睡眠呼吸暂停专家：大多数患有这种“沉默杀手”的人永远都不会发现！| 安迪·加尔平博士

如果你想用可穿戴设备，那也可以。

If you want to use the wearable, you can do that.

可穿戴设备的问题有很多。

The problem with the wearables is numerous.

它们在感知和问责方面表现出色。

They are awesome at things like awareness, at accountability.

对于总睡眠时间这类指标，它们还算不错。

They're pretty good for things like total sleep time.

但在某些方面，它们真的很差。

They're really, really bad.

可穿戴设备的一个主要缺点是预测深睡和快速眼动睡眠。

And a major pitfall for wearables is predicting things like deep sleep and REM sleep.

你知道我在想什么吗？

Do you know what I do you know what was I was thinking about?

我在想某些时候，我做过一些行为上的事情。

I was thinking about certain times where, I've done certain things behaviorally.

然后我上床睡觉，醒来感觉糟透了，我的穿戴设备对我说，是的。

And then I got in bed, woke up feeling terrible, And my wearable said to me Yeah.

你昨晚睡得非常糟糕。

You had a bad really bad night sleep.

我大概能把这些联系起来，找出因果关系。

And I could kind of put two and two together and kind of establish cause and effect.

然后我几乎可以，我想，之后去测试一下，说，好吧，别那样做，或者早点上床，或者温度太高了，不管是什么。

And I could almost, I guess, test that then going forward and say, okay, don't do that or maybe get in bed earlier or the heat was was way too high, whatever it might be.

我可以通过A/B测试来获得更好的结果。

And I could sort of AB test my way to a better outcome.

对。

Yeah.

所以它们能给你提供总睡眠时间之类的数据，就像我说的。

So they can give you things like total sleep time, as I said.

你要小心的是那些综合睡眠效果评分、睡眠质量评分。

What you wanna be careful of are the aggregate sleep effectiveness score, sleep quality score.

那些数据在趋势上可能并不准确。

That's the stuff that directionally won't be there.

不过你刚才说了个很有意思的点，就是你感觉状态更差了。

But you actually said something interesting a second ago, which is you felt worse.

这才是我们需要重点关注的唯一趋势性指标。

That's the only directional thing we need to have to pay attention to.

如果你心想：哇，我今天感觉更糟了。

If you go, Wow, I feel worse today.

然后呢

And then

你可以回溯一下，对，这是因为昨天我做了A、B、C，或者我今天感觉好多了。

you can go backwards and go, Yeah, that's because I did A, B, C yesterday, or I felt better today.

这可不是唯一的指标。

That's not the only metric.

话说清楚，我并不是建议大家把可穿戴设备都扔了。

And to be really clear, I'm not advocating to ditch all the wearables.

我们大量使用它们。

We use them extensively.

关键是要小心区分哪些数据值得关注，哪些不值得。

It's just really being careful about what data from those we pay attention to and what we don't.

所以我们现在做的事情是找出那些常常被忽略的大主题。

So stuff that we do now is find big themes that they're oftentimes missing.

这里有个很好的例子。

Here's a good example.

我们有大约一千两百天的数据，我记得是来自一枚Oura戒指。

We had twelve hundred days of data from, I think it was an Oura Ring.

我们确实发现，在我们的一位客户身上，静息心率每下降一次，比如从每分钟65次降到64次，他的睡眠时间就会增加六分钟。

And we are actually able to find that in one of our clients, for every one drop in resting heart rate, so his resting heart rate, say, went from 65 beats per minute to 64, he got six more minutes of sleep.

所以我们觉得，好的，太棒了。

And so we were like, okay, great.

你想多睡一个小时。

You want to add an hour to your sleep.

我们继续来提升你的心血管健康吧。

Let's continue to work on your cardiovascular fitness.

每次他变得更健康，静息心率下降，睡眠时间就增加了。

Every time he got more fit, his resting heart rate dropped, he slept more.

另外，每次你投入并专注于放松调节，睡前静息心率会降低，睡眠时间也会更长。

Additionally, every time you put and you invest in down regulation, you'll lower your resting heart rate going into bed, you will sleep longer.

所以他是个典型例子，就像说，我试着上床睡觉，该做的都做了，但就是躺不住。

So he was a classic case of like, I try to go to bed, I do all the things, but I just can't stay in bed.

所以让他睡得更多的关键，是让他的身体状态能够支持更长的睡眠。

So the key there to get him to more sleep is to put his physiology in a position that would allow him to have more sleep.

对他来说，这就像煤矿里的金丝雀，是个预警信号。

And for him, like that was the canary in the coal mine.

这就是可穿戴设备能发挥的作用，从数据和教练的角度来看，都是无法替代的。

So that's the type of stuff where wearables can be You can't replace that, not only from a data, but from a coaching perspective.

我很容易就能跟他沟通，告诉他，这是你的数据。

It was so easy for me to communicate to him, here's your data.

这就是我们的目标。

This is our target.

而且他是个特别忙的人。

And he's an extraordinarily busy person.

他说，太好了，我只需要关注一件事。

He's like, Great, I got one thing to pay attention to.

想尽一切办法让睡前心率保持低水平。

Do whatever it takes to keep that heart rate low going into bed.

明白。

Copy that.

那他当时心率高是什么原因？

What in his case was making his heart rate high?

说到睡眠，任何你生活环境中的、生活方式里的、身体状态上的因素，都可能影响它。

When it comes to something like sleep, anything that is in your physical environment, that's in your lifestyle, that's in your physiology can impact it.

我之前提到过，睡眠变差的一个原因就是环境中的这些物理变化。

I mentioned earlier, one of the reasons why sleep is getting worse is because of these physical changes in our environment.

现在每年在睡眠上的花费大约是六千亿美元，但过去六十年里，我们的总睡眠时间却减少了六十分钟。

Annual spend on sleep is like $600,000,000,000 right now, but yet we have seen a sixty minute drop in total sleep time over the last sixty years.

所以你看，这正好是反过来的。

So you're seeing an inverse.

我们花在睡眠上的钱越来越多，但睡眠质量却越来越差。

We're spending more on sleep and sleep is getting worse.

我想你的团队打印了一些卡片，我们可以一起看看。

I think your team printed out some cards here and we can go through them.

