Can improving your overall sleep quality be as simple as taking some deep breaths? When our Heart Rate Variability (HRV) changes, it will determine how good we feel throughout the day and how well we sleep at night. Dr. Ty Canning tells us all about a new type of biofeedback device, the most accurate health tracking device you can get on the market. With this device and a few other tips around breathwork, he explains just how the Lief biofeedback device can actively cue us to change some of our health habits. In this episode of Sleep is A Skill Podcast, you’ll gain insights into one of the most straightforward solutions for a good night’s rest and learn how to improve your quality of sleep over time.
BIO:
Dr. Ty Canning, Psy.D., is a Clinical Psychologist who specializes in behavioral sleep medicine and sexual wellness. The majority of his clinical work is done with The Clinic, a San Francisco based private group practice. He is the founder and director of the Precision Psychological Medicine Corporation and a consultant with several tech companies, including Lief Therapeutics and Lover.
EPISODE LINKS:
https://getlief.com/
Use code ‘sleepisaskill’ for a 10% off discount!
SHOW NOTES:
📈 What is an HRV Biofeedback Device, and how does it improve your sleep?
📈 Dr. Canning’s personal experience with using the Lief device
📈 How our HRV responds to the environment around us
📈 Why this device is better and the most accurate you can get on the market
📈 Devices take on tracking HRV but not influencing it – Lief can change it.
📈 You can’t control digestion, you can’t control other things, but you CAN control this!
📈 Recommendations for raising HRV and shift habits or responses in your life
📈 What you can do to break the cycle that reaffirms not getting a full night’s rest
📈 How our sleep systems have changed over millions of years
Dr. Ty Canning, Psy.D.: Sleep Is A Skill Podcast [Video Glob...
Fri, 11/13 10:15AM • 35:54
SUMMARY KEYWORDS
hrv, people, heart rate variability, day, sleep, stressed, heart rate, device, breath, wear, moment, breathing, readout, parasympathetic nervous system, heart, exercise, absolutely, biofeedback, bit, clinical
00:00
Hi. And welcome to the sleep is a skill podcast. Ty, thank you so much for taking the time to be here. I really, really appreciate it.
00:13
Absolutely happy to be here. Thanks for having me on.
00:15
Absolutely, yes. So we already got an opportunity to speak a little bit before we started in. And there's a lot. So I think we could just start at the beginning of how it is, you know a little bit about you and how you got involved in HRV as it relates to this product belief, but also just your passion around that.
00:38
Absolutely, yeah. So, a little bit about my background, I'm a licensed clinical psychologist. I did my citee program at the PG SP Stanford Consortium. I've been doing clinical work for about the last eight years now. And about five years ago, I started to specialize in sleep, behavioral sleep medicine, and have done done a lot of rotations, and then my postdoc in a behavioral Sleep Medicine, space. And also, actually, about five years ago, I started working with Ron, the founder and CEO of leaf therapeutics. And he asked me to help him with sort of the clinical side of his device, which is a HRV. Tracking, and also biofeedback HRV biofeedback device. That's the place in which I'm getting onto your podcast at this moment.
01:39
Right. Got it. Okay. Very cool. So, yeah, you are certainly have a lot to discuss in the world of sleep and how that relates to HRV. And how that's all interconnected. But so maybe you can help explain for people that aren't as well versed, just a little brief overview of HRV. And why we care about that metric as it relates to sleep.
02:03
Absolutely, um, HRV is, I guess, at the, at the most basic level, the variability in heart beat from B to B. So our hearts are constantly responding to our internal and external environment. And when we, for example, when we breathe in, our heart rates go up to increase sort of blood oxygen transfer and, and the lines. And then when we breathe out, our heart rates go down to conserve energy. And there's this constant variation, moment to moment of our heart rate. And that is what heart rate variability is, as a measure. heart rate variability is also linked to a lot of different systems in the body. So the vagus nerve is innervated, to the heart, the lungs digestive system, and that is connected to the parasympathetic nervous system. So when we increase our HRV, we're activating pretty directly the parasympathetic nervous system, I know, it's a little bit of the, you know, the, the leg bone is connected to the fiber on there, but it's, that's sort of the order of operation.
03:22
Got that? Okay, really cool. And then, you know, because it's depending on the the people in the audience, some people are already avidly tracking their HRV. And some people, it's kind of a newer concept. So I appreciate you, kind of giving us the groundwork there. And now for those people that are well versed in HRV as far so why might they want to really take on improving and making a difference with this metric, particularly if they're looking to optimize their sleep?
