Episode Transcript
[00:00:00] Speaker A: Welcome to the Heart Rate Variability Podcast. Each week we talk about heart rate variability and how it can be used to improve your overall health and wellness. Please consider the information in this podcast for your informational use and not medical advice. Please see your medical provider to apply any of the strategies outlined in this episode. Heart Rate Variability Podcast is a production of Optimal LLC and Optimal HRV. Check us out at optimalhrv.com Please enjoy the show.
Welcome, friends, to Heart Rate Variability Podcast. I am so excited to have my friend Dr. J. Wiles here on the show today. Jay, I feel like we're kind of old friends at this point, having known each other for a couple years and talking on and off about heart rate variability, the work that you're doing, and now obviously really excited to share your work at Absolute Rest, which has just been a great partnership for us here at Optimal hrv. So, Jay, welcome to the show and I would love to start just a little bit of an informal introduction to yourself and then we'll, we'll nerd out a little bit about the role heart rate variability has played in your career.
[00:01:17] Speaker B: Absolutely. But yeah, thanks so much, Matt, for having me on. It is true, I think that for people who don't know because they're just hearing our voices now, you and I, it was probably, what, a couple years ago we met at aapb.
[00:01:29] Speaker A: Yeah.
[00:01:30] Speaker B: And I think people just kind of looked at us together and probably thought those are the two most gigantic people we've ever seen. Because you and I both are really tall.
[00:01:39] Speaker A: Yeah.
[00:01:39] Speaker B: So, so, so, yes. If you ever see us at conferences, it's the two Giants walking around.
[00:01:45] Speaker A: Yeah. It's good to get us on the same team for pickup basketball if you need some rebounding, at least.
[00:01:49] Speaker B: That's right. Exactly. Yeah. Rebounds is probably all I'm going to offer you. You probably don't want the ball in my hand offensively.
[00:01:55] Speaker A: That's okay. I'll do the shooting for us.
[00:01:57] Speaker B: There you go. It. I love it, man. But yeah, so, so, so good to have be on here. And you know, I, I, I always tell people, like, when it comes back to my, like, my background, like, I kind of just happened upon this world of hrv. Like, I've made a career out of it and, and we'll get into that here. But, you know, I, I actually had no clue what, like, HRV biofeedback was or biofeedback in general when I was in training. So I'm a clinical health and performance psychologist and done a lot of my work in sports psychology. For, for, geez, last decade or so. And, you know, when I was getting my training initially through the Department of Veteran affairs, so as an intern and as a, as a fellow, I was always interested in integrative health. So kind of at the intersection of, you know, lifestyle, behavioral medicine and mental health. So obviously we know there's a huge correlation between changes that occur kind of within the mind and how it can affect the body and then also vice versa, the body and the mind. And so I always knew that I kind of wanted to go down the field of health and health psychology because I just was always interested in that personally. So I come from a background of athletics as well. I was an athlete. And so that was just always kind of a passion of mine. And it wasn't until I was working with the Department of Veteran affairs for my internship year in Richmond, Virginia, that I came across this thing called HRV biofeedback. And I really, honestly, I didn't understand it initially. I, I, I was kind of just like, trying to dabble in everything, kind of as any good, like, internal resident would. It's like, try out. But it wasn't until we actually started publishing studies on the efficacy of HRV biofeedback for chronic pain that I was like, oh, goodness. Like, this stuff works. And people have to remember too, this was pre the advent of any type of wearable technology. And like, mobile devices were just like, they were a thing. But we weren't like, tracking HRV with wearables yet. We weren't doing HRV biofeedback on the phone. Like, that wasn't a thing. This was all kind of brilliant pre that. And I just remember the first time I ever stepped foot into the, to the clinic that was using HRV biofeedback. It was a, it was called the Veterans Integrative Pain center in Richmond, Virginia. The, the Department of Veteran affairs hospital there. And what was so interesting about it is that it was a fully integrated center that was helping individuals who were, I should say veterans who were experiencing chronic pain, helping them to titrate off of opioid medications, because this was at the heart of the opioid epidemic. And so many of these individuals were kind of like, I don't know, you know, if this stuff's gonna work, but I'm willing to try it because I'm so sick and tired of medications and also sick and tired of being in, in chronic pain. And so within the context of this clinic, it was multidisciplinary, so we had, you know, MDs and physicians we had massage therapists, we had psychologists, we had nutritionists, dietitians. Like, it was kind of the whole gamut. And so people would come in and they would do things like mindfulness groups and they would do chiropractic care and adjustments. There was just a whole wide variety of integrative modalities. And one of them happened to be heart rate variability biofeedback. And when I first kind of saw HRV biofeedback, I kind of thought to myself, this is just kind of like a technology enabled, like breathing practice. In a sense it kind of is. But I kind of think I undermined it, like the power of it. But then when I started to see people like within the context of session, really buy into it and really just kind of, I could see the efficacy of it. Like, for me, I was, I was bought in. I thought, oh, this is super interesting because we're taking something like slow paced breathing and we're quantifying it objectively. And so people have that layer of evidence in front of them that this thing is working for them. And so for so many of these veterans who tended to be very tentative with the types of approaches that they would take because, you know, don't, God forbid you give them anything too. Woo woo. Like they run for hills. They're not that interested. They, they saw this and they're like, oh goodness. Like, I can actually see changes in my nervous system in real time. And also, and then again, we published studies on this. My subjective experience of pain went down through the control of my nervous system. So it was kind of at that point in time where I was hooked and the rest is history. I mean, I've kind of created a long term, you know, career now out of doing, you know, psychophysiology, applied psychophysiology and HRV biofeedback. But it all started right there within the VA of all places. Which is actually kind of interesting because the VA is known being like quite antiquated in their treatment modalities. So I was like, whoa. To be exposed to that at like kind of the early part of my career. I see myself as very fortunate to have fallen into that.
