Have you ever stared at the ceiling in the middle of the night, convinced you haven’t slept at all? Or dozed off the second your head hits the pillow, only to wake up feeling like you barely slept?
Apparently, not only do many of us not sleep well, we also unwittingly lie to ourselves about the sleep we thing we’re not getting. The way we perceive our sleep often doesn’t match reality. or many people, anxiety and stress color the way they experience their sleep. Even if you technically sleep soundly, you may feel like you tossed and turned all night. So, how do we actually understand how much or little we’re sleeping and how “good or bad” that sleep is? And, more important, what we can really do about it?
My guest today is Dr. Christopher Winter, a leading sleep expert who has uncovered fascinating insights around this perception gap. Dr. Winter has practiced sleep medicine and neurology since 2004, but his fascination with sleep began back in 1993. He runs a neurology and sleep medicine clinic in Virginia, has authored two popular books on sleep, and hosts the chart-topping podcast Sleep Unplugged.
I wanted to speak with Chris because I understand how troubling insomnia and poor sleep can feel. But what I’ve learned is that sometimes our thoughts about sleep do more harm than the lost sleep itself. Dr. Winter offers a refreshing perspective and practical solutions to help anyone struggling with anxiety around sleep. His message provides the perfect balance of inspiration and actionable advice.
In our conversation, we’ll dig into the latest research on sleep and bust myths around how much rest we really need. Dr. Winter will share ways to change your mindset and reframe your relationship with sleep. Imagine waking up feeling refreshed, even after a night of tossing and turning. I’m thrilled for you to hear Dr. Winter’s insightful guidance on starting each day energized and ready to pursue your passion.
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photo credit: Jen Fariello
W. Chris Winter, MD: [00:00:00] Paying attention to sleep and valuing sleep, but working on not stressing about it. Let’s control what we can control. Be in bed by 11:00. Be out of bed by seven. There. That’s what you can control. Those are tough choices to make, but that’s where we’ve got to be. And then understand that sometimes we’ll go to bed and not fall asleep right away. We’re okay. We’re normal. That’s fine. Like just being in bed resting can be wildly restorative for people. Find time to rest. And if rest turns to sleep, good for you.
Jonathan Fields: [00:00:34] So have you ever stared at the ceiling in the middle of the night, convinced you haven’t slept at all? Or maybe you’re not going to sleep at all? Or am I the only one? Or maybe you’ve dozed off the second your head hits the pillow, only to wake up feeling like you really hadn’t slept very well, if at all? Apparently, not only do many of us not sleep well, but we also unwittingly tell ourselves stories about this sleep that we’re not getting that aren’t entirely true. The way we perceive our sleep often doesn’t match reality, and for many people, that leads to anxiety and stress that even more colors the way that they experience their sleep. Even if we technically sleep soundly or more soundly than we realize we are, we may feel like we’re tossing and turning all night long. So how do we actually understand how much or little we’re sleeping and how, quote, good or bad, that sleep is? And more important, what can we really do about all of this? My guest today is Doctor Chris Winter, a leading sleep expert who has uncovered fascinating insights around this sleep perception gap and so many other strategies to actually get better sleep. He’s practiced sleep medicine and neurology since 2004, but his fascination with sleep began way back in 1993. He runs a neurology and sleep medicine clinic in Virginia, and has authored two popular books on sleep and hosts the chart-topping podcast Sleep Unplugged. And I wanted to speak to Chris because I understand how troubling insomnia and poor sleep and all the different ways that we sleep or don’t sleep can feel. But what I’ve learned is that sometimes our thoughts about sleep do more harm to our actual sleep than the lost sleep itself, and he offers a refreshing perspective and practical solutions to help anyone struggling with anxiety around sleep.
Jonathan Fields: [00:02:17] His message really provides the perfect balance of inspiration and actionable advice. In this conversation, we dig into the latest research on sleep and bust myths around how much we really need, and Chris shares ways to change our mindset and reframe our relationship with sleep. So imagine waking up feeling refreshed even after a night of tossing and turning. I’m thrilled for you to hear what Chris is. Insights are, and guidance on starting each day energized and ready to pursue your passion and how we can all get better sleep and also feel like we’re getting better sleep. So excited to share this conversation with you! I’m Jonathan Fields and this is Good Life Project.. The domain of sleep has been, I think, on so many people’s minds for so many different reasons. It’s not a new issue or a new question or a new topic. But if you like the state of the world, recently, over this last chunk of years in particular, has been affecting people in a lot of different ways during their waking hours. But also, I feel like a lot of people are talking about disruptions in sleep that they’re experiencing as well. And a lot of people are wondering, what does the sort of perpetually raised level of ambient anxiety have to do with their ability to, quote, get a good night’s sleep? So I’d love to dive in there, maybe, and get your take on this.
W. Chris Winter, MD: [00:03:45] Yeah, I think that it’s interesting. Use the term get a good night sleep. It’s a hard thing to define and people define it differently. I think it’s a better term than how does ambient stress level affect people’s ability to get sleep? I think might be different. I think that anxiety and sleep have an interesting relationship in the sense that when individuals struggle with anxiety, it often colors not only the way they sleep, but also the way they feel about their sleep or they perceive their sleep, which becomes very problematic. If, you know, I just fell today, I didn’t know somebody had mopped my floor and I ran out in a hurry for no reason and just bit it and slid across the floor and slammed into a door frame. And there was nothing about perception there. I had a big gash on my shin. The door frame was dented. There was little bits of tissue and hair on it. Not to be gross about the situation, but it’s all very. If you showed ten people that they would tell you the same thing if they saw it on video. So it’s interesting when you talk about sleep, that perception is very problematic, particularly in individuals who struggle with anxiety, in the sense that I see patients on a daily basis who it is their impression that they’re not sleeping.
W. Chris Winter, MD: [00:05:03] And when you look at research about anxiety and sleep, the way we feel about our sleep, the way we perceive our sleep tends to affect the way we perform and function during the day as much, if not more, than the way we actually sleep. So there’s a massive connection between stress and sleep, and understanding it completely can really help people out with their sleep. Because what starts to happen is, is the stress impacts somebody’s perception of sleep, then the perception of the sleep becomes its own stress. I have gone years without getting a good night’s sleep, and no doctor can fix it, and no pill can help. That becomes its own stress, regardless of peace talks in the Middle East or what’s happening in Eastern Europe, or whatever you’ve got on your mind causing you stress. So I think the more people understand about sleep in general and that interplay between stress and our mental health and sleep, the healthier their sleep will become.
Jonathan Fields: [00:06:04] Take me deeper into this difference between the perception of how we’re actually sleeping, because it sounds like what you’re probably describing is people reporting the perception that they’re really not sleeping well. But then is what you’re also arguing that if you put them into a lab and then you actually track their sleep, that oftentimes they are sleeping better than they think they are, and it’s, oh, absolutely.
W. Chris Winter, MD: [00:06:26] And that goes both ways, too. They’re definitely people out there who feel like they’re two hours of sleep. They get between the hours of, you know, 2 a.m. and 4 a.m. when they wake up and start looking at the stock markets, or the trauma surgeon who thinks that she’s doing okay with two hours of sleep, that that’s enough and that’s good. I mean, the range goes in both directions. But, you know, when it comes to anxiety and sleep, absolutely. In fact, the first question I usually ask after somebody’s had a sleep study and these are very objective. This is not a situation of sure, there’s always going to be error in any kind of medical test, but this is one of those things where how did you sleep or how many hours did you sleep last night? And the patient might say, you know, I think I slept about 30 minutes. It took me until about 530 to go to sleep. And I woke up at six when the tech came in. That’s not at all what neither the, you know, the tracings and the the the electrical activities. We might. But here, I’ll show you the video if you’d like to see. So does this video I’m showing you match up with what you thought happened. And it’s really interesting to talk to people about these types of things.
