Transcript of Episode #125 SPECIAL ROUNDTABLE EDITION Featuring Dr. Dave Rabin and Mollie Eastman!! The relationship between mental health, sleep and nervous system regulation!

Today's episode is sponsored by Apollo Neuro. Apollo Neuro is the leading doctor-recommended wearable technology. Apollo's award-winning Smart Vibes AI works effortlessly behind the scenes, automatically integrating into your life to deliver gentle, personalized vibrations that activate your vagus nerve, helping you fall asleep faster, stay asleep longer, and wake up balanced, focused, and ready each day. Not only that, but the Apollo Neuro is the first and only wearable that improves your HRV. Apollo is effortless. Simply wear it throughout the day and night and let it do the work for you. It's safe for anyone and everyone with no side effects and is the only wearable that can be worn anywhere on your body. Optimal health requires both the mind and body to be in line, and Apollo is the key to establishing that connection. Check the description below to save $90 with my special discount. Take control over your health today with Apollo Neuro. All right, everybody, welcome back to the Dylan Gemelli Podcast. I have such a treat today. This is not a normal type of show. I have a virtual roundtable with two of my favorite people in the world. First, I just want to fill everybody in on the type of discussion we're going to really get into the neuro side of things, uh, sleep, its effect on our overall health, how these tie in together.

I've got two of the best experts on the planet to get into this. I'm going to talk about all the ways that I'm screwed up and how, and how they've helped to fix me. And, uh, it's going to be a blast. So I have first Molly Eastman. She hosts Sleep Is a Skill. She is one of the prominent figures that discusses sleep along with other aspects of health. Don't get it confused. She is a wealth of knowledge in a variety of places, but she is a specialist in sleep. And then of course, I have everybody's favorite neuroscientist, Dr. Dave Rabin, is the end-all be-all for me on everything neuro-related, mind, body, and spirit connection. He's got The Apollo Neuro, an amazing new book coming out, and together we are going to try to help people improve their stress, their sleep, and their overall wellbeing. So thank you guys for taking the time today. I'm really looking forward to this.

We're not trying Dylan.

We're doing it about this. Thank you, Dylan.

Do or do not. There is no try that easy again. Little Star Wars little way Yoda wisdom.

You know what?

I was reminded of that recently at our local ice cream shop.

A good boy. Wow.

There was a sign that, that a sign with that message from Yoda there, and then underneath it said, no free tastes.

Yeah, exactly.

We're speaking all things health at the ice cream store. I love it.

See, you never know where, you never know where you're gonna find it.

No, no, it's everywhere. It's prevalent. All right. So, all right, now I've spoken with both of you at great lengths on my own show in private. You guys have talked together as well. You're both experts in your field. I really want to start hitting home right now on the effects that sleep is going to have neurologically, how it's affecting our moods, our levels of stress, and then how that correlates into our metabolism and things that you're gonna see on blood panels and some of the big problems that we encounter in today's world and what causes problems with sleep and stress intertwined. And then we'll talk about how we deal with it. So Molly, why don't you go ahead first and just talk about some of the, the key components here that you're finding are affecting sleep negatively?

Ugh. How much time do you have? Uh, the keys, the keys, the keys, the things that are affecting sleep negatively. Um, one of the things that I like to start with that can sometimes be confusing for people, but I think makes a lot of sense, is that in 2001, the EPA did a study and they found that the average person was spending around 93% of their time indoors. And that has divorced us from these rhythms of nature. So when we're divorced from these rhythms of nature, we really lose this diurnal rhythm. And when we learn, lose this, this kind of active by day and at rest at night piece, this makes a big problem for really a lot of aspects of sleep.

Okay. Dave, you wanna correlate in off of that?

Yeah, I, I mean, Molly got straight to the point, I think, right? Which is that all living beings, mammals especially, we'll zoom in on for a moment, live by a circadian rhythm. And that rhythm is their day and night cycle rhythm. And it's a rhythm that's sync— that's supposed to be synchronized with nature. So we are, we are, let's, you know, we can get down to the physics of it, right? Like we're vibrational beings. Every cell has a rhythm at which it's doing stuff. Our breath rate has a rhythm, our heart rate has a rhythm, and we have a day and night cycle rhythm. And women have a monthly menstrual rhythm, right? And there's all these different rhythms and phases of aging and growth. And so day and night is one of the most important that regulates our overall functioning of our nervous system to know that between this time and this time, we should have high energy and be awake and alert and ready to learn and ready to hunt and ready to do all the things that require tons of energy. And then at these times, we should be ramping the body down for rest and recovery and nourishing and reproduction and digestion and like all of that important stuff.

Stuff, right? All the healing stuff. And so when we get exposed to lots of different kinds of stimulation from the environment, number one nowadays probably being your smartphone that's sending blue light into your brain all the time at incredibly high levels of information bombardment consistently. And, you know, that's overstimulating the nervous system and disrupting our natural rhythm because we're supposed to just be receiving light from the sun. Now we're getting light from screens and not just smartphones, right? But all screens we're getting light from and we're getting light from artificial lights that are non-screen artificial lighting and all those, all those lights, unless they're made to not have blue light, have blue light and blue light disrupts melatonin and circadian rhythms and our relationship with natural rhythm, right? So that when we start to do things that restore natural rhythm, that's when we kind of like get sleep back in, in on track and back to health, but it's hard because we have to first eliminate a lot of the things that disrupt that rhythm in the first place. Okay.

