Anna West: Sleeping to perform

Transcript

Gary McCoy: [00:00:12] Wearable technology use in professional and elite sports is now commonplace. Understanding athlete load volumes for practise and conditioning is an essential part of each athlete's individual profile. But what happens when athletes have the same measured loads if they respond differently? I encountered that directly, working with an NFL team in 2016. Two wide receivers with identical load volumes had significantly disparate responses. I recall explaining to the coaching staff that the answer lies in how each of them were recovering. Recovery can take many conscious programming forms, but when it comes to identifying the largest pillar of recovery, nothing is more important than sleep. In 2017, I dove deep into the recovery science pool, experimenting with technologies that quantified individual sleep patterns, while looking for experts globally that understood exactly what that data means to a high-level athlete. At a conference in London, Anna West appeared. Just another practitioner in a long line to meet her at this conference. The more we talked, the deeper the discussion got, the further she unpacked sleep science and its critical importance at all stages in life. Needless to say, I believe Anna to be best in class at not only interpreting data from sleep, but more importantly, the behaviour modifications relative to maximising daily athlete adaptive responses. Anna's information is one part of the equation. But what I truly enjoy is her ability to take a step back, analyse the entire human and individualise her process. It's unique in a world saturated with linear data and critical to the depth and understanding of the human kinesome. Anna, it is so great to see you and catch up and thank you for taking part in our podcast.

Anna West: [00:02:16] I think I'm the one to thank you. Nice to see you again.

Gary McCoy: [00:02:19] Yeah, it's been a while. So we first met back. I think it was like 2016, 2017, somewhere in there. At a conference I was attending, I was hosting a roundtable for one of the Leaders in Performance sessions and we got the chance to catch up. Because at that point in time in my career with technology, I was looking at a product called Whoop and I was trying to understand sleep for the first time. And it was starting to, at that point in the US sports market specifically, sleep was starting to become, like, in vogue, right? People starting to talk like how can we measure sleep, why aren't we measuring sleep? And it was kind of coupled with this thing called recovery. And I started looking out and the knowledge base that I could find to really educate myself around the science in that domain, I kept landing back at you. So when I had the opportunity to connect with you live and we sat down over dinner, I just remember talking for hours about your experience with sleep, not just like as a science, but the applied component of all of that science. It kind of blew my mind, some of the some of the things you'd done, but where did it all start for you with sleep? Anna, how did you how did you arrive into this space?

Anna West: [00:03:34] How did I even arrive here? I love you say that you started putting an interest into sleep and trying to understand it. And I think in all fairness, we are still trying to understand what sleep is, how it affects, and how it's dominating in the athletic domain as well. We have theories and there is a lot of science that came out lately which is very usable. But there are still some black spots where we don't know. And that's where applied science is super good because that's trial and error, right? Can we see that there's a difference? And trial and error also means that what we try does not always work on everyone, but you might see results for someone. Hence why it can be super difficult also to create specific guidelines when it comes to sleep and athletic performance. My start into the sleep area was I wouldn't say that it was by coincidence, but maybe a bit of coincidence and luck. I have a background in sports science. I'm a nurse as well. And straight out of university, I was super green, and super lucky to be hired into the medical technical company that was specialised in sleep. I spent quite a few years in this mixed field of research: athletic performance, military. And was super lucky, I think, at that to be able to kind of bridge the gaps between science and applied science and what happened in the athletic field when I started ten years ago. I think everybody knew that sleep to a degree was important. Honestly, the investment in sleep was quite low. We all knew that it was important. But actually, seeing sleep recovery as an investment area wasn't the case.

Anna West: [00:05:11] We saw a lot of research projects. I took part in a lot of research projects as well. And where I personally missed an outcome was actually the translation, right. So, we conclude that sleep has an impact, but how do we actually implement it? And back in 2016 a time slot came up where it was the right time for me to to continue down that consultancy road. And I'm a huge techie fan, but I'm also super happy to now be in a position where I'm not super dependent on which technology I need to implement in this project of study, because I honestly don't believe in a one size fits all philosophy.

Anna West: [00:05:56] And I think from a methodology perspective, it's super important also to understand that a technology might work super well in this athletic environment, but in this athletic environment, it might not be super good, and no offence towards any technology companies, but that's a little bit of the standard mindset, right? We want to create something that fits everyone. And very often you will hit a big target group. But a good example would be Whoop. Where you were working is wrist-worn, right? So let's say you're playing tennis or volleyball: It's not really optimal. Oura, which is different technology in the market now, which is a ring, maybe you're wearing one. I can't really see it.

Gary McCoy: [00:06:46] I am.

Anna West: [00:06:51] Yeah, I am as well. But it's going to be slightly inappropriate if I...

Described listening: [00:06:51] [Anna holds up her middle finger as Gary laughs]

Gary McCoy: [00:06:51] I won't say what finger that was being worn on.

Anna West: [00:06:51] That was a good icebreaker. Sorry. So, wearing a ring is also not for everyone, right? So, the important thing is that we have maybe a portfolio of devices where the data accuracy is high, where the data is comparable, but because you can't force people to wear just any device. For me, I think a core important feature is actually that people want to wear it because I'm not going to get any data on my side if people are not wearing it anyways.

