Dr. Josef Witt-Doerring, MD is a psychiatrist renowned for his expertise in the field of drug tapering and withdrawal management. With years of experience in clinical psychiatry, he has developed a particular interest and specialization in assisting patients with the safe and effective tapering of psychiatric medications. His approach is patient-centered, focusing on individualized plans that prioritize the patient's well-being and functioning.
Dr. Josef Witt-Doerring, MD is a psychiatrist renowned for his expertise in the field of drug tapering and withdrawal management. With years of experience in clinical psychiatry, he has developed a particular interest and specialization in assisting patients with the safe and effective tapering of psychiatric medications. His approach is patient-centered, focusing on individualized plans that prioritize the patient's well-being and functioning.
SHOWNOTES:
😴 Why can sleep anxiety worsen insomnia symptoms?
😴 What happens when sleep becomes your biggest fear?
😴 How psychiatric medications may affect long term sleep
😴 Why tapering too quickly overwhelms your nervous system
😴 Could your thought patterns disrupt deeper nightly rest?
😴 Why perfectionism can sabotage healthy sleep habits
😴 What if poor sleep links to hidden anxiety?
😴 Why obsessing over sleep trackers may increase stress
😴 Could journaling calm racing nighttime thoughts naturally?
😴 Why many fear functioning without proper sleep
😴 What happens when you stop forcing perfect sleep?
😴 How acceptance and mindset shifts improve natural rest
😴 And many more
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The information contained in this podcast, our website, newsletter, and the resources available for download are not intended to be medical or health advice and shall not be understood or construed as such. The information contained on these platforms is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation.
Welcome to the Sleep Is a Skill podcast. My name is Mollie Eastman. I am the founder of Sleep Is a Skill, a company that optimizes sleep through technology, accountability, and behavioral change. As an ex-sleep sufferer turned sleep course creator, I am on a mission to transform the way the world thinks about sleep.
Each week, I'll be interviewing world-class experts ranging from researchers, doctors, innovators, and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper. Ultimately, I believe that living a circadian-aligned lifestyle is going to be one of the biggest trends in wellness, and I'm committed to keeping you up to date on all the things that you can do today to transform your circadian health and, by extension, allowing you to sleep and live better than ever before
Welcome to the Sleep Is a Skill podcast. What if the very medications meant to help your mental health are the reason you feel stuck? Today, we're joined by Dr. Josef Witt-Doerring, a psychiatrist specializing in special and effective tapering of psychiatric medications. After working with the pharmaceutical industry and the FDA, he began questioning how these drugs are prescribed and what really happens when people try to come off them.
We unpack the realities of tapering, the risks of going fast, and why a slow, individualized approach matters. We also explore sleep anxiety, insomnia cycles, and how perfectionism and control can quietly sabotage your sleep. If you're navigating medications, anxiety, or restless nights, tune in now to learn a more grounded, sustainable path to healing And welcome to the Sleep is a Skill podcast.
Our guest today is a delight. Dr. Josef, thank you so much for taking the time to be here. I'm so grateful for the work you're doing, so really, really thankful that you're carving out some time today. Thank you. It's a pleasure to be here. Awesome. Okay. So this is a big topic, this topic of tapering, and you've so much more to cover, and yet I love that you're helping to support just the concept for people of the literacy of what this can look like, of how to taper thoughtfully, mindfully, and so much more.
And, you know, I'll let you kind of introduce how you think about, about this. But- Mm-hmm ... how did you get yourself into this arena? How did you become such a thought leader and expert in this domain? Sure. Yeah. So, uh, from a really young age, I was always interested in, like, self-help, therapy, and, and all- Yes
of that. Interested for my own reasons. Um, and I went into medical school, and I thought, you know, psychiatry might be a really great place to merge this interest with philosophy, self-help, you know, psychology, and so I went in that direction. But shortly after becoming a psychiatrist, it was apparent to me that we weren't really interested in, um, building people up and cultivating, you know, their relationships or their work, or, you know, even really working maybe on their metabolic health, which we've come to learn is really important for mental health as well.
Um, and so what I saw was that it, it had essentially become like very, like, checklist medicine. You know, people would come in, the appointments would be really short. You'd ask them what symptoms they had. You would diagnose them based on simply the symptoms that they listed, um, with a very... with, with either no or a very rudimentary understanding of, like, their life story, you know, their relationships, all of the super intuitive things that you would think to look at, you know, when understanding why someone's depressed or anxious.
You know, work, relationships, health, all, all that stuff, and we would just put them on a medication. And that did not sit right with me because intuitively, uh, it doesn't make sense that you can really fix someone, uh, without understanding their problems. And so I started poking around in the literature. I learned that, you know, there really isn't any sort of chemical imbalance, um, out there, and, and so that we're actually kind of using these drugs just for their drug effect.
Um, and that can be totally okay. You know, they're, they're... You, you can use drugs for their drug effects, and they can be therapeutic. But the problem was, is that for many of my patients, this just didn't work for them. You know, they would get on the drug, they would have this honeymoon period where maybe for like, you know, a year or two it would work, but then their body would adapt to the drug, they would need a higher dose, and so on and so forth.
And eventually they would be maxed out, and the med wouldn't really be helping them that much, and then they would be kind of stuck in a hole. Now, instead of helping people out of this hole, um, and recognizing these problems, what I would see was that we were being trained to call these patients, like, resistant in some way, and then stack on another drug, and then go through that same sort of cycle of tolerance.
