Natural Ways to Improve Your Sleep | Podcast #199

High-quality sleep is essential to one's overall health. For numerous people, sleep deprivation led to risks in blood pressure, heart disease, obesity, and diabetes. Upkeep your well-being through the natural ways you can enhance your sleep.

Watch this video to know how Dr. J and Evan Brand explain the relationship of sleep to temperature, exercise, gut issues, blue light exposure, and smoking. Don't forget to like and share!

Dr. Justin Marchegiani

In this episode, we cover:

01:00    Temperature and Sleep Quality

02:45    Top Metabolic Things Moving Sleep Issues

09:42    Benefits of Sleep

04:00    Work Hard, Rest Hard

18:30    What Keeps You Up at Night?

Dr. Justin Marchegiani: Hey, there. It’s Dr. J. Welcome ladies and germs. Hope you guys are having a phenomenal Monday. Evan, what’s going on with you?

Evan Brand: Hey, man. Not too much. Uh– The sun is shining still. Summer is still here. I thank the Lord. Uh– We had some weird like cold weather for a couple of days, and I thought, “Oh, man. I don’t know if I’m ready for this yet.” But today, it’s back to the heat so I’m enjoying it.

Dr. Justin Marchegiani: Summer down here has been hot as you know what. But-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -I got like a little portable air conditioner unit outside of my central air, just good. It’s like, dude, I just can’t keep up with it. I got like my three or four monitors and then my treadmill and my– my– my stepping desk as well. I got like a little step or so. From sitting, I can– I can bike. From standing, I can walk and just all the heat that comes off in like a– a smaller office, it just gets contained in– I think I just get it– get it out.

Evan Brand: Yeah, maybe that should be strategy number one for today’s topic on improving sleep, which is make sure your environment is cool enough, because I’ve seen that some of the literature where they do like sleep studies on people that have the temperatures above like 70-72 Fahrenheit, people start getting restless.

Dr. Justin Marchegiani: Oh, yeah. Hundred percent agree with that. Yep. Sleep quality, sleep– We were talking about sleep today, in case you guys didn’t know yet. But, temperature’s important. I mean, I try to keep it in the upper 60’s, low 70’s. Uh– One thing I’d done recently because, you know, I’m in Texas right now. It’s hot as heck and it’s really expensive to keep everything super cool. So one thing I invested in recently is called the BedJet, and the BedJet’s excellent. I’ll see if I could put a link down below for you guys to get that–

Evan Brand: I love– I love that thing.

Dr. Justin Marchegiani: Have you gotten it?

Evan Brand: No. Remember you showed me when I was at your house?

Dr. Justin Marchegiani: Yeah! Yeah, I showed you at my house. Yeah. So you saw it-

Evan Brand: I love those.

Dr. Justin Marchegiani: -but it’s great. It basically goes underneath your sheets, and then it pumps in air. Now, it can warm the air up, but it can only cool the air as low as the air temperature. But it’s nice because it can pull in if you have like 75° or 76°, you know, temperature in your room, and it’s cool and already air-conditioned. It can pump that air in and it kind of stays underneath there that can kind of cool you a bit, and it’s very, very cool. And I put it on low like– I mean, you know, it’s the very low speed.

Evan Brand: Yup.

Dr. Justin Marchegiani: Maybe like it’s a 10%-20% of max, and it just comes– keeps a little bit of air in there, which keeps me cool, which is really nice. And– You know, especially in the summer, if a little bit of humidity that kind of– it can– the sheets can kind of stick to you. It feels a little uncomfortable. It’s just enough to cool that off.

Evan Brand: Yup. That– That’s– So temperature’s huge. I mean, many people-

Dr. Justin Marchegiani: Temperature’s great.

Evan Brand: -work that.

Dr. Justin Marchegiani: Oh, I agree. Totally. So, the temperature aspect’s great. I mean, I always sleep great when it’s like uhm— when it’s colder, when it’s around 69 or so, and then you can kind of really stay warm underneath through. That’s really the kind of the optimal temperature, 65-69, but in summer, it’s a little hotter, especially if you’re in a hotter place– places in the US. And then next step to that, let’s kind of go into a couple of other metabolic things? What are your– What are your top few metabolic things you want to start with?

Evan Brand: Well– I mean, blood sugar’s the biggest one. I had so many issues with my blood sugar for probably my whole life, just being raised on a Standard American diet, rich in carbohydrates, refined sugars, and so my blood sugar was probably one of the biggest, you know, movers for my health. And if you’re blood sugar’s crashing at night, your adrenals have to kick in to crank up and create some extra Glucose through the Gluconeogenesis process, and then all of the sudden you wake up and your heart could be racing, your mind could be racing, etc. So for me, you got to work on adrenals. I just want to give a couple statistics first. People may, you know, feel like sleep is just their issue and they may not know that many, many people struggle with it. So, if you’re looking at some of the CDC– I mean, they’re– they’re saying 50,000,000+ people have some sort of issue with sleep. Fifty million people in the US alone, so that is huge. And then, of course, they’ve got this whole list of uh– health conditions that are tied in to sleep issues, so it could be things like Stroke, Cancer, Arthritis, Depression, Diabetes. We know that if you’re not sleeping well, you’re blood sugar’s messed up from not sleeping well. And blood sugar can mess up sleep, so it’s like this big connected spiderweb. That’s a lot of people. Fifty million people struggling with sleep.

