Dr. Nicole Moyen (Eight Sleep) on Temperature, Women's Sleep, and Menopause

What is what is up with the 2 30 to 3 a.m. time? Everyone I know complains at some point like I just wake up at 2 30 or 3 a.m.

The short answer is I don't think we have a clear understanding of exactly what causes that wake up. Um there's not one single answer, I should say.

What's the key? I've heard a million things. Like, what am I supposed to do? Like do a handstand and drink a glass of water, like what, you know, like what everyone's got this miracle thing. And I'm like, I just think reading a book, I don't know.

The advice is really only lay in bed for 20 minutes trying to fall back asleep if you cannot get out of bed because now your your mind is associating bed with working through problems. Go do something boring, right? Keep the lights dim. Definitely don't go check work messages. Don't read a really exciting book or play video games or something. So it's something that would make you sleepy, make you tired, and help you fall back asleep. Don't eat food, things like that.

All right, here we go.

Dr. McCole Moyen. Thank you for joining me. I'm a huge fan of AT Sleep. I was just telling you this. I'm just gonna say it right off the bat. Like, you know, when I uh interviewed Alex Sadurain back in 2023 on this podcast, you know, I I really insisted on trying it. And it's fundamentally changed my life. And I think more so, and this is probably goes really into the meat of what we're gonna talk about today, it changed my my wife's life. And, you know, I don't know how much you would want me to talk about that, but you know, there was there was a lot of temperature regulation issues, and she now sleeps like a baby. And um, so there's a there's a lot going on with eight sleep. I'm a huge fan of technology. Like I was telling you as well, uh, you know, people ask me, like, what's the one thing that I've tried that I would recommend to other people? I say it's eight sleep. You know, price tag is high, right? But I think it's worth it, you know, absolutely, because we spend money on a lot of stupid shit, right? But like this is the one thing that I think is really sleep is really worth it. So, okay, so you're the senior director of science and clinical research at 8 Sleep. You have access to a lot of data now, you have a lot of insights, you're working on a lot of really cool projects, and I'm sure you get you really excited with your background, which we'll get into in a second. But now that you have, you know, a ton of data to sit on, does 8 sleep work? And how do you know?

Yeah. Yes, it does work. What what's amazing is we keep doing similar studies where we have people sleep with the pot on for a week, two weeks, turn it off, and or vice versa, switch it up. And we consistently see an improvement in heart rate, improvement in heart rate variability. So improved cardiovascular recovery is just this repeated phenomenon we continually see, likely a result of the cooling during the night. So that is one that we consistently see over time. Right now, we're running a study actually to see the long-term effects of pod use. So if you have a year plus use on the pod and you consistently have low, lower heart rate, higher HRV night after night, does that result in a decrease in cardiovascular disease, et cetera? And of course, we see improvements in sleep as well, which I'm happy to dive into further.

Yeah, yeah. Well, let's let's get into your uh just kind of verify your background because you're you you're an athlete, right? Probably still are. I don't want to make any assumptions. You got a PhD from Stanford. Um, you've worked at uh Fitbit Whoop, now eight sleep. So you've really committed your life to like sleep research. So maybe walk me through a little bit. How did you get to this point? Well, where did the interest in sleep start? And now it's hot, right? Like sleep is the thing.

Yeah, it didn't used to be. It used to be cool not to sleep. So I think it's definitely shifted in the last five to ten years. Yeah. So so I started out in exercise science. And like you mentioned, I played soccer. I was an athlete. I played D1 soccer in college, and that was really my focus is like, how do I optimize my performance? And I found that so intriguing of how do you peak somebody for their performance? How do you keep them from overtraining? And so that's why I majored, got my bachelor's and master's in exercise science, and um started doing research in my master's degree in temperature regulation and really trying to understand how heat and hydration impact performance. And that sort of continued for me. Um, and and then I jumped into Fitbit and Whoop and really started to understand how you can do research in industry. And I think that those, both of those places gave me a very strong foundation of how to apply academic research to an industry setting. And when I got the reach out from ASleep, it was at first, it was like, oh, this is a mattress. And then I was like, wait, it's not a mattress company. Actually, we're doing all the things that wearables are doing, but we can optimize temperature throughout the night. And coming from a temperature regulation background, I had never thought about temperature during sleep. And I will say, most people who study heat and hydration don't think about temperature during sleep. It's sort of this like forgotten variable. And so I was just really intrigued of like, from a science perspective, let me solve this new problem. Um, and there's a lot of low-hanging fruit, a lot of things we don't know. And so when I was started at eight sleep about four and a half years ago, now that was like the problem that was presented to me is like, go figure out how to optimize temperature for sleep or optimize sleep through temperature. Um, what do we need to do? And that was very exciting for me.

I mean, that's a very narrow field.

Yeah.

Yes, but it applies to literally everyone, right? Because everyone can relate to waking up too hot, too cold. So yes, it's narrow, but at the same time, not really. Yeah.