第一张卡片特别好。

The first one is a really good one.

世界现在变得更亮了。

The world is physically brighter.

事实上，有NASA的卫星数据可以证明，现在世界确实变得更亮了。

In fact, there's data from NASA satellite data that can look and say, world is physically brighter now.

你被期望和新加坡、澳大利亚还有美国保持联系，这意味着你得熬夜到更晚。

You're expected to be communicating with Singapore and Australia and The US, which means you're gonna be up later.

你的工作得继续。

Your business is going to be on.

你的灯也得开着。

Your lights are going to be on.

还有一种现象叫天光，就是地球上的光往上照，碰到云层，又反射下来。

There's also a phenomenon called sky glow, where the light from Earth is going up, hitting the clouds, and being shot back down.

所以这让我们的世界更亮了。

And so it's keeping our world brighter.

所以当你听到人们说要买遮光窗帘和眼罩，你会想，我小时候可没这么干过。

So when you hear people talk about things like you gotta have these blackout curtains and masks, and you're thinking like, I never did that when I was a kid.

这有什么大不了的？

Like, what's the big deal?

就是因为这个。

It's because of this.

我这儿找到了一些图表。

I mean, there's some graphs that I found here

对。

Yeah.

对。

Yeah.

这些图表能说明这一点，我待会儿放屏幕上给大家看。

Which kinda demonstrate this, which I'll put up on the screen.

对。

Yeah.

现在越来越多的人搬到城市里住。

More people are moving into urban environments.

你看一些研究，不是说吓唬人，但有些研究发现，搬到城市后，焦虑和抑郁的比例上升了百分之二十多。

If you look at some of the studies, not to be dramatic, but some of the studies have found things as high as anxiety and depression are up twenty plus percent when you move into the city.

这很大程度上归因于光和噪音这些因素。

And that's largely attributed to things like light and sound.

城市里光线特别亮，声音也特别吵。

It's extremely bright and extremely loud in cities.

这并不意味着城市不好，或者你不能住在城市里。

It doesn't mean they're bad or you can't live in them.

只是意味着你需要额外采取一些措施。

It just simply means that's why you have to take extra steps.

我想很多听众会想，安迪，我的卧室很暗。

I think a lot of people listening to this will think, well, Andy, my my bedroom's very dark.

很好。

Great.

但你说的其实不是这个意思，对吧？

But that's actually not what you're saying, is it?

因为我是这么想的，我们现在在纽约市。

Because the way I was thinking about it is we are here in New York City now.

如果我昨晚十点走去商店

And if I walked to the shop last night at 10PM

对。

Yeah.

然后走回来的时候，我在外面接触到了很多很多光，而那时候我的身体本不应该接触光的，所以即使我回到那个黑暗的房间里，这也会影响我。

And walked back, I was exposed to so so much light outside at a critical time when my body should be not exposed to light so that it's gonna impact me even when I get into that dark room.

其实还不止这样。

It goes even better than that.

现在有证据表明，你早上和白天接触的光线会大大抵消你刚才说的那个影响。

There's evidence now that the light exposure you have both in the morning and throughout the day dramatically counteracts what you just mentioned.

所以，是的，你出去走了走，做了那件事，那时候外面还有光，你在睡前那三四个小时接触到的光线比以往任何时候都要亮。

So yes, you went for that walk, you went for that thing when light was still out, and you had a brighter light exposure in, we'll just call it, the three or four hours before bed than you would have had ever in the past.

但是你可以通过在白天和早上适当接触光线来减轻这种伤害。

But you can mitigate that damage by seeing light appropriately during the day and in the morning.

哦，好的。

Oh, okay.

这其实是我朋友安德鲁·休伯曼多年来一直在谈论的事情，我一直拿他开玩笑，笑话他。

And this is actually something my friend Andrew Huberman has talked about for years now, I've always joked and laughed at him.

但后来我想，天哪，他这次说得太对了。

But then I'm like, damn, he nailed this.

他在这方面真是领先太多了。

Like, he was way ahead in this one.

早上接触光照会影响你第二天晚上的睡眠。

Light exposure in the morning will impact your sleep at night the next day.

他总是解释说这是在设定你的昼夜节律，但其实不止如此。

He always explains that it's setting your circadian rhythm, but it's more than that actually.

我当时就觉得，哦，随便吧。

It's like that's the part where I was like, yeah, whatever.

反正我在同一个时区。

Like, I'm in the same time zone.

我干嘛要关心这个？

What do I care?

现在我才明白，因为如果你在一天晚些时候接触大量光照，那么早上的光照反而能帮你减轻那种影响。

And now I'm like, oh, because then if you are exposed to a high amounts of light later in the day, that exposure to light earlier will help reduce that damage.

哇。

Wow.

有一连串的机制在影响你什么时候该清醒，什么时候该睡觉。

There's this whole cascade of things that influence when it is time to be awake when it is time to go to sleep.

这些机制既跟激素有关，也跟神经活动有关。

And this is both hormonal based as well as neurally based.

所以你的大脑会根据光线、运动、兴奋程度、食物摄入以及刺激物等因素来启动或抑制某些功能，当然还有其他很多因素也会起作用。

So your brain will shut down or activate in response to light, in response to exercise, in response to arousal, in response to food, in response to stimulants, and a whole host of other things.

白天早些时候接触到的光线，就是用来设定这个节律的。

That light earlier in the day sets that rhythm.

好的。

Okay.

所以就像是在启动

So it's like starting the

它在开始计时。

It starts the clock.

明白了。

Okay.

它启动了睡眠压力。

It starts the sleep pressure.

这是，哦，这是农村与城市环境的对比图。

This is oh, this is the graph of rural versus urban plot.

所以，是的，我的意思是，可以看得很清楚。

And so, yeah, I mean, can see that pretty clearly.

这里的红线是农村环境中的噪音，而这里的噪音是城市环境中的。

The red line here is the noise in in a rural environment, and this is the noise here.

夜间声音的理想数值大约是35分贝。

The typical number you wanna see for sound at night is like 35 decibels.

对吧？

Right?

所以如果你看农村环境，你大概就在那个水平，而看城市环境，你的基线在60到70之间。

So if you see the rural environment, you're cruising at about that, and you see the urban environment, you're looking in the 60 to seven as a baseline.

