The Woman Who Helps NBA Stars To Sleep: Stop Having Showers Just Before Bed! Dr Cheri Mah

Intro (0s)

• Dr. Cheri Mah, a renowned sleep doctor and performance expert, has helped athletes in various sports, including the NBA, NFL, MLB, and Formula 1, improve their performance through sleep optimization.
• Dr. Mah's research has shown that sufficient sleep can significantly impact athletic performance, leading to faster reaction times, improved free throws, and faster sprint times.
• The video will explore practical strategies for improving sleep, including the timing of showers and baths, the impact of sex on sleep, and the best pre-sleep meals.

What do you do and why do you do it? (1m59s)

• Dr. Mah is a sleep physician who advocates for prioritizing sleep. She believes that good sleep is essential for optimal performance and well-being.
• Dr. Mah emphasizes that many people sacrifice sleep and don't prioritize it, leading to poor sleep quality and undersleeping. This can negatively impact their overall health, mood, and performance.
• Dr. Mah highlights the significant benefits of prioritizing sleep, particularly for elite athletes. She explains that sufficient sleep can lead to improved performance, faster reaction times, and better decision-making. She believes that sleep is a free, healthy, and safe way to enhance overall well-being.

Who do you work with? (4m22s)

• Dr. Cheri Mah works with a variety of professional sports teams and athletes, including the San Francisco Giants, Golden State Warriors, Philadelphia Eagles, Nike, Under Armour, and ESPN. She helps these organizations and individuals improve their sleep, scheduling, and travel habits. She has even been able to predict when NBA teams will lose based on their schedules and lack of sleep.
• Dr. Mah also works with CEOs and other executives to help them optimize their performance. She believes that many of the principles she teaches athletes are applicable to high-performing individuals in any field, as they all face similar challenges like pressure, decision-making, and the need to perform at their best.
• Dr. Mah's work resonates with people who are busy, travel frequently, and struggle with sleep, even if they are not professional athletes. She emphasizes the importance of sleep for overall health and performance, even in areas like fitness and injury prevention.

What are the misconceptions about sleep? (7m6s)

• Misconception about sleep duration: There is a misconception that everyone needs the same amount of sleep. In reality, individuals have different sleep needs, and the recommended minimum of 7 hours is just a lower threshold. Some people may require 8, 9, or even more hours to feel well-rested.
• Importance of finding your individual sleep need: It is crucial to find the amount of sleep that allows you to function at your best during the day. This individual sleep requirement can be determined by experimenting with different sleep durations and observing how you feel and perform.
• Small changes can make a big difference: Even small increases in sleep duration, like 15 or 30 minutes, can significantly impact performance and well-being. Studies have shown that a mere 15 minutes of extra sleep can be the difference between an A and a B grade in high school students.

Study that increases performance by 12 (10m46s)

• A study was conducted on adult male basketball players to examine the impact of extended sleep on performance. The players were encouraged to sleep 9-10 hours per night for 5-7 weeks to "pay back" their accumulated sleep debt.
• The study found significant improvements in performance, including a 9% increase in free throws and three-point shots, a 12% faster reaction time, and a 4% increase in sprint speed. These improvements were considered significant, especially in elite sports where even a 1% improvement can make a difference.
• The study participants increased their sleep by an average of 1.5 hours per night, demonstrating the potential for sleep to be a game-changer in sports. The improvements in reaction time, specifically, could be particularly impactful in sports like soccer, where goalkeepers rely heavily on quick reflexes.

NBA players losing based on schedule (14m11s)

• Dr. Mah conducted a study called the "NBA Schedule Alert Project" to determine if game outcomes could be predicted based solely on the schedule, without considering team strength. The study found that over three seasons, Dr. Mah was able to accurately predict when an NBA team would be at the highest risk of losing based on factors like travel and time zone changes, with a success rate of 76% to 86%.
• This study highlights the significant impact of travel and scheduling on team performance. The results suggest that these factors can be more influential than previously thought, even surpassing the impact of team strength.
• The study also draws a connection to the "Monday Night Football" study, which found that betting on a West Coast team playing an East Coast team during night games resulted in a 68% win rate over 25 seasons. This is attributed to the West Coast team's body clock being more aligned with the optimal performance window of 4:00 PM to 8:00 PM, regardless of the actual game time. This advantage holds true whether the game is played on the West Coast or the East Coast.