I mean, there's a lot of people who are probably listening too. Like, I love the room ice cold, right? Like I love it when it's like 63 degrees in my room. And you know, now we have actually the research and the science to prove it. And maybe before we get into all the the um amount of data and research that you have to share, Dr. Moyen, like what how does it collect the data? Maybe walk us through, because I don't have the newest version of it. I have the older one. I know there's been a lot of really cool features, and it shocks it shocks me that you guys can get all the data from this match card, like my resting heart rate, my HRB, so much data from this thing, it it kind of blows my mind. How does that how does it all work? Maybe walk me through how the the consumer experience.

Yeah, so it eight sleep pod cover is essentially like a fitted sheet that you put over your. So it's not a mattress, it's like a fitted sheet that goes over your bed. And inside of it, there's sensors around chest level that can detect the vibration, piezoelectric sensors that can detect the vibration of your heartbeat, of your breathing. And from that, we can get heart rate, respiratory rate, heart rate variability, we can get sleep stages, total sleep time. Um, we can also detect snoring. Um, so and we can do this on each side of the bed separately. And then we also have water tubes that run through that provide temperature regulation to each person separately on each side of the bed.

Okay. Okay. And how much data do you guys have now?

I'd have to double check the number. We have millions of nights. Yes. Um we have close to 200,000 members, uh, millions of nights of data.

Yeah. Is there anything um so far that you researched through the data? And I think you said what was it, three and a half, four and a half years now with sleep cycle? Is there anything that's kind of blowing your mind?

I think so. I think one of the things that a lot of people don't think about with sleep. So we try to optimize everything. I think now we're in this biohacking space where everyone's trying to optimize everything and how can I maximize this, optimize this? And one thing that I think has sort of surprised me, and maybe it shouldn't have, but it does, is that there is a ceiling effect for like how optimal your sleep can be. And so I think that's like, that's something people don't think about. But it's true, if you think about anything physiologically, there's only so low your resting heart rate is gonna go, no matter how much training you do, no matter how much you uh work hard, right? And this is where elite athletes, if they do this intense training program, they might, they're trying to eke out like 1% improvements. Whereas you take a couch potato, put them on the same training plan, they're gonna see like huge improvements, right? So same thing. If you put somebody who has like very poor quality sleep and you modify certain levers, they're gonna see huge improvements. If you take someone who's already sleeping well, right, it's it's there's a ceiling effect in a sense. Um, and so I think that's been interesting to me because what we can do with eight sleep really well is if you're getting a low amount of deep sleep, but you're still sleeping seven hours a night, the temperature regulation is gonna help improve your deep sleep. So we can change the composition of your sleep to improve the quality of it, right? And so I think that's where the the nuance comes in.

You know, it's uh I reflect on my experience so far with eight sleep, and it's it's made me a joke, it's baby kind of soft. Cause like I'll go to a hotel somewhere and I'm like, I'm trying to crank down the temperature to like 62 degrees as low as AC goes, or I go, you know, like I'm gonna be uh camping on the river this weekend and I know I'm gonna be too hot and I'm gonna be grumpy in the next morning, right? So it's like I used to not think about that stuff, but now I have to like so finally it's like the uh it's like the double-edged sword of optimization. Right.

Yes, completely agree. I feel the same where it's like you didn't think you needed it, and now that you have it, when you're sleeping away and away from your bed, you're like, Oh god, I'm so hot. This is terrible. And my husband and I both complain about it. So yes.

Well, there's like uh is it Huberman that says he travels with his? He like packs one up and he travels.

Terrible.

Yeah. I mean, I don't know. That's getting a little bit too much. But okay, so let's talk about some of the really like cool uh research that you're doing. I mean, specifically like women's health. And I know that is it's it's a great time to be in the women's health field. Like there's getting a ton of attention, it's getting a lot of more funding reasonably, right? So maybe outline like how have you started to identify where the opportunities are in women's health through the data that you're looking at and what are some of the exciting things that you're you're finding.

Sure. So we we kicked off our women's sleep initiative about a year ago now. And what we did initially is we're like, let's see what temperatures women are sleeping at. There's notably not a lot of data or research, past research, about temperature regulation and sleep in women, especially in different life stages. Um, and so what we did is we sent out this survey to all of our female members and we said, if you're willing to fill this out and tell us, are you menopausal, are you perimenopausal, postmenopausal, are you taking hormone replacement therapy on birth control? Do you have PMOS, endometriosis, et cetera? We had over 1,800 women fill this out voluntarily. And so what we did was we looked at the data and we said, okay, what temperatures do women taking HRT versus not taking HRT hormone replacement therapy have versus women who are regularly cycling pre-menopausal on birth control versus not. And same thing with pregnant women. And what we found is that menopausal women and pregnant women have the coldest temperatures on the pod. And then we have women taking hormonal birth control who are almost five degrees Fahrenheit warmer on the pod. And so we just see this really nice uh change in temperature needs across different life stages.

Okay. So here's the question I have with any biometric, right? Any kind of wearable. We have all these wearables. The administration now is pushing for everyone to have a wearable, right? Has it actually affected sleep? And I call this the now what problem because I feel like a lot of consumers get information sent to them now from multiple devices, right? But really like where the huge gap is, well, how do we how do they actually make make it worthwhile? Like what what can they change? What are the actionable items for it? So, you know, as you identify all these things, how are you actually able to get the information people at the right time and make it actionable so that they can improve their health and and sleep overall? If that makes sense.

