Ask the Doctor (2017–…): Season 1, Episode 2 - Diet - full transcript

Like many people, Dr Shalin Naik believes he is lactose intolerant. He wants to know if there are any health risks to giving up dairy. Dr Sandro Demaio finds out how our diet can be used to treat depression.

Day after day, night after night,

our body never switches off.

We are a living, breathing organism.

But how can we function at
optimum capacity 24 hours a day?

Well, that's where we come in.

Doctors Renee and Sandro,
and I'm Shalin.

We're three medical professionals

and we're on a mission to find out
just that.

In this episode we ask the question...
why am I so tired?

Good morning.

We'll look at how much sleep you need
at different stages of your life.



Is that number, eight hours,
actually correct?

Are teenagers just being
difficult when they stay up late at night?

Thought we had a deal.
No phones after ten o'clock.

Yeah, well...

You must feel a bit like
helicopter parents sometimes?

Yeah, you do.

Can we retrain our brains
to get to sleep earlier?

It's really hard,

having to just lay awake
because I wasn't able to fall asleep.

And I confront a major cause
of marital disharmony.

It's a symphony of snoring.

It's the Opera House.

I don't snore that bad, do I?

As we look for answers
to getting a good night's sleep.



We spend a third of our lives
sleeping,

and that's meant to be good for us.

But sleep disorders are risking safety,
affecting mental wellbeing,

and costing billions in lost productivity
and health care.

As a stem cell biologist,
I put in long hours at the lab,

and travel the world speaking circuit.

And I recently married
in not one but two wedding ceremonies.

You need to be well-rested
for major life events like these...

but you also need to keep on top
of your day-to-day routine.

I've been married to my beautiful wife,
Dimmi, for just a few months now.

Things are going great.

There's only one small issue.
That's in the bedroom.

The problem is, I snore.

Now, my snoring has often
been the subject of ridicule.

I'm referring to Shaz's snoring.

I wasn't even safe
at my own wedding.

This, my friends, is the stuff of legends.

Thing is,
I don't think it's that bad,

and I'm hoping science can back me up.

- Hi, darling.
- Hi, babe, how are you?

I've got some good news.

- I'm going to Sydney to a sleep clinic.
- A sleep clinic?

Yep. We're going to try
and address my snoring.

- Really?
- Yeah.

- Fantastic.
- Yeah.

Hmm, that went down well. Too well.

Maybe things are worse than I thought.

Shalin's snoring
is pretty constant all night,

and if I go to bed after him,

I have a lot of trouble falling asleep
and staying asleep.

And when I wake up in the morning
I feel like I'm not rested,

and before Shalin,
that never used to happen.

Now, I'm a man of more than
a few personality quirks,

so Dimmi already puts up with a lot.

I don't snore that bad, do I?

Well, I guess that answered that.

Snoring is caused by a disrupted airflow,

or a narrowing of the airways,

often little more than an annoyance.

But it can be indicative of
a serious underlying health condition,

obstructive sleep apnoea,

where breathing can intermittently
stop completely.

And with nearly one in five of us snoring,

it's more than enough reason
to wake up feeling grumpy.

Good morning.

Being overweight,
having a poor diet and drinking alcohol

can all contribute to snoring,
but my lifestyle is pretty healthy.

So to get to the bottom of my issue,

I'll need to spend a whole night
in a dedicated sleep lab.

- I'm off to Sydney.
- OK.

I'll see you tomorrow.

- Good luck with it all.
- Thanks.

I've come to Sydney's Woolcock Institute,

where sleep specialists can map
my breathing, heart rate,

quality of sleep,

and most importantly of all,
tell me why I'm snoring.

I'll be looked after by Dr Dev Banerjee,

a sleep specialist
and a medico-legal expert

in the field of sleep medicine.

A man who also enjoys
the occasional Bordeaux.

OK, take a seat.
- Thanks a lot.

Welcome, welcome to the sleep unit.

- Thanks very much.
- So, tell me why you're here.

Well, I'm here on behalf
of my long-suffering wife.

We're recently married,
but the snoring problem hasn't solved

and I've come here to try
and get some help with that.

So tell me about the snoring, then,
because it's multi-level, the snoring.

- Yeah.
- Could be nasal.

- More nasal.
- Yeah.

Could be back of the palate...

...or back of the tongue.

So it depends.

Would you like me to do that again?

So actually there's a science behind it.

It's a symphony of snoring.

It's the Opera House.
This is where we are.

So, do you think your good wife has
described the symphony of your snoring,

if it's nasal, palatal,
or related to your tongue?

She's done one better.
She recorded it for me.

