This week, we talk about heart rate variability and all five million impacts it has on your body. Well, just two of them: sleep and mindfulness. Dr. Raouf (Ron) Gharbo completed his specialty residency medical training in Physical Medicine and Rehabilitation at an elite program at The Ohio State University Medical Center in Columbus, Ohio. In this episode of Sleep Is A Skill, Ron talks about his story and why he believes measuring heart rate variability is important. Get your heart rate up with this one!
BIO:
Dr. Raouf (Ron) Gharbo completed his specialty residency medical training in Physical Medicine and Rehabilitation at an elite program at The Ohio State University Medical Center in Columbus, Ohio. Prior to specialty residency training, he learned a holistic translational approach to medicine at Ohio University Heritage College of Osteopathic Medicine in Athens, Ohio. Dr. Gharbo is board-certified by the American Board of Physical Medicine and Rehabilitation, the American Board of Electrodiagnostic Medicine and accredited by the Academy of Integrative Pain Management. He is a long standing EVMS Clinical Associate Faculty member of the Department of Physical Medicine and Rehabilitation.
SHOW NOTES:
💓 Ron’s story and why he believes measuring heart rate variability is important for your health & its relationship to sleep
💓 Oxycontin and the opioid crisis of 1996
💓 How Ron’s work contributes to the scientific backbone of sleep and mindfulness
💓 Why heart rate variability is an important metric in the conversation about life transformations
💓 Heart rate as a measure of load and heart rate variability as a measure of recovery
💓 What modifier has the most impact on HRV
💓 Diaphragmatic breathing vs. chest breathing
💓 How blood pressure is incorporated into biofeedback
💓 The worst-case scenario for your circadian rhythm
💓 Why your heart rate decreases when you lay down
Check out Dr. Gharbo’s website: https://www.anshealth.co/
Email Dr. Gharbo: rsgharbo@gmail.com
Connect on LinkedIn: https://www.linkedin.com/in/raouf-gharbo-270b242a/
Mollie McGlocklin - The Sleep Is A Skill Podcast - Ep 033
Sun, 2/7 12:18PM • 46:33
SUMMARY KEYWORDS
hrv, people, diaphragm, sleep, recovery, wearables, brain, heart rate variability, measure, skill, heart rate, device, biofeedback, non rem sleep, big, podcast, therapist, load, nocturnal, physical
00:04
Welcome to the sleep as a skilled podcast. My name is Mollie McGlocklin. And I own a company that optimizes sleep through technology accountability and behavioral change. Each week, I'll be interviewing world class experts ranging from doctors, innovators, and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper. Let's jump into your dose of practical sleep training.
00:35
Welcome to the sleep as a skill podcast. My guest today is Dr. Ron Garbo. And He is an expert on all things HRV, among other things, but he's certainly his go to in this area of HRV. And many of you that have come to sleep as a skill are either in the conversation around HRV and improving it for yourself and your own measurements, or are learning newly about it, or if you don't know about it, then get ready, you're going to have a real dive in deep on this topic that can be so important for overall health and well being can be a really huge reflection of our nervous system and kind of how we're processing the world around us and any other stressors, be an external internal that might be at play and impacting our health and well being and of course, our sleep. So in case you haven't noticed, we have had a lot of podcast episodes recently that we are getting out that we recorded from back in 2020, during the pandemic, and that had been in the vaults ready to be released. And I'm so excited to release this one. Because you know, this topic we could have nonstop podcast episodes about and there would still be questions about this, this particular area. And I do want to throw out that this guest had also been on a podcast that I'm very fond of called elite HRV that I was so grateful to have the opportunity to appear on last year. And so if you are looking to go even deeper on this topic, you can also see this guest on elite HRV and go deeper with all the many podcasts that they have on this in this area on on there. So a little bit about our guest today. Dr. Ron Garbo is board certified in physical medicine and rehabilitation and neuromuscular electrophysiology. He's greater than 20 years of clinical specialty practice in neuro rehabilitation and integrative chronic pain management in coastal Virginia. And his background is with the Virginia Commonwealth University, and Department of physical medicine and rehabilitation. And he has been a part of research around chronic effects of neuro trauma, and remote brain health. So we are going to talk about a lot of things in this podcast but get ready and my hope is that you have some practical takeaways that you can begin to put into your sleep and your health really immediately. And as always, don't hesitate to reach out if you have any other questions around either what we discussed in this podcast or other podcasts or the newsletter