Episode 58: Lighting and Sleep

How does lighting impact on sleep and health? Is it really a big deal? To understand the interaction between lighting, sleep and health we spoke to Assoc Prof Sean Cain, a leading expert in lighting research, from Monash University.

Dr Moira Junge (Health Psychologist) and Dr David Cunnington (Sleep Physician) host the monthly podcast, Sleep Talk – Talking all things sleep.

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Audio Timeline / Chapters:

  • 00:00 – 25:00 Theme – Lighting and Sleep
  • 25:00 – 26:32 Clinical Tip
  • 26:32 – 31:10 Pick of the Month
  • 31:10 – 32:50 What’s Coming Up?

Next episode: Sleep and Suicide

Links mentioned in the podcast:


Guest interview:

Assoc Prof Sean Cain has many years of experience in the field of sleep and circadian rhythms research in both animal and human models. Dr Cain is currently the president of the Australasian Chronobiology Society. He has trained in the conduct of human circadian rhythms and sleep research at Harvard Medical School where he studied the impact of sleep and circadian misalignment on health. Dr Cain is an Associate Professor in the School of Psychological Sciences at Monash University. Sean has many years experience in the field of sleep and circadian rhythms research in both animal and human models and is the primary investigator on a number of grants. Follow Sean on Twitter at @circadian247

Regular hosts:

Dr Moira JungeDr Moira Junge is a health psychologist working in the sleep field, who has considerable experience working with people with sleeping difficulties in a multidisciplinary practice using a team-based approach. Moira is actively involved with the Australasian Sleep Association (ASA) and a board member of the Sleep Health Foundation. She has presented numerous workshops for psychologists and is involved with Monash University with teaching and supervision commitments. She is one of the founders and clinic directors at Yarraville Health Group which was established in 1998. 

Connect with Moira on Twitter – @MoiraJunge

Dr David CunningtonDr David Cunnington is a sleep physician and director of Melbourne Sleep Disorders Centre, and co-founder and contributor to SleepHub. David trained in sleep medicine both in Australia and in the United States, at Harvard Medical School, and is an International Sleep Medicine Specialist, Diplomate Behavioral Sleep Medicine and Registered Polysomnographic Technologist. David’s clinical practice covers all areas of sleep medicine and he is actively involved in training health professionals in sleep.

Connect with David on Twitter – @DavidCunnington. David also regularly posts information on sleep to his Facebook page.

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Welcome to Sleep Talk, the podcast about all things sleep brought to you by SleepHub.com.au. Here are your hosts, Dr. David Cunnington and Dr. Moira Junge.

Dr. David Cunnington: So welcome to Episode 58 of Sleep Talk, the podcast talking all things sleep. And welcome again, Moira.

Dr. Moira Junge: Hi, Dave. Hi, everyone.

Dr. David Cunnington: For this episode, we’ve got Associate Professor Sean Cain joining us. And thanks very much. Great to have you on again, Sean.

Sean Cain: Yeah, thanks to both of you for having me back.

Dr. Moira Junge: Welcome back. You are a star performer, a third time I think on the show in 5 years. I think that’s a record.

Sean Cain: Great. Always happy to come back for sixth.

Dr. David Cunnington: Yeah. And I was looking back, Sean, your last one is sort of late December 2018 so it’s a good 2 years and you have certainly been doing some great work so looking forward to teasing you out about some of that work.

So the theme for this month’s episode is light. And so there are lots of talk about light and its impact on sleep and then a broader impact again on health. We hear it in the media. We see it in the way technology is being developed and technology companies have changed their operating systems to help us manage light. So we are going to try and knot out what’s the real story. Is it that big a deal? How does it work? What type of things we should do? And Sean, we are going to get you to give us all the answers.

Sean Cain: I’ll see if I’ve got all the answers to give you.

Dr. David Cunnington: And Moira, is it something that you see with people in your practice that they are asking about light or conscious about light?

Dr. Moira Junge: Yeah, for sure. I mean obviously, for the last 20 years I’ve been talking to them about the importance of the light-dark cycle in terms of how much it influences their sleep alongside the many other things like the racing minds and other habits. But it’s probably in more recent years that they are the ones often bringing it up to me and asking lots of questions. And in fact, I see a bit of a subgroup of people often, not always, but often very, very anxious about their sleep.

