Dr. Ashtaad Dalal SPILLS the Tea on Sleep Hacks Gone Wrong!

Hello and welcome to Sleep is My Waking Passion. The podcast where we get real about sleep and how it shapes your life. I'm Dr. Allison Cole, a triple-borded pulmonary critical care and sleep medicine physician who's learned to thrive despite having chronic insomnia. And now I'm here to help you do the same. Hello and welcome to another episode of the Sleep is My Waking Passion podcast. I am deep into season 7, moving on with season 8 and I have a super cool guest today. This is Dr. Ashtod DeLal. He is amazing. I met Ashtod at the ASM Advocacy Committee. He is a member there where I co-chair and he has brought so many wonderful insights. He's also really novel and that he gets stuff that I'm really into. So he's sort of into what new tech is out there using AI to help streamline our workflow. Like you're really progressive and that's one of my favorite things about you that I just love having you in my orbit because I have someone else that I could bounce ideas off of. What's the best AI tool right now that we both like? So he is board certified in family practice and sleep medicine. He practices full-time at PMA Health and Falls Church, Virginia. He has a couple of academic affiliations, one being Georgetown University, Smarty Pants, and the second is his training alma mater, which is LSU. So this gentleman went from Louisiana all the way over to Virginia. He happens to be very special in that he is a huge advocate for healthcare reform essentially. That's what we do in the Advocacy Committee. We really try to push the boundaries of sleep health and get the government and the people that work within our government to really understand the importance of prioritizing sleep health in this country. He also happens to be a member of the Alliance for Patient Access. And you do some other things too. Like you're really, really into giving a lot of your time for wonderful causes. So that's awesome. Now I appreciate you having me on one other time commitment that I've taken on just this year is the president of the DC Sleep Society. So I just stepped into that role and you've got to update your LinkedIn page. Molly, do you need to update my LinkedIn page? You're right. But it's very recent as of the last few months, so yeah, but again, just big focus on networking and advocacy and how we can kind of push the field forward and help spread the importance of sleep and sleep health for everyone. But again, really appreciate you having me on today. Congratulations. That's so wonderful. I love seeing that. Thank you. I love when state societies are really robust. Jersey has a really-- Well, DC, not a state yet. Oh, it's just within the Washington, DC, that area. It encompasses the DMV, right? So it's DC, Maryland, Virginia. So it's professionals from all three areas. Whoa. That's way bigger than one state. Well, Maryland and Virginia have their own. So we kind of are this catch-all for Northern Virginia, Southern Maryland. And so people who are in the area tend to kind of congregate in the DMV. I love the DMV, that's so great. Yeah. It's just so unique. And you don't realize it until you have conversations like this. Like in Jersey, we just have the New Jersey Sleep Society. What I was going to tell you is, you know, there's another society that's more for like the internal medicine folks, and they're really, really powerful. I don't feel like New Jersey Sleep Society has its mojo yet. I think it's on the rise, but-- Overall, I feel like we need to push it forward, you know? We need a president like you. Like, can you just take over the New Jersey one and make it cool? That'd be awesome. It looks like you care. It was born and brought up in New York, so the tri-state area, very near and dear to me. That means we got a little feistyness in us, right? Right. Speaking of getting a little feisty, you and I have many patients who want to talk to us about things that they see, and there's a lot of information on TikTok and Instagram. I want to turn it over to you. I want you to pick one of the sort of sleep aid drawers that is really popular on social media that you want to address today. What would you say would be number one for you? So, sleep aid wise, I would say, hearing more and more about magnesium glycine. Oh, yeah, I saw this online, it said to take it. I think it works better for me than melatonin, but am I taking it right? Magnesium three in a, and L-theanine. What are all these things? I keep reading and hearing about them. Are they legitimate? Do they work? What are your thoughts on them? Is it just nonsense, or is it legitimate? And my response usually is, I think, of the ones I named, all legitimate in terms of having a potential to have a positive impact in terms of improving one sleep, sleep quality. I think it's important to dig in a little bit deeper, which isn't, you know, we're just 30 seconds sound bites at best, really, can't have the attention span further than that. So, hearing about something, but then doing one's own research, okay, what is this? What is this about? How does it work? And talking about AI, that could