Episode 26: Benjamin Smarr, PhD

Scott Parish Body Clock Podcast

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Dr. Benjamin Smarr combines his experience in research focused on developing personalized, predictive tools for future medicine and education to specialize in circadian rhythm, sleep and computational biology at a postdoctoral fellowship at UC Berkeley.

Transcript

Dr. Sohaib Imitaz: Hi, guys. Welcome to another episode of the Body Clock podcast by Owaves. Today, I have Dr. Benjamin Smarr, who is a scientific adviser for Owaves. Benjamin has a very rich academic career. He has been a Ph. D. student at the University of Washington in neurobiology and behavior.

He also studied at the University of California and now he’s a postdoctoral fellow at UC Berkeley specializing in circadian rhythm, sleep, computational biology, neuroscience, and I’m sure he’ll be telling you a lot more about his background. Benjamin has been working with our Owaves team. And he’s one of our experts and we’re very fortunate to have him on the podcast. This is going to be a deep dive into everything sleep and time.

So Benjamin describes himself as a time specialist from a physiological perspective. So I think he’ll be amazing knowledge for students listening to this and the general public. And I’m quite excited to learn a lot from Ben. So hi, Ben. How are you?

Dr. Benjamin Smarr: I’m doing really well. Thanks for having me on. That’s a very kind introduction.

Dr. Sohaib Imitaz: No, I think you deserve it. I mean, we’ve been very lucky to have you on Owaves and shaping where our app is going. And that’s very telling in all the kind of studies we’re trying to carry out. But you are actually the first sleep specialist.

I know you have a lot more than that, but we have not actually had a guest who knows much about sleep on the podcast as of yet. We’ve had quite a few people with nutrition, exercise, mental health so I would really like if you could add a lot to that angle, as I’m sure you will. So to start off with, can you explain to listeners how you got interested in lifestyle and your background? What kind of data and what you believe in for where healthcare is going?

Dr. Benjamin Smarr: Yeah, that’s a great question. I’d like to tell people that I’m a recovering biologist. So I had all of my schooling. In fact, since I was a little kid, I was really interested in watching bugs and figuring out about behavior and sort of what makes people tick eventually got me into neuroscience. And at some point I realized we do all of this research on cells or on model organisms and yet we really don’t know what the humans look like that we’re comparing to.

We really don’t know how behavior, hormones, neural activity, anything is actually changing across the day in a way that helps to make us healthier or not. We have this sort of snapshot view, right, where you say the knee bone is connected to the shinbone. So that how your cholesterol should be within some given human range or temperature or anything else. And, you know, so somebody comes into the clinic and you go, yeah, your heart rate is within the human range of heart rates.

That’s got to be good, right? Your cholesterol is within the human range of cholesterol values. That’s got to be good. And what we’re missing,  what I got into in grad school, is thinking about how could we get ahead of behavior by taking advantage of change that is not random. Change that is predictable. And so things like circadian rhythms, sleep cycles, ovulatory rhythms for women, seasonal change.

There are all of these timescales where change is not random. And so if you start to say, well, what is changing biologically on those timescales? You start to realize the answer is absolutely everything. And so that just converted me. And I said, OK, this is really exciting. You know, knowing what time of the day my research subjects think it is or what time of day my body thinks it is, completely changes the values I should expect for what temperature am I?

What is my cholesterol? How active is my stomach? How well am I going to be able to metabolize something? All those things are changing all the time and they’re changing in a fairly predictable, cyclic kind of a way across the day, across days, across weeks. And we don’t know what that looks like, right? That is not in medical texts. The knowledge doesn’t exist in large part because the tools are brand new tools, right?

We didn’t use to have wearable sensors or social media accounts generating this kind of continuous timestamp data so that we could have done the research. And so to learn how to do it, I had to teach myself a lot of data science techniques. I had to teach myself a lot of math and of course, with a lot of help from the community.

I’m not saying it’s I’m doing it on my own. It’s a wonderful community. But, you know, getting away from knowing biological facts as discrete things and getting into building tools that let us look at biology now that we can look at it as a dynamic system to a time rather than only being able to capture snapshots.

Dr. Sohaib Imitaz: I really love how you explain that with time being so central to the whole explanation, because being a doctor myself, that’s something I’ve always questioned, especially someone who loves math and data. Why when we take a metric a certain time, it can come back completely differently? – and we’ll be used that the same metric on patients, on the database- Electronic health record, when really if you would take it at night, it would be a different value, but we don’t consider these nuances. I’m glad that you look at it from how time and biology, physiology is not constantly varied throughout the day. So really, we have to be compared to a relative at that point.

Dr. Benjamin Smarr: And more than that, in fact, if you don’t mind. I mean, you’re absolutely right. Right? And it warms my heart to hear you say it because a lot of clinicians still have not caught on. Not only is it about getting smaller error bars, right? If I measure my temperature at noon, I know that it’s gonna be higher than if I measure it at midnight.

And so I can put it into a smaller bin. But beyond that, the shape of the change itself is information, right? The analogy I like to use is, if all I know once per day is the power of radio waves in the room, all I can tell you is that radio waves seem to exist. If I can watch them change over time, then I can listen to the radio and there’s an enormous amount of information coming over the radio.

I can determine that I’m listening to a given song. I can listen to NPR. That’s the difference we’re talking about. It’s going from saying I think radio exists because I’m aware that radio waves are in this room, you know, and they have some average power to actually being able to watch them change in real-time and listen to the radio. So there’s this enormous amount of information that our bodies are giving off and we just are completely blind to it right now.

Dr. Sohaib Imitaz: That’s quite a stellar analogy, and I would agree. And being one of the few doctors who can think from a data perspective, something definitely I’ve encountered. And before we go into this further, I think we should explain to the listeners what are circadian rhythms and why is sleep important for us.

Dr. Benjamin Smarr: Yeah. Great. So circadian rhythms are the rhythms that our bodies are generating in an attempt to anticipate the day. So a way I like to think about it is that since the earth has been rotating, takes about 24 hours to go around since life began. It makes sense that life got used to anticipating those changes, right?

The difference between getting sunburn and getting seen and freezing to death and not being able to photosynthesize like these are big differences. They mean survival at a big scale. And so even since just single-celled organisms. There’s been a very strong evolutionary pressure to be able to anticipate the day to get ready for the sun, to get ready for the night rather than just respond because they happen. And so that internal anticipation is this clock that we have.

And because it happened so early in the evolution of life, it’s actually inside the individual cells. And so as a human, what our body has to do is keep all of those cells coordinated so that they’re trying to do the same things at the same time. That used to be pretty easy because there used to be, you know, the sun was the only source of light and that dictated a lot of what you could do and when you could do it.

These days, we can do anything we want at any time we want. I can eat a pizza and watch Netflix at 2:00 in the morning if I want to. But the problem is that food is acting as a timing signal to my GI tract. That light is acting as a timing signal to my brain. They’re going to try to talk to each other. They’re gonna try to talk to the rest of my organs and the rest of my organs are going to go, “What are you doing? It’s the middle of the night. I was trying to recover.

I was trying to get ready for the next day.” And so that conflict that we cause ourselves by taking these different oscillators, these different clocks, and sort of jerking them around instead of letting them know what’s coming stable day to day. That just makes it really hard for our body to do its job. It’s really hard for our body to coordinate. And that’s one of the reasons we see the emergence of modern disease so, things like cancer, developmental disorders like ADHD and autism, things like dementia at the end of life or obesity and heart disease throughout adult life.

All of those things are exactly the things we see becoming more common resulting from circadian disruption. This is physiological friction of not letting people have a stable sense of time with their bodies. So circadian rhythms is that daily sense that our body is trying to get and it manifests in everything. So you see it in hormones. You see it in behavior. You see it in, you know, what kind of intelligence you’re able to exhibit, what kinds of skills you’re able to use, how quickly you can switch attention. And one of the big places that everybody can come to this and go, “Oh, I know that is sleep.”