Gary McCoy: [00:07:24] Exactly. And look, you bring up a really good point. And I think I'm now, as of this weekend, I'll be on my fourth sleep technology. So started with Whoop, went down that pathway, moved over, did a little bit of work with a company called Rise Science, that had a sensor that goes just simply under the mattress and looked at the data coming from that. Without stating my own personal confidence intervals in tech, Oura ring for me has been really good because of the low friction in my lifestyle, it kind of matches. But I also just invested in Eight Sleep at the recommendation of not only our president at Kinetyx, but also the head of performance for the San Francisco 49ers. He was so engaged with that technology, that they've ordered a hundred of those units to take into camp with the San Francisco 49ers. That's how that's how confident he is in that technology. So, the confidence interval and the lifestyle kind of have to go together to provide you data so that you can understand that athlete, correct?

Anna West: [00:08:23] Can I can I challenge you a little bit?

Gary McCoy: [00:08:26] Please! Please challenge me!

Anna West: [00:08:26] Is it unfair to do it already? Look, I trust in technology, but I really also have seen in my way of working that technology needs to be implemented in a clever way, because you can take an Oura ring... I can give you an example. I can't tell you who, but I just recently did a project with, I should probably say, a soccer team. This that's how you know it in the US and where you're based. They started with what I call like the cherry on the top. Right. They acquired all the technology. They asked players to wear it. And exactly my fear of technology, two months down the road, nobody was actually wearing it because a lot of people started to see data that one: they didn't want to see, and two: they didn't know how to translate it. So, you can have a super, super good technology available. You can collect a lot of data. But if people don't really know, again, going back to translation, if they don't know how to translate it, we will all have bad sleep data, me inclusive. But if we don't have the the tools and the strategies to actually turn that negative data picture around, the easy way is actually just to take it off and put it away, right? Because then we're not confronted. And I, I actually like when people get to see their negative sleep data, to be honest, because I think it's super important that we embrace that nobody like no one will ever sleep with, you know, stars and signs every day. Because the athletic world and the domain that an athlete is trying to optimise sleep within does really not respect sleep hygiene, you know, a consistent rhythm, etc. etc. So we will have off days. The thing is that we need to embrace those. And know, OK, if an off day is coming up, how can we at least create a scenery which makes it more optimal, but not fully expecting that that day will be one hundred percent? And that's where I'm always cautious about technology and I'm always trying very much to embed into my methodology: Which profile am I working with? Because if you have very boxed thinking right, you want things to be to the point, you want to have a good score every day, etc, etc. Then wearing the technology can be stressful.

Gary McCoy: [00:10:45] It can. It's the requirement with a human athlete, it is chaos theory relative to all the physical systems that are interacting and all the separate measures that potentially could come off that individual. When you couple that with this continuous attempt at linearity of measurement and quantification, instead of stepping back and getting deep into the qualification of those units and understanding, to your point, selecting the right technology for the right application for that individual athlete. It can't be one size fits all, right? It's got to be variable in that department. But stepping back and knowing what you know about the array of technology that's available, how do you approach that with an athlete? Do you first have an individual discussion if they're using say, no technology? And how often is that now because athletes are so exposed to tech, right? Do they come to you or go, hey, I've got this! Anna, interpret this data for me!

Anna West: [00:11:47] It varies to be fair. And there's a big cultural difference in between countries and between sports as well, right? And there is also a big cultural difference between how early on the athlete, on an individual level, has learnt to take care of himself, right? So give you an example: If you're a triathlete on a super low budget and you don't really get a salary and you need to make sure that everything is balanced between, let's say, school work, training, blah, blah, blah, blah, blah, quite early on, you become quite, I wouldn't say thorough in your rhythm, but but you become very much aware of your need. At the other hand, if you are a football player and very early on you get a very high salary, you are very used to having a chef, etc, your way of implementing and taking care of yourself might be super different. I'm not judging anyone. Right, because my application and my way of working with people is very non-judgemental. We need to approach people where they are, with the competencies that they're giving to be fair, right? But let's say you're, I don't know, you're a football player who grew up in a home in Africa and you move to Europe. You grew up in a dormitory with 50 other players. Suddenly you're put in a football academy in Europe. You get your own flat, blah, blah, blah, stuff like that. The conditions for you to actually have your lifestyle rhythm in is going to be very different as well. So, every time I'm applying something, I look at who I'm working with, with no judgement, no nothing. But I'm really just trying to adapt it to who I'm working with. And look, there are a million questionnaires available in the field that you can use to to create a baseline understanding of sleep in your athletes. And the last couple of years, like the predominant ones that were used actually in athletic research as well, were questionnaires that were available and used in the normal population. And then a few years back, you kind of recognised the fact that we can't really use those in an athletic setting. Then we developed, in the sleep science field, questionnaires which were special for the athletic field. In my opinion, that's super nice. But we we tend to forget the fact that athletes in an athletic world are also people in the normal population.

Gary McCoy: [00:14:14] Yeah, right.