W. Chris Winter, MD: [00:07:31] We even have a name for that. We’ve had many names for it over the years Twilight sleep, sleep state misperception, paradoxical insomnia. So that’s kind of one piece of that puzzle. And a lot of times showing somebody, you know, here you actually slept almost six hours last night. It wasn’t 30 minutes, as you reported to me when I asked you what happened. And as they watched the video, there’s this little light bulb that goes on with somebody that, wow, you know, maybe my partner was. Right. You know, they’ve been telling me for years when I wake up and say, I don’t sleep, that’s not really what they’re observing. And as an irrational human being, pretty functional and successful, given the fact that I don’t think I’ve gotten any great sleep since the second Bush administration. Like, you know, just when you kind of just rationally think, do you think you’d be as successful and look as good as you are and healthy as you are if you were only getting one hour of sleep, does that make sense to you? Does it make sense to you’re actually starving to death but gaining weight? Does that logically make sense to you? So yeah, I mean, we see this on a very frequent basis. And the concept of good sleep, bad sleep is really fascinating that people have actually done research about how people feel about their sleep, just their perception of it.
W. Chris Winter, MD: [00:08:46] Are you a good sleeper? Well, I’ve been a bad sleeper all of my life, and that the way you feel about your sleep tends to influence your function during the day more than the way you actually sleep? So if you take that trauma surgeon example, she only got two hours of sleep last night. She was literally in the emergency room or the trauma suite until 4 a.m.. She went to the call room. She lay down and at 6 a.m. a nurse called her and she had to get up and deal with something that was going on in the ICU. So she got two hours of sleep, if not fewer hours. Yet if you talk to her, she’ll say, I feel great. I’m a great sleeper. And what’s really ironic is she might be considering herself a great sleeper because anywhere she goes with it, regardless of circumstances, if she closes her eyes and leans back, she can fall asleep. And in today’s world, that’s a great sleeper. The person who can sleep very quickly in any situation because God forbid, we’re in bed and 20 minutes after we’ve turned the lights out, we’re still awake.
W. Chris Winter, MD: [00:09:43] Like that’s a problem. In fact, I was just talking to a reporter recently and she said, what are some tips for people who don’t fall asleep right away? I said, why are you making this into a problem that we need tips to solve? I don’t think that’s a problem any more than you’ve eaten four pieces of pizza and you don’t want to eat a fifth. What are some tips and tricks for eating that fifth pizza? Pizza? Do we need those tips or tricks? To me it sounds like you’re full and you shouldn’t eat anymore. Like your body’s telling you, I don’t want to eat more pizza. Now we’ll listen to that message. This might wakes up at 3:00 in the morning and doesn’t feel like going back to sleep. We tend to ignore that and think our body is wrong. We need to go back to sleep. What can we do to get one more extra hour of sleep? Because we absolutely have to have it to be our healthiest self, and if we don’t have it, we’ll be dysfunctional the next day, whatever story you’re telling yourself. So it’s a very interesting situation when it comes into the perceptions and realities of sleep and need and how much people need to function and what we tell ourselves to believe to be true.
Jonathan Fields: [00:10:39] What you’re describing sounds like there’s a almost like a psychosocial element to sleep in that, you know, we’re it’s not just what we experience, but it’s what we think we’re experiencing. And then it’s also the messaging that we’re getting about what we’re told we should experience. And it all blends together into a bit of a cocktail that can sometimes go down easy and sometimes cause us a whole lot of stress that actually isn’t even there.
W. Chris Winter, MD: [00:11:05] I could not have said it any better. That’s exactly right. And if you, you know, think about, think to yourself how many articles, newspaper programming, internet, TikTok videos have you seen talking about the problems of being able to fall asleep too fast, being too good at falling asleep? Everything’s the opposite here. Here’s the headline. The breathing technique that guarantees you fall asleep in 30s or less like it’s all geared towards falling asleep faster, staying asleep, being more unconscious during the night. We give very little attention to the people who are really struggling. It’s grandpa who comes into your house on Christmas Eve and sits down and while opening presents, falls asleep in the chair at 6 p.m.. Oh, that’s grandpa, grandpa being grandpa. Oh man, I wish I were. I could sleep like grandpa boy. He’s a he’s a champion sleeper. You know, if there was a sleeping contest, grandpa would win. Grandpa’s got a big problem. Now, if you talk to other family members, they’ll tell you. Oh, I wish I could be like him. I get in bed, it’s going to take me an hour to fall asleep. That problem is not at the level you probably think it is, because we sort of. We confuse sleep deprivation with insomnia. They’re really kind of antonyms. They’re not synonyms. You know, sleep deprivation is the individual who’s trying to, you know, make a mortgage payment and buy some Christmas gifts for his kids. So he’s working a full-time job during the day, gets home, has dinner, sees his kids, and then goes out and drives an Uber at night to make a few extra money.
W. Chris Winter, MD: [00:12:34] Hustles a little, you know, a little money to put some things under the tree and is sacrificing his sleep to do that, and is nodding off at stoplights and is falling asleep at his construction job. The next day, sit down and his work truck to have lunch and immediately falls asleep. Nobody really looks at that as being a problem. Like, wow, look at John, man. John. He’s a guy. He can he can sleep. That guy’s a great sleeper. No, John is deficient in sleep, so his body’s looking for it. Any chance he gets he. Is hope that John doesn’t find it in his work truck. Driving home from job number one, getting ready to go to job number two like so. It’s not that we shouldn’t pay attention to insomnia. Insomnia is a problem in its own right. It’s just like you said, it gets such a big part of the pie when it comes to the landscape of media attention, that we do create a narrative that to some degree is false, that if you don’t fall asleep fast, if you wake up in the night and can’t go back to sleep, then you are in danger of some terrible things happening to you. You’re not in any kind of danger. When we compare you to John.
Jonathan Fields: [00:13:33] What I’m wondering here is, is there then this compound effect where it’s almost like a meta anxiety that that starts to kick in, that says, okay, so maybe there’s stuff going on during my day or during my life that’s causing me a lot of stress and it’s somehow seeping into my sleep. But then I wake up at 2 a.m. and I can’t get back to sleep. And then there’s this, this spin cycle that starts to happen in my head that says, this is awful. This is terrible. I’m never going to sleep for the rest of the night, and then I’m not going to sleep again. And then it’s going to I have this trickle-on effect and cause X, Y, and Z all sorts of awful stuff in my life. And that anxiety about your inability to sleep then makes it even harder to sleep. Do you see that in a meaningful way?
W. Chris Winter, MD: [00:14:11] 100%. And generally, by the time somebody gets to see me because of their insomnia, that’s exactly what’s happening. And I even did a podcast episode about just that, and I called it the Trauma of Insomnia. I mean, some people have described what you’ve just outlined as being sort of a mini form of PTSD and that level of, you know, meta anxiety to borrow is necessary for the whole thing to work. You have to care for it to work. So it’s just like you said every night, you’re now going to bed with the weight of the world. I’ve got to sleep, or else terrible things will happen. Or I’m dreading going to sleep because for the past 20 nights, it take me hours and hours and hours to fall asleep. I have no reason to think tonight will be any different. Somebody asked me one time in a sentence, what’s the secret to great sleep? And I said, it’s being equally happy in bed, awake as you are asleep. If you can truly get to that place, it doesn’t have any hold on you anymore. If you’re a, you know, a youth, you know, a little kid who’s playing basketball and you don’t really care if the ball goes through the net or not. When you shoot it, you’re just out there having fun. You get to socialize with your teammates. You get a juice box and some Fritos at the end of the game, and what happens between the buzzers doesn’t really matter to you. Then you’ll never have trouble, you know, shooting free throws or things you don’t care versus the little type A players that you know are the ones that got the, you know, the father who’s all over them in the game.
