Please enjoy this transcript of an episode all about getting more and better quality sleep. It includes some of the best advice from multiple guests about rest and regeneration. Transcripts may contain a few typos—with some episodes lasting 2+ hours, it’s difficult to catch some minor errors. Enjoy!
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Tim Ferriss: Hello, boys and girls, ladies and germs. This is Tim Ferriss. Welcome to another episode of The Tim Ferriss Show, where it’s my job to deconstruct world-class performers of all different types, to tease out the habits, routines, tactics that set the extraordinary apart from the average, the objective being to really pull out the details you can apply. Now after more than 250 conversations or close to 300 episodes now, you and I start to spot patterns and themes across every possible domain. A lot of the people who are the best at what they do, regardless of where it is, tend to do a lot of the same things or focus on the same things.
This episode contains some of the best lessons I’ve learned about sleep, recovery, and regeneration, where I have really applied my focus than almost any other foundational pillar in my life. Why? Because if you get sleep and recovery right, it magnifies everything else incredibly. To a much greater extent than even diet or exercise, I find.
Getting sleep and recovery right is critically important. The recommendations that we’ll cover include people like strength coach Charles Poliquin, who has trained athletes from 20+ different sports, including Olympic gold medalists, NFL all-pro players, Stanley Cup champions and much more.
Charles Poliquin: I don’t do The 4-Hour Workweek, but I like to do the 4.5-hour workday.
Tim Ferriss: I also include tips from Amelia Boone. She has been called the Michael Jordan of obstacle course racing. She is the most decorated athlete in what they call OCR.
Amelia Boone: Maybe I can become a fat-adapted athlete because, for longer races, I didn’t want to have to rely on gels and ooze and stuff like that because, after a while, it can be too much on your stomach.
Tim Ferriss: I then talk to the comedian, Mike Birbiglia, who has a very particular nighttime ritual that has helped him learn how to sleep after many problems.
Mike Birbiglia: The biggest thing is getting off of social media. Getting off of Twitter and Facebook.
Tim Ferriss: And Dr. Peter Attia, one of my favorite docs on the planet, shares his best lessons and takeaways related to rest.
Peter Attia: At the time, I literally said to my wife, “I’m going to go get a gastric bypass.” She was like, “You are the most ridiculous human being that’s ever lived.”
Tim Ferriss: So without further ado, let’s get started. I will kick it off with a few points of my own. I have been a lifelong insomniac, specifically with onset insomnia. Certain people have trouble getting to sleep. I’m in that camp or had been for many decades. Other people have trouble staying asleep. I am not in that camp, but a lot of the recommendations will apply. There are a few things in the last 12 months, in particular, that I have reapplied and reevaluated and continue to recommend. There are a few things right off the bat. No. 1, a white noise machine of some type. Like a Marpac Dohm, M-A-R-P-A-C D-O-H-M device.
Some hotels at the higher end have started to include them in rooms specifically because they help sleep so much, in my experience. Then cooling. Temperature is probably the single-most important variable in sleep conditions and certainly sleep onset. For me, that means as cold as I can tolerate. Often around 65 degrees Fahrenheit. Then if we want to look at the downstream effects on mental health or stability of sleep timing, I recently had a conversation with Ray Dalio, who is the founder of the largest hedge fund in the world, Bridgewater Associates.
They manage about $160 billion in assets. He shared with me how his son – who suffers from bipolar disorder, or I should say, manic depression, could be labeled any number of ways, much like yours truly – has found that his symptoms are mitigated tremendously by going to bed by 11:00 p.m.
I can corroborate this. As a lifelong night owl, my stability tends to be much more under control, much more even keel when I go to bed by 11:00 p.m. There are a few things that also assist across the board in my experience. Again, I’m not a doctor and I don’t play one on the internet. Something called N-acetylcysteine (NAC) and lithium orotate in very low doses. We’re talking about five milligrams here. I’ve found this to be extremely helpful for sleep and also just general mental wellbeing. Last, I’ve experimented with polyphasic sleep, which means fragmenting your sleep into shorter periods with interspersed rest.
There are many different formats. The most infamous of which is probably the uber-man protocol, which requires a mere 2.5 hours or so of total rest per day, but you have to take many naps in order for that to function.
If you miss one of your naps, woe unto thee because you are going to have at least two days of complete zombie state. It is not for people with significant others or ambitions of any type, generally speaking. But Matt Mullenweg, for instance, who is the CEO of Automattic and is thought of as the lead developer of WordPress – which now powers something like 27 or 28 percent of the entire internet – did the vast majority of his coding in what he would call his most productive year while following polyphasic sleep. I tended to do very well with monophasic sleep, which is what you think of as normal.
An eight-hour block of sleep from whatever is it, say midnight to 8:00 a.m. However, I have found I function best across the board physically and mentally if I get around 7.5 hours. I know it’s very specific. 7.5 hours of sleep at night and then another 1.5 hours, so 90 minutes, which is an ultradian rhythm, around 3:00 or 4:00 p.m., whenever possible.
That reinvigorates me to such an extent. The 90 minutes is very important. 60 does not do it for me, nor does 30. 90 minutes will allow me to put in, if I so desire, an entire additional equivalent of a work shift like seven or eight hours without fatigue. It’s pretty phenomenal. Let’s then move on to more tips on sleep and restfulness from other folks that I hope you find extremely valuable, or at least as valuable as I have. Charles Poliquin. Let’s start with Charles. Charles, @strengthsensei on Twitter, has a wealth of knowledge related to training, nutrition, and supplementation. The guy is an encyclopedia.