And so, the messages around light have only, unfortunately, going to make them more and more anxious about being a little bit too rigid, a bit too ritualized but too panicked about that light. So it’s really important to have more nuanced discussions around how there’s such a big individual difference in sensitivity and in what light is around in their houses anyway. So I’m really looking forward to this discussion.

Dr. David Cunnington: All right, Sean. So what’s the truth about light? Is it as important as what we hear about in the media?

Sean Cain: I believe it is. But some of the things you hear maybe are a little untrue and some of them are true. Some of them are a little close. There are nuances that I think aren’t always out there in the messaging. So some of the things that probably aren’t a big deal are the kind of light you get from screens during the day. Our clocks, our internal clocks, they really want bright light in the day and dim light or darkness at night. And if the system craves that then we should be giving it to our clock. So really, I wouldn’t recommend wearing blue-blocking glasses during the day when we want to get lots of light. So I think some of the messaging around blue light always being bad is not helpful.

So the reason why people think blue light might be bad is that the photoreceptors, these are ancient photoreceptors that evolved before visual photoreceptors in the eye. Their job is to detect basically is it day or night and send that signal to your brain. Those particular photoreceptors are very sensitive to blue light so it doesn’t take much. But you want lots of blue light in the day and that’s great so wear any kind of lens that blocks any blue in the day? It’s not a problem. But at night, yes, you want to avoid it. So you want strong signals for darkness at night. So you do want to avoid it.

So it’s this message that blue light is always bad. That’s not the case. And the amount of blue light that it takes to damage your eye is way more than we’d ever get from any of these devices, hand-held devices or screens. So it’s a bit messy but I do feel in general that a lot of people are getting some of the important messages.

Dr. David Cunnington: It’s interesting there’s a paper this week or so actually looking at the effect of the blue light blocking glasses on eye strain from screens showing they had no effect. And so, it really – glasses being a $50 add-on, extra revenue for the spectacle for the salespeople, it’s not for eye strain and according to you, definitely not during the day to protect ourselves from sort of blue light. And in fact, the opposite, we don’t want to be protecting ourselves from blue light during the day.

Sean Cain: Yeah. If anything, we just don’t get enough light in the day. So I’m often going on about avoiding light at night. But the other side of it is people have to get some strong light signals in the day. We are living in this too dim in the day, too light at night kind of world because we spend lots of our time indoors and both of those things are not great.

Dr. David Cunnington: And we’ve all certainly experienced that in the last 12 months with being more confined indoors than what we usually would. And that work from Ken Wright where he took the teenagers out into the woods and they lived in the woods for a week or so and entrain their rhythms and really very quickly settled into that light-dark cycle according to sun time really does reinforce how we’re just primitive biological beings that do respond to the natural world around us as long as we get exposed to it and don’t distort it.

Sean Cain: Absolutely. That’s now a classic paper that they showed what the rhythm of these people was under a kind of artificial lighting conditions. And people were very – highly variable in the timing of their melatonin rhythms and sleep. You bring them out into the woods, go camping for a bit, and suddenly there’s very little difference in the time people were sleeping. But also, their circadian times or their melatonin rhythms lined up perfectly with nighttime. So their melatonin onset occurred at dots where it’s supposed to and the offset is from the dawn. It just lined people’s bodies up the way they evolved.

And the more we approach a natural light environment, I think in general, the better we’re going to sleep, the better we are going to feel, and the more productive the next day. Let’s maybe try to get back to the way our bodies evolved to be.

Dr. Moira Junge: Hear! Hear! I think that’s one of the most important things I think about with sleep, in general, is how do we evolve?  What’s natural obviously, with light? Obviously, moving your body, the kind of food you put into your body. The kind of stress level is what’s reasonable and how much work too. It’s the sort of the bottom line really, isn’t it? Let’s get back to basics.

Sean Cain: It just doesn’t seem to go well for us when we fight against our nature so …

Dr. Moira Junge: Well, I mean the other pressure is going out there. I mean we can’t all go out camping in the woods for a week.

Sean Cain: I don’t really like camping at all but there are other ways to get good light cycles.

Dr. Moira Junge: So Sean, are there particular groups of people who are more vulnerable to the negative effects of light?

Sean Cain: Yeah. We are just really beginning to understand that but it’s likely that there are some people who are getting sensitive to light and some people who are very sensitive to light and that can have negative consequences on mood. So we’ve studied people with major depressive disorder and found actually that they had quite low sensitivity to light. And they didn’t line up their bodies to the light. They are cyclical in a healthy way. They are quite advanced.