Anna West: [00:14:16] So you can't really put these borders up between the two worlds, because as soon as someone leaves the training ground, he's actually also just a normal human being. So what I have done and how I am working, going back to your question, is that every time I engage with a team, with an individual athlete, basically anyone, I'm conducting a screening, which is a screening tool that I've worked on for the past 5, 6 years, basically compiling the best of two worlds into one questionnaire. And then I'm asking a lot of questions which would probably, in your perception, be very non-sleep related, which could go towards motivation, even more the emotional perspective of where people are. Family related questions, questions around the environment to understand, is this a very top down, you know, controlled environment? Do you have a lot of penalties? Because if you get penalties in the morning, that can actually breed quite a lot of sleep disturbances, especially amongst young athletes, because they're afraid of getting up too late and blah, blah, stuff like that.

Gary McCoy: [00:15:45] Yeah,

Anna West: [00:15:46] So I always conduct the screening and in that screening as well, technology. And here's the answer to your question, is is a part of it right? I always ask people if they're already using technology. I'm always curious to understand how they're using that technology and what kind of technology they are using. If they're not, I'm always then trying at the back of the analysis, trying to figure out, based on my experience, hands-on experience from the field, which technology would actually suit this person best?

Gary McCoy: [00:15:47] Right, right. No, it makes a lot of sense. And the interesting components here, and you touched on it, like if a team implements a sleep technology and it's kind of pushed down from the top, which quite often in the US, yeah, just like I mentioned, the forty Niners: boom, everyone's going to have this measurement tool. With that, I mean, Eight Sleep is kind of really interesting because it adjusts temperature, there's a whole battery of stuff, even inclusive of the data that can potentially come off that. But when an organisation does that, that's pretty invasive, right? You're now asking to measure what I do in a very private area of my life. How do you see that in Europe primarily? Have you seen that with teams? Has there been push back because it starts to become even a player union discussion here in the United States?

Anna West: [00:16:40] And I get why and I respect that, that players might find it very intrusive into their private domain as well. The way that I've always applied is, is that there's a very, very clear line about communication when it comes to the data and who sees the data. So, when I work on an individual level with the player, they know that everything that he/she and I would discuss is confidential. And I never report back to to the management. And if I'm engaged in a project description where that is required, I honestly don't want to do my project because I think that that trust is extremely important when it comes to the data side of things. It needs to be very clear and sealed as well. Who sees the data, right? Let's say you have a team and a player is fearing that his negative sleep data is going to the head coach and that that negative data ultimately leads to him not being selected for the next game. Then you have a problem.

Gary McCoy: Exactly.

Anna West: [00:17:45] And and you can create a lot of cultural trust problems if these lines are not very clearly defined. At the same time, I have to say honestly, when I when I engage in projects where this is very clear, I don't meet resistance, because then the player knows that this is a confidential relationship. The staff around me, and I think before you hit the record button, I said, I don't want to sit on a pedestal somewhere because I'm not the one creating the success here. And I think it's super important to highlight that, if you want to create success in an athletic environment with athletes, the whole environment is a part of how you can create success. I'm a co-pilot, right? And the way that we support athletes to get better sleep, is once they realise that they're the pilots of the aeroplane. But I can give them coordinates to where it's a good idea to move their plane towards. At the same time, the environment is a super important co-pilot as well overall. A good example would be like in the morning, a player comes in, and let's call him Tom, the kitman, sees someone with bags under his eyes. Once Tom is educated and realises small signs of of sleep disruption and so forth. You know, Tom is a really good source of information as well. And if Tom knows that I'm around, he would like go: hey Anna, I noticed this morning when he came and got his suit, he looked really, have you talked to him? And the success comes when people start to understand the signs, but also when, of course, scheduling and planning and so forth takes into consideration: Who are we dealing with here? And even though I don't like to say that we run these one size fits all models, I don't like them. But in theory, we need to create them to a degree, right? Because if it's a team sport, everybody needs to to translate this knowledge into a specific framework. It's important that you have late kick-off times, playtimes, because that's where you will have the most viewers that goes straight against normal sleep physiology. But we can't change that. We can't change game times. But every player will be exposed to it. So, in that sense, we can create tools that that kind of helps all of those with a late kick-off time. But then one player might respond in one way to that. Another player might respond a different way. The kick-off time is going to be the same.

Gary McCoy: [00:20:18] Yeah. Yeah, it's incredible. I was about to ask you a question and I realised in positioning this question that, oh no, hang on a second. I'm thinking I'll call it very American here, very linear and wanting to make an application, kinda have an application discussion. So, I'm going to pull back a little bit here. And I mean, that's just what you do Anna, you change my thinking quite often. Thank you for that.

Anna West: Is that good or bad?

Gary McCoy: Yeah, it's brilliant, but it's but now I've got work to do cognitively, right? So, my experience, early days with athletes trying to understand sleep was like back in early 2007, when I was first employed by a professional team full time. And one of the things I'd start to do, I'd ask athletes when they came in, because they didn't have any tech at the time, I'd say: "How'd you sleep last night?" "Oh yeah, pretty good." "How long did you sleep?" "Oh, about eight hours." The same same answer for everybody, right? And that's when I started to realise, OK, ask, what time they went to bed, what was the last time they remember going to bed and falling asleep? Then what time did you wake up? And that would give me, it was never just eight hours, it was a conglomerate of kind of quantitative data. But then when the technology came in to play and this was my pure interest in, I guess I would put sleep in the middle of this thing called recovery, right? That's what I was interested in as an applied sports scientist. How do we recover? And I posited a theory. If we recover deeper, we might be able to extract more on the back side. The next day we might get better outputs. But when I started to dive into the science, I really had to understand sleep more. We look at the various types of sleep, whether it's slow wave sleep, deep sleep, whether it is really light sleep, whether it's REM related sleep. If you are looking at data for a specific individual, do you try to apply that data set, the qualitative information around sleep, against their outputs? I'll give you an example of that. I know when I'm having a good day, if I was to look at, say, my Oura ring data, I've got right around this two hours of deep sleep in there, in those cycles. And that seems to be a very subjective correlation for me personally. But do you look at those qualitative blocks and try to measure for that individual this appears to be optimal?

