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Hey everyone, it's Mikki here, you're listening to Mikkipedia and this week on the podcast I speak to Dr Alex Bartle, all about sleep. Dr Bartle is a leading sleep specialist and he shares insights into the key habits that make the biggest difference in sleep quality, the science behind sleep stages and the common misconceptions that keep people from getting the rest they need.

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We also discuss the impact of modern lifestyles, caffeine, alcohol, and wearable sleep trackers, as well as strategies for managing shift work and jet lag. Plus, Dr. Bartle breaks down the connection between sleep, metabolic health, and mental wellbeing. And he shares his own go-to tips for better sleep. Whether you're struggling with insomnia or just looking to optimize your rest, this episode is packed with practical advice, and I think you're really gonna love it.

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So Dr. Alex Bartle is a distinguished sleep specialist and the founder of the SleepWell Clinic in New Zealand. He began his medical career in general practice in Christchurch in 1978, and driven by a passion for sleep medicine, Dr. Bartle earned a master's degree in sleep medicine from Sydney University and established the SleepWell Clinic in March, 2000. Under his leadership, the clinic has expanded nationwide, offering comprehensive assessment

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and treatment services for various sleep disorders, including snoring, sleep apnea, and insomnia. Dr. Bartle is a member of the Australasian Sleep Association and has been an invited speaker at international conferences, sharing his expertise on sleep health and its impact on overall wellbeing. In addition to his clinical work, Dr. Bartle frequently shares his expertise through various media platforms. He has appeared on radio programs, such as the Health Hub,

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discussing topics like improving sleep habits and addressing sleep disruptions during seasonal changes. And despite the fact that Dr. Bartle is such an expert and has been for decades now, he is just so good at being able to speak really plainly about sleep and the issues. So I think there's just gonna be so many take homes for you. I think you're really gonna love it.

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Before we crack on into the interview though, I would like to remind you that the best way to support this podcast is to hit the subscribe button on your favorite podcast listening platform. That increases the visibility of Micopedia and amongst literally thousands of other podcasts out there. So more people get to hear from experts that I have on the show, like Dr. Alex Bartle. All right team, enjoy the conversation.

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Bartle, Alex, thank you so much for taking the time to speak to me this afternoon. You're such an expert in all areas of sleep and your name has always popped up when I've talked to people in research about sleep. I've seen numerous articles, I've listened to you on the radio several times discussing it. So I'm really pleased that you're taking the time to speak to me today. Pleasure. And what I'm really hoping you'll tell me is one,

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sleep is overrated and we have just far too hyper-focused on it. And two, no, that red wine doesn't really matter. So we'll see how this conversation sort of rolls out. And Yeah, I mean, to start with, yes, sleep has been very much underrated, unfortunately. And, you know, whilst we talk about the three pillars of health, which are exercise, nutrition and sleep, sleep is really the one that's been left behind.

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It's not very sexy basically, I mean you're looking smart and six pack abdomen and you know doing all these other things is great but sleep is pretty, you know you're out of it so why should people worry? The problem is we know now it has such a huge impact on the rest of our lives that it is really important and it needs to be, you know there are masses of books on nutrition, masses of books on exercise but almost nothing on sleep.

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which really tells the whole story. And so that's why I'm keen on getting it out there a little bit. Yeah. And how did you get interested, Alex, in the area of sleep? Yeah, I really not quite sure. I was a GP for 30 years in Christchurch. And towards the end of that, I started looking for other interesting things. And I went on a course on sleep medicine in Sydney, and it just blew my mind. It just blew my socks off. It was just so interesting. And it impacted.

04:35
Interestingly, it impacts on almost every aspect of my general practice. In other words, it does impact on all parts of our health, whether we're children, whether we're oldies, whether we've got obesity, whether we've got diabetes or heart problems, anything we see in general practice, sleep has a part to play. Yeah, it's so interesting, isn't it? Because if I think now compared to say, even seven or eight years ago, like the conversation around sleep is particularly, I guess it's in the circles that I

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sort of associate within the health space, we are way more aware of it and how it affects other areas that, that as you mentioned, diet and exercise that we're interested in. Yet also coupled with that, the environment seems to have changed so much that it makes it more and more difficult to get that one thing that most people need to improve upon. Hi, that's a very good point. There is a new book out saying that, that says, sleep like a caveman.

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which is which is really just started to read it. It's just come out and I just thought, oh, that sounds pretty, pretty sensible. Because it is, you know, particularly the technology that's changed lately is really having quite an impact on sleep. And whilst you know, it does impact more information on sleep, all these sleep watches and rings and all those things give you more information about sleep. It's actually what you do in the end that actually makes a huge amount of difference. And I'm hopeful.

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with more information from all these devices that we will actually learn that maybe we should be doing better. Yeah, interesting. So Alex, if you were to zoom out and look at maybe 80-20, so you know, what can you do? What are the 20% of behaviors or strategies that provide 80% of the benefits with sleep? What would you say to that? Well, just to get it back to the clinical side of it, there are two major aspects of sleep that I look at. One is poor quality of sleep.

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the other is inadequate quantity of sleep. If you're looking at quality of sleep, they're often very good sleepers. They'll say, no problem, why sleep? I just put my head down and go straight to sleep. Within seconds I'm asleep. Well, they may have a problem with quality of sleep. In other words, they may have something like snoring and sleep apnea, which affects, you know, at least 20% of the adult population over 40. It's hugely prevalent and very destructive of our sleep, and indeed in the end of our health. The other one obviously is not enough.

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is poor quality or inadequate quantity of sleep, which is insomnia. Really clinically bad insomnia that affects our daytime. By definition, insomnia has to affect daytime. It affects about 15% of the adult population or the population because it happens in children as well, of course. So they're huge problems. I mean, if you talk about asthma and diabetes, they're

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sleep problems are right up there with those other problems that impact, indeed impact on these other health issues as well. So if we're looking at wanting to sort out snoring and sleep apnea, then they need to be tested. You need to see, is this a major issue for health? Because at a certain level you need to do something about that, either weight reduction or stop drinking too much alcohol, maybe using a device of some sort.

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If it's quantity of sleep, if it's insomnia, that's a more complex issue. And certainly there are lots of strategies that you could learn, which we'll perhaps talk about later, though actually will help improve your quality of sleep. So, you know, I'm only getting four or five hours sleep each night. Clearly that's inadequate. Yeah. It's super interesting, isn't it? Because I can think of, you know, good friends of mine who are in like, like on the out, if you look at them, like they do.