He has authored more than 600 articles and written eight books, including what I believe is his latest, a very short gem entitled, “Arm Size and Strength: The Ultimate Guide.” You should check out Charles and his arms, I kid you not.
NHL guys ended up listening to him because they saw what he looked like in person. When Charles and I had our conversation, I asked him which supplements he uses for improving sleep. I should also update this because noting that I, in the last few weeks, have been experimenting with something that he produces called the Yin Reserve, which includes several different components that he alludes to in this conversation.
Charles Poliquin: The question comes from Danielle Matthews Kazimurcha, a typical Irish name. “Which supplements do you currently use for improving sleep?” Personally, I’m a big fan of magnesium threonate. I take six capsules at bedtime, mixed with grams of theanine. I will post a page on where to get these ingredients on the website. The next question comes from Marcus Beemer.
“There are many things you might regret, but what’s the thing that comes to mind most often?” Well, what would I change if I could do it again? I wish The 4-Hour Workweek would’ve been published when I started my career. People tell me often “You are very lucky.” I got very lucky by working 20 hours a day for years on end. When you work that many hours, and that doesn’t include training. So for years, for about eight months out of the year, I would only sleep three hours a night. I would say that’s my biggest mistake. I said yes too often and I should’ve been concerned more with the quality of athletes I trained.
The problem is, when I would get [inaudible], I would get the whole national team. Once I established credibility, being consistent with results, when I would negotiate with the national team, I would tell national team, “These are the guys I’ll pick. These are the guys I will train.” So it would save me time on writing programs, administering programs, monitoring programs, teaching technique.
But you need to have the reputation before. I spent a lot of time doing that. What I’ve learned over the last few years is that you get known for the jobs you turn down, not the jobs you accept. A few months ago, Ellen Maroulis won the gold in Olympic wrestling for women. It was the first time America did so. For weeks, I’d been asked to do seminars, write books, take on more national team athletes, train foreign teams. I said no to every one of these requests.
Why? Because [inaudible] I don’t do The 4-Hour Workweek, but I like to do the 4.5-hour workday. One thing I do regularly is I take a week off a month to rest, to read. I take three months vacation a year. Probably having a child was the best thing for me to learn how to prioritize things.
I really started to cut back on the amount of work once I had my daughter. But the biggest mistake I’ve ever done was to work far too much. Now I’ve got guys like [inaudible]. You do, but you should still figure quality over quality. If you want to understand the concept better, I strongly suggest you read The One Thing and to read The 4-Hour Workweek. It’s just a mental outlook to what you do. The next question is from Jonathan Anderson. “Thanks to Charles, I’m now big into Omega-3s, [inaudible] remission.
Dr. Barry Sears says 3:1 EPA to DHA. I’m taking that ratio but at a greater expense. Is it worth it? Should everyone go on it? Well, Dr. Gaigneault, of course, he passed away a few years ago, was probably one of the smartest guys on that topic. What we know is that it’s actually better to vary the types of fish oil.
There’s an axiom you should respect. The more you’re dealing with information, the harder the EPA ratio to DHA should be. So a lot of brands will sell you a 6:1 ratio. That will bring down inflammation better than a 3:1 ratio, actually. If you’re concerned with brain, so if you have ADD, ADHD, borderline personality disorder, all the studies on brain disorders show that a high DHA Omega-3 product is better. Usually, you want an 8 DHA to 1 EPA ratio. But there’s no magical fish oil.
The other thing we know now from research, it’s better to take products like Omega-3 [inaudible] from Designs for Health, who has also mixed in D3, K1, and K2 into the product because those actually increase absorption and you don’t need as large a quantity.
Of course, your supplement is important fat-soluble vitamins. The next question is from Rodney Lee. He asks me, “You’re not a big fan of foam rolling. Isn’t foam rolling a massage?” My beef against foam rolling is that it would be trying to build a bridge one pebble at a time. It takes far too long. There’s such a thing as the principle of training economy. Tim’s big on that, whether The 4-Hour Body or any of his books, you have to have the maximum amount of return in the least amount of time. People waste a tremendous amount of time foam rolling.
The amount of time they waste on foam rolling could be trying to get flexible, could be done in a good 20-minute active release session or Rolfing technique or the [inaudible] method.
There’s a lot of stuff out there that exists to get rid of adhesions and improve range of motion. Let’s say if you have a good active release practitioner and you’re foam rolling because you have a tight shoulder, if the guy does a good job and let’s say you’re the worst-case scenario. You’re about as flexible as a crowbar. Within five treatments, you’ll have 100 percent range of motion and if you’re a complete, certified idiot, you will still maintain those gains for six months.
In my opinion, going to see a very good soft tissue practitioner and invest the time and money into that, will save you all these countless hours of foam rolling because you will have the results and it’ll be more permanent if you see a soft tissue therapist. The next question is from Morgan Brown. “If you only had to pick one important factor between sleep, food, and exercise, which would you pick and/or how would you prioritize them?”
Well, Morgan, that’s like asking me for optimal health, should I prioritize my liver or my heart or my brain or my adrenals or my kidney. All of those are important. If you don’t have a brain, forget it. If you don’t have a heart, forget it. If you don’t have a liver, you’re not going to live very long. So you can’t prioritize so much. Let’s say if we look at prisoners at Club Fed. They can sleep as much as they want. Is the sleep restful? Probably not because maybe your cellmate wants to kill you. The food? The food is prison food. It’s not the greatest, but they do have plenty opportunity to exercise and they have weight rooms.