[00:06:34] Speaker A: That is great. And there's the Richmond, Virginia crew. I've started, like, there's some really great work being done in your neck of the woods that I don't know if y'all like meet for tea or coffee every once in a while. But you know, it's just, it's just like, you know, a really cool, a hub of autonomic nervous system Seems like a whole bunch of HRV nerds.
[00:06:57] Speaker B: Yeah, it's amazing work. When you're in Richmond, you've got two things that you can do. You can either be a foodie or you can be, or you can be into nervous system functioning or just a combination of the bowl.
[00:07:08] Speaker A: There you go.
[00:07:09] Speaker B: Known for its foodies and I guess known for its biofeedback.
[00:07:12] Speaker A: Awesome. And I would love to kind of continue the thread with.
As you look at the overall health and wellness and obviously working in the VA with vets struggling with the opiate use, I would imagine you've got probably some post traumatic stuff going on there with them as well. And you know, I kind of the, the, the dual learning that was probably, I would imagine knowing you, I know is in your head about. On one hand, looking at this for recovery from some really difficult things like kicking an opiate addiction could be one of the hardest things you could possibly do. But also looking at the peak performance aspect of your thinking around, you know, sports and sports psychology and performance as well, and I wonder just kind of that balance as you were getting in this field and how it's continue to look at this really cool thing with folks that are struggling, but also folks that are wanting to increase their performance as well.
[00:08:14] Speaker B: Yeah, it's, it's interesting that you can use a modality like heart rate variability, biofeedback for both things. Right. And actually the intention and the focus, focus is quite similar, if not the exact same for them. It's just directed at a different outcome. So for instance, when I was working with the Department of Veteran affairs, so I worked there close, close to a decade and then I, I moved on. And I'll explain a little bit about kind of my journey after that. But when I was there, you know, I was in charge here in the state of South Carolina with working on building the whole health programs as a part of the whole health initiative with the va, which is basically the integration of integrated or multidisciplinary modalities to help with individuals who have comorbidities or veterans with comorbidities. And so just kind of strengthen the language a little bit because I know I'm using a lot of clinical terms, comorbidities being individuals who have kind of a comorbid or together, if you will, medical ailment and mental health ailment. So veterans like you mentioned, most of these it's going to be anxiety, but most particularly PTSD and then, you know, chronic pain, diabetes, you know, cardiovascular disease and so forth. And so I Got to see kind of the power that biofeedback had clinically with these individuals who were kind of chronically stressed and had their sympathetic nervous system on kind of like chaos mode all the time because of, you know, their, their history of their, the things that they experienced with, with PTSD and, and within the context of the military, and then also too the effects of things like chronic pain and other medical conditions. And so I got to see like HRV biofeedback really work for those individuals and helping to downregulate their response and improve things like sleep, improve things like over mental wellness. And because of that, I kind of dove down the rabbit trail, if you will, and kind of saying, well, okay, this is very effective for people clinically and I think that that's great. But as an athlete and someone who's also kind of just worked historically with a lot of high performers, is there some potential overlap here? And I started to get into the literature, which there was, there's a lot more now. There wasn't as much back then, but looking at biofeedback as a mechanism for helping people with sports performance or even with individuals who, let's say are like top performing executives, like a high level of cognition. And I started to say, okay, I think that there's actually some overlap here. We don't have to focus solely on things that are clinical here. We can actually focus on kind of more the peak side of things, the optimal performance side of things. And so I think that's one of the beauties of HRV biofeedback is it can be used in a wide, diverse kind of settings, if you, if you will. And so it was back in, I guess that would have been 2020 actually. No, it was 2018 is when I decided, you know what, I'm going to kind of pursue kind of that peak performance route. I didn't see a lot of sports psychologists playing within the context of the use of applied psychophysiology. And I thought, oh man, there's an, there's an opening here. And I actually, I had my foot in the door in kind of the health and wellness space. And I was introduced to a lot of just like high performers and professional athletes. And so I kind of just made a little bit of a niche, if you will, and kind of doing something that looks a little bit different in the sports psychology sector. So sports psychology historically has focused a lot on mindset and behaviors and then of course on cognition, which is obviously a very much inner intercorrelated with mindset. But it hasn't focused as much on psychophysiological like regulation and nervous system monitoring. And so I said, okay, there's probably an opening there because many athletes very similar to my veterans who are very tentative to kind of go see a psychologist, many athletes are very tentative about it as well. So sports psychology is, probably has a little bit less stigma than clinical psychology, but there's still something about it that a lot of peak performers are like, I don't know, do like, does this actually require going to see a psychologist? Like how might this benefit benefit me? And over the years that's gotten a lot better. I think that you see most sports organizations are leveraging the use of psychologists and individuals kind of within that context. And so it's gotten better over the years. But one of the things I was able to offer and bring to the table was the use of heart rate variability, biofeedback and even peripheral biofeedback to individuals who were high performers and top level professional athletes in the mlb, pga, NFL, NHL. So it kind of goes the, the gamut. And what I think they find so valuable about valuable about is the evidence. So like a lot of these individuals are very data driven. So you think about PGA players, you think about MLB players, they're super focused on analytics. And now kind of as the game sport has become even more flooded with, with the ability to collect data and through the use of AI, these individuals are like, I kind of want to know, I want to know my numbers, I want to know like where I'm at, where I'm headed. So for a lot of these individuals, like the use of kind of nervous system monitoring and then also training, like it just clicked with their paradigm because for just so used to data all the time, they're always kind of crunching numbers. And so honestly Matt, it was kind of an easy sell for a lot of these people that I had an in with because they were like, yeah, if this is going to give me more data, this is going to help me kind of increase performance by 1%.