be an applicable use for AI right there. Enter the correct prompt. Okay, what are peer-reviewed journal articles saying about L-theanine? Is it really going to help with my sleep? Or is it just someone who gets some sort of kickback from the company because they're chilling for them? Maybe you seem glycinate, that's certainly a supplement that I recommend to my patients. There's certainly evidence behind it as well in terms of not necessarily being a true sleep aid, but can help with muscle relaxation and kind of the wind down that is so important prior to getting ready to go to sleep, really. I kind of print out a handout that I have pre-populated, I'll print it out, handed to patients, goes over what magnesium glycinate is versus magnesium citrate, not to take that. You're going to be living in the bathroom, you will not get a lot of sleep. Exactly. You're having a colonoscopy prep, probably should avoid the mag citrate and opt for the mag glycinate instead, gives the dosage kind of recommended duration prior to the desired bed time that one should be taken this. And then I'm a big advocate of keeping like an extremely subjective sleep log or sleep diary, almost like a spreadsheet. And that kind of segues into this whole wearables phenomenon, let's say, that encompasses so many different products. So wearables I think is maybe more colloquial vernacular for these devices. Consumers sleep technology might be another. Some of these companies might argue that it's much more than sleep, so don't just call it a consumer sleep technology, call it a wearable, whatever it is, right? So these are the Apple watches, the Fitbits, the order rings, the womb bracelets. I'm like wearing two of them too. Should we tell? Exactly. My thought on this is pros and cons, like with so many things, but increasingly in the last, I don't know, four years, talking to patients, whether they're there to seem me for true insomnia or not, they're very eager to kind of put their phone in my face and say, what does this mean? Why is this happening? This is how old I am. It's comparing to people, my age, my gender, why am I only getting this much deep sleep and REM sleep and core sleep in my sleep score is this. And this phenomenon, if it progresses, they've kind of coined a term for it, or those insomnia, which is really this condition where individuals become so fixated on achieving perfect sleep as it's indicated by these wearable devices that they actually develop or have worsening of their insomnia to begin with. So like counterproductive, really, they start experiencing anxiety, not for any other reason, but other than what this data is showing them based on their wearable and they're checking it the next day, in some cases, they're checking it in the middle of the night if they wake up. Oh my God, I knew it. See, I knew it. I knew I wasn't sleeping well. And then it reinforces this kind of negative thought and these intrusive thoughts that is absolutely counterproductive to helping with their insomnia. So really, it started with looking at cases where these healthy sleepers began losing sleep due to obsessing over this tracker data and we're seeing people just trust their smart watches or these wearables more than their own experience of sleep. And ironically, it's that pursuit of ideal sleep data so that their numbers look good and they get a better sleep store that actually becomes the reason that they're not sleeping well in the first place. You have touched on so many good points. I want to rewind just a scotch because I think something that you mentioned when you comment on supplementation before we hit on the wearables that people are using, you know, sort of consumer wearables, commercial product wearables, which will become key in what we talk about. But you touched on something that I think is really profound, which is a lot of the quote over the counter aides like magnesium glycinate, like a lot of these other supplements. It's not the same effect as a sedative hypnotic prescription pill where it's just trying to switch you from on and off. You touched on something that I have found in clinical practice, which is it's about sort of allowing you to downshift. So if you need a tool for your wind down routine, I think they're pretty safe. They have pretty good safety profile. So if you're looking at benefits versus risks, probably the benefits outweigh the risks. I also wanted to point out that I think certain populations of patients may actually do better on some of the supplements. I want to give you an example. I had a patient that we were talking about, L3 and 8 and we were talking he had read that it could kind of help with managing his anxiety. He is very specifically has some autism spectrum traits. He already takes a little bit of low dose melatonin, which I've talked about in prior episodes as being actually good for autism to help with sleep because of how they produce melatonin or lack thereof potentially. But he is a very anxious kind of person had a lot of sleep anxiety and so our sleep restriction was so slow to get him into a better place. And the supplement actually there's some data