Have you got an example?

- I have, I have.
- Let's hear it.

Let me find it for you.
It's a little bit embarrassing.

Oh, we like humiliation here.

Wait for it.

I hope Dimmi appreciates
what I'm putting myself through here.

This is excruciating.

What I heard at the beginning
was a few sort of silence moments.

Yeah.

It wasn't necessarily your wife
obstructing your airway with a pillow

or anything like that.

It's a bit like...
...and then there's a gap.

There's a...

...then there's a bit of silence,
then there's a...

- Yeah.
- So, who knows.

There might be a bit of apnoea
and a bit of gasping in there.

I'm intrigued by that audio.

I think there's something
really interesting to find tonight.

I'm going to ask you if you can
put this through your pants

- down to the floor.
- Alright.

Do you like the dinosaurs?

I love dinosaurs.

Cool. Me too.

So, before we find out more about
Shalin's snoring problem,

we asked you,

"How much sleep do you average a night?"

Most of us know
getting a good night's sleep is important.

But despite this, one in three people

are constantly getting far less
than they actually need.

It's bad news,
because over the past decade or so,

a growing body of research has linked
a number of dangerous health outcomes,

like heart disease
and high blood pressure,

with a consistent lack of sleep.

Now, common wisdom tells us

we need to get eight hours of sleep
each night to stay healthy,

but is that number actually correct?

Perhaps a good place to start
answering this question is with age.

Newborns need a truckload of sleep,
up to 17 hours a day.

Then as we start adding years,

the amount of recommended sleep
begins to come down.

But even into our late teens,

up to ten hours is still recommended.

Which is why this place is so good.

I'm in a sleep lounge
on a university campus.

I love this idea, because studies suggest
that well-rested students

get around 15% higher results in exams.

This is Darcy, a student here at RMIT.

Until a second ago,
he was having a snooze.

So, Darcy,
how often do you use the sleep lounge?

Roughly around once a week.

And how helpful is it
to have a place

that you can come to
to have a quick nap?

It's pretty good,
because it means I can, like...

If I've got an 8:30 start in the morning,
it means I can catch up on that sleep.

So, what about the rest of us?

Do we need eight hours
to function at our best?

Well, it all depends on the individual.

Some people run fine
on seven hours' sleep.

Others need nine,
and some even ten hours.

So it might be better to think about it

in terms of how much sleep you need
to avoid those bad health outcomes,

and the best research suggests that
for most people,

seven hours is the minimum
to stay healthy.

And I, for one,
am not going to argue with that.

As a medical doctor
who takes a holistic approach to health,

I am concerned about a particular group

who are really suffering from
a lack of sleep... teenagers.

- Hi.
- Welcome.

- Monique?
- Hi.

My name's Monique.
I'm 17 years old. I'm in Year 12.

On a weeknight,
I'm averaging on about five hours' sleep.

So, tell me a bit
about how you sleep at night.

So, I go to bed about one or two o'clock
in the morning on a school night,

and then have to wake up about seven,
so it leaves me really tired.

Right, so if I put you in bed at,
like, ten o'clock at night,

- and said "sleep", you just...
- Yep. No.

The majority of the time
I think that I can't get to sleep

because I'm either on my laptop
or on my phone.

But then also I'm having trouble
actually falling asleep.

So,
did you get that assignment finished?

No.
- Why not?

'Cause I was on my phone.

- Until when?
- Twelve.

I thought we had a deal.
No phones after ten o'clock.

Yeah, well...

Obviously that didn't happen,
right?

Where's your mum?
She's on her phone, is she?

Yep. Hypocrite. Mum!

My parents have tried taking my phone
and my laptop away from me,

but I still won't be able to get to sleep.

So is Monique simply being
a typically difficult teenager?

Well, her parents, Greg and Marissa,
are struggling to work out the answer.

Do you guys blame Monique? Like,
do you think that she's just doing it?

- No.
- No, I don't think so.

I don't think... It's not a blame thing.
It's a situational thing.

The environment that she's created
for herself

just revolves around her room.

At dinnertime we see her for
the hour that we have for dinner,

and then it's straight back up
to her room,

which, you know, concerns me

in that she's going to be 18
and be an independent person

without the social interaction
of the family,

because she just stays in her room.

She's a worry, that one.

- She's our biggest worry.
- Yeah, I know.

Only 'cause she takes after her father.

I don't think she takes after her father
at all.

He's a pretty decent guy.

Monique's lack of sleep
is clearly affecting her family,

and in this crucial final year
of high school,

it could also jeopardise her future.

My biggest concern is that she's just
going to continue to lose focus on school.

