The Melanie Avalon Biohacking Podcast Episode #148 - Dr. Michael Breus (Part 2)

TRANSCRIPT

Melanie Avalon: Hi, friends, welcome back to the show. I am so incredibly excited about the conversation that I am about to have. It is with a repeat guest. That's how you know that you have a good one. It's about a topic that is honestly, I get asked a lot, actually, what do I think is the most important thing in the whole health and biohacking world? It's really hard to say one thing, but I cannot emphasize enough the importance of sleep. I am here today with one of the honestly, one of the world's sleep experts, Dr. Michael Breus. I had him on the show before and we talked. He's had a lot of books, but we talked a lot about his book, The Power of When, which is about the different chronotypes that affect sleep, as well as pretty much everything that you do in life. He's also the author, as well as a lot of other books of the upcoming Energize!, which is about body types and how that relates to everything. That conversation was amazing, you guys loved it, but we didn't really actually even get into biohacking sleep, which is something I get questions about all the time. Sleep hygiene, all of these devices, and light, and temperature, and how does that affect everything. So, we decided to do a Part 2 and dive into all of that. I'm just so grateful to have you here, Dr. Breus and for your work, and thank you for coming back.

Dr. Michael Breus: Thank you for having me. I'm excited to be here.

Melanie Avalon: When it comes to sleep, there are the various chronotypes like you've talked about and I am a resident dolphin insomniac. I do all of the things, literally, all the things. But my question with that there and maybe this is a good moment to recap what your chronotypes are. Do some people need to pay more attention to sleep hygiene than others based on their chronotype or would everybody benefit from doing “all the things?” What are your thoughts on that?

Dr. Michael Breus: It's a great question and it's got an interesting answer, which is, yes and no. Yes, there are certain chronotypes that will benefit more, but no, all chronotypes will benefit a little bit. What does that mean? You are the chronotype that actually would be able to get the most benefit from sleep hygiene recommendations. Part of the things that we know about dolphins, which is the fourth chronotype, these just to remind people, again, are people who are very intelligent, a little bit on the anxious side, a little bit on the OCD side, and so they are high energy, very good at what they do, but difficulty sleeping, oftentimes insomniacs, and are just running at a different speed if you will. What we find is that some of them are genetically not great sleepers. That being said, we try to do everything else in the environment in order to help the sleep that they are going to get. Dolphins in particular, we like to have a good sleep environment, good sleep hygiene, and we'll talk through all of those points. 

Lions can sleep through just about anything. They're usually athletes. By the way, lions, again are early birds. That's my new term for them. But these are usually my COOs of a company. They're the people who are managing people, getting up at 5 o'clock in the morning, all of that kind of crazy stuff. They sleep so well, generally speaking that they don't actually require a whole lot more. Now, wolves, on the other hand, that's my chronotype, by the way, are the night owls. We have a tendency to not even go to bed until midnight most nights. And so, if things aren't in a reasonable environment from a sleep hygiene perspective, it could be 1 o'clock in the morning before we go to bed.

Melanie Avalon: That is crazy. Yeah, I historically thought I was a wolf when I just briefly heard about the chronotypes. But then I read the book and I was like, “Oh, this is everything about the dolphin is me.” I'm sure you get this question all the time, but out of all the things you can do, is there one thing that is the most important, like, controlling the light, controlling temperature, controlling the sound?

Dr. Michael Breus: Actually, there is, there is. This is a strange one, though, but it's less environmental than you might expect, but it's waking up at the same time every single day including the weekends. If you could only do one thing, let's say, you're willing to make one change and that's all you're willing to do, waking up at the same time every day does two very important things and it's specific to melatonin. When you wake up, let's say at 7 AM every day, if that's what your chronotype tells you that you should be doing, so that would probably be a bear chronotype, two things happen once you get light into your eyeballs, which of course happens the moment that your eyes open. Number one, the light signal, the blue light, in particular sends a signal to your pineal gland to turn off the melatonin faucet in your head. But there's a second thing that happens at that very moment and it actually sets a timer for when the melatonin should start again. If you wake up at the same time every day, it makes it much easier to fall asleep when you want to at night, because the consistency of the melatonin production when it starts the timer. 

