The Undeniable Link Between Sleep And Chronic Disease

Introduction to Sleep, Longevity, and Dr. Lufkin 0:00

Even my colleagues are still teaching things that, in my opinion, are incorrect. You know, basic concepts about these chronic diseases, and these diseases are all linked by common mechanisms that underlie, that drive longevity and aging and all these disease and that sleep is a factor in. But at the basic level, it's metabolic problems, its insulin resistance, inflammation, these cause all of the four chronic disease I have, they cause all of the diseases that limit our longevity. This is Dr. Talks.

Hi everyone and we're continuing on with the Sleep Deep Summit, new approaches to treating sleep apnea and insomnia. I'm your host Dr Audrey Wells and next up on my list of interviewees is Dr. Lufkin is a full professor at both UCLA and USC School of Medicine. He has an academic focus on the applied science of longevity. And in addition to being a practicing physician, he is the author of over 200 peer-reviewed papers, has 14 books available in six different languages, and the latest one is called Lies I Taught in Medical School, which is now available for pre-order.

Welcome, Dr. Lufkin. Yeah, hi. Can I call you Audrey or please call me Rob if you want. Let's do it. I'm so happy to be here, Audrey. This is great. Thank you for including me in your program. Yeah, this is just so in line with my passion for sleep medicine and really highlighting the benefits that healthy sleep can afford every single person who takes the time and energy to put into fixing their sleep.

Defining Longevity vs Healthspan 2:00

And I want to tap into your expertise about longevity because one of the things that I talk about a lot is the way that investing in your healthy asleep is like an insurance policy for later on in life. Would you agree with that? Absolutely. And for me, there's so much about sleep that I wasn't aware of even in training as a doctor and then as practicing physician. There's such a revolution in the knowledge about our understanding of sleep, quantity, and quality. That's why I'm so glad to see you doing this wonderful summit just to help us all learn more about it.

And, you know, I, always feel like I'm learning too. This is a product of my life's work. And you, know I want to ask you first of all, about this concept of longevity. So will you define it so that people can really get a grasp on what you mean when you talk about aging well and longevity? Yeah, well, first of all, longevity is just, it's how many years you live, right? It's a very simple concept. And if that's all we do, that probably not enough, because you tell people, hey, you're going to live an extra 10 years, and they go, Well, is that 10 more years in the nursing home or 10 year more with chronic diseases where I'm disabled and infirmed?

So anytime we talk about longevity and lifespan, We usually want to mention health span as well. So lifespan is the number of years that you live. Health span is number healthy years you have. And if we're going to increase the lifespan with longevity, we want be sure and it's implied that we wanna be and increase healthspan aswell. And today there's been a revolution in our understanding about longevity so that finally these things are really possible, that we can do significant things that really change our expected lifespan.

I agree with this concept. You don't want to necessarily live longer if that quality of life is low. So when we talk about your health span, I think that really underscores the point that we want spend the last 10 years of our life enjoying life,

Chronic Disease and the Limits of Aging Well 4:20

being active, social, and really enjoying our health and vitality. I wonder if you can talk about the way chronic disease erodes our longevity. What does that take away from us? Yeah, basically, when you look at longevity, how long we live, one way you can see what determines that length is look the diseases that kill us all. Statistically, you could go on the web, they're published every year, and it's the same five diseases, that account for 80% of our deaths. So statistically, we're most likely to die of cardiovascular disease, Alzheimer's disease cancer, and a couple others.

But the ones I mentioned are the chronic diseases that are associated with aging. And so these chronic disease literally determine our longevity because they determine when we die. The fact that these diseases come on for the most part over a gradual period of time and begin to erode our health span, that basically take away from our quality of life. So no matter how long we live, if we don't have good quality life, it's not a good thing. Yeah, and we were talking before I hit the record button about your book, Lies I Taught in Medical School, which is a fantastic title.

And I was saying that on the first day of my medical school, Which was at the University of Michigan, I remember that concept that about half of what I Was going to learn would be outdated. We're always trying to catch up. This was 20 years ago for me. What kind of lies did you teach in medical school? Yeah, I love that. I loved that concept. In the title, it does attract attention. It's a little bit of clickbait, but I wanted people to pay attention to hopefully get the message there. But there are a number of lives that I came across through my own personal journey with chronic diseases when I got hit with several of them when when I still had youngsters in elementary school, and I was prescribed four prescription drugs for those four diseases.

And I realized that this wasn't going to end well, basically, having the diseases in such a young time. So it forced me, even as a medical school professor, to re-examine the concepts that I had and what people I have been teaching what other people are teaching and I began to drill down in the literature and looked at some of the most recent articles that that are now you know these are peer-reviewed controlled

Reversing Disease Through Lifestyle Changes 7:10

studies and it showed how the thinking has changed especially about these these four chronic diseases that i had. And I I changed my lifestyle I basically my the foods I ate, the exercise, stress, and of course, sleep. When I changed all those, interestingly, I went back to see my doctors and they said, wait a minute, something's wrong here. I can't believe it. You've reversed your disease and you no longer need the prescription. So basically, long story short, is able to reverse all four of those diseases with these lifestyle changes.

in studying this, and this is nothing that I discovered or invented. It's other smarter people than I have made these discoveries, but it's just not very well known in the scientific literature. And today, even my colleagues are still teaching things that in my opinion are incorrect, you know, basic concepts about these chronic diseases. These chronic disease are all linked by common mechanisms that underlie, that drive longevity and aging and all these chronic diseases and that sleep is a factor in.

