflammation and ultimately kind ofour overall health and longevity and like I mentioned, we also understand a little bit of that interface on say like themusculoskeletal level, the neurological level of understanding that missed sleep can dramatically impact like theirinfluence to this things like that. So from a big macro perspective, when we’re talking about sleep, we’re justtalking about a normal biological function that’s kind of woven in to every creature that creeps and crawls[indiscernible] desire or [indiscernible].
Carl: Robb, your phone every now and then fades in and out. I don’t know if you’re in a good spot where you’resitting or if you’re mobile and walking but we lost the last couple sentences there.
Carl: But you were saying, you want to just pick it up? Robb: Just basically, the big picture of sleep is just that it’s a inner goal feature of pretty much everything aliveand similar to exercise levels, similar to different food intake we have kind of a genetic optimum woven in to us.
Robb: And our diet, our lifestyle really is kind of add odds with what’s kind of woven into our genetic.
Robb: Really kind of racking out when the sun goes down and then getting up when the sun comes up and somefolks have talked about like Polyphasic sleep and some things like that. It’s a really interesting point. The keyfeature was that, I think that this is why when we make a general recommendation for folks almost nobody racksout when the sun goes down. We play on the internet. We watch TV. And so what we do is we expose ourselvesto a photoperiod that is significantly longer and of significantly greater intensity than what we would have normallyexperienced. And this has some interesting effects on insulin sensitivity and also more and more and more onlinking more of this stuff back to problems with systemic inflammation that is actually born of kind of Dysbiosis ofsystemic problem of Lipopolysaccharide this part of the exoskeleton or the our cell membrane of bacteria whenwe are exposed to a photoperiod that’s too long our immune system doesn’t prune back the intestinal bacteriathe way that they should and we actually get some Lipopolysaccharide that migrates via the M cells and theepithelium and it holds this Lipopolysaccharide into circulation. And if Dr. Connelly can point out, somebody whoexperiences acute severe sepsis they become very, very insulin resistant, they have a broad ranging systemicinflammation and they can die from this because of blood sugar dysregulation, because the inability for the liver,the pancreas and the brain to communicate effectively about how to manage blood sugar maintenance. Andwhat’s happening in my opinion and it’s pretty probably kind of percolating up within the evolution of biologycommunity, is the lack of sleep and extended photoperiod is actually leading to some systemic inflammationthat’s probably born of kind of literally bacterial overgrowth.
Carl: I want to just make a statement or actually a question for your consideration Robb, and that is that for thepart of our audience that is athletic minded, performance minded, there is some evidence that disruption of thesuprachiasmatic nuclei which is not just responsible for the hormonal milieu that occurs but also fine tuning thereceptors that these hormones then interact with can actually, there’s a lot of guys out there who believe that, drug using or not, that they can burn the candle at both ends and still see the results that they want. And it’s beenmy experience that that interfering with proper sleep can actually push back your progress regardless of thepresence of drugs or not.
Robb: Yeah, I mean, without a doubt. I do a fair amount of work with some of our special operations folks havedone some work with naval special work errands from other groups. What we see is the selection process inprofessional athletics, in special operation groups in the military for people who typically can maintain normalhormonal functioning, a reasonable kind of nerve transmitter signalling even while pretty beat up, while sleepdeprived etc. This similar to almost everything that we see whether it’s carbohydrate tolerance or maybe grainintolerance or something like that. We see a spectrum within the population at large. But that said, just becausesomebody can tolerate this stuff, say like one guy can “get by on 5 hours of sleep and still have what is for himpretty good performance” doesn’t mean that he’s not going to perform better both in the short run and in thelong run, something that folks forget we’re talking about potentially performance health and longevity. So, howlong can you maintain this work output and at what percentage of say like your genetic optimum, something thatyou’re 32 years old and all the systems are firing that’s usually when males kind of report their kind of best lifts,most explosiveness, all that sort of jive and then from there it’s just kind of a slow slide into the grave. Well,depending on how you manage lifestyle features you can maintain much more of that. Again, these guys in thespecial operations community, they have dudes that will barely sleep, they’ll go out and drink all night and they’llsmoke everybody on PT test but 5 years, 10 years down the road, the toll that it’s taken on this people iscatastrophic. And so, it really is kind of burning the candle at both ends and not to get preachy about it like if folkswant to live a particular way, by all means go for it but we’re not going to pharmaceutical our way out of that.
Now, it may supplement things, it may augment things for a period of time you may manage it better than withoutbut you’re not getting away and escape.
Vince: Robb, I’m making a few notes here. It would seem that when you’re younger and of course if you’regenetically predisposed to be able to handle some of these things better as you mentioned, wouldn’t that makesense and you could talk to this point that you’re pushing certain hormones and the hormones will obviously haveto dock with receptors as Carl just mentioned over time is that clarity or sensitivity tune down is that what is goingon over time, you can handle it for a while but all of a sudden it’s like faulty spark plugs.
Robb: Yeah. I think, again, it’s like almost anything, like one of my best friends Charles is half black half Filipino ifyou stick he and I out in the New Mexico sun, I’m going to get a sunburn quicker than Charles because he’s gotgenetic adaptation that presents him, he’s going to be able to withstand more solar radiation before he gets hisskin gets damaged. If we move both of us to the Arctic Circle, Charles is going to develop rickets first becausehe’s not going to manufacture as much Vitamin D. And so, what we’ve got within an individual is their genes, sotheir genome, and then we’ve got the epigenome which is the environmental interaction with genes and we justhave basically potentialities there. Some people are going to potentially get by better than other folks onabbreviated suite. Most people who end up going into medicine like just the kind of the selection process. Theycan navigate a functioning at least at a certain level getting by on less sleep but what we find is that thesurvivability of physicians is not too much better than NFL linemen which is horrible.
Robb: And so you absolutely pay that back somewhere. And again, with the interest of that, I don’t really knowbecause obviously we need like night shift yard auction stuff like that but I think having some eye towards that sothat people can do the best of their ability instead of doing like 36 or 72 hours on or something like that. We needmore punctuated elements to shift work it. Then there’s sort of this control recognized shift work which iseffectively extended photoperiod. They recognize that there’s a known percentage on pro with ionizing radiationin asbestos. And so that, it definitely it causes an impact but again we have a spectrum of either susceptibility orresistance to that. When part of what’s happening with the sleep immediately is that we lose insulin sensitivity,immediately we start seeing disruption of liver functioning mainly related to glucose metabolism. So we may havehigh levels of blood glucose but the signalling between the brain, the pancreas and the liver kind of goes south inthe sleep deprived state. So now we burn through glycogen, we breakdown glycogen first and then we start takingup gluconeogenesis to pump out blood sugar in that sleep deprived state. It looks almost identical becauseeffectively it is. It’s almost identical to the type 2 diabetic individual which also looks almost identical to thesubject individual. And when we start doing that stuff, when you talk about all kinds of different hormonalsignalling, if we up regulate cortisol production then via the pregnenolone steal we’re suppressing bothtestosterone and oestrogen production. We have 3 or 4 different mechanisms where elevated cortisol productioncan curtail thyroid production ultimately directly cortisol inhibits the conversion of T4 to T3. So if we see normallevels of thyroid releasing hormones, thyroid stimulating hormones, good levels of T4 or T3, elevated cortisol, thenwe know that we’ve got a problem there in sleep, overtraining, all these things can drive right into that. And thenas these progresses along we can start right into the hypothalamic dysregulation and block thyroid productionright at that spot. So, on a big, kind of big picture level we immediately have mechanisms affecting insulin, leptin,growth hormone, cortisol, and testosterones. And I mean, if you mess that stuff up, what the hell can you do otherthan like cry yourself to sleep watching Hallmark commercials and stuff like that. Everything goes south.
