Why Seasonal Light Matters for Peak Performance

Dr. Cameron Chesnut 0:00

Welcome to the Five Codes Podcast, where we discuss evidence-based methods to elevate yourself to the next level through optimizing the way you look, move, perform, feel, and connect. Today's deep focus episode is especially timely for those of us that live in the northern hemisphere as the seasons are changing. Especially if we live up at northern latitudes, our days start to get a little bit shorter, later sunrises, earlier sunsets, and that's especially pertinent for me where I want to be at peak performance, at my peak cognitive function, regardless of what the season is. You don't want your surgeons showing up for surgery a little groggy because it's the middle of the winter and they live in the northern hemisphere. So I'm going to walk you through a little bit of how I use light regularly, but especially as the seasons are changing to maintain my sleep cycle, my peak performance, be in the right mood, alertness, cognitive function, all of those things. This also will go into a little bit of what I do for my patients. And again, all of my patients are traveling to me. I have very specific retreat homes that I have set up for you to stay in. And the light in those spaces is also optimized for these same things to restore your sleep architecture after surgery, which is really important to your recovery, to help your healing process after surgery with natural light exposure, with circadian-friendly lighting throughout the day. I'll talk about how I use it in a very specific situation like surgical recovery, but I'm also going to talk a lot about what I personally do. And that's going to be some very basic, simple things like how I see sunlight, when I see sunlight, what my strategies are around that, some very simple tools that you might be able to use, ranging from really inexpensive to a little bit more elaborate. And then some of the more complex systems I've actually set up, like when I built my home, how I based a lot of my home architecture, even or the lighting system around something that has to do with a circadian rhythm or a circannual rhythm. A circadian meaning a daily, every single day type of rhythm, and an circannual rhythm meaning how we how we know where we're at when we're rotating around the sun, what the tilt of the earth is, sort of how we know we where we are in the space-time continuum. And it's really cool how our brain actually knows that and where it gets its information. A lot of this is relatively new

The Cortisol Awakening Response

Dr. Cameron Chesnut 2:16

if we look at science, knowing that we've had a circadian rhythm for some time. We've known that, but we didn't know exactly what microadjusted it. And the spoiler alert, we now know it's light, and a lot of it has to do with how that light interacts with our eyes in very specific ways. So we're going to talk about that a little bit. As we jump into what a day looks like, I want us to understand what wakes us up in the morning, what gets us out of bed, and that's actually a natural rise in our cortisol. Cortisol is called the cortisol awakening response, the C A R. And this is important because cortisol often gets this bad rap that it's like a stress hormone. But cortisol is actually kind of our get stuff done hormone a little bit too. It mobilizes fuels, and we can see that. I actually, on my continuous glucose monitor that I'm wearing, that I wear all the time, can see how my cortisol levels rise in the morning as it's mobilizing glucose. I can see I haven't eaten anything, my glucose levels are rising. There's only one thing that's making that happen, and it's cortisol. So it usually peaks about an hour after we wake up, and that's part of our normal rhythm. It goes with some body temperature changes. This is that circadian rhythm type of idea. But our circadian rhythm is actually a little bit longer than a 24-hour cycle. We know this from some studies of people, you know, basically in dark caves with no signs of what time it is. And it's light that helps microadjust that. So the way that we can kind of stay on rhythm, and I'm talking now really about a day-to-day basis. I'm not going to get into as much of what some travel strategies might be for jet lag. We'll go into that a little bit more later. But this is like every single day. The best thing you can do in the morning is to see sunlight

Morning Sunlight in the First 30 to 60 Minutes

Dr. Cameron Chesnut 3:46

or daylight within 30, maybe 60 minutes of when you wake up. I am very religious about this. I go outside and I move or I have coffee, or if I'm not operating, I'll have coffee. But I'm on a surgery day, I'm out there kind of just moving around, mobilizing, and looking in the direction of the sun, looking east, basically. I was just on a at a conference in Las Vegas and I was using my compass on my phone. This is the most used purpose of the compass on my phone is to go outside, find east, and look up into the sky. So if you have direct sunlight, if it's a sunny day, you're seeing the sun rise, great. It doesn't have to be sunrise. The sun could be up if you wake up after the sun's already up in the morning, but it's important, the timing of this is important. This window is key. We want to hit that window. It's going to help get us ready for sleep that night, help regulate our cortisol response because we want it to peak in the morning and then go down in the evening. The timing for this matters. Get daylight in your eyes. Five or ten minutes is great. If it's a cloudy day or a really cloudy day, dark, stormy day, you might need more. You might need 30 minutes of daylight just looking east. And again, you could be outside walking, working, you know, don't be looking at your phone or something like that. Take a friend out, take your pets out, you know, do something. I take my kids outside and they do it with me. So this is part of their routine now as well. And they feel this. They go into their world more alert. It helps regulate their sleep cycles. Um, they feel better too. So, you know, at a very primal level, my kids also enjoy this with me. So, and it's kind of some fun bonding. So, but that is a very basic thing. Now, what happens for me if I'm up before the sun