Yeah. Totally. This is a great question. And what we know from some studies is that people, there's a novelty effect. When they first get their wearables, they're looking at all the data, they're tracking it. We do see some improvements and behavioral changes, right? They're like, oh, okay, because I'm being tracked or rewarded for this thing. I get a badge if I go to sleep and get this many hours of sleep, right? Or they're trying to tweak their recovery score or their sleep score. They want to get it closer to 100. And so we see this novelty effect where people are really engaged and they're motivated and they might see changes in all of these metrics, positive changes. We also see that I can do the opposite, where it highlights conditions that people didn't know they had. So it it alerts them to like, hey, actually, my deep sleep is chronically really low. I wonder what's going on here. Or REM sleep is chronically really low. Um, or my heart rate is really high, my resting heart rate's 90. Maybe that's bad. Should I look into that, right? And compared to a population average. And somebody might not know that until they start tracking it. So I think there's a lot of value in it, but we definitely see in research that people do tend to drop off their wearable use and the novelty effect wears off roughly around three months or so, sometimes up to six months. We find that the people that continue to use it are those who have some sort of conditioning that they're managing. So the data is helpful in managing that condition, or they're trying to do something like lose weight and they can track their workouts or exercise habits and sleep, et cetera, or they're an elite athlete and tracking all of these metrics for their training. So they have to have an underlying motivation to be tracking this data and has to be useful to them in some way, other than just like, oh, this is interesting. What's unique about AIDS sleep is that we can modify people's temperatures throughout the night. So when we see issues, we directly modify that. So if we see low deep sleep, we give you a different temperature to increase the amount of deep sleep that you have that night. And we do this nightly and in real time. So that's the nice thing about AIDSleep and what we see in our data is that we do have, we actually have a study, we haven't posted about it yet, but we looked at people who just got our pod and who had been tracking their sleep versus hadn't. So they've had a wearable before getting the pod versus hadn't. Those who had no wearable actually had a huge improvement in reported sleep quality. They were like, this is amazing, 86% improvement. And then at the six-month time point, that dropped off to about 25%, that they're reporting a 25% sleep quality improvement. And this is the same for the people now, they match the people who had a wearable previously. So around the six-month point, they're still saying my sleep quality is improved 25% from not having the pot as well before, right? Which is huge. But now they're matching the group that had the wearable before. So there is some sort of novelty effect there of like, I can see it, now I understand it. It either it's better than they thought it was, or they start to see improvements over time. I think more research is needed for sure to understand this. So the summary is I don't think it's a bad thing, but I do think we have to have ways to automatically improve sleep that aren't solely reliant on the person.

And that's where I see the difference in what you guys do is that it's it's the it's the tracking and the analysis and the intervention all in one.

Yes.

Right. And it's it's um passive for the user. Exactly. Like you don't have to, you just set it and it should improve, which is huge because everything else is like, okay, you know, if I have an aura and you know, I'm tracking my data, now I have to fix some suggestions on what to do, but then it's on me to go do it. And that's that's a very big distinction. And um, out of curiosity, what is a good amount of deep sleep?

So what's interesting is the literature will say, oh, you should get an equal amount of deep and rem sleep. They should be both be around 25%, and then the other half should be light sleep. What we see in our data consistently is deep sleep's around 15 to 20 percent is considered good. Your REM sleep's gonna be 20 to 25 percent. We very rarely see them like equally balanced in somebody. So that's generally what we see in our data.

Okay, okay, good. That's really good to hear for me personally.

Yeah, me too.

Walk okay, so maybe you know, the the big difference between men and women, I have to tell anyone who's listening to this, is like men generally age in a linear fashion, right? Women have different phases of their life that are very distinct, very um, you know, unique as as they age through these these phases. So maybe walk me through as you're you're realizing what's been interesting about what you found in each stage of a woman's life and how have the um interventions changes or what should people think about as they enter into these different stages.

Yeah. I'll I'll talk about two primary ones since those are top of mind and things we're actively working on, which is menopausal women and pregnant women. So for menopausal women, um, we just ran this massive study in close to a hundred peri and post-menopausal women. And we had them sleeping without the pod for a week and then with the pod for a week, temperatures on. And then we also had them take core temperature pills. So I don't know if you're familiar with these. You basically swallow a pill, it travels throughout your GI tract and emits the temperature through Bluetooth to a little device. So we can record it through really until you basically excrete it. We can record your core bite temperature. So you also get a good pulse on like technical.

That's fun. Yeah.

