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Scot: Does it feel like it's a struggle to be healthy? And the Core Four that we talk about here on the show, nutrition, activity, mental health, and sleep, can seem simple, but in practice actually execution can be challenging.

Troy, I've got a question for you. What's your biggest kind of Core Four or other health challenge?

Troy: Sleep, without question.

Scot: I knew you were going to say that.

Troy: You knew I was going to say it. It really is. Sometimes I feel like I'm making progress and I feel like, "This is good," and then I'm just like, "I am just doing miserably with this." I'm waking up at 2:00 in the morning and I'm lying there and I'm just kind of staring at the ceiling for two hours. So sometimes I think I'm doing well. Other times I'm just like, "I have no idea how to sleep."

Scot: Huh.

Troy: Yeah. It's just a crazy thing.

Scot: What's that do to your self-esteem?

Troy: Exactly. As Mitch said before, "Babies do it. Why can't I do it?" Babies do it. My baby sleeps better than I do at this point.

Scot: Mitch, how about you? What's your biggest Core Four challenge or other health challenge?

Mitch: So I think the biggest thing that I've been kind of dealing with lately is getting back up to the activity levels I'd like to be at, but that's mostly because I injured my ankle again. I'm back in physical therapy. Where going for a jog and listening to a murder podcast used to be really fun, these days it's like, "Oh, I've got to make sure I'm going slow. Oh, I've got to make sure I'm babying my ankle, blah, blah, blah."

So it's right back to that situation of having to scale everything back a little bit for where I'm at right now, and that's been kind of a frustrating situation.

Scot: Already, at this point, I love what you both said. It makes me feel so much better that you said at one point things were good, but you're struggling to get back to the way they are, because that's what I constantly struggle with. I constantly struggle with, "I do pretty good, and then all of a sudden I don't do great at all." It's so intermittent. I'm just not very consistent, and both of you kind of brought that up.

For me, it's activity. That's the thing. I cannot seem to be consistent. I will go pretty well for a month, month and a half, do some weights, maybe get out and do some other sorts of things, get my heart rate up, and then all of a sudden it just all comes to a screeching halt, and I'm not exactly sure what's going on.

So here's something you as a listener should know up front. Some of the episodes we have very specific recommendations of things to do, and others, like this one, are just guys talking about their health and health challenges as a way to create some new understanding or knowledge that might help with some insights that could help us and hopefully you on your journey to be eating healthier as well, and maybe even being a little kinder to yourself.

That's one thing I've already picked out of this, is I've got to go back to that. Maybe always being perfect isn't the standard I should be measuring myself to. So that's today's show.

This is "Who Cares About Men's Health," with information, inspiration, and a different interpretation of men's health. I'm Scot Singpiel. I bring the BS. The MD to my BS, Dr. Troy Madsen.

Troy: Scot, I think this is a great topic for the middle of winter when everything just seems like you're just getting by. This is a good topic.

Scot: And the hardest working guy that I know of . . .

Mitch: Oh, man.

Scot: . . . when it comes to his health . . . I'm serious, man. I know that you feel like you have your struggles or whatnot, but you're working hard and getting it done. This is Mitch Sears on the show.

Mitch: Well, thank you. Yeah, it is a constant struggle, but yeah, it's something I do try to work hard at. I appreciate that.

Scot: I think for this conversation that's about "Why does it seem like it's a struggle to be healthy?" I think a great place to start is what is healthy even? What is this standard that we aspire towards? Because society has a different definition than perhaps maybe we have or what a more realistic kind of definition is.

So what is healthy from a man's perspective? What is the pursuit of health? How do you define that, Mitch?

Mitch: Well . . . Oh, man.

Scot: I totally understand where you're coming from. That's a good question.

Mitch: That's such a big question, because yeah, it's like . . .

Scot: Here's the thing though. You have to consider that question in order to figure out what are you even comparing yourself to, and is that fair to yourself?

Mitch: For sure. And that's kind of the thing that has been really interesting, having been someone who's started to take interest in their health over the last few years with this podcast and everything.

It seems like men especially, and this is just my kind of experience, are getting all sorts of goalposts and gold standards from a bunch of different places, and very few of those places are actually backed by research or everyday regular people, etc. So much of it is focused on getting ripped, getting tons of muscle mass. "Men's health is sexual health" is one of the mantras that I hear all the time.

I think that it makes it hard, because when you first start to really care about your health, unless you're actively trying to participate and check in and think about what it actually means to you as an individual, it's really easy to look at a cover of a "Men's Health" magazine and be like, "Oh, man, I am not as handsome as Ryan Reynolds, and therefore I am unhealthy." I don't know.

Scot: Or the influencers on social media.

Mitch: Oh, yeah. They're terrible. They're the worst. It's garbage.

Scot: Okay. You kind of talked about your opinion of how the media and society defines health. How do you define it then?

Mitch: Well, it's a constantly changing and shifting idea. And for me, the big central idea is "Am I feeling my best? Am I able to do the things I want to do? Is my health in one way or another limiting me from enjoying my time on this beautiful planet of ours?"

And so that's how I do it these days where it's like, "Eh, do I have 12 abs? No. But can I go for a hike in a pretty trail in the mountains? Yes or no?" That's kind of where I'm at.

Scot: Hey, Troy?

Troy: Yeah.

Scot: Do people have 12 abs?

Troy: Twelve abs? Yeah, good question.

Scot: I thought eight was the . . . Can you have a 12-pack?

Troy: A 12-pack.

Scot: You're the doctor here.

Troy: That's a good question. Yeah, I don't know. We'll have to go back to the cadaver lab, which I dreaded in medical school, and count the abs.

Scot: Troy, how about you? How do you perceive society's kind of definition of health versus how you define health?

Troy: I mean, I think society . . . I think Mitch hit on that already. It's a lot about image and how you appear to other people. I think that's a big piece of health in terms of societal definition, where I like to think of health . . . I think Mitch kind of touched on it already. My definition would be having the physical and emotional capacity to engage in the activities that I find rewarding, and hopefully having that capacity for many years.

And I think for different people, that means different things. Someone in their 60s, they want to engage maybe not in high-intensity activities or endurance activities or things like that, and that's their definition of health. They want to play with their grandkids or they want to spend time with friends and they want to have that capacity. And for them, that's what health is, versus maybe someone who's younger who wants to be more engaged in activities.

So that's how I see it, is having that capacity to do that. And again, I think it just means different things to different people.

Scot: Yeah. I'm sensing, getting back to what Mitch said about it can mean different things at different times, that it's an evolving idea, right?

Troy: Yeah.

Scot: It's not a destination. It's something that you're always kind of pursuing.

Troy: Yeah, for sure.

Scot: And then also I'd like to add to what both of you said. It's an external thing. I think that's huge, right? You look at somebody and you go, "Oh, they're healthy," but really maybe they're not. Maybe inside things aren't that great because of other lifestyle choices they're making, right?

Troy: Yeah, and it's so true. I think one thing, really, I appreciate about my job is that you do meet a lot of people who definitely have very much a public persona being very fit and having a wonderful life, and you gain a lot of insight into what's actually going on in their lives and you realize it's not always that way.

And so I think we often compare ourselves to other people and we compare ourselves to that image and that persona, whether that's the image of health or happiness or whatever it is, but everyone has their struggles.

I meet these people. Sometimes they're local celebrities or whatever it may be, and you realize they have their struggles too. We all do. And they're struggling with personal health issues, or maybe it's substance issues, other things they may bring up, emotional health issues.

And so I certainly don't take any pleasure in the struggles that they're facing, but I think it just puts things in perspective when we do start to compare ourselves to those people who really do seem like their lives are just perfect.

Scot: We're on the same podcast together, so maybe this is why our answers are so similar, because we all kind of have the same bit of thinking. But I'm really surprised because my definition of health is very much the same.

It empowers me to do the things I want to do. It's feeling good, it's functioning well, it's not being tired, it's not hurting or aching more than I really need to do, my brain is working, and I feel happy and finding satisfaction in my work because, from a mental health standpoint, I'm feeling good. I'm doing things that are going to help me with my longevity and ability to function as I age.

So that is my definition of health, but it's also something I feel like I have to manage every day. And this is one thing I think about, is how the modern world almost makes it more difficult to be healthy.

You ready for a soapbox moment? I'm going to go ahead and climb up on my soapbox.

Mitch: Yes.

Troy: Ready or not, I think we're going to get it, so let's hear it.

Scot: So I think about this a lot, and I don't know how much of this is true, right? But for example, activity used to be something that was a part of life. In order to survive, physical activity was involved. Now, there are a lot of people that still do have physically active jobs, but I spend a lot of time at a desk, so I've got to figure out a way to then fit that into my life.

And I feel like eating was a lot more simple, right? But in today's age, I'm constantly bombarded by commercials for food that's been chemically created to be addicting. And billions of dollars are spent on this to get me to eat this food that's convenient and not necessarily great for me.

And then I have a phone with apps on them that seem to suck up more time than I ever want them to, that I could be spending on healthier activities like exercise and sleep. And again, using psychology to making sure that I'm addicted to these apps, right? And I'm watching more and spending more and more time.

And then these daily images and messages about what it is to be a man and a healthy man that doesn't necessarily resemble me at all. I feel bombarded by that. So I feel like I'm constantly thinking about it and constantly having to manage that.

And don't get me wrong, I'm not saying, "Let's go back to the way things were," but I don't think health is something you can take for granted. I think you have to have kind of a plan and be mindful about it. Do you guys buy into any of that or am I just spouting crap?

Troy: No, it makes sense. Sometimes it feels like the cards are stacked against us. Again, you're exactly right. So much has been based on human psychology and addiction and feeding into those patterns, whether it be with diet or with, like you said, apps, or engagement with social media, those sorts of things.

It really has played off a lot of, I think, addictive tendencies that we have as humans to do those things, and so we have to be aware of it, and it's a struggle. I think that alone, the fact that there is so much understanding of our psychology and so much of that plays into our psychology and tendencies toward certain addictive patterns, it's a battle. There's no question.

Scot: And I feel like this can be going on without you even realizing it.

Troy: The simple reality is you can't just go with the flow and be healthy. You just can't, because the flow really pushes you toward those things.

Scot: I love that analogy.

Troy: Yeah, you really can't.

Scot: You're right.

Troy: You figure most Americans are overweight or obese, and that's the flow. That's the majority there. So if you're just going with the flow . . . Yeah, you kind of have to swim upstream in a sense to really be able to get beyond so many of those things that just draw you in. I think it is a huge struggle.

Scot: What are some of the challenges that you guys have experienced with either the Core Four or some other health things, and how did you overcome those?

Troy: Obviously, a big one for me has been sleep, and I can't say I've overcome it, but I think a lot of what we've talked about has been healthy, of trying to have more regular patterns in place and addressing that.

But I think some of the bigger issues for me where I have felt like I've had some success have been definitely activity. And for that, I think it's just been saying, "I'm going to do this and I'm going to try and do it every day and be consistent." And not expect heroic efforts on a daily basis, just to expect a consistent effort and just keep it up. And for whatever reason, that seems to have worked for me so far on the activity side.