But at the basic level, it's metabolic problems, its insulin resistance, and its inflammation. These cause all of the four chronic disease I have. They cause the diseases that limit our longevity. The importance was making this information known to people. And so, for example, many people still teach that a calorie is just a calory. If you want to lose weight, and weight is a problem in our society. up to half of adults are overweight or obese and it's growing. And obesity can be a precursor for metabolic dysfunction, diabetes, and all the diseases I mentioned.

But the simple idea that a calorie is a calories, if you want to lose weight, you just exercise more and eat less. That's been proven to be wrong, but it's still being taught and it is not working for people to lose weight and there are much better ways of doing it if we understand the metabolism. Other concepts related to, in the book I go through each chapter is one of the lies and the chapters, I'll give you the chapter titles and you can plug in to lies, basically hits each of those diseases.

We do obesity, we do diabetes, you do hypertension, cancer, Alzheimer's disease, cardiovascular disease and then ultimately longevity. And there's a lie or a misconception associated with each one of these that I go into. I think one of the points that I really want to highlight here is the idea that a person who's interested in aging well and having a long health span has a lot of control over how that goes. These lifestyle changes that you're talking about are something that person can learn about and implement and literally change the course of their health.

And oftentimes, I don't think that power, people aren't really stepping into that powerful enough and relying too much on medications, pills, and not skills. So I really love it that you're highlighting that getting information, getting empowered with knowledge is something that can use as a tool to affect your

Metabolic Health, Insulin Resistance, and Weight Loss Myths 10:50

own course. Yeah, absolutely. That was probably the biggest takeaway of this whole experience. I mean, there are a lot of longevity drugs out there. You're rapamycin, you're metformin, your 8-carbose, other things like stem cells, and there're a lotta things you can do, but the most powerful longevity effect of all, beyond all of those, is related to our lifestyle. Nutrition, exercise, stress, sleep. All those things play a key role in longevity. And what just blew me away was how big a role it was.

Not only for longevity, but for even the chronic diseases, I will argue that lifestyle is a more important factor than any of the prescription drugs you could take. In other words, if you have type 2 diabetes, and you need insulin, you could take the insulin to control your hyperglycemia, but you shouldn't stop it without a doctor's help. But it is possible in the majority of patients with type 2 diabetes to reverse their type-2 diabetes with dietary interventions and also controlling the rest of their lifestyle, including sleep.

But once you do that, the insulin resistance can be reversed and then you go off those medications and you can control it with lifestyle. Many of the medicines that we prescribe for those chronic diseases treat the symptoms of that disease, you know, hyperglycemia with insulin or If I put a stent in my heart with a heart attack, you know, in the coronary arteries to open up the blood vessels, everybody thinks that's a cure for a hear attack. Of course it's not, it doesn't change the overall survival.

It may keep me from dying in a moment, but I will still go on to die of a heard attack eventually because it does not change an underlying disease. And to do that, We need to reverse lifestyle factors and metabolic health, insulin resistance and all these things. And the beauty of it is we all control our lifestyle. We get to choose every single day when we wake up in the morning, we get choose what we're going to eat, what were going exercise, you know, how much, and we can control the stress and set our sleep goals as well.

Yes, and I think really grounding ourselves in that message that we can decide how we're going to eat, how are we going sleep and how were going move. Those are fundamental to our long-term health. I want to circle back to something that you said before. One of the lies that your taught was that a calorie is just a And a very popular topic right now are these weight loss medications, these injectable GLP-1 medications. And then there's trisepidide, which is also GLp- 1 and GIP dual agonist medication.

Now, I'm boarded in sleep medicine and obesity medicine. So I've got kind of a double interest in this. My concern with these medications is that without the foundation, from healthy nutrition, physical activity, and good sleep practices, the effects of the medication could be too fast and also come with muscle loss. There's a connection with muscles loss and longevity.

Muscle Loss, Frailty, and Longevity 14:20

Can you elaborate on what that is? Yeah, muscle loss is one of the phenotypes of appearances of aging. When we see old people, we all see gray hair, loss of hair and wrinkles, but we also see frailty or sarcopenia, as it's sometimes called in the medical expression, where people lose weight and they just sort of waste away. That's one problem with aging and When people become more frail, they lose their vitality. They can't exercise as much. For a number of metabolic reasons, muscles contribute to glucose metabolism.

When you don't have as many muscles, that's a bad sign. You're able to fall down and you can fracture your hip, which is a fatal injury in many elderly patients. Eventually, they don't survive it. So frailty is a real problem in muscle wasting. That's why any of these longevity strategies, things like turning down mTOR with either rapamycin or with or with lifestyle, with intermittent fasting, dieting, and certain sleep strategies affect mTOR as well. mTor is the master survival protein that is really the strongest candidate associated with, if there ever was a longevity effect it would be on mTOR.

