603: The science of sleep, sex, & sharing a bed | Wendy Troxel, Ph.D.
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What if one of the most powerful tools for improving your mental clarity, your relationships, your hormones, even your longevity, was something you're already doing every night, just maybe not well enough? Today's guest, Dr. Wendy Troxell, is here to make the case that sleep is not just a pillar of health, it's the foundation. A licensed clinical psychologist and certified behavioral sleep medicine specialist, Dr. Troxell is a senior behavioral scientist at the RAND Corporation.

an NIH-funded researcher and one of the nation's leading voices on the science of sleep and its impact on our lives. In today's show, we're diving deep into the surprising ways sleep influences our health span, not just how long we live, but how fully we live. We'll explore why sleep is so tightly intertwined with our cognitive health, emotional well-being, and even our ability to stay connected with the people we love. We'll also dig into the science around sexual health and sleep, including the fascinating research on how sleep affects libido, hormone levels, and intimacy.

Plus, Dr. Troxell shares practical tips for navigating menopause-related sleep challenges, her strategy for beating the dreaded 3 a.m. wake-up, and how to use wearables without falling into perfectionism, and why heart rate variability might just be the most insightful sleep stat of them all. The show's packed with actionable takeaways, so let's get to it. So at the highest level...

What's your view on the role sleep plays in achieving our maximum health span? Great question. I mean, first of all, I think it's important to explain my view of health span, which is a life fully and richly lived. And

It's not only about the duration of living, but really, again, the fullness of life across multiple domains that matter to us as human beings. And when you think about...

The role of sleep in contributing to a full and rich life, you know, it really affects every domain of importance. From our physical health and well-being, our ability to do the things that we love to do as we get older, our mental health, our cognitive ability, our ability to remember and to connect with other people.

Of course, our relationship health, I think that that is something that we don't always think about, but it's so critically tied to the quality of our sleep. And when we think about the factors that also contribute to healthy aging and health span, our social connections are absolutely critical. So sleep plays a role there too. So when we think about

all the domains that matter for us in terms of living a full, rich life, I can give you data really across the spectrum that sleep matters. There's almost no domain of human functioning and health span that doesn't do better under well-slept conditions. - Well, you mentioned relationships, the importance of connection, and it's a great segue to couples and sleep. You literally wrote an entire book on this.

And so at the highest level, what are some of the challenges and opportunities when it comes to couples and sleep? Well, the first thing to think about when you think about the challenges that couples can and do face is, first of all,

The time we spend asleep is arguably the single biggest proportion of time in a day that we routinely spend in close proximity to our partner. So if the average adult spends, you know, roughly one third of their lives asleep, that's if they're getting, you know, the roughly eight hours of sleep per night that doctors and scientists recommends, that roughly one third of their lives, if you're sharing a bed, is with a partner. And

Other health behaviors, if you think about them, maybe you occasionally go for a run with your partner, maybe you have meals with your partner, but there's really no other critically important health behavior that occupies so much time. So when you think about it that way, it sort of opens the door to recognizing that having some challenges is really quite normative.

So the types of challenges that couples face, I mean, I think the one that gets the biggest attention of all is, of course, having a snoring partner, because that can be very disruptive to sleep. And there's all sorts of jokes about it. It often sort of leads to the pattern of sleep divorce, which we can also talk about. But beyond snoring, there are many other issues that play a role. You know, maybe you have differences in sleep habits.

preferences in terms of the temperature of your bedding or your bedroom. Maybe your partner insists on bringing their phone or tablet to bed and you're really rigid about practicing good sleep hygiene behaviors. Maybe one of you tosses and turns or just is a light sleeper. Or maybe you have children or pets who like to weasel their way into the bedroom, making threes a crowd. Maybe there's pain that

makes your sleep disrupted, which makes it harder to share a bed with another person or other issues that we see across the lifespan, like menopause or the presence of other sleep disorders, which can make sleep

sleep already challenging on an individual level. And then when you add another person in, it can just compound that challenge. And the final example that I want to mention, because it's so true for so many couples and they often forget, is that some couples are on very different sleep-wake schedules, whether by

by external demands. For instance, their work requires them to work at different hours. Or we also have to recognize that just because we fall in love with a person doesn't always mean that we're going to be matched perfectly in terms of our intrinsic circadian rhythms. So if a lark pairs with an owl, that can also create some issues as well. So those are some of the common problems that couples face. And I think this is so critical because a couple could be like the perfect match.

