Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
Yogurt That's Not Yogurt: My Accidental Sleep Cure
I’ve personally struggled with insomnia for years, unable to sleep more than a few hours at a time, experiencing frequent awakenings, sometimes awakening at 3 or 4 in the morning and unable to get back to sleep. And I tried almost everything short of prescription sedatives: tryptophan, 5-HTP, megadose melatonin, GABA, theanine, the antihistamine diphenhydramine, self-hypnosis, YouTube videos that claim to help you sleep within minutes. The few that worked left me feeling drugged the next day and, if they did not work, I was often left irritable and fatigued.
All this changed when I began experimenting with microbiome strategies. It’s become clear that the gut microbiome plays a major role in determining the quality, length, and content of your sleep. An outsized role is played, however, by the phenomenon of endotoxemia, the entry of bacterial breakdown products into the bloodstream and that is the topic I’d like to focus on in this episode of the Defiant Health podcast. The experience is so preliminary that it has not yet been validated in clinical studies. But if the solution is as easy, inexpensive, and accessible as something that looks and smells like yogurt (it’s NOT yogurt, of course), then why not give it a try? You may be among the roughly 50% of people who experience dramatic improvements in the duration and quality of your sleep.
YouTube channel: https://www.youtube.com/@WilliamDavisMD
Blog: WilliamDavisMD.com
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Books:
Super Gut: The 4-Week Plan to Reprogram Your Microbiome, Restore Health, and Lose Weight
I have personally struggled with insomnia for years, unable to sleep more than a few hours at a time, experiencing frequent awakenings, sometimes awakening at 3 or 4 in the morning and unable to get back to sleep. And I tried almost everything short of prescription sedatives, tryptophan, 5-htp, megadose, melatonin, gaba, theanine, the antihistamine diphenhydramine, self-hypnosis, youtube videos that claim to help you sleep within minutes. The few that worked left me feeling drugged the next day, and if they didn't work, I was often left irritable and fatigued. All this changed when I began experimenting with microbiome strategies. It's become clear that the gut microbiome plays a major role in determining the quality, length and content of your sleep. An outsized role is played, however, by the phenomenon of endotoxemia, the entry of bacterial breakdown products into the bloodstream, and that is the topic I'd like to discuss on this episode of the Defiant Health Podcast. The experience is preliminary in that it has not yet been fully validated in clinical studies in clinical studies, but if the solution is as easy, inexpensive and accessible as something that looks and smells like yogurt it's not yogurt, of course then why not give it a try? You may be among the roughly 50% of people who experience dramatic improvements in the duration and quality of your sleep.
William Davis, MD:Over the last several years, we've learned a lot of new lessons on the relationship of the gut microbiome and sleep. We'll recall that, of course, sleep is a brain function that determines whether you get sleepy at the appropriate time, whether your brain will proceed through the expected four phases of non-REM and REM sleep, whether you'll sleep a full night or be interrupted by frequent awakenings, whether you'll wake at an inappropriate time, like 3 am, and not be able to fall back asleep and dream content, of course, and so it's clear that, while the brain is in the primary control of sleep phases and sleep content and duration, it's the gastrointestinal microbiome that has a heavy and profound influence over the brain and its capacity to conduct sleep. One of the lessons we've learned, for instance and this has never even been borne out in any human clinical study, we've learned it by anecdote and experience is that when we ferment microbes like Lactobacillus roteri or Lactobacillus casei the Shirota strain that you can obtain as the Yakult product, perhaps Lactobacillus fermentum and perhaps Bacillus subtilis these are microbes that a lot of us who are making these yogurts and using my method of prolonged fermentation typically 36 hours at human body temperature we get these huge counts of microbes, typically in the hundreds of billions, and many of us not all of us, but many of us experience deep, profound sleep. Now, that was important for me personally, because for decades I've been a chronic insomniac. I think it was made worse by medical education and training where you were forced to stay up all night many times, sometimes several times a week, or your sleep came in fits and starts, where you're allowed to sleep maybe an hour or two and then have to go back to the emergency room or back to the floors resuscitate somebody. That's what much of my life was like, and while maybe I started with some bad sleep habits to begin with, it was made far worse by 30 years of disrupted sleep in training and in practice. So I start this process with the yogurt. It's not yogurt, of course right, it looks and smells like yogurt. It's a fermented dairy. Product or other fermented food Doesn't have to be dairy, of course. Product or other fermented food Doesn't have to be dairy, of course. But we consume it, and I personally was converted from a chronic insomniac, sleeping in fits and starts, frequent awakenings, having difficulty sleeping more than a few hours, to long, deep sleep, often seven and a half, eight hours, filled with vivid dreams.
