Michael Breus
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So it turns out that's there a perfect time of day to do just about everything. Kate came to see me for incurable insomnia. It was pretty interesting. It started out with an occasional night or two of having some difficulty sleeping. So she did what a lot of people out there do: she turned to a glass of wine. She had one. Then she started having two. Then she started having three - said this wasn't such a great idea. So she went to over-the-counter sleep aids. She tried several of those; they didn't work very well. So then she went and sought professional medical help. She talked to her doctor who gave her a prescription for a sleeping pill. It actually worked - for about three months. She came back, said, "It's not working." He said, "Double the dose." Okay? This is very common, by the way. When that stopped working, he changed the prescription. Same scenario: doubled the dose, stopped working. Same scenario: doubled the dose, stopped working. When she showed up in my office, it was pretty interesting to me because I had a lot of things I wanted to talk with her about. One thing I learned: during this period of time while she was doubling the dose, this wasn't the only area that she was having issues. She was having problems at home and having problems at work. She wasn't getting along with her family. Her work productivity had decreased greatly; she was afraid she was about to get fired. When she came to see me, she said, "Doctor Breus, I don't think that I have a sleep problem." She said, "I think I sleep at the wrong time." I said, "What do you mean?" She said, "If I could go to bed at 2 AM and wake up at 9 AM and then go to work, my life would be great." I said, "Well, why don't you do that?" She said, "Well, I don't think my boss or my family would be too on board with that. I said, "Let's see if we can figure this out." So I called her boss, with her permission, and said, "I want to do something with Kate. Would it be okay if she doesn't come in until 10, 10:30 in the morning?" Surprisingly, her boss said, "Sure, no problem. But by the way, I'm going to fire her at the end of the week." (Laughter) No pressure, right? So I had five days to save Kate's sleep and her job. So we decided to implement this schedule: she went to bed at 2 - family was all on board - got up at 9, went to work by 10, 10:30. So I called her boss at the end of the week, kind of cringing on the phone, hoping it was going to go well. and he said, "I don't know what you did to her, but her work product has improved 100%. She doesn't fall asleep at meetings anymore. She participates in everything. This is fantastic." Then he said, "Can you help me with some of my other employees?" (Laughter) So I was so excited; I went to call Kate, and her husband picked up the phone, and he said, "I don't know what you did to my wife, but I like her again." I was like, "Oh my God, this is amazing." I said, "Get Kate on the phone." Kate hops on the phone. I say, "This is fantastic. You got your job, you're doing better with your family." She said, "I've started to notice some things. When I get to work, if I try to read detailed information at 9:00 AM or 10:00, it doesn't go so well. But at 2:00, I'm much better." I said, "That's interesting." She said, "I can't even eat breakfast. I have no appetite. But 10:00 at night, I'm famished." And then it dawned on me: Kate had a specific type of chronotype. She was a night owl. You may not have heard the word "chronotype," but you've probably heard of "early birds" and "night owls." When you look at the historic medical literature, you'll find three chronotypes: there's early birds, there's people in the middle we call "hummingbirds," and there's people at night that we call "night owls." Well, when I read the literature, one of the things I noticed was insomnia really wasn't represented there. And so I decided to create a new category. I renamed them all, and I'd like to share them with you today. The first, early birds, are replaced by what I call "lions." Lions are my COOs of a company. They are very Type A personalities. By the way, they get up between 4:30 and 5:00 in the morning usually. They're the ones who are sending emails constantly, before you even - eyes have popped open. They like to make a list every day, and go from step one to step two to step three to step four - very regimented thinkers. But there's a problem with being a lion. I know it sounds fantastic - all that - but they wake up up 4:30 AM. Dinner and a movie is out for these people, right? They can never make it socially. But it's pretty interesting - about 15% of the population. Next are the bears. These represent the people in the middle. Being a bear is the best. Roughly 55% of the population. Oh, by the way, these animals all have the same chronotypes, so a lion's chronotype is actually early; their first kill is usually before dawn. Bears get up with the sun, fall asleep when the moon comes out. So they're more like all of the regular people in the world. Bears, generally speaking, are extroverts. They have a tendency to be very social people. These are the folks that get work done. It's fantastic; I love hanging out with bears. They invite you to their home for dinner, or they're buying drinks at the bar or something fun like that. Great group of people to hang out with. Definitely more of a societal glue, if you will. Then we've got the wolves. Wolves represent the night owls. I'm fully going to admit right now, I am a wolf. Roughly 15% of the population, these people have very interesting