03:55
Absolutely. Yeah, I mentioned briefly before we got on to recording but a lot of the things out there a lot of the devices out there are tracking HRV but they're not teaching you how to directly influence it. And so what leaf therapeutics or leaf, yeah, leaf as a, as a biofeedback device is doing is helping you actually directly change your HRV and improve your HRV The reason that that's important is in relation to sleep. HRV there's a there's a study done in 2015 by Gabriella Warner. And what they found in that study was that pre bedtime heart rate variability was correlated with well in high pre bed time HRV was correlated with reduced sleep latency, improves quality of sleep, reduced number of arousal. And this makes this makes good sense when you are a you know, are ancestors, right? These sleep systems are 100, you know, 100,000 years old. If your ancestors sleeping in caves, and you are not feeling safe, you're going to have a low HRV. And that's going to contribute to poor sleep quality, which in that situation is actually going to help keep you alive, right, you want to be sort of on edge throughout the night. So if you're in a dangerous, potentially dangerous situation, your HRV is going to be low. And that's going to lead you to not sleep well, which ancestors sleeping in caves, great situation to not sleep well. However, in our modern day society, the things that contribute to low HRV, and our stress levels, those are things that are not life threatening. And then when we don't sleep, well, it ends up sort of reinforcing the cycle. So contrary to that, if you are feeling safe and secure and relaxed, you're going to have a high art HRV, and you're going to end up sleeping better. So with lif and with this as a bio feedback device, you can directly intervene to improve your HRV and therefore lower your stress and therefore improve your sleep.
06:13
Awesome. Okay. So normally, I wouldn't do this with a podcast, you know, getting so into the actual product itself, but I do feel like so many people, and I get so many emails about, okay, my I cannot move my HRV it's just stuck. Like, I there's must be something wrong with me. But so I do think that this is a unique thing enough, that makes sense and warrants to speak to so just, if anyone's you know, for the for the watching element of it, this is kind of what it looks like the product. And so it's, you know, a couple inches big and you would put it on, on yourself throughout the day. And so maybe we can speak a little bit to So once this thing is on you throughout the day? Or or if you have any kind of or if you could walk us through what this would look like and how does it help us distinguish to shift our HRV? In the moment?
07:11
Great, great question. It's constantly tracking HRV. It's, it's pushing those notifications to your phone via Bluetooth. And actually, let me backtrack just a little bit. Regardless of it pushing or not pushing information to your phone, your phone can be, you know, you could leave your phone in your car and be you know, without your phone and still have the device function exactly as it should function. So within the device, it's also tracking your HRV. And it gets a sense over the course of a day or two, when you first start wearing it. Where your baseline HRV is and where a healthy range for you is. When you go outside of that range, mainly when you go lower in that range, then it's going to give you a little alert, it's gonna give you just a little vibration, a very discreet, silent vibration that you feel because it's on your skin. And then it's going to help guide you in a breathing exercise. The breathing exercise takes advantage of this increase in heart rate on the inhale inhalation and the decrease in heart rate on the exhalation. And it's really trying to maximize the deceleration of your heart rate, which is the way to maximally impact your parasympathetic nervous system and get you into a state of calm and relaxation as quickly as possible. That, yeah,
08:45
that's God, that's great. So so that's happening, right? And then so there's so many people that say, Okay, so then but what do I do? So now it's, I'm dropping, right? And this come on? Is it breath work? Do I need to is it alert for me around types of foods I'm eating air quality, is, you know, just all of these different things people have questions about, he's there kind of like a top down approach that then you have people work within to then when now we know it's kind of tanking. And then what do we do in that moment?
09:24
The short answer to your question is it's breath. Yeah, short answer is yes, it's breath. And the reason for that is the fact that the vagus nerve, which is connected to the parasympathetic nervous system, is connected to your heart, your lungs and your digestive system. So when we have this fight or flight response, your heart rate is going up, your breathing is becoming shallow and rapid, your digestion is shutting down among a bunch of other things. The only thing that I don't know about you, but when I'm sitting here, I can't just be like, Oh, I want to increase my heart rate. Oh, I want to like change my diet. digestion, the only thing I have access to is my breath. The only thing I can directly influence on my own is my breath. So that's why the breath is the entrance point for increasing your HRV. Over time.