But I think it's always a struggle of just saying, "Well, why am I doing this as much as I am? Do I really need to do this to get the results that maybe I want?"

So that, for me, I think is the struggle in other areas where I feel like I'm doing a pretty good job. It's more kind of that temptation to ease up on it or maybe say, "Well, this isn't really necessary," or, "Maybe it's not worth it," or, "Maybe I can get results by not doing what I'm doing and maybe cutting that in half," or something like that. So that's, I think, the challenge I face in some of those areas outside of sleep.

Scot: I want to ask you a question about sleep. I mean, is there really anything you can do? I know you've done some stuff, but part of it is just the job you have, which is, again, a result of the society we live in.

Troy: It is, yeah.

Scot: I mean, then the question is, do you beat yourself up too much about it or . . .

Troy: Yep, I do. And then it's just that spiral. And I think we've talked about that before. I think Mitch has talked about it.

Scot: The shame spiral, he calls it. I love it.

Troy: It's the shame spiral or it's the anxiety spiral. I think we get so anxious about not sleeping that we can't sleep. And that happens to me. And so sometimes I'm just like, "Just don't worry about it. Who cares?"

But you're right. That is very tough to do. And I think, again, there are just certain realities of a 24/7 society that needs people who are available for services or emergencies or whatever it may be at hours when people used to sleep on a regular basis. So I think there's that reality too.

But even that aside, sometimes I feel like I'm in a pretty good sleep pattern and then I might have a week or two without a late shift and I still find that I'm struggling. But again, maybe that's just that cumulative effect of working late and working nights.

Scot: And as far as your activity, what's the difference between you and then Mitch and I? Do you just have more willpower? Do you just have more discipline?

Troy: I was going to say obsessive-compulsive disorder, because that . . . No, I'm saying for me, it's the obsessive compulsive . . . I don't know.

Scot: A lot of times when we talk about health and fitness and the Core Four, it could be easy to go, "Well, you just have to have more willpower. You just have to have more self-control. You have to have more discipline." And maybe that's true to some extent, but are there other things at play that have helped you do that? Or are you just mentally made of sterner stuff than we are?

Troy: I don't know about sterner stuff. Maybe more disordered than you are. Yeah, I don't know. I tend to pride myself, I think, on trying to be very consistent on things, and it's been very good in a lot of ways. I think in terms of just medical school, you do have to have very much a Type A personality and you have to have a certain level of kind of that OCD tendency of very focused and like, "I'm doing this every day."

So I think it's been helpful in some ways in terms of success. It also kind of drives you crazy sometimes, so yeah. And maybe that's part of it for me, honestly. That may be a part of it for me, is just for whatever reason with this routine in particular and just with running in particular, it's been very much . . .

And then you get in a pattern where you've done it every day and it's like, "Well, I can't miss a day." I honestly have not missed a day in almost eight years, so it's been good. I feel like I'm in the best shape of my life, which I love feeling, and I've seen my cholesterol numbers continually improve. So I think there's been great reward there.

But again, I think my point in saying all this is it doesn't come easy. You do get in the habit and you have that habit and that helps you get out the door, but still it's hard. I enjoy it once I'm out there, but often it's hard to get out the door.

Scot: Mitch, what's your take on willpower or discipline being the reason that maybe some of us struggle to maintain these healthy things?

Mitch: That's actually something I have been spending a lot of time thinking about lately with the new diagnosis of ADHD and kind of figuring out what works for me, what doesn't.

A lot of times in the past, I would beat myself up that I was not performing, that I was not able to have enough willpower, that I was unable to do certain things, right? And these days, it's more recognizing that sometimes it's not all willpower. It's just consistency, a general trend towards positivity, a general trend towards doing a little better, the dao of Kaizen, little improvements every day.

It's not necessarily an all or nothing, and if you hold yourself to such a high standard and you don't meet it, it doesn't necessarily mean you don't have the willpower. There are a lot of other things that could be going on too that are preventing you from getting there.

Scot: Mitch, what's kind of your overall challenge then?

Mitch: We've mentioned a couple of times over the last year, my health got a whole lot more complicated than I was expecting. Everything from mental health issues, to physical injuries that I'm back in physical therapy for, to hormonal things that we have figured out and got me on some medications, etc. There's a lot of small progress being made on a lot of different fronts, but it does not feel like I'm actually accomplishing what I want to some days.

Scot: Yeah, I feel you completely. It's like you go on Instagram or TikTok and they've got a Reel, and it's somebody who wanted to get in shape at the beginning of January, and then within that 15-second video you see the before and the after awesomeness. And even though you know better, it just seems like, "Oh, that was an instant transformation."

Mitch: Yes. You get that before and after effect, right?

Scot: Yeah.

Mitch: For me, like we talked on a recent goal episode, it was like, "I want to get back to having X amount of activity all the time. I want to feel better about my mental health. I want to sleep better, etc." I'm doing okay at a bunch of those, but it's so easy to just say, "Well, I don't have enough willpower. Oh, this sucks," when I've got to keep reminding myself that I am not a Instagram influencer, that their whole job is to look happy and look fit, right?

I have a lot going on. I have a lot of stuff on my plate. I've got a job. I'm teaching classes. I am overcoming an injury, mental health stuff, whatever. Oh my god, I am doing okay for where I am right now. And that's kind of some of the stuff that . . .

It's so easy to just be like, "If only I had more willpower, I could be like these other people. If only I had enough willpower, I could be like Troy Madsen." But "right now, I'm doing okay" is where I feel some days.

And so it's just this kind of different approach to it that I've been taking and being a bit more kind to myself. And I find it's easier to do little good things if you're in a good headspace than beating yourself up that you weren't perfect every day.

Troy: Yeah, there's no question. And we've talked about that a bit before too, but I think that being kind to yourself is so essential because it's when we're not kind to ourselves that I think we really do kind of fall off the cliff in terms of our activity. When we do expect perfection or we compare ourselves and just get frustrated, that's when we just kind of throw in the towel and are like, "Ugh, this isn't worth it. Why am I doing this? I'm accomplishing nothing." So I totally agree. We have to be kind to ourselves.

And for me, like I said, in terms of the activity, I feel like I've been very, very consistent there, but then there's the diet piece. That's kind of improved and then it's gotten worse, and sometimes I'm wanting to eat some sweets and I want to drink soda and these kinds of things. But there, sometimes I do kind of feel that tendency. Certainly when we travel, I'm not eating like I should. Then you kind of get frustrated and unhappy with yourself.

But again, I think you just kind of have to look big picture and say, "Overall things are good and I'm not going to be perfect with this, but I'm happy with where I am, and I'm better than where I was 10 years ago. So that's good."

Mitch: Right. So, in that same vein, as someone who deals with a lot of anxiety, someone who deals with the shame spiral, as I've come to call it, this idea of, "Oh, no, I'm not performing as well," and then you feel bad about feeling bad and then it just gets worse and worse, one of the mantras for 2023 that I'm adopting from the younger generation is this idea of if it's worth doing, it's worth doing half-assed.

I don't know how else to say that. We'll have to bleep it because half-butted doesn't sound right, but . . .

Troy: Halfway?

Mitch: Halfway, sure. There you go. Yeah. But it's this concept that perfectionism and the idea that you have to hold yourself to that 100% standard and you have to hustle for it and you've got to push for it can be so detrimental, because what if you don't achieve it? What if you don't hit that 100% mark?

So, as such, the kind of approach is . . . Say you want to work out six days a week, whatever that is. It's better to be consistent, so even if you can't get your butt to the gym three to four times a week like you'd like, going for a walk for 20 minutes is still activity and it's still good for you. Will you see as much of a result as if you were to go in and do whatever? No. But at the very least, you are still doing it, right?

And so, for me, if I can't get my strength training in, if I can't get enough of a jog in or whatever because of my injury that I'm dealing with or whatever, I'll just walk around the block a couple times. Because even doing it just half of what you wanted to do is better than nothing at all, or hating yourself that you didn't hit that.

And it goes to nutrition. If you're not eating healthy every single day, that's okay, right? Just get yourself a chicken sandwich instead of a Baconator. Those kinds of small choices that are like, "Is it the best thing you could be doing right now? No. But it's good enough and it's at least a step in the right direction."

Troy: That's so true. Yeah, I'm a huge believer in that as well and just this idea of . . . I think you're far better off doing something and doing it halfway and doing an okay job of it, but doing it consistently, than you are of doing something extremely well but doing it irregularly. I think you're going to get more results if you just try and stick with it.

Whatever it is, just kind of do whatever you can, and maybe it's not great, rather than having these huge workouts at the gym, but just feeling burned out by it and not wanting to do it more than maybe once or twice a week.

Scot: I'm going to go ahead and throw mine out there. And actually, in homage to Troy, I'm going to recognize what I feel like I do well most of the time. My nutrition, I feel pretty good for the most part, if I'm being honest with myself.

It's easy to beat myself up. Over Christmas break, I ate a lot of salted caramels at 100 calories each, four or five at a time. But I'm off those, right? So that wasn't great. But generally, I feel pretty good about my eating. I don't eat a lot of processed foods or anything like that.

Generally, I feel pretty good about my sleep. Generally, I am feeling better about my mental health, but that activity thing, especially weight training, is always a challenge.

And the thing that I'm trying to do . . . Like I said, I always come up with these little tricks. Sometimes at the end of the day I'm so tired, I just want to do something mindless, and then that's when I go to the phone and I start scrolling, right?

And I saw something that said, "There are these little moments in our day where we make a decision that's going to dictate what happens for the next hour of our life." So I think about that a lot.

I'll pull out my phone when I know I want to exercise and I'm like, "This is that moment. This is that little decision that's going to take the next half hour of my day, or hour, and going to prevent me from doing the thing that I want to do." And then for some reason, it's easier to make the choice of the thing I want to do.

So that's been helpful for me, and I think it could apply to a lot of things. It could apply to eating. It could apply to a lot of stuff in your life. So just that notion that there are these little small moments throughout our day that the next thing we do is going to dictate what we're going to be doing for the next half hour.

Troy: That's true. I think also, though, I like kind of rewarding myself by just mindlessly scrolling on the phone and feeling like I've earned that time because I did exercise and I did the things that I wanted to do. I'm like, "I'm just going to sit here."

And sometimes Laura will make fun of me because I've got a game on the TV, and I've got a game on my iPad that I'm watching, and I'm scrolling through ESPN on iPhone, and I'm like, "I'm going to do this completely shamelessly because who cares? I already ran today." I think there's kind of a trade-off there too.

Scot: But it's a mindful decision. You mindfully made that decision, which took active management again, right?

Mitch: Yeah. Intention versus just defaulting.

Scot: Going with the wave, as Troy said.

Troy: That's true. Yeah, you're right. It is. You're right. You do have those choices you can make, but then at the same time, you can make the choice later and be like, "Hey, I've earned this. I'm just going to enjoy this time. I'm just going to turn my brain off."

Scot: But the worst thing, Troy, is when I reach one of those little moments in my day, and yet I still choose the thing that I shouldn't choose. And I'm willfully doing it and I'm even admitting it to myself at that point. I'm like, "This is that moment and I've chosen to do this instead." It's just almost like waving my fist at authority.