So one of the really big things that our body has to do every day is recuperate, clean off the stage, set the props back up and get ready to run the next day’s show. And so sleep is a big part of that. So sleep is not really one thing. Sleep is actually also a core. But fundamentally, what it’s doing is emptying metabolic waste that we generated by being active. It’s cleaning up all of our attention, right? So if we experienced a whole day’s worth of things, our brains can’t just store everything infinitely because there’s only so much space inside of our skull.

And so we need to get rid of most of it and figure out which little bits we want to keep and rehearse those a few times so that they’re really stuck in there. Sleep is your body’s time to do this because you can shut off the outside world. You can stop being active. You can stop taking in new information. And so it gives your body that time to run maintenance, get organized, and then live the next day.

Dr. Sohaib Imitaz: So with that sleeping, so essentially you’ve marked a lot of functions; which sleep is important for. But in particular, so with that in mind, would increase sleep ensure better performance? Would it mean these processes are happening more efficiently or is there an optimum number of hours to sleep? Does it vary from individual to individual, which I’m guessing is the case?

Dr. Benjamin Smarr: No, that’s right. I mean, there definitely is an optimum, but it’s different for person to person and it depends on a lot of factors. It’s not a set number. So, for example, the more physically active you are, the more metabolic waste you’re going to generate. And some metabolic waste, just meaning, you know, the smoke from all the little cellular fires.

There’s all this waste product that your body has to get rid of because it’s being active and burning energy. So the more of that builds up, the more your brain says, “I really, really, really need sleep.” And then the longer that you’re in deep sleep at the beginning of the night, which is helping to flush all of that out. There are some standard things like little kids seem to want to sleep more. In early adulthood, people seem to be able to sleep a little bit less.

Into old age, people act as though they need less sleep, which is to say old people tend to sleep less well. But actually, if you could help them consolidate that sleep- be more active, get more sunlight during the day, they make use of a little bit more sleep than they get usually. So one of the things that probably kills a lot of us is because we start being less active and aches and pains and whatever else. Stop getting that sleep drive as intensely.

We stopped sleeping as well. And the more sleep falls apart, the more our bodies are unable to do maintenance. And so the more our bodies fall apart and our brains fall apart. And that’s a downward spiral whereas people sleep fractures with their age. The longer you can stave that off, usually the longer you can stave off things like the onset of dementia or serious illness.

Dr. Sohaib Imitaz: So with sleep, can you train yourself to sleep? Better to sleep? Does a more constant routine or rhythm improve your sleep over time and equally? Can a frantic or dysregulated sleep pattern make your sleep worse and make it more difficult to get back to that good pattern? Is it something we improve similarly to running or bicep curls? Eating healthy? Is it something we can train?

Dr. Benjamin Smarr: Oh, yeah. Oh, yeah. No, sleep. Sleep is definitely something you can train. Sleeping is a skill. And it’s a skill that people don’t invest nearly enough, in my opinion. I mean, that’s a general statement. But you talked earlier about on this show, having done nutrition, exercise, you know, sleep is what makes that work.

And so investing in good sleep, getting into a routine. Letting your brain recognize the sleep environment, the sleep time and again, the circadian rhythms. Knowing what time your body expects to sleep by having a stable bedtime and a stable wake up time. Those are a really big deal. And the better you get at that, absolutely, the more stable your sleep will be. The more regenerative your sleep will feel and the stronger, faster, smarter you’ll be the next day.

So there was recently, no credit to me at all, but there was recently a really big success helping to get the naval fleet, United States Navy, on to a circadian rhythm of watch bill. This was work by Nita Shattuck and it was some simple experiments showing that, for example, if you’re on a 30 hour day, right, so five hours on watch, 10 hours doing something else, five hours on watch, 10 hours doing something else over and over.

You never get a 24 hour day, right? You’re six hours jet-lagged every day effectively because that’s that adds up to 30 hours instead of 24 hours. And these sailors, she was doing tests with their reaction times which were way worse than if you were completely drunk. Honestly, there the worst reaction scores I’ve ever seen for any group of individuals. Luckily, you know, all they’re doing is managing nuclear reactors.

So it can’t possibly be that important. But you know, it’s tongue-in-cheek. But it was scary. And so she was able to get this in front of the right individuals and get the policy sidelined up where they said, “OK, we get it. If you put people on 4, 8 instead of 5, 10 or 3, 9, you know, that adds up to 24. That’s much healthier.” You know, we get it. Putting sailors on those watch bills, it cuts all these problems in half. It’s just an amazing improvement.

Dr. Sohaib Imitaz:  So tweaking something like that seems to be quite phenomenal.

Dr. Benjamin Smarr: It’s a big payoff. But I’m sorry, this is a shaggy dog story. But where it’s coming to, where we started with your question, was that the way she got the sailors excited about it was nothing to do with the policy. It was nothing to do with bar graphs. It was cultural. It was saying sleep is a weapon, right? Sleep is not something that I’m telling you to do and you’re too macho, you don’t need it.

Sleep is what makes you sharp, right? And if you don’t sharpen your blade, it’s not going to be as good. And this mantra of sleep is a weapon, and so you invest in it because it makes you smarter, it makes you faster, it makes you tougher. That was really successful. That was able to get into that culture much better than just some doctor saying,” I told you need sleep more.” So that was a huge win, right? And it absolutely true.

Sleep is a tool that makes you a more effective human being to say nothing of living healthier longer and so helping people get that message and helping change the culture, right now. A lot of people don’t sleep because they feel like they can’t. They feel obligated to do work or take care of their kids or all kinds of real things.

It’s just that sleep is always the last priority. So helping create a culture where, you know, your friends, your co-workers, your network say, “Ok, but like, make sure you’re getting your sleep because that’s going to be how you contribute to our team effectively.” I think that’s a really important cultural change that certainly I try to promote. And that I think Owaves is in a nice position to help get that message out to help promote mindfulness about these things.

Dr. Sohaib Imitaz: Definitely. Culture change is the real prominent factor in all of this. And with sleep, it’s interesting because we do live in a society where at times being someone who is quite interested in entrepreneurship myself, entrepreneurs and even students.

Obviously, you’re an academic. Do pride themselves on being able to function on less sleep. And it’s almost seen as a badge of honor. And now we have to be looking at how detrimental is that actually to that performance? Could they be even better if they slept? Are they actually lagging behind? Because I think the quality of time spent in productivity, you can probably perform such a higher potential than the length of time just working without being, you know, engaging your cognitive progress.

So that’s really interesting. So with behavior cultural, I remember seeing LeBron James O on Owaves and it was like I think he slept like 10 or 11 hours. And obviously he’s working out every single day for multiple hours. The demands on his body are so much that he does need extra sleep. Would you think that helps culture change, knowing that people who train hard work hard in any capacity? They make time for that recovery because recovery is something in which sleep is probably the best way of actually recovering.

Dr. Benjamin Smarr: Yeah, no, I think it’s great. I mean, I love examples like that, but I’m out in the Bay Area and so we had the Warriors getting lots of attention over basketball, right? And, one of the things there were a bunch of news articles about was they make time for sleep. They value making that investment, especially if they’re doing away games, right? Getting over their jetlag. Getting their sleep every day. That’s terrific, right? I mean, there’s nothing like a good example of how the investment pays off to help other people want to get a part of it. I think that’s great.

Dr. Sohaib Imitaz: I do think from that… I’m going to put a very difficult question here, so if I put you in between a rock and a hard place, how would you choose sleep timing? By sleep timing, obviously, you know, before midnight, eleven or ten, whatever is optimum for you and your circadian rhythm? Sleeping at the right time and regularly or sleeping at the right time, which is not too late, but it’s irregular? So it may vary an hour or so every day or maybe more. Or sleeping constantly past midnight but at the same time every single day?

Dr. Benjamin Smarr: It’s a great question, and luckily I don’t have to make up too much of an answer. Okay. You know, within the caveat of different people are different. And people change across their lives and that sort of thing. You know, we know from shift workers that if you’re jumping around a lot right now, we’re not talking about an hour. I’m talking about, you know, eight hours, ten years.

That kills you. If you’re working a funny shift and it’s stable. That’s still not as good for you. I mean, it is better right? The stability is big, but it’s still not as good as if you’re working a stable shift at a reasonable time. And so my answer to you is if it’s in fact, an hour of wiggle room, you know, your body is supposed to be plastic. That’s reasonable. If sometimes you go to bed at 9:00 and sometimes you go to bed at 2:00 AM, OK, we’re not talking about an hour anymore.