Anna West: [00:22:48] I think there's actually not a straightforward answer to that one, because sometimes I do. But what I like to do more is look at the trend curve, like the development over time in relation to where the athlete would be from a mental perspective. Because let's say you have two hours of deep sleep, the Oura ring, gives you a high score, but currently you're not getting picked for the team. You're in a bad place. You're not motivated. You might have a very nice sleep output, but you still feel like, low on energy, fatigued. Then it's actually not because you're not sleeping and recovering well, it's because your other factors are disturbing the feeling of a positive output. Hence why I would never let the data stand alone. I would use them as indicators for a discussion. Because if I see that someone, sometimes you can also on the Oura you can actually blind the data, you can do that on the Whoop as well. So if I can see that someone, and in some cases it's actually quite good that you can blind the data, so that people can't really see. But you can initiate a discussion asking them. Rather, going back to your questions back in the time when you were asking athletes coming in, rather asking them: "How many hours of sleep did you get? When did you go to bed?" Ask some questions about mood related aspects. So: "how did you feel when you woke up this morning, were you energised?" "Are you motivated to train?" "Are you sore?" Because there are a lot of questions which lead back to the quality of the sleep that you've had. Does it make sense? You can have someone sleeping if they reported back with a non-documented sleep saying, look, I slept eight hours last night, but if we measured that person's sleep, he might have spent eight hours in bed, but only sleeping five hours. You can use the data as guidance towards something. And you can always argue if the validity of the data is going to resemble if I had them in a sleep lab somewhere. But then again, if I had them in a sleep lab somewhere, the sleep would probably also be disturbed because they were not in the right setting and framework. So, I always used the data as an indicator and I used the data to, together with the athlete, track a trend curve so that we can see if there are variables that are the same. Let's say you have a match day -1. Do you always sleep bad before a game? Match day +1? Do you always sleep poorly after the game? And then we can start to figure out, OK, if this is actually where your challenge, your problem is, that's where we need to create tools that suit you from a personal perspective.

Gary McCoy: [00:25:31] Right. And going from that Anna too, the very first thing like, when I when I've broken out those sleep cycles and look at it, it's like, OK, am I looking at data that I can functionally change? Can I change any of this data? It's like what my body's doing during sleep it's doing during sleep based upon its need, and understanding that I've looked at even a whole battery of things like sleep supplements, right? Have you seen anything other than say, like, I started to dive in, with the amount of travel I was having, and my sleep was broken up. But is there anything I can do to manage that? And I was always struggling to find supplements and everyone's like on melatonin, melatonin, melatonin. And ok, so I try melatonin, I wake up groggy, trying to put two and two together, six cups of coffee later, I felt like I was bouncing back, right? So I was on this really negative cycle with that. And then I read some study somewhere that looked at melatonin and said, yeah, some of the almost cognitive processing gets dishevelled with that as a supplement and not to can that. But in terms of in terms of the science around an additive, a supplement. Have you seen anything? Are you looking at anything? Do you avoid everything? How do you approach it?

Anna West: [00:26:51] Super blurry, right? And if you look at the science side of things, it goes in in a thousand different directions. Melatonin has a proven positive effect short term, right, and should be used short term. Supplements, I always debate this when I'm working with a nutritionist on the side as well, because, are there nutritional aspects that we could add into our line of work around sleep recovery, right? And then, yes, there has been research published about protein versus carbohydrates, and then you have the whole debate again, because if it's match day -1 and you want to lower carbohydrates, what comes first, the hen or the egg? And there is always a debate about personal preference as well. Like how would you go about the supplement? Do I try to avoid it? Yes and no. What I always do is that I try to always go down the natural route first, meaning that excluding just trying to create quick fix solutions that we might not need if we did other things in a different way. So we would in theory, we were all born to sleep, and because we're talking about athletes, the prevalence of severe sleep diagnostics or diagnostics where you actually need treatment is quite low, right? You will have sports where you have like basketball or rugby with a big neck size. We know that the prevalence of sleep apnoea and so forth is higher than in other sports. But in theory, we are always talking about people with an active lifestyle, a healthy body, and, and, and, so I usually always say that 90 percent of the time sleep disturbances in athletics is more mental. It comes from pressure, congestive scheduling, etc. So there are a lot of things that we could work around from a natural perspective because your body's actually working quite well, right? And sometimes you might benefit from a kick start if you're, like, extremely out of sync, using melatonin. But I always try to develop it as a habit, because we want to avoid to create the bandage habits, because at some point you need to pull it off and we don't want to have an infected wound as well. I always have the debate as well with the medical side of it when I'm working in a team, because it's super bad if I'm going down the natural route and then you have a doctor who's prescribing sleep medication because someone so that needs to be aligned. And I'm super fortunate in that case as well, because I'm very often working with clinicians, doctors who are very onboarded into not prescribing sleep medication. But I have tried a couple of times where I'm working with athletes and then they're sent off to, let's say, national duty. And then the methodology and the perspective is different because they need them to perform in this very short window frame and then it's just the easy way out. So going back to your question, I respect that some supplements can aid, but I wouldn't use them as a dominant tool in the way that I'm working.