Carl: Now Robb, I’ve got a question for you. Since, we understand that we’re hardwired to sleep when the sungoes down. In fact melatonin production generally occurs with the onset of dusk. And we’re designed to arisewhen the sun rises or the photoperiod occurs but that’s a pretty long period of time. It’s far longer than therequisite 8 hours that we’re told that we need to sleep. And, I remember doing a show a long time ago where thiswhole notion of Polyphasic sleep, was it necessarily sleep during daytime once and a while, which if your bodyneeds it you’ll probably should. But this notion that as humans maybe before even Palaeolithic times, we wouldgo to bed so to speak when it got dark. But we didn’t necessarily sleep all that time. We would sleep for a while,wake up, we really couldn’t do much because we didn’t want to go out and be eaten by something so we laidthere and then when we fell back to sleep again and we had maybe several of these episodes of sleep. Can youshed any light on this notion that do we have to sleep a certain amount of time, concurrently hours or is it okay tosleep in little partials so to speak? Robb: Well, I think the key feature of all of that is photoperiod and then that when we get the photoperiod kind ofdialled in then we produce melatonin, we suppress cortisol levels and then we sleep to the degree that we need tosleep. I think the way that modern humans sleep is actually an attempted adaptation to try to pack in as muchresorted sleep in the time that we typically allot ourselves.
Robb: If we take it so normally, we go into REM sleep and then like stage 1, stage 2, through stage 4, stage 4 islike the deep restore development where neurotransmitters status is re-established and what not. If we takesomebody and sleep deprive that person significantly for weeks on end and then allow them to sleep or even a few days, that person will tend to pass through the stages of sleep very, very quickly and they will tend to sleeplike the dead and they’ll sleep that whole 8-9 hours or whatever and they will have much more tight REM sleepcycles and it will transition from cycle to cycle much more quickly. And so, I think that that’s on the far end of thespectrum where we take even a modern living human being subject them to significant sleep stress and thenwe’re going to see their sleep patterning really, really tighten up like all the grizzle gets trimmed out of therewhereas that we’re living a more in spectrally consistent lifestyle, they might think that we’re going to accrueprobably the same amount of sleep, it’s going to be broken up and a bit Polyphasic but again the real key withthat is that photoperiod is less. And so, the recommendations that I’ve given to our clients and I mention in ourfolks is just blackout your room as best you can into the degree that you’re sleeping in a dark room that will buyyou a pretty good chunk towards re-establishing normal neurotransmitters, keeping you lean, keeping insulinfunctioning good. It’s shocking what just sleeping in a dark room will do for folks. It’s amazing what other thingsyou can do from pharmaceutical to extremely monitoring your diet and other things. Those things will end upcomparatively failing relative to what just a good toll of night sleep will do.
Carl: We can’t ignore the fact that we live in an RF soup in this day and age whether that’s from routers andcordless phones to sailor transmitters that perhaps cast shadows on our homes but we live in this soup ofelectromagnetic field if you will in a very, very high frequency ranges one gigahertz and above and there is lots ofevidence just study after study that shows that these frequencies create a neuro-excitability in the brain. Studiesthat, everything from close proximity like cell phones to just ambient RF and there is some evidence that thesefrequencies can actually impede the production of melatonin all the way up to stimulating the brain to a pointwhere the brain cannot go through all of the different phases of sleep. I’m in total agreement with you about theprevalence of diseases, modern diseases if you will and it’s not one thing. We can look at diet absolutely plays arole but sleep plays a role as well. Is it possible in your humble opinion to even get good quality sleep, even if youblackout the room given the fact that we are in this RF soup.
Robb: Well, I think it’s going to be better whether or not it’s a good, when we vacation we tend to go off the grid,I mean, like mega off the grid so we’ll go to this little islands up the each coast of Nicaragua and I mean, there’sliterally, not even like a generator on the island or if there is, it’s still [indiscernible] site.
Carl: Do you notice that you sleep differently? Robb: I totally do. I sleep like a dead man in when your back pack you tend to.
Robb: That’s very observational, it’s N equals one the study size and all that but it’s kind of a whacky thing toooccasionally the power goes out, a power accident, lightning strikes, something like that. And all of a suddenyou’re just not quite as frisky and you just kind of want to go to bed.
Carl: And there’s a noticeable vacuous feeling about when the electricity goes out in the whole town which hashappened several times here in Louisville. It’s like this is, it’s almost like the same sensation when it snows where everything seems so quiet and serene and peaceful. And it’s not just an audible change. It’s actually achange in the way you feel.
Robb: Yes. Yes. It is almost like that goal hum from some place that you don’t know where it’s really comingfrom.
Carl: Yeah. Interesting. Very interesting.
Vince: I was going to say Robb, my wife and I, we visited her parent’s farm and it’s way, way out in the middle ofnowhere. They just basically got, I think a cable connection that, it wasn’t a telephone line and I sleep like a deadman. You’re not kidding. I mean, it’s so quiet, so dark, obviously much less stuff going on. It’s unbelievable. It’slike when I go there I’m going to the sleep centre.
Carl: The sleep centre, that’s funny. There’s actually, I actually talked about this about a year and a half ago,there’s actually carbon based paints that are made as a primer that you can paint your bedroom with that act asan RF shield, take a Spectro analyzer in your bedroom. I always thought metallic but the person who thought meabout this said, “No, metallic would actually attenuate, would attract RF” but there’s carbon based paints thatyou can paint your ceiling and walls with and then you can get carbon panels to put beneath your rug for instanceand you can shield your bedroom by 90% of the RF that’s getting in there and kind of make a little cocoon foryourself. And I predict that in the upcoming years, this is going to be a regular thing that people are going to betalking about.
Robb: So, do I have to take down my ads for temple hats off my website.
Carl: They do work. I can attest for that because I do wear one.
Robb: I’ve been making a mint off those things so that’s going to suck.
Vince: Speaking of tin foil, Vegas has tons of shift workers, 24 hour town, I grew up there and the most commonin the 60’s and 70’s way to block the sun out was renal draft tin foil on the windows.
Robb: Increasing profits obviously. The gambling scene is funny. It’s dark but not super dark. You’ve gotnicotine, alcohol and push up bras everywhere and it spends every dopaminergic neurotransmitter I can think ofother than just directly snoring cocaine. So, that’s a good scene there.