Melanie Avalon: I was going to ask, was the sleep hygiene? Was it starting more in the morning than the evening? So, I guess, looking at it that way timeline wise, sleep hygiene starting in the morning, your wake up, is there anything else to focus on, the bright light exposure?

Dr. Michael Breus: Sure. Here's the thing that's so interesting when you talk about sleep with people is, people don't usually start thinking about sleep until night. That's almost too late, right? I want people to start thinking about sleep when they wake up in the morning. I know that sounds a little crazy. I am the sleep doctor and all that kind of stuff. But if you start to really get into the habits in the morning time, it makes the nighttime so much easier. The first habit I talked about, of course, was waking up at the same time every day. The second habit that's equally as important is getting that sunlight, that dose of sunlight. How long should it be? Usually, somewhere about 15 minutes. I prefer people to be outside in the fresh air. There's actually data to show if you get Sun through the window, it's less effective from a circadian rhythmicity standpoint. That doesn't mean during January in New York, you need to be going outside for extended periods of time. We're only talking about 10 to 15 minutes here, folks. That's number one in terms of being able to help you with that. 

But number two, that's about the amount of time that your body needs to start the development of vitamin D, which is of course, something that we get as a reaction from the Sun. Having that exposure in the morning to light in particular turns out to be incredibly, incredibly important. But doing it on the outside adds another feature, which is fresh air. And so, a lot of people don't know or think about it, but the air quality in your room can absolutely have an effect on your quality of sleep. There was a recent study from NASA that came out that was looking at temperature, air quality, and humidity. What they discovered was that of course, we all know it's better to sleep in the cool. However, there is a lower-level limit there of approximately 65 degrees. You do not want to go sleep in a room or in an environment that is under 65 degrees. The reasoning for that is, your body, when it hits REM sleep can't shiver, because it goes into a state of paralysis, which is supposed to happen. But if it's 65 degrees and your body ain't moving, you're going to get cold fast and your body is going to pull you out of that REM sleep. Understanding how temperature affects you throughout the day turns out to be incredibly important in the evenings. 

The second thing that you really want to do is hydrate. So many people don't recognize the fact that they wake up dehydrated. I think we talked a little bit last time that sleep in and of itself is a dehydrative event. We lose almost a full liter of water each day. The very first thing that I like to have people do, well, let me back up. The very first thing I like to have people do when they wake up in the morning is swing their legs over to the side of their bed, and sit upright, and take 10 full deep breaths. People always like, “Michael, why do you want to do that?” Number one, it's a good way to wake up your respiratory system. But number two, it helps you become centered and present. That is one of the most important things that you can do to start your day. Once you do that, you want to drink at least 15 ounces of water long before you hit the caffeine button. Because hydration is the key factor for number one giving you energy throughout the day, but also, helping you sleep at night. 

Then the third thing is those 15 minutes of sunlight that I mentioned before. I like to get people to start a little morning routine, if you will. Now, of course, there can be variations of this. People can throw exercise in there for certain times for each chronotype. But being able to have that morning routine really sets the pace for your day and oddly enough, it really helps at night. Now, if we switch to the latter part of the day and we start to look at what are the things that we should start doing to set us up for a good night's rest, here's a couple that I always recommend for people. Number one, if you're going to be a caffeine drinker-- Would you believe that 62% of people drink caffeine every single day? That's crazy statistic, right? No nutritional value for caffeine, by the way. No reason to have it in your body.

Melanie Avalon: I thought it'd be more, maybe.

Dr. Michael Breus: Yeah. Well, every day is the key. If you ask them during the week, it's over 90%. What we know about caffeine is, it has a half-life of between six and eight hours. During the daytime to help set yourself up for better sleep at night, my recommendation is always to stop caffeine by 2 PM. Again, if you figure eight hours to get at least half of it out of your system, and most people are thinking about that around 10 o'clock, then you're at least got half of that caffeine out of your system. But the truth be told, I'd much rather you stop your caffeine by 10 o'clock in the morning, if at all possible, because the quarter life of caffeine, that's how much time it takes for only one or 25% of it to be remaining is 12 hours. So, if you stop drinking caffeine at 10 AM, you still have 25% of it floating around your system at 10 PM and that's a very small dose, hopefully, to allow you to get better sleep.