That’s a problem. But to the extent that it’s, you know, sort of call it 10:00 or 11:00, maybe for an adult and if you’re younger, it should be later. Than yeah. That to me is much more healthy than saying, well, I got my eight hours, but I’m already pushing myself up much later than my body wants because I’m staying up, doing one more thing and one thing and one thing. There’s a time at which your body is going to want to go to sleep.

You can push that, but you’re not working with your body anymore, right? Same way if you’re doing a workout. Like if I just jerked my back, maybe I could lift more weight. Yeah, ok, but that’s not a good workout. That’s not how you build good technique and good muscle.

Dr. Sohaib Imitaz: Would you say the timing of sleep is almost more important than the quantity of sleep?

Dr. Benjamin Smarr: I absolutely would to an extent. Let me put that another way. I did a data mining study on college students, as many thousands of students looking at how their sleep habits affect their grades. I should say correlate with their grades. And everybody says, “Oh, duration, duration, duration, duration, duration.” There was absolutely no correlation with duration and grades.

The majority of students are getting seven or eight hours of sleep, in fact, on average. There was a very, very strong correlation between the stability of sleep time and your grade. And if you jumped around a lot, your grade was worse and it was an R squared value of like .78.

It’s a very, very strong correlation. So from that, what I take away and I’ve done this a few different times in a few different methods and the results are always the same. The duration is not useful as a predictor, and stability is extremely useful as a predictor. So that tells me the stability really matters and that makes sense from this point of view. Like we all know, jet lag is miserable. All we all know that if our bodies are lined up stable, it makes sense that they would know what’s coming and be able to make use of that better.

Dr. Sohaib Imitaz: So with the kind of cycles of sleep being regular being the best way, what are the ways that people can get a regular routine? I know Owaves using the app. Having a regular schedule. But life is quite dynamic. Sometimes you have to stay up or at times you’re giving up social opportunities that may only arise just certain times. How do you balance that? Is there a certain amount of days in a year that is an arbitrary time period that you can maybe extend your bedtime a few times and you’ll be fine?

Dr. Benjamin Smarr:  I think it’s not about being prescriptive. I think it’s just about realizing the opportunity cost. So I think right now the culture says sleep is a waste of time. And therefore, if I can stay up and talk to people, and if I can stay up and do work, you know, good for me. The missed cost of that is that you’re not socializing as well as you think you are. You’re not as attentive as you think you are the next day.

And those are also costs, right? And so I think it comes down… the way I do it to myself and, you know, I sleep a lot and I feel good about that. I just think about the quantity versus quality arguments always. Would I rather drink a bunch of wine or have a glass of really good wine? Well, I would rather have a glass of really good wine. So it’s the same thing you say, well, I can exist in a conscious state more.

But it’s going to be less quality and it’s gonna make me unhealthy or I can just recognize that having good quality day involves having sleep. I think you have the same argument with people going to the gym. Going to the gym is stupid. It wastes an hour or two hours out of your day.

How can you afford that? But of course, you say, “Well, but you know, I have to be healthy. I have to maintain my body. Of course, I’m going to make time for exercise.” So it’s the same argument. Of course, I’m going to make time for sleep. It’s important. It’s what keeps me healthy. It’s what keeps me mentally sharp. It just has to be a priority.

Dr. Sohaib Imitaz: So with attention and behavior, that brings me on to mental health. Because a lot of behavioral aspects obviously lead into mental health and mood. And I have obviously, seen studies where sleep deprivation can really impact decision making the next day, can affect, you know, your anger response, your amygdala is a bit more.

There’s a heightened response. So it seems like there’s a correlation that normal people in the public don’t see that. Okay. We’re sleep-deprived. So we made bad poor decision or we reacted that way. And that eventual downstream would lead to mental health problems. And you’re someone looking at data and kind of can connect those dots. Could you tell me more about how important that is for mental health and behavior?

Dr. Benjamin Smarr: Sure. I mean, you’re exactly right. I guess, I’m going to separate the two things, right? There is keeping yourself healthy and there’s exacerbating pathological states. One can become the other. But for most of us, of course, the things you mentioned are exactly right. If you’re not sleeping well, one of the things that sleep is doing is it’s emotionally refreshing you.

It’s giving you that emotional resilience for the day. And so, you know, what are the stereotypes of high schoolers being punks and hard to deal with as a teacher is because when purity happens, all those hormones delay the clock by several hours. But your school day has not delayed by several hours. And so now you’re being asked to get up way earlier than your circadian rhythm really wants you to.

So most teenagers in public school at least are chronically sleep-deprived and chronically jetlagged and they have emotional resiliency problems. These things are related. We know this. We know if you let them sleep in longer, and if you shift the day, complaints from teachers go down, dropouts go down, drug use goes down. It’s just very clear. And of course, as you know, there are a million adult analogs as well.

If you’re allowed to sleep in recovery, you’re much less likely to be angry. You’re much less likely to be volatile. These are very important things for daily maintenance and overtime. They do add up. And you, for example, if you’re chronically sleep deprived or if you’re chronically jetlagged and I use the term jet lag not to mean flying from one place to another, but your day is shifting, right? You have an unstable schedule. Social jet lag then that can lead to things like depression over the very long term that can lead to earlier onset of dementia. So it definitely adds up in that way.

At the same time, for people that really have a pathological, you know, call it a bipolar disorder or one of the schizoid disorders. Those can be and we’ve known this for a long time. Those can be triggered by sleep deprivation. And so in terms of patient management and in terms of, you know, again, we’re tools like Owaves, I think actually can do a lot of good is by creating it a tool that helps you to be aware of these things, right? That helps you get feedback about, am I sleeping regularly? Am I forgetting to do something important like make time for healing?

Getting away from those things can trigger an event in somebody who has a brain that is going to be triggered in some threshold that way like that. Similar, in fact, even for things like epilepsy. But basically, if your brain is able to recover and you keep pushing it and you keep pushing it, it’s much more likely to react in an inappropriate way. So whatever the thing is that you have that you know that goes awry, you’re just rolling the dice that much more.

And so both from an acute mental health maintenance point of view and from a long term mental well-being point of view, having that regular sleep and valuing it and having that reinforced by the people around you, that’s a big health outcome. Positive thing. That’s a big deal.

Dr. Sohaib Imitaz: And moving from that; that links in quite well with the quantified self-movement. I know you’re very involved. With that myself. I’ve kind of really fallen into that. And I use the Oura Ring at the moment just to see how different parts of my day affect my sleep. And there are other devices.

I was in contact with Will, recently, with Whoop. Something that is getting quite popular. So obviously, he was a Harvard Business School and I think it’s pretty cool what he’s doing with the Whoop. And then at the Consumer Electronics Show this year, sleep had its own almost domain. It was kind of emphasized.

So technology and data is something you’ve got to be a master of is really coming to the mainstream now. And if we can say so, as we discuss with students, behavior changes, et cetera, due to sleep, timing and deprivation, I myself personally, I know that when I’m not well slept, I do suffer from a kind of brain fog.

And without these devices, there is no way of kind of quantifying it. I know they’re not 100 percent accurate on kind of measuring the different segments which were going to sleep, deep sleep versus REM, light lights, et cetera.

Dr. Benjamin Smarr: Yeah. And I mean, I actually have some pretty strong opinions about whether you should care or not, but yeah.

Dr. Sohaib Imitaz: Which will be good. So I’ll get you to explain that a bit more. But I can kind of see the correlations that OK, my sleep wasn’t geared by the quality from looking at these things and working. And OK, that’s why I have brain fog or like if I know if I’ve slept well normally you can tell yourself as well. And you know, like because I know periods of when I’m sleeping well, I’ll be more creative.

I know. I can be happier and creative and someone who’s into innovation. I need ideas. So I’m always kind of trying to look at broad perspectives of different industries and to be creative and come up with ideas. I’m always missing Royan on Slack or WhatsApp on the days I’ve slept better, I am genuine more creative.