Um, so we did this in post-menopausal women and also compared to age match men. And roughly the age was around 55, 56 years old. And what we saw were two main things. One, we reduce hot flashes in general, uh on average by 56%. And this was regardless of whether women were taking hormone replacement therapy or not. It worked, it was equally effective in both groups. The other thing, core body temperature makes this nice U shape during sleep where it cools in the first half of the night and then starts to rise in the second half of the night. And I can talk more about that if if you'd like. But what we see with aging is that U starts to flatten out. And that starts to contribute to some of the poor sleep quality that we see a lot with aging. And so what we saw with that is the pod when people slept with the pod temperatures on essentially restored that U-shape in both men and women. And the graphs are really beautiful. I can send you the link for that, but it it's really cool. You sort of see this flat line during sleep with core temperature, and then when they're on the pod, this U shape restores. And that restoration of the U shape and decrease of core temperature is what we're believing we believe is reducing the hot flashes in women. And I'm happy to go into that further.

Like what why is the U shape important historically? Why is what does that mean?

Yeah, so so it's your circadian rhythm and everything in your body goes off of this roughly 24-hour clock. And this is important because your hormones are secreted at certain times of the day. Um, your body knows what to do at certain times of the day. That decrease in core temperature in roughly an hour before you fall asleep is what triggers sleep onset and it helps you fall asleep faster and it also promotes deep sleep. So you need cooler body temperatures in order to get good, good quality deep sleep. Um, and then in the second half of the night, as your core temperature is rising, that's when you get majority of your REM sleep. And what most people don't think about during REM sleep is that your body is essentially paralyzed, which means your temperature regulation system is also impaired. So this is the second half of the night typically is when people tend to wake up too hot, too cold because your temperature regulation system is not working as well.

What is what is up with the 230 to 3 a.m. time? Everyone I know complains at some point, like, oh, I just wake up at 2.30 or 3 a.m. Like what is going on at that time? I do it like once or twice a week and it's very, it's annoying.

Yeah. So, so the short answer is I don't think we have a clear understanding of exactly what causes that that wake up. Um, there's not one single answer, I should say. And so I think the research is still emerging there. Um, it could be like in rare cases, hypoglycemia. That's not a super common reason. In general, that's typically the sh the switch point between when you're shifting more from like deep sleep, lower core body temperature, to increasing body temperatures. And so it could be that the temperature in your room is off. Temperature regulation might help. It could also be due to cortisol increases. However, the literature there isn't really well supporting a spike in cortisol during that time, but it could be. Again, there's not like a clear reason why people wake up, but that typically is that middle of the night switch point when you're shifting from deeper to sleep to more lighter and REM sleep.

Yeah. I feel like, I mean, just you know, n equals one in my experience, it generally it's it's most likely a cortisol issue because it happens when I have a lot of my mind, right? Stress about work or a project or something personal is going on. It's like that's that's when it happens. And you know, the biggest thing is like, how do you fall back asleep? Like what's what's the key? I've heard a million things. Like, what am I supposed to do? Like do a handstand and drink a glass of water, like what, you know, like what everyone's got this miracle thing. And I'm like, I just think reading a book, I don't know.

Yes. I mean, the the the advice is really only lay in bed for 20 minutes trying to fall back asleep if you cannot get out of bed, because now your bot your mind is associating bed with working through problems, issues, et cetera. So it now is like a pattern recognition in your mind of like when I'm in bed, I solve problems, I think through work-related things. Um, and I think sometimes because this happens to me, it's like takes me five, 10 minutes to even realize I'm thinking about work stuff because you're so used to doing it. And you're like, wait, I have to shift my mind or like do something else. So I totally get that. But the the advice is really get out of bed after 20 minutes. If it's not working, go do something boring, right? Keep the lights dim, do something boring like folding laundry, reading a super boring book. You shouldn't do something stimulating. Like, definitely don't go check work messages. Don't read a really exciting book or play video games or something. So it's something that would make you sleepy, make you tired, and help you fall back asleep. Don't eat food, things like that.

Yeah. You know, it's it's an interesting question. Like, how much of when people do have sleep issues, how much is physiology, right? And how much is psychology? Because we really have no idea on the psychology component. But I mean, if you had to take a if you had to take a broad stab at that, what what would you say?

I would say a large amount is psychological because we know from cognitive behavioral therapy, which is largely psychological, and getting people to change their behaviors and how they think about sleep, right? They they prescribe cognitive behavioral therapy for people with insomnia, CBTI. And we do see that that program improvements in perceptions about sleep, reduction in perceived insomnia symptoms. So it is a lot of it is very psychological, right? But I think there's a lot of things that we can do from a routine and behavioral perspective to improve the way we're viewing sleep and helping to train our body physiologically, right? The mind body.

Yeah. Okay. That makes sense. Great answer. So tell me about pregnancy mode and what you guys are doing with that. So it's not just pregnancy, but it's also postpartum. Like what are what are your what are your some interesting findings there?