Melanie Avalon: I'm already going to make two changes to my routine. I turn down the temperature to 60 degrees at night, maybe I should make an adjustment there. That's fascinating about the shivering. I did not know that. I wonder if people who have more brown fat, so they do the non-shivering thermogenesis if they can tolerate colder temperatures at night with the REM sleep.

Dr. Michael Breus: Probably. 

Melanie Avalon: Wow, that's fascinating.

Dr. Michael Breus: I think that can change over the course of time. As you get more cold tolerant or if you live in that universe, right? If you live in upstate New York, or Toronto, Canada, or Sweden, [laughs] it's pretty cold and those people have a little bit better adaption. So, they can go a little bit colder if they want to.

Melanie Avalon: It's so fascinating. I love it. And then the breathing, I definitely need to integrate that into my routine. It actually made me think of a question that's a little bit interesting. What if there is something that is working for you in your sleep hygiene habit that is not what is normally prescribed, specifically, when it comes to electronics, and social media, and things like that? For me, two things that I do that I know are not normally prescribed. I find that if I do right upon waking, check an email or something, it gets me going because I tend to be a little bit groggy in the morning, and it wakes me up. And then on the flipside, I do really well reading at night, but it's on an electronic device while winding down. What are your thoughts on that electronics and sleep hygiene?

Dr. Michael Breus: Absolutely. Let's talk it through, because it's not as complicated as people like to make it, okay? Number one, all electronic devices that emit light, emit a form of frequency of light, that is called cyan or blue light. It's between 460 and 480 nanometers. The truth of the matter is, you can purchase blue light blocking glasses and you can watch whatever the heck you want all night long. I could care less, because blue light blocking glasses actually work. However, however, there's some things I want to teach your listeners about how to purchase good quality blue light blocking glasses, because these have become commoditized and the quality that's out there, quite frankly, is pretty crappy. Full disclosure. I have my own line of blue light blocking glasses, because the quality out there is so crappy, I wanted to make them for my patients. If people want to check them out, they're at sleepdoctorglasses.com. 

But here's what you need. You actually need the amber colored lenses. People are like, “Come on, Michael, I don't want to walk around looking like Elvis Costello or Bono, or those guys who wear all those funky shaded glasses. I don't want to do that.” The truth of the matter is, there's three different factors with for blue light affecting your eyeball. One is the frequency. While you can coat the lenses, so that it filters out the frequency. Two is the brightness. This is the thing that many people are not doing is they're giving people clear lenses. Clear lenses do nothing to decrease brightness, and therefore, have less of an effect. I would argue almost no effect. The third factor is angle of light. And so, what you want is you want a glass that actually covers a large portion, almost from your eyebrows down to below your eye orbits. That way extra light isn't sneaking in from the sides. If you had those three factors using blue light glasses, you could read on your Kindle, iPad, whatever you want all night long. I could care less. 

However, I do want to give you a couple of tips. Number one, I don't recommend reading nonfiction before bed. A lot of times that has a tendency to be very self-revealing. To be fair, you probably really don't want to think about those types of things right before bed. Go with a fantasy, a romance novel, a fiction book, whatever it is that you enjoy for yourself. I would argue that that would help with less engagement. The thing we really don't want to do when we're falling asleep is do things that would pump us up. I tell people all the time, “You probably don't want to listen to heavy metal music while you're trying to fall asleep. You probably don't want to watch a horror movie before bed.” Those are the types of things that from an engagement standpoint turn out to be far more effective than the blue light component that might be coming from a television, an iPad, or a phone.

Now, I also have to have a little bit of disclosure here to you. In my room every single night my wife cannot fall asleep without the television on. Yep, you heard it here. The sleep doctor himself has the TV on almost all night long. Now, you're going to be like, “Oh, my gosh, this is crazy. This is pure heresy, Michael. What are you talking about?” The light doesn't particularly bother me. Number one, I've been wearing my blue light blocking glasses probably for 30 to 40 minutes before I come into the room and guess what, I put on an eye mask, and I go to bed. The noise doesn't really bother me. If it does, I can use earbuds or ear plugs and it allows my wife to be able to fall asleep. 