William Davis, MD:Now a lot of us I have not done this, but a lot of my followers have they wear these so-called actigraphic devices. These are things like the Aura Ring or Fitbit or Apple Watch that record sleep phases. Now they're indirect measurements of sleep phases. In other words, the true measurement of sleep phases requires multiple EEG electrodes on the brain, right on the head, and that's how you identify all the various phases of sleep. These actigraphic devices worn on the wrist or finger right, like the ring, don't directly measure EEG phases of sleep. They measure it indirectly using algorithms that incorporate indirect measures like heart rate, changes in heart rate variation, heart rate variability, respiratory patterns, movement, temperature, and they extrapolate to EEG sleep phases. Now I've asked some of these companies for their algorithms. They won't share them because they're proprietary, but the existing evidence suggests that, even though they're indirect, these actigraphic devices in general it's hard to speak for each and every device because the algorithms used are different 80 to 90 percent accurate, that is. If you compare duration of sleep phases using one of these actigraphic devices against a formal EEG test, you see about 80 to 90 percent correspondence.
William Davis, MD:So they're pretty good and one of the things that my followers have been telling me when they restore these microbes, but especially lactobacillus roteri, is a lengthening of REM sleep, often on the order of about 25%, which is really interesting. I'd like to see that formally documented. I don't know if we have the funding or time to do that form of clinical study, but if true, it potentially means extended REM, means better mental health. It means better, deeper sleep, more restorative sleep, because it's REM where a lot of consolidative memory, a lot of other psychologically advantageous phenomena occur. So it could potentially be a really interesting thing to formally document. But in the meantime you don't have to have it formally documented. You can measure it yourself or you can just enjoy the benefits of having better sleep. That may include extended REM periods.
William Davis, MD:But all that said, one of the great lessons to learn about sleep is the influence, the outsized and important and profound influence of endotoxemia. Now, if you've been following my conversations, you recognize what that means, but if you've not, if you're new to this conversation, I invite you to review my many other YouTube channel videos or my Defiant Health podcast and my thousands of blog posts on my williamdavismdcom blog or, of course, my books, most recently the Super Gut book. So endotoxemia is a situation where Bacterial byproducts break down and are released into the intestines and then absorbed into the bloodstream. So the primary toxic compound released is endotoxin, lipopolysaccharide, endotoxin. This is a component of the cell walls of mostly fecal microbes, proteobacteria. These are species that may sound familiar, like E coli and salmonella, campylobacter, pseudomonas, also causes of infections, but they reside they're supposed to reside in your colon where they can be happy and quiet and don't bother you until something happens like you take an antibiotic and an antibiotic kills off numerous beneficial or we say commensal species that were keeping those fecal proteobacteria at bay, keeping them suppressed and present at limited numbers. When you lose those suppressive, beneficial bacteria, those fecal microbes over-proliferate and, even more remarkably, come to ascend into 24 feet of small intestine.
William Davis, MD:The small intestine is very poorly equipped to deal with a flood of fecal microbial species. They are themselves inflammatory. They inflame the small intestinal wall. Small intestine is permeable to begin with because that's where you're supposed to absorb all the nutrients from your diet, like amino acids and fatty acids, vitamins and minerals. So the already permeable small intestine is made more permeable by the release of these endotoxins and the presence of these fecal microbes in the small intestine. That means you have an open door to the release of those endotoxins, the lipopolysaccharide endotoxin, and you have a flood of lipopolysaccharide endotoxin entering the bloodstream, first into the portal venous circulation that drains to the liver and then into the systemic circulation where they obtain access to your brain and thereby can exert effects on sleep. So there is emerging evidence to tell us that people who have colonic dysbiosis, disrupted microbiome composition confined to the colon, but even more so SIBO, small intestinal bacterial overgrowth where those fecal microbes have invaded and colonized the small intestine, very permeable small intestine.
William Davis, MD:That flood of endotoxemia has major effects on sleep, disrupting sleep, causing insomnia, causing fragmented sleep, causing early awakenings, abbreviating sleep, making you restless. So endotoxemia a major player. Another factor is the vagus nerve. So when you have colonic dysbiosis, and more so with SIBO, you also send disordered signals via the vagus nerve. Now this is combined if you lost lactobacillus reuteri, for instance, a major player in vagal signaling to the brain, made worse now by endotoxin and SIBO, we send disordered signals to the vagus nerve. That also adds to sleep disruption Because it's the vagus nerve that's responsible for the parasympathetic or relaxation response If you have factors like SIBO and endotoxemia and loss of rotary causing a reduction in the relaxation response mediated by the vagal nerve and an activation of the sympathetic fight or flight response.
William Davis, MD:That is also disruptive over sleep. You know we see this play out in many situations that is also disruptive over sleep. We see this play out in many situations that is disrupted gastrointestinal microbiome, colon, small intestine, endotoxemia, loss of keystone microbes that mediate vagal nerve tone. We see this in people, for instance, with irritable bowel syndrome. Even though it's an issue that is unique to the bowels, it frequently is associated with major sleep disruption. Likewise, fibromyalgia, muscle aches, joint aches and pains. We also know that people with fibromyalgia also have a high level of endotoxemia and disrupted sleep. There's one very interesting study performed by Dr Mark Pimentel at UCLA in Los Angeles. He's done a lot of the basic work on SIBO very good work and he showed in one study, for instance, that people with IBS irritable bowel syndrome who are tested for the presence of SIBO using hydrogen gas detection as a mapping device, he showed that 84% in his study of people with irritable bowel syndrome test positive for SIBO. Even more remarkably, in the people who had fibromyalgia, 100% tested positive for SIBO and tested positive to a severe degree. And all these people have disruptions of sleep.
