THE ACCRESCENT™ PODCAST EPISODE 239

Leigh Ann Lindsey (00:01.785)
Well, Dr. Singh, welcome to the Accrescent Podcast. This is a long time in coming.

Sleep Vigilante (00:07.0)
My pleasure, it’s great to be here.

Leigh Ann Lindsey (00:08.821)
Yeah, after having met in, think, early January, we had talked about doing this conversation. And so I’m so, so excited that we got it on the calendar and we’re here. And this is something that is so relevant to all of us, but also especially the demographic I’m working with a lot, which is cancer and chronic illness. I’m really excited about how this can be so impactful in healing journeys of that level. But we always love to start with a little bit of an origin story. So tell us, how did you become the

sleep vigilante.

Sleep Vigilante (00:41.32)
my. So oftentimes I say that I didn’t choose the field of sleep. The field of sleep chose me. And I’ll take you to a story in 2002. It was August and I was a grad student who had graduated medical school in India and I was on my way to Geneva, believe it or not, after studying public health. The idea was to do preventive medicine and change public health.

and introduce interventions that would impact population health. Coming from India, you know, it’s a large population and not as well supplied healthcare. That was my goal. So I’m going to go to the World Health Organization and we had just come off of a successful Pulse polio immunization campaign. So that was the dream. So here I am sitting in Chicago, ready to get into the School of Public Health, get my masters and be on my way to Europe, right? To the headquarters of World Health. And of course,

life had other plans. in that starting semester, I was sitting across a researcher who had this question for me. So young man, what do you know about sleep? And so how did this become? So this answer would determine whether I get a scholarship or not. So it was a research facility looking for research assistants and in exchange they would offer a stipend and some support and tuition, right? So

Here I am trying to find someone to pay for my $13,000 first semester fees. And this question was in front of me. And I said, oh God, the answer is kind of nothing. I don’t know much. Don’t say that. So I look back at her and I say, sleep, not as much as I would like to know. And there was an awkward pause and the researcher, I was hoping wouldn’t call my bluff and said, got up.

Leigh Ann Lindsey (02:12.387)
Mm-hmm.

Leigh Ann Lindsey (02:20.473)
Yeah.

Sleep Vigilante (02:35.766)
and said, you know, you’re right. We don’t teach our kids about this. We’re not teaching it in the curriculums. And it’s very serious. And look at all this research grants I have. None of this made sense. The acronyms NIH, CDC, none of it made sense. I’ve just, you know, two weeks off of the airplane understanding Celsius and Fahrenheit, let alone NIH and CDC. Right. So that’s how it began. She said, OK, will you help me with my research? I said, of course. Are you afraid of the dark and going to the sleep center at night helping these patients? I said, of course not. I come from Mumbai.

Leigh Ann Lindsey (02:54.893)
you

Sleep Vigilante (03:05.614)
This is Chicago feels like Alice in Wonderland at this point. And so she said, fine, I’ll give you $600 a month as a research assistant stipend. And is that okay? I paused. said, $600. I started converting it into rupees. And it was a lot. And I said, wow, this is good. It’s a good start. I was paused and silent. And she said, she thinks it’s maybe not enough. And she says, fine.

I will maybe waive your tuition for the first semester. How’s that? If we add that in, will that work? I said, are you kidding me? Of course. I said, yes. And so that’s how it began. One semester became four. I learned all about sleep research, helping to pay my grad school tuition fees, graduated with a master’s in public health. And that changed the course forever. I loved the field so much that here I am 24 years after that moment.

not left the field. I kind of fell asleep and I never woke up is what I like to say.

Leigh Ann Lindsey (04:03.699)
Uh-huh. You’re the master of metaphors, I learned, in doing some research and preparing for today’s conversation. You have so many great analogies, which I love, because we’re all about imagery and analogies here. I’m excited, especially having been in the field for so long, I’m excited to get into, what do we know, like what’s changed in the field in 20 years? What were they talking about 20 years ago? What were sleep tips 20 years ago that maybe now…

have been blown out of the water, or have been even reiterated by even more research. But before we get to some of that, I think the most important place to start is why should anyone care about this episode? Does sleep really make that big of a difference? What is the ripple effect? And I’m really happy if we spend a little bit of time here getting into the nuance of this of…

Sleep Vigilante (04:45.025)
apps.

Leigh Ann Lindsey (04:54.483)
When we have poor sleep, how is that affecting us maybe in the immediacy, but then when poor sleep persists chronically, how does that start to ripple out into the rest of our life, the rest of our health?

Sleep Vigilante (05:05.958)
I love that. First of all, you’ve opened the floodgates here, right? So sleeplessness or sleep loss was almost a trophy, right? For the longest time, somebody who survived on less was the superior being, the soldier, the macho, the warrior. And somehow this kept going on for several thousands of years. And unfortunately, it was quite the opposite. And this part of the world,

I think to a larger extent would give you trophies for sleeping less and working more, right? The whole workaholic culture. And we have learned a lot about this so-called dormant or passive state as not being so. So I’ll tell you, one of my favorite quotes about this comes from 1972, a gentleman called Sir Alan Rexhaven, who actually gave us.

Leigh Ann Lindsey (05:40.943)
Mm-hmm.

Sleep Vigilante (06:00.248)
the technique how to measure and score sleep stages. Remember, all of us are wearing something like this right now a day. So you’re looking at your REM sleep, non REM. Where does all this come from? It comes from Dr. Rex Chaffin and Kales decided in the late 60s how to measure brain waves. And they were the ones who said, wait, there’s activity going on when in your deepest sleep, if you put some wires in your brain, you will see flickering. So there’s something going on inside. Knock, knock. What’s who’s there? And so and so

Leigh Ann Lindsey (06:24.862)
Right.

Sleep Vigilante (06:30.113)
That started to make us all think that something is going on. And we used to think this is a passive dormant state. And so he said this, if sleep doesn’t serve an absolutely vital function or rather functions, it’s probably the biggest mistake that evolution ever made. Because think about it, right? Evolution says, hey, Lily, hey, Abhinav, protect yourself, don’t get killed, make more of your own kind, basically, right?

Leigh Ann Lindsey (06:57.145)
Mm-hmm.

Sleep Vigilante (06:58.817)
Basically, so survive and don’t get killed, make more of your own. When you’re truly sleeping, you can neither protect yourself from predators, you cannot kind of truly make more of your own and you can’t go gather food. So why a third of your life, human life is spent in this vulnerable state. If it did not have an extremely important function, why is it even there? And that’s what he said. So I think we have learned that piece by piece every decade passing.

Leigh Ann Lindsey (07:19.129)
Mm-hmm.

Sleep Vigilante (07:25.771)
In the late 1920s, we were able to determine brain waves. Then in the late 50s, early 50s in Chicago, again, we discovered REM sleep. Like, what’s going on? In REM sleep, the brain is having almost an awake-like state, and it’s consuming a lot of energy. Like, my gosh, what’s going on over here? And now we’ve learned in the 70s that, my God, if you sleep less, there is more memory problems. If you sleep poorly, poorly means quantity and quality, right? So both come into play here.

You are more irritable. You forget more. There is more heart disease. Then in the 2000s, we started looking at appetite. If people sleep less, they eat more. Like, my, weight loss became an issue. And then in the mid-2010s, we started learning about people who slept less are forgetting more and are not able to clear toxic brain waste. And so is this now going to accumulate more? So we started looking at it as more of a washing machine, a pressure washer that takes place every night.

And as you look at your spinning washing machine, it goes into different cycles, right? It’s not spinning or quiet. Hot water spin, cold water spin, soap spin, stop, rinse. There’s so many different stages and that’s how you’ve got to view sleep as a cycle that takes about seven or eight hours in an adult. And if you cut it short, guess what? The clothes are going to be dirty and wet. So if you stop your washing machine before it’s done, you know what happens. And if you do it recurrently,

Leigh Ann Lindsey (08:31.14)
Mm-hmm.

Leigh Ann Lindsey (08:43.693)
Yeah.

Sleep Vigilante (08:50.303)
lot of health problems head to toe can happen. And we’ve learned that people are finally waking up to the importance.

Leigh Ann Lindsey (08:56.375)
Yeah, can we get into the specifics of that a little bit? What are some of the different areas poor sleep affects, right? There’s kind of the immediate thing that I think a lot of people can resonate with, which is, I woke up, I didn’t sleep great, I’m a little groggy, I’m not as energized, my focus, my memory isn’t as good, maybe my mood isn’t as good the morning after poor sleep.

But I think there could be lot of signs and symptoms, symptoms and systems that start to be affected that people might not actually be correlating to sleep. Like some of the things you’ve said already, heart disease, weight gain, how is sleep affecting the immune system, the detox system?