or the on the website or sleep assessments, we really aim to be accessible and again, so do not hesitate. You can always reach me at Mollie mo l Li e at asleep is a skill.com. And right on sleep is a skill.com website. as well. There's lots of contact information, social media, all those sorts of things to follow and get in touch with us if you'd like to go deeper. But without further ado, let's jump into today's podcast. Now before we get into the podcast, I do want to take a quick minute to give a shout out to our sponsor better help or as I like to call it a therapist in your pocket. It's the exact app that I use when I was going through my really challenging period of insomnia while traveling overseas. And the ability to maintain a consistent therapist in real life was just really not an option for me since we were jumping around from country to country. So the ability to with using my phone have video calls weekly with my therapist that was paired with it. For me Actually, I connected with a great therapist right off the bat. But I do know other people who have been able to kind of shop around with some other therapists on that app until they find a great fit for them. And in between those calls. One of the things that I found was really helpful is that you can also send voice notes, text messages, images in between that you no longer weekly video call so that you do have this really very real ongoing connection and support that I certainly at least in my experience hadn't felt with real life therapists that I've used in the past and also the pricing structure. is much more competitive than a lot of the real life therapists that you can come into contact with. So I found it to be a lot of benefits. I recommend it to a lot of people that are just kind of going through struggles in their life or just simply want to be able to uplevel and get bringing that level of reflection and awareness into their life, about what's both working and not worth getting. And you can certainly cancel at any time and for our sleepy community, the better help company has hooked us up with 10% off if you go to better help.com forward slash sleep is a skill again, better help calm forward slash sleep is a skill.
05:39
All right, Ron, thank you so much for taking the time to be part of this leap as a skilled podcast. Thank you. Thank you.
05:45
Pleasure to be here.
05:47
Thank you. Awesome. So I already am clear on our conversation before we started in that we have a lot to cover in a short period of time. So we're gonna just go right in. And I think where we can start is to learn more about you and your connection on this topic around why you believe that measuring your heart rate variability is something that is really crucial non value. So to learn more about your personal connection on this topic?
06:17
Yes, sure. So I'm a physical medicine and rehabilitation specialist in Williamsburg, Virginia. I do neuro rehabilitation, and integrative and interventional pain management. And I finished my residency in 1997. So I have a long experience. And Oxycontin was introduced in 1996 most lucrative drug launch ever by far off the opioid crisis. So my entire career is this opioid crisis. And about five years into it. I ended up having a heart arrhythmia, atrial fibrillation, which is usually an arrhythmia for typically 70 year olds. And I was 37. And the internet Reddit in the emergency department, we both looked at each other atrial fibrillation, because we're both kind of curious. That was a big wake up call that I was unhealthy. The cardiologist said, I didn't have any risk factors. And I asked if it was stress, and he said, No, this was back around 2002. I think they'd answer that differently now. But it was stress. And then I started a process and found mindfulness, and really didn't actually find out about hurried variability until around 2009. And I've been passionate about it ever since. Because I think it is uncertain. It's unlocking many of these sleep and mindful and autonomic nervous system secrets that people have been searching for years. So I want to say, I don't believe what I do in my clinic is different from what people have done for 1000s of years when they've changed the trajectory of their lives. But when you think we're on to, is giving it a scientific backbone, a structure to make it reproducible, and make sense out of it. That's what I think I've done for the last 10 years.
08:22
Wow, okay, so, so many questions as you're, as you're speaking, and, you know, maybe just to provide some context for people because, you know, we've got people coming in, and all all different levels of, you know, kind of their quest around improving their sleep and their health. And maybe it's helpful to start even at the beginning for just the basics of, you know, really understanding what is heart rate variability? And why is it an important metric in this conversation that you're speaking to around, you know, really transforming your life? And, and how do all these things interconnect? Because I know it's such a exciting area. So I'd love to hear more from the kind of like HRV 101.