So, in that case, you could argue people can get a good physique. If you look at the book of [inaudible], Josh Bryant, some pretty good physiques were built behind bars. But then again, [inaudible] guys will make you safe and they will give you Paleo foods, all of these guys will grow a lot.
I’m not sure taxpayers would agree with that, but you can’t prioritize them. You can’t say I’m going to sleep to muscle growth or I’m going to exercise to muscle growth or I’m just going to eat to muscle growth. You need all three.
Tim Ferriss: Next up is Amelia Boone, who you can find on Instagram @arboone11, A-R-B-O-O-N-E-1-1. I think she’s just Amelia Boone on the Twitter. Amelia has more than 50 podium finishes in obstacle course racing and is widely considered the most decorated in the sport. I’ll give you just a few examples of her finishes. In the 2012 World’s Toughest Mudder Competition, which lasts 24 hours, she finished second overall out of 1,000+ competitors. Keep in mind that those competitors are probably 80-90 percent male. Second overall. This was ahead of every single competitor except for one male, who ended up winning the whole thing.
He beat her by a mere eight minutes. She won the 2004 World’s Toughest Mudder eight weeks after knee surgery. She’s a beast in the best way possible. Amelia is also a three-time finisher of the so-called “Death Race,” which not surprisingly has been discontinued. The name tells you all you need to know. She dabbles in ultra-running in her spare time. She’s also a full-time attorney at Apple, by the way. As someone who pushes her body to the limits, she’s learned the importance of rest and how to make the most of it.
What does your nutrition look like? Were you serious earlier when I asked you about breakfast?
Amelia Boone: Yes.
Tim Ferriss: All right. What was your answer? We were doing a sound check and I asked her what she had for breakfast. What was your answer?
Amelia Boone: Pop-Tarts.
Tim Ferriss: Pop-Tarts.
Amelia Boone: No, that’s actually – so Pop-Tarts has become kind of this running joke in the obstacle racing community with me.
Because when I won the Spartan Race World Championships in 2013, I was so far ahead. I was like 20, 30 minutes ahead of the next woman. The race director yells out at me, he goes, “Amelia, what’d you have for breakfast this morning?” I’m like, “Pop-Tarts!” I actually did, randomly that day because they’re a really good source of easily digestible carbs.
Tim Ferriss: Millie? Is that was you said? Or did you say your full name?
Amelia Boone: He said it, sorry, said Amelia.
Tim Ferriss: I got it.
Amelia Boone: Sometimes I can’t say my own name. It kind of became this thing that I would just pre-race ritual that would be like a good luck thing to have a Pop-Tart. Because I’m a really big person into superstition and it’s grown from there. Now I see – I was at a race the other weekend and everyone around me was eating Pop-Tarts. I’m like, what have I started? What?
Then everyone posts these pictures on Instagram of them eating Pop-Tarts. They tag me in it. I’m like, ohmygod, I’ve created a monster.
Tim Ferriss: Well, this actually could be an incredible opportunity for you to do whatever you want. I remember watching Pumping Iron and Arnold Schwarzenegger is talking about the guys who’d come up to him and ask him for advice and he’d give them the wrong advice. He would tell them to go into the shower and the gym and scream while they’re posing. You could actually pull an incredible April Fool’s joke but announce it a year later after everyone has already embraced it.
Amelia Boone: All right, so now I’m like, well, what’s the next thing?
Tim Ferriss: What other superstitions do you have? Not limited to racing, necessarily.
Amelia Boone: Yeah. I’m one of those people that it’s the same – I will wear the same sports bra. So we race pretty much in sports bra and compression shorts because you want as little clothing to hold down the mud as possible.
I’ll wear the same – if I did well in a race, I’ll wear the same outfit for the next race. Especially the same headband. Then if I don’t do well, that one gets discarded. It’s that kind of typical sports stuff. I actually have – this is kind of embarrassing – but a small, little, stuffed dog that travels with me to all races. Because I’m typically by myself in really cheap, sketchy hotels because these races are in the middle of nowhere. So it’s my little guard dog.
Tim Ferriss: How big is the stuffed dog?
Amelia Boone: Oh, it fits in the palm of your hand.
Tim Ferriss: Where did you get that?
Amelia Boone: It was given to me as a gift.
Tim Ferriss: As a protection.
Amelia Boone: As a protector.
Tim Ferriss: A guardian.
Amelia Boone: As a guard dog. So yeah, it’s silly stuff like that.
Tim Ferriss: Outside of Pop-Tarts –
Amelia Boone: What do I actually eat?
Tim Ferriss: Yeah, what is your, let’s just say you’re four weeks out from a race. What is a day of food look like for you?
Amelia Boone: Honestly, it’s one of those things I’ve struggled with that I’ve tried to do everything. I tried to do Paleo. I tried to be like maybe I can become a fat-adapted athlete because, for longer races, I didn’t want to have to rely on gels and ooze and stuff like that because, after a while, it can be too much on your stomach. But I’m just never going to be the paradigm of good eating. I couldn’t stick with the whole trying to – I couldn’t go far enough into the fat adaptation. I was miserable. I like ice cream way too much.
Tim Ferriss: It’s somewhat contraindicated for contestants in fat adaption.
Amelia Boone: Exactly.
Tim Ferriss: Much to my chagrin, anyways.
