Dr.
Mark Hyman’s SLEEP MASTER CLASS
Lesson 6: Exercise, Brain
Health, Stress, and Sleep
I hope at this point, you’re starting to see some
major connections between all systems of your body
and sleep. It’s so true that what you do to one, you
do to the other. Poor sleep affects your entire body,
mind, mood, and soul, and those areas affect your
sleep. Your exercise, brain health, and stress are no
exceptions.
The Benefits of Movement
“The American Association of Sleep
Disorders has actually come out and said
that exercise is an effective way to treat
sleep disorders. Exercise has been shown
to increase low-wave sleep. This is your
deep restorative sleep phase. Exercise also
decreases sleep onset so it takes you less
time to fall asleep. Lastly, exercise can
increase sleep duration so you can
sleep longer.”
-Dr. Mary Pardee
I am sure you’ve heard it before, from me, in the news,
from your doctor, etc. that exercise is super important.
The more studies are done concerning the effects of
exercise on every aspect of your life, including sleep,
the more conclusive it is: you cannot achieve optimal
health while being sedentary.
And when it comes down to it, the type, duration, and
timing of exercise is not as important as just doing it
in the first place. Starting small or low and slow will
still affect you positively.
Exercise is important for sleep in a number of ways.
When you exercise, your core body temperature rises
and then cools after your workout. The cooling of your
core body temperature helps to signal sleep onset.
Exercise also helps use up energy throughout the day
and helps increase adenosine—both which affect your
sleep drive.
“Fitness level is now being tied to your
ability to sleep and get really good sleep
quality. Take for example, one study that
Lesson 6: Exercise, Brain Health, Stress, and Sleep 1
I looked at. This study was on athletes
who were no longer exercising because
they were injured, so they were out of
commission for a little bit but they were
still really fit. What they found is that
these fit subjects who are no longer
exercising, still had superior sleep quality
compared to their non-fit counterparts. I
find this fascinating because now we’re
realizing that it’s not just the exercise but
the results of the exercise. It starts to ask
the question, when somebody can’t sleep
or they have poor sleep quality, should we
be saying, are you fit enough to sleep?
This is something that we haven’t talked
about in medicine or in health in general.”
-Dr. Mary Pardee
There are different types of exercise: aerobic,
resistance training, high-intensity interval training
(HIIT), and play. Aerobic exercise is considered the
endurace type exercises—running, bicycling, vigorous
walking, rowing, swimming, etc. Resistance training
is lifting weights, using resistance bands, or exercises
the require exerting force, whether pulling or pushing.
HIIT is a series of extremely high-intensity movements
for a short duration followed but a period of rests (for
example, sprint for 10 seconds rest for 30 seconds,
repeat). Play is participating in sports, wrestling
with your kids, doing obstacle courses, things that
incorporate movement into fun activities. Play is my
favorite! I also love tennis, and racket sports that
involve aligning your feet, hands, and brain all at once
are linked to longevity.
I want you to know that while some studies may
indicate that certain types of exercise are most
beneficial for sleep, my main focus is getting you
moving and not overly worrying about specifics here.
Movement is so important for your overall health,
mood, longevity, sleep, and it helps to increase blood
flow and oxygen delivery to your brain, which is great
for brain health.
Dr. Mark Hyman’s SLEEP MASTER CLASS
Brain Health
I think we have all experienced feeling particularly
cranky after a night of poor sleep, or felt brain fog, lack
of focus, maybe even hyperactivity. It’s so clear that
sleep has a major impact on our brain health and we
can see it in how our brains suffer following
disrupted sleep.
One major issue that is becoming all too common is
the over-prescribing or unnecessary use of stimulants
in response to the symptoms experienced following
low-quality sleep. While certain stimulating drugs
are sometimes helpful for certain people, if they are
given when not necessary, they act as a “band-aid”
and won’t actually help the underlying issue of poor
sleep. That’s why I recommend a Functional Medicine
approach to fully understand the root cause of low
energy, lack of focus, or poor cognition, which always
involves an emphasis on good sleep.