09:02
Yes, so I'm involved in several research studies. So, but the explanation I can give are very simplified. Sure, if ands, or buts. So, this is not directed at my research colleagues. But this is to make some sense. So these are some generalizations that are a nice starting off point. Think of heart rate as a nice measure of load, and heart rate variability as a measure of recovery. It's more sensitive than heart rate. When measuring recovery because it involves the diaphragm, we do an average heart rate, because it varies because the diaphragm speeds up and slows down your heart rate. And just remember, the bigger the better. And the way you can easily remember that is the stronger your diaphragm is, the bigger the variation, the bigger the variation in general, is healthier. So the easy way to remember the largest modifier Long term of HRV is exercise, a strong diaphragm is a secondary pump to the heart. So you won't want large HRV. at rest, there's no point in measuring it when you're an exercise because the heart is moving so fast. So, you measuring load in exercise heartrate is the best measure of load. But sleep, you want to be in recovery mode, and you want large diaphragmatic excursion. So this circadian dance between the brain and the heart and we measure with HRV is going to come down a lot to the diaphragm. And this is what I want you to remember, a strong, flexible and coordinated diaphragm will assist the heart so the heart can take a break at night and reduce its rate to the stronger the diaphragm. more flexible it is. So that's why diaphragmatic breathing is better than chest breathing, you're strengthening flexibility. And then you can get into what's called cardio respiratory synchronization, which the heart and and the lung get synchronized and then in a very specific way. And that's what we talked about heart rate variability, biofeedback, that can then incorporate blood pressure. So now you have a synchronization of another system. And then it can even have a synchronization with the brain that could be measured with EG, and then that's even bigger at night. So I want you to think the worst case scenario is to play video games nonstop, no exercise, catch a cup of cat naps, and you're persistent sympathetic tone without any exercise without any deep sleep. That would be the extreme of one. And the other extreme is you want great variation in your circadian rhythm. So you want to be able to handle high level exercise, so high heart rates for periods of time. And then the other extreme, I want you to think of deep non REM sleep is the other extreme, that's when your deepest of parasympathetic mode. That is when you have big diaphragmatic excursions, and it's coordinated with the rest of the system, even coordinated with ECG and blood pressure, heart rate goes down. And that's when you're cleansing the brain with these. The diaphragm also affects cerebral spinal fluid flow. So the toxins that build up with Alzheimer's, it's possibly believe that some of those can get flushed out during deep non REM sleep with these long diaphragmatic excursions and flushing out as the heart rate your brain is that your skull is this enclosed cavity can only handle so much fluid. So you need your blood pressure and your heart rate to go down when you lay down. You don't have to push blood as hard up into the brain. Because you're laying down you're not fighting gravity. And then you want the heart rate to go down and less blood in the brain and the diaphragm to help assist and to flow and to flush out those toxins tau and potentially reduce risks for Alzheimer's. And that ends up this was called cardiac dipping. This transition from awake to sleep ends up being the key feature between whether you're talking about hypertension, pre diabetes, fibromyalgia, concussion versus, you know, concussive syndrome versus somebody who does well. It's this transition from load to deep recovery. You want greater variability in your circadian rhythm, and you want greater variability. And the fundamental thing that I see in society that was true for me, is persistent, sympathetic activation.
14:17
And in our clinic, we call it racing brain insomnia. So I'll ask the reason you're not sleeping, is it? Because is the, you know, the lumbar stenosis, or is it your racing brain? And then I'll suddenly get this wide eyed. If I could just get a vacation from my brain. Yeah.
14:33
Mm hmm. Absolutely. And so when you first of all, just this is incredible. I'm taking so many notes as you're speaking. And number two, so when people say that because that's most of the people that are coming to sleep is a skill that is one of the persistent complaints naturally is that hyper aroused state and that inability or that perceived inability, inability to make a difference with that symptom? So what do You say to people when they when they answer yes, that's the problem. I can't turn off my brain. And how do you connect that for them with HRV.