Surgery Mornings Before Sunrise and 10,000 Lux Lights

Dr. Cameron Chesnut 5:18

is? And this is going to happen to me basically every day once fall hits and once we start getting into the true winter and the spring months, is what happens then? Sun's not up and I've got to go to surgery. Well, I want my cortisol levels to rise as per usual. I don't use coffee to do this. I don't drink coffee on surgical days. In my opinion, you don't want your surgeon reliant on substances to be sort of at their peak performance when they're in the operating room with you. So I do this in other ways. I use a little bit of exercise, which helps raise my cortisol levels in the morning that are already rising. Again, this is not causing the cortisol levels to rise. It's happening no matter what. That's why we wake up. But we want to ride that wave early in the morning and kind of microadjust it to the right timing for us so that it's happening when we need to be at our peak. So I'm using a little bit of exercise on a surgery morning and I'm using light exposure. And when I cannot get actual real sunlight at first, I will use other tools. Let's call these like if we're in this like food analogy, my whole foods is the sun, but now I'm using some supplements when I can't get the whole foods that I need. To do that, I have a system in my house that is a circadian-friendly lighting system. And when it's the wintertime in the morning, I have a very specific setting that I turn on and it's very bright at a very specific wavelength at 480 nanometers. This stimulates these options, these proteins in some of the cells of my eyes called melanopsin proteins. That's like the peak stimulus. That's like a blue or cyan type of wavelength, kind of transitioning between blue and green. So some very specific wavelengths that they're very specifically sensitive to, trying to turn them on. And we'll get into that biology in a second. Any bright lights like the ones I'm sitting under as I'm recording this are good. They're not going to hurt, and they might help a little bit because we want some of that bright light. But interestingly, they're not bright enough to really have the effect. Your phone, these types of, you know, your house lighting, they're not going to be enough light to really get the response that we want. So in those situations, I'll use a 10,000 luxe light. And luxe is L U X, it's just a measure of brightness. And you'll hear this kind of thrown out there. It's a really, really bright light. Um, people will call this like a seasonal effective type of light too, because we know that light rhythms also affect our mood. And some people feel that a little bit more than others. But I have these 10,000 luxe lights in various places throughout my house. I also have them in our retreat homes for my patients. But I will use those sort of all morning as I'm getting ready, as I'm getting ready for surgery, as I'm exercising, anything that I can do to get as much of that brighter light in my eye, again, within that first 30, 60 minutes, a lot of times it's pretty immediate afterwards. And that's one of the light strategies that I will use. You can get those anywhere. I use some from Calatherapy, K-A-L-A. We'll link to that here. I have no affiliation with them. They're not wildly expensive. I would definitely suggest that if this is an issue for you where you wake up before the sun often, wherever you live, and you need to kind of get to peak mood, get to peak cognitive function, attention, focus. This is a really good tool to kind of keep things on the rails a little bit. So just a 10,000 lux light, definitely something worth looking at. Probably a pretty good investment for that. The whole house lighting system that I mentioned is a system I use called Ketra, which is great because I can program the exact wavelengths that I want for various functions. So in the morning, that is stimulating me. But as spoiler alert, as we get to the evening, it's the opposite effect, right? So there are some things that lack a

How Your Eyes Tell Your Brain What Time It Is

Dr. Cameron Chesnut 8:45

little bit in that morning protocol when it's pre-sunrise. When I am getting just the 10,000 luxe lights or just the overhead lighting in my home that's specifically for this, it's missing some of the longer wavelengths. So one of the cool things when we get daylight in our eyes or morning sunlight in our eyes is that we have some very specific cells in our eyes that react to those light. It's literally their only job. They're called intrinsically photosensitive retinal ganglion cells. And intrinsically photosensitive means they respond to light no matter what. That's what they are doing. And they have these little proteins in them called melanopsin proteins. And they absorb those very specific wavelengths of light. They're interestingly, even I think even more interestingly, located more primarily on the lower part of our retina. The retina is like the back of our eye. It's actually an extension of our brain. But on the back of our eye, they sit on the bottom part of our retina because they are used to viewing the upper visual fields, which is the sky. That the sky reflects on the bottom of our eyeball, which kind of makes sense if we're thinking about the geometry of it. And that's where a lot of those cells sit that are just literally their only job is to tell our brain how much light they're getting, what the wavelengths of the light are, what time of day it is, to help us know again where we're at in this space-time continuum on a daily basis, then sort of on an annual, yearly basis, like where are we at? What's happening in the world? So those cells are very important to understand as we're looking at what makes them tick. And we know the wavelengths that kind of really hit them, but one of the other things that our eyes are really paying attention to is the contrast between longer wavelengths of light, which is sort of like the red and infrared types of wavelengths. But for us in the visible spectrum, it's red light. And the contrast with shorter wavelengths of light, which is blue light. And the below the blue light on the visible spectrum is the ultraviolet, the shorter, shorter wavelengths. A short wavelength tends to have higher energy, like an ultraviolet light, and a longer wavelength like an infrared or a far infrared is like a little bit less energy, but longer wavelengths and penetrate deeper. So these are important functions. This is not an episode on red light, it's not an episode on sleep. This actually pairs really well with our previous episode on red light, which I would encourage you to go watch. It's one of our most watched episodes ever. Um, but all of these play together, red light and sleep, and the kind of light rhythm, the circadian rhythm that we're talking about, all are really important together. So when I'm using these 10,000 lux bright lights, they're missing some of the longer wavelengths. And so I know that these intrinsically photosensitive retinal ganglion