They love each other. They enjoy hobbies together. There's alignment in every part of their relationship. The spark is everything's there. However, I want to talk about this with you. If there's something off as it relates to how the couple sleeps together or don't sleep together in the case of a sleep divorce, it's

it has a severe impact on the couple's sexual and relational health. There are unintended consequences. Absolutely. And we spend so much time sort of, you know, perseverating and focusing on the media loves the topic of sleep divorce and how, how couples are sleeping apart. But,

we're so frequently missing the most important question for couples. And what I really pose to couples and the reason I wrote my book is rather than thinking about there being one right way to sleep with or without your partner, what we really want to be focused on is how critically important sleep is for the quality of our relationship. As you mentioned, we know, for instance, that

Sleep is critically important for our sexual health. Among women, for instance, for each extra hour of sleep a woman gets, she experiences a 14% increase in sexual desire. That's a really powerful effect among women and can have a very powerful effect for the relationship.

The converse, however, in the not so good way is true for men. Studies have shown that just after a short, you know, week of a sleep restricted schedule in a laboratory setting, healthy young men, these are, you know, participants in the age range of like, you know, 20 to 22, you bring them into the lab and you sleep restrict them for only five hours per night for about a week's time. These healthy, you know,

young men will show a reduction in testosterone by about 10%. And to put that in perspective, that's the equivalent of aging a man by about 10 years in terms of this critically important sexual and reproductive hormone. So again, we have data to show the benefits of

of getting the sleep you need for a woman's sexual desire and satisfaction, we can also see, at least in terms of the hormone testosterone, which is very important for sexual health among men, that when you don't get the sleep you need, that can really have a pretty devastating effect on a man's sexual health. So again, it stands to reason for a couple to prioritize sleep.

But it really goes well beyond the impact of sleep. It's not just on the couple's sexual health, which is, of course, an important dimension of a good quality relationship.

But when we think about all the other building blocks of a healthy relationship, you know, all of the factors that, you know, preeminent relationship researchers like John Gottman have studied, we see that sleep is really foundational to those core building blocks of a healthy relationship. Like being a better communicator, like being a better problem solver, like having relationships

good, healthy emotion regulation skills, and being empathic towards your partner. All of these critical and foundational relational building blocks are improved under well-slept conditions. And was it fair to say that if you have partners who are on the same page with regards to sleep etiquette,

That makes for a stronger relationship. It absolutely can, because of the converse of that is if you're not on the same page, that's really intense fodder for conflict. And again,

You know, that's where I think just opening the conversation to couples having discussions about what's working and what's not working in the bedroom when it comes to sleep, not sex in this regard. But like that's often lacking. As you said a couple of minutes ago that, you know, couples may be perfectly aligned in sort of all of their waking activities and sleep.

They may put a lot of conscious effort into that, but we rarely as a culture think about, you know, as we enter a relationship or even when we're in the midst of the relationship, you know, how compatible we are in the roughly eight hours per day that we spend in this unconscious state that we call sleep. And just because a couple is perfectly compatible during the daytime does not mean they're going to be automatically compatible at night.

That also doesn't mean that it's a death knell for the couple. It just means that they have to address the issues that come up in a healthy and honest way so that conflict or resentment doesn't arise. And would it be fair to say if you took a couple and let's say they both have great sleep etiquette, they are both great sleepers, if you were to separate them?

and measure their sleep. As a couple, would their sleep be better than separating the two? I'm assuming the answer is probably yes. That's a really interesting question. The data on, you know, do people sleep better with their partner or apart is actually interesting.

a little bit confusing or a little bit mixed, I would say. So there have been studies that have looked at this. They take healthy couples and they, you know, for a few nights have them sleep by themselves. And then a night or two, they have them sleep with their partner. And when sleep is measured objectively, like with the wrist worn sleep tracker, the studies actually show that there are slight decrements in sleep. Sleep is somewhat worse

when sharing a bed with a partner as compared to the nights when they sleep alone.

However, when you ask those same people, do you prefer to sleep with your partner or do you prefer to sleep alone? Most will say they prefer to sleep with their partner. Now, what this speaks to is, first of all, we know this already, that objective and subjective measures of sleep do not always cohere. And that doesn't mean that one is more right than the other. The subjective experience of sleep is very important, as is the objective one. But they tell you different things.

But what it also says, sort of this disjunct between the psychological experience of sharing a bed and maybe the objective consequences of having to share a bed, it suggests that for some couples, the psychological benefits that they receive from the closeness, the security and the safety they derive from sleeping next to a loved one,

tends to override, at least psychologically, the somewhat minor objective costs of sharing a bed. Now, what can happen, though, is when couples, there's probably some threshold when those minor disturbances that we can measure objectively, if they pass some threshold, let's say you have a partner that is snoring loudly throughout the night or is thrashing and taking your sheets so that you really cannot sleep,

That's probably when some couples cross a threshold where, you know, even though there are some psychological benefits, now the objective costs are really overriding those psychological benefits. And that's where some couples may choose to have the conversation about separate beds or separate bedrooms, sleeping apart because their sleep is so disturbed. So they no longer are benefiting even from the psychological side of things.