But we think more than the effect of low light sensitivity on the internal clock, it’s probably having a really important effect on other areas of the brain. So we know now that your ears serve dual functions of hearing, which is obvious but also balanced. The eye serves dual functions of vision, which is the obvious conscious one. And all of these other really ancient functions, one of them is to tell the clock what time of day it is.

But there are other direct connections to areas of the brain involved in emotional regulation and how you process the feeling of loss and fear. We have a paper that’s under review now showing that light switches off or at least reduces the activation of the amygdala, an area of the brain involved in producing fear. Not only that but it enhances the functional connectedness of the prefrontal cortex and amygdala. So light also enhances your ability to control your emotions.

So we think that when – in depression maybe, part of the problem of low sensitivity is misalignment of the clock. I think more immediately it’s probably impacting mood directly. These are these ancient nonconscious, nonvisual functions of the circadian photoreception that they existed before vision even. This is old lizard-brain stuff.

But that’s on the end with major depression. There is low sensitivity but we are finding and others are finding as well that bipolar disorder is associated with heightened light sensitivity, and that might sound good but if we live in very irregular light cycles, and so it could cause what would feel like a perpetual jet lag in someone because even a little light amount of light can have such a big effect and shifts your clock backwards and forwards all the time. It can be quite disruptive and impacts your mood.

And those are two examples but I’m sure that we will find as time goes on that there are all sorts of examples of maybe not just sensitive, or insensitive but people who have highly variable sensitivity and anything else that I can’t imagine at the moment.

Dr. David Cunnington: And how are you going about measuring that sensitivity or identifying people who you think are sort of more vulnerable or less vulnerable?

Sean Cain: We are pretty excited about some fairly new measures of the pupil. So the circadian photoreceptor that’s very sensitive to blue light is called melanopsin, and it is a very weird photoreceptor. So the visual photoreceptors, the rods and cones that everyone knows about, they can turn on and off really quickly on a millisecond scale and if they didn’t, you wouldn’t have – you wouldn’t be able to look around your environment and kind of see detail. It would all be smudge. But the circadian photoreceptor, melanopsin, evolved to detect something in very, very long time scales like whole days. And so, once it’s turned on, it doesn’t have to turn off because it’s trying to monitor a day.

One of the ways that we can use that to our benefit is to test the pupil’s response to light so we know it senses the blue light. The blue light will – your eye will – your pupil will constrict under the blue light. And when you turn off the light, that pupil doesn’t redilate after blue light because once that melanopsin has been activated, it’s still sending a signal to your brain that you’re looking at light. And we know this is likely to be part of the reason why some people have less deep sleep in the early night than they could have.

So you might fall asleep after you’ve been in your blue lights in your environment, all those LEDs on people’s ceilings, you might fall asleep after that but the depth of that sleep, the amount of slow wave sleep can be quite less. So we’re probably all living a little less rested than we could just because of the light and just because of this prolonged effect of the melanopsin. But not to get off on that too much, but we are using the pupillary response to blue light to measure someone’s sensitivity.

But it probably goes way deeper than that. We think there are multiple levels at which light sensitivity can be changed. We think some of them are trait sensitivities. So not something that is ever going to change in your lifetime. But some of them we think are actually state sensitivity, so changing your mood state could also directly change how you respond to light.

Dr. David Cunnington: So when am I going to get a tool in the clinic? When am I going to be able to look at the patient in front of me like the one I saw yesterday who has had major depression, not responding to TMS and say, “Right, let’s work out your light sensitivity and how to modulate it?”

Sean Cain: I fail to get a grant to make that clinical tool but I’m going to keep trying. But I do have one in mind. So we really want a suite of circadian clinical tools to be created. So hopefully soon we will get some money to build that very device.

Sean Cain: So you talked a bit about home lighting, and that’s what I want to move on to because that’s one of your other recent papers. We just recently replaced the LEDs at home and we had the electrician come around. I must say the electrician is in his 60s and he goes, “Oh look, I’ll put these energy-efficient LEDs in and replace them all with very bright LEDs, bedrooms, living rooms, everything. They would be energy-efficient LEDs.” With absolutely no thought whatsoever about the wavelength of light, the consequences for sleep health. We’ve now got four very bright LEDs that I go to sleep to with them on every night at around 10PM so yeah, I’m worried about my slow wave sleep now in the first part of the night.