Red Light in the Sauna and in Your Eyes

Dr. Cameron Chesnut 11:15

cells, they're looking at the contrast between longer wavelengths and shorter wavelengths. And this is why you'll often see me early in the morning inside of my sauna with really bright red lights on. Now we're talking about red light panels. My sauna panels are also from calotherapy just because they are hands down the best sauna panels I've ever found. They function at very high temperatures, and I like a really hot sauna. But that is part of my morning rhythm as well. I will side note this to say that red light in your eyes is a really common question that I get. Should you be getting red light in your eyes? And I talked about this in the podcast episode just on red light a little bit, but it's worth mentioning here because we're talking about specifically different wavelengths of light in our eyes and timing of those wavelengths. So much of the current medical red light literature is in the ophthalmology literature. And we know that red light in your eyes, on your retinas, on these the cells of your ear rods and cones in your eyes, that you know, we've all heard of those that collect light can improve our visual acuity. How well we see things, our color differentiation, and very interestingly, the timing of that red light is important to improving that visual acuity. It needs to be in the morning. So this is just another one of these examples I think that's really interesting about having timing of our red light. And so, or all of our light really, but red light in the morning helps improve our visual acuity. So you do not want your eyes to hurt. You should not be staring at the sun in this process, solar gazing. If it's too bright, look away, get the light in your eyes. It should not be uncomfortable. Um, same when you're in your red lights. If it's too bright, close your eyes, cover them up, whatever it is. But we do want to get these wavelengths in our eyes. And so this is part of my morning routine, especially in the winter. My 10,000 luxe light, my which I'm using when I'm exercising, I'm using as I'm making my internal bath. Literally, it's sitting in front of me as I'm mixing up my 40-ounce internal bath in the morning that I take every single day. Um, and I'm using red light in my sauna. So I have all of these like awakening responses to help help microadjust my cortisol levels. I'm using exercise. You can do this with coffee, which I don't drink on surgical days, but I do sometimes on non-surgical days. That's a great tool, which is another reason it's probably best to kind of wait on your morning coffee if you can, because again, I as I mentioned that the peak cortisol response is supposed to be about an hour after we wake up. It's supposed to kind of dip its nadir, should be about four to six hours after we go to sleep. We want really want to maintain that rhythm. You do not want your cortisol levels rising in the middle of the night. You will wake up. And if you've ever done a cortisol test, which you can do in a salivary test, it's really kind of cool. If you wake up in the middle of the night, that's one of the times they want to test. Did your cortisol levels rise? Is that why you woke up? What happened? But we want to kind of stick to that, like peaking in the morning, falling throughout the day, dropping in the middle of the night, or four to six hours after we're sleep, and raising back up again. And these are some key strategies to do that. So you can use light exercise, caffeine, uh, a meal, as long as it's not too high and specific type of carbohydrates can also help this as well. So you have all these levers of exercise, light, um, food, caffeine, that these are some spoiler alerts for traveling too, that can kind of help reset your circadia, then microadjust your cortisol levels as it's rising in the morning. So that's really cool. And again, I'm going to reiterate that your phone is not enough. Looking at the light through sunglasses, not enough. Not through windows, not through windshields. You want to see natural daylight with your eyes. If you have contacts or glasses, that is fine. You just don't want to be blocking out these wavelengths 30 to 60 minutes. If that's the only thing you take away from that, that should be the one probably take away from this. And then in the winter, the carryover is it might be worth getting a 10,000 lux light. Um, it's it's a very low investment if that's something that is important to you and you find yourself doing this all the time. So that's my morning routine. I'm