that shows that it might actually help to calm you down and allow you get to sleep. And that's something that he added. We talked about it, which I love the fact having open dialogue with your patients, which is the key. Let's talk about it. What's important to you? These are the risks. These are the benefits. If it's something that you want to try, these are the dosing. That's what we did. We went over what a standard starting dose was, where his limit was and I again reiterated, that's not going to switch everything off and everything's magically better. But if it can help you down ship so that you can manage, I think that's a really, really important point for a lot of these supplements. So thank you for bringing that up. I love that you're also talking about orthosomnia because it has definitely been the consults that I've had sometimes. Like if you're looking at it from the perspective of, if you really perceive that your sleep is quite good and then your ororing tells you it's not, which has definitely been in my office, I'm like, just stop listening to the ororing, like just not, like don't do it. I mean, this person even went so far as we had a formal sleep setting. I'm like, your study is fine. Like I can legitimately tell you with gold standard monitoring, there's nothing here that I am worried about. I think you're doing great and it's like they couldn't wrap their head around it. So yes, that's a real concern where I do think just to be a counterpoint where it might be helpful is, you know, I've had some patients where I really struggle to get them to fill out that sleep diary. I mean, I talked about how important it is. I give them multiple options. You want paper. I give you paper. You want an online one. I don't love it as much, but I'll make you an online one. So I have a little like Excel spreadsheet. You can fill out. I like the ASM one where you shade the boxes. I think it just gives such a nice pattern. But again, if I can't get a patient to do it, what do I use? Well, that's where, you know, the whoop and the orer and all these other things. I'm like, just can you just give me some semblance of what the heck your sleep is showing you? And again, with the caveat that, you know, there's indications that if you're a good sleeper, at least the Apple Watch technology may actually be pretty accurate in terms of sleep staging, but who's the type of person who like uses these devices? They're kind of people who don't sleep great or they're looking at that down in the middle of the night. And the problem is that those are the people for which it is the least accurate. So, and these are not commercial devices that were ever really designed to provide medical data in the classic sense. I like the fact that some of these technologies may alert you that you might have a problem with sleep disorder breathing. I think that's really helpful or cardiac arrhythmia, potentially if it picks that up. And they'll eventually evolve to that. No doubt where there is kind of, okay, validated, objective studies performed, but right now I don't think we're there. I think I misspoke a while back when I combined L.T. and E.N. and L3 and A just to clarify and go back. The other thing you said that I really liked out and was, yes, I'm a big fan of it being a two-way street, it has to be a team sport when it comes to sleep, right? There has to be buy-in from the individual. If there's not that buy-in, then it really just doesn't work. And that concept of like you were saying a silver bullet, no, there needs to be effort, discipline, consistency, in conjunction with whatever else we've discussed, whether it's supplements or prescription pharmacologic agents, whatever it is. But at the same time, if there's not an effort put in and there's not adequate discipline and consistency, like I said, it's not going to happen. And I agree with you that that is actually, in my opinion, the best use in terms of sleep of these wearable devices is using it to look at patterns, routines, and then using that data, which can be difficult and difficult to interpret for some also, mind you, using that data to inform kind of behavioral changes. That's the best utilization of this. And drilling down in terms of sleep staging and percent time and awakenings after sleep, it's not there yet, in my opinion, and it can actually, like I was saying, be a big disservice to the individual, actually, and be counterproductive. So my thought is people need to be aware of that and use them, but use them for what they're most appropriate for. And I feel like that education part of it is lacking across the board. I would have to agree with you. I also think that there's so much information, and so many times it's information from people that want to, that may truly be scientists, may be very intelligent with what they're saying, have strong arguments, but are not clinicians. I think that's really important because they can have great tremendous influence because they're a scientist saying stuff, particularly about sleep. But is it actionable? Are they making it in a way that you're not somehow also sending a message to people who