[00:13:23] Speaker A: Right?
[00:13:23] Speaker B: I'm, I'm, I'm in. And so that's kind of where I developed. You know, my, my own companies have a consulting company called Thrive Wellness and Performance. And so for the last, you know, I guess close to 2018, so it's been now like seven years I've been really focused on working with a lot of high perform, the peak performance side of things and I've seen like really great results. And I will say too, the one thing that I'll throw as a caveat because I think sometimes I think, oh man, it's just kind of the biofeedback that's moving the needle. I do think that that is moving the needle, but it's also, I'm incorporating a lot of other different types of therapeutics and interventions and I know that you guys at optimal and ina especially is big on mindfulness and I'm a huge mindfulness guy as well. So it's a combination of things that I've seen really effective. But the consist training of nervous system functioning through biofeedback has been a thing that I've seen move the needle substantially for these people.
[00:14:17] Speaker A: I love it. I'd love to go back to kind of your pre HRV self to now where you're at and I'm just kind of curious with your background as you started to learn and then become an expert in heart rate variability in the autonomic nervous system.
I just love to hear how thinkers like yourself, how did that change or inform, you know, the person that you're trying to help? You know, and as you mentioned, that could be a professional athlete to someone struggling with an addiction and trauma. I, I would just love maybe a little bit at the meta level and we can drill down in there just how heart rate variability has changed the way, you know, you, you see the humans that you work with.
[00:15:03] Speaker B: Yeah, I, I, I think like any scientist, I am a skeptic at heart. So for me, I was initially a skeptic. I mean, I saw this thing within the VA and I was kind of like, well, prove it. Prove that this works. And honestly Matt, like, even though I saw it and we published data, I still was like, I think I need to experience this for myself in order to really believe it. And that's just kind of a matter of how my brain works. It's like you can tell me all day long that something is effective and show me the science behind it. And I'm like, okay, that's really cool, but let experience it myself and then let me see how this kind of works with other people as well, not just myself. So I think like the first thing that was kind of like the light bulb for me is that I was like, well, you know, I am a back then, back in the day, I'm a trainee, I'm an intern. I was a fellow. I'm stressed out of my mind. Like I'm working crazy hours. Like I'm not, I'm doing, I'm not practicing what I preach like that, that was for sure, like my health wasn't the greatest because I was just so focused on like getting, you know, being, being the top of my game, if you will. Little did I know that this could have really helped me be at the top of my, my game. And it wasn't until I started to really explore this myself that I thought, okay, like, I can actually see like the, the benefits of it. So like, for me, I started to do biofeedback daily. So I tried, I tried, you know, doing it daily, which I had great. You know, again, this was prior to like anything being on the phone. This was kind of like old school encoders that I still use today. But I remember hooking myself up to a nexus within the clinic, trying it out and just kind of becoming hooked. And it wasn't because I just thought it was so fascinating to watch what was happening in real time, like with my nervous system. What was fascinating was that I subjectively felt better. Like I would do a session and I would be like, this makes me feel better, it makes me feel more calm. And I always have had this interest as an athlete in physical performance, but also in cognitive performance. So really kind of being able to center in and focus and like get things done and get things done more efficiently. And I noticed that that started to improve really substantially because it was improving my sleep, which was improving nervous system functioning. And then just in general, I would feel both acutely and then also chronically just better. Like I just could feel more mentally clear. So for me, I said, okay, this, if this is happening to me, I now have official buy in. Let me start to just try to slowly introduce this, you know, to the performance world and see kind of what their response is. Because initially I had worked with some high performers, even veterans who were, you know, special operators back in the day. And for them, like, they'd be willing to try some mindfulness practices, they'd be willing to try some, you know, slow paced breathing. But I never found that anything stuck with them. Like behaviorally, it was a lot more difficult for them to kind of continue it on because it's almost like there wasn't as much structure identifying barriers. Whereas when I was able to introduce biofeedback, they're like, oh, I've got structure now around this. We're going to do a 10 minute session or a 20 minute session and I know exactly what I'm doing for the duration and I have this data to review both in real time, but also at the end of the session with Jay. And so therefore they, they had this, this. It was just Kind of like nicely in a box for them. And they, they needed that. And so I think that that is one of the biggest things I've seen, like in terms of evolution of kind of my career and how I use help benefit. You know, my, my clients is really focusing on kind of that structured component. So it's like they get the layer of evidence that this is working, but they also, like, I think that's one of the biggest things that keeps them coming back for more because I've, I've had so many people, Matt, who are like, they'll do some slow paced breathing, they'll do a mindfulness practice, and at the end of the session they'll be like, yeah, I think I feel better. Like, you know, subjectively I feel more relaxed. Great. That's like, that is key point number one. Subjectively you want to feel, feel better. But I think for them it's that when they get that extra layer and they say, oh goodness, it's not just that I subjectively feel better, but objectively I also see what this did to my nervous system in a matter of minutes. Not, you know, hours, but minutes.
[00:19:23] Speaker A: Yeah.
[00:19:23] Speaker B: For them that is the buy in to say, okay, well then can I use this pre game, you know, before I, before I have, you know, my, my hockey match or before I have my baseball game? And, and then they start to kind of create behaviors around, you know, biofeedback and managing kind of their nervous system functioning. So I think that those are kind of the key aspects. I'm not sure if I fully answered your question there definitely.
[00:19:45] Speaker A: So I would love to kind of jump forward, you know, kind of the last time we. Well, in the recent part of Matt and Jay's conversation, your work at absolute rest. Now, one of the things I'm jealous of right from the start is one, do you get to wear scrum scrubs? Because I've always, every time I've had a zoom with you for the last few months, you show up in scrubs. And I'm immediately jealous of that fact.