15:09
So you need a couple things. I tried to find what I call intentional recovery a couple of years ago. And so I just had a chapter accepted for an integrative rehabilitation textbook. And I try and define intentional recovery is valuing, understanding. And now measuring recovery in a purposeful manner. And what that'll do, you have increased value, it's sort of a GOV, to your burning the candle at both ends. Sure. And I think heart rate variability will end up being the most practical measure of sleep quality, Eg is in microvolts, very delicate, heart rate, his muscles in your body are wired differently than your heart. So your heart rate is about an order of magnitude electrical signal, more durable than any other electrical signal in your body. So heart rate variability will actually, I think, be the most pragmatic measure of sleep quality. And the companies with the wearables, I think they're doing a nice job will only give people their overnight HRV. Because it's movement artifact during the day, blah, blah, blah. And I think the most important, will be longitudinal nocturnal HRV. And you'll get queued in when you're burning the candle at both ends. And you know, going into this weekend, you might need to say no to some social events and recover, as opposed to cutting the corner yet another weekend, that sort of thing.
16:52
Wow. Okay, so many of the people that are listening to this have are tracking their sleep or are considering tracking their sleep. So just to underscore, your takeaway was certainly in alignment with kind of the aha moments that I've seen for people and for myself with sleep and measuring that nocturnal HRV is really just this it can occur is just this next level connection with your body that just mimics you know, how you feel and getting to see that in, in black and white in some sort of numerical range. So I'm almost I have so many questions for you, I'm just gonna start, you know, kind of firing off some of the ones that some of clients have asked, you know, regularly about this HRV and speaks to what you're what you're pointing to. So one, I'm wondering if you could illustrate just as far as that connection with that circadian rhythm flow with our HRV. So as you've pointed to, there is that that the nocturnal readout is particularly valuable, because of you know, that we have this extended period of time where we don't have a lot of other variables that we might be dealing with were during the day, however, we do have people that will be curious to get some sort of answers on where they fall compared to others. And I know that's such a tricky thing to even try to do. Could you explain more about why it's so unique to each person and why they can't really, or it's challenging to compare? Yeah, go ahead.
18:25
Don't. So don't compare yourself to other people. Yeah. And don't look at just one day or a few minutes. A lot of the companies are giving morning readouts over a couple minutes. We're very resilient. We can handle a day or two without poor sleep. So, you know, I work with some athletes that were training for the Olympic Trials coming
18:45
up in April, unfortunately, that's, but one of the big things I do is tell them what not to look at. So right now, the device world is exploding because there's so much potential, but so many of their algorithms are proprietary and blinded. You don't know the quality. We're not yet. We are on the cusp of the medical wearable age and COVID. You know, as we increase telehealth and remote monitoring, this is that point where it was already increasing, it's going to explode because tracking your nightly temperature and your nightly HRV will be predictive of illness and it's already used in the military as predictive of viral illness is predictive of mortality. If you get a blood borne severe blood infection, they can predict mortality in the ICU from those recordings in the emergency department. So it's a very sensitive marker of distress. So you have to remember HIV is incredibly sensitive, but not specific physical or emotional distress. And they use different parameters and this and that, and so the guiding Prince Is you measure against yourself on the same device, the different companies, the values may be different. Don't worry about a day or two could be bad sampling error could be just that bad day, who knows. But it's really you want to click to the weekly and the monthly trends of your own, everybody has a different if you had a rib fracture, that changes, you know, the excursion of your diaphragm, so your numbers per age, gender, all these things factors. So you really want to measure yourself last couple of weeks versus a couple of weeks before then, and watching the trend lines. And that's what's going to end up being the most important. So if I have several months of my HRV, and I, I've been watching my temperature and my HRV to make sure there aren't that I may be able to see if I'm going to get COVID. So compare against yourself over weeks and months, not minutes, hours, or even a day or two.
21:05
Got that? Yeah, you know, it's certainly still with different levels of sleuthing have had different clients that have been able to find some sort of chart, you know, where it's like, and typically these charts will relate to people during the day time. So their daytime HRV readouts and based on you know, gender and age range. So would your advice to them be like, Listen, don't even go by that it's kind of apples to oranges when you're comparing daytime HRV and against totally, you know, particular setting different groups that they have all kinds of other variables going on,
21:42
maybe at the 500 level class, but we're doing one on one today.