may be not following all of those steps that are scientifically backed by rat model studies and the like? Do we have real concrete evidence that it's effective in humans? If there is a risk-benefit ratio, and we don't necessarily have the evidence, but what the evidence shows is not showing any harm, and some people are anecdotally reporting benefit okay, but let's just be careful with how we're delivering that message because people really hang on to people that they think are intelligent, good communicators, but they may not be saying something that clinically is really relevant, and there can be some inherent harm in that. I bring that up because there are some longevity people that are really big on TikTok and things. One of the things that kind of gets me is that I think there actually is real utility to using things like mouth tape, but I feel like there are people that are very, very passionate about their ability to fix your sleep apnea. Listen, don't ignore all those doctors. Just go get one of these. Your sleep apnea is going to go away, and it makes me crazy because I'm like, stop. Don't listen to those people because they're really convincing. You're saying ignore all the doctors. That's assuming that they have even talked or consulted with the doctor, which is a big assumption to make. So I get this question about mouth tape a lot, a lot, a lot, a lot, and just like you said, certainly a lot of influencers pushing it, and you look and you see, oh, are they getting kicked back for this product and hostage tape and terrifying-looking stuff. This is my take, and this is exactly what I tell patients, is in the absence of having ruled out sleep apnea, using mouth tape, in my opinion, categorically, is not only not a good idea, but potentially dangerous, really. If the person has had a sleep study that has ruled out sleep apnea, and we're talking about primary snoring, and they want to try and mitigate that, sure. You want to try using mouth tape and see if it helps. Absolutely. I'll give them a name of one of the different phone apps that kind of records snoring decibel levels throughout the night in chart set. Usually I'll tell them to do a baseline with no intervention, no mouth tape in this example, and see what that looks like, okay, and now let's do it with the mouth tape. So it gives us a little bit more objective data rather than maybe relying on a bed partner to say, oh, you know what, that's really working for you, or you know what, there's no change. I don't know what's going on. That's not working. But without having ruled out sleep apnea in the first place, not a good idea, in my opinion. A couple of things to kind of expand upon what you said. You mentioned rule out sleep apnea, and I know there's a lot of people listening who are going to say, well, my home sleep test was negative, right? And we know that there's certain limitations. So when, you know, Ashtata saying, rule out sleep apnea, at this point in time, you really need a polysomniagram to be crystal clear that you understand exactly what's going on. Or multi-night test. So in all furnishing, do a multi-night home sleep apnea test. Either one, you know, has pros and cons to it. But yes, you need more information. One of the things that I talk to patients about, especially when I see, I have them, I kind of like to have them look up, and I like to look at their nostrils, and whether or not when they sniff, do their nostrils kind of stay open, or do they collapse? And that's a really easy way to fix some nasal valve and competence, which I learned that from an ENT. And if you can fix this part, and you can breathe a little bit better through your nose. So proving to yourself, like if you have restriction, if you have no air going through your nose, especially in that case, because you've got a deviated septum, you've got a giant polyp in your nose, whatever it may be, some people are really severely congested. You can't use mouth tape if they are only other airway is your nose, and it doesn't work well. Okay. So number one, yeah, we're all going to be in agreement. That's bad. If you can fix some nasal valve and competence, they have all sorts of cool do-hickeys now that I've seen advertised where they show examples of nasal valve and competence, and then the people are like on TikTok, and they're like, oh, I can breathe so much better. Yeah, they're showing the coddle maneuver to say, well, if you can do that, and it feels better, well, then you might have this, and you should buy this product. Yeah. So I mean, but if you can either use a breath-right strap or mute or nose-a-van or any one of these things that sort of opens up in stents to open your nose, if that works for you for better flow, then it becomes a matter of retraining. I don't like any mouth tape that completely closes off the area 100%, so it always freaks me out when I see these influencers, and they've got literally just a taper on their lips, and there's no hole, there's no nothing, right? It's your airway, and you don't want to go to sleep with no airway. You are able to breathe both through our nose and our mouth for a reason. Evolutionarily, that