But I would love to get what you're doing at absolute rest. It's been a great, we've been honored to be a partner with you at optimal hrv. But I would just love to get what you're currently doing now with absolute rest and a little bit about your program.
[00:20:32] Speaker B: Program, yeah. So it is cool that I get to wear scrubs because it makes life easy. I wake up in the morning and I'm like, there we go, pull it up. And they're very comfy I'm always like.
[00:20:41] Speaker A: Why don't therapists get outfits like, you know, we need. I've done, you know, depending on your role. I've been, I've been, you know.
[00:20:48] Speaker B: Yeah, it'd just be great if anything, just to have a level of comfort, like.
[00:20:55] Speaker A: So jealous.
[00:20:56] Speaker B: That's right, man. So I, you know, I started with Absolute Rest back in September of, of last year and it was one of those things again, I, I feel like I'm telling a lot of my story is like I just happen to come across this. Well, this is another one of those things that ended up just kind of like finding its way into my life. And it's. And that's the beauty of life sometimes, right? Is that sometimes things are just kind of offered in front of you. And I'll be honest with you and the guys at Absolute Rest know this, so I'm not saying anything that isn't overstepping a boundary, but when they first approached me, I kind of thought, yeah, no chance I'm going to do anything else. I, I've made a really nice career in kind of working with high performers and professional athletes. Things were really kind of picking. It was just, it was a good time. So when they kind of proposed something to me, I think initially I was like, I don't really know. But then when we started getting into the weeds, I was like, okay, I think this is a really good opportunity. So Absolute Rest at its core, it is a significantly comprehensive sleep clinic. That's the best way, is the best way to pun it. And we do really kind of, I won't say cater to, but I would say because it is a higher price point experience, it does tend to cater to a lot more of like top performing, like let's say executives, professional athletes. But really we just know that at the foundation of good health and wellness, mental and physical health is good sleep. And so many people struggle with sleep. I mean, it's just like a core issue. And as someone who has historically had poor sleep, I was kind of more of like, oh, personal peak interest here. Because sleep is not, we're always trying.
[00:22:34] Speaker A: To figure out ourselves as much as anything else.
[00:22:36] Speaker B: Yeah, that's right. That's. That's right. Right. And so.
Excuse me. So the, the core of Absolute Rest is that it is a multidisciplinary 90 day program that is intended to help do number one diagnostics. So we do full in home sleep studies. So instead of having to go to a lab which is extremely artificial and people normally sleep horrible in a sleep lab because you're hooked up to a bunch of stuff. You've got like a plastic pillow and you got people basically like watching you on night. Yeah, just a weird scenario. So we have in home testing so people will do a full polysomnography. So what we're looking for there is obstructive sleep apnea or central sleep apnea, sleep disordered breathing. So anything that could be kind of more medical related, we do a full blood panel. And we're actually starting to introduce genomics or genetic testing as well. And then we do a whole battery of psychological tests, which is where I come in as the, as the psychologist. So I'm the director of behavioral medicine at Absolute Rest. And our whole goal is to kind of piece together a narrative and a whole story around someone's sleep and their sleep issues. So looking at it from the medical side of things, from the behavioral side of things, and then also psychological. And this is very different as, as, as you may know, Matt, than going to a normal sleep lab where it's just like you do a polysomnography, they diagnose you with, you know, some type of sleep disorder if you have it. And then here you go, here's your cpap. Good luck. That model unfortunately just doesn't work like behav.
Hate CPAPs. I mean, it's not to say I do not want to down CPAP because we, we, we have had plenty of people who go on cpap, but a lot of times they just give you a CPAP and they expect you to throw it on and the next thing you know, like you're, you're able to do it all night. It's not that behaviorally easy as people make it out to be. So our goal is to have again, a whole team around you throughout the 90 days. And it is 90 days. So it's intensive. So we meet with individuals and kind of share with them their diagnostic testing. So we let them know, like, hey, we noticed there's apneas or hyp or different difficulties with sleep disordered breathing. The other one that we're really looking at, which I think most of the listeners here will find fascinating, is that if you were to wear, let's say like a whoop strap or an aura ring, you can look at some sleep staging, but the fidelity of that information is pretty low. Like it's not meant to be like medical grade. Whereas we actually do autonomic testing with a, with a, a ring called a sleep image ring, which is an FDA cleared ring. And one of the things that we're able to look at is obviously heart rate variability, but we're also able to look at slee sleep fragmentation. So basically that's when people have these sympathetic surges at night that will kick them in and out of sleep stages or will cause them to become awake. And so many people have a high level of fragmentation that can be a result of sleep disorder, breathing, but also stress. It's a huge one for the people that we work with. And no one's immune to this, right? I mean we have so many high level. I'm talking about the most elite professional athletes you can think of. Of that have horrible sleep fragmentation. Their nervous system is way out of whack when they sleep. And so one of the things that I've come in as a part of, you know, my role is to introduce biofeedback prior to sleep. And what we're seeing is that it's helping to reduce people's fragmentation. They're staying into deeper stages of sleep for longer. And our whole goal is to publish these studies. I mean we're going to be using optimal HRV data to publish this. So. So stay tuned. I'm sure we have a lot more, A lot more to come here. But, but it's, but it's a, it's a great program. And I think the big kicker, or I would say the, the, the strongest or most robust component of absolute rest is that you. Everyone has what's called a clinical sleep specialist who walks with them along their journey. They're basically a behavioral specialist because we know that behavior change is hard and behavior change around sleep, like reducing phone usage, you know, having good stimulus, control, control, it's really freaking hard. So we have someone there alongside the way. So again, it's just a fully integrative program that really is tailored to helping change. Kind of just the foundation of sleep in 90 days.