So what I always like to do, like I said, it's talk about my, my problems and then correlate this, how we fix it. So this is a really good question, I think, for you both to answer back to back here. So in relation to sleep, so I, I have a tendency, a bad one, to stay up late, 2, 3 AM. And I, and I have so much to do that I should be sleeping till 10 or 11, but obviously that's not going to work with work. Right. So I'm only sleeping and it's not good sleep either to go to bed that late. And, you know, I've maybe 6 hours if I'm lucky. And so I guess my question is one, for people that tend to stay up later, how negative effect does that have on the sleep quality? And what is your recommendation on fixing circadian rhythm? And then in turn, how does that affect someone mentally throughout the day? Is it causing like lack of clarity, brain fog, inability to stay focused? What are some of the things that really have a negative effect for staying up too late and having the improper circadian rhythm?

Because you, like you were saying, it's not where it's supposed to be in the sleep cycle.

Yes. Well, real quick, I think some people like this term that kind of, uh, came up in popularity around COVID, but actually does have some research around it. Which is Revenge Bedtime Procrastination. And yeah, it's a fun little label, but ultimately it points to this procrastinating on the thing that serves us. By the way, I, the way I got into sleep, just for context, was because I did everything not to do around sleep and used to be an extreme night owl, all kinds of issues with sleep. So it's not, uh, I know it intimately, uh, but this tendency to stay steal time from our day, and often that's spilling into our sleep opportunity. So just, you know, one concept to maybe have in the back of our minds. But at the same time, I think overall, whether it's going to bed too early, going to bed too late, one of the things I see every single day for people is this sleep inconsistency. So often like a yo-yoing is what it looks like. So I work with a lot of people with wearable data, so I get to see what the actual results look like with their sleep day in, day out.

And what I often see is maybe one of those nights, like you were speaking to, where people, they stay up later and they're pushing, maybe they're researching, they're reading, whatever the heck they're doing, and then they stay up too late. So then it splits, like cuts into their sleep opportunity. They don't have as much sleep, they build up sleep pressure. So then that subsequent night, often many times we see a change in the following night of what time they go to bed. So what we see there is sometimes people will say, oh, I gotta get this under control. I'm gonna go to bed super early tonight, which sounds really logical and like you are being responsible and getting things on track. But unfortunately, this is the exact pattern or some variation of it that I see all, all the time where people are then making up for that sleep, getting an overabundance of sleep. And so then they keep being in this vicious cycle of now not having enough sleep drive, sleep pressure, adenosine buildup throughout the course of the day so that they're sleepy when their regular bedtime that they would like to have comes around.

And what this all points to is this poor sleep consistency, a routine nature to sleep. And sleep loves consistency. If you don't get much else out of what I'm talking about, just that, that the more consistent you can be with sleep— and especially in recent years, we have more research to kind of support this concept that at certain times, while it might seem counterintuitive, if you are met with this opportunity of, do I sleep in later to make up for, kind of cope with this lost sleep, or do I maintain consistent wake-up time? Actually, it appears that maintaining that consistent wake-up time, even if you get kind of a rough, you know, stretch of night or two, overall it tends to actually support us so that we're not continually weakening that circadian that strength of that circadian rhythm.

Excellent. Dave?

Yeah, it's really interesting because consistency is a key, like, signal to the nervous system of safety, right? Consistency provides familiarity. It provides something we know that's repeatable over and over again that we don't really have to think about so much. And that's like one of the critical factors that allows deep and REM sleep to happen. And deep and REM and sleep in general, because sleep is our most physically vulnerable state. Of existence, right? Where we're basically unconscious for the deepest parts of it. And sometimes, you know, physically paralyzed for some of the deepest parts of REM sleep. So we're, you know, we're pretty vulnerable during those states more than any other. So for us to be able to access those states, we have to feel safe. And that consistency of rhythm around sleep and wake time is so incredibly important because it allows us to just be able to know that You know, around this time we're going to bed, around this time waking up, and you can just outsource that and you don't have to think about it that much anymore. And if you don't hit it exactly, it's okay. But the point is that you have these kind of consistent marks, markers in the day that you can like save points almost that you can like, you know, pin to and around so that you can feel your body knows the familiarity of winding down at that time.

It knows when to release the melatonin that starts the wind-down process. And ideally it's changing a little bit, right? Cuz it's aligned with the sun and the season you're in. Speaking of other rhythms and cycles, right? Like our sleep patterns during the winter are definitely different than those during the summer. And that's okay. And I think that's what I think gets to answer your question, Dylan, about deep and REM sleep and total sleep, because there are, you know, when we talk about sleep requirements for different people, we know that women generally speaking need about an hour more sleep than men. And when they're pregnant or breastfeeding, they probably need even more than that, more than men. And generally speaking, people, we talk about people needing between 8 and 9 hours of sleep at night to be as like healthy adults. But if you're getting mostly light sleep and not getting deep and REM sleep, it doesn't really matter that you're getting your 8 hours or 9 hours a night as much because your quality of recovery is not as good. And so all of our like emotional memory consolidation, all of our long short-term to long-term memory storage, all of the like when the body takes out the trash of, of the waste of the cells, a lot of that happens during deep and REM sleep.