Sleep Vigilante (09:37.16)
yeah. everything. I mean, how much time have you got? You know, we can do one episode of one system every day for the next four months. Every week we can do an hour. It’s so fascinating. I I still remain fascinated by the impact that sleep has. Sleep is one of the true head to toe impacts, right? And you need it for your whole body. We say sleep is generated by the mind for the whole body.

And so let’s start, you pick an end, right? So immediate sleep loss. So anytime you’re sleeping lesser than your required recommendation, recommended hours of sleep, you’ll notice that you can feel the effect the next day. All of us can. So think about your all-nighter that you’re gonna pull for submitting a paper deadline. Think about editing you’re gonna do on this podcast, and I hope it doesn’t take you too late in the night. Think about.

Leigh Ann Lindsey (10:32.495)
you

Sleep Vigilante (10:33.069)
a red-eye flight. Think about the flight you took from Delhi. Remember, when we were all coming back. So, I mean, it’s not your comfortable environment. People don’t sleep very well on planes. And how you feel the next day? You feel tired, you feel forgetful, you feel reaching out to high calorie foods, your appetite’s off, you’re not smiling as much, your skin’s not feeling as good. Sometimes you start sniffling, right?

Why do people say, I just took a long flight. It must have been somebody on the plane who was coughing and now I have this cold. So it’s a two-fold problem. People miss one piece of it, which is that they didn’t sleep well on the plane and then there was somebody who was sniffling and coughing and so now they’re more likely to that contract, that infection because their immune system was vulnerable. And so the short-term pieces, short-term recall, when you sleep,

in different stages, your memories get arranged, organized, the interactions you had get archived. Think about a librarian. He’ll put the new books, the new incoming books, or the books that people were reading and spraying around and leaving around. He’ll pick it up, put it back in the right shelf, right section, right category. So that’s how sleep is for your memory. Short term, packing into the long term memory. Now let’s say we are meeting right now.

So when I go to sleep, you go to sleep tonight, this interaction will get archived into Lily’s files. So in my mind, sleep is gonna help me do that, and for you and me. And if you don’t, then it’ll get lost. That’s why people say, I forgot, where did we meet again? I don’t remember that. Because you may have not have slept well to consolidate those new memories. Then old memories, things that need to be purged or duplicates happen there. Things that you learned. Let’s say I learned something today.

Leigh Ann Lindsey (11:58.041)
Mm-hmm.

Leigh Ann Lindsey (12:05.134)
Yeah.

Sleep Vigilante (12:20.576)
that needs to be resolved and consolidated, again, memory. So short-term memory, long-term memory, executive memory, declarative memory, all happen in different stages of sleep. So that’s memory, very, very important, right? Then comes mood regulation. So now we know that rapid eye movement sleep is important for mood resolution. So if you’ve had an unfavorable interaction, if there is some trauma that you’re carrying forward, and you talk a lot about healing and you’re doing some impressive work there, and whether it’s psychological trauma, emotional trauma, physical trauma,

that you’re trying to resolve, in REM sleep we have learned that it tries to put them in a place where it’s resolved and addressed, right? So if you’re receiving therapy or if you’re yourself trying to get out of a situation mentally, REM sleep helps. Therefore, you’ll notice that if you sleep short, let’s say you get six hours on a chronic basis. Let’s say we have an individual who only sleeps six hours and thinks it’s enough. Whereas normal sleep rhythms for adults are between seven and nine.

Leigh Ann Lindsey (13:15.117)
Mm-hmm.

Sleep Vigilante (13:19.658)
So if you’re cutting your one hour short, that last two hours is rich in REM sleep. 80 % of your entire night’s rapid eye movement sleep happens in the last two hours. And if you slice off one, then you’ve lost 50%. So now depression, now think about, now multiply that by years of repeated sleep loss and rich REM sleep loss where mood regulation takes place. So now you’re more anxious, you’re depressed, you carry trauma longer.

Leigh Ann Lindsey (13:19.705)
Mm-hmm.

Leigh Ann Lindsey (13:30.802)
wow, okay.

Sleep Vigilante (13:47.745)
You feel unhappier. You’re not able to enjoy things because the resolution of negative memories is not taking place effectively. this was shown in younger adults. Now throw the modern technology in there. People scrolling till late at night. Guess what? They’re going to lose that last hour or two. So you see how all these compounds, so mental health is a huge problem in our society right now. The state of mental health for our entire country and the world, feel.

Leigh Ann Lindsey (14:05.263)
Mm.

Sleep Vigilante (14:16.668)
is at stake here and sleep is one of our protectors that we’re not utilizing.

Leigh Ann Lindsey (14:20.779)
Yeah. Can we talk about it in relation to the immune system? How is poor sleep affecting the immune system?

Sleep Vigilante (14:25.438)
yeah. Lovely. So it’s one of my favorite topics. I was talking about this not too long ago. So immune immunity. So let’s talk about what happens. So when you sleep, you have about seven or eight hours of let’s say length required, right? For most the first half of your sleep cycles, whereby a lot of repair happens, right? So it’s called the growth hormone phase, the slow wave sleep phase. A lot of pro inflammatory cells are being released.

So pro-inflammatory, why is that? Why do we have inflammation in the first half? Because your own immune system, the attackers need to come out and clean the germs, remove the offending antigens from your body. That happens in the first three to four hours. So a lot of attack cells are out interleukins, they’re called cytokines, chemicals that will cleanse and attack anything that’s not favorable, right? So that’s in the first half of the night. Second half of the night is the anti-inflammatory agents are out there. the, think about the,

Leigh Ann Lindsey (14:53.164)
Mm. Okay.

Sleep Vigilante (15:22.314)
the dumpster van who comes and collects your trash or the macrophages, the certain parts of the immune system are out that are collecting all this first half of the night fight and debris, right? So they are all collecting. Now that requires a half and half balance. So if you sleep less, again going back to the quantity loss as well as the quality loss, if you are two hours short, then you tilt in the favor of more pro-inflammation and less anti-inflammation.

Leigh Ann Lindsey (15:52.183)
Yeah, like we’re taking, we’re collecting the trash, but it’s not actually getting taken out anywhere.

Sleep Vigilante (15:52.33)
and now your inflammation is higher.

Correct, not all of it is going. So now you’re accumulating, right? So they’ve shown that there are more infections, common colds. They did a study in San Diego, I believe it was San Francisco, that people got infected more. They introduced rhinovirus in the nose, made people sleep less, and the people who slept less were more likely to get symptomatic. They’ve shown this in vaccines. They gave vaccines, sleep-deprived individuals, the antibodies didn’t form as well. So now talk about the pandemic, right? So if you were sleeping poorly, the vaccines are not gonna be as effective.

Leigh Ann Lindsey (16:22.649)
Wow.

Sleep Vigilante (16:27.456)
by creating those antibodies. And yeah, it keeps going. And we used to do on-call nights in the hospital. You do long nights and you work 30 plus hour shifts. At the end of the week, you’ll get catching a cold, likely.

Leigh Ann Lindsey (16:29.624)
Yeah.

Leigh Ann Lindsey (16:42.799)
Yeah, oh yeah. No, my best friend’s partner is an oral surgeon. And he had to do some residency in the ER. he was like, no offense to ER docs, but he was like, the last person you want working on you is an ER doc, because they’re so sleep deprived. It’s so powerful. And that’s not to say that ER docs can’t do great work, but yeah, the power of the sleep deprivation. Totally. Yeah.

Sleep Vigilante (17:08.148)
It’s challenging, Yeah.

Leigh Ann Lindsey (17:13.423)
Talk about, I feel like there was one other piece I wanted to ask about. You mentioned, what about some of these other diseases and how it may be correlated? You talked about heart disease really briefly. I’m also curious about, and it’s not that we need to get super into the nitty gritty if we don’t have those data, but how could sleep be contributing to heart disease? How could sleep be contributing to something maybe like dementia or Alzheimer’s? How could sleep be contributing to something maybe like cancer?

Sleep Vigilante (17:40.158)
yeah, again, the cancer piece is a little more complicated. It acts via the immune system, right? So if you’re hyper activating your immune system and you’re not letting your anti-inflammatory pieces do their thing, then you set this balance off. And if there is more inflammation in the body, you start to get different areas suffering. We also know that in poor sleep, in shift work actually, there is a study in nurses, you can look this up, who were working nights.

So night shift nurses have a higher propensity of breast cancer risk. Check that out straight up. So it’s actually there was a time when the World Health Organization listed shift work or night shift work as a potential carcinogen.

Leigh Ann Lindsey (18:15.844)
Wow.

Leigh Ann Lindsey (18:25.06)
Wow. That’s wild.