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everything right, if you like. So, you know, healthy, they don't drink, they're active, they have a very good diet, and they try to optimize their sleep, yet they still just get four to five hours. Are there people, is there a genetic difference in the quantity of sleep that we either get or even need? Yeah, I mean, there is a genetic predisposition opportunity. But overall, we know that less than six hours on a regular basis, we all get less than six hours occasionally, of course we do. You know, mums with young babies, for example,

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chronically sleep deprived. But we know that long term, less than six hours is not good for us. And whilst we hammer on about getting eight hours sleep each night, the reality is that most studies now serve that actually even in primitive societies would manage usually about seven hours sleep if that. Six and a half, seven. There's a huge study out of Germany recently that says about seven hours is pretty much the optimum. Some people do need eight, some people need nine. But once you get up to nine, you're going to have to get up to

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beyond there's usually something wrong with their sleep quality because they're needing so much sleep. But certainly there's certain amount of genetics whether it's a morning person or a night out for example is partly genetically run as well. So the key factor about a lot of these people who are otherwise very fit, healthy, looking after their diet, keeping lots of exercise is cognition, is actually a thinking process. And they're thinkers, they're worryers often. The other word for insomnia is hyperarousal disorder.

09:48
Oh, interesting. The fuzzy brain. Yeah. So you can't just shut that damn brain down. Yeah. And has the prevalence of insomnia increased over the years or have we gotten better at diagnosing it? I imagine that with sleep apnea, just the changing health status of the population may have, you know, that makes sense to me that that would increase. But what about insomnia? Yeah. Well, the problem is there haven't been any major.

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big studies done sort of 40 years ago, 50 years ago. So we don't really know whether it has changed greatly. The impression is that it has got worse, there's more anxiety, more stress in the communities generally. I mean, I think there are so many other variables. I mean, in New Zealand, we're very sheltered here in New Zealand. If you look at the rest of the world, I mean, almost anywhere else apart from New Zealand and possibly Australia, it's in a nightmare situation. Can you imagine what it's like if you're in

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Gaza, if you're in Israel, it is a nightmare. And so it's all this anxiety and worry that's going on. And in the past, of course, we've always had some of those worries, but it seems to be more global now than it ever was. Alex, can you walk us through the key stages of sleep and why they are important for physical recovery, for brain function?

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and just overall health. Like are there four stages of sleep? There were five at one point, weren't there? Yes, that's exactly right. Yeah, levels three and four are now just level three. So level one is very light sleep. It's just as you're falling asleep. In fact, your brain is probably half awake still. You know, if someone comes into the room or you're noting toward your snoring, they say, no, I was awake, I was listening to the TV. But if you actually asked them what the TV was playing, they wouldn't know. So it's sort of half asleep. And that's about

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5 to 10% of their sleep when you're first just falling asleep. That's level one non-REM sleep. You're always going to non-REM to start with. Level two non-REM sleep, we spend at least 50% in level two non-REM sleep and that goes throughout the night. And whilst its calculator has been light sleep, so if you wear these wrist-based monitors, it'll always say it's light sleep. There are some very specific parts of level two sleep, K-complexes

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all particularly do with memory, cognition, thinking, processing, that sort of thing. Before after about 20 minutes or so, we'll go into deep non-REM sleep, which is now level three. It used to be level three and four, but now level three. That is when we are really quite deeply asleep and it's quite hard to wake us from that. Our brainwaves are very slow and deep. We do a lot of our repair. There's a lot of...

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growth hormone, a lot of immunity happens then, anti-cancer cells are produced at that stage. So it's very much good for our physical wellbeing. For example, if you do a low night sleep study on an all blackout for their rugby match, you'll find they have slightly longer deep non-REM sleep. Deep non-REM sleep, which is at level three, comprises about 20% of the night.

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So if on your watch you see, oh you're only getting 18 or 20% of deep non-ruby sleep, or it's not enough, yes it is, that's normal. 20% of you have deep non-ruby sleep. After about 90 minutes, going down 20 minutes into deep sleep, about 70 minutes in deep non-ruby sleep, you come into very light sleep, which often is a little patch of REM sleep, rapid eye sleep. Usually very short, maybe five minutes or less.

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before you go down deep again into the deep non-REM sleep. Now towards the end of the night, you get almost no deep non-REM sleep. So the deep non-REM sleep only happens in the first really three or four hours of the night. That next three or four hours of the night is largely light sleep, level two non-REM sleep, or REM sleep. Now REM sleep is very light. Our brain is as active in REM sleep as it is in quiet wakefulness. So our brain is very active at that time, but the key factor is that we can't move.

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a spinal weakness or paralysis. And so we don't act out our dreams because we recall dreams from this very light level of sleep. We do dream in deep non-rem sleep as well, but we don't remember that because we're in so steep sleep. If you're woken out of a deep non-rem sleep, you can often remember that you've had a little bit of a dream. But generally we recall dreams from this much lighter level of sleep at the end of the night. Is that a REM sleep? Alex, I don't know if you know

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It's not a recurring nightmare, but if I have a nightmare, one of the things in it is that if I'm being, if I have, there's a presence of someone I'm trying to get away from and I'm trying to move and I actually can't, like, and I physically can't move and actually can't even form like a scream in my dream. Is that in part the physical nature of what REM sleep is? That's exactly right. It's your REM sleep actually, shall we say, morphing over into our wakefulness. So we're coming awake.

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Normally our brain clicks into gear immediately and we so we don't realize that we've been paralyzed for the last two hours or whatever. But sometimes we particularly it's nearly always fearful. So you're fighting somebody off. You want to run away. You try to escape somehow. Being strangled or something in horrible is happening. You're waking out of that dream and you can't move. It's quite terrifying. It often matches only a matter of a second or two. It's called sleep paralysis. It's pretty common actually in younger people.

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Late teenage, early 20s, quite common. If it's happening repeatedly and people in their 20s and they're very, very sleepy, it is one of the tetra, one of the four symptoms of narcolepsy. But they're usually very obvious to pick because they're so sleepy. But sleep paralysis is one of the features, one of the four main symptoms of narcolepsy. And then you mentioned that we get a lot of the deep sleep happens in the first part of the night. So is this a case for

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getting to bed earlier. I've often heard that the two hours before 12 is worth like four hours after 12. Like, is, no, you're calling BS and AM. That's making a difference. So if you go to sleep at midnight, that first three or four hours, three to three or four in the morning will be deep non-representative. If you go to bed at nine o'clock and fall asleep, it'll be nine to one. And so it doesn't matter when you sleep. And you know, for a night owl, they often can't go to sleep, and which we may talk about later.

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We can't go to sleep until midnight, one o'clock. If you're a teenage and we get quite a lot of these delayed sleep phase teenagers, they often can't get sleep till maybe three, four, five in the morning, but they can sleep on till two in the afternoon. So it's called a delayed sleep phase. But they get the same amount of deep non-REM sleep and REM sleep as anybody else. They just get it at an inconvenient time in terms of going to school or work. Yeah. And I imagine this must have impacts on...

16:47
their whole circadian biology then if we're thinking how important, I mean, we'll probably talk about this later, but the morning sun is for resetting circadian rhythm. That's what they might miss out on. Yeah. Well, yes, that's right, except for when they wake up at two o'clock in the afternoon, if they get outside, then that will suppress the melatonin then. But you can alter that and then we'll come on to the treatments of maybe this telacype which is actually...