21:47
Yes, got it. Okay.
21:50
Very cool.
21:51
I wouldn't do it. So, yeah, I'm working with potential Olympians. And what I'm telling them to do, one of the things is worrying about needless things. Yeah. So I tell them to click off of certain things, and we're going to track and it's it's cool some of the devices, you know, when competed in a wrestling tournament in Italy, and I'm tracking the numbers from Virginia, and then we can talk about what's going on. So it's, it's amazing.
22:22
Pretty cool. Really cool. Wow. So it's really interesting, because to your point that we it's, arguably we're embarking on this kind of wearable precipice or revolution around the opportunities for so many people to be able to get in this conversation. And you know, of course, to lesser or greater or lesser degrees have, you know, I'm sure there's different wearables that maybe you support a bit more or less, do you have certain recommendations, or is it, you just see that there's an evolution right now of particular types of wearables that you would endorse,
22:57
there is a, there's a huge amount of variability. Yeah. And there's still much to be sorted out the beautiful thing as Be careful of literature out there, that's by wearable companies, and it's proprietary data. The beautiful thing is, is I don't have to say what HRV is going to tell us, we actually have incredible high quality medical studies dating back in the early 90s. And off of 1000s of patients, not dozens of patients based on ECG, as opposed to ppg, which is the risk devices. So we have an immense amount of high quality data. So usually when something is new, you'll hear this is what it's going to say, I don't have to do that. So much is proven. This is the most sensitive marker of physical and or emotional distress. Like with the basketball team I work with, and one freshmen might be dehydrated. Another one might be failing calculus, and another one's parents might be getting a divorce. Their numbers are dropping, it still requires somebody who knows what they're doing to figure out why their numbers are dry, more than simply a brain candle at both ends, or more than one. So it does take some skill. But if you know yourself, if you just stick with yourself at first, and you measure overnight, HRV weeks and months. That's the best starting point, even if the two different companies are ones using HRV RMS SD and the other ones using SDN and blah, blah, blah, blah. You're comparing yourself on the same device. Wow.
24:49
So great. So So now you've got people coming to you and they have this longitudinal nocturnal HRV data, and it's trending downward. In recent months, what would be some of your top? And granted? I know that again, this is simplistic, but what would be some of your top recommendations that people consider to begin to improve their HRV? Do you get certainly spoken to the diaphragm? And, you know, understanding the connection to the breath and movement? And do you also get nuanced on, you know, food types and food timing is there, you know, kind of thermal element that you bring in around cold therapy, heat therapies, are there particular, you know, workouts that you suggest? types of breath work? What are some of your kind of top down approaches to that?
25:40
Sure, sure. There's two of them. And I'll start broadly, great. You know, you told me a little bit about yourself. And so the first one, I would say, is back to intentional recovery. And it didn't sound like you value recovery, nor now spent several years trying to understand it. And now you're starting to measure it. So first of all, does the person even value and understand recovery. And the devices help help, you know, when somebody is decision making is deteriorating. And their numbers are deteriorating, and they feel terrible. And you can correlate between the values, the way they're performing the way they're feeling, you can now get under value, understand and measure. So. So that's where the wearables are critical for me to get them value in recurring. And we are on the cusp, I think we've spent decades on pushing people to maximize load and acceleration and how long they can handle load. And we've really, pretty much gotten close to the limits of human ability with load tolerance. And we're going to see the low hanging fruit and performance is recovery, faster, steeper, deeper recovery will allow you to handle more load in the future. So better recovery leads to greater load. So that this is why I think that nocturnal lunch tuned overnight. HRV is the low hanging fruit in human performance, whether it's cognitive in the physician world, or athletic or both, to recover better, so I need the devices to get you to value it. The other thing, I think, and I can make an argument for this, that the best primary way to be intentional about sleep before you go to sleep, his heart rate variability, biofeedback, I think there are several methods, float tanks, all kinds of things that can trigger a parasympathetic response. The advantage that heart rate variability biofeedback has is first of all, it's low risk. But you're teaching something. You're teaching a skill, like sound of that right
28:06
now. Yeah.