How I Change the Lighting During Surgery

Dr. Cameron Chesnut 15:05

sitting at my office right outside of my operating rooms in a whole nother level. Uh, my the light in our entire office in inside of my operating rooms is also very keyed and specific to what I'm doing, so much so that the wavelengths change throughout my surgery. Um, there's times that are honestly just a bit more chill, kind of like flowing, and there's times that I need to be more activated. And we will literally change the lights throughout the day so that we're activated when we need to be activated and we can chill when we need to chill. It's really important for my team, too, who's also in surgery with me. We can have surgeries that are five hours or we can have surgeries that are 10 hours, right? We want to not, we want to optimize the light environment that we're in to keep us focused and peaked without sort of overexhausting our system, if you will. So that's kind of a fun fact that we are constantly adjusting the lights throughout the day. I'm talking the overhead lights, um, the surgical lights that I'm using to be at different things. If we really want to get nerdy about it, it also affects the fields that I'm viewing visually, uh, different light temperatures, which is measured in Kelvins, is now we're getting into the weeds a little bit. But that helps me see different things when I'm operating, different types of contrasts. I'm I'm really nerdy about this, and I'm changing all those things when I'm operating. But the news for you there is you might want to carry some of these things into your productivity time, your workspace, whatever that applicability is for you. And it might be that same 10,000 lux light at your desk for a bit if you are carrying your morning early on into work and things like that. So something to think about. When we switch gears into

Why My Surgery Starts the Night Before

Dr. Cameron Chesnut 16:40

what's happening in the evenings, this is this would have been a great place to start this episode as well, because for me, my cortisol response really starts in the evening. My next day, my surgery tomorrow really starts tonight. I mean, I've been preparing for that for a long time, but when I'm really getting to the nuts and bolts of my circadian rhythm, I'm focusing on what's happening at night because this is also a really important time to understand what happens with how our eyes and ultimately our brain interact with light. I talked a little bit about those intrinsically photosensitive retinal ganglion cells and how they communicate with our brain. Well, there's some very specific brain areas that they're using. One of them is the paraventricular nucleus, which sort of affects a lot of our hypothalamic pituitary axis. That's kind of like part of the cortisol response. There's part called the suprachiasmatic nucleus that sits right adjacent there in similar areas right on top of our optic chiasm. That's why it's called the suprachiasmatic nucleus. But these are all getting direct inputs from these intrinsically photosensitive retinal gantlion cells to kind of help our brain start distributing information from to our endocrine system to know what time of day it is and how to change our responses. We're getting information from our skin to some degree too,

UV Light, Wound Healing, and Natural Pain Control

Dr. Cameron Chesnut 17:55

which we can go into a little bit. Um, you know, we've talked a lot about light in our eyes, but when we get to ultraviolet light and our skin and our eyes, there's an important response there too. And this is almost like a bad word in some of medicine and the dermatology world and the aging world, like ultraviolet light is bad for us, right? Uh well, I'm gonna go out on a limb here and say that like artificial ultraviolet light, probably not so good for us. That's like tanning beds and things like that. Now we're getting into the you know whole foods versus supplements type of thing. Like that type of a dose is not so great for us because it's not mixed with a full spectrum. The sun is by definition a full spectrum of everything, it has all the electromagnetic wavelengths kind of contained within it for all intents and purposes for us. And so ultraviolet is a key part of this, and we have different types of ultraviolet, A, B, and C, things like that. But we know that ultraviolet has a key interaction with parts of our skin. We know about vitamin D production. That's an interesting little caveat we'll talk about. Um, one of the really cool things for me that I like to utilize is that our skin is essentially a neuroendocrine organ as well. So it has its own way to affect our endocrine system when our skin sees light, especially ultraviolet light, right? There's a skin gonatal axis that affects our sex hormone levels. But the important one for me is that we know that ultraviolet light on our skin affects our wound healing, our stem cells, even our hair growth and things like that, right? So the proliferative cells of our skin are affected by the amount of ultraviolet light they're getting. Basically, wounds heal better, skin heals better, your hair grows better when your skin is getting ultraviolet light. It needs to get ultraviolet light on it. This is important. So in my retreat homes, I have sun decks. And the sundecks are very specific. Where we're at in our northern latitude, they face primarily south, and that's where our solar angles are for the most part. And you can see east and you can see west at the same time as you're looking at them. You also happen to be looking at a beautiful body of water and mountains and trees, but there's a spot specifically where you can be away from everything else, elevated up in the air, and getting solar light in your eyes and on your skin in a way that you can be decent. I have, I built this at my house too, right off of our primary bedroom. We have what we call, you know, our diving board, and it is literally just sort of like a sundeck, if you will. It's a small space that, you know, my family, my wife, and I can go sit on and very specifically get early morning sunlight for us. It's right there. Um, so these are structural parts of healing. These are important. When we're talking about recovering from surgery, we know this, this has been well documented in the medical literature as well, that when you have exposure to light, not only do you heal better, heal faster, have an easier recovery, your pain control is also better. Now, I'm super proactive about this in general, but something like ultraviolet light affecting our pain perception, of course, that's something I'm going to leverage. I want to leverage that, right? And so the way that that works is when ultraviolet light affects hits our skin, it causes a response. This is a, I'm going to call this a hormetic dose, right? Meaning more is not better here necessarily, but some is necessary. We need a little bit of this stress on us. It's just like exercise is a hormetic stress. You know, too much of it is not good for us, but we need a little bit of it. Um, you know, saunas, cold plunges, all of these things, if you do them too much, they will kill you. But they're also in smaller doses very appropriate and sometimes like necessary or good for us to do. So let's think of ultraviolet that same way. When we get that on our skin, we get all those proliferative benefits like I talked about for wound healing, but we also make something called POMC, pro-opio-melanocortin, which is part of our skin's way to respond to ultraviolet light and get ready to protect itself. But when this POMC gets cleaved, one of the things it releases is a hormone that makes our skin darken, like our taning response, basically. But it also makes a beta endorphin an endogenous pain. Molecule, if you will, something that responds with our central nervous system and helps control our pain. So ultraviolet light, via the same mechanism by which it darkens, our skin also gives us a beta endorphin release. It makes it improves our pain control, our pain response. And I think that's really important and interesting to think about, especially if we think about a lot of the world is like hide from the sun, it's bad for you, you shouldn't be getting it. I've always been a little bit counterculture in that world. Um, but there's if this doesn't highlight why, I don't know what does. We need sun in our eyes, we need sun on our skin. It has to happen. That doesn't mean that more is better. We need to be respectful of the time of year, time of day, our baseline skin tones, but these are good things for us, right? And so I'm taking advantage of that in my own home. I'm taking advantage of that in my recovery homes where my patients are sort of at their retreat when they're here recovering with me. So these are things that I'm leveraging. As we get into you know routines for the evening, um, by the way, we want that ultraviolet light on our skin to be happening earlier in the day. It's important for it to happen earlier in the day. When it happens later in the day, it can have some effects on our dopamine levels. So ideally, we're getting it early in the day, if if all things go as per usual.