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relatively common, not necessarily to that degree, but it's often for young teenagers can't get to sleep till midnight, one o'clock in the morning, that's quite common, but they still have to get up at six o'clock to get to school or work, which means they're cutting their sleep short. Yeah, and I've often heard it argue that society really favors morning people, the morning sort of people much more so than those evening types because of the way that we do things, like it's much more suited to someone like me than it is.

17:42
maybe my husband who is much more, I mean, he trained himself to get up early and hello, he has to work. But I think he would much like he would definitely be a later person than I am. Yeah, I mean, you can train that to some degree. And using light, which I'll talk about perhaps later is actually how we often do that. But because that's the most common, what they call

18:11
It's important that we understand that because you're quite right, the society likes us to get up early. In fact, so many things, you know, in the army, in boarding schools, they're up and having cold showers at five o'clock in the morning. And they're realizing now that that's actually not a very good move. Because these youngsters are actually falling asleep on the way to school or, you know, first period or two at school is just a waste of time anyway. So actually in America,

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typically they used to start and still a lot of them do start school at 7.30. Whereas in more anglo-centric, English-centric, we usually start schools at 9 o'clock which is better. And in America, quite a lot of schools are moving to starting school later at 8.30 or 9. So they're beginning to realize that this circadian rhythm problem with teenagers is actually quite major and making a huge difference to how people function. Yeah, for sure. And I guess it's a...

19:04
be almost a misstep to have schools or schools starting at say 10am if we think that their parents have to be at work by 8am. Like it's, I mean, there's this, it's just not congruent with how society is right now. No. What I would really love to have done, which I'd left Christchurch by the time the earthquake occurred, but immediately post earthquake, a lot of schools were destroyed and so they had to, and so they had morning school, some schools were starting at 8 o'clock to 1 o'clock.

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And a different school would come in at one o'clock and do one o'clock till six o'clock or five o'clock. What would have been fascinating is to see how students coped with the morning school compared with the afternoon or midday afternoon school because that mucked up their circadian rhythms completely. But you're quite right, society runs and workplaces as well as schooling runs on a normal, so 8.30 or 9 till 4.30 or 5. So when we kicked off, we were like, yeah, let's have a chat about some of these.

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misconceptions about sleep that people have. So if you were to have to name two or three of some of the biggest ones that you come across, what would they be? Well, one of them is going to bed too early. So I can't sleep at 10 o'clock. So I'll go to bed at nine o'clock and then give me an extra hour. That's the wrong way. You need to go to bed later. Always go to bed later. Spending so much time indoors is not healthy. I mean, here I am in an office, which I spend most of my day in.

20:31
Outside light is completely different to indoor light. And the more we spend time outside in our natural environment, the better. And to that end, and I have to be very careful what I say here, is wearing sunglasses is not helpful for sleep. It makes the brain think it's still asleep. Now our ancestors didn't have them, but our ancestors didn't have glare. They didn't have tilt slab buildings, concrete slabs, and tarmacadam rose. They had trees and plants. So this intense light, which is...

21:01
In my office, it's less than a thousand lux. It's probably only five or six hundred lux. Outside, I'm in Auckland at the moment and it's sunny. Middle of the day, so it's going to be something like 70, 80 thousand lux. It could even be up to a hundred thousand lux. So, 80 thousand lux outside, less than a thousand lux in here. This is where I'm living most of my day, which my brain is not helpful. And the brain is affected by light hitting your retina, back of the eyes. And so, it's got to hit your eyes. And it's particularly the blue and green wavelength of light.

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that suppresses melatonin, does three things. Does many things, but three particular things. One, it suppresses melatonin, so it wakes us up. Number two, it alters the size of your pupil. It's called the retinal hypothalamic tract. So it goes from the retina, the special cells, to the middle of the brain. It comes back to the eye, constricts the pupil. As you know that, when you go up bright light, the pupil comes down. The third one is it starts producing serotonin. And serotonin makes us feel good, and it's particularly

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This blue-green light, which for thousands of years has been our natural environment, has been blue and green, that impacts on these retinal ganglion cells suppresses melatonin, wakes us up and produces serotonin. Now chemically, serotonin converts to melatonin at night. So the more serotonin you produce during the day by spending more time outside, the more we sleep at night. We produce more melatonin at night. Hence when your mum said to you many years ago when you've been camping and tramping, you'll sleep well tonight dear because you had lots of fresh air.

22:30
Well, it's actually nothing to do with the air. It's the light. And the light is crucial, but it's not clear, bright light. It's shaded blue-green light. So going for a run, going for a walk, going for a cycle through the local park or gardens, where shaded light is ideal for us. But if you go out and wear sunglasses, then you're not suppressing melatonin. Pupils aren't altering their shape, so because you're doing it, you're blacking it out for them. And you're not producing all this lovely serotonin. So...

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If you had macular degeneration, glaucoma, cataract, something, eye pathology, yes, you may need to wear sunglasses. But for most of us, we don't have those pathologies. So particularly shaded blue-green light going for that walk or runs through local pago gardens, that's going to help you sleep. Yeah. Alex, a couple of questions around the glasses or just vision even. So one, does this, like how does say blindness affect someone's ability to sleep?

23:28
So I'm interested in that. And my next question, if it's okay just to ask on the back of is what about the blue light blocking glasses or the blue light blocking function of many people who wear vision glasses? Like I see this a lot. So can we address both of those? Right, the first one, blind people, yes. A lot of blind people still have that written or have the like the straightened words. So it's not universal.

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If that is blocked as well, then it really does have a major impact. So their sleep can be all over the place and it often starts, you know, if they've been blind from, if they've had retinitis, pigmentosis or whatever, they've had eye cancer or whatever as children, they often just sleep anytime, or they want to sleep anytime. They want to wake anytime. And it's a bit of a nightmare because we live in a society that needs to be awake during the day and sleep at night. And so we do have to use melatonin to help them sleep at night.

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and often a stimulant in the morning. So it can only be really manipulated with medication. And so it does have a significant impact, but it's not all the people who are blind people, but it's many people who are blind people. And you have to not have that retinol or have the lamic tract, that pathway. Yeah, and the second question is, what about a lot of the glasses these days that people get to correct their vision have blue light blocking in them? Yeah, well, blue blockers is what we recommend.

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at night time because that blocks the blue light which suppresses melatonin. So we want melatonin, so we want to block the blue light. So if you're watching TV for example, the old fashioned TV, which not many people watch these days, I do, but not many people watch TV, you can't get rid of blue off the TV. So wearing blue blocking glasses may help get rid of some of this blue light that's affecting you, that's getting rid of melatonin which you want. But during the day we want blue light.

25:23
and so blue-green light. And so wearing glasses that have a bit of blue-green on, especially in the morning, but you know, the cheap one, we have blue-light glasses, so they produce blue light. We use those for people who, for example, have to be at work very easy in the dark, so they don't have option to be outside at all in the morning. And their blue-light glasses are very effective because it suppresses melatonin, you know, at maybe 5, 30, 6 o'clock in the morning when they have to get to work.