How do we shift some of that? Is it really that important? How do we start to get sort of that broader cultural shift, get it out of the, we’re in the lab and managing people with sleep disorders and we think about it to the, yeah, 60-year-old electrician who is coming around and giving people advice about lights?

Sean Cain: Yeah. We just have to keep talking about this. I certainly don’t want to be an alarmist but also, people aren’t generally treating light with the respect that it deserves. We are just not used to thinking that light is important. We just buy these bulbs. We don’t think about the bulbs. When we want to get light bulbs, they’re a few bucks and you buy them at the supermarket in the same manner as your toilet paper. So it doesn’t seem like a very important thing. But we just have to keep kind of getting the message out there. And I do think that there are more people who appreciate it.

So if I think back to 10 years ago when I was also doing and talking about similar things back then, it was very obscure. But now, most people know a little bit about it. And in the lighting industry, they’ve really been accepting it. So most people who are working in the lighting industry like making lights are well-aware of this stuff and they know that you should go for more warm lights and not more white and cool blue-enriched lights. So more and more people are getting it but I think we just have to keep saying it over and over and over again until it’s in the public consciousness.

Dr. Moira Junge: That’s true to get that education for the general population, the health care settings, hospitals, residential facilities, workplaces. Do you think it is just education and just keep talking about or …?

Sean Cain: I think so. I think it has been working. Every year, I ask my students have they heard of circadian rhythms, and every year, it’s more and more people. Have you heard about the importance of light and light quality? And it’s always more and more and more so I think it is a matter of time before virtually everyone knows it. But we are up against this attitude that light is just something that you push a button on a wall and it goes on. It’s at our beck and call. It can’t really be important. So it will be a bit of an uphill battle but I do feel that people are listening.

And as far as hospitals go, because the lighting industry is interested in kind of doing evidence-based things as things have become more and more solid as far as evidence-based, the very high importance of light, they’ve been adapting it more.

So I actually wrote an editorial in sleep, the journal of sleep, which will be out next month, and it was about a paper where this new psychiatric hospital put in all circadian-informed lighting. And it was just a beautiful showing real important effects within a hospital setting and freely moving people. So you might want to check out the March issue of sleep and read the editorial and that very nice paper.

Dr. David Cunnington: That sounds great. And in your paper, you talked about a device that you use to actually measure ambient light that people were exposed to. If that was more broadly available, that might help with the education piece because people then become aware of the nature of light that they are exposed to.

Sean Cain: Yeah. I was really hoping – this has been a project we started 7 years ago, the idea of making these devices and we finally just got our first paper with our device out in early November of last year. The device measures all wavelengths of light and it models the impact of light on your circadian system and all these nonvisual effects of light. We really made it in the first place to be able to feedback information to people. Now, I call it melanopic eye, which I find clever but it’s kind of a third eye. This system is part of – it’s partly defined by its nonvisual, nonconscious nature. And so, you kind of need a device to be like a third eye and to tell you what’s going on with this type of light.

And so what I wanted to do is make the nonconscious conscious through technology. So we pick it up with a device and it feeds that information to an app and then the app tells you, you need to get more bright light in the day and at this time. And that light that you got in your environment, that’s way too blue-enriched so get rid of that and get a new one. And people – we have people interact with it and choosing a healthy light environment I think, that would be fantastic and that would come from that device. If people can be in a nice and healthy light environment just for a week, they will really notice impacts on their sleep and impacts on their mood. It doesn’t – you don’t need to do it right for too long to see an effect. So I just try to talk people into doing it for a week. And in Ken Wright’s camping paper, that’s all they did. And it just set everything right.

Dr. David Cunnington: So you talked to us about the hospital. I’ll certainly look out for that paper because that hopefully will set a benchmark if you like particularly in psychiatry. What about in other settings? So what about the home setting, just the general population? So what should they do about their home lighting?

Sean Cain: I also have bright overhead lights and I never used them. So I’ve got some lamps around the house and I bought some smart lights at Bunnings. And I set them up to be as bright and white and blue as possible every day and starting at the same time. And very, very dim, warm, basically as dim as I can have it so that I could still have some useful light and very warm. And I just set it. A lot of these bulbs are Wi-Fi-enabled so they are set up in your home Wi-Fi environment and they’re app-coupled. So you set it all up on the app and you set it and forget it. You’re kind of back to nature in a way without having to camp which I’m not a fan of the whole insect thing in camping or being like uncomfortable and not in my bed. But you can get those camping benefits on your clock by setting your home lights.