Dr. Justin Marchegiani: Yeah. Definitely a lot. New study that just came out uhm— over the weekend actually, and the study looked at what’s the optimal amount of sleep for healthy– for– for cardiovascular health. They found six to eight hours was the optimal dosage for sleep. Too high actually had an increased risk factor, and then too low also had an increased risk factor. So six to eight was a sweet spot. They weren’t quite really sure what that mechanism was of that. Could just be a correlation versus causation kind of thing. I really have a hard time thinking that if I get 8½-hour sleep, uhm— I’m gonna increase my risk of heart disease. That doesn’t quite make sense to me from a mechanistic standpoint.

Evan Brand: No, it doesn’t.

Dr. Justin Marchegiani: But, hey. Six to eight, that makes sense, so if you’re getting less than six, for sure, you got to curtail that. But I do think, for me, if I’m not doing a ton of higher exercise– harder exercise– seven hours is essential. I do notice though, if I’m exercising more and I’m lifting more weights, you know, eight to nine becomes like important. So if I’m like more busy, I actually cut down a little bit on the morning tense exercise ‘cause it just requires me to get more sleep to recover.

Evan Brand: Yep. Yep, well said. So the exercise piece– I think exercise is a great sleep inducer, as long as it’s not too stimulating and not too close to bed. So, you know, depending on the weather, like 7:00 PM, if we can go for a walk– you know, I’ll try to take my wife and the baby down the street and back.

Dr. Justin Marchegiani: Yeah.

Evan Brand: You know, 15 to 20-minute walk, I’m much more ready for sleep if I do that.

Dr. Justin Marchegiani: Oh, totally. I– I agree. I mean, the big thing with sleep, in general, and exercise is the fact that it revs up– it revs up your sympathetic nervous system. So the healthier you are, the more you can kind of go on and off. Right? On-off. So, if you can turn off– on and off, and you can regulate and get that sympathetic stress response down, that’s great. Awesome. So maybe, like for me, I do like Tabatas around 7:30. Maybe some push ups, I do like, you know, ten to fifteen thousand steps during the day on top of that. So I get my 10,000 to 15,000 steps and I do like a little bit of Tabata action, and that’s–

Evan Brand: And you’re saying 7:30 PM?

Dr. Justin Marchegiani: I do it, but I mean, my Tabatas five minutes, so it’s not like-

Evan Brand: Okay.

Dr. Justin Marchegiani: -you know, a long thing. But I’m fine with that. That’s not a problem. So that’s– that’s helpful but if you have some neurological adrenal stuff, you may got– you may want to be careful of the timing of when you do your exercise. Maybe do it in the morning, or you may be fine with a Tabata or an interval thing that’s shorter, right? We just want to make sure, number one, we feel good after the exercise; two, we can emotionally repeat it. If the workout’s shorter, it’s u– most people can wrap their head around to it emotionally. It’s not draining them out. And then, three, how do you feel that next day or that next night, if that was a morning workout. That way you can kind of gauge in the intensity, the frequency, and the duration of how long your workout is, and you can adjust those variables accordingly to get you in that place where you can check all three of those boxes. Do you feel better? How do you feel emotionally afew minutes after? Can you repeat the movements? And then how so you feel later that day or that next morning?

Evan Brand: Yep. Well said. The next thing we have to mention is the timing or the schedule of sleep. If you’re working swing shift or night shift, that is bad news. We know, if you just type in “night shift nurses sleep study,” it’s something crazy, like a 50% increased risk of breast cancer if you’re working night shift. I mean, think about it. We didn’t evolve to be up at night. And if we were up at night, we were hanging out by a fire, which is gonna be a pretty orange or red colored light, and we– maybe we were chasing away a hyena or something or a bear that was gonna come eat our children when we were hunter gatherers, but we weren’t up at night under fluorescent lighting working in a hospital, looking at a computer screen. So if you’re a night shift nurse or a night shift anything, like I was when I was in college, I mean, it destroyed me. And I think one of my biggest down– you know, I guess one of my biggest downfalls or the thing that destroyed my health was working at midnight, and would work all the way through the night and I would get off at 5:00 AM and I would go to sleep at 6:00 AM. And I would try to sleep from 6:00 AM to 2:00 PM, and I survived but I did not thrive at all. So, people may yell at us, “Oh! Just, Evan, I have to work this shift.” Okay. If you absolutely can’t change it, you can’t get another job, you can’t work with the sun, I hear you, but I hope that there’s an alternative to where people can get off of that.

Dr. Justin Marchegiani: I a hundred percent agree. If you have the ability, great. Awesome. Make it a priority. Or if you get paid in a lot more and that’s what you need to do, fine. It is what it is. You just kind of have to know that you’re going up to the plate with two strikes against you, so you really gonna have to make sure that your nutrition is– is borderline perfect. You’re gonna have to make sure you have some good adaptogens going and some good adrenal support going. And then, ideally, you know, make sure– It’s tough because then what do you do on the weekend? Do you keep that same cycle going? Do you go back to a normal rhythm? Uhum– That’s where it becomes dicey. I mean, I would probably say, “Keep the rhythm going to keep it consistent so you at least have a good rhythm.” But you got two strikes against you, and you really have to make sure everything else is dialed in regarding hydration, regarding uhm— adrenals, regarding adaptogen and regarding nutrients, and not even say gut function because we got to make sure there’s not a lot of gut stress and we’re absorbing and assimilating and then utilizing our nutrients efficiently.

