Blinkist Podcast with Sleep Expert Max Kirsten

Transcript

Max Kirsten: Hi Ben, thank you for inviting me to come on the show.

Ben Schuman-Stoler: Thanks for coming on the show, this is great. This is our second sleep expert!

MK: How’s your sleep, are we going to talk about yours or are we going to avoid that?

BSS: We can try, but I have to say, especially in the past few weeks, I’ve been pretty good. I’ve been bringing a lot of stuff home, of like, getting the cell phones out –

MK: You’re doing your sleep hygiene!

BSS: I am, I’m all about it.

MK: That’s good! And have you got any devices? We’re in the 21st century so I think devices are kind of cool to have but the people that sleep the best don’t need devices, they don’t need anything, just sleep don’t they?

BSS: Which kind of devices do you mean?

MK: Well, there’s a whole bunch of these gadgets, you know, you can be wearing your fitbits, or you can have things actually fit to the bed under all the pillows. I’m fascinated by all this stuff but I have to say I’m quite keen to keep the technology to a minimum, generally. That said, when I get some of this stuff I’ll be trying it all out and my room will be like a techno jungle.

BSS: I actually did write down, one my questions is, do you use any of the new tech for sleep? And then I wrote down besides your own app, but your app isn’t a sleep app, right? It’s for quitting smoking.

MK: Actually my sleep app — which I took down last year — I had two — I took them down and I’m re-packaging them at the moment. I also have a free one that people download which is 20 minutes to fall asleep. Really nice thing to listen to. But the real question is — I don’t listen to myself. There’s something a bit weird about listening to yourself.

BSS: You mean you don’t put yourself to sleep?

MK: I do, but I don’t listen to myself to do it.

BSS: Who do you listen to?

MK: I don’t listen to anyone. I do a sequence and you can ask me about that.

BSS: You have your own routine, right?

MK: That’s true. Before I became a sleep coach I suffered from sleep difficulties, I would hesitate to say insomnia but I certainly would say it looked like insomnia, it sounded like insomnia and probably was. It was semi-infrequent but I found that going to bed was beginning to be something that I didn’t look forward to. I treat lots of people with insomnia now, anxiety-related sleep conditions. And I would lie in bed trying to figure out how can I fall asleep? Why am I still awake? What do I need to do? So I originally set out to conquer that for myself and in the process of looking at everything, listening to everything, I was also training to become a clinical hypnotherapist and in the process of all of this I discovered how to relax at a very deep somatic level and that became a part of it. I then created a blend of techniques that I’ve distilled into something that I call the ABC of Better Sleep but is basically a sequence that you can do not to try to sleep — because that’s always the thing with people with sleep difficulties, they try to sleep, and people who sleep well never try to sleep — trying to sleep is the worst thing you could ever do. Same thing as trying to relax or even trying not to think of the color red. It’s not helpful.

You know, I used to be a person that woke up in the night. Lots of people either have trouble falling asleep, which was one of my issues — thinking too much — but I almost invariably used to wake up in the middle of the night and it would be like UGH and it can be the loneliest place in the world. You wake up in the night and you feel like everyone on this side of the planet is already unconscious. And then I now have this thing that I do and I think of it more as a game, it’s a technique but it’s a pleasurable process that feels like a game. So that even if I get out of bed if I’m not annoyed. I actually look forward to getting back into the bed, and getting comfortable. that’s the starting point of the sequence that I teach people.

BSS: So let’s break this down. You mentioned suffering. You said you were suffering, you didn’t wanna call it insomnia but it looked like insomnia. It’s an interesting word because Arianna Huffington also used that word a lot and said there’s so much unneeded suffering that we’re doing to ourselves, so why did you use that word in particular?

MK: Arianna’s great — I wish I could talk to her with you I’m a big fan of her book — but I agree. We’re doing this to ourselves. We’re not even aware of the effect of everything coming in. You know, caffeine is interesting. I like caffeine but there’s a time we should be phasing it out (and there are some people it doesn’t agree with). Towards the evening the last caffeine most of us should be having should be approximately eight hours before bed at least. Because otherwise the effects of it are going to still be there when you want to sleep. And I can think of plenty of times when I sat in a nice restaurant with some nice friends, maybe it’s Friday night after a busy week and someone says would you like to have coffee now after your meal and someone says, “Oh yeah,” and before you know it we’re all ordering espressos! I think maybe people in the US are a little bit ahead of that now but I have to say a couple of my friends quite happily have a coffee before bed. These are the things we do to ourselves, I think at our peril. I mean look, coffee and devices is only two small elements of what can lead to having sleep difficulties. But I think anxiety, the worries of all that’s happening in our ever-changing world, and I think if sleep hygiene is a new kind of subject, I think veering away from most of the national news towards bedtime is no bad thing.