Troy: Yeah. Exactly. But then hopefully you can just kind of forgive yourself and move on from it. That's part of it too, is recognizing, "Hey, I willfully made this choice. It's probably not the choice I should have made, but I'll maybe make a different choice next time."

Scot: All right. Did we get any insight from this conversation? At the top of the show, I mentioned that some shows we have some great solid steps that you can take and things you can do. This one was more of just trying to make some sense out of some things that are going on as we struggle with our own health and our own health issues and the things that give us challenges and trying to explore why that might be. Did we create anything new? Mitch, do you have anything?

Mitch: For me, it's nice to hear that other folks are going through this too, right? It's so easy to get in your own head and only be watching the influencers and thinking you're not doing well enough. I really do appreciate, Troy, to know that you struggle with stuff too. I don't want to say I love that, but it is very appreciated that . . .

Troy: You can love it. Please love it.

Mitch: I love it. Best thing. No, but it's nice to know that, "Hey, there are other people also on their own journey and maybe I need to quit comparing myself to everyone."

Troy: Yeah, I think for me too, hearing about some of your struggles and just talking about some of my struggles. I think that's probably the takeaway for everyone, is I don't think you've ever got it made. I think that's the bottom line. With fitness, you've never got it made. It's never easy. It's always challenging, no matter what habits you've developed.

That pattern can help you to keep that habit going, but I still think there's a mental challenge every day and you're always going to face those decisions, like you talked about, Scot, of "What am I going to do with this moment right now?"

And you're always going to face just the flow and avoiding the flow, which just seems to kind of drag you into a lot of the stuff you just don't want to do in terms of the eating habits and being fully absorbed in social media or whatever it may be. So I think that's my takeaway.

Scot: I feel like my takeaway was something that Mitch said, which is that health to him is something that you're . . . It's a work in progress, right? And sometimes . . .

Mitch: WIP.

Scot: Sometimes in your work in progress, you're in a better position than you are at other times, but it's just always kind of a work in progress.

And I agree with Mitch. It is also good to hear that this feeling that you're constantly managing it is something that goes beyond just me.

Well, we hope this episode was useful to you as we discussed some of the struggles that we have. And a lot of times when you're talking about the Core Four and our health, there are some things that are playing against us that we don't even realize, whether it's society or whether it's our own attitudes.

What is your struggle when it comes to the Core Four and being healthy? And have you figured out how to overcome it yet, or do you still struggle with it? Are you still looking for answers? We would love to hear about your journey. Send that email to hello@thescoperadio.com.

And regardless, whatever your struggle is, good luck and be kind to yourself. Thanks for listening, and thanks for caring about men's health.
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This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Getting up at 5:00 in the morning and then grinding into the night to get things done, that's a badge of honor. "I'm not lazy. I'm getting it done. I'll just get a couple energy drinks and do it again tomorrow." Probably heard the saying, "I'll sleep when I'm dead." That feels pretty manly to say, by the way.

Regardless, if it makes you feel good to tell people how little you sleep, or there are other reasons you're not getting sleep, sleep has proven health benefits and not getting enough can have similar downsides as not getting enough activity or good food.

You could have the other three core four dialed in and if you're not getting enough sleep, it could sabotage at all. That's how important sleep is.

So today, on the "Core Four: Back to Basics" series, we're going to talk about sleep, how good sleep improves your life and how to get better sleep.

My name is Scot Singpiel. I bring the BS to the proceedings here, and the MD to my BS is Dr. Troy Madsen. And before you say hi, I want you to say, "I'm Dr. Troy Madsen, and I'll sleep when I'm dead," in your manliest voice.

Troy: I'm Dr. Troy Madsen, and I'll sleep when I'm dead.

Scot: Also we've got Mitch Sears in the mix. Same thing.

Mitch: I'm Mitch Sears, and I'll sleep when I'm dead.

Troy: Sounded like you were thinking about it. You're like, "I'll sleep tonight."

Scot: We have one opportunity for our manliness to be saved here, and that's Thunder Jalili.

Thunder: I'm Thunder Jalili, and I will sleep when I'm dead.

Scot: There you go. All right. So, today, we are going to talk about the benefits of good sleep. And for some reason, I think society kind of undervalues sleep. What do you guys think of that? When we think about being healthy, it's pretty common to come to nutrition or exercise, but sleep is just as crucial as we're going to learn in a couple of seconds. Is it just me, or does society kind of devalue it? And why do you think that is?

Thunder: I think actually American society maybe does devalue sleep. I think it's part of our work hard work ethic, get it all in and don't be a wimp, and get your stuff done, because other cultures around the world aren't like ours. The Spanish, they value sleep. They have a nap built into the day. We're not like that.

Troy: Yeah, I agree. I think we definitely undervalue it and it certainly is a badge of honor for a lot of people. And as someone who works in the healthcare profession, I can say it is absolutely a badge of honor. If you can talk about how little you sleep or let's say you say, "I just came off a night shift and I didn't go home and sleep, and now I'm here in the office working all day," that's a badge of honor. It's not like, "Wow. That's stupid." Yeah, no question about it.

Mitch: I remember when I was working in broadcast, you would come in and the night shift would be coming off and they would have their pile of energy drinks and they would just be very proud of how much caffeine they were functioning off of and "still getting a good job done." That was always very like, "What are we doing?"

Scot: Dr. Madsen or anybody, do you think that people just don't realize the benefit of sleep? Because a lot of times it's the first thing to get jettisoned, right? When things get tight in your life, that's where you'll cheat, either getting up early or staying up late to get things done. Do you think it's just because people don't realize what that tradeoff is actually costing them?

Troy: Yeah, it may just be that we don't quite realize the magnitude of the effect. I think we recognize, "Yeah, there's some detrimental effect, but those effects are more immediate. I'm tired, but I can use caffeine. I can drink some caffeine or whatever, and that will eliminate that short-term effect." But I do think we definitely undervalue the long-term effects.

Thunder: Yeah, I agree with that. I think cutting sleep is an easy thing to do in the short-term to get things done, and there are ways to get around it, like Troy said, with caffeine. So I agree with him completely.

Scot: All right. I think that's a good segue into talking about the benefits of getting enough sleep and how it can impact your health. Thunder, go ahead and kick us off on that.

Thunder: So there are many benefits to getting good sleep. I'll just share a couple with you. One is sleep is actually tied into maintaining healthy body weight. And I know that's a big focus of what we've talked about on this show in the past. We talk a lot about the exercise and the nutrition component, but getting enough sleep is also a valuable contributor to healthy body weight.

The other thing that's great about sleep is it helps you keep your stress levels low and it helps improve your mood. If you think about it, think about the nights that you haven't gotten a good night's sleep and you wake up the next day and you're just kind of a little grumpy or a little off and things are bothering you. That's something everyone has experienced, and that's really that function of not getting enough sleep.

So having that regular sleep schedule can definitely improve with that. It gives your mind a chance to reset at night and reduce your stress level.

Troy: Yeah. Thanks, Thunder. And the other thing too that I've definitely seen plenty of studies that have shown that sleep lowers your risk for diseases like diabetes and heart disease and cancer as well, like long-term studies.

It's a little scary because I've often seen these studies done with shift workers like myself, which is kind of depressing, but it is one of those things. They do find those who don't sleep well do have higher risk of diabetes, heart disease.

I think the obvious thing we've talked about already is it does help you to think more clearly. But this is something that's been quantified in multiple studies. They've kept people awake for 18 to 24 hours and just noted their ability to perform tasks just declines over time to the point where . . . At 18 to 24 hours, you're at a point where your technical skills, and your focus, and your attention are on par with if you were legally intoxicated. So definitely effects there.

I think we all know we've had those experiences when we don't sleep well, we get sick. Sleeping well helps us to stay healthier, get sick left less often, and helps us look better too. We look better. We look healthier. Our appearance is improved when we sleep well, when we're well-rested. So that's a big thing as well.

Thunder: Don't have those bags under your eyes.

Troy: Exactly. Get rid of the bags.

Scot: I'm noticing the last two episodes that that's been Troy's thing, appearance. So do you want to talk about something?

Troy: I'm feeling self-conscious about my appearance and I need to sleep more. Maybe that's it.

Scot: You look wonderful.

Troy: Thanks, Scot.

Scot: We're going to hit up here some of our sleep struggles and then what we've done to try to work through those or not work through those.

But first, Mitch, let's talk about, like we have in past episodes, the basics. These are kind of the rules that you want to try to incorporate when you're talking about sleep.

Mitch: Yeah. And these are the ones that have been kind of tried and proven from research and studies, etc. So these are kind of the things that have the most evidence behind them.

The first thing that you want to do with your sleep is to prioritize it. And it's important to realize that when you prioritize sleep, it also means that it's not just quality of sleep. It's also quantity of sleep.

So what they're saying is that you need to get at least a minimum of seven hours and that you can't really just make it up. You can't sleep four hours one night and nine the next and expect it to be as healthy as if you were to get seven hours each night.

The other thing is that in order to get a better quality sleep, try to go to bed at about the same time every night and wake up at the same time every morning, which is something that we've kind of talked about before with Kelly Baron on a previous episode about everything from your sleep hygiene to making sure that you're going to bed and waking up at the same time every morning.

Now, the other thing you want to make sure to do is to not underestimate how things you do during the day can impact your sleep. A lot of things you do throughout the day can really impact not only the quality, but the quantity of sleep that you're actually getting. So make sure that exercise, nutrition, and mental health are all big factors that go into your sleep.

Stress, anxiety, depression can all impact how well you sleep every night. Activity, exercise during the day is good, but not less than two hours before bedtime. They've shown that that can kind of interrupt your sleep cycle, if you work out too close to going to bed. And finally, caffeine, alcohol, and nicotine four to six hours before bedtime and big meals before bed can impact your quality of sleep.

So you just want to make sure that you're not working out too close to bed, but you should be working out through the day, and to kind of avoid some of these different chemicals that can really impact the quality of your sleep.

The other thing is that sleep environment needs to be dark, quiet, and a comfortable to temperature. By making sure all of those things are kind of in place, it will really improve the quality of your sleep.

And make sure that you are not doing things that engage your brain like screens, TVs, games, radio, talking on the phone. If you do those things too close to sleep, it can also impact the quality of sleep that you get.

And finally, if you've tried everything else and you are still having trouble with sleep, go talk to a doctor and rule out that you don't have a sleeping disorder.

Scot: Some good basics there. So let's hit the sleep struggles. I want to start with Troy because you work in the ER, you work crazy shifts, you might be working during the day for a few days and then you do an overnight shift. What is one of your sleep struggles?

Troy: My sleep struggles are so plentiful, it's difficult to choose from them. But like you said, Scot, I do shift work, so I end up working nights, evenings. And for me, evening means I get to bed at like 2:00 or 3:00 in the morning. Night means I get to bed at like maybe 9:00 or 10:00 in the morning.

Scot: Wow.

Troy: Yeah. And so I'm trying to do that and then turn around double back and do a 7:00 a.m. shift the next day and do a 10-hour day on that.

So I have no doubt, and I think talking to Kelly Baron, it was very clear I do suffer from shift work sleep disorder. It's not something I really had prior to doing shifts when I started my residency training.

