Sleep Better to Break Habits: A Neurologist's Guide with Dr. Sui Wong, MD
In this episode of The Adaptive Mind, I sit down with Dr. Sui H. Wong, a neuroscientist and neuro-ophthalmologist based in London, to explore the fascinating world of sleep science. Drawing from her dual expertise as both physician and researcher, Dr. Wong illuminates the intricate connection between quality sleep and our mental capabilities, from willpower to emotional regulation. She breaks down complex sleep cycles into practical insights that can transform your nightly routine and, by extension, your daily life.
After listening to this episode you'll learn:
- The science behind sleep cycles and their impact on brain function
- How quality sleep influences willpower, habit formation, and emotional stability
- Common sleep misconceptions and why they might be holding you back
- Evidence-based strategies for establishing a healthy sleep routine
- Practical tips for improving your sleep quality, starting tonight
Whether you're struggling with sleep issues or simply looking to optimize your rest for better mental performance, this conversation offers valuable insights into one of the most fundamental aspects of human health. Join us as we uncover how the quality of your sleep might be the key to unlocking better habits, clearer thinking, and improved overall wellbeing!
Brady Dowling: So today we have Dr. Sui H. Wong on the podcast. She is a neuroscientist and neuro-ophthalmologist based in London. In addition to her clinical work as a medical doctor and physician, Dr. Wong is an active neuroscience researcher who translates pertinent and clinically relevant questions into research to improve person-centered patient outcomes. Dr. Wong is also the author of Sleep Better to Thrive, which will be much of our focus in this conversation. Thanks so much for joining us and welcome Dr. Wong.
Dr. Sui H Wong: Thank you so much. It's such a pleasure to be here.
Brady: Yeah, thank you. So I guess to get started, can you talk a little bit about your background and specifically kind of like what got you into this field and interested in sleep as well?
Dr. Sui: Thank you. So I am a medical doctor. So I went to medical school and during my medical school training, I realized I love everything in medicine. So I couldn't decide which area of medicine to specialize in. And in the UK, we do one of those residencies that starts off with a general internal medicine. So I went to all the different subspecialties. And when I came upon neurology,
Wow, it was amazing. It was so fascinating and it was also a lot of emerging treatments. So was really drawn to neurology. So yeah, so I went on to complete my neurology training and the UK, it's a very, very long path, something like 10 to 12 years compared to a four to five year residency in the USA to be a neurologist, medical doctor. And of course I then was very interested in the vision side of brain.
And I therefore did my further training in neuro-ophthalmology. But the whole time, as I'm doing my clinical work, so my day job is as a jobbing doctor, so as a clinician, physician. And there's always these questions about, why does something happen? How can we do something to improve the situation? So that's where it comes in translating some questions that come from the clinics.
two research questions. So my research is very much about interventions, about lifestyle-based interventions is a big passion of mine, and one of that would be about sleep. So specifically how I came into sleep was that in my day-to-day job, I realized that a lot of people have conditions that's really affected by poor quality sleep. So one of the conditions I look after is a rare one called idiopathic intracranial hypertension, where people have
high pressure in the head and they are at risk of problems with their vision. But as part of my work, I realized a lot of them had problems with sleep and that is part of the process of doing a deep dive into it. So yeah, that's a long and short of sleep. And of course, some recent research trials I've been doing with using sleep interventions, improving quality of sleep in other neurological conditions to help with fatigue and sense of wellbeing.
Brady: Amazing, it sounds like you follow a similar process to me when I'm getting into something, which is sometimes I just chase things and keep going into whatever is applicable to me and whatever is pertinent.
Dr. Sui: Yes, absolutely. And I think that's the fun thing, I suppose, with you looking for your podcast guests, talking about topics, you get the chance to really do a deep dive and that's where the fun is.
Brady: Yeah, absolutely. thinking about sleep, can you talk just on like a very high level of what's happening in our brains when we sleep and then also go into how our sleep can aid or really be a detriment to our mental health?
Dr. Sui: Indeed. So when we sleep, it's not just the light switches off and we are sleeping. A lot happens in the brain. It's really quite fascinating. So on average, when somebody falls asleep at night, they go through lots of cycles of sleep. So two terms I'd like to introduce to your listeners, if they're not familiar with it. One is called sleep cycle, and the other one is sleep stages.