characteristics. These are my artists, my actors, my authors, my musicians. These are very creative people, but oddly enough, introverted in many different ways. They can make things look fantastic, but if they create a list during the day, they go from step one to step twelve to step seven to step fourteen. We have no idea what these people are doing, which is usually me. And what we discovered over the course of time is they're very loyal friends, very intelligent people, but at the same time, everything is shifted later in the day. Then we finally got a new category that I call "dolphins." Believe it or not, dolphins sleep with half their brain asleep and half their brain awake, so they can be [sleeping] but still looking for predators. I thought that was a good representation of my people who don't sleep so well. Here's what's interesting about dolphins: they are just like lions, but they've got so much anxiety that they really have a difficult time out there. So they're very Type A personalities. Oftentimes, they self-diagnose themselves as insomniacs. Sometimes they have health issues; they're very health conscious, for sure, but they've got just enough obsessive compulsive disorder in them so they never quite finish a project, tinkering around at the last minute; meanwhile, everybody that's watched them says, "Oh my gosh, your stuff is amazing." Now, why would it be important to know what your chronotype is? Here's where it gets fascinating. So it turns out that our hormones actually work on a very predictable schedule, but our schedules are based on our chronotypes. So somebody with a lion chronotype will have a very different hormone schedule than somebody with a wolf chronotype. Let's think, just for a second, about Kate. Turns out that Kate was a wolf. Right? She wanted to go to bed at 2 and wake up at 9, but she was living the life of a bear. So she would go to work on a bear's schedule with melatonin still pumping through her brain. Of course she couldn't do well up there. What's great about this is it's not just work. There's so many different areas that we can actually apply your chronotype and figure out the perfect time of day for you to do something. I'll go through four different activities right now. I'm going to do eating, caffeine, exercise and intimacy. Don't worry, I save the best for last. So let's talk about eating. It turns out that when you want to digest food, it's almost like Grand Central Station in your gut, right? You got trains coming in from all directions, and when it all moves smoothly, trains go in and trains go out. But if you're not eating at the right time, your digestive system isn't ready, and guess what happens? Pile up of pounds. So what I've done is I've created, actually, a schedule for people. So once you figure out what your chronotype is, it turns out if you eat within a 12-hour block, you'll maintain your weight with almost any kind of diet. In an eight-hour block, you'll actually start to lose weight. Again, if you keep that block in your particular chronotype. So I've listed them all up here for everybody to check out. Next, let's talk about something else that we all kind of eat, kind of don't. As a wolf, I'm not a big fan of breakfast, but a lot of people out there are big fans of coffee, right? Or caffeine. Caffeine is the most abused substance in the world, but what's fascinating about caffeine is that lots of us use it to help wake us up in the morning. Why? Because our schedules are out of sync because we're not leading our chronotypical life. So it's pretty interesting, but when you look at how you wake up in the morning, you need two hormones, cortisol and adrenaline, to pull you out of a state of unconsciousness. Well, if you compare cortisol and adrenaline to caffeine, there's no comparison. Cortisol and adrenaline are dramatically more powerful to pull you out of that unconscious state. So why on earth are so many people drinking caffeine in the morning? Because they're not synced with their chronotype. Their cortisol and adrenaline isn't coming up when their body wants it too because an alarm is going off, making them wake up at 6:00 AM. So if you're going to use caffeine, believe it or not, the best thing to do is to wait 90 minutes after you wake up - nobody likes it when I say that part, just to let you know. But that's okay. Wait 90 minutes after you wake up, when your cortisol level is slowly starting to dip, and caffeine will actually catch it and help move it up and give you that alertness that you're looking for. Now, I'm not a big fan of using caffeine every day or many times a day, but if you are, I've actually created a schedule based on your chronotype of the best time to drink caffeine for it to give you the most power for the punch. Now, you'll notice up here that wolves only get one time per caffeine. Because we're so awake at night anyway, we certainly don't need to add caffeine to the mix. Next, let's talk about exercise. So I'm a runner, and I love to do cardio, and we all know that when we do cardio, it's actually so very healthy for us. Now, that doesn't mean we have to run a marathon. But if we can just be active for 20 or 30 minutes each day, it can have tremendous improvement. Because when we don't, we have a buildup of oxidative stress, lots of inflammation. We're now learning inflammation really seems to be the root of all evil, but the great news is, it's all very reversible if we do our exercise. But the best time to do exercise can turn out to give us different results. Did you know that if you went for a run at one time of day, you could lose weight, but at