Evan Brand: Yeah. I tell you, when I worked that shift, my lunch hour was like 3:00 or 4:00 AM. Your body’s not wanting to digest food. I don’t care how long you work night shift, you never feel like you’re fully satiated after a meal at 3:00 or 4:00 AM. I mean, there’s a lot of hormonal stuff going on in the middle of the night that your body’s not really wired to be eating a grass-fed steak and veggie, so I never felt good no matter– no matter how quality the meal was. So I think, in that aspect, you can hack it. Maybe you can hang in there, but eventually, you got to get off the night shift. I mean-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -it is a killer.

Dr. Justin Marchegiani: I agree. Now, regarding sleep, what are some of the benefits of sleep? Now, getting– not getting enough sleep can cause blood sugar issues because part of the sleep is its restoration of your hormones, repairing  your— your organs, repairing all the– the physical and the biochemical structures of the body so you can function optimally. So, 10:00 PM to 2:00 AM is that Growth Hormone Window so we have a lot of physical repair happen at that time. And then, 2:00 AM to 6:00 AM, we have more of the biochemical kind of repair happening. And, ideally, getting closer, going to bed on the other side of midnight is ideal. I mean, for me, I’ll be straight up. I’m not perfect. I typically get to bed around 11:30. I try to do like 11:30 to 7:30. That’s kind of my gig, and then I’m operated to go at 8:00, but you got to figure out what works best for you. I mean, if I had more health concerns and more issues, I would be more on top of that, but I– I feel relatively good and– and I manage my stress and I wind down at night, so I feel pretty good with that. But in general, if you have any health issues, you’d want to be more on the other side of midnight. So getting to bed closer to even 10:00 o’clock would be ideal, just so you maximize that growth hormone output steroids that happen around 10:00 PM.

Evan Brand: Yup. Well said, and bright light in the morning, that’s really important. People don’t talk about what you do during the day to influence your sleep. People think, “Okay. What’s the magic supplement I need to take before bed to help me sleep?” Well, the magic supplement may be getting outside first thing in the morning in getting bright light exposure. So right before we jumped on this call together, I was on my bike. I rode my bike without my shirt, getting as much sun as I can, just down the street– down the street and back, you know, 5-10 times. I felt good. I felt amazing. I still feel good from it. I know I’m gonna sleep better just because of the exercise piece plus the sunlight telling me that it’s morning. It’s daytime. It’s time to get going. It’s time to peak the cortisol.

Dr. Justin Marchegiani: Yes.

Evan Brand: And you and I test cortisol on every client, and we see a lot of times that people in the morning or in the afternoon, they have a lowered or a flatline Cortisol rhythm. And we have to improve upon that because if you don’t have a peak, then you can’t have a drop. So if you’re just flatlined all day, you’re not gonna feel very good. And then sometimes, what you and I see on the testing is we see that they have an inverse cortisol pattern or maybe it’s too low in the noon and afternoon, and then it kind of spikes at night. And then those people are the ones who they laid down but they’re too wired and tired. So we really have to focus. We have to test, first of all, you got  to get the data. We have to test the adrenal function, and then we have to help modulate that cortisol rhythm if it’s off. Otherwise, it doesn’t matter if you take Melatonin or some other magic sleep supplement. It might not work.

Dr. Justin Marchegiani: One hundred percent. So again, that reverse cortisol rhythm is the hallmark of a sympathetic kind of overload or sympathetic dominant person. Their fight or flight nervous system response is more activated and is starting to go up at night. And the WHI ha– HERS II study show the greatest correlation of cancer was a decreased cortisol gap between their cortisol in the morning and their cortisol at night. So the lower their cortisol got in the morning, which should be higher, and the higher their cortisol at night, this gap– this spread between morning and night– the smaller that spread got, showed a greater increased correlation risk of cancer than even smoking.

Evan Brand: Whoah!

Dr. Justin Marchegiani: So, it’s really important that we keep the sympathetic nervous system– you know, we keep it so we can oscillate and adapt between parasympathetic and sympathetic. So a couple things we do is adaptogenic herbs; can be really helpful.

Evan Brand: What are you taking there?

Dr. Justin Marchegiani: That’s just some Ashwagandha-

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: -and some extra vitamins. Uh– On top of that would be, of course, a really good anti-inflammatory nutrient dense diet, uh– along with blood sugar stability, ‘cause sometimes low blood sugar going into bed can create cortisol uhm— surges in the middle of the night.

Evan Brand: I remember when my nervous system was screwed up. This was like 2015. It’s like three and a half years ago. I was about to move back to Kentucky, and– and I called Justin. I was like, “Justin,” I was like, “I’m freaking out, man.” I was like, “My heart is beating a thousand beats a minute. I can’t get it to slow down.” And that was when I was about to move so the house was in boxes. Do you remember this?

Dr. Justin Marchegiani: Yup. I remember this.

Evan Brand: The hou— The house was in boxes. We were getting ready to pack up and move the next day, and you said, “Hey. Just try like a gram of Magnesium.” So that’s what I did, and then I ended up doing like an Epsom Salt Bath too with some essential oils, and I calmed it down. But I’ll tell you from firsthand experience, if your nervous system is screwed up, if you have more stress– you know, people say the term, “Work hard. Play hard.” If you don’t work hard and then rest hard, you’re– you’re gonna be messed up. And for me, you know, I had all of these impending uh– transition of moving and such, and I was not mitigating my stress properly. I was doing my adaptogenic herbs, which is great, but I was probably not getting enough exercise, sunlight, etc. So I’ve been there, done that, and it’s not fun. So, you have to make sure– I’ll just kind of say it in a different way. However much stress you have in your bucket, you’ve got to have an equally large bucket of de-stressing activities: meditation, massage, float tanks, herbs, going to bed on time, blocking blue light at night, etc.