Sleep Vigilante (18:27.283)
And so it’s out there. And that’s the first sort of problem. Everybody’s eyes open like, my goodness, what do we do about this? Then you talked about heart disease. Sleep and so the American Heart Association, I give them full credit, have come out and said, life’s essential eight. They’ve listed eight things as life’s essential eight. This is American College of Cardiology. I want to say about two years ago, things like nutrition, exercise, cholesterol, blood sugar, hypertension, so blood pressure.

and they’ve gone on and the eighth element that they added to the wheel was sleep. So they’ve realized that sleep loss or less sleep, it accelerates the inflammation inside the blood vessels and if you have inflammation inside the blood vessel, things will stick on it. And if things stick inside your blood vessels, guess what? You’re gonna start to get blockages. And if you start to get blockages, will start to get hardening of the blood vessels, you’ll start to get narrowing, so heart attacks.

blood pressure is higher, heart attacks are higher, strokes are higher, irregular heart rhythms are higher with certain sleep disorders like snoring and sleep apnea, which are very common, and 80 % of the sleep apnea in the US remains undiagnosed, and even more so in the world. So all of this leads to more load on the heart. It’s like poor sleep for your heart is like driving with the handbrakes on. If your handbrakes are on, it takes way more effort

Leigh Ann Lindsey (19:42.222)
Yeah.

Leigh Ann Lindsey (19:51.905)
Mm-hmm.

Sleep Vigilante (19:54.678)
for your car to move, way more gas is consumed, way more effort is put in and the car will undergo damage over time. So that’s your heart. Alzheimer’s is an interesting link. It’s probably the breakthrough discovery of I think between 2014 onwards is that during sleep, a group from Denmark found out that when you sleep and I sleep at night, in the first half of the night, we have this thing called delta sleep or slow wave sleep.

Leigh Ann Lindsey (20:01.771)
Mm-hmm.

Sleep Vigilante (20:24.775)
in which you get these giant waves of cerebrospinal fluid. It’s the fluid in which your brain and spinal cord bathe, and they kind of float all night and all day, all your life. When you sleep, the cells sort of shrink a little, and the gaps between these cells increase, and there is a more faster flow of cerebrospinal fluid, thereby removing the trash. Something known as beta amyloid is a brain

metabolic waste that’s created every day and it needs to be cleaned. It’s like CLR on your pipes. We in Indiana have a lot of calcium in our water so it deposits on the pipes and it needs to be cleaned. If it doesn’t, guess what? It becomes hardened and those hardened plaques are called tau. One of the hardened plaques are also known as tau proteins and tau proteins accumulate to give you Alzheimer’s disease. So we are thinking there is a link that could it be that broken or fragmented sleep may be a

Leigh Ann Lindsey (21:04.676)
Mm-hmm.

Leigh Ann Lindsey (21:17.914)
Mm-hmm.

Sleep Vigilante (21:22.013)
a risk marker for Alzheimer’s down the road. So everything connects and yeah, the least we can do is protect our sleep.

Leigh Ann Lindsey (21:28.708)
Mm-hmm. Yeah.

Yeah, absolutely. In a conversation I was listening to of yours, you were talking about the work you do with professional athletes and the basketball teams out there. And you give such a great example, which is these professional athletes, the level between, you know, the MVP of the league that year and then number two might be one or 2%. And so these athletes are so committed to what’s going to give me the edge. Even a one or 2 % could be massive. And I’d love to

you talk about that a little bit, but I think there’s also such powerful parallels to cancer patients, which is for the cancer patient, one or two percent could actually be really massive in supporting their healing recovery. But talk about that a little bit with your athletes.

Sleep Vigilante (22:18.345)
Yes, athletes are superior humans, right? Let’s look at them as they are at the prime. This is a 25 year old at the prime of their athletic prowess, hand-eye coordination, speed. What am I going to add to them, right? So that’s how I looked at this 10 years ago when I was invited to take care of a few of these athletes in the basketball world. I was wondering, the science hadn’t matured then. They were at the top of the game. And you’re absolutely right. The edge.

Leigh Ann Lindsey (22:21.104)
you

Sleep Vigilante (22:44.519)
is just one or two percent of a difference can make or break a career, can make or break an injury recovery, can get them hurt more. So we learned three things in the sleep and athletic science. Basically, an athlete wants to have high performance, High performance, low injury, and fast recovery. Three things, right? So now their life is based on these three elements. If they can maximize this, they’re golden.

Leigh Ann Lindsey (23:05.081)
Mm-hmm.

Sleep Vigilante (23:12.459)
So that’s why I tell them this and I’ve learned and we’ve learned through science that enhancing sleep or protecting it will support all these three pillars of athletic success, which is performance improves, that we’ve shown. If you sleep more as an athlete, they need more than the normal humans like us because they push their bodies through more. Their physical body needs, 100%. They need longer durations than the common person.

Leigh Ann Lindsey (23:34.362)
there’s a lot of recovery that needs to happen.

Sleep Vigilante (23:41.631)
They don’t, they’re not getting it because their careers are littered with travel, hotel rooms, late nights, late games. So it’s called the athlete sleep paradox. They need more, get less. So now performance suffers. Injury risk is higher. So when they play back to back games, different cities, they’ve not rested enough, just like how you and I are more susceptible to.

Leigh Ann Lindsey (23:54.906)
Mm-hmm.

Sleep Vigilante (24:06.347)
colds, common colds, and viral infections when we are not slept well, they are susceptible to more injury because their tissues haven’t recovered. And you push them again, they’ll break, right? And then the last thing is recovery and then injury and then faster recovery. So I tell them this, the difference between a good, great, and a legendary career essentially is coming down to a few things.

You’ve got your nutrition in order. You know, you’ve got your best trainers, best coaches, best technology improving your performance. What’s left? What’s left is your sleep. And if you can pay a little attention, and believe me, not many are maxing their sleep and enhancing their sleep, you could make the difference. And they’ve started to listen. Every team, professional team has a sleep physician consultant on board now. And that’s wonderful to see, wonderful to see.

Leigh Ann Lindsey (24:48.325)
Yeah.

Leigh Ann Lindsey (24:59.908)
Yeah, yeah.

It’s so neat. And again, just that parallel of I wanted to share that. I wanted to share your perspective of that with the athletes because I think it’s very, very similar to that of cancer patients, which is in a lot of ways their body is being put under immense performance. There is so much that’s being asked of them, whether it’s something like chemo or radiation or surgery, there is deep, intense recovery and detox that’s happening. And so they might need to sleep way more than they might normally.

And I see patients wrestle with this of I’m still trying to work while I’m doing these treatments. I’m still trying to obviously take care of my kids. And a lot of what we spent time on is encouraging them, hey, this is the time to ask for help.

to bring in the resources, to let go of the self-critical voice that’s telling you because you’re sleeping 10 hours that that’s bad and you’re lazy. It’s like, no, no, no, no, no. The body really, really needs that. This is the time to give that to ourself.

Sleep Vigilante (26:03.925)
couldn’t agree more and for the best, for the treatment to do its best possible sort of result, to have the best possible result, they do need to enhance their sleep. And I’m happy to say that some of the oncologists in my area, and just because of me, you know, yelling with a loud speaker for the last 15 years, they’ve started to hear, but I wish the work that you’re doing as well and others like us to really harness this aspect for these cancer patients because

They’re going through a life event. It’s very difficult emotionally, mentally. Now they have this physiological, organic, biological disease that they’re trying to fight against this particular time. They need every bit of help they can get, nutritionally, sleep-wise. You’re right, it’s like a peak athlete. They need the same elements of being their best to succeed and win against this cancer.

Leigh Ann Lindsey (26:53.391)
Mm-hmm.

Leigh Ann Lindsey (26:57.86)
Yeah. Yeah. The body’s being asked to perform a lot.

in a very different way from the athletes, but absolutely perform a lot. And it reminded me, I interviewed a cancer, an oncologist a few months ago, and she was so specific. She literally said, you know, aside from chemo and radiation, we don’t, I don’t give them anything else to do except sleep. Like we don’t do, we don’t work on anything except sleep until it’s optimized.

And once sleep is optimized, then we’ll talk about diet, then we’ll talk about supplements, then we’ll talk about adjunct modalities they might want to do in conjunction. But she was like, if your sleep is not optimized, it doesn’t matter what supplements you’re taking. They’re not going to be as effective. It’s not going to be as impactful. And that was so powerful to hear.

Sleep Vigilante (27:29.002)
as well.

Sleep Vigilante (27:43.811)
I love that.

Sleep Vigilante (27:48.295)
I love that. And you know, it comes, it brings me to one of my favorite lines. I always start one of some, very many of my lectures this way by saying, hey, who in the audience feels sleep is an important pillar of health, the third pillar of health? Everybody raises their hand, right? The few who didn’t look at the others and also raise their hand like, okay, okay, we got it. And then I say, okay, let me do this thought experiment with you, just like what you did now. I said, if I gave you the best nutrition, if I gave you…

Leigh Ann Lindsey (28:07.727)
you

Sleep Vigilante (28:16.232)
the best exercise gym coach, but I gave you the worst sleep. What do you think the outcomes or the returns on those health interventions would be? And everybody goes silent like, okay, what’s the answer? Then I show them a graphic where sleep is really foundational on which you build with good nutrition, you build with good activity exercise, you build good with emotional spiritual balance on top of this. If you put that,

you’re gonna win, there is no chance that you’re gonna lose. I call it the Lego piece one. If you’ve ever made a Lego, you open the packet, open the instruction, they say, piece one, where’s piece, piece one is usually a rectangular flat plate, you sit down, right, and then you start building on it. I said, sleep is your piece one of Lego. If you just view it like that, you will have much more success with your other health interventions.