Vince: My father was born and bred in the business and said it’s the only dope you don’t get to get by. There’sno product. It’s in the mist.
Robb: Just along that line I’m actually supposed to do a gig for a mega dig casino chain and what their problem isthat it’s a their employees are racking up staggering healthcare cost related around metabolic arrangements,crash in, all this other things and it’s the shift work, shift work and booze and a bunch of other stuff. But it is soshocking that these people are the higher ups are kind of like, “Okay we need to do something” or it’s like eitherone bankrupt us from the healthcare cost and two it’s kind of frightening because they’re literally looking at justlike a whole blip or a whole generation of this people dying really, really prematurely due to the complications fromtheir work.
Carl: Well, I wasn’t going to bring this up because I didn’t know if it’s appropriate to discuss in this show but nowthat you’ve said this it begs the question. You take an organization like that, when you point out to them, “Well,you’re killing people because you’re making them work the graveyard shift.” What are they going to do? Do youthink they’re going to go, “Okay, we’re going to be a casino that closes at 10 o’clock at night or what does UPSor FedEx do? Clearly, this is something that needs to be examined.
Robb: Well, the thing is that, for me, I’m pretty libertarian in my politics so I don’t want to go in and try to regulateit or shut it down per say I would really like to educate both them and the folks who are working there. These folksthat are being exposed to an extended photoperiod and eating a really poor diet a very pro-inflammatory diet,they’re not getting enough omega 3s, I mean, on and on and on. Can we at least figure out a way to say, “Heyguys, if you could choose like a stake and a salad for dinner before you go to bed after you get off shift versus agiant plate of nachos or a pizza then you might live long enough to see your kids graduate college”, but I mean,that’s also a big feature of this is that these folks working these jobs, they’re probably taking care of their kidsduring the day and then working the night shift at night and so it’s not necessarily just like the evil corporation butthey’re providing legitimate work for people that need it but then you just have a remarkably unhealthy culturethat grows out of the whole thing. How do you fix that? I mean, we could go to a different scenario in which itdoesn’t look so unseemly which is that police, military and fireman.
Robb: Do we just have our police officers and fire-fighters just not responding? And that’s part of the reason thatthese people really are providing a service and they really in my opinion are providing a sacrifice because theytake a significant impact on their health not just from the stress and the difficulty of the job but also because of theshift work. And that’s part of why I absolutely love those folks because they don’t even know in some ways howhard they’ve got it, how difficult that work is when you throw in the shift component.
Carl: But see, I can appreciate those jobs and I can understand why those jobs may require a more heroic effortor commitment. But the fact that, I mean, I can remember a day I’m dating myself. But I can remember a daywhen businesses were close on Sundays and where TV stations went off the air at midnight because people wereasleep by then.
Carl: The ever raising competition for dollars has people working round the clock not just, I mean, let’s face it,workers are lining up to take that graveyard shift. I am not saying companies are being villains here butcompanies in order to be competitive, how are they going to cut back, how is FedEx going to say, “You knowwhat? We’re going to deliver packages the following afternoon because we’re going to let our workers sleep atnight because it’s healthier.” And people are going to go, “Wow. That’s a really noble idea. Hey, call UPSbecause this package has to be there by 9AM.” Carl: How do you get people to understand that we’re killing ourselves in the pursuit of green bucks here? Robb: I don’t know, I mean, for me, what I try to do is just try to educate folks as best I can, so like that UPS shiftworker, when that woman or that guy comes home from work, then what I want them to do is eat a pretty low carbmeal and generally they’re probably going to need to eat low carb in general and hopefully they lift some weightsand then do a little bit of activity to keep their muscle mass and their insulin the best they can and theysupplement with vitamin D and they supplement with fish oil and when they go to bed they sleep in the pitch blackroom and they protect that nugget of sleep that they do get with bayonets and barbwire.
Robb: And that will improve things. Does it make it optimum? Absolutely not but then, at least providing someeducation for these folks so that when they’re like, “God, I feel like I’m dying and I’m only like 35 years old and Ifeel like I’m just aging like crazy” and it’s like, “Well, you are.” And so, we’re going to provide a little bit ofresources for you to think about your food, to think about your sleep, your sleep hygiene and everything. They’ll go to bed and they’ll have kind of a dark curtain and they’ll put on a sleep mask but they don’t understand thebiophysics of the whole thing which is that any of that ambient light that’s trickling in is just adding to their totalphotoperiod exposure and it’s not doing them any favour so it’s very deleterious.
Carl: But Robb, is it, I mean, I had Dr. Russel Ritter on my show a couple of times. Is it simply darkness? Or isn’tthe body also attuned to more than just darkness? Wouldn’t it benefit a shift worker to come home at 8AM in themorning, put the blinders on, get in that pitch black room, quiet room, but also take maybe 600 micrograms ofmelatonin just to kind of ensure that the body produces some? Robb: Absolutely. Absolutely and I mean, how expensive of a fix is that? I mean, maybe 6 bucks for like the 6months of life.
Robb: I mean, yeah, yeah. And then we’re talking about dramatically improving the quality of life in a lot ofpeople, dramatically improving probably the services provided and let’s think about that was like police, military,fire and medical scenarios in which people’s lives are at stake and then let’s look at the health of theseindividuals and by providing them some education about sleep in a dark room, take a little melatonin, eat a lowercarb diet, lift some weights and do a little bit of exercise everyday to re-establish your insulin sensitivity as bestyou can, that will save their lives. And that doesn’t hardly cost anything, I mean, now compliance with the wholeother deal but I mean you can have people existing on a normal schedule and they can do all kinds of squirrelylifestyle stuff to kill themselves. So, you’re not going to save everybody with that. But the problem that I see is justthat there is no education about this topic at all. And this is a lot of the thing that I end up doing for the specialoperation community is just making this dudes aware that, “Okay, you are going to be awake for two or threedays at a time occasionally when, and that’s just your job, you’ve signed up for it, we’re not going to be pussiesabout this and we’re just going to deal with that.” But, when you get home or you get back from an operation, youneed to sleep in a pitch black environment and it’s been pretty cool, the folks that we’ve worked with, they’regetting some really good support from the higher ups who not surprisingly are doing these things, sleeping in thedark room, keeping their carbohydrate intake matched to what their physical expenditure is and stuff like that. So,it’s improving their insulin sensitivity. We’re considering things like food intolerances because those things allfeed into systemic inflammation and stuff. We’re making sure that the guys and girls get adequate vitamin D andthese are dirt cheap interventions which provide just shocking return on investment.
Vince: Yeah. Well, I was just going to mention Carl I know we’re getting ready to take Layne Norton.
Vince: After the break in a minute here with Layne Norton and Dr. Connelly? Vince: I wanted to just bring one thing up which is, I have a 14 year old daughter and her, I mean, talk aboutpushing the envelope with the homework and the activities that they have, they’re really pushing it into the latehours and now with all the electronic devices that they communicate with. That’s probably going to come back tobite us for sure.
Robb: We just might get sophisticated enough that we no longer able to reproduce at some point.