Amelia Boone: At a certain point, I think I realized I’m performing well, I’m winning races. So why change? If it gets to the point where I’m not doing well –
Tim Ferriss: Performing.
Amelia Boone: – then I’ll take another look at my diet and switch it. But at this point, it’s like I run so much, I put in so much time that I’m like whatever, I enjoy food. I’ll eat whatever I want.
Tim Ferriss: If we were to look at the World’s Toughest Mudder, what do your routines look like? You said you’re a creature of habit, as am I. The hours before the competition, let’s just say the day of, what are your routines?
Amelia Boone: I always get up super early before – well, I get up super early, in general, every morning.
Tim Ferriss: What’s super early?
Amelia Boone: So my alarm typically goes off right around 4:00 a.m.
Tim Ferriss: That’s why you didn’t flinch when we were talking about Jocko Willink, the SEAL Commander.
I’m like, “And he wakes up at 4:00!” Zero response. I’m like, uh oh. Another one. Here we are.
Amelia Boone: Yeah, 4:00 a.m. Actually, on race days, it’s almost like I sleep in a little bit.
Tim Ferriss: When do the races start typically?
Amelia Boone: They generally will start – World’s Toughest Mudder is a little bit different. That one starts at 2:00 in the afternoon now. But just a regular obstacle race will generally be like 7:30 for the starting time.
Tim Ferriss: I got it. So that starts at 2:00 p.m. So let’s use that example. You wake up at 4:00.
Amelia Boone: Oh, yeah. And then I drive myself crazy for the next however many hours, twiddling my thumbs.
Tim Ferriss: What other type of body prep or mental prep do you do?
Amelia Boone: I generally use the distraction technique. I try to not think about it, really. I can sit there and make myself miserable over and over. Picturing the race or whatever. But I find it helpful, actually, to do a lot of work in the mornings before races.
I’ll catch up on emails. I’ll do things from my attorney life. In terms of body prep, I do a lot of foam rolling, mobility, things like that. The older I get, the more I realize I can’t just jump out of bed in the morning and be as spry as a chicken.
Tim Ferriss: You’re 32. Is that right?
Amelia Boone: 32, yeah.
Tim Ferriss: 32. I would imagine you still have a couple of good years left in you.
Amelia Boone: It sometimes feels a lot worse though, let me tell you.
Tim Ferriss: The mobility work that you do. What does that actually look like, in detail?
Amelia Boone: I generally carry an arsenal of every single, from a golf ball, a lacrosse ball, a softball, a foam roller. I’m really focused on loosening up hips, loosening up hamstrings.
Every single, different, little torture device has – the golf ball is for the foot. The lacrosse ball works well on the glutes. The softball is great for the hamstrings. I’m just getting the muscles warmed up and loosened and prepped. I actually – from a lot of various, nagging injuries that I’ve always had, I have little physical therapy routines that I always do too. Like to get your glutes activated and things like that.
Tim Ferriss: What type of movements do you do for glute activation?
Amelia Boone: There’s this fantastic exercise called Jane Fonda’s that anybody who’s ever been in –
Tim Ferriss: Are these for glute [inaudible]?
Amelia Boone: Yeah, [inaudible], where you’re sitting there and you’re like man, I should really have leg warmers on right now.
Tim Ferriss: You’re talking about – is this the best leg, the reverse thigh master?
Amelia Boone: Pretty much, yes. The reverse thigh master.
Tim Ferriss: On your side.
Amelia Boone: Yeah. And variation – doing fire hydrants like that too.
Like a dog lifting its leg. There’s all super-sexy things that people – if you do them in a gym. People are like, oh, god, there’s that girl.
Tim Ferriss: I tell you, I think you probably get more attention doing fire hydrants than I do. Unless I’m in a gym in a Castro, which it might be a similar experience? Do you use any other modalities for prep? Do you use any stim? Do you use anything like that pre-race? Is that set aside for other purposes?
Amelia Boone: Pre-race, not so much, no. That’s more like recovery. Recovery I’ll compression boots and stim.
Tim Ferriss: Are compression boots the compression socks or are these actual boots?
Amelia Boone: The boots that inflate, you know? The air pressure chambers that supposedly flush out lactic acid.
Tim Ferriss: And that’s post-race?
Amelia Boone: That would be post-race, yeah.
Tim Ferriss: Well, let’s talk about post-race then. In terms of facilitating recovery. So you finish the race. Is it true that you have not slept for days on end after races? Or is that an exaggeration?
Amelia Boone: No. It is true. Any long race that I’ve done. World’s Toughest Mudder is a 24-hour race. I’ve done other races that are longer, 48 that are 60 hours. I feel like I can’t sleep afterward. You feel like you should be able to. You’re like wow, I was just up for three days straight running around in the woods, but my mind – your body is so physically exhausted, but my mind is still on so much, like on overdrive, that I just can’t. For instance, this year, after World’s Toughest Mudder, we all went – there was a group of us staying at a house.
We sat around, drinking beers and watching a football game. I’m like man, I should really be getting drunk right now, or something like that. It’s like I’m drinking, I’ve been running around in a wetsuit all night long. I’m like, I don’t feel anything. I don’t feel any effects of the booze or anything like that. I was like, it just must be this adrenalin still pumping through me.
Tim Ferriss: Did other people have a similar experience? Or is that unique to you?
Amelia Boone: I think no because everyone else just passed out and went to bed. So I was like, “Hey, guys! Okay, everyone’s asleep right now. Okay, cool.”