Leigh Ann Lindsey (28:51.408)
You

Leigh Ann Lindsey (28:57.648)
Yeah.

Mm-hmm.

Leigh Ann Lindsey (29:07.928)
Yeah. Everything else you’ll do will be so much more impactful. Until it’s optimized, they won’t be as impactful. And it’s free.

Sleep Vigilante (29:17.64)
Yeah, it’s free. It’s exactly it’s there in your house every day. You don’t need any fancy accessories. It’s really very basic. It was born with you. Think about it. You you came pre-programmed with this operating system called Sleep. Nobody taught you.

Leigh Ann Lindsey (29:36.398)
Yeah. Yes, totally. Totally. And then we’re, you know, we’re, we’re primal animals in a very modern world that, you know, 50, I think about this all the time, how the industrial revolution, my God, I mean, we’re like 50 year, you know, barely even a hundred years into that. The time it takes for evolution and things to change. That is not enough time for our bodies to be able to adapt to how drastically our lives have changed.

in terms of being outside, movement, the sunshine exposure we get, the sleep, the technology, it’s absolutely wild how we’ve changed our daily lives and routines in the last even just 100 years.

Sleep Vigilante (30:18.503)
Absolutely. And you know, the invention of light, I often joke and say, you know, the invention of artificial light, we celebrated and, know, Edison, who invented the artificial light, claimed, sleep is a waste of time, quote unquote, it’s coming in the way. And he then gives us kind of the enemy, right? He gives us artificial light, which revolutionized how we do things. But now something called too much of a good thing is there is also a saying like too much of a good thing can also be a problem.

And I think light in the evenings is becoming a societal health hazard. Excessive stimulation, especially with these bright screens in our face, for too much, know, too close to bedtime, a lot of it, and dosing makes the poison. The same little bits of something can be fine, but you add a large dose, you could hurt yourself. And I think we all have to wake up to that problem too.

Leigh Ann Lindsey (30:51.578)
Yeah.

Leigh Ann Lindsey (31:06.821)
Yeah.

Completely, okay, so let’s get into how to support sleep. Now, I have like three tiers of questions in my mind. We’ll see what we’re gonna be able to get to. But I wanna throw them out there just so we kind of have it in our heads. So one is just, yeah, what are things we maybe should do less of? What are things we should do more of? I wanna talk really specifically about snoring and sleep apnea because I think those are so widely accepted or unknown. And if those are present,

What can we do about that? And then I do want to spend a little bit of time on.

like sleep devices, sleep hacks, sleep enhancers. But I wanna save that for last because the reality is I think people are gonna be able to get good sleep without a sleep supplement, some of these more techy things or supplement-based things or biohacking type things. So I wanna start with just what are the really simple things that most people could change today, this week, then we’ll start to move through these a little bit more.

Sleep Vigilante (32:09.704)
Yeah, so the simplest one I say is MSAP ASAP, which is make sleep a priority as soon as possible. Once you have invested in that thought, I’m not saying go buy gadgets, but just invest in the thought. Like if I slept well, so much can improve. Just that thought, number one, right? So make it a priority. Second piece I say is consistency. So my mentors would say be consistent, be persistent, but flexible when you have to. So don’t be too rigid.

because rigid things break, flexible things bend, right, and survive. So have a consistency with your wake time. Now, if you plant your wake time as a certain within half hour, right, so I’m gonna get up at a certain hour on most days, including the weekend. So develop a consistency about your wake time, follow that up with the consistency of your bedtime, right? And so those two things have

Choose your favorite. Some people like to be a little later. Some people like to be a little earlier. Social situations, families, demands, whatever. Pick your windows and then about a half hour to 45 minutes before that climb into bedtime, have your routine set. Just like a good athlete. Think about from Kobe Bryant or Roger Federer to LeBron to Sachin Tendulkar in cricket. All of them have routines. Whether they’re playing well or not well on the field, they have a process. They repeat. Right? So that’s how sleep is.

Leigh Ann Lindsey (33:35.856)
Mm-hmm.

Sleep Vigilante (33:38.363)
Imagine you have multiple trillions of cells in your body. Everything responds to a rhythm, which is set by light and dark. So it’s like an orchestra that is in sync. be in sync. then, so we talked about bedtime, wake time, get some morning light. I know these sound very fundamental, but it is very fundamental because sleep is a basic, natural necessity for all of us.

Leigh Ann Lindsey (33:45.04)
Mm-hmm.

Sleep Vigilante (34:04.862)
Morning light if you can. You guys in California have lovely amounts of sun, so share some with the rest of the world. And get morning light is a great idea. Reduce your evening light and stimulation. Keep the lights more yellow and soft tones rather than bright whites in the evenings. But about two to three hours of bedtime, start to dim the lights around you if you can. If you have to be close to a screen, make sure the screens are dimmed and just enough light for you to work.

Leigh Ann Lindsey (34:10.073)
Uh-huh.

Sleep Vigilante (34:30.409)
A wind down routine, 30 minutes. Take your favorite pick, a stretch, a little Tai Chi, something gentle, a shower, a journal, a book, a reading. I call it the Sings, know, Abhinav’s foreplay method. It’s a shower, journal, read, breathe. If you did that over and over, it’s a routine. You pick your favorite four. Make sure your bathroom doesn’t have too much bright lights.

as the last thing you do before you go to bed, you switch it on and you brush your teeth like, bright lights in the mirrors and all of this. So watch for those mirrors. And then repeat, and then repeat. And if you do this and you still struggle, say something. Don’t sleep on your sleep problems. So that’s the first thing people can start doing to see where their natural sleep number lies.

Leigh Ann Lindsey (35:09.072)
Mm-hmm.

Leigh Ann Lindsey (35:18.434)
Yeah, I want to point out something that you just said, is let’s start by optimizing kind of sleep time, wake time, and then that pre-sleep routine. Try that for a bit. Be consistent with that for a bit. And if sleep is still really bad, that’s a cue that we might need some deeper support in some way, potentially.

Sleep Vigilante (35:38.045)
Yes, absolutely. Get in touch with your own sleep rhythms, right? So once you ask that, that’s a wonderful place to start. Yeah, I would say that for sure.

Leigh Ann Lindsey (35:50.234)
What are some, I also want to talk about eating, eating times. Is there an ideal time to go to sleep? Is there an ideal time to wake up?

Sleep Vigilante (36:01.385)
So everyone is a little different because some people are early birds, they’re designed to be a little 5 a.m. in the gym kind of people. Some people are like me who are little late birds who are kind of owls, so who like to work late into the evening and then struggle in the mornings, who are not morning people. We are sunset people. There are some sunrise people who want to go and catch the sunrise wherever they go.

So you find out your type and by now you should know as an adult, you’ll probably know what your type is. Unfortunately, society is not very kind slash looking favorably on late people because the owls are not, they don’t get the same cred as the larks do, right? So the first person in the office. that’s just how society is. So find out who you are and you can start to then work.

with that. So if you have to move these natural tendencies, there are ways to do it with the help of a professional you can. And if you found those two things, that’s a good place to start. And the other question you said, Lily, was?

Leigh Ann Lindsey (37:05.324)
Eating, I’m kind of interested, is there kind of like a good cutoff time? And then also, even if you’re an owl, is there a time where it’s like, even if you’re an owl and you stay up a bit later, you really want to try to be in bed and asleep by blank time or no, that doesn’t really, as long as you get seven to nine, it doesn’t matter when you’re getting them?

Sleep Vigilante (37:06.533)
Eating. Yeah. Yeah. Yes.

Sleep Vigilante (37:25.085)
Yes, if you can get your seven to nine and you go to bed at midnight and wake up at let’s say eight-ish to get your eight somewhere there and your social life, your work, your family is okay and your environment can manage that, you’re good. So it’s okay. As long as you keep it consistent, that’s the thing. And then every now and then when you have to attend social events and travel, that’ll happen. But most of the time if you can keep it in this range, you’re good. With your seven to nine, if you can get in your

in your choice of time. If you want to go to bed at 10 and wake up at six, that’s you, right? That’s you and get going. If you want to go to midnight and do eight, that’s you as well, but keep it consistent. And then the meal time. So what we call zeitgeber, there’s a German word that says, giver, zeitgeber. So it gives you the cues. So the body, like I said, is the entire orchestra. Light is your most strongest zeitgeber, which…

which sets your rhythms through your eyes, through your retina. There’s a place in your brain which receives the signal saying, bright light equal to wake mode. And light fading. equal to dark equal to, hey, melatonin, where are you? Melatonin rises. Melatonin is like the dinner bell. It’s not the dinner, it’s the dinner bell. It’s the signal. So please don’t eat the bell.

