Episode 496: Dr. Michael Breus: The 4-7-8 Breathing Trick That Fixes Middle-of-the-Night Insomnia

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Now that I'm in my 40s now, falling asleep is not the problem.

Right.

The problem is getting up, like getting up in the middle of the night.

Oh, yes, I that that happens all like by

I can fix that.

How he, so this is my problem.

So I get fall asleep, no problem.

Yeah, 3:30, boom, I'm awake.

And then once I'm awake, got the answer.

Yeah, I can't fall asleep again.

Got the answer for you.

It's going to take me about three and a half to four minutes, just letting you know, because I know you usually like short answers.

This one's going to take a minute.

Okay, go ahead.

So, first of all, this is my number one video on YouTube.

This video has gotten 5.4 million views at this point to answer this question.

And this question is the number one question that I get asked.

The number two question is, what bed should I buy?

It's kind of interesting, right?

Really?

I swear to you, it's crazy.

What bed should I buy?

I'll talk to you about that.

Let's fix your insomnia first.

Okay.

So when people wake up in the middle of the night, it's actually not your fault.

Let me explain.

When you wake up in the, well, I'm sorry, when you go to bed at night, your core body temperature rises, rises, rises until it hits a peak.

When it hits that peak, it begins to drop, usually around 10, 10.30 at night, depending on your chronotype.

Remember my animals?

Yeah.

That'll change a little bit.

But as soon as that happens, your core body temperature continues to drop, drop, drop.

At some point, your core body temperature has to raise, otherwise you're going to become hypothermic.

I'll give you one guess as to what time that usually is for you.

Three o'clock in the morning.

That's exactly right.

So every human on Earth wakes up at some point in time during the night, usually between one and three o'clock in the morning.

That's because of this increase in core body temperature.

However, most people don't even know that they've woken up because you have to be awake for about 45 seconds to actually realize that you're awake and they

and they roll over and they're back to sleep.

You, however, are not.

So let's talk about that situation right there.

Okay.

So when you look at that situation right there, there's a few different biology aspects that you need to know and understand.

So number one, my first thing is I tell people, don't go pee.

Now, I want to be clear, if you got to go to the bathroom, go to the bathroom.

But hold on for a second.

90% of people tell me they wake up and they say, Well, I'm up.

I might as well go pee.

So there's a statistic that people don't know.

In order to enter into a state of unconsciousness, you need a heart rate of 60 or below.

What do you think happens to your heart rate when you go from a lying position to a seated position to a standing position and go pee?

It's much higher.

Much higher.

So when you get back, then you got two issues.

You got to get your heart rate down and you got to get yourself back to sleep.

So don't go pee unless you really have to go pee.

Now, a lot of people turn to me and they say, well, Michael, I feel like my bladder is full or something like that.

And so I say, number one, are you on your side when you wake up?

75% of people are.

I said, roll to your back and count to 20 and see if you still have to pee.

Because what happens is a lot of people squunch their bladder.

right while they're on their side and when they just kind of stretch out and lie on their back and relax for two seconds they're like oh actually i don't i don't have to pee so then they don't have to get up so then they can move forward with the process of trying to lower their heart rate i want to be super clear if you got a pee go pee all right yeah Number two, don't look at the clock.

Now, this is also another thing that almost everybody does.

Yeah.

Right.

And they instantly do the mental math and they say, oh, shit, it's 3.30 in the morning and I got to get up at 6.20.

Sleep, sleep, sleep.

And you try to force yourself to sleep.

Got to be honest with you, JC, in the history of time, no one has ever been able to force themselves to sleep because your energy is going in the wrong way, right?

When you're saying sleep, sleep, sleep, your heart rate's kicking up.

And the anxiety kicks in.

Right.

That's the biggest factor is when you do the math and you're like, oh, no, this is going to be a disaster.

Yeah.

Right.

And your heart rate, bita, bait, bait, straight up.

Okay.

So if you can avoid it, don't look at the clock.

Now, I'm going to be honest with you.

Everybody looks at the clock.

Everybody looks at the clock.

But if you can, avoid it.

What I do is I tell people, look, charge your phone in another room or charge it in the bathroom.

People always say, oh, I can't charge my phone in another room.

What if my kid calls me in the middle of the night?

Number one, your kid hasn't ever called you in the middle of the night.

And I didn't say turn it off.

I said, put it in the other room.

