Webinar recording - Stress less, sleep more: a sleep workshop with Dr. Michael Breus

Watch Webinar - Stress less, sleep more: a sleep workshop with Dr. Michael Breus

Join Apollo Neuro co-founder and inventor, Dr. David Rabin, MD, PhD for a conversation with Dr. Michael Breus PhD, also known as The Sleep Doctor™, for a workshop on improving sleep by managing stress. This is the most frequently requested expert topic, and we’re thrilled to bring this to life. Please join these two renowned experts for a deep dive into your relationship with sleep in order to change sleep habits immediately.

Dr. Rabin and Dr. Breus discuss:

  • How to change the way we think about sleep
  • The top advice Dr. Breus gives patients
  • How to manage stress throughout the day to allow for better sleep
  • How to use the Apollo wearable for better sleep
  • Methods for bringing stillness to the mind and body so you can sleep
  • How they personally use Apollo for improved sleep, plus personal tips and tricks


Transcript

Dr. Michael Breus (00:20:04):

So, hi, everyone. Hopefully, you guys can hear me. If you can hear me, somebody, do me a favor and throw something in the chat. Oh, there we go. Thank you, Chuck. Thank you, Sparky. Oh, there we go. Wow, we've got a lot of people here. That's amazing. So, I know that Dr. Dave is having some Zoom-related issues, but don't worry. He's going to be here soon. So, what I thought I would do is do a quick introduction of myself. Some people here know me. Actually, I saw an old friend from LifeVantage that swung by here and then an old friend, Dr. Jim Moss, I think might be in the audience as well. So, lots of fun people here, lots of people here to have a good discussion about sleep.

Dr. Michael Breus (00:20:46):

Today, what Dr. Dave and I were interested in was talking about the effects of stress on sleep. So, Patricia asked me, "Is this an Oura Ring?" Yes, Patricia, it is an Oura Ring. And we're going to talk about Oura in a little while. We've actually done a wonderful study with them. Also, people out there who have Oura, we actually have something that we want to maybe have you get involved with us as well. So, we're super excited. It looks like my good friend, Dave, is getting here quicker. I saw him jump. There he is. He's on the green screen. Perfect. We're definitely trying to get you there. If you want to tilt your camera down, Dave, can you tilt your camera down?

Dr. Dave Rabin (00:21:29):

Yeah, yeah, Zoom has been really killing me today.

Dr. Michael Breus (00:21:33):

Don't worry about it. It's no big deal.

Dr. Dave Rabin (00:21:34):

Sorry, guys. We are almost there.

Dr. Michael Breus (00:21:37):

There we go, and you have the beautiful background just showed up. I love it.

Dr. Dave Rabin (00:21:43):

Thanks, Zoom.

Dr. Michael Breus (00:21:44):

Yeah, Zoom has been a little bit crazy. And let's be honest, the world is a little bit crazy right now. So, it's okay that we have a little bit of this this morning. We're all humans and we're all excited to be here to talk about sleep. Oh, thank you, Carrie, for saying such a sweet thing about The Power of When. I certainly appreciate that. Are you ready to hop on and get going, Dave? You almost there?

Dr. Dave Rabin (00:22:07):

I am good to go. I just wanted to again, thank you, Michael, for carrying the torch for me while I was getting all Zoomed up. I really appreciate that. And thank you all so much for taking the time out to join us today. We have a very exciting show for you. And Michael is a good friend and colleague who doesn't need much introduction. Michael is a clinical psychologist, double boarded and both the diplomat of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine.

Dr. Dave Rabin (00:22:47):

He's also appeared in interviewed on CNN, Oprah, The View, Anderson Cooper, Rachael Ray, and Fox and Friends, just to name a few, which is where many of you may have heard of Michael and also through The Power of When, which is a fantastic book about circadian rhythms and chronotype switch. It's something that we'll get into a little bit here. And one of the things we're really excited to announce on this particular webinar for you all is that Michael Breus is joining the Apollo team on our Scientific Advisory Board of esteemed leaders as our sleep expert on the Apollo team.

Dr. Dave Rabin (00:23:24):

And we're so excited to have him onboard advising us on our direction as a company and particularly with respect to science and research in the sleep department, which is really fantastic news. And we have really enjoyed working together so far. So, I just wanted to thank you, Michael, for being here. I really appreciate it.

Dr. Michael Breus (00:23:45):

It is my absolute pleasure to be here, number one. And thank you for asking me to be on the advisory board. This is awesome. So, here's the bottom line guys is many of you know me. So, Dave and I have known each other for quite a while. I've been playing around with this science with him. He's been having me try different things. And I have to be honest with you, generally speaking, if I don't like science and I don't like the product, you're never going to hear me talk about it. You're never going to hear me come forward with it. But this was something that was very unique to me and I want to talk about why I wanted to be part of the advisory board if that's okay. Can I do that? Is that okay?

Dr. Michael Breus (00:24:23):

So, let's be honest, I get approached by lots and lots of companies all the time. And they don't necessarily have solutions. They have ideas. They have thoughts. They have a couple of products, but they don't have well-researched solutions. And for me, it's always been about the science. Many of you know that about me. And when David and I started playing around and working together, I was like, "Come on. Can you really do that?" And I mean, you remember I was questioning, I was giving him a hard time like, "Come on. That's not even possible."

Dr. Michael Breus (00:24:52):

And he's like, "Hold on, just look at the data. Look at the research. Look at what we did." And so honestly, I'm more than impressed with the science that's been put around my Apollo than almost any device on the marketplace. Certainly, from a wearable perspective, I like it a lot and I'll explain why that is. Well, so many of you see that I have an Aura Ring. Full disclosure, I'm also on their advisory board. Yup, he's got one too. He's got his Neuro on. And so, at the end of the day, we'd like to work with groups that have good science, that have good metrics, and that are really interested in collecting the data, because that's how we answer our questions. And that's the biggest idea that we're always trying to look at.

Dr. Michael Breus (00:25:34):

Oh, there's a question that popped up here. I can answer that real quickly, so that it doesn't distract us. So, Karen asked, "Does this product compare with the sleep bracelet of Philip Stein or the sleep induction for sleep induction and sleep maintenance? So, very interesting question. I'm very familiar with both Philip Stein and the Apollo product. So, I think I can jump on that one really quickly and then we can get back to where we were. So, Philip Stein is much more of a passive product. It's got a small disc in it that's impregnated with a frequency that then emanates from it for a certain period of time. Apollo does something completely different.

Dr. Michael Breus (00:26:15):

While they may look like, "Hey, this is a technology of a frequency that's going to be adding something and helping me with my body," they do very, very, very different things. The good news here is that when we look at Apollo, the data that we've seen on this has actually shown that it increases something called parasympathetic tone, which is that rest and digest system that's in our bodies. There's been no data for Philip Stein to be able to do anything even close to that. And I know because I help them run their first study on their first product.