W. Chris Winter, MD: [00:15:51] You’re a free throw form was terrible. Like you create sort of an anxiety. I remember a coach sitting all of the parents down one time before, like a little rec league season started, he said. They’ve we’ve surveyed kids and this has been done for years and years and years. We’ve surveyed kids who play youth sports. Their number one complaint about the process was you parents. And it was really eye opening to me because I don’t I don’t get it. I looked at my kids and thought, none of these kids are going to be professional athletes, so I’ve got nothing invested in here. I’m going to be much more concerned about their spelling homework than their free-throw shooting average. But it was interesting. I mean, everybody, myself included, gets wrapped up in these types of things. And so if you’re getting wrapped up in your sleep, yeah, it becomes the self even. And it’s funny because you ask people why do you think you sleep poorly. Well it’s the divorce. Oh really? Going through a divorce. Oh no. No, the divorce was 17 years ago. Oh, so you think the divorce 17 years ago is why you’re having trouble sleeping last Tuesday night? It may have started a process, but it’s exactly what you described. It started something 17 years ago. But now the process is fueling itself. It’s creating its own energy right now.
W. Chris Winter, MD: [00:17:03] Forget about the divorce. Maybe that person’s gotten back together with the love of their life. I have no idea. But that thing started the problem. And that becomes a very difficult thing to break, because in those 17 years or five years or six months or whatever the time period is between it’s starting and them actually coming to see you, lots of weird beliefs and behaviors have sprung up from that, and it takes some time to unwind those things. You know, it’s sort of like somebody coming up to me out of a crowd saying, hey, Chris, you’re adopted. No, I’m not. You know, Bill and Sally Winter are my family. No they’re not. I’ve got documents. Right. Let me see that. Oh, those are fake. No way. Those are real. No, they’re real. And you can believe it. Like it’s that kind of thing. Like you’ve gotten to know this entity, this beast for so long that to be challenged. And this happens a lot in the clinic when I tell a patients, look, it’s impossible not to sleep well, maybe for most of your patients, but I don’t sleep, you know, they’re not giving me a hard time. They’re not lying about it. I got better things to do. To be my clinic and tell me things that aren’t true. That’s what they believe. So now you’ve got to unwind this thing and try to appeal to different parts of their psyche to help help them understand that you’ve got a problem. It’s a serious problem, but it’s not necessarily the problem you think it is, and it’s a problem that you’ve ultimately got control over.
W. Chris Winter, MD: [00:18:20] And you can see that in people who struggle with insomnia and come out the other end. It’s often just a it’s a moment, it’s a belief. It’s an altered way of thinking about it. It’s not the right blue blocker glasses or the right pillow. It’s much, much deeper than that. It’s a fundamental reimagining and re-understanding of what it means to sleep. And you see that I think with adults in sports, like, I don’t feel the way I feel when I played sports when I was little. If I want to go out and play game, I know enough about myself and my ego is strong enough. Now, as a 50-year-old, I don’t care if I miss every shot in the game. I still get to eat dinner. It doesn’t fundamentally change my life at all. But when you’re little, it’s hard to get out from under that. You don’t want to be embarrassed, but you know other kids, you know you’re missing all the shots. You don’t want to be responsible for losing the game. There’s all these things you believe to be important. As you get older, you’re like, this was a game of eight-year-olds in a church gym. Like, why did I think it was that important at that time? Like, I have a very different perspective on that situation now. And that’s what we as insomnia doctors are often trying to help people is to rapidly attain that perspective.
Jonathan Fields: [00:19:33] Yeah, I mean, it sounds like what you’re describing is, is like sleep performance anxiety. Basically.
W. Chris Winter, MD: [00:19:39] It is for a lot of people. It is.
Jonathan Fields: [00:19:40] But it also sounds like what you’re saying is that when this persists over an extended window of time and you have this like repeated things, like you start to tell the story to yourself over and over and over, it becomes a part of your identity. So unwinding the sleep issue also means that we need to actually talk about unraveling that identity that you’ve stepped into as a, quote, bad sleeper or disrupted sleep or a person who never sleeps. Does that make sense?
W. Chris Winter, MD: [00:20:11] Oh, 100%. I’m surprised that you get that as a non-sleep. That’s when it becomes really malignant. I have a belief that everybody has their thing. You know Jon, you’ve got an amazing podcast and you’ve got a voice that a lot of people relate to and want to hear. And, and perhaps your partner makes the best Christmas cookies, you know, and then your friend down the street is an amazing artist. This other person is just the funniest person. Everybody’s got to have their thing. And it’s interesting for some people that their thing becomes the fact that they can’t sleep. That is a big part of their identity. In fact, I remember when my first book came out, my kids were younger and they were really interested in the reviews. They thought that was amazing. Oh my gosh, dad, somebody wrote a review about your book from Lake Placid and and they really liked it. And then then inevitably some bad reviews started coming in. And I remember one of them in particular, their name on Amazon was like tired 89. So at some point years and years and years ago when you had got on Amazon, you set up your Prime account, you’re going to order some laundry detergent and some parts for your mower or whatever you’re ordering. You had to come up with a name and you chose tired 89. That’s going to be your Amazon name. And I thought to myself, you know, it was a very negative review, which is fine. I really appreciate those because you just learn so much from them. And this book is terrible. Don’t waste your money. It doesn’t do anything. You know this guy? I’m not even sure he’s a real sleep dog.
W. Chris Winter, MD: [00:21:43] It was this guy that, you know I’m fine with. It creates this sort of longing that God, I want to meet tired 89 and go have a cup of coffee with him or her or them or and just talk to them. There’s just so much anger and frustration and fear and and you can tell it’s all kind of built to protect something that is under attack. You know, I have told tired 89 that their parents are not their parents. And now, look, I got pictures to prove it right there, there I am as a baby. And there’s Fran and you know Frank and that’s okay. That’s. It’s almost like there’s seven steps to healing insomnia. There’s denial and anger and resolution, whatever the steps would be. And some people are just further along than others, but that that personality identity is a big hurdle in the thing. Who wants to sit there and say, you mean for the past 14 years and all these sleeping pills and all this money and all this time and all this specialists, it was just I was sleeping all along, all these stories I was telling my coworkers about going weeks without sleep. That was not true. It was just my perception of it. I can get why somebody would be like, screw you, man, you don’t know me. You know, I get it. That’s why it really takes some time to really work with people like this sometimes. And it requires a fair amount of motivation and openness and willing to put yourself in some, some tough spots. And, you know, everybody’s at different places when it comes to their ability or their readiness to do that kind of thing.
Jonathan Fields: [00:23:21] Yeah, that makes a lot of sense to me. I think on the other side of the spectrum, part of my curiosity is, you know, you describe that that, uh, E.R. surgeon who goes and goes to the call room closes her eyes and, like, within seconds, she’s out and she got two hours and she opens up and she feels really good. And and maybe you have folks who take the mantra. I’ll sleep when I’m dead. You know, like, I’m just. I’m going to go, go, go. I don’t need it. It’s fine. And basically the importance of sleep in their lives, and I think a lot of folks may feel this when they’re young or also and they’re sort of like new in their career and they’re trying to prove themselves and putting in a lot or maybe younger in their lives when they’re young parents and they’re working full-time job or two full-time jobs and, you know, have little kids or toddlers or babies at home. And they just kind of say, like, I’ll deal with this later. But when we get to that opposite side of the spectrum, when the pendulum swings all, all the way in that direction, when this is very real, talk to me about how this true lack of sleep that accumulates over time, that where the deficit actually doesn’t go away. How does this start to show up in our psychology and our physiology and the way that we live our lives?