So we have to get those sleep stages, which requires, you know, even more of an emphasis on safety. And I think that's where consistency becomes really important. And, you know, Michael Breus talks about this too, right? Like when you start to get to, and I think the literature shows when you start to get to about 21 days of consistent practice that your circadian rhythm starts to reset around that new pattern, which is why the Apollo has a 21-day challenge because within 21 days you can easily get at least 20 minutes more sleep a night that's concentrated in deep and REM sleep. So that consistency to your point is like spot on. And I think if you actually get more deep and REM, then your, your total sleep time does not need to be as high all the time. So like I will, this, like maybe this isn't the best for my long-term health, but once in a while I, and probably comes from my training in the hospital, I will let, I like to work till 2 or 3 AM too. So I'll stay up till 2 or 3 AM at work and I'll, allow myself to have one morning of sleeping in a little bit, but like an hour or two just to get, make sure I get like 6 hours.

But then I'll go back to my consistent rhythm afterwards and it just kind of restores and it's just fine. But you know, I don't usually find that I have to make that up at any other time.

Yeah. I just wanna underscore that real quick in case, cuz one of the things I see when we talk about insomnia, there's over 100 sleep-wake disorders and insomnia, difficulty falling asleep, staying asleep, early morning awakening. It's an interesting one because that's a group where we might actually think about sleep and communicate our goals with sleep a little bit differently than other sleep disorders. Because often, just speaking in generalities, commonly a lot of insomniacs that have long-term insomnia, they know a lot about sleep and actually sometimes it can freak 'em out more. And I've been there too, to learn more and then start, oh no, well I only got this amount of sleep last night. And now I'm gonna throw everything off and, and a lack of self-resiliency and relating to that ability, um, to kind of get back on track and trusting that ability in, in their bodies. So I appreciate what, you know, Dr. Dave speaking to because it's a big deal. Uh, in that group, a lot of what we're almost, you could almost think of it like exposure therapy to being exposed to times when you're not gonna get perfect sleep and Orthosomnia is a whole conversation when we talk about tracking, you know, really being okay with periodically not getting, you know, 99 or whatever on these sleep trackers and that sort of thing.

And then oddly, that loosening up of the grip and speaking to the safety point can spill into improved results, at least in that group commonly.

Yeah, it's— when I sleep, I mean, I can pass out on the drop of a dime, man. Like, you don't— it takes me like this. It's like the wake up in 5 and a half hours and Queenie put a clock next to me so I'd stop looking at my phone to check the time. 'Cause what happens is I look at the phone and I see 100 notifications and then I start looking at 1, look at 2, look at 3, and then before you know it, you're up. You know? And it, it, the phone is the detriment. What I've tried to do is I have, um, the mattress where you can turn the massager on and I flick it on and it kind of helps me go back to sleep. Just that nice, 'cause I do it when I get into bed and it gives you a nice little rhythm. To try to do it. The problem is, as you know, if you're waking up at 8:30 or 9, even with the sleep mask on, it doesn't seem— I can sense the sun somehow and it makes it hard to go back to sleep. And I think that it's just, it's just not natural.

I think is, is without getting into science or without getting into anything, it's just not really natural for your body. And I know there's studies both ways and everything. And, but I think that that's what it comes down to is you're just going against the grain. One of the things that I try to do, and I'm curious for both of you, ways to wind yourself down properly and then start your day off properly to get into the right rhythm is I always get outside right away, even though it's not early enough and it gets too damn hot here like today, but getting outside and getting in the sun early. I'm trying, and I'm curious what you guys recommend on the wind downs at night because the day, like you said, we have a tendency to work late and that's not really a great, great way to wind down. It's, it's because your mind's still going. And I have a tendency to look at screens, whether it's computer or phone. And then, then because I want to relax, it's like, okay, I'm looking at my sports scores or stuff on my phone. And it's not really relaxing.

So I try to, I've used different types of supplements, don't work. When I use the Apollo, it certainly helps, but I still have the mind that, that I have to get under control. So I'm, I'm wondering for you guys, Morning, night, what's some of the best ways without having to take supplements or medications? What are natural free things that we can do that are healthy, safe, and effective for both of you?

Well, um, real quick, I'll just jump in, uh, with the point that on my podcast I've asked now over 300 people what their morning routine and their nightly routine is. And so you see different, you know, all kinds of variations with everyone, myself included, but. Across the board, one of the things that seems to come up is more of that rhythmic nature, that bringing us up regulation by day and down regulation by night. And really, if we have this opportunity, of course there's always outliers in certain parts of the globe where you get the weird periods where it's 24 hours of sun and all the things. But for most of the time, mostly when we can follow these rhythms of nature, when we can start our day with bright light exposure. Exposure outside. An app I often recommend, it's called My Circadian App, or there's other apps that, right, you can actually just log and see how much lux is in your environment. You don't have to do this for a long time often, but just to get the sense of it, because commonly people have no idea. I know I didn't before I got into all this, that the different, like I'm behind a window right now.

If I just, you know, after this conversation, go outside, the lux is gonna shoot through the roof just by getting beyond that window. And they're different. We might think, oh, well, what's the big deal? And I don't think we're that much different in certain regards. I mean, this is a leap, but if you think of a fern, right? And you put a tarp over it and then expect that it's gonna thrive. We think we're so, you know, without getting any sort of sunlight continually, we think that we're more divorced from that sort of way of being. I would argue that we're not that far up. We need these, uh, kind of elements of nature to inform us. And then we can use those as a blueprint of where we put, uh, what we call kind of chronobiology zeitgebers or time givers. And those can often look like that light-dark timing, temperature timing, meal timing, exercise timing. And I like to put in just for a component of this, like a, the impact to these is thought timing. And so when you speak about, you know, the phone piece and what have you, actually having those those upregulatory conversations, those engaging conversations.