Dr. Michael Breus (00:26:44):

So, I'm very aware of what the two products do. This one is much more of active solution than that one, which I would consider to be more of a passive solution. Also, this one doesn't tell time. That one usually does. And that one is actually very stylish to wear on your wrist. I've had a couple of comments about this one asking me some strange questions, but to be fair, this one does something very, very different. So, with that, we can go ahead and launch back in. I just wanted to make sure we answered that one question.

Dr. Dave Rabin (00:27:14):

Thanks, Michael. And thank you all for dropping your questions in. I think there's going to be definitely time for Q&A. We're going to try to keep all of the questions in the Q&A box, if possible. So, there's a little Q&A box for all of you listening on the bottom right. If you could post your questions in there, we'll make sure to keep track of them and try to answer as many as we can before the end of the hour. And please, there's a couple ground rules I want to be extra clear about so that we don't set expectations incorrectly.

Dr. Dave Rabin (00:27:45):

We will not be answering questions about personal medical issues on this particular webinar, because we are not your doctor. And while we are providing advice that can be helpful to you and your life, if you have questions, please consult your doctor about your specific situation and you can reach out to us offline and our team. And we'd be happy to help. If you have questions about specific issues with your Apollo or things you want to learn about how to use Apollo better, you can post them, but we highly recommend reaching out to our customer service team who is ready and waiting and excited to talk to you about anything they can do to help you have a better experience.

Dr. Dave Rabin (00:28:23):

So, for those who don't know me, I'm Dr. Dave Rabin. It's a pleasure to meet you all. I am a psychiatrist and a neuroscientist by training. I practice clinical psychiatry, mainly focused in my practice on PTSD, depression, anxiety and substance use disorders. However, sleep is always a problem across all of those people, all those kinds of challenges. And so, we have in many ways been led to, when working with these people at the University of Pittsburgh, trying to figure out new ways to help folks who are struggling with chronic stress on the mental illness side cope with sleep and balancing sleep better. Because just balancing sleep, as we know in many of these disorders, makes a tremendous difference in outcome.

Dr. Dave Rabin (00:29:10):

Michael talks about this a lot. And really tackling a core issue which is safety and how safety is actually reflected in our bodies in balancing of the recovery system, what we call the parasympathetic nervous system or the vagal system that helps you redirect precious resources, blood, oxygen, et cetera, to the organs that are important for recovery, and the things our body doesn't rest, like reproduction, digestion, immunity, metabolism, sleep and recovery, and all of these things.

Dr. Dave Rabin (00:29:41):

So, Apollo really came out of this idea of how do we use the sensory stimulation around us like sound waves to deliver these gentle soothing feelings to the body, to the skin, like a soundtrack composed for your skin instead of your ears that helps you feel a little safer on the go, so that you can feel able to regulate. And we can all feel more able to regulate our stress response system more effectively, allow it to turn on primarily when it's needed, and then allow it to turn off so we can get to sleep when we need to. Michael?

Dr. Michael Breus (00:30:14):

So, this is a really interesting point. And one of the things that I had to think back to was my high school biology for a second and remember that sound waves are matter waves, right? So, a lot of people don't think about that. They think of light waves that go through things. What's cool about sound waves is they actually move things. So, back in your teenage years, you had your speaker on your desk and you're cranking the volume, the whole desk would shake, the water would shake and things like that.

Dr. Michael Breus (00:30:44):

That's what we're talking about, but the good news is we don't have to crank the volume here. Dr. Dave discovered specific frequencies that actually when they push against the skin actually help us with our parasympathetic system. So, I just wanted to throw that in there, because it took me a while because I had to go back and be like, "Wait a second, soundwaves, light waves. What's what?" So, that was a helpful hint for me.

Dr. Dave Rabin (00:31:08):

Yeah, and just the idea that we have control in some ways over what slow, soothing stimuli we associate ourselves with and what we pay attention to like breath, right? And other things that make us feel safe, really authentic, genuine, non-judgmental human connection to our friends and family, soothing music, soothing touch, they all contribute to helping us feel more balanced so that we can sleep better at night. So, getting to the exciting stuff, based on what we know now, Michael, what would you say is the best way we can change how we think about sleep to make the biggest difference in our lives?

Dr. Michael Breus (00:31:52):

I think there's a lot of different things that we can think about here and it's easy to get lost in a lot of the details. So, I think the first thing I want to tell people is everybody out there can sleep. I just want to be very clear about this, okay? It is a human function. Just like breathing, we can all do it. Some do it better than others and sometimes we get in our own way to sleep. And I think that's one of the areas that's so nice about what the science does is I don't know about you guys, but the pandemic's been pretty stressful, right? And it's a new kind of stress too, right? It's not that, "Oh, I've got traffic in LA" stress or I've got, "Oh, my boss is a pain in the ass" stress.

Dr. Michael Breus (00:32:31):

It's like, "I'm worried about my health, I'm worried about my children's health, I'm worried about my grandparents health, I'm worried about my best friend's..." I would never had to worry about my best friend's health before. So, it's a whole different level of stress, I would argue, that we're getting, and that, I think, is having a dramatic effect on our sleep. So, for me, I was trying to find a solution for my patients that could help lower their stress without saying, "Oh, and by the way, now you have to go to the gym for an extra hour. Now, you got to do three hours of breath work or meditate or whatever." And to be fair, I do all that stuff.

Dr. Michael Breus (00:33:07):

And we can talk about morning routines and then the importance of those as well, but I would argue that there's so much damn stress out there right now that I personally was looking for a solution to help lower that stress without it having to be a super duper active thing that I was constantly having to do. And to answer your question, most people don't even think about sleep when they wake up. They think about sleep at the very end of the day. I call sleep like that shock absorber of your life, right? Because you never think about that. You're having a long day. Oh, well, I'll just stay up late and work longer. That's not healthy. That's not the right idea. So, I tell people all the time, you really need to think through this idea of how does new stress come into your life?

Dr. Michael Breus (00:33:51):

And are there ways that you can do to reduce said stress to get back to levels that are normal and then even further for success and be able to excel and succeed? And so, for me, when I started wearing the Apollo, that's what happened, right? It was interesting in patients. And by the way, for folks out there with the Oura Ring, we actually did a study, a retrospective study. This was the coolest thing ever, right? So, they go back and they call it Oura. And they're like "Hey, guys, here's what we want to do. We've got people who've got Apollo's, who've got Oura's. Can we look at their historical data before they got the Apollo and see what happened?" That's where the money is, right? Because at the end of the day, that's where all the good data was.

Dr. Michael Breus (00:34:34):

And we learned so much about what happened there that now we can actually incorporate all of that into the Apollo and now people get to sleep better. Now I will be very honest with you. It took a while for me to sit there and say, "So you're telling me that this thing that's buzzing on my wrist or buzzing on my ankle is actually going to make me sleep better. Come on. It doesn't happen overnight. Help me understand how this whole thing works."