And eventually we'd have patients who would be on, like, you know, five drugs, uh, who were actually worse because the human brain was not designed to be on drugs chronically for, for years and years and years And, and so I just want to make something really clear before we kind of go off on a tangent. I do recognize that these medications can be very helpful for some people, and that some people do, do need them.
The nuance is, is that we're actually putting a lot of people, uh, who don't need them on these drugs, people who could have been helped with other obvious things. Um, and so this is not to discount the role in, in some mental health conditions, but clearly the case, and from my vantage point in the US, is we're using them way too much.
And so I would bring these issues up with my attendings, and they would say, "You know what, Josef, don't worry about it. They are safe and effective. These are approved by the FDA, nothing to worry about." And I just didn't buy it. And so I ended up, um, deciding I wanted to specialize in clinical research because I wanted to understand the evidence base behind how we were using these drugs in this way that just did not seem intuitive to me.
I ended up working at Janssen, which is the pharmaceutical arm of Johnson & Johnson. I ended up working at the FDA, and then I-- and then briefly at a few other pharmaceutical companies. And m- my, you know, becoming an expert in that area, going behind the scenes, I essentially came to the conclusion that we are prescribing these drugs completely outside of what the evidence base shows.
Um, and the most egregious part of this is that these drugs are studied, like literally for like eight to twelve months. Uh, sorry, eight, sorry, eight, eight to twelve weeks. Um, and I-- there's never been a study that's gone longer than a year, and then we're putting most people on them for years. And so just that issue there, the fact that these, uh, aren't studied that long and then we use them long-term, is reason to be concerned.
But then there's also a lot of side effects, um, as well that are quite serious that people don't hear about, um, which I learnt about, one of them being withdrawal problems. And so this is, this is a really roundabout way of coming back to the why do I have a taper clinic now where I help people coming off, come off the drugs.
Well, by going through all of this and, you know, having-- and, and my own clinical experience, what I learnt was that there is a fraction of people who have an extremely difficult time coming off these medications. Uh, I don't know exactly how many people it is. It could be ten percent, it could be fifteen percent.
But when they try and come off these meds, uh- It, it's unbelievably painful and, and, you know, I'm not even talking about, like, you know, a lot of disruption for, like, a month or two. Like, that's what I would say is normal. That's normal withdrawal when people come off. You know, it hits the fan, it's really bad for a couple months, and then they get better, and they kind of move on with their life.
That's actually the normal thing that happens even with a fast taper. But there's still a big group of people out there, um, that when that happens, either, um, the withdrawal is especially brutal and long-lasting and it just makes them give up and they feel like they can never get off the drugs, and then people will just tell them they need to stay on them forever 'cause their brain is broken.
Well, that's not the case. They just needed a slower taper. And there were some people who developed a neurological injury called protracted withdrawal, which sounds bonkers because this is, you know, people haven't heard about this before, but it's being spoken about more and more. Some people, when they come off things like benzos and SSRIs too quickly, they'll actually develop a neurotoxicity And the way to avoid that is by doing a slow taper.
And so I learned all of these things through this kind of odyssey through the pharmaceutical industry and the FDA and, um, and what I was seeing with patients, and I just decided that people needed an off-ramp. They needed a... There needed to be a safe off-ramp for people who were having a really hard time coming off these medications.
So back in 2020, I started this practice with my wife, and, and that's what we've been doing ever since. We've been helping people do complicated drug tapers to, to get them off psychiatric medications. Wow. Ugh, doing some important work because we often see people that are coming our way, and of course working with their respective teams, although we have often trouble finding people like yourself that are able to speak intelligently on what kind of these proper tapers can look like.
And as it relates to sleep, we're often seeing sleep being so massively impacted. I'm curious what you see when you think of this topic of sleep and some of these medications. Naturally, as you hit on some of these big ones, the benzos, speaking Z drugs, you know, kind of close sister, and then of course antidepressants and other medications that can find their way into sleep, some with, uh, certain components, some very acutely.
And so when we think about this, how do you navigate this topic of sleep? I know it's a hu- a huge blanket topic- Yeah ... often, but how do you think about that? Yeah, sleep is, uh, s- you know, sleep is a big reason for getting on psychiatric medications. Um- Yeah ... and I actually think insomnia has become an even bigger deal now, uh, actually for, like, some psychological reasons.
Like, yes, I do think, you know, we're exposed to blue light, and, you know, social media- Yeah ... and, and, and all of those things. Yeah. Uh, but, but the other thing that I noticed is we've become obsessed with sleep. You know, it's really hard to not, like, turn on social media and see- Yeah ... influencers out there just like, "Sleep is so important.
If you're not sleeping well, you know, you know, you're, you're hurting your brain," or, you know- Freaking people out ... it's the best- Yeah, totally freak people out Yeah . It's, it's the best thing that you could do. If you're not having great sleep, you know, that, you know, you need to really panic about that. I actually think we induce sleep disorders now by how, how we put sleep up on a pedestal.
Um, and this isn't... I, I don't wanna sound like I'm diminishing the importance of sleep because, like, I, I've suffered from insomnia myself. Like, I know you're, you're less functional. Uh, uh, you know, it's painful. It's kind of harder to do things. Like, I, like I know it's challenging. But the, the, the way we, we, we inflate its importance, I think we freak people out.