Gary McCoy: [00:30:24] Right, no. It makes a lot of sense. And so let's talk about the things that you believe are controllable. And this is whole, I guess I want to call it a science. There is more of an understanding now about sleep hygiene and using that terminology to state how do we go about sleep? How do we get into that? Like a study that I just read literally the other night, trying to shut my brain off and go to sleep. So I start reading, doing some research. And I read the study that really is reanalysing say, blue light and the effect of blue light on our bodies. In the last study I read, there was a statement in there. Well, it's not it's not actually the light. It's actually the activity that your brain is going through. While using those devices, which is probably more prevalent to and not being able to shut down and get into good sleep patterns and rhythms. Sleep hygiene. Anna let's talk about that a little bit like best practises, for you? Again, it's going to be lifestyle dependent, individual dependent, team and sport dependent, travel schedule in there dependent. Right. There's all those dependencies. But what are the commonalities through that? What have you seen?

Anna West: [00:31:40 Let's take the cell phone, right? Because it's so common. And I always say, like, if you want me to come out and do an educational workshop with, like, the five best bullets on how to sleep better. Google, because it's much more inexpensive. And advice number two is always like, put your phone away twenty minutes at least before you go to bed. And if you take another advice, it would be an hour. I'm not black and white when it comes to that, because, like even from a study perspective, studies recently came out actually looking at an elderly population who started to sleep better because they were on the phones feeling connected to people, giving them a positive feeling before going to bed, using the phone. I've done, and this is not published studies, but I've done some studies on some of the athletes that I'm working with. And I actually did a quite interesting case study that was like a couple of years back with an athlete who was very negatively affected by social media, and he was very much aware about it himself. And then I, I work with him for quite some time, and we agreed that he tried for a period of time to completely disengage from social media. Why we tracked his circadian rhythm. And that was HRV stress relations, stuff like that, and what we could see that in his case, his data all just turned green, right? You disengaged from social media. You could fall asleep at night looking at the sleep quality, it came up. Even his schedule changed a little bit, so he got more hours of sleep and that really worked out well for him. But then I might have someone else who, in the process of putting the phone away, would be more towards like the fear of missing out. So I'm not on my phone and I'm not following along what's happening. And that breeds stress. It just works straight against the production of a sleep hormone. So if you're stressed out, you produce Cortisol. Cortisol and what you need to fall asleep just really doesn't work well together. So, again, it would be super nice if you could just line up this recipe saying if everyone just goes off the phone an hour before bedtime, everybody would gain a high sleep quality. But you've just had a year of lockdown. You're still in lockdown or at least not allowing people like me from Europe to travel into the US.

Gary McCoy: [00:34:18] Or vice versa, I tried to get over and see you.

Anna West: [00:34:23] It's interesting because a year back, we might have seen one reaction to the cell phone, but during a year of lockdown where this was maybe the way that you were able to say good night to your child living in a different country that you couldn't travel in to see. This might have given you something completely different. That's why I think it's super, super important that when we talk about sleep hygiene, the best that people can actually do to help themselves to do a little bit trial and error. But reflect, and I always work with passive and active choice making, right? So, I'm never telling someone to do this or to do that. But try to do this, see the effect, try to do that. And then trying to figure out as well, what are you just doing without actually being aware of you doing it versus what do you actively do? And a good example, and I always pull it out of people who are probably sick and tired of hearing the example, but it's super good. So, a lot of athletes, they have a pretty poor ability to hydrate themselves. Right. They know that hydration is super important, but they tend to forget it during the day. So how is hydration and sleep disorder combined? A lot of athletes, when they didn't drink enough or sufficient during the day, they will get thirsty late afternoon, evening. They know that water is super important. So, they just start to drink a lot of water. So, drinking a lot of water is, again, not a sleep disease, but it leads to you having to go to the toilet three, four, five times during the night. Every time you need to push yourself to go to the toilet, you break your own sleep cycle going back to the sleep phases.

So let's say you were sleeping, and you break sleep cycle because you have to go to the toilet. You need to start all over again. Ultimately, the quality of your sleep will be lower. But again, hydration is not a sleep problem, but you not hydrating yourself leads to a lower sleep quality. So, again, if I am to create success for an athlete like that, let's not talk about sleep, sleep quality, but let's talk about what you're doing during the day. That leads to the fact that you can actually get a good quality sleep at night. Napping, big subject right, because that goes a little bit back to sleep hygiene as well, because sleep hygiene in my head is not only the hygienic factors you just before you go to bed, it's the combination of factors that you do throughout the day that leads to your ability to fall asleep at night. And I think it's a very misunderstood that sleep hygiene is hygienic in the sense that we understand brushing our teeth, making sure we air the room. But sleep hygiene starts from the minute you wake up in the morning. Sleep hygiene is also you making sure that you get light exposure, that you don't stay inside all day because that messes up your rhythm. Sleep hygiene is that you on a day off don't see yourself as treating yourself by staying the whole day at the couch. That's poor sleep hygiene because that leads to lower recovery, but also quite often a pushed back rhythm with an inability to fall asleep at night because you didn't do anything during the day, right? So I think it's so misunderstood to talk about sleep hygiene as a factor that we do just before we go to bed.