Leigh Ann Lindsey (38:35.972)
Mm-hmm.

Leigh Ann Lindsey (38:39.728)
Leigh Ann Lindsey (38:44.958)
huh.

Sleep Vigilante (38:45.532)
People consume it thinking, it’s dinner. No, it’s a very weak sedative, but it’s a signal. All of your body cells respond to that. And they’re, okay, restaurant is shutting down, So the liver, the heart, the muscles, the intestines, everything knows that, okay, we’re all synchronizing for sleep mode, optimizing for sleep mode. Then the other zeitgeber is activity, movement. So exercise is a zeitgeber. Food is a zeitgeber. What times you eat your meal, because have you noticed?

Leigh Ann Lindsey (39:08.228)
Mmm.

Sleep Vigilante (39:13.276)
that you get hungry at a certain hour. And if that time passes, you don’t feel as hungry, even though you may not have eaten. Have you noticed that? Because that is, isn’t it? Your dinner, your evening snack, your lunch, you get hungry at a certain hour. That’s why when you travel, let’s say to Europe or to India, your signals haven’t caught up yet and you feel hungry at different times because your body is still aligning to the new place. So that’s how you can tell that all these meals,

Leigh Ann Lindsey (39:20.758)
Mm-hmm. Yeah. yeah, totally.

Sleep Vigilante (39:41.892)
light and activity, social rhythms, all these are zeitgebers. And all should happen at the same time around the clock is when your body synchronizes the best. That’s what we call jet lag. When you travel across time zones, it gets thrown off very quickly and you can feel it immediately the next day. So meals. So anything, once you’ve had your dinner, give yourself at least three to four hours after dinner before climbing into bed. Ideally three to four hours. Sometimes it’s not possible because of variety of factors.

but your dinner should be at least three to four hours if possible. Yes, you can have a small snack, a snack that can fit into your palm. So pick a handful of whatever that may be, some dry fruits, almonds, some favorite fruit, whatever you want, low, less processed snacks, and that could be a close to bedtime snack if you do get hungry. Or in health conditions like diabetes and et cetera, you have to be careful with your caloric intake. You don’t want to go starving too long either.

Leigh Ann Lindsey (40:28.345)
Mm-hmm.

Leigh Ann Lindsey (40:32.376)
if you really need something.

Leigh Ann Lindsey (40:39.362)
Yeah, it’s just, it’s so powerful, right? Because I do think we as humans can get pretty in our ego of, I can hack years of evolutionary biology. And the reality is, no, this is such a, actually a magnificent system here. And so when I’m eating and then trying to go to bed 30 minutes later, or every light on my house is on,

Sleep Vigilante (40:57.894)
Yeah.

Leigh Ann Lindsey (41:05.954)
until the moment I go to sleep and then I shut it all off, like there are so many conflicting messages the body is getting, so it’s not able to produce the things. Now maybe some people are passing out in bed because they’re so exhausted, but I think, is it fair to say, like just because you can fall asleep quickly doesn’t necessarily mean you’re getting good sleep.

Sleep Vigilante (41:27.72)
No, and now we come to what are the elements of quality sleep, right? So that’s a great segue. So I look at it as proper sleep has two basic parts. There is an external environment, which is your bed, your room, your temperature, your pillow, your pets, your sound, your light, your outside environment. And there is an internal environment, which is your mind and body. The body, such as hunger, pain, arthritis.

reflux, things like that are going on inside your body at night that can impact your sleep. And the most difficult one is mind, right? So it’s an internal, if your mind is busy and working on something, tough luck, it’s gonna keep trying to do that. So you can’t take those things to bed. That’s why we say, know, reserve the bed for intimacy or sleep, and that’s about it. And don’t take work or these difficult thoughts or difficult conversations to bed. Have them outside bed.

Leigh Ann Lindsey (42:17.594)
Mm-hmm.

Leigh Ann Lindsey (42:24.186)
Mm-hmm.

Sleep Vigilante (42:24.338)
And that’s why these three things need to be in the right place for you to get quality rest. And then if you have all of this and like you mentioned, I have so many patients who say, Dr. Singh, John, his head hits the pillow and he’s gone. And I’m up for an hour tossing and turning and staring at the clock. Now hits the pillow and gone isn’t sounding, isn’t normal either. It sounds very enviable like, wow, I wish I had that, no.

Leigh Ann Lindsey (42:48.29)
Uh-huh.

Sleep Vigilante (42:52.498)
He’s probably so sleepy at that point. He’s been fighting it for, he’s hit the pillow and gone. At least 10 or 15 minutes is what it takes. For the, yeah. Yeah, up to 30 minutes actually we allow as normal. So once you’ve laid down, closed your eyes, up to 30 minutes we call it within normal range for falling asleep.

Leigh Ann Lindsey (43:00.952)
Yeah, is a normal kind of wind down fall asleep, yeah.

Leigh Ann Lindsey (43:15.618)
Yeah, I think that’s just really powerful. And yeah, and just a reminder that the way we can help ourselves is let’s make sure we’re giving our brain and body all the right cues.

And in fact, let’s start there before we start talking about supplements or biohacking or this or that. You can only out hack. You really can’t out hack the cues. If you’re giving your brain all of this bright light before bed and then chugging a melatonin supplement, I’m being dramatic for effect. I don’t know that that’s going to be able to totally counteract that.

Sleep Vigilante (43:27.548)
Yes.

Sleep Vigilante (43:46.631)
Yeah.

Sleep Vigilante (43:50.662)
No, and know, quick fixes are appealing because they promise sort of immediate relief. We’ve become a culture of we want to hit play and see that 20 second short and get our material. It’s not how life works. It’s not how the body definitely works. The body does not work on shorts or reels. The body works on long form, repetitive messaging and consistency.

So short term meds, you know, I look at supplements, meds, I’m not bashing any one of them. They all have their place, but they are all like training wheels. Think about you trying to ride a bike and training wheels. Do training wheels move the bike for you? No, they help you not fall over or tip over, but you really have to put the effort to move the bicycle. And after a while, most people should get rid of the training wheels because if you did everything right,

Leigh Ann Lindsey (44:39.93)
Mm-hmm.

Sleep Vigilante (44:43.503)
you shouldn’t be needing training wheels to ride a bike. Same thing with sleep. So once their job is done, they helped you through a difficult period of time, life, cancer, recovery, illness, separation, some sort of a difficult time, you should look at an end date on all of these. And some supplements don’t have as much proper valid science behind them, right? They promise more on the bottle. We always say marketing is easier. True science is hard and expensive.

Leigh Ann Lindsey (44:45.412)
Mm-hmm.

Leigh Ann Lindsey (45:12.451)
Yeah.

Sleep Vigilante (45:13.671)
And so, and that’s how, you know, gotta help your own body’s natural rhythm, understand what your sleep rhythms are, what your sleep number is. Is it seven? Is it seven and a half? Is it eight? And you can find that out by living in an alarm-free two weeks and see when you naturally go to bed, when you naturally wake up. Yeah, so that’s your sleep number, right? Is it seven, seven and a half, eight, 8.5? Correct. When you naturally go to bed, so you can figure out your quantity.

Leigh Ann Lindsey (45:28.752)
interesting

Yeah. Like when you naturally wake up.

Sleep Vigilante (45:41.903)
And you can figure out your alignment, like when does your body like to sleep? And listen to your cues, like the famous song by Roxette, right? Listen to your heart, listen to your body’s cues. And then you’ll know, this is my number. So if an eight hour person sleeps seven, it sounds respectable, but they’re cutting themselves short by an hour. And yeah.

Leigh Ann Lindsey (45:48.858)
Yeah.

Leigh Ann Lindsey (45:52.791)
Mm-hmm.

Leigh Ann Lindsey (46:02.156)
Yeah, yeah. And then if you’re stuck in a place of God, just feel like I could sleep and sleep and sleep and sleep and never wake up. We got some issues we gotta work with.

Sleep Vigilante (46:10.76)
Yes. And then the third and important piece that you described, like, okay, if you’re doing all of these things and you’re getting your seven to nine hours and you still wake up feeling not great consistently, then you really, it’s time to say something and don’t keep, you know, self DIY your own 33 % of your life. Think about it. If you had an investment portfolio, right? And you had $13.5 million, would you,

Leigh Ann Lindsey (46:38.958)
Yeah.

