Episode 2: Is sleep the key to living a long life?

Nov. 1, 2022 | 27 mins

Join our host Brent Bishop as he chats with Dr. Mark Boulos, a sleep specialist from Toronto Ontario. They will discuss sleep, and whether it is the key to living a long life.

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Brent:

Hi and welcome to Beyond Age, a Manulife exclusive podcast where we chat with experts to uncover the truth about holistic health and aging to help keep you living healthier for longer no matter your age. I'm your host Brent Bishop, and today I'm joined by Dr. Mark Boulos from Toronto, Ontario, a sleep specialist. He's an associate professor in the Department of Medicine, Neurology Division at the University of Toronto. He's also a staff sleep and stroke neurologist at the Sunnybrook Health Sciences Center. Today we'll be discussing sleep and whether it is the key to living long life. Welcome Dr. Boulos.

Dr. Boulos:

Thank you so much. It's really a pleasure to be here. Thank you.

Brent:

I'm so glad to have you here. I'm really looking forward to this topic today. I believe it's a universally important topic and let's face it, sleep is something we absolutely need and we can't do without. Before we go a little deeper into things, let's start off by just telling us a little bit more about you and why you got into this field.

Dr. Boulos:

Yeah, I have a pretty cool job. I get to be a doctor and a researcher, so all the clinical challenges, all the troubles we have, I have that unique opportunity to investigate them and to research them. So I'm a neurologist, as you mentioned. I'm a neurologist at Sunnybrook Health Sciences Center in Toronto. Also a professor with the University of Toronto. And my areas of interest are stroke and also sleep disorders. It's kind of cool, but I get the opportunity to study how do sleep problems affect vascular disease? And what I mean by vascular disease is things like strokes, heart attacks, those kind of things. And I'm also a researcher. I'm a researcher through the Sunnybrook Research Institute and I get the opportunity to investigate the things that are of interest that come up in my clinical population. So when I see some of my clinic or on the ward who has a certain problem, it's a cool opportunity cuz you get to investigate and delve further into that.

Brent:

That's great. I find sleep so fascinating and just in terms of the benefits of it, I mean I'm sure we can all attest to, you know, when you've had a poor sleep versus when you have a great sleep and how you feel the next day and how you perform. You know, most of us also realize that it's important for overall health and just performance the audience. I know they're going to get some great information and benefit from it, but I'm also selfishly interested just for my own needs and my own reasons as well about just my sleep patterns have changed a lot. And maybe you can talk about how do your sleep patterns and your habits affect your day-to-day life and our bodies long-term?

Dr. Boulos:

Absolutely, absolutely. Well first of all, every one of us has a different circadian rhythm. So you might know some people who like to stay up all night, sleep in, start the day kind of late. Other people are quite the opposite. They want to sleep real early, wake up earlier and they feel, you know, the morning's the best part of their day. So every one of us has what we call a chronotype, which is where our body is adjusted to either sleeping a little earlier, waking up earlier or sleeping a little later and waking up earlier. So if our bodies get out of sync with that, then you know with our chronotype then we can develop health problems. So for example, say I'm someone who really is like more of a night owl, but my job forces me to wake up early in the morning because I have to be somewhere a job commitment. I might be sleep deprived, right? Because my body might be saying, Hey Mark, go to bed like at two in the morning but I got to be up by seven to make it to work on time by eight. You know, that might actually affect my health pretty badly and it could be the opposite of course for other people with different chronotypes.

Brent:

Hmm, interesting. So Dr. Boulos, what can you tell us about how good quality or poor quality sleep can have an impact on healthy aging?

Dr. Boulos:

Yeah, great question and so important to address. Some sleep disorders have been shown to increase risk of things like dementia and stroke down the line. So for example, sleep apnea. Sleep apnea is when you stop breathing in your sleep intermittently throughout the whole night. Sleep apnea has actually been shown to be a risk factor for dementia. Basically people developing cognitive impairment over time. So if one has sleep apnea their cognition will actually be reduced and they have a higher risk of getting dementia like Alzheimer's disease. Sleep apnea has also been shown to be a risk factor for things like stroke, heart attacks, high blood pressure, increased weights, even early death. So it's super, super important to be aware of and to recognize and to treat it. The other thing is that there are other sleep disorders as well that have also been shown to be troublesome for sleep.