Tim Ferriss: When you cross the finish line as such, you’re done, what type of recovery starts? What are the actions that you take in the hours following the race?
Amelia Boone: I think one of the most important things that people should do that they don’t is you have to stay moving. People want to finish a race, and especially a long one, and just lay on a couch or go to sleep. That is the worst thing you can do because you’re going to wake up and not be able to move anything. I generally try to stay walking. I try to stay active.
I will hop again on a foam roller or something like that. You don’t want to be too aggressive afterward. You’re not going to hop on a softball and roll out your glutes because that’s going to hurt really bad. But then just try and stay active. That is in the next day too. Gentle movement and things like that.
Tim Ferriss: Are you a proponent of ice, ice baths, or anything like that or not?
Amelia Boone: I’m not a scientist, whatever. All I know is what works for me. People have different opinions. If I can get into an ice bath, I will, but it needs to be immediately. There have been races where there’s a lake right next to me. If it’s cold enough, then I’ll just go jump in the lake and use that as an ice bath. But if you’re waiting four or five hours, I don’t think it’s going to end up helping you in the end.
Tim Ferriss: I want you to correct me if I’m wrong. In 2012, World’s Toughest Mudder, how did you place?
Amelia Boone: I won for females, but I was second overall in 2012.
Tim Ferriss: Second place overall.
Amelia Boone: Yeah.
Tim Ferriss: How did that feel?
Amelia Boone: It was a really interesting race.
Tim Ferriss: How many competitors?
Amelia Boone: This was about 1,200 people, I believe. It’s generally every year. There were about 1,200 people. This one they moved it to November, so it was supposedly a tiny bit warmer, but actually, it wasn’t. It was actually colder in 2012 than it was in 2011. I guess I didn’t realize – I knew I was winning for women. At this point, we were getting close to the end. I was about 80-some-odd miles in. As I’m on the last lap, they’re like “Okay, you’ve won for women. But the guy that’s winning is like nine
There are all these people from Tough Mudder headquarters and all these men are yelling at me, willing me to go on because all they want me to do is to win overall. You’re so tired at that point, and so delirious, that I guess I didn’t even realize the import of that situation. How massive that would’ve been. I was just like, “Leave me alone. I hurt. I’m tired. I’m freezing. I’m covered in ten millimeters of neoprene.” I’m like, “I get it. I’m trying to move faster, but my body won’t let me.” So I ended up finishing about nine minutes behind the male overall winner. It didn’t really hit me until a day or two later, where I was like, “Oh, I was that close. Oh, okay.”
Tim Ferriss: Mike Birbiglia @birbigs, B-I-R-B-I-G-S on Twitter, is one of my favorite comedians. Certainly one of the best-known and busiest comedians in the world. Both behind and in front of the camera, his standup blends elements of theater, film, storytelling, and comedy. The guy just seems unstoppable. He’s been very deliberate in studying a lot of crafts and tying them together, which I find fascinating. It’s reflected in a lot of his successes. A sold-out tour as a solo act, New York Times bestselling books, off-Broadway shows, feature film, TV, the whole nine. I asked Mike about his nighttime rituals and he, in fact, is famous for very severe sleepwalking disorders.
Mike Birbiglia: I find the FitBit was helpful for me because it tracks my sleep. It tells me this thing about my sleep which is –
Tim Ferriss: Tells you how much you were walking the night before?
Mike Birbiglia: No, it’s true. It not only tells me – I don’t know if you know about this. It not only tells you how long you slept, but it tells you the quality of sleep during. In other words, it tells you that you slept technically for eight hours, but you were awake for an hour of that. So it’s actually quite helpful.
Tim Ferriss: I like it. So you use it primarily for your sleep then?
Mike Birbiglia: For my sleep, yeah. I like the steps thing. I like trying to get to 10,000 steps a day. That’s helpful. You’ve got to remember, I’ve slept over at hospitals countless times for sleep studies because I have REM behavior disorder. It’s like $3,000 per visit. Some of it’s insurance, but some of it I have to pay. This thing basically does a sleep study and it costs $100.
Tim Ferriss: What type of nighttime rituals do you have? I mean, you mentioned easing in instead of crashing into the wall. Do you have any particular kind of wind-down or evening rituals?
Mike Birbiglia: I try to do – there’s actually a good podcast called – not to be mistaken with Sleepwalk with Me – there’s a good podcast called Sleep with Me.
Tim Ferriss: That could go a lot of directions, okay.
Mike Birbiglia: It’s this guy named – I think he calls himself Scooter.
Tim Ferriss: Sounds trustworthy.
Mike Birbiglia: He has this really uncanny skill of talking in circles and slow and circling back to the first topic and then the next topic and then another thing and then a digression. The next thing you know, you’re asleep. It’s pretty fascinating what he does.
Tim Ferriss: I’ll have to try that.
Mike Birbiglia: That’s worth looking into. I try to write in my journal. Honestly, the biggest thing is getting off of social media. Getting off of Twitter and Facebook. I think, in relationship to what we were talking about earlier – I was saying the thing about Oliver Stone that he joined the Army and that’s how he became self-reliant. And how ultimately everything in your life leads to who you are and what you’re able to accomplish. I think that social media is weirdly the exception to that. I think that social media is this weird kind of looking in the mirror all the time thing that is not helpful for being productive or learning. I don’t know if that’s true, but that’s been my feeling lately.
Tim Ferriss: I think the dose makes the poison certainly.
Mike Birbiglia: Yes.