Sleep Vigilante (46:40.337)
Would you DIY a third of those? Let’s say you had 39 million. Here, I give you some more, Leely. I give you $39 million, okay? And I say, you know, a third of those, why don’t you just DIY them? Go to Yahoo stocks and mess around. Would you do that? No, you wouldn’t. And that’s exactly how many minutes of sleep you have in your life. 39 million is a lifetime of sleep, minutes. 39 million is lifetime of minutes.

Leigh Ann Lindsey (46:47.82)
Thank

Leigh Ann Lindsey (46:56.63)
Yeah,

Sleep Vigilante (47:07.591)
A third of those is sleep, which is 13.5 million. And I did a little fun talk on this several years ago. It was called What Would You Do for 13.5 Million? And that’s the number of minutes you have in your lifetime for sleep if you sleep about seven to eight hours a night for about 75, 70, 80 years on an average lifespan.

Leigh Ann Lindsey (47:24.974)
Yeah, yeah. And would you take that to an expert to go help me optimize this as best I can? Totally. So to that, so those are some beautiful kind of gentle, free daily things everyone can go out and do right now. I know we’re running out of time, so I’m going to squeeze these in. Snoring and sleep apnea. Two things. One, it’s correct me if I’m wrong. It seems like snoring is just so widely accepted as normal. Is that true? Is it normal?

Sleep Vigilante (47:29.617)
Yeah. Yeah.

Sleep Vigilante (47:43.653)
Yeah.

Sleep Vigilante (47:55.122)
So loud habitual snoring is not normal. Two questions I always ask everyone is, do you think snoring is normal? They’ll say, yeah, it’s a sign of deep sleep. And then do you think snoring is common? yeah, it’s very common. So the second part is right. The first part is not quite. So infrequent here and there snoring, mild, doesn’t bother anyone, happens five times a month with a blocked nose, maybe okay.

But habitual snoring, is more than three times a week in your usual state of health, no sinuses, constantly getting elbows by your bed partner, ouch to couch, right? If you’re getting ouch to couch more than three times, four times a month, then something needs to be done. Snoring is the vibration of the back of your throat. And eventually leads to possibly to an apnea, which is no flow.

If this happens more than five, 15, 30 times, that’s obstructive sleep apnea. Air flow stops, oxygen drops, body panics, and says, Lele, breathe. And Lele is sleeping. And then it jolts you with adrenaline and you go, and over and over. Potholes on a road. How many do you want to hit per hour? Equal to damage your car, heart disease, stroke, arrhythmia, dry mouth, bathroom breaks, forgetfulness. And your eight hours are now worth five.

Leigh Ann Lindsey (48:55.866)
Mm-hmm.

Leigh Ann Lindsey (49:01.146)
Yeah.

Leigh Ann Lindsey (49:15.17)
Yeah, so if they’re snoring with that consistency, it almost is like a cultural joke. Like, yeah, you know, my husband snores, my wife snores, my partner snores. It is what it is. And I’m such a sleep.

Sleep Vigilante (49:24.401)
Yeah.

Leigh Ann Lindsey (49:29.976)
psycho like I’m sorry we’re sleeping in different beds I don’t care like I don’t care sleep is too important I’m not I can’t be woke I can’t be woken up by you what they don’t realize is they’re also being woken up even if they’re falling back to sleep immediately it’s super disruptive

Sleep Vigilante (49:31.623)
You

Sleep Vigilante (49:35.206)
Yes!

Sleep Vigilante (49:46.469)
Yeah, 99 % of the people who snore loudly have no idea that they do. And it’s always their partner complaining. And one person snoring loudly repeatedly is two people sleeping poorly, them and their bed partner. And so now you’re compromised two people sleep and then they get more tired. They get more focused deficits. They get diagnosed with all kinds of mental health problems, sadly. And that is occurring because of poor sleep. It’s being nudged forward. So poor sleep is like that gasoline into every fire you can think of.

Leigh Ann Lindsey (50:15.568)
Totally. Totally.

Sleep Vigilante (50:15.569)
from head to toe. And so get that screened, it’s easy to screen, there are home tests available, and it changes lives. I mean, the number of lives that it changes almost immediately, almost immediately.

Leigh Ann Lindsey (50:28.96)
Yeah. Now say more about the screening. Is this for snoring specifically or sleep apnea? Both.

Sleep Vigilante (50:35.322)
Yeah, so snoring plus airflow restrictions, plus oxygen drops, plus brainwave fragmentation, all together is one event. If you have more than five of these events, it’s called obstructive sleep apnea. If you have more than 30 of these events per hour, it’s called severe sleep apnea. Severe sleep apnea will cut your lifespan by almost seven years, believe it or not. You live less and you live poorly. So many people will say, I’ll sleep when I’m dead. Yeah, you’ll get there quicker.

Leigh Ann Lindsey (50:53.899)
wow. Okay.

Leigh Ann Lindsey (50:57.825)
my gosh.

Sleep Vigilante (51:05.444)
You’re on a fast pass. It’s a Disney fast pass to all kinds of health problems. And screening is not difficult at all now. There are many ways to get this screen. Often people would fear, I don’t want to go to a sleep lab. Who’s watching? Wires on my brain. Nobody’s watching. Don’t worry about that. You can do this at home with gadgets that you can now wear and are well validated to pick up at least the moderate to severe cases. You know, we can capture those.

Leigh Ann Lindsey (51:05.749)
Right, Don’t… Totally.

Leigh Ann Lindsey (51:19.907)
Right.

Leigh Ann Lindsey (51:33.999)
Okay.

Sleep Vigilante (51:35.302)
And then the milder ones probably need the lab to visit. If the home test doesn’t answer the question, you can always go to the lab. But always seek help, say something. Don’t wait 10 years. You wouldn’t wait 10 years on a check engine light, would you, on a car? So why would you wait 10 years on something that’s your check engine light of your body?

Leigh Ann Lindsey (51:51.416)
Yeah, no, I hope not.

Leigh Ann Lindsey (51:56.556)
Yeah. No, I think you gave a stat earlier, something like 80 % of people who have sleep apnea don’t realize they have it.

Sleep Vigilante (52:05.198)
and are not diagnosed and they driving tired and sleepy next to you.

Leigh Ann Lindsey (52:09.168)
Yeah. Now is the main, I mean, it might be an obvious assumption that they don’t realize they have sleep apnea because they’re asleep and maybe they don’t have a partner in the bed who can catch some of those different like symptoms that are happening in the night.

Sleep Vigilante (52:22.502)
Absolutely. So they don’t have a way of gauging their own sleep. So they think that, hey, I’m fine. Nobody’s telling me. And till they travel and share a hotel room with a friend, till they get a procedure and they’re recovering from anesthesia in an anesthesia recovery unit where the nurse comes and says, hey, buddy, you’re not breathing. You better go get this checked out. Or till they have a cardiac event, God forbid, where the cardiologist says, hey, buddy,

Leigh Ann Lindsey (52:37.136)
you

Sleep Vigilante (52:51.428)
you’ve got to go get this checked. You’re on your fourth blood pressure medicine, you got to go get this checked. And many times, and you nailed it, that our primary care colleagues are so pressed for time. And so this really falls to the bottom of the preventive screening questions. And I wish we would integrate this early on, just like your mammogram, just like your colonoscopy. We should ask the question, hey, how do you sleep?

Leigh Ann Lindsey (53:11.417)
Yeah.

Leigh Ann Lindsey (53:20.858)
my gosh, yeah. is it the kind of thing where if you’re having poor sleep, you’ve made some of these changes, you’re still having really poor sleep, just go get an at-home sleep apnea test? Or are there some really clear signs and symptoms that you’re like, hey, if you’re having these things or they’re not that clear, it’s kind of hard to know?

Sleep Vigilante (53:32.804)
You can or…

Sleep Vigilante (53:39.62)
Yes, so we did a little small infographic and I’ll share that with you. can link this down in the connections. It was called ignore the snore no more. So when do you ignore the snore no more? When you have what I call a list of appetizers and a list of main course items. And the appetizers are this. So if you wake up feeling, my mouth is dry. I went to the bathroom three times. Why am I doing that? I’m forgetting. I’m sleepy. My lids are heavy. I’m tired. I can’t remember stuff.

Leigh Ann Lindsey (53:44.943)
Okay, good.

Leigh Ann Lindsey (53:56.176)
You

Sleep Vigilante (54:07.205)
My reflux is acting up. I’m unable to lose weight. My blood sugars are running high. If these things start to happen, think about it like, wait a minute, I should get a sleep screening. Have I asked myself? When you look at yourself in the mirror and brush in the morning, ask yourself, hey, how have I been sleeping? How do I feel? Am I at 60%, 50 % right now? Or am I like 80, 90 %? And if the answer is low consistently, forget what your wearable is saying. It’s time to go ask and.