We don't wanna cut those out entirely, but put those by day when we need to handle certain things. And then the juxtaposition at night of the downregulation aspects of thought. Mm-hmm. And the last thing I'll say to that is that we had, um, one of the sleep coach for the Olympics, uh, on the podcast a couple times. And one of the things that he really noted was Uh, in the, for your question around the evening and downregulation, a lack of novelty being the thing that we're really going for. Just boring stuff. Not to make it, you know, miserable.

Thinking. Yeah.

Right. Just familiar stuff. And it doesn't have to look fancy. It doesn't have to be lotus position necessarily. I mean, my husband and I love The Office and we've seen every single episode, so it's very familiar and safe, you know, and now there's a whole stack of things that you could do to bring in safety and routine and joy and peace and all that. But it might look different for each person.

Yeah.

I love the idea you mentioned. Cause I don't think people think about it so much this, the way that we're talking about, which is like the amygdala, which is the fear center of the brain, is a, is not just sensing fear. It's contrast detection, right? So it detects newness and unfamiliarity and novelty, uncertainty. And when you're trying to fall asleep, you don't want novelty. You want a lack, an absence of novelty because novelty is stimulating by nature. Right? It makes the amygdala tune in and be like, oh, we should probably pay attention to this. And we don't, we don't want that. And that's why it's often so hard for people to fall asleep the first night they're in a hotel, even like a really nice new place, but it's because it's new. Right. And then after a few days you start to settle in. So, so yeah, but I think that really highlights the amygdala at the core of a lot of how we think about sleep as being something that requires safety. And when you start to think about safety in that way, you start to realize all the different things that make the body feel or perceive that it might be unsafe, which gets me to my favorite, which is having thoughts about how you cannot sleep for some reason, or how there's something wrong with you that you can't sleep that maybe we came up with on our own, or maybe somebody told us that there was something wrong with us that we can't sleep.

But those thoughts are directly activating to the amygdala because they make us, if there's something wrong with you, then you actually become a source of lack of safety to yourself. Right. And so those are, those are directly inhibiting to access to sleep. So one of the, my favorite routines for people to do, and I did this for myself many years ago for many, many years, and it was very helpful, was just to remind myself rather than like notice when I'm having thoughts about why I can't sleep or why there's, I might be struggling with sleep and then just remind myself instead of thinking about those thoughts, remind myself that I, my body was born to sleep a third of my life and that my body loves sleep and I love sleep and, and imagine myself, like close my eyes and imagine and breathe like I'm sleeping and imagine I'm sleeping right now. And then sleep just started to come more easily because you're just resetting the thought loops that are the disruptive fear-inducing thought loops. And you could do that with, with, that's like the whole practice of meditation. That's just like one iteration of meditation that we can apply to sleep to redirect your attention to something that you can control, which is like rewriting your story around how you relate to sleep as a safe thing.

Yes. When, and we've all talked about this and Dave, you've written about this, you know, that this is my favorite thing to get into is connecting mind, body, spirit together. And I feel that sleep plays like a massive role in that regard when we're looking on a chart of what's most important to make that connection and to to do that. Now, I have tried to read a little bit before bed, which tends to help, like read a prayer for me. I know that's not for everybody, but that's kind of what I've tried to do. But what, what type of role, how big of a role is sleep in, in that full ability to bring health into like full alignment? How big of a role do you guys feel that plays in determining the direction of our health? And when we're looking at diseases and, and inflammation and cortisol and—

Green's the most important. We can stop you right there. Right? Most, most important role.

Yeah. You, the foundational thing you struggle to find if you go to PubMed and put sleep and just about anything that's important to you, they're longevity, aging, cardiovascular health, fertility, diabetes, your waistline. Like, I mean, the list is endless of really good mountains of research in many aspects of health and wellbeing. And I think it's one, I'd hope one of the reasons why we're starting to have a bit of a sleep renaissance, and maybe it's the combination of getting conversations like this out. So I appreciate you having a forum for this. Maybe wearables, something seems to be in the air where people are beginning to get the message of how important this is. Um, And, you know, Dr. Dave spoke to glymphatic drainage, glymphatic drainage with a G versus lymphatic drainage with an L is, you know, really was only discovered around 2012. And now our understanding of how this helps cleanse the brain predominantly in the first half of sleep, largely around deep sleep. And when we see that there's a huge impact on, um, cognition. So previously when we think about possible correlations and linkups with neurological disorders like Parkinson's, Alzheimer's, dementia, we might not have thought that there could be things that maybe we could do decades in advance to support general health and wellbeing in that area in the terms of cognition.

And yet it looks like sleep could be one of those things among many other things that can make a difference for your health.