Dr. Michael Breus (00:34:58):

So, fortunately, Dr. Dave explained to me how the sympathetic and the parasympathetic system work, and in particular, how his frequency technology on the Apollo has an effect on that. And I think that's what was so fascinating to me, because quite frankly, I tell people to strap this thing on their ankle and then do their thing. They do have to create a profile, which is something that I actually did. I use it as an alarm clock too. Did I tell you that I do that, Dave?

Dr. Dave Rabin (00:35:25):

Yeah, I love that feature. I use that too.

Dr. Michael Breus (00:35:27):

Yeah. So, this will buzz to wake me, so I don't have an alarm clock anymore, because this thing will buzz to wake me up and then boom, I'm awake. And I also use it actually to remind me to go to sleep at night. So, I have it come on at a particular time and then it's like, "Oh, that's right, Michael. You need to go to bed now." Actually, I replaced my alarm clock with this thing. So, I mean, I think it's interesting when you start to look at it from those types of angles and start to see how is it affecting... Dave, I have a question for you, which is in the Oura study, I know we've talked a lot about it, but I want to give that information to all these people out here that are listening to it.

Dr. Michael Breus (00:36:04):

Some of the more finite things that we learned in that study was if I remember correctly and I'd love for you to dive in on the details on this was you need to wear it for approximately three hours a day for longer than three months and that's when we start to see the biggest benefits. Am I correct in saying that?

Dr. Dave Rabin (00:36:20):

That is correct, at least three hours a day, five days a week are where we see the biggest differences in biometrics and how people feel. And from what we can tell, the difference, which you can check out on our website where we highlight the preliminary results of the sleep study that are in 580 people that is currently being written up for publication, it's so interesting to look at the journey of how we did this study, which you said, right? It was because of COVID that shut down sleep labs that we did this. And it was because of you, the people listening to this conversation and were using Oura Ring that were generous enough to share your data with us that allowed us to do this work.

Dr. Dave Rabin (00:37:02):

And what we found was just by adding Apollo to your life, you get a statistically significant improvement in deep sleep and total sleep, right? So, just thinking about that alone across all 582 people, we saw that just adding Apollo to your life, despite everything else that might be going on your life, what how much you're drinking, how much you're smoking, how much you're working, how much you're sleeping, despite all of that, just adding Apollo to your life induces a statistically significant improvement in deep sleep and REM sleep, right? That's pretty remarkable, despite the variability, especially if you're a statistics person.

Dr. Dave Rabin (00:37:36):

It's very unlikely that you would see that, because there's so much variation in use and none of these people were instructed on how to use the device, right? It's just the instructions in the box. So, real world sample. So, then we saw that one group of people in particular that had much, much better outcomes than everyone else and 20, 25% improvement in deep sleep, 10, 15%, improvements in heart rate variability and resting heart rate, that were huge numbers like exercise level numbers, right?

Dr. Michael Breus (00:38:05):

So, I want to break down a couple of the terms that you just threw out there, because there might be some people-

Dr. Dave Rabin (00:38:09):

Please.

Dr. Michael Breus (00:38:10):

... who may not remember some of this stuff. So, deep sleep for everybody, we call that in the science world stages three and four sleep and that is your physical restoration. So, what he's saying, which is remarkable, by the way, is if you just have this thing on and you set up a profile so that it starts and stops and you don't even have to think about it, all you have to do is charge it every few days. If you wear it for at least three hours a day for five out of seven days, you're going to get this thing that's going to happen to you no matter what. Deep sleep is interesting, physical restoration. So, if you've got aches, if you've got pains, things like that, that's what we're talking about might be a very interesting thing to start to think about.

Dr. Michael Breus (00:38:50):

So, I just wanted to tell people what deep sleep do. That was the other one, HRV. That's a biggie. And actually, you and I should probably talk about that a little bit anyway, right? Because a lot of people may not know what heart rate variability is or means and how that looks as a health metric, right? So, I'm going to give a very brief description and then Dave's going to get into the details of this. Heart rate variability is exactly what it sounds like. It's how often your heart rate varies from beat to beat, right? So, sometimes it might be beating fast. Sometimes it might be beating slow. The breath of that difference is what we're talking about.

Dr. Michael Breus (00:39:31):

So, what is the average when you go from a low heart rate to a high heart rate? That is your heart rate variability, and you can look at that throughout different points in time. Here's the cool thing. This is arguably the best metric right now that we've discovered for overall health and wellness. So, whether you have an Apollo, an Oura, or whatever, you should be thinking about HRV as an overall metric of wellness. And by the way, the higher that your HRV is, the better. And it's not easy, you need to look at it, think it through, and then look for ways in order to increase HRV. You're on, Dave.

Dr. Dave Rabin (00:40:10):

Yes. So, thank you for that. And HRV is so interesting because it was a metric that was discovered in the '60s with biofeedback and basically looking at how to teach people about breath, because we knew as scientists, common sense to many of us, that breath and just focusing intentionally on our breath dramatically reduces heart rate, decreases the speed of our thoughts, decreases our blood pressure and our respiratory rate, because we are influencing the system through our breath, which changes the pressure in the lungs, which shifts the whole dynamic of the body, which is one of our best anxiety relief techniques. And biofeedback is a tool where you watch your breath patterns and your heart rate patterns, and you can train yourself to do it.

Dr. Dave Rabin (00:40:53):

For anyone who's interested, it's 50 years old. It's completely non-invasive. But what's so interesting about it is that it showed us in the field for the last 50, 60 years now that you can influence the resilience of the body. So, what state the nervous system is in response to stress and in response to breathing and focus changes, right? And that is directly correlated with how we feel. So, when we are stressed out, our heart rate goes up, the distance between the heart beats gets smaller, because there's more heartbeats crammed every minute, right? And then therefore, the heart rate variability, the difference between the time between each beat goes down, right?

Dr. Dave Rabin (00:41:32):

And so, high heart rate and low heart rate variability in the moment of exercise are great. We want that. In the moment where we're just waking up in the morning or we are trying to fall asleep at night, not good, right? Because that's a signal in terms of the biomarkers of our body that our body's saying, "Hey, I feel threatened right now. There's something going on internally or externally that I perceive as threat. You're not safe enough to sleep. So, you shouldn't sleep," or "You should sleep lightly. So, you can wake up anytime anything comes that might potentially harm you." And so, a lot of this is about practice, which is what we do with our patients is helping them to be aware first that this is going on. Apollo is an awareness tool, right?

Dr. Dave Rabin (00:42:18):

It helps us be aware that we are safe in the moment and then we can make decisions from standpoint of safety in terms of allowing ourselves to enter recovery state, doing breath work, instead of thinking about how there's something wrong with us for not being able to sleep to your point earlier, right? One of the biggest culprits of insomnia is the negative thought loop of there must be something wrong with me because I can't sleep. Why can everyone else sleep and I can't? And this is the beauty of where Michael's work and my work directly interface. And it's something that we can all change to these practices.