Speak with your doc about it. Like, hey, do I need a screening? And then there is a tool called the Stop Bang Score, S-T-O-P-B-A-N-G, stop bang. And we can link that. It was discovered by Dr. Francis Chung in anesthesiology at University of Toronto. And it’s a list of eight questions. And if you score, and it’s yes, no questions. So do you snore? Yes. Are you tired? Yes. Do you have somebody seen you stop breathing? Yes. Do you have blood pressure? Yes. Is your body mass over?

35 is your age above 50, are you a man and is your neck above 16 inches? If you have yeses to more than three, three or more, the risk starts to rise. So it’s an elegant, easy question that your listeners can implement on themselves. It’s a yes, no question. And if they score high, they should go get evaluated because it’ll save lives, change lives.

Leigh Ann Lindsey (55:09.902)
Mm-hmm.

Leigh Ann Lindsey (55:20.994)
Yeah, the at home screening. Is that something that still has to be prescribed by a doc or is that something someone can go order online right now?

Sleep Vigilante (55:29.434)
They can with the help of a clinician. So because it’s a medical test, so somebody has to interpret it and somebody has to discuss it with the particular individual. However, I will add this, there are devices like the Apple Watch, the rings and certain wrist wearables that are actually giving sleep apnea screening risk scores now. So it’s like a risk stratific. You can wear it, turn it on and it’ll capture

Leigh Ann Lindsey (55:34.039)
Okay.

Leigh Ann Lindsey (55:53.06)
Wow, okay.

Sleep Vigilante (55:59.184)
crude way what your sleep apnea risk is. And if it’s high consistently, then they can go ahead and reach online. There are multiple places online where they can talk to a doc or a clinician. And that clinician can take a quick history and send a home sleep study to the comfort of the homes. It’ll arrive in the mail. You can wear it, send it back, and they can do an analysis and guide you further from there. So it’s convenient for sure. It’s easy. Don’t tell me now that, I don’t want to go to a lab. That’s why I don’t want to do this. No, those days are gone.

Leigh Ann Lindsey (56:20.794)
Yeah.

Sleep Vigilante (56:28.653)
You can do this at home.

Leigh Ann Lindsey (56:28.898)
Yeah, I mean, that’s, I didn’t even know that because I would have, would have been the first thing I thought too, which is you’ve got to go in, you’ve got to do, it’s this whole big intensive arduous thing. So it’s really cool to hear that the science has progressed on, all fronts, how we test it, how we treat it, all the things.

Sleep Vigilante (56:46.403)
Yes, 100%, 100%. I wish more people would utilize this and whoever’s listening, please ask yourself, you sleep well? And if you don’t, why? And if there is some snoring involved that’s frequent, please get yourself a sleep apnea screening.

Leigh Ann Lindsey (57:02.552)
Yeah. So I’ve taken us a little bit over. Do you have time for two more questions? Or we can have a hard stop if you need it. OK. OK. I promise I’m going to.

Sleep Vigilante (57:05.477)
That’s okay. Yes, yes. No, I’m all good. I have time. I blocked till nine o’clock my time, which is another good hour if you want.

Leigh Ann Lindsey (57:14.608)
I promise I’m gonna land this plane very soon. But I have to, I wanna ask about two things. One, which has just become really trendy in like the last year. So we gotta get the sleep vigilantes input on it. But I wanna start with melatonin. Because I know so many people supplementing with melatonin. When sleep gets bad, this is I think the first thing people think of. And I just would love your two cents on it. Is this supportive? Is it doing anything? Is there a time and a place for it?

Is it stopping our own melatonin production? Answer all of those right away. No, I’m kidding.

Sleep Vigilante (57:49.493)
it’s the word, tell you, and like melatonin and more melatonin is the new and of our sleep society. So I’ll tell you that, let’s back up here. So what is melatonin? Melatonin is a hormone. And in the US, it’s classified as a food supplement. So that’s the starting, we’ve got off on the wrong foot here, okay? Parts of the world have melatonin behind the counter prescription only, and it’s restricted. Second.

Leigh Ann Lindsey (57:57.123)
Yeah.

Leigh Ann Lindsey (58:08.83)
Right?

Leigh Ann Lindsey (58:14.479)
Uh-huh.

Sleep Vigilante (58:16.79)
Our bodies produce about less than a milligram, from 0.3 to 0.9 milligrams of melatonin in a cyclic manner, rising at night and dropping as the sun rises. Every night, every 24 hours, there’s a circadian cycle to melatonin. It’s just not taken any time. It’s not a food supplement, my opinion. Number three, melatonin is sold as over-the-counter in gummies, in drops, in creams, in lotions, believe it or not.

Leigh Ann Lindsey (58:46.106)
Mm-hmm.

Sleep Vigilante (58:46.405)
Welcome to the US, right? So you’ll have one, yes, many, many varieties and the aisles are just endless. So it’s telling you two things, that society is not sleeping well and people are reaching for help. Point number four, melatonin dosing in younger kids frequent dosing has shown to alter puberty hormones. And so that’s not cool. You’re interfering with their growth and development there.

Leigh Ann Lindsey (58:49.857)
Yeah.

Leigh Ann Lindsey (59:09.86)
Wow.

Sleep Vigilante (59:16.165)
Can it suppress your own body’s ability to produce melatonin? That has not been clearly established yet. Then is sporadic use okay? Sporadic use may be okay. Melatonin shows up in your bloodstream about 30 to 40 minutes after you take the medicine, right? Whatever dosing. Dosing typically under five, under three milligrams. I would not recommend crossing these dosings.

Frequently stay the lowest possible you can one two or three milligrams. Don’t go more than that There’s really no need on a regular basis if you find yourself crossing those doses Then the problem is not the melatonin you do not have a melatonin deficiency number one I have people taking 20 30 milligrams of this and still not Sleeping so then the problem is not the melatonin. It’s the chronic insomnia That’s behavioral and we need to really tackle it from cognitive behavioral therapy and other things

Leigh Ann Lindsey (59:54.672)
Great.

Sleep Vigilante (01:00:10.018)
Time and place where is the time and place of melatonin so melatonin? For jet lag so when you’re traveling like we travel remember all the way from India like you know ten and a half hours away Trying to adjust to a new time zone. Yes, absolutely. That’s where it works the best I use this in athletes when they travel many many time zones if you cross more than two or three time zones You will feel jet lag if you want to align your body Closer to the new place you could use melatonin to adjust before you left use melatonin to rapidly acclimate

and shorten your jet lag. Yes, absolutely. The term we use there is called chronobiotic. It’s a signal to your body clock. That’s how you use it. If you’re using it as a sedative hypnotic, as an insomnia agent, then tough luck. It’s not designed like that. So it may induce a mild amount of drowsiness, but that’s about it. And again, if you need it every day to sleep and you start panicking because your melatonin bottle’s missing or it’s low,

Leigh Ann Lindsey (01:00:46.498)
Mm-hmm.

Leigh Ann Lindsey (01:00:54.895)
Yeah.

Sleep Vigilante (01:01:06.181)
then you need to bring up insomnia and to get it tackled properly rather than rely on that melatonin. And lastly, my good friend Kelly Barron did this paper from Utah. She’s in Utah now, researcher, that a melatonin over the counter bottle, hear this out, and I hope it doesn’t scare you, that a melatonin bottle, which says five milligrams, let’s say, okay, per dose, can have anywhere between 10 % to 500 % of advertised dose inside the pills if you randomly.

Leigh Ann Lindsey (01:01:12.258)
Yeah.

Sleep Vigilante (01:01:36.335)
do the study. So that is concerning, isn’t it?

Leigh Ann Lindsey (01:01:37.413)
Yeah.

100 % and it’s just so fascinating right because when you say it’s a hormone There’s no endocrinologist out there who would just randomly throw thyroid medication at you without testing your thyroid, right?

Sleep Vigilante (01:01:51.769)
Yes, yes, estrogen, testosterone, are these available in gummies outside? No. Is adrenal hormone available as gummies? Is parathyroid hormone available as chewables? No. Why? How are we doing this to something that’s a hormone?

Leigh Ann Lindsey (01:01:57.86)
Yeah

Leigh Ann Lindsey (01:02:07.778)
Yeah, it’s wild. Okay, amazing. Love that. That was super crisp and clear. Last question I have to ask about is mouth taping.

Sleep Vigilante (01:02:16.613)
Oh, okay. You’re gonna get me canceled on this. Okay, fine. So mouth taping, please, to the mouth tapers. These fads, I tell you. So I almost want the mouth taping people to… Okay, I’m gonna keep this scientific. I’m gonna keep this scientific. So what is mouth taping? Mouth taping is you stick a piece of adhesive, right, on your mouth. So then, as a touted…

Leigh Ann Lindsey (01:02:26.704)
you

Leigh Ann Lindsey (01:02:35.204)
Do a sleeve study.