28:09
So what you're doing with heart rate variability, biofeedback is remember I said, the diaphragm, strength, flexibility and coordination, you're creating this coordination between the heart and the diaphragm. And when they are coordinated, you then have this parasympathetic vagal tone to the brain and has brain effects. So So I like to say my guess is you're stuck in a racing brain of trying harder, as at some point, trying harder doesn't work. And those are the people that come to me whether it's a physician and burnout, a patient with chronic pain that's coping poorly, or an athlete, that trying harder worked, and it does work. But now they've gotten to a point where it's working against them, and you're, you're on the other side of the inverted you have the performance curve. And so something different has to happen. So you have to adapt. And I use the word adapt, because I think resilience says can you handle more of the same And sure, HRV is a marker of resilience, but I want something different from you, I want you to be able to adapt to make decisions to clear your head and to clear your head. You need to have good, deep non REM sleep, what's going on, then, we see that there's a coupling between the diaphragm, the blood pressure, the heart rate, the HRV, and even eg recordings, delta waves. And when there's this synchronization, you are in the most energy efficient state when your diaphragm is coordinated with your heart. So during the daytime when you're alert, and you're turning the little device and most of the companies decided that when your parasympathetic dominant you'll be green and when you're resting assistance of Vedic activation your read. So when you turn the little devices from red to green, you're in a more efficient state while awake? Well, you want to be even more so in that state, in deep non REM sleep, but your unconscious, if you turn off, if you create a little ritual routine, you turn off your technology and you do the breathing, before you go to bed, the thought is that if you practice this regularly, and the body is starting to unravel and starting to loosen up, so you can get the heart rate down, so forth, oh, we're gonna do that thing. Now, we're gonna do that coordination thing. And then where you do it regularly, you'll slip into that and go into recovery deeper, steeper, and longer and better quality. And who wouldn't want to have more efficient sleep? So that's why I like, but it doesn't always work. But I do think I'm not saying it's better than a float tank and this and that, at resetting the autonomic nervous system. I'm not saying that what I am saying it's an active skill of diaphragm coordination. And so, for me, it is a paramount initial primary step, everything else supports that. And to try and prove that coordination, so the HRV, biofeedback coupled with HRV wearables is just the next level to bring the two together. So it's recognizing the value of recovery, and being able to modulate it real time.
31:38
Wow, got that. Okay. So. So when people are trying to make a difference with this area, you will really make, you know, hit this point home that they want, it is a skill, they do have a say in it. And what are some of the more unexpected ways of impacting HRV. Because you know, of course, some of the obvious ones that we see day after day for people that are tracking their nocturnal HRV, some of the kind of ones that we expect, but we're often surprised by just how much you know, of course, drinking, we'll see a big hit in that eating a large meal late, we'll see a big hit in HRV. What are some other maybe lesser known or understood ways that people might be inadvertently impacting their HRV and kind of just having no clue that they're playing a role in that?
32:29
It is very clear that alcohol impairs this dipping and recovery. So I work with a wrestling coach, and he had thought about eliminating alcohol for religious reasons. You don't even need to do that. Yeah, they're joining this team, to be world class athletes. If they value recovery, they should, you know, the more you drink, the less you recover. And because they're amazing athletes, they do fine for a few days or weeks. And you know, then you hear sometimes things like, you know, it doesn't bother me, well, it doesn't bother you in the short run. So alcohol, it really is, is huge. recovery, and so I don't have to get moral with you. Yeah, we can just, and that's one of the fun things that we'll do is we can compete on recovery numbers, right? in a fun way with that, because, you know, if you get too aggressive, your h or you know, you get, so it keeps you, you can have a fun competition. And again, not your numbers versus my numbers would be sort of a percentage difference of my numbers compared to myself versus your numbers compared to yourself. That's one thing. The other, I'd like to mention, I work with another athlete, she done Transcendental Meditation for for two years. She's just, she's unbelievable athlete, but an unmanageable racing brain, and she got stuck. And that's the words we use. But you get stuck in persistent, sympathetic activation. And I got her to do the biofeedback for several weeks, and we had the most interesting telephone conversation because I like to say this is the backbone to meditation. Meditation is several things. It's like to say meditation is moment to moment, awareness of thought, breath, and emotion. Yoga is those plus stretching and position. And Tai Chi is those plus movement, but there's also breathing. And, you know, when you hear somebody who says, I tried meditation doesn't work for me. I don't accept that. So let's back off and let's just do the diaphragm portion. might not get the other stuff. But let's start with the diaphragm and I can hold you accountable. Do this twice a day, the second time just tonight. I will track you for a few weeks. It doesn't matter that you're in Arizona, and I'm in Virginia. And it's easier if you've tried transcendental meditation, but If not, anyway, after a few weeks, and I call the biofeedback training wheels, I don't want you on it forever. I want to, I want you to work off. And so she finally felt what recovery meant. And she says to me, I've been doing Transcendental Meditation for two years. And it was on my to do list each day. And now I feel it. And now I look forward to it. And I said, you don't need the device anymore. You feel it. So you can feel this shift of synchronization, that people are trying too hard to meditate and failing. They're not feeling it. And so there's a sensation, a moment to moment awareness of this shift between the diaphragm and the heart, and the brain can pick up on it. Thanks.