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and it's dark. So blue light glasses suppressing military in the morning is great. But of course, the cheapest way of doing it is getting outside because you're not only getting outside and getting the proper light, but you're also doing some exercise. Yeah, well, so a couple of things with that. So first, can you clarify? So you can purchase glasses that actually produce blue light in New Zealand? Yes. Okay, amazing. I have

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pair of glasses that suppresses blue light and I wear them at night and they're orange tinted, they're great, but they didn't realise that the opposite were available. Because of course during winter, like here in Auckland, we get the sun rises at about 7.30ish, but in Dunedin, the sun seems to rise at about 8.30. So those blue light glasses would actually be a great idea for people, for us in winter.

26:43
We've got these glasses that actually can produce blue light in the morning, but also can switch to producing amber light at night time. So you can use them both ends of the day. That's amazing. Yeah. So in the past, we've had to have a box, for example, that produces blue light and you have to sit in front of this box. But if you have glasses, then you can go and have your breakfast and read the paper or whatever you can do in the morning. And while you're suppressing melatonin and waking yourself up in the morning. Yeah, it's amazing.

27:12
So I'm thinking about, you know, if I go to spec savers and I look around at all the glasses that are available, there are some of them that say that they block blue light and people wear them all day. So in that instance, they're better off getting maybe a couple of different types of glasses, ones without the blue light blocking to wear during the day, but maybe they wear their spectacles that have the blue light blocking at night. Absolutely, yes. I mean...

27:37
It's a bit, you're having glasses to try and cover all options and that doesn't work because it changes throughout the day. And I've always been puzzled, I'm never quite sure when I go to an optician I talk about this, whether they talk about blue blocking glasses or blue enhancing glasses. So that's the key factor when you need to ask about that. Does this produce blue light or does this block blue light? Because if it's during the day, I want the blue light and at night time I don't want the blue light.

28:05
Yeah, no, that makes sense. And I'm definitely going to look at those blue light producing glasses. My dad is a very bad sleeper and he lives in Dunedin. And he does a lot, which is actually good for his sleep hygiene. But still, I think it's that it's the lack of blue light, I think, in Dunedin is one of the things throughout the day. That's why we do have this thing called seasonal affective disorder, lack of morning light, particularly.

28:35
get grumpy because we're not producing the serotonin we should be doing. And of course, we see it particularly commonly in Nordic areas, of course, in Sweden, Norway, Finland, those areas you see quite a lot of that in winter. Yeah, yeah, interesting. Alex, you mentioned wearables before, and our ability to track sleep through our watches or our aura rings. How much of that data can we actually rely on? To your point before, you mentioned that, well,

29:03
Having data is one thing, but acting on it is another. But is it helpful all the time? No, not particularly, to be honest. I think sometimes it's quite useful. And in fact, I've seen somebody this morning who had been alerted to the fact that his oxygen levels were dropping quite a lot at night and he was a bit worried about that. The reality was that it normally drops at night anyway. So he was probably not, but he actually came in and had no night sleep study. We've done some other things as well. But it's not only knowing what happens,

29:33
But why? What does it mean? That's a key factor. To that end, we quite, you know, some of these watches are better at doing that. Now they have a they'll tell you what you should be doing. We use we do use oar rings, which are perhaps a little bit more accurate. A lot of them work on heart rate variability. So it's measuring the variability in heart rate. And so it always puzzles me why here we are wearing a watch on the back of our wrist, which is not where the pulse rate is. I mean, why don't you wear it on the front of your wrist?

30:01
And that's why I quite like the Aura Ring because it's a ring around your finger and you've got these digital arteries that run down the side of your finger that it's measuring. But you know, and it may be slightly more accurate, but for sleep and wake, they're not too bad, about 75% accurate. But if you're dealing with deep non-rim sleep and rim sleep, so measuring the actual quality is probably about 70% accurate compared with polysomnography, which is where they wear these things and do the overnight sleep study as well. So measuring brain leads.

30:30
and then they can measure it accurately and see how accurate these is. They're getting better. But, you know, we get so hooked up on this thing. And really what I want to say is forget the wash. How do you feel in the morning? Are you getting satisfactory sleep? Are you getting enough sleep? It's a good quality. I'm waking up tired. Well, you know, what you watch, it tells you some things that you're not getting good sleep, but you need to be able to do something about it and understand a little bit about what it means.

30:59
So it's a little bit frustrating, but they're there. We're not going to get rid of them. People love to monitor this. Yeah, we love to monitor everything, right? Like, I mean, doing something about it is the thing that people struggle with, but actually monitoring it is no problem. I'm interested in those sleep studies, just in that I struggle to understand how reflective that might be of real sleep for the individual doing it, because it's such a...

31:25
an unfamiliar environment for them. So how does it translate into what their actual sleep is like? I mean, it must because this is what you do. Well, look, I'll tell you what, you're absolutely right. The main test that's been done for the last six or seven decades or eight decades is polysomnography. And that's 24 leads all over you. It can be more, but the traditional one is 24 lead in hospital being in a separate environment. Now, when they...

31:53
they rarely do this because it's so expensive to do two nights in a row, you find there's about a 25% difference. There's that first night effect it's called. So that first night they don't sleep very well. The second night they sleep much better. So it can be up to 25% different. And I think a lot of the time, particularly when you're measuring it for sleep apnea, people are so damn tired that they fall asleep. It doesn't matter how many leads they've got, they're going to fall asleep. So yes, it does, it gets in the way. What we do is home studies. So

32:23
send out equipment so they sleep in their own home, they put the equipment on themselves. Many places, including us, we do quite a lot of study with just an oximeter. If you're just looking for snoring and sleep apnea, we just use a thing on your finger. So we send out the kit, they put it on the finger or on their head. We've got a new one now that goes on the brain, which measures the actual brain waves as well, which is fantastic. And people can set it up themselves, do it overnight, put it...

32:50
take it off, put it back in the container, we send it back to Christchurch, which is where my base is, and they download it there, then we see the patient and we got all the data. So it's now done in their home, which is better. But as you know, 100% I had someone again this morning who was really irritated by the nasal problems that go in your nose. And, you know, they're all a little bit irritating. It's not a normal sleep or they feel they can't sleep on their tummy or on their side because you've got all this equipment on them.