W. Chris Winter, MD: [00:24:31] Yeah, I mean, I think it’s it’s slowly devastating. It’s Russ I always think of it as rust. I mean, you could stay up all night tonight. I just pulled an all-nighter at some point in their life, and life went on. You were pretty grumpy the next day. You may have, you know, fallen asleep watching jeopardy or something, but it wasn’t that big of a deal. In fact, maybe you were somebody who pulled the all-nighter, and the next day really wasn’t that tough for you. I mean, for some people, it’s a bear. Other people, it’s like they pull an all-nighter and they’re. I remember in medical school, there were some people that could just. You were up all night with them on call, and you knew they were awake because they were standing right there next to you, you know, filling orders and doing procedures all night long. And the next day they’re they’re fresh as a daisy. And you’re like, you know, the professor keeps calling on you, Chris, what are the three signs of an aortic? You’re like, ah, what is an aorta? And like the next person? Oh, I got it. You know, Jennifer next to you knows all three of them. And she’s she had found time to shower. And she actually looks okay. Like, you know, how did you do that? And to some extent that’s genetic. And it’s a very interesting sword, double-edged sword in terms of our abilities to function with inadequate sleep. We can do it. And some people do it much better than others.
W. Chris Winter, MD: [00:25:40] That’s there’s some genetic factors that allow some people to thrive and others to not. And it is interesting that we tend to reward those people accidentally. You know, it’s funny you mentioned people who don’t value sleep. There is a weird middle ground of people who value it. They want to do the right thing. But like you said, their job doesn’t allow it. The law clerk, the intern. I valued sleep, but sometimes you’re like the idea of, hey, it’s 11:00 and I know the air is full, but I can’t stay up all night. That’s terrible for my health. I’m going to pay the consequence for this in my 60s. Like nobody cares about that. Like, everybody just kind of looks the other way in a weird way. So the number of ways it’s hurting us are just they’re not able to be counted. They it really is. I don’t want to sound alarmist, but if you’re somebody who’s like, look, I get five, I go to bed at midnight, I get up at 5 a.m. and work out and then go to the office. I don’t sleep anytime outside of that. I really don’t sleep in on much of the weekends. You know, if I feel sleepy when I’m reading, you know, financial reports during the day, I just stand up in my office and walk around and drink a ton of coffee. Like, I can do it. I can do it like, sure you can, but at what cost when you’re in your mid-50s? I mean, I remember a sleep specialist, a mentor of mine always had this phrase.
W. Chris Winter, MD: [00:27:02] I can never remember what it was like. 55 fly and die. Meaning that you just sail along until you’re 55 and then you die, and then nobody can figure out at your funeral, man, he was so successful and he ran triathlons and he was always involved in these things. Why did he die? Well, he died because he didn’t sleep enough. And we know individuals who shortchange themselves when it comes to sleep are more likely to get dementia and heart disease and die, you know, die of a car accident. I mean, it just becomes beyond maybe appealing to their rational sense, because I talked to a lot of smart people during the day, way smarter than I am. I don’t believe they don’t believe it or know it. I think it becomes something like a habit or yes, I’m going to do that. When this project wraps up, I’m going to start getting the sleep I need, and that project never wraps up because it always leads to the next project or the next thing. And I wrestled with this too, Jon. This was my sleep struggle, which was I’m good at staying awake late and sleep depriving myself and being functional the next day. Really good at it. And I’m certain it allowed me to get, you know, good marks on certain rotations. I’m sure it helped me in high school. I could easily stay up all night and get work done and, you know, function well the next day in college. But at some point you do have to ask yourself.
W. Chris Winter, MD: [00:28:25] Just because you can. Should you do it? I can do it. I don’t even feel like I’m struggling or suffering that much the next day. You know, my wife won’t say you’re yawning a lot. What time do you go to bed last night? And I’ll lie, of course. Oh, I don’t know. 12, you know, actually two. But you know who’s counting? So, you know, a lot of travel, you know, people taking red eyes. I’m always like, let’s get that. I’ll take the red eyes. I’ll be back in the office so I can actually see patients that day instead of just being like, look, I’m gonna cancel patients that day and get some sleep before I fly home. Like, you know, just dumb stuff like that. So I think that that’s the end of the spectrum that I have to work on. So I always look at people. Do you need to worry more about sleep or do you need to worry less about it? So I’d probably be the person who needs to worry a little bit more. Read Matt Walker’s book and really consider it versus, you know, another person who might, you know, we were talking about earlier, the insomnia patient, maybe not read Matt Walker’s book and read my book, because if you read Matt Walker’s book, your level of anxiety about, you know, quote-unquote, not sleeping is going to go through the roof. So you got to find the right tool to bring everybody to the middle, I guess.
Jonathan Fields: [00:29:30] Yeah. I mean, that’s so interesting that you describe it that way, because it does make sense. You know, if you’re on the end of the spectrum where you’re already sort of like shaming yourself and you have this perception gap about like what your sleep really is, you wrap yourself around the identity of a bad sleeper and then you start to read about, oh, well, like if you don’t sleep enough, the risk for life-altering or ending disease goes up dramatically. Inflammation goes up, cognitive function declines, physical performance, mood relation, blah blah, blah. All this stuff that’s going to freak you out ten times more. Whereas if you’re on the other side of the spectrum, it might actually be a little bit good to understand, a little bit more like the damage that you’re potentially doing to yourself.
W. Chris Winter, MD: [00:30:08] Yeah, absolutely. And there’s an identity there too. It’s the tough guy, you know, like, oh, he’s sleeping or dead or, you know, sleeps for the week. And that’s why I like to see people. Who’s that Navy Seal guy like Jocko Willingham or something like that. He’s this big, big. And he gets on there and he talks about, you know, how important sleep is. You know, now, I’m sure you know, somebody had said during, you know, Seal training, you know, it’s pretty late. And I’m sitting out here in the ocean, you know, can we go to bed now? No you can’t. So there’s there’s reasons for staying up late. Sometimes you can’t stop a trauma surgeon in the middle of the night because it’s midnight. But I love hearing people like. I mean, I can say it, you know, nobody really cares about what I have to say. But you hear somebody like that guy say how sleep is important and how he values sleep. And it’s not always, you know, doing more is better. I think you kind of create a healthier identity of, you know, you don’t want to take a lot of pride in being the individual that can stay up all night and be great the next day. That’s not necessarily a superpower you want, you know.
Jonathan Fields: [00:31:07] Yeah. So when we talk about sleep, also, I want to deconstruct what we’re actually talking about a little bit more. Because when I think about sleep, sitting here at this conversation, I have an Oura ring on. I get up in the morning, I download my sleep data from the app, and it shows me these four different stages of sleep. And it’s sort of like approximately how much time I’ve spent in each one of them. Talk to me a little bit about what these stages are and why each one matters or doesn’t matter as much as we think it does.
W. Chris Winter, MD: [00:31:34] I’ve said from the beginning, I like trackers. We just did the last episode of the podcast. We did, we did on trackers. It was long overdue. I, I think it deserved sort of a conversation in the sense that I think that they often get a little vilified in terms of, oh, they’re not accurate, like a sleep study. Well, no. But who has the means to have a sleep study every night? And there is something to be said for data that might not be quite as accurate, but it’s longitudinal, meaning that you’re looking at your data every day, versus one random Tuesday night in February where you went to an artificial sleep lab at wires taped all over your head, and some technician that you just met 30 minutes ago watching you online on a camera. You know, we’re getting there’s some strengths and weaknesses here. So you’re sleeping in your own bed and most people have an Oura ring completely forget about it. So there’s not that sort of nervousness of being in a weird bed with wires, or you’re just sleeping like you normally do. Now, that’s not to say that some people don’t get kind of wrapped up in that data, but I like the I, I think data is power, even if it’s not perfect data. I mean, I think that there’s power in terms of a trend if you’re always scoring in the 90s and now all of a sudden you’re scoring in the 50s because you’ve started drinking more or you’re spending more time at your partner’s apartment, and she’s got 17 cats and you’ve noticed, wow, when I sleep at her place, I’m getting scores in the 50s and 60s when I sleep and by myself in my own place.