And I would guess that physical touch, just in the most innocuous sense between couples, is beneficial in the bed. It absolutely can be. And, you know, there's a good sort of neurophysiological basis for that. The hormone we call oxytocin, we call the love hormone, you know, it can be released during sexual activity and orgasm, but also just

But by a close human touch, hand-holding, cuddling. And oxytocin is associated with stress-reducing or anxiolytic properties. So it can create a calming response, which could be particularly beneficial for sleep prior to bedtime. What I say to couples who may choose that their sleep is better while sleeping apart, maybe you still benefit mentally.

from the psychological closeness and the potential benefits of oxytocin release via cuddling, you know, in the moments before either of you goes to sleep, including if you go to separate bedrooms. But you try to preserve that critical and often sacred time that couples have. It's often the only time couples have just to themselves, you know, right before either partner's actual bedtime.

So for a couple out there who's listening and maybe struggling to get on the same page as it relates to their sleep, what should they do? Obviously, not everyone can see you. I know there are all sorts of different issues, but how should we be thinking about that? Yeah, well, not everybody can see me and you can get my book though, and that has some great tips for couples. But yeah, the first strategy is to talk about it. You know,

The biggest problems couples face when they start having challenges when it comes to their sleep is they don't talk about it. It's entirely this reactive phenomenon where one person just stomps out of the bedroom in total agony and frustration, leaving the other partner potentially feeling hurt and

and abandon, right? And so we don't want sort of those feelings of abandonment or hurt or resentment to arise on either side. So the strategy is to have a conversation about it and do so at a time when you're both capable of having healthy communication, which means you're both relatively well rested. And generally speaking, you know, these, you know, good, healthy conversations do not happen in the middle of the night at 2am after your partner just woke you up. So time it

well, open the conversation about really focusing on how sleep is really and in the quality of sleep that you both are getting is a relationship enhancing endeavor. We both win when we're

we're well-slept. So this is not about you, my partner, keeping me up all night and ruining my sleep. Rather, it's about how do we as a couple work together to figure out the solution that's going to make us both as healthy sleepers as possible? Because when we're well-slept,

We're better partners to each other. So we make it a we problem if there is one, and then we look towards a we solution, not a finger wagging, nagging sort of thing that makes the other partner feel blamed or shamed and may want to withdraw. Rather, it's how do we work on this together? Because

I know when I'm well slept, I can regulate my moods better. I'm less irritable. I'm a better communicator. I'm more empathic. I can understand where you're coming from better. And that makes me a better partner. And that's so important to me that I want us to address this. So it really is turning the

sort of tone around and focusing on this is a goal that, a mutually beneficial goal. That's generally the best strategy. - And what about for a woman who's listening, who's maybe going through menopause and sleep is becoming more difficult? - A prime time for sleep disturbances, yes. Menopause is associated for women, you know, and the menopause is a, you know, it's not a singular event. It often is a protracted event,

sometimes lasting the whole transition upwards of 10 years. Sorry to inform some of you who might be going through it right now that it can be quite protracted. And about 60% of women who are going through the menopausal transition, meaning that they're in either the perimenopause or actually transitioning through menopause, experience some level of sleep disturbance. And the sleep disturbance not only can have a major impact on the woman's

health, quality of life and her mood, but it also can have a major impact on the relational health. And

So in the case of, for instance, the very prevalent sleep disturbances during menopause, this is truly a time for couples to, again, address this head on, be honest about it. Sometimes labeling what's happening can be very helpful among couples. I use the term I'm slangry. It's like we have hangry, but for when you're hungry and angry, but like...

People's moods really go down the tubes when you're sleep deprived and sometimes labeling it and saying, unfortunately, this is part of this biological transition that I'm going through. And when I'm not sleeping well, I'm more irritable and kind of bringing awareness to your partner and hopefully having your partner meet you halfway just to recognize, okay, this is time limited and giving space when needed,

Thinking creatively about, well, how do we solve this? And for instance, in a situation like menopause, when women are really struggling with sleep, you know,

Keeping the menu of options open, including considering treatment for menopause, whether it's hormone replacement therapy or getting specifically treated for the sleep disturbances that the woman is experiencing, that's really important. And some temporary solutions within the couple if your sleep is really disturbed at this

period of time and you're awakened by every little noise or movement, you know, your partner's even slight movements may become more aggravating. So that might be a time to do a temporary sleep separation, really just to give you some space and to recognize this is not all about your partner, but it's allowing for, you know, recognition that this is a challenging time. It will not last forever, but we're going to work through it. And any solution, you know, is time limited.