That's where it's all going to fall apart.

They're so reliant on technology
for school

that there's no line
that you can stop and say,

"OK, well, now you can stop studying."

I mean, it's difficult.

You must feel a bit like
helicopter parents sometimes.

- Yeah, you do. For sure.
- Yeah.

But it's almost like
she's starting to give up.

Monique's predicament is serious,
but it's actually not uncommon.

- Nice to meet you, Chris.
- Nice to meet you.

- Thank you so much for your time.
- Thanks for inviting me.

So I've invited a sleep specialist
to help Monique and her family.

Dr Chris Seton is a paediatric
and adolescent sleep physician

who works in the Sleep Investigation Unit
at Westmead Children's Hospital in Sydney.

He also likes ocean swimming.

So, a lot of teenagers now are sleeping
two, three hours less than they need.

Wow, so you're talking six hours
or something in a night?

- Six, seven hours.
- Why is it they sleep less?

It's mainly, not only, but mainly to do
with screens and digital technology

and the need to be connected now,
electronically, 24 hours a day.

So we're now a 24-hour society

rather than a sort of
12 or 14-hour society.

About 15% of teenagers have
what we call a late body clock,

so their melatonin,
which is their sleep hormone,

lags at night.

It doesn't come up
and put them to sleep on time.

So that's called delayed sleep phasing,
and it's a sort of social jetlag.

So, I mean, this lack of sleep

must have huge impacts
on the average teenager's life.

It does. They're not always aware of it,

but it affects their mood,
their behaviour, their learning.

It affects a lot of body systems,
so the kids get sick a lot,

they miss school,
they're late from school.

It sort of sounds like you already
know Monique, to be honest.

Dr Chris will explain to Monique
how she can retrain her brain

to get the number of hours' sleep
she needs at her age,

which will help her
with her day-to-day life.

I'm going to introduce you
to Chris here. Chris is our...

- Hi, Monique. Nice to meet you.
- ...sleep expert.

- Welcome.
- Thank you.

Come through.

So, Monique, I've had a chat to Chris

and I've told him some of the stuff
you've talked to me about.

Why do you want to do this?

Well, I feel like
it definitely affects, like,

being able to have time with my family
and my friends,

and it is quite frustrating
and it makes me angry

that I'm not getting
the right amount of sleep.

You don't sleep much during the week.

And we could call you a 'screenager',
perhaps.

A screenager!

Would that be fair?
- Yeah, sometimes, like, I think,

like, "Oh, what's happening,
like, what am I missing out on?"

- Things like that.
- FOMO.

Yeah, FOMO. A fear of missing out.

So, when you use the screens,

the blue light that comes out is lowering
your melatonin, your sleep hormone.

So your brain thinks that
in the first part of the night,

your bed is a place of wakefulness
and excitement.

And we need to decondition your brain

to train it back to know that
the bed is a place for sleep.

OK.

And so one of the things was limiting
your use of the devices at night

- to an hour before bedtime.
- Mm-hm.

So to break Monique's
poor sleeping habits,

Dr Chris has prescribed a nightly
11pm curfew for the next six weeks,

with a pre-bedtime routine
involving reading for relaxation,

listening to chillout music,
and a hot bath.

So, when you're in the hot, deep bath,
your body temperature goes up.

When you get out of the bath,
your body temperature plummets

and the low body temperature
helps you get to sleep.

And then right at the end of the routine,
it's good to have a snack and a drink,

not because you're hungry or thirsty,

but because, again,
this acts as a sleep cue.

So after three or four weeks,

if you have the traditional milk
and biscuit before you go to sleep,

the psychology of that is the brain
sees that as a trigger for sleep.

So, Monique,
what are you most scared about?

Knowing that I have to get to bed
at a certain time,

whereas usually it's just, like, free.

I can go to bed when I want,
that kind of thing.

Right now this is an agreement
you're making with all of us...

- Yep.
- ...in front of all of us.

Are you really motivated?

Yes, I am very motivated.

- Yeah?
- Yeah.

You saw her say that.

As she begins
six weeks of brain reprogramming,

Monique's first step is
to send off a saliva sample,

which will measure her melatonin level.

If her new sleep regime works,

her melatonin level should drop
in the morning,

which means she's had
a good night's sleep.

So far, we've learned our lack
of sleep can be affected by our biology,

as well as behavioural patterns
in different stages of our lives.

But is there anything we can do

to treat the most common physiological
cause of tiredness... snoring?

If, like me, you're one of many people
with a snoring problem,

a trip to a sleep centre
might be in order.

I'm in the process of being wired up
for an overnight sleep test.