Carl: But you know what? Don’t laugh, I mean, reproduction, people think about reproduction the wrong way. Ifwe can’t reproduce it’s because we’re not supposed to because this species is not supposed to go on anyfurther. So, it is really scary and you’re right. And being on the cell phone for a half hour before going to sleep, foras little as 15 minutes can actually impair your ability to get into the deepest stages of sleep for the first 3 hoursyou spend with your eyes closed so because of that neuronal stimulation that excitatory effect of those higherfrequencies on the brain. So, make sure that your kids shut the cell phones off at least a half hour before youintend for them to go to sleep.
Vince: And you can’t read any romance novels either Carl.
Vince: Well, no, you can’t get excited. So you can’t Tom Clancy novels and romance novels, you can’t do thateither.
Carl: Why? They stimulate you too much before sleep, is that what it is? Robb: I think the romance novels are fine for the ejaculation they always remind you of medical school point andshoot which is a parasympathetic sympathetic and so you’re actually trying to do in a full system reset.
Robb: If danger goes enough, then it’s kind of like flipping the reset switch.
Carl: There you go. You know what? I have to confess. I’m a big proponent of watching one episode of FamilyGuy right before going to sleep because I believe that a good hard laugh before you go to sleep is verytherapeutic.
Carl: There you go. There you go. Alright, Vince, you want to go ahead and take our musical interlude now? Vince: Sure. We’re going to take a quick musical break and we’ll be back with Dr. Connelly, Dr. Layne Norton,and Robb Wolf.
Carl: There you go. We’ll be right back.
Vince: We’re back with Dr. Connelly, Dr. Layne Norton and Robb Wolf talking about sleep duration.
Carl: Dr. Connelly, you did a lot of listening this last segment.
Dr. Connelly: That’s because I was catching up on my sleep.
Carl: You stinker. What stage of sleep were you in Dr. Connelly before I interrupted you? Robb: I have that effect on people, when I talk, usually they’re called illusioning of the bowels or they talk right upin a narcoleptic style.
Vince: I have to mention something to the listeners. Dr. Connelly sleeps like 1.5 hours per night.
Dr. Connelly: No, I actually sleep 2.3 hours per night.
Carl: But truthfully, do you sleep very short periods of time? Dr. Connelly: Yeah. I think it’s a function of, a mandatory adjustment to lifestyle, as active clinically between theOR and the ICU that I was directing, I would frequently spend most of my evening in continuously interruptedsleep patterns whether it’s in the hospital because I was the call attend, on the call attending or whether it was athome. I had unusual responsibilities because of my position on the cardiac transplant team that if we had atransplant patient regardless of whether it was on-call or not I still was on call. So, I spend several nights in thehospital just out of necessity because going home would have been ridiculous. And as a result of that lifestyle, Igot very acclimated to extremely short sleep duration over a period of many, many years, decades actually.
Carl: Do you feel that, has that had an effect on you? Has that any effect on you, you think? Dr. Connelly: Well, I think to, on point to what Robb had said, I think the impact on me was mitigated by the factthat regardless of my lifestyle from the standpoint of sleep duration, my waking hours were always structuredaround getting as much resistance exercises I could and obviously I practice nutritional surveillance for my entireadult life. So I think the impact on me would have been less mitigated as compared to maybe one of mycolleagues who didn’t have the proclivity that I did for exercise and nutritional consistency. I can’t tell if it did ornot. I know that from the standpoint of my energy levels and so forth that it appears to have had no impact. Therewere rare occasions where I would be forced by virtue of emergency case loads to just stay up for 3 nightsstraight with no sleep at all. One of the interesting things I found personally was that I learned very early on that ifI was going to be challenged by an extended period of waking in an environment which required me to beextremely focused mentally. These emergency cases at night involving people who are best door were not casesthat you could take a nap through. So, I found that if I did try to grab say like an hour or two hours of sleep inbetween the finishing case and the next case that it would put me in a state of complete dysfunction. Staying upand pushing through was always a better choice than trying to grab a couple of hours because after the couple ofhours, I was pretty much non-functional. It was really dramatic demonstration that, you accrue some significantdeficits physiologically and cognitively when you’re acute sleep deprivation which is different than truncated sleepduration over time. I had several instances when I was acutely sleep deprived and I found this personally that if Itried to grab a couple of hours, 2 or 3 hours sleep in between those periods, it was devastating on myperformance capabilities. So I would just push through. And interesting enough, the last time this happened to mewas the last year that I had in the operating room environment. I agreed to take an extended on-call period duringthe Christmas holiday because I was not married and did not have children and my partners did. So I acceptedthe holiday call willingly. And I had a case come in about 7PM on Christmas Eve that was a dissection of the aortathat required the hypothermic circulatory arrest technique where in order to fix this guys aorta, we had todisconnect from his heart and replace it with a Dacron patch and re-implant his carotid artery. So, his cerebralcirculation had to be interrupted for a protracted period of time which normally is pretty bad for you. That happens.
So, we resorted to examining the patient into the cardiopulmonary bypass machine and cooling his bodytemperature down to 18 degrees centigrade and arresting his heart in the process of cooling. And we, since itdrained all the blood out of his body, restored him with an electrolyte amino acid potassium insulin glucosesolution to keep his anaerobic capability at its highest level of functionality so that the tissues would not devitalizeand then operated on the guy for an hour and 16 minutes with no flow or no circulation to the head. And he hadMorphine syndrome, a connective tissue disorder that creates very abnormal connective tissue in the root of theaorta. So we had to end up doing this on-off technique 4 times and it lasted, that case lasted 27 hours. So,starting at 7PM on Christmas Eve, I went all the way through 27 hours and had essentially a horrendous postoperative nightmare with him that lasted into the next day and then subsequently two other very acute casescame in. So it ended up, this was starting on a Thursday evening essentially operated or work the ICUcontinuously from Thursday evening to Monday morning with zero sleep.
Dr. Connelly: That was kind of the epitome of my experience in the standpoint of acute sleep deprivation andconcomitant high velocity stress. And it was interesting that the night that I actually retired, I went to sleep thatMonday night at my usual late hour and I woke up the next day at 4:30 like I always do. So, it’s kind of a curiousdemonstration that you can become quite adapted to this and get your normal 4 or 5 hours of sleep and even aprotracted period of acute deprivation, I could still, I was functioning normally, I obviously didn’t have theopportunity to assess my acute insulin response to a glucose load or anything of that sort. But from the standpointof functionality, a perceived level of fatigue and what not, I was fine if I got 4 hours after 3 full days of deprivation.
Carl: Wow. Dr. Connelly, earlier in the show and this discussion that we’re having right now with you makes mewant to ask you for your professional opinion. When someone is in the hospital, it’s quite regular practice to wakethem up throughout the night for this, for that, sometimes they’re waking them up because they have to checkvital signs, sometimes they’re just waking them up because the nurse has to go in and do something in the room.