Now, I'll tell you something. When I first met my wife, I said, “Honey, we can't stay in the same room with television on.” She said, “Michael, I've been sleeping with television for my whole life. Good luck with that.” I said, “Don't worry, I'm asleep doctor, I'm going to figure this out.” I moved the TV out of the room, she kicked me out of the bedroom. I mean, literally, kicked me out of the bedroom. She said, “The only way you're getting back in here, buddy is if you put that TV back in here.” So, I did and I decided to study her. What I discovered was, she doesn't even watch TV. She actually just listens to it, so her eyes are closed. She tells me that it's just enough of a distraction to stop her brain. Because she calls it monkey mind. Sometimes, she gets in the bed and she just can't stop her brain from going, going, going, going, going. And so, this is her distraction technique. Quite frankly, we stick the timer on the TV, 90 minutes later, the whole thing kicks off and it's fine.

Melanie Avalon: That's incredible. I love it so much. Okay, I love hearing that about the light, and the reading, and that's actually, so every night my routine. I have the blue light blocking glasses on, I put all the filters on the electronic devices to affect the light on the screen, and then I only light my apartment with red light at night. Actually, that's a question I've had. Do you have any thoughts? 

Dr. Michael Breus: Now, that sounds interesting.

Melanie Avalon: Yeah. The red light near infrared therapy devices.

Dr. Michael Breus: On red light? 

Melanie Avalon: Yeah. I use them. My apartment from the outside looks ridiculous, but-- crosstalk] 

Dr. Michael Breus: I was going to say, it must be kind of crazy. 

Melanie Avalon: Do you have thoughts on near infrared, and red light, and if it would have any effect on our circadian rhythm? I've heard that maybe you shouldn't use near infrared before bed, but curious your thoughts.

Dr. Michael Breus: There's absolutely positively no data on this. I can tell you for a fact, because I wanted to create my own red light therapy for bed and I could not find any science to back it up. What is good about red light before bed, quite honestly is that it's not blue light. That's the biggest advantage is when you have a red-light therapy, there's very little, if almost no blue light being emitted. You're basically putting blue light blocking glasses on your eyeballs when you're using red light therapy or having red light therapy. Does it have an effect? Maybe. But again, the effect is more than likely the fact that you're not being exposed to blue light. But as of right now, we have almost no data to suggest that red light therapy could be helpful for sleep. There is one area that I do think that far infrared, red light therapy can be helpful for sleep and that's inflammation and pain. We know that far infrared does have a very nice effect on inflammation and a good effect on pain. Both of those things can of course be highly disruptive to sleep. So, we could say that tangentially red-light therapy can be helpful when it's reducing inflammation and reducing pain.

Melanie Avalon: To that point, I also do a far infrared sauna session every night and I find that that really helps my sleep.

Dr. Michael Breus: That's different because you've got to eat, okay? Remember, there's data to suggest that if you heat the body approximately 60 to 90 minutes before bed and then allow the body to naturally fall back to its temperature, it can be highly sleep inducing. So, the far infrared in the sauna is actually probably the best thing that you could possibly do. Because you lower your blue light exposure and you increase your temperature.

Melanie Avalon: Perfect. Awesome. I love what you said about the engaging and engaging things. Actually, when I'm doing my reading at night, I start with nonfiction because I'm prepping for shows but then I switch to what I call my just fluff reading, just fun stuff because I don't like the engaging aspect. I'd heard that evolutionarily engaging in social media and things like that would be, like evolutionarily, we wouldn't have been talking to people at night, so that it sends the wrong signal to our brain. I don't know if that's actually scientific or do you have any thoughts on that on social interactions at night?

Dr. Michael Breus: I would agree partially. I think that social interactions can be stimulating, but I'm not convinced that it has to do with the reasons that you just talked about. I think that when you talk to somebody and you'd say something that has any emotional valence to it whatsoever, you start a cortisol chain going, it's very simple. This is one of the main reasons why we tell people, “Look don't have big emotional discussions right before bed because if you do, good luck. You're never going to fall asleep.” If you get into a fight with your partner or you're talking with your child and something's not going well, you're going to be up for the next three hours. I would argue that the social engagement actually could be positive and I would also tell you that if it was a positive engagement, then we would have a far greater likelihood of showing optimism. We all now know there's data to suggest that optimism before bed not only helps you fall asleep more quickly, but gives you more positive dreams.