10:15
I love this so much, because I just feel like it's it's been, it can often land is like that soft skill like or, you know, a fringe thing like, Oh, yeah, sure you're breathing, whatever. But give me the good stuff. What do I need? And yet? Well, when it comes to that point, I think it really helps people to really get the gravity of that moment to moment activity that we're doing often on, obviously, autonomically. But how we can tap into having our own say and how that goes. So go ahead, I was gonna ask you just Yeah, go ahead.
10:50
breath, breath is so underrated. And unfortunately, it's been pulled into this sort of colloquial like, Oh, just take a deep breath kind of thing. Yes. And, and it really does a disservice to how important our breath is. And it also unfortunately, keeps people from taking advantage of such powerful tool.
11:13
So true. And that's why you know, for a lot of the people that are listening tend to be more of that kind of type A, or, again, this is stereotypes, but like, part of what we hear is that challenging aspect of how to slow down. And I think if even if it takes a metric like this, and a tool like this, I think it can be an awesome, awesome entry point, to awareness, and that real time kind of biofeedback. So then is there a suggestion to around the type of breathing or techniques or is it varied? How do you approach that for the slowing of the breath?
11:59
I will describe this at the risk of the common misunderstanding that something that is simple is easy. So it's very simple. It's not easy. So basically, the long and the short of it is we see for a reason. Yes, we do it because it's soothing. And that's, that's really all this is you're taking a natural, easy inhale, and you're having a long, smooth, slow exhale.
12:42
Wow, got that.
12:44
And, and the thing, the reason why the biofeedback portion is important, right? Just Just First off, if you're listening to the podcast, you should start breathing this way right now.
12:57
Right,
12:58
short, short, easy, natural inhales, not super short, but like a natural inhale. And then a long, smooth flow, that slow exhale. The reason why the biofeedback is important is that we're not always aware that we're stressed. I don't know about you, but I've had moments where my toes have been curled for an hour, and I'm like, oh, why are my toes? What am I toes hurt? Oh, yeah, I've been stressed and curling my toes for last hour and didn't even notice that.
13:28
Exactly.
13:31
What leaf does is it alerts you to the fact that you're stressed? Which, you know, again, like it does, it seems like, Oh, well, I already know, when I'm stressed. The fact of the matter is, we actually don't know. And we're stressed we're notoriously bad for recognizing our own stress. So it helps you recognize when you're in a state of stress. And then the reason why the biofeedback is important for the breathing is that it makes the breath training really efficient.
14:01
Got it? Yeah, because a lot of people I've spoken with that they're they're looking to particularly impact or, or to shift their results with their HRV. They might have gotten. So some examples. people doing a lot of different testing, and maybe they get back their cortisol results throughout the day. And they see that either one they've like flatlined, or two they're having really high spikes in cortisol, and they're trying to pinpoint at different points throughout the day when they're particularly stressed. Do you see situations like that? where people have kind of abnormal responses throughout the day based on either just long term chronic stress? And is this something like are there groups where it's almost like a lost cause? Or is there always something that we can do no matter where they're beginning?
14:52
Um, I like to think that nobody's lost cause and that's me being a psychologist And, you know, really believing in the power of people to change. People do have different kind of tendencies in their bodies. So for example, and this is not the only one, it's just the most sort of accessible and relatable. One is that when we're hungry, our cortisol levels are going to skyrocket and our HRV is going to go down. low blood sugar is correlated with high. Yeah, with high cortisol and high cortisol is correlated with low HRV.
15:40
Great call out because a lot of clients are wearing continuous glucose monitors, and trying to really pinpoint and regulate that blood sugar stability throughout the day. So would you say that this could be a nice compliment? If you're looking to kind of even that out, you can see very clearly when that's happening when you're having that instability in the blood sugar.
16:03
We haven't gotten data yet to kind of show the direct correlation between belief readout and a blood glucose monitor. But I would predict that it would be pretty well correlated.
16:19
Absolutely, yes. Well, I will start mining that data over here on my side. I guess
16:27
the reason the reason I present that as an example is to go back to your original question is that there are trends throughout the day for everyone. So you know, if you have a meeting with your boss, at three o'clock every Tuesday and your bosses, you know, you're not a huge fan, and it's a stressful thing. Your HRV is going to start going down around 230. And guess what, when you're wearing the leaf, you get that alert that says, Oh, hey, by the way, you're stressed, and you're about to go into your meeting with your boss, probably you should do a breathing exercise, going right into that meeting, so that you are more relaxed, and you're going to be more effective.