And anybody who stayed in the hospital for a few days knows that you don’t get good sleep. What impact doesthat have on recovery of a patient? Dr. Connelly: Well, I can’t give you a real objective answer to that Carl but obviously that practice is problematicfrom the patient’s perspective for sure. But as you said, a lot of the instances, this is really kind of a necessityespecially with people who are somewhat unstable who are on vasoactive or metabolic medications they reallycan’t be left unmonitored asleep for extended periods of time. But I know in the situations where I was in practice,most of those patients who required that kind of interruption were always in high monitoring units, either ICU orstep-down ICU and the regular patients would pretty much be left alone.
Carl: Wow. Okay. Okay. What, Dr. Connelly, you sat back and listened for quite a while, while Robb wasdiscussing and answering our questions. Did you have any opinions or there was anything that you wanted to sayabout that portion of the show? Dr. Connelly: Well, I think that in large measure I agree with everything Robb said. The perspective that wantingto make sure we check everybody out on with respect to the listening audience is that it’s important to realize thatthey’re in a relationship between what occurs normally as metabolic regulation as a function of circadianphysiology is representative of really on a micro scale what happens when you have, in all mammals, an occasionwhere that mammal is confronted with an ongoing depletion of energy stores as would occur in a protractedperiod of fasting or low-calorie dieting. And since we’ve been pretty obsessive about counselling people againstthe methodology employed by most diet programs which is essentially calorie restriction of a pretty significantnature, one of the things that we need to remind our listeners who are on board with us with respect to how tomodulate body composition appropriately are not relying on a pure calorie strategy. It’s interesting to note that inhumans there is data that shows that there’s a sort of compounding effect on the adverse effects of truncatingsleep duration and essentially low-calorie dieting in that a recent study about a year old that was done inUniversity of Chicago looked specifically at that, was there a compounding effect between abrogating a person’snormal sleep duration significantly while having them on a typical low-calorie diet protocol. And, what’s interestingis that in that study there was a dramatic intersection between those two variables, both of which would tend toessentially reduce metabolic exchange rates as measured in this case by the RMR and also to impact non-restingenergy expenditure in a way that would typically in an adaptive situation occurring naturally in the world with amammal or human. For example, seasonality of food availability and things like that that essentially, in thosecircumstances, the response of the metabolic regulatory system is to reduce energy expenditure and conservevital structures and the adjustments in all of the circulating hormones, cytokines, and their ancillary players arekind of adjusted in tune to that. This is different than a one dimensional response to a perturbation in a systemthat we call homeostatic response or in other words if your body temperature elevates because your working out hard in the gym and your body temperature starts to go up, there’s an immediate homeostatic response to thatthat essentially involves an objective response in the formation of sweat. And in essence, that’s a onedimensional homeostatic response to a single variable perturbation of body temperature. There are other thingsthat occur that are invisible from the standpoint of that specific stress and response that are really not homeostaticbut what are called allostatic and those changes are adaptive and they involve a highly orchestrated integration ofresponses that accrue and are incurring in parallel to a primary homeostatic adjustment. The observation from alot of different parameters and studies in biology suggests that allostatic adaptations if protracted can bemaladaptive in the long run. And one of the issues that has a very prominent degree of significance with respectto what is the consequences of having chronic sleep disruption or shortened sleep duration in terms of ourprimary focus which is always been how to optimize body composition is that we know from this recent Chicagostudy that if you are reducing energy deliberately via dietary strategy and have as an attendant complicating factorshort sleep duration, you’re going to reduce your ability to oxidize fat which is your primary goal and you add theadded maladaptive response of accelerating tissue os. So once again, under circumstances where these twothings are occurring simultaneously, it’s important to remember Robb’s point that you have some tools to offset,not eliminate but to at least mitigate some of the adverse metabolic regulatory consequences that would accrueand those would be pay attention to the macronutrient distribution of the food that you’re eating especiallysurrounding your waking and sleep cycles and that I would agree very emphatically with Robb that you need to bemore conscious of protein intake in a very conspicuous way and you need to be very, very conscious aboutrestricting carbohydrates. As we have said over and over and over again, this particular solution set has a greatdeal of variability within the confines of the human race there is a huge range of responsiveness and susceptibilityto the adverse effects of these kinds of perturbations in waking and sleeping cycles. And this is evident at thelevel of all aspects of glucose regulation and body fat oxidation and so forth and so on. But if you’re a person whohistorically knows that you are prone to gain fat, then this issue of short sleep duration and the dietary intersectionof short sleep duration and your energy intake, your activity profile and the macronutrient distribution that you’reaccustomed to can have a pretty significant effect. So, in essence, we know that a short sleep duration type ofprofile chronically over time will tend to reduce the proportion of energy expended as fat. That will deteriorate yourbody composition over time to more fat less lean tissue. Not good. If you compound that with a truncated calorieintake because you’ve listen to somebody on the news say that despite all the hoopla about this, that and theother thing, it still all boils down to calories in and calories out. And you simply can’t resist embracing thatproclamation then short sleep duration will compound the adverse effects of that calorie restriction. So again, inkeeping with the main sort of message here, is that there are a lot of variables that are fine-tuned to control higherbody senses in response to energy deprivation and excess. Those are intimately related to circadian rhythms thatprimarily skew, as Robb said, off of light-dark cycles. And obviously, the manifestation of this in the extreme is,are rocky, are gray, North American gray, ground squirrel who hibernates. And all of these manifestations come toa zenith of precise regulations in those animals that hibernate successfully. So, I think we should probably takemaybe our last music break at this point and then come back and have the gang kick around some ideas abouthow to practically address these issues and in and out of the gym.
Vince: We’re back! Discussing sleep deprivation and want to turn the show over to practical solutions to fighteither occupational hazards, environmental hazards or if you’re just battling the bulge and you suspect that sleepmay be a problem. Dr. Layne Norton, we haven’t heard from you yet.
Dr. Norton: Thanks Vince. I’ll be the first to kind of say that this is definitely not my area of expertise buteverything I can gather from the research I’ve seen on sleep, probably the organization has done more researchon sleep than any other I’d say is the military. They have a very obviously vested interest in performance andhow sleep intersects with that considering especially some of their commando type units or high level SpecialForces units are going to be often operating on very limited sleep. What I’ve seem to see here is a lot of this problems you get with sleep deprivation isn’t necessarily the fact that you’re getting sleep deprivation, it’s thefact that it causes you to have a very pronounced stress response. Dr. Connelly mentioned earlier that once hewas in his routine of what he was doing and got adjusted to that, that he didn’t really have that many problemswith kind of the weird sleep schedule he was all in and this is kind of what some of the research has shown is thatyou’re going to have an odd sleep cycle but if you’re adjusted to it and if you know what’s happening, it makes adifference. Let me expand on that. The military did some research where they looked at if they woke people upfrom a truncated sleep without telling them. So, they wake them up after, let’s say, 3 hours and they administersome kind of test, some kind of tactical test in order to test their cognitive ability and their performance ability.