And I, I think a lot of the people who end up on sleeping medications have severe anxiety about sleep. Yeah. Um, and, um, the, just the panic they feel about not being able to sleep drives them to look for a biological cure, and this could come in the form of a cabinet full of supplements that you rotate through or, you know, whatever new gadget there is, or benzodiazepines, which I would say are probably the worst.
Absolutely. Mm. And it, it's so true because I think there's two buckets when we talk about sleep. There is the group that is sleeping fine, and they don't really think about sleep very much, and maybe it hasn't been prioritized. And so for that group, the education piece can be impactful and important and can spur kind of a prioritization.
For the insomniac group, it can actually make things so much worse to then learn all these problems of all these things that are gonna happen or could happen if we're not getting our sleep. I was certainly one of them, that sleep anxiety went through the roof, right? Me too. Oh my God. So that, it's the paradox is that we can support the growth of the muscle of how to, uh, have that resiliency and learn about some of the things that can support.
But oddly, so much of the breakthrough comes from letting go of the attachment to getting r- great sleep. If that makes- Well, yeah, I mean, that makes sense to me. And I, you know, I, I, I don't focus on this as much as you do, but I see a fair amount of insomnia. And I, I can speak- Right ... from my own experience.
I am a, um, I am a problem solver. And so, you know, when I started having problems with sleeping, you know, I'm gonna get a... You, you wouldn't believe the stupid things that I've done, you know. I, I, I looked for biological things. I, I had the cabinet full of supplements. I did take Xanax for about six months.
You know, I took, um, uh, you know, I bought an air purifier. I, I got a, um- And I even, I was like, I live at altitude 'cause I'm in Park City. I was just like, maybe I'm not getting enough oxygen. Um, and so I ended up getting, you know, this, this, this, this oxygen concentrator. I wore a stupid EMF hat. Like, if you wanted to laugh at, like, the, the stupid things that, that people did because they were desperate about sleep, I, I was that, uh, problem solver.
Um, and what I ended up finding out for me was that I needed to stop putting sleep on a pedestal, and the way through it was actually to work on my anxiety. Hmm. Um, and that was really the, you know, the... I, and I didn't want to look at that because I'm, I'm, and which is crazy for a psychiatrist. I'm naturally someone that just bowls through difficult feelings and things that are uncomfortable.
I was addicted to my phone at night, um, and the, and I had to sleep with my phone in my room, watching something to go to bed. I would whip it out in the middle of the night because I was so uncomfortable with my own thoughts. Yes. Um, I just didn't, I didn't want to experience them. And, you know, they, they were things like, you know, as a business owner, you know, different problems in my business.
What if things are gonna fail? And, you know, also there were things about insomnia. Oh, you know, I'm, I'm having such bad insomnia. I'm gonna make poor decisions in my business and, you know, and then, and then things are gonna go off. And so The, the, I, I needed to do a lot of, like, anxiety work on that, which you know, I was just like, "Oh my God," you know, you're just like, "I'm, I'm so pathetic.
Like, my brain doesn't even work. I can't even sleep. I can't even do this most natural thing." Believe me, I had the anger, and the rage- Wow ... and the pity party, and the why is me. Yeah. And I mean, the biggest thing that I had to do was just to confront all that. No, it's okay. You know, I can function without sleep.
Yeah, I'm, I'm doing well without sleep. I've, I've, I've built this business in a state of insomnia at times, and, and, and- Yeah ... that's okay. And these thoughts that I'm having, I can't just kind of push them down. I need to actually, um, journal them. Uh, and, and again, I'm like, "This is so gay." And I'm just, like, sitting there with my journal, and I'm, and I'm, and writing down all these things, and I, I'm, I hate this, but I actually needed to process them, you know.
The business is okay. Thing, things are okay. And- You know? Yeah ... just to underscore what you just said, it's so true. One of the things that I often reference- Yeah ... we've had two times sleep doctor for the Navy SEALs, Dr. Kirk Parsley, if you've seen him by any chance. So I share about him because he is a MD for the Navy SEALs and was, used to be active duty back in the day, and has been regarded as or thought of as, uh, instrumental in getting so many Navy SEALs off of Ambien, Lunestas- Mm-hmm
you know, major kind of addictions to sleeping aids. And one of the things that he has pointed to that made one of the biggest difference for the, you know, most skilled among us was actually brain dumping. You know, just dumping out what's in our mind and journaling about it, exactly as you said, which I think can be thought of as, like, a soft skill or a nice to have, but when you see that people in, you know, combat are doing this and it's making such a measurable difference in their ability to calm do- I mean, it's a big deal.
Yeah. I tell you what it did. It, it did way more than the MAG3 and 8, Apogen, MAG blah, blah, blah, you know- Yes ... all of the different, all of the different, you know, things that are kind of sold online. I bought an Eight Sleep, which was, like, six grand. Ah. And believe me, like, I like it and it's nice- Yeah ... but it wasn't the key for me.
You know, I, I, I was doing everything I possibly could to avoid a- an- anxious thoughts and trying to suppress them, and I was trying to find the solution in the physical. Um, and- And so, you know, maybe I was kind of a little harsh on sleep influencers earlier on. I think there should be sleep influencers, but I always appreciate the people who reduce anxiety about sleep.