Melanie Avalon: If you are in an argument with your partner, is it better to just table the argument to the next day rather than discuss it then. They say, “Don't go to bed angry.” [laughs] 

Dr. Michael Breus: That is an old tale that I completely understand. It really depends upon the subject matter and the couple. As a general guideline, I would say, if you're going to have a big discussion, have it at 6 o'clock. Don't have it at 8:30 or 9:00. Now, somebody might say, “Well, we got to put the kids down, we got to have dinner,” great. Make a schedule, have a meeting with your partner, and sit down, but just don't do it before bed or wake up early in the morning, and do it then, and then you have a far less likelihood of it affecting you later.

Melanie Avalon: What about sleep tracking? How do you feel about wearables and tracking your sleep?

Dr. Michael Breus: I'm a big fan and full disclosure, I'm the Chief Sleep Officer for Oura Ring, O-U-R-A.

Melanie Avalon: Oh, wait, did I know that? I don't think I knew that. I love Oura. I've had Harpreet on the show twice.

Dr. Michael Breus: Oh, I love Harpreet. He's a great dude. I work with them and I love the Oura Ring. But there's some interesting aspects to it as are all wearables. Number one, just for the sake of information, Oura and Fitbit were just placed on a head-to-head study against all the other wearables. Those were the two that came out on top in terms of being able to accurately measure total sleep time, and when you fall asleep, and when you wake up. Then after that, Oura did a second study looking at accuracy of sleep staging and they are roughly 85 or higher percent accurate in sleep staging, which by the way is the exact same number that we see with full nighttime polysomnography in terms of night-to-night variability. 

Do I like tracking? I do like tracking. However, for some of those dolphins out there, tracking can become obsessive. There is something called orthosomnia, which has started to creep up. Now, that all these devices are out here and that's where people are becoming so obsessed with their sleep data that it's causing anxiety and of course, then more insomnia. If you're not one of those, folks, and you can check your data once or twice a week, then I think there's tremendous utility in being able to track your data. In fact, many people don't know this, but I'm also a high-performance sleep coach. I work with athletes, celebrities, CEOs, and folks who really need that level of assistance. We work with people to develop their sleep schedules in this very manner.

Melanie Avalon: That's incredible. Yeah, with Oura, I actually, despite being like the biohacking person, it took me so long to actually get one because I was so worried that it was going to make me neurotic. But what I love about it, I love how it talks to you, though. It's very kind, it's very understanding. When I got it and it was telling me that I should go to bed at 1:30 AM, I was like, “Okay, we're good. It knows, it knows. When people do have Oura Ring and they get information about their different sleep stages, can you hack your different stages? If it says you're low on REM or low on the different types, is there anything you can do to address that or do you just address your sleep in general?

Dr. Michael Breus: No, there's actually things that you can do to specifically address that. Here's the fun part for me and you know now that your audience is so well versed in chronotypes, what I do is I take a baseline weeklong measure with the Oura Ring for my patients. By the way, all of my patients are required to wear some form of a trackable because I can then dial in and through that trackable and be able to give them real time information. Once we get that all logged in, then we look at them when we move them to their correct chronotypical sleep schedule. And guess what, magically, at least half of the things that they were missing, get better. It's pretty amazing. What we see is when people fall into what I call their chronotypical swim lane, we see increase in delta sleep, which is stage III/IV, which is where growth hormone is emitted, which is where the glymphatic system pulls all those neurotoxins out, so, really good thing there. We also have a tendency to see an increase in REM sleep as well, which is also very beneficial because remember that's the mental restoration where you're moving information from your long-term memory to your short-term memory. Just by adjusting your schedule and consistently, because we talked about waking up at the same time every day, those are the big things that you want to look for.

Melanie Avalon: Some other rapid fire sleep things. I've had James Nestor on the show. How do you feel about mouth taping?

Dr. Michael Breus: First of all, James is a wonderful investigative journalist. He's a dear friend. Believe it or not, his father is a pulmonologist. So, he deals with sleep apnea. When he brought to the forefront mouth taping, here's what I can tell you. Does it work? Number one, you need to make sure you don't have sleep apnea. That is the number one rule of mouth taping. Have a sleep study done, have a home sleep study done, have somebody listening to your sleep. If you snore, you do not need to tape your mouth, because you could have sleep apnea. To be clear, when you stop breathing and your mouth is taped, it is no bueno. 

