Sleep Like a Caveman
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Brett McKay here and welcome to another edition of the Art of Manliness podcast. For several decades, people's reported sleep quality has declined. This despite the fact that specially optimized sheets, mattresses, and sleep trackers have emerged during that time. And despite the fact that the amount of time people are sleeping hasn't decreased for over 50 years. In other words, people aren't sleeping less than they used to, but are less happy about their sleep than ever before.

My guests would say that to improve our experience of sleep, we'd be better off looking past the reams of modern advice out there and back in time. Way, way back in time. Today on the show, Dr. Moran Vandelaar, a recovering insomniac, sleep therapist, and the author of How to Sleep Like a Caveman, Ancient Wisdom for a Better Night's Rest, will tell us how learning about our prehistoric ancestor sleep can help us relax about our own.

He explains that the behaviors we think of as sleep problems are actually normal, natural, and even adaptive. We talk about why hunter-gatherers actually sleep less than we think we need to, how their natural wake periods during the night might explain our own sleep patterns, the methods they use to get better sleep, and why our modern efforts to optimize sleep could be making it worse. Moran shares when it's okay to use a smartphone before bed, the myth that you have to get eight hours of sleep a night, how to intentionally use sleep deprivation to improve your sleep, and more.

After the show's over, check out our show notes at aom.is slash cavemansleep. All right, Ryan Vandelaar, welcome to the show.

Yeah, thanks. So you are a sleep therapist. You got a new book out called How to Sleep Like a Caveman. And what you do for a living is you help people who have sleep problems like insomnia. They can't sleep. What's interesting about your background is you yourself experience sleep problems throughout your life. Can you tell us about your troubled sleep and how it influences your approach to helping patients? I think I was 28 years old when I first developed insomnia, chronic insomnia. So I was suffering from chronic insomnia for three years.

And well, the main thing I found was I was feeling very hopeless and helpless because I was trying to control the sleep problem and checking my alarm clock. And it actually pushed me further away from a good sleep. So at one point, I even tried taking a sleeping pill and it didn't work. So that was extra frustrating. So it was a combination of many things. But I think hopelessness and helplessness were really on the foreground. Yeah.

When you experienced your sleep problems, was it having trouble falling asleep or staying asleep or waking up earlier than you wanted? What did that look like? I think it was both. Sometimes I had difficulty falling asleep. It would take me about one and a half hours before I fell asleep.

And at other points, I was having difficulty maintaining sleep. So I woke up in the middle of the night checking the alarm clock, not able to get back to sleep again. So it was very different. So with your book, How to Sleep Like a Caveman, you look to our evolutionary history to figure out, well, maybe there's some things we can learn from our ancient ancestors about how to improve our sleep.

Starting off, how do we know what cavemen slept like? Yeah, that's a good question because we don't exactly know because if you want to study sleep rhythm, you have to have people that are alive. So it's very difficult to find people

any clues on how people really slept like a rhythm from archaeological findings. But what we can do is we can look at people that still live in the same circumstances like we did when we were cavemen. So a lot of research is done in the Hadza tribe. That's a tribe in Tanzania. And they have been studied a lot and also looking at sleep.

So we know a bit more about their rhythm and their rhythm is much more influenced by their environment, their natural environment. So light temperature. And that's how we got clues from the past. And you also talk about some of the sleep problems we have today. A lot of people experience today. They might have their origin thousands of years ago with our caveman ancestors. Talk about that.

Yeah. Well, I think one of the main problems nowadays is insomnia. So problems in trying to fall asleep or maintaining sleep.

Actually, if you look at evolutionary theory, then they say that being awake during the night was actually kind of a safety thing because when you're awake during the night, you could wake and you can see whether there's impending danger. And so what we see in the Hatha tribe as well is that they're awake for over two hours on average during the night.

And I think that's a thing that we've lost during the past hundreds of years. Okay, so let's dig in deeper into what we can learn from hunter-gatherer sleep and how we can improve our own sleep. And I think this question about that piggybacks off of what you just said about they're awake.

for two hours sometimes while they're sleeping. Let's talk about sleep duration first. If you read most articles about sleep these days, it's like you have to get eight hours of sleep. And if you don't get eight hours of sleep, you're going to have health problems. You're going to die early. You're going to get dementia. And it's scary. So how many hours do hunter-gatherer tribes sleep? Well,

Well, I think, first of all, there's a big difference between popular articles and scientific articles because they say different things. So what we usually see in the scientific articles is that actually seven is the magic number. And between six and eight is quite average if you look at sleep duration. But if you look at the Hadza tribe in Tanzania, then they sleep between 6.2 and 6.5 hours on average per night.