William Davis, MD:We also know that a lot of depression is driven by endotoxemia. There are some very interesting studies being generated, mostly out of Germany, where they've taken very oddly they've taken lipopolysaccharide endotoxin purified and isolated from bacteria and then injected it into normal non-depressed volunteers. Which is kind of iffy because if you miscalculate even by a little bit we're talking about millions of a gram kind of dosing If you miscalculate by a little bit, you actually hurt somebody really bad, maybe even kill them. Nonetheless, this study has been done several times where they inject normal non-depressed people with lipopolysaccharide endotoxin to mimic the situation of endotoxemia that occurs with SIBO and colonic dysbiosis and these normal non-depressed people become depressed, clinically depressed, within about three hours. Mri scans of the brain show all the hallmarks of depression.
William Davis, MD:So the science is evolving but pointing towards this idea that a disrupted gastrointestinal microbiome, but specifically SIBO and endotoxemia, can be major drivers not just of fibromyalgia or irritable bowel syndrome or other conditions, but also insomnia, other forms of sleep disruption. You can appreciate that. Giving you a sedative or telling you to do things like count sheep or take deep breaths, that may be helpful. But if you don't address the gastrointestinal microbiome, especially seabone endotoxemia, you're destined to have only limited success. In other words, you can do all those things, you can use all those sleep aids, even take melatonin or other sleep aids, but if you don't address the disrupted gastrointestinal microbiome, not only will you have only partial success at best, if any success at all, in managing sleep, but you're going to have other health problems. For instance, the consequence, the long-term consequences of unaddressed, uncorrected SIBO can include weight gain, abdominal fat expansion, higher blood sugars, type 2 diabetes, hypertension, depression, anxiety, cognitive impairment, depression, anxiety, cognitive impairment, parkinson's disease, rosacea, psoriasis, go way down the line, almost all the modern common chronic diseases of humans.
William Davis, MD:No-transcript process. So we address the microbiome. How do we do that? Well, my way of doing it is to restore some of the lost microbes, but specifically microbes that we know colonize both the small intestine and the colon, because that's where all this occurs, right, both small intestine and colon and choose microbes that produce bacteriocins, natural peptide antibiotics effective in killing those fecal microbes, as well as some of the other species of SIBO and colonic dysbiosis. That are species like Staphylococcus, streptococcus, enterococcus. So we're going to choose microbes that colonize the small intestine, produce bacteriocins and also are able to survive the rigors, the demands, the toxicity of stomach acid and bile acid. So I choose three. I choose a strain of lactobacillus roteri, a strain of lactobacillus gasseri, and my most recent recipe has substituted bacillus coagulans for bacillus subtilis only because we found that the coagulans was not that reliable in generating high numbers. We want high numbers to overcome the invading fecal microbes, so I switched out the bacillus coagulans Still a very interesting microbe, by the way for other reasons, for bacillus subtilis.
William Davis, MD:Subtilis is easy to ferment. You can ferment it in sure. It's 24 hours rather than 36 hours. You can also ferment a little lower temperature, like 90 to 95 degrees fahrenheit, and it's also a great producer of bactericins. It's a huge producer of bactericins. Put all those three together.
William Davis, MD:I call it SIBO yogurt. It's not yogurt, of course, has nothing to do with the stuff in the store, it's completely different. It just happens to look and smell like yogurt and the process of making it is similar Not identical, but similar. We're going to use prolonged fermentation. Lactobacillus roteri, for instance, doubles every three hours at human body temperature. So we're going to ferment it for 36 hours. 12 doublings at human body temperature hours, 12 doublings at human body temperature, around 100 degrees Fahrenheit, 37 degrees Celsius, and if we ferment Roteri.
William Davis, MD:By itself we get something like 300 billion microbes per half cup or 120 milliliters serving. You have a choice Ferment each microbe individually. That's how you get the biggest numbers of all. And if you really want a wallop of an effect, that's how you do it. Or you can co-ferment all three. You won't get as high a number, so it's not quite as potent, but it still has worked for many people Probably want to start from scratch every several batches only because one thing we don't know is when you co-ferment those three microbes, what's the relative shift in numbers over time as you make subsequent batches?
William Davis, MD:So if you get to I don't know fifth batch or so, start from scratch. We have not yet performed the DNA sequencing required to tell us what's the composition, say, at the fifth batch, what percentage is rotary, what percentage is gas right? What percentage is bacillus subtilis? We don't know. Someday down the road we'll do that, but right now, because we don't know, start from scratch. Another way to do this is to make your first batch with all three co-ferment and reserve some of that first batch and make subsequent batches, not from some of a prior batch but from the original batch. That way you more or less preserve the third, third, third that we presume to be the composition of the SIBO yogurt. But no, you have an exceptionally wonderful, accessible thing you can do. You can make in the comfort of your kitchen, easily, safely, inexpensively. That has the potential to push back all those sources of endotoxemia, as well as restoring some of the microbes that may contribute to sleep.