33:16
So they're not sleeping in a normal position. So you're absolutely right. It does impact on their sleep to some degree But it gives us an impression. Yeah, for sure. Yeah, I'm Slight tangent you mentioned, you know sleeping on stomach sleeping on side. I love to sleep on my stomach I always have like hugging myself sleeping on my stomach with my head turned this way I know I actually do get a visual of what my skeleton might look like and I'm like, oh that just feels uncomfortable But it's not it's not uncomfortable but I what I find is that my nose blocks and I do that and then I start snoring like

33:45
That's not normal, is it? Well, sleeping in different positions, people come up with all sorts of theories about, you know, your this sort of personality if you sleep on your back. I'm a tummy sleeper too, actually, as it happens. But it's less likely to snore than if you're on your back. Purely mechanical reasons in that if you're on your back, the tongue falls back and obstructs more easily and you snore more if you're on your back. But

34:12
It's what you get used to in lots of ways. And I was liken it to, you see a cat getting into their sleeping place, and they'll often get in and sort of do a little circuit, and then lie down and go to sleep. That's their sleep position. And I might start on my left side, and then before I go to sleep, I'll turn onto my tummy on my right side. And so I go to sleep. So you have a little routine, if you like, which says to your brain, I'm about to go to sleep. How important is...

34:40
a sleep routine actually. Like I, cause I like that's just a tiny snippet of a sleep routine, but when should, if I'm serious about wanting to improve my sleep, when should I start thinking about that? Yeah. Well, sleep routine is really, really important actually, but sleep routine that works for example, we say to people or it said to people, go to bed at the same time and wake up the same time every day.

35:05
To a degree, that's true. But if I go to bed at 10 o'clock every night, and I go to bed regularly at 10 o'clock, but I never sleep till midnight. Now, then I've got two hours of tossing and turning. I see this quite a lot, but I go to bed very regularly. You know, I go to bed even at 9.30 at 10, regularly every day, but I just can't sleep. Go to bed at midnight. Start by going to bed when you're going to sleep, and then you can move it forward. And then when you're stable, then you're going to bed and going to sleep maybe 10.30 or 11 every night. Stick with that. And then in the morning,

35:35
Getting up and your morning routine is possibly more important. You know, weekends by all means have an extra hour of sleep if you want to, but sleeping on until 10 or 11 midday is not actually helpful. It just delays the whole circadian phase. So regularity of sleep. And I usually start the process or think about sleep process probably an hour before bed.

36:00
Particularly for children, I like that, you know, starting really with the shower, night time shower or bath for a child, making sure the lights are getting dimmed and then reading stories and reading that sort of thing. So routine in children is really important. Adults, we tend to produce our own story of how we get to sleep and it probably is, a lot of it these days is online.

36:26
is either watching telly or these days for most young people, they don't watch telly at all. They just use their computer and iPhone and that's really hard thing to break. Yeah. And is it important to break it for everyone? And I ask this question because I'm horrible if I've got my, like, I put my blue light blocking glasses on, I read my Kindle. That's almost like a Pavlov's dog's reaction. I'm like, okay, I'm tired now. Put my eye mask on. I'm asleep. But my husband,

36:54
he gets to bed, he doesn't seem at all affected by the overhead light, the way that I feel I am. And then he reads the BBC news, he catches up on sport, and then he falls to sleep. And both of us report a similar, yeah, I feel refreshed. So it's like, it's just different. Very good. What I say to people is when they, if they're watching TV, looking at their computer, put it down and go to sleep, so what? They're not going to come and see me anyway. That's fine. Yeah, good cause.

37:23
I think it does impact to some degree on the quality of sleep to some degree. But in the end, calming the brain down before you go to sleep is for a lot of people I see at least because they've got insomnia problems is really important. So the other thing to say is the three issues with smartphones and computers, it's not just the blue light because most people I talk to, I talk to a year 12 and 13 students.

37:53
They all know about night shift. They all get rid of the blue light. They say, isn't that enough? Well, no, it's not, because there are two other major problems. One is that it's close to your eyes. So it's flickering, watching a movie, gaming, Instagramming, TikToking, whatever, close to your eyes. So it's flickering close to your eyes. The second problem is it's interactive. You're working with it. You're YouTube and Facebook, and you've got rid of the blue light. Whereas, when they started to look at TVs, which is the old-fashioned, the other side of the room TV, it's distant.

38:21
It's passive, you're just watching a movie, you're not working with it, but it is back to blue. You can't get rid of the blue off TV. But when they're data studies, the old fashioned TV versus the computer or iPhone, the iPhone was not as good. So the fact that it's blue light, but it's not close to your eyes and not interactive made a difference. So it's that interactivity and that flickering. Now you say you read a Kindle, reading is quite a different process. Your eyes are scanning words. So it's not flickering. It's not.

38:50
So you flick a page every now and then, but your eyes are scanning. And whether it's a book or a Kindle, the jury used to be out on whether we should be using Kindles, but the reality is it's the same as a book. Okay. Amazing. And so that's no great problem. If you read, and it's quite a nice calming thing to do before you go to bed. Yeah. Yeah, for sure. So what about TVs in the bedrooms, Alex? Like, is that still a no? And I'll just publicly state, I don't have a TV in the bedroom. And because...

39:19
I feel like I should get an A plus for that. You know, like listen to me, because I think surely that's the best. But again, are we all just different into how we're going to respond? We react differently to it, absolutely, because I mean, you're one who shouldn't have a TV in the bedroom, your husband's one, he couldn't care a damn whether it's in the bedroom or not. He goes to, he puts his head down and goes to sleep. And sleep a lot of the time, which I talk about a lot is to do with confidence. And he doesn't even think about it. He just puts it down and goes to sleep.

39:47
You would put it down and think, oh God, what's going to happen tonight? I wonder if I sleep and I've got a busy day tomorrow. Your mind is racing. This is so true actually. I end a lot of people in my, in the health space. He's, he's in the health space. He's a nurse, but in a different area, like these, we, we hyper focus on optimizing everything, but actually probably to the detriment of, of, you know, what we actually want to achieve. And it's often our personality.

40:16
I mean, people are very high flying people who are really big thinkers, they're flat out all day. They can shut off at night and go to sleep. Some people, not even necessarily high flyers, but they're so buzzy brain that they just can't sleep. You know, you perhaps a bit more in the second category and your husband's in the first category, he's a thinker, but he can switch off just like that and go to sleep. What we're trying to do with a lot of the sleep stuff that we do is to get them confident that they can actually go to bed and go to sleep.

40:44
because they've often lost, I go to bed at 10 o'clock, I go to bed at nine, still can't sleep. You need to be able to get confident, I can sleep, I don't need a pill, which can come to on in a minute, I'm sure. Yeah, yeah, actually, let's address that now because so many people do rely on medications to help them sleep. As I've heard it explained as getting punched out, like you're knocked out with a pill and it's not actually giving you the quality sleep. Is that how you see it? There are some tablets that do that.

41:12
Zopaclone will possibly do that, things like triazolam, which is no longer available but used to do that, benzodiazepines do that. And Zopaclone is a pretty simple drug, it's pretty effective and well sort of more likely to sort of just go through the GABA system in the brain which will help you go to sleep. But there's just an article come out just recently, I won't go into the technicality, maybe come into this later. But yes, basically anything you use to sleep.