17:12
This is so exciting. I mean, because you know, the implications of this can be so profound, if more and more people were to take this on, just the course of your day can look very, very different. And then the experience of putting yourself back in the driver's seat versus Oh, my God, why did my day go the way my day when then you can kind of beforehand preemptively make a difference. Wow. Yeah, really cool. Okay. So then, a bit more about the actual product itself? Because again, I think it's might be new for a lot of people. What does it look like throughout the course of the day? Are you able to exercise with that? Will that give off weird readouts? What? Is there any sort of recommendations around that?
17:56
Yeah, great, great question. So it's designed to be worn all day. It's not designed to be in the shower, the eg the electrodes just don't like it. So you know, that's not a not a thing. can't wear it while you swim. The stability while you're exercising is very good. That being said, when you exercise, your HRV is going to go down? Yes, because your heart is responding appropriately to a stressor, exercises, a stressor, right. So it's a good stressor, but it's the stressor is your heart rate is going to be like a metronome while you exercise. And that means that your heart rate variability, the difference between you know, your heart, the difference in your heart rate from beat to beat is going to change, it's going to go down. So while you're exercising, it's not going to necessarily give you that useful of data, it does track your heart rate. So if you're interested in that while you're exercising, and that can be helpful. But in terms of HRV as a biomarker in terms of its utility, while you're exercising, probably not as useful. Sure. Recovery afterwards. Absolutely. So if you are done with a high intensity workout, and you want to return your HRV back to a good high rate, high level, then you can use the leaf biofeedback exercise to get yourself back into a state of high heart rate variability.
19:26
Got it? Okay. And then, so we're wearing it throughout the day, we're seeing tendencies, you know, that mid afternoon possible drip or different, you know, depending on the person naturally, so different times throughout the day, and then we get to the evening and as you indicated to for improving our sleep, that being really aware or having that ability to be aware of what our HRV is looking like leading up to bed, it can be really powerful. Are there particular things that you suggest for people to do that seem to have good reasons for raising that HRV pre bedtime
20:04
I, again, at the at the risk of sounding redundant, the breath, the breath and the device, the device, the device guides you through the breath. And it guides you through the breath in such an effective way. So, initially, when we first start breathing in that way, our heart rates change after the breath. So we inhale and our heart rates, then just millisecond later they go up, we exhale or her age, just a millisecond later, it goes down with the device, what you'll notice is that it's showing you that little bit of lag. And it's going to help you to line up your breath, and your heart rate variability perfectly. And when our breath and our heart rate variability is lined up perfectly, that gets us into a state of what's called coherence. It's coherence between the breathing and the heart rate and the heart rate variability. And for whatever reason, when we get into that state of coherence, it's like 10 acts on our parasympathetic nervous system, it just like, rockets it through the roof.
21:16
Wow, so interesting. And then do we keep it on while we sleep? Or are we taking it off before bed? How does that look, before we actually fall asleep?
21:28
Some people wear it at night just for their own curiosity on their heart rate variability, you're probably not going to get like a biofeedback dose in the middle of the night. Because your heart rate variability at night is going to be pretty high. Generally, it's going to be higher than your baseline generally, during the night, you know, when we're, when we're sleeping, we tend to be fairly relaxed. It's a prerequisite, we sort of have to be relaxed to sleep. So therefore, when we're sleeping, we're relaxed. So no, I typically take mine off at night. Yeah, I don't worry throughout the night.
22:05
Make sense? And now I know, I'm sure this question is challenging to answer. from a perspective of, you know, people want to know, like, Okay, so what can I get out of it? So, is there any expectation of the amount that they can raise their HRV? Or is it just across the board? You know, depends on the person's commitment? And like, Are there timelines that you suggest or that you see a standard for people? Or is it vary case by case?