Dr. Justin Marchegiani: One hundred percent. Like in my line, I have a product called Magnesium Supreme, which is a Magnesium dimalate, which is great. There was this other Magnesium uh– powders that are great. I’ll do a little bit of Magnesium with some Collagen, which has Glycine in it, and the Glycine can be really calming and relaxing too at night time. So I’ll do that before bed as well. People can also do some of the decaf Tulsi teas are excellent ‘cause that kind of has an adaptogenic effect. Some people would do even the Ashwagandha, which is great. Ashwagandha Supreme’s awesome. Do that one to two caps before bed. Just do recommend testing it out during the day just to see how you do. Some people, they get really energized with it, so you– you want to just make sure it’s not– you’re not one of those people that really get over– overly stimulated with the Ashwagandha. You can always do some other teas like the Camomile tea. The Tulsi decaffeinated teas are excellent ‘cause that’s Holy Basil, which is kind of a– a similar adaptogen as Ashwagandha, where it help– really helps calm and relax. You can always do some sublingual or liposomal GABA. We can even add some L-Theanine, too, which is an amino acid that’s really calming and– and relaxing as well. Uh– Anything else you wanted to ask, Evan? Al– Also uhm— Phosphorylated Serine is a nice adaptogen that helps calm the Hypothalamus’ response to Cortisol, so it can help really relax that Cortisol response at night, in case you got this reverse Cortisol rhythm pattern that’s happening.

Evan Brand: Yeah, and–

Dr. Justin Marchegiani: What, Evan?

Evan Brand: yeah, I do. Yes, and I’ll first comment on the Phosphorylated Serine. People may think you’re just pronouncing it different or wrong. You’re not. No. This is different than Phosphatidylserine. This is Phosphorylated, so there is a difference that’s he is talking about. I’m a huge fan of Lemon Balm. I have Lemon Balm tincture [crosstalk] in my– Yeah. I’m growing it in my garden but it’s a lot easier to just buy an organic Lemon Balm tincture. So I do that, and then, Motherwort, another favorite. Uh– There’s a couple different herbalist that I look to for education about herbs. And one herbalist said that taking Motherwort is like getting a hug from planet Earth, and I would agree with that statement completely. It’s a weird thing to describe how are you getting a hug from planet Earth? But when you take Motherwort, you just feel like you’re cuddled. You feel like you’re getting swaddled like a little baby. And so I take Motherwort and I just go lay down, and it’s basically– uh– I mean, It just takes all of your worries away. It’s a very, very calming thing to do, and it’s really great for people with heart issues– you know, atrial flutter, atrial fibrillation, any other type of like a sympathetic overdrive heart issue. Obviously, if you’re taking pharmaceuticals, you got to see if that stuff matches up. But if you’re not on pharmaceuticals, Motherwort is a really good go-to.

Dr. Justin Marchegiani: Excellent. We can also do things like Melatonin. I always recommend if you’re using Melatonin, if you have good benefits with Melatonin, try to use more of the 5-HTP with B6 first ‘cause that provides more of the building block amino acids to make the Melatonin hormone. I always like providing more of the building blocks and precursors. Some people, they just have burnt out their Serotonin from stress or from too much sugar or inflammation. So those building block kind of pulls to make their Melatonin can be lower. So I was recommend that utilizing some of the 5-HTP with B6 first. I think that’s great. And if you need Melatonin kind of in a punctuated fashion, I always have some lipo– a sublingual version by my bed. So if I’m just coming off a weekend where I was up a little bit later, [clears throat] or if I’m up at night where I’m more stimulated, I can just get it in my system in five or ten minutes and have it be done ‘cause it’s going to my sublingual tissue so it’s there right away.

Evan Brand: And dosing on that is how much, typically?

Dr. Justin Marchegiani: I tend to always start super low, so anywhere between two to three hundred micrograms and up to one milligram. Most people they all start at even at three milligrams, right? So I try to start super low because I just need the– the kind of the sedation-relaxation, kind-of-going-to-sleep effect. I don’t need it to kind of nurse me throughout the night.

Evan Brand: And most people overdose on Melatonin.

Dr. Justin Marchegiani: Mm–

Evan Brand: What we see when we test people is that people that are doing like 5-10 milligrams Melatonin, well, look at their Cortisol pattern, and they don’t have that morning spike with their Cortisol like they should ‘cause the Melatonin opposes Cortisol and vice versa.

Dr. Justin Marchegiani: Yeah, so– I always say, we’ll give them like a 1 mg like sublingual lozenger and we’ll have them nibble off a third, and just see how they’re doing. And they can gradually increase it if they need it. So I’m fine with that. And also, just– sometimes people wake up in the middle of the night. They have a pattern or a rhythm of having a hard time going back to sleep. There can can be stress that happens just sitting there wondering if they can go back to sleep. So, sometimes, if you’re that person that’s– it’s better to almost as nibble on a little bit of Melatonin ‘cause then at least you’re done what you need to get back to sleep, and that helps negate that Cortisol response from you wondering if you’ll get back to sleep.

