Harnessing Sleep Science For Peak Performance | Dr. Allison Brager

**Dr. Gabrielle Lyon** (0:00)
Welcome to The Dr. Gabrielle Lyon Show, where cutting-edge science meets innovation and practical application for everybody. In today's episode, I sit down with my friend, Dr. Allison Brager. Now, she is a neurobiologist. We talk all about sleep. This is not your typical sleep conversation. Dr. Allison has extensive information and experience with military special operations and what we learn from her. It's not about in the perfect world how you sleep, but when things go sideways. And let's face it, things go sideways all the time. We do not live in the perfect world where we can sleep eight hours, wake up, meditate, do our normal morning routine. We learn everything you need to know about sleep and beyond. Please sit down with me in this conversation with Dr. Allison Brager.
Dr. Allison Brager, welcome to the show. I am thrilled to have you on. Actually we've been trying to connect for, it has to be a couple of years that I have just been begging you to come on. And here you are. Welcome.

**Dr. Allison Brager** (1:12)
Thank you. Yeah, I think it's been at least eight years, right?

**Dr. Gabrielle Lyon** (1:17)
I have followed your journey. So you're a PhD. You're a neurobiologist. You're going to have to tell us what that means. Also wanting to be an astronaut. So up for astronaut selection, which will be amazing.

**Dr. Allison Brager** (1:30)
Yeah.

**Dr. Gabrielle Lyon** (1:31)
But please tell us a little bit about what you do.

**Dr. Allison Brager** (1:33)
Sure. So I have training in neuroscience. I was fortunate. I went to undergrad at Brown University, which at the time had like one of the only neuroscience programs outside of Harvard built into their undergraduate curriculum. So I had no choice but to get exposed to neuroscience because it was built into psychology, is built into computer science, is built into like every part of the curriculum. I knew I wanted to either go to med school or do a PhD. But after I started working in adolescent sleep lab, I realized, oh, I definitely really want to pursue this further. So I got my PhD in neuroscience. I worked with, he's now retired, but he was the world's expert in understanding non-photic or non-like cues that entrain sleep and circadian rhythms. So he had a big focus on exercise and all the neural anatomical brain structures and pathways involved with how that happens for entrain sleep and circadian rhythms.

**Dr. Gabrielle Lyon** (2:38)
And really ahead of the ahead of his time.

**Dr. Allison Brager** (2:40)
Yeah, what's crazy is he had done this work since the 80s, had about three, four decades of continuous funding from the National Institutes of Health. But one of those things where you're studying such a complex area of biology, but with no, I would say, societal recognition or awareness because it ends up in, although flagship, but highly technical journals.

**Dr. Gabrielle Lyon** (3:07)
Yeah, and also now it seems that circadian biology is really taken off.

**Dr. Allison Brager** (3:13)
Yes.

**Dr. Gabrielle Lyon** (3:14)
And the influence on our health is really great. Tell me a little bit about what you're up to now.

**Dr. Allison Brager** (3:20)
So I actually am an active duty neuroscientist. I've been doing that for the last eight years. I started at the Walter Reed Army Institute of Research. Right now, I work with Army Special Forces, and really, it's just taking the principles and practices of neuroscience and neurobiology and applying it to improving safety, increasing performance, and even bettering overall health and wellness of our warfighters. So we do a lot of unique studies where we're either doing, for example, biomarker captures to understand how we can use that to improve safety and performance, or we'll even be involved with new use cases for existing medications. So we do a lot of randomized clinical trials around existing, for example, sleep medications and repurpose those medications in collaboration with the FDA for use in combat situations.

**Dr. Gabrielle Lyon** (4:18)
That's fascinating. Can you give me an example of these medications?

**Dr. Allison Brager** (4:23)
One of the studies that we, when I say we, this is the team back at the clinical trial center at the Walter Reed Army Institute of Research, so back in DC, is doing a head-to-head comparison of the pharmacology of suvorexant.
Trade name is Balsamera, so it's a Merck drug. It is an orexin antagonist versus your classic standard sleep hypnotic or benzodiazepine like Ambien or Lunesta, and so when you look at the pharmacology of Ambien or Lunesta, it is extremely long half-life, right, and it's a global inhibition of the neurochemical GABA in the brain, so if you are in a situation where you are overseas and you're under fire and you have to wake up in the middle of the night, well, when you wake people up at peak blood concentrations of this drug in the middle of the night, they're essentially drunk. Their vigilance, their cognitive ability to process, even basic tasks is impaired because that drug stays in your system for so long. So one of the things we know about these new age sleep medications, like suvorexin, is it's a very targeted effect, right? It's only impacting orexin receptors, which only lie in very specific parts of the brain, largely the hypothalamus, like the lateral hypothalamus, for example. And so when you wake people up at peak blood concentrations under this drug, they're able to maintain their vigilance. They're able to regain their cognitive capacity. And they don't have that feeling of grogginess or drunkenness like you have with the classic benzodiazepines.