another time of day, you could perform better? It's true. So what I've done up here is I've created a schedule for folks - and you can do any type of cardio, not just running, with this - to look at what are the best times to do things. I'll go through this really quickly since this is something a lot of us do. Lions have a tendency to [run] at 5:30 in the morning. Now, why? Number one, they're up - not me, but they are - and they actually do a really good job because what will happen is they'll run on an empty stomach, not a dehydrated stomach - let's be clear here, they hydrate - but if you run on an empty stomach, you burn more fat. And so for lions who might be concerned with that, running at 5:30 is a good idea. Big problem here, though, is watch out for injury because your body isn't warmed up yet. Next, we go to bears. Bears will be best if they do their cardio at 7:30 in the morning or around 12:30. There's a hint here, though, with all of you bears out there, if you don't exercise before 12, you're probably not going to do it. I've learned this from many of my bear patients, for sure. But having two times of day represents two different things: for bears, if they run at 7:30 AM, it's more fat burning because they run on an empty stomach, and at 12:30, it's actually better performance. When we look at wolves, we really don't like to do anything in the mornings, and so running in the evenings turns out to be really good for me, being around 6:00, and if I run on an empty stomach, meaning I had my lunch at noon and haven't eaten in a while, that can be fat burning or it can promote performance. And dolphins turn out to be best at doing cardio early in the morning. Why? Because it calms down their anxiety. Many of my dolphins are, again, my insomniacs; they have a lot of anxiety. And so this allows them to really start their day in a much easier way. Now, we'll get to the subject everyone wants to talk about, usually, with me, which is intimacy. Believe it or not, there are perfect times of day to be intimate. Turns out you need five different hormones in order to be intimate: you need estrogen, progesterone, testosterone, adrenaline and cortisol all to be raised, and you need melatonin, the sleep hormone, to be lower. A survey that was done discovered that roughly 74% of people are intimate between 10:30 and 11:30 at night. I'll give you one guess what their hormone profile looks like. It's not estrogen, testosterone all raised and melatonin low. It's literally the opposite. So what is the recommendation from the sleep doctor? Believe it or not, intimacy in the morning could actually be much better for both parties, not only from a performance standpoint but also from a desire standpoint. Now, one question that I get asked very often: Well, what happens if my partner isn't the same chronotype as me? What are you going to do? Don't worry, I've figured it all out. Come see me. We'll talk about it later. (Laughter) Now, let's talk about another big question I get asked quite often, which is about, Will my chronotype change over time? It turns out we all experience all of the chronotypes. So when we're infants and babies, we're lions, right? Anybody who's ever had a child knows this, because they go to bed early and they wake up really early, sometimes a little too early for the likes of all of us, right? Once they hit the toddler age range, they actually turn into bears. They go to bed kind of when the sun gets down; they wake up kind of when the sun comes up. It's a little bit easier to manage them. And then the teenage years hit, right? I don't know about you - I've got two teenagers at home, and all I can you is it's a miracle that I can get them up in the morning sometimes. Teenagers, biologically, their whole circadian rhythm shifts, and what ends up happening is - it's not their fault - but they want to stay up until 2 and sleep until 2 the next day. It's not so easy to deal with some teenagers, but I promise you it's not their fault they don't want to wake up. Yes, you probably should let them sleep in on the weekends. What's interesting now, though, is once you hit adulthood, about 18 to 20, your chronotype sets, and you're usually that for a good 20 to 30 years until you hit, probably, 50, 55 age range, and then it happens again, but this time it's different. Instead of being a teenager who wants to stay up late, when you hit age 50, 55, you turn into an early bird, and you're eating your dinner at 4:30 in the afternoon, and you're waking up at 4:30 in the morning, right? Whole different ballgame going on here, but this is your biology speaking to you. Other things that can be pretty interesting when we talk about this is if you become medically frail - if you have a medical situation - those medications can actually affect your chronotype as well. The final question that I get asked all the time: Can you hack your chronotype? Can you change it because you don't like that you're a bear or a lion or a wolf or a dolphin? So here's the deal: you can, but it's kind of like having jet lag. And by the way, we're all shift workers if we're not a bear, because remember, the world works on a bear's schedule. So if you're a lion, a wolf or a dolphin, you're already kind of hacking your chronotype to fit it into the schedule that's already out there. My preference is talk with your boss. Remember Kate? Remember how much better she did when all I did was talk with her boss and move her schedule? I think everybody in the room, once you know what your chronotype is, you can lead a more productive and happier life. And with that, thanks. (Applause)