You can still hear it, but I don't want it to be easily accessible for you to get the piece of information to realize that you're in an anxious situation.

Okay, let's say I haven't gone to the bathroom or I have and I haven't looked at the clock.

Michael, what do I do now?

So there's something that I learned a little bit ago to help lower your heart rate actually quite rapidly.

It's called 478 breathing.

I did not develop it.

It was developed by a very smart doctor, Dr.

Andrew Weil, Harvard-trained naturalist.

Okay.

I know him.

Yep.

Super interesting guy, right?

So he actually created this breathing technique for the Navy SEALs.

So when you're a Navy SEAL and you're shooting downrange, if your heart is beating too fast, you can change the trajectory of the bullet.

So he helped all the Navy SEALs lower their heart rate to a point where they could fire in between heartbeats.

That happened to be 60, which is our magic number.

So we're on.

So I teach people how to do 478 breathing.

Now, there's two things that, well, three things that I want you to understand here.

Number one, four, seven, eight is exactly what it sounds like.

You breathe in slowly for a count of four, you hold for a count of seven, and you breathe slowly for a count of eight.

Back out.

I'm gonna be honest with you, when I first tried it, I couldn't do it.

So I modified it, made it a four, five, six breathing.

So my hold was a little shorter, and my output was a little shorter.

And it took me about a month to be able to kind of get my lungs used to this.

But here's why it works so well: when you're counting, you can't think about anything else, which turns off monkey mind, which is what you probably get when your mind starts going.

So, by counting, you are occupying your mind, and when you're breathing and counting, you are occupying your mind and you are lowering your heart rate at the same time.

Pretty cool, right?

Wow, so you count you do four in four in, hold for seven, push for eight.

Now, it's not a hard push, it's a light push.

Now, here's where the trick comes in: okay, you need to do about 10 to 12 cycles of that for your heart rate to get lower, right?

I lose count.

Happened to me all the time.

So I came up with this crazy method that'll help me.

So when I'm lying there with my eyes closed, I put my hands out like with little fists, like just down by my side.

And when I breathe and I do a 478, I stick out one finger.

Then when I do another 478, I stick out a finger.

And by the time I get to 10 fingers, I know I've done 10 cycles.

I can either go backwards or I can just stop when I'm there.

Okay.

Wouldn't you be sleeping by then?

Hopefully.

A lot of people are.

Again, it doesn't take that long to do this, four seconds, seven seconds, eight seconds, right?

But you need to do it nice and slow, nice and relaxed.

And the goal is to lower your heart rate.

So, because that, I think what you just said is exactly the thing.

Monkey, I get monkey mind, right?

I start thinking of all my problems and I get such anxiety.

I know.

And then, like, it just feeds on it, feeds on itself.

Of course.

And then 3:30 is now like 5.30.

And now, I'm really upset.

Right.

Cause you got to talk to the sleep doctor for the podcast next day.

And you're like, what am I going to say?

Exactly.

I'm like, oh my God, I'm going to be so tired.

I'm not going to have any energy again.

And then, it takes you down a bad rabbit hole, right?

Absolutely.

Absolutely.

But there's more.

Okay.

Because I want to know how to get rid of monkey minds in the middle of the night.

So by distracting yourself is basically one of the only ways.

So the 478 breathing does a really good job of that.

Okay.

That's number one.

Number two is you also want to think about something called yoga nidra.

So old from very ancient, ancient, ancient.

But one of the things we know, some people call it non-sleep deep rest i call it yoga nidra okay but there's data to show that it is actually rejuvenative so lying in your bed with your arms kind of in the corpse pose and relaxed is actually helpful now it's not the same as sleep but it's probably worth 30 sleep so an hour of that is probably worth 20 minutes of sleep so here's another thing to just yeah no the data's there like i wouldn't say it if there wasn't data here's what's fascinating is you could lie there for an hour chilling out and your your body is rejuvenating for what would have been roughly 20 minutes of sleep so you're doing yourself some good so even if you're not doing yourself some good you're actually doing yourself a little bit of good all you need to do is just cross your arms and just like this cross them just like this close your eyes and just breathe that's it and you get about 20 of what it would be if you were actually sleeping exactly so that's good to do in the middle of the night because you know you're because what people are freaking out about is they're like oh my god i'm not going to feel good i'm going to not rejuvenate this isn't going to go well I'm going to do this wrong and that wrong.

And what I'm telling you is, is while it's not at the same pace, you're still doing yourself some good.