Players who slept more sprinted faster (17m3s)

• A study conducted in 2011 found that NBA players who slept more sprinted significantly faster, improving their sprint time by 4% over a standardized distance.
• The study involved a sprint drill performed after every regular practice, and the results showed a clear correlation between increased sleep and improved athletic performance.
• While some teams and athletes are aware of the benefits of sleep for performance, the momentum is shifting towards a greater understanding and implementation of sleep strategies as a competitive advantage.

Athletes who have changed their careers by focusing on sleep (18m49s)

• Andre Iguodala, a former NBA All-Star, significantly improved his sleep habits and saw a dramatic increase in his performance and career longevity. He was already a successful player but wanted to extend his career. By working with Dr. Cheri Mah, he focused on improving his sleep hygiene, including establishing a consistent bedtime routine, adjusting his nap schedule, and making healthier nutritional choices.
• Iguodala's improved sleep led to a measurable increase in his performance. He saw a significant increase in his free throw percentage, points per minute, and three-point conversion rate, while also experiencing a decrease in fouls. These improvements helped him win the NBA Finals MVP award and extend his career for an additional 10 years.
• Iguodala's story highlights the potential for sleep to enhance athletic performance. His experience demonstrates that even elite athletes can unlock new levels of performance by prioritizing sleep and making changes to their sleep habits.

Where to start getting better sleep? (22m5s)

• Dr. Cheri Mah emphasizes the importance of creating a sleep environment that resembles a dark, quiet, cool, and comfortable cave.
• To achieve this, she recommends using blackout curtains, eye masks, earplugs, and a white noise machine to minimize light, noise, and temperature distractions.
• These tools are particularly helpful for traveling, as they can create a more conducive sleep environment even in non-ideal hotel rooms.

Does sound/music hurt sleep quality? (23m18s)

• Dr. Cheri Mah believes that listening to a radio or podcast while falling asleep is acceptable if it's a habit you're accustomed to and helps you relax. However, she advises against watching TV before bed due to the bright light's stimulating effect.
• Dr. Mah is a proponent of white noise machines, especially for masking external noises like garbage trucks or construction. She highlights the emergence of adaptive white noise machines that adjust volume based on environmental changes.
• Dr. Mah recommends earplugs for blocking external noise, particularly during travel. She also mentions that earplugs can be used at home to dampen noise.

Does temperature matter? (24m39s)

• Dr. Cheri Mah recommends sleeping in a cooler environment, ideally between 60-67° Fahrenheit (16-20° Celsius), as this temperature range has been shown to promote sleep.
• She suggests gradually decreasing the room temperature by one or two degrees every few days to find the optimal temperature for individual comfort.
• Dr. Mah advises against taking hot showers or baths immediately before bed, as this raises core body temperature, which can interfere with sleep. Instead, she recommends shifting the shower time to an hour and a half before bedtime to allow for a gradual decrease in core temperature, potentially improving sleep quality and promoting deep sleep.

Food timing for better sleep (26m44s)

• It is generally recommended to avoid eating large meals within 3-4 hours of bedtime. However, if you find yourself hungry late at night, a pre-sleep snack can be a good option.
• A balanced pre-sleep snack should consist of approximately 50% complex carbohydrates and 50% lean protein. Examples include cereal and milk (whole grain cereal), cottage cheese and fruit, or whole-grain crackers and peanut butter.
• The goal of a pre-sleep snack is to provide slow-digesting fuel to help you sleep through the night and avoid waking up hungry. It should also help you feel satiated while you try to fall asleep.

The food to eat before bed that will destroy your sleep (29m9s)

• Consuming certain foods before bed can negatively impact sleep quality. Dr. Mah advises against consuming alcohol, caffeine, fried foods, and sugary carbohydrates before bed. These foods can lead to increased heart rate, disrupted sleep patterns, and potentially even acid reflux.
• The exact mechanisms by which these foods affect sleep are still being researched. While the field of sleep and nutrition is growing, there is not yet a complete understanding of how specific foods impact sleep stages and quality. However, studies have shown that eating certain foods before bed can lead to more awakenings during the night and affect overall sleep quality.
• Sleep deprivation can create a vicious cycle of poor sleep and unhealthy food choices. When individuals are sleep-deprived, they are more likely to make poor food choices, such as reaching for sugary snacks or high-fat foods. This can further disrupt their sleep, leading to a cycle of poor sleep and unhealthy eating habits. This cycle can contribute to weight gain and other health problems.