So for example, insomnia, if people can't sleep well, they can't fall asleep at night or if they wake up and they have a hard time falling asleep. Again that's what we sort of refer to as insomnia and there's different types but insomnia has also been associated with a whole host of different medical issues as well. Again, you know, insomnia has been associated with you know, things higher risk of heart attack and stroke and other adverse medical conditions, never mind the closest association with things like mood disorders like depression and anxiety. Other things are a little bit more controversial. I'm personally a restless leg syndrome researcher and there is some research also suggesting that if you have restless SLS there's no doubt that it can really, really, really worsen things like mood and anxiety issues. And the patients I see, you know who, who have pretty bad restless slag syndrome, uh, my heart goes out to them because it's a often a lifelong condition that's difficult to treat.

We can get it under control but these patients really suffer from quite a bit of sleep loss, sleep fragmentation, poor quality sleep and again, restless leg syndrome is really closely linked to mood and anxiety issues. Never mind a host of other things, it's controversial weather, restless leg syndrome, how closely linked is it to things like, you know, heart attacks and strokes and so on. But the evidence of that regard is evolving, you know, sleep quality. So one real important thing is that you get the right amount of sleep throughout the night. We generally say try to keep your sleep at night. Most sleep experts are saying try to reduce the amount of napping or even try to eliminate napping, but it's best to get that consolidated. You know, most sleep experts are saying seven to nine hours of sleep and everyone varies for how much sleep they actually need.

Brent:

Absolutely. So you did talk about recommendation on how long somebody should actually be sleeping for. You've mentioned seven, eight, maybe even nine hours, but is more better like if you can get 10 or 11 hours of sleep, is that going to benefit you more?

Dr. Boulos:

Yeah, great point. So you know, the extremes of sleep have been shown to be harmful. For example, less than six hours of sleep has been shown to be associated with things like heart attacks, stroke, mood disorders and other medical problems. So getting less than six hours of sleep is harmful for you. And so generally speaking, everyone should at the very least try to get more than six hours of sleep. However, getting more than nine hours of sleep has also been shown to be linked up with strokes and heart attacks as well. And it's interesting. So sort of like the two ends of the curve, every one of us has probably genetic and physiological differences that dictate how much sleep you really need. So some people are okay on six hours of sleep, seven hours of sleep, you know, eight hours. Some people might need a little bit more than nine, but the recommendation from most national organizations is that you need at least seven to nine hours of sleep.

Okay? But with medical issues coming less than six hours and medical issues also coming with more than nine hours and there's probably a whole host of explanations we can, you know, elucidate on those extremes. So probably if you're in bed for more than nine hours, it probably suggests that your sleep quality isn't good or you may have a mood disorder. We know that depression and anxiety disorders, which may make someone stay in bed longer, are also associated with a whole host of negative consequences. And so it may not be just that you're getting poor quality sleep, it also may be you have another underlying medical issue that's contributing to that overall, you know, increased risk of harmful medical diseases like stroke and heart attack and so on.

Brent:

Well that's interesting that beyond nine is also sort of risk factors because I do remember, well definitely not recently but years ago being in bed 10 hours for instance and noticing how groggy I felt versus having a normal, you know, seven to eight hours and feeling much more refreshed.

Dr. Boulos:

It's almost like too much sugar. You know, you maybe one scoop of sugar is good in the coffee but you know four isn't right and you know, too much of a good might not be good. There are exceptions here. I want to just make clear, like if you're sick, like for example, I remember I broke my back a number of years ago, I had to be in bed and if you're down with a flu or you're down with a cold, your body needs more sleep. So at the times of medical illness your body may need more. But we're talking here outside of you know, any acute medical issue or something like that, any acute medical stressor, seven to nine hours is recommended. But neither of the extremes, like not more than nine, not less than six. So it's about when you get the sleep, does it match your circadian rhythm?