Dr. Dave Rabin (00:42:53):

So, Michael, on that point, I think this is interesting, right? Because Apollo from the sleep study that I shared the link to, we're seeing that when people use it over three months that they're getting 90% on average deep sleep improvements, 14% on average REM sleep improvements on average across the three months cumulatively speaking, 4% average decrease in heart rate, 11% at resting heart rate, 11% average increase in HRV, and 30 minutes more sleep at night that's concentrated in deep and REM sleep, our most restorative sleep cycles.

Dr. Michael Breus (00:43:27):

Yeah, sign me up, bro.

Dr. Dave Rabin (00:43:28):

Right, right. Just by wearing it three hours a day and five days a week because it's acting on the touch pathway, which is parasympathetically stimulating just like exercise, just like breathwork, just like meditation. And so, my question for you is all of these other techniques are really great firstly or many of them are, could you talk about how some of those other techniques that you think are the most interesting? And do you see Apollo as being synergistic with those techniques or complementary?

Dr. Michael Breus (00:43:55):

Absolutely. So, this is a great question. So, nobody sleeps in a vacuum, right? So, there's lots of stuff that's going on all the time. And so, we definitely want to think through some of the different ideas about, "What are all of the different things that we can do in order to get a great night's sleep, right?" So, one of the big ones really has to do with and we mentioned it earlier, you got to start thinking about sleep in the morning, not 20 minutes before bed, right? So, what does that mean? Get up at the same time every single day. So, you're going to hear me say this a million times. All right, and I'm going to explain to you why I'm going to say it a million times.

Dr. Michael Breus (00:44:30):

If you get up consistently, including the weekends by the way, guys, including the weekends, what you will discover is your circadian rhythm or your internal biological clock functions better. Let me explain to you exactly what happens when you wake up in the morning and why you want to wake up at the same time every morning. When you wake up in the morning, your eyes open up. If the sun is up, which hopefully, it is, sun comes in and it hits a particular type of cell in your eye called a melanopsin cell. This cell then sends a signal to a place in your brain called the pineal gland, which turns off the melatonin faucet in your head. Remember, guys, melatonin is that key that starts the engine for sleep, so we got to have it.

Dr. Michael Breus (00:45:09):

Well, here's the problem. It's great that it gets turned off and everybody knows about that, but there's a second function that happens in the morning from sunlight. Once it turns off the melatonin faucet, it actually sets a timer in your head for about 14 hours later to start melatonin production. So, it gets very interesting. So, let's say you're waking up every morning at 6:00 in the morning. Fourteen hours later, which is about 8:00 at night, is when your melatonin is going to kick off, you'll be able to fall asleep at about 9:30, 10:00. Now, it's Saturday, and you went and partied on Friday night. And you really had a good time and you've decided to sleep in not till 6:00, not till 7:00, but till 9:00. It's not an unreasonable thing to think about, right?

Dr. Michael Breus (00:45:56):

Let's say you went out and you went to a concert, get home at 2:00 in the morning, what have you? When you get up at 9:00, here's the problem, your brain can't tell time. It only knows it's 14 hours later. It doesn't know that normally, your melatonin kicks off at 8:30 or 8:00 rather. If normally you were getting up at 6:00 and now you get up at 9:00, melatonin production doesn't start up for another three hours from your normal startup time. And that's when everything gets wonky. So, number one, just wake up at the same time every single day. I promise you it will make your life easier. Like I was telling you before, I use my Apollo to actually wake me up at that same time every day.

Dr. Michael Breus (00:46:37):

Now many of you may not even need an alarm as it were. You might wake up naturally at that time. If you do, that's awesome. That's exactly where you want to be. A few other things that I talked about with people that are going to be very helpful for sleep. Number one, you can't get out of a conversation about sleep without talking about caffeine, okay? Let's just be honest, right? So, caffeine is a stimulant. It has no nutritional value. There's no reason it should ever be in your body. Yet it is the most consumed substance in the world. Honestly, it's more consumed than-

Dr. Dave Rabin (00:47:09):

You'll make a lot of enemies there, Michael. You're going to make a lot of enemies.

Dr. Michael Breus (00:47:12):

I know, I know, I know. But here's the thing. Here's the thing. I'm okay with you drinking coffee, but you want to know when to stop, right? And so, remember, caffeine is a halfway between six and eight hours. So, as a general guideline, I ask people to stop by 2:00, right? So, eight hours after 2:00 is 10:00 when most people fall asleep. So, it makes sense, right? Now, if you can move that up to 12:00 or even 10:00 in the morning, have just your one cup and be good. I'm not going to complain about that. I think that's awesome. I don't think there's any problems there. The next biggie, alcohol. Alcohol is the tough one, right? There's a really big difference between going to sleep and passing out. Okay, we don't like the passing out. We like the going to sleep.

Dr. Michael Breus (00:47:53):

So, when we think about that, we want to say, "Hey, I enjoy an adult beverage at dinner, but I need some time between dinner and lights out in order to be able to actually digest and get that alcohol out of the system." Average human, it takes them one hour to digest one alcoholic beverage. So, here's the general guideline. At dinner, you can have two drinks with after each drink, you have one glass of water. So, if you have one glass of wine, one glass of water. You wait one hour before lights out. Two glasses of wine, two glasses of water, you wait two hours. You really want to stop at 2:00. And I'll explain why.

Dr. Dave Rabin (00:48:30):

Same to men and women, Michael?

Dr. Michael Breus (00:48:32):

Well, that's a little different, right? So, for men, I think depending upon their size and their metabolic structure, it could be a little bit different. So, that's actually a fair point. So, know your limits, right? But here's the thing. If you're up to the point where you've had your second drink and you're starting to feel a little tipsy, stop and I'll explain why. Because what that means is your brain is a little toxic. And so, it's going to spike something called cortisol. Cortisol is like the antithesis of melatonin. They work in opposites. So, you really don't want to be an energetic drunk trying to go to sleep. It just doesn't work very well. So, if you can, stop alcohol three hours before bed. Other big thing is morning time. I'm always, always talking about mornings for people.

Dr. Michael Breus (00:49:14):

So, the thing I like to tell people is we already talked a little bit about it, sunlight, you definitely want to get some sunshine every morning. So, I ask people to do three things when they wake up. Take 15 deep breaths, drink 15 ounces of water, and spend 15 minutes in the sunshine. Hopefully, you put on a robe. I'm just saying, put on a robe. So, at the end of it all, I think there's a lot of things that people can do that are active and passive that can be super-duper helpful for their sleep. If I can, I wanted to bring up one topic that I thought would be an interesting topic for people, which is the idea of wearables.

Dr. Michael Breus (00:49:48):

Are wearables a good idea? Are wearables a bad idea? What are people thinking about those? Because temporarily, we're in that wearable space with this thing, right? So, how do we connect with that? Is that a good thing? Is that a bad thing? So, I thought I would bring it up. I can give my take and then you can give yours if you're cool by that.

Dr. Dave Rabin (00:50:06):

Sure. Yeah, absolutely. Can you mind if I add something about the alcohol before you do that?

Dr. Michael Breus (00:50:09):

Please.