35:50
Okay, so so we cannot overlook the importance of meditation. And because, you know, it's so interesting, I have a wide spectrum of people that I work with asleep is a skill. And, you know, some people, it's just even the idea of tracking their HRV in general is just amazing, mind blowing. And for other people, they want to know all the gadgets and gizmos, and all the top things that they can do, right. So there's like a big spectrum right there. But what I'm getting from you, too, is to not overlook the importance and the magnitude, because even just, you know, on a on a biological and physiological level, it makes the most sense to tap in as one of the first places to begin is meditation and getting aware of that in a different way.
36:37
Can you simplify that a little bit more, please, meditations, three or four different things, just go with diaphragmatic breathing with a device that's even less than meditation. So what I do is really simplify and stick to what I found are those two most important starting points, getting you to track this one number, so that you value it and understand it. And let's set aside all those other gadgets. And get good at that and then get learned at shifting. And what I heard you say in what you're saying is, they can become obsessive gadgets. And so I'm very, very attuned to words, they matter a great deal. If you are a high performer, and you obsess or crave, I want you to think of the words obsess and crave as a canary in the coal mine. What you're saying, and what the marketing strategies are trying to do is they're trying to make you passive. If you are craving getting a letter grade of an A, you are obsessing about becoming a state champion. That is the road to passivity, you becoming passive to this greater thing. So just be aware, when you start to crave winning, that you're, you're not not necessarily in trouble yet. But I want people queued into those words, when what you were describing to me was obsessing over data. Data will make you helpless if you're looking at too much. And so everything I'm about is making people less helpless. I don't want you to dependent on the tools and I don't want you to dependent on me, eventually, I want you to be free of both of us.
38:28
Yes. So you speak for so well to one of the overarching principles and sleep as a skill is what we call the desert island approach. And it's looking at the goal being that you can be dropped on a desert island with nothing but the clothes on your back and know yourself as the type of person that can get great and reliable sleep night after night without a single thing. And I'm certainly as a, as someone who has been traveling, you know, for the past three or so years, you have a backpack and a carry on and certainly your real estate, both mentally and physically become even more you're more attune to what matters and what doesn't matter. You can certainly carry around, you know, some fancy mattresses and you know, all the the gadgets that might get hooked up to those things. So suddenly you become much more lean on what matters and what doesn't. So I love that.
39:24
So the best example I've been able to come up with isn't something to aspire to is a ninja the model of a ninja. There are times where one has to actually fight for survival. A ninja can do that. There are times when somebody has to recover. A ninja can do that. There are times when you have to be able to restrain activity and this is the perfect example this COVID moment. Yeah, too much movement. Too much activity is dangerous. So you have to learn how to not to be still too Still without wasting energy. And so, over non stop, over aggressive lifestyle will hit a wall, the people who adapt best would be the people who can move between those three states. aggression, on rare occasions when it's necessary, you got to get up, get out of bed, put your shoes on, get to work, exercise, you got to be able to recover. And then you also have to have this courageous stillness. That's energy efficient. So we know chess champions will lose a lot of weight playing chess, because their brains are grinding away without physical activity. So you have to be able to do that efficiently. So the ninja ends up being the best model of what to aspire to. I can't really think of many other examples out there that have that great adaptability.