And once in two days, they nap for like on average 17 minutes. So that's their total sleep time. Okay. So they're in bed, you said about eight hours, and they sleep actually for six hours? Yeah, they're in bed maybe above nine actually, nine and a bit. So they're awake a lot. So during the night, it's like two, two and a half hours awake. Yeah. Yeah.

And that discrepancy between hours in bed and then how many hours you actually sleep, that produces what's called sleep efficiency, right? Yeah, that's true. Right. So if you...

sleep most of the time while you're in bed, you'll have a higher sleep efficiency. But if you sleep less than you are in bed, then you have a lower sleep efficiency. Your sleep efficiency drops. Yes, that's true. And I think what we've done in the past couple of years, we've put a lot of emphasis on the sleep efficiency. And in the media, they usually say that you have to have a sleep efficiency above 85%. But that would mean that the whole...

Hazard Tribe would actually be a bad sleeper while they themselves don't see themselves as bad sleepers. So that's very interesting. So I think that a lot of that sleep efficiency is also based on what we think is good around sleep, but that's not what everybody experiences. And you cannot generalize that to other people and other countries. Yeah, for us, you know, living in the West, we want to compress all of our sleep and just one, we want to get it done in one fell swoop. And so our goal in the West is,

typically is something like, I go to bed at 10, I'll fall asleep in 10 minutes, and then I'm going to stay asleep for the rest of the night until my alarm goes off in the morning. Yeah, yeah. That's what people want. And that's what is frustrating because a lot of people don't get that. Yeah. Yeah. And that's what causes insomnia. It's like, well, I'm in bed, but I'm sitting here staring at the ceiling for an hour, hour and a half. And then I wake up an hour, hour and a half before I actually wanted to wake up. And that just causes a lot of frustration.

Yeah, yeah. Yeah, that's true. It causes a lot of perfectionism around sleep. And it's also, I think a lot of things are caused by the things we read in the media and what is coming towards us when you look at information. Yeah. Well, let's talk about definition of insomnia we've been talking about. I think people have an intuitive understanding of what insomnia is. Like you can't sleep when you want to sleep. Yeah. Is there like a subjective insomnia and an objective insomnia? Is there a difference between the two?

Well, usually if you look at insomnia disorder, then it's actually always a subjective complaint. So what you see is that people have difficulty initiating or maintaining sleep. To speak of chronic insomnia, you have to have three bad nights during the week. So three nights with sleep problems and also suffer from daytime consequences. Because if you don't suffer from daytime consequences, then we don't speak of insomnia. And I think there's a very big difference between subjective and objective sleep because

because objective sleep is actually the sleep measured by polysomnography or actigraphy. And polysomnography is like a sleep study. So we measure brain waves, but also other indices, body indices. And an actigraphy is a wrist-worn band in which you can see what the activity level is. And it's a medical device, so it's not to be compared to like an app or a watch. And it can give an indication of how somebody has slept.

And there is often a big discrepancy between the objective and the subjective sleep. Yeah, some people who have sleep problems, they go to a sleep doctor, they get a professional sleep study done, and the results say, yeah, you slept well,

seven hours, like you had great sleep. And the person's like, no, I slept awful, that was not good sleep. That's where that discrepancy can come from. - Yeah, I saw a lot of those patients. And the thing is that they did a research a couple of years ago, it was actually from the town that I'm from in Eindhoven, the Netherlands. And what they found was that in general, it takes about 20 to 30 minutes for a person to realize that they are sleeping if they are sleeping. So if you wake people up before those 20 minutes, then more than half of people say, I wasn't sleeping yet.

So that's really strange. So our brain is sometimes playing tricks on us. - So the Hazda tribe, do they experience insomnia?

If you look at, there's been a study by Samson and he asked whether they experienced sleep problems and between 1.5 and 2.5% actually experience sleep problems regularly. But if you look at the West, that's around 20%. So that's 10 times bigger. The amount's 10 times bigger than in the Hazard tribe. And that's because the Hazard tribe, if someone's

waking up for an hour or two. They don't see that as a problem. Okay, this is normal. Yeah, it's quite average. Yeah. And then in the West, we're like, oh my gosh, I wake up. This is a problem. So you have more people reporting sleep problems than the Hazda tribe. Yeah, yeah, yeah. Yeah. And so in the Hazda tribe, when they do wake up, what do they do? They just...

