#341 - Overcoming insomnia: improving sleep hygiene and treating disordered sleep with cognitive behavioral therapy for insomnia | Ashley Mason, Ph.D.
Release Date: 03/24/2025
#403 ‒ Peptides: separating scientific promise from marketing hype
The Peter Attia Drive
In this episode, Peter returns to the topic of peptides, offering a clear and accessible guide to a field surrounded by both genuine scientific promise and widespread misinformation. Peptides are increasingly marketed for everything from injury recovery and muscle growth to longevity and improved appearance, often with claims that extend far beyond the available evidence. Rather than promoting or dismissing peptides as a category, Peter presents a practical framework for evaluating any peptide: what it is, how it is supposed to work, and where the science is strong, weak, or simply absent....
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#402 ‒ NMR blood analysis: how heart disease risk, insulin resistance, inflammation, and mortality risk can be assessed from a single blood sample | Jim Otvos, Ph.D.
The Peter Attia Drive
Jim Otvos is a biophysical chemist who pioneered the use of nuclear magnetic resonance (NMR) spectroscopy to measure lipoprotein particles and developed the first FDA-cleared method for directly quantifying LDL particle number (LDL-P), a technology that has since expanded to provide broader insights into metabolic health, inflammation, insulin resistance, and mortality risk. In this episode, Jim recounts the unlikely story of transforming a flawed cancer test into a new way of measuring lipoproteins, explains what standard cholesterol tests can miss and why LDL-P and apoB can inform...
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#401 ‒ How curiosity transforms medicine: extraordinary discoveries that changed modern healthcare
The Peter Attia Drive
In this episode of The Drive, Peter explores how seemingly obscure basic science discoveries have laid the foundation for some of the most important medical breakthroughs of the past half century. Rather than focusing on the clinical applications of modern therapies, he traces the fascinating stories behind the scientists, experiments, and unexpected discoveries that ultimately led to transformative drug classes, revealing how groundbreaking advances often emerge from research with no obvious clinical goal. Through these historical case studies, Peter provides a new perspective on the...
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#400 ‒ AMA #87: Environmental pollution and longevity: air pollution, noise, light, EMFs, and practical strategies to mitigate health risks
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter explores the evidence behind environmental pollution and its impact on long-term health, separating well-supported risks from less substantiated claims while providing a practical framework for deciding which exposures deserve attention. He explains what environmental pollution encompasses, where it fits within the broader hierarchy of longevity interventions, and why studying its health effects is uniquely challenging. Peter examines the evidence linking air pollution to disease and shares actionable strategies for improving indoor and...
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#399 ‒ The evolution of Alzheimer's disease and dementia care: how early detection, personalized treatment, new therapies, and a multimodal approach are changing the landscape | Gayatri Devi, M.D.
The Peter Attia Drive
Gayatri Devi is a nationally recognized neurologist specializing in memory disorders, including Alzheimer’s disease and related dementias. In this episode, Gayatri explains how to think about dementia as a spectrum—including Alzheimer’s disease, vascular dementia, Lewy body dementia, and mixed presentations—while exploring the evolving biology of amyloid, tau, and neuroinflammation and why brain pathology does not always correlate with symptoms. She discusses her approach to detecting subtle cognitive decline in high-functioning individuals, the role of biomarkers and APOE4 testing...
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Building strength and muscle mass: how to optimize training, nutrition, and more for longevity (AMA #71 rebroadcast)
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter dives deep into the topic of muscle mass and strength, examining their essential roles in both lifespan and healthspan. Drawing from over 30 hours of prior discussions with experts including Layne Norton, Andy Galpin, and Mike Israetel, this episode distills the most important insights into one comprehensive and up-to-date conversation. Peter explores why muscle matters for longevity, metabolic health, and injury prevention, and clarifies the differences between muscle mass and strength, including which is more vital for aging well. He...
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#398 ‒ AMA #86: GLP-1 RAs and muscle loss: new data, better questions, and how to preserve muscle during weight loss
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter explores the effects of GLP-1 receptor agonists—including drugs such as Ozempic, Wegovy, and Zepbound—with a particular focus on their impact on muscle. He examines how much lean mass people actually lose during treatment and how those changes compare to weight loss achieved through other methods, while explaining why measurements of lean mass on DEXA scans can sometimes be misleading. Peter discusses the effects of these medications on bone mass, fracture risk, strength, and physical function, highlighting why functional outcomes may...
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#397 ‒ Endometriosis and adenomyosis: diagnosis, fertility, reproductive aging, and emerging treatments | Renato Tomioka, M.D., Ph.D.
