A Good Podcast On Sleep

Last week I shared my takeaways from Tim Ferriss’ conversation with Andrew Huberman, Ph.D. A recommended sleep stack, which I subsequently purchased, was part of those takeaways. This week I found an episode of The Consistency Project on sleep. I listened expecting to hear overlap and confirmation of Huberman’s advice. Boy was I wrong. In fact, the episode is mainly dedicated to calling his recommendations into question for lacking scientific basis (something EC Synkowski emphasizes).

I got my stack in the mail Friday. In two nights of use I’ve found it easier to disassociate from my thoughts at bedtime (a benefit Huberman spoke about) and therefore fall asleep quicker, and I’ve experienced deeper sleep. This is purely anecdotal as I don’t wear a sleep tracking device. Perhaps it’s just placebo, something EC Synkowski discusses. I bought a 60 day supply and I’ll at least see that through, but I’m still pretty conflicted based on EC Synkoskiw’s advice that not one of the benefits Huberman cited has been scientifically proven. 

It’s worth noting that a main reason for her skepticism is an overall disbelief in supplements, regardless of their purported benefits. Her belief, which I share, is that most everything can be achieved by getting diet and exercise right. Regardless, since these are two experts I regard highly I’m determined to understand how they could differ so greatly and I’ll be looking into the “disconnect” over the next few weeks.

If you need help sleeping, she recommends following these 14 Guidelines for sleep published by The American Academy of Sleep Medicine. 

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.

• Set a bedtime that is early enough for you to get at least 7 hours of sleep.

• Don’t go to bed unless you are sleepy.

• If you don’t fall asleep after 20 minutes, get out of bed.

• Establish a relaxing bedtime routine.

• Use your bed only for sleep and sex.

• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.

• Limit exposure to bright light in the evenings.

• Turn off electronic devices at least 30 minutes before bedtime.

• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.

• Exercise regularly and maintain a healthy diet.

• Avoid consuming caffeine in the late afternoon or evening.

• Avoid consuming alcohol before bedtime.

• Reduce your fluid intake before bedtime.

It’s a lengthy list, but with the right routines, you can easily knock off most of them. We follow as many as we can and have an informal routine. Every night as bedtime approaches, around 10 o’clock in our house, we start turning off and down the lights. We set the temperature to 67 Fahrenheit (Jen thinks it’s 68). We don’t drink ☑️, and I try diligently to not have caffeine after 12 noon. I also stretch every night for 4 minutes before bed. Quad stretch, calf stretch, hamstring stretch, and elevated pigeon on the bed. I hold each position for 30 seconds (4 muscles, 2 sides, = 4 mins). Stretching really helps get me into bed relaxed.

Which ones do you practice? Which ones do you struggle with? What’s one thing you could change that would improve your sleep habits?

A Good Podcast: Tim Ferriss w/ Andrew Huberman

Sleep, stress, light exposure and the benefits to mood and depression

In this episode Andrew Huberman is very clear, by taking control of our bodies, and moving, we have the ability to turn off stress and take charge of our health. And while their nearly 3 hour conversation touched on a large number of topics, I found the information I learned about fear and anxiety, resetting your circadian clock, and ways to optimize testosterone to be the most interesting and actionable. This was a fascinating conversation that I thoroughly enjoyed. 

Fear and Anxiety

“Fear,” Dr. Huberman say, “it’s the anxiety that you feel when you don’t know what behavior can remove a feeling of helplessness in the face of a threat.”

And it’s that feeling of anxiety that activates your sympathetic nervous system, and sets off a cascade of responses in your body you’ve likely felt recently. Liked increase heart rate and respiration, dilated pupils, and a narrowing of your vision.

But, he points out, because, both vision and respiration have a bi-directional relationship with our internal state, we can change one by changing the other. Said another way, by focusing on our breath (exhaling more than we inhale), we can reduce the speed of our heart rate. And by widening our field of vision, like staring off into the horizon, we can reduce levels of alertness and stress, and thereby increase calmness.