Now, let's say that you don't have sleep apnea. Mouth taping can actually be very beneficial, but people need to understand the technique. You would not take a piece of tape and go horizontally across your entire smile. It would be a quarter of an inch straight up and down. The good news is, is that if you do snore, or you do gasp, it should have enough lack of stickiness to be able to pop off, so that you can breathe.

Melanie Avalon: Listeners, I have a video on my Instagram of mouth taping to dismantle some of the myths out there about what it might be. Another rapid fire question. What are your thoughts on EMFs? I have an EMF blocking canopy. I stopped using it because I wasn't sure if I had it “installed right.” EMFs in general, Wi-Fi, EMF blocking, clothing, what are your thoughts on that?

Dr. Michael Breus: Here's what I can tell you. If you discover that your EMF sensitive, this could be a big deal. I've been seeing patients for approximately 22 years. In my entire career, I think I've seen three people that turned out to be EMF sensitive. That being said, there are grounding pads that can be very effective. There's now a paint that you can paint your walls and literally create a Faraday cage in your bedroom. There are definitely tools that you can utilize, if you discover that you're EMF sensitive. The next question is, “Michael, how do I know if I'm EMF sensitive?” What I would tell people to do is, if you have some form of a sleep tracker like we were discussing before, the Oura Ring, what I would do is do a week of time with your router off. So, turn the router off on your computer system if you can and see if your sleep improves. That would let you know fairly quickly if you are one of those EMF sensitive people.

Melanie Avalon: Yeah. Actually, one of the biggest jumps I saw on my Oura Ring was when I got this device called a Soma Vedic that is supposed to reduce EMF. I was really skeptical. I didn't think it was going to do anything. But I saw substantial jumps in my Oura Ring. I was like, “Oh, this is pretty impressive.”

Dr. Michael Breus: Yeah. I saw there's now a company in Spain that actually has a mattress. This is even more interesting. It's not just an EMF shield. It actually helps reducing the oxidative stress that's associated with EMF exposure earlier in the day. I've only seen one study on it and it's out of Spain. I've never seen it here in the United States and I just learned about it about six months ago. But there are now people who are trying to advance that technology. 

Melanie Avalon: I am going to look into that. That is right up my alley. I know we don't have that much time, but in the supplement world wise, do you have thoughts on things like CBD? I personally take low-dose naltrexone. There's a lot of stuff out there are there. Or, is there any other supplement that's like amazing theanine, GABA, melatonin? [chuckles] There're so many.

Dr. Michael Breus: Here's what I'll tell you is, I have a very specific philosophy on supplementation. Number one, you got to make sure that your body has what it's supposed to have. Before you go running out and buying a bunch of supplements, go to your doctor and do some bloodwork. You want to look at melatonin, magnesium, vitamin D, and iron. Those are the biggest ones to see if you have any deficiencies in those. If you have deficiencies, this is where you start. You don't just run out and buy valerian and hope for the best. When in fact, it turns out that you've got a vitamin D and magnesium deficiency. If you just fix those, you'd be just fine. I like people to look at the vitamins and minerals and make sure everything in the body is up to par or standard. Then let's see how you sleep. “Okay, Michael. We did that and it didn't work very well. We're still sleeping like crap and we don't know what to do.” If that's the case, there are several things that you want to think about. Melatonin is a circadian mover. Melatonin is not a sleep initiator. Many people think that melatonin is a sleeping pill. Nothing could be further from the truth. Melatonin is a circadian pacemaker. Period, end of story. 

There are two parts to the sleep system. One is a buildup of adenosine to cause your sleep drive. The other is the release of melatonin for your circadian rhythm. You really need to find out number one, are you melatonin deficient? Because 90% of people out there are not. Also, melatonin should never be used in kids. In Europe at high dosages, melatonin is a contraceptive. Yes, you heard that correct. It is a contraceptive. I can't think of anything worse for a young female developing body than administering a contraceptive when it's not gynecologically necessary. I'm not a huge fan of melatonin other than in situations of jetlag, where it is completely appropriate to use. 

Now, there are some people who can use a little small dose of melatonin and it can be helpful. By the way, most people don't know this but the correct dose of melatonin is somewhere between 0.5 and 1.5 milligrams. That is it and 95% of the melatonin is now sold in an overdosage format, 3 milligrams, 5 milligrams, 10 milligrams. It's terrible. Personally, I like to use a product called Herbatonin. It comes in 0.3 milligram and it is 100% organic. If you're looking for melatonin you might want to look there. There is however one group of children that can use melatonin and these are children on the autism spectrum. We have discovered that larger dosages, 3, 4, 5 milligrams can be very effective for helping those kids sleep.