Evan Brand: Yeah. I would also like to bring up emotional stress too. If that’s unaddressed, that’s gonna keep you up at night. So if that’s a financial worry, or a relationship problem, or you hate your job and you don’t want to go to work the next day– something like that, you got to address it. So, I would try to write down a big list of all of the stressors. What are the things you can control? What are the things that you can do? What are the action steps to resolve those stressors? And then, for some of the stuff you can’t control, like maybe you’re stuck in this job, you don’t like this boss right now, maybe you can do some EFT– and you tapped about it. You know, even though I don’t like this boss, I deeply love and accept myself, and you just do your tapping and affirmations. That could help too. And then– I know you may have a couple of other things to go into, but we should definitely just really hit on the fact about testing ‘cause you brought up the Serotonin and how people burn that out due to stress. We don’t just guess with that. We always test people, and we can measure it.

Dr. Justin Marchegiani: Oh, totally. Yeah. I mean, on the stress thing– I mean, what I’ll do is I’ll just use my– my to-do list, either on Google Task or just on my iPhone, and I’ll just punch in what are– what are the top three things that are keeping me up. ‘Cause the big thing is, as long as I’m taking action on those things, it’s usually the– the uncertainty and the lack of action taking on a– a stressful task that creates the uncertainty. So– Hey, what are those top three things? And just make sure we’re doing something to close the loop, so we’re always doing something. So we’re not sitting back and kind of being a spectator so to speak.

Evan Brand: Yeah, being paralyzed from it.

Dr. Justin Marchegiani: Hmhm– Yeah. Always make sure you’re doing at least something to get the monkey off your back.

Evan Brand: And then did– did you have other categories or body systems you wanted to hit on? I think we hit the gut briefly. I will say that gut infections can mess up your sleep. When I had parasites, my sleep was terrible.

Dr. Justin Marchegiani: Yeah. Infections can be a stressor, and these infections are more active at night time, so the inflammation they create at night, the body may respond by producing more anti-inflammatory hormone, i.e., Cortisol. Cortisol’s also stimulatory as well, so that could wake you up. So we– you know, we do our best to clear out the gut infections. That could be more of a long-term strategy. We may use palliative things first, like I mentioned, the Magnesium, the Calm, the Motherwort, the– the 5-HTP with B6, the Melatonin, all of the healing and soothing and calming herbs, and adaptogens first. And then, of course, we get the patient ready so they can get to that next step and do the killing efficiently. We may work on the blood sugar stability before bed and have something by their nightstand in case they are waking up with low blood sugar. They have uh– easy smoothie or an easy bar right there at their nightstand, and they access if needed.

Evan Brand: Yeah, good. Like a little fat bomb, you know, like a little big chunk of coconut or something like that that’s gonna give you some fats.

Dr. Justin Marchegiani: Yeah. EPIC Bar, one of these collagen bars, or a little smoothie that’s already made in a shaker cup– It’s already ready to go. We just don’t want you having the to get up, go to the fridge, the bright light pops on, or you having to use your head to make– to mix whatever you’re doing. I just kind of want to on autopilot. So if you need something, it’s just there, ready to go.

Evan Brand: Yup, yeah. So parasites for me, I mean, that was the biggest one. I had an H. pylori infection too. That screwed up my sleep. My sleep is much, much better now. Of course, you know, with the baby, we’re– we’re getting there. We’re almost out of the woods with her sleep, so I’m gonna be sleeping much better. I already am sleeping better than– than previous, but uh– Let’s talk about the testing too because I think it’s important. People can go and buy all these supplements. You can buy Melatonin, Ashwagandha, etc., etc. And as you mentioned, it’s more palliative. It’s not really root-caused. So you hit on the adrenals. We talked about testing for that. We do that with Saliva panel. You can measure the 24-hour rhythm or you could do urine, but either way, you want to look at the morning, how the day progresses, and then evening, take a snapshot there. If there’s Cortisol issues, you have to fix it because that could be messing up your gut, ‘cause if the Cortisol’s too high, that’s catabolic. So then it’s eating your tight junctions away in your gut. Then you have leaky gut. Then you get autoimmune condition. Then you’re really screwed. So, you got to test adrenals, and then step two– you mentioned the brain chemistry, the serotonin– so we run organic acids testing on everyone through urine. It’s a great test, and it looks at, also bacterial infections and yeast, dopamine levels. It looks at your endorphins, amino acids, etc. And then step three– we talked about the gut– getting the gut tested, running a stool test– we do this at home. So if you work with Justin or I, we send a test kit to your house. You collect stool. You look for all the infections, and then we come in and we address those. And then, maybe, we’re doing some of the stuff behind the scenes along the way, but you have to fix those big body systems if you really want to sleep good and have long-term health.

Dr. Justin Marchegiani: Absolutely. So we have kind of the anti-inflammatory, nutrient dense, low toxin diet going. We’re working on the gut. We’re working on the hormones. Oh! Also, low progesterone and some hormonal imbalances, I see it with a lot of my women that have severe PMS or they’re perimenopausal or menopausal, postmenopausal. The hormonal imbalances from progesterone and estrogen, either going low or being out of balance at certain times of the month, can easily throw off the cycle, or– I’m sorry, sleep– easily throw off your sleep.

Evan Brand: Now, would you say that– would you say like Estrogen Dominance is what’s happening?