BSS: So say something about what sleep hygiene really kind of is, because it’s a weird term. I don’t think everybody — or people who aren’t familiar with your work or this trend of talking about sleep — what is sleep hygiene and how do you make a good one?

MK: Well you’re right, Ben, it isn’t what everyone’s aware of. Perhaps only the people with sleep difficulties. I assume everybody’s a sleep coach or everyone is seeing one and of course there are lots of people who sleep wonderfully. They get into bed and can even sleep in a car park or in a queue — some people can sleep anywhere — and there are people who have difficulties. And the first thing is to eliminate the externals, which can be contributing to sleep issues. Sometimes it’s the last thing that people realize. I’ve just been doing a sleep clinic in London here, in Shoreditch, something called a pop-up nap station as sleep ambassador for Eve Sleep who –

BSS: You know, they sent us a mattress!

MK: Oh they did?!

BSS: Yeah we had a little nap station in the office. They’re great.

MK: So that would be one of the sleep hygiene questions: What do you sleep on? What’s the room like? What’s the light like? That’s a big one. Do you have a dark room? How dark is it? Some people have, they like the light to come through the window at dawn. Some people rise at dawn and sort of go to bed when sun sets except they don’t because they’re on devices. So you know, limiting lights — ideally black. The brain makes melatonin as the evening progresses — it’s the hormone that regulates the main sleep cycle and that’s why coming away from screens, reducing light, lowering the light down so that the eyes which really do two things, of course we see with our eyes but they’re one of two parts of the body with multiple function, the eyes are also a light meter and we’re not aware of this but the optic nerve is regulating and measuring the amount of light that’s coming through and as it senses that it’s getting dimmer and dimmer it’s telling the body that it must be the time to begin to make melatonin, more and more of it, for sleep. So winding down is important but I think having as much black or at least very darkened room — I personally go for total, extreme black I like to put on an eye mask, it has this foam edge around it so that zero light comes around the side of my eye mask. If someone opened the blinds and there’d be streaming light around me, I’d be in total black, unaware of the new day until I decide that I’m ready for the new day.

BSS: Wow, I have a colleague who says he sleeps with the curtains open because the sun wakes him up naturally, he doesn’t use an alarm –

MK: Well I think that’s actually wonderful, the romance of that is wonderful. As a parent and as a hard working adult, and I do work hard, and I struggle, and if I was to just have no curtains and be waking up at, I don’t know, at the moment sunrise in London is around 4:30–5:00 in the morning. If I’m up at that time and yeah I’m an early bird but I think I’m more of an owl. I could force myself to do it, all the things to get ready to do, my son to get to school, and then work. I’m not quite sure what happens later in the evening! I certainly can’t go to bed when the sun sets, that’s for sure, and I can’t live by the circadian rhythms of just sunrise and sunset. But there are those who can do it and if they’re sleeping well and they can get up at the sunrise, I admire that.

BSS: So what about somebody like a snoozer, someone who has trouble getting up or is always groggy, or constantly hitting the snooze button?

MK: OK, I think it’s interesting with snoozing as opposed to napping, napping is something you take in the afternoons and preferably for no longer than 30 minutes, 20 minutes tops. I’d love to talk to you about napping in a moment. But the snoozer is wanting that little more, is not quite satisfied, maybe they weren’t sleeping that well earlier and they just wanna try — the ones I see anyway — they’re the ones who kept waking in the night and lay there for extra hour, tormented, and finally when they do fall asleep they so don’t want to get up if they can help it. It’s usually a sign of an unsatisfied night’s sleep. I now have come around to the realization of just how extraordinary sleep really is so you know I’m all for napping I’m all for snoozing but you know I think napping is an area now and certainly in business, I do more and more lectures with corporations and the city and companies for their staff and this whole new era of napping — the idea of having 20 minutes at work would have been unthinkable 10–15 years ago. Bosses would’ve thought just forget it, it’s an interruption with the work day. But now that there’s some real research, people who take short naps perform at a much higher level — are you familiar with the coffee nap?

BSS: I’ve only read about it. I haven’t done one.