My sleep specialist, Dr Dev,
thinks my breathing might be compromised.

Sleep apnoea is a condition where
people stop breathing in their sleep,

which is why it's called 'apnoea',
it's 'without air'.

There's no doubt that sleep apnoea
is associated with cardiovascular disease,

such as hypertension.

There's some association
with strokes as well.

We really want to provide
a holistic approach

to make sure that individual
lives long and well in their life.

It's all starting to feel a lot
more serious than I expected.

And don't get me started
on all these contraptions.

Are you sure I'll be able to sleep
in this, though?

Oh, yeah, don't worry. You'll be fine.
Like, most people sleep quite well.

What I hadn't appreciated was
just how many wires I'd have on me.

I'm uncomfortable and I feel ridiculous.

- Hey.
- How do I look?

- How's it going?
- It's alright.

What are all the wires doing?

The wires on the scalp are measuring
electrical signals in your brain,

something called an EEG.

- It's measuring brain activity?
- Yeah, absolutely.

So, the chest belts
are measuring breathing,

so whether you have difficulty
in breathing, in stopping breathing.

We're just going to put
the nasal cannula on.

There you go.
This measures airflow, by the way.

Oh man, could this get any worse?

It'll get better from now on.

I don't see how.

So, looks like you're all wired up, then,
and ready to go.

So I'm really looking forward
to seeing the data tomorrow,

and sleep well, sleep tight.

Thanks a lot. See ya.

Well, I'm covered in all these wires.

I doubt I'll get to sleep,
but they assure me I will,

and we'll find out how it all goes
tomorrow.

Bye.

So what actually does go on
when we sleep?

Look at those KPIs.

Look at the leaderboard,
all the way up the top, that's Gary.

We've all been here.

Right in the middle of something
important, kicking life goals,

when suddenly you realise...

...you're not wearing any pants,
and everyone is laughing at you.

Yes, Gary is fast asleep.

But why do humans and animals
need to sleep at all?

Especially when it leaves them
dangerously exposed to predators?

Well, the truth is that there are a
whole lot of theories about why we sleep.

But scientists have observed
some super-interesting stuff

happening while we slumber.

In our brain, the pituitary gland
releases hormones

that turbocharge the upkeep and repair
of our internal tissues and muscles.

And our immune systems
produce crucial proteins

that help fight disease
and aid recovery from illness.

It also turns out there's a kernel
of truth in the old idea of beauty sleep,

with research suggesting sleep deprivation
contributes to biological ageing,

and that you look less attractive.

But it's only in recent years

scientists have discovered what could be
a critical reason for shut-eye,

and it's all to do with thinking.

What?

Researchers have observed
brain cells shrinking

by up to 60% during sleep.

The gaps created allow the brain to be
flushed out with cerebrospinal fluid,

removing waste toxins that build up
when our brain is awake.

Some scientists believe
this nightly cleanout is essential

for healthy brain functioning
in all of us.

But sadly for Gary,
it also means night after night of...

So, what are your tips
for a good night's sleep?

Good morning.

Good morning.

I haven't been able to take up
any of your good suggestions

during my night in a sleep clinic,

where I've just endured
a less-than-restful sleep

under surveillance.

I want to keep sleeping.

I'm here to find out if I'm one
of the one in five snorers

with the more serious
underlying condition,

obstructive sleep apnoea,

and whether there's anything
my long-suffering wife Dimmi and I

can do about it.

Feels like I've only had
a few hours' sleep,

but I'm ready to go talk to Dr Dev
in a bit.

But first I'm going to jump in the shower
and get myself a coffee.

After a splash of cold water
and a caffeine hit or three,

I'm feeling more human.

You've had some breakfast?

- I've had some brekkie.
- Alright.

My glucose levels are up
and I'm ready to hear the verdict.

Ready to go. OK. Well,
there's a lot going on, actually.

So there's some clues in here about
why my wife might be a little bit upset.

Well, these are the electrical currents
that is generated by your brain.

But what was interesting
in this part of sleep

was the actual breathing pattern,

and the snoring as well,
and how restless you are.

- Now, even better...
- Yeah?

...do you want to play this live
and hear the snoring?

I don't know what I'm letting myself
in for,

but for the sake of science, let's do it.

No, no, no, no,
for the sake of your wife, let's do it.

- For the sake of my wife, let's do it.
- Let's do it.

That's alright.

- Do you hear the audio?
- Yeah.

So, here, you've completely stopped
breathing now. Do you see that?

Can't hear any breathing.

- Far out.
- Far out, man!

Do you see the straight line there?

So, you are stopping breathing
for around 20, 30 seconds.