And before I got smart lights and set them up to be automatic, I had a real problem remembering to turn my lights down manually and I’m obsessed with it because my whole life is talking about this and researching it and I can’t remember to do it. So I don’t think anyone should do it. And in a way, if you are setting it up automatically and you’re not thinking about it, well, that’s how we evolved too. We didn’t decide when sunset was going to happen or when sunrise was going to happen. It was in charge of things and we followed. And that’s the way it should be in our homes too.

Dr. David Cunnington: What should a workplace look like?

Sean Cain: I think workplaces are pretty easy because if everyone is working in normal working hours in the day, we actually wanted white bright and blue-enriched and that’s good, the brighter, the better. And you have to worry about eye strain and a lot of people really suffer from that more than others. You want good vision under those conditions so some lights are better than others. Some have a really good color rendering index and some of them do not. But if you can see well under the light and you can get it as bright as possible and still comfortable, that’s all you really need to do.

Now, it’s another story when we are talking about night work or shift work. And then the bright, white, blue-enriched light at night, it’s going to mess with your rhythms but at the same time, you can’t be up working under dim lights and not being alert. So you’re going to have to choose one bad thing or the other, which is you’re going to be up alert and safe or you’re not going to affect rhythms.

Dr. Moira Junge: Sean, where can people get more information?

Sean Cain: We are always doing research. One of our projects that we’ve got going is HMRC-funded project on how this kind of light sensitivity is a part of the treatment of depression and how antidepressant medications really seem to target the system. But we are always looking for philanthropic donations if anyone else – anyone out there wants to support our work, especially our work on depression because we feel even though we have funding, there’s so much more to do. And again, we want to create better treatments for people that are circadian-informed.

Anyone can get in contact with me through my email, so Sean.Cain@Monash.edu. If someone wants to give philanthropy, they could – I can direct them on how to do that.

Dr. David Cunnington: There are also some resources that people can access. There’s a website that’s run by a group called the Center for Environmental Therapeutics. It has actually got some really nice resources about – as a broader term, if you think of light as an environmental therapeutic, that’s sort of one way of thinking about it. And the previous podcast episodes that Sean has joined us for when he was talking about rhythm and mood, that’s Episode 33 and one was screens and the effect of light on adolescent sleep, and that was Episode 9.

Dr. Moira Junge: I just like to add another website there for resources, Dave. It’s the WorkAlert.org.au. It has got a number of handy hints and information both from the employer and employee perspectives.

Dr. David Cunnington: Sean, what’s a clinical tip or a tip for people based on what you’ve talked to us about?

Sean Cain: No one is going to be harmed by being very deliberate about their light-dark cycles and going for the goal of bright days and dark nights. It means getting outside the house a little more deliberately during the day. And we know that going outside and getting light in the day actually boost your rhythm, the strength of your rhythm. So it helps your core clock in the brain pull together all the hundreds, if not thousands of rhythms in your body. So bright light in the day is important. We are usually talking about avoiding light at night but a really light in the day, getting lots of bright light is strengthening your rhythms.

The other half of that is avoiding too bright a light at night. We are all pretty sensitive to light at night, some more so than others. And right now, there’s no easy way for an individual to know for sure if that nonvisual system is sensitive or not because it’s not a visual system. So you might be sensitive to the visual effects of light but that doesn’t mean that this other system is sensitive or insensitive. As far as we know, they’re not related.

So everyone could do well to avoid too bright a light at night and to set up their light on a timer so that they don’t have to think about it. Going back to nature while comfortably inside your home.

Dr. Moira Junge: So pick of the month time, what’s yours, Dave?

Dr. David Cunnington: It’s another book. You know how I love my books. Well, this book got released in January of this year, it’s called When Brains Dream: Exploring the Science and Mystery of Sleep and it’s written by Antonio Zadra who is a professor in the Department of Psychology at University of Montreal and Professor Robert Stickgold from the Psychiatry Department of Harvard Medical School, and it’s great. I really like it. Mind you, I’m a bit biased. Anything Robert Stickgold sort of writes, I’m a big fan of because that was one of the guilty pleasures of being in Boston was being able to go to lab meetings where Robert Stickgold would talk or small groups and just be able to pick his brain and listen to how he thought about things, just a wealth of experience and a lot of perspectives. So it’s a really nice book.