MK: Ok it’s something that came out of some research and this is one of the reasons why we set up the nap station in East London — although part of it was so that people could come see the various beds and things as well — but these pods, and they’re setting them up more and more and I was reading about it in Arianna’s book as well — the zeitgeist really is to make this time for staff it’s better for their overall health, you know a 30-minute nap boosts your immune system and some extraordinary things happen. It’s counterintuitive, but the idea of having a small coffee before taking a nap. I mean I wouldn’t have even thought that — it’s madness — there’s research about how if you have a little coffee and then a nap, it takes time for the caffeine to be absorbed, and during the nap your brain is having a chance to do its cleansing process — I’ll talk about that in a second — and then the caffeine sneaks it in about 20 minutes and by the time you awaken — as long as long as it’s not more than 20–30 minutes — you feel more refreshed and more able to do whatever it is you were going to do. Your cognitive function is improved. They were doing this research and the purpose of it was to see if a light sleep if you’re driving would make you a better driver, whether having a coffee and then a break would make you a better driver. It turned out that having a coffee and a short nap made you a better driver and that’s where the research comes. But it’s very interesting, and someone’s just recently coined this — I wish I had said it but I’ll say it to you first because I’ve doubt you’ve heard it: nappuccino.

Although personally I think I prefer something like a flat nap.

BSS: Right, a flat wink.

MK: Exactly and you don’t even necessarily need to nap everyday but for those who’ve been sleep deprived, let’s say you’re jet-lagged or you were up all night at a party, a nap is going to reset you. It’s a very powerful thing.

BSS: So when I mentioned to my colleagues that I was talking to a sleep coach, a sleep expert, and someone who does it professionally, they were like, that’s impossible, that’s not a real thing. And I said of course it is, you know, why not? There’s mindfulness training, there’s all sorts of training to make us better people. How did you do that? How did you end up being a sleep specialist? What do you call yourself? Do you call yourself a sleep specialist? A sleep coach?

MK: I refer to myself as a sleep coach, I’ve been called sleep expert, I mean I’ve learned how not to sleep to become expert at that. But as a sleep coach, part of my training I did here in London with the London Sleep Center with the help of Dr. Irshaad Ebrahim, the consulting psychiatrist for sleep there, and I’ve been on various courses, I looked at CBTI, Cognitive Behavioral Therapy for Insomnia, I’ve looked at various methodologies, sleep medicine — I am generally against medications although sometimes people come to see me with all sorts of things they’ve been taking — but the goal to me in my ethos is to help people get natural sleep. To get away from all the pills and to get into a much cleaner way to approach sleep and to relax and to then enjoy it.

BSS: So you studied it. But why was it so personally interesting to you?

MK: Well because I came from a position of having had insomnia myself and then in the process of my work as a clinical hypnotherapist — I was seeing more and more people for anxiety-related sleep difficulties and insomnia that I found that just hypnotizing people to have better sleep wasn’t broad enough to help them to overcome the full issue, the full picture. So then I started to blend teaching people how to do self-hypnosis and combined it with some of the other things that I’ve discovered, autogenic sleep training, and a mindfulness-based one that I like to teach. And I developed these in the course of developing my sleep programs that are on my website. And I had several apps, the sleep programs I was developing several years ago, that have won awards both in the US and over here for helping people sleep –

BSS: I listened to The ABCs of Sleep.

MK: You did? You didn’t tell me that.

BSS: Well yeah, that’s how I got all my questions, you know?

MK: So you’ve been learning the A and the B and the C?

BSS: Yeah, I wanted to ask you about relaxing the eyelids but you know you got to let the conversation flow.

MK: Well let’s talk about it.

BSS: We can talk about it. But I’m curious about both. I like hearing about your techniques, but I’m also really interested in the patients you see — and what’s the most difficult sleeping case you’ve had? Can we talk about that, too?

MK: What was great about doing the thing at the nap station actually is that it was the first time I’ve ever had like a walk-in sleep clinic. So you know people were queuing up on the Saturdays I was there and I had people who had parasomnias, people who would wake up in the night paralyzed and terrified they couldn’t move, that was a usual one, because you know some people don’t sleep very deeply for a number of different reasons that have to be identified but when we sleep there are different phases of sleep and the REM phase, which is the dreaming and rapid eye movement phase of sleep, is also interestingly when we are the most physically disconnected, paralyzed, from hurting ourselves in bed while we’re dreaming. So you don’t knock things off the table or punch the wall. So when people are in this sleep state, this phase, it is possible, particularly if they’re not going into deep state at all in the first place, there are things like, even alcohol interferes with sleep architecture, but some people just pop up almost mid-dream. They’re still dreaming but they open their eyes and they know they’re in bed but they also find that they don’t seem to be able to move. And for some even, bits of the dream are seeping into their waking experience it’s very unusual but it can be quite alarming.

BSS: What’s this called again?