Tim Ferriss: There’s a point where you’re like, oh, this Tylenol is helping my headache. Then, oh, my stomach lining just fell out of my ass.
Mike Birbiglia: That’s extreme. Has that ever happened?
Tim Ferriss: No, that hasn’t actually, literally happened to me. But there’s definitely a point where things in excess become their opposite. On the flip side, what do the first 60 to 120 minutes of your day look like? Are there any particular rituals that you have in the morning?
Mike Birbiglia: It’s a little bit like Memento every day.
Tim Ferriss: Injecting your wife with insulin over and over again?
Mike Birbiglia: Just like a lot of times if I’m not focused, I will wander. Until I have coffee, forget about it. I’m a heavy coffee drinker.
Basically, if I’m on a project, if I’m shooting a movie, I have a complete and exact plan for the next day. If I’m writing a movie, like I said, I put notes next to my bed. Mike, wake up. Go to the coffee shop and write. I think that when I don’t have a routine, I’m a mess and I’m not productive and it’s not helpful. That’s what I’d say. It’s inconsistent. The other thing is, I travel. With the Thank God for Jokes show, I toured 100 cities in a year.
Tim Ferriss: Wow.
Mike Birbiglia: It’s very hard to have rituals when you’re going to 100 cities in a year.
Tim Ferriss: Yeah. I wonder if it makes the value of the rituals even greater if you are able to maintain some semblance of a routine when touring? I don’t know. I’ve never done that. Do you have a favorite venue in the entire United States if you had to pick one?
Mike Birbiglia: Oh, gosh. There’s so many. [Inaudible] Theater in New York City feel like home because I’ve been on that stage a lot.
The Comedy Cellar in New York feels similarly. I think that in terms of a pound-for-pound venue, I think the Chicago Theater is probably your best concert venue in America. Chicago Theater seats about 3,000 people, and yet, as a performer, you feel like you’re talking to people in your living room. As an audience member, it feels like you’re watching someone not in your living room, but it feels intimate.
Tim Ferriss: You’re a collector of good advice. What is the worst advice that you hear or see being given out often? That could be in any domain. It could be comedy. It could be writing. It could be movies. It could be completely unrelated. Anything.
Mike Birbiglia: It’s all about getting your dream, pursuing your dream. I feel like there’s something. I don’t know what the exact advice is that drives me crazy.
I think that there’s a cultural thing right now that it is kind of irksome, which is that people feel like – I read it recently in The New York Times, where someone said, I’m forgetting her name who wrote this, but she said “If I had advice for college students, it would be don’t ask what do I want to be when I grow up? Ask how can I help or how can I change the world or how can I be of service to other people?” I think the be whatever you want to be is perhaps to be reconsidered to how can I be of service when I’m on the earth for such a short amount of time?
Tim Ferriss: Way back in episode 50, it seems like 100 years ago or yesterday, depending on my frame of mind, I introduced you to Dr. Peter Attia, who on Twitter is @peterattiamd, A-T-T-I-A-M-D. So @peterattiamd on the Twitter. Peter is an ultra-endurance athlete. He would say former, I was never an athlete. But he swam 25+ mile races. I would consider him an endurance athlete. He’s a compulsive self-experimenter, which is part of why we get along so well. He is one of the most fascinating human beings I know. If you want to hear a hilarious story, by the way, look up Peter Attia jet fuel Ferris.
You can listen to an audio snippet of the first time that he consumed experimental, synthetic ketones in his kitchen. It is a hilarious story. Anyway, Peter earned his M.D. from Stanford University and holds a Bachelor’s of Science in mechanical engineering and applied mathematics from Queens University in Kingston, Ontario, Canada.
He resided at Johns Hopkins Hospital as a general surgeon, then conducted research at the National Cancer Institute under Dr. Steve Rosenberg, where Peter focused on the role of regulatory T-cells in cancer regression and other immune-based therapies for cancer. Given his expertise in nearly all things health, I asked Peter to explain some of what he’s most excited about as it relates to recovery.
It’s possible to try to optimize health to the point where it’s in your best interest to just sit in the metal box and absolve yourself of interacting with anything in life. I think that you maximize your performance at the same time. What are some of your obsessions in that realm at the moment or interests?
Peter Attia: Well growing up – Tim, you know I grew up in Canada, and so obviously hockey was sort of the most important sport for any good Canadian kid growing up. But actually pretty early on, around the age of 13, my interests actually shifted towards boxing and martial arts. That became really the focus of my life. You know, I never really did it in moderation. Even in high school, I was training six hours a day. Very hard. Even though in amateur boxing it’s only three rounds, I was always thinking about the next step, which was being a professional. At the time, that was 12 rounds of boxing. Everything I did was geared towards I had to run 10 to 15 miles in the morning, not just 4. I had to jump rope for 30 minutes, not just 15.
I had to spend this many hours sparring each day. My foray into my care about the body’s performance always came through the lens of performance. It was how does the way I train or how does the way I eat impact my performance initially in a boxing ring? At the time, it was highly crude.
In fact, I suffered from the issue that I’m sure a lot of 14-year-old boys which suffered from, which we’d all kill to have that problem again, which is I actually couldn’t gain weight. I started my career at 127 pounds. By the time I was 16, I was a solid middle-weight, which is 160 pounds. But as you may know from your experience, most people live 10 pounds above their weight class and then come down to it. I was only 4 percent body fat. I actually lived and fought at about 158 pounds. To keep that weight on, I would eat about 6,000 to 7,000 calories a day.
