Why can't you sleep? Dr. Jerome Puryear, MD, an obesity medicine physician who diagnosed his own sleep apnea, explains what is actually going wrong at night and how to fix it no matter what shift you work. Dr. Jerome Puryear, MD, Dipl. ABOM, is an obesity medicine physician and interventional radiologist who spent years surviving night call before a doctor told him he was overweight and pre-diabetic. A sleep physician made the diagnosis he had missed in himself: obstructive sleep apnea. He went on to add board certification in health and wellness coaching, found the Puryear Wellness Institute, and write Sleep Deprivation: A Doctor's Guide to Why You Can't Sleep and How to Get Better Sleep. On this episode of Dialed In Health, host Melissa Goodwin asks him the questions you would ask if you were sitting across from him. In this episode When a sleep problem is worth seeing someone about: three or four bad nights a week, for two or three weeks straight. Seven to nine hours is the recommendation, but duration is only half of it. Waking up exhausted after nine hours means quality is the problem. What a microsleep is, and the 18 wheeler crash he watched happen three miles from a rest area. The most dangerous window to be on the road when you are short on sleep. Insomnia versus sleep apnea, in language you can actually use at an appointment. Why alcohol before bed shortens the time it takes to fall asleep and then fragments the whole night. The caffeine sources nobody counts, including decaf. What sleep trackers can and cannot tell you, and the one metric he trusts more. Straight answers on melatonin, prescription sleep medication, CBD, and THC. How shift workers build an intentional sleep plan instead of accepting bad sleep as part of the job. How sleep loss drives hunger through ghrelin and leptin, and how that connects to weight. The idea of drifting, and the question he asks people who keep putting their health last. Questions answered in this episode How many hours of sleep do I actually need? Seven to nine for the average adult, though it varies with age and illness. If you sleep nine and still wake up exhausted, the problem is quality, not hours. What is the difference between insomnia and sleep apnea? Sleep apnea is airway collapse. Breathing stops, oxygen to the brain drops, and snoring with gasping is the warning sign. Insomnia is not being able to fall asleep or stay asleep. When should I see a doctor about my sleep? When bad nights happen three or four times a week for two or three weeks straight. Bring a sleep diary. If you get brushed off and you think it is serious, ask for a specialist. Does alcohol before bed help you sleep? No. It sedates you so onset improves, then fragments the rest of the night so the deep restorative sleep never arrives. How do you sleep well if you work night shift? Bright light while you need to be awake, blackout when you sleep, noise and doorbells handled, and meals on a schedule instead of eating through the night to stay awake. Do CBD or THC actually help you sleep? THC can sedate you but does not produce restorative sleep. CBD gummies carry a specific risk: the effect arrives late, so people keep taking more and the dose lands far past what they intended. Chapters 0:00 Sleep is the one thing most of us are getting wrong 1:14 The doctor who lived it: radiology, night call, and burnout 2:33 How he was diagnosed with sleep apnea 5:01 How do you know if your sleep is actually a problem? 6:00 The 18 wheeler story: watching a driver fall asleep 7:09 What is a microsleep, and why is it so dangerous? 9:34 Why sleep is the foundation: memory, heart, and immunity 11:23 The most dangerous hours to be on the road 12:21 How many hours of sleep do you actually need? 13:28 What a real sleep plan looks like 15:09 Caffeine, hidden sources, late workouts, and alcohol 17:53 Are sleep trackers and wearables worth it? 20:44 How a physician finally got in touch with his own health 25:41 The everyday habits sabotaging your sleep 28:02 Why screen light in bed suppresses melatonin 29:34 Insomnia vs sleep apnea: what is the difference? 31:28 Sleep, hunger hormones, and weight 32:41 Why he wrote the book 36:48 Shift work sleep disorder: the chapter nobody else wrote 38:38 Sleep hygiene, and the idea of drifting 41:03 Melatonin, prescription sleep meds, CBD, and THC 46:30 Myth: you can catch up on sleep over the weekend 47:03 Myth: some people only need five hours 49:31 Myth: snoring is harmless 49:44 Myth: bad sleep is just part of night shift 51:45 How long should a nap actually be? 53:14 Where to get the book and find Dr. Puryear About the guest Dr. Jerome Puryear, MD, Dipl. ABOM is an obesity medicine physician and interventional radiologist, a board certified health and wellness coach, and the founder of the Puryear Wellness Institute. His book, Sleep Deprivation: A Doctor's Guide to Why You Can't Sleep and How to Get Better Sleep, is available on Amazon August 31 and on pre-order now. Website and book: drjeromepuryear.com Resources mentioned Sleep Deprivation: A Doctor's Guide to Why You Can't Sleep and How to Get Better Sleep, by Dr. Jerome Puryear, MD Puryear Wellness Institute Ramelteon, a prescription melatonin receptor agonist Cognitive behavioral therapy for insomnia Third party supplement verification If you need support 988 Suicide and Crisis Lifeline: call or text 988 SAMHSA National Helpline: 1-800-662-4357 Drowsy driving is dangerous. If you are fighting to stay awake at the wheel, pull over. About Dialed In Health Health and wellness is confusing. There is a new trend every week, everyone has an opinion, and half the time you cannot tell what is legitimate and what is good marketing. Dialed In Health brings in the people who actually do this work, providers, practitioners, and experts who see clients every day, and asks the questions you would ask if you were sitting across from them. Hosted by Melissa Goodwin. Follow the show If this episode helped, follow Dialed In Health wherever you listen, and please rate and review. Reviews are how other tired people find this show. Watch on YouTube: @dialedinhealth Full transcript and every chapter: dialedin.health/podcast/episode-33-why-cant-i-sleep Find a vetted provider: dialedin.health/the-directory Apply to be a guest: dialedinhealth.kit.com Transcript Full transcript on the episode page: dialedin.health/podcast/episode-33-why-cant-i-sleep This episode is educational and informational only. It is not medical advice and it is not a substitute for evaluation, diagnosis, or treatment by a licensed provider. Talk to your own clinician before changing anything about your health, your medication, or your sleep.