22:36
It is case by case, a lot of people see improvements in their baseline HRV. After two weeks, wow, the program that we're doing is an eight week program. So we recommend people wear the device for at least eight weeks, we have a, we have sort of like a coaching model, where people have a personal coach that they can reach out to, we have built into the app, sort of instructions and guidance and troubleshooting and all that that's already already built in there. So we recommend that people wear it for eight weeks, as many hours during the day as they can and want to. And there's, there's so many reasons why having something that's going to alert you in the moment when you're stressed, is valuable. First off, it just helps you become aware of what's going on around you. It helps you identify the things that stress you out the times that will that you get stressed. And then having that sort of consistent companion of something that's going to guide you through a breathing exercise in that moment. And it's going to remind you of like, Oh, hey, this is important. That that is valuable. And after eight weeks or so, you know, you a lot of people do choose to then just get the device forever. And they purchase device instead of renting it from us they purchase it and you know, after eight weeks, they still have the they'll have the device and they'll use it. You're gonna get pretty good after about eight weeks of, of using the device at recognizing your own stressors, you're going to be much more aware of your stressors in the moment, because you've gotten that training of like, Oh, this alerted me in that moment. So instead of having your toes cold for a half hour, you have your toes cold for a minute and then you're more aware of whatever that state is.
24:40
Not that Okay, so and then from the psychological perspective, do you find certain clients that are people that are using this that when they get that alert that they almost get more stressed or it takes a period of time for them to learn how to what to do in those moments, for example, like I'll have different people that say I tend not meditate, it makes me more anxious. Is there any of the kind of expectation or framing that we say for people that okay, it might make you a little freaked out for a little, but it will over time be beneficial?
25:12
Absolutely. So I have worked with some patients who just really, at first do not like to know what's going on with their heart. It freaks them out. And once they realize that, they can influence their heart and their heart rate in a hurry variability and a really positive direction that makes them feel better, that reticence pretty quickly goes away.
25:37
It's great, I love it.
25:40
Yeah, in terms of ramp up time, in terms of the server, nothing there in terms of ramp up time. When we first start breathing, in any sort of deliberate way, it's tough, it's tough to change your breath, it's automatic. So initially, you know, and a lot of us have heard like, Oh, we should be taking deep breaths, we should be inhaling a lot. So having this shift in focus from deep inhales to long, smooth, slow exhales is, it's a little clunky at first for a lot of people, but it's worth it.
26:17
Wow. So in your first of all, I just want to say that I'm like, smiling ear to ear tip thing, because I this makes me very excited for certain clients that, you know, just have had long, long term, identity, or connection to I'm an anxious person, I'm a depressed person. I like a lot of labels. And this idea that even for for those folks, then we can get in there day to day moment to moment and really helped to rewire that connection. That's just, I think, very, very exciting. And certainly important for this conversation around sleep, because then it just seems to often be heightened for many people. In that time, when they're just there's nothing about them and the bed. So really, really great stuff. And the other Yeah, the other thing I would say two is, I know that now this company has a different kind of clinical approach. So this is like a medical grade piece of equipment. We're not just saying like, Oh, you know, just another wearable? That's hasn't totally been tested or verified? Could you at all share a little bit any about some of the different kind of clinical results that you guys have been finding?
27:32
Um, let me see, I don't have them on the top of my head. I have I was not directly Oh, that's fine. In the in the study that we did. I was an advisor. And so I was loosely involved.
27:46
Oh, totally, absolutely no worries about,
27:49
I don't know, I'm not going to be able to give you exact numbers. But I do know that at the end of the eight week program, people's reported stress levels and levels of anxiety, depression scores, as well, using the using some really gold standard Ph. Q. GED scores went down to below clinical threshold. So people who were reporting being above the clinical threshold threshold, after eight weeks, they were reporting below clinical threshold. So it did help significantly over the course of those eight weeks to reduce people's stress and improve their mood.
28:33
Wow, really cool. Okay. And then the other thing I was going to ask is, for those people that say they're tracking, they have bunch of different trackers, and they're getting HRV numbers from all kinds of different sources for and they're trying to understand, like, why on one on one piece of measurement tool, am I getting an HRV readout? That's very different from another one. Is there a particular method that this is utilizing to inch like to ensure that there the results for that HRV are up to that clinical medical grade?
29:17
a? Yes. And I, I have like a little snarky thing to say sorry, but yes, my personality, you'll notice a lot of the a lot of the trackers, where are they located? Right, yeah, and risk, right. As far away from your heart, you're not going to get good HRV data from that far away. That going directly over your heart and it's measuring the electrical signals, not just the peripheral, registering of your heart rate changes through oxygen, blood, you know, heartbeat, stuff like that. Yeah, it's right over the heart. It's the most accurate you can get.