Gary McCoy: [00:37:58] Yeah, it's not like it's ABC and there's, do these three steps and you will guarantee your sleep for the entire eight hours. But on that on that pathway, naps. let's talk about those for a second, because one of the things that like in my time working with athletes and understanding naps, well, first and foremost, there was this ego that kind of predominates a lot of male athletes that I've worked with specifically that says: "I only sleep three hours last night, I can go all day today."

Anna West: The warrior.

Gary McCoy: The warrior! I have this badge of honour that on,”three hours sleep I did this." And I know that attitude is changing. With requirement, we certainly see that attitude is changing with requirement.

Anna West: I see that as well.

Gary McCoy: But tell us about naps and their currency and their effect on an individual, doesn't even have to be an athlete, during the day. How do you look at this?

Anna West: [00:38:54] I think, like from a cognitive perspective, science definitely tells us that they will have a positive effect. I always see it a little bit like running the quick programme on a dishwasher, right? You just do it quickly and then you come out and you feel a little bit cleaned and energised. From a scientific perspective, there's definitely voices around the length of the net and the benefit in relation to the to the length of the nap. And that's where I become a practitioner, right? Because we need to apply something that that goes for the majority of the athletes. I'm always favouring short naps and and I am favouring naps. I think it's a very good idea to do a nap as long as you don't have difficulty falling asleep at night.

Gary McCoy: [00:39:37] Right. So, the nap sometimes could be looked at from a strategy to overcome potentially what was missing the night before. But you've also got to look at it forward. Right. Look forward and go, OK, is this it's going to affect this evening's quality of sleep?

Anna West: [00:39:51] I always try to to voice the fact of trying to keep the nap under 30 minutes. What I see is very much that there is an age-related thing as well when it comes to napping. As long as you're a younger athlete with no, let's say you don't have a family, you have nothing to return back to when you leave the training ground. Then you have a different scenario when you're you're an older player with a family and different requirements, you come back home and you don't really have time for the nap. What I see very often is that amongst the young players, there's a really, really high prevalence of over napping. Right? You come back home and you take a nap. But I always say, like no athlete, never, ever in history would take a nap with the intention of harming himself. It always comes from a good place. I want to regain some energy, but then again, if you over nap in the afternoon, you push your rhythm, you push your ability to fall asleep in a negative direction. You taking a nap ultimately leaves you with an inability to recover as well as if you didn't take a long nap, right? And if you didn't translate that into performance perspective, your freshness, your alertness, your reaction time, the cognitive side of things is going to be affected negatively on the next day. So, you need to educate them. I'm never going to tell them you can't sleep for two hours, but you need to educate them so that they understand what's the output if you choose to do A, what's the output, if you choose to do B? And if you tell them that this is the risk, it's quite often quite impactful because none of them really wants to risk what's coming out of having, you know, a long napping pattern.

Gary McCoy: Right, right. And to your point, it's never one size fits all.

Anna West: [00:41:45] No. And I always tell them as well that in the beginning, if you've had a napping routine for a long time where you sleep longer hours in the afternoon, look, they're all going to hate me in the beginning because they will wake up from that short nap feeling like A, they want to continue to sleep, B, they will send me a lot of negative thoughts like, hey, this doesn't really work. But if you continue, if you're consistent, if you continue to do it, the body will adjust as well, right? And it will recognise the pattern and then you will have the positive outcome. Where I always see a problem is that if they're not consistent around doing the shorter naps, then it's less effective. Then I'm starting quite often to see that they will have problems with the sleep late into the night as well.

Gary McCoy: [00:42:20] What I love about your position here, too, is one of the things that kind of aligns for me, as I've always said, that athletes and understanding them and understanding their potential and understanding how to manage an athlete, the real foundation, is emotions. And you're tying sleep into that. And you're tying it in in such a way that, how do you feel in the morning when you get up? And how does this make you feel? And you're tapping into the decision-making process of the athlete to make choices which are made from an emotional position. So that enhancement of the foundation for that individual athlete, how you're using sleep is a currency to enhance that foundation. It's almost like for me if like if I had a guy come out and mix concrete, you've got the additive. You're adding a really, really solid foundation for the growth of that athlete. Have you had experiences where your effect on that athlete has been, let's say, life changing. But let's not say life changing as in game changing, right? He scored more points. Yeah, those things are fine. But what does that mean for his life overall? I mean, give me an example of something like that.

Anna West: [00:43:47] It would be so much nicer if the athletes were actually sitting here and telling the stories rather than trying to promote myself.

Gary McCoy: [00:43:50] I know you don't like to self-promote, but I'm going to put you on the spot here a little bit.

Anna West: [00:43:59] I can give you a few examples, because I think they're quite describing for many, many other athletes out there. So, one athlete that I've worked with for the past years, and I started working with him when he was in his mid 20s. And he I think he's he gave me a really, really nice compliment, not towards me, but more towards the process. He said, and it sums it up really nicely, "Anna, I seriously, I would have loved to meet you so much earlier on in my career," because his problem, was that he was massively stressing about the days where he was unable to fall asleep, which was very often match day -1 an postgame.