睡眠时声音真的很重要吗？

And it really matters sound when you sleep?

影响很大。

Tons.

真的吗？

Really?

是的。

Yeah.

和其他任何因素一样大，甚至更大。

As much, if not more, of any other factor.

声音的关键问题在于不连贯。

The big thing with sound is inconsistency.

很多人会在房间里放白噪音机。

A A lot of people will do things like put a sound machine in the room.

大多数人因为那个原因把音量调得太高了。

Most people put them too loud because of that thing.

所以通常默认音量是40到50分贝。

So you put them pretty common default is like 40 to 50 decimals for a sound machine.

更多的数据表明应该低于40分贝，尤其是对孩子来说。

More of the data suggests sub 40, especially for kids.

如果你给孩子用白噪音机，大多数人放得太近而且声音太大。

If you're using a sound machine for your children, most people put them too close and too loud.

什么是白噪音机？

What's the sound machine?

就是一个小设备，能发出白噪音。

Just a little device that makes a white noise.

它的作用是消除很多低水平的不规律声音。

And what that does is it cancels out a bunch of low level inconsistent sounds.

哦，明白了。

Oh, okay.

比如狗起身的声音、窗户吱吱响、汽车经过的声音，它都能帮你把这些噪音抵消掉。

So the dog getting up, the window creaking, the, you know, the car driving by, and so it can kinda cancel that noise level out.

为什么我听着播客入睡就能睡得很好呢？

How come I can have, like, a great night sleep listening to a podcast falling asleep?

而我伴侣就不行。

Whereas my partner can't.

她需要安静，而我几乎觉得必须听点什么才能睡着。

She needs silence, and I I I almost feel like I need to listen to something to fall asleep.

很可能，如果你不那样做，你会睡得更好。

Most likely, you would do better if

不那样做？

you didn't do that.

真的吗？

Really?

是的。

Yep.

对。

Mhmm.

你睡觉前把它们关掉。

You turn them off before you go to sleep.

对吧？

Right?

不是。

No.

对。

Yeah.

好。

Okay.

那样永远睡不好。

That will never lead to your best sleep.

好。

Okay.

实际情况是，你上床睡觉时，脑子里还在想事情。

What happens is you get to bed, and something is happening cognitively.

嗯。

Mhmm.

然后你会想，我需要点东西让我放松下来。

And you're like, I need something to switch me off.

转移我的注意力。

To distract me.

对。

Yeah.

很好。

Great.

如果我们把这个拿走，你可能会睡得更差，因为你会躺在那里，熬过那段难熬的时间。

If we took that away from you, you might sleep worse because you're gonna sit there and struggle through that moment.

明白。

Mhmm.

如果你想升级一下，我们会说，好的。

If you wanted to go from upgrade, we would say, okay.

让我们想想，有什么方法能真正让你在认知上放松下来，给你同样的效果，但又不会在夜里打扰你的睡眠。

Let's figure out what is actually a way for you to down regulate cognitively, give you that same thing that won't then disrupt your sleep throughout the night.

你之前遇到过这种情况的人吗？

Have you dealt with people in that situation before?

非常常见。

Super common.

播客在这种情况下非常普遍。

Podcasts are an incredibly common one with that.

电视、书，我的理念是退一步，解决根本原因。

TV, books, my philosophy is let's step back and solve causes.

我们要解决限制因素，而不是掩盖它们。

Let's solve constraints rather than mask them.

这边有一堆不同的补充剂。

You've got a host of different supplements over here.

你在这张桌子上看到的每一样东西，都有中等到强的科学证据表明它有助于睡眠。

Everything you see on this table has moderate to strong scientific evidence that it will help us sleep.

那些是什么东西？

What are those things?

这酸樱桃汁看起来真不错，味道应该也很好。

So lovely, delicious looking tart cherry juice.

我待会儿会解释为什么这里放这个。

And I'll go through why that is there.

这里有些洋甘菊茶。

You've got some chamomile tea.

你可能会在芹菜素的补充剂形式中看到这个。

You would see this in the supplement form of apigenin.

这其实是一种很常见的做法，就像浓缩的洋甘菊。

It's a really common way of that as kind of like distilled chamomile.

看看这些可爱的猕猴桃。

Look at these lovely kiwis.

有趣的是，这其实正是研究中的做法。

What's funny here is this is actually what happens in in research.

研究人员会让人们在睡前吃两到三个猕猴桃，然后你会发现，吃了猕猴桃之后，人们通常睡得更好。

They will give people two to three kiwis that will eat them right before bed, and you will very routinely see people sleeping better after ingestion of kiwis.

在循证列表中排名靠前的，当然还有镁，以及各种形式的镁。

Other things that are high on the evidence based list are, of course, magnesium and various forms.

现在关于镁对睡眠的研究，更多转向一种特定形式，叫双甘氨酸镁，而不是苏糖酸镁。

More of the research now on magnesium for sleep is turning to a particular form called magnesium bisglycinate rather than threonate.

那个也排在前面。

That's up there as well.

你还会看到像欧米伽-3这样的东西。

You will also see things like omega three.

就是常见的鱼油。

This is your common fish oil.

哦，这个其实挺有意思的，因为你的化验单上显示这个需要改善。

Oh, this is actually interesting because this popped up on your labs as something we have to work on.

哦，我的检查结果。

Oh, my test.

对。

Yeah.

我们待会再回来谈

We'll come back to

这个，稍后再说。

that in a second.

好的。

Okay.

然后，当然，还有褪黑素。

And then, of course, you've got melatonin.

对吧？

Right?

所有这些问题都和你播客遇到的问题一样。

The issue with all these is the same that you have with your podcast.

它们在做完全相同的事情。

These are doing the exact same thing.

所以我们可以做的一件事就是，放弃播客，然后选择其中一个或多个选项，因为它们在做同样的事情。

So one thing we could do is say, diss the podcast, and let's go with one or multiple of these options because they're doing the same thing.

它们都是让大脑休息的。

They're cognitive turnoff.

芹菜素或者洋甘菊就能起到这个作用。

Apigenin or Chamomile specifically will play that role.

这相当于合理地让前额叶皮层休息一下。

It is a reasonable switch that says frontal cortex turnoff.