'Cause there is a group of people who are like, "You got to measure this, and you got to look at that, and you need to kind of have this metric, and you need to look at... And you want your deep sleep and stuff." That stuff tortured me, and I thought that was, like, the way to go to kind of look at all these metrics and, and stuff like that.
It made things like a thousand times worse. And when I started to listening to people like Daniel Erickson, and there's a, a guy, um, I think Devon Burke. There's a couple s- Yeah ... sleep people out there who, who really actually just focus on acceptance, commitment stuff, like letting go. Like, that was the... I like, I like their stuff.
I'm partial. I, I'm, I'm just coming at this from my perspective . Yeah. Uh, but it's also what I see, uh, in my patients. I, I love that stuff. I, 'cause I think anxiety is one of the biggest drivers. But your anxiety about insomnia, I see it in so many people, is such a problem. Yeah. Well, I hope I don't get lumped in with these elusive sleep influencers-
because one of the things that we've seen over the decade that we've been working with people- Yeah ... we especially work with high-stakes poker players. And one of the things that we see is that there can be this fine line in awareness of the fact that, to your point, so much of making a difference with sleep is how we're impacting our days, how we're spending our lives.
And ACT, or A-C-T-I, acceptance commitment therapy for insomnia, is one of the primary drivers that we utilize to help make a difference for people. Awesome. So could not agree more. And there also is- Yeah ... the group outside of insomnia that is dealing with not prioritizing sleep, not caring about sleep. So it's like two different groups.
So how do you address those? So we talk to insomniacs very differently than we would talk to people that could care less about sleep. They're getting four hours of sleep and say it's fine. So two very different conversations, for sure. Yeah. Yep, yep. Music. Um- You sound like one of the, you sound like one of the good ones.
Well, you know, I've given my life to this topic because I see how much of a difference when the upset that happened for me when I went to multiple doctors and was left with just sleeping pills and no plan. So the upset is very clear and concerning when we see that that is something that is just, that's the path for people.
And yet, so that's what's so important for people like yourself that are getting this information out there, because it's one of the most life-changing things when we can start to address that I can have peace of mind when I lay my head on my pillow. Okay, so having said that then, when we talk about things like benzos, Z drugs, antidepressants, or other things that might spill into people's experience with their sleep, how do we navigate that?
Because to your point, you mentioned that sometimes there's this acute experience, and then other times it's more lasting, like protracted experience with how some of these symptoms and often falling into their sleep. So what do we do with that? How do people think about that? I would love people to talk to someone like you and your team and anyone that you train because, because sometimes, um, the reason that we get on these medications is, again, it's like, it's anxiety about sleep.
It's like, "I can't have a bad night's sleep. If I have a bad night's sleep, I'm gonna crash my car. I'm gonna, I'm gonna get fired from my job," blah, blah, blah, blah, blah. And it's like, are those things really true, you know? And, um, you know, sleep can also... There can be other things going on, uh, with sleep that are just related to your general health.
Like, you know, how physically active are you? Um, and, you know, uh, you know, there's some nutrition components as well that go into it. And so what I would love to see is, is- The anxiety about sleep being addressed first, and then also the, the non-drug approaches being used. Because when, when you end up just parking someone on, on a drug, I, I know for me, i- i- you know, it was a way to avoid other problems.
It was a, a way to avoid this chronic anxiety that I have about performance. And, um, and, you know, when I wake up, it's like time to get to work, because if I don't work every single second of every single day, you know, I'm gonna fail and I'm not gonna be good enough. It's just- Yeah ... just random, random stuff that just gets kind of crammed in there, uh, from your upbringing or the way you were drilled through school or whatever it is.
Um, and so the first thing I would just tell people is make sure that you're not masking another problem that needs to be addressed. I mean- Yeah ... clearly, like for me, it's just like why do you need to fall asleep looking at your phone? That's not- Yeah ... normal. Do you hate being with your thoughts that much that like if you are d- you know, you can't like watch something, like y- you need to have it there like an addiction?
Like it was obvious for me that I was, you know, looking... It's just not obvious at the time, but for me looking back now, it's like there's, there's something there. And so just talking with someone that knows, that knows about sleep and, and and its, its role so you, you don't end up just, you know, papering over like a real problem that, that needs to be addressed.
Because this is happening for you. You know? The- Yeah ... the problems with insomnia are happening because you need to move through something. Ugh. Could not agree more. I love how you said it's happening for you, 'cause I feel like that's one of the bigger breakthroughs that can often come for people as it relates to from a myopic view around sleep, is when we see there's a gift here, and it often can be one of the bigger driving forces for people to take action.
I mean, nothing will get you in action more than when you haven't been able to sleep for night after night after night and willing to kind of take new action that you might not normally do. So I'm so glad you framed it in that way. So is that something that you kind of prepare people for? So if they're coming in and they're saying, "Okay, I've been on," whatever, "Xanax for a bunch of years, and now I want to begin this tapering process," do you give the heads-up that we might see something with sleep, or do we just proceed?
And I know you're gonna do low and slow and very mindful, so we're trying to minimize as much of that impact. Yes. But still talk about that sleep piece. Yeah, yeah, yeah. So in-house it is something that I want to build out in my practice. But I actually think sleep coaching and sleep skills is actually pretty technical.