[00:26:45] Speaker A: I love it. I, I'm just curious as your career has shifted, you know, into this work. You know, I'm sure you could have take. Taken a lot of what, you know, you learned along the way way. But I kind of want to working with a special. I mean the fact you're doing like genetic testing is, you know, mind blowing on what that could open up with sleep. But I'm kind of working with all these specialists and then bringing your expertise in this and as you kind of outing yourself ahead of time, as I will, as well as somebody who. We got way too many thoughts in our head to sleep, but those thoughts don't do any good for you. If you don't get a good night's sleep. So I just kind of wonder, you know, kind of your. What kind of insights might you have had? Kind of really doing a deep dive into, you know, healthy sleep, sleep quality and helping people improve that.
[00:27:37] Speaker B: Yeah. So, you know, a part of, a part of my interest in health and wellness has always been in sleep because I know it's such a core foundational behavior. I mean, I could, I tell people, you can have your nutrition on point, you can have your exercise on point, you can even have good stress resiliency on point. But if you have poor sleep, which can be due to a slew of things like it's going to impact your overall health and wellness, I mean, we see this as, you know, poor sleep is related to basically every, you know, poor outcome. Cardiovascular disease, diabetes, cancer, Alzheimer's, like, poor sleep. Not only can it be a foundation for a lot of those, you know, poor symptom presentations, but it's certainly going to exacerbate the, the, the, the, the negative symptoms there. So for me, it is a matter of saying, well, how can we improve someone's behavioral routine? And then how can we help them to downregulate nervous system functioning? That could be kind of pulling them out of these deeper stages of sleep. And so I think that so many people just don't realize, like, the effects of poor behavior around sleep. So the biggest culprit, and most people might already be thinking about this, the biggest culprit is people using their cell phones in bed. Probably the worst one, because they get, they try to go into their bed, they get a little bit tired, and they're like, you know, I, I feel like I should be able to go to bed. And then they're like, well, let me just look at, you know, Instagram for a few minutes or Tick Tock or whatever it may be. And that turns into 30 minutes, an hour, two hours or so. What they're unfortunately doing is they're starting to take that stimulus which is very excitatory, their phone uses, use, and they're making that association with their bed a place that should be really just dedicated to rest. They're now kind of bringing in something that is, that, is that, that is just pulling kind of that stimulus to, to a different direction. And it becomes conditioned. It essentially becomes conditioned that this is a place of wakefulness and not of rest. So for most of these individuals are like, well, if you want to stabilize your nervous system, let's get this thing out of the room. So we actually started Here recently there's a new device, I think it's phenomenal because it so simple, it's a little like NFC device called a brick. And, and I have no association with this company but it's all over social media and so we started using it in our company. But basically you just tap your phone onto it and then it bricks your phone. So like essentially allows you not to be able to use any apps that you like selected unless you physically touch that again. So we have people put it like in a very like difficult position or place to get into in their home. So if they're sleeping upstairs, we have them put that device down downstairs, tap it and then they go up and now they cannot use their phone. The only things that we let them use is like our app which is absolute rest because they're doing sleep studies, optimal HRV they're allowed to use and a couple, a couple of other things that are not stimulatory but are intended to help downregulate. And what I found is that when people do that and they don't have access to their phone, that helps substantially like more than just about anything. And it goes to show you just how addicted we are to our phone is and, and just how much control it has over us. And so with that we have people brick their phones. And this is probably the most important part of people's day in my opinion. What we've seen help is that we have them do a wind down routine for about 30 to 45 minutes prior to bed. The first thing that I have them do after they brick their phone is that they actually will do a 15 minute optimal HRV session. So they, they, they'll do their resonance frequency biofeedback for about 15 minutes minutes. And then after that they can do things like you know, you know, get ready for the, for, for the evening and whatever way, you know, brushing teeth, just things that are very like non stimulatory, read a book, those types of things. And then when it's lights out time, it's in the bed, there's no devices, it's dark room and they go to sleep. So I think like the biggest thing there is just developing that behavioral routine which is all about structure and then downregulating the nervous nervous system. I cannot begin to tell you how much we've seen that in and of itself move the needle. Now of course if someone has sleep disordered breathing, let's say for instance, they're having apnec events which all of us have by the way, and we generally have around five an hour or so. But when it goes above five and into 10 to 20, now it's a little bit more concerning, if you will. But for many of those people, you know, we're doing different types of interventions and strategies, behavioral and medical strategies, strategies that will help to reduce kind of sleep disordered breathing. But it's kind of a combination of all of those things. But I think that if I was going to tell anybody, like, what's the biggest lever to improving sleep? It is structure around your sleep and it is downregulating your nervous system prior to sleep with those things. If you can do those things consistently, you will see improvement in sleep. Like, we just, we know it, we have the data, we've seen it time and time again. And if it's any, if it's any like motivation for people, this is what we have, top level athletes, I'm talking about number ones in their sport. This is what we have them doing and it's working for them. Guarantee it will work for you.
[00:32:44] Speaker A: Yeah, I would love to throw some just in. And not necessarily, if you're like, you know, don't have a firm stance on it, we can knock that out. But now being like, I'm getting the gray and the beard and all that, it's like I've watched society go from minimizing the importance of sleep to almost you're lazy if you get eight hours of sleep to I really believe, shifting back over to, oh, wait a minute, we're human, we're mammals, we need sleep to perform at our best. And that has been this huge shift. But, but as this shift happens, in a capitalist society, you know, people want to, you know, make money off this. And so you see these different things come about. I just love to get, if you don't have an opinion, opinion, that's fine. But. But I would love to, I'd love to throw a few things at you just to get your. And let's just call this Jay's opinion.