The Peter Attia Drive
Renato Tomioka is a leading expert in reproductive medicine and gynecologic surgery whose unique skills allow him to diagnose and treat some of the most impactful yet frequently overlooked conditions affecting women’s health. In this episode, Renato explores endometriosis and adenomyosis, explaining what these conditions are, why they often go undiagnosed for years despite affecting millions of women worldwide, and how advances in MRI and specialized ultrasound are transforming diagnosis beyond traditional surgical laparoscopy. He discusses the decision-making process behind hormonal...
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#396 ‒ Breast cancer screening: understanding risk, deciding when to start and how often to screen, and choosing the right imaging strategy
The Peter Attia Drive
In this episode, Peter explores the critical topic of breast cancer screening, examining why thousands of women continue to die from breast cancer each year despite the availability of effective screening tools. He explains the strengths and limitations of current screening strategies, reviews the recommendations from major medical organizations, and discusses why screening guidance can often seem confusing or contradictory. Peter outlines a practical framework for understanding breast cancer risk and personalizing screening decisions, including when to begin screening, how frequently to...
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#395 - Brain lipidology: understanding APOE, cholesterol homeostasis, Alzheimer's disease risk, and the effects of lipid-lowering therapies on brain health | Tom Dayspring, M.D.
The Peter Attia Drive
Tom Dayspring is a world-renowned lipidologist and one of the most thoughtful teachers in the field of lipid metabolism. In this episode, Tom returns to The Drive for a deep dive into the relationship between lipids and brain health, beginning with the fundamentals of cholesterol transport before exploring why the brain’s cholesterol system operates almost entirely independently from the rest of the body. Tom examines the roles of apoB, apoA-I, and especially apoE in cholesterol homeostasis, discusses how APOE genotype influences Alzheimer’s disease risk, and unpacks the complex links...
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Ashley Mason is a clinical psychologist and an associate professor at UCSF, where she leads the Sleep, Eating, and Affect (SEA) Laboratory. In this episode, Ashley provides a masterclass on cognitive behavioral therapy for insomnia (CBT-I), detailing techniques like time in bed restriction, stimulus control, and cognitive restructuring to improve sleep. She explains how to manage racing thoughts and anxiety, optimize sleep environments, and use practical tools like sleep diaries to track progress. She also offers detailed guidance on sleep hygiene; explores the impact of temperature regulation, blue light exposure, and bedtime routines; and offers guidance on finding a CBT-I therapist, along with sharing practical steps you can take on your own before seeking professional help.
We discuss:
- Defining insomnia: diagnosis, prevalence, and misconceptions [3:00];
- How insomnia develops, and breaking the cycle with cognitive behavioral therapy for insomnia (CBT-I) [7:45];
- The different types of insomnia, and the impact of anxiety, hydration, temperature, and more on sleep [11:45];
- The core principles of cognitive behavioral therapy (CBT) and how CBT-I is used to treat insomnia [20:00];
- Implementing CBT-I: time in bed restriction, sleep scheduling, and the effect of napping [29:45];
- Navigating family and partner sleep schedules, falling asleep on the couch, sleep chronotypes, and more [39:45];
- Key aspects of sleep hygiene: temperature, light exposure, and circadian rhythm disruptions [44:45];
- Blue light and mental stimulation before bed, and the utility of A-B testing sleep habits [52:45];
- Other simple interventions that may improve sleep [57:30];
- Ashley’s view on relaxation techniques and mindfulness-based practices [1:02:30];
- The effectiveness of CBT-I, the role of sleep trackers, and best practices for managing nighttime awakenings [1:04:15];
- Guidance on intake of food and alcohol for good sleep [1:16:30];
- Reframing thoughts and nighttime anxiety to reduce sleep disruptions [1:18:45];
- Ashley’s take on sleep supplements like melatonin [1:21:45];
- How to safely taper off sleep medications like benzos and Ambien [1:26:00];
- Sleep problems that need to be addressed before CBT-I can be implemented [1:38:30];
- The importance of prioritizing a consistent wake-up time over a fixed bedtime for better sleep regulation [1:40:15];
- Process S and Process C: the science of sleep pressure and circadian rhythms [1:45:15];
- How exercise too close to bedtime may impact sleep [1:47:45];
- The structure and variability of CBT-I, Ashley’s approach, and tips for finding a therapist [1:50:30];
- The effect of sauna and cold plunge before bed on sleep quality [1:56:00];
- Key takeaways on CBT-I, and why no one should have to suffer from insomnia [1:58:15]; and
- More.
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