Well, sometimes they talk with tribe members or they just stay in the bed usually. So they don't really get out of the bed. Sometimes they do, but it's not like they're really active during the night. So they're quite low in activity level usually. And so what's the takeaway from that for us, someone experiencing...

insomnia and getting really frustrated that they can't sleep or stay asleep? I think if you're in the bed awake and you feel quite relaxed,

then I think a good thing is to be aware of the fact that being awake is actually quite normal. So it is easy to say, but don't frustrate immediately. But if you feel frustrated or if you feel that your tension builds up, then sometimes it's best to go out of the bed and do something else that really relaxes you and then go back to the bed when you feel sleepy again. Okay. Okay. So I think that's really good advice because I know earlier this year, well, it was actually last year in 2024, um,

For some reason, I just started waking up sometimes at 4.30 in the morning. This never happened to me before. I started waking up at 4.30 and sometimes it's 5.30. And I remember it freaked me out. I was like, oh my gosh, something's wrong with me. I might have to go see a sleep doctor. And I was worried I wasn't getting enough sleep. But then I got to the point where I was like, you know what? I'm okay. Like I get up and I do something kind of relaxing and then I'll fall back to sleep. And I feel fine in the morning. Everything's fine.

Yeah. Yeah. Yeah. And that gives a lot of reassurance. And that's why you don't have the buildup that usually people have that have insomnia. They really fear the night before they go to bed. So one takeaway from hunter gatherers is don't stress out if you wake up in the night, because that's normal. And another takeaway with sleep duration is that you don't need to obsess about getting eight hours of sleep. The Hadza, I mean, they're getting just

about six hours of sleep and anywhere between six and eight for most people you're gonna be fine i think it's very important to look at your sleep need i mean it's also very important to give yourself enough opportunity to sleep so some people say well i only need for five hours and then they're sleepy during the day so i think it works both ways so on one end you have to really look at your sleep needs so how much sleep do i need and really give yourself enough opportunity to sleep

But if you're tense around sleep and if you can't sleep and you experience insomnia, then sometimes it can help to really shorten your bedtimes. So that's one of the strategies you do to enhance your sleep. Yeah, we'll talk about that in a bit. Sleep deprivation is really interesting. Yeah, so that's something I saw with my own sleep this past year when I started waking up earlier. I just kind of embraced it because I would wake up at 5.30 or 5.00

and I would feel fine during the day. Like I wasn't tired, I wasn't taking a nap, and I just kind of like, well, maybe I don't need as much sleep as I thought I did. Yeah, yeah. And I think one of the things too I had to embrace, you talk about this in the book, as you get older, you know, I'm in my 40s now, you have a natural tendency to want to sleep less. What does evolution tell us about that? Like why do we have this tendency across...

humanity to sleep less as we get older? What's going on there? - Yeah, I think the main difference when you're getting older is that your quality of your sleep changes. So what you see is that people who get older, they actually have less deep sleep and they tend to wake up more during the night. So that's what we usually see when people age. And there's one hypothesis, it's called the Sentinel Hypothesis.

And it says that as people age, they're actually better able to wake during the night. So if older people lose their function of more hunting and gathering, then they have more function during the night because they're more awake during the night. So they can wake for the rest of the tribe. Okay. So I'm waking up early because I'm looking out for my family.

Yeah, that's it. I'm going to reframe it that way. That's a good way to reframe it. So we've talked about the fact that you don't necessarily need eight hours of sleep. But in the media and or online, you see these articles saying if you don't get those eight hours, if you don't get enough sleep, there's all these dire health consequences. You know, it can increase your chances of getting diabetes. It can increase the chances of getting dementia. It can increase weight gain.

So what does the research actually say? If you don't get those eight hours of sleep, are the consequences as dire as you often hear? Well, if you look at mortality, then you see that people who sleep less than five to five and a half hours and more than nine hours are actually at risk of dying immediately.

sooner. So it's not like if people sleep less than eight hours, this happens. They say that seven is actually the magic number here again. So around seven, the mortality is lowest.