Dr. Dave Rabin (00:50:11):

Because I think it's really interesting that you bring this up. One of the exciting parts about the work that Michael and I do, but connecting with our clients and you, is really inspiring radical self-inquiry, right, which is really just learning about yourself in a really fun way and really exploring your own body and trying to figure out what works and what doesn't, right? Going to the wearables, many of you who use Oura Ring and Apple Watch, if you want to do the experiment, track your Oura Ring averages and you can sign up for our sleep study. We'll be sending out a link shortly in the chat, and you could share your Oura Ring with us. And we can actually determine whether or not and what groups you fit into in our sleep study. And we're grateful for the information.

Dr. Dave Rabin (00:50:53):

And you can also do the experiment on your own where you drink some alcohol right before bed and you measure your HRV. But when you do that in the morning and then you drink some alcohol and you stop three hours before bed and then you measure HRV in the morning. And then you use Apollo without alcohol and you can see your HRV in the morning. Assuming that most other factors are controlled, it's fairly reliable. I don't tend to endorse anyone's experiments of science, but you can fairly reliably induce an HRV, heart rate variability drop and a resting heart rate increase just for one night of shifting this single factor on alcohol. And correct me if I'm wrong, I think the statistic is something like 80%.

Dr. Dave Rabin (00:51:41):

I think this is from The Lancet article a couple years ago. Something like 80% of people who use a stimulant caffeine included in the morning, but also methamphetamine included, 80% of those people wind up using some sedative at night, prescription or alcohol related.

Dr. Michael Breus (00:51:56):

That's correct. Yeah.

Dr. Dave Rabin (00:51:58):

We're all misguided.

Dr. Michael Breus (00:51:59):

Yeah. So, what Dr. Dave is talking about is the balance that people are constantly trying to achieve. So, they're taking something to stimulate then they're taking something to put them to sleep. And to be honest with you, that's not what we're about. We're all about the natural. We want your body to function the way your body should function. And I like wearing wearables, because it allows me to understand myself. I think your point of that we are a company of self-exploration, it couldn't be closer to the truth. That's exactly what we want to do is we want to look at data. We want to understand what's going on. Now, to be fair, not every wearable out there is as accurate as the next, right? And so, we have to think about these things.

Dr. Michael Breus (00:52:40):

One of the questions that I get asked all the time since I've worked with Oura is, "Well, my sleep data is not always so accurate, Dr. Breus. How do I deal with that?" Well, I talked to people about this all the time and here's the thing. Don't just look at a single data point. Don't just look at one night, did it work? Did it not work? Look across a week or so and look for changes or what we call the delta, right? So, let's say that Apollo or rather, Aura says that you're getting 14 minutes of deep sleep every single night. That's probably not accurate. But if it says you got 14 minutes one night, 407 the next, and 236 the next, I want to know what happened on those two nights to see how that affected your sleep. Because I know you got more than 14 minutes, if you will.

Dr. Michael Breus (00:53:23):

So, I try to describe to people that you don't want to live and die by the data. Use the data as a guide, if you will. I think that helps people out a lot. Now, there also is, by the way, something called orthosomnia, which is where people have gotten so involved in their tracking that it gives them anxiety and it actually prevents them from sleeping. So, I want to send out a small word of caution to people.

Dr. Michael Breus (00:53:49):

If you're an obsessive compulsive person and you're already tracking a million things, you might not want to be tracking this as close and living and breathing on set data. Remember, we're all humans. We all have a lot of variation in us. And so, if it didn't work one day, it's probably going to work the next day. So, just give yourself some time and don't lock, lock, lock into those numbers.

Dr. Dave Rabin (00:54:16):

Yeah, that's absolutely correct. And this is the biggest mistake that I think most wearable users make, whether it's Apple Watch or Oura Ring or the less accurate devices like any number of other things that are out there, that these are not clinical devices, right? These are not from a laboratory. They have not been certified in any rigorous setting with a few exceptions. And for that reason, they're not as accurate for point of use measurement where the conditions have to be just so. For example, when we measure resting heart rate, we try to measure it first thing in the morning when you're waking up.

Dr. Dave Rabin (00:54:52):

The Oura Ring actually does that really, really well, but many other wearables don't, because they don't have the algorithm as accurate with detecting exactly when you wake up in the morning and measuring heart rate in that time and throughout when you're sleeping. So, it's interesting, because it's exactly what Dr. Breus is saying, right? It's the trending of the data over time that is really what matters. Sure, if your HRV is in the dumps one day and you know you haven't slept well the night before and you know you're not feeling very well, it could be confirmatory that maybe you should not push yourself extra hard today.

Dr. Dave Rabin (00:55:27):

And that's used by many elite athletes and many folks in the elite military world for training and for knowing when to send people out if they're really looking terrible and you're not showing it physically. But in general, trend, trend everything that you do. Again, trend that it's your awareness and the expansion of our awareness over time and allows us to trend these different things, including, "How do I feel in my body when my deep sleep was 10% over the last two weeks?" Right?

Dr. Dave Rabin (00:55:59):

Not how do I feel necessarily right now, and is that number telling me that I slept badly when I feel like I might actually feel rested, which I have lots of people coming to me as well about. So, I think it's really about trending over time. And as we trend, we start to understand the patterns of how the environment and how things we do is actually impacting our life and our quality of sleep and recovery.

Dr. Michael Breus (00:56:19):

Yeah, I couldn't agree with you more. I think it makes intuitive sense, but also, sometimes you get obsessed with the numbers. So, just the word of caution is average, right? There's a reason why we do averages in statistics. And that's true in science. We don't look at individual one night it happened type of thing. We look at across over many nights. So, think of yourself as maybe a small science experiment, if you will, and just allow yourself to understand how that data is working for you. I wanted to talk about one more area if I could. I really thought that one of the areas that's been interesting for me that I learned a lot about was the differences between the sympathetic and the parasympathetic nervous system.

Dr. Michael Breus (00:57:03):

And to be fair, when I was in high school biology and when I was in graduate school, we really didn't go through it the way I think you we really need to to understand it. One of the things I wanted to express to people is sympathetic nerves. So, you have an autonomic nervous system that's made up of two places, sympathetic and parasympathetic. All right. Sympathetic, I always think that that song from the Rolling Stones, Sympathy for the Devil, so I'm running away from the devil. So, I'm always thinking that that's the action one, which it is. That's the fight or flight. And then the parasympathetic is the rest and digest. So, here's what's so fascinating is HRV is actually... If I'm saying this correctly, and Dave, correct me if I'm wrong.

Dr. Michael Breus (00:57:46):

HRV is a measurement of the sympathetic and the parasympathetic as they work together, right? So, your heart rate goes up, that's the sympathetic. When your heart rate comes back down, that's the parasympathetic. So, the way we can think about HRV is actually through these autonomic nervous system and how it fluctuates back and forth throughout an evening. So, it's fascinating to me that we're measuring that as well. The other thing I wanted to put out there, again, about the wearables thing that we were talking about, most wearables, they pull data from the human, right? That's what they do.