29:55
I love that you said that. That was so great. I have that similar sort of thought for me. When people will reference the wearables with the sleep stages readout, and how challenging slash just not happening it is to be able to get that from a hand or wrist. It's not the case,
30:12
I cannot tell you also the number of times that I have to like help reduce somebody's anxiety for them saying, like, hey, my wearable is telling me that I'm getting light sleep all night. And it's like, so they're like, I'm only getting you know, I'm only getting 10% 15% of deep sleep, and I'm only getting 15 20% of REM sleep, and the rest of my sleep is light sleep. Nobody bothers to explain to people that you're supposed to be in stage two, this sort of like lighter stage of sleep for 50% of your night. Nobody bothers to tell you, they just tell you that you're getting light sleep, and it's really not helpful.
30:49
Right, exactly. And the placement, you know, so much of the polysomnogram is, you know, the head based element, the electrical component, or certainly the brain electrical component in this conversation, we're HRV the heart. Yeah, really, really important distinction. So thanks for thanks for that. clarity. That was awesome. And then so quick question just for you are, what is has your experience? Have you had a personal experience with HRV? and tracking? With a tracker like this? Is this something where you have done it for a short period of time? And then and you kind of know the deal? Or do you come back to it? What is your approach on a personal level?
31:31
On a personal level, I wore the device through the various iterations of it, we affectionately affectionately referred to view zero as the as the egg box, it looks like a little scrambled egg. And it was like a little sunny side up egg, delicate wooden box that was like, really quite clunky, the vibration was really loud. So it's been really exciting to watch the iterations over time. And now we have this smooth, flexible, you know, the charge lasts all day is, you know, the data is really clean, the vibration feels smooth and nice and subtle, but you know, good enough that you can feel it. And it's just, it's been so great to experience the iterations. And, yeah, I go in and out of wearing my my device, just like anybody sort of goes in and out of having a regular meditation practice, regular exercise practice, you sort of, you know, you wear it for a few weeks, and one day you're out and about and forget about it, and then maybe it sits on the shelf for a day or two, and then you pull back on it, I still surprisingly, I still find, and I'm, I'm personally surprised by this, despite being on the team. And I'm surprised that I still get value out of it. Hmm. Wow, being being a psychologist, I, I am, I like to think of myself as fairly reflective and self aware. And I still find myself in these moments where my toes are cold. And I don't know why. And so whenever I wear the leaves, I do get value out of it, it just, it tells me that that tells me when I'm stressed. And it helps me get out of that stress state as quickly as possible.
33:13
Wow, really very cool. And I like that approach that no matter even if you're someone that's your livelihood is day in day out, understanding this kind of psychological component to health. And yet, you too can continue to improve upon how you're responding to your stimulus in your environment. Of course, life is demand dynamic. And there's different variables that are coming our way different diets that were a part of different all the things so really, really cool that this is available. And the next thing I wanted to say was so for people that are curious about learning more about this, how can they learn more? How can they follow what you guys are up to and presumably the many extra the new iterations of this product in the future?
34:03
Uh, go to our website, get get leaf.com.
34:08
Yes, Aye. Aye.
34:11
Aye as in relief, that was the exactly the part that we talked about that we brainstormed on. So get leaf calm with an eye relief, ie F.
34:21
So great. And you guys have a couple different options I believe to have, you know, so even if you want to kind of like you said you, you know, rent the product or buy it out, right, you know, so no matter where you are financially, you know, there's kind of different price points to be able to get in there and start to have that awareness.
34:38
Yep. And we're working on getting it getting our device approved for use through insurance companies. Oh, right now right now it can be built out of network. So the given that it's an FDA approved the remote patient monitoring device, we can bill for out of network We're working on getting in network with some major insurance companies. But for now we're we're we are debt we're approved to submit through insurance companies so they can be covered by insurance.
35:12
So huge Well, this feels for me like the future. And also just, you know, mental health itself, certainly physiological health, of course. But just that ability to have a look and have a say and have an awareness of how to change that moment to moment is huge, huge, huge. So I really thank you for what you're doing and for taking the time to speak with us and educate us about this a little bit more.
35:38
Absolutely. Thank you so much, Mollie, for having having me on.
35:42
Thank you. Whoops, hang on, sorry, two seconds. This might say, oh, okay, hang on.