I have plenty of times where I think I don't struggle so much to get to sleep. I generally fall asleep once I get back into my regular routine, but then I will often find that I'm awake four hours later and just lying there and not sleeping. So that's probably the biggest for me.

I feel like I can get to sleep, I can fall asleep, but then I'm often awake a few hours later and not sleeping at that point. So that's definitely a struggle and I think not an uncommon struggle, definitely for people who do shift work, but I think a lot of people I've talked to have that issue as well.

Scot: Yeah. I look forward to hearing if you have some things that you've figured out of work around that. I mean, you can't totally fix it, right? The best you can do is kind of make the best out of a worse situation.

Troy: Yeah.

Scot: Thunder, how about you? Do you have any sleep struggles or you do all right?

Thunder: In general, I do all right. But my sleep struggle that does come up from time to time, believe it or not, is temperature. If it's too warm, I have trouble sleeping. So I have to be aware of that. Most of the time it's fine, especially in my own house, but when I travel, sometimes you're out of your comfort zone and you're someplace where the temperature may not be right.

So I try to do what I can, make sure I'm not putting too many covers on the bed because if it's too warm, it's tough. Hopefully I can adjust the temperature in a room, things like that. But that's my main challenge.

Scot: I'm pretty fortunate that I haven't had a lot of struggles. I have a job that allows me to have a pretty regimented sleep schedule. And for the most part, I fall asleep. For the most part, I sleep through the night. And then for the most part, I'm able to wake up in the morning when I need to. So I am pretty fortunate.

I think my biggest challenge, though, is I'm always thinking. My brain is always going, and sometimes I'll just lay in bed and I can't quite shut it all off. And part of it might be my fault. Maybe I was doing something too close to bedtime, but that's kind of mainly the struggle that I have.

How about you, Mitch?

Mitch: So I guess I have a slightly different story here. I have always struggled with waking up feeling refreshed. Every single night, it just feels like I haven't gotten any sleep the night prior and it's day after day after day, month after month.

I've been working with my doctor for the last year to try to figure out what I should be doing. And from stuff that we've talked about on the show, I've made sure that I go to bed at the same time every night. I'm waking up at the same time in the morning. I've played around with using a little bit of melatonin sometimes before bed. I've tried making sure not to look at screens or anything beforehand, and it doesn't seem to help.

And it was just recently after trying all of these things, my doctor had me do an at-home sleep study and they think they have found that I have sleep apnea. So I am waiting to go to do a formal sleep study in the next month or so and kind of figure out what's going on.

The struggle I've been having is I try everything and I still feel so tired. And when it comes to the Core Four, I'm working on my nutrition, I'm working out, I'm doing all the mental health things I can, but sleep has been one that's been really troublesome. And it eventually led me to talk to the doctor and we might be able to actually fix it now that we can find what's going on.

Troy: That's great you did that, though, Mitch. You talked to them and you went and looked for help. Yeah, that's a common story I hear from people where they say exactly that. They feel like they're getting plenty of hours of sleep, but they are just awake and they are not refreshed.

And I'm guessing they talked to you about in your sleep study, or in the sleep study you'll do, if they do see that, you wake up so many times at night due the sleep apnea that you're really not sleeping a whole lot, or at least good, deep REM sleep.

Mitch: Yeah. And that's kind of what they've explained. It's like, "Hey, if you have a sleep disorder, whether it be apnea or . . ." They talked about some restless leg syndrome. They talked about all these different kinds of things that can keep you up through the night. It doesn't matter what you're doing. It doesn't matter how often you're going to bed. It doesn't matter how healthy you are with your sleep hygiene and your hours and everything. If your body has something a little messed up that is waking you up all night, it doesn't matter. So that's where I'm at.

Troy: You're going the right direction. That's good. That's good to hear.

Scot: Mitch, do you find that impacts you, any of your other Core Four, like your nutrition, your . . .

Mitch: Oh, yeah.

Scot: How so?

Mitch: So I find that on days where I have not had any restful sleep and it's been day, after day, after day, when your energy level is so low, the idea of cooking a meal goes right out the window, right? In my sleep deprived state, all I want is a Big Mac. You go straight to the fast food whenever you can.

When I'm tired, I find that I can't work out the way I'm supposed to. When I go out for a jog or something like that, I can't go nearly as far as I think I need to. The whole process is really kind of frustrating and your heart rate gets up higher than it's supposed to, etc.

And mental health-wise, things . . . We're living in a very stressful time right now and I find that on the days where I don't get enough sleep or I'm not able to sneak off and take a nap in the middle of the day, I get really stressed and my anxiety gets high and I'm quicker to be frustrated and all sorts of things.

And it's been really surprising, ever since starting working on this podcast, that I'm focusing so much on all aspects of my health, but sleep was the last one. Sleep was the one that was like, "Eh, that one will figure itself out." But here I am learning that maybe I have something else going on. And hopefully, by working with my doctor and finding out a treatment plan, maybe in the next little while I can start seeing better results elsewhere.

Scot: That's a great point about how "maybe it'll just work itself out," right? This notion of "something might fix itself," I think that can be kind of dangerous, and I think a lot of us guys have that.

Mitch: And that was kind of the thing that was interesting when I first started speaking with my doctor. He was like, "Well, yeah, if you're having trouble sleeping, you might be having mental health stuff. Why don't you go talk to someone about that?" and, "Oh, when you start getting more activity, I'm sure you'll feel tired by the end of the day," and, "Oh, if you improve your nutrition and drink less caffeine, I'm sure your sleep will kind of fall into place."

And so, for the last year, I've really been working under that assumption that sleep is easy, sleep is going to just happen if I do all these right things. But if you're out there and you've been trying everything, maybe it's time to talk to a doctor.

Scot: All right. Let's go ahead and talk about maybe three struggles or three things that we've learned and what we've done to overcome those. And again, the hope is that if somebody else is struggling with something similar, this might be a new, fresh idea for them.

So I'm going to kick things off with this notion of a dedicated bedtime, being sure that you get to bed at the time that you've decided to get to bed. For me, it was 10:00. And it was challenging because if it was 9:15 or 9:30 and my wife and I were up and we were hanging out and she wanted to start a show, I'm like, "Well, it's going to be 52 minutes. I can't do that. That's going to put me past my bedtime."

Or sometimes I feel like I don't have enough time in the day to get things done. And I'm sure that's something that a lot of men deal with. And so, as a result, you push into the night, or what I've learned is you kind of have to prioritize what's important or ask for help to get all the things done that you need to get done. You can let go of some of those things.

So a dedicated bedtime has really, really helped me, and it helps me wake up a lot more refreshed, but it is challenging for those reasons and other reasons as well.

Troy: Scot, I'm going to jump right on that, and I'm going to say also a dedicated wake-up time. That's been big for me. We talked about that also with Kelly and just saying, "I'm going to get up every day." For me, it's, "I'm going to get up every day by 7:00 a.m. regardless."

And certainly, I have shifts where I have to get up early. I don't care if it's the weekend, whatever. Granted, I did mention there those times I'm getting to bed at like 3:00 or 4:00 in the morning, so I might sleep in a little after that. But once I'm in my regular routine, I'm up at 7:00, and I know I'm going to get up at 7:00.

Just knowing that, it kind of helps mentally, because before, I would kind of give myself this nebulous wake-up time. If I didn't have a shift or if I didn't have something going on early, I'd be like, "Well, I'll just get up when I wake up, because I have to make up for my missed sleep."

And then during my night sleeping, I would just lie there and I wouldn't really fall back asleep and I would just be like, "Well, I don't really have to get up. Okay. Maybe 9:00. Maybe it'll be 10:00." Kind of this mental thing where I just kept putting it off in my mind.

But I think knowing, "Hey, I'm going to be up at 7:00," something about that mentally just lets me know, "This is my sleep time, and I'm going to take advantage of it and I'm not going to sleep past that, so don't think I'm going to be able to make up what I'm missing now by sleeping in until 9:00."

Thunder: So I'm going to jump on the regular schedule bandwagon as well. I'm also all about that, going to bed about the same time and waking up about the same time.

I will add one thing about the waking. I usually wake up around 6:30, give or take a little bit, and I never have to set an alarm because I'm used to waking up at 6:30. So all the things that you have to do in life that you have to wake up early for and you need to set an alarm for, I never do that, and I find it cuts down on my stress level the night before. You're not thinking, "Oh, I've got to wake up extra early," or, "My alarm is going to go off," or something. You just wake up at your normal time.

The new thing I'll add to that is I have a bit of a relaxation routine that I engage in almost every night, and that is I read a little bit before bed. And for me, that works. I'm talking reading out of an actual book, or a magazine, or sometimes I'll read on my Kindle with a black screen.

So that kind of helps my mind disconnect from whatever was going on during the day and get lost in something else for a little bit. And I don't last too long reading. Maybe I can do like 10 minutes to 30 minutes, depending on what it is. So that's part of my routine, that little relaxation moment.

Scot: All right. Mitch, you're up.

Mitch: So the thing that it really helped me out is I'm the worst millennial. I am on my phone up until . . . I used to be, at least. I was on my phone up until the moment of my bedtime. What I have found is that regardless of your phone, most modern phones, whether it be an iPhone or an Android, they have digital wellbeing settings. And if you can go into there and turn them on and respect them, it has really helped me make sure that I'm not doing too much screen time before bed.

On my phone, at least, I set in my bedtime. I'm like, "Hey, I want to start winding down. I want to stop using my screen for an hour before bed. Here's when I want it." And when the phone hits that time period, it turns off all my notifications, it turns super-duper dim, and black and white.

And it seems kind of dumb because it's like, "Well, I can still use the phone." But for some reason, the lack of color, the fact it's super dim, the fact that you can't hear anything, it really helps just kind of disconnect and set it aside before I go to bed.

Scot: That was a big thing for me too. Up until recently, I would go to bed and I'd get out my iPad and I'd scroll social media, and then I'd find something that enraged me and then I couldn't stop thinking. Somebody would make some comment and then I would spend the next hour coming up with what my comment would be back to them, right? So, for me, getting rid of that social media has been absolutely crucial.

And the other thing that I struggled with too, and, Mitch, tell me if you did this, are the Instagram Reels, which are like TikTok videos, right?

Mitch: Oh, yeah.

Scot: I'd watch those. And even if I'd quit an hour before bedtime, then I'd have one of those stupid songs playing in my head and I couldn't get it out and fall asleep.

Mitch: Well, it's so easy to just get sucked into that hole too. You're just scrolling, and swiping, and swiping, and swiping and the next thing you know, it's like, "Oh, man, I've been doing this for two hours."

Troy: And how much of our life do we waste just thinking about snarky replies to other people's snarky replies?

Scot: Right?

Troy: I totally hear you on that. It's like, "What am I going to say to this?"

Scot: That I would never ever actually enter in, but I'll spend a lot of time thinking about what it's going to be.

Troy: Yep. I'm going to think about it, and it's going to be good. It's going to keep me up all night.