So I have like a two-part follow-up question. So I think of sleep etiquette and I think of, you know, you want a dark room, you want a cool room or a cool bed. I swear by the age sleep, I love it. I like, it's ruined me. I have trouble when I don't sleep in a cool bed. You want to be mindful of what you're consuming, whether it's your phone, your media on TV, you don't want something a little too heavy that's going to keep you up. You want...

to be mindful of your last meal. Ideally, three hours plus distance between last meal, you'd be mindful of what you consume at that meal, how heavy that meal is, you're having a big dessert, alcohol, obviously very detrimental to your sleep, activity level at night. You probably don't, if you do a hard workout close to bedtime, you're probably gonna not sleep great. Those are the things that immediately come to mind in like basic sleep etiquette. Is there anything I'm missing? First of all, I love your term, sleep etiquette. It's so much more...

you know, doesn't sound so dirty as sleep hygiene, which I've never liked that term. It feels like we're doing something wrong when it comes to bed and we're like, you know, if we don't have good sleep hygiene, then we're somehow, you know, dirty in bed. Um, so I, I like sleep etiquette. Got you girls. Maybe we'll, maybe we'll send them to finishing school, you know? Yeah, exactly. Um,

Yeah, I think I think you hit, you know, the real high points in terms of setting the stage for a good night of sleep. I would say one thing that I see quite frequently clinically that is, you know, just a major problem for people who are doing all the right things. Otherwise, you know, they, you know.

limited their alcohol intake. They've limited their caffeine intake. They keep the lights low. They have optimal bedding. They have a great sleep environment. And lo and behold, still when they get into bed, their minds are racing and they just can't shut them off. So, and that feels sort of out of your control. To address that in this sort of

The inability to stop those thoughts when you get in bed. You know, my I have a favorite strategy, which is called a scheduled worry exercise. And what it involves is picking a time during the day. It can be, you know, at least a few hours before bedtime, but it can really be any time in the evening.

where you set a timer. And I actually like to use like the old fashioned egg timers, if you can have one, because there's something really concrete about setting that. You set it for 10 or 15 minutes and you grab a, you know, pad of paper and a pen. And for 15 minutes, you allow yourself to go hog wild.

You just write down every thought that you have, all the thoughts about how you screwed up during your day or the worries about what may happen tomorrow or the future family event that you're worried about. You just really let your brain sort of vomit on the paper as much as possible for a period of 15 minutes. And then when that handy dandy egg timer goes off,

It's a really concrete reminder. Okay, it's time to literally and figuratively close the book on that worry. And you do this practice for a period of two weeks for starters. And you may find that sometimes

But, you know, over subsequent nights or days of practicing this, it's actually hard. Like at the beginning, you might have lots and lots of worry thoughts. And as the days go by, you might actually find like, oh, I'm slowing down on, you know, how much vomit I can produce of worry.

And that's actually a sign that you're really starting to express and let go, download some of these worry thoughts that might otherwise invade your sleep or your ability to fall asleep or, you know, pop back up at three o'clock in the morning. So that's one of the best strategies that I know of that is research based that can really help with that tendency to have racing thoughts, which affect so many people right at bedtime.

Oh!

Oh, and he stumbles. Oh, right into the kitchen without missing a beat. Jim, now that's a man who eats his protein-packed Oikos. With 15 grams of complete protein in each cup, Oikos Triple Zero can help build strength for every day. Oikos, stronger makes everything better. It's such a great suggestion. I'm going to, I will employ that one. In terms of, if I go back to sleep etiquette, are there practices that you find can help

women suffering in menopause to incorporate into their etiquette routine that maybe not a silver bullet, but might help some people? Absolutely. I mean, all the things that you mentioned are sort of foundational that work for everyone, including women going through menopause, where we can just call this a vulnerable period where you're at high risk for sleep disturbance.

In addition to the things you talked about, I mean, I think I would really highlight the importance of, you know, thermoregulation, temperature regulation, given that, you know, one, not the only thing that can, you know, disrupt women's sleep during the menopausal transition are hot flashes. But even women who aren't experiencing hot flashes during menopause,

can have insomnia-related symptoms. But to sort of help manage that particular symptom, having a thermoregulated mattress or cooling pad, keeping the ambient temperature cool. So generally speaking, we want our rooms at

night to be cooler than we would feel during the daytime. So somewhere between, I generally say between 65 to 68 degrees Fahrenheit is sort of where you want your ambient room temperature to be.

Use bedding that is sort of light and use layers of bedding that you can throw off as the night goes on and as your temperature changes. Another strategy for women sort of recognizing that one of the most common symptoms of sleep disturbance among women going through menopause is that three o'clock in the morning or four o'clock in the morning wakening.