Um, it, it, and, and so I often will recommend different sleep coaches and books and, and things like that to, to supplement- Sure ... w- what I do. Um, um, but, um, most patients who come to me coming, who want to come off, uh, from benzos or antidepressants, they're having, like, so many side effects with the drug. It, it's almost like they've...
They're on a super high dose. The doctors are ready to cut them off. They've got some memory impairment. They have brain fog. They hate how they feel in the morning. They've already sort of decided, like, "This drug and this path is not working for me." And there's- Yeah ... there's not a good ending to this. And so I, I personally work with some people who are really motivated, and they're just like I just need to be off, you know, regardless of what.
Usually they're not sleeping great anyway, uh, because after being on these drugs for years, they're, they're, they're, they're not working that well. Um, and so we do these, these very gradual tapers to bring people off without a lot of withdrawal. And then we, uh, we help them find people who are really trained and skilled with, um, evaluating sleep and the anxiety, and then also telling them how to, you know, you know, spend a day to, to kind of prioritize sleep and, you know, build out their sleep environments in a, in a place where it's conducive to sleep.
And, and so that's, that, that's my approach, uh, to insomnia. I love that. No, so good. Yeah. And you know, when so many people will be tapering off, sometimes they might go into what, as we kind of pointed to, often can be potentially like a pitfall where they might say, "Well, is there some sort of supplement I can take or something I can do to get me through this period of time?"
For you, is it more of like a, "Listen, we're already messing with your brain neurochemistry as it is. We don't want to be throwing additional things on it." Is it very case by case? Any call-outs there when some people are, like, desperate and saying, "Can I take something to ease this?" Yeah. I haven't really thought about it too much.
Yeah. I kind of just go, go by my gut. I- Yes ... I don't like to have hard and fast rules, like- Right ... um, and so if someone says, "Hey, you know, taking MAG3 and 8, that, that really helps me." Um- Yeah ... and you know, we're getting them off Xanax, that's fine. You know, that, that, that- Yeah ... like, I'm, I'm, I'm totally okay with that.
Sure. The, the, the one thing that I, I just want people to make sure that they're not missing any anxiety component. They're not trying to re- replace a benzo with a cabinet full of supplements. Because if there is- Yeah ... something going on there, uh, as long as you're, you're addressing them in, in unison.
'Cause I actually don't think you can fix this problem unless you fix, like, the anxiety about sleep. Yeah. Yeah. Yeah. Yeah. Yeah. Not that this stuff is gonna touch if that is the fixation, and that's the fear. The fear of the fear freaks everyone out into the wee hours of the morning. Mm-hmm. So, yes, I'm so glad you said that 'cause, you know, some- I see that people might fixate on some of these things, taking some of these things, what have you.
And yet- As we often see, nothing outdoes just the mindset piece so commonly. Yeah. So- Totally So with every person that we bring on, we do ask them four questions around how they manage their own sleep. I so appreciate you also- Yeah ... sharing what you went through for a period of time with some of that insomnia, and I really think it's so important because so often people might have...
I know for me, I had fears of like, "Oh, no. Am I stuck like this forever?" Like you know, and I remember going down Google rabbit holes of, "Am I gonna have to be on different medications for the rest of my life? What's this gonna look like? Oh, my gosh." So to have examples like yourself, a success story of... And to navigate and to have a relationship with sleep, from the sounds of it, really, really important.
So thank you for your vulnerability. So the first question that we ask everyone is, what is your nightly sleep routine looking like right now? How do you think about that area of life? As someone who squarely falls into the camp of a sleep anxiety person- Yes ... the less I think about it, the better I do. I, I know some- Yeah
people have kind of like fleshed out routines. Yeah. I have to tell myself, you know, being exposed to light at night, it's okay, you know? Yes. I was exposed to light at night when I was a teen for a long time, and I never had any problems. And so I, a lot of it is mental work for me. Like- Yeah ... I like to read in bed.
Um, I mean, I have like a red light. I don't know if that's helpful or not helpful. Like, it, it's, it's, it's something that I bought when I was in a panic. And so- ... I'll sit down- Turn around ... and I'll, and I'll read. I'll read with my Kindle, which may b- may have a little bit of blue light, but I have to tell myself, "Listen, Josip, there's lots of people out there reading Kindles- And they-
that have like the blue light there who are doing just fine. And then so um, and so for me really, it's, it's just reading. I try not to think about it. I know people talk about like, when are you gonna have your last meal? I try not to think about that too much. Sometimes I eat right before I go to bed, and I'm fine.
You know, sometimes I, I, I don't. What, what I do notice is that having more carbs in the evening, even though that's metabolically not good, that does personally help me. Um- Hmm ... and so I might have a bit more carbs, uh, in the evening, something like a sweet potato, quinoa, slow release carbohydrate. I think there's some science behind that, that it helps with like tryptophan- Wow
absorption in the brain, and that can help with melatonin. Sure. Sure. I notice that because if I eat a lot of meat, uh... Well, if, if, if I don't eat carbs and I'm kind of doing more of a keto thing, I usually feel more wired at night. Um- Hmm ... and, um, and then I try and just be physically active every day. I, you know, I try and either lift weights, you know, run, run three miles, um, swim- And so I'd, I'd say my sleep routine is I, I, I need to keep it as simple as possible because otherwise I've come from a place of obs- obsessing about it.