Sleep, getting good deep sleep and good overall sleep architecture definitely prevents dementia. That's like the, probably the single best thing that we could do on a regular basis that would prevent us from getting dementia. Cuz it clears amyloid protein plaque out of the cerebral spinal fluid. So we now know that, like, that's pretty darn cool, right? Like, that's the time where the most amyloid plaque that builds up over the course of the day of using our brains and our brains being stressed out from day-to-day activity gets actually cleared and digested and broken down. And that stuff is the stuff you don't want to accumulate and sit around, right? Cuz when it sits around, it gloms together and kills cells. So getting that good, great sleep architecture ideally, which is not without med— not without substances. Like some supplements can be okay if they're dosed and the right, the right kind, but prescriptions, sedatives and hypnotics and alcohol all impair access to those deep and REM sleep states. And that's probably in part why we see that people who take benzodiazepines and opiates and alcohol have increased risks of dementia when those substances are used long-term because they're also not getting deep REM sleep where you, that you need to clear.

And, and the early, you know, the the, the good, good architecture that allows you to clear your body, to clear all that waste. And so, yeah, but I think that amygdala piece is really important because safety is at the, at the core of how we get the body into a state that it allows its maximal waste clearance functioning to happen, which the downstream result is preventing horrible outcomes that we, none of us want, like dementia, right? When we think that, like, we make it so complicated in a lot of ways, but trying to break down what's happening with each individual diagnostic category, but that's not necessarily what matters, right? Like it's not about the name of the diag specific diagnosis or kind of dementia because when you really look at what's happening to the cells in those disorders, they're all breaking down and getting screwed up the same way. It's all accumulation of misfolded protein that gets accumulated because the body's not clearing enough waste, right? So there's like common mechanisms now that we understand that help us to also understand why sleep is so important and how to prevent some of these things we never knew we could prevent before.

And technology can now help, which is really exciting. Like Apollo is actually improving deep— is the first technology that has been proven to boost deep and REM sleep architecture in people just by wearing it, right? Like there's nothing that you can wear that just boosts your deep and REM sleep percentage of, you know, architecture over time and improves your body's ability to get deep quality rest when you're in bed. So like that's not gonna be the first technology of its kind, right? Like hopefully we see lots of technology that starts to be working in the same way where we can improve the way that the body's functioning as like an AI assistant to your, to your health system, right? Not to just your, your essays and schoolwork, but like actually to your body's ability to maintain its own circadian rhythm. Like AI can help with that. It can run in the background when we're unconscious, you know?

Yes. You know, I love these because we get deep into it and we get a really nice thorough explanation. I'm gonna do it on a different angle. I'm gonna do it on the obvious. So like for instance, it's very common understanding and sense that when you have a nice good sleep, you generally don't wake up groggy. You don't kind of have this, it takes you forever to get outta bed feeling. You, you look at something and it's very clear. If you don't sleep well, you're groggy, you have trouble getting up, you don't want to get up. If you look to read something, it's not it's not setting in, like it's not absorbing. I read prayers in the morning when I wake up, and when I have a bad sleep, I don't absorb it. My eyes start to fall down. I don't do well right off the bat. And so it's, it, it's like also when you take a drug, even over supplementation, like way, this is way back. So, you know, this is prior time for me, but I would sometimes take NyQuil at night to try to help me sleep. Even went as far as to take Xanax at night or muscle relaxers that I had for injuries.

And you wake up feeling like you had a party night, like you were up all night drinking. You wake up feeling horrible. Now, I told you guys, I did like a nervous system reset last week and I went to bed at 10:30 and woke up at 8 o'clock and they were knocking on the door to wake me up. And I haven't slept like that in, I think since high school. And it was the best feeling ever. Now, of course, I fell right back into staying up late. But the point is, is some of these things are quite obvious to people, yet we still do it. And I see the alternatives now, and that's where I want to shift to in talking about this. So obviously I have the Apollo on, and Dave, I want to talk to you about that because my problem with the Apollo is I'm so focused wearing it during the day and I get so intertwined at night as I pass out without putting it on when I wear it all day to help me throughout the day and don't use it. I want to talk about using it at night more so.

And then Molly, I want to tie that into how that correlates with Oura, how we look at these results, how we interpret them and, and see how it's impacting us and the things that we need to be looking at. Maybe we'll touch on HRV, 'cause a lot of people still don't know about it, don't know what it means. Think of the lower numbers better, like there's confusion on it. So I'd like to discuss all of these, how it works together and the, the proper ways to utilize this to get the best out of it. So Dave, like, talk about how do we wind down with the Apollo? How should we use it? What mode should we be on and when? And to get the most out of it. And then Molly, maybe you can talk about interpreting the results and an understanding. You can both talk about some of the data points that we're looking at because it's confusing, man. You pull these things up, you don't even know what the hell you're looking at, and you look for reference ranges or things that might not even be accurate.

Oh, for sure. Yeah, I'll do, I'll do a quick overview of Apollo and then I'll pass to Molly. But I, so I think the Apollo is a technology that we developed that's in the same context and based on the same understanding of circadian rhythms we've been talking about this whole time that Molly first started talking about where the body operates on a day and night cycle and it likes to be on a day and night cycle that's consistent with the sun and the moon. And that is our baseline. So when you asked Molly earlier about what should people be doing to help them feel more energized during the day and wake up more easily and fall asleep at night and have an easier time going to bed at night. What did she do? She told you what we tell all our patients and what we try to do our best ourselves, which is that she curates her environment, right? To be more energizing and more wakeful and to do more wakeful and focus-related activities that require more energy during the day. And then she has more relaxing, more soothing wind-down type activities that happen at night.