How much sleep are you getting? And also is it good quality sleep? So in my clinic patients who come in with you know, terrible sleep apnea, even if they got seven hours of sleep, they're never refreshed. They wake up in the morning feeling tired, you know, and that's a huge, huge challenge. And then some of those people end up going on C P A P, which some listeners may be familiar with. And then you know, there are things like sleep hygiene that we also really emphasize. So simple things that you can do that will improve your sleep quality regardless.

Brent:

So sleep hygiene, what actually is sleep hygiene? Is it things you do prior to sleep to make sure you're getting a more restful sleep and maybe how can we improve it?

Dr. Boulos:

Sleep hygiene are these simple rules or you know what we call rules of thumb to get good quality sleep. And they're simple ways you can change your behaviour throughout the day, particularly in the hours leading up the bedtime. And sleep hygiene helps people attain the highest quality sleep they can get. So for example, one important bit is to avoid napping or to reduce any napping throughout the day so that you have a strong urge to sleep at night. Other things are to reduce the amount of water leading up the bedtime or just don't drink water in the hours leading up the bedtime. So you don't need to wake up overnight and use the washroom. Likewise, things like caffeine, we say no caffeine, you know, within six hours of bedtime just so again, you're not perked up during the day. Other things are simple like exercising in the morning when you exercise in the morning energizes you throughout the morning, you know, you get a little bit more exhausted throughout the day and then by nighttime you need to crash in your bed.

But if you exercise in the evening, I'm sure you've experienced this before, exercise has this real energizing effect, right? It's like I want to exercise in the evening. You do that and you realize, geez, I'm just not quite so tired at bedtime. So again, that's why mostly specialists are saying exercise in the morning rather than in the evening we say leave the bedroom for sleep or for you know, intimacy time with your partner. But you know, the bedroom shouldn't be used for things like work or you know, using your phone or watching tv, electronics. All these things should be left out of bed.

Brent:

That's a good point. And that's harder and harder to do for a lot of people. I'm sure myself included.

Dr. Boulos:

<laugh>. Absolutely. I'm the first on that, right? Because you know, your emails are just clicking away every couple of seconds and things you have to get back to and, and you know, and Brent this is something I wanted to raise you, you that societal stress and societal expectations put us under a lot of pressure, right? To stay up at night, to finish work, to finish certain demands, you know, and I think a lot of people can relate to this that you know, and myself included, you know, you're behind by a few hundred emails, you're kind of stressed out, you want to get 'em all done, right? You know, when you want to get through these things. For me there's research commitments, clinical commitments with my patients. So you always feel under this really strong obligation to be, you know, up and running and doing your very best, which I think is appropriate. But that pressure affects your sleep, right? Whether you're getting less sleep because you're, you know, you're cutting off your sleep or you're getting poor quality sleep because you know your mind is running through, okay geez I got to get that done before this day and all that kind of stuff. Right?

Brent:

Absolutely. I can totally relate to that. I think that's one of my big sleep obstacles personally is I probably shouldn't drink so much water before bed. I fall asleep no problem. But I get up to go to the washroom, I go back to bed and I'm tossing and turning for you a couple of hours and it's because my brain is just so active on that list of things that I need to do. So that's my personal obstacle. I'm sure some listeners share that as well. But what other obstacles do you find most people face as we age? You mentioned sleep apnea is one of them.

Dr. Boulos:

Yeah, absolutely. Sleep AP is the most common one and the one that we see as associated with the most vascular risk and the most medical complications. So imagine your bed partner is kind of like grabbing your neck <laugh> and choking. It sounds funny but it's the way it is, is that your airway's actually repetitively closing on itself as you can imagine. That drops the flow of oxygen to your brain, the flow of oxygen to different parts of your body and it puts stress and strain on blood vessels. All those features, all those physiological changes or medical changes in your body, they have the impact of harmful consequences like raising your blood pressure, contributing towards unfortunately things like obesity and weight gain. And overall if you follow people who have sleep apnea over the course of many years, they actually have a higher risk of stroke, heart attack and even early death.