Gary McCoy: [00:46:33] Right.

Anna West: [00:46:33] But in his case, it was was actually a quite positive case because on an overall level, his sleep was pretty good. Right. Which meant that the days that he was actually stressing severely about actually didn't impact him as negatively as he thought. And that's where data actually is quite positive to use, because we could clearly demonstrate that he had the majority of the days in a very, very positive zone. And because he then had a one off once in a while, it didn't really matter because you also saw how quickly his body would adjust after, again. And then I always gave him the example and I also showed him data from other people where this was not the case, showing that let's say you have a very out of sync rhythm, you have very different bed and wake times, and then you have this post game sleeping problem, then your body will not adjust as fast. And I think he's a very good example of someone who's stressing about something which is super unnecessary. But because nobody really ever told him and because sleep had become, for him, a measurement point. "I need to do this right in order to be able to deliver my performance at a very high level." And he didn't manage to focus on all the days where he actually did a lot of good stuff for his body.

Gary McCoy: [00:46:06] Right. So, Anna, looking forward five years and understanding where technology is today and to look at the gaps that exist in the market, like you said, there are blind spots and stuff we don't know about sleep. If you could wave a magic wand and have one thing. Is there something missing? Like as an artist, you're an artist to me. I want to give you an extra colour that you can approach your canvas with, is there something, is there one thing that you would say you would want?

Anna West: [00:46:37] I think in order to do so, we need to to go back and look what happened the past 10 years, right? There were so many things that came out from a technology perspective, from a perspective of our ability to optimise sleep. In theory, it would be super nice if if we could simplify a lot of things, because to a degree, all of the technologies as well coming out are complicating sleep to a degree, right? Because everybody wants to optimise. One of our very, very big challenges and there's also research on this is our homes as they are built today because they're very, very, very isolated and warm. And if we look at the body and the way that the body works, evolution has really not done a lot of things to us. We still want to sleep in a cave when the sun goes down and we want to come out of that cave when the temperature rises and the sun's out. So, if we could imagine having not just commercial products, but actually working, really good products that would stimulate the cave man, cave woman inside of us even better. I trust that that would be successful. 10 years ago, I did a project in a football club where we divided the squad into two and asked one part to just stick to whatever they were sleeping in and the other part of the squad, we asked them to wear a dry fit material. Remember, this was 10 years ago. Back then, I'm actually quoted for this sentence. I said, "if I could ever find a sleep garment that could support players to not sweat as much during the night, I would be a millionaire." Today, 10 years after, there are quite a few products in the market. And I am using amongst my athletes very good garments that are available now that supports their thermoregulation. So, the things we discover along the way that can support without complicating, and that again can be slightly independent because we react different to stuff. Where I don't believe that we are creating progress is that that we are too much worrying that people need, you know, accessory a, b, c, d, e, f, g in order to be able to fall asleep.

Gary McCoy: Right.

Anna West: That's not going to support anybody to a better sleep.

Gary McCoy: [00:49:03] What I found personally is that everyone's kind of looking for lightning in a bottle. They will apply one technology and it's a linear measurement and that's everything. That's all the answers I need. And it's one line of data. And my position has always been, look, the human body, this is chaos theory. There are so many different variables that are interacting. Have you found working with clubs and working with athletes that we have this kind of, yes/no binary path point because of the linearity of data? Or is that something that you have to step back and alter the optics and the lens of how teams, coaches, and athletes are looking at sleep? Do you have a clean canvas that they get it day one? Or is this something that you have to teach them how to really look at this?

Anna West: [00:49:57] To a degree, you have to teach it right, because, again, what they expect is quite often that it's very easy to quantify the output of a better sleep. Working with sleep is not just quantifying that all the players start to sleep more hours or that the quality of the sleep is going up, right? You use the term multi data sets, right, when it comes to the output of sleep. This is exactly the output, it would be super easy and also for me, a much easier business case if I could come and say this is the exact point where I will make a change.

But that's not the case because sleep is basically the bottom of the pyramid and the precondition of success in all the other domains surrounding an athlete. And in a lot of the other domains, you have a lot more direct, measurable impact numbers, right? But in theory, and research supports this as well, you can say that quite often you can see that when when athletes, they start to sleep better, they will have better decision making, faster sprint times. They will solve cognitive assignments better and so forth. But is it straight down to sleep? Sleep because it's improved, or are there other aspects as well that would would interfere with that outcome?

In in my methodology, I don't believe that sleep is the only thing. But because, again, if I'm working in a team and it's multidisciplinary and we and we have a super good psychologist at the side as well, and people learn to destress performance factors, it's also measurable in the higher sleep outcome. But how do you measure something like that? There are a lot of immeasurable gains that comes from sleep. So if you ask me what I would like down the road in 10 years, it's something that I can maybe more easily quantify. To qualify the output of the process.