Which probably goes down to her lighting and the kinds of music she listens to and the kinds of things that might be on her TV or where her phone is located in her house, right? Who she talks to at different times, everything. And so we have the ability to curate the surroundings that we, that we, and that's a very special opportunity that we've been afforded as human beings. So that in aligning that curation, like in the music, for, for example, with our bedtime, so it's calming and soothing music and not energizing and new music that helps the body know, especially if it's the same song every night, we do this for babies, right? And it helps them wind down and start to naturally allow entry into sleep states because of the familiarity. So we wanted to create something like that for people that didn't require music and didn't require your ears or your eyes or any other thing, because those were already being used in and people were still struggling with sleep. So we realized that soothing touch is one of the fastest pathways into the safety nervous system. In large parts, you're studying music, MDMA, and other touch-related healing techniques that work with the safety pathway and the vagus nerve in the brain.

And we found that soothing touch activates the vagus nerve immediately. And so started composing soundwave songs using soundwaves for the skin and the touch receptors in the bass, like subwoofer frequency range. Instead of the ears. So to the body, Apollo is music and it feels like a mom, like rocking and shushing a baby back to sleep or, or like being, you know, in the womb. Like the idea is that it kind of reminds the body through the skin of a familiar feeling of safety that is much slower and deeper and more soothing at night and like right before bedtime and then in the middle of the night and then is much more energizing and vibrant during the day. To give you more energy, but still feel safe and in control in your own body. So it's all about circadian rhythm regulation and just giving the body the right signals that align with your goal energy states and the app, you just, you can do it on demand, but you just, and if you have an iPhone, you can try it by downloading the app on the iPhone, Apollo Neuro app now and join in with us.

But you can basically just set your bedtime and your wake-up time and it will keep you awake between those times and keep you asleep between the times you want to be asleep. And That's it. And when you just get that consistency down with whatever tools you have, this being one of them that actually boosts your deep and REM sleep, you know, effectively via Oura and total sleep via Oura from the study that's coming out should be this year, hopefully, uh, in 1,000 people. But we can actually see that people strongly benefit as much as Ambien or other leading prescription sleep aids from using tools like Apollo. So this is really, really exciting. Now there's other options, right? You don't need to rely on some of these sedative sleep aids that cause, like Ambien has terrible side effects, right? Like you, I've had patients who've eaten the entire contents of their refrigerator and then woken up with a sink full of dishes, you know, and they have no idea. And then they gain like, like 50 pounds in a month and they have no idea what's going on. And we're like, you were sleep eating, right?

Like who needs that? No one.

No one needs that. Yeah, exactly. Oh my God, that's amazing. Yeah. Well, real quick, cuz that's such a soapbox, um, conversation for me. Long-term use of these different medications of benzos and Z-drugs for sleep. And of course there's exceptions and what have you in certain situations, but they're really not approved for long-term use than the way that we're seeing them. So if they is dealing with that, I do just wanna put out a couple different resources, or one key resource is Benzo Information Coalition. They're a nonprofit dedicated solely to helping to educate around some of the perils of utilizing these things. Um, over the long term and what can come up. So I'm so glad you spoke to that. Um, and I'm so happy that we're starting to see more things that, um, could be from a more holistic approach that can make a difference with our sleep. Because so often people hate some of the stuff I'll often say around sleep cuz it's like, oh, okay, so mostly it's boring stuff. Mostly it's doing the same thing fairly repeatedly, and of course we're gonna have spontaneity here and there, but a lot of it is, can we maintain a level of routine to our, to our days and to our nights?

And so having something else external that could help support that experience is exciting because really in our modern day and age, we need a lot of that to support that. So what do we see with wearables? Lots of things. And now granted, wearables might not be for everyone. Uh, there's certain Use case.

You're referring to wearable, wearable trackers, right?

Yes. Wearable trackers. Yes. Thank you. But good distinction. Wearable sleep trackers. Um, as opposed to, I can't imagine that there's many people that couldn't wear an Apollo, is there? Right?

No.

I mean, Apollo, Apollo works with, like, has a partnership with Oura, so they work really well together. But yeah, I mean, Apollo can work for anyone who's trying to make their sleep better, right?

Like young or old.

You don't have to.

Yeah.

Yeah. You, yeah. And you, you don't have to look at the data either. The data is like an optional part of Apollo. The main purpose is just to help you sleep better. If you wanna look at the data and see your sleep improvements, you can, but it's cheery. It's not about like, you know, you slept terrible last night, fix it, or else I'm gonna tell you you slept bad again.

It's again and again. Yeah, exactly. Cuz that's what will, you know, there's a certain group that might do well with wearable sleep trackers that the whole design is to open up and maybe get some sort of score. There might be periods of time where a little statification or updating could make sense for for some groups. However, mostly what I'm seeing in the, the groups that I'm with, um, is often really empowered if, you know, kind of educated and looking at the data in a way that can work for them. Um, so what I mean by that is things like Oura, Whoop, there's certain brain-based trackers, there's other things that you can do to get this information. But on a daily basis, you get to see certain things, not only around your sleep, and some of this can really act as red flags of where you might wanna get tested for sleep disorders. I am a bit bit bullish on that. I would love to see everyone tested not just once, but multiple times throughout the course of their lives for sleep disorders, kind of akin to how we would get blood pressure tested whenever, just do it one time and then make all kinds of recommendations off of that for the rest of your life.