40:53
Awesome. So okay, you said so much. And I know there's so many things that I want to touch on. And I know we have limited time, but essentially, a couple things that I'd like to throw out of just some questions that different clients seem to bring up, you know, again, and again, when they start looking at their nocturnal HRV. And so just kind of read a couple of them and see if you can shed a bit more light. So one is one thing that people will comment on is they wonder why on some nights when they haven't slept much, do they seem to have a higher HRV? Do you have any clue on that one? Or is that just an anomaly?
41:33
Again, it's incredibly nonspecific, it might take 20 or 30. Questions?
41:38
Yes. Okay.
41:40
Yeah. And so what, again, we want to focus in on several trends. Don't get worked up.
41:50
At that, now, how about for the non dippers. So we've different clients that will find that their heart rate is not really dipping throughout the night. And as it correlates with their HRV. They're not finding some of that rise that they would like to see. Do you have any thoughts on that? Or is that another two specific one?
42:12
No, back to the basics. Right? I don't look at behaviors. I'm very distinct. I look at health, what I call healthy decision making great two types of decision making that runs people into trouble. And one is this hyper vigilant survival, fight flight or freeze limited options, decision making. And then when you're in that place for too long, you become exhausted, but you still mentally focused in on what you want to achieve, but you're exhausted and that leads to craving and helplessness. So you have to cue me back to what the question was.
42:51
So the non debating throughout the night for there,
42:56
that is an early predictor of all kinds of disorders. So everybody has a different chink in their armor. Yes, it's may be migraines. Mine was atrial fibrillation, and other persons may be anger or alcohol. There are behavioral and physical chinks in one autoimmune disorders. And so this is a sign an early sign. So I don't want you to get too worked up about it. But it is an early sign that your circadian rhythm is not healthy. And you got to go back to the basics. And I like to say the basic decisions are, the term in my chapter I'm using is honest, purposeful movement. And Tai Chi is a good example. You know, exercise, gets back to thoughtful intake. And that means the type of food low carb foods. So I've been shown to be good for circadian rhythm as well as not alcohol. So, so decisions on intake decisions on purposeful movement, and then decisions around intentional recovery. Breathing with the diaphragm is the doorway to better decisions on those three, if you're getting making good decisions on those three, the good things unfold.
44:12
diaphragm is the doorway. I love that. Wow. Great, great quote right there. Well, I think that's a great place for us to almost put a bookmark and I would love to even grab you in the future to do a part two, because I get the real sense that there's so much gold that you have to offer. So to that point, how can people learn more about you follow your work, be a part of what you're learning and producing and putting out there.
44:40
So as far as for the consumer world, the social media that that I do is LinkedIn. So if you're on LinkedIn, please connect with me reach out to me enjoy a question on the podcast. I can even be emailed through there. So that's that's how I engage that I hope as more couples, we have a chronic pain study coming out with heart rate variability biofeedback, we're waiting on, we're supposed to hear. But COVID put a suspension $4 million artery variability for concussion and PTSD. That's, we're still waiting to hear on that. So there's some research elements, but I want to put more out there for the consumer world. And hope we can do that. And next time, I have some practical tips that we can
45:33
talk about, Oh, wow.
45:35
So awesome. Well, that's enticing. I definitely want to get you back again, then to go get in the weeds a bit with you a bit more on all that you have to share and all the all the wisdom you have to impart. And I certainly have learned a lot on this on this episode, and looking forward to learning more from you. So I really, really appreciate you taking the time. And just thank you for sharing what your what you learned. Sure. All right. Well, thank you so much.
46:01
All right. Thank you.
46:04
You've been listening to the sleep is a skill podcast, the number one podcast for people who want to take their sleep skills to the next level. Every Monday I send out something that I call Molly's Monday obsessions, containing everything that I'm obsessing over in the world of sleep, head on over to sleep as is gil.com to sign up