Physical activity such as running or weight training can also help to alleviate stress and the body’s response to it, but Dr. Huberman put’s special emphasis on the power of respiration and vision as the fastest, easiest, and most obvious ways to control involuntary arousal, and reduce stress.

In short, we can actually turn off the stress response by changing the way we view our environment, regardless of the environment.

Tips for Optimizing Overall Health

Get your biology right, and start by figuring out your sleep, “the fundamental layer of mental health.” If you need help falling asleep, he recommends the following supplements 30 - 60 minutes before bed:

• 200 - 400 mg of L-Theanine (note: avoid L-Theanine if you suffer from sleep walking or night terrors)

• 200-400 mg of Magnesium L-Threonate

• 50 mg of Apigenin (a derivative of chamomile)

And when you wake up, practice resetting your circadian clock. Focus on “the four most powerful stimulus… (in order).”

• When you view first light (2 - 10 minutes of sunlight upon waking up)

• Exercise daily

• When you feed (eating early helps)

• Social cues, interacting with people or animals (your dog) early in the day

Learn how to focus and defocus, have fun and stay in a mode of adventure. Develop a practice like journaling that allows you to “data dump and experience what’s internal.”

Tips For Optimizing Testosterone

Get sleep right (see above), limit chronic stress (see above), and train hard but not too long (overtraining can reduce testosterone levels). And if you’re in need of a boost, he recommends taking 400 mg of Tongkat Ali (helps promote free testosterone) early in the morning, and 425 mg of Fadogia Agrestis (stimulates the testes to produce more testosterone). (I bought the sleep and testosterone stack from Momentous)

A Good Podcast: Prenuvo co-founder Andrew Lacy

How I Built This With, Guy Raz: Full body preventive health care with Andrew Lacy of Prenuvo

I’d heard of Prenuvo, a company that offers full body MRI scans to detect potential diseases in the body before they become symptomatic, on a podcast a few years ago. They popped back into my conscious recently when I came across this article, How Much Would You Pay For Peace of Mind?, detailing patient complaints of inaccurate reporting, false positives, and an overall feeling of anxiety due to the uncertainty of their scan. So when I saw this episode with Prenuvo co-founder Andrew Lacy, I tuned in to hear what he might have to say in defense.

Prenuvo currently operates 9 locations, 8 in the U.S., and 1 in Canada, with 11 more in the pipeline (they’re coming to Denver in August 2024). For $3,000 and 1 hour of your time you can get a full body scan that can detect things like early signs of cancer, liver disease, aneurysms, and even multiple sclerosis. The preventative medicine industry is now a $250 billion per year market that’s growing, and Prenuvo seems well-positioned to take advantage.

But with change and new technology comes criticism and fear.

Many doctors are sounding the alarm stating that the false positives (16% rate of occurrence) created by scans such as these leave people with anxiety and could result in unnecessary and expensive treatments or surgeries (i.e. removing a benign tumor).

But Andrew Lacy doesn’t see it that way. With 32% of scans revealing a legit abnormality according to a meta-analysis, Andrew see the pros largely outweighing the cons. The difference he says is in their custom software and hardware, specifically designed for fast and efficient whole body scans. He believes that we should be looking at the body as the sum of its parts, not its individual parts (like generic MRIs do). By scanning the whole body they’re able to make connections, like telling you about your heart by looking at your brain. 

Change is hard, especially when it has the potential to disrupt a whole industry. As preventative medicine continues its march to eclipse sick medicine, these dinosaur healthcare companies have taken notice, and are doing their best to sow doubt in the minds of would be patients and doctors. The dollars they stand to lose are enormous. Just as one example, ever year we spend $100 billion on late stage cancer drugs. Meanwhile to scan the whole population of the United States every 2 years would only cost $60 billion according to Andrew. Pretty compelling.

There are real concerns, like the potential for false positives, and complaints of poor service and inaccurate reporting (the severity of which increases drastically when it comes to your health). But if there’s one thing that Andrew Lacey is right about, it’s that a whole body approach to your health is essential.