Scot: All right. Number two for me. Now, I don't know if this is a type of meditation or what, but it's a little exercise I do. It could be considered maybe a form accounting sheep or whatever. But if I'm struggling falling asleep, I will pick a color. That kind of tends to be my go-to. So I'll pick the color green, for example, and then I'll just let my mind go and think about things in my life that are green or in my past that have been green.

Troy: Oh, wow.

Scot: It takes me down this kind of memory lane. My parents' first car that I remember was this big green Plymouth from the 1970s. And then I'll think, "Oh, I had a toy box. It was a frog, and it was green." I just kind of let my mind go where it wants to with whatever color I've picked, and I find that after a few minutes of that, I feel kind of tired or I might just fall right asleep. So it's a little weird, but it's worked for me.

Thunder: So it's so boring that it puts you to sleep?

Troy: I guess so. I just feel like that would be too engaging. You would really be thinking way back into your childhood and trying to come up with all different things. I don't know. That's interesting. You just kind of let your mind wander and somehow that puts you to . . . I've never heard of people doing that, but whatever works.

Scot: Yeah. I mean, I get the engaging part because I have caught myself in the trap where I'm engaging and thinking about it too much. I think, for me, the trick really is just to let your mind wander through your past and just those things that were green. So anyway, that's mine.

Thunder: It almost sounds like a type of meditation. You pick one thing and you just kind of reflect on it and just let your mind go on it.

Scot: I don't know why it works, but it works. Who's next?

Thunder: Another thing that works to me for me is related to . . . We talked a little bit about temperature of the room is important. So we have this Nest thermostat in our home and it's programmed to start reducing temperature around 9:00. And it's great in a winter because by the time I want to go to bed around 10-ish, the temperature of the bedroom is probably like around 65 degrees, which for me is a good temperature.

So it's kind of good. It's automated, so I don't have to do it. It just happens every evening, and that is part of what helps with my sleep schedule.

Troy: Well, kind of along the lines of making sure you're addressing external factors, for me, it's about white noise and sleep mask.

Six years ago, I reached a point where I said, "I'm going to do everything I can to try and optimize my sleep and do what I can to optimize it and control what I can in terms of environment." For me, that meant white noise.

And for me, white noise means I actually have earbuds I sleep with that are made for sleeping. They're comfortable. They're soft. And then I just have a white noise thing I play that I listen to there, just kind of a sound of a fan or something. And I wear a sleep mask.

For me, that's made a big difference just being able to have that, control what I can, trying to eliminate the light, and noise, and all those sorts of things.

Mitch: And even for people who aren't doing shift work where you might be trying to sleep during the daytime, there are a lot of little itty bitty lights that are turned on in every room, in my house at least, whether it be a little power indicator light, or whether it be the light on a fan, whatever. And it has been night and day since I've gotten my sleep mask how quickly I'm able to fall asleep and stay asleep.

Scot: Tell me more about these earbuds that you have in because I've seen Bose advertise these sleep-only earbuds, but they're super expensive, right?

Troy: Yeah, crazy expensive.

Scot: Yeah. So did you find a cheaper alternative, and how do they work?

Scot: Mine are super, super cheap. It's like $10. They're designed to be ergonomic flat. They're noise-blocking. So they're just earbuds. They're soft. It did take about a couple weeks to get really used to them and comfortable with them.

Thunder: Hey, Troy, have you ever tried just foam earplugs?

Troy: Yes, I have.

Thunder: I've done that on occasion when I'm somewhere where there's a lot of ambient noise.

Troy: Trust me, Thunder, I've tried everything. And once again, I'm probably going to admit things here that are very embarrassing, but I not only have tried foam earplugs, I've tried foam earplugs with construction-type . . . like those noise blockers, those big headphone things that construction workers wear.

Mitch: Oh, my.

Troy: I'm a side sleeper, so I actually took an old pillow and I actually hollowed out a little spot in the pillow.

Scot: Oh, my.

Mitch: Oh, wow.

Troy: I was that desperate to try and block noise that I tried it. And I actually used that for a couple months. I took a lot of heat from Laura, from my wife, making fun of me, that I was that desperate that I tried that.

Finally, just these ergonomic things, these earbuds with just white noise going through it, that's what worked for me. So trust me, I've tried it.

Scot: Mitch, what do you have?

Mitch: So one of the things that is a constant struggle for me is I'm a list maker, like, "What is my to-do list? What am I doing next?" And when I try to fall asleep, for the longest time, it would just be, "Okay. What do I have to do tomorrow? I'm waking up, I'm doing this, I'm doing this, I'm doing this."

And what I found is that I keep my day planner . . . When I'm going to bed, as part of my ritual, I take the day planner, I climb into bed, I take my little pen out, and I write everything down that I'm going to be doing the next day. And for me, at least, that has really helped cut down the anxious thinking about the next day that typically happens when I try to fall asleep.

Troy: Yeah. I've heard of people doing that. And just doing a notepad, not typing it on your phone because you don't want the blue eye to mess you up. You just have a notepad, something is on your mind, write it down, deal with it later. That's a great idea.

Scot: My last one is another weird one. It works for me. I don't know if it'd work for anybody else. But sometimes when I have a hard time falling asleep . . . I'm a side sleeper, but I will lay on my back with my knees bent. Can you kind of picture what that looks like? What? Why are you laughing?

Mitch: You're just curled up and thinking about colors, and that's . . .

Troy: That's called a fetal position, Scot. You're doing it on your back.

Scot: No, I'm not on my side in the fetal position. I'm on my back and I've bent my knees, right? So if you were to come in the room, you would see this big bump of where my knees are in the comforter, right?

Troy: Yeah.

Scot: So I will lay on my back with my knees up. I mean, 99% of the time, if I can't fall asleep within five minutes, if I do that, I will fall asleep.

Troy: Wow.

Scot: I don't necessarily fall asleep on my back, but I get so tired from that position that I will turn over to my side and I can fall asleep. I don't know why it works. I don't know how I discovered it, but there it is.

Troy: I just want to be a fly on the wall in your house, Scot, and just see this, just see you lying there and sleeping with your knees brought up to your chest.

Mitch: And then talking about snakes and cars.

Scot: No, it's not all way up to my chest. I'm not that flexible. It's just like a 45 . . . Yeah, it's like a 45- or 90-degree of your knees.

Troy: I'm trying to think of the physiology of this, how this might work. I will tell you there are certain things called vagal maneuvers that basically increase the blood flow to the head and slow the heart down.

If someone comes in with a very rapid heart rate in the ER and something called super ventricular tachycardia, we will do a procedure where we lay the head of their bed down and lift their legs up at the same time to increase that blood flow. And that sort of has a calming effect on the heart rate.

So I'm trying to think of this physiologically, Scot. I don't know if there's anything to that, but it's interesting you do that and you found that works. Maybe there's something to it.

Scot: Thunder, you're up next.

Thunder: Well, this last one may be kind of old fashioned, and it doesn't actually pertain to me exactly. But I think having a television in the bedroom, a lot of people have that. I think that could actually interfere with sleep. I've never done that, but similar to being on the phone, being on a tablet, laptop, whatever, I think having a TV on when you're in bed trying to go to sleep . . . Again, it's something to engage your mind and keep you active. So that's something I think we should consider.

Scot: And Kelly Baron, when she was on the show, talked about the bedroom is for two things. It's not to watch TV. It's to sleep and to . . . I guess we're going to go to Troy next.

Troy: And to make sweet love. Is that what you want me to say, Scot? Anyway, Scot, moving on from that, this third thing I'm going to say is something I am going to try. And I will tell you I recently celebrated a birthday. For this birthday, I received a gift, and my sister was so excited to send me this gift. She said, "This is something I heard about on the podcast." The gift I received was a toilet light. So Mitch suggested this. This is one of the gifts Mitch suggested getting.

Mitch: Yes.

Troy: And I have now been using it for about a week. It's awesome. It's got a motion sensor, Mitch. It's everything you described. You come in . . .

Mitch: I told you.

Troy: Yeah, it's so cool. It's like a joke kind of gift, but I've used it and I'm like, "I love it." You come in and it just . . . I've got it on this very dim, purple light. It just hangs over into the toilet. It just lights up the bowl like this little beacon in the night, like, "Oh, there it is." I don't have to flip on lights. I'm not struggling to find the toilet. It's great.

I think it definitely helps you to avoid those interruptions in your REM sleep where you're flipping on lights and you're too focused on the task at hand, so to speak. Instead, you've got the toilet light, great, in and out, go back to sleep.

Mitch: I love that. A couple of my friends also purchased. So I don't know how much reach we have in this podcast, but some toilet lights were bought this Christmas season because of what we were saying. And I cannot be more delighted because everyone has been saying, "This is ridiculous. I can't believe I spent $10 on this." And then the next day they're like, "It's wonderful. This is the best thing. I don't have to wake up. I don't have to turn on the lights."

Thunder: Yeah. Add me to the list. I also have a toilet light.

Scot: What?

Mitch: Yes!

Thunder: Yeah. And it is, it's awesome. The only thing that I don't like about the toilet light is it . . . or maybe it's just the one we have. When the batteries start to go low, it flashes red like a police siren.

Troy: Oh, no.

Mitch: Yeah.

Thunder: So that's the one thing. You walk in there and batteries are always like, "Flash, flash, flash." It's like, "Oh, my gosh." It's very bright red. But love it.

Mitch: It's interesting you thought police siren. I thought poltergeist the first time I woke up in the middle of the night and there was a flashing light in my bathroom. I was like, "My house is haunted. I've got to go figure this out."

Troy: Your toilet. Something is going to emerge from the toilet.

Mitch: Yeah.

Thunder: But all in all, it is really a great invention.

Troy: Well, we've got three believers here, Scot. I think you're next.

Scot: Yeah, I guess.

Troy: Now I know what I'm going to get you for your graduation.

Scot: Oh. Yeah.

Troy: Because we know that's coming up soon.

Scot: Oh. Mitch, you're taking us out with number three.

Mitch: So the last one is actually a tip for my partner, Jonathan, and it's kind of this same thing. If you have difficulty sleeping and it has something to do with not being able to turn your brain off or not being able to just let go of the anxieties of the day, the thing that he does every night as part of his sleeper team that he's come up with is he has a series of positive affirmations and mantras that he tells himself.

At the start, again, I think there's a touch of toxic masculinity where I'm just like, "You're doing what? You're positive self-talking before bed?" I don't know. I need to be better about that. But he has seen a significant . . .

Scot: Go ahead and incorporate that into your self-talking.

Mitch: Right. I've got to bring that in to me, right? But he's found a lot of real benefit from it. And I've been trying it out recently where it's just . . . If you are someone who's struggling with any sort of negative self-talk or any sort of . . . if you go to bed and you replay the bad moments that happened through the day, if that's you, this has been really helpful.

And it sounds cheesy and it feels ridiculous. You're looking in the mirror telling yourself something, but it works for him. And since I've been doing it, I've been finding myself able to go to sleep faster.

Thunder: Mitch, I think that's awesome because I think we're good at being hard on ourselves about different things and replaying those in our mind, but we're not good at the opposite, patting ourselves on the back when we need to.

Scot: This turned out to be a far more entertaining show than I could have expected.

Mitch: Not the snooze fest?