Yeah. And so be physically active, and then, like do something mellow in the evening. And reading, that helps. And I, I have to share, share this. I, I, I wouldn't say I have perfect sleep. I sleep between six and seven hours every night. Sure. Probably like once every two weeks I'll, I'll sleep less than six hours.
It'll be like, you know, maybe f- four or something like that. I think that's just normal for me. You know, I, I think some people out there just, just, just sleep less. I'm functional. I can do things on this. And so I also had to get away from this idea of I'm gonna sleep eight to nine hours, like some people say is ideal.
I also had to just kind of come to my own terms of, you know what? You've actually kind of been a six to seven hour a night sleeper, and that's good. That, that's good for me 'cause, 'cause when things are bad it's like four to five hours, when I'm like really in a panic about it. Sure. Sure. Yeah. And so just being very grateful for the sleep that I do have.
I never talk about it anymore. I used to drive my wife crazy kind of bitching about like all of the sleep problems. Yeah. I never mention it. I try and live my life as normally as possible, and I have to just keep on reminding myself that even if I have a bad night- It, it's not the end of the world.
Everything is okay Yeah Try and make the best of it. I mean, that's, that's, that's kind of my that's, that's how I approach it. That's cognitive therapy. Yeah. Beautiful right there. No, and, and I love what you said about the six to seven hours, and if anyone's listening and kind of in a similar camp, it's... We see that all the time.
Like, one of my favorite podcast episodes was with David Samson, who is a sleep anthropologist and studied the Hadza tribe in Africa and looked at their sleep patterns. And as far as looking at some of the closest approximation to kind of hunter-gatherer tribes that we can think of, that they often would have far less than this recommended seven to nine hours.
Usually a sweet spot around, like, six hours and change or so. Might have a nap by day, and no sleep anxiety. Like, there just wasn't language for sleep anxiety. It was no discussion about it because why? They lived outside. They live in alignment with the rhythms of nature, community, work ability. Yeah.
They're addressing things that aren't working. They're in a tribe-like, you know, space, whatever. And one of the things that's so great is it points to some of the literature that we have where it's kind of this U-shaped curve or the sleep need that is required for individuals. And with that U-shaped curve, it really does couple outside of that seven to six-hour range.
When we start getting chronically less than six hours, maybe things might, whatever. Yeah. But also to your point of one-offs, we're so resilient. We're able to experience those times and really thrive. The body is meant to be able to handle those. Think about times when we'd be in battles or what have you back in the day, and that would be something that we could summon.
So I love that you speak to that 'cause for, for insomniacs, that's what we need to hear. Yeah. Yeah. And I, and I, you know, from... I mean, just by going through, uh, medicine, I was sort of forced into that. One of the things that actually helped me w- where I've seen other insomniacs suffer is this idea that I can't function unless I sleep well.
Mm-hmm. As someone who's struggled with insomnia off and on, I have done some of the most important exams of my life on two hours of sleep. Um, I have, you know, worked in hospitals, like, you know, really late, um, you know, sleeping poorly, and I've just been fine. I've driven really tired, and I've been okay.
And so I always had this big reserve of I can perform- reasonably well, even if I'm chronically underslept and feel like shit. Yeah. And so I, I... That was really helpful when I was trying to get out of this big pity party. I'm like, "No, you can still have a good day. You can still kind of function." And so I would ask people to do that.
Um, you know, if they're, if they're stuck in this place where they feel like they cannot function without sleep, is it's, it's bullshit. You can. Um, just, you just need to have some of these experiences. Yeah. You need to have the right mindset and, and, and, and it's okay. And then the more you worry about it, the more, um, the, you, you know, you just make it worse for yourself.
Oh, it's so, so good. 'Cause, yeah, to touch on this kind of performance anxiety that so many of us will experience that spills over into this world of, "Well, how am I gonna get through the day? How am I gonna do this and that? Ah." And it can really be maddening. So I so appreciate you pointing to that ability.
And part of the way through is that experiencing sleeplessness for extended periods of time and realizing it's not so scary. So love that you pointed to that. Yeah. So did we miss anything in your nightly sleep routine? If not, we, um, check in on morning sleep routine, with the idea that how we start our day can impact our sleep.
Okay, so morning. Um, morn- mornings f- uh, mornings for me are no caffeine. Um, and I know this isn't the case for, for everyone. Yeah. I find I'm exquisitely sensitive to caffeine. People will think that I, maybe I'm just overly anxious. Even decaf, um- Sure ... I find if I drink decaf in the morning, I wake up more in the middle of the night.
Yeah. I don't know why that is. It's just a pattern I've noticed with myself. Yeah. After about five days of drinking decaf, I have more nighttime awakenings. I don't know if I'm in withdrawal from caffeine, and it's happening in the middle of the night- Mm ... and my body doesn't like that. Uh, it's, it's possible.
And so for me, no caffeine. Um, and I... Another thing that is, uh, a struggle as a workaholic, I used to always love waking up and diving straight into work. I don't do that anymore. I, I wake up, and I try and work out, and I try and go for a run. Because I know if I get that out of the way before the day gets crazy, and my daughter wakes up, and all of these different things kind of happen around my house, uh, at least I've sort of spent that energy, and that will also help me sleep.