But those are only associations. So we don't know anything about causality because these are big population studies. And if you look at chronic disease, then you see a very clear association between objective sleep problems like sleep apnea, which is a sleep disorder in which you have breathing stops during the night and desaturation, so lower oxygen in the blood. And that is really associated with things like higher cancer risk,

high blood pressure, cardiovascular disease. But if you look at insomnia, then this association is not there or much lower. And what you usually see in the media is that it is said sleep problems lead to, but they don't define what kind of sleep problems they're talking about. So this is a lot of confusion going around what they are talking about when you say sleep problems. Okay. I think that's heartening for people who, you know, their sleep problem is they just have a hard time getting to sleep or staying asleep because they have insomnia.

And they think, oh my gosh, I'm going to die of a heart attack. I'm going to get dementia. The research says, yeah, there's not really an association. If your sleep problem is insomnia, you don't have to worry as much. But if you have a sleep problem like sleep apnea, where you basically stop breathing while you're sleeping, then that's a concern.

Yeah, that's right. Yeah. Well, tell me more about the dementia thing because I'm getting in my 40s now and that's something I'm thinking more about. I'm like, oh my gosh, what can I do to make sure I don't get dementia? What does the research say about the connection between sleep duration or sleep quality and dementia? Yeah.

Here it also says that if you suffer from sleep apnea, then the dementia risk might be bigger. So I think it's always important if you snore very loudly, if you have breathing stops during the night, it's very important to see a physician because sleep apnea is actually a disorder that is often not recognized.

and it has very severe consequences, very severe physical consequences. So I think that's a very important thing. Okay. So if you do have sleep apnea, you might have to get like a CPAP machine, help you breathe. Yeah, for example. So I think this is actually really good information because I think one of the things that can contribute to the stress of sleep

wanting to get to sleep and stay asleep. You know, the stress of insomnia is that these headlines are going through people's heads like, oh my gosh, I'm laying in bed and I can't sleep. And that's what makes them even sleep worse. Yeah. So yeah, I think this information is useful. So it just kind of calms you down a bit and you won't freak out as much if you're having problems sleeping.

Let's talk more about cavemen and hunter-gatherer sleep and what we can learn from them. You mentioned at the beginning that hunter-gatherers and potentially our cavemen ancestors, their sleep schedule was guided more by their environment. So the physical environment. So we're talking light, temperature, even seasons affected their sleep. What do we know about that?

Well, what we see is that, for example, in the Hatha tribe, there's a bigger difference between the sleep in summer and in winter. So what you see is that there is almost an hour difference between the seasons. And what we see in the West is that actually,

actually that difference is not that big. And I think that's also because we use heating, we use a lot of light. So the differences between the seasons are not that big for us. But what we can learn from these people is that, for example, in the morning, they get a lot of bright lights. And in the early afternoon, they get a lot of bright light. And you get more bright light if you go outside, because outside light is much brighter than the light you get when you're in an office.

And I think that what a lot of people do is they go to their work, they're in the office, and then at night they put the lights on in their living room. And there's not that much difference between the evening and the morning or the afternoon. And I think that we can work with light by being more outside. I mean, it's

And even a walk of 20 to 30 minutes might do, just not sitting behind your desk eating your sandwich there, but going outside might do the trick already. So it's not like you have to be outside all day. And another thing is dim the lights in the evening is very important. And also use temperature. So don't make it too hot, the ambient temperature too hot during the evening because that is very unnatural.

Okay. So get more light in the morning and in the afternoon. So get outside. That can help. And if you live in an area where there's not much light, so if you live in the extreme northern parts of the world during the winter, there's things you can do. You can introduce things like the light lamp. You can do that. That can help. There's things you can do to help with that.

Yeah, it's very important to look at the lux. So the amount of light that comes from the light lamp and if it's, usually we say at least 10,000 lux would do the trick. And something you talk about too, another myth about sleep that you debunk, you hear a lot of people say, well, if you want to improve your sleep, you have to wear blue light blocking glasses or turn your smartphone screen yellow. And the research says that actually doesn't do much because your smartphone doesn't emit that much light.

That's true. Yeah, a lot of smartphones don't exceed 10 lux and you need more than 10 lux usually to stimulate your biological clock. So, I mean, the light is more blue and we are more sensitive to blue light, but the amount of light that is emitted from a smartphone is just too little to stimulate the biological clock. Now, if you look at light around you, so that is very important and also to make it not too bluish.