And I first want to say that waking up in the middle of the night is not in and of itself a problem. Sleep is a highly dynamic state. And so waking up in the middle of the night is partly just part of the process of sleep. It's the inability to fall back to sleep that

That becomes a problem. And for some people, when you start doing it night after night, it also becomes sort of habit forming. And what happens when we're awake at three o'clock in the morning and lying there wishing we were asleep and we're not? Well, that breeds frustration and anxiety. So the habit that's forming is not only, you know, the inability to fall back to sleep, but it's being awake and frustrated in bed.

So my number one strategy, again, I practice it myself.

is if you wake up in the middle of the night and you find that you're not able to fall back to sleep within 20 to 30 minutes, and the best way to gauge whether 20 to 30 minutes has passed is not by looking at the clock. In fact, nothing good ever comes from looking at the clock at three o'clock in the morning. Instead, you kind of know, you toss, you turn. If you find that it feels like about 20 to 30 minutes has passed, the best thing to do is actually get out of bed

Get out of bed and go to another room, ideally, where you can engage in some relaxing but distracting activity. People get this technique wrong because they think, oh, I need to go do something boring. It's not about that. The first technique is to get your brain off the fact that you're not sleeping and you're really frustrated about it. So read a book.

watch TV, do a mindfulness coloring book, knit, fold socks. I don't really care. It needs to be done in low light conditions, but it needs to be engaging enough that your mind gets off the fact that you're not sleeping. And you do this activity until you actually start feeling sleepy again, and then you return to bed. And what's so critical about this is that it's breaking the habit of worry and frustration and anxiety in bed. And for women going through menopause, like

Given that we kind of know that a large percentage of women will experience some level of sleep disturbance during menopause, what we want to do is prevent the onset of a more chronic sleep problem like insomnia, which really happens when we start sort of perpetuating habits like being awake and frustrated in bed. So we want to break that habit so this transient sleep disturbance doesn't become a more chronic one. And...

What's the time in your view where you've elapsed? Is it five hours of sleep, six hours of sleep? Or if you wake up, maybe you should just get up. That's a really tricky one. Actually, I was seeing a client yesterday and we were talking about this. She said, well, you know, if...

I wake up at 430 and I remind her, but you don't actually know that it's 430, right? Because you're not supposed to be looking at the clock. It's like, oh, right. But it is hard because if you know that morning is coming, you know, at what point do you just abandon the effort? That's a tricky one because, you know, because it really depends on, you know,

How, you know, is it really the middle of the night still or is it, you know, pretty close to your wake up time? I would say 4 or 4.30 is a good one for people who wake up around 6, 6.30. It's like you're waking up, say, two to three hours before you would typically wake up. Two to three hours. In that case, I would. This is a great opportunity to practice this habit.

Because you don't, you know, a two hour deficit, your sleep is not something that you want to then train yourself that, okay, it's all right for me to wake up at 430. If 6am is your, you know, wake up time, and that's what you generally do. But now you're having this, this, you know, middle of the night, 430 awakening, this is that's where the

activity, which we call stimulus control, getting out of bed, it's a great opportunity to do a reset and teach your brain that you actually can fall back to sleep. Now, I have to acknowledge that there might be some nights as you first practice this and you start breaking the habit, you know, it might be that you're going to fall back to sleep

pretty, you know, soon before the alarm's going to go off. And that's not a very pleasant state to be in. But remember, the ultimate goal of this strategy is to break the habit of the early morning awakening and the inability to fall back to sleep. So the goal here is to teach yourself a strategy that allows you to fall back to sleep, even in those early morning hours, which is, you know, kind of a witching hour for sleep as we get older. It's very common.

to have those early morning awakenings, but it is possible to break through them. What you don't want to do is if you just abandon the effort or even trying to fall back to sleep,

with this technique, you then are likely to turn on the lights, start work, do all these things that are going to send now a signal to your circadian rhythm that 4.30 is an appropriate wake-up time. And if you don't want it to be that, if it's not allowing you sufficient sleep, then this is again, what you want to do is practice a technique that's going to teach yourself how to fall back to sleep. Truth be told, I've done both. There have been many times where 4.30 has happened and I've just gotten up

and gone with it. And today, for example, 4.30 happened. Colleen, my wife, decided to get up and just go for it. I said, give me a few more minutes. I'll make coffee. And that was an hour and a half. She ended up making coffee herself and going to the gym. Yeah, she gave up on me. She said it was a good thing I didn't wait for you to make coffee. So I've done both. But I hear you. I think that's a good...

I think that's a good practice that most of us can try to follow. How do you think about, look, like wearables? I think they're amazing in that, you know, I'm wearing my aura, I'm wearing my whoop, I've got my eight sleep. I can look at sleep eight different, you know, a zillion different ways.