kind of kept our race alive. So we should lean into that, in my humble opinion. But for tape that won't 100% close off your airway, and you're awake, especially to start, you could start to practice what it means to nasal breathe and start to retrain your breathing, but that's a responsible way to do so. And why do I do that? Because I'm still going to rule out sleep apnea, because if I still find the sleep apnea, I know that I'm probably going to find a mask, like nasal pillows that will help to stent the airway open for you, especially if you're blocked. And if you can breathe through your nose better and you're not mouth breathing, I have more options for masks that are not top-gun fighter pilot covering everything on your face, kind of things that people don't like where they feel like there weren't a gas mask. And then sometimes I use it as an alternative to a chin strap, again, in that highly compliant patient. But I did a little post that was a little tongue in cheek about it, but the reality is there, I think there's some utility to it, but just not with these Yahoo's on the internet or saying it's for it. Like, you still need to be tested. What you just said is the second instance where I like mouth tape. So one is we've ruled out sleep apnea, agree with what that means, how one might define that with a degree of certainty, right? The other is using it in the place of a chin strap, so the patient has sleep apnea, uses positive airway pressure therapy, but they're having oral venting. Then again, I think mouth tape, really good solution, and great way to implement it and mitigate that oral venting where the air kind of cycles out of the mouth. If their mouth falls open and they're using a CPAP or VIAP. Have you had anybody ask you about any products that are like in the, I'm going to call it like the tens unit kind of stimulation kind of devices, either it's like stimulating your vagus nerve or it's stimulating the vestibular system to help you sleep at all? Not really. I've had a few patients ask me about devices that can stimulate like lucid dreaming and what my thoughts are on that. Oh, like LMI or something, it's one brand, I think that it's like a band that goes on your head and it's supposed to change your brain waves. What have you uncovered? I haven't looked into that, but it's been on my mind mostly because I'm curious about these devices, but like I can't go around buying all these devices to try. Crazy, you know, so I'm like, all right, hopefully one day I'll meet someone who uses it. It depends again on what the intention and purposes, you know, what's the end goal for the individual? What are they trying to get out of it? And what is the likelihood that this device that they have pursued or they're inquiring about might help accomplish that goal, right? I have a thought that, you know, you're better off doing X, Y, and C. It's lower cost and easily done and accomplished. Do that. Why go out and spend money on something that maybe hit or miss for them. So I guess it kind of depends. And again, that goes back to the team's sport aspect of it and kind of shared decision-making and that aspect of it just depends, because there's so much out there is really just getting inundated with data left, right, and center. So then how do I properly adapt my behaviors based on these inputs or outputs, I guess, and make improvement progress in terms of my sleep and sleep quality? So long-winded answer is, you know, I think it just depends on what the goal is. In terms of these kind of nerve stimulators, certain things that haven't really had too many patients ask about those. Well, I'm going to show you one, because I think this is pretty freaking cool. This is modia sleep, and you wear it like a headband and then kind of goes around like that. And then these kind of stick on the back of the neck. I can tell you that the idea is that you, I think you wear it every day for like 30 minutes. It's part of your wind down routine, really. But the idea is that it's stimulating the vestibular system, which then kind of sends signals to the hypothalamus, and that's supposed to help you kind of wind down and relax for sleep. Promote sleep promoting no treatment, or is there something, yeah, sort of sleep promoting in that aspect, but not that it's going to, like you're just going to put this on and be like, you know, just, I'm knocked out, right? That's like every American dream I feel. Can I have something right now that just fixes everything, right? But I thought it was worthwhile to show just because I have played around with this. Modius was kind enough to, or newer valence, the company that makes this device was kind enough to let me play around with it once your feedback and what's been your experience with that. So what I can tell you is even from the very first day now, thankfully, and this is what I want everyone to leave the message being that if you struggle with your sleep, if you're really diligent, like oshtod had said, with making sure you have a regular wake time that you have a routine that you would hear to that you eliminate the things that make you stay up