As something like sleep apnea, very prevalent, is very dynamic and it will shift and change throughout the course of your life. Even if you didn't have symptoms of that before, it might show up as as you age and things change. We can see signs of possible sleep disorders, lots of restlessness, you know, lots of movement showing up on your wearables. If we're seeing kind of fragmentation throughout the course of your night, lots and lots of wakeups, and often that maybe you don't even remember, that can be another sign that we might wanna get tested and make sure we're not stepping over some of those sleep disorders. But then even beyond that, I would also say, of course, in that sleep category, we can make lots of information, see and glean information around, are we spending too much time In bed, that's another really common one. Ironically, when we're dealing with things like insomnia, a lot of people will spend inordinate amounts of times in bed to try to squeeze out a little bit of sleep, and then they start having kind of counterproductive experience and relatedness with their bedroom. They're actually the one group that if you travel, as opposed to most of us will experience what Dr. Dave was speaking to, that first night effect when you're traveling where you, you know, just You're not sleeping the best.

Insomniacs sometimes can be the only interesting group where, because they don't have prior history related to this new space where they might actually sleep decent because they don't have all that negative, um, you know, kind of conversation in the background. This is all the thinking wants of sleep, right? But with our wearables, when we look at things like heart rate, respiratory rate, heart rate variability, body temperature, blood oxygen, you mentioned HRV, you know, really the time between our heartbeats, and it can give us somewhat of a proxy or, um, a estimation of how our nervous system is faring day to day and moment to moment, second to second. And what's interesting is now some of these wearables will also show us your daytime stress, which can get a little layered because sometimes people now get stressed about the stress metrics, which can get very meta. Um, but what's really cool about that is it can speak to what we've been chatting about around these rhythms of if we can kind of have a bit more of a pulsing of engagement, to say the least, or, you know, activation by day and then a clear kind of sloping down into the evening of downregulation and all those kind of connected metrics.

So body temperature's starting to cool, heart rate's starting to cool, to lower, and then heart rate variability starting to to your point, go up a bit from your baseline as opposed to some people that will get confused. It's supposed to go up, it's supposed to go down. Uh, it's a longer conversation, but ultimately we're looking to find kind of your baseline. And then from your baseline, if we are seeing trends where it's dropping consistently below that, it just might give us pause to see, is there something that's impeding our ability to recover? If it's markedly dropping, we really wanna kind of take a look. And then in the other regard, if it's going above our baseline, that's often, these are blanket statements, but often, uh, a sign that there's, we've been able to kind of recover throughout the course of the night. There are exceptions, arrhythmias, certain, say if you get surgeries or kind of instances where the body is kind of forcing a parasympathetic response, you might see some abnormalities. But mostly you can pan back, pan out, look at your trends, and then really get a clear, um, whole slew of information around how you're faring as it relates to your daytime stress load and your nighttime stress load.

And often they're very much coupled because I guess what I'll end with is that largely how we are by day gets mirrored in our nights. So how we are by day tends to get mirrored in our nights. And you can see that with, um, the connection with Oura and Dexcom to the tune of, I think it was around 75 million. To demonstrate the connection with metabolism and sleep. So you can look at your CGM data and overlay that with Oura Ring and see, I'm spiking and crashing my glucose day all throughout the day, and it's also happening at night, and it's correlating with some of those wakeups that I'm having consistently as a example, right? So yeah, it allows you to get really deep into this information and then make it practical so that we can ultimately not have to think about it that much.

One thing that Molly, we've talked about this multiple times and you've brought it up multiple times, is like the overdata. We have to be careful, but we do want the data. So you have, you have to use the data as a tool, not as something that you just live and die by. It's, it's just there to give you guidance so we know what to fix, but don't let it dominate your thoughts or it's gonna have an adverse effect. I'm a, I, everything I do is based on data, but I've learned how to temper what I'm reading and looking at and going, Okay, dude, like, this is what you need to fix. Just chill and do it. You know, you have to talk to yourself and tell yourself that. So don't let our tools that are helping us actually go against us. Just be careful with that, you know? And so I— there's one more question I want to ask you guys, because you would know this better than anybody. And Dave, every time I've ever seen you do an interview, talk with you, doing interviews on here, you always have a Wired set on. And it's— I know why.

Because of the, the EMF and the protection. I get asked constantly about Oura, about Apollo, about wearables, and I think it would be good to end on this. Could you just clear up some confusion on EMF concerns with certain wearables? And if it is something that people need to be aware of or worried about when it comes to specifically, especially Apollo and Oura, but anything in general, things that, that come up constantly in comments that I see that are like kickbacks or serious questions are what about the EMF with these?

Yeah, I think this gets into what I wanted to mention as a good segue from our prior conversation about trusting your body, right? Like data is, is measured, is a way that we're trying to measure what's happening in the body with feeling that we're actually feeling, right? So it's not, it's a way to observe certain patterns, but every time you measure something that's happening in reality, you're getting one degree of separation away from what's actually happening. Mm-hmm. Right. There's somebody now observing what's happening and trying to quantify it. And so when we measure that, you lose a little bit, right? That's why every single test that we have in medicine has a false positive and a false negative rate. There's a chance when you run any test, whether it's a wearable or whether it's a blood test, that that test is gonna incorrectly be positive or negative, right? There's a certain small percentage that that's gonna happen every time. And I think that's not, that's not really taught well. So like a lot of people outsource the truth to their wearable devices. And their data, but the data is just an observation that is off, you know, for sleep and HRV and heart rate is mostly correct for most people, but for deep sleep and REM sleep and actually sleep staging, it's incorrect for many people.