It’s really terrible. It’s quite interesting because days in sleep deprivation, which were my orthopedic rotations about four months ago, I wasn’t having many creative ideas. I was stressed, sleep-deprived, my sleep pattern, circadian rhythm was all over the place due to night shifts. And it’s very interesting. So could you go into the quantified self or what technology is your opinion on Oura Ring, Whoop? What would you recommend?

Dr. Benjamin Smarr: Yeah. Yeah. No. So I mean. So those who don’t know Quantified Self has been around for about 11 years. It’s still run by one of the founders, Gary Wolf, who I’m lucky to know because he’s also in Berkeley, it turns out. Terrific guy. And what he’s helped people do by creating this platform is to figure out ways to tell stories about themselves that are quantitative.

So the story you just told me is a terrific example where you say, “I was measuring my sleep. I was measuring how it changed as a function of doing these different medical rotations. And I was writing down how many creative ideas do I have per day.”  Right? “I was writing down how many times do I text Royan in a day.” That’s a great example of a story where you say, you know, in my life, this quantification shows me that these things seem to have a relationship.

Quantified self is not predicated on a particular topic. It’s just the idea that if you start measuring things, you can see where there are patterns or sometimes whether or not patterns that you had imagined that might have been and that it informs your self-awareness, it informs your decision making.

And if you can tell that story to others, you pass along that armature or you allow them to build their own tools for self-discovery help, hopefully. And I mean, I’m actually not just a fan of this. I think this is the future of medical science. I think this is profound. You know, we didn’t used to have the ability to look at lots of people’s sleep by using an Oura Ring like you were talking about, right?

That data just didn’t exist five years ago. It could not have existed five years ago. And so there are no medical textbooks that cover that because how would you have ever known what you were looking at? Medical textbooks and our culture generally tend to treat towards the average. They tend to say somebody should sleep eight hours, right, maybe if you’re lucky. It says if you’re young, it changes for when you’re old.

If you’re male, it changes from when you’re female. But even then, those are these very, very clumsy boxes dropped on top of humanity, which is the most complex thing humanity is aware of, right? And so. The only way forward in my mind, if we run out of classical knowledge, how do we get more knowledge from all these amazing tools? You’re never going to do it by me running a study in a lab on a handful of people.

How am I ever gonna know the differences between you and me and everybody listening? If all I ever do is look at a handful of people, the only way we can do this is by building a community where people get to be part of discovery. You get to learn about your creative ideas. I get to learn about when and I’m a better cook. You know, my fiancé learns about when is she gonna be the best runner. So everybody has their own interests. And a lot of people are interested in disease management, especially as they age. All of that is real.

All of that is experience that ought to be engaged with. And there’s this incredible opportunity right now for people in the medical environment and people like myself on the research side to reach out. And rather than say, “I’m doing this thing and it’s important that you could be a data point,” actually listen. Actually build relationships. Actually say, “What do you care about?” Let’s help you value science.

Let’s help you value somebody with medical perspective, listening to you and thinking about how could we explore this. That’s very challenging from a cultural standpoint, especially in medicine. I hate to say it. Medicine has this culture of being right, right? Patients need somebody who’s authoritative. They need you to say, “Yes, this is the problem.” And we’ve drawn back the curtain now, right?

We can see much more than we used to be able to see. And medicine does an enormous amount of good for an enormous number of people. And this weird anti-vaccine thing is a great reminder that we should not take that for granted. But if we say that’s the end of medical knowledge, we’re depriving ourselves of all of this new learning that’s possible with all of this new tech that we’ve developed. That would be criminal. So I think the only way forward is to change the nature of the institutions, right? Break out of the lab.

Break out of the hospital and break out a patient receiver consumer mindset. Not to get too hippie on you here. And really think about the community. Really think about valuing people sharing rather than tricking them into sharing. Really think about valuing hearing people’s stories rather than tell them, “No, that’s not the standard.” Everybody is different, right? We’re all humans, but we are fairly individual humans. And so capturing that fine-grained difference is the only possible way we’ll ever get to things like personalized medicine or predictive medicine.

It just doesn’t make sense otherwise. So you can tell, I’m sure, I’m very passionate about this. I think people engaging in self-discovery in responsible ways, using state of the art scientific technique, but appropriating it with new tools rather than just say, “Well, I guess that’s for scientists.” I think that has serious transformative power for our human well-being globally. And anything that can help move that forward, I am all about it. Anything that is a barrier to that. I think it’s harmful and it ought to be torn down. So let me stop myself there because I can go on and on.

Dr. Sohaib Imitaz: That’s so good to hear. And I can see you’re so passionate about that. And it’s interesting how doctors get very little teaching on sleep. And then if you present them with metrics like heart rate variability, which I did to a surgeon recently and they hadn’t really heard of it. And exactly.

They just can’t understand the technological advancements, these tools. National directors don’t even know the Oura Ring exists. Surely there’s something going wrong. If the guardians of health, the so-called guardians, aren’t aware of where health is moving and if a patient comes to you with this data, you can’t really interpret it. So getting back to that question, are you an advocate of someone? Do you measure your sleep?

Do you use the Oura Ring? What do you think is useful? And could you tell the listeners about deep sleep versus REM sleep? And is one more important than the other as well as, I’ll throw in something else, genetics? So night owls, morning larks, how much do we vary by? Is it true? Is it false?

Dr. Benjamin Smarr: Yeah, yeah. Yeah. Great questions and all of them are right for the kind of discovery work that I’m talking about. Right. So broad strokes working in reverse order, maybe.

Dr. Sohaib Imitaz: Perfect.

Dr. Benjamin Smarr: Clocks being cellular machines are largely dictated by genetics. Biological clocks, I mean. Circadian clocks. So it definitely seems to be the case that if you’re genetically…You know, the machinery is a little bit sticky and your clock takes longer than 24 hours to run, you’ll try to live a longer day. So you’ll end up staying up later.

You’ll take longer to warm up in the morning and you’ll stay up late into the night. And the opposite is true. And so people like me who have a short clock. You know, I get up between five and six and I hop out of bed and I’m ready to go. And by eight o’clock, I’m pretty much not useful. And I just want to read a book and go to sleep, right? How? I’m like the stereotypical old man. You can find that to a certain extent.

It’s plastic to a certain extent, but it seems to be remarkably resilient to what your genetics is. Meaning, for someone like me to try to stay up late and go to parties and socialize and network is really hard. And similarly, you know, obviously a lot of my students are late types and they’re at a time in life when their clock has been delayed by puberty.

And so if I say, “Well, let’s have a meeting” at you know, what to me is late, right? “Let’s have a meeting at 9:30 or 10:00.” They go, “Ahh, do I have to get into lab by 10:00, God.” So you know, they can do it because I can make them do it. If I’m mean about it, I try not to be, of course, but it’s not good for them. So there is some plasticity, but really it’s a part of who you are. It’s part of your genetic identity.

The same way that we think about race and gender and these sorts of things, right. It really is part of our human diversity. So we should be measuring that. We should be valuing that. How do we do that? So, yes, I wear an Oura Ring. The way that I use the Oura Ring is I just scroll way down to I click on my little sleep button and it gives me a score. I don’t care what score they think my sleep was.

Scroll to the bottom and I look at the continuous heart rate or I look at the temperature deviants across days. Those are real data, right? So if you look at the heart rate, what you want to see is you’ll get a little graph of your heart rate across the night. And what you’ll see is that if you’re healthy, it stays relatively flat, it stays relatively low, and it has ripples. So you’ll have sort of three, four or five humps that describe that night. And those are your sleep cycles. And so that’s very good.

That’s showing that your body is going through a regular cyclic kind of sleep that’s very healthy. What a lot of people might notice is it starts very high and then it sort of precipitously falls down in the first half of the night and then it starts to bump along. That probably means you had a drink or a big meal too late in the day. And your body was still dealing with that when you went to sleep. So that’s the sort of thing you can look for and you can start to say, “What am I doing?” How is it affecting the shape of these data? And how do I learn about what’s good for me, right? What are the right habits?