later, doom scrolling, too much alcohol, whatever it may be, right? Whatever. Sugar at night, whatever it may be, if you can eliminate those things exercising too close to bedtime. Yes. Thank you. If you're doing the good behaviors that promote sleep and you're very consistent with making sure you're only in bed for as long as your body is capable of sleeping, right? And you're waking up pretty much every day at the same time. The majority of times you're going to be okay. So for me, even though they were like, you can use it sort of as needed after you kind of use it more consistently for 30 days, they're dealing with patients who are just at the start of their insomnia journey. So I think it just helps them downshift again, getting to that. Just transition you out of that like sympathetic, like, oh my God, I'm going 1000 miles an hour. I can't relax. How can I sleep? Hyper vigilant. Yes. You know that hyper visually at like and just kind of promoting that parasympathetic nervous system. It was cool. So I don't know if you've done a lot of boat riding. I did a lot of boat riding as a kid on a tiny 16 foot, it's called the lakeside fisherman. It had that name because it was meant for lakes. That's what we could afford, but my dad didn't like to go fishing on a lake. He wanted to be in the Atlantic Ocean. And the best fishing in the Atlantic Ocean is when there's small craft advisory wardings. So I would be on this boat where it's like, it's just crazy. No, granted a lot of sea sickness for me. I now still like don't love boats as a result of that. Yeah, this sounds like trauma. But one of the things that I do recall are the many trips where like when it was calm and you were just sort of floating along, it's like a rocking motion, you know, like being in a car too. And so if you're somebody who is like, you know, turns into that this narcoleptic type of person who's like, I'm ready, I'm ready to go to sleep as minute I hit a car. You know, like when I'm a passenger, I'm out. When I'm in a bus, I'm out, when I'm in the plane, I'm out. This might really work for you. If that gentle rocking motion is something that your body really, really, really likes. I think it's kind of neat and it does work. It does work. What was interesting for me is the very first time I really noticed the sensation it was giving. But then the times after that, it didn't feel like the like it almost felt like I was used to it already. So it was like, is it working? Like in my mind, I was like, what am I going to notice? I mean, in the end, I think it did decrease the time to fall asleep, which is basically what they've got, I believe it's they got FDA approval for that for insomnia, specifically because they were able to show that there's some benefit to your sleep architecture. So it's not cheap, but it could be kind of cool to explore a little further. So how much are you talking? They initially have been selling these for 1100 dollars, but they do have other programs that you can get involved in where the cost is, first of all, you can rent it for a month, which is like 99 bucks for the month. So you could literally just use it for a finite period of time and really give it a test run. And if it's working for you, great, otherwise you can return it. And then they have ones where you can just buy it out for like half the cost. So they do have deals, but I didn't want this to turn into an infomercial for modias sleep certainly, but it just happens to be one of the, you know, I think Ruchir Patel, who I spoke with, who does a lot of things with inspire. He actually also was exploring a very similar therapy. I don't think it went anywhere to the point of actually advertising it, but there's some data that supports that this stuff actually might work. And so I find it fascinating as like another tool, particularly if you have someone who's very sensitive to medications or maybe they're, there are a lot of medications already. And you really, if they're doing all the cognitive behavioral therapy stuff, that's what I was talking about. And I said, your behaviors, you're doing all the right things that we know help you sleep and yet you're still struggling. This might be another tool that you could potentially use as long as you don't have a contraindication to it. When you were talking about the boat and kind of rocking on the boat, my mind went to, oh, so maybe we need like a snoo for adults, have you seen those, you know, like for infants, like, maybe that's what's needed. No one's done that yet. And same thing. Can you imagine like a king size snoo? It would be a big snoo. It would be a big snoo, but people rent those also because they're, you know, priced the way they are. I just also had another thought about another product that I get asked a lot of questions on, which is eight sleep or sleep eight pound for goodness. Yes. I've got questions on that too. And that I'll tell you sleep eight, right? And so they kind of have two main products. Isn't it eight sleep? You're right. You're right. It's eight sleep. Eight sleep. Yeah. Pad for your own mattress versus their mattress, whatever. But anecdotally, just, again, not