W. Chris Winter, MD: [00:32:55] It’s in the 90s. There’s value in that. So, you know, I think that looking at these devices in terms of how much sleep we’re getting, I think they do a great job overall. So again, when we’re talking about the individual who says, look, I don’t sleep okay, great. Get a get an Oura ring, get a Fitbit, get a, you know, Withings Band or Apple Watch, whoop band, whatever you want. Wear it for a month. Is that what it’s telling you? No. It says I’m sleeping seven hours a night, so it’s clearly broken. No, I don’t think it’s broken. I think it’s actually. Reflecting what’s going on, and maybe you can find some comfort in that. Ask your partner what’s your partner think you’re not sleeping, or you’re sleeping closer to 6 or 7 hours a night? Your partner’s sitting there looking like, yeah, honey, I think it’s right. That’s that’s what I’ve been telling you for the last three years.
W. Chris Winter, MD: [00:33:38] So I think a lot of people, it can be used in that way. The flip side, like we were talking about the trauma surgeon. You know, I lie all the time about my sleep. You know, I go around and tell people, oh, I sleep seven hours a night. That’s not what my if my phone could, like, interrupt me at the dinner party, you would like buzz and like, you know, because I’m lying about it like, no, no. This past month, you’re averaging 5.5 hours. So I think it can again start to help people move in two different directions. Okay, well, gosh, maybe I’m sleeping a little bit more than I thought I was. So it makes me feel a whole lot better, because I know that not getting enough sleep can make really a problem for you. Or hey, Chris, you’re not getting seven hours like you’re exceptional nights are now your normal light. So no, you can use this data to try to carve out a little bit more time to sleep and watch your favorite HBO docudrama a little bit less right now in an effort to get some more sleep. I think where they struggle a little bit to some extent is staging sleep. That’s a tough thing to do. So when we think about staging sleep, we’re talking about light sleep, deep sleep, dream sleep.
W. Chris Winter, MD: [00:34:40] And then there’s also sort of a transitional sleep, you know, we call it in one, which doesn’t have a whole lot of meaning outside of an academic sleep center. So it’s really three things light sleep, deep sleep, dream sleep. We spend about half of our night in light sleep. The other half is some mix of deep sleep and dream sleep. You know, maybe 5050. For a lot of people, just understanding that can be really helpful. I have people come all the time like, look, I’m only getting like 20, 15, 20% deep sleep. I want 70%. Well, that’s never going to happen, you know? So it’s sort of like I’ve noticed I’m only getting about 33% carbohydrate. I want 100% carbohydrate. Now, you actually don’t like carbohydrate, protein, fat. All three are really important and they’re important in the right ratio. So understanding the ratio of what is typical for an adult or a kid and what your device is telling you is really important. And so in terms of what’s most important again is protein more important than carbohydrate. Not really. It just does something different. So we have this kind of it seems like we always talk about deep sleep as being the most important. And maybe it is from the sense that deep sleep makes you feel not sleepy. So it’s sort of the fundamental part of sleep in the sense that if you are a squirrel trying to survive, it’s going to be difficult for you to do that.
W. Chris Winter, MD: [00:35:53] If you don’t have the energy to wake up and go find a nut and protect yourself from a predator. So I think deep sleep is that sleep that makes you feel rested to some degree motivated to do things. If you’re falling asleep during an art history lecture, you did not get enough deep sleep either because you didn’t get enough sleep in general, or you got plenty of sleep, but something interfered with the quality of it. Rem sleep or dream sleep is very important to. It’s more about concentration-focused memory processing. It’s a little bit more opaque than than deep sleep in terms of if you don’t have enough REM sleep, you’re going to get through your day, okay. You’re just going to put your car keys in your refrigerator. You know, that little injury you got at the gym is going to bother you more. You might have a little bit more depressive thoughts or lack motivation to want to do something. I don’t want to go to the gym today. It’s kind of gross outside. I don’t want to do that right now. Like so all these things have meaning. So we you know, I think it’s sort of like a balanced diet.
W. Chris Winter, MD: [00:36:50] We want to have our properly balanced sleep at night. And I think those little devices, even though they’re not perfect, can be telling, especially within a if you’re like, look, I’ve been wearing this Oura ring for five years. Over the last three months, the trend of my deep sleep has significantly changed from where it was before. If somebody came to me in my clinic and told me that, I’d pay attention to that, because whether it’s right or wrong, it was measuring something one way for a long period of time. And now it has changed. So to me, I’ve done sleep studies for less, especially if somebody’s saying, look, not only is this changed, I don’t feel good. I’ve actually fallen asleep in in front. I teach, I teach fifth grade, actually, not at off. During a pop quiz, I gave the kids a quiz and I was sitting at my desk grading papers. I fell asleep. I’ve never done that in the 17 years I’ve taught, and my device is showing that I’m not getting a lot of deep sleep, and I really haven’t fundamentally changed the way I sleep. Shoot, yeah, I absolutely pay attention to that. So I think these things can be great tools for people if they just make sure they’re kind of put in the right place, if that makes sense.
Jonathan Fields: [00:37:59] Yeah. And that makes a lot of sense to me. I tend to use it in that same way. Actually. I focus more on like what’s the trend and how is it matching up with how I’m feeling? I guess the one one question that still remains for me though, is that, and maybe this is mythology. Maybe you can help clear this up for me. Is that the notion of deep sleep not just being related to how you’re feeling in the next day, like, are you groggy or not? But the long-term implications of not enough of that one? It is deep sleep in terms of its ability to sort of cleanse the brain, to remove things that what might accumulate over decades and then lead to diagnoses like dementia or Alzheimer down the road, that that is something that as I get further into my life and I sort of like see those numbers, I’m like, huh, should I be paying more attention in particular to that? And if it dips below, like if I’m noticing a trend where like, that’s really dropped for like a week or maybe two weeks or three weeks, how much concern would you have about something like that? Or is there just mythology around, like deep sleep is the most important. You need to get a minimum of X, and it’s really just a balance of all. As you’re saying.
W. Chris Winter, MD: [00:39:03] I think you have a right to be concerned. I think it’s sort of like it can sometimes approach, though I am becoming shorter as time goes on. Like I’ve been measuring myself on a wall since my kids were little. Like, there’s a little mark that says dad and then all their measurements. And so when they started to pass me, I was like, this is bullshit. Like, I there’s no way you’re taller than I am. So I remeasured myself. And I was shorter than the mark I had made and distressingly, went to my primary care doctor. He’s like, oh yeah, Chris, men start shrinking around the age of 30, I can’t remember. It was much younger than what I thought it would be. So to me, losing deep sleep is probably part of the aging process. It’s the reason why older athletes don’t recover as well, etc. so I think we have to find the right balance between concern and, well, I’m exercising, I eat well, I’m on a good sleep routine, what else can I really do? And that’s where I think people start getting snookered into. Well, you can buy this little device that vibrates on your neck at a certain frequency. It’s been shown in monkeys to increase their deep sleep by 50, up by. As much as I love that phrase as much as 50% like that’s the problem that I have is the whole biohacking thing. Like, listen, why don’t you biohack my height? How can I be taller? I don’t want to shrink anymore. Like people say, you can’t really do it like we could, I don’t know, shove some stuff in between your vertebrae or something, you know, like it’s just part of the process here, which kind of stinks, like. But, you know, so I think that if you saw a dramatic decline in your deep sleep and some things had changed about your life and you’re really not exercising, you eat terribly and you drink a lot of alcohol at night, I could figure out a bunch of ways.