So when I see someone in my clinic who I think has sleep apnea, we try to get a sleep study as soon as we can. You know, we want to treat sleep apnea if we find it because it has a very high risk of, you know, medical comorbidity, what we call or these medical consequences. Even sleep apnea has been attributed to, as I'm sure you've seen on the news, Brent, like you know, things like car accidents and right train accidents that's not just about a sleepy Uncle Joe, you know, falls asleep at the dinner table once in a while. It's real consequence and it has implications for driving for public safety and also there's even a cost effectiveness thing. Interestingly enough, they were saying that people with sleep apnea and covid even had a higher risk of death. If one had covid and then also had had concomitant sleep apnea, previous sleep apnea in the past, they had a poor chance of recovery at a higher risk of doing poorly. So again, it has a whole host of consequences just as you alluded to there.

Brent:

Wow. I know you have a special interest in sleep monitoring. You know, just going off of this topic of sleep apnea, how can sleep monitoring help improve our sleep as adults? And when should we seek this out? I mean, how do you know if you have sleep apnea?

Dr. Boulos:

I think if you're getting the right number of hours, it's one thing if you're just like sleeping four hours a night or five hours a night and you feel sleepy, well that's going to be the most of us, right? You got to hit those seven, eight hours. Some people need even nine hours of sleep to feel refreshed the next day. Every one of us is different in the number of hours of sleep we're getting. Or even if you are feeling refreshed, but your bed partner's saying you move around, you're sleep a lot, you snore things happening during sleep that are concerning to yourself or your bed partner and that's the time to get checked on. There's lots of specialists out there who are very happy to check people out, you know? But if your sleep quality all of a sudden is no longer good, you're feeling exhausted or they're snoring or something that, or other people also complain like grinding teeth. Something I actually have a particular interest in is also movement in sleep and partial leg movements in sleep. And sometimes leg movements in sleep can even be quite disruptive to one's sleep and can prompt a medical referral all pretty appropriate. So you know, it's those cues and those clues that tip you off that maybe see your family doctor or see a specialist for sleep.

Brent:

Right. Sleep apnea, I didn't realize it could be that catastrophic in terms of your overall health and perhaps the health of others as you mentioned as well. We're going to take a quick break and we'll be right back after this message.

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Brent:

Welcome back to beyond age. So Dr. Boulos, are there any myths about healthy sleep that need to be debunked? I know in my field in exercise there are several myths, you know, that used to be the truth but now they are no longer because we know better. And is there some common knowledge about sleep that is still rooted in fact?

Dr. Boulos:

A lot of people come to my clinic and say, oh should I try this herbal supplement or should I try this or try that? But you know, your body was designed to sleep on its own most. If there's an illness, you should be able to sleep naturally. You know, fall asleep naturally wake up naturally without anything and unless if you're prescribed something by a specialist or by your family doctor, like a a physician, generally speaking, I actually try to avoid and I try to encourage my patients to avoid unnecessary use of supplements or even sleeping pills. So there's one thing you're going through a stressful time in life and we know that's going to be a short time, say for example surgery or unfortunately it's a significant loss in the family or a loved one. You know, it's understandable how someone may need like a medication or like a sleeping pill to get over things, which is of course completely understandable, underwrite circumstances.

But I have a lot of patients who come and they rely on sleeping pills for the long, long, long run. And in the long run that's not beneficial for you. In fact, sleeping pills can cause, you know, especially as one gets older to be cognitively impaired. So it can affect their cognition, can affect their ability to walk safely and elderly people that can actually contribute towards falls. You know, try to do things naturally and try to avoid, you know, the use of sleeping pills. Cause in the long run it can affect you. You know, same thing with supplements. You don't know what's in a lot of these supplements, particularly if they're not health regulated or they're not monitored.

Brent:

Another question for you though, I know a lot of people will use melatonin and what are your thoughts on using melatonin? Can it enhance our sleep?