And the final aspect of all of this is an idea set that I call acceptance, right?

Here's the deal.

You've been in here before.

You've actually were here last night.

Yes.

Okay.

Exactly.

And guess what?

Your head didn't pop off.

Nothing terrible happened.

But you don't make great decisions at three o'clock in the morning when you're thinking about those kind of things.

So what I try to remind people is trust your body.

Okay.

Your body does this thing right before it goes to sleep, it kind of scans you throughout the daytime and says to itself, okay, this damage has occurred.

This emotional situation has happened.

Okay, we need about this much of deep sleep.

We need about this much of REM sleep.

This much is how much we need to get for total, you know, rejuvenation, blah, blah, blah.

And it changes every single night.

But, like, if I'm doing, if I'm waking up in the middle of the night, five nights in a row, doesn't that just overall ruin my

health?

So that is a great question.

So, no, so we're going to go from what do I do about it in the middle of the night to what happens if it's happening multiple nights in a row and I can't control it, Michael, right?

Because I think that's what happens, right?

Because you get what I feel, what I think a lot of people do, is that if it's happened once or twice in a row, you get nervous to go to sleep.

It's going to continue to happen.

Yeah, you get almost like a phobia to going to sleep.

Right.

Cause you're like, oh my God, I'm going to wake up again.

Right.

Blah, blah, blah, blah, blah.

So this is where where people usually use alcohol, right?

Bad idea.

Alcohol destroys stage 3, 4 sleep, which is the physical restoration.

So drinking yourself to sleep at this point is never a good idea.

I actually think, to be honest, what people are doing more than drinking now are they're taking gummies.

Yeah, so let's talk about cannabis and sleep, right?

So especially if you're in a state where it's been legalized, which is almost all of them, 28 now going on more.

Yeah.

Here's what you need to think about when you're thinking about cannabis and sleep.

And by the way, I've written more about this topic than anybody else in the country.

So if you swing over to the sleep doctor.com and type in cannabis and sleep, you'll learn a ton.

But here's the basics of it is, number one, there is no data I've looked to show that CBD does almost anything for your sleep.

Okay, let me repeat myself.

CBD does almost nothing for your sleep.

However, CBD is good for pain and it's good for anxiety.

So if you have anxiety that's preventing you from sleeping or you have pain that's preventing you from sleeping, CBD might actually be a pretty decent tool to use.

CBN, as in nighttime, that's what works for sleep.

There's one paper that just got published about three or three or four months ago that showed that the nighttime awakenings are actually helped.

by CBN.

It slows them down significantly.

Now, what's CBN?

CBN is one of the constituents within the cannabis plant.

So there's THC, there's CBD, there's CBN, there's something called CBG, there's also something called CBC.

There's several different components that a lot of people don't know about.

But if you're going to the dispensary and you're looking for something to help you with sleep, you really want to be looking for this component called CBN.

And you would probably want a ratio of three of those for every one CBD and every one THC.

THC is the component that makes you feel buzzed and makes you feel fun and all that kind of stuff.

Now, you notice I'm saying it's okay to have some THC.

Let me explain.

THC at high amounts will lower your REM sleep and increase your heart rate, which we don't want either one of those, but at lower amounts, it will lower anxiety.

So I would argue that you want something that's high in CBN, because that's what helps with lowering your awakenings, CBD to lower some anxiety, and THC to lower some anxiety to help you enter into sleep.

Now, I want to be very, very clear.

You don't have to take marijuana to help you sleep.

But if this is something that is habitual for you or something that you feel comfortable with, that would be a formulation that I would look at.

The other thing I think is important to look at here is if this is happening on the regular, you probably want to come and talk to somebody like me, like a sleep specialist who's been trained in something called cognitive behavioral therapy, because there's a technique called sleep restriction that I would use in that case to be able to consolidate the amount of sleep that you get.

So, while this is going to sound very, very strange, we talk about it a little bit in the book.

This is what we do: if you're normally waking, let's say you woke up at 3:30, you're up until 5:30, then you fall back asleep for an hour, and you just don't want that.

What I would have you do is I'd have you go to bed.

What time do you normally go to bed?

10.

So, I'd have you go to bed at 10:30 or 11.

So, notice later than normal.

So, build up that sleep debt, right?

And then I would have you get up at probably five.

Okay, I would restrict the amount of time that you have in bed.

Now, you're going to say, Michael, I already don't sleep.