So to date, there's only been one research paper that we're aware of that has looked at core body temperature changes during pregnancy. And they brought women in. This is difficult because women are a protected group when you apply for ethics or IRB approval. Um, because it's sort of this catch 22 of it's if it hasn't been tested in pregnant women, we don't know what it might do and we don't want to harm the fetus or the mother, understandably so. And then the other way, because they're protected and it hasn't been tested, we continue to not have that information. Um so, anyhow, there's only been one paper on core body temperature in pregnant women, and they brought them in at various points throughout the pregnancy. And what they generally saw is that core body temperature decreased over time. And along with that, their preference for room temperature decreased. So they they wanted roughly a seven degree colder room temperature by their third trimester, which I've been pregnant, I could attest to that. That is definitely true. You just feel like really, really hot towards the end there, and you want the room temperature colder. So what we see in our data actually matches that, which is really fascinating. And what's unique about our data is we have over a hundred pregnancies on the pod, and we see them three months before they get pregnant, during their entire pregnancy, and then six months postpartum. And we see this clear trend where temperature that they select on the pod is decreasing over time, which presumably matches this decrease in core body temperature and this decreasing preference for ambient temperature or room temperature to be coolder. Um, and then in the postpartum period, we see that their temperature preferences return back to baseline roughly eight weeks postpartum.

Okay.

But we see the biometric data doesn't return to baseline even six months postpartum. It's still different from their pre-pregnancy baseline. And so I think this is true. Most women would tell you the six-month checkup, they still don't feel like themselves. And our data is supporting that. Like you're still not back to baseline. And the last piece I'll add to that is breastfeeding. We really don't know how breastfeeding impacts temperature regulation, biometric data. Um, there's just not a lot of research showing how breastfeeding impacts any of your physiology, really. Uh, there's very few papers. And to that end, also like sweating, exercise. Uh, we just really don't even know how it impacts your fitness, too.

Yeah. I mean, it's uh for guys, like it, it's fairly simple. Like we just, you know, we feel like we get enough exercise, right? We if we do these these fundamental things, maybe, you know, do a sauna every once in a while, that's really hot right now. That tends to improve my sleep quality dramatically. But there's just a lot more factors going on with women. And uh I guess the question I have for you is this is like what makes in your role and the the data and the the technology that you have, how does that make the opportunities for your research unique? Like how can you do things that other people can't? Um then what other what things are you doing that other people aren't?

So what's unique, like we mentioned before, we can we can modify the temperature of the bed to help improve people's sleep. And we're seeing that with menopausal women, we're reducing hot flashes, improving sleep quality with pregnant women. I didn't mention this, but we're actually, if we compare our pregnancy data, biometric data, to that of wearables, we're actually seeing that the women's heart rates increase less while they're pregnant than wearable studies, presumably because of the temperature regulation. And we see that consistent like decrease in heart rate, improvement in HRV when using the pod. And we're actually seeing that sleeping on the pod and having temperature regulation is attenuating those sort of negative changes with pregnancy. And we're also seeing in the postpartum period that people are losing less sleep when sleeping on the pod versus not. So I think temperature regulation is sort of this underexplored area or biological lever to improve sleep. And we keep seeing that. And especially with women where their hormones make such an impact on their sleep and their body temperatures, we can really move the needle there for them and improve sleep quality. So that's one. And then same thing with aging, like I mentioned, right? We're improving the circadian rhythm for men and women who are aging. Um, so I think there's a lot of areas where we just don't even, it's the beginning, I think, not the end of what we can do with temperature regulation. But at AIDS sleep, what we're also exploring is we we view it as holistically like anything in the bedroom, anything in your sleep environment, how can we modify it to improve your sleep? So we're continuing to explore those kinds of things with research. One example of that that's already out, right, is elevating the head of the bed when snoring's detected to stop snoring. So everything we think about at eight sleep is like, can we detect it? If we can, can we improve it? And we prioritize the things that we can detect and also improve, not just detect. And I think that's what's differentiating us from a lot of other players in the space who can detect things, but it's on the person to go find a way to improve it.

Right. Yeah, because there's a lot of other factors, right? I mean, there's there's the overall environment. So air quality, there's light, there's sound. I mean, what are the what other areas do people not really consider when they're trying to build a good sleep environment for themselves?

Yeah, air quality, light, sound. You mentioned the big ones. I think those are the main, the main drivers that people have really explored. Um, and then the other one that's sort of forgotten is consistency and making sure you go to bed at the same time, wake up at the same time every day. And we generally within 30 minutes to an hour. And what people don't think about is if you are modifying that greatly, then that is sort of wrecking havoc on your body. It's almost like you're traveling to different time zones multiple times throughout the week if you're varying your bed times and your body can't handle that very well. And there's a huge study from the UK Biobank that just came out. I don't know if you've seen it, where they actually showed that sleep regularity or going to bed, waking up at the same time was a better predictor of all-cause mortality than total sleep time. So that factor is now becoming more important than how many hours a night do you sleep in predicting disease outcomes.