Dr. Boulos:

Yeah and for some people it actually can be very beneficial but under limited circumstances. So for example, if you're a shift worker. And remember how, Brent, we had alluded to and discuss this circadian rhythm, so say I usually go to bed at 10 and wake up at, you know, seven hours later I wake up at five or maybe I'm a midnight sleeper and I wake up at seven and get out of bed. You know, so that's my sort of circadian rhythm. But say I've been put on a night shift and of course a lot of people may end up with night shifts and so on depending on their work, use of melatonin can actually help people fall asleep if they're shift workers and maybe beneficial under those circumstances. Another circumstance under which melatonin can be useful is jet lag. So you know, so you're flying a transatlantic flight or whatever, you know that might actually be helpful to help you get back onto your circadian rhythm.

Older patients as well. As we get a little bit older, our body begins to lose that rhythmicity that we had when we were younger. And melatonin may be helpful in older people, however, in otherwise healthy individuals, melatonin being used as a sleeping pill usually doesn't work. Some people won't try it and some people will rave at its success. I find that the majority of people, however say, has no overall impact on sleep if they're otherwise pretty healthy and not jet lagged or not a shift worker or whatnot. You know, melatonin's not so high in cost and frankly it's already a naturally occurring substance in your brain. So it might be worth a shot, you know, and see if it benefits you. Again, as I just want to be transparent that most of the time it doesn't work but in some the odd person it may be beneficial and to that person it might be helpful. I don't think there's any evidence suggesting that a low dose of melatonin would be harmful for long-term

Brent:

Use. Good to know. Yeah, I often use it for jet lag for that very reason because I travel quite a bit.

Dr. Boulos:

Well that's exactly as like a media guy like yourself. I would see that be really important if you're traveling the world in under work circumstances. Right? It would be helpful. And also the shift work, right? It really helps. Like I'm on call all the time as a stroke neurologist. It can be actually very, very beneficial for getting back onto their circular rhythm. Again, your body should be able to do things naturally if you're otherwise a healthy person and if you have some medical illness, that's no problem. That's what the doctors are there to help. And I usually try to be a little bit, not medication averse, but you know, don't use that as the first step. Can you do things naturally? So of those cutting out things out of your diet or out of your regimen is actually beneficial too. Like you know, caffeine near bedtime would be a common thing to just chop out and that would really improve a lot of people's sleep.

Brent:

I also find for myself being in as dark of a room as possible and I like to sleep in a cold environment as well. So my air conditioning is cranked up in the summer and you know, some of my best sleeps are when I'm camping in the fall. <laugh>, to be honest with you.

Dr. Boulos:

It's so funny. I had a patient of mine, their heater broke down in the winter and this person was having years of troubles of sleeping. And then in the middle of the winter in the dead cold of I think December or January the guy's heater broke down. He had the best sleep of his night <laugh> because his room went down to like almost refrigerator like coldness, right? But you know, actually the research will support that. That having your room cold is actually good for you. So having a room a little bit cool then everyone has a preference, right? So if you turn everyone's room into a refrigerator may not be good for everyone. But generally speaking, colder room is better. And a lot of people, again, blackout curtains is what we recommend to our patients. So when light hits your retina, there's this thing called this retinal hele pathway, which is in plain language, it's the pathway that connects your eye to the center of your brain that controls sleep, which is called the hypothalamus.

As soon as light hits your eye, the brain thinks that you're awake or that you should be awake. It's this activating sort of thing. So light, even a small amount of light and every one of us is different in terms of sensitivity for, you know, how much this light affect you and, but basically a little bit of light. That's how the cave men and women knew to wake up, right? Cause they didn't have their little, you know, Fitbit or whatever or Apple watch hanging off their arms, didn't know what time it is. Yeah. Or a clock. They just did it by the sun by when the sun rose up. So as you said, you know, blackout curtains are really dark. Environment plus also cold environment is really beneficial. The other thing I really benefit from is earplugs. I personally use earplugs because you know, kids run in just to get something from the bedroom or your wife walks in to do something, you know, you don't want to get any noise. So I find that's beneficial. Can you seal off your senses so no light, no sound and you're tuck in a nice little cool environment.