If I went to sleep earlier or later, did that change the shape of this thing? Separate from that, they try to use the data to back project onto your cortex. So when we talk about sleep cycles and you had asked me about different kinds of sleep, so deep sleep, REM sleep, slow-wave sleep. These are types of sleep that are characterized by the activity on the surface of your brain, your cortex, and basically how many sorts of crackly noise is going on electrically versus how much are these big, long, slow waves coordinate the activity.

And when you’re in sleep, people back in the 70’s discovered that you could see patterns to when you’re in REM sleep or when you’re awake, your cortex is going, “up, up, up, up, up,” and it’s really doing things. When you’re into deep sleep, it’s going, “whoa, whoa.” It’s making these canonical brain waves and helping to get itself back on track. And get coordinated, flush things out. And unfortunately, from my point of view, that has been canonized as sleep.

It’s not sleep. It’s the behavior of the cortex during sleep. And your heart has its own behavior. Your liver has its own behavior. Your temperature is doing different things. And we haven’t done a good job of capturing all of that sleep that is not happening in your cortex. So when you look at your Oura Ring or your Whoop or your Fitbit or your Apple Watch, all of them will say, “Here are your sleep stages, here’s your slow-wave sleep, here’s your deep sleep, here’s your REM sleep.”

None of them are really measuring that, but all of them are measuring something like your pulse rate or your heart rate variability or if it’s an Oura Ring, your body temperature. Big fan of body temperature, which is one of the reasons I like Oura. And they’re saying, given that we can see this thing sort of has these ripples, you know, three, four cycles in a night. How accurately can we guess from that what your cortex was doing? Because that’s what people say sleep is. And so that must be what we’re aiming at. And that’s fine. But I fundamentally disagree.

I think saying your cortex is the only thing we should care about is to devalue the rest of your body, which is also making use of the sleep, which is also feeding back to your brain to affect its sleep. And so one of the fields that I hope people contribute to developing through using these wearable devices and exploring with themselves and telling stories and sharing. What actually does sleep look like outside of just your cortex?

What actually are the healthy patterns of sleep? How is that affected by your behavior, by your diseases, by your aging? If you get pregnant or not, all of those things definitely affect your body. Your body knows it and responds. And we’re not good at reading that yet. The reason I think that’s so important is that when you’re asleep, you’ve gotten out of your own way, right? You’re letting your body just do what it wants to do. So it’s a great moment for reporting for your body to report. And if we learn how to listen to that better than we have done.

We can make a whole bunch of much more precise diagnoses. We can follow progressive illness or progressive non-illness like pregnancy in a way that just right now is fantasy. So I think that’s incredibly compelling. I think not capturing that information is crazy. But again, part of that is education, and it’s getting people to appreciate that sleep is not one thing. It’s not localized only on the surface of your brain. And we should build on that. We don’t throw it out.

We should build on that knowledge and expand it to actually include your entire body as a system. So that if all I have is your heart rate and your temperature, I know what to do with that. And I can still tell you a lot of health information that right now we don’t have the knowledge to make good use of.

Dr. Sohaib Imitaz: So do genetics play a part in this? Is the consumer genetic companies tell your chronotype? How do chronotypes work? What is the actual difference between people’s kind of sleep patterns? Is there is a certain range?

Dr. Benjamin Smarr: It’s an active research area. I mean, it’s a great idea. And there are definitely now some snips that you can look at on 23andMe, for example, that they say have some correlation with your circadian rhythm. It’s just actually a very complicated problem.

Your clock genes are many, many dozens of different gene products. They end up interacting with most of your genome. So something a lot of people don’t know. Most of your genes, the majority of your genes, when they get to be active, is regulated in part by your clocks. And so, we don’t have enough knowledge about the differences between different people’s behavior, sleep, et cetera, and their genes to have that kind of map. Be very precise.

You can learn something right now just by going and getting your genes sequenced, but it’s not where it will be, right? Let’s say five years from now, far enough that none of us can really see clearly. It’s totally possible that by then we would have a much better understanding of the kinds of sleep structure that we expect, that look healthy, that are correlated with specific gene suites, and that we might be able to say “You’re a seven-hour sleeper and you’re a nine-hour sleeper and you’re predisposed to extra deep sleep, et cetera, et cetera.” Right now, that knowledge is not really in place. We need to build it.

Dr. Sohaib Imitaz: And how does one work out how much sleep they need?

Dr. Sohaib Imitaz: Exactly. I don’t know how to work it out for you. So that’s one of the reasons that I do self-experiments. Quantified self-kind of stuff, as I say, what’s the kind of knowledge that I can get? Sometimes it’s subjective. How do I feel when I wake up? How sharp do I seem to be? Some of it’s quantitative. What’s my heart rate? What’s my physical resilience to a workout? Etc., etc., Am I getting sick? And I can go back and I can look at, well, what was my sleep like for that? How stable has my routine been? Just flying to the UK for a meeting and now everything is messed up.

The more that I do that, the more I get a sense of the kinds of variables that are at play that I can then fold into my own academic research. And I do that. I think the force amplifier going forward though is to get everybody. I mean, as many people as possible to do these things because you will have experiences that I couldn’t possibly add to it, right? I’m not you. And so if we don’t capture that in some way; if you don’t share that in some way, how will we ever know? So I just think that’s incredibly important.

Dr. Sohaib Imitaz: Crowdsourcing all that data and knowledge, which I think you’re right. So do you think supplements or are there any supplements you think might help with sleep? Or also adjuncts like blue light blocking glasses? I’ve started using them recently. Do they work? Is that a good thing?

Dr. Benjamin Smarr: I think sunlight is the best thing. You know the list of pills you could take is semi-infinite. I won’t go into all of that. The blue lockers do have some effect, but as far as I can tell. Getting good sunlight during the day really buffers a lot of the problems that you have at night. It’s just such a strong time signal that if you really let yourself get sun exposure, certainly your skin, certainly your subdermal layers, certainly your eyes and your brain, take that as information to tell the rest of your body.

This is definitely daytime. And if you get those strong cues during the day, you’re much more resilient to looking at your computer screen at night. Not to say that blue blockers are not also a good idea. Not to say, you know, a lot of people are deficient in vitamin B12, vitamin D. Things like this that you can take. But one thing to think about whenever you take a pill, your body was generating or metabolizing whatever that was in some rhythmic fashion to which you are mostly blind. And you just thrown a big bolus on top of it. And that may or may not have been the right thing to do depending on whether or not that screws up the timing of what your body was already doing.

So I tend to be much more a proponent of sort of intelligently crafting your diet, trying to eat at a routine time and letting your body make use of those things rather than say, like, “Before I go to bed, I’m going to throw a bunch of stuff in there because I heard it was going to sleep.” It’s unlikely to do a ton of acute harm, but it’s unlikely to be as useful as everybody would like it to be. And the money and the energy are probably better spent doing some thoughtful self-experimentation and investing in better curtains. Blackout curtains or something like that.

Dr. Sohaib Imitaz: So as you said, light is very important and so are our routines in forming these habits. With a lot of the students obviously working with Owaves probably the most erratic time of your life when you’re trying to form a lot of these habits, right? I mean, the being at the universe for quite a few years, I remember it was a constant struggle. But motivation is something which is hard to measure. But I know when I’m living a healthier life or I’m sleeping well, I am more motivated, generally.

Dr. Benjamin Smarr: Absolutely.

Dr. Sohaib Imitaz: And with that for more measurable. Or you could say things that are more visible. A lot of people do comment on things like people look tired. Now, look, it’s hard to quantify unless you kind of use some type of visual comparison. So skin, I’ve heard. I’ve heard things I skin turnover happens at a certain time before 2:00 a.m. I don’t know if we can be that specific, but just, you know, what’s out there in the media. So if you’re sleeping late, you’re not getting the optimum skin to skin cell turnover.

Dr. Sohaib Imitaz: And with that, obviously, you talked about kind of your different organs having their own kind of rhythms. So are you accumulating more fat at night if you eat, if you’re eating late? I feel these types of metrics for people who are young can really help motivate them.