And it's been so helpful in that I've been able to identify certain practices and techniques, whether it's, you know, dinner time or the cooling mattress or, wow, alcohol really affects my sleep. And I've made such drastic improvements. But for some, there's performance anxiety and there's desire to perfect their sleep. My take is

For some people, it's like self-awareness. But what's your take on wearables, how we should use them, how we shouldn't use them? And from your view,

What's really insightful? What isn't? Yeah. Well, you know, I'm a scientist by training. So naturally, I, you know, love data and I think data is really cool. And I think it's really useful to inform our behaviors.

And it is. And, you know, as you suggested, there are basically pros and cons of wearables. And it really depends on what you're expecting out of them and how you use them and what's your reaction to them. So from a data perspective, we know that sort of a core step of any effective behavior change is

involves monitoring a behavior. And for that purpose, sleep trackers are a wonderful innovation, just like stepping on a scale gives you very useful information if you're trying to lose weight and is a great way to sort of maintain healthy weight. Similarly, having data from your watch or your ring or your mattress, it can be very useful for monitoring trends in your own sleep and identifying patterns

associations between behaviors that you might engage in during your waking hours and how that impacts your sleep at night. So as far as a sort of first step of behavior change, it can be very effective.

But it's most effective when used by looking at its trends over time within you as an individual, not you in comparison to anyone else that, you know, you see posting their data on social media and that you feel envious of because they're 100 percent sleeper and you're not. No, it's really not.

useful at a between person level. It can be very useful within an individual for you as a person to see your trends over time, never to look at it on a nightly basis as any sort of

absolute value. I really discourage people from getting overly concerned about a single night's data. Rather, we want to look across two weeks, 30 days of time, and ideally be sort of tracking also other behaviors that we're engaged in during the day if we're experimenting with reducing our alcohol

intake, for instance, or if we get a new bed that has temperature regulation, notice changes over time. That's where this can be really useful because it can inform our waking behaviors, things that we actually have some control over.

Where I see issues is when people become overly obsessed with the numbers and with the pursuit of some idea of perfection, whether it be 100% sleep score, which I can tell you just does not exist. That's a made up number.

There's no such thing. We don't know what 100% sleep is. So if you're achieving it, well, pat yourself on the back. But again, who really cares? It's about how you feel during the day. And by the same token, if you're getting data that your sleep is really crummy and that's making you feel

really bad or more anxious or more worried or stressing out more about your sleep, then I would suggest, well, maybe this isn't working for you anymore because it's just probably reinforcing what you already know, which is your poor sleeper. And you probably need some help beyond your sleep tracker because what sleep trackers also are not is

is a therapeutic device. They're very helpful at monitoring behaviors and can do, you know, for instance, you know, with temperature regulation in beds, they certainly can have a mild therapeutic effect, but they are not an intervention in of themselves. So if you're really struggling with sleep and the tracker, whatever it is, is just confirming how poor your sleep is, then, you know, do what actually works, which is actually to seek therapy.

effective evidence-based treatment to help you improve your sleep. Well said. And in terms of looking at the data, is it fair to say when I look at my trackers, I'm staring at it right now, what I tend to pay attention to, REM and DEEP. That's what I look at. The first thing, I don't look at sleep score necessarily, although it's like flashed right in front of your face, it's hard to miss. I

total sleep. I look at REM and deep. And then from there, everything else is secondary or tertiary.

What's your view? So I would sort of I'm sort of the opposite. I mean, I mean, I do sort of look at an overall score and I'm very interested in my HRV because I just think it's a cool metric. And that is definitely the one that has a very powerful effect on sort of the overall outcomes that various sleep trackers provide. And it's very sensitive to alcohol, as you noticed.

The issue with REM and deep sleep, any measure of sleep architecture, we know that those are the dimensions that ambulatory, in-home, commercially available sleep tracking devices are least validated at measuring. They're not terrible, but they are not the gold standard assessment. And furthermore, we don't really know

what to do about it. If, for instance, you know, I had a client once tell me that she was really distressed because, you know, she was only getting, according to her sleep tracker, which has a lot of air

error in it. You know, 5% of deep sleep, let's say, I don't even remember what it was. But otherwise, you know, she was getting solid sleep. She felt good during her day. She wasn't over consuming caffeine during her day. And I said, so wait, what's the problem? Well, my sleep tracker tells me I'm only getting this and I should be getting this. Well, first of all, you know, we know that there's inherent error in these devices. It's not the same thing as a laboratory sleep study. And

But also, we don't currently have any intervention that's, you know, evidence-based and randomized controlled trials that shows that it specifically increases any particular stage of sleep. So this pursuit of more deep sleep or more REM is, you know, really questionable because

The reality is that all stages of sleep are important, including the lowly stage one sleep, which is light sleep.

