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Episode
Ask Me Anything Part 25: Sleep Talking, Long Covid, CBD/CBN, and Bedroom Environment
~43 min
Episode Brief·YouTube

Ask Me Anything Part 25: Sleep Talking, Long Covid, CBD/CBN, and Bedroom Environment

Matthew Walker
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TL;DR

The four things you'd lose by not watching

4 items

TL;DR

The four things you'd lose by not watching

4 items
1

Sleep talking is common and mostly benign, often occurring during light non-REM sleep, and rarely reveals true secrets. However, violent thrashing with sleep talking could indicate REM sleep behavioral disorder, which requires medical attention.

2

Long COVID can cause significant sleep disruption, including fragmented sleep and altered REM sleep, persisting for months. Cognitive Behavioral Therapy for Insomnia (CBT-I) and potentially low-dose Trazodone are current treatment considerations, though more large-scale trials are needed.

3

While CBD and CBN are marketed as sleep aids, current evidence suggests limited, often small, benefits, and a risk of tolerance development with increasing doses. Good sleep hygiene and CBT-I are considered more effective for sleep improvement.

4

Optimizing bedroom environment for sleep involves maintaining a temperature of 67-68°F (18.5°C), ensuring good air quality (CO2 below 1000 ppm), and humidity between 40-60%. Sound levels below 30 dB are ideal, and white/pink noise can help mask disruptive sounds.

Protocols

Concrete recipes — what, when, how much, and why

8 items

Addressing Sleep Talking Concerns

WhatEvaluate if sleep talking is causing daytime distress or disrupting sleep. If it's benign and not causing issues, no treatment is needed. If accompanied by violent movements, seek medical attention.
For whomIndividuals experiencing sleep talking, especially those with associated violent movements.
WhySleep talking is largely benign, but violent thrashing could indicate REM sleep behavioral disorder, a serious parasomnia with neurological consequences.
CaveatsFactors like stress, fever, sleep deprivation, and alcohol can increase sleep talking. Certain blood pressure medications might also play a role.

If it's not troubling you or it's not causing you daytime distress, it's not disrupting your sleep where you feel sleepy during the day, you don't have to worry about it. It's largely benign.

Managing Sleep Disruptions in Long COVID

WhatConsider Cognitive Behavioral Therapy for Insomnia (CBT-I) protocols. Low-dose melatonin or Trazodone may be prescribed in some cases, but consult a medical provider.
For whomIndividuals experiencing sleep disruptions due to Long COVID.
WhyLong COVID causes significant and prolonged sleep fragmentation and altered REM sleep. CBT-I is a well-established treatment for insomnia, and Trazodone has shown anecdotal effectiveness in case reports.
CaveatsThese are current considerations, not definitive treatments, as large-scale randomized trials are still needed. Always consult a medical professional for prescriptive advice.

Stanford has come out with some cognitive behavioral therapy for insomnia protocols for long COVID. But overall, I don't know of many really effective management techniques above and beyond cognitive behavioral therapy.

Optimizing Bedroom Temperature for Sleep

WhatSet bedroom temperature to approximately 67-68°F (18.5°C). For individuals 65 years or older, consider a slightly warmer temperature around 70°F.
For whomEveryone, with a specific adjustment for older adults.
WhyOptimal ambient temperature is crucial for thermoregulation during sleep. Older individuals may need a warmer room due to poorer thermoregulation.

Setting your bedroom to the ambient of around about 67 68° or about around 18 1.5° C rather than the Fahrenheit that I just gave you is probably optimal for sleep.

Improving Indoor Air Quality for Sleep

WhatEnsure good ventilation in the bedroom to keep carbon dioxide (CO2) levels below 1000 parts per million (ppm).
For whomEveryone.
WhyCO2 levels above 1000 ppm significantly impair sleep quality and lead to next-day cognitive dysfunction.

Carbon dioxide levels above 1,000 parts per million significantly impaired sleep quality. And that impaired sleep quality also led to cognitive dysfunction the next day.

Maintaining Optimal Bedroom Humidity

WhatKeep bedroom humidity between 40% and 60%.
For whomEveryone.
WhyDry air can irritate respiratory airways, leading to scratchy throat, congestion, and nosebleeds, which disrupt sleep.