Why Screens Hit Harder at Night

Dr. Cameron Chesnut 23:15

Um, in the evening, we kind of switch gears with light a little bit because our sensitivity to light changes throughout the day. And so in a cruel twist of events, um, the same lights that I was talking about with screens, with your phone, with the overhead lights in your house, with computers, TVs, these are not powerful enough in the morning to move the needle for us. When we're talking about our cortisol awakening response and adjusting our circade circadian rhythms, they are not powerful enough to do that in the mornings. But when we start talking about getting them at night, when we're supposed to be getting, again, long wavelengths or no wavelengths of light, say after the sun has gone down, then we are exquisitely sensitive to them and they can be wreak havoc on our ability to sleep afterwards. This gets into a different hormonal pathway involving melatonin that we haven't talked about yet. And melatonin gets released from our pineal gland in our brain, and it's responsive to light. So early in the morning, back to that time, when we get light in our eyes, one of the things that that light does is it kind of washes out or crushes out all of the melatonin that we might have left in our central nervous system from sleeping the night before. So that's good. It makes us feel more awake. It has a similar effect on adenosine, actually, washing out adenosine. And for those of you that are familiar with the mechanism of coffee, coffee is blocking adenosine receptors. So light in the morning can make up for some of that, you know, adenosine that maybe didn't get washed out overnight. And a good night's sleep, most of our adenosine should get washed away. Um, nonetheless, we start to build it up throughout the day. And if we don't flush it all out overnight, light in the morning can help with that. And it purposefully, in a good way in the morning, gets our melatonin levels down low out of the way so we can feel alert and awake. In the evening, we want our adenosine to build up a little bit, which is why we don't want to drink caffeine too late. We want our melatonin levels to sort of rise with lowering light levels and increasing amounts of darkness. That's that's meant to do that, right? If we get these bright light sources at night, we will suppress. I was gonna say crush. That's the only word that really comes to mind. We will suppress our melatonin levels to a dysfunctional degree. We don't want that to happen. As the day goes on, it gets even more and more important towards that. And we've all heard this before like no blue light at night, no screens, blue light blockers, things like that. So those are important tools we'll talk about in a second. But if we really want to get to the most important tool that we can get to sort of buffer ourselves against this is number one, viewing afternoon sunlight. Now we're talking about times around sunset or in the evenings. If any light in our eyes during the day is helpful, if you can only get it at noon, get a little light in your eyes at noon. Do what you need to do. But seeing those long contrasting wavelengths again in the evening, um, and again, I'm talking about contrasting wavelengths. When the sun is lower in the sky, we tend to get less of the blue wavelengths and more of the yellow, oranges, and reds, right? That's why sunsets look the way that they look and why sunrises look the way that they look. And in the middle of the day, it's much more blue. It's much more white light type of a color, right? So our brain reads those to know what time of day it is. So when we see those evening lights, we get