So I, as I've become more successful in my work, and I have more of a team helping me, I've kind of shifted more to prioritizing just, you know, 30 to 45 minutes of physical activity in the morning. Um- And that's it. It, that- that's it. I, I wake up, and I work out, and I don't drink coffee. That's- I mean, the breakfast of champions right there.
I mean- Yeah ... it's fantastic. I love that. Um, and I love the awareness- Yeah ... too, of seeing what the impacts were when you were navigating that caffeine route or even decaf route, and that awareness- Yeah ... of what works for you. So that's fantastic. And it's so, it's so not fun because I love being high on stimulants.
I know. I used to be a stimulant-aholic. I... Coffee in the morning, multiple Diet Cokes- Okay ... just filling my mouth with nicotine pouches. I just, I loved that stuff. Um, and, and that's how I ended up on Xanax. So, so, so it, it wasn't, it wasn't a good, it wasn't a good fit for me. And, and, uh, you know, I cheat sometimes, and I have slip-ups, especially with nicotine.
Yeah. What I do notice with nicotine, because I sl- I track my sleep, and, and I'm, I'm even questioning whether I should be doing that, but- Yes, I- ... I'm, I'm just such a data geek ... get there. Yeah. I, um, it, it messes with my deep sleep where, you know, when I'm, when I'm using nicotine pouches, like, later on in the day, I notice my deep sleep, uh, scores go down.
And so I'm like, "Okay, that's, that's kind of like a trade-off." And so I, I just, I, I, I routinely stay away from stimulants, but hey, you know, we're all human, and then, then sometimes you just wanna be high on stimulants and have a good time and, and do that. And so I just, I just cop it on the chin, and I, I don't stress- Ah
about it. Yes. No. Well, I, I love that awareness, and I love that kind of, um, transparency of some of the things that you've seen. 'Cause yeah, we've certainly seen in so many of our kind of clients, not in the insomniac domain as much, but more in kind of just, like, optimizing or high performers or athletes, and they'll be looking for alternatives outside of alcohol.
And so instead of, you know, alcohol being such a clear hit to wellbeing and HRV and heart rate and whatever, and so they might explore things like nicotine or kava or other things as an alcohol replacement. And but yeah, pointing to some of the, the deleterious effects of that, I think it can be important, too.
But I hear you. It's, it's a fine line. So good. Then what might we see on your... The third question is, on your nightstand, what might we see there? On my nightstand, there is a red light, um, and it, uh, you know, for that sort of, like, nice sunset sort of vibe. Oh. It's, it's not... It, it's much redder than that, though.
It's, it's more murder room than a- ... you know, nice, nice, nice sunset. And so you got that. Uh- ... you have a Kindle, and, uh- Love it ... you have an Eight Sleep, um, and, um- For me, I like to sl- this is so funny, this is so personal. Yeah. I like to sleep in, in light pajamas. Like, I like sleeping in, uh, pajama pants, uh- Yeah
with socks and a T-shirt. And because when I was having a hard time with insomnia, it was like I had to learn to get out of bed when I was just, like, lying there for, like, an hour in the middle- Yeah ... of the night beating myself up. Uh-huh. And so I found that sleeping wearing some clothes made it a lot easier when it was a bit chilly to say, "Hey, it's been 10 minutes, I'm not sleeping.
Time to get up, time to do something else." Yeah. And so that's just kind of a habit to be- Prepared in case I need to get out of bed in the middle of the night and work on a puzzle- Right ... or read a book in the, in the living room. And so- Yeah. Um- Oh, a puzzle was one of the things you would do. I love that.
Yeah. That I remember. Yeah, yeah. Good. I've heard that. And then I, I also, I also sit there. I'm like, "This is so gay," you know? You know, I, I can't sleep. I can't do like one of the most- The rage. Yeah ... no- one of the mo- one of the most normal, fundamental things- Oh, my God ... ever. I'm sitting here with, with a journal sometimes.
I'm sitting here with a puzzle, and I'm just like- Yeah. Let's go rage ... men, men used to go to war, and I have sleep anxiety. You know, what is- Oh, my God. You know, what is this? Believe me. I know. I remember when I was dealing with my acute periods of insomnia, we were traveling full-time, my husband and I.
We've been together 14 years. We were traveling internationally, and I remember going the airports and being like, "Ugh," just, like, jealous of kids sleeping, parents slee- everyone's asleep, you know? Just, like, they were so effortlessly. Uh, just could, you know- Yeah ... no trouble at all. And just being like, "What?
How is this..." You know, and the upset, the anger, like, all these emotions that I had never allowed myself to feel as this, like, you know, oh, get it right, you know? G- uh, 'cause we see some of the tendencies for insomniacs, perfectionism, some of these ways of being that might show up reliably with our sleep. So love that you're sharing all that, and the puzzle, fantastic.
I haven't heard 'Cause what do you do? What do you, what do you do- What do you do? ... in the middle of the night if you can't just- I know ... go on YouTube and just binge, you know? And, and you can't work. Exactly. I, I have to find something to, to do, so yeah. I know. Totally. And everyone says, like, "Oh, yeah, fold laundry, do the dishes."
It's like, ugh, who wants to be doing this at 3:00 in the morning or whatever? So, uh, love to at least find a little bit of joy in that where we can. Okay, so the fourth question would be: what would you say to date has made the biggest change for you in managing your sleep? I would say dropping the perfectionism.