But I mean, you can also dim the lights a bit so that it doesn't really have effect on your biological clock. You don't have to wear orange glasses to have the same result. And you still recommend people not to use their smartphone right before bed because it's not for the light. It's just that smartphones can get you amped up.

up and kind of stress you out and get you just thinking more and that can help that can prevent you from falling asleep. Yeah, that's right. And a recent review in 2024 by Gratisar shows that actually for some people using a smartphone might even help to fall asleep. I think it really depends on what type of person you are. If you're very busy in your head and you have difficulty finding enough rest, then sometimes a smartphone can get you off your thoughts.

So it distracts you a little bit and that might help you sometimes to fall asleep. But that's, it's always, you always have to look at the personal circumstances. Well, you talk about in the book, one thing that you did when you're having sleep problems that helped, I think a therapist or a doctor recommended, it's like turn on the TV. Yeah. And it did, like it worked. It relaxed you and you're able to fall asleep. It worked for me. Yeah, definitely. Because I'm somebody with a very busy head. So for me, it works. Yeah. We're going to take a quick break for a word from our sponsors.

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And now back to the show. So going back to temperature, you want to keep it cool. Is there an ideal temperature you want to keep in your room to help facilitate sleep? Yeah, usually in your bedroom, they say between 16 and 18 degrees Fahrenheit.

Okay. Or is that Celsius? I think it'd be like 60. Oh, Celsius. Sorry. Yeah. Celsius. Yeah. Yeah. I think it's like 68 degrees Fahrenheit is the number that I hear. Fahrenheit. That's true. Because otherwise it would be very, very cold. That would be very cold. Yeah. And something that I do, it's interesting. My wife, she likes it warmer.

And I'm a hot sleeper. And so something that's helped me is I've got a chili pad. It's a thing you put underneath your mattress and kind of runs cold water beneath you. Oh, yeah. And that keeps things down to about 68 and it helps me fall asleep. Something I noticed though is I'll...

Right before I wake up, so like 4.30, I'll wake up and I'm like, this is too cold. I actually want to be warmer now. And I think you talk about research. We want it cooler when we fall asleep. But then as we get closer to wake up time, we actually want it to be warmer because it helps us wake up. Yeah, it helps us wake up. Yeah, yeah. The body warms up again. That's true. Yeah. And also, it's very good to have a cooler...

cooler environment before falling asleep. But sometimes people have very cold feet and hands, and that might prevent you from falling asleep because then you have this vasoconstriction. So the blood vessels, they really contract, and that creates more difficulty for the body to lose body temperature. And that's why some people with cold feet and cold hands cannot fall asleep properly. So if that's you, wear socks, maybe wear some mittens. Yes.

Yeah, sometimes that works. Yeah. Yeah. And then seasonality. I mean, you mentioned that in the West, our seasons are pretty much the same. But I've noticed I tend to sleep more during the winter because it's darker and longer because I just want to go to bed earlier than I do during the summer.

Yeah, and that's a natural thing. That's a natural thing. So people tend to sleep like 12 to 25 minutes longer during the winter because it's more dark. So they get less active during the evening and their biological clock also gets less stimulated in the evening. So that's why they fall asleep earlier or lie in the bed longer in the morning because the morning light is getting up faster.

later. Again, that's useful information to know because if you feel like you're sleeping less as it progresses through spring and summer and you think, oh my gosh, something's wrong with me. It's like, well, maybe not. This is just your natural rhythm where you want to sleep less because it's lighter out longer. Yeah. So another thing you talk about hunter-gatherers do is they move a lot during the day. How does that influence their sleep? Well, if you look at the relationship between exercise and sleep,

then you can say that being more active builds up more adenosine. And adenosine is a neuromodulator and it creates sleepiness. So if you have higher levels of adenosine, then you get more sleepy. And so being more active actually makes you more sleepy and tends to give you more rest. So you fall asleep more easily and have less problems maintaining sleep.

Okay. So adenosine, that builds up what's called sleep pressure or sleep drive. Yeah, that's right. Yeah. Okay. And so something you can do to increase the sleep drive is just move more throughout the day, get some physical activity in. Yeah, that's the first thing. Yeah. What about something I read a lot about when it comes to sleep is that you shouldn't exercise right before bed. Is that true?

Well, studies show that if you exercise too much, like one to two hours before going to bed, that might create more problems falling asleep. So that's right. Yeah. Okay. Yeah. And when it going back to movement and sleep, I know if I look at my life, the times where I've slept the best, it's when I moved the most. I remember the best sleep I ever got. And I think about it still. I'm chasing that high. I'm still chasing it. It's when we, my wife and I went to Rome for vacation and yeah,

you know, in Rome, like you walk everywhere. It's not like here in Tulsa where you have to drive everywhere. Rome, you had to walk everywhere. And I remember we got back from a day and we just laid on the bed and we both just fell asleep. And then we slept, I think 12 hours. I mean, I'm sure there was some jet lag going on with that. Sure.