They found that it was severely impaired. However, if they told them the night before, they said, “Look, we’regoing to be waking you up in 3 hours and you’re going to be taking a test.” Just by telling them that, just by doingthat, it improves their performance significantly. So, there seems to be some kind of this just cognitively knowingthat you’re going to have truncated sleep seems to help in terms of how to get not be such a problem. So Iguess, for those of us who are not in the military, the kind of the comparable thing was the, “Okay. Well, we knowyou have an early flight the next morning. You’re going to have to get up early.” For one day, you can pushthrough that and you’re probably fine. The problem comes to be where you’re going to sleep and then your doggoes nuts in the middle of the night and wakes you up and now you take it back to sleep and now you’restressed. It has that stress response and that stress response manifest in the way of hormonal, even proteolysisin terms of muscle protein breakdown and performance in resuming your everyday activities. And so, I think that,for example, we’ve kind of had this debate before in the show, is it worthwhile to wake up in the middle of thenight and eat something or you don’t have a meal or stake or what have you. This is something I’ve always donebecause our lab has shown that most of the protein synthesis drops off after an overnight fast and Connelly statedmany times that he prefers that, that he prefers to sleep all the way through. I don’t think there’s a right or wronganswer here but I am accustomed to getting up. I know that I’ll be getting up, cognitively I know this, I know ithappens every night because I wake up to go to the bathroom, I drink a lot of water before bed and it’s neveraffected my performance at all. Even cognitively, sometimes I’ll wake up, I’ll go drink my shake and while I’mdrinking my shake, I’m going through emails on my phone and just kind of answering emails. So, cognitively, itdoesn’t seem to affect my performance because I know that I’m going to be doing that. Now, if I get woken up anhour in to sleep or two hours in a sleep, I haven’t had much sleep if it’s something more abnormal than what I’maccustomed to, then I’ll have problems. And that’s kind of what this research has shown that if you have, youcan become accustomed to weird sleep cycles as long as you, one, it’s regular, it’s not kind of irregular and two,you know kind of ahead of time exactly what’s going to be happening. Whereas if you have a very irregular sleepcycle where you don’t really know when you’re going to be getting up, that seems to be the worst case scenario.
Again, this is not my area of expertise but that’s kind of what I’ve gathered from the research and kind of theoutcomes of this or as Scott said, increase muscle protein breakdown, decrease fat oxidation and that’s probablybecause when you go to sleep, when you sleep for long periods of time, your body responds by trying to sparecarbohydrates, increase fat oxidation to spare that carbohydrate and that’s in a form of increase growth hormonewhich increases lipolysis and several other things. So when you get sleep deprivation and irregular sleep youhave decrease growth hormone output, you have decrease testosterone, increase proteolytic activity and so it’skind of a convergence of things you don’t want happening together. So, I think, again, most important thing is justto kind of try to make sure your sleep cycle is as regular as possible and kind of know when you’re going to haveto have abnormal sleep. Those seem to be the two biggest things at least from what I can pick out from theresearch.
Vince: Thanks Layne. And so, Robb, in your opinion, awareness versus, let’s say, the shock factor of a car alarmgoing off or a dog barking, what’s your play or take on that? Robb: That makes a ton of sense honestly, I mean, that definitely makes a lot of sense but the unknown alwayskind of trips this up worst than the known and that’s part of why in this selection committees whether it’s ameeting on a professional sport team or something like the fields or rangers or something like that. They try tofigure out as many horrific ways to make these guys experience the unknown and discomfort in a comparativelycontrolled environment, one which they’re probably not going to get killed so that when they’re thrown in to a completely unknown, completely open ended uncontrolled environment, but to some degree they can match thatstuff up intellectually and physically and stuff like that. My thing with that though is that it’s my opinion that thatstuff still comes at a cost that I still think relative to and otherwise like ideal sleep scenario that you’re going tosee some sort of negative side on that and so it would be interesting to check out some of the studies there likewere these folks just within operational parameters, did it take them off of optimum, it would be interesting to seesome of that. But I have no doubt that trying to stress inoculate people making them more aware getting them ona schedule such as they know what the stressors are going to be, is going to be if you’re but then that’scompletely emphatitical frequently to the very nature of the way that these folks operate. It is interesting like firehouses they no longer have the blaring alarms that just jolt you out of bed. It’s actually, it starts off relativelyquietly. It’s not a jolting up a noise. The guys don’t hit the deck quite as quickly and get going but they are findingthat they also don’t die from the experience. So, kind of lose a little up front but you keep a lot on the back end.
Vince: Yeah. The anxiety factor is got to play huge in all of this, short and long term. And then it’s kind of like notreally watching your diet but thinking you can over exercise to overcome it.
Vince: Well, I’d like to talk a little bit about nutritional interventions beyond higher protein, lower carbohydrate,things like that, like maybe magnesium, I know you’ve talked about that before Robb, we talked about melatonin.
Robb do you want to start off and maybe talk about some things that folks can do to, I guess, stack the odds intheir favour a little bit more? Robb: Yeah. Yeah. The standard deal like magnesium citrate, I really like the natural calm stuff just because ittaste kind of good you throat some of that and some water. Those on melatonin just seems to be huge as to thevariance as to what will produce results in people, some people respond very favourably to as little as like aquarter of a milligram but I have a friend of mine who’s a fundee at the University and she will routinely prescribepeople 30 to 40 milligrams of melatonin depending on their situation. So, that shit’s a shocking variability in theamount that folks take. When I travel, I will take 5 to 10 milligrams if I’m on a really, really tight sleep schedule,say like, I rise on an evening and then the following morning I have to speak and I’m going from west coast toeast coast. So it’s going to be really hard for me to rack out and go to sleep and I’ll do 5 to 10 milligrams in thatis so much better. I may be a little bit groggy the next day but it’s infinitely better than lying awake until 3 or 4o’clock at night and then waking up 2 or 3 hours later and needing to get going. I’ve actually read some stuff indoing vitamin D in the evening because of some of the effects on calcium, some of the effects that the calciumwould have on neurotransmitter status and what not, I’d historically recommended people take the vitamin D inthe morning. And this first kind of got on my radar when I was at a naval special warfare speaking gig and theyhad a sleep expert at the event and he had some pretty interesting insights but I was kind of tickled that the rest tothe protocols he was recommending, pitch black room on a little bit on the cold side so he had to like curl upunder the blankets, magnesium, lower carb diet, etc. etc. etc. He was totally spot on with all, I would flip aroundand said he’s the sleep expert not me but I’d flip that around and say he was in pretty solid agreement on that. Itplayed around with some things like valerian and what not. I just haven’t seen good juice out of that stuff. So, Iwould say one thing. Folks will frequently have a drink or two in the evening with the kind of misguided thoughtthat it’s going to help them sleep but it just destroys melatonin production, curtails growth hormone production, itmay kind of conk you out but the sleep quality is terrible and that this is some stuff that we see again out of themilitary where they have go pills and no go pills, the no go typically being something along the line of Ambien andthey will put you out but the restored development that the sleep is just not all that good as compared to likemelatonin or something like that. But sometimes you’re so fired up that you need something that’s a little bitmore aggressive to actually get some movement.