Dr. Michael Breus (00:58:25):

They pull some data and they analyze it. This is a very different technology. Those devices, I call those pull technologies. This is a push technology. This is the first thing that I've seen that actually puts something into you that has an effect that we know is positive and works well. I mean, Oura Ring, it's great, but at the end of the day, it's not pushing anything into me. You know what I'm saying? It's not doing anything, whereas something like an Apollo is. And so, I wanted to also make that differentiation for wearables, because you want to think through that as a part of your life as well.

Dr. Dave Rabin (00:59:02):

Yeah, I really appreciate that. I think that's one of the biggest reasons why we developed Apollo is because there are a lot of things out there that track and tracking is amazing. And we work very closely with many of those technologies, Oura Ring included. At the same time, we still have to be the ones that take the action from that data and interpret the data and then process it and do something differently with it. And frankly, unfortunately, the world has gotten so hectic and stressful for many of us that ain't nobody got time for that. So, we have to have more technology that helps to get us out of our phones ideally and back into real life and nudging us into the states we want to be in, rather than just expecting us to make all the decisions.

Dr. Dave Rabin (00:59:48):

Obviously, for many people, that information from the wearable trackers is very helpful. At the same time, there are many of us who aren't even at a point to do something with that data. And so, that's where Apollo comes in. We're doing these little techniques like getting some sun in the morning and waking up and doing 15 breaths. And these relatively small suggestions that maybe take a total of 30 minutes a day can actually be life changing over time. And on that note, talking about circadian rhythms and schedule, right, because this is something that's really important. We talk about regularity. A lot of people think regularity is boring, but we are rhythmic creatures, right? Our whole lives operate on rhythm.

Dr. Dave Rabin (01:00:30):

Our whole biochemical and molecular milieu of the cortisol and the hormones and the melatonin and orexin and all these different things that are going on in our bodies that regulate sleep and wake and hunger and energy metabolism are all rhythmic related to the environment on the cycles and environment around us, right? It's quite phenomenal. And so, in that way, part of why we developed scheduling was to help people more effectively structure circadian rhythms, the sleep and wake cycle, because that's one of the biggest problems that at least I see as a psychiatrist, treating people who have sleep trouble as a component of their disorder or just people having sleep trouble at all. And getting that regularity is so critical.

Dr. Dave Rabin (01:01:16):

And so, we built this scheduling feature, because we listened to you, our audience, who wanted this feature and demanded it. And we said, "We're going to figure out how to make a feature that can run Apollo automatically for you to keep a rhythm for you and help you adjust as much as possible to the rhythms of your daily life without having to have your face in the phone choosing everything every time on your own." How critical is that scheduling rhythm in your mind, Michael? And what's your rhythm for the day as being the busy guy that you are?

Dr. Michael Breus (01:01:45):

So, this is a loaded question. I'm just letting you guys know that, right? Because Dave already knows what my schedule is. So, everybody out there knows that I love circadian rhythms. I live by my circadian rhythm called my chronotype. And so, there are four chronotypes out there. So, you might not have heard of the term, but you've actually heard of the concept before. If you've ever been called an early bird or a night owl, those are chronotypes. And this actually works well with an explanation of how Apollo works as well. So, as an example, I'm a night owl chronotype, which means my melatonin doesn't turn off until very late in the morning time, right? So, what does that mean?

Dr. Michael Breus (01:02:26):

That means I can now understand when my hormones are active and not active at certain times. And I can find certain times in my day to do certain things and I'll already be there, because naturally, my hormones are already there. And so, what Apollo actually does is it tighten those features for me as well. So, I already know, as an example, that I'm a night owl and that in the morning time, I'm not very good with details, right? And so, what do I do then? So, actually, this is going to sound a little kooky, but this is actually what I do is I set my Apollo for focus during the times when I know I'm not going to be focusing. I'm not going to have that focus ability.

Dr. Michael Breus (01:03:03):

And so, I'm like, "Okay, I have to focus right now. I can't reschedule this podcast or this lecture that I'm going to give or what have you. So, then I'll turn on my Apollo." I'll say, "All right, I want to focus." And that actually helps me during that time of day when I might need it. So, I actually found unique case studies on myself. I mean, I've been using it for almost two years now. So, I like to play around with it and find fun things to do with it. But knowing and understanding your chronotype can actually be very, very impactful for you in a whole host of ways. The biggest one that everybody always ask me about is sex, right? So, Dr. Breus, what's the best time of day for sex, right? And believe it or not, we actually have a hormonal circadian answer to this.

Dr. Michael Breus (01:03:47):

So, I'll give a brief answer, if you will. So, step number one is you need five hormones to successfully be intimate. You need estrogen, testosterone, progesterone, adrenaline, and cortisol all need to be elevated. And melatonin, the sleep hormone needs to be lower. So, we did a survey and guess what? Most people are intimate somewhere between 10:00 and 11:30 at night. What do you think your hormone profile looks like at that period of time, right? Melatonin is high and all those other things are low. So, that's hit number one, as to when you may want to consider to be intimate. So, hit number two, if you have intimacy with a male partner, what do most men wake up with in the morning? An erection.

Dr. Michael Breus (01:04:32):

If that's not Mother Nature telling you when to use that thing, I don't know what is, right? So, there's a circadian rhythmicity to this. And it is this way with just about everything out there, right? So, for example, if you know the circadian rhythm of your daughter, right, so my daughter, she's 18. When she was 16, I would come in the morning and I would say, "Hey, Carson, what's up? Are you excited for your day?" How many 16 year olds do you know like to be woken up by their dad saying, "Hey, have you got anything exciting?" None, right? But if I walked in at 2:00 in the afternoon when her circadian rhythm was more on and I said, "Hey, what's going on?", I have a 90-minute conversation with my daughter.

Dr. Michael Breus (01:05:09):

There's nothing more important to me than conversations with my daughter at all. So, for me, it opened up this whole window of understanding that you can actually manipulate yourself by understanding where your rhythms lie. What's also cool is now you can actually do it with Apollo as well. So, let's say I want to have that conversation with somebody, but I'm feeling a little off. I can click this thing on. Dave, go for it.

Dr. Dave Rabin (01:05:34):

Yup. And that's how I use it too actually. It's an interesting story. I don't have a daughter, but thinking about how we can optimize it, not even manipulate, but really just restore a sense of agency, right? We're reminding ourselves. We're not manipulating anything. We're really reminding ourselves that we are in control of the way that we feel by being aware of the times that we feel differently. And being aware of the times where we're more able to do certain things like be empathetic and connecting to others and open to that and present and other times when we're not. And that's really useful information. And that said, we can't always work on that kind of clock.