This was another great episode of How I Built This With, Guy Raz.

The Peter Attia Drive: Dr. Tom Catena

The Peter Attia Drive: Dr. Tom Catena (from 2019, recently re-aired)

“I think maybe the modus operandi of my life is always looking for, what’s the opposite of greener pastures? Browner pastures (laughs)”

That’s a quote from guest Tom Catena, M.D., the only physician working in the Nubah Mountains in Sudan, where a civil war has raged for over a decade, devastating the community, injuring thousands and taking countless lives. If it sounds like this episode is going to be a depressing one, it’s far from it. On the contrary it’s quite uplifting.

Tom Catena, M.D. is a fascinating man. He knew from a young age that he wanted to be a missionary but he didn’t know in what capacity, so he become a physician. He figured he could use his profession to serve others. And that's exactly what he’s been doing for more than a decade. Sacrificing time with family, the comforts of home (the U.S.), and an easy medical practice complete with all of the modernities the states have to offer.

I loved this conversation because I don’t think I’ve ever heard someone as authentic and genuinely good as Tom Catena. In every single way he is the person we all strive in our head to be, but very few actually become.

Throughout this episode there were a few things that stood out to me.

What are you willing to sacrifice?

During the conversation Dr. Attia starts to lament on wishing he was as good a person as Dr. Catena is. After all they are both physicians, and Dr. Attia has chosen a much different path than Dr. Catena. He’s chosen to serve people in the familiarity of home, on topics (longevity, lifespan) that he is passionate about. He is not in the classical sense of the definition, a missionary.

But Dr. Catena’s response is very real. Dr. Attia’s role in this world, or specifically in this struggle in the Nubah Mountains, is to use his platform (this podcast, his newsletter, and website) to bring awareness to the struggle where there hasn’t been much (if any) before. I know I had never heard of it prior to listening to this episode.

He asks the question in a sense, to think about what it is your willing to sacrifice. For Dr. Catena the answer is comfort, friends, family and high paying job. Everyone’s answer is going to be different. But it’s important that we all don’t fall into a feeling of apathy because we believe we aren’t able to contribute in the same manner as someone else. Rather we should ask ourselves, what are we willing to sacrifice, and use that to guide us.

The bloated U.S. healthcare system.

The hospital that Dr. Catena runs operated on donations. Dr. Catena earns $350 a week for his services. He serves a community of roughly 1,000,000 people. He (Dr. Catena) explains that if he had a $1,000,000 annual budget, he could:

• treat 130,000 out patients

• perform 2,000 surgeries

• treat 6,000 in patients

• treat several thousand maternity patients

• deliver hundreds of babies

• vaccinate thousands of children

For comparison a surgery in the U.S. could run anywhere from $20,000 - $150,000 depending on the surgery being performed and where. The U.S. spends over a trillion dollars per year on healthcare and yet we remain one of the most unhealthy nations in the world. So where is all of our money going and how much better could we be doing. Not just monetarily, but in serving the people who need it most.

Suicide, or lack thereof, in the Nubah Mountains

In all of his time in this war torn region of the world (over 10 years), Dr. Catena has only experienced one suicide. A man who shot himself and completely shook the community.

Meanwhile in the U.S. suicide ranks among the top ten causes of death in every age demographic except 0 - 10. That’s only counting fast suicide. Slow suicide (alcohol, drugs, over consumption of food) over a lifetime makes up pretty much all ten of the top ten causes of death in this country (heart disease, stroke, cancer, diabetes etc…).

How a war torn region of people can remain so steadfast in their desire to live, compared to a nation that has everything, is described in great detail in the book Tribe, by Sebastian Junger.

The Starfish Story

Lastly, this is just a great anecdote for anyone that feels like they couldn’t possibly make a difference. The Starfish Story.

I hope you enjoy this episode as much as I did.

This short article about Tom Catena, MD is a short version of the podcast episode: He’s Jesus Christ