W. Chris Winter, MD: [00:40:50] Maybe we could improve the quality of your sleep. But the super fit 60-year-old that comes in runs six miles a day. He’s got seven different sleep trackers and is concerned that his deep sleep is at 17%. He wants it at 22. Because of this article he read about dementia and the lymphatics. I don’t know what to do with that. Like, listen man, you’re already exercising. You’re in the top 1% of people your age exercising. I don’t have any kind of magic pill to increase that. You’re aging and there’s not a whole lot you can do about it, I guess, is where where that would be. So I think that’s where we have to focus our it’s like triage, you know, let’s focus our resources on the people that we can help here versus the people who are just gone and the people who are actually in really good shape, but they’re just, you know, help me, help me. Listen, you’ve got a little nick on your finger. It’s not that big a deal. Let’s let’s focus on these other people who can. We can really help. There’s not much I can do for you besides put a Band-Aid on that finger. So that’s where I sometimes see that the sleep tracker creates anxiety and a sense that we can fix something that I’m not sure medical science has the ability to fix at this point. But if you look hard enough on the internet, you’ll find something that’ll fix it. And it only cost you three easy payments of $49.99.
Jonathan Fields: [00:42:04] Always. I want to dive into some of the things that we can do. But before we get there, I know you also made this really interesting distinction between insomnia and I think you call it hard insomnia or chronic insomnia. And I was curious about that distinction, actually. Yeah.
W. Chris Winter, MD: [00:42:21] It’s just something I kind of came up with in the sense that I fundamentally believe that if I am dealing with a patient that comes sort of like with an open mind and a fair, you know, average degree of intelligence, we can make their insomnia much better. But I’m also willing to admit that there are some people that you just it just you can’t really crack the shell. And what those people consist of is, to some degree, a mystery. I guess what I was saying about that was you might be somebody who, for the rest of your life, when you go to bed, it takes you two hours to fall asleep. But here you are. You got a job. I mean, a lot of it has to do with the way we internalize it. I mean, if you’re trying to threaten me, there’s lots of ways you could do it that would get my attention. Threatening me with wakefulness in my bed at night is irrelevant to me. I like being in bed awake. It doesn’t. I don’t care about it. So to some degree, I think that there are individuals who struggle with insomnia that are just going to struggle with insomnia. And it’s like chronic pain, like, listen, we’ve done everything we can do. We’ve done a nerve block. We’ve MRI’d your knee a million times. We see nothing structurally wrong with it. We’ve done exploratory surgeries, we’ve scraped on the meniscus, and yet this debilitating pain is still there. It’s a tough conversation to have with people that we don’t have any more to offer you. We don’t know what to do it. You might need to start exploring ways almost to come to terms with it, that it’s going to maybe be there until somebody comes up with a great solution for you that we haven’t thought of.
W. Chris Winter, MD: [00:44:01] I mean, Western medicine does not nearly have all the the answers that people think that we do. And I think that that was really what I was trying to say about individuals with this insomnia that have seen 100 sleep doctors way smarter than I have, and nobody’s ever been able to figure it out. Then it’s time to make a choice here. Like you’re 34 years old, you’ve been to 17 different sleep doctors, had seven different sleep studies. Nobody can find anything wrong. We’ve tried all these different medications. Nothing works. So I would say maybe stop seeing doctors and let’s just sort of start working on the acceptance of this. And now you’re going to lead a life. I don’t know, maybe, maybe there’s analogies with like an amputation, you know, traumatic amputation. Trying to get the leg reattached is not going to happen. It’s time to come to grips with the fact that you are going to operate the rest of your life without this limb. I don’t want to offend amputees, but there is some degree, I’m guessing, of. Okay, well, I’ve got to start now leading my life with this sort of new difficulty that’s been hoisted upon me that I really didn’t want, because doctors in 2023 cannot create a new leg for me, which is exactly what I deep down want. I want to go back to where I was before. I liked having both legs, you know, we struggle with things like that in the medical profession, I think. I don’t think we’re very good at that.
Jonathan Fields: [00:45:22] Yeah. I mean, that was my curiosity just, you know, like, as an aside, almost like for you, this is your profession, your profession for, you know, like a significant amount of time when somebody like that shows up and you’re literally like, like I’m looking at everything that you’ve tried and looking at everyone who you’ve seen, and this is the last thing that you want to hear. But what I got to tell you is effectively, I’ve got nothing for you. I mean, yeah, just for you as a as a doctor, like.
W. Chris Winter, MD: [00:45:47] I come from very, you know, a rural place. And I’ve never looked at doctors as being particularly expert at any. One of my favorite quotations about medicine in general is doctors. We’re here to distract you until nature takes its course. I’ve always thought that was pretty funny. The other one I always liked was doctors are just people who’ve read a few more books than I have. I thought that was a good one too. So I mean, to me, I actually like that part of the journey. The part where, like, you know what? I’m going to take my white coat off, which is not true because I don’t I don’t typically wear one. And let’s just talk about what we can do going forward here. That’s not me doing more tests and things like that. And I always make promises with patients. And the promise is, listen, if you go somewhere else and you see an acupuncturist, you go to a cool yoga studio in Soho, New York, and something clicks or works, or you determine you’ve got this weird digestive problem or celiac disease, you have to call me and let me know what worked, because the only way I’m going to help the next person in your situation is if you educate me about what made the difference for you. So again, I didn’t write that book as a way to sort of create all the answers. And the end of the book, which you’re referring to, was that sometimes we don’t have the answer. And it really sucks to kind of hear that. But I think that there’s a therapeutic process that begins at that point and goes forward.
W. Chris Winter, MD: [00:47:14] It’s not, oh, well, I can’t do anything for you. So pay your co-pay and get out of my office. I’m going to be there for that patient as much as possible. That’s why when you read the tired 89 Amazon review article, it’s one star. I hate this book. I’m throwing it away. Never buy it. It’s the worst. This guy is terrible. What I when I read that, it’s like, oh, I want to meet this person. It’s not oh, we get this review taken down off Amazon or that’s unfair. That’s not you know, it’s it’s it has nothing to do with that. It’s more like it’s too bad that we’re meeting this way because I’d really like to sit down and talk with you. Maybe after an hour you’d feel just as strongly about how terrible the book is, but maybe we would start to crack some. And I always like to think that that person took the time to write that review. And as much as they don’t like it, it started them thinking about some things, you know, some little things, some little seeds were planted in there that might take a few months or years to grow. But maybe when that patient sees the next doctor and she says, yeah, he’s right, you sleep. It’s just there’s some things maybe wrong with your sleep, but yeah, it’s you’re not here because you can’t sleep. And, you know, the patient hears that a few times. Maybe we started a process that allows something to happen down the line that I’ll never be aware of. That’s the positive spin. I like to think about things anyway.
Jonathan Fields: [00:48:29] Now that makes sense. So if you I mean, we’ve talked about this, you know, the perception gap how getting really honest and actually maybe even getting some data to sort of like show you and actually, you know, things are maybe better than you think you are, maybe starts a process of reimagining and shifting your identity and maybe letting go of the anxiety. What are some of the more granular things, like the more basic things when you’re talking to somebody and says, okay, so have you tried this? Have you tried this? Have you tried this? Or like, here are the three, five, six, seven things that you want to get into the habit of doing either every day, every night that maybe no one of these is going to be a miracle cure. But if we start to, like, do them on a repeated basis, they’ll have a cumulative effect. What are some of the core things that we should be thinking about along those lines?
W. Chris Winter, MD: [00:49:13] Yeah, that’s a great question. I mean, I like things that are actionable. I think starting your day at the same time is really helpful. Our bodies just like that, we like nothing’s accidentally happening in our body. I didn’t just accidentally secrete a massive amount of testosterone into my bloodstream. It’s going to happen on some sort of. And that’s what’s so fascinating about the body, is that the timing of everything is just absolutely exquisite, and we can help our bodies do that by timing external things. And we call those external things site givers or time cues. So if we look at a clock and we see, oh, it’s 6:00, that doesn’t really do much for our brain. But if we always eat our breakfast the first thing in the morning, that that stimulus of food going into our gut every day at the same time becomes a marker in time that we start to look at. And if you don’t believe me, eat your lunch and dinner and breakfast every day at the same time. And look and look and see when you start to feel hungry. I remember working at a summer camp one year, and we always take the kids to the dining hall at this college at the same time every day, and I would find myself getting hungry on the walk over. In fact, it became a joke with the kids like, are you hungry yet, Chris? I’m like, no, not yet. It hasn’t hit me yet. But there it went.