Brent:

I think I have to put that on my list as the earplugs because I'm so audible sensitive. If there's a siren that goes off or you know something, it can be far, far in the distance. But it definitely aggravates me <laugh> in my sleep.

Dr. Boulos:

It really does. And every one of us is sensitive, right? So some people are really deep sleepers. But I personally like you, I'm a pretty light sleeper and you know, over time I think a lot of your listeners can allude to this when I was in my teens and twenties to fall asleep again would be no problem. But as you get a little older, the ability to fall asleep again deeply gets harder, right? And so you do want to get good quality sleep and try to maintain, you know, the quality of sleep as long as you

Brent:

Can. Gotcha. Gotcha. So Dr. Boulos, I know sometimes when I, I'm on the couch, I've had a long day, I'm watching Netflix <laugh> and I fall asleep to Netflix. So I know a lot of people will associate why not move that scenario into the room, the bedroom so that you could fall asleep to the tv. Another thing that a lot of people will do is have a shot of whiskey or have a cocktail or a couple cocktails before bed. Alcohol's a depressant as we know. And I think a lot of people will use these ways of trying to get to sleep. What are your thoughts on that?

Dr. Boulos:

Great points and great questions is it comes up so often, you know, in our clinical care. So you know, a lot of people will ask just as you alluded to Brent, is can I watch TV in bed? TV has a relaxing effect. It takes my mind off of maybe the day's troubles. But one of the challenges with TV as we discussed is that it does have that light stimuli and you know, any light shining on your eye can activate basically, as I mentioned before, this thing called this retinal hypothalamic pathway. Whenever light goes on your eye, it actually tells your brain to wake up or to be alert. So TV also has sound of course and you know, and can also provide noise stimuli that and for sensitive sleepers that may not be good at all. And finally the content of television may not be beneficial as well, right?

So say I see something terrifying, you know, we often do on TV with all the terrible things going on that are, you know, accidents in our own communities and so on are terrible stories. Sometimes, you know, having that content and bringing that into the bedroom, it can be actually very, very, very harmful. Our recommendation is not even to have a television in the bedroom and keep the television outside of the bedroom again because you don't want to have that harmful audio, visual stimuli or even emotional stimuli keep you up at night. So yes, some people will say I can fall asleep with the tv. But in the long run the harms we believe are greater than the benefit from it. You know, other things like drinking alcohol before bed. We actually recommend no alcohol within a few hours of bedtime. The reason for that is that the alcohol relaxes you as you know, <laugh>.

That's why you drink it usually most of the time. But it relaxes you but also relaxes your airway. And a relaxed airway at night can actually increase your risk of sleep apnea. I had a very pleasant patient who I saw in my clinic for many years and he was actually quite a uh, heavy drinker. And every time we did a sleep study, he saw that he had really high sleep apnea. I would see him every few weeks and tell, hey listen my friend, you know, just try to cut back on your alcohol cause it's contributing towards your risk. He actually had a very strong personality, actually managed to cut alcohol out of his lifestyle and his sleep apnea went away. That's a dramatic case, but it does at the point that alcohol can worsen any underlying sleep apnea.

Brent:

Wow. I knew those two factors weren't good. <laugh> <laugh>. But I think it helps to understand how detrimental they can be for long term.

Dr. Boulos:

Of course that's tough though, right? Cuz people know all habits and you know, sleep is sort of like a learning thing that's so intrinsic to, right? So you figure out in your own life how you get away with things, right? And how do you strategize falling asleep?

Brent:

Gotcha. Yeah. So Dr. Boulos, one of my personal issues is I go to sleep fine, but then I wake up whether it's to go to the washroom or I just wake up and my mind's awake and I'm just restless. Should I just lie there and force myself to try to relax my mind and get to sleep?