MK: This is one of the parasomnias. It’s a waking paralysis and rather than being completely alarmed by it, which is easy if you never had it happen to you, is to understand it first of all. To know am I dreaming am I awake and to know that you can go back to sleep or even — I’ve had it, it can be in a nightmare, it’s not one of the best — we’re talking about some of the more unusual and extreme ends of what I do. Another lady who’s seeing me at the moment awakes every half an hour and we’ve eliminated almost everything that it could possibly be and she’s been to see lots of people before she came to me and the only thing that we can truly identify is that she has a lot of anxiety, very low level, all of the time. And it means that she finds it almost impossible to get to deep sleep because she’s got very higher levels of adrenal stress cortisol that makes it very difficult to fully truly completely relax and let go. The autonomic nervous system is in two parts, and the sympathetic, which sounds wonderful, has all to do with stress, fight or flight and life’s challenges, and the parasympathetic is when we feel safe and relaxed. Sometimes people see me for IBS or digestive problems and they often have these problems because they’re constantly in the sympathetic stress state and teaching people how to relax and let go and to re-set the autonomic nervous system back to the middle really, because some have autonomic nervous system imbalance which is if you like why this lady was finding it so hard to sleep — because of her physiology. So she’s going through a relaxation program daily as well as at night so she can begin to create regularly, throughout the whole day, a training for her to get physical relaxation and also I’m helping her to overcome her anxious thinking, because thoughts are the ones that cause the chemicals in the first place.

BSS: So let’s take this case again. Can you use your — I wanted to talk about eyelid relaxation that you talk about in The ABCs of Sleep — so like can you use that for this kind of case, this woman? Or is it the kind of thing that’s too kind of general to help her.

MK: Absolutely, and I taught her to use the ABC technique which in its cutdown version is to relax your eyelids to the point where they feel so relaxed they won’t work and then to spread the relaxation through the B, the breath, through the body. To take her to the point where she’s beginning to feel more and more deeply calm and relaxed. That’s the first place to get to. If, on the other hand, your mind is constantly in a circular motion looking for things to be worried about, the next thing to go wrong, then it’s probably highly likely that these people take that to bed with them. If they’re already in a sort of hyper-vigilant state and dreading going to bed because of another night of waking up every half an hour — doesn’t make you want to go to bed does it — so the combination of sleep dread (or not-sleep dread actually), there need to be a re-programming. Learning how to relax is part of it. Learning mindful you know CBT, really, mindfulness-based Cognitive Behavioral Therapy to understand and to recognize when one is thinking this stuff again and again and to observe it rather than just be in it and to see these thoughts like clouds and to be more interested in the sky between the clouds and to recognize that these thoughts are what make us feel let’s say negative and therefore anxious and the feelings that go with that.

BSS: It’s like you have to take a step back, be objective about your own thoughts?

MK: Step back, and see almost as though your thoughts are coming in a loop by habit rather than even just consciously deciding to have anxious thoughts. Half of my work is to get people to wake up and to snap out of negative loops and mind patterns, to become more present. And the other half of my work — and this is how I became a sleep coach — is helping people to let go and become unconscious. It’s the most wonderful process. It’s so undervalued, sleep, I mean I think of sleep as a spiritual experience, it’s a subjective thing, but I think of sleep as when we let go into the universe, I think of sleep as well as the letting go process about getting out of the way, it’s nothing to do, it’s just a wonderful opportunity to just release and to let go into the safety of relaxation that takes you away to let’s just say the C of dreams. I say the C of comfort that leads to the sea of dreams.

BSS: Right and it’s very calming, unfortunately I listened during the day so I couldn’t go all the way into relax mode if you know what I mean.

Well let’s see what I got. We could do a quick-fire round? You want to do a quick-fire? Let’s do five.

MK: OK.

BSS: Alright here we go, quick-fire round, number one: what’s the most common lie about sleep that we see in our daily lives?

MK: Wow, what’s the most common lie that we see in our daily lives?

BSS: Or what do you find yourself most commonly having to debunk?

MK: Ok that’s interesting. I’m trying to think of the best way to answer the question. That somehow there’s some magic trick to sleep. Some people are ritualistic. I mean, I think routine is good, but the idea that you’ve always got to do one thing — I think sleep is effortless. There’s nothing to do!

BSS: There’s no silver bullet.

MK: There’s no silver bullet and in fact we’re all different so anyone who tells you the best way is this, it’s flawed from the moment they say it because we’re not all the same.

BSS: Number 2: is there a healthiest sleep position, like side sleeping, belly sleeping?

MK: Without a doubt the side is the very best way both for the position of the spine but also it seems that when we sleep or even nap that the side position is the side that helps for the cerebral spinal fluid in the brain to cleanse itself better.