Optimal ranges for humidity in a bedroom probably somewhere between about 40 to 60%. If your air gets too dry, your airway gets too dry. When your airway gets too dry, it disrupts your sleep because it wakes you up with a scratchy throat.

Choosing a Sleep-Supportive Mattress

WhatOpt for a medium to firm mattress, preferably made from natural materials like cotton and wool. Replace mattresses older than 7 years.
For whomEveryone.
WhyMedium-firm mattresses provide optimal support, and natural materials regulate temperature better. Older mattresses lose support, leading to discomfort and spinal issues.

Looking at the data, medium to firm is generally the best advice for most people. Natural materials like cotton and wool will regulate temperature better than synthetic materials.

Controlling Bedroom Sound for Sleep

WhatAim for ambient noise levels below 30 dB. Use white noise or pink noise machines to mask disruptive sounds in noisy environments.
For whomEveryone, especially those in noisy urban settings.
WhyExcessive noise is a pernicious disruptor of sleep. White and pink noise can effectively combat external sounds by providing a consistent, masking background.

What we know is that if you have an ambient noise that is below about 30 dB... is generally acceptable for good sleep. If you're in a noisy inner city environment, white noise or pink noise can effectively mask or help disrupt or combat those sounds.

Prioritizing Sleep Consistency

WhatGo to bed and wake up at the same time every day, including weekends.
For whomEveryone seeking to improve their sleep.
WhySleep consistency (regularity) is the most impactful behavioral and environmental trigger for improving sleep, even more so than optimizing other environmental factors.

If you wanted one suggestion to try to course correct your sleep above and beyond those things, I would say the behavioral environmental trigger of consistency, of regularity will do you a greater service.

What's new

Personal practice updates, fresh positions, predictions

4 items

Sleep Talking (Somniloquy) Neuroscience and Implications

0:01:30

Sleep talking is remarkably common and generally benign, occurring in 60-70% of the population at some point. It's more prevalent in children and decreases with age. It primarily happens during lighter non-REM sleep stages, with content often mundane and fragmented, contrary to popular belief that it reveals deep secrets.

Why this matters: Challenges common misconceptions about sleep talking revealing secrets and provides a detailed neurological explanation for its occurrence and differentiation from more serious parasomnias.

Sleep talking, or somniloquy, is a parasomnia, a disorder occurring in or around sleep. It is the most common parasomnia, affecting a significant majority of people at some point in their lives, particularly children, with prevalence decreasing in adulthood. The content of sleep talking varies depending on the sleep stage. During REM sleep, speech tends to be more emotional and narrative, often recounting dream experiences. However, during non-REM sleep, especially Stage 2, sleep talking is typically mundane, fragmented, and incoherent, consisting of a few words that don't make much sense. The speaker emphasizes that sleep talking rarely reveals true secrets or thoughts reliably, debunking a common Hollywood trope.

Contrary to popular belief, sleep talking rarely reveals true secrets or thoughts about anyone reliably. If you think that someone is confessing crimes or hidden affairs during their sleep-talking events, you're markedly misguided.

Also said
“Probably about 60 to 70% of the population will be sleep talkers at some point in their lives.”— Highlights the high prevalence of sleep talking.
“The content during REM sleep is usually much more emotional and narrative. So people might recount speaking out their dream experiences. Whilst when you get sleep talking out of nonREM sleep, the way that you know your partner is talking out of being in nonREM sleep is because they tend to be really mundane and just fragmented.”— Explains the difference in content based on sleep stage.

Long COVID and Sleep Disruptions

0:13:30

Long COVID is associated with significantly higher rates of sleep disturbance (1 in 2 people) compared to the general population (1 in 10). These disruptions, including fragmented sleep and altered REM sleep, can persist for 3-4 months post-infection and correlate with cognitive impairment and increased inflammatory markers.

Why this matters: Highlights the specific and prolonged impact of Long COVID on sleep, differentiating it from typical insomnia and linking it to broader health markers.

Sleep disturbance is a common and persistent symptom of Long COVID, affecting approximately 50% of individuals, a rate significantly higher than in the general population. These sleep issues can last for several months after the initial infection, though there appears to be a remission curve over time. Studies on Long COVID patients in sleep laboratories reveal fragmented sleep, increased time awake at night, and reduced sleep efficiency. Additionally, REM sleep quality and timing within the sleep cycle may be altered. There's also a higher prevalence of breathing-related sleep disorders, particularly central sleep apnea, in Long COVID patients, likely due to respiratory physiology disruptions rather than airway collapse. The severity of sleep disruption in Long COVID correlates with cognitive impairment and elevated inflammatory markers like interleukin-6 and C-reactive protein.