Because a healthy sleep profile is like a healthy diet. It does not consist of broccoli alone. So I think we sort of misguide ourselves by pursuing, you know, oh, I want more deep sleep. Rather, we should be practicing the habits that are going to give us the best opportunity for the full composite of all stages of sleep.

including light sleep stage two, which we spend most of our time in, REM stage three and deep sleep. So I think it's somewhat misguided approach because again, the data has error in it. And what we really wanna be doing is

The basic things like following a regular sleep-wake pattern, probably one of the most critical factors that will actually, you know, improve your REM sleep, improve your deep sleep, as well as your stage one and two sleep. So it's sort of the whole package matters, not just selectively amplifying any one of these stages. Interesting. So I hear you loud and clear.

One, it's about how you feel in the morning. Two, if you're looking at the data, it sounds like the wearables aren't as good quite yet at distinguishing between all the different sleep zones, if you will, and patterns. Like probably directionally, but like not as good as they maybe portray. Correct. And is it fair to say, you mentioned HRV and I've seen correlation. HRV...

maybe more accurate with the trackers. And that's maybe the number we should pay more attention to than getting into the sleep zones if we're looking at quality. You know, I find that, you know, that, you know, HRV can be reliably measured, right?

with, you know, many of the commercially available trackers. And, you know, HRV is such an interesting indicator because it's associated with, you know, so many different physiological and sort of emotional outcomes. You know, what it is is it's basically a marker of the balance between parasympathetic and sympathetic nervous symptom activities. So the sort of balance between sort of your tendon response

Tend and befriend or rest and digest response versus your fight and flight, fight or flight response. And so it's a really good metric and it's associated with, you know, all sorts of health and performance outcomes and also well-being and also, you know, correlates with different sleep stages. So I tend to rely more on HRV. It's also very sensitive of it.

as I mentioned, to specific behaviors that we have control of. So I actually find that very effective to use data, you know, because if it's something that I don't really have control of, like I don't know how to on a single night improve my deep sleep because we don't have a specific strategy for that yet.

But I can tell you that by reducing alcohol intake, you know, I can see on a night by night basis that will have an impact on this biometric. And so that's useful to me because I can then take that information and use it or not. Well, there's probably some correlation. I'm guessing if you are able to improve your HRV, your sleep will likely improve.

Absolutely, including some of those deeper stages of sleep that is sort of the holy grail for many people. It also speaks to this idea, and we've talked about this on the show, and I think our listeners get this, sleep just doesn't start at 7.30 p.m. Sleep starts the moment you wake up. And the practice of increasing your HRV is what goes on throughout the entire day. I like that in terms of it's something you can measure more accurately and you're working towards that.

through a variety of lifestyle practices, if you will, to increase your HRV. And then it kind of takes the pressure off the sleep sub-regard too. Absolutely. And I mean, this is a sort of simplified version of what HRV is, granted. But to me, I like to think about HRV as a good metric of my, it's like my emotion regulator. And you're right that, you know, my ability to sort of regulate and calibrate

And my, you know, emotions and behavior throughout the day from the time I wake up in the morning, you know, I'm making choices and I'm engaging in behaviors and I'm interacting with people, all of which is can really sort of shift this balance in my sort of in that emotion regulator I have inside. And HRV, again, is a metric of that.

all of that can impact my sleep. How regulated am I as a human being in terms of dealing with the stresses that are ubiquitous in life? They come whether you want them to or not, but it's how you manage them. And for me, HRV, you know, and whether that stress is, you know, interpersonal stress or work stress or physical demands from exercise, you know, HRV can be sort of a way of looking at

that regulation or regulatory capabilities. And that's really a sign of resilience. And so for me, again, it's a simplified definition of this, but for me, that's helpful to think about it, that it doesn't just start at night. It's really from the time you wake up, how are you engaging those regulatory mechanisms in your body? And I would probably guess that insomniacs

are more likely to have a low HRV and world-class sleepers have high HRVs. It's not always that simple, but yes, there are, you know, we do see different patterning of sort of HRV responses and sort of other indicators of sympathetic versus parasympathetic activity. And it actually throughout the night, it is different among people with insomnia versus healthy sleepers. We also see different patterns of brain activity

activation in individuals with insomnia as compared to those who are healthy sleepers. And it mirrors what people with insomnia will say, which is that there are parts of the brain that though they may be in a sleep state, are also simultaneously showing signs of a waking state. So it's that is a classic, you know,

sort of clinical description that people with insomnia will say is like, I, you know, you know, may have been asleep, but I, my brain never felt like it shut off. And yeah, and so there's a number of measures that do suggest that there's some differentiation between healthy sleepers and poor sleepers or individuals with diagnosable insomnia that mirror this, you know,

clinical presentation, which is just that inability to shut the brain off. Where do you think sleep science is going? What's next? Oh, that's a good question. You know, we've seen such a, you know, kind of paradigmatic shift in

in sort of the cultural view of sleep, the recognition that sleep matters, really just in the past 15 years. It's really been this revolution, to quote Arianna Huffington, where, you know, when I began my career, you know, 20 years ago, you know, my job was to convince people that

that sleep mattered, you know, and that we had to sort of, you know, search, you know, getting the evidence out there of, you know, all the bad things that are going to happen to you when you don't get enough sleep. And, you know,

Of late, you know, the great news is there, I do believe there has been a major cultural shift that people do recognize the importance of sleep in many sectors of society. There's some sectors of society who still believe that sleep is a thing you do when you're dead, but there are major portions that get it. But we just don't.