W. Chris Winter, MD: [00:50:28] Like, I’m just got hungry, you know, because your brain’s like, okay, every day at this exact time versus when I was a college student, I never ate at the same time. Every day you talk to military people, they’ll tell you things like, I go to the bathroom at the same time every day because everything is so regimented and you don’t have to be militaristic about it. But starting your day off at the same time every day is really helpful, especially if you’re somebody who struggles with your sleep, because a lot of those people go to the thought process of I had a bad night, took me three hours to fall asleep, or I woke up at two in the morning and took me hours and hours to go back to sleep. Therefore, on Saturday I get to sleep in until noon. That way I’m ensuring myself, you know, getting the right amount of sleep when in fact that might be hurting you a little bit because now your brain’s not getting any sort of penalty for doing what it did in the night. So getting up at the same time every day and moving forward is a great way to kind of help to ensure your brain understands when sleep is supposed to happen. Because if you’re sleeping in until noon on Saturdays and Sundays, your brain’s kind of like, when do we get up? Sometimes we’re up at six, other times we’re up six hours later. What is the wake-up time? If you’re messing with a wake up time, you’re almost inevitably messing with a breakfast time.
W. Chris Winter, MD: [00:51:38] Sometimes we eat breakfast at noon when the sun is directly above our head. Other times we’re eating it at six in the morning when the sun hasn’t come up yet. Like, that’s very disruptive to a brain. I think the other thing that we can do is exercise. You know, listen, I think exercise should be like brushing your teeth. I don’t know that I’ve ever met somebody who says, look, I try to brush my teeth, but I’m pretty busy. Pretty busy guy here. Got a lot going on. So I get to brushing my teeth once every other week or so, if I’m lucky. No, I mean everybody brushes their teeth probably twice a day. You might forget from time to time, but you didn’t choose to not brush your teeth because you were pushed for time. That doesn’t happen. And if you can brush your teeth for two minutes, you can walk on a treadmill for ten. Somebody says, look, every time the commercials come on. On my favorite show, I walk on a treadmill. Then you’re exercising, and I think we’ve got to get away from the idea. You know, for most people that exercising is optional. It should be right up there with brushing your teeth, especially if you’re struggling with your sleep, because it’s the exercise and that energy exertion that’s creating the drive to exercise. And the pro athletes that I work with, they can have really radically different sleep schedules in and out of season, because when they’re in season as a soccer player running up and down the field, it creates a drive to sleep.
W. Chris Winter, MD: [00:52:54] So if you’re somebody who’s struggling to fall asleep or stay asleep, exercise more. All right. Chris already exercised 20 minutes every day. Exercise 40. It will help if you care. I think the other thing that we have to be careful of is we talk a lot about eight hours of sleep. That’s really a bell curve average of a distribution of a population. And there’s a lot of people would say, you know, the average really isn’t eight. It’s seven. Seven is the number when you look at research, seems to be linked to the best health outcomes. As you go higher than seven, get into 8 or 9 or fewer than seven, you know, six, five. That’s where you start to see all the terrible things you talked about cognitive decline, heart disease, all that stuff start to go up. So, you know, I meet a lot of people who go to bed at 9:00 and their alarm set for six. I’ve got no problem with that. But you’re seeking nine hours and you’re here because it takes you an hour or two to fall asleep. Well, if it takes you two hours to fall asleep, you’re still getting seven hours of sleep. That might be what you need. And that this idea that you need nine or can get nine is actually the problem.
W. Chris Winter, MD: [00:53:57] It’s sort of like getting having a bunch of buddies that are professional football players, and you get in your mind that to be elite, you have to eat a pizza and a half every night because that’s what they do. Well, you’re just a five foot eight sleep doctor, and now you’re going to your doctor needing an appetite, stimulating your appetite. Why can’t he can’t finish my dinner. A not-so-great doctor will give it to you. A good doctor would say, well, why can you not tell me about your dinner? It’s a it’s a two pieces. I eat one large pizza and a half of another one. Why are you doing that? Because that’s going to make my health great. No it’s not. So you’re saying you get halfway through your first pizza and you don’t want any more food? That’s not a problem. That’s your body saying you don’t want any more pizza. You’re not A66 football player trying to gain weight and be on the O line for the Packers. So I think we get this weird expectation because, again, of the media that if you’re not getting eight hours of sleep, you’re going to die a horrible death. And that’s a terrible pressure to take with you to bed at night. If somebody says, look, Chris, I get seven hours of sleep every night. When I try to get eight, I often struggle to fall asleep. And when I get my seven, I.
W. Chris Winter, MD: [00:55:00] You could give me an opportunity to take a nap during the middle of the day. I don’t think I could fall asleep if I tried. Then that sounds like you’re doing pretty well with seven, and understand there’s a lot of people out there whose seven is the number. For them. It’s not eight. More is not always more. So I think you have to be very careful with that as well too. I think consistency of schedule extends beyond just your wake-up time. If you can exercise in the morning every day, if you can try to eat your meals at the same time every day, if you can seek bright light in the morning and eat your lunch at the office outdoors and try to dim lights in the evening on the same sort of schedule. I think that 24-hour schedule can really impact people’s sleep quite well. And then the final thing that I think is really important is just get have a plan for having troubles with your sleep. If somebody if I meet somebody at a dinner party and they’re about my age and they say, you know, Chris, my entire life I’ve never had a bad night of sleep, I would find that fascinating and really jarring versus, yeah, you know, several nights a month I might struggle to fall asleep. I’m like, yep, well, there you are. You’re normal. That’s how normal people operate. Normal people sometimes don’t feel hungry for lunch, so they skip it and they think to themselves, weird because I like lunch, but I’m just not that hungry today and they don’t question their appetite.
W. Chris Winter, MD: [00:56:20] There’s no dire consequence. Oh, God, I just skipped lunch. I’m going to. I’m starving to death. That’s it. I think this is the beginning of the end for me. Like I should give away all my possessions because I skipped lunch. Nobody goes to that place with appetite, man. You have two nights where you don’t sleep the way you’ve anticipated. You’re going to sleep. It can be really rough for some people versus, oh, I had two nights of bad sleep. Oh, well, I’m sure tomorrow will be fine. So I think that paying attention to sleep and valuing sleep, but working on not stressing about it. Let’s control what we can control. Be in bed by 11:00. Be out of bed by seven. There. That’s what you can control, man. Gilded Age, we got a new episode and I forgot about that. It’s 10:00. It’s 11:00. I could watch that. See what happens with the railroad and the fight over the opera house. Or I could. Go to bed, get my sleep, and deal with watching the Gilded Age tomorrow. Those are tough choices to make, but that’s where we’ve got to be. And then understand that sometimes we’ll go to bed and not fall asleep right away. We’re okay. We’re normal. That’s fine. Like just being in bed resting can be wildly restorative for people.
Jonathan Fields: [00:57:25] Where do you fall on, um, screen time in its proximity to whatever it is that you’re doing to get into bed or fall asleep because of it? Seems like that’s become religion these days. You know, like you need to be off of computers, off of TVs, off of this, or put blue blockers on them and all this stuff, you know, 1 hour or 2 hours before you do this, or else it’s going to just profoundly disrupt your melatonin production or whatever. What’s your take on that?