But I think the movement, like the amount of physical activity we did that day, it was like the best sleep. It just felt refreshing and revigorating. It's a lot of sleepiness. Yeah, yeah, definitely. Yeah. And so I've noticed in my own life when I don't move a lot, I tend to not sleep as well. So I just try to make sure not only to keep my regular exercise up, make sure I'm getting up throughout the day from my job and doing some pushups, taking walks because it really does help.

Those are things that work. Yeah, definitely. Yeah. Let's talk about the sleeping environment of hunter-gatherers. They didn't have fancy mattresses. They slept on beds of leaves and grass on the ground. What about sleeping with other people? Did they sleep with other people by them? Yeah, actually, we think, well, if you look at the Hadza tribe, they sleep with 20 to 24 people around the fire. And we think that the same thing happens in

in the past, so in prehistory. So yeah, I think they slept with a lot of people and they could easily take watch during the night for each other. - How did that influence their sleep? Did that disturb them at all?

Well, if you look at the research on sleeping together with a partner or with somebody else, then you see a very, very interesting thing because on the one hand, people subjectively feel that they sleep better. But sometimes if you sleep with your partner, they find that objectively you sleep worse. So there's a big difference in how people experience sleep and how sleep objectively is. And possibly that has to do something with safety, with built-in safety. When you sleep with somebody else,

then you feel more safe. Okay. But then it can also mess up your sleep because your sleep partner elbows you or takes all the covers or whatever. Yeah, definitely. Yeah. Any recommendations for that? Let's say your spouse, the person you sleep with, like they're just a really restless sleeper and it's interrupting your sleep. Any advice on how to handle that?

Yeah, I think it depends on what the restlessness is, because if it's like turning and tossing and turning, then you might think about two mattresses, possibly two duvets. And if a person really snores, sometimes earplugs might help. But in some cases, I've seen patients who were so tired that

because of the sleep problems that I advise them to sleep in separate rooms. And sometimes sleep really improves. And I think there's a really stigma on that in Western society, not sleeping together. But then again, if you have a partner that's totally tired and worn out, then I think that's not a good thing either. So I think it's very important to discuss that with your partner to see whether you can make arrangements on that or maybe sleep comfortably.

a couple of nights separately from each other, but I think it's very important to discuss it with each other. - Let's talk about sleep hygiene and what hunter-gatherers do to improve their sleep hygiene. An important part of sleep hygiene is winding down before bedtime. Do hunter-gatherers kind of have a wind down time before they hit the sack?

Yeah, they do. They actually sit by the fire, tell stories to each other. There are stories that are not too upsetting, so not about conflicts or things. And what you see is that a lot of people have different rhythms like we have. So we have morning people, evening people and everything that's in between. And yeah, so they really wind down before going to bed. They are not too active anymore.

And I think sometimes the thing with us is that we run to the bed and then expect for us to sleep immediately. And I think that's not how it works. So what do you recommend to patients you deal with who are having sleep problems? Like how early should they start getting ready for bed? Like when should the wind down time start? Yeah, usually I say one to one and a half hours before going to bed. So don't do anything anymore that has to do with work.

Don't be too active anymore. I think those are things that can really work. Maybe watch a series, something that's a bit boring, maybe not too exciting. I think those things might work. And then dim the lights and cool down the house or your bedroom. Cool down the house. Yeah.

Something that's come up more with people in sleep when they're paranoid about sleep, something they'll often do is resort to a sleep tracker. So maybe on their Apple watch or they'll get, you know, the aura ring or something like that. Do you recommend people use sleep trackers to improve their sleep?

Well, it depends on what kind of person you are. If you're a bad sleeper, I would not recommend it because first of all, if you look at the measurements of sleep, these trackers are completely unreliable. So sometimes they say you had 30% deep sleep and 20% REM sleep. And the thing is that they are very inaccurate when it comes to measuring types of sleep. What

What they can do in people who sleep well is they can make an estimation on how long you've slept and how long you've been awake. Just a rough estimation. And that's actually the only thing they can really do well. So I would not recommend them to people who are already experiencing insomnia. Okay. Yeah, because they can actually exacerbate the problem. There's like a new type of sleep disorder. Yeah.