You're making this worse.

My anxiety is going to be through the roof.

What are you talking about?

This sounds crazy, but you take no naps during the day and you wait again till that night at 11.

What I'm doing is I'm naturally building up your sleep deprivation to use to my advantage.

So if you do this for five to seven days in a row, by the way, you shouldn't do this on your own.

You should only do this under the supervision of somebody who knows how to do this because there's some things that can go wrong.

What'll happen is your sleep consolidates and now you're no longer awakening in the middle of the night.

So then what I do is once I've gotten you six solid hours, I start to stair step you out.

Slowly, I can get you six and a half, seven hours, I can get you to wherever you need to go.

Wow.

So that, so you're basically eliminating the time in bed where you're just like, you know, thinking

and like, and basically just like ruminating.

Right.

Exactly.

We take that out.

So you go to bed later and wake up earlier.

Exactly.

And then you over time expand on it.

Exactly.

That's what you guys do in like sleep clinics?

Yeah.

Well, so remember, in sleep clinics, we treat all kinds of sleep disorders.

So this is how most sleep clinics would look at treating insomnia if they're using a method called cognitive behavioral therapy.

To be fair, some sleep clinics would rather use pills and medication.

So they might put you on a medication like an Ambien or a Sonata, a Restoril, Valium, Xanax.

There's lots of medications out there that can be helpful for sleep.

However, then you got a sleep problem and a pill problem.

Well, that's the thing.

Like anybody I know who's ever taken Ambien, they get addicted to that stuff and then they can't fall asleep without it.

So here's what I'll tell you is I think Ambien and all of the sleeping pills have got pros and they've got cons to them.

While some of the newer technology pills don't don't have a physiological addiction to them, if you haven't slept well in 20 years and I give you a pill, you're going to want that pill again and again and again.

100%.

Right.

So there's a psychological component to it, I believe.

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What about using Benadryl to fall asleep?

Such a good question.

So when you see all the PMs out there, all that is is the analgesic plus Benadryl, otherwise known as diphenhydramine.

Hold on to your socks.

So to be clear, there is direct evidence to show that consistent use of Benadryl on the nightly as an anticholinergic leads directly to Alzheimer's.

You didn't think I was going there, did you?

No, I did not.

I know.

That's what I'm trying to say.

ZQuil, the PMs, you name it.

If you're down in a Benadryl on the regular, you are absolutely positive.

The data is very clear.

You're walking into the door of Alzheimer's.

I've never heard that.

I know.

Isn't that crazy?

That's so scary.

Isn't it?

I'll show you the data.

It's nuts.

How?

So,

oh my gosh, because that actually is the only thing that works.

If I can't fall asleep, like and it's been days.

No, I want to be clear.

If you use it once in a while, it's not, you're not going to have Alzheimer's.

I'm talking about people who have to have one of these PMs every night.

Right.

I'd much rather you come see me in my clinic, right?

And let's talk about it and let's figure you out.

But wait a minute.

So that's crazy.

No.

I've never heard.

See, every time you're on this show, you, I, there's never a time, like every time I learn so many new things, it's unbelievable about sleep.

So, what about like,

I heard you talk about vitamin C in sleep.

Does vitamin C actually help you?

Vitamin D.

I heard vitamin C.

So, here's what I can tell you: what I'd run bloods on.

So, if somebody was to be part of like my clinic or work with me, I would have them go to their doctor and I have them do blood work.

So, to be clear, I'm not a big supplement guy when it comes to sleep.

I'm a big, let's fix the body guy.

Get to the root cause.

Right.

So, So what are you deficient in?

There's three things that if you're deficient in, I know for a fact they affect your sleep.

Vitamin D, magnesium, and iron.

If you are deficient in any one of those three, there's no universe that you're getting a good night's sleep.

So I always have everybody talk to their doctor, get their blood work, bring it in.

Let's fix that first and just see how your body is operating at that point.

If you'd be surprised, probably 25, 30% of the time, that's all it takes and people are sleeping better.

Let's say you don't have that and you're saying to me, okay, Michael, I want to, I I need something to help me fall asleep.

I don't want to take something like Benadryl.

I want something that's a little bit more natural, kind of not into the cannabis and gummy, gummy scene, or maybe I don't live in a state where that's legal.

You've already told me that alcohol is a bad choice.

What are we going to do?

I can't call a cognitive behavioral therapist in the middle of the night, right?