[00:33:39] Speaker B: Yes, with this.
[00:33:41] Speaker A: Because I think the research is shifting. So the first one is I'd love to get your thoughts on melatonin.
[00:33:46] Speaker B: It's a really interesting one. So melatonin is one of those where, you know, a lot of people have overused it. The problem with melatonin is that if you think about what melatonin is, is at its core it's a whole hormone. So we have to remember this is a hormone. So I think that the evidence suggests now that for individuals who are like prepubescent, so prior to puberty probably shouldn't be taking melatonin because it can indeed affect like people's hormones. Now afterwards, here's what, here's what we say is that obviously melatonin is a hormone and when it's taken exogenously, it's still a hormone, but we make melatonin. We should be making melatonin. And the biggest driver to the creation of melatonin is actually sun exposure. So people should be getting sunlight. It's basically the first thing they get in the morning to help to set that circadian rhythm so that we can have this appropriate creation and secretion of melatonin at the right times. Now when you start to kind of utilize a lot of, let's say artificial technology or lighting to stay up to 1, 2, 3am and then you're sleeping, you know, only like until 6 or 7, you're giving yourself a small window. You're really messing up kind of the natural cycles of your melatonin. On what a lot of people do, they try to take more of it exogenously and then you can kind of create this nasty cycle. So we will use melatonin at times, especially for people who are traveling across time zones. It can be helpful or effective. But what we say to people is, is that sleep is a completely 100% or should be a complete 100% natural process. We naturally create melatonin and so therefore melatonin or even any supplement for that matter can be used. But we say that it should be sparsely used. It shouldn't just be kind of every night. We rely on the, on that exogenous supplement in order to improve sleep. So I think that melatonin is kind of a double edged sword here. We can see it being effective and we use it, but we don't make it a habit of people using it every single night. And we also, when we do give melatonin, it's a very, very low dose.
[00:35:53] Speaker A: Yeah, yeah. It's just this interesting thing that I think got accepted as harmless and effective. And I, I've seen the research just, you know, except for the time zone changes as you mentioned, it seems to be the only effectiveness thing that's sort of left over there. And you are artificially putting a hormone in your body that you can get naturally too. So I think it's, it's one of.
[00:36:20] Speaker B: Those things across the counter. You could just get, go anywhere and get it. And I think that that's what, a little bit scary.
[00:36:25] Speaker A: Yes.
[00:36:26] Speaker B: Is that, I mean, these supplements aren't regulated by the fda. And so therefore people can kind of just use whatever dose they want. And what they don't understand is, is that there can be therapeutic use cases like if you're traveling across time zones to help reset the circadian rhythm, but to do it as something that you do habitually every single night. There could be potentially damaging side effects from taking a hormone consistently that you should be aware of. And we do who don't at absolute rest at least like to recommend that.
[00:36:54] Speaker A: Yeah. Another thing I'd love to hear your. Your thoughts on because it's sort of another thing that's shifted in. And now I, I'm. I'm hearing some legit warnings about it. Is the, the ambient sort of drug category. I believe hypnotic is the, the maybe the right language there. Having tried that.
Wow. Is all I have to say. I woke up in a. At a conference in Adizia Hotel. Hotel. Very convinced I had just murdered somebody. Which for the record, I've never murdered anybody anywhere.
[00:37:28] Speaker B: Let's make that very clear.
[00:37:31] Speaker A: So. But I swore for like an hour afterwards I knew to run away from the cops.
That was my last ambient experience. But I wonder working with folks and that being handed out. I just told my primary care physician that I wanted it and I got had it. Just sort of where, where that plays into your thinking around sleep.
[00:37:53] Speaker B: Yeah. Ambien and then other, you know, Lunesta, a lot of those prescribed types of medications for sleep, for sleep aids. I think that there was a period of time especially, I mean it's kind of very similar to opioids where it was just being overly prescribed. I mean, you could go, like you said.
[00:38:07] Speaker A: Yeah.
[00:38:08] Speaker B: To your primary care physician, got sleep problems. Here's the solution. It's, you know, here's your, here's your Lunesta, here's your Ambien. And of course that caused significant problems with addiction. And we also saw that these individuals, once they got on it, coming off of it was very, very hard, very difficult. Very similar to like coming out of opioids. Like, if people go on opioids and they're on there for a sustained period of time, the side effects can be brutal. I mean, you basically are detoxing. And so what we say we have. We still have a fair amount of people who will come into our program and they've used it because for them it's like, I'm struggling so bad. I just need something to help out. And so for most people that are coming in, we say, listen, we don't want just to immediately take you off of it, because that's going to be a hard process. But a part of our program is that we want to titrate you off of it under kind of the supervision of our medical team as well as your own physician who's the prescriber and so everyone who comes in it. Because again, if you think about like the ethos of, of absolute rest, we are saying, how do we return somebody to the natural state of sleep, which just does not require any type of exogenous supplement or medication. It's again, not to say that there aren't potential use cases for these medications, but in general, kind of very similar to like, ADHD medications, overly prescribed. This is kind of falling in the same category. So we are going to try with every single one of our clients to get them off of that medication. Because what is somebody would really want to take Ambien for the rest of their life every day and have kind of the grogginess that people experience. And then some people develop such a tolerance for it that it stops working like it stops being effective. And they're just taking a hardcore, you know, controlled substance that isn't actually like helping them with sleep. So for many people, we're saying, we're saying, how do we return them back to natural sleep? Through other medical interventions, conservative interventions, as well as behavioral, psychological interventions. So again, it's not to say, just kind of put. Put this out there. It's not to say that, like, you know, the bad guy is Ambien and that everybody should, should be off of it. But it is one of those overly prescribed ones that if you're coming through our program, our goal and intention is to titrate you off of it.