Dr. Justin Marchegiani: Well, it can because Estrogen Dominance tends to imply lower progesterone, and progesterone kind of open those GABA chloride channels and GABA is an inhibitory neurotransmitter, which means it helps you relax and turn off. So, GABA’s kind of the switch that allows the sympathetic nervous system to go off and the parasympathetic to go on, which is important so you can wind down and chill out. So, that can be helpful. So some of our cycling patients or even our menopausal patients will give some progesterone at or around bedtime, or we’ll have them dosed their progesterone at around that time of the day anyway. So it really help with relaxation.

Evan Brand: And you’re talking like how much?

Dr. Justin Marchegiani: Uh– It depends, but typically with patients, we’ll do anywhere between 25 mg to 50 mg.

Evan Brand: Man, that’s like a typical dose. Like you’ll see like a teaspoon of like a micronized progesterone. It’s like a pretty standard dose.

Dr. Justin Marchegiani: Yeah. Twenty-five to 50 milligrams is pretty good. It just depends on how low the person is. We may go up more, above that– you know, go up to 200, and just if we continue to see benefit or improvements, that’s good. And if we see lower levels that will give us more motivation, then we should go higher. But I always like to start lower with hormones because progesterone can sensitize Estrogen receptor sites, so people can get symptoms of Estrogen dominance as they increase their progesterone because of that receptor site sensitivity. So starting lower tends to help the body adapt to the dose-type of responses. Kind of like it’s easier to get into cold water if you can kind of start with warm water and gently nudge the temperature downward. Kind of like that.

Evan Brand: Yup. Well said. Were there any other body systems or things we didn’t hit on yet?

Dr. Justin Marchegiani: Well, we talked about the amino acids and the neurotransmitters. We talked about uhm— B6. We always like to combine there ‘cause B6 is really important to uhm— these neurotransmitters converting and synthesizing. So, if we have Mitochondrial stress, if we had dysbiosis, B vitamins are made in the gut. A significant amount, obviously a lot, will come with food and– and healthy meats, and good animal proteins, and good plant material. And then after that, uhm— minerals are important. People that tend to eat lots of sugar and excess carbohydrate and refined sugar, they’ll be depleting their Magnesium ‘cause Magnesium’s one of those nutrients that gets burnt up with excess carbohydrate metabolism. So Magnesium’s really important. That will help uh– have a– a really good relaxation kind of effects. So that’s important as well. And then, just some of the diet– some of the lifestyle strategies is keeping the– the lights down at night, blue-blocking glasses can be great. I use them sometimes. For me, I can go from sympathetic to parasympathetic like that, so it’s not like this huge thing. But I think if you have a hard time coming off of a TV or a movie, or just in general, that could be a good thing to kind of help the parasympathetics turn on faster and better, so keep that in mind. I will find like– I find watching TV like at 9:00 o’clock or 8:30, and I have those glasses on. I’ll want to go to sleep so– so much faster.

Evan Brand: Oh, yeah.

Dr. Justin Marchegiani: Really, just like, “Whoah!” I’m just like– So I mean, it’s like go to bed a little too early so– so I like a little bit of stimulation so I know I’m ready.

Evan Brand: Yeah. I mean, I– I’ve got a pair of it I gave my wife to wear, and we both wear them. We get super sleepy quick and we basically just–

Dr. Justin Marchegiani: Yes.

Evan Brand: We have uh– salt lamps on at night, and that’s pretty much it. We don’t really have any overhead lights at night, so we– we try to live like we’re hanging out at a campfire in the evenings-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -and it– and it works great.

Dr. Justin Marchegiani: And for me, we have blue-blocking uhm— night lights so– In my son’s room if we need to or– In our room, if we need to, we have night lights. So if we need a little bit of light, which sometimes we do, is at least not emitting any blue light, so that’s not gonna stimulate the Melatonin. Right? It’s the blue light that gets the Melatonin going, so more of the infrared uh– red frequencies tend to be less Melatonin s– uh– less Melatonin-inhibiting.

Evan Brand: Yep. Yep. Well said. So the light piece you cannot ignore. Like you take all the perfect supplements, you got a big bright light or you’re checking your phone right before you go to bed and you’re not using blue-blocking technologies, then you’re screwing yourself up for sure. I saw a question uh– if you’re ready to hit questions, it was a-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -question about PQQ, and whether it improves sleep or not. I did find a study on that, and it was just titled exactly that, “Oral supplementation PQQ on stress–”

Dr. Justin Marchegiani: Uhmhm–

Evan Brand: “-fatigue and sleep,” and turns out that yes, it definitely does help in terms of sleep onset sleep duration. And it does help to reduce fatigue, tension, anxiety, depression, anger, hostility, and confusion. So, PQQ’s great. I mean, we do use some of PQQ and some of our protocols. It’s a great [incomprehensible]

Dr. Justin Marchegiani: [incomprehensible] from mitochondrial function? It’s– There’s research showing that it actually can help regenerate Mitochondria.

Evan Brand: That’s so cool ‘cause when you hear about Mitochondria, it’s kind of like brain cells. People used to think that once your Mitochondria get damaged, you’re toast, but you’re not. You can actually regenerate Mitochondria, which is cool.

Dr. Justin Marchegiani: A hundred percent. Any other questions you want to highlight here, Evan?

Evan Brand: Yeah. Let’s see here. There was one that said, “If I’m in a toxic environment, is it smart to do fasting if I wake up at night hungry?” That’s kind of a confusing question. Do you understand that one?