所以你可以通过播客达到这个效果，也可以通过食物或补充剂来达到，如果你愿意的话。

And so you're getting there through the podcast where you could get through theirs through food or supplements, if you'd like as well.

猕猴桃。

Kiwis.

对。

Yeah.

猕猴桃有科学证据表明对某些人改善睡眠有帮助。

Kiwis have scientific evidence that they improve sleep for some people.

这很常见。

It's really common.

如果这有等级之分的话，你可能会说一级、二级和三级，一级就是那些实际上，挺让人惊讶的，镁、洋甘菊、褪黑素，当然，还有很多随机对照试验。

If there's, like, levels to this, you'd probably like, level one, two, and three, level one being things like actually, surprising enough, magnesium, chamomile, melatonin, of course, lots of randomized controlled trials.

一级是最好的。

Level one being the Best.

最好的

The best of the

最好的。

best.

最好的，最高质量的。

The best, highest quality.

那你会说，什么，镁、猕猴桃？

And you'd say, what, magnesium, kiwis?

对。

Yeah.

猕猴桃可能算二级或三级吧。

Kiwis would probably be like a level two or level three.

好的。

Okay.

所以关于它们的研究还不错，足以把它们列在这个表上，足以说明有数据支持。

So there's been good studies on them, enough to put them on this table, enough to say there's data there.

所以你会得到一些下面的产品，比如芹菜素，还有其他植物化学物质，它们要么稍微降低认知功能，要么降低觉醒度，让你进入某种放松状态。

So you're getting some product below it, in this case, epigenin, in this case, other phytochemicals that either reduce a little bit of cognitive function, they reduce arousal, they put you in some sort of checkout state.

然后这边这个褪黑素，很多人都知道。

And then there's this one over here, melatonin, that a lot of people are aware of.

效果很强。

Strong.

褪黑素属于哪个级别？

What level is melatonin?

褪黑素的证据可能比其他所有东西加起来都多，

Melatonin probably has more evidence than the rest

因为它是一种药物。

of these things combined because it's a medicine.

它是一种药物。

It's a drug.

关于它的研究非常多，从儿童到衰老、骨骼健康，还有很多其他方面。

There's a ton of research on it from children to aging to bone health and tons of other stuff.

对吧？

Right?

它是一种激素。

It's a hormone.

这个产品你会卖得动的。

You're going to be able to move some units with this one.

吃两个猕猴桃，没人会特别担心风险因素。

Nobody is going to be super concerned about risk factor profiles with eating two kiwis.

但一旦到了像褪黑素这样的级别，你就得认真讨论风险和收益了。

But you start getting to the level of something like a melatonin, and now you have to have real conversations about risk versus benefits.

我们通常不会按常规剂量使用褪黑素。

We typically don't use melatonin at the dosage that's normal.

所以褪黑素的常见剂量是五毫克，有时甚至到十毫克。

So a common dosage for melatonin is like five milligrams, sometimes even up to ten.

哇。

Wow.

我们通常会用零点三毫克，或者零点五毫克，大概是那个剂量的十分之一。

We will typically use like zero point three, maybe zero point five, so about a tenth that dose.

很多时候我们想找一毫克的，然后切成两半，类似这样。

A lot of times we're trying to find like one milligrams, cut them in half, kind of things like that.

除了少数特殊情况，我们真正使用褪黑素的唯一原因，是确实需要重置昼夜节律。

The only real reason we use melatonin outside of some fringe cases is when we actually legitimately need to reset circadian rhythm.

比如旅行、倒时差之类的。

Travel, jet lag, things like that.

在这种情况下，它确实有效，也确实有用。

And it is effective and it is useful there.

小剂量使用是安全的。

It is safe in small doses.

人们对褪黑素的误解是，我每晚都靠它入睡，或者半夜醒来睡不着，就去拿一颗褪黑素。

Where people mistake melatonin is I use it every night to go to sleep, and or I wake up in the the night, can't go back to sleep, I go grab a melatonin.

为什么这样不好？

Why is that bad?

它没用。

It doesn't work.

它没什么？

It doesn't what?

对。

No.

因为褪黑素的作用是重新调整昼夜节律。

Because the thing that melatonin is supposed to do is realign circadian rhythm.

如果你在半夜，你已经处于那个节律中了。

If you're in the middle of the night, you're already in that rhythm.

它不会起任何作用。

It's not going to do anything.

其实，虽然我不希望大家这么做，但如果你真的很难再入睡，从认知上讲，吃这个没用，你不如去喝点洋甘菊茶之类的。

You would in fact not to I don't want people to do this, but you would actually be better reaching for something like a chamomile perhaps because if you're having a hard time getting back to sleep cognitively, this is not gonna do it.

另一个问题是，我们做了很多晨尿检测。

The other issue is we've done a lot of morning urine testing.

有不少研究对比了药片里的实际剂量和标签上标注的剂量。

There's enough studies that look at the dosage that's actually in the pill versus on the label.

实际剂量可能高出100倍。

And they can be up to a 100 x higher.

100倍？

100X?

我们在晨尿中也看到了这种情况。

And we see this in morning urine.

我们看到有些人总是感到疲倦。

We have seen people who are consistently tired.

他们的睡眠看起来并不糟糕。

Their sleep doesn't look horrible.

他们做的都是对的事情。

They're doing all the right things.

又冷又黑。

It's cold, it's dark.

他们在冥想。

They're meditating.

他们做了所有这些事情。

They're doing all this stuff.

他们甚至服用了中等剂量的褪黑素。

They're popping in even a moderate dose of melatonin.

第二天他们尿液中的褪黑素含量是参考范围上限的100倍，这意味着他们第二天剩下的时间都处于超剂量褪黑素状态。

And the amount of melatonin the next day in their urine is 100x the upper end of the reference range, which means they're spending the rest of their next day in a hyper dose melatonin state.

所以他们不得不靠兴奋剂来恢复

So they have to live then on stimulants to get back

感觉。

to feel.

太糟糕了。

Horrible.

他们会感觉昏昏沉沉的，而且

They would feel sluggish and

第二天醒来，你会觉得，天哪，这就是我们所说的睡眠惯性。

You wake up the next day, and you're like, man, it's what we call sleep inertia.