So through the night, somebody will cycle through different levels, different stages of sleep, from light sleep to deep sleep to rapid eye movement stage of sleep. So that whole thing you can consider as one cycle. And through the night, somebody will cycle, will go through a few of those cycles. So that could on average be about 90 minutes per cycle for adults. that could be, somebody could cycle for about
five or six times through the night, depending on how many hours they sleep. for each stage, there are different functions to it. In fact, I think we are only touching the surface of how much we understand about sleep. And I love all the work by sleep scientists. So I'm not a pure scientist, as I've just described, I'm a physician, doctor, scientist. So a lot of pure scientists.
doing research into sleep signs has been wonderful to really shed light into this. And we know that certain stages of sleep have specific benefits. For example, deep sleep would be really important for clearing toxins in the brain, for consolidating memory, so a deep rest state. And for the REM, the rapid eye movement stage, will be particularly important for emotional regulation.
for immune system function, for willpower, for resilience, emotional resilience, and of course the light stages are also important for the body, bodily repair, muscle repair, so there are loads of benefits to sleep.
Brady: Yeah, absolutely. And you started to touch on a little bit about how sleep aids or maybe prevents habit changes and prevent potentially breaking habits or addictive behaviors. Can you go a little bit more into that? You touched on willpower and emotional regulation, but if you could provide a little bit more color on that.
Dr. Sui: Yes, of course. in our pre-interview chats, I said that I'm not an addiction specialist. So my concept about addictive behaviour would be things that I see that I be describing more like cravings for food, for example, just to give an example. when somebody is sleep deprived, we know that the signs show that the blood flow to the prefrontal cortex, so that's the part of the brain that's towards the front.
kind of just behind our forehead and that's really important for making decisions or willpower and that blood flow in that area tend to reduce with sleep deprivation. And that's one and the other aspect is that we know when people are particularly deprived of their rapid eye movement sleep stages, it could be more difficult to manage ups and downs of stresses and emotions. So those two in combination in my clinical practice, I see
can have a very bad effect on, let's say, if somebody is wanting to create a change in their behaviour to cut down on reaching for junk foods or sugary treats. It's harder to resist when they're sleep deprived because of all these factors. And also, interestingly, there is research to show that when somebody's sleep deprived, they tend to go for more sugary things, whether it's because of their willpower or whether it's...
the body needing some other boost and they're reaching for the quick hit, which of course then has got the after effect of creating a sugar crash and a whole roller coaster. So talking about sugar and mental health and wellbeing, I'm working on a book. I was just submitting the final edits yesterday and I was just going through that chapter I wrote about sugar and mental health and wellbeing and there was this
data to show that when there is lot of fluctuations in blood sugar levels with metabolic health dysfunction, let's say somebody's blood sugar shoots right up or crashes down and they have resistance to insulin, response to insulin or pre-diabetes, there is more likelihood for inflammation and also more likely for them to get difficulties with mental health challenges.
Brady: Interesting. Yeah, from what I've come to understand, inflammation is a big negative in the body. I mean, I'm sure there's a purpose for it and benefits to it at times, but yeah, being able to decrease inflammation through sleep seems very beneficial and very appealing.
So we talked about briefly about how sleep can be beneficial or detrimental for breaking habits. Can you talk a little bit about how sleep can affect our ability to build new habits, maybe something that might be productive, like journaling or waking up and going for a run, something like that in in terms of, yeah, us building habits that we want to build.
Dr. Sui: Yeah, so I think probably a key thing would be to do with willpower, of course, and the other one is getting into a regular routine. I was thinking about this question about broadly habits and sleep, and I was thinking more along the lines of learning a new skill. So let's say if somebody say, they want to build a habit of playing their musical instrument, playing their piano, and to be able to
play the piano, they may want to be learning more challenging pieces, they may want to kind of push a little bit, practice certain things, they may want to practice certain kind of maneuvers with their piano playing, which could be quite difficult to achieve as they are doing it. And what's interesting is that a good night's sleep helps the brain process it. So what may have been challenging
a particular challenging piece of the music or how the hand moves around the piano keyboard after a good quality night's sleep, the brain does something with what was tried. And so that is kind of the way I think about building on habits. Another nice way I like to think about sleep is this concept of a keystone habit. I love this whole, there are a few really lovely books about habits. I'm sure you've come across them.