Scot: Yeah, not the snooze fest I thought it was going to be. I was like, "What are we going to talk about?" But I think we've learned a lot about each other.

Troy: And I'm so glad you shared, Scot. I'm so intrigued by your sleep techniques. Anyway, it's definitely been entertaining.

Scot: Yes. It's been a good show. So I think the takeaway is that the Core Four . . . Sleep is one of them. And a lot of times, if you get your activity, and your nutrition, and your mental health right, the sleep will take care of itself. But sometimes it doesn't. Sometimes maybe the sleep is the first thing that you need to tackle.

The Core Four don't live in isolation. They all impact each other. And like Mitch explained to us, how sleep impacts those other three for him is absolutely huge.

So hopefully you got some good tips here. Hopefully you have a better understanding of the importance of sleep, and thanks for listening.

We are going to talk about next week, in our "Back to Basics: Core Four" series, mental health. So that'll be next.

If you have a technique that you would like to share, you can get a hold of us. It's so easy.

Troy: Yeah. You can reach out to us, hello@thescoperadio.com. We're on Facebook, facebook.com/whocaresmenshealth. Call our listener line, 601-55SCOPE. I would love to hear who is going to try Scot's elevation of the knee technique tonight when they can't sleep and tell us if it worked. I'm going to try it, Scot. If I can't sleep, I'm trying it, and I'm going to give feedback.

Scot: All right. I look forward to that.

Thunder: I'm going to try the color technique.

Mitch: Oh, yeah.

Troy: The color technique. I'm going to start with color and then I'm going to move on to knees. That's my strategy.

Scot: I'm glad I had an influence on you guys today.

Troy: You did.

Scot: As always, it's awesome. Thanks for listening and thanks for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Welcome to the "Sideshow" on "Who Cares About Men's Health." We're going to talk about an article that I found about sleep. This is kind of interesting. But the first question I have for you guys, Troy and Mitch, is would you like a sleep consultant? Would you like to have somebody in your life that would help you make sure that you're getting the optimal amount of sleep?

Mitch: Are they sitting and watching me sleep or . . . Because that's the first thing I thought of. I don't know if that's accurate, but just what do you mean?

Troy: Yes. There are people who do that.

Mitch: I know. But it just sounds . . .

Troy: They're also called stalkers, but yeah.

Mitch: Just pull up a chair and watch me toss and turn.

Scot: That's right. Maybe you should lay on your left side, Mitch, for a little bit. I notice you seem uncomfortable on your right side.

Mitch: Right.

Scot: "Thanks, sleep consultant."

Troy: I'm going to say no, I would not want that just, because it would just make me more frustrated than I already am. I know my sleep is not good.

Scot: So this is kind of interesting. In the Olympics, Olympic teams, a lot of times they have coaches and trainers and physical therapists and massage therapists and all that so they can perform at the height of their abilities. In Tokyo, the U.S. weightlifting team had another person on the team to help athletes perform at the top of their game. It was a sleep performance director. They're the only Olympic team to have such a thing on their staff. And this person's job essentially . . . He said, "I'm a sleep doper, is what I am. I just try to manipulate using people's natural rhythms and sleep to make sure that they get the maximum amount of sleep and recovery."

Troy: Sorry, which team was this?

Scot: The U.S. weightlifting team.

Troy: Oh, wow. And only the weightlifting team. It wasn't like the soccer team or anyone else?

Scot: Yeah. This year, it was just the weightlifting team. So Jeffrey Durmer, Dr. Jeffrey Durmer, he's a neuroscientist who specializes in sleep, and he's been doing this since 2013. He's been a sleep consultant that helps optimize athletes' performance through sleep programs and just using natural physiology and science to improve the sleep.

I thought this was an interesting thing. He said, "What we found is the concept of overtraining syndrome really is not about overtraining. It's about under-recovery." And when we talk about the core four, we talk about activity, nutrition, emotional health, and sleep as important components to your health. And I think that really underlines how important sleep is, first of all, that Olympic team had a sleep consultant, and then this notion of under-recovery.

Something else that the doctor said that I really, really liked was this notion of, "Don't think of going to sleep as ending your day. Think about it as getting ready for tomorrow." You guys like that?

Troy: I like it. Here's my thought on sleep. And it's funny, I was just thinking about this today. Sleep is the new smoking. I feel like we're going to look back . . . honestly, I think we're going to look back in 30 years and be like, "What were we thinking?" in terms of our approach to sleep, in terms of often disregarding it. Obviously, we're seeing changes there, but we feel like, "Oh, anyone who sleeps eight hours a night is weak. I admire people who sleep five hours a night and look how productive they are."

And I think in 30 years, we're going to look back and be . . . kind of how we look at smoking in the 1950s and '60s now. You look back at the doctors who would smoke and appear in ads and be like, "Smoking is healthy." It's funny. Maybe I thought about that because I'm actually listening to a book on the history of tobacco right now.

Yeah, I feel like sleep is the new smoking. And in 30 years, we're going to be like, "Wow, we were stupid."

Scot: The doctor said that the most important part of his job as a sleep performance director is first educating the athletes about the benefits and necessity of sleep. So there's this mentality, like you referenced, Troy, "I'll sleep when I'm dead," or when you're an athlete, you've got to use all those waking hours to train.

Troy: Yeah.

Scot: So that's the first thing. And then the second thing is to actually help the athletes and the individuals sleep better. And we've talked about some of this stuff before, but I think it's worth repeating. I would like to have a sleep expert on and talk about this notion of, out of the three of us, maybe one of us does better going to sleep at 3:00 in the morning and sleeping their eight hours until whenever they get up. This notion of you have to get up at 6:00 in the morning or 5:00 in the morning, that doesn't necessarily work because everybody has their own kind of natural sleep rhythms, if you will.

Troy: Yeah. But it's fascinating to me too, and I think we talked to Kelly Baron about that, the idea that there are short sleepers out there. People who function just fine on three, maybe four hours a night. And her response was that, "No, they don't. These people don't exist. They just have learned to be tired." They've learned to be tired, and that's how they function.

We all need sleep. We're not superhuman. And it's so prevalent in the medical profession. That's what's so hard for me. It's just this idea that it's crazy how . . . As medical professionals, sure, I'm going to tell patients who need sleep, but among our profession, how we disregard that. And we even look at people who prioritize that as weak or unfit.

I think in our society, larger society, it's in so many areas people disregard it. And certainly in the tech industry, I think there's a lot of that there where it's like, "Yeah, you can work all day and party all night, or work all night too and get by on four hours of sleep," and that's the definition of success. So, hopefully, that'll change.

Scot: Yeah, the short sleeper notion that Dr. Baron talked about, I think about that a lot. The notion that they've done research. There are still these people in the world that say, "I only need four hours of sleep, and I work great. I actually do better than if I sleep too much."

But what their research found that I wanted to also throw out there is they do things to really keep themselves awake. They drink a lot of caffeine beverages, or a lot of sugar beverages, or they really amp up their excitement level and their intensity to try to push through it.

So it's not necessarily they don't need fewer hours of sleep. It's just they found strategies to get around that and cheat sleep a little bit, which, as you said, cheating sleep, not a good idea.

Troy: Yeah. And I think as they studied those people, too, they found that they engage in multiple what they referred to as microsleeps during the day, where essentially, their brain is turned off. Their eyes are open, but their brain is off, which is a little scary if you're driving. That happens and they may try napping or just . . . essentially, involuntarily napping, just doze off for 10, 15 minutes just to try and . . . Their body is trying to compensate.

Mitch: Well, for me, when I'm hearing Troy talk about the social impact of how it's cool not to sleep, etc., I think the one that I get tripped up on a lot is, "Am I sleeping right?" And for sleep to be such a standard biological process, there's a part of me that's like, "Oh, I have to have the most perfect sleep hygiene. Am I sleeping right? How do I optimize whatever?"

And so I guess what I wonder is, does the consultant help you figure out how to do that? Because that would be great, especially if you're trying to personalize and figure out what works best for you, rather than just what works for everyone.

Scot: This consultant in this article did give some suggestions, so I'll go ahead and go through those. We have heard some of them. There's a couple of them that I hadn't heard before.

So wind down before bed. Slow down 30 to 45 minutes before you go to sleep. This individual suggested setting an alarm even to remind yourself to do that. How many times have you been like, "Oh, geez. I've got to go to bed now"? You don't get that 30 to 45 minutes to wind down. So meditation, reading, stretching, anything that helps you settle.

The second suggestion is to cool your core. So take a warm shower or a bath and then rapidly cool your body in the air.

Troy: Oh, interesting.

Scot: And that helps you fall asleep faster. Also, belly breathing will help with that as well.

Troy: Haven't heard those before.

Scot: Treat the bedroom as a recovery sanctuary. So the technology stays out. We've heard that, right?

Troy: No TV.

Scot: You can't be reading that stuff. Yeah, not only the light of the technology, but sometimes the content when you're scrolling and looking through the comments of Facebook or social media

Troy: Yeah, it gets your blood pressure up.

Scot: Don't add anything until you've eliminated stuff. So light, noise, heat, bed discomfort, or objects that stimulate wakefulness.

Include sleep as part of your training. This was the notion that sleep is your basis for your performance the next day. So think of your sleep as the beginning of tomorrow, instead of the end of today.

And then be mindful of your own sleep habits and patterns. Are you giving yourself enough time to sleep with a regular routine?

And if you still are doing all these things, you're winding down, you're trying to get the eight hours, and you're getting to bed on a consistent time, you're getting up at a consistent time, and you still don't feel rested, then they suggest you get professional advice from a sleep physician.

So there are a couple extra tips for how to make your sleep a little bit better. Any final thoughts on that?

Troy: Yeah, it's got some interesting points in there. Again, I hadn't heard that about the shower and then cooling your body core down after that. That's an interesting concept.

The other stuff, like you said, Scot, the screen time, that makes great sense, and having that 30- to 45-minute wind-down time, definitely essential just to slow the brain down, decrease all the external stimuli, and then be ready to go to sleep.

Scot: Hey, this is Scot. Thanks for checking out the "Sideshow" episode. By the way, I've got a couple of extra little sleep tips. So these are some thoughts and concepts that have come up over the course of the podcast tying back into the core four, and just remembering how your activity, your nutrition, your stress, your sleep, and your genetics can impact your health. They all interrelate. They're not separate things.

So, over the course of the podcast, we've learned nutrition can also have an impact on your sleep. So take a look at how late you're eating, how close to bedtime you're eating, how much you're eating.

We've talked to Thunder Jalili about intermittent fasting. And if you stop eating before bedtime a few hours, sometimes that can help you sleep. I know it definitely changed the way that I sleep when I stopped eating, say, at 6:00 p.m. versus having a snack at 9:00 p.m. or 10:00 p.m.

Another one of the core four is activity. So getting some activity can help you with your sleep. Again, I know from personal experience if I get the activity that I need to get during the day, but not too much because if you overtrain, that can actually limit your sleep, but getting some activity, making sure that you get out and being active will help you with your sleep as well over time.

Of course, stress can really impact your sleep. So we have some old episodes on some better tools to deal with stress you might want to check out. Or you might want to get some sort of help and find somebody you can talk to to get those tools to deal with stress.