41:41
whether it's Sopocan, which is actually a pretty good sleeping tablet, it will zonk you out most of the time, or whether you're using something that's over the counter, they all become sleeping pills. So if it helps you go to sleep, it becomes a sleeping pill. Now, a lot of these things over the counter don't make any difference because there's very little in them, but there is a huge placebo response. About 50% of anything you take for sleeping is placebo response. Okay. I'll give this example, for example.

42:10
We take it as opaclone and we'll zonk out of sleep. So we reduce it to three quarters, to a half. We're trying to weed ourselves off, and yeah, and still sleep down to a quarter. Not bad, pretty good sleep still. To a quarter, to zero, almost impossible. That going from a quarter, which is actually almost nothing in it at all. I mean, chemically, there's always bugger all in a quarter of an opaclone. But you go from that to zero, and I can't sleep because you're not putting anything in your mouth. You're not doing, I can't do it myself. I need something to help me sleep.

42:39
So you get melatonin, which most of the time doesn't make any difference. Even the manufacturers of circadian, which is a two-milligram cellulose, said it really didn't make any difference under 55-year-olds. So here are people being prescribed it at 30s and 40s. And it's not designed, actually, for until you get older, but a lot of GPs will prescribe it. Most of that, oh, it's got sleep on the bottle, it's a sleep hormone, hang them this night and go to sleep. So it's giving them confidence, it's this thing that's doing it for me.

43:07
Now, if I don't have this thing, I've got to do it for myself. And I can't do that. I've lost confidence in being able to do it myself. So that's why when they come and see a sleep clinic, then we try and get them to be confident that they can do themselves. OK, so that's interesting. So I think my follow up question was going to be what non-medical treatments work for sleep. But you've just answered my question, really, haven't you? Because I take magnesium, you know, and I feel it's part of my routine to take magnesium before I go to bed. But

43:37
And interesting, I have actually looked at research around magnesium, tried to do a deep dive. There's almost nothing on sleep. There's absolutely nothing on it, all sleep. Yes. There was a study a little while ago in the elderly population who do get magnesium deficiency. We do need some magnesium for sleep, so don't get me wrong. But we should be able to get enough magnesium in our diet if you're having a reasonably normal diet to actually fulfill our need. But taking extra magnesium in the elderly did make a tiny bit of difference. So don't knock it completely. But that's where the studies come from.

44:08
But in the end, it's what we do and in terms of treatment for insomnia, there are three issues or three things we talk about. Number one, sleep hygiene. Most people know all about sleep hygiene. They don't do it very well and I always go through sleep hygiene because there are a lot of stuff there that they haven't thought about, particularly light, noise, temperature, particularly light and temperature, two fundamental things that we need to get right. The second one is stimulus control. Stimulus control says bed is for sleep.

44:37
The implication being if you're not asleep, you shouldn't be in bed. And number three is sleep scheduling, which is actually improving your sleep efficiency. That means the amount of time in bed that you're actually sleeping. So you might be in bed from say nine o'clock to seven o'clock, so you're in bed for 10 hours, but you think you're only sleeping for five hours. So that's a 50% efficiency. Now to improve sleep efficiency, we either give you a pill so you can now sleep six or seven hours out of that time, which...

45:05
will last temporarily, but it won't last long term. Or what we do, and I shouldn't go into my secrets now, but it's out there, is restrict your time in bed. So if you're only in bed for six hours and sleeping for five hours, you're not sleeping any less than you were now, but most of the time in bed now you're asleep, which gives you confidence, oh, it is now a place where I can sleep. Then you can increase your time in bed. Yeah, I've heard actually of sleep restriction to help with that insomnia. Is there a cognitive behavioral element to that?

45:34
That is CBTI. Cognitive behavioral therapy is sleep hygiene, stimulus control and sleep scheduling. That's CBTI. So cognitive behavioral therapy is for insomnia. It's different to CBT in lots of respects, but it is the behavioral stuff. Understanding why are we doing those things. So when they come and see me for an hour, I'll try and explain why are we doing these things. Why are you telling me not to go to bed until one o'clock in the morning? I mean, you're nuts.

46:04
I want to go to bed and go to sleep at 10 o'clock. So tell me how do I do that? Well, you won't do it. Yeah, until you do that. Yes. That's right. And explaining the process and drawing out the circadian cycle and how and why it works. Yeah. We know getting out of bed in the middle of night is really important. I think one of the questions you were asking me is, what do I do if I haven't had a bad night? And I do sometimes have a bad night's sleep. And I get up and the huge study was done where they got up for just 15 minutes.

46:34
And that's usually for 75% of people in the study, they were able to go back straight away and go back to sleep. What were they doing? Just up? No, there's a process. So we get them to get up to a warmish environment. That's not the problem in Auckland, but in Christchurch in winter it's a problem. So you need to prepare a place to go to. Dressing in by your bed. I may be up in the middle of the night, so let's prepare a place. Warm, dimly lit, no more than 40 watt bulb. So you're not getting up to the kitchen and putting the lights on. Writing pen and paper.

47:03
So you got it ready to go. So you're gonna get up and spend some time writing down. You got a clock when you look up. Now you don't have a clock in your bedroom because we don't want people to keep looking. Clock watching is really negative. That's one important thing we say. So they don't know what the time is. You get up, oh, it's two o'clock. Well, I've probably been awake since 1.30. 15 minutes later, you're back in bed. About 75% of people were able to go straight back to sleep. And the answer, the thinking was this. When we lie in bed, oh.

47:30
Mole hills become mountains, as I say. We catastrophize at night. We're lying there, minds going 19 to the dozen, and we can't do any about it, we're just panicking. Get out of bed, you can actually take a bit of control. We can actually take control of it. We write stuff down, I've got to email this person, I've got to, so you actually take control of your life in a summer space. By doing that, only 10 or 15 minutes is all you need. You can go back most of the time, and I do it too. I can get up for 10 or 15 minutes, I go straight back to sleep.

47:59
rather than the traditional saying which is you get up until you're sleepy again. The problem with that is that it's often an hour and a half, two hours before you sleep again. So a lot of people don't want to get up at it because I get out of bed, I'm going to be awake for the next hour and a half, two hours and I want to try and get back to sleep now. If we say now, 15 minutes is all you need. People are much more likely to get up and actually adhere to that and get back to sleep. Break that cycle of panicking like, do not do anxiety or panic in bed.

48:28
Because bed becomes a panicky place. Amazing. Alex, I've often heard that people often talk about having uninterrupted sleep as the gold standard. Yet, I'm up going to the bathroom maybe once, not all the time, but maybe 50% of the time. Or I just wake up as I'm sort of turning over and going back to sleep. Is that something that I need to worry about? No. Waking is normal.

48:57
They've done lots of studies on students who say they just go to sleep and wake up in the morning. You do brain leads on these students and there are quite a lot of them they did. All of them had worked in two or three times during the night. Now the answer is this, just before you fall asleep you have a period of amnesia. Two or three minutes you don't remember. So for example, if people, and you may never have done this, but your mum or dad probably have, they're reading and you know not to sleep while you're reading. You'll always have to read that page again. You've only got two or three minutes of amnesia.