Dr. Dave Rabin (01:06:20):

And so, you're using the tools or environment, using breathwork, using music, using things like movement, and meditation, mindfulness. And Apollo as well can all help to optimize the experience to that. For me, as an example, you might not know this seeing me today, but I used to have a lot of nervousness around public speaking and presentations. And I used Apollo now for about four years. I am probably one of the longest users. One of the times that I noticed it making the most single biggest impact for me was because I was giving a talk at the University for a lot of my colleagues who were people who were typically very critical, as many of us in the academic world know.

Dr. Dave Rabin (01:07:04):

And I had just spent a lot of time and I noticed that I'm spending a lot of time thinking about what the people are going to ask me, what they're thinking about me. And it starts to creep in while I was talking, to the point where my heart starts to race, I'm sweating. Am I breathing fast? And I'm no longer paying attention to the content that they're there to hear me speak about, because I'm so caught up in what I'm thinking about and directing my precious brain resources to thinking about what they're thinking about me, right? And it instantly clicked in that moment, as I felt the Apollo wave wash over me. It was like, "Wait a minute, I don't have to think about that. They're here to hear me talk, right?"

Dr. Dave Rabin (01:07:43):

If I talk and do what they're here to hear me do, then they're going to have a better experience here anyway and I'm going to give a better talk. So, I don't need to spend all of those extra brain resources and cycles thinking about what they're thinking about me, because that's not something I have control over. I have control over being present with what I'm saying and doing right now, because that's what I'm here to do. I've done it before, I know how to do it. All is well. And all of a sudden, using that Apollo became almost like a training tool that I took in and out of those situations over time to the point where I don't even need it anymore, because I am so comfortable just talking and communicating.

Dr. Dave Rabin (01:08:24):

But that's example of practice makes perfect. There's no such thing as perfect. Practice makes mastery. I had no intention or even thought that that could happen, right? And then just by using it in that way, I retrain my brain to not turn my stress response on when I'm on stage or presenting to a large group or what have you.

Dr. Michael Breus (01:08:45):

Yeah. And actually, this is funny, because you and I were talking about this a couple of weeks ago and we were like, "Maybe we should run a study with Toastmasters," right? I mean, the number one fear is public speaking and you had told me the same story like, "Dude, I could never do that before. Now, I'm great at it." And so, I think there's so many interesting ideas here that we can think about ways that we can use this to be beneficial. I mean, like you said, your number one fear of public speaking, that's certainly something that people can get involved with and say, "Oh, okay, that's good." Oh, somebody just said neuroplasticity and action. Exactly, I love it. That's right.

Dr. Dave Rabin (01:09:23):

Yeah. So, maybe this is a good time. Are you up for a little Q&A?

Dr. Michael Breus (01:09:31):

Sure.

Dr. Dave Rabin (01:09:31):

Lightning round.

Dr. Michael Breus (01:09:32):

Absolutely.

Dr. Dave Rabin (01:09:33):

So, I'm going to try to stay focused here. There's a lot of amazing questions coming in. We're going to try to get through as many as we possibly can. I also want to announce before we jump to lightning round that I have dropped a link in to the chat a couple times. This is a link for anyone who's here to sign up to be qualified for our sleep study. We're expanding the study from what is currently 1,500 people to 5,000 people.

Dr. Dave Rabin (01:10:02):

And this will be one of the largest sleep studies that's conducted completely remotely using wearable technology that has ever been run in the real world and it's extremely exciting. And in exchange for joining us, you will get access to our beta team, which will also give you access to all of the new and most exciting features of the Apollo technology before everyone else. So, please click that link that I dropped, reach out, and let us know if you're interested. So, you can change the sleep world with us together.

Dr. Michael Breus (01:10:36):

Absolutely. All right, let's do some Q&A.

Dr. Dave Rabin (01:10:42):

So, someone asked a question about PVCs? I don't want to answer it specific to Apollo because we don't have evidence about Apollo reducing PVCs, which are fast contractions in the heart that are unexpected, not necessarily anything that's damaging or bad, but they are unpleasant. Would you want to talk for a second about how sleep impacts cardiovascular function?

Dr. Michael Breus (01:11:03):

Absolutely. So, one of the things that we generally know is that if you've got decent sleep, it means your heart's working pretty well, right? So, we definitely see if you've got disruption in your sleep, let's say you've got an undiagnosed situation called sleep apnea, for example, right, where you're stopping breathing in your sleep, your heart rate slows down, speeds up, slows down, speeds up. That's when we see significant cardiovascular risk associated with, for example, apnea being a sleep disorder. Now, somebody might say, "Well, look, doctor, I don't have sleep apnea. I sleep just fine. I just don't get enough sleep. Does that have an effect on my heart?" You bet it does.

Dr. Michael Breus (01:11:39):

There's data now to show that people who get less than 6 hours and more than 10 hours, so in that window, have a double mortality rate, double. So, it's interesting. Some people always say, "If people sleep too long, is that a bad thing?" Well, that could mean they have poor quality sleep. They could have an undiagnosed sleep disorder. They could have depression, narcolepsy. There's a whole host of reasons why people sleep longer periods of time. So, we have to be careful and think about that, but it's definitely something that you want on your radar for sure.

Dr. Dave Rabin (01:12:12):

Yeah, definitely, and thank you for that. And for those of you who are more interested in this more, check out our webinar with Dr. Brian Donohue, who is a former Chief of Cardiology from University of Pittsburgh and also an advisor to Apollo, when we really deep dive into the cardiovascular function. Let's see here. One question was about using Apollo on specific vibration patterns. And does Apollo specifically do sympathetic or parasympathetic? It actually does both. I think the important thing, going back to what Dr. Breus was saying earlier about HRVs, HRV is a measure of the balance between the stress response sympathetic and the and the recovery response system parasympathetic. It's not one or the other. It's both.

Dr. Dave Rabin (01:13:01):

Higher HRV, higher heart rate variability means you're likely to have better balance between these systems and your recovery system is well supported. That being said, there are certain Apollo modes that can boost relaxation and help with focus and calm. And there are other ones that actually help with energy. We try to label them as best we can. The energy wakeup, for those who are asking about it, it's not a parasympathetic stimulating mode in general. Will it make your HRV lower? Not really, but it is very stimulating. It can feel a lot like a shot of espresso in a very, very short amount of time that you can turn off as you wish, but keep in mind that that vibe that is energy and wake up is not intended to be particularly calming. It's intended to wake you up.

Dr. Dave Rabin (01:13:53):

All the modes, clear and focused, social and open, rebuild and recover, meditation, mindfulness, relaxation, wine, and sleep are all intended to be very calming for a specific situation. And some of them give you a little more energy, a little sympathetic boost as well as parasympathetic, and other ones are more dominantly parasympathetic. We just give guidance to the vibration patterns. You should try them out and we empower you to experiment with them on your body. They're not going to hurt you. Keep the intensity low to start, so that you're not overstimulating yourself, but just experiment with them and see which ones work best for different situations. Lots of people like relax and unwind better for sleep and sleep and renew. That's totally fine.

Dr. Dave Rabin (01:14:35):

But play around and lots of people used the meditation and mindfulness for pain. That's another good one, for aches and pain. So, play around with these and see what you think and what works best for you.