Yeah. Yeah. It's driven by the devices to be like, oh my gosh, my sleep score was terrible. Yeah. And they just freak out even more and it makes sleep even harder. That's how it works. Yeah. Yeah. I've noticed that I've used some of those sleep tracking devices and they're interesting. I just kind of used it as I just wanted some information about my sleep. I didn't really put much credence to it, but I had a few moments where the device said I had really poor sleep and

But I'm like, I feel fine. I feel great. I'm energetic. And then there was moments where it said I had great sleep and I'm like, man, I'm really, I'm groggy. I'm tired. I had to end up taking a nap during the day. So yeah, not incredibly accurate.

Yeah. And so for some people, it's very important that sleep score and it really leads the day and how they feel. And then if you have a poor score, then it can really influence your day negatively. Yeah. Do you recommend maybe keeping a sleep diary in some cases, you know, just like kind of manually tracking your sleep?

Yeah, I think so. I think for insomnia, it helps very well. I think one of the treatment steps we do in cognitive behavioral treatment is using a sleep log. So sleep diary, and it is to create a better picture of how somebody is sleeping, at what time they go to bed, at what time they wake up, and how many times they wake up during the night. So I think a sleep diary, sleep log may help very, very well. Yeah.

So let's talk about some potential solutions. Let's say someone's listening to this and they're having a hard time sleeping. They're not happy with their sleep.

I think oftentimes people resort to, okay, is there a supplement I can take? Is there a new mattress I can get, a new pillow, whatever, even sleep medication. But what you found is the most effective tools to help with insomnia is cognitive behavioral therapy, I, so CBT-I. Yeah. So that's for insomnia. The I stands for insomnia. And then sleep restriction, which you mentioned.

mentioned earlier. Let's talk about CBTI. What does that typically look like for a patient in broad strokes? Yeah. So the full cognitive behavioral treatment sleep restriction is usually a part of the cognitive behavioral treatment for insomnia. And the full cognitive behavioral treatment starts with psychoeducation. So about what is normal sleep, what can you expect? So those are the first steps. Then you talk about relaxation techniques,

And then you start looking at behavioral techniques. And the behavioral techniques are things that people can do to really give their sleep a boost and not be awake, stressed out during the night. So the first one is a sleep restriction method. And the second one is stimulus control. We've been talking about that before. That's going out of bed when you're really tense, doing something that relaxes you and go back to bed. And what we see is that sleep restriction is actually a highly effective

That's the other method. And that's shortening your bedtimes to create more sleepiness. You get a better buildup of adenosine or adenosine. And what you see is that people have less difficulty falling asleep and maintaining sleep. So those are actually the steps of the CBT-I. And sleep hygiene is also a part of it. So you look at light, you look at temperature, and especially not watching the clock. I think not watching the time is also very important.

Okay. So CBT, you're gonna start with psychosocial education. So this is the things we've been talking about today. It's like, Hey, you know what? You don't need eight hours of sleep. You're not going to die. If you get less than that, if you get six hours, you're going to be fine. Even if you get five hours, occasional occasionally, you're going to be okay. And it's just reassuring people like you're fine. You're not going to die. And then, um,

And also just telling people like, you know, it's normal to wake up. That's going to be okay. You just got to go back to sleep. And then the sleep restriction aspect, once you start helping people under reframing their problem, what they think is problematic sleep, the restriction is like, you're actually telling people, okay, instead of going to bed at 10, you're

We want you to go to bed at maybe midnight. Yeah. So that you wake up your normal time of six. The goal is to actually make you sleepier during the day the next day because we want to build up more sleep, the sleep pressure. And so you fall asleep. That sounds like a hard sell to people. It's like, yeah, you're actually going to be tired for a couple of weeks to improve your sleep. Yeah.

Yeah, especially the first three to four days are very, very intense because for a lot of people, the problems, they get bigger during the first three to four days. People tend to get more sleepy during the day because of the buildup of sleepiness. Sometimes they get more tired, more concentration problems, that kind of thing. And then after four to seven days, you usually see slight improvements in sleep. So people have less difficulty falling asleep and have

less problems maintaining sleep. And then after two weeks, usually people say that they sleep much better. And you also see that the daytime consequences of the sleep problem, they disappear after two to three weeks. So I think it's a very powerful method that usually works within a couple of weeks. Okay. And then as you're, what's interesting about the sleep restriction, you're gradually over time, maybe after two weeks,

you're going to increase the time you're in bed. So maybe you start off going to bed at 12, waking up at six, and then two weeks later, it might be, well, you're going to go to bed at 1130 for a while. Usually we work with a quarter of an hour. So you expand the time with a quarter of an hour. Okay. So this process could take a few months, correct? To kind of get you back on track.