49:25
So what they do when you look at the brain leads of these students is they've woken up, they've gone straight back to sleep within two or three minutes and have no recall. Oh, interesting. But people think they sleep through the night, nobody sleeps through the night. And the problem is if you wake up and look at the clock, it immediately has an emotional impact. Oh bugger, it's midnight and I'm awake again. Now I shouldn't be awake. Yes, you should go back to sleep. Stop fretting about it. It doesn't matter whether it's midnight or four o'clock in the morning. Waking is normal. Go back to sleep. Oh, that is such a reasonable.

49:52
response to that question because this is something I talk to people about all of the time. And I guess my other question for you, completely again another side tangent, is sometimes when you go to sleep, you feel like you've been asleep for hours. You wake up and it's 10.30 and you're like, whoa, and you actually feel it's like a bonus. But have we just bypassed all stages of sleep and gone direct into, I don't know, some sort of deep sleep or is that just a...

50:17
I suspect in that case, I mean, it depends how long it is. If it's something like 80 or 90 minutes, you've probably been through one sleep cycle. Often we do find, you go to sleep at 9.30, you wake at 11, but that's one sleep cycle you probably have. Or for a nap, for example, we often say if you wake up within 20 minutes or so, you haven't even gone into deep sleep by that

50:46
Sleeping, waking in two phases was common, not invariable. So they've done lots of studies in these primitive societies and some do wake in the middle of the night. Some have very fragmented sleep. And they think it was partly, you know, historically a survival thing. So we didn't sleep solidly for eight hours, you know, that didn't happen. In fact, there's more literature saying we now sleep in two phases. So often for three or four hours when we came in from the fields, have an hour or two in the middle of the night.

51:17
And there are prayers for after first sleep, for example, implying there are two levels of sleep. And Chaucer, for example, talks about all the antics that go on between first and second sleep, which you can imagine. And then you go back to sleep at two o'clock in the morning, and you get up when the sun comes up at seven o'clock in the morning, so you're off. So waking in the night is a very normal phenomenon. Yeah. Oh, that's I think, yeah, because of, again, people's anxiety around it, they're just not. It's just hard to know, you know, what's what's what the right thing is. But this is the thing.

51:46
We actually shouldn't necessarily do what's this blanket right, but actually figuring out what works for us. Yeah, yeah. I mean, absolutely. And the key factor really is how do you feel during the day? And the problem is a lot of people for quite a lot of years may get only five hours sleep every night and think, oh, I only need five hours sleep. But actually, in the end, they'll suffer. I mean, I quote Thatcher, which you may remember some years ago, purported only to have sort of four hours sleep a night.

52:15
Well, she ended up with Alzheimer's, which is what happens when you don't get enough sleep. You're not having enough time to clear the beta amyloid and tau proteins out of the brain, which you need sleep to do that. And of course, there is that relationship between sleep deprivation and insulin sensitivity and blood sugar management and other disease processes.

52:41
And I wonder how much we know whether or not is it the sleep deprivation itself that leads to these issues or is it that being sleep deprived then makes us crave more of the things that then drive these disease processes? Like, is it like, do we know? Yeah, yeah, no, that's a good question because initially we'd say not enough sleep doesn't allow you to go through all the important things that happen in sleep. So we're missing out on a lot of the very important functions that sleep has so that people don't...

53:09
haven't fully understood until fairly recently. The second problem is that, of course, if we sleep deprived and we're a bit more tired, then two particular things happen with fatigue. Fatigue does two things. One, lack of motivation exercise. So we're just lacking. We get home from work, we're tired, and yes, I'll get my tea ready, and I'll sit and watch TV, but that's all I've got the energy to do. So going to the gym, going for a run, going for a walk, and it can happen because I'm tired. So fatigue is number one. Number two,

53:38
is an auto-sormones in your brain called liptin and ghrelin. Liptin levels will drop, ghrelin will dry out when you get tired and it sets your brain, I need to eat something. So you tend to, and we don't snack on lettuce leaves and celery and carrots, we snack on high carb stuff generally. So we're going to, particularly in the afternoons when we get that dip, in the evenings when we're getting tired in the evenings. Now, for example, you see this all the time, people have a meal, maybe six o'clock or so, at eight o'clock they're sitting watching telly and they're thinking.

54:05
I'm a bit picky, I'll have a few chips here or have a biscuit or two. Why are you wanting something to eat? You've just had a big meal for him sake, but you're wanting to snack because your brain's tired and it says it needs some food. And I liken it to, again, going back to history, which is what I really enjoy doing, is saying, well, fundamentally, why do we do this? Well, many thousand years ago, we probably hadn't eaten for a couple of days. And so we'd get a bit tired and the brain would...

54:30
kicking and say these hormones are kicking and say you need to catch another sabre tooth tiger or you need to pick some more berries to keep us alive. So these hormones are designed to keep us alive, fundamental stuff. Nowadays, we get tired for all sorts of other reasons, work and stress and worry and family what have you. And there's so much food available that these hormones that tell us we need to eat something are now killing us because we're putting on too much weight. So you see a big guy who's obviously got sleep apnea walking down the street eating an ice cream.

55:00
He's probably saying to himself, I shouldn't be eating this ice cream, but my brain is screaming at you because I'm so knackered, but I need to eat something. Yeah, for sure. And so then Alex, do you have a set protocol that you work with your patients to put into place if they have a night or several nights of sleep deprivation in terms of what they do during the day? Like in terms of exercise or diet or things like that, caffeine, for example? Yeah. Well, things like that. I mean, caffeine.

55:28
has a long half life, so it hangs in the body for a long time. So we say, if you're having trouble with sleep, well, avoid caffeine in the afternoon. One study recently has been done in Auckland where they stopped caffeine altogether, that did help a bit. But caffeine comes in all sorts of guises. For example, people are having a hot chocolate before you go to bed, well, there's caffeine in the chocolate. So it's actually the energy drink. Milo, for example, is an energy drink, not a sleep, but it's used often for sleep.

55:55
So alcohol will help you go to sleep but it'll wake you up more. The alcohol converts to aldehydes that are quite alerting so they'll tend to wake you up more. But in general, what we do during the day has a major impact on our daytime, on our nighttime. As I say, spending more time outside, a bit more energetic but not doing any physical exercise just before you go to sleep. I had a guy who thought if I wear myself out physically then I'm going to sleep really well. So he got himself a cross trainer.

56:25
And for an hour before he bed, he worked out on his cross-train and he got himself totally flopped out on the bed, totally exhausted, because there's no way he could sleep. Too wired? He was just so wired. So physically, a physical thing, you need to keep at least two or three hours before you go to bed. But exercise during the day, particularly exercise outside, without sunglasses, is going to help you sleep. Nice. I saw a study actually, maybe it was a few months ago, that looked at the effect of sort of high-intensity exercise to help.