Dr. Justin Marchegiani: Well– I mean, I would say– So like, do you mean– I’m gonna make some assumptions– meaning toxic like poor air quality or mold in the environment? I mean, I would say, number one, you’re gonna– as long as you have access to good quality food, I would say, eating is gonna provide the nutrition to run those detoxification pathways. Alright, part of the benefit off fasting is uhm— you’re not putting any food in your body, so you give your gut a chance to rest. So if your gut’s inflamed or stressed, that makes sense, but if your gut’s already healthy and you’re putting really good food in your body, well that nutrition’s important to run your metabolic pathways. Your metabolic pathways either go in debt to run, meaning they– they burn up other tissues, which may be good if it’s fat, but they need nutrition to run. As far as I’m concerned, your fat does not store a whole bunch of uh– vitamins and minerals. It has a lot of caloric reserve. It doesn’t have any mineral or fat reserve, and you may have some fat-soluble vitamins stored in your liver– A, B12– B12 tends to be a little bit– even though it’s a water-soluble vitamin, it tends to be stored in higher amounts in the liver from what I understand. Uhm– But in general, I would say, you– you want to make sure you have good nutrition to run those pathways optimally.

Evan Brand: Another question here. It was about uh– Samuel. He said, “Seems like the blue light blocker fad is winding down. Is it still effective for proper sleep?” Of course it is. It’s not a fad. It should stay here forever. Blue light is never gonna not affect Melatonin. Period. Once the– Once we figure that out, I think that’s a lifetime strategy.

Dr. Justin Marchegiani: I still don’t understand why a lot of people just have them on during the day ‘cause I just like, “What’s the point?” Because don’t you want that stimulation during the day? You want that Cortisol.

Evan Brand: You do.

Dr. Justin Marchegiani: So I don’t understand. I see people like Dave Asprey and uhm— Dr. uh– Jack Kruse. They have them on during the day, and I’m just like– I mean, maybe if you have some kind of timezone switch and you’re trying to adapt to a timezone maybe and you’re overly stressed and you’re trying to decrease that stress response, fine. But during the day, I would think you’d want to have that Lead exposure especially in the first half of the day, and then the last half of the day, maybe after 5:00 PM if you’re trying to get that nervous system to quiet down, maybe you’d throw in the blue-blockers to help accentuate that parasympathetic shift.

Evan Brand: Yeah, I chatted with Dr. Mercola about it. He says the only time and reason that he wears the blue-blockers during the day is if he’s in like a conference hall or something where it’s all artificial lighting-

Dr. Justin Marchegiani: Artificial light.

Evan Brand: -and he has no sunlight. So, if it– if you’re getting exposed to fake blue light during the day, and you still have sunlight-

Dr. Justin Marchegiani: Uhmhm-

Evan Brand: -opposing it with windows or your outside, you’re in good shape. But whe— when you have nothing and you’re in like a dark hall, and all you have are these fake lights, that’s when I know Mercola said he will use the glasses. And so that’s kind of the– the two cents there. Charlie asked, “Should you eat carbs like a sweet potato or honey before bed? How long before bed for optimal sleep?” I don’t worry about the timing, but I do feel like I sleep a little bit better with some starch at dinner.

Dr. Justin Marchegiani: Yeah. I think people that have lower Cortisol at night, tend to go lower at night do little bit better with some carbs. So I think, number one, if you know your adrenals tend to be a little bit lower in the cortisol side, try it. Just try doing a little bit of carbs before bed. If you have a device like a FIT-BED or an Oura Ring but has some HRV attached to it, try it and then see how your HRV, which is kind of uh– window into your nervous system. See how that looks at night time. But I mean, if you’re having times where you’re waking up at night, definitely throw a little bit of carbohydrate in there with some protein and fat, and see if that makes the difference.

Evan Brand: Yup. Uh– Elizabeth said she used to have trouble sleeping and she was told she had parasites, so she got rid of the parasites and she slept. So yes, that’s awesome.

Dr. Justin Marchegiani: Yep. We see that a lot. That’s great. Awesome.

Evan Brand: I know–

Dr. Justin Marchegiani: And you got uh– major questions here you want to run down that are pertinent to the podcast here guys? Do you have any questions? Try to keep it to the sleep podcast. I’m gonna try to, in the notes, always put like in the beginning like, “Hey this podcast is on whatever topic.” In that way, you guys can chime in accordingly.

Evan Brand: Uh– Yeah. Mike asked, “Blue light is for the light of the morning, why would you want that all day?” So– I mean, the sun emits blue light all day until-

Dr. Justin Marchegiani: Yes.

Evan Brand: -the spectrum starts changing and then you start to remove blue light naturally as the sun sets. So that’s how it’s supposed to happen. The atmosphere starts to filter out the blue and greens, and then you transition into darkness. So that’s how it suppose to work, which is why being on the computer at night with no blue-blocking software or the glasses is– is not good. So I don’t do any– pretty much any screen too late, and if I do, it’s always with the blue-blocking glasses or software on.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I think that’s all the pertinent ones.

Dr. Justin Marchegiani: Yeah. On my iPhone, I have the night shift on and I went in and I– I like turned off all the blue so it’s only red at night. And that doesn’t mean I can be on my phone right before bed, like if I’m like– I don’t know– like getting my alarm set or making a couple of notes on my to-do list for tomorrow, doesn’t affect me at all, but I also have to have all of the blue off, 100%. And I have the light on the lowest possible uh– setting as well.

Evan Brand: Yeah, like the brightness itself-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -turned down? Yeah.