But with mTor, the important thing is that when we turn it off to increase longevity, that concern was that we would trigger muscle wasting. The important things is when you turn mtor down, we don't get muscle-wasting. Actually, muscles are maintained. Drugs like rapamycin, which turn down mtor do not result in muscle loss and frailty. keeping an eye on muscle wasting and with the obesity drugs, I mean, there's a lot of potential problems with those. But muscle-wasting, as you pointed out, is one of the important ones.

So how can people maintain their muscle mass? Maybe in the face of taking an obesity medicine drug or even in just getting older as the years go by, we tend to lose our lean muscle. What do you recommend? Yeah, I mean, on my longevity journey with my chronic diseases, had a dead bod. I was sort of maybe 10 pounds overweight. Actually, hadn't crossed over into the overweight mark, but all my muscle definition was gone. It had extra fat there, and I reverse that when I when i adopted the lifestyle factors the Lifestyle features that reverse my chronic diseases.

They also reverse the the fat accumulation but the importantly I didn't do it without with muscle loss and I kept the muscle Loss and the approach I used

Intermittent Fasting, Ketosis, and Better Sleep 17:20

was You know, as you know as an obesity doctor, the three macronutrients, fat, proteins, and carbohydrates all affect the fat storage hormone insulin very differently. And what I did was the insulin causes our body to store fat and that's what was causing my body accumulate fat. So my approach for my dietary approach was just to Avoid the macronutrients that drive fat storage, which were carbohydrates, but are also non-essential. The other two, you don't really want to cut back on, proteins or fats, because those are essential.

And so I went to a low carbohydrate diet, also called a ketogenic diet in some form. So I began going into ketosis a lot. The interesting thing about ketoses or a low carbohydrate diet is my insulin levels went down. My insulin resistance dropped, my inflammation dropped and my appetite actually goes away too when you're in ketosis. So it was very easy to begin intermittent fasting, which I do now. And for me, I love it. I have one meal a day when my kids come home from school at lunch, dinner time.

And the rest of the day, I just, you know, work out. I do my other activities of daily living. But the key thing is I'm not seeing muscle wasting. And just seeing the fat loss. It's possible with these lifestyle strategies, even reducing caloric intake to preserve muscle mass. Yeah, you know, I'm right there with you with intermittent fasting. It's a plan that I adhere to. I've been successful with it and it fits very nicely into my lifestyle. And I also have sort of a family dinner at night and I do kind of 20 and four split.

So I have a four hour eating window. And this works for so many people, and it can help keep insulin levels down, which promotes utilization of those fat stores. So people who are looking for a sustainable and long-term solution dietary-wise, intermittent fasting, I think, represents a really nice choice. And if I could, just to follow up with that, one thing that was interesting, and I'd love your take on it. When I began intermittent fasting and this nutritional shift, I noticed my sleep dramatically changed.

And I was able to sleep the full night. I got much better sleep.I would wake up naturally in the morning without an alarm clock. It seemed to have a balancing effect on my asleep as well, which was unexpected. Yeah, this is commonly seen. And I would say there's probably a couple of points that I bring up. One is that carbohydrates, especially late at night, are not very well metabolized. So that can lead to some sleep disruption, nighttime awakenings, waking up to go to the bathroom, and even acid reflux.

If you're having any sort of spice or garlic with the meal, that could be competitive with your sleep. The other thing is, there's a certain component of circadian timing that comes with nutrient ingestion optimization.

Key Takeaways from Lies I Taught in Medical School 21:00

So if you're eating earlier in the day, during the biological day, the circadian day. Your dietary enzymes are primed to be efficiently taking care of that meal, and it leaves you feeling robust. You're not sort of dragging after the meal. you're, not having episodes of hangar pains come up or anything. And I think a lot of people find that so reassuring and it cuts back on all the psychological chatter that can happen when people are trying to lose weight or change their dietary habits. So just having that soothing reassurance to your brain that this is the new pattern now goes a long way toward making these types of eating patterns sustainable.

That makes sense. Yeah. So as we close here, I wonder if you can maybe leave us with the highlights of what people can expect when they read your book. How might it help them to improve their health span? Yeah, just my book is kind of my story, what worked for me and was a revelation for and hopefully other people will be able to benefit from it, but again what we mentioned before was just that It's not about necessarily going to a doctor and getting a pill, although, you know, we're both doctors, there is a place for that, but for these chronic diseases that we all face and that are probably going kill us in the long term and determine our longevity, The real wake-up call and the message I would like everyone to get is the power that they hold in their own hands by the choices they make in the lifestyle.

And again, as I said earlier, the beauty of it is every morning we wake up, we get to choose what lifestyle we want and we can start fresh every day. I love that. And really highlighting people's empowerment as they determine what their health looks like is such an amazing message. Thank you so much, Dr. Lufkin. It's been a pleasure to speak to you today. Thanks, Audrey, and thank you for doing this summit. I'm really looking forward to hearing the other speakers as well. Fantastic. Take good care.

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