One would be Atomic Habits, famous Atomic Habits, James Clear loved him before he wrote the book, when he was writing his blogs a long, long time ago. And another one is by Charles Duhigg. Charles Duhigg was the title of the book, but it's about habits as well. One of them, I can't remember which particular book, because I've just wrote about this not long ago.
is that they talk about the keystone habit. So you think of the keystone like the keystone of a bridge where it kind of holds the arch together. There are certain habits, it was James Clear talking about the example of running. So it's about certain habits that would really pull things together. So I oftentimes think of sleep as a keystone habit. So for example, if say somebody wants to get up and run in the morning as their new habit and they have to get up at a specific time.
And sleep is quite key to it, to be able to get up. And working on that would lead to a sequence of changes. And of course, when one has good quality of sleep, their wellbeing is better, and then they're more likely to push themselves a little bit more to get on with a habit that they are trying to implement.
Brady: Right. I've heard I think it's also sometimes known as linchpin habits that some people. Oh, yes. Yeah. So this habit that basically you start to perform it and then when you're performing this habit, it actually makes it easier to perform other habits. So like you mentioned with sleep and then with exercise are a few of the big examples. I think, yeah, we've kind of touched on it, but proper diet, having a diet that's going to really like build your
Dr. Sui: Yeah, I like that. Yeah, yeah, yeah.
Brady: your brain and your physical energy, stuff like that can also aid in starting new habits like that.
Dr. Sui: Absolutely,
and I often say to people who are trying to start new habits is to figure out which one they find they want to work on, just work on one, gradually build it up, and then as they build it up, they make the sense of success, of achieving it, makes them want to do it more, and then they can tag on the next habit that they want to tag on. For example, if somebody say, I want to wake up at 6am in the morning and not just snooze my alarm until 8am.
AM is, late for work, that sort of situation. Okay, 6 AM, they continue to build on that. They start to add in, you know, a sense of achievement. They start to get the sense of achievement of waking. And then with that, then they go, all right, okay, I'll start to go for a walk in the morning for five minutes and such things. And then you kind of build from that. And then with that, there's a sense of, well, I've done so much effort now with waking up, going for my run.
I'll have a healthy breakfast, that sort of concept. So it kind of builds on, yeah, like I like the word you use, lynchpin habit. That's like Seth Gordon, lynchpin.
Brady: Yeah, exactly. Yeah. And even the way you're talking about it makes me think just from your example that when you're doing these things, you're also building your confidence in yourself and probably your self-talk is improving. So that's like another byproduct that you can get from some of these habits.
Dr. Sui: Yeah, yeah, yeah. Yeah, absolutely. And sometimes I think that it's also like a muscle. So sometimes when somebody's feeling maybe less confident about new habit, but they will know in themselves that they have in them to build a habit because they've done it before. So it's kind of doing an inner reflection that they actually do have the capability and they just need to start small and build it up. And that with this
inner sense of confidence. I think that's when it's more likely for people to succeed. And it's good when people have this inner sense of confidence that comes from evidence that they've done it, rather than feeling like, what's the evidence? Yeah.
Brady: Yeah, exactly. I think that plays into breaking habits as well. When we become so focused on breaking a certain habit and we only are focused on the success and failure of that one thing, it can be more tricky than when we start to, let's say, work on building up one habit and we get that confidence. And then that confidence can play over into if I'm maybe trying to break my habit of eating candy, maybe it'll...
fall over into that one. I think, yeah, there's a lot of this kind of synergy between these different things happening.
Dr. Sui: Yeah, yeah, yeah. And there is this other thing I always love to share with people building a habit is to focus on the process. So process is the goal. I would love to attribute it to somebody. I can't remember who I first heard it from, but I have saved this quote and I keep sharing it with my patients that the process is the goal. So for example, if somebody say they want to lose weight, the goal is not to lose 10 pounds. The goal would be to build a
a regular morning exercise habit and then what they track is how many minutes of exercise they do in the morning and then the by-product of that would be losing 10 pounds for example.