Well, usually what we see is that people, what I've seen in practice is that sometimes people come in, they're in the bed for like nine hours and they sleep for five and a half or six hours. And then what you usually do is you start out with total bedtimes that are similar to the sleep times they reported last week. So if they say I've slept for five and a half hours, then they go to the bed for a maximum five and a half, usually plus a half hour, so around six. So they're in the bed for

a maximum of six hours, then you wait a week to two weeks, usually sleep improves in 80 to 85% of cases. And then you start expanding the bedtimes again with a quarter of an hour. And sometimes people feel that when they're in the bed for maybe seven, then they've actually reached their optimum because if they go past those seven hours, they have more sleep problems again. So actually, usually it takes about four to six weeks to treat a person with insomnia.

- Wow, that's fast. That's really great. Any advice on how to figure out how much sleep you need to get? - Yeah, I think the most important thing to do is to look how you sleep when you're on holidays

So the second week of your holidays, you have to find out at what time you start getting sleepy and at what time you spontaneously awaken. If you do that and you find that out, then you really know how much sleep you need, but also which chronotype you are. So whether you're a morning person or an evening person or somewhere in between. What do you do if you're chronotype? Like let's say you're a...

an evening person but you have a job that requires you to be a morning person anything you can do to mitigate the consequences of that yeah i think i think there are some things you can do is you can work with bright light in the morning if that's possible so that really pushes your rhythm a bit more back and what you can do is you can create a more dark environment before going to bed and go to bed

on time. So I think that's very important because for evening people, it's sometimes very difficult to go to bed on time, but still your natural rhythm will always be leading. So you can do something with that, with these methods, but it will never change you to being a morning person. So what people sometimes do in the weekends is they're in the bed a little bit longer. So one to one and a half hours to compensate a bit for the hours that they miss during the week.

And sometimes this may help, but it's very important to not overdo it. Right. You don't want to sleep in too much because that's just going to throw off your sleep schedule for the rest of the week. What we've talked about a lot of things people can do to help them get a better night's sleep is

Is there one thing you recommend people start doing today that will immediately improve their sleep? I think not watching the time. I think that's a very important one. We know from research that if you watch the time, then it takes up to 20 minutes longer to fall asleep again. So I usually pay a lot of attention to that. And a lot of people with insomnia find it very difficult to not watch the time when they're awake. But I think it's a very, very powerful method to decrease insomnia.

All right. So just get the clocks out of your room. Yeah, definitely. Yeah. And for me, the big takeaway from the book is like, just don't freak out as much about your sleep if

if you are having problems with sleep, because that just causes more problems. And when you wake up at 4.30, it's like, oh, okay. Well, you shouldn't know it's 4.30 because you don't have a clock in your room in the first place. Yeah, that's true. But if you do wake up earlier, you're just like, okay, it's okay. I'm going to pretend like I'm a Hazda tribe member and just kind of sit here and relax and doze back to sleep.

Yeah, just let the perfectionism go a little bit and be more relaxed around being awake during the night. We need to be more relaxed about being awake during the night. I love that. Well, Moran, this has been a great conversation. Where can people go to learn more about the book and your work?

Well, first of all, the book, I mean, you can already order the book, so it can be ordered from Amazon. So Sleeping Like a Caveman. And I also have a website, Marijn Vandelaar. I think you have to spell it out in the details. We'll link to the show notes. Yeah, yeah. So that's where they can find more information. All right, Marijn Vandelaar. Thanks for your time. It's been a pleasure. Yes, thanks. Same for me.

My guest today was Moran Vandelaar. He's the author of the book, How to Sleep Like a Caveman. It's available on amazon.com and bookstores everywhere. Check out our show notes at aom.is slash cavemansleep. We find links to resources. We delve deeper into this topic. ♪

Well, that wraps up another edition of the AOM podcast. Make sure to check out our website at artofmanless.com. You can find our podcast archives and check out our new newsletter. It's called Dying Breed. You sign up at dyingbreed.net. It's a great way to support the show. As always, thank you for the continued support. Until next time, this is Brett McKay reminding you to not list AOM podcasts, but put what you've heard into action. Every day.

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