Sleep disturbance is common in about one out of every two people with long COVID, which is much higher than the average one out of 10 people who don't have long CO. So, it's markedly higher. There's something going on with long CO that causes sleep disturbance.

Also said
“What's interesting is that that sleep disturbance can persist for 3 or 4 months after the initial infection.”— Emphasizes the prolonged nature of sleep issues in Long COVID.
“The greater the severity of their sleep disruption caused by long COVID, the greater the cognitive impairment and the greater the degree of inflammatory markers in their body particularly things like interalucan 6 which is a pro-inflammatory cytoine as well as C reactive protein.”— Connects sleep disruption in Long COVID to cognitive and inflammatory outcomes.

Efficacy of CBD and CBN for Sleep

0:20:00

Despite widespread marketing, the scientific evidence for CBD and CBN as effective sleep aids is nuanced and often limited. While some studies suggest minor benefits for CBN (50-100mg) in reducing nighttime awakenings, the overall effect on sleep quality is small, and there's no clear additive benefit when combined with CBD. Long-term use of cannabinoids for sleep shows a significant risk of tolerance and dose escalation.

Why this matters: Provides a critical, evidence-based perspective on popular cannabinoid sleep aids, contrasting marketing claims with scientific findings and highlighting potential downsides like tolerance.

The speaker addresses the growing market of CBD and CBN products for sleep, noting that the scientific evidence is far less conclusive than marketing suggests. Early reviews of CBN (cannabinol) found insufficient evidence, with most supporting studies being small and outdated, lacking clinical trials with validated sleep measures. More recent rigorous placebo-controlled trials for CBN (e.g., 20mg) showed a reduction in nighttime awakenings and sleep disturbance severity, but the overall effect on sleep quality was small. Interestingly, adding CBD to CBN offered no additional benefit. Dose-response studies for CBN (25-100mg) showed improved sleep quality relative to placebo, but no significant difference compared to melatonin, which itself has mixed evidence for efficacy. For CBD, a 2024 study found subjective sleep improvement in 50-75% of users, but again, adding CBN didn't enhance these effects. A systematic review of medical cannabis (including THC, CBD, CBN) found no robust long-term benefits for sleep problems. A UK registry study showed initial dramatic improvements in sleep and anxiety with cannabis use, but by 18 months, most benefits were lost, while THC and CBD doses had increased by 500% and 900% respectively, indicating rapid tolerance development. The speaker concludes that while higher doses of CBN (50-100mg) might offer some specific, small benefits, it's not a 'magic bullet' and tolerance is a significant concern. He advises prioritizing good sleep hygiene and CBT-I over cannabinoids.

The answer is much more nuanced than the marketing would have you believe. Well, let me break it down. Let's start with CBN. canabonol. There was probably the best review back in 2020 or 2021... they found that quite a startling conclusion. If you looked at all of the studies, there is basically insufficient evidence that supports any benefit of CBN.

Also said
“The overall effect on sleep quality was pretty small. And I'm not sure if you look at it, you would say it's really that meaningful.”— Qualifies the observed benefits of CBN as minor.
“By month 18, their THC dose had increased by 500%. And their CBD dose had increased by 900%. So in other words, they were chasing the benefit that was gradually declining over time despite their dose increasing.”— Illustrates the significant problem of tolerance and dose escalation with long-term cannabinoid use for sleep.
“If anything, you're probably much better off sticking to good sleep hygiene and cognitive behavioral therapy because if you're looking to CBN or CBD as your salvation, you're probably stepping over dollars to pick up pennies when it comes to your sleep benefit relative to those other things.”— Strongly recommends prioritizing established sleep interventions over cannabinoids.

Bedroom Environment Factors Beyond Temperature

0:30:00

Beyond optimal temperature (67-68°F), air quality (CO2 below 1000 ppm), humidity (40-60%), and mattress quality (medium-firm, natural materials) are crucial for sleep. While EMF effects are largely unproven at household levels, phone use in bed disrupts sleep psychologically. Sound levels below 30 dB are ideal, with white/pink noise useful for masking.