你会非常迷糊。

You're wildly groggy.

你起不了床，或者整天都提不起精神。

You can't get out of bed, or you're just getting throughout the day.

这就像那种“别跟我说话，等我喝完咖啡再说”的反应。

This is a like, don't talk to me until I've had my coffee kind of response.

对吧？

Right?

这不是你该经历的正常的清醒状态。

This is not a normal waking physiology that you should be going through.

估计那就是从便宜渠道来的褪黑素，没经过检测。

Presumably, that's just melatonin from sort of cheap sources that haven't been tested.

那能解决你大部分的问题。

That's going to knock off a huge part of your problem.

对吧？

Right?

所以这就是为什么我们总说，没人需要补充剂。

Only this is why we'll always say you don't no one needs supplements.

就是说，没有哪个正常人需要靠补充剂才能过上幸福健康的生活。

Like, no essential person needs to have any supplement to live a great, happy, healthy life.

如果你选择用补充剂，那就买那些经过第三方检测、透明公开的公司产品，他们把检测报告放在网站上，让你随时可以查看，就是为了这些原因。

If you choose to use supplements though, just buy them from third party tested, transparent companies that place their testing on their websites that give you open access to it for these exact reasons.

维生素D也有类似的准确性不足的问题。

Vitamin D has a similar profile of inaccuracy.

另一个问题就是，假设你买的是高质量的产品。

The other issue with that then simply, let's say you're buying it from a high quality source.

你剂量太大了，而且吃得太晚了。

You're dosing it too much and you're taking it too late.

所以要比你想象的时间更早吃，在睡前提前吃，这样身体才有机会在第二天早上之前把它分解掉。

So take it earlier than you think before bed so that your body has a chance to break it down before the next morning.

大概什么时间？

What kind of time?

起效有多快？

And how quickly acting is it?

这因人而异，但很多时候你会看到像提前一小时这样的建议。

It's person to person dependent, but a lot of times you'll see things like an hour before.

有些人会在十到十五分钟内就有反应。

Some people will feel a response in ten to fifteen minutes.

有些人会接近一小时才有感觉，但那个时间范围差不多。

Some people will feel it closer to an hour, but that's a pretty good window.

等等。

Hang on.

如果是凌晨两点，你正要上床睡觉，那就别吃了。

If it's 2AM in the morning and you're and you're getting in bed, don't take it.

完全别吃。

Don't take it at all.

好的。

Okay.

我们只在特定情况下使用它，然后就会停用。

We're going to use this in very specific situations, and then we're coming off of it.

大多数时候，这不应该成为你每晚的常规习惯。

This is this should not be a part of your nightly routine most of the time.

我吃褪黑素时，大脑里到底发生了什么？

What exactly is going on in my brain when I take melatonin?

因为很多人都在吃，我们知道它会让我们感到困倦。

Because a lot of people take it, and we know that it makes us feel tired.

但了解其机制，我认为，会帮助我们理解其应用。

But understanding the mechanism, I think, will help us understand the application.

所以它其实并不会真的让你感到困倦。

So it actually doesn't really make you feel tired.

这就是问题所在。

That's part of the issue.

它的机制是调整昼夜节律。

The mechanism is a circadian shift.

它是在告诉你的身体系统，现在是夜晚了。

So it's telling your endogenous system that this is nighttime.

所以它不会像那样一下子让你眼皮打架。

So it doesn't hit you with like a, all my eyes are there.

它带来的是皮质醇水平的变化。

This hits you with a shift in cortisol.

它带来的是肾上腺素、去甲肾上腺素、血清素等一系列激素的变化，这些激素在体内流动，告诉你：你需要处于这种状态，这种状态与睡眠模式相符。

This hits you with a shift in a whole cascade of epinephrine, norepinephrine, serotonin that are moving around and saying, this is a milieu that you need to be in that is consistent with the sleep pattern.

好的。

Okay.

所以我吃了它，然后它调节我的其他激素，这些激素理论上会妨碍我感到困倦。

So I take it, and then it regulates my other hormones, which would be getting in the way of me feeling tired theoretically.

那可能更符合它的实际作用。

That's probably more appropriate to what it

是的。

does.

好的。

Okay.

因为，是的，我吃过几次。

Because, yeah, I've taken it a couple of times.

再说，总是因为时差问题。

Again, always for jet lag issues.

对。

Yeah.

大约三十分钟到四十五分钟内，我就觉得有点困了。

And within about thirty, forty five minutes, I feel a bit drowsy.

然后我就发现眼睛开始闭上，然后就睡着了。

And then I found my eyes going shutting, and I'm off.

太好了。

Great.

然后你过了那两三天的时间，把它收起来，然后你就恢复正常了。

And then you get out of those that two or three day window, put it back away, and and you're off and going.

对。

Yeah.

那是个很好的使用场景。

That that's a good use case for it.

错误的使用方式就是觉得没有它我就睡不着。

The mistake is when this is like, I can't go to bed without.

我一般对这些东西都很害怕，因为，是的。

I'm generally scared of all these things because Yeah.

说实话，越有效的东西我越害怕。

Honestly, anything that's effective, I'm more scared of.

对。

Yeah.

所以当然。

And so Sure.

它真的很有效，这让我不太敢频繁使用。

It's really effective, which makes me hesitant to use it frequently.

对。

Yeah.

这是一个很好的默认立场，

It's a good default position to be in, by

顺便说一下。

the way.

对。

Yeah.

真的。

Really.

这是个好策略。

It's a good strategy.

对。

Yeah.

因为做这种播客，你学到的一件事就是，凡事都有取舍。

Because I one of things you learn from doing a podcast like this is you just learn that everything has a trade off.

永远如此。

Always.

而且，再说一次，这可能不太符合逻辑，但我一般会认为，收益越大，另一边要付出的代价也越大。

And I and again, this might not be logically sound, but I assume that the bigger the upside, the bigger the trip like, trade I'm making on the other side as a general rule.

所以，你知道，唯一我还没能完全搞明白代价的东西就是咖啡。

So do know you the only thing that I've still not been able to, I guess, understand the full trade off of is coffee?

嗯。

Mhmm.

因为它的好处太明显了。

Because the upside is so significant.