Sleep Vigilante (01:02:45.56)
cure for sleep apnea and snoring. There are many places who are saying snoring goes away and we’ll fix your sleep apnea by our mouth tape. So if it’s for that, absolute no-no. Because guess what? How were we designed to breathe through our nose, right? And if our nose gets blocked, we have an emergency breathing pipe, which is our mouth. Correct? So the fact that you have to breathe through your mouth is telling us…

Leigh Ann Lindsey (01:02:51.892)
okay, wow.

Leigh Ann Lindsey (01:02:56.452)
Yes.

Leigh Ann Lindsey (01:03:05.412)
Mm-hmm.

Sleep Vigilante (01:03:11.448)
that something is not getting you enough air through your main pipe, which is your nose. Whether it’s allergies here or sleep apnea here, something is blocking the flow. And so nature has designed the mouth. Like, okay, you use it for eating, use it for chewing, swallowing, also for breathing in case you need to. And suddenly you blocked your emergency escape with a mouth tape. Think about it.

Leigh Ann Lindsey (01:03:15.418)
Great, great.

Leigh Ann Lindsey (01:03:29.805)
Mm-hmm.

Leigh Ann Lindsey (01:03:35.716)
Yeah.

Sleep Vigilante (01:03:35.874)
So now, if you’re having snoring and sleep apnea, it’s like you pushed a mute button on somebody screaming for help.

So now if it’s for that, please don’t do that. Now, if it’s for, let’s say you get scenario number two. So if you get prescribed a CPAP breathing machine, let’s say a common therapy for sleep apnea is a little air pressure machine that blows air at a certain pressure through a little mask, keeps your air passages from vibrating and it keeps it nice and stable and open. Okay, so if you’re doing that and you’re learning how to use a nasal mask and you keep opening your mouth, so in those few weeks of training,

Leigh Ann Lindsey (01:03:46.564)
Mm-hmm.

Leigh Ann Lindsey (01:04:13.677)
Mm-hmm.

Sleep Vigilante (01:04:13.699)
you to breathe through the nose, maybe short term use of mouth tape may not be a bad idea. Sometimes we use chin straps to keep mouth closed so that you can breathe through the nose. So that’s the only place where I have sometimes used mouth tape, but the way it’s publicized as a cure for snoring and sleep apnea, no, please don’t.

Leigh Ann Lindsey (01:04:21.444)
Uh-huh.

Mm-hmm.

Leigh Ann Lindsey (01:04:36.314)
Yeah.

Sleep Vigilante (01:04:38.884)
Like I said, it’s like you blocked your emergency exit. Why would you do that?

Leigh Ann Lindsey (01:04:42.64)
Is there any case where… Like it’s funny, right? Because I don’t think I snore, I don’t think I have sleep apnea. When I’m really good with my routines, my sleep is great, I wake up really refreshed. With that said, there are on the rare occasions times I wake up, I’ll wake up and my mouth has kind of fallen down or something. Is there any situation in which gently closing, keeping the mouth taped

causes you to breathe through the nose again if it’s not a sleep apnea cause. I don’t, does that make sense?

Sleep Vigilante (01:05:16.162)
And that’s a scenario number three that we didn’t touch on, right? So nasal breathing, the wonderful book by Daniel Nester, which talks about breathing and breath, think. So nasal breathing is great. And you’ve got to figure out why are you not breathing through your nose, right? So is it allergies? Is it narrow nasal passages? Is it anatomy? Is it sinuses? That’s a good conversation to have between you and your primary care doc to say, okay, where am I? How can I improve this? And meet an ENT specialist to see

Hey, is there enough passageway and why am I not doing this? So as long as you don’t have sleep apnea, like you say, great, as long as you’re not snoring, good, you’re waking up refreshed, to train yourself through breathing through the nose, that may serve in that aspect as a trainer tool to help you breathe through your nose a little more. And you can practice a lot of yoga techniques which are called pranayama, which actually teach you nasal breathing and alternate nostril breathing. And I believe in all of that actually, helpful.

Leigh Ann Lindsey (01:05:48.464)
Yeah.

Sleep Vigilante (01:06:14.319)
to the patients and everyone. So yeah, I would say I would agree with you. As long as there’s nothing else going on with your sleep and breathing, it may not hurt in that scenario to learn more nasal breathing.

Leigh Ann Lindsey (01:06:14.466)
Yeah. Okay.

Leigh Ann Lindsey (01:06:25.936)
I mean, I hear in that is one, of course, yeah, we want to be really discerning here because if we are masking symptoms of sleep apnea, that’s a really big issue that’s not going to get resolved with mouth taping. In fact, it might even get exacerbated worse. What I hear in that second piece is what it makes me think of is I talk with clients all the time about breathing patterns and how breathing patterns reflect a nervous system that’s in a state of fight or flight. And so in some ways,

Sleep Vigilante (01:06:35.8)
Correct.

Leigh Ann Lindsey (01:06:55.98)
I see that maybe being for some people who are breathing through their mouths gently at night, not because of sleep apnea or nasal issues. It might be a nervous system state they’ve been in and during the day they’re in such an agitated state that they’re breathing through their mouth, they’re taking these really short shallow breaths and then that gets carried on into the night. And so that could be a case where like the sleep tape is just supportive and helping go.

No, we’re good. We can breathe through the nose. We can take those big, deep, long breaths.

Sleep Vigilante (01:07:22.979)
Yeah.

Sleep Vigilante (01:07:27.844)
I agree that, I think that’s a great point you make and there may be that segment who will definitely benefit. Yes, any day if you can breathe through your nose, it’s going to be better for you in general because that’s our primary passageway and yes, it has parasympathetic benefits, slow deep breathing calms your entire internal agitated self and yeah, 100 % and that’s why adding some of these other techniques of breathing also help. Yeah, definitely.

Leigh Ann Lindsey (01:07:54.212)
Yeah, I get so resistant to anything that becomes trendy. And it’s just also the way of the world and the way of pop culture is the thing becomes trendy and then it becomes the solution for all issues. Ice baths.

Sleep Vigilante (01:08:06.008)
Mm-hmm.

Sleep Vigilante (01:08:09.412)
That’s right.

Leigh Ann Lindsey (01:08:12.428)
Mouth taping. And so we just, we really have to be discerning and go, hey, there might be a time and a place and there is benefit. And also more is not better with all of these things. There’s, there’s some people this is really for, there’s some people this is totally contraindicated for. And pop culture isn’t great at educating on those things.

Sleep Vigilante (01:08:32.524)
Yes, that one solution for all problems is a problem in itself because then you will put people in harm’s way because you over promise like, this will solve all the problems. I wouldn’t. Yeah. And I couldn’t agree with you more that always have a chat with a professional. mean, now you have all these tools to look up symptoms and maybe maybe drive you a little more anxious. Whoever is looking up, you know, their problems, but always have, you know, I look at it like this.

the best AI tool that knows you the best is kind of your primary care clinician and you yourself, right? So you yourself know yourself the best, second to your family. And then third is your primary care person who you’ve been having a decent sort of doctor patient relationship over the years. They’ve seen you grow, they’ve seen you going through different, you know, health things or screenings and you bring up a problem with them, they are in the best position because all these giant, you

LLM models, they’ve been trained on so much. Like they don’t know you specifically. They are just trying to put their best guess forward. So use them, but take that information and consult with somebody who is your well-wisher, who has nothing to gain from, you know, finding or selling you something or finding something new for you, create a problem, then offer the solution. Who has none of that involved? So I would say that. Use common sense when it comes to these things.

Leigh Ann Lindsey (01:09:36.847)
Yeah.

Leigh Ann Lindsey (01:09:58.414)
Yeah, completely. Well, Dr. Singh, I’ve taken us way over our time. You’re so generous. Thank you so much. Just so that the audience can hear, it’ll be linked in the show notes. But let people know where they can find you, where they can learn more.

Sleep Vigilante (01:10:04.994)
My pleasure, my pleasure.

Sleep Vigilante (01:10:14.668)
Yeah, so sleepvigilante.com is my website. You can see my good author. I want to give a shout out to Charlotte Jensen. She and I wrote a book together called Sleep to Heal. And it was inspired by so many years of seeing so many people.

come on forward and improve their sleep and really improve their life. So it started off with learning from these patients. So I just shared some of those examples. You can find it. Tell me how you find the book when you read it. It’s supposed to be a friendly book, not a sermon and a preaching. And so it’s not supposed to scold you. Then, yeah, wherever you are, you know, in my 20 some years of doing this, no…

Leigh Ann Lindsey (01:10:46.947)
huh.

Sleep Vigilante (01:10:55.534)
patient ever came back to me and said, or no individual that I’ve been able to help, luckily, came back and said, hey, I’m sleeping better, and I hate you for that. It never happened. It never happened. So please live better, sleep better, and if you want a life max, start with sleep.

Leigh Ann Lindsey (01:11:05.526)
Right. Right.

Leigh Ann Lindsey (01:11:14.222)
Yeah, amazing. think that’s such a beautiful place to close it out.