Why this matters: Expands on lesser-known but impactful environmental factors for sleep, providing specific metrics and debunking some common concerns like EMFs.

While temperature is a well-known factor for optimal sleep (ideally 67-68°F or 18.5°C, slightly warmer for older adults), several other environmental elements significantly impact sleep quality. Air quality is critical; CO2 levels above 1000 parts per million have been shown to impair sleep and next-day cognitive function. Good ventilation is a simple way to improve CO2 clearance. Humidity between 40-60% is optimal, as overly dry air can irritate airways, leading to discomfort and sleep disruption. Volatile organic compounds (VOCs) from furniture or paint have some correlational evidence with poor sleep, but robust studies are lacking. Mattress quality is important, with medium-to-firm mattresses generally recommended, and natural materials like cotton and wool offering better temperature regulation than synthetics. Mattresses older than 7 years are often associated with poorer sleep due to deterioration. The impact of electromagnetic fields (EMFs) from devices like mobile phones on sleep at typical household levels is not supported by robust evidence; however, phone use in bed significantly disrupts sleep due to psychological factors like doom-scrolling and FOMO. Finally, sound is a major disruptor; ambient noise should ideally be below 30 dB. White or pink noise can be effective for masking disruptive sounds in noisy environments. The speaker emphasizes that while these factors are important, sleep consistency (regular bed and wake times) remains the most impactful behavioral intervention.

Air quality is more important than most people realize. There was a great study in 2016 and they found that carbon dioxide levels above 1,000 parts per million significantly impaired sleep quality. And that impaired sleep quality also led to cognitive dysfunction the next day.

Also said
“Optimal ranges for humidity in a bedroom probably somewhere between about 40 to 60%. If your air gets too dry, your airway gets too dry. When your airway gets too dry, it disrupts your sleep because it wakes you up with a scratchy throat.”— Explains the mechanism by which humidity affects sleep.
“The evidence for EMF effects on sleep at least typical household levels are very limited. There is no really good robust data that for example mobile phones near your bed disrupt your sleep through EMF. They don't. But they do disrupt your sleep through the psychological effect of being there and the doom scrolling and the bed rotting and the sleep procrastination that they produce.”— Clarifies the actual mechanism of phone-related sleep disruption, distinguishing it from EMF concerns.
“If you wanted one suggestion to try to course correct your sleep above and beyond those things, I would say the behavioral environmental trigger of consistency, of regularity will do you a greater service.”— Prioritizes sleep consistency as the most impactful intervention.

Recommendations

Products, supplements, and tools mentioned in the episode

1 item

Using Lavender Scent for Sleep

Practice

Incorporating lavender scent into the bedroom environment.

The speaker mentions that the National Sleep Foundation's annual poll on sleep in the bedroom found that fresh-smelling scents, particularly lavender, subjectively improved people's sleep quality the most. He explains that the olfactory system has a 'quiescent effect' on the nervous system. Manipulating the olfactory environment with calming smells like lavender can quiet the nervous system, which in turn positively influences sleep. This is why many products like lavender drops and pillow sprays are popular.

I read a few studies showing that odors can have a nice relaxing effect. So having maybe a lavender smell in your bedroom has been shown to increase sleep quality.

Also said
“It does seem to be that the alactory system has a quuscent effect on our nervous system. And when our nervous system is quieted by calming smells through the alactory system... you can manipulate your nervous system. And when you manipulate your nervous system, you manipulate sleep.”— Explains the physiological mechanism by which scent influences sleep.
Find Using
Disclosed sponsorships3speaker disclosed

AG1 (Athletic Greens)

Supplement Sponsored · disclosed

A daily nutritional supplement for overall health, now with an upgraded 'NextG' formulation.

DisclosurePartner of today's episode. Speaker buys it himself.

The speaker, Matthew Walker, has been using AG1 for over four years and purchases it himself, emphasizing his personal commitment to the product. He highlights the new 'NextG' formulation which includes upgraded probiotics and additional vitamins and minerals. He appreciates AG1's commitment to scientific rigor, noting their four human clinical trials that demonstrated a marked boost in healthy gut bacteria. This continuous adaptation to new scientific findings and formula improvements keeps AG1 at the cutting edge. He values companies that subject their products to clinical trials.