没人能跟我讲清楚喝咖啡的坏处，除了有人说如果中午以后喝会影响睡眠。

No one can articulate to me the downside other than they say if you have it after midday, it's gonna impact your sleep.

但我心想，得了吧。

But I'm like, come on.

肯定还有别的代价。

There's gotta be.

我在课上常说的一句话是：生理学里没有免费午餐。

The phrase that I'll say in my class all the time is there's no free passes in physiology.

关于咖啡，我们确实有一项由我同事本·豪斯博士主导的荟萃分析。

With coffee specifically, actually we have a meta analysis led by my colleague, Doctor.

是他整理出来的。

Ben House, puts this together.

但如果你看看咖啡因和睡眠方面的研究，会发现很有意思：一旦睡眠不足，你的身体机能和认知表现都会下降。

But if you look at the research on caffeine and sleep, it's very interesting because if you go through sleep deprivation, your physical and cognitive performance goes down.

这点倒不意外。

No surprise there.

咖啡可以抵消这种影响。

Coffee can offset that.

具体来说，起作用的是咖啡因。

Caffeine specifically is the thing.

但根据数据和荟萃分析，它并不能真正让你恢复到最佳状态。

But what it doesn't do, at least the data and the meta analysis suggests, is it doesn't actually put you back into the augmented spot.

意思是，如果你昨晚睡得很好呢？

Meaning, if you did you sleep great last night?

我觉得是。

I think so.

对。

Yeah.

整晚都睡得好。

Full night okay.

假设你处于最佳状态。

Let's just say you're there.

如果我们把你带出去，让你扔那个药球，做握力测试，再跑几个来回冲刺，或者你想做什么都行，你会表现得很好的。

If we took you out and we had you throw that medicine ball, and we did a grip strength test, and we did some sprints up and down, or whatever you wanna do, you would perform well.

然后如果我们给你咖啡因，你会表现更好。

And then if we gave you caffeine, you'd perform better.

这就是为什么我们叫它“促力”的。

It's why we call it ergogenicate.

它是一种表现增强剂。

It's a performance enhancer.

咖啡因主要对耐力型运动非常有效，但它是一种人们会使用的兴奋剂。

Caffeine is really effective primarily at endurance based events, but it is a stimulatory thing that people will use.

所以假设你有正常的基线表现，那么咖啡因会提升那个表现。

So let's just say you have normal baseline performance, then caffeine augments that performance.

如果你睡眠不足，睡眠本身会降低你的表现。

If you go into sleep debt, the sleep itself will reduce your performance.

而咖啡可以让你恢复到正常水平。

And the coffee can bring you back to normal.

但它不会让你回到你休息好并且摄入咖啡因后的那种增强状态。

But it won't bring you back to that augmented state that you had when you arrested and caffeinated.

这很重要，因为很多人会想，哎呀，我今晚不睡了，或者我不太担心睡眠，因为我明天多喝点咖啡就行了。

This is important because a lot of people will be like, ah, I'll throw away the sleep or I won't worry about it as much because I'll just take more stimulus tomorrow.

而且我感觉很好。

And I feel great.

你感觉会一样好，但你的表现不会那么好。

You will feel as good, but you will not perform as well.

所以，如果你是咖啡因使用者，要发挥最佳表现，你需要既休息好，又摄入咖啡因。

So what you need to perform at your best, if you're a caffeine user, is to be both well rested and then caffeinated.

在你的睡眠环境中，另一个要注意的是所谓的“人体工学”，也就是你的枕头、床和床垫。

Another thing you wanna pay attention to in your sleep environment, labeled ergonomics here is your pillow, your bed, your mattress.

这主要取决于个人感觉。

This is mostly based on feel.

在这方面有什么禁忌吗？

Is there any no gos in this regard?

其实也没有。

Not really.

真的没有吗？

Not really?

没有。

No.

除非，比如说你有一个同床的伴侣，你们睡在一张太小的床上，结果会碰到对方或者挨着对方，而你不喜欢这样。

Unless, let's say you have a sleeping partner and you're sleeping in a bed that is too small, and that results in you hitting each other or touching each other, and you don't like that.

所以除了这些，床架本身真的没什么好担心的。

So other than those, the framework themselves, there's really nothing to be concerned with.

那Eight Sleep床垫怎么样？

What about these Eight Sleep beds?

Eight Sleep非常棒。

Eight Sleep is fantastic.

Eight Sleep其实不是床垫，而是一个调节温度的床罩。

So Eight Sleep is not a bed, it's a cover, which regulates temperature.

如果你睡觉的时候觉得热，那就有问题了。

If you are in a bedding situation where you're getting hot, then that's a problem.

所以如果Eight Sleep能帮你调节温度，那是个很好的解决方案。

So if then an Eight Sleep will help you regulate that temperature, it's a great solution.

如果你没有这种情况，那你完全没问题。

If you're not in that situation, then you're gonna be just fine.

所以温度调节真的很重要。

So temperature regulation is a really big deal.

而且你经常会看到有人这么做，不管是买那种产品，还是买更凉爽的床单，或者透气性更好的床垫，你经常会看到他们睡得稍微好一点。

And you'll quite often see people that do that, Whether that's getting a product like that, or it's getting a sheet that's cooler, or a mattress that is better with ventilation, then you'll oftentimes see them sleep a little bit better.

我们清单上的下一个是屏幕使用。

Next on our list is screen usage.

每个人都被告诉过，而且你知道，可能没有什么比睡觉前看屏幕更有害的了。

Everyone has been told and you know perhaps nothing's more destructive when you're sleeping on a screen.

更有趣的是那些人们通常不谈论的事情。

What's more interesting here is the stuff that people generally don't talk about.

其实问题不在于屏幕使用时发出的蓝光直射你的脸。

It's not the fact that necessarily screen usage is shooting your face with a bunch of blue light.

屏幕更危险的地方在于，你在寻找新鲜感时产生的兴奋感。

What's more dangerous about your screen is the arousal associated with the search for novelty.

寻找新鲜感。

The search for novelty.

那是什么意思？

What does that mean?

你在听播客、刷社交媒体、玩游戏，这些都是由解谜驱动的。

You're engaging in a podcast, social media, a game, it is puzzle driven.

是解决问题。

It is solution.

是兴趣。

It is interest.

是投入。

It is engagement.