[00:40:20] Speaker A: I love it. I love it. And I love the message you're giving too, is that to titrate you off of it is meaning we need to have a strategy to help you successfully get off this medication, which, you know, addiction is such a devil psychologically and, and for your nervous system as well. So. So doing that in a safe way, I want that. That is such an important message for folks as well.
[00:40:46] Speaker B: Yes.
[00:40:47] Speaker A: So. So the final thing, and you've already kind of mentioned this, but I, since you brought it up, I got to get Jay's opinion on blue light.
It seems like, you know, I've got some people that I know that their prescription glasses they wear all the time blocks blue light, which to me seems ridiculous, but, you know, it's like, so. But. But I think the message is this blue light is bad, bad. But then you've got folks like you and I who's like, you gotta get some of this in the morning. You gotta, you gotta, you got, you gotta get your eyes maybe not staring at the sun, but exposed to it. I think it's a better word. And then, you know, it may just be a placebo effect. But I love my blue light blocking glasses and swear by them. And I'm okay if it's just a placebo. So I'm curious. I heard you talk about it a little bit already. I'd love to just get Jay's perspective on blue light.
[00:41:41] Speaker B: Yes. So I will go on record right now and say that blue light is not inherently bad.
[00:41:47] Speaker A: Thank you.
[00:41:48] Speaker B: You need blue light. So do not wear blue light blocking glasses all the time or especially if you're outside, because the biggest zeitgeber or the thing that will adjust circadian rhythm. There are two things. The number one most powerful is light. The number two, one is actually food. So. And movement and exercise are also a part of it as well. But light is the number one thing. So we have to remember that the sun contains all spectrum of the light, including blue light. So I think when people think about blue light, they think about, you know, electronics. So, you know, I'm looking right now at a laptop, you know, I've got my cell phone here and I've got other sources of like blue, blue light. And I think that, you know, it's really interesting because when we look at the research regarding blue light, especially on things like melatonin creation and production, we don't have a ton of evidence to say to suggest that excessive blue light, like having blue light within the environment, actually affects like natural melatonin production. However, what we do know is that light is the biggest signal for waking up in the morning, but also as we go to bed at night, it's not nearly as much what the research is now saying. It's not as much as like the blue light intensity that is the cost for a concern. It's just overall light intensity itself. So, you know, you can think about it. If you are in a room that is chock full of fluorescent lights late at night, like, are is that going to prime you to go to sleep? And the answer is no. You're going to be like, probably like, you know, geek. I mean, tweaking out a little bit because you're like, oh my gosh. It just makes me feel like stimulated. What the research is kind of showing us is that the blue light in and of itself may not be the culprit it's just the intensity of the light itself. So like the brightness of the light because at nighttime it's supposed to be naturally more dim. So kind of throwing on all these artificial lights can affect our ability to like feel tired. Now the blue light blocking glasses are really interesting because I will be the first to say that I wear them at night, but predominantly to help block the intensity of the light. Because at first I was thinking, okay, there is some compelling evidence that the blue light in and of itself itself is the thing that is kind of causing melatonin production to, to go down. But then when you look at more recent evidence in the re. In literature, it's just not that clear cut. I, I think that there is some evidence to suggest that blue light or light intensity exposure at night should be limited, but to like you know, throw on the red colored glasses or whatever it may be. I just don't know if there's enough convincing research of it yet. But so that all to say kind of I packed it up is to say blue light is not inherently bad and get it first thing in the morning at night. I mean this is what. So for instance. And then I'll finish that statement. For instance, if people think about the treatments that are being used for SAD seasonal affective disorder is that they're actually in front of blue light panels and they are effective. Like there is research suggest that they are effective. So if we become scared of blue light, blue light panels like in front of us, then we're kind of just almost like avoid kind of like neglecting the research, if you will, which says that these can be very helpful for mood regulation in the winter times for a lot of people. So it's not inherently bad. I think at night time, like if you want to be more conservative and say, hey, I just want to like limit the intensity of light. Like what we tell people is like if you have the ability to dim lights, like do it like. So for instance, like my home has like the, the, the Phillips led, like where I on my phone just like turn them all down. So I do that and then like if I'm in my bedroom prior to bed or actually I would do this more my office where I do like my pre sleep routine. I'll still throw on some like blue light blocking glasses. Is it like, is it removing the blue light which is then helping me with sleep? I don't know. But it's reducing the intensity of the light which in and of itself can, can be good. So I think that the, the Matt, the verdict is still out on whether or not blue light is something that we should be like trying to actively avoid at night time. But I do think that the research is pretty clear that the intensity of light at night should be dialed down. It doesn't make sense to have on lights everywhere when you're trying to downregulate prior to sleep.
[00:46:00] Speaker A: Yep. And I just love it too. And I, I, I'm, I'm a full, you know, I, I wish people, more people would lie to me so I could just get the placebo effect right as much as possible. But it is like from a behavioral perspective as well. I found it like especially, you know, now that, you know, here in Colorado shadow it gets dark. You know, maybe we've hit 5 o'clock now I've got a mountain right to the west of me, so I get a little bit of a artificial sunset as well. But just to like, okay, it's it's evening now and during the summertime it may be like, okay, I'm gonna go to bed in an hour now it's like I'm gonna go bed in four hours. But it's still just like.
[00:46:40] Speaker B: Good point.
[00:46:40] Speaker A: Getting, getting myself into that routine, dimming the lights that down, just paying attention when I go to the bathroom, not flipping all the lights on, but just the one in the corner that's not that bright. I think all that, whether it's blue light or that intensity piece or the behavioral part of the placebo effect, it's like I keep.