Just to give you an example of lunch, because it was the one meal I can really remember. It was an entire loaf of bread, which is 14 pieces of bread. So that was seven sandwiches, with a two-liter jug of orange juice. Then at the cafeteria, I would buy a plate of French fries and some other nastiness.
That was lunch every day in high school. Yet, I had a 27-inch waist and no fat on me. Not just because I was exercising six hours a day. I think more importantly because we’re very metabolically different when we’re 14-year-old boys, than when we’re 40-year-old boys. If you fast forward I don’t know how many years, athletic stuff has always been important to me. The sport has shifted. By the time I was in my early 20s, the obsession switched away from boxing into other things. More recently, in my 30s, the obsessing became swimming. Ultra long-distance swimming.
Tim Ferriss: How long is ultra long-distance swimming?
Peter Attia: Yeah, it’s kind of a fuzzy definition. I think most people define ultra-long as anything over 16 miles. But I think that’s somewhat arbitrary. It’s sort of like it’s one of those things like you know it when you see it.
Peter Attia: Exactly, right? Is this one-mile swim across the river ultra-long? Not really. Is that 25-mile swim long? Yeah, that’s ultra-long.
Tim Ferriss: What’s the longest swim that you’ve done?
Peter Attia: About 25 miles.
Tim Ferriss: That is a long swim.
Peter Attia: In my 30s, and this is now a different chapter in my life. Obviously, I’m not in high school. I think at the time I was working at McKinsey and Company in San Francisco. I’m still managing to spend an average of four hours, three to four hours every day swimming. Because it’s not linear. I spend eight hours a day on the weekends and then maybe only an hour and a half to two hours a day Monday through Friday. But I’m obviously burning a lot of matches. And yet, interestingly, my weight is getting higher and higher and higher. I went from being 170 pounds to 205 pounds. The composition of that weight wasn’t what I wanted.
It wasn’t like I was gaining all this muscle. I was getting fat. The blood tests showed that I was basically pre-diabetic. All of a sudden, the dietary strategy –
Tim Ferriss: What were the indicators that you’ve looked at?
Peter Attia: You do something called an oral glucose tolerance test, which is they draw your blood and then you drink this horrible, nasty drink of glucose and then they measure your insulin and glucose levels an hour later, and then again two hours later. This is coupled with other standard blood tests like your triglycerides and something called a hemoglobin A1C, which measures the amount of blood sugar that’s basically sticking to your red blood cells.
Tim Ferriss: Is it fair to say hemoglobin A1C is sort of a running, three-month average of your fasting glucose or is that completely, scientifically –
Peter Attia: It’s actually pretty close. It’s not fasting. It’s basically a three-month running average of your aggregate glucose level.
Tim Ferriss: Aggregate glucose, got it, okay, cool. Not [inaudible].
Peter Attia: Yeah. So anyway, basically all of these tests were pointing in the wrong direction. I had something called metabolic syndrome.
Again, I think there are a lot of people that find themselves in that situation. To your question about what’s the personal motivation? I think what pissed me off was – and I remember saying this to my wife. I said, “You know what pisses me off is I’m working too hard to be in this situation.” It’s one thing if you’re sitting on the couch eating Doritos all day long, but my diet was actually much cleaner as a 35-year-old than that French fry, sandwich-eating kid in high school. Obviously, it still wasn’t the right diet, but the point was I was busting my ass to be fit and healthy and watch what I eat and frankly, I just got aggravated beyond words.
We joke about it now, but at the time, I literally said to my wife, “I’m going to go get a gastric bypass.” She was like, “You are the most ridiculous human being that’s ever lived. We’re literally going to have to talk about your marriage if that’s what you’re considering at the weight of 205 pounds.”
I actually did got and see the top bariatrician in the city of San Diego. It’s kind of a weird story. Even though I was obviously overweight, I was the thinnest person in the waiting room by a long shot, right? It sort of put in perspective, like Peter, you think you’ve got problems? These people each weigh 400 pounds. When it was my turn to go and see the doctor, the nurse took me up to the scale and weighed me. I got on the scale and I’m like 210.
She’s like, “Oh, this is fantastic. Are you here for follow-up?” I’m like, “No, I’m here,” it was a real eye opening experience, Tim. Because frankly, throughout my entire medical training, which was in surgery and then again in surgical oncology, which is cancer surgery, I had never paid attention to this problem, never. If it didn’t have anything to do with cancer, if it didn’t have anything to do with [inaudible] surgery, I didn’t care.
Tim Ferriss: Orthorexia is used as a derogatory term, but I think you’re very meticulous in your own testing and perhaps even separate from [inaudible], but you’ve introduced me to quite a few interesting tools or concepts. For instance, the idea of synthetic ketones. Maybe you could just comment on that as a taster for people. Although taste might not be the way to put it. You can explain that. This was an eye opener for me. I remember hanging out with you, having dinner not too long ago where you speced out the chemical structure of beta hydroxybutyrate and the number of other ketone salts, right? Or am I –
Peter Attia: No, they’re actually salts or esters.
Tim Ferriss: Or esters. But what are synthetic ketones and why might people care about them?
Peter Attia: Well, to explain it, I’ve probably have to spend a minute explaining what ketones are biologically or what we call endogenous ketones.
If you think back to what our ancestors were doing up until a few hundred years ago or certainly a few thousand years ago, we were basically often going 24 hours or longer without food. That was just the nature of how things worked. When you’re in the hunter/gatherer mindset, that’s your life. The human body has only really evolved to store a finite amount of glucose. There’s only two places we story glucose. One is in the liver, one is in the muscles. It’s only that stash in the liver that’s accessible by the brain. Because the glucose that gets stored in the muscle, it can’t leave the muscle. It circulates within the muscle.