LED Junk Light and the Power of Evening Sun

Dr. Cameron Chesnut 26:30

even more fine-tuned in our in our microcycles of our circadian rhythm, which is good. But we also buffer some of the effects of some of the junk light that we might get later at night. I'm going to use this junk light kind of purposefully here, assuming that we're talking about LED lights later in the evenings when we're not meant to be getting it. I talked about this in the red light episode, but um the current LED lights that we we are using are probably just really not great for us for our mitochondrial function and our overall health. Um we talked a little bit about them being like asbestos level of a public health crisis because they are very peaked and spiky in the blue light ranges and have no shorter, excuse me, no longer wavelengths of light. It's really concentrated and bright in those peak blue wavelengths, which is why they look very white often, and we're missing a lot of the long wavelengths that you had when you there used to be incandescent bulbs. Um, and so we want to be thoughtful about that with our lighting and the especially in the evenings when these like really bright LEDs can really disrupt the sleep that we have coming later, whether it's an overhead light, a LED lamp, your phone, your TV, your computer, any of those things, right? We want to be thoughtful of those things, we want to be aware. So we can use the sun in the afternoon and evening to help buffer those effects a little bit, but we can use some other tools as well. The simplest one is don't be on those devices. That's not always possible, of course. Um, you can turn on red mode on your devices so it gets rid of the blue wavelengths. That's also fun fact, side note. A really great way to probably decrease your social media usage. Try this. If you're if you find yourself doom scrolling at night or like, oh what, I just wasted 20 minutes on my phone doing whatever, turn your screen on red mode, and social media is a lot less interesting to look at. So that's kind of a fun, fun little trial there for you. Uh, if you have to be on it at all. Also think about the content you're consuming, right? Is it stimulating and activating and you know all the things that are catching our

Evening Tools: Blue Light Blockers and Better Bulbs

Dr. Cameron Chesnut 28:30

attention are probably not what you want to be, you know, consuming right before you go to bed, right? So that hour before bed is definitely the most important, but the whole evening is also quite important. And so, you know, what do you do? Well, here's some tools. Let's go into some tools that we can use. You have blue light blocking glasses. At this point, I'm guessing everybody that's watching this podcast has at least heard of these or seen them. Those are kind of the amber red lenses. There are some steps above that that are like all shorter wavelength blocking. So that's not just blue, but it's also green wavelengths as well. Um, this is be some of those long, like even I talked about that 480 nanometer wavelength that really stimulates the melanopsin receptors is kind of like almost in the green area, right? If we talk about the visible light spectrum. So we want things we want uh glasses that block all of the shorter wavelengths that we can do. So that's an important and relatively simple tool. Again, we're talking in this like you know, $100-ish dollar price range, probably for those types of things. So that's that's one thing that we can think about. Um the bulbs that you use in your house. This is a big one too. And I don't think that a lot of people think of this. They just have bulbs in a sort of thoughtless, they get LEDs, they're hyper-efficient, they last tens of thousands of hours, but they're probably crushing your health too. So there's some bulbs. The bulbs that we use in our retreat homes, again, in my home, I have a Ketra lighting system that is adjusting to the rhythms of the day, knowing what the solar angles are throughout the day at night. In my home, it looks like a campfire, um, which is a you know, a side note. It looks like there's candles burning in there, which drives my kids and my wife nuts sometimes. If we're trying to eat dinner and it's late at night, it can be really hard under campfire or under that orange light. So, you know, we can adjust that a little bit. But in general, my house in the evening looks like a red campfire. Like that's that's kind of how it's a signature of our home, honestly, um, so that we can keep our melatonin levels appropriately rising as they should be in the evenings. Well, if you don't have the ability to do a whole house system, there's some really cool bulbs that you can use. In our retreat homes, we use bulbs from a company called Bond Charge. Again, no affiliation, no connection to them. They're just really slick, easy-to-use lights that have different wavelengths with different clicks. So you can have them on a blue light setting in the middle of the day, blue like a heavy blue. You can have them a little bit more sort of in a warmer yellow, or you can have them like reddish at night, back to that sort of campfire idea. And so this is what I want my patients using when they're with me as well in their recovery process and in their preparation process for surgery, because I want their rhythms to get in line so that we can get our sleep architecture as restored as we can. The anesthesia protocol that I'm using is very focused on restoring sleep architecture, while lighting is also really important. It would be crazy to do this elaborate, in-depth anesthesia protocol, in my opinion, and not be pulling the lever of lighting, which is arguably more important in the long run, right? I want this happening before they come to me too, because interestingly, yes, every single day we can microadjust our circadian rhythm, but this is really happening. If we really, if you miss a day, this isn't like, don't do not get stressed about this. Like I had a day where I was in Las Vegas. Truth be told, I literally did not see the sun or the or the natural sky for an entire day. I did not go outside. Um, and that I didn't love that. It was just sort of how the schedule lined up that day, but I sure as heck made sure that the day before and the day after that I was outside facing the proper directions as much as I could, because in reality, it's a few days of cycling that really determine where our circadian rhythm is at in the process. So don't miss a bunch of days in a row. Do what you can. Um but this is what I'm doing with my patients. I want them coming in in a good rhythm, and I want to get back on the rhythm right away. And in the winter, um, that's you know, the things can be a bit disrupted. And so I'm really focused on this for them. And the circadian-friendly lighting in my retreat homes is an important part of that to get people sleeping properly. When we sleep well, we recover well, it makes the overall experience much, much, much better. So I use these bulbs from Bond Charge inside of our retreat homes to accomplish that there. So again, very inexpensive. Um, it's honestly, if it's me and I'm just giving like side advice, I would say in the evenings, if you're if this is like resonating with you and you want to do this, ignore your can lights in the ceiling. Yes, you can replace those and do what you want with them, but honestly, really worry about the lights at the lower levels, your lamps, your floor lighting, things like that, and use these type of bulbs in there because you don't need as many of them, um, and you can easily control them. And as I mentioned before, our eyes are actually also paying attention to where the light is coming from spatially, meaning we have receptors at different parts of our of our retina that are paying attention to where the light would be in the sky. And so in the evenings when the sun goes down, our eyes would be accustomed to light coming from a lower physical level spatially, and we can mimic that with lamps, floor lamps, things like that in our home. That's where, in my opinion, you know, do the investment in these very specific types of bulbs, leave the overhead lights off if you can, and boom, you're cruising along in a pretty good setting there. So a couple of pretty easy tools to do there. If you have the luxury of having a true circadian-friendly system, it might auto-adjust throughout the day. And so, you know, as it's dark, it'll keep getting more and more red, orange until it's