就是在寻找下一个目标。

It is search for the next.

这才是更可能导致睡眠问题的原因。

That's the stuff that more likely than not cause sleep disturbances.

那些研究电视、平板、手机和阅读对睡眠影响的实验发现，这些活动对睡眠的危害其实差不多。

In the studies that have looked at things like TV time versus tablet versus phone versus reading, those all can be equally dangerous to sleep.

举个例子。

Here's the example.

我睡前喜欢看电视，而且是大电视，屏幕还特别亮。

I am a TV before bed guy, A giant TV with a blast of blue light.

但我照样睡得很好。

I sleep great with that.

我妻子对睡前光线特别敏感。

My wife is really struggles with light before bed.

她也会看书，但她选的书我觉得不太适合睡前看。

She will read, and yet she chooses to read things that I don't think she should be reading before night.

然后她会被读到的那些话题给惊醒。

And then she'll wake up because of the topics that she's reading.

而我是在看电视，比如看一些关于尤利西斯·格兰特的纪录片之类的，那种东西简直无聊透顶，完全提不起兴趣。

Where I'm watching things on TV that are, you know, documentaries on Ulysses Grant or something, and you're just like, that is the least engaging thing ever.

所以问题不在于有没有光。

So it's not the fact that the light is there.

我平时听播客的方式跟用这些设备差不多，毕竟我整天都被各种人追着要注意力和时间，早就习惯了这种状态。

I use that stuff much like you use your podcasts, which is my entire day is so driven by somebody wanting my attention and time.

我必须得有个能让我大脑切换状态的东西，告诉我可以下班休息了。

I have to have something that gives me a cognitive switch that says, you get to turn off.

我想补充一点，这是我这周一直在琢磨的事。

I wanted to add something to this, which I've been thinking about this week.

在Meta的财报电话会上，扎克伯格提到他们利用AI调整了旗下Instagram、Facebook和WhatsApp等社交应用的推荐算法。

So in Meta, Meta owned Instagram and Facebook and WhatsApp, etcetera, in Meta's earnings call this week, Mark Zuckerberg talked about how they changed the recommendation algorithm on social media apps using AI.

这正是我们一直预测会发生的，我们也一直在思考创作者经济以及它带来的影响。

And this was something that we've always forecasted would happen, and we've been thinking about the creator economy and how it impacted.

但具体对听众来说，他说的基本上是，每次你在Instagram上发东西，不管是Reel还是普通帖子，现在都会喂给一个大型语言模型AI。

But specifically for people listening, what essentially he said is every time you post something on Instagram, whether it's a real or a or a normal post, they now feed it to a large language model in AI.

然后AI实际上——我在这里再总结一下——会观看它，并且现在能理解它看到的完整上下文。

And the AI effectively, and again, I'm summarizing here, watches it, and it can now understand the full context of what it's watching.

所以如果它看到的是你和我现在的片段，它会明白那是Andy Galpin。

So if it's watching a clip of you and me right now, it'll understand that that is Andy Galpin.

他拿着一张卡片。

He's holding a card.

他穿着黑色T恤。

He's wearing a black T shirt.

他们会看文字记录。

He's they'll look at the transcript.

他会知道你说过什么。

He'll know what you said.

这一切都很关键，因为这样一来，它不再需要像过去那样看标题和标签，就能比以往任何时候都更了解上下文，从而决定谁最想看那个内容。

And this is all pertinent because it then can without in the past needing to look at the caption and the hashtags, it can then decide with way more context than ever before who exactly would want to see that.

这对Instagram或其他社交媒体应用或TikTok用户来说，最终的影响就是你会比以往任何时候都更沉迷其中。

And the net impact of that for for the user of Instagram or these other social media apps or TikTok, whatever it is, is you're gonna be more retained now than ever before.

你刚才说到这个，我在想他们会不会考虑一天中的时间段。

And as you were talking about that, thought, I wonder if they think about timing of day.

比如，我在想他们会不会觉得晚上11点有某种内容能让安迪一直刷下去，而早上9点你准备去上班时又是另一种内容。

Like, I wonder if they think at 11PM, there's a certain thing that's gonna keep Andy scrolling versus something at 9AM when you're off to work.

当然，他们会考虑。

And of course, they do.

因为在财报电话会议上，马克提到这使留存率提高了，我记得是15个基点。

Because the and, you know, they were talking about on the earnings call, Mark was saying how it's increased retention by, I think, 15 basis points.

而且有句话是这么说的，说现在已经有两大类内容可以供选择。

And there's this quote where he said that there are already two large sets of content to draw from.

第一类来自你的朋友和你关注的人，第二类来自你不关注的创作者。

First, from your friends and people you follow, and second, from creators that you don't follow.

但现在将会有一个全新的、几乎无限的个人化内容宇宙，我从中推断他们的意思是，借助一个叫Muse的新大型语言模型，我们实际上会生成新的内容给安迪·加尔平看，这些内容不是任何人制作的，不是人类制作的。

But now there's going to be a whole new and nearly infinite universe of personalized content, which from that I infer what they're saying is with a new large language model called Muse, is we're actually gonna make new content to show Andy Galpin that no one made, no humans made.

我们会做出我们知道安迪会喜欢的内容。

We're gonna make stuff that we know Andy will like.

所以我说这些，是想说在这次关于睡眠的对话中，我们一直在讨论创作者。

And so I say this to say that in this sleep conversation, we've talking about its creators.

我们基本上一直在说，如果你是个创作者，情况会变得非常困难，因为现在，即使你有一百万粉丝，也不重要了。

We've been saying basically, it's gonna get really difficult if you're a creator because now, if you have a million followers, it doesn't matter.

对。

No.

如果珍妮一个粉丝都没有，但她做出了比那个百万粉丝的家伙更有趣的内容，那么珍妮的内容就会被所有人看到。

If Jenny has zero followers, but she makes something that is contextually more interesting than the million follower guy, Jenny's things gonna seem be seen to everyone.

但实际上，现在你将与一个AI竞争，它会不断生成超级个性化的安迪·加尔平内容。

But actually now, you're gonna be competing with an AI that's gonna be churning out super personalized Andy Galpin content.

比如，那种安迪在晚上11点会特别喜欢的内容。

Like, that just Andy would just love at 11PM.