Yeah, uh, Dr. Kristen Holmes, I'm sure you know her from Whoop, right? She had done a study on that and she came on and we talked about it extensively. And it was, it was really interesting. She was just so excited. She was really excited about this findings, and it makes a lot of sense. When I talk to the people I talk to on the show and go to the conferences I go to and the meetings that I take, everyone's in the fitness and wellness industry. I think everyone's pretty aware for the most part, right? I mean, you walk around, you know, an industry conference, everyone's got some kind of wearable, everyone's trying to optimize, um, everyone's drinking less. Like we had a dinner and I was blown away with like we had a minimum for drinks for the dinner because we were hosting. And we were like, I was going around and I'm like, you guys gotta drink something. Like somebody's gonna drink something because I'm gonna end up paying for it because no one drinks anymore, right? I'm like, well, next time we're getting rid of that budget. But it's it's just really so the point I'm getting asked is like, what outside of like this little ecosystem or echo chamber that we have here, how aware are people of the quality of their sleep and how important it is? Hey friends, artificial intelligence is moving faster than most of us can keep up with. That's no secret. We can all feel it. The pressure to keep up is very, very real. And no, I'll get to that next week is not a strategy. So I am proud to say that our presenting sponsor is Perfect Gym. The people building tomorrow's infrastructure for gym and health club operators. I have sat down to talk to thousands of leaders across the fitness industry, and one theme keeps coming up. The right tech can make or break your business. Perfect Gym isn't just another management system. They are part of the Sports Alliance Group that is Europe's leading fitness software company, and it's now all in on the US market. So in the age of AI, being data ready isn't just a buzzword. It is critical for survival. This, my friends, is the disruption we have been waiting for. Member management, billing, scheduling, reporting, one platform, zero duct tape, single studio or multi-location franchise that scales with you, zero growing pains, and their open API connects to over 50 technology and payment partners. No closed ecosystem, no getting boxed in, just better data, better decisions. Perfect Gym is trusted by international fitness chains because they focus on what actually matters. That's operations, retention, and growth. The European market has spoken. Now it's America's turn. Check it out at us.perfectgim.com. To their health.

I think that's a great question. And I think we have to ask the people working with, you know, the gym goers, like the personal trainers, the right, the people that are seeing these people regularly. I think the the space that you're talking about and the people that we regularly interact with in our field is sort of this little bubble of we have access to all this knowledge and understand all this and can go look things up for ourselves and and track our own data and understand what it means. But I think the majority of the people are still fighting for time in their day to just get a workout in. And then if they are getting that workout in, like what do they do? How do they do it? How do they not get injured? Right. Are they doing the right thing? And how do they get a quick meal on the table for their family that's healthy? And I think like, I think everyone's just limited in time right now. And so I always just say anything's better than nothing when it comes to exercise. And I think you would agree exercise is one of the biggest levers that can improve health and and overall sleep quality and everything. But I think that in general, we're still fighting for that.

Yeah, I mean, it doesn't, you don't have to be extremely aware to notice, right? Like I use this example. I was at a, I think it was Beyond Active, great great event. Ross and Blair do a great job. And but I it was there's an escalator, our the conference was at one floor, so it's fitness and wellness industry people. And then the next floor up was a different conference, and I ended up taking the escalator one floor more than I should have. And walked around, I was like, this is definitely not our industry, right? It was such a shocking realization, like how quick I noticed. I'm like, oh yeah, like this is general population for the most part, and this is the you know, the unique eco chamber that we live in. So it was it was very, it was very telling. I want to ask a couple other things too. So I I know you're not an expert in GLP ones, but it's it's such it's such a a big deal right now. I mean, it's really I'm shocked. Like I'll go to just a barbecue and you know, people will be openly talking about, yeah, you know, I'm on a GLP one now. And this is like people like they're just looking to lose 15, 20. You know, it's just because and you know why, like the distribution is everywhere. You can go online, you can get a compounding pharmacy, you could be here in two days. And, you know, I you know, I was talking to Juliette Starrett about this on our quarterly reports. Like, I thought doing injections at home would be a thing that people wouldn't want to do. That would be like a turns out everyone's just shooting themselves up with stuff all the time. It's only gonna get bigger and bigger and bigger. So, what have you noticed? Has there any been anything that you've seen through the technology and research and data that you guys have, how GLP ones are maybe affecting sleep in any specific way?

Yeah, so not specifically in our data. We haven't looked at that yet. Um, but we do have a large percentage of people who are members using GLP ones. But in the research in general shows that when you first start using GLP ones, your sleep can actually become worse as and this is largely a result of side effects. So some people feel nauseous, some people like have other like have to use the restroom more or different things that might disrupt your sleep that are not necessarily like a negative effect of the drug or the drug impacting your sleep, but it's more the side effects impacting your sleep. And then once people get used to it or or find the right dosing, then their sleep can improve as their metabolic health improves, as their weight loss becomes better. Maybe they're exercising more and now they're sleeping better as a result of that or eating healthier and now they're sleeping better as a result. So there's a lot of like interactions, you know, there where sleep can be improving.

Yeah. It's a tri I mean from from what I've seen, in general, it raises resting heart rate increases, HRB drops. Is that what you've noticed? I mean, generally speaking, that it it has some some effect on recovery, at least initially.

Yeah, yeah. And I think that's just largely from side effects, getting used to getting used to a new medication, right? And the body's adjusting.