The Hour Before Bed

Dr. Cameron Chesnut 33:50

at sort of the longest wavelengths we can see. Um then we get into some habits, you know, like timing around this. I mentioned a little bit of like this hour before we go to bed is this magical window. That's when it's best to just like literally not be on a screen for a bunch of content reasons, too, as far as stirring your brain up. You know, that's where I would say like, you know, put your short wavelength blockers on, your blue light blockers, if you will, and you know, get some low light and read a book. Do it under candlelight, you know. Like, of course, that's not what most people are doing, but um kind of like take that to heart a little bit and read something sort of like that's easy to read, that's not revving you up too much. And that's a great sort of wind-down routine. Not I have never had a TV in my bedroom. Um, that's it's just not part of you know my family's routine. Nobody has them in their bedrooms. Um, it's not what that's for. And it disrupts your sleep wildly. There's just honestly no way around that. And this is gonna wreck people. People are gonna argue, they're not gonna like this. Um, don't do it. If you have to be watching TV before you go to bed, again, back to maybe you're wearing some very specific glasses that are in that like tool range that's affordable that you can do. But I'd encourage you to try not doing that, right? Um, it's not not what that time is for, not what that space is for. Um, maybe that some other parts of the quality of your life go up if you don't do that. Um, so that hour before bed is really, really important to turn your phone to red. Maybe that'll help cut out your social media use,

Darkness in the Middle of the Night

Dr. Cameron Chesnut 35:15

to be off of any screens, kind of get into your wind-down routine. It's really important. Interestingly, if you have to do it, use your glasses. Now we're talking about like middle of the night scenarios. In the evening, our melatonin levels should rise, like I'm talking about. It makes us sleepy, helps us go to sleep. Um, and then it rises throughout the evening. When if it's the middle of the night, middle middle of the night, and you wake up and you gotta go to the bathroom where you gotta keep as little or no light as you can to accomplish that task that you have to accomplish. I try not to open my eyes if I kind of find myself waking up in the middle of the night because it takes little to no light in your eyes in the middle of the night to completely drop your melatonin levels down all the way, you know. We're we're again, I'm gonna use the crushing word. You are stopping those from happening. Um, and that really is gonna disrupt your sleep rhythm. Is it the end of the world if it happens one time, this, that, and the other? No, but you don't want to make that a habit, right? So now we're talking about some getting into a little sleep, but what does your sleeping environment look like? Or do you have bright lights outside your room? Do you have blackout curtains? Do you have a bunch of LEDs inside of your room going on, right? This is, I'm the guy who travels in my hotel rooms with black tape that I literally put over all the LEDs that are shining in there. Um, that's important for if I wake up in the in the evening or even getting those through your eyelids, you know, when your eyes are closed. That's a real thing. There's some interesting studies showing that our blood glucose regulation, our blood glucose regulation is worse, our blood sugar levels are worse if we have light in our sleeping environment. Like we know that that is not a great issue. Um, and so that's important to understand that again, back to like sort of junk lighting affecting our physiology, rubber meeting the road, that is happening even when you're sleeping, right? So you want your sleeping environment as black, dark as it can be, let alone temperatures and things like that, because we know that our circadian rhythms are fluctuating, have fluctuating temperatures. We're not gonna get into that because this is about light, but light in the night will disrupt your melatonin levels, it will disrupt your sleep, and it can take some time to go back. So if you wake up, if you gotta go to the bathroom, take care of your kids, whatever it may be. I mean, I've been there, I have three kids, it's the middle of the night. Like, and it's it's true for your kids too. Do not turn the lights on, don't do it because you got a crying baby and they're they're just as sensitive as you are to what's happening with their circadian rhythms. You do not want them exposed to light in the evenings, um, night lights and things like that. I would that's a whole nother topic, um, and even can affect uh vision of your kids if they have sort of the wrong types of lights. We had a brief phase with one of our kids wanting a night light, and that thing was like the dimmest, reddest thing that could have ever existed. And it just sort of scratched that little itch for having a night light that was very short-lived. So I'm not a fan of those. Um, but I also understand real life too. So do not get light in your eyes in the middle of the night when you're supposed to be sleeping. Don't do it. Once you get, once it's time to wake up and you start wanting adjusting your circadian