56:54
minimize the blood sugar issues that come from sleep deprivation. And it was a favorable thing. So one of the recommendations that the authors made was, hey, if you've got a bad night's sleep, then one way to sort of offset some of the cravings that could occur is actually do that early exercise to help with that blood sugar management because that will then potentially, you just, it'll change the types of foods that you crave throughout the day. Like from a nutrition aspect, I thought that was like quite a clever sort of move.

57:24
Yeah, quite clever thinking. Yeah. I mean, you know, exercise in the morning is good for so many reasons in terms of getting metabolism going and use up some of the interesting that you know, often diabetics find that in the morning, their sugars are higher than it is often during the day, which is interesting without having ingested anything. But the metabolism means that we often have higher, slightly higher blood sugars when we wake in the morning than we would maybe later on in the day. So a bit of exercise then is not a bad idea. Yeah, for sure.

57:53
And you mentioned alcohol and aldehydes, and I kicked us off by sort of my desire for you to tell me that was fine to have a red wine, but I'm thinking you're making a serious case for day drinking as opposed to having a drink at night with our dinner. Well, I think it's the quantity. I mean, we used to talk about the old J-shaped curve, you know, one unit of alcohol is not too bad, zero is not as worse. Or, you know, and then one, you know, two is...

58:22
Okay, three or four suddenly gets worse. So nowadays, of course, just recently, they've come in and said that any alcohol is actually not good for us. But in terms of sleep, for a woman, and we're taking averages here, for a woman, three or four units is going to be Moikisnoor, for a man, four or five units. Four units in a half a bottle of wine, a bottle of wine, maybe eight units. A can of beer, five percent, three thirty can of beer is one unit.

58:50
and 30 ml of spirits is one unit, and 100 ml of wine is one unit, so 12% wine or whatever, so on averages. And so we look at units of alcohol, it doesn't matter whether it's spirits or wine or beer, it's the units of alcohol that counts. And it's muscle relaxant. So if you mates or yourself have had a big night out on the booze, you're going to snore that night because you're going to relax the muscles in your throat, which is how we snore and have a sleep.

59:17
So there is that ethic and of course it breaks, it quietens you down to not so you can get sleep more easily but you tend to wake up more at night. See my problem is Alex is that I enjoy craft beer and they're slightly higher in the alcohol percentage and one beer is like a big night out for someone like me. That's my problem so I just have to share that craft beer and actually it's probably a better outcome. I'm really mindful and I want to be mindful of your time.

59:46
I'm interested just a couple of final questions, Alex. So when you got interested in sleep and as your understanding has evolved, have you shifted in what you do for your health and your sleep hygiene? Not massively to be honest, but if I have a bad night's sleep, I'm more aware of why. And so I'll say, yeah, that was a bad night because of such and such. So I'm more aware of why I don't sleep very well.

01:00:14
Generally I do sleep quite well, so it's never been a major problem for me. But I do have some bad nights and usually I know why because there's something in my brain that's buzzing away and getting in the way. And I have measured my potential for snoring. My wife tells me I occasionally snore, but I sleep mainly on my side or front, so snoring is not very common. I've rolled onto my back and we do move around at night. So although I might start on my side, I do occasionally end up on my back and that will mean...

01:00:42
I'll maybe snore a bit then. So it's mainly partners who get in the way, who will tell you. Remember that you don't know anything about your snoring. So when they say, no, I don't snore, well, you don't know whether you snore or not because you're asleep. That's true. In fact, I had a client once who told me that she actually had an app on her phone and she wanted to know, so she recorded herself and she could hear. That's the data she used to then book in with a sleep clinic. Well, we use an app called Snore Lab. Ah, interesting. And that measures noise. Yeah, yeah, yeah, yeah.

01:01:11
So that'll be, so if you buy yourself, remember if your dog snores or your partner snores, it'll measure their snoring as well. So you need to be by yourself. Yeah, good call. And Alex, if you're thinking about the, I guess, the direction of sleep research, like is there anything that you're particularly excited about over the next couple of years to help better, I guess, to help us better understand sleep? Or have we really learned all there is to know?

01:01:38
Absolutely not. No, there's so much more to learn. And unfortunately, it's the sort of situation where we don't know what we don't know. Of course. And only by doing studies that we find out. The huge study that was so mind changing in the last decade has been the learning about the glymphatic system, this brain washing out of the bad things that happen at night, started measuring it in rats to start with in 2012 and now in humans.

01:02:04
and a lot more is known about that now when it happens in deep non-REM sleep and how it gets interrupted and how it's impactful on our brain function and particularly our silence. So there's lots of really interesting stuff happening, which again, as they're studying more, I don't do the studies, but you know, where they're done in the States and Australia, particularly very big for research, fascinating stuff. Are there conferences that you go to to learn more about sleep specifically or is it just part of your usual, like, I don't know, medical conferences?

01:02:34
No, no, I mean, I try and go to a conference once or twice a year, which isn't enough for me. I'd love to go to more when I have to fund it all, unfortunately, so I work for myself. So I don't get university study, which is where most studies done, of course. But, yeah, so I try but otherwise it's try and keep up with all the literature basically in on the internet as much as I can. So every day I'm downloading something that's of interest. Yeah, yeah. No, that sounds awesome, Alex.

01:03:02
Can you let people know where they can find more information about you and your sleep clinic and the work you do and actually just more information in general? Well I run with one other person, well with a whole big team of us, a sleep well clinic, it's called a sleep well clinic, it's based in Christchurch but we've got clinics all around the country. We do testing remotely so we can send equipment out to anywhere in the country.

01:03:28
And we do zoom consultations as well as face to face consultations. So we can do it and see anybody from anywhere in the country. And it's called a sleep well clinic and we're the biggest private clinic. And we do more sleep, sleep studies than most of the hospitals put together. Yeah, amazing. We're very busy. Yeah. Oh, that is lovely. Alex, I think, you know, I got through maybe a third of the questions that I had.

01:03:51
down here but I felt like we actually hit on quite a few key areas that a lot of people will be interested in so that was wonderful. Thank you so much for your time. Thanks very much. Thanks for asking me.

01:04:15
that and I heard Alex I think maybe just after Christmas just before New Year on the NewstalkZB channel over the Christmas, on their Christmas show so he's super accessible and absolutely contact that SleepWell clinic if you've got any issues with sleep and I've got links to Dr Bartels LinkedIn plus the actual SleepWell clinic where there are links also to those glasses that we discussed.

01:04:42
Next week on the podcast guys, I speak to Kent Johns, former radio broadcaster, now health coach, an advocate for mental wellness and just an all-round awesome guy who's really made it his life mission to help improve the quality of people's lives. And we have such a great discussion. I think you're really gonna love that. Until then though, you can catch me over on Instagram threads and Twitter @mikkiwilliden, Facebook at mikkiwillidenNutrition.

01:05:11
Head to my website, @mikkiwilliden.com, and why not join my recipe portal for just 12 bucks a month? Get some super awesome inspo from the ever-increasing collection of great recipes. All right, guys, you have the best week. See you later.