Dr. Moira Junge: That sounds great because I’m a fan of Antonio Zadra too from imagery rehearsal therapy. He has written so widely on that. So thanks for the tip.

Dr. David Cunnington: No worries.

Sean Cain: I’ve started reading that book actually.

Dr. David Cunnington: Well, there you go. What about you, Moira?

Dr. Moira Junge: Well, a paper that just very recently, February 2021, in sleep medicine. It was by a group from RMIT as well as China, with a lot of affiliations in both. I don’t know Fei-Yi Zhao. He or she is the first author. Looking at – it was a systematic review and meta-analysis of looking at the effects of acupuncture on insomnia. And obviously, they looked at the 11 studies that only meet the criteria that are pretty poor quality methodology, etc., and low evidence but emerging enough evidence to see that even – subjective and objective improvements within sleep with acupuncture.

And the only reason I sort of bring it up and it took my eye is that we just need to do more and more. It’s good to see some studies like that because a lot of things that are sort of so-called complementary are the evidence-based yet. But we just need people to do randomized control trials and get them into the evidence-based until we know for sure because even in my day, back in the 1990s, I couldn’t put meditation and yoga into my work because it wasn’t in the evidence-based. It wouldn’t be an ethical for me to do in my practice. But we now know because people have done appropriate trials. They’re well and truly evidence-based. So that’s just my pick of the month. I’ll put it in the show notes.

What about you, Sean?

Sean Cain: Well, my pick is actually a review article that was out last month in February 2021 in the New England Journal of Medicine. It’s on circadian mechanisms in medicine. So this to me is a bit of a landmark piece. Now, this is the journal that any physician would read. It’s at the top of medical journals. And so it’s great to see such a comprehensive review of why circadian rhythms are important.

One of the reasons why this is such an important paper is that there is possibly no training in circadian rhythms when people are trained to be physicians or almost nothing. But it is fundamental and we are realizing over the past 20 years, we are realizing that all aspects of health are impacted by circadian rhythms. We know now there’s not just this one master clock in the brain. There are dozens of clocks in the brain and trillions of clocks throughout your body and your body is made to do certain things at certain times of the day. And now, it’s being appreciated more and more that healthy rhythms are fundamental to all aspects of health. And when rhythms start to degrade because of the poor light-dark cycles or lack of decent exposure to bright days and dark nights, that will start chipping away at your health.

This is really important because now, physicians are going to see circadian rhythms and not think maybe it’s some hippie thing, which is what it was like when I started doing this 20 years ago. It’s like, “Circadian rhythms, no, it’s nothing I’m interested in.” But between this and the 2017 Nobel Prize in Medicine or Physiology going to circadian rhythms’ researchers, now we are finally getting fully legitimized and more people are realizing just how important circadian rhythms are for health.

Dr. David Cunnington: So lookout in coming episodes for a couple of different topics, so one is lucid dreaming. I had a hot tip from Karen Hitchcock, the TikTok goes off with things on lucid dreaming. So I reckon we will try and get what actually is the evidence around that. Can we get people to lucid dream a bit better? What are the potential uses for that? So that’s something I’m working on.

The other thing I’m working on is this concept of some of the, you’ll like this Moira, some of the economic determinants around sleep and this concept of sleep as a luxury item. If you’re comfortable enough in your life then it’s the luxury that you can afford to have. But if you’re not comfortable then maybe sleep is more challenging.

Dr. Moira Junge: Oh, it’s the truth really. It is a luxury item. And if you don’t have to do two jobs, etc., etc., you probably are going to be able to get more control over how much sleep you get or less opportunity to sleep.

Dr. David Cunnington: So thanks very much, Sean, for your help with this episode. And we are really privileged to have you as a resource we can draw on.

Sean Cain: I love doing it and I’ll come back any time you want.

Dr. Moira Junge: Thanks, Sean. It’s always great to have you.

Dr. David Cunnington: So thanks a lot for listening. Send us any suggestions for other episodes or people you’d like us to interview at Podcast@SleepHub.com.au. And review us on iTunes, tell your friends, and subscribe. Thanks a lot.

This podcast is not intended as a substitute for your own independent health professional’s advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider within your country or place of residency with any questions you may have regarding a medical condition.



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