Dr. Justin Marchegiani: The brightness all the way down. All of the blue totally off so it’s just red that’s showing and it’s just the– the tiniest bit. But then if I have to like– let’s say I have to go on a comp– the computer like late to do some work, something got missed, then I will use my blue-blocking glasses just because I got all these monitors on. So that’s when it’s really nice. If you have to do work a little bit later, use your glasses for that.

Evan Brand: Yep. Excellent. Kruse said something interesting last time I spoke with him, which is he thinks people should be wearing scarves around their neck because the blue light penetrates through the skin and it can affect the thyroid and cause Hashimoto’s. I think it’s an interesting thought.

Dr. Justin Marchegiani: Oh my gosh! Okay. Uhm– [laughs]

Evan Brand: I’ve been interviewin—

Dr. Justin Marchegiani: Here’s the deal. I’m always open to trying it so like if you feel less stimulated, great. Awesome. Give it a try. Will that cause Hashimoto’s, I’m not really worried about it. Uhm– There’s way other– way more triggers that people are already activating with Gluten and with infections and blood sugar. I’m not worried about that. Now, if uhm— And also VItamin D is really important, right? Vitamin D has a major effect on the immune system and can help modulate the immune response, but I wouldn’t– I wouldn’t [laughs] jump to that conclusion on the Hashies first but I think it’s worth trying if it helps you feel less stimulated for sure.

Evan Brand: Right. Right. Yeah. I mean, I think if you’re desperate, that’s something you should definitely look at. If it reduced your antibodies like let’s– I think the only way to track it would be if you had all other variables dialed in and then you put on the scarf at night, so therefore the blue light didn’t penetrate to the thyroid and then all those antibodies went down but you did nothing else. That may be a way to quantify it but that’s hard. It’s hard to quantify.

Dr. Justin Marchegiani: Yeah. For me, like blue light I think is optimal because there is some data, I think, In TS Wiley’s book, uhm— “Lights Out.” She talked about, I think, a study at the University of Chicago where they had people like a sleeping– sleeping, and then they would like shine a light. They would like put a light right in the back of someone’s knee.

Evan Brand: Yes. That’s right.

Dr. Justin Marchegiani: And it would like wake them up or pull them out of sleep. I’m not sure if it woke them up or it just made their– their sleep uhm— their sleep study look, you know, more unfavorable so to speak.

Evan Brand: I– I think it down-regulated Melatonin too.

Dr. Justin Marchegiani: Yes.

Evan Brand: And it was literally a light the size of like a nickel behind the kneecap, and that was enough to affect Melatonin.

Dr. Justin Marchegiani: Right. So I look at like blue-blocking glasses at night time is like the lights are down to a– a dimmable level, and maybe you want to watch TV or some Netflix or check out your iPad or whatever, like that’s where I find it’s really good. Ideally, you want everything kind of dimmed down.

Evan Brand: Agreed.

Dr. Justin Marchegiani: So you don’t want all the lights on, all the lights on, and then the blue-blockers on.You’d want everything down and then you’re using it just so you can engage with your technology, or watch a show and not be– you know, overly sympathetically stimulated.

Evan Brand: Yeah. That’s an important note. Is environmental light needs to be reduced as well. You can’t just blast yourself. “Oh! I have blue-blockers. I’m fine.”  I agree. It’s got to be both-

Dr. Justin Marchegiani: Yes.

Evan Brand: -which is why I did nothing but salt lamps at night.

Dr. Justin Marchegiani: Yeah. Best investment everyone can get is number one, uhm— like for your bedrooms, get blue-blocking night lights and/or like a night– a bulb that’s like a blue-blocking bulb, and/or number two, in all the major rooms that I’m in like around night time, they all have dimmer switches. So if I have to use lights in my bedroom, I put on the absolute lowest setting; of my TV room, lowest setting; or for like– you know, around my TV or bathroom, absolute lowest setting. That way, I can at least, you know, decrease the intensity if light has to go on.

Evan Brand: Yup. Yup. I think that was all the questions. So if people want to reach out– I mean, we always test people. Could you take some of these supplement recommendations and benefit? Probably so, but we do like to test people and figure out what’s really going on. So if you want to reach out, you can do so to Justin at his site, justinhealth.com. Justinhealth.com. And if you want to reach out to me, it’s evanbrand.com. We love helping you all. We love getting the data. We love seeing the difference too, like after we implement something and then the Cortisol rhythm’s fixed and then the sleep is fixed, it’s like, “Oh! That’s why you’re sleeping better. Look at your Cortisol. It went from 12 units at night to now it’s one unit at night.” It’s really satisfying to see the results on paper.

Dr. Justin Marchegiani: One hundred percent. And we appreciate the awesome questions from everyone who kind of chimed in, and we think we’re one of the only people that does a live podcast like this and answers questions just live, right? We’re functional medicine health improv here so we appreciate the great questions. Give us a share. Give us a thumbs up. Make sure you hit the uh– notification bell. And anyone that– your friends or family that that needs more help or wants to chime in and be part of this great conversation, we appreciate uhm— you sharing the word. So thank you so much, everyone and Evan. Today was a– a great podcast as always and let’s talk real soon.

Evan Brand: Take care, bye.

Dr. Justin Marchegiani: Thanks. Bye.

References:

A recent study about Optimal Amount of Sleep for Cardiovascular Health

Night Shift Nurses Sleep Study

The WHI Estrogen/progestin and HERS II Study

“Lights Out” by TS Wiley

https://www.evanbrand.com/

https://justinhealth.com/