Dr. Benjamin Smarr: Yeah, yeah, yeah. That’s a good point. So because a lot of these things are our feedback loops, right? You if you have the motivation, you sleep. As a result, you get better motivation. Yeah. The fat is a great one, right? And such and pin down at the sock has been really leading this charge. But there’s a whole bunch of researchers actually now engaged in the field. I’ve done some of it myself. And it definitely seems to be the case that, you know, you eat exactly the same meal at 2:00 AM versus 2:00 PM. At 2:00 PM, your body burns it up and uses it to keep you going. At 2:00 AM, it just puts it on the shelf as fat. Same exact meal, right? So it’s not just what you eat.

It really is definitely, also, when you eat. In a way to think about that is, you know, just like your brain needs to sleep so that you have emotional refresh and memories and all that. You know, your liver needs to have time to clear toxins out. Your stomach needs to have time to regenerate. And so if you throw things on top of them at the wrong time. They’ll stop what they’re doing and they’ll say, “Oh, OK, crap. I guess there’s a big piece of pizza here at 2:00 AM. We need to deal with that.” But A, they’re not gonna do it as well because they weren’t ready for it. And B, they’re not doing the maintenance. They would have done otherwise.

And so, you know, at a certain point, you can think of it almost just like desperation where your body goes, “I don’t know what to do with this. Just put it somewhere, please.” Right? And so again, having a routine, letting your body anticipate what’s coming and respecting the fact that time is a biological variable. You have genes for it. Your physiology is based on it. You just have to roll with it a certain point if you want to be healthy.

Another analogy I like to use is feeding people wood pulp. It would be very cheap if we could just feed everybody wood pulp. It would be very economic. So why don’t we do it? We don’t do it because you can’t digest wood pulp, right? You would starve to death. Say nothing of having splinters in your teeth. You can want to eat wood pulp. You can make economic arguments for eating wood pulp. But biologically, you just can’t. Time is the same thing.

You can want to stay up 24 hours in a row. You can want to get more work done. Biologically, you just can’t. Your body is built-in with these rhythms, and the more that you can settle instead of fight against them, the better your body is it at pretty much everything.

Dr. Sohaib Imitaz: Performance has really improved, it seems because performance is very important academically during college and with sports athletes in particular as well, I think. Are there some studies which show that the time they practice or train? I’m thinking maybe Simone with academic performance with exams. Can you train yourself at certain times to you know, that behavior?

Dr. Benjamin Smarr: Absolutely right. That’s right. The time of day, according to your biological clock, is part of the memory. And so if you play or if you take an exam at the time of day when you practice for it, you’ll do better.

Dr. Sohaib Imitaz: I’d say you’re feeling sleepy in the middle of the day, should you sleep? How do you answer that question?

Dr. Benjamin Smarr: I’m pro-nap generally.

Dr. Sohaib Imitaz: Yeah.

Dr. Benjamin Smarr: You know, even nocturnal animals have siestas after lunch. It turns out it seems to be a pretty basic thing that there’s this big rise of energy and activity after your main sleep out, whatever that was. And then, you know, after several hours, there’s a rest period. There’s an intermediate sort of smaller maintenance cycle. And then there’s a big boost for humans in the evening. I think there’s a reason that siestas are part of a lot of different cultures.

Pretty much every continent still has cultures that celebrate siesta. And one of the things that I think is kind of a shame is the push to get everybody on to, I guess, what I think of as factory time, like 9:00 to 5:00, because there’s such an economic impetus behind that. It tends to bowl over the accumulated wisdom of a hundred thousand years of human beings being human beings, meaning that more and more countries are getting rid of siesta.

So long lunches are this sort of thing because obviously it’s so important to be in the office 9:00 to 5:00. I think it’s very short-sighted. I think that if you see that everybody in the world seems to have a trend towards doing something that seems to have been an important part of culture stomping on it because it’s cheaper right now is probably short-sighted.

Dr. Sohaib Imitaz: And with broken sleep versus unbroken sleep. Is it about getting a number of hours you may need? Does that number of hours vary by day? Say, if I’ve done some heavy lifting one day or, you know, I’ve been very physically active or alternately been quite stressed and worked really hard in other sense or maybe emotionally drained, are there certain levels of exhaustion that in your sleep needs varies from day to day? And then if you’re someone who’s sleeping but wakes up and then sleeps again is not the same as continuous sleep, should we value continuously more than broken sleep?

Dr. Benjamin Smarr: It depends on how broken it is. I mean, definitely those changes in need, right? So the sort of simple model for this within the sleep and circadian communities is what they call the two-process model. And that’s basically the idea that what puts you to sleep is your physical exhaustion. So exactly like you say, if you’ve been really active, if you’ve been working really hard, your body just has more wear and tear to deal with, and that translates into sleep pressure.

And so you’ll go to sleep and you’ll stay asleep longer in proportion to how active you are. Around the middle of the night, your circadian system comes on, and that’s the second process. And independent of whether you worked hard or not, your circadian system will say, “OK, well, it’s the early morning. You should probably be asleep for that.” And that’s, you know, promoting then partly the change from deep sleep to REM sleep, which is deep sleep happens earlier, REM sleep, mammals later. And that’s partly why they’re coming from different drivers.

Different processes, and so it makes sense if you think about it, if I didn’t work out a lot, you know, maybe I’ll go to sleep at the same time. But I just won’t have the sleep pressure to stay asleep. So maybe I’ll wake up around midnight and then my circadian clocks will kick in and I’ll go back to sleep and I’ll stay asleep for a few hours because of those. So there’s a reason why lots of people wake up in the middle of the night.

If you’re asleep and you stay in bed and you sort of wake up, you go, “Oh, I’m awake and you roll over and you go back to sleep.” It’s probably not ideal, but it certainly isn’t the worst thing. What’s a problem is if you really can’t consolidate your sleep. Which part of what I was talking about with aging earlier, where if you really have fractured sleep, you sleep sort of a half-hour at a time and you’re tired all through the day and you’re taking a lot of naps.

That’s really bad for you. So having enough consolidation that you can get some good sleep makes a big difference. And to the extent it’s interrupted one or two times, you know, that’s a great quantified self-opportunity. What am I doing? What could I change? That helps me sleep through the night. Where it gets more serious is, you know, you’re aging. You have if you’re obese, maybe you have sleep apnea. And that’s waking you up potentially many times a minute.

That’s really killing your sleep quality. And that’s literally, therefore, probably kill you. And figuring out, in that case, is not how do I sleep for a few more minutes? But how do I get my body to a state where it’s able to do consolidated sleep? That should be a big priority.

Dr. Sohaib Imitaz: I’m talking about the quantified self again. It’s quite interesting because you reminded me of now continuous glucose monitoring being so widely available as of now, I know exactly why I’m looking to actually use one in self-experiment, but it’s interesting because I’m how your glucose responds to insulin response changes with changes in your sleep in the morning. And that’s something you could really measure and find out what is affecting the timing of your meal as you exercise, but especially in your sleep deprivation. So that’s something I’m excited about.

Dr. Benjamin Smarr: Now, it’s very exciting. I mean, there is only gonna be more tools in the future. There’s only going to be more data that we have access to. It’s an incredible time to start getting interested and learning how to think about these tools and how to think about your own body. I’ve done a bunch of different experiments on myself with the glucose monitors. Now, Gary agree to heart rate and temperature and sleep timing and all these things. It’s fascinating.

You learn so much so quickly. Just because you have a new lens, you have a new part of your body that you can actually see. It’s so cool. You know, a lot of times the effects are not subtle. People sort of, I think, anticipate like, “Well, but I’d have to know how to do signal processing analytics to make sense of continuous glucose.” You really don’t, like you look at it and if it’s a gigantic mountain that lasts for hours, you did it wrong. You know, you can eat lunch and you get up and you walk around. It was down fast. If you just sit there all day, it stays up longer. It’s really clear you can definitely see how your body deals with it differently.

Dr. Sohaib Imitaz: It’s really empowering.

Dr. Benjamin Smarr: Yeah.

Dr. Sohaib Imitaz: Coming into your day with all this kind of data or collecting on yourself, how do you generally run your day? What time do you wake up? What time do you sleep? Do you fit in socializing, exercising? When do you have your meals? Do you do time-restricted feeding or fasting? Do you use any sleep adjuncts? You know, weighted blankets? Is a cool temperature used like that to help you get to sleep? Can you tell us about that?