Right.

So

there are a few supplements that have been shown to be very helpful for sleep that are pretty gentle.

Something called GABA.

So GABA is kind of like the breaks of the brain.

It definitely can help you slow down your thinking, lower your anxiety.

Valerian root, um, specifically valerian combined with hops has been shown to be actually quite effective, as effective as sleeping pills in some cases.

So, that's kind of interesting as well.

What's it called?

Valerian root, and like hops from beer hops as a combination.

That's been shown to be effective as well.

So, there's a couple of things out there that you can figure out and work with.

Ashwagandha can be helpful for

creating anxiety or lowering anxiety and things of that nature.

What about just taking magnesium?

So, I'm a a huge fan of magnesium because roughly 75% of people are

deficient in magnesium.

And I did a study with a group about magnesium and they had me test their product.

And I got to be honest with you, I was blown away.

You told me that before, that you did that study, that like it was like way above any other.

Yeah, so it's called upgraded formulas.

And this guy came to me and he was like, I want to prove to everybody that my magnesium is the best for sleep.

And I was like, that's a pretty tall order.

And he was like, let's go.

And so we did a double-blind placebo controlled study.

So exactly like a drug trial, but with magnesium.

And people acted as their own controls.

It was the most, the strongest design of a scientific study that you could have.

And all the researchers were blinded.

They had no idea what they had given people.

So that's why this double-blinded placebo-controlled study.

And this guy's magnesium was through the roof.

I mean, people were sleeping significantly better.

Deeper sleep was better and falling asleep was better just from magnesium.

Did you test other magnesiums to see?

What we did was we tested against a sham and then we tested it against, yes, so we tested against another magnesium, we tested against a placebo.

Okay, how about melatonin?

So melatonin is interesting because there's pros and there's cons.

I'll tell you, there's only really three instances, maybe four, where I have a tendency to like melatonin.

I think melatonin works well for jet lag.

I think melatonin works well for shift work.

Melatonin is also used in something called REM behavior disorder.

By the way, melatonin can actually be helpful with ADD and ADHD.

There's some new data on that.

And then I think melatonin works well in people with a melatonin deficiency.

So as we get older, one of the things we know is that the aging brain doesn't make melatonin nearly as well as it once did.

And so a lot of people have less melatonin as they hit the 55, 60, 65 kind of age range.

And so that's when melatonin might not be a bad idea to take on the regular.

So like people who are aging, like you were just saying, just to kind of

can I make one quick comment?

Yeah.

Melatonin is not for children period full stop people don't know this in uh europe at high dosages melatonin is a contraceptive it is yep see i'm i'm dropping bombs on you left and right you really are what do you mean so at high dosages melatonin actually affects the uh the the entire cycle like women's entire cycle so it actually affects birth control so as an example if you're taking birth control pills and you decide to take melatonin your birth control pills could easily become less or ineffective.

FYI.

Melatonin also affects SSRIs, so antidepressant medication.

So if you're taking Prozac, Zolof, something like that, and you just hop on over to the drugstore and grab yourself some melatonin, you could easily have a problem with that.

It also affects your blood pressure medication and diabetes medication.

So it's a hormone.

It's not just this root that we're getting from somewhere.

It's a synthetically produced hormone, which affects lots of things in the body, which is why I don't like it, especially in kids.

No kidding.

I know.

And also, like, it's also not something to be, to get addicted to either.

Correct.

So, so basically then, magnesium, vitamin D, you say, are two that you're like comfortable with.

Super comfortable.

And omegas.

And omegas.

Well, you, yeah.

So, wait, what do you mean?

So talk about the omegas.

So you say GABA root and hops.

No, I said valerian root.

Yeah, valerian root.

And hops.

And then I said GABA.

is one of the ones that I like to use and as in terms of overall supplementation.

Yeah.

So you wanted to know about omegas?

Yeah.

So one of the things we know is that omegas help with a whole host of different functions in our body, which then relate to sleep.

So, as an example, one of the things that omegas do is they help create the membrane around cells that makes them stronger and stronger and stronger.

So, less bad stuff can kind of get in.

When less bad stuff is in, that means better sleep, especially with mitochondria and things of that nature.

There have been a few studies that have looked at like if you take an omega, does it actually improve a particular stage of sleep?

We've never been able to focus that, but what we have seen is when people take omegas regularly, that they actually report higher quality sleep.

Higher quality sleep.