Yeah. Yeah, it's it's a really interesting time. You know, I don't want to make this another GLP episode, but like all the potential benefits, right, that we're just thinking just outside of of weight loss. Like there seems to be a lot going on, and now it's becoming, you know, a longevity drug and all kinds of interesting things. So we'll we'll see where this goes. One more thing I want to talk about, and I I didn't put it on our outline, but uh sleep apnea. You know, there's there's a lot of uh undiagnosed sleep apnea. I've told this story numerous times. Like my dad had really struggled with sleep apnea. You know, he did the CPAP, he did all this stuff, and you know, ultimately I think it really affected the later years of his life. He just couldn't get good sleep so far. And um even with the CPAP and all that, which I you know I don't really like as an intervention personally, but um and then I got diagnosed with you know minor sleep apnea years ago, and I've just been able to manage it just fine, right? I think, well, at least my data from Aid Sleep says I'm doing just fine. But, you know, maybe under what kind of new understandings are you getting about sleep apnea? And then um, you know, is that something you guys are focusing on or plan to focus on? Because it seems like a tremendously large problem that can be addressed.

Yes, and it is. Um I think roughly it's estimated roughly around 80% of people are undiagnosed with sleep apnea, and up to one billion people worldwide could have sleep apnea. That is 80% of that undiagnosed. So it is it is a very large percent of the population. We are working on it, yes. And um this is publicly stated. Uh so we are working on FDA um clearance for two different things um related to sleep apnea. And again, we are hoping to not only detect, but also provide intervention for it. So um that's that's currently what we're working on. But I will say it's sleep apnea, the more I've been working on it, the more we've been collecting data, I will say it's very complex and and nuanced. And there's also so much variability, night-to-night variability and different things that people can do, like behaviorally, that can impact their apnea hypotnia index or the severity of their sleep apnea night to night.

Yeah. I mean, maybe if you can't expand on that a little bit, like why is it so complex? Like why what what what makes it such a challenge?

Yeah, there's the there's different reasons you can have sleep apnea. So one can be central sleep apnea, which is nervous system related. Another one can be more obstructive, which is typically like your tongue is blocking your airways when you're laying back, or you have a certain amount of like uh fat or things in the way here in your neck that's blocking your airways. And so being on your back versus your side, you might sleep better on your side and your airways might be more open. The first step is like what kind of sleep apnea do you have? And then what would the treatment best treatment be? The CPAP, like you mentioned, works by just forcing your airways open and pushing air through and like keeping them open during the night. So that is one route you can take. But things like alcohol can increase your AHI. Exercise tends to reduce AHI mostly through long-term reducing your weight, your body weight, right? And then helping to get body fat off and and opening the airways a bit more. So there's there's lots of different factors that can impact your sleep apnea.

Is there a is there ever a world where aid sleep can directly connect the positive effects of exercise? Like, you know, we we know it. Everyone knows it. It's obvious, right? But as a fitness industry, I think one of the biggest challenges is as we get into this, I think it's the convergence of fitness, health, and wellness. It's all kind of coming together in one thing. The biggest problem is we've never been able to be like, you know, someone sends uh a client to a gym with whatever ex medical problem. We can't come back and say definitively, yeah, the exercise was a huge component of why this person's doing better. So is there anything we can show in your world that exercise improves sleep, like definitively?

I think there's been a lot of sh research showing that, right? That exercise improves sleep. We we do integrate with Apple Health data. So we can see if people are exercising and we can, as a result, modify the temperature of your bed too. So like if you exercise too close to bedtime, you can raise your your core body temperature, which can prevent you from falling asleep easily and kind of prevent you from getting the deep sleep that you might need because your core temperature is elevated throughout the night. So we can do things like that. But yeah, I'm not sure if you've seen like a good example of of people doing that. Or are you saying like this is open in the space and we need somebody to be doing this?

Yeah, I want to see somebody doing it. I haven't seen it yet. And I could be missing it, especially like an N equals one. Like, okay, um, you know, uh this particular user or client or patient, whatever you want to address the person as, has this particular health issue, right? And now they're exercising. And now, due to the data that eight sleep shows, we can show that like this was an ex-permanent sleep, which has done this to their, you know, their basic biomarkers, a direct feedback loop.

Yes. I think that would be great. And I think I think there are some people doing that, but it is, yeah, it's still left up to the person to deduce, like, oh, my VO2 max has improved because I started this training program, right? Or my resting heart rate is lower because I did this training program. And I I I totally get your point. And I think that would be great. I mean, you would just have to say, I'm starting this new training program and this is my baseline, and now track my progress over time. And then theoretically, somebody could surface the insights saying, like, your heart rate went down, your strength has gone up, right? Like if you're also tracking like how many reps, the weight you're doing, et cetera. And then also, as you know, the gains or improvements are going to be specific to the type of training you're doing. So I think that's also a nuance to showing that information.

Well, that's the promise of AI, right? I know you guys have a strong AI component in what you guys do at AIDSleep. That I think it's the was it the autopilot? Yeah. Is that what you call it? Yeah. I think that's a promise, like pulling together all this disparate like data from multiple sources, right? That now is just very, you know, siloed into different areas and making it very unique to each individual user and personalizing and then having a really strong record of what works and what doesn't work as far as one's health. I think that's it's it's going there. It's just a matter of how fast it's going to get there. Yeah. Since okay, this is the question I think for most people would really benefit from. I don't know why I save it to the end, but so you have a background in exercise science. You were an actual personal trainer. You worked at 24-hour fitness. We talked about this. It's awesome. You know what it takes, right, to change someone's behavior for the best.