What to do for a racing mind? (34m3s)

• Dr. Cheri Mah recommends spending 10 minutes processing racing thoughts outside of bed in dim light every night. This can be done through activities like stretching, deep breathing exercises, journaling, or writing a to-do list.
• These activities help activate the parasympathetic nervous system, which calms the body and mind, and dampens the sympathetic nervous system, which is responsible for the "fight or flight" response.
• Reading before bed can also improve sleep quality by reducing exposure to light and calming the parasympathetic nervous system.

What is the parasympathetic nervous system? (35m34s)

• The parasympathetic nervous system is responsible for relaxation and winding down. It is the opposite of the sympathetic nervous system, which is responsible for the "fight or flight" response. Activating the parasympathetic nervous system helps to slow down the heart rate and breathing, which can help prepare the body for sleep.
• Dr. Mah emphasizes the importance of slowing down before bed. She compares it to driving a car: it's easier to gradually slow down and come to a stop than to slam on the brakes. This process of slowing down the body and brain helps to improve sleep quality.
• Dr. Mah highlights the importance of sleep for athletes. She describes how she helped NBA player Andre Drummond improve his sleep by addressing his sleep environment, reducing his power naps, and making other lifestyle changes. She also shares the story of NFL player Ryan Jensen, who was diagnosed with sleep apnea and saw a dramatic improvement in his performance after receiving treatment. This story demonstrates how sleep can be a crucial factor in athletic success.

Emotional link to better sleep (39m40s)

• Sleep deprivation affects emotional regulation: When we are sleep-deprived, our emotional regulation is compromised, making us more irritable, grouchy, and prone to reacting with our emotions rather than with thoughtful consideration. This is because our brains are not functioning optimally, and we rely more on our instinctive responses.
• The amygdala plays a role: The amygdala, the part of the brain associated with fear and emotions, is more active when we are sleep-deprived. This can lead to heightened emotional responses and potentially impulsive decisions.
• Recognizing the impact of sleep on emotions: The speaker acknowledges the significant impact of sleep on their own emotional state and decision-making. They have learned to recognize when they are sleep-deprived and adjust their behavior accordingly, avoiding important decisions and interactions to prevent potentially negative outcomes.

Perception change on the importance of sleep (41m44s)

• Sleep is crucial for effective decision-making. The speaker emphasizes that even small amounts of sleep deprivation can significantly impact cognitive performance, leading to poor judgment, slower reaction times, and increased errors.
• Sleep deprivation can have disastrous consequences. The speaker cites the Challenger space shuttle disaster as an example of how sleep deprivation can lead to poor decisions with potentially catastrophic outcomes. The investigation concluded that fatigue and insufficient sleep among key decision-makers contributed to the launch, ultimately resulting in the explosion.
• The speaker highlights the importance of prioritizing sleep for optimal cognitive function. They argue that sleep is essential for making sound decisions, whether in high-pressure situations like athletic performance or in everyday life.

Cognitive performance and sleep (44m1s)

• Cognitive performance is sensitive to sleep loss and gain: Studies show that reaction time, a key indicator of cognitive performance, is significantly affected by sleep deprivation. Even a small increase in sleep duration (e.g., 15 minutes) can improve cognitive performance. Conversely, chronic sleep deprivation leads to slower reaction times and increased errors.
• Sleep debt can be paid back, but it takes time: While a few nights of recovery sleep can improve how you feel, it may not fully restore your cognitive performance to baseline levels. Multiple weeks of consistent, adequate sleep are needed to fully recover from sleep debt.
• Even small increases in sleep can have a positive impact: Studies have shown that even one additional hour of sleep per night for five days can improve cognitive reaction time and processing speed in athletes.