Dr. Benjamin Smarr: Sure, absolutely. So I’m pretty routine. Maybe not surprisingly, it started with a passionate hatred for my alarm clock in high school where I hated it so much that I would wake up literally one minute before it would go off so that I could turn it off. And that was part of the Inception, right? At the time, I didn’t know anything about circadian rhythms. Back in the 80s and 90s, we didn’t know about that very much.

And so it was one of those things that stayed with me. And I go, “Wow, how did my body know how to do that? But what’s the point of the alarm clock if I can get up when I need to?” So I don’t use an alarm clock. I think they’re terrible. They smash them at the end of your sleep. So if you can avoid them, I recommend it. I wake up. Let’s call it on average, six-ish. And I’m pretty seasonal, so I’ll sleep in more when it’s dark out, I’ll wake up early or when it’s light out.

Just something I’ve learned.  And I tend not to eat breakfast. I used to like breakfast, but I realized that I get my best work done in the morning and if I eat it, it sort of slows me down. I spend time digesting and then I sit down at an hour has gone by between cooking and cleaning and digesting, and I just value the time too much. So I like to get up and as soon as possible put my mind to work. And then by sort of eleven or twelve, I’m already becoming stupider. And so I’ll take a walk. I’ll eat my lunch. I’ll try to switch tasks right in the morning.

I try to do creative work. I love doing data analytics. I love sort of writing pieces. In the afternoon, it’s time to slog through paperwork, it’s time to slog through cleaning the lab benches, etc. Much more rote stuff. And then I’ll eat dinner at probably between 6 and 7, which feels early to me still. I used to eat later, but it’s just become my habit. And so the effect is I’m not really eating outside of between like 11 a.m. and call it 8 p.m. from the end of dinner. And so that means there’s a lot of hours in the day where my body is able to process all the stuff I put into it that I’m not just throwing extra wood on the fire. And I think that’s really good.

So definitely looking at my glucose data and others that have done this kind of thing with me, it’s very clear that your glucose becomes more stable as a result. I’ve been able to actually look directly at my stomach contractions across the day. They start to line up with your meal timing. It’s very cool to see it. And so, yeah, it definitely feels like your body is getting used to this and anticipating what’s coming and making better use of the energy. So that’s really good. It helps you to lose weight for sure.

If that’s your thing. And then like I said, I’m an old man, right? So like, by 8:30. Honestly, I’m getting tired. I’m very happy to be asleep by 9:30. Usually, I’m probably not actually asleep until 10:00 because I’ll stay up and read or something like that. But you know, that means that I’m getting a good 8 hours every night between 10 and 6. And in my eight hours right there, I go to sleep because I’m tired. I wake up because my body wakes up, not because of an alarm clock. And that just feels really good. When I travel and I can’t do it, I feel the difference.

You know, if I’m on vacation, we’re doing the holidays, right, and you’re feasting and you’re staying up late drinking with your family and your friends. It’s good for a little while, but at some point it just becomes tiring. And part of it is just it’s interfering with this normal rhythm that my body has. So that’s my day. You know, socializing, I guess what I really like is lunch and dinner meetings, right? If I can socialize with somebody and we share a meal and we talk things through that seems very civilized. That seems to fold in well. I’m not really a stay up late drinking with your buddies kind of guy. There was, you know, in college. I did more of that and it’s fun. But I feel so much better when I get my sleep that I value that more.

Dr. Sohaib Imitaz: Cost-benefit analysis.

Dr. Benjamin Smarr: It’s just organic. It just feels so good. I know my body works and it feels good and my brain works and it feels good. And that like that. And it just I’m so aware now the difference. I think one of the things we go to college in this culture and you stay up late and you drink and you eat pizza and you just sort of beat the hell out of yourself and you get used to it, right?

But when you stop, when you get off the wagon, you realize how different it feels when you try to go back, right? You get your body into a healthy state and then you go, “Well, like I’m young and I’m resilient. I can still do this.” And you’re just much more aware of how much it actually hurts. And to me, I just don’t care enough. So I stopped doing a lot of that stuff except rarely whether like I’m at a conference and it’s people I don’t see except every couple of years. I value the time. I stay up. I really make use of the time. But I don’t do it idly. It has to be something that really matters to me.

Dr. Sohaib Imitaz: Too many humans. It feels like are living in a suboptimal state. And you kind of forget what it feels to feel a lot and, you know, conscious and, you know, not tired. And you’re right. When you get used to one state that becomes normal.

Dr. Benjamin Smarr: When you can almost normal, and it’s insidious.

Dr. Sohaib Imitaz: Yeah. And do you exercise? Do you make time for any sports? I know you’re very busy with all your academic work.

Dr. Benjamin Smarr: I’m not a big sports guy. You know, I, again, sounds old many. I like doing hikes. I walk several miles a day just instead of commuting. And then I do Tai Chi. It feels good. You know, it stretches your tendons. It gives you a space to sort of mentally slow down. It provides a sort of a frameshift in that way for me. So I like that a lot. But no, you when I lift weights sometimes, but honestly, the habits come and go probably seasonally. I think in the summer I feel a lot of energy and I lift weights and I go, “Rawr.” And then in the winter, I just want to turn into a bear and like, eat food and be in bed all day.

Dr. Sohaib Imitaz: You’ve got your rhythms that are seasonal.

Dr. Benjamin Smarr: I mean, I seem them too. I don’t fight it. It just is.

Dr. Sohaib Imitaz: And do you make any time for conscious awareness and meditation or mindfulness?

Dr. Benjamin Smarr: I do very little, but I think my answer to this sounds funny just because it seems to be different from how other people do it, but through various events too long to describe here I got exposed to mindfulness and meditation and self-awareness and things like this actually at a very young age. And to me, it’s part of my life. I mean, I’m almost… The flip side, which is unfortunate, which I’m willing to confess is that I’m almost never just mentally in one place, right? So I’ll be doing work all or even- I’m sorry, I’ll be having a conversation and half of my brain is on some other thing.

And a lot of times what it’s on is sort of doing body scan stuff. Right. Doing breathing stuff, saying, how am I doing? How can I reset myself back into a relaxed state? Am I feeling distracted by things or am I feeling excited about something? If I’m not feeling excited about something, whereas my attention such that I can figure out what the problem is and get back to a healthier state.

I think these things are incredibly important. And you know, all I can say is people tend to think of me as positive and energetic and patient and resilient. And I take that as input that these things are doing something. You know, I’m mostly aware of the things I want to improve. So I don’t know where I am in the scheme of things, but it feels very weird to choose not to try to be self-aware in that way, I guess.

Dr. Sohaib Imitaz: They seem like some amazing traits that a lot of people strive to have and it seems like your balance is working for you well. But as you said…

Dr. Benjamin Smarr: I mean, it takes years of discipline. Things aren’t easy. It’s just I happened, you know, through no fault of my own, I happened to get on the bandwagon very young. And so I’ve had many years of practice at this point. And I think it makes a huge difference.

Dr. Sohaib Imitaz: Good things are always difficult and it’s something you practice. But it’s interesting how you can align these kinds of traits with someone who is kind of very looking at things from a data perspective and quite quantified.

Dr. Benjamin Smarr: Oh, totally. I mean, I think one of the big opportunities we face is recapturing a lot of folk wisdom, right? So, I mean, I mentioned Tai Chi, but I talked to lots of clinical practitioners who, you know, they go, “Well, I do osteopathic manipulation or I do acupuncture or I prescribe herbs.” And I see it a fact, right? And it’s not canonically Western medicine. But to suggest that what doctor is between the use of 1750 and 1990 discovered is the end all and be all of biological knowledge is completely ridiculous. And so is all of folk wisdom definitely effective?

No, clearly. On the other hand, did that knowledge evolve in a system where people were trying to figure out what works? Absolutely. So throwing it all out makes no sense. And I think one of the really cool things about self-experimentation is you can start to build communities and actually make discoveries happen, right? You can get people together who say, “You know, I’m doing taichi or I’m not. And I’m looking at my heart rate over the day.