BSS: OK — does it matter left or right?

MK: It’s an interesting question, I think it doesn’t really matter because nobody just sleeps on one side. If you look at any time-lapse photography people are on their back or side, all those things but I think predominantly that the best side to sleep on from a physiology point of view, I understand, is on the left side and that has to do with the blood pressure and the fact that your heart is slightly to the left and by sleeping on your left side predominantly, it is better for your physiology and I believe it means you’re slightly less likely to have things like heart attacks and strokes. Not to worry anybody.

BSS: All these stomachs sleepers just had a freakout.

MK: It’s interesting about stomach sleepers. Stomach and on-their-face sleepers are the ones who are most likely to grind their teeth.

BSS: Really?

MK: Yeah because they’re kind of putting their head onto their jaw, into their face. When I work with people who have you know tooth grinding, one of the techniques is to get people to sleep with their airwaves open, head slightly tilted back so the jaw naturally falls away from the teeth. It seems completely unnatural for someone who’s not used to that but between that and I like to use hypnotherapy for teeth grinding as well, I find that’s the best way of making the change so they don’t destroy their teeth.

BSS: Alright, number 3: pillows. Best pillow, does it matter?

MK: Well I think pillows are very subjective, I think if you sleep on your face, if that’s the way you have to do it, you want to have a soft pillow because you don’t want to be having your head completely tilted back if you’re sleeping on your face, but I think that side sleepers would benefit from a reasonably firm pillow — the Eve Sleep ones are unbelievably amazing, but there are others.

BSS: Alright, number 4: how does it affect us to sleep outside? Is there a difference between sleeping outside or inside?

MK: That’s a good question, I like that. I recently went camping with my son and I certainly think there’s a big difference and I was sleeping in this tent and I haven’t been camping for decades and it wasn’t quite summer yet so nights were very very cool and the coldness of the air on my face at that time of year wasn’t for me ideal but I did vaguely sleep. Honestly I couldn’t wait to get home to the luxury of my bedroom. I personally think sleep is for sleeping, the less disturbances there are, minimum light, definitely the room should become slightly cooler as the evening progresses when you fall asleep. Ideally a cooler room when you fall asleep. I mean sleeping out on the patio or on the roof if you’ve got a roof terrace, at a certain part of year in the middle of a heat wave, could be fantastic, but I wouldn’t recommend it all year.

BSS: Sub question: when you went camping did you bring your mask thing that closed out all light?

MK: Very good question. You know what? I so did.

BSS: Yeah?

MK: Here I have a sleep box with a number, not all my masks are the same. I have probably ten different kinds, not all ear plugs are the same I have more than ten. There are even ear plugs for women, different sizes and widths, you know channels are usually narrower for women or when they want to hear their kids or certain sounds but the one I like, with the foam, that one I took with me and I was definitely glad when I was in my freezing cold tent with my son. That was the one luxury, other than the fact that I like to wear sleep socks which I know is odd but I’m very tall and it helps circulation to my feet. It’s one of the things that people with sleep difficulties — and they actually have cold feet! Sometimes I go through all the different questions around the environment and physiology just to find out people have cold feet when they sleep.

BSS: There’s a Seinfeld episode with George and Jerry are in a hotel room for some reason and Jerry likes to, he’s a feet tucker, he likes to keep his feet tucked, and George likes to kick off the blankets. You can add that in your next book or do some kind of deep analysis.

MK: That’s great. I’ll have to research it. Did you say George was the feet tucker?

BSS: I think Jerry was the feet tucker.

MK: So George likes to kick his feet out, so George probably then doesn’t want to wear sleep socks either because he likes the air circulating.

BSS: Right.

MK: My wife is warmer than me, she likes to kick the covers off but I still like to keep the covers on the lower half of the bed so my feet stay warm. GOD we all have these weird variations! It’s amazing anyone can sleep the night with anyone else!

BSS: Alright so last one: what’s the one rule for sleeping? Like, Huffington has one rule: no phones in the bedroom. Hands down.

MK: Let’s just assume that’s a given. Although there are lots of people who like to have their iPhone apps measuring and Fitbits and such and I’m not sure how to reconcile that but ultimately good sleep you don’t need devices. You can use them to learn to sleep better but it’s like nobody should listen to recordings every night, it’s just learning. Once you get past all of that, and assuming there’s no phones or electronics around you then I would say the number one rule is never try to sleep. Sleep is effortless, you never try to sleep, you relax, you get out the way and by getting out of the way, that’s the way sleep happens: you relax and let go.

BSS: That’s a perfect ending!