Sleep debt and how it works (47m49s)

• Sleep debt is a concept that suggests that when you consistently get less sleep than your body needs, you accumulate a "debt" of sleep. This debt can build up over time, and even if you get a good night's sleep one night, you may still be carrying over some of that debt.
• While there is no definitive proof that sleep debt is a real thing, there is evidence to suggest that it can have a negative impact on performance and well-being. Dr. Mah explains that she has seen improvements in athletes' reaction times, fatigue levels, and performance when they are able to pay back some of their sleep debt through sleep extension interventions.
• Dr. Mah emphasizes that the improvements seen in athletes are not simply due to better training. She explains that they have tried to control for training variables and have seen improvements in performance even when training has remained consistent. This suggests that the improvements are directly related to the sleep extension interventions and not just better training.

Muscle memory and its connection to sleep (52m22s)

• Muscle recovery and sleep stages: Deep sleep is associated with muscle recovery and regeneration due to the release of growth hormone. REM sleep, the final stage of sleep, is linked to memory consolidation and skill development.
• Sleep cycles and memory: Sleep occurs in cycles of about 90-120 minutes, with the proportion of deep sleep and REM sleep changing throughout the night. Deep sleep is more prominent at the beginning of the night, while REM sleep increases in the early morning hours.
• Muscle memory and sleep: Muscle memory is a type of memory that requires sleep for consolidation. Sleep acts like a "save button" for new information and skills, allowing them to be stored in long-term memory and retrieved later. Without adequate sleep, the foundation for new skills and memories is weakened.

What's a nappucino? (54m35s)

• A "nappuccino" is a combination of a caffeinated beverage and a short power nap, designed to boost alertness and performance.
• The caffeine from the beverage starts to take effect around 15 minutes after consumption, while the power nap is typically 20-30 minutes long.
• The ideal scenario is to fall asleep within 5-10 minutes after consuming the caffeine, allowing the caffeine to kick in as you wake up from the nap, resulting in a combined boost in alertness and performance for a couple of hours.

Do naps work? (56m5s)

• Dr. Cheri Mah explains that naps can be beneficial even if they are too short to reach deep or REM sleep.
• The benefits of naps come from staying in lighter stages of sleep, which can provide alertness and performance boosts.
• Longer naps can lead to sleep inertia, a feeling of grogginess upon waking, which can negatively impact subsequent sleep and performance.

Is the snooze button bad? (57m39s)

• Hitting the snooze button multiple times can disrupt your sleep cycle, particularly your REM sleep, which is crucial for learning and memory consolidation. This is because you are likely waking up from REM sleep each time you hit snooze, interrupting the natural progression of your sleep stages.
• Consolidating your sleep by waking up at the desired time without hitting snooze allows for a longer period of REM sleep, maximizing its benefits. This means you'll get more out of your sleep and potentially improve your cognitive function.
• The cost of fragmented sleep due to snoozing is a reduction in REM sleep, which can negatively impact learning, memory, and overall cognitive performance. By waking up at the desired time, you can ensure you get the most out of your REM sleep and reap its benefits.

Are there different chronotypes? (1h0m10s)

• The speaker discusses their personal preference for working late and their belief that they might be an "evening owl" or "alow chronotype." They explain that they schedule their day to avoid early commitments, allowing them to sleep in and wake up naturally.
• Dr. Cheri Mah confirms that there are different chronotypes, with some people naturally being "evening owls" who prefer later bedtimes and wake-up times, while others are "morning larks" who thrive on earlier schedules. There is also a group in the middle who don't strongly lean towards either.
• Dr. Mah emphasizes that the speaker's strategy of aligning their sleep schedule with their chronotype is a great way to maximize productivity and well-being. She points out that many people, especially night owls, are forced into schedules that don't match their natural rhythms, leading to sleep deprivation and potential negative consequences.

Does school start too early for kids? (1h2m46s)

• The speaker believes that school starts too early for kids, citing personal experience of feeling tired and struggling to focus in class due to early school start times.
• Studies have shown that later school start times for high school and middle school students in California have resulted in improved attendance rates, higher GPAs, fewer mental health issues, and reduced car accidents.
• The speaker emphasizes that adolescents naturally have a shifted body clock, leading them to want to go to bed later and wake up later. However, forcing them to wake up early for school creates a sleep debt, negatively impacting their learning, memory, and overall health. Shifting school start times to allow for more sleep can improve student performance and well-being.