嗯。

Mhmm.

这周我跟我的团队说，我说，照顾好自己就行了。

I said to my team this week, I was like, just take care of yourself.

你懂我的意思吗？

Do you know what I mean?

就是说，你要意识到，当你打开手机的时候，AI在尽一切可能留住你。

Like, just be aware, you know, when you open your phone, that the AI is doing everything it can to retain you.

对。

Yeah.

我的意思是，别老看手机就行了。

I mean, just don't be on your phone.

我们这些年一直在说这个，但天哪，你面前全是劣势。

We've been making this argument for years, but jeez, you got every disadvantage possible coming on your way.

而且，我们都是人。

And and look, we're all human.

我记得上次我来这儿的时候，你提到过，你醒来手机就在旁边，但你未婚妻，好像一天中最糟糕的时候都不碰手机什么的。

I I think I remember last time I was here, you were talking about how, like, you wake up and your phone's right there, but your your fiance, like, doesn't touch your phone for the worst hour of the day or something.

就像一直充着电，充到中午什么的。

It's just like on the charger until noon or something.

你就会想，什么？

You're just like, what?

我更像你。

I'm more like you.

对吧？

Right?

就是我的手机在我房间里。

Where I'm like, my phone is in my room.

又不是隔了三个房间。

It's not three rooms.

我就是不用台式机。

Like, I'm just not doing a desktop.

对吧？

Right?

我们一开始就说，你现在的环境和以前完全不一样了，而且情况只会越来越糟。

And we started this entire piece by saying the environment you're in is just different than it's ever been before, and it's not getting any better.

到了某个时候，你必须做出决定：你到底在不在乎自己的健康？

And at some point, you have to make that decision of, do you care about your own health?

你在不在乎第二天因为没做好而留下的遗憾？

Do you care about the thing the next day that you didn't do well?

你更在乎的是那个，而不是下一条短视频。

And you care more about that than you cared about that next reel.

是什么让我们明明都懂你说的这些，却还是选择无视，然后拿起手机？

What is it that's causing us to understand everything you just said, but to ignore it and to pick up our phone anyway?

我们整个人类的生物本能都在驱使我们去寻找新鲜感。

You are hard driven to the entire biology of our species to search for novelty.

其实，我是从体育的角度来看这件事的。

In fact, I look at this from the lens of sports.

你为什么在乎卓越的表现？

Why do you care about high achievement?

我为什么在乎表现？

Why do I care about performance?

这有直接的联系。

There has direct translation.

当有人突破障碍时，我们所有人都从中受益。

When someone breaks a barrier, we all benefit from that.

我可以给你举几个直接的例子。

I can give you direct examples of this.

比如，你可以去看约瑟夫·坎贝尔的《英雄之旅》。

But we have every story you want to go to Joseph Campbell hero's journey.

或者回到赫拉克勒斯的故事，还有马拉松的起源。

You want to go back to Hercules, the story of the marathon.

随便从历史中挑一个故事，你实际上看到的是什么？

Like you pull any story from history out and what are you actually looking at?

你看到的是有人做了前人从未做过的事。

You're looking at somebody did something that no one has ever done before.

比起普通的输赢，你更在意纪录。

You care more about records than you do regular wins and losses.

为什么？

Why?

因为那是前所未有的。

Because they're novel.

为什么你更感兴趣看梅西打破纪录，而不是另一支球队用同样的进球赢得比赛？

Why are you more interested in watching Messi break that record than you are the other team winning in the exact same shot?

因为你亲眼看到了。

It's because you saw something.

你见证了人类历史上第一次有人做到某件事。

You got to be there when someone did something for the first time in human history.

我从新奇事物中获得更多的多巴胺刺激。

I get more of a dopamine hit from the novelty, from the new thing.

但不仅仅是多巴胺刺激。

It's more than the dopamine hit, though.

这是一种使命感。

It's a sense of purpose.

你的人生有意义，因为你参与了一件别人从未见过的事情。

Your life mattered because you got to be involved in something no one else has ever seen.

即使你只是远在3万公里外的电视旁观者，你也成为了其中的一部分。

And even as that bystander on TV 30,000 kilometers away, you got to be a part of that.

这一切都归结于我们天生就喜欢奖励新奇事物。

And that all comes down to we are so wired to reward novelty.

那么现在回到你的生活，你必须思考，如何摆脱这种核心驱动力？

So then now that comes back to your life, you have to be thinking, how do you walk away from that core drive?

我想起在学校心理学课上学到的一个研究，关于鸽子获得可变奖励的实验。

Thinking about a study I read about in psychology class in school with pigeons getting variable rewards.

对。

Mhmm.

我可能会讲得乱七八糟，但请耐心听我说。

I'm gonna butcher this, but bear with me.

他们拿了一只鸽子，给它一个小杠杆让它按。

They took a pigeon and they got a little lever for it to press.

每次它按下杠杆，有时候会得到奖励。

And every time it it would press the lever, and sometimes it would get a reward.

他们研究发现，如果奖励是随机的，

And they found from the study that if they made the rewards variable, I.

也就是说鸽子无法预测奖励什么时候来，它就更可能不停地按杠杆。

E, it couldn't predict when it was coming, the pigeon was more likely to keep pressing the lever.

也就是说，

I.

如果它不知道什么时候会有多巴胺刺激或者食物奖励，它对这种行为就更上瘾。

E, it was more addicted to the behavior if it didn't know when the dopamine hit was coming or the the treat in that case.

刷社交媒体有点像老虎机那样，奖励是随机的。

Scrolling on social media is kinda like the slot machine of variable rewards.

我就是不知道接下来会看到什么。

I just don't know what I'm gonna get.

但每四次，你懂的，滑动一次，我就能看到点东西，或者每四十次。

But every fourth, you know, scroll, I get something that Or every fortieth.

对。

Yeah.

或者每四十次。

Or fortieth.

那更好了。

Even better.

对吧？

Right?

因为越不可预测，你就越容易觉得，再来一次，再来一次，再来一次，再来一次。

Because the more unpredictable it is, more likely you are to be like, one more, one more, one more, one more.

对吧？

Right?

比如，如果来得太快，你反而没那么在意了。

Like, if it actually comes too quickly, you care less.