Or I’m taking my herbs and I’m seeing how that’s affecting my sleep and I’m quantifying it.” You know, we can start to figure out which for whom, what works and for whom and how would you know? Rather than just say, I believe in it or not. You shouldn’t believe anything. You should have reasons for thinking things.

Dr. Sohaib Imitaz: And with that, so as someone who’d like to self-experiment, do you believe that we need to give our body a bit of change from time to time? And you someone who is obviously probably very short of time and a lot of times with or the pace of academic research and the demands put on you, because the people who construct research and, you know, who make jobs, they are not necessarily looking at things from a circadian perspective or when they’re setting deadlines.

They’re not consciously aware of the person on the other side and looking at their health. So do you think our human body as a physiological system is something which maybe you can push through for a few days and be hyperactive and distracted and get the work done? But then you need to like you have these cycles, have a period or a cycle of when you’re kind of just functioning at your normal self and you’re not pushing yourself to this extra degree and you’re keeping this normal routine and rhythm.

Dr. Benjamin Smarr: I mean, I think that the rhythm enables the sustainable push. I think at this point, outdated analogy would be if for a little while and then it breaks down. And if you want to have sustainable creativity across decades. It’s just not a wise way to approach the problem. So I haven’t pulled an all-nighter since, except for I’m doing experiments which require 24 hours of gathering data because their circadian experiments, right?

I don’t do that for grant deadlines. Anything that I wrote between midnight and 5:00 a.m. would be garbage anyway. So I just plan that in. I think that it’s definitely the case that you should have plasticity. Why be healthy if it makes you fragile? That’s not health. So if you’re healthy, I think the whole point is like, occasionally; yeah, you know, enjoy a cream-filled doughnut. Do it. Stay up all night and watch the Star Wars trilogy again.

Dr. Sohaib Imitaz: Do it. At USC that’s something that is popular.

Dr. Benjamin Smarr: Yeah, fine. So, you know, you should enjoy life. What’s the point otherwise? On the other hand, to sustainably do that means not just burning yourself out. And I think the reason that I’ve been as successful as I’ve been so far, which is to say, you know, I haven’t drowned yet, is specifically because I don’t freak myself out and panic and stay up all night trying to do one more thing and one more thing and one more thing. And as a result, I have energy in the morning and my brain works cleanly and I get a lot done rapidly.

That works for me. So my suspicion is that a lot of people get in their own way, right? And I mean, I’m sure I still do this, of course. But I think there’s this culture issue of, you know, the amount of hours a day you spend working is proportional to your value. And I don’t believe that’s true. I think the quality of the work you do should be proportional to your value. And one of the ways to increase the quality is to do less invest in things like eating good food, cooking, loving your family, getting good sleep, and then when you turn on a problem, you’re really ready to crush it. You’re not just sort of chipping away at it half-assed.

Dr. Sohaib Imitaz: And to that, planning seems to be essential, and I couldn’t have summarized everything any better myself. It’s that balance between having these routines and rhythms, but in that also enjoying the moments in between.

Dr. Benjamin Smarr: Yeah, yeah.  Exactly that.

Dr. Sohaib Imitaz: And with that, do you have any tips for any in particular students who are struggling with maybe workloads? Or I mean you’ve explained it throughout this podcast of how it’s counterproductive, and down the line, you end up paying for the short term gains you could say, and there’s no long term benefit. But if you’re having trouble with the workloads or even trouble sleeping, is there anything, in particular, they can do to help with sleep and workload?

Dr. Benjamin Smarr: I think it’s very hard. You know, especially these days. Unfortunately, students are given just sort of an arbitrarily large volume of work for no particular purpose, as far as I could tell. And there’s a huge amount of social pressure that you have to get A’s and of course, if you don’t get into these schools than you might as well kill yourself. And some people do. It’s pretty messed up.

The advice I give my students is, to the extent possible, don’t do things because of fear. If you want to take a class in Eastern art history and you’re a pre-med, do it. Thinking that you’re going to scare yourself into having better grades than all the other scared pre-meds by taking slightly more biomedical classes and that somehow that’s what’s going to differentiate you, doesn’t make any sense. It’s just the herd stampeding away from the perceived lion. Just don’t. Make time. Value your own life. Do things that you think are interesting and let that help you understand where your energy is so that you can be using it productively over a long period of time.

It’s very hard to do in the moment. It’s very hard when you’re caught up in a system to be able to step back from it and not say, but the wheels are going to crush me if I step out of line. As far as I can tell, you know, if you have something you want to put your energy into, it’s very hard for other things to actually crush you. As long as you’re actually doing things, right? As long as your hobby is not lying on the couch. You gain perspective by doing things differently. You gain energy by doing things differently. You gain self-confidence by saying, I’m not going to do what everyone else is doing. I’m going to pursue what I’m interested in.

Those are all real skills and real values. I’ve never had somebody tell me, you know, Ben, the science you do is really good, but I’m looking back to your transcript and you didn’t only have A’s, so we’re gonna stop working with you. On the other hand, I have people approach me every day saying, “Wow, you have these really interesting perspectives that don’t seem to be standard for the people in your field. Let’s talk about that.” Right? Those don’t come out of magic.

Those come out of me choosing to read history and choosing to take walks and choosing to talk to people in sociology departments and choosing to do experiments on myself, even if I’m not going to make a paper out of it. Life gives you perspective. You know, I think to the extent that you can. You should try to embrace that. You know, I don’t want anyone to make their own life miserable and stopped going to classes and then be stuck with a ton of medical school debt. But trying to build habits that let you feel empowered in your own life. I mean the opposite, just the alternative. It just sounds really depressing.

Dr. Sohaib Imitaz: I think from what you’ve said, so many people can derive so much value and meaning and purpose from that going forward, especially young people.

Dr. Benjamin Smarr: I hope so, yeah.

Dr. Sohaib Imitaz: And hopefully Owaves can be that platform that has experts such as yourself disseminating such grand knowledge and wisdom upon young people to kind of help not only optimize their health but improve society as a whole. Because if we make these marginal gains in people, think how far as a society we can go in terms of academia and technology and advancements.

Dr. Benjamin Smarr: I mean, I think it’s a big opportunity. And the reason that I like Owaves is, it’s a tool for self-awareness. It doesn’t require remembering to charge things extra. It doesn’t require a lot of extra money. It’s just sort of part of your environment. But it’s helping you think about how am I allocating my time? Am I having a stable routine?

Are there other people that I could be building things with? In terms of, you know, time for the gym, time for relaxation, time for work, time for focus. It’s amazing to me how much of a difference, even just a little reminder can be. And those little tools that help you build, habits that help you become mindful are extremely valuable. So, yeah. I think Owaves has the potential to help do a lot of good with people.

Dr. Sohaib Imitaz: Which is great to hear. And you’ve imparted a lot of knowledge and hard science and data upon the listeners today. But also you’ve left with quite a few strong philosophical points as well, which is good as a complimentary freebie for the listeners. So nice. It was great talking to you, Ben. And I love that you’re part of the Owaves team and we’re working together.

And we get to work on such advanced things, which can help so many people. And we can kind of bounce ideas off each other and you bring that quantitative but also scientific background. And I think as a whole team, we can really make Owaves something. And I’d just like to ask, where can listeners follow you or find out more about your research and what you’re up to?

Dr. Benjamin Smarr: My response to this is always that I am very Google-able. But, you know, in terms of news articles or public outreach or science, I try to publish everything, open access. It’s easy to find things. I guess the other side of that is if anybody is interested in specific projects or thinking about problems, I’m always happy for people to reach out and get a hold of me.

Dr. Sohaib Imitaz: That’s very kind of you. And obviously, I’ll be working with you and talking with you very soon as well. It’s been a pleasure having you on the Owaves podcast. As someone who is incredible with Owaves and just generally really leading the frontier of change in medicine and the future. And hopefully from this podcast inspiring so many young people to do the same, but living a better, healthier life and really emphasizing their routine, circadian rhythms, and sleep. So thanks for being on the podcast, Ben.

Dr. Benjamin Smarr: Yeah, it is a great pleasure. So thank you very much for hosting. It’s a fun thing to be part of.

Dr. Sohaib Imitaz: Thank you.