What parents should know (1h4m32s)

• Start early with sleep hygiene: Dr. Cheri Mah emphasizes the importance of establishing good sleep habits and routines for children from a young age. This sets them up for success in prioritizing sleep throughout their lives.
• Cultural shift needed: Dr. Mah believes that we need a cultural shift in how we view sleep. Instead of seeing it as something to sacrifice, we should recognize its importance for health, well-being, and overall performance.
• Even parents struggle: Dr. Mah, a new mother herself, acknowledges the challenges of getting enough sleep with a young child. She shares her own strategies for maximizing sleep quality, including power naps and optimizing her sleep environment.

Sleeping travel tips (1h7m47s)

• Pre-flight strategies: Dr. Mah emphasizes the importance of having a pre-flight strategy to minimize jet lag and travel fatigue. She advises against panic packing the night before a flight, as it can disrupt sleep. Instead, she recommends packing early and aiming for at least 7 hours of sleep the night before a flight. Additionally, she suggests adjusting your body clock a few days before travel by going to bed and waking up a half hour earlier each day, especially if you are traveling across multiple time zones.
• In-flight strategies: Dr. Mah recommends staying hydrated throughout the flight to combat dehydration, which can worsen jet lag. She also suggests starting to synchronize your sleep and meal times with the new time zone you are traveling to. She encourages travelers to invest in a travel sleep kit, which includes items like an eye mask, earplugs, noise-canceling headphones, and a travel pillow, to create a more conducive sleep environment.
• Post-flight strategies: Dr. Mah notes that it takes approximately one day to fully acclimate to each time zone crossed. She emphasizes the importance of continuing to follow the new time zone's schedule even after arriving at your destination.

Sleeping drugs (1h12m13s)

• Melatonin can be helpful for adjusting your sleep cycle, especially when traveling, but it's important to be aware of potential side effects like grogginess and the fact that supplements are not always regulated. Dr. Mah recommends using NSF Sports certified melatonin for athletes, as it has stricter regulations.
• Apps can be helpful for adjusting your sleep cycle when traveling by providing personalized recommendations for eating, sleeping, and light exposure. Dr. Mah recommends an app that her team uses and will link it in the video description.
• When traveling, it's important to stay hydrated, minimize or eliminate caffeine, and avoid alcohol. Dr. Mah also recommends using noise-canceling headphones and wearing sunglasses to minimize light exposure at certain times.
• It's important to allow yourself time to adjust to a new time zone. Dr. Mah recommends avoiding important meetings and strenuous exercise on the first day of travel. She also suggests using caffeine and power naps strategically to help you through periods of low alertness.

Does sex before sleep hurt quality of sleep? (1h16m1s)

• Dr. Cheri Mah emphasizes the importance of associating the bed with sleep and sex only, avoiding activities like work or using electronic devices in bed. This helps to strengthen the connection between the bed and relaxation, promoting better sleep.
• While there is no extensive research on the impact of sex on sleep, anecdotal evidence suggests that sex before bed can improve sleep quality for some individuals.
• However, Dr. Mah acknowledges that a bed partner's movements, snoring, or other sleep disturbances can negatively affect sleep quality.

What is the most popular question Cheri Mah gets asked? (1h17m34s)

• The most popular question Cheri Mah gets asked about sleep is whether it's possible to oversleep. While some people feel groggy after sleeping for 9-10 hours, this is often due to a shift in their sleep schedule or accumulated sleep debt, rather than oversleeping itself.
• Studies have shown that people who sleep for 10-11 hours may have a higher risk of disease and mental health issues, but it's difficult to establish cause and effect. It's possible that these individuals have other underlying conditions that contribute to their longer sleep duration.
• Mah emphasizes that a single night of 10 hours of sleep doesn't necessarily mean you're oversleeping. The key is to maintain consistent sleep hours to avoid disrupting your natural sleep-wake cycle.
• Another common question Mah receives is about snoring. While it's often considered a normal part of aging, snoring can be a sign of sleep disorders like obstructive sleep apnea. This condition can lead to fragmented sleep and a lack of restful sleep.
• Mah recommends consulting a primary care doctor and potentially getting a sleep study if you experience frequent snoring. This can help identify any underlying sleep disorders and ensure you're getting quality sleep.