You know, thinking that I have to do this, and I need this supplement, and I need to eat at this time, and I need... You know, oh, no, I, you know, I had some nicotine today. I need to panic. Uh, you know, is getting into this weird mindset where I thought I was, like, this extremely complicated, like, computer program where a million things needed to line up for sleep.
Yeah. I mean, for me, I was my own worst enemy when it came to that. I needed to drop all of that shit, you know, get rid of the supplements, like, and just go back to basics. Sleep is a natural thing. Um, sleep happens to you. Sleep is not something that you can control. Um, and, uh, for me, that, that, that was, that was what released me from Beating myself up at night- Mm
and stressing myself up, and get- getting to the point where, like, I would be, like, sleepy, and then I would go into my room, and I would, like, almost have a mini panic attack. Like, I would get into bed- Wow ... and I would, like, just s- I, I'd just be up. Yeah. I had, I'd s- I'd just tortured myself. You know. Yes. You know, with- Yes
with, with, with, with my mind. And so th- that, that was a big thing, you know, is it was, it was anxiety. Oh, wow. Well, myself, and I'm sure people listening can absolutely relate to what you're sharing. And even if people are listening in their, you know, in the camp of, you know, just the sleep optimizer or whatever, knowing that we all have these periods of time where things might ebb and flow.
So for most people, they're gonna experience some period where their sleep is not working as well as they'd like it to. And for some of us, really becomes a defining period of our lives. So wherever you might find yourself, I think that there's so much wisdom in what you just shared. So, so grateful. Yeah.
So how can people find you, follow you, work with you, and what are the ideal people to come your way? Is it that they're considering tapering, that they need guidance, they're in the midst of it, it's not working? Sure. Yeah. Sorry, there's like five questions, but Okay. So I am the guy if you are having a hard time coming off medications.
Um, and so, um, uh, you know, there's a, there's a few things out there. Not everyone will need my services. I mean, you may be able to come off the medications, uh, fairly quickly, although I don't recommend that. I rec- I recommend a slow taper. But if you are someone who, you know, you start, you, you feel like, "I am stuck on these medications.
There's no way I can never get, I could ever get off," and you're just sort of sadly resigned to, "I just have to be on this for the rest of my life 'cause there's no way," that's when you should think about, uh, learning more about me. Yeah. Um, so, uh, the Dr. Yosef YouTube channel, and I apologize, it's, it, it's, it's, uh, it's, it's Josef spelt with an F.
It's the German version- Okay ... not the American PH version. Uh, but you can find me on YouTube- Yeah, yeah. We've got, uh, we have heaps of, uh, free resources over there. Uh, we have, like, dedicated videos on how to taper off, like, benzos, like Xanax, where we lay the whole thing out. Um, you can join our mailing list through our website, taperclinic.com.
In each of the emails we send out, we, we send out a, um, a free drug tapering course. There's like, I don't know, there's, there's hours of stuff in there. It walks you through exactly how to taper off your medications, what equipment you need, how to do all the calculations, um, and, um, and it's all free. Um, and so if you just jump on our mailing list, you can also find it below our YouTube videos.
And, um, if for whatever reason you are wanting someone to take you by the hand and actually just do this with you and, you know, you don't wanna think about it at all, we are in, uh, the 14 most populous US states, and so I think that goes all the way down to, like, North Carolina. Um, and so if you're in any of those states, we, um Uh, you could join, uh, you could join our clinic and, uh, me and my team can help you design a taper and, and safely come off.
And the other thing that I want to mention- Sure ... on my website, if you go to the... Le- let's say you don't live in one of those states, or maybe you, you're even an international listener, on my website in the Contact Us section, I've put, uh, three different directories to drug tapering savvy, uh, providers, and they're- Yeah
all over the world. And so if what- if for whatever reason you can't work with me, go and look in those directories and you'll find someone who knows how to do, um, all the things that I teach. Oh, I'm so grateful that there are people like yourself out there sharing this information and educating, no matter where you're, what corners of the globe you might be on, that you can be able to access support versus just, you know, silently suffering on our own or siloed or- Yeah
going to our doctors and then just being told, "Oh, you know, you can go and kind of go to one of these clinics where you get off these things in, like, a week or a- Don't do- ... long weekend" Don't do that. Don't do that. I, I want, I want a PSA for people. Please. Do not go to... Don't go... If you've been on benzos for any longer than six months, do not go to any, um, like, detox place where they pull you off in two weeks.
It's super dangerous. Um, and, uh, you could get one of those neurological injuries, protracted withdrawal. It's probably, like, th- there's a chance that it could happen. I, it might be 20% of people. Um, so there's a good chance you'll be okay, but listen, you don't want to gamble with your brain health. Um, and so my PSA to people is if you are coming off this med and you're in severe withdrawal and you're really not feeling well, restart that drug as soon as possible and come down in a much more controlled way.
Risking your brain health is not worth it. Ugh, I could agree more, 100%, because, uh, sadly, we'll see some of the downstream effects of that when people did try to navigate these things, not being educated by someone like yourself and can help guide them, and it's just so sad to see, and it can create all these other problems downstream.
So thank you- Mm ... for the work you're doing, for taking the time, and for sharing your wisdom and just getting this information out there. It's so important. Yeah. Thank you for having me, and, um, it's been a pleasure. You've been listening to the Sleep Is a Skill podcast, the top podcast for people who wanna take their sleep skills to the next level.
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