Yes.

Or for the better. You know, when you look at sleep, how do you think our industry can be leveraging sleep in such an important critical thing of someone's health, right? Like if someone can get seven hours of sleep and they were gaining five, you get them to seven, they're going to show up at the gym, they're going to have more energy, they're going to be in a better mood, their motivation's going to be higher, they're psychologically going to be in a better place. Like we, you know, we all know these things. So how can we help, you know, how can we start to integrate sleep into our practices as fitness professionals and operators to uh to unlock that more?

I think that's a great point because when I was a personal trainer, this is 15 plus years ago, I never talked about sleep to my clients. I always talked about nutrition, like give me your diet logs. What are you doing? Right? Like, how are you handling your food? And we never talked about sleep. And I'm glad now that's entering the conversation because that's how we're going to get people to recover from their workouts. And also something most people don't talk about is light sleep, is essential to memorizing and sort of ingraining those movement patterns that you're learning at the gym. So if you get a new client in, they're learning the mechanics of a squat or a snatch or a clean or whatever. And that is all being facilitated through light sleep. And nobody talks about light sleep, they talk about deep and rem.

Never.

Yeah. And then deep sleep is when you're getting that muscle repair recovery. So, regardless, like as you mentioned, sleep is crucial to recovering from workouts. And a lot of times when people first start a training program, they're very sore, they're very tired, they don't want to keep coming back. It feels hard initially, right? And I think as fitness professionals, we almost, at least I know, I would like to drill people at the beginning because they would want to see results quickly, right? But then I think that's that's the the hard part too, is because they're they're tired, they're fatigued, they're not prioritizing sleep. So the way I would start the conversation now, if I were still in that uh profession, is I would ask for a sleep log at least for a week or two to see like how often are you sleeping or having have them fill out the PSQI, the Pittsburgh Sleep Quality Index, and just get a rough gauge of like, are they using sleep medications? Are they like when do they roughly go to bed and wake up in the morning? Right. And that's and how how consistent is their schedule? So if they then it's a conversation of like, what is your bedtime routine look like? Right. And then if it's like, oh, I put my kids to bed at 8:30 and then I'm catching up on work, and then I want some me time and then I'm up till 11:30, 12, which is a lot of people, and then they're trying to get their workout at 5:30, 6 a.m., they're barely getting the sleep that they need, like you mentioned, right? So then it's having that conversation of like, okay, let's see what we can lever. Can you try going to bed 15 minutes earlier? And let's try that for a week. I think what happens is people try to make these massive changes, as you know, right? And same thing with changing exercise, nutrition, et cetera. It's like start small. So I would say, let's start small with the sleep changes. Let's try to get your sleep schedule regular and then start to tweak other things about it, right? So it's like, can you do this one thing this week? Next week, let's add one additional thing and make it manageable. And hopefully they see the benefits of those changes in their sleep and how they're showing up, not only, you know, in the gym, but also for their family, for work, et cetera.

Yeah. Uh that's so well said. And I mean, ultimately what you what you stated earlier is spot on. It comes down to time. You know, like what's the best benefit of someone's time? Sometimes the best use of their time is just chilling out watching Netflix for 45 minutes at the end of the day. You know, truthfully, right? Like, totally. You know, like that is really and people are like, oh, I could be doing like, no, you just gotta, I I have that problem. Like, I feel as soon as I sit down, I feel guilty, right? I'm like, but no, I've been going since 5.15 in the morning. I need to stop. So yeah, great stuff. And I think the other people the thing that people can do is um within our industry is just get educated. Like, listen to an interview like this. This was highly educational. I learned a lot. I think just having that kind of knowledge in your toolkit is extremely valuable because you can have a better conversation, you can have a more understanding conversation of what's going on in people's lives and especially different phases of their lives, like women's um health and and all that. So um this this was awesome. Oh, last question I always ask your moine is like what if people are listening right now, you know, what do you need help with? What's a challenge you're facing? If people are going to reach out, or if you want to talk to people about something, what would that be?

Oh, that's a great question. What do we need at the company?

You personally, like maybe in your research or um, I'm open to talking to anyone about, yeah.

I mean, we're always interested in collaborating with people uh where what whatever they may think would be ways to optimize sleep, to uh talk about women's health, any anything along those lines would welcome any conversations, collaborations.

Okay, great. And I also saw uh according to your LinkedIn that you guys are hiring. So now you gotta go.

Yes, we are scaling very quickly at the company. So um we have a lot of open roles. So if anyone's interested in working at 8 sleep, please do reach out.

Yeah, awesome. Well, thank you so much for your time today. This was uh this was great. Um, you know, I could keep asking you questions forever, but uh, I know you gotta carry on. So this was a pleasure. Ladies and gentlemen, Dr. Nicole Boyan.