How common is sleep apnea? (1h20m21s)

• Sleep apnea is a common disorder, affecting approximately 26% of individuals between the ages of 30 and 70. This means that roughly one in four people within this age range may have sleep apnea.
• Many individuals with sleep apnea remain undiagnosed and untreated until later in life, often in their 60s or 70s.
• Common symptoms of sleep apnea include feeling tired during the day, needing caffeine or power naps to stay alert, waking up frequently in the early morning hours, and snoring loudly. Individuals with sleep apnea may also experience pauses in breathing or gasping and choking during sleep.

What excuses do we hear for prioritizing sleep? (1h22m17s)

• Dr. Cheri Mah addresses the common excuse of "not having enough time" for sleep, stating that it's not a valid reason. She believes everyone can make time for sleep by prioritizing it and making strategic choices throughout the day.
• She suggests implementing a wind-down routine, optimizing the sleep environment, investing in sleep tools, and making better choices during the day to set oneself up for better sleep.
• Dr. Mah emphasizes that prioritizing sleep in the off-season is crucial for optimal performance during the season. She argues that trying to optimize sleep during the season is playing catch-up and puts athletes at a disadvantage compared to those who have invested in sleep during the off-season.

Sleep and injury proneness (1h23m52s)

• Studies have shown a correlation between insufficient sleep and an increased risk of injury in athletes, particularly in adolescents.
• Athletes who sleep less than 6 hours are more prone to fatigue-related injuries, while those who sleep less than 8 hours have a 1.7 times higher risk of injury compared to those who sleep more than 8 hours.
• The exact reason for this increased risk is unclear, but research suggests that insufficient sleep leads to greater variability in biomechanics, causing athletes to move differently and potentially increasing their risk of injury.

Waking up early makes Steven hungry (1h25m35s)

• The speaker, Dr. Cheri Mah, describes a personal experience of waking up early (4:00 AM) for a flight. She notes that when she wakes up at this early hour, she feels very hungry, but not when she wakes up at 8:00 AM. This is because waking up earlier shifts her body clock, creating a state similar to social jet lag.
• Dr. Mah explains that this early morning hunger is likely due to hormonal imbalances. Hormones like leptin and ghrelin regulate appetite, with ghrelin increasing hunger and leptin promoting satiety. Insufficient sleep can disrupt these hormone levels, leading to increased hunger and cravings for unhealthy foods, particularly in the evening.
• Dr. Mah emphasizes the connection between sleep and weight management. She suggests that addressing sleep issues can be crucial for achieving weight goals, as poor sleep can disrupt hormonal balance and contribute to unhealthy eating habits.

Is waking up in the middle of the night normal? (1h27m32s)

• Waking up in the middle of the night is a normal part of the sleep cycle and can happen as you transition between sleep stages.
• You may be consciously aware of these awakenings or they may occur unconsciously, and a wearable device might even show awakenings you don't remember.
• Frequent awakenings that make it difficult to function during the day should be investigated by a doctor, as they can be caused by environmental factors, alcohol, caffeine, stress, a racing mind, a bed partner, or underlying sleep apnea.

How much does alcohol affect my sleep (1h29m15s)

• Dr. Mah explains that while she doesn't have specific statistics on how alcohol affects sleep duration, studies show that moderate to high alcohol consumption is strongly linked to fragmented sleep and more awakenings during the night.
• This means that the quality of sleep is significantly impaired after consuming alcohol, potentially impacting performance and well-being the following day.
• Dr. Mah suggests minimizing or eliminating alcohol consumption before bed, advocating for drinking in the morning or early afternoon instead.

Guests last question (1h30m10s)

• The guest was asked if they would change their worst mistake if they could, knowing it would change everything afterwards. The guest responded that they would not change their past mistakes because they believe that mistakes are learning opportunities that shape who we become.
• The guest shared their personal experience with sleep and how they used to view lack of sleep as a badge of honor. They now prioritize sleep and believe it is crucial for productivity and overall well-being.
• The guest emphasized the importance of sleep for athletes and encouraged everyone to prioritize sleep as it can significantly impact performance and overall life quality. They also shared their contact information and encouraged listeners to reach out with any questions.