AG1 has just released the new formulation, which is AG1 NextG. It's still one scoop once a day, but now comes with many upgraded probiotics, plus additional vitamins and minerals. I also explored their four human clinical trials to prove out their efficacy with the data showing a marked boost in healthy gut bacteria.

Also said
“Any company that holds their scientific rigor to the flames of clinical trials means a lot to me.”— Explains the speaker's trust in the product due to its scientific backing.
Find AG1

Caraway Cookware

Product Sponsored · disclosed

Non-toxic, ceramic-coated cookware designed for easy cooking and cleanup.

DisclosurePartner of today's podcast.

The speaker, who admits to being a poor cook, praises Caraway cookware for its naturally non-stick ceramic coating, which prevents food from sticking and makes cleanup very easy (90 seconds with warm water). He particularly values the non-toxic, third-party tested ceramic coating, which is free of 'forever chemicals.' He notes that the product has over 100,000 five-star ratings, indicating widespread satisfaction. Caraway has also expanded its product line to include a kitchen timer and Bakeware Plus collection, which the speaker uses to enhance his kitchen's appearance.

Carowway's ceramic coating is so naturally non-stick that I cannot burn a single thing. It's remarkable. Eggs slide off rather than welding themselves permanently to the pan. And cleanup takes just 90 seconds because of that non-stick material.

Also said
“Also, the non-toxic ceramic coating matters a great deal to me. It is third party tested and it has no forever chemicals. That really is essential.”— Highlights a key health and safety benefit of the product.
Find Caraway

David Protein Bars

Product Sponsored · disclosed

Protein bars with a high protein-to-calorie ratio and zero sugar.

DisclosurePartner of today's episode.

The speaker, who consumes many protein bars, highly recommends David Protein Bars for their exceptional nutritional profile: 28g of protein, 150 calories, and zero sugar, which he states is the best protein-to-calorie ratio he has encountered. He emphasizes that protein is crucial not just for muscle but also for metabolic health and satiety, making these bars particularly effective for keeping one full. He notes the high demand for the product, with the full flavor lineup often sold out on their website, suggesting their popularity and quality.

Each bar delivers 28 g of protein, just 150 calories, and zero sugar. That's the best protein to calorie ratio I've seen. And the taste is legitimately good.

Also said
“Protein isn't just about muscle. It's essential for metabolic health and for keeping you full. And David's unique ratio makes these the most satiating bars out there.”— Explains the broader health benefits and unique selling point of the bars.
Find David

Notable quotes

Lines worth pulling out — contrarian, specific, or perfectly phrased

6 items
Hollywood loves this type of stuff that you utter out your deepest, darkest, guiltiest secrets in a muttering of somniloquy. But no, the PIN code to the safe.
Humorously debunks the common misconception that sleep talking reveals deep secrets, contrasting it with Hollywood portrayals.
We are giving scientifically descriptive advice, not medically prescriptive advice here.
Clearly defines the scope and limitations of the advice provided in the podcast, emphasizing it's for informational purposes, not medical treatment.
If you're looking to CBN or CBD as your salvation, you're probably stepping over dollars to pick up pennies when it comes to your sleep benefit relative to those other things.
A strong, metaphorical statement underscoring the speaker's skepticism about the efficacy of CBD/CBN compared to established sleep interventions.
I cannot cook an egg without creating a carbon-based archaeological artifact.
A self-deprecating and humorous admission of poor cooking skills, making the subsequent endorsement of Caraway cookware more impactful.
Just because there isn't evidence doesn't mean that there isn't an effect but the evidence for EMF effects on sleep at least typical household levels are very limited.
A nuanced and scientifically cautious statement regarding the lack of evidence for EMF effects, acknowledging the possibility while stating current data limitations.
It's almost as though what we believe happens is that you get this burst of autonomic activity from the nervous system and it rockets you from deep sleep in the basement and you try to get to the penthouse of wakefulness, but with these parasomnia events, you get stuck on the 13th floor.
A vivid and memorable analogy explaining the mixed state of consciousness during parasomnia events like sleepwalking and sleep talking.

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Topics covered

sleep talkingsomniloquyparasomniasnon-rem sleeprem sleepsleep disordersrem sleep behavioral disorderlong covidsleep disruptionsinsomniacbt-itrazodonecbdcbncannabinoidssleep aidstolerancesleep hygienebedroom environmenttemperature
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