an infomercial, not a paved sponsor for them. But anecdotally, really amazing feedback actually, right? And it makes sense, patients will ask, oh, well, why did my oxygen level go down during my sleep study at all? And right, going back to kind of what you were talking about in terms of how humans breathe, my compensatory mechanisms and, you know, if there's nasal blockage for whatever reason, then we have our mouth to rely on that sort of thing. Going back to that kind of primal aspect of it, sleep, the whole idea is, right? Our body recovers and restores itself and gets ready for the next day. So physiologically, everything winds down, right? Our heart rate drops, our blood pressure drops, our respiratory rate drops, our oxygen level will drop. The question becomes, you know, how low does it go and how long does it go there? Segways, maybe into another conversation about hypoxic burden. That's a different topic. But your core body temperature drops as well, right? And that helps also with the wind down. That's why you hear people say, oh, you should take a hot shower or hot bath, right? Because there's no better way to cool the body down than evaporative cooling. So a byproduct of taking a hot bath or a hot shower is that evaporative cooling that takes place afterwards after you're done. And that helps with the wind down. So I think working with that principle, right? Eight sleeps says, okay, we're going to monitor your body temperature. We can do that. And we're going to regulate it with this, you know, external source. And of course, then there's data involved, which goes back to, oh, look at my sleep score. I'm sleeping better with eight sleep. But my point is the kind of logic, objectively there is extremely legitimate. And again, I'm speaking anecdotally here in terms of the feedback I've had has only been positive. But again, similar price point to the product you were mentioning before. Yeah. So not cheap. No. They do make cheaper options. Yeah. But I think what makes eight sleep particularly cool, no pun intended. And this is just for me kind of researching it a bit because I've had people ask about it. I haven't had anybody actually go for it yet. Is that you can time it. So I had a friend of mine who was like, you know, I'm fine. I can fall asleep great. Like I'm comfortable. And then it's like at the, you know, the witching hour when he wants to sleep longer is when he starts to warm up. And then he's like, no, I'm awake and I can't get to sleep. And I'm all sweaty. And I'm like, wouldn't it be cool if you could time the eight sleep to cool you down? So I believe that it's kind of neat that way because you can sort of set it to do different things at different times. That's my understanding of it, which I think is just a really useful feature, particularly if you're somebody who you may be too cold when you first get into bed and not want something that's going to cool you down because otherwise if it's too cold and you can't go to sleep, I'm one of those people. I actually, I know it's like 65 degrees or whatever. I'm like 71. And for me, that's a lower than what I used to be when I was younger. That's like my now I'm in my late 40s temperature and it's probably going to go down further. But for right now, if it's too cold, like, you know, when I go to the hotel room and it's 68, I'm like, I am freezing right now. This is the worst. I just can't, I can't get to sleep if it's too cold. I'm with you. You think, right, there's like a common joke or a common meme where it's like the best partner to find is one who agrees on the temperature in the room when going to sleep. Are you cracking up because my husband still would, it would be an Arctic tundra. So he is very, very much compromising with me, which I appreciate. We just do lighter blankets because I see be like, uh, sweating. That's about right. That's about right. Ashtad, this is, we could like, I could seriously talk to you for hours. It is such a pleasure to have seen you recently at sleep, to have you be part of my world, to share this experience with you. You are a load of fun. I can't wait to do more fun things on the advocacy committee with you. Lordly knows what next year holds for us. And yeah, fun chat. Come back. Talk to me anytime. Anytime, anytime. More than happy to. Struggling with sleep, Dr. Cole is here to help whether you need a comprehensive sleep coaching program, suspect you have sleep apnea or simply seeking a second opinion. She's available for consultation in New Jersey, New York, California and Georgia, with more states coming soon. Schedule your free 10 minute review of services today to find out which visit is right for you at AskTheSleepMD.com and start your journey to better sleep with a trusted sleep expert. Please be advised that the sleep is my waking passion podcast is for entertainment and educational purposes only. It does not constitute medical advice. Always consult your healthcare provider for personalized guidance. For my full disclaimer, please visit AskTheSleepMD.com and while you're there, don't forget to sign up for my free newsletter. Sweet dreams and happy listening.