Vince: And you mentioned, real quick, magnesium, what about the relationship with calcium? Is there arelationship that you suggest Robb? Robb: Definitely and I tend and this is maybe being a Nervous Nellie and Dr. Connelly can probably comment onthis and set this straight one way or another, I’m a little nervous about very much calcium supplementationbecause of some fears of cardiac events because calcium is the precipitator of most clotting cascades and thereis some stuff in the literature that seems to indicate, aggressive calcium supplementation can be problematic. Butagain and again, the thing that I’m falling back on is that when looking at a lot of these studies in sick populations,if we’re dealing with another healthy population and this is going to be a problem. But if that’s, that’s why Ihistorically kind of aired on the very conservative side on the calcium supplementation.
Vince: Interesting. Well then the other topic I wanted to just touch on with the whole crew is the neurotransmitterprecursors. I know you mentioned herbal valerian but what about 5-HTP or tryptophan? Robb: For me, again, I’ve seen more juice come out of melatonin although, I’ll throw in a copy out of that,depending on how different people are wired up, I’ve seen 3 to 4 grams of Gaba do amazing things for certainpeople. So I think depending on which access of the neurotransmitter scene you’re trying to address that helppeople to fall asleep then I have seen both Gaba and melatonin in my opinion have seem to work better thantryptophan or 5-HTP.
Vince: Well yeah, I agree, especially if you have a whole gutful of protein, those precursors and the amino acidprecursors tend to not work much at all.
Vince: Layne, do you have anything else to add as far as on the nutritional, beyond the surveillance of your diet,maybe some tricks you have up your sleeve? Dr. Norton: I think, since we will cover that, I definitely, if I have trouble falling asleep melatonin will usually put meout pretty good but it’s a nice, it’s hard to describe but I guess it’s kind of a nice, I’m in the 3 to 6 milligramrange that was pretty low for me. And it’s kind of a nice relaxation. It’s not really, you just in a point where youjust won’t, you’ve got to go to sleep. It’s kind of like a nice, makes you relax then you kind of gradually drift offand which I prefer as opposed to something just puts me right out. So that’s definitely one thing. As far as kind ofmitigating the problem, I guess if you’re somebody who’s just really on the go and you, you can only get 4 or 5hours of sleep at night and that’s all excusable for you and those sorts of things because I know some peoplethough they told me like, I work a job, I commute, spend some hour with my family, for me to train, it all boils downto, yeah, I can get 6 to 7 hours of sleep but that also means I don’t train. Obviously, our little secret getting into,all I want to say it’s always better to train some than not get that sleep but if I was fit between, I was healthier, 5hours of sleep versus 6 and have 8 hours of training in there I would say by 5 I will be out of training. So, you’ve got to kind of live life that way and you’re making sacrifices, I think you need to treat kind of the symptoms interms of stress responses. And so, taking something that will help restore any kind of lost testosterone increases,something like ascorbic acid that will kind of moderately increase kind of make up for whatever decrements youmight get from lack of sleep. I got to be careful. I don’t want to make that recommendation gladly you need to,VAA is still pretty new, they don’t seem to be any health effects associated with it but as always you need to kindof wait and see what happens. As far as stress, there are some decent herbal things that will reduce cortisol andI’ll be honest with you I can’t think of some of them off the top of my head but there are a few things out therethat will reduce cortisol and the reason I don’t really know those things at hand is because most times I don’tthink that reducing cortisol is that big of a deal. Everybody kind of gets all up in arms about the cortisol responseto training and you want to limit cortisol response to training. I think that’s pretty stupid. I think that short termincreases in cortisol really don’t mean that much to stress response, mobilization response to training, actuallysome of the research out there they’ve actually found that groups that get the dust hypertropin response totraining also to the highest cortisol response. I’m not big on trying to mitigate short term lyses in cortisol inresponse to exercise. However, long term low level increases in cortisol as a stress response are definitelysomething that I don’t think are a good thing and I think trying to limit those to kind of a supplementation routemay have benefits especially when you get sleep deprivation. I guess that would kind of be what I would throw inthere as kind of a way to mitigate things. I’ll also say that training wise, I’d probably stay away from doing awhole bunch of cardio, I mean, if your goal is, if you have very limited time to where you’re trading sleep fortraining, weight training is going to have a bigger metabolic impact on your muscles than getting on treadmill for30 minutes and just walking or whatever, you kind of got to pick your training in terms of what you’re going to bedoing because you’re trading minutes. So I would definitely favour a quicker phase weight workout as opposed tocardiovascular work.
Vince: Interesting. Well, what about the 500 pound gorilla that was always in my life which is caffeine, they’re themost widely used drug on the planet.
Dr. Norton: I think that, caffeine’s one of those tricky things because those people who metabolizes slowly, thosepeople who metabolizes quickly, those people who are very responsive to it, very sensitive to it, there’s peoplewho aren’t very sensitive to it. So it’s tough to really make general recommendations for caffeine consumptionbut I would say it begins to be a problem when you can’t function without 3 cups of coffee but then you need asleep aid to get to sleep. Like that’s the problem. I don’t know, it was Robb talking about, I mean, it’s not maybeon the pain scale of taking go pills and then Ambien. But I’d say if you got in a cycle where you’re taking a bunchof caffeine to get up and take a bunch of melatonin to go asleep, that’s probably a problem.
Robb: Herbal elements at that point I think are not good.
Dr. Norton: Yeah. Exactly. You kind of somebody switch it out for decaf and tell you its caffeine.
Vince: Well, it’s like most of our, all of our shows, we have the educational piece but then we also have thepractical piece that comes from really awareness what are you doing on a day to day basis. And if you’re one ofthose people that has trouble sleeping but has to use 2 pots of coffee to get it up then maybe you need to makesome adjustments.
Dr. Norton: Yeah. Exactly. I think that maybe a case where it’s time to start seeing a physician who specializes insleep because obviously you are tired because you’re having trouble getting up but you’re having difficulty alsofalling asleep.
Carl: You know what the problem with that Layne, is that most physicians who “specialize in sleep” are just goingto prescribe something like Ambien or some sort of sleep aid.
Carl: And you know what? Robb made an excellent point, I know physicians that recommend to their client thattheir patients who are having trouble sleeping have a glass of wine before bed and I’ve known for a long time thedisruptive qualities of alcohol, people, just because you close your eyes for 8 hours, doesn’t mean you’re reallysleeping for 8 hours, there are people who take antihistamines to help them go to sleep. That’s the frustratingpart. Sleep is so important but it’s really hard to get good advice on how to correct sleep problems. What do youthink about that Robb? Robb: I definitely agree, I mean, histamine production is the precursor to growth hormone production. So you’lldo a little bit of Benadryl or something like that or some of the similar antihistamine products and it’ll kind of knockyou out but you’re really not sleeping, really not recovering all that well. What I’ve just seen over the course oftime is running a gym and kind of seeing people roll in and stressful jobs, high achieving people, all the rest of thatbut to get in this kind of zombie life stupor and they function and they go on like they may run very big, verysuccessful companies and stuff like that or have a lot of important things that they do. I think they’re just waytougher than I am, the schedule that they keep would kill me and they’re far from optimum in doing some of thesethings like the sleep aids it doesn’t really do them any good, it’s a short term deal because you went through atime zone change or something like that you see that being solid. But there again, you quit running your business,I mean, what do you do, I think you do the best you can to manage the stress, try to go to bed earlier, cover thesleep hygiene. It goes back around again like lowest carb diet, resistance training, mitigate other stressors,vitamin D levels, taking Probiotics, there’s some other things that’s typically they are not on the radar of folks butif we try to make them aware of it and try to hand hold them through the process.