Still need strategies to, you know, you might understand that it matters, but we still don't know how to get there to deal with the sleep disturbances that are really prevalent. So I think where sleep is research and sort of focus is going. I mean, there's obviously a lot of investment in sleep now, and that can absolutely breed innovation and important research.

findings and strategies to better manage the sleep disturbances that people are still facing, despite knowing how important sleep is. I think that, you know, we will start to see more interventions that aim to do what I mentioned we don't currently have, which is

strategies to selectively amplify specific stages of sleep, whether it be increasing REM sleep or increasing deep sleep, while at the same time sort of increasing sleep health as a whole. I also think, I hope that we will start to look at, you know, sort of upstream influences on our sleep, recognizing that sleep doesn't just operate, you know, in this isolated fashion, you know, on our own. I hope that we'll start to look at even

policies at a societal level that contribute to our sleep, whether it be school start times, interfering with our teenagers' ability to sleep, or shift work schedules, which affect a major portion of the population, or even addressing sort of population level issues of, you know,

half the population going through menopause and us really not having great strategies for dealing with the very common sleep disturbances in women. So before we wrap up, we have to touch on kids and teens and sleep, which you just mentioned. You literally did a TED Talk on this that went totally viral. What is, as a parent of two little children, I have an idea of what's problematic here, but give us the scoop. What is going so wrong with kids and teens and sleep?

Yes. So I did this TED Talk when I had two teenagers in the home. And as a sleep researcher, it absolutely, you know, crushed me on a daily basis to do something that I felt was, and I knew because I study sleep, what felt abusive to my child, which was to...

you know, forcibly shake him out of bed at the ungodly hour of 6 a.m. so that he'd have time to get to the bus, which picked him up at 6.45 a.m. to go to school, which started at 7.30 a.m. Knowing that teenagers, you know, as a developmental group, show a biological shift in their circadian rhythms. This is specific to

to the teenage years, around the time of puberty. Teenagers see about a two-hour delay in the release of the hormone melatonin, which we call the hormone of darkness. Of course, it signals that it's the time for sleep. In teenagers, it's about two hours later than what we see in adults or younger children, meaning that teenagers are

naturally, biologically are predisposed to go to bed later and wake up later than adults or, you know, our elementary school age children and younger. At the same time that they show this biologically driven phase shift,

our schools start earlier and earlier, such that the average school start time, it's not just my child who is experiencing this, the average school start time in the U.S. is about 8.03 a.m. What this means is that as a society, we are setting a constraint on the opportunity for our teenagers to get the sleep that their developing bodies and brains desperately need. And we know that about 70% of teens are

are regularly sleep deprived, meaning that they're getting less than the minimum eight hours of sleep per night that is recommended for their age group. And the policy switch that many, you know,

individual school districts have done, and even the state of California, is to follow the science and delay school start times to allow teens to get that extra sleep in the morning. Because the solution is not just telling them to go to bed earlier, because they can't, because you cannot override one's circadian rhythms. For all the school administrators listening, let's roll back.

Start time. Please do. Please do. Look at the data. It's been out there for 30 years. It's quite robust. It's pretty much unequivocal that later school start times benefit students' well-being, academic performance, even sort of the overall well-being of the school. And the relationship as the parent is ripping the child out of bed and saying, you need to go to school and...

Exactly. Families are less stressed. You're no longer doing this daily abuse of your child. You know, all that guilt aside. Yeah, yeah.

We covered a lot today. Is there anything we didn't cover that you'd like to touch on or maybe share some information about you and where people can find you as well? Well, I could obviously go on and on. It's a pleasure to talk to you. And I love to talk about sleep, but I think we covered a lot and happy to do it again. You can certainly learn more about my work. My website is wendytroxel.com. I have two TED Talks, one on school start times and adolescent sleep.

and another on couples and sleep. And of course, you also can check out my book, Sharing the Covers, Every Couple's Guide to Better Sleep. And yeah, it's been such a pleasure talking to you. Well, thank you. And I just love the title of the book. Oh, thank you. Thank you, Wendy. Thank you.