Plus I think I share this with her. I think I look like a young Bono, which my wife says, you don't look young or like Bono at all. But for some reason I see Bono staring me back.
[00:47:11] Speaker B: In your heart, you feel it. In your heart, you feel it and that's all that matters.
But to your point, like I think that that is a really good, a really good appraisal that if it's a behavior that is like an anchor behavior that helps you start or kick start that pre sleep routine, like I think that that's totally fine. It could be that, hey, my pre sleep routine starts with me putting it on or my pre routine starts with me bricking my phone tone. Anything that you can do to anchor kind of that pre sleep routine? I think that that in and of itself is fine. Like you said, who cares if the wearing of a blue light glasses is fully placebo? If that is the behavior that then helps you to down regulate in terms of all the stuff that comes after it. I am so for me, like, I think that even if I found out that there's no such thing as these even helping whatsoever, that it still could be a great way to anchor your behavior behavior and kickstart that, that pre sleep routine. And if that's the case like I'm, I have no qualm.
[00:48:10] Speaker A: I love it. Well, I'm gonna, I could, I could just talk about this subject that I, I, I'm excited about the research. It just gives us an excuse, not that we need one to have you back on the show. I, I love to ask thinkers like you this kind kind of question to, to, to wrap up, you know, going back to your journey. You've, you've been a part of the heart rate variability, HRV biofeed back sort of progression from the clinical setting to the home setting, obviously with your hyper focus on sleep and the connection to performance. I would love for you to put on your future glasses here and as being part of this rapid change in how we deliver hrv, HRV biofeedback. Where do you see us going as a leader, a thought leader in this field also really with your hand, hands inside the clinical work as well. When you look five, 10 years in the future as we get AI and all this good juicy stuff that hopefully will help us and not kill us coming on board, I just, I would love to see when Jay looks ahead, what do you see where we're going with this technology and with this science?
[00:49:22] Speaker B: Yeah, well, I think first and foremost I'm very excited for where we're going because I think that in the next five to 10 years with the advancements in you know, technology, both hardware, but mostly kind of with software and AI that we are about to see kind of just like a whole future of data analytics open up that we aren't used to now. And so I think that, that, that number one would be kind of the utility of different data components that we're going to have. So like right now we have plenty of research to demonstrate evidence of so many biometrics that can be helpful in the terms, terms of psychophysiological monitoring but also in training, intervention and biofeedback. But I think we're going to open up our level of awareness to things that maybe we thought, oh, I don't know if that's useful and we might find that it's very useful because we were able to do a lot more research with the use of AI. I think that one thing that I always come back to with biofeedback is that I think that biofeedback in and of itself is an extremely valuable tool to be used. But I think that where it shines the most is in conjunction with other therapeutics or other in interventions. So like mindfulness interventions, I'm a big ACT guy. So my training was in acceptance and commitment therapy. And I. There was a, there was a research article published in the AAPP journal. I think it was not this past month, but the month before, but it was looking at a model of biofeedback with act. And I'm like, oh my gosh, I think that this is going to be it because I've done that historically as I've incorporated a lot of those. But I think that if we look at the advancements of technology and the ability to both provide amazing data analytics, analytics, let's say, on somebody's biofeedback session, but then also combine some of the therapeutic interventions of other mindfulness practices or even things like act, I think that that combination of things is going to be exponentially more helpful than any of these solutions alone. So I think it's going to be a lot of the combination of these interventions that, that are going to help. I think there's going to be a lot of really cool technology that comes out that incorporates a lot more, you know, heart rate variability, biofeedback and monitoring that just makes it more easy and more accessible. And I think that that in and of itself because, because the one thing for behaviorally is just reducing barriers. And so sometimes for people it can be a barrier to have to have their phone, have to have a hardware piece, you know, and some people are willing to get over that because they find so much value in the training itself. But I think in the future making it more accessible, I mean, just making it easier to do is going to be huge. But again, I still stand on, on kind of like this platform situation saying that I think that those are going to be helpful technologies, but I think it's going to be the integration of other evidence based interventions with biofeedback that is going to be kind of the thing that moves the needle. And I honestly, I really believe that biofeedback, for instance, is going to become commonplace. Like I can see basically everybody who's a therapist or trained as a, you know, mental health therapist, social worker, psychology, psychologist, utilizing this as an active training component within the context of their sessions. So I think that there's a lot of good ahead of us. But I think that once we start to see kind of the meshing of like evidence based interventions, I think like it's gonna. I know from my. A performance perspective, I think I'm gonna see my. My clients really buy into that and really enjoy kind of the. The results of having all of these things combined.
[00:52:45] Speaker A: Awesome. Well, Jay, it is great to take this journey into the future with you. You.
And it's just been such an honor to partner with you and absolute rest knowing the great work that you done. And like I said, I. I hope to have many more conversations with you, my friend, moving forward, because you are just. Hey, I. I love a wealth of knowledge and energy at the same time that I just. The first time I met you, I was like, what? I just, like, this dude is as tall as I am, which always freaks me out because there's like, one out of every 100 people is our height. And like, oh, man. I, you know, just so much there and just been a fan of the work that you've been doing, and it's. It's an honor to partner with you all. So I want to thank you. We'll put information about you. You got a great website. I checked it out, unfortunately for me, right before we got on because there was this delicious salad on your side. I just got hungry right away as I met the end of my fast here, so I'm gonna go eat a salad. Thanks to you.
Information about absolute rest in the show notes as well. So, Jay, I want to thank you, my friend. This has been an absolute pleasure to have you on the show.
[00:53:52] Speaker B: Thanks so much, Matt. Can't wait to do it again next time.
[00:53:55] Speaker A: All right, thanks so much as always. You can find show notes, everything else at optimalhrv. Com and we'll see you next week.