Melanie Avalon: Okay, maybe, one last topic we can end on which is your actual body in the bed. I have two questions about it. One, side sleeping or sleeping on your back. I hear so many things about this. I'm a side sleeper. Is that okay? Do I need to sleep on my back?

Dr. Michael Breus: Well, here's the thing. The most advantageous sleep position is on your back unless you snore or have sleep apnea and that's simply because it's the best way to displace weight across the skeletal frame. The second-best way is sleeping on your side. It will depend a lot on your mattress. If you have a good bed that has enough give and isn't pushing back up against your skin too hard, by the way that's one of the things that's going to make you flipflop and move around in bed at night. Unfortunately, 72% of people I think is the number, people sleep on their sides. We think that has a lot to do with opening up the spinal column and helping it rehydrate those discs. I don't think sleeping on your side is bad. To be fair, I used to be a stomach sleeper for years and years, which is the worst position you can possibly sleep in. I was able to teach myself to rotate to the side. It's been much better ever since.

Melanie Avalon: I forgot about stomach sleeping. I have a mattress cooler which I absolutely love. That's a game changer for me.

Dr. Michael Breus: Oh, dude, I love those.

Melanie Avalon: So, last sleep question. Is it true that the bedroom is only for sleep and sex? Is sex okay in the bedroom or should we actually not do that before bed?

Dr. Michael Breus: Here's what I'll tell you is, it depends on you. If sex is one of those things that helps you relax, then there's nothing wrong with having sexual activity before bed. The data would suggest that many men have a tendency to fall asleep after sex, whereas women have a tendency to be more energized after sex. If you start to look at it from a hormonal perspective, as you know from The Power of When, we have an entire chapter on when should you have sex. It turns out from a hormonal perspective, having sex in the morning is much better hormonally, because all the hormones that you need to have successful sex are elevated where the sleep hormones are decreased. I don't think I have any problem with people having sex before they fall asleep or even when they wake up. Also, the oxytocin that gets emitted makes you feel wonderful and so that's also either a great way to fall asleep or a great way to start your day.

Melanie Avalon: Awesome. Well, thank you so much, Dr. Breus. This has been amazing. One of the things you mentioned was the positive thoughts before you go to bed, and I love doing a gratitude exercise before bed. The last question I ask every single guest on this show, because I just really, really believe in the power of mindset and gratitude is what is something that you're grateful for?

Dr. Michael Breus: I believe in gratitude as well and I also want to highlight that. People should be doing a gratitude list before bed because of this optimism idea. I am 100% grateful for my family, I am 100% grateful for my puppies, [laughs] because they give me so much joy, and I'm really grateful that I have opportunities to educate the world about sleep and the importance of sleep. Very few times as a clinical psychologist, you get the opportunity to help millions of people almost overnight. I feel incredibly grateful for being able to have opportunities like coming on podcasts like yours, appearing on television, having people to my website. So, I'm super grateful that I have the learning and the opportunity to spread that knowledge. 

Melanie Avalon: Well. Thank you so much, Dr. Breus. I as well, I'm just so grateful for the work you're doing. It's changing so many lives. I'm grateful. We got introduced through our mutual friend, Adam. I'll do a shoutout for him, because he'll probably listen. But thank you for everything you're doing. 

Dr. Michael Breus: Yay, Adam. 

Melanie Avalon: [laughs] Hi, Adam. So, I'll put links in the show notes to all of your work. Energize! will have come out by now, but listeners definitely check it out. Any other links you want to throw out there for people to follow you?

Dr. Michael Breus: I'm on all social media that you can possibly imagine as thesleepdoctor.com. One fun little thing is, believe it or not, if you go on TikTok and you search for sleep doctor, I've got quite a few videos on there that are fun, educational, and pretty short.

Melanie Avalon: Perfect. Well, thank you so much. This was so wonderful. Enjoy the rest of your day and sleep well. [chuckles] 

Dr. Michael Breus: [laughs] Thanks. Hey, wishing you some sweet dreams, Mel.

Melanie Avalon: Thank you. Bye.

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