Carl: The vitamin D thing makes perfect sense because when is vitamin D produced in sunlight? Dr. Norton: I think I’m messing this up. But I think it’s a little bit interesting like the light-dark cycle in thephotosynthesis. I think we get some of the precursor stick of steroid manufacture during the day and then I thinkthe actual vitamin D production happens at night. I could be wrong on that. I’ll double check that if I’m wrong athousand pardons but I think we actually get a precursor stick of steroid production during the day and thenactually it’s kind of a night cycle thing where the D is actually produced so that would make sense, I just thoughtof that.
Carl: Well, I mean, vitamin, maybe I misunderstood, Dr. Connelly, am I misunderstanding, isn’t vitamin Dsynthesize on the surface of the skin and works its way in to the skin after sunlight exposure? Dr. Connelly: Yeah. There’s some pathway for alternate roots of synthesis but the sunlight aspect of it ispre-eminent and with respect to the issue of this supplement and stuff for sleep, the things that have alwaysimpressed me are the natural agents which act with, in the confines of the pre-eminent neural circuitry patternsthat influence sleep wakefulness through impacts on Rexigen A and B and some of the other Gaba and NMDApathways. Obviously, that leaves you with a couple of obvious choices. One is melatonin and there’s somerecent data on a new form of protracted release melatonin that’s I think a 2 milligram dosage that has an alteredrelease characteristic. The safety inefficacy studies on that have been continuing to come out and show especiallyin older adults that that’s a really a precocious supplement. The other thing that people have talked about thatyou guys have mentioned is the magnesium and I think people underestimate the power of magnesium becauseit’s not as well-known sort of in the public domain as the melatonin story is but magnesium has a powerful effectin the pathways that you would really want to target. It’s a pretty potent Gaba agonist and it works in doses like30 millimoles so you don’t have to worry about any kind of gastrointestinal issue or anything like that. It’s a prettyeffective supplement for sleep. I don’t think many people know that but for those of the audience who are lookingfor something, you’ve tried melatonin maybe not been satisfied with it, you may consider adding the magnesiumas a solution to that.
Carl: Robb, do you have any opinions on transdermally delivered magnesium oils and creams and stuff like that? Robb: I’m going to piss somebody off here but it doesn’t make any sense to me. We met Malone tonight, he’san organic synthetic chemist at Harvard, he and I dug through the literature and I tried to figure out what the heckI would have to do to divalent metal ion to make it transdermally absorbed and/or if there have been any simplestudies, just basic kinetic studies where we would apply this stuff dermally and then see an uptick in plasmamagnesium concentration and I’m just not seeing it.
Carl: So, it’s not even getting through the skin, you’re saying.
Robb: It doesn’t make any sense to me that it would. Otherwise, when we jump in salt water we would eliminateand pop like a red blood cell. So, in Lester’s sub, this is getting out there and just getting wowo in trying to do ahat tip to a bunch of observational stuff. If there’s something to it, then maybe it’s modifying some sort of dermalelectrical conductivity because of the divalent metal ion floating around on there. We know for a fact that Epsomsalt baths are very therapeutic. They’re not absorbing into us. But we know that there’s something therapeuticthere, that see, bath types up, salt water types up, things would be therapeutic for recovery but as far as themechanism, if it is doing anything, I am daggered as to what the mechanism is.
Carl: Cool Dr. C, how much magnesium do you need to take you think for it to be effective to help sleep? Dr. Connelly: The studies that humans that really look at very objective, empirical and markers such as forexample EEG changes, and nocturnal neuro endocrine fluxes and some of the hormonal cascades that arerelevant to the issue, the optimal dose of, if memory serves me correctly, is about 30 millimoles of divalentmagnesium.
Carl: So, okay, 30 millimoles, does that translate to any type of oral dose? Are we talking about just plain oldmagnesium? What is it? Dr. Connelly: It will again depend on the form that you took to salt form so you’d have to just pick a particularcompound to determine what its aggregate composition is and then do a simple calculation, go to online and sayconvert this to millimoles of magnesium.
Dr. Connelly: But 30 millimoles of magnesium is what I remember the efficacious dose in humans to be to asagain absorb not only symptomatic benefits in other words efficacy for promoting sleep but also in terms ofrecording reversal of sleep EEG changes that occur with insomnia and also balancing the nightly release of neuroendocrine factors that that’s the dose that I recall as being effective for those two parameters.
Carl: Okay. Vince, we’re coming to the end of the show. Do you want to wrap it up? Do you want Dr. Connelly togo ahead and summarize what we’ve discussed here? Vince: Well, I just would say that, what I grab from it was being aware, we’re in a situation right now of modernliving, so to speak, that isn’t probably optimal. So, we have to do everything we can to optimize our sleep hygieneas Robb would say and I think this show touches on just about everything you can do with respect to this. I didhave one question actually for the group, maybe Dr. Connelly. With the wide use of prescription, are there anythat don’t disrupt your sleep as versus another? Dr. Connelly: I don’t really pretend to know that literature. The problem with a lot of this commonly sold sleeppreparations is that may be show and that is that sleep curtailment is really is endemic, I mean, let’s face it. Sleepcurtailment is now part of modern existence and it’s important as incest to understand what some of theconsequences of that might be and to try and mitigate those with activity profiles and nutrient surveillanceprotocols that would minimize the midnight smack, all that is going to be delivered to the metabolic regulatorysystem what are those issues they are downward regulation of total energy expenditure on a long term basis witha more adverse impact of skewing reduction in fat oxidation in favour of carbohydrate oxidation hence thedeterioration of body composition. This is usually intended if protein intake is not absolutely optimized with atendency to compound the loss of mean body mass which most humans suffer as a result of aging. So, this isanother variable. Another non-calorie based variable that can sort of pile on with other non-calorie basedvariables that are also characteristic of our daily modern existence. And they are simply issues that again remindthose who care about what’s going on with their body and how it functions and how it looks that sleep durationhas an impact on these variable that’s substantive, it’s not trivial. So, if you are someone who by necessitybecause of your requirements for your daily life have less than 6 or 7 hours of sleep, that probably would, I wouldurge you to be more conspicuous and more aware of your exercise and dietary habits and the person who’sgetting 8 hours or more a night. So I think from my perspective that’s the important message from the show, isthat like many other variables that have no a priority caloric value, sleep deprivation can have a significant impactover the long term on your optimizing your body composition which extensively is what most people listen to this Carl: Okay. So, we’re going to wrap it up then on that note. Thank you very much Dr. Norton. Thank you verymuch Robb Wolf. Of course Vince Andrich and to the listeners thank you for listening to the Body RX Showtonight. We’ll see you in two weeks.
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