We have this organ, the brain, which weights maybe 2 percent of our overall bodyweight, but probably accounts for 20 percent of our body’s metabolic demand. On top of that, it ordinarily functions exclusively on glucose. So you have this problem which is you have an organism that is wildly dependent on glucose.
We can only store a fraction of what we need. We can only store about one day’s worth.
Tim Ferriss: About 400 grams? Like 1,600 calories?
Peter Attia: It really depends on the size of the person, but yeah, that’s probably about right for average. Remember, most of that, by the way, is not accessible to the whole body. The trick that we evolved was rather than make glucose out of protein, which is a pretty easy thing to do, the problem with that is if you want to make glucose out of protein, you have to break down muscle. The last thing you want to do when you’re out there trying to find your next meal is lose muscle at the expense of getting glucose for your brain. What if there was a way we could get the brain to use fat? That’s the problem that needed to be solved.
The solution was a beautiful one. Which is we can break down fat, of which even the leanest hunter/gatherer had days and days, if not months of fat, on their body.
What if you could break that fat down in the liver into another type of molecule distinct from glucose that the brain specifically could actually utilize as fuel? That’s where ketones enter. What our bodies do when prolonged fasting occurs, and by prolonged, I really mean it even begins at 24 hours of fasting, is we start breaking down our own sources of fat. We start making this thing you referred to, beta hydroxybutyrate, not to get too geeky on it, but beta hydroxybutyrate and another member of that family called acetoacetate. They exist in an equilibrium.
These things get shuttled into the Krebs cycle, which I think your readers will be familiar with. It basically becomes another substrate for making ATP. All of a sudden, and George Cahill, who is sort of a luminary in this field, passed away a few years ago, but George Cahill was one of the leading godfathers in metabolism at Harvard University. He did some legendary experiments in the ‘50s and ‘60s where they had subjects that they would starve for 7 to 14 days and just measure glucose levels and ketone levels.
You’d think that after 14 days of not eating, a person would be mentally foggy, not well. It turned out it was just the opposite. After a couple day lull – you know this personally, Tim, because you’ve done these long fasts – after a couple days of hell, it’s actually the reverse, right?
Tim Ferriss: You feel amazing. You feel unbelievable.
Peter Attia: What Cahill showed was what fraction of the brain’s energy was coming from those ketones. So that’s relevant, that’s starving. But look, outside of the odd, let’s do a one-week-a-year fast sort of thing, how does that play into something beyond that? Well, the other way you can achieve ketosis, though not to the same extreme, is through something called nutritional ketosis, which is restricting the one dietary component primarily that restricts ketone formation and keeping, at a minimum, the other one that also restricts it.
Those are carbohydrates and proteins, respectively. If you eat a diet that has very little carbohydrate in it and only a modest amount of protein, and the rest of it made up from fat, you can also generate ketones.
Now, to your question, it turns out that you can drink or consume in some fashion, but they’re all typically liquid. You can drink these ketone molecules directly. That’s what we call these exogenous or supplemental ketones. They come in multiple different forms. They basically exist as a beta hydroxybutyrate ester, a beta hydroxybutyrate salt, and an acetoacetate diester. I’ve tried all of these things.
Tim Ferriss: Why don’t you recount your first experience consuming?
Peter Attia: Yes. The first one I tried was the beta hydroxybutyrate ester, which a very good friend of mine sent me. I had been told these things taste horrible. I had talked to two people who had consumed them before. These are stoic dudes.
These aren’t – this isn’t like a six-year-old kid. This is like stoic, military dudes who said, “Oh, man. That’s the worst-tasting stuff on earth.” I knew that, but I think that piece of information was fleeting in the excitement when the box came. I tear open the box – and also there was a note in there that explained a somewhat palatable cocktail that you could mix – like how you could mix this with ten other things. I just disregarded that. I just took out the 50 milliliter flask and I chugged it. I remember it was like 6:00 in the morning because my wife was still sleeping.
All these thoughts go through your mind. First of all, you drink it and it tasted like how I imagine jet fuel or diesel would taste. If you’ve ever smelled distillate, it’s this horrible odor and you can imagine what it would taste like. This is what it tasted like. My first thought was Goddamn, what if I go blind? What if there’s methanol in here?
Like, what did I just do? Then my next thought was just, ohmygod, you’re gagging. I mean, you’re really gagging. If you puke this stuff up, you’re going to have to lick up your puke and this stuff. It’s just going to be a disaster, right? I’m retching and gagging and trying not to wake up the family and trying not to spew my ketone esters all over the kitchen. It took like 20 minutes for me to get out and do my bike ride, which was the whole purpose of that experiment.
Tim Ferriss: Must have been a record setter.
Peter Attia: Oh, God. Those things are unbearable.
Tim Ferriss: Well, there you have it kiddos. I hope you found these tips as helpful as I did and that your sleep benefits from them. If there are other topics, other themes you’d like me to piece together by going back into all of my episodes and trying to find specific patterns, please let me know on Twitter @tferriss. That is Twitter.com/tferriss. Or you can leave comments on the blog post associated with this podcast. You can find show notes for this one and every other podcast I’ve done at Tim.blog/podcast. And until next time, as always, thank you for listening.
Posted on: February 2, 2018.
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