- What?
- And look at this bit.

The oxygen levels start going down.

- I stopped breathing for 20 to 30 seconds?
- You stopped breathing for 20 seconds

and the oxygen levels just drop
a little bit down. Not too low.

- You don't go blue, alright?
- I hope not.

- Hopefully, don't go blue.
- I've survived till now, but...

- You've survived.
- ...that's pretty scary.

But there's... Yeah, it is scary,

but you've been doing it for a while,
actually, and...

Jeez.

...overall,
there's nothing to worry about.

There's no major health issue,
which is good to hear.

- Alright. Bonus.
- Alright?

- But...
- But?

...a number of apnoeas.
It came to about 12 an hour overall.

- OK. Right.
- Sounds a lot.

Anything under 15 an hour
is regarded as mild.

- Right.
- So it's not a health issue.

Damn right,
12 near-deaths an hour seems a lot!

It may not be a health issue now,
but it soon will be

if my poor wife doesn't start
getting a better night's sleep.

The main thing is really
to try and sleep on your side.

Sleep on my side, yeah.

You could try one of those
dental gum shields.

- OK.
- There's different types and varieties,

but the bottom part is slightly ahead
of the top part.

That's just bringing my jaw forward.

Yeah, yeah, just bringing the jaw
forward a bit.

Takes a little bit of getting used to,
but it can be quite effective.

- Can I have a look at that?
- Yeah, yeah, sure. So...

It's a relief
the treatment's so simple.

By moving my jaw forward,
this device will keep my airways open,

and hopefully, my relationship snore-free.

So, are there any other bits of advice
you can offer for Dimmi and myself?

Yeah, I've got another gadget
that's quite commonly used, actually.

Do you want to see that as well?
- Sure.

- OK. It's called earplugs.
- Oh.

Winning.

It's been six weeks
since 17-year-old Monique

began her pre-bedtime routine
to retrain her brain.

It was prescribed by adolescent
sleep specialist Dr Chris Seton

to help her get a proper night's sleep.

Since then,
she's been documenting her own progress.

It was really hard, going to bed at 11:15

and then having to just lay awake
because I wasn't able to fall asleep.

In the morning I felt, like,
as tired as I usually was.

The program is helping, like,
to an extent.

I am feeling when I wake up
a little bit more happy

and more inclined to get out of bed,

but not drastically different.

So Dr Chris and I are back
to see Monique at the end of six weeks.

- Hi, guys! Welcome back.
- How are you?

I'm very good, thanks. How are you?

- Nice to see you.
- Nice to see you too.

My gosh, look at you.
I think you look less sleepy already.

And first impressions are very positive.

- Guys, come on through.
- Thank you.

So, how have things changed for you?

It's quite different.

Getting up in the morning I feel quite,
like, happy and things like that,

- which is great.
- You actually feel different?

Yeah, I do,
especially when I get to school.

Like, I feel like I can go into class

and I don't feel like I need to sleep
in that class.

So what you've done is,
you've retrained your body clock.

- Your body clock was running very late.
- Yep.

So you were very awake late at night,

very sleepy in the mornings,
and you've reversed that.

And it's great. I'm really proud of you
that you've kept at it.

- Have your friends noticed?
- Yeah.

Some of them are even thinking,
"Maybe I should do this." Like...

- Oh, yeah?
- ...it's pretty good.

- We could start a revolution.
- Yeah!

Congratulations. High five.

Well done.
- Thanks.

Come here.

When she's happy,
she just lights the whole house up,

and there's been a lot of smiling,
happy Monique in the last few weeks.

And the timing
couldn't have been better,

in this crucial final year of high school.

It's been a godsend for us,
you know, so we're quite hopeful

that it's going to help her do
what she needs to do for the HSC.

And what have you got on at school today?

I have a test on, but I feel pretty good.

- Oh, good.
- Yeah.

Good to see your happy, smiling face
in the morning.

Monique's dramatic transformation

is supported by the results
of her last sample.

Her melatonin level is now lower
in the morning,

which means she's had
a good night's sleep.

Even my friends and family

are seeing differences in my attitude,

just being able to, like, be happy

and participate in things which
I usually wouldn't, which is great.

It's been quite a journey for me
discovering just how crucial sleep is.

Not only for general recovery,
but also to optimise brain function.

I now also know that while some teenagers
are wired to stay up late,

they can retrain their brains to feel
tired earlier, and so can we all.

Swapping our screens
for regular bedtime cues,

such as chillout music and a warm bath,

could help prepare us for
the life-changing sleep we need.

But what I've mostly learned is,
it's true what they say...

happy wife, happy life.