Winter Melatonin and Bone Density

Dr. Cameron Chesnut 38:16

rhythm and your cortisol levels, that's when you want to get light in your eyes. I talked a little bit at the beginning about this circannual, circadian meaning day, circannual meaning yearly rhythm. And melatonin brings this up for me because in the winter months, um, we're built to have a little bit higher melatonin levels. We have less light, more darkness, our melatonin levels naturally rise, which is really interesting because uh melatonin has effects on other things. There's some antioxidant properties to it, um, has effects on other tissues. One of those effects being increasing bone density, which when I learned that, I was very fascinated just to be like, how cool is that? Like, we know that our skin needs ultraviolet light to make vitamin D, which is important to bone density, in the summer when we have ultraviolet available to us. Now we're talking in the winter where there's not as much ultraviolet available, natural ultraviolet light. And so there's this almost like backup system built in, it seems to me, where our melatonin levels can also have a positive impact on our bone density when we're not getting as much ultraviolet light. Like we are so solar powered. Um, you know, it's incredible. We are solar-powered batteries, basically, us as humans. And this dives into that a little bit. So in the evenings, limit your light. Um, we want our cortisol levels to drop in that four to six hours after we go to sleep. We want them to start rising again. We want to keep our rooms dark. And then that next morning, the whole cycle starts all over again. It's the sunlight within the first 30, 60 minutes. It is the luxe light all over again, the 10,000 luxe light all over again. Um,

How I Used Light in Medical School

Dr. Cameron Chesnut 39:50

and this is my rhythm. It's funny when I really think back to this. Um, these are things that this I had a lot of these stories. My journey with red light as I was a young athlete, knowing that it worked, but not really having the mechanism as worked out. That was uh it's been a really cool thing for me to see where my knowledge have red light, I'm gonna say our knowledge is a field of medicine has come with red light, but I used it decades ago, uh, knowing the efficacy then, but not having as great of an explanation as I do today. When I was in medical school, I went to medical school in Seattle, um, the northernmost latitude, big city, basically in the United States, and winters there, well, they were tough, rainy, um, dark. And I, when I think back to that, like I used a 10,000 lux light then to study. Um, and I had no idea what I was doing. I was, I knew that I was training a lot as an athlete while I was in medical school. And I knew that when I had this light in front of me, it was like, you know, in my crappy little house in my hole that I studied in eight hours a day, I just had this circular sort of 10,000 lux light in front of me. I knew that I felt better, I studied better, I was more alert, I was more awake, I slept better, I trained better, my recovery was better. And when I really think about it, I had literally no idea what I was doing, um, but I was, I was, you know, using these systems. I was in training my entire system around the light exposure that I was getting when I had my study light on, and I felt great and I functioned great. And I so in some sense I've been using this since you know the early 2000s when I was in medical school, um, just again, not really knowing what it was doing then, but just leveraging sort of how I felt, right? So it kind of is cute for me when I think about my kids now, who I man, if I knew, if I knew then what I know now type of thing, it's fun to share that with them, it's fun to share it with you. Um, but I just had this natural gravitation towards this performance that I was getting out of this good light. And my kids, I see it in them now. They feel the same thing when they're getting natural light in the mornings. Um, it's that same phenomenon happening all over again, or in the winter for them when they're getting their 10,000 looks light. And I adjust things a little bit for my kids. I'm not as maybe aggressive

Key Takeaways

Dr. Cameron Chesnut 42:02

with their pulling these levers for them. It's a little bit more of a natural fluctuation because thankfully my kids don't have to wake up and be absolutely a peak performance and flow state for a surgery like I do. And so much of my life revolves around that. So these are the tools that I'm using to accomplish that. Um, and I hope that you pulled some real pearls out of here about strategies that are free, strategies or tools that you can use that are kind of low entry barrier, um, timing, um, real big on timing there, like when you're getting the light, what type of light you're getting at what times of days and what what to avoid. And I think that there's a lot of tools in here that you can use for whatever your unique situation is, whatever you want to be at peak performance for, or sometimes honestly just kind of feeling better and having a great day when it's that darkest day of the winter, December 21st in the you know, northern hemisphere that we're in. I hope that you find a lot of good use for the tools that I just gave you. If you have any questions or topics you would like me to explore further, please leave them in the comments. I read them all and they often help shape the future conversations here. But I also want to be clear that the views shared on this podcast are my own and are not associated with or representative of my clinical teaching affiliation with the University of Washington School of Medicine, nor should this be taken as individual medical advice. Thank you for spending your time with me. I appreciate you being here, and I will see you on the next episode.