It's only about 65% accurate at best, deep sleep and REM sleep. So, you know, we need to be looking at these things. We need to be taught how to look at these data correctly and to understand what the, the truth comes from feeling. So if you wake up feeling good and rested, I get this with my patients all the time and I talk about it in the book that I've coming out, A Simple Guide to Being Alive. But these stories about people who, so many people who I've met over the years who tell me that their, their tracker data is telling them that they sleep terribly. But when I actually ask them how they feel, they say they feel fine. And so I'm like, well, did you actually sleep badly or is it more likely that your tracker had an error and you're actually trusting the data more than you're trusting your own self? Like try sleeping without the tracker for a few weeks and see how you feel. Like take a, take an old school sleep diary. And I would tell you like at least 50% of those people don't come back for another appointment because they're so attached to the data.

Right. And so, and so I think like with, with the going back to the Bluetooth and trusting your body piece and the headphones, for me, like I haven't seen, I, I don't, I look a lot of research. I haven't seen a lot of good clinical research studies showing that EMF that comes out of our phones and our, and our headphones and at the levels that we are exposed to causes any significant problems for people long term. But I know, I know that I get headaches from using Bluetooth headphones and from putting my phone close to my head. And I don't, I don't like getting headaches, and I don't like to think about what's happening in my brain when my head, my head hurts from putting this thing next to it. And so that's enough for me. And so I just stick to my wired headphones that don't give me headaches. Yeah, you know, but I'm not waiting for the data to tell me that it's screwing me up. It's gonna be too late by the time that I love it.

Uh, yeah, real quick, I'll just say that, um, on the conversation around wearables and data and trusting your body, yes. Uh, I was just in a, uh, piece in New York Post all around looking at a deep dive around orthosomnia. So if people are thinking that, oh, maybe that's me, that could be some more information. And ultimately, I think everything I do day in, day out around sleep and wearable data is this very fine line of both educating. And then educating from a place that ultimately we don't have to think about it. It's true. It's a very tricky thing because you can— automation, right? It's, it's a little, it's hard to balance that because often when sleep isn't working, you're, well, just, we want to effort, especially if we're achievers and we say, well, just gimme the information. I'll read the books, I'll do the things. And oddly, this can often backfire. But see, you're really important points. So, um, what I would stand in is this concept of sleeping a skill. And there is conversations and there's elements of some of the things that we've been speaking about today that often hearken back to ways of being that maybe just would've happened nature, uh, naturally if we lived a bit more in rhythm with nature.

And a lot of it is that. Um, and I think that's what Apollo is really speaking to, is to have this sense of safety, wellbeing that often comes in the simple things in observing sunlight, you know, kind of downregulation and quiet evenings and all these things that maybe we've moved away from.

Getting cuddles.

Getting— well, isn't there like a hug feature too? One of— yep. So come on.

And Apollo and Oura also have airplane mode. So all wearables that are worth their salt have like now have an airplane mode in them so you don't get any Bluetooth radiation. You can wear them all the time. There's no Bluetooth, no EMF at all really from those devices. So that's great. So now like devices are getting designed around our needs. Finally.

Absolutely. And when it comes to sleep and EMFs, largely, even if we're, you know, oh, look at that. Okay, very well.

Always in focus mode, Dave.

Dylan loves focus mode.

He is. It's, I wonder this guy. But ultimately when it comes to sleep, we don't really need too much going on. We could argue. And so whether you're just staying a little conservative, there's not much that we need to have in our kind of fear to, to David's point that the companies that are being thoughtful around this often provide ways so that we can have that airplane mode so we can have the peace of mind, which is really what we're going for, I think.

Yeah, I love it. You guys are amazing. I love doing this. We should try to do it more often that, you know, I, I was joking with Molly cuz I said, oh, I sent my mom and my wife to go get their nails and toes done for Mother's Day. And I said, and I'm just gonna work, but this, this is just fun. It's not work. It's just a pleasure and it's fun. And it's, it's always so nice to talk with, with you two and to get this kind of information out. And it's fun and it's helpful. And I hope that people really take the things that we're teaching to heart and prioritize something like sleep, prioritize their mental health, and listen to people that are taking time out of their day on a Friday to record when I know that, you know, We all have certain things family-wise and things that are going on, but we want to put this information out for everybody. So I appreciate you guys tremendously. I will link everybody where to follow you. And these are, remember everybody, I bring on experts like this that are the best at what they do for a reason, and they're trying to really make a difference significantly for all of us.

So Molly, Dave, thank you for not just this, but every single thing that you do and for being such good friends. With me personally and the things that I get to learn from you selfishly on my own that I get to share with everybody else. So I appreciate you guys thoroughly. I really do.

Our pleasure.

Thank you so much. I so appreciate the work you do and thanks for creating a forum to talk about my favorite topic on the planet. So really important. Really important.

Yeah. Really appreciate it.

Well, I love you guys. You know that. And I want to thank everybody for listening. So stay tuned for plenty more to come. Dr. Dave Rabin. Molly Eastman and Dylan Gemelli signing off.