Brady: Great. Yeah, we'll find it and we'll put it in the show notes. Okay, so I think we've almost touched on some of these, but can you talk about just some very simple tips for improving sleep?
Dr. Sui: Thank you. So there, I love to share the key things about getting to a routine, first of all, and that would be thinking about going to bed at the same time every night and waking up at the same time every morning. So that would be seven days a week, if possible. Of course, we're not aiming for perfection. 80 % of time, if you get there, that's great. And it's oftentimes the intention. And it's...
That would mean, so let's say somebody wakes up at 7 o'clock in the morning on weekdays, they may be feeling a bit sleep deprived and on weekends they may want to wake up at 9 or 10 in the morning, but I ask them to take a leap of faith with me to wake up at 7 in the morning so they can get to a regular routine and then work back the timing of what time they need to go to bed. So how many hours somebody needs does depend on the individual.
So it may be that they restart by saying eight hours or nine hours, depending on what they're currently doing and how they're feeling when they wake up in the morning, and then keep to that similar routine on weekends as well. Which means for some people, they will end up going to bed a little bit earlier on the weekdays. And as somebody does this over the next, over two to four weeks, their body starts to get more rested and they're not chasing sleep debt.
They're not always trying to recover from sleep deprivation. So that means it's less likely for them to want to sleep in on the weekends. And as they're getting there, I prescribe a nap. I prescribe a nap at about noon for half an hour. So it's just enough to refresh somebody and then they get, they don't feel so tired. And then they get, yes, during the day and then they are still sleepy by the time nighttime comes.
The key thing about naps is not to a nap too late in the afternoon. There is this build-up of a chemical in our body called adenosine, and when we sleep, we kind of clear that amount of sleep pressure that comes from adenosine. So that's why it's early in the day. And the second thing is why half an hour? Because of the sleep cycle.
Once we sleep for a bit too long, we get into really deep sleep and that makes it so much harder to wake and it makes people feel really groggy and just feel worse off when they've had a nap.
Brady: So it sounds like a half hour is almost not getting into the sleep cycle or just doing it short enough so that it's not going to affect us in the nighttime.
Dr. Sui: That's right. So it gets into light sleep, but not into the deep sleep. So it's enough to refresh. And sometimes people may, I may suggest that they just close their eyes, put on their, what do call it, the alarm to set off at 30 minutes. And some people may not realize that they have slept, but as the alarm goes off, they go, oh, oh, I've actually slept. For some people, if they can't fall asleep, I suggest that they put on like a little body scan meditation.
called a yoga nidra, which I have a recording of, which comes with one of my books on mindfulness that I've written, that comes with this yoga nidra for rest. And that also works quite well. So those are the first things I ask people to start off with. And then other things would be to consider the sleep environment. What's the temperature in the room? How much noise is there outside? How much light is coming to the room? How much light is within the room?
As people are having to fall asleep, sometimes their minds may be really very active. So I have little tips such as journaling, just put all their thoughts on paper and then they can deal with it the next day. Or to stop their mind from just keep thinking about certain things, they may listen to a podcast or an audio book on auto-timer and for about half an hour or something. And then as they're listening to it, they're
body is tired, their brain is tired and then they fall off the sleet without following their own inner thoughts to just ruminating or problem solving. Which also comes with the next bit where I say, because podcasts or audiobooks are often on the mobile phone, I said to put it at the other end of the room. So that's not the last thing you're looking at and not the first thing either in the morning. So mobile phone.
far away across the other, just outside the bedroom or just at the edge of the bedroom door. And then that kind of helps to unwind. And many, many more tips. As you have said in this book, sleep better to thrive that you like.
Brady: Yes. Yeah. mean, just what you've said right there was so packed with so many good tips. And I was reading or listening to the book on audiobook. it is. Yeah. Just chock full of really good tips. I think of the ones you mentioned there, like there are so many that I'm always like reminding myself of and trying to improve how I'm doing them. I think one of the easiest is, well, to me, the sleep environment, because you don't have to adjust.
necessarily your timing of your sleep, we should, we should be focused on that, adjusting your environment, making it really dark, making it really quiet. Depending on where you live and your lifestyle, that can be a very easy and doable and really consistent one that you just do it once and it's almost done forever.