Dr. Michael Breus (01:14:46):

I saw a question that I thought I would ask you because I actually don't know the answer, but I think I do, which is if you're currently taking medication like sleeping medication or anxiety medication or let's say you're taking a supplement like melatonin or valerian or something like that, will Apollo affect the effectiveness of that and/or can you use both at the same time? I saw question that looked at that.

Dr. Dave Rabin (01:15:12):

So sorry, that was Apollo and medication.

Dr. Michael Breus (01:15:14):

Correct.

Dr. Dave Rabin (01:15:16):

So, we have not seen any contraindications of Apollo being used with medicines, which means we haven't had any adverse reactions in folks. I think that it goes without saying that if... I guess, because I'm a doctor, so it goes without saying, right? But in general, using Apollo regularly can lower your blood pressure a little bit in a healthy way, in a more balanced way, just like exercise. And so, if you are on blood pressure medication, especially if you're on a lot of blood pressure medication, which many people are, talk to your cardiologist or your doctor.

Dr. Dave Rabin (01:15:53):

Just make sure you're checking your blood pressure regularly, so that you can trend it as we were talking about earlier, because if your blood pressure is going down as you use Apollo, which happens to many people, it might go down one point per day, but that's still over a course of even every week, but over the course of several days or several weeks, that actually becomes measurable. And then you can actually talk to your doctor about what to do with your medicines to make sure that you're not taking too much medicine. The goal of the medicine, the goal of our treatments is all to help your body regulate itself the way that it knows how. The less medicine you need, the less interventions you need, the better.

Dr. Michael Breus (01:16:33):

So, the bottom line for folks is if you're on blood pressure medication, be sure to be taking your blood pressure weekly, if not daily, and record that data for your doctor to then present to your doctor. So, that way you and your doctor can make a decision as to where your blood pressure medication may be. I couldn't agree with you more. For me, the way I was thinking is this is not something that's designed to replace a medication in any way, shape, or form. So, if you happen to find over the course of time that you're sleeping better and things are working better and all of that, that's awesome.

Dr. Michael Breus (01:17:07):

But you really do need to have that conversation with your doctor about, "Why are you on the medications you're on? Why are you on this specific dose that you're on and what that plan for the future is?" So, I want people to know and understand that and I want to be very, very clear about that. There's another question that I thought was interesting that I actually messed up when I first got my Apollo, which was intensity, right? So, the first thing I did was like, "I'm going to jack it all the way up to the top and have the best of that." I thought it would be poignant to have a quick conversation about intensity, because I know that in many cases, less is more.

Dr. Dave Rabin (01:17:45):

Yes, absolutely. The idea that Apollo is not distracting as well, so we want that to fade into the background. if you stop noticing it, that's a good thing and it really works. And what we call the sensory thresholds, that's where we just start to notice the feeling of any feeling. It's right where you just start to notice it that it's the most effective.

Dr. Dave Rabin (01:18:07):

The reason why the intensity is there and this is really important is that when you're in a noisy environment, when you're working in the ER as a doctor, when you're on a plane, when you're on a bus, you're in a car ride, or when you're in a rock concert, and you have lots of ambient noise around you, lots of stimulation, there's construction going on outside, et cetera, that's when turning the Apollo intensity up becomes a real asset, because it creates almost like a noise canceling effects of the noise around you in your environment. By bringing more stimulation to the skin, it helps us tune out all of the extra stimulation coming from the outside that may not actually be useful to pay attention to.

Dr. Dave Rabin (01:18:49):

So, that's where the intensity becomes a real tool, but we always recommend start at the lowest intensity that you can feel in the moment and then gently increase in there. And I've shared some tips and tricks here for everyone who wants to learn more about this. We have an article that I wrote about how I personally use Apollo and how I recommend folks to use it especially for first timers, but it's good to get a refresher anytime. And you can check that link out in the chat. And Michael, I want to be extra respectful of your time because you've been so gracious taking this time out today. Do you have a couple more minutes or do you need to run?

Dr. Michael Breus (01:19:28):

I'm going to have to run in three or four minutes. So, let's do one or two more quick questions and then I got to have to jump out.

Dr. Dave Rabin (01:19:35):

Okay, well, I have an easy one for you. How much water is appropriate to drink before bed, and what time should one stop drinking water or liquids of any kind?

Dr. Michael Breus (01:19:45):

So, I'm a big fan of liquids but you don't want to have to wake up all night to pee, right? So, what I tell people is if you can stop approximately 90 minutes before bed, you're going to be in good shape. The key factor here though is if you're diabetic, that's not a good idea. So, you want to make sure that you can talk with your doctor about that. The big thing we want to avoid is nighttime awakenings multiple times to have to urinate. So, I'm always asking people to avoid or go to the bathroom about 45 minutes before bed. The thing that you're looking forward to know that you're well hydrated is your urine should be clear.

Dr. Michael Breus (01:20:18):

Now, to be fair, if you're taking a bunch of supplements, it might be bright orange or something like that, because sometimes supplements can do that to your urine. But as a general rule, when you use the bathroom about 90 minutes before bed or 45 minutes before bed, if it's clear, you know you're well hydrated. You don't need to drink any more water. You can stop that for the day. And to be fair, sometimes medication makes us thirsty or we might be doing something that makes us thirsty. Really be cognizant of the amount of fluid that you're taking in within the last hour and a half before bed, because it will absolutely have an effect on your sleep.

Dr. Dave Rabin (01:20:55):

Yes, that is good advice. And I really appreciate you spending this time with us today, Michael. I couldn't be more grateful, because I know how busy you are.

Dr. Michael Breus (01:21:07):

This has been super fun. And did you see how many people we have?

Dr. Dave Rabin (01:21:10):

Yeah, a lot of people.

Dr. Michael Breus (01:21:12):

We have 830 people. At one point, we had 960 people. Clearly, this is a community that loves sleep, that is interested in the Apollo. So, I'm excited to have the opportunity to just to talk to your tribe and understand more of what's going on. And quite honestly, I think we should do more of these. I think people would dig it.

Dr. Dave Rabin (01:21:31):

They clearly do and we would love to have you all back. And we'd love to do this again with you, Michael. This has been a lot of fun, and again, just really appreciative. And for all of you who are interested in learning more, check out the links in the chat, check out the sleep study on the Apollo page. And you can get the preview of what's going to be published soon. And join our sleep study, be a part of the research. There's not that many opportunities to really do this and be a part of groundbreaking research. It's changing how we look at sleep, how we sleep, and you can do this. You can be in it with us and help us change and improve sleep for all of us together. So, I really appreciate your time. Thanks for tuning in and hope to see you all again soon.

Dr. Michael Breus (01:22:14):

Absolutely. I'm wishing everybody out there some sweet dreams. Check out the Apollo and check out some good sleep. Michael Breus, signing off, guys. Take care.

Dr. Dave Rabin (01:22:23):

Thanks, Michael. Take care, everyone. Have a great weekend.