W. Chris Winter, MD: [00:57:51] Yeah. I mean, to me it’s Usain Bolt shoes. Like, you know what I’m saying? Like it’s, you know, he’s getting ready to run a race and you’re like, well, you know, I got some better shoes and those that you’re wearing, the little radically changed the way you’re going to run. No they’re not. I mean, you might shave a quarter of a second off here or there. And then the flip side is, if I wear his shoes in the race, it doesn’t change anything about if I’m trying to get my running to the level of his. The shoes are the last thing. So to me, do these things make a difference? Yes. Are they making a big difference for the people who come to see me? Absolutely not. Oh, you know, Chris, I couldn’t took me six hours to fall asleep. I’ve struggled ever since I was a teenager to sleep. And I got these blue blocker glasses and it’s all fine now, said nobody. Ever. So that’s not to diminish their importance. It’s just that. What are you looking to achieve, Chris? I’m a pretty good sleeper sometimes. You know, I do struggle a little bit to fall asleep. It’s not that big of a deal, but I have a job where I have to be on a screen pretty much late into the night, every night to get the game film ready for the coach the next day. Okay, well, here, try these blue blockers that might help you initiate sleep a little bit faster.
W. Chris Winter, MD: [00:59:02] Great. So I think that’s where we have to kind of be with these things. I always I always find this advice to some degree laughable. Like, okay, well two hours before you go to bed, screens need to be off. Great. Check screens off. What am I doing now for the next two hours, between 8 and 10:00 when I go to bed? Just going to sit here in the dark, look at my hands like, what? What are you? So the idea that we can’t sit down and watch a little TV before we go to bed, I think is absurd. Like, just dim the room, maybe not have a cup of coffee with it. But if you want to watch an episode of Yellowstone, see what ripping the guys in the barn house are up to before you go to bed, go right ahead. And if you’re doing that every night, it starts to become a marker of good sleep. To me, I’m just waiting for the person who said I’ve had disastrous sleep all my life. But I stopped watching television in the hour before I went to bed, and now that’s all gone. Like, I think these are details. These are like little fine tunings that we do like, hey, I’m Usain Bolt’s track coach. I’ve noticed that on your start, you’re hitching your left elbow. I want you to bring that a little closer to your body, because I think that’s going to give you a little bit more thrust in your start and maybe shave an eighth of a second like that.
W. Chris Winter, MD: [01:00:17] Instruction is not for the person who shows up at the track and says, I’ve never run before. Teach me. Okay, well, okay, you’re wearing work boots. Let’s start there and let’s stretch and we’ll do a very light workout. And tomorrow we’ll build upon that, and we’ll get you up to a place where that thing I just told Mr. Bolt will apply to you, but it doesn’t apply to you right now. It’s irrelevant to you because it’s just a it’s a and we spend so much time talking about these things in the media. Blue blocker glasses and dropping your temperature from 67 to 65. Meaningful. Yes. But for the vast majority of people who are buying that magazine at the checkout line because they’re really struggling with their sleep, you’re not there yet. We need to unwind a lot more things before we start working on which blue blocker glasses are going to work best for you. These are not really solutions to problems. These are adjustments we make to people who are already sleeping pretty well, but want that score on their Oura ring to go from a 93 to a 95, that’s what those people are. That’s what that stuff’s for, I think.
Jonathan Fields: [01:01:31] Yeah. I mean, it’s interesting to hear you say that because it’s what goes along with that is a certain amount of just forgiving your humanity. You know what I’m saying?
W. Chris Winter, MD: [01:01:38] Yeah, absolutely.
Jonathan Fields: [01:01:40] I want to live in the real world. I want to, like, grab this TV show with my partner, lying on the couch with dim lights in the room. And of course, that’s going to be okay. And that rather than focusing on these tiny little things that might be tweaks or optimizers, why don’t we start out with the bigger things.
W. Chris Winter, MD: [01:01:56] 100%.
Jonathan Fields: [01:01:57] And simultaneously forgive those little things and the fact that we’re not doing them? Because if we obsess on them, they’re actually going to become another stressor, which. Then because it piles on to the problem, of course.
W. Chris Winter, MD: [01:02:09] Absolutely. And there’s nothing wrong with trying. I mean, if somebody out there is listening is like, nope, nope. I bought some blue blocker glasses from Swanwick and changed my life then. Great. I’m really happy for you. I just don’t think when I look at the population, that’s something that most people could bank on not to pick on them. I love Swanwick’s glasses. I think they’re great. I have no financial relationship with them. I’m just. But I don’t want to be disingenuous of like, oh my God, your years and years of sleep problems will be solved by this noise machine that you’re going to sit next to your pillow like that, unless you’re years and years of problems because of a dog that sleeps next to you, it makes a lot of noise. I don’t think it’s going to do anything for you. Pink noise, purple noise. Green noise. Brown doesn’t matter. It’s that’s these are just little tiny little adjustments here that we’re talking about. They’re not. Oh, it was because I was using a brown noise machine. I needed a pink noise machine. That was the reason why my sleep has been miserable for the last decade. Yeah, no, it’s not the way that works. Save your money.
Jonathan Fields: [01:03:06] Yeah. No, that makes a lot of sense. I love the fact that it was sort of like, you know, the end of the day. It’s like, let’s get back to the basics. Let’s focus on the fundamental, like your basic lifestyle 100%.
W. Chris Winter, MD: [01:03:18] And media doesn’t want to hear about basics. Podcasts like basic media does not like basics, because we got to get your attention on the cover of that magazine. If it says, hey, exercise is good for sleep, nobody cares about that. Like everybody’s like, yeah, I’ve heard that before, right?
Jonathan Fields: [01:03:32] It’s like it’s sort of like, you know, those things that you were told when you were nine years old pretty much still applies.
W. Chris Winter, MD: [01:03:38] That’s right. Right. What about the person who crinkles aluminum foil and whispers in the microphone on the what about that like, yeah, sure. Fine. If that’s your thing. But it’s not going to touch exercise.
Jonathan Fields: [01:03:49] Right. And it’s like you’re saying like it’s not that none of these things matter. And like, it’s not like you shouldn’t try them all. It’s just like.
W. Chris Winter, MD: [01:03:55] Sure, try away. It’s free.
Jonathan Fields: [01:03:57] Let’s put things in the right perspective, in the right order, in terms of like how they might actually play a role in contribute makes.
W. Chris Winter, MD: [01:04:03] Helping somebody, somebody watching.
Jonathan Fields: [01:04:07] This feels like a good place for us to come full circle as well. And it always wrap these conversations with the same question, which is in this container of a Good Life Project. If I offer up the phrase to live a good life, what comes up?
W. Chris Winter, MD: [01:04:18] To live a good life. Find time to rest. And if rest turns to sleep, good for you.
Jonathan Fields: [01:04:26] Hmm. Thank you. Hey, before you leave, if you love this episode Safe bet, you’ll also love the conversation we had with Dr. Aric Prather about the fundamentals of sleep hygiene. You’ll find a link to Aric’s episode in the show notes. This episode of Good Life Project was produced by executive producers Lindsey Fox and me, Jonathan Fields. Editing help By Alejandro Ramirez. Kristoffer Carter crafted our theme music and special thanks to Shelley Adelle for her research on this episode. And of course, if you haven’t already done so, please go ahead and follow Good Life Project. in your favorite listening app. And if you found this conversation interesting or inspiring or valuable, and chances are you did. Since you’re still listening here, would you do me a personal favor? A seven-second favor and share it? Maybe on social or by text or by email? Even just with one person? Just copy the link from the app you’re using and tell those you know, those you love, those you want to help navigate this thing called life a little better so we can all do it better together with more ease and more joy. Tell them to listen, then even invite them to talk about what you’ve both discovered. Because when podcasts become conversations and conversations become action, that’s how we all come alive together. Until next time, I’m Jonathan Fields signing off for Good Life project.