Dr. Sui: Yeah, and I think when people get into a really good quality cycle of sleep or regularity, with the regularity, one of the key things is because of this concept of the suricadian rhythm. The suricadian rhythm is the inner body clock. At the base of our brain, there is this master clock that tells us when is morning and when is night time. And when we get to this regular pattern of sleep, it really helps our body clock regulate. And I think
When somebody really gives it a try to just get to this regular pattern, get good quality of sleep, they may be so amazed and love the impact of good quality sleep on their life that they will just naturally want to do it because they feel better for it.
Brady: Yeah, absolutely. And you've talked about how personal some of these things are, finding your sleep schedule, things like that, and almost having this mindset of being a scientist like you. Yes, yes. And we talk about that on another episode, but that concept of being a scientist is really like very pervasive in our lives and can help us in so many different areas.
Dr. Sui: Absolutely, absolutely. And I tell the people I look after to question what I say. That's a really good start. It's a guide and I would love to hear the impact of the efforts and to see are there things that we need to consider, what other factors are involved, etc.
Brady: Yeah. And as we come to a close, can you talk about maybe some misconceptions about sleep or about the effects of sleep or how how we should be sleeping?
Dr. Sui: Yes. So I think a misconception is that maybe hopefully less now would be, I can sleep when I'm dead. That kind of phrasing. It's very old school and I still hear it sometimes. And actually, sadly, if people are sleep deprived, they probably have a shorter life because of the illnesses that come with it. So let's not have that. Let's go good quality sleep, good quality life, live a good life.
So that would be, I think, the key misconception. And the other thing to say is, if you have a bad night's sleep, it's okay. Don't worry. You have the chance to try again the next day. So what I definitely want to leave people with is that they are left with a sense of curiosity and feeling interested to try something to improve their sleep and not be left with the, my gosh, I can't sleep and then get into this fear cycle. You know, don't need that. Just...
It's okay. Next night, another opportunity, do some breathing exercises, do some journaling, listen to an audio book and it's okay. The body will rest a minute when it needs to rest. And all these tips are to enhance quality of life really.
Brady: Yeah, that's something that is maybe easier said than done, but I think just like all of these tips that you've left people with, it comes with practice. And once you adopt that mindset of, know, I had a bad night's sleep last night, but I'll just sleep better tomorrow night, or I'll take a half hour nap today or whatever it is.
Dr. Sui: Absolutely, absolutely. And then I say to people like, bad night's sleep, just get up and just pretend it didn't not happen. You know, I say in a slightly joking way, but actually when we act like it didn't happen, the body, you know, there is a chance for the body to just get going and then get a chance to just reset the next night.
Brady: Awesome. I love that. Okay. I think we've covered so many really good things. And like I said, there's even more in sleep better to thrive. And I love your mindset. I love the way you approach things and thank you so much for coming on. I guess one more thing that we'll ask is just where can listeners find you? Where can listeners find your work?
Dr. Sui: Thank you. I have a website and it's drsuiwongmd.com. I'm actually, I would love your listeners to sign up to my Thursday Tips, my Thursday Tips newsletter where I share bite-sized brain health tips to thrive. It's very popular. It's less than one minute read. Every Thursday, I share three tips and one question.
Brady: Awesome, that sounds very doable. Well, thank you so much.
Dr. Sui: By the
way, I should give the link for that one. It's bit.ly forward slash dr w o n g brain b r a i n health, Dr Wong brain health. Okay. I should shorten that.
Brady: Yes,
I'll include that in the show notes as well. So there will be no confusion about it. So yeah, check the show notes and you'll have all those links. But thank you so much, Dr. Wong. This is really excellent. think a lot of really good tidbits and information for people to use and put into practice right away and get benefits.
Dr. Sui: Thank you so much for this invitation and thank you for doing the work that you do when sharing good quality podcasts, empowering people with health information.
Links & Resources
- Dr. Sui Wong's website
- Sleep Better to Thrive by Dr. Sui H Wong
- Atomic Habits by James Clear
- The Power of Habit by Charles Duhigg
- Dr. Wong's Thursday Tips Newsletter