Dr. Boulos:

You know, what would we generally recommend is if you've been lying in bed and you can't fall asleep after about 20, maybe 25, 30 minutes sleep experts recommend that you get outta bed, do something boring, <laugh>, you know, do the laundry, which I'm sure a lot of us have <laugh> and then try to go back to bed again. You know, but the habit of trying to, you know, toss around and lying in bed for more than 20, 30 minutes can actually be harmful. The reason for that, Brent, is that you don't want to associate your bed with anything except for sleep or for relaxing. So you really don't want to have your bed associated with inability to fall asleep, tossing and turning, worrying about things or television or the use of television or what you might have seen on television or other things like your phone or whatever. That's why we generally say avoid the use of TV in the bedroom. Avoid the use of electronics. Again, your bed should only be for sleep and for, you know, intimacy time. Yeah,

Brent:

I would've never thought to get up. Cause what I do is I kind of fight with myself and I'm like, do I look at my watch? Do I look at my watch? Cause I don't want to know the time and how long I've been in bed for. But that's something I think I'm going to try to implement. I know we're coming towards the end. Maybe what we can do for the audience is leave with maybe two takeaways. Let's say top adult sleep tips for a restful and long life.

Dr. Boulos:

Yeah, absolutely. So I, I think number one is everyone knows themselves and everyone knows like how they slept. Like, you know, earlier in their life when they might have gotten better quality sleep. So if you find that your quality of sleep is regressing, you know, or you're not getting good quality sleep or you or your bed partner have noticed concerning features in sleep, like snoring, kicking your legs in a really restless sleep, again, poor quality of sleep overall, get it checked out. There are tons of doctors out there who would love to help you out and you know, people with all kinds of expertise to get sleep problems checked out. So I think the best thing you could do, just like you had chest pain, you wouldn't, you know, sit around and was like, oh, hopefully it'll get better. Right? You know, it's like you're going to get it checked out.

And I would say the exact same recommendation for sleep, sleep has been added now by the American Heart Association, as you may know, as sleep duration is now one of the vital signs. So one of those vital signs for good health. And they've added that to things like blood pressure, cholesterol levels and so on and so forth. So top world organizations are seeing the value of good quality sleep. So get it checked out is probably the biggest and most important take home message. You know, the other take home message would be, you know, try to get sufficient number hours of sleep. So that may be like myself, I shift my schedule. I'm more of a night owl as many of my colleagues and students will know. And I don't take meetings in the morning. You know, I, most of my work is done in the afternoon evenings.

I've sort of circled my life around that and worked my life around that. And I think others, if you have the flexibility to do the same, my heart does go out to people who are sort of like night hours like me, but can't shift their schedule. But if you have the ability to, you know, shift because a lot of people don't want to do evening shifts. I love evening shifts, you know, bring 'em on, right? That's where I'm clicking on the best. Right. So basically, you know, try to adjust yourself and adjust your lifestyle. This is easier said than done, but try to get those seven, eight hours of sleep to get restful sleep every night. And that might mean personal sacrifices, which might be not easy, but the right thing to do overall for better health.

Brent:

Great point. So I, if we have any symptoms, make sure you get it checked out any symptoms of sleep disruption as you mentioned. And then secondly, if you can adapt your schedule and your lifestyle to enhance your sleep duration, do that <laugh> for better health.

Dr. Boulos:

Right on. You're right on. Exactly.

Brent:

I really appreciate your time. I'm sure you know, our listeners feel the same way. A lot of important information that we can all benefit from. So thank you so much Dr. Boulos for your time today.

Dr. Boulos:

It's really been my pleasure. Thank you so much for the kind opportunity. Thank you.

Brent:

So that's it folks. Thanks for tuning in to Beyond Age, an exclusive podcast from Manulife. Tune in to the next episode where we talk to Professor Stewart Phillips, a professor of kinesiology and Canada research chair from Hamilton, Ontario about whether exercise can slow the decline of aging. Don't forget to visit our website, manulife.ca/LiveHealthier for more tips, videos, and content from Manulife that can help you live healthier for longer, no matter your age.

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