Gary McCoy: [00:52:11] Yeah, incredible. It would be awesome to say, if you had one button on your smartphone that you were dialling up the environment for that athlete, right? And then being out to see the markers around that performance, right? Yeah, I could certainly see that as being beneficial. Heart rate variability was something we jumped on over at Whoop and looked at that data set. And I know that there's so many different ways to capture that information right now. I'm failing my promise of my previous question being the last one, but bringing up bringing up that card, pulling that card out of the deck now. I often started to look at say, OK, is sleep affecting HRV, or is HRV affecting sleep, is it a separated measure? Do we really understand the science of this? When is it collected? How is it collected? There are all these variables even surrounding that line of information that made it difficult for me to really get a grasp on it. Is more better? Or is it purely the balance within the sympathetic nervous system that I really want to understand and its effect on recovery? Do you do you look at that data at all or has there been any insights from that?

Anna West: [00:53:03] I definitely look at all the data. But again, going back to one of your previous questions, I try to avoid to look at that one single day, but more to look at the development of a trend curve. So rather than saying that specific measure, then saying more this specific measure in that in a longer period of time, and because that allows me to see... Maybe I should give an example. So, a player in a transfer window who is super stressed out about not knowing what will happen next will probably have an effected HRV, right, because he's stressed out about it. And if I see an effected that HRV, do I at the same time see a decreasing sleep curve over time. I would always look at it on more days rather than looking at it on one day to understand what's going on and how we can actually impact it as well the other way around, right? Because if you're a super stressed out about the transfer window, this is probably not going to be the last time in your athletic career that you need to deal with a situation like that. So, let's take this as a stress related situation that you will have to deal with a lot of times moving forward. So which tools can we use, taking into consideration that we see a decreasing trend curve. I don't know if it makes sense, but...

Gary McCoy: [00:54:44] No, it makes a lot of sense. Anna, you have a unique ability, and I mentioned this to our team at Kinetyx before we engaged in this podcast. I said, I remember from you the way you look at an athlete and this holistic viewpoint that you have, is something that, like I said earlier, you change the way I think about things, and you make me stand back and get out of my data lines and go, OK, let's look at trends, look at those analyses. Let's try to figure out how this all fits together. That ability is really unique, having met practitioners around the world. Have you ever thought, I think you could well, you could write a book on how to assess the human athlete and just to create the optic on what is necessary, that it isn't just: these are not binary things. It's not one plus one equals two. I've used the term chaos theory, but you have an ability to stand in the middle of that chaos and see patterns and understand and manage it and move it forward positively.

Anna West: [00:55:53] Yeah. And the interesting thing is, if we could create an algorithm at the back of that, you could multiply me, right? But you can't really do that.

Gary McCoy: [00:56:03] Yeah, yeah. That's what we're trying to do here. We want to steal Anna we want to multiply her.

Anna West: [00:56:09] No, no. But again, that makes me sound like I'm sitting on a pedestal and I'm making myself super unique. I think I'm not. And I am honestly very supported and helped by data in my process and in my business as well. Because if I didn't work with data, it becomes quite fluffy as well, right? And that's where that's where I actually like the tools and the data and the baseline measurement, because then we clearly quantify that we move people from A to B. This was a starting point, this is where we are. And I'm a super nerd when it comes to sleep, of course. But in making sure that I am actually tracking process and data, not for me, but also for the player to see. Where was your starting point? What I do when I profile the players is that I always categorise them in in a traffic light. Red, yellow, green, right? But a green profile is actually doing a lot of things pretty good. So we need to support him to do pretty good things even more, because then we can gain some very important margins. And these margins are very important in high performance sport. So if we are working with someone who already has a high barrier of performance, he's probably thinking, hey, I'm doing things good. I don't need to change anything at all. But if we can still have this as a baseline measurement, a good baseline, we just add extra things on it by quantifying data. But if we didn't quantify it, he might not see the change and the difference. So I'm a huge fan of data and and seeing patterns, but also using that data in a very low practical way.

Gary McCoy: [00:57:51] Well, Anna, your insights are always those for me when it comes to understanding this area of sleep and recovery for an athlete. And I know you don't put yourself on a pedestal. Let me do that for you, because I think obviously from this conversation onwards, I'll continue to do that. Firstly, I can't thank you enough for taking the time with us today to dive into this domain a little bit. We're on this journey to try to get a better indication of the individual human movement and how we can evolve an athlete to be, to reach their optimum genetic potential, of which the domain you are critically focussed on is, I think, probably the most important, if not the most important thing we need to understand moving forward, it's certainly in the hierarchy of one of two of those first ordered metrics that are necessary for athlete evolution. So Anna, thank you. I can't wait till we're live again together. And I know you've had you've had some environmental challenges in your part of the world right now. So mate, first and foremost stay safe, and I know you're about to get on a well needed vacation where you will sleep probably really well, right?

Anna West: Doing what the preacher preaches, right?

Gary McCoy: Yeah, exactly. But the questions she posed today are likely the ones that are going to keep me awake tonight.

Anna West: Yeah. That's what happens when people start to work with me, right?

Gary McCoy: Yeah, I love Anna. But man, now she's made me think and that's keeping me awake.

Anna West: That's not very successful.

Gary McCoy: Anna, thank you so much.

Anna West: Thank you so much for having me.

Gary McCoy: [00:59:31] Thanks for listening to the Human Kinesomic project. Our music is provided by the incredibly talented Joanna Magic. I hope you'll join our community at Discord.gg/Kinetyx. Team, the game is just beginning.