Alcohol and other substances can impact your sleep as well. Alcohol is notorious because a lot of people think it actually helps them fall asleep, but research has shown that you do not sleep as well after you've had alcohol. You don't get into that deep sleep. So that could be another cause. And other substances you might want to check out for smoking or drugs.

And then there could be some medical conditions that some of the symptoms might be sleep-related. They impact your sleep. Obviously, the obvious one is you have to get up and go to the bathroom. It could be something going on with your bladder, your kidneys, or it could be a health condition that you're not aware of.

So if you're not sleeping, those are some other things you can check out. A good first step is to go to your primary care physician and just let them know that you're not sleeping very well, and you can start working through some of those things.

You can also check out some of our past episodes where we talked about sleep. Episode 6, we talked about if sleep trackers work or not. Episode 11, how to beat your insomnia. So some tips there from our sleep expert, Kelly Baron.

And then Episode 44, tips for better sleep. And those are some of the sleep hygiene things that we briefly talked about here, but we have a little bit more of an expanded conversation with sleep expert, Kelly Baron.

And then Episode 45, that's your mental health toolbox episode. Just such a great fallback episode with some exercises, some breathing exercises that might help you as well.

All right. Thanks for checking out the show. Next week, we're really super stoked because we're going to have a migraine update. We had a show about men and migraines and we learned . . . Well, we knew Troy had migraines, but we learned that Mitch also suffered from migraines, even though he wasn't admitting it to himself. And they both went to a doctor to find out more to see if they can get help, and we'll find out about that next week on "Who Cares About Men's Health."

One last thing, if you know somebody that would get use out of this podcast, please do us a favor and share it with them whether it's on social media or in person just by saying, "Hey, I've got a really cool podcast you might enjoy," if there's a specific episode that might help somebody. It's the best way to help us get into the ears of more men and help more men care about their health.

Other ways you can reach out to the show if you want to contact us include hello@thescoperadio.com. You can go to our Facebook page facebook.com/whocaresmenshealth. And then we also have our listener line. You can leave a message at 601-55SCOPE. That's 601-55SCOPE.

Thanks for listening. Thanks for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

There are times when you know it's right to sleep and you know that there are times of the day that your mood's a little better than others. And you know that there's a time of day when you're hungry and there's a time when you're not. And there's a time when you emotionally go up and down, and it turns out that your body, our bodies, have a circadian rhythm.

That means throughout the day, some things are more or less on and some things are more or less off. And this is called the circadian rhythm, and it turns out there are controls of our circadian rhythm that don't have anything to do with necessarily when the last time was you ate or what the lights are outside although there are social cues to how you decide when you're going to eat and sleep and be happy and take your tests. But in general, your circadian rhythm is set by cues inside your body.

Now, with us in the studio today is Dr. Chris Jones. Dr. Jones is an MD and a PhD, and he studies when creatures do stuff. He's a chronobiologist. He studies when creatures do stuff and why they might do those things when they do.

Dr. K. Jones: Can I call you, Chris?

Dr. C. Jones: Oh, all right.

Dr. K. Jones: I can call you Chris, as long as they don't call you late for dinner, right? And in the interest of full disclosure, Dr. Chris Jones has lived with my chronotype for over 45 years. So he has a lot to say about chronotypes, and he can speak up about mine if he ever wanted to. So welcome to the studio. Now, we're going to ask Dr. Jones or Chris, Chris, how would you define chronotype?

Dr. C. Jones: Basically, there are two obvious chronotypes. One is the so-called morning lark, people who wake up very early and they're very happy when they wake up early. And then there are night people who don't fall asleep until sometimes well after midnight, 2:00 or 3:00 in the morning, and we call those people night owls.

Dr. K. Jones: So how is your chronotype determined, and are you born with it?

Dr. C. Jones: Yes, definitely. We think this is a genetic predilection to be either a very morning or very night person.

Dr. K. Jones: So, certainly, there are mutations that make people morning people or evening people, but in fact, all of our genes work together to fine tune our chronotype. So if you were to look at people, there are some very few really morning people, and there are some very few really late people, but then there are sort of morning people and there are sort of evening people, and there are a bunch of people in the middle. There's a bell-shaped curve of times that people like to go to sleep. So does your chronotype change as you go through life?

Dr. C. Jones: Yes, absolutely. The adolescent period is a time when we become later and later and later sleep onset people. In other words, sleep phase delay, and every parent of an adolescent knows that their kid is wide awake at midnight, who knows what they're doing out on the town. And even in very rural circumstances, like the jungles of Central America, sociologists know that the moms and dads in the jungle have no idea where their children are in the dark at night and what they're up to.

Dr. K. Jones: But they do know that they kind of stay up late when everybody else is sleeping and then they wake up late. And we know from researchers in the Kalahari Bush that the word for teenagers means owners of the shade, meaning they keep sleeping in the shade all day because they've been up all night. And this is part and parcel with being an adolescent is you get to be more of a night person. And then what about later in life?

Dr. C. Jones: Well, some people actually use 20 years old as the end of adolescence because that is the age at which people stop getting more and more of a night person or sleep phase delayed sleep schedule. Later in life, things get more variable, whatever your sleep schedule was in your teens, 20s, and maybe your 30s, you know, we're pretty healthy and our genes are working well, but you get to be my age and you don't sleep quite as deeply and sleep schedule could be a little more variable. So it's like everything else, the older you get, things start to fall apart.

Dr. K. Jones: Don't say that. Well, so older people tend to be a little bit more morning people, but whether it's their biology or just because their joints hurt or it's time to get up because they can't sleep that much more.

Dr. C. Jones: Well, the bladder and the joints are the two biggest complaints that elderly people have about their disruptive sleep. They attribute it to bone and joint pain and the bathroom calling and things like that.

Dr. K. Jones: Oh, the bathroom calls me.

The planet has its own chronotype, and it changes where you are in the planet. And particularly, in the very upper and lower latitudes, when the days are very, very long in the summer and the nights are very, very long in the winter, there are some serious problems when the planet doesn't want to work with your own chronotype. What happens to people who are living in very northern climes when it's bright all the time, what happens to their mood or their sleep?

Dr. C. Jones: First of all, it's thought that the sleep-wake cycle and a lot of the way our brain works evolved in the deserts of Africa, Equatorial Africa. And then we migrated north into the Scandinavian countries. So the folks who live in the Scandinavian countries may or may not have evolved as much as they would have liked to those northern climes. But basically, it's as you said, there are months in the year where it's dark for most of the 24-hour day-night cycle.

Dr. K. Jones: And during the time that it's light people get a little manic when it's light all the time. There's a famous movie called "Insomnia" with Robin Williams and Robert De Niro, and a detective moving up to Alaska to solve a mystery gets a little crazier and a little crazier because he can't go to sleep. It's easier to kind of huddle in when it's cold and dark, so you tend to sleep a little bit longer in that winter months. People get a little more depressed in the winter months. So the planet has its very own chronotype, but it changes through the year.

Your circadian rhythm isn't only just about your sleep. It's about your emotional highs and lows. People tend to get a little bit more depressed at night and are sometimes a little bit more activated and positive in the morning. And there's also some evidence that the evening time is time for people who have a tendency toward depression. It's a time when people tend to involute. They tend to look inward a little bit more. In the evening time, they're tired. They have a tendency toward depression.

And so, when you're thinking about having conversations with people that might be important, it's important to know where they are. In the morning, people are often a little bit more activated. Not everyone. Certainly morning people are, they got the get up and go. They're feeling pretty optimistic. I think of all the farmers on the planet who have to get up early and get going and they have to feel like they can get stuff done, and there's some biological cues for this.

But in the evening, before we go to sleep, we tend to be more involuting or turning inward and shutting down a little bit all our activities in the brain. And some people get a little bit more depressed at that time and having conversations that might be important, you have to spend some time understanding where somebody might be in their daytime schedule.

Dr. K. Jones: So you have a certain chronotype, you would like to get up at a certain time, but life isn't always like that.

Dr. C. Jones: Usually, that means the person is sleep-deprived. If you don't have the option of falling asleep when your brain really wants to fall asleep, you probably will not fall asleep. And therefore, you'll be sleep-deprived the next day, and that has profound implications for relationships with other people because you're irritable. It also does not impress the employer because you've been late to work. Whatever your work schedule is, it may or may not work with your circadian rhythm.

Dr. K. Jones: Well, and there's some data that says shift workers or night workers who haven't flipped over completely to working nights have a higher rate of cancer. And this has to do with an important hormone made by the brain and now we know it's made throughout the body called melatonin.

And melatonin seems to have some anti-cancer activity in our own bodies, maybe because it's such a powerful antioxidant melatonin is. And people, particularly women, and we've studied this in nurses is that nurses who spent most of their career working night shifts have significantly higher rates of breast cancer. Melatonin may be acting, perhaps there's an antioxidant effect. It's important not to suppress your melatonin because it's there for a number of reasons, and people who work in bright lights all night long and are trying to sleep during the day may be suppressing their melatonin. And that might be some of the activity that might make women more likely to get certain cancers.

Adolescents who are often taking tests, so when I think about my test taking years, although as a physician, I took tests right up until my 60s, but you take tests and when you take your tests, your intellectual health, so what is the chronotype of your brain? When I think about adolescents who might have to take SAT tests at 8:00 in the morning or they have to go to school at 8:00 in the morning and their brain says they should still be asleep, so your intellectual health, there are times of your day when your brain is really on and you've sat across the table from me, looking at me at 9:30 at night and looked at me and said your computer is shutting down, I can watch it. So there are times when your brain isn't working. What do you do about that?

Dr. C. Jones: Oh, it's really hard to argue with your genetic morningness, eveningness sleeper type. There are some things you can do to nudge it one way or the other, and the most powerful is to fix morning wake-up time with lots of light and fix the evening as very dark, as dark as you can, but that doesn't always work for everybody with a very morning or very evening biological genetic sleep schedule.

There are times when you're feeling really sharp and there are times when you're not so sharp, and actually in some of the web-based chronotype questionnaires, they would ask you as they're trying to figure out whether you're a morning person or a night person, when you feel like your work is most productive, or when you feel like you do best on a test. And people often know this, they know when their brain is the sharpest, and that plays into their chronotype, their intellectual wellness.

Dr. K. Jones: Clearly, if you're doing finances, it's important for you to know when your brain is the sharpest, when does it like doing arithmetic. Now, I love arithmetic and I'm a morning person. So I like to do my finances and think about finances certainly before 2:00 in afternoon. But for couples who might have different chronotypes, our sleep psychologist has a really important quote about when couples should talk about money.

Dr. C. Jones: Absolutely. This is from the experience of Dr. Laura Czajkowski, a psychologist at University of Health Sleep Center for quite some time. And her recommendation, very strong recommendation for people who have insomnia or difficulty getting to sleep, one major factor is to schedule the money discussions before noon. Do not wait until the afternoon. It's too close to the evening bedtime. What you want is to get the real sort of irritating discussions that can arise long before you have to go to sleep.

Dr. K. Jones: And when you're actually interested in solving problems and not interested in going to bed or not going to bed angry with someone, so always do your financial discussions before noon, according to the sleep psychologist. Just that you know, you do your finances when you're cognitively most alert and you don't do your financial discussions with your bed partner after noon.

Culturally, around the world, there are some cultures whose religious practice is focused on the rising of the sun and certainly Eastern Indian practices in terms of morning yoga. Yoga is not usually done at 10:00 at night. It's something you do in the morning. And some spiritual practices are morning-based.

In Western culture, we go to church in the mornings, but we tend to pray at night. And everyone has a different way of expressing their spiritual life. But it often is based either on morning or evening. It's not usual that we are expressing our spiritual practice throughout the day, except in some quite observant religious cultures. And I think specifically about many monasteries, which might actually pray seven times a day and their prayer is based on the first thing in the morning, the midday, noontime, afternoon and evening prayers, and then there is a bedtime prayer. And, of course, in Islam, they pray multiple times a day.

However, for many cultures, their spiritual practice may be morning based or evening based. And for people who don't have a particular culture, they may find their own time, which is best for them. And it may be based on their chronotype. It may be based on their social time. It may not be so busy in the morning that moms don't have a minute to think about their spiritual life. And it's something that's done later in the day.

But people who tend to work on their spiritual life tend to do it at about the same time of day. And knowing when that time of day is, recognizing how it's important to you, being able to express it to the members of your family, so that you have a little bit of quiet time to indulge, or it's not an indulgence, it's actually important practice of your spiritual life is going to be important in terms of being able to make sure you have the time to do your own spiritual awareness and connections.

What happens in a household with 2-year-olds and 17-year-olds and 40-year-olds and 75-year-olds? How do you work a house when you've got so many people with different chronotypes either because of their age or because of their biology? How do you get along and do so without disrupting each other's hard-wired biological sleep-wake schedule?

Dr. C. Jones: It's really an exercise in relationships between people. And I hate to say that because I'm a guy, but that's really what has to happen. People have to realize, you know, mom's been up early because she's breastfeeding or she's up late because she's feeding somebody or somebody's screaming. And we know from a brainwave recordings that even a whimpering noise can bring a sleeping mother up very close to wakefulness and sometimes full wakefulness. So now you've got a sleep-deprived mom, and sleep-deprivation is really good at causing irritability.

Dr. K. Jones: Well, that's not personal. You're not talking about this personally, given that I spent so many years as an OB, was chronically sleep deprived for about 35 years. But so your brain works . . . when you're sleeping, your brain actually is working, it's sorting out what's important, it's remembering things that are really critical. So you may wake up at 2:00 and if you're really awake, it's like, oh, I forgot to send someone . . . I need to send someone something. And in the olden days, you wrote it down and when you woke up in the morning, you gave someone a call. But now, we can actually post something at 2:00, even knowing that someone won't get it until they wake up.

It's not uncommon for people to remember something that's important when they wake up at 2:00. And that's a time when your brain has been sorting out what you need to remember and what you don't need to remember. That's when you'll say, "Oh, I'll just send her a text." Now, I don't recommend doing that in the middle of . . . because then you really wake up and then you get very fragmented sleep. So it's better just to roll over, not turn on a bright light screen. Just roll over, write down the note. Just tell yourself to remember it in the morning, because things that you tell yourself before you go to sleep tend to be things that you remember.

We've been talking for about a half an hour about sleep, wake, your chronotype, circadian rhythms, when you wake up, when you're sad, when you eat, are you a night person or a morning person, and all parts of your life which are affected by your circadian rhythms. And tomorrow is another day. So not living your chronotype has some biological effects. People who do shift work are more likely to gain weight. So people who aren't sleeping well. So increased rates of obesity, increased rates of cancer, increased irritability, difficulties at home, all those can happen when you're not able to live your chronotype.

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It is in your genes

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Dr. Gellner: It's 3 a.m. and you hear that cry from your infant or toddler's room that you dread every night. Why do they do that and what can you do? I've got tips on little ones sleep issues for you today on The Scope.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kids Zone" with Dr. Gellner on The Scope.

Dr. Gellner: I'd like to start by calling this Scope piece the "Don't do what I did with my own kids." podcast. I was that mom who felt so bad that I wasn't home for my kids because I had to work that I used any excuse I could to have extra snuggle time. Boy, was that a mistake. I try to let my patients' parents know about my experiences so they can hopefully get more sleep than I did during those years.

Recent data shows that one in five infants who have trouble sleeping may continue to have challenges during the toddler years. And, yes, some of this can be blamed on the behavior of parents. You hear your little one crying. You wait to see if they go back to sleep, and then if they don't, you go rush in there to pick them up or give them a bottle.

Well, guess what? Your child is training you very well to do what they want. It's not on purpose really. Babies learn to be comforted when they wake up from newborn on. Then as they get older they should start sleeping through the night. But some babies become trained night criers or trained night feeders. These are called sleep associations. They really don't know how to go back to sleep on their own unless they're rocked or cuddled or fed.

Parents often will tell me that they will go into their baby's room and the baby only feeds for a few minutes and then is sound asleep again. That's because they aren't waking up for nutrition. They're waking up to go back to sleep in the manner that they were put to bed in the first place.

This is learned hunger. This occurs in children who are drinking a bottle or two of milk or nursing for prolonged periods at night. They have learned to expect food at night to go to sleep. So when they wake up, they're looking for it.

If your child is over seven months, healthy, and feeding multiple times a night, then this is your problem. Most babies are able to sleep through the night by six months old. Now, of course, kids are going to wake up more if they're sick or something is off with their routine. But, in general, they should be able to get back into good sleep patterns easily if you are consistent. If kids are waking up several times a night, both you the parents and the child are going to be cranky the next day.

So how do you fix this? First thing is to get your child to go to sleep on their own by putting them to bed when they're still sleepy but awake, no bottle, no pacifier, no cuddling. Have a good bedtime routine and do the same thing every night. For our kids, it was PJs, brush teeth, story time, usually the same three books every single night to the point I didn't even need to look at the book anymore and then say the good nights.

Sometimes you have to move bedtime 15 to 30 minutes later to make sure they're really ready to conk out. Yes, they may fuss for a few nights, but they should learn, if you are consistent with this, that when it's time for bed, it's time for bed, not an extra drink of water, not just one more story, or being rocked for 15 more minutes.

Bedtime routine done, then lights out. Dark, quiet, maybe a night light if needed, or soothing music. We have an ocean sound CD that our kids have listened to since birth, and they're double digits now.

Trust me, I know how hard this sleep training thing is. My older son decided that 11 p.m. was a good bedtime. I would hold him as he fell asleep, again, mom guilt, and then when he woke up, he'd need me to hold him until he fell back asleep again.

Funny thing is that if his dad put him to bed and he woke up, he'd be like, "Oh, it's just you, dad," and go back to sleep, because my husband made my son self-sooth from early on, and so our son learned that Dad wasn't going to pick him up or cuddle him.

Now if I put him to bed and he woke up, you'd think that me closing the door was because I was putting him in a torture chamber and he'd scream and cry until I went back and held him or stayed by him and then he went back to sleep. Our younger son was just a sleep nightmare for a variety of reasons, including night terrors, but that's a whole different subject.

Bottom line is this is a very common issue and one that most pediatricians have experience with either as parents or having worked with other parents facing the same problem. If you're having a hard time with getting your little one to fall asleep and stay asleep without waking to eat or be comforted and your child is over six months old, talk to your child's pediatrician, we can help.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com

Announcer: Need reliable health and wellness information? Don't listen to the guy in the cube next to you. Get it from a trusted source, straight from the doctor's mouth. Here's this week's listener question, on The Scope.

Interviewer: Today's patient question is about sleep. This particular individual's having a hard time falling asleep at night. So they'll go to bed, they lay down, but you know, they can't get to sleep. Dr. Tom Miller, what do you recommend to your patients in that situation?

Dr. Miller: Well, first thing I ask is, what's changed? Is there more stress in their life? Is there something going on at work? Is there a family problem? Is it related to depression, perhaps? I'll look at those issues.

The next thing is, are they following a sleep schedule? Are they getting to bed at the right time, same time? And are they getting up at the same time each day? Because of our busy lifestyle we're sometimes all over the place. Monday through Friday, we may have some variable times in which we go to bed because of when we're going to work and we have morning meetings. And then on the weekends maybe we stay up late and go out and then get up late.

These kinds of disruptions in sleep patterns make it difficult, even more difficult to get a normal night sleep. The first thing I'd say is let's try to get you back into a regimented sleep pattern, so that you go to bed at the same time each night. After that try to mitigate the stress. You know, what are you doing at work or what can you do with work or family that would help you. Sometimes this may result in counseling or maybe even in the most extreme case, a change in job, you know, so that they . . . if it's bad enough, that they can get sleep.

And then ultimately if folks are still having trouble falling asleep, a short course of medication designed to help people fall asleep can be helpful. But I don't like the idea of using those long term because they have some problems associated with them. So there are number of medications on the market as prescription medications that do help people fall asleep, and they're pretty effective in small doses, for, say, up to two weeks. The other thing that I will talk to folks about is alcohol. If they're using alcohol to get to sleep, that's not a good idea.

Interviewer: All right, so you're not a big fan of the medications generally because they can actually cause more problems down the road when you stop taking them. Is that correct?

Dr. Miller: I think the problem with meditation is we jump to that as a solution before we look at sort of lifestyle issues. Whether you're, you know, increasingly stressed at work, whether you have frustrations, whether there might be depression, those are the issues that I like to tackle first before moving on to medications. You can do them simultaneously, but not assessing the lifestyle aspect of insomnia would not be the right way to approach this problem.

Interviewer: So take a look at the lifestyle, try to get that consistent sleep pattern. If you go to your physician at that point, if those other things aren't working, they might put you on a short course of some sleeping medication. If you come off . . .

Dr. Miller: As you're working on your lifestyle changes.

Interviewer: Yeah, yeah.

Dr. Miller: Getting to bed at the same time, tackling those frustrations at work, trying to regiment your lifestyle in a way that allows you to reduce the amount of stress and frustration that you might have in your life.

Interviewer: Yeah, those are underlying causes.

Dr. Miller: Underlying causes.

Interviewer: And if they get to the point where they've tried those things and they feel that they've put in a good effort towards those things, still not working, where do you go from there?

Dr. Miller: We start looking at sleep patterns and thinking about things like obstructive sleep apnea. We think about depression. Has the physician done the right evaluation to sort out whether the person has anxiety state or is depressed? There are different treatments for those problems. So, as we go down, you say an algorithm for insomnia, we will get to those sorts of things where we are digging in a little deeper to try to find a solution and treatments.

Interviewer: So it sounds like the first step for a lot of people is something they can do on their own. It's just take a look at their life and see are there causes of stress and what can I do to perhaps reduce that, maybe finding professional help.

Dr. Miller: Yeah, the majority of folks with insomnia usually have this for a short period of time. It doesn't go on for a long periods of time. So, for instance, in grief response if someone in the family has died and you're not sleeping, you know, treating that short term likely will result in a return to normal sleep patterns, as would be the case with stress at work. These things usually disappear as soon as the stress is resolved.

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