“We know that America is the number
one prescriber of prescription stimulants
in the entire world. Rates of ADHD are
continually increasing for both adults and
children. The reason behind this is the
thought that we need more stimulation
to the brain to actually focus and increase
energy levels. But I want to start to
question this idea, because is it really
more stimulation that we need or are
there other things that are going to help
us focus more? You see we’re inundated
with stimulation all day long. We’ve got
billboards to look at. We have commercials
to watch. We’ve got Instagram DMs to
respond to. We have emails coming in
constantly. Is it really more stimulation
that we need or is there something else?”
-Dr. Mary Pardee
“The data is out now that at least 50% of
the time, there’s probably a misdiagnosis
of ADHD, and it’s actually a sleep disorder.”
-Dr. Mark Burhenne
Lesson 6: Exercise, Brain Health, Stress, and Sleep 2
There’s a lot of problems with the unnecessary use of
stimulants. First, they may be inappropriately given in
the first place. If 50% of the cases of ADHD alone are
misdiagnosed and corrected by correcting sleep, how
many others are incorrectly assessed?
Second, stimulants are very addictive and are
considered one of the most commonly abused
substances. It is not easy to break that cycle, so
consider trying some sleep tips before starting the
stimulant cycle.
And third, stimulants significantly affect your sleep.
They stimulate you by altering your neurotransmitters.
By increasing the creation, release, and reduced
reuptake of norepinephrine and dopamine, namely,
stimulants can alter your body’s natural ability to
effectively utilize neurotransmitters.
Many stimulants have a very long half-life. This
means that after so many hours (between 14 and 18
for Adderall, for example), HALF of the medication is
still active and in your system. So if you are taking a
stimulant 14 hours or less before bed, your sleep and
sleep drive suffer. If your sleep suffers, you are more
likely to want the stimulant the following day, which
sabotages the following night of sleep. You see how
this cycle is very disruptive.
The use of stimulants, especially when not necessary,
can have an impact on neurotransmitters.
Neurotransmitters
Neurotransmitters are chemical messengers that relay
important signals between neurons and muscles.
Neurotransmitters can be excitatory which stimulates
a response, inhibitory which suppresses a response,
or they can be a neuromodulator which means they
affect more than just other neurons.
Neuromodulators
Dopamine is important for motor control,
motivation, and reward—commonly referred to as
the “feel-good” chemical.
Norepinephrine (noradrenaline) helps regulate blood
pressure, heart rate, liver function, and others.
Serotonin helps with sleep and sleep onset, mood,
appetite, and memory. It is also created in the gut
in response to food and plays a role in digestion
and motility.
Dr. Mark Hyman’s SLEEP MASTER CLASS
“... there’s a huge link between depression
and serotonin deficiency, which causes
insomnia, or, is it the other way around?
Is it that the low serotonin causes
the insomnia, which then leads to the
depression? I’m going to group them
all together and say, serotonin is huge
for sleep.”
-Dr. Afrouz Demeri
Histamine helps support metabolism, temperature
control, hormone regulation, your sleep-wake cycle,
your immune system, and others.
Excitatory Neurotransmitters
Acetylcholine stimulates muscle contraction, activates
the pain response, and helps regulate REM sleep.
Glutamate helps with learning and memory.
Inhibitory Neurotransmitters
Gamma-aminobutyric acid (GABA) helps reduce
neuronal excitement throughout the nervous system
(helps to calm you down internally).
“The neurotransmitter GABA is also made
by your friendly bacteria in your gut. If
someone doesn’t have a healthy gut or
a healthy microbiome, they’re not going
to make enough GABA in their body.
And lack of GABA leads to a lot of
anxiety for patients.”
-Dr. Judy Hinojosa
Glycine plays a role in your motor and sensory
pathways.
Your neurotransmitters are made and released based
on so many other factors going on in your body. They
respond to sleep (both positively and negatively),
gut health, blood sugar regulation, diet, exercise, etc.
One of the most impactful things that affects your
neurotransmitters is stress.
Lesson 6: Exercise, Brain Health, Stress, and Sleep 3
Stress
Stress is certainly a subject we are all too familiar
with. It’s such an important topic that research
shows—even if you eat the perfect diet, exercise the
recommended amount per week, take your vitamins,
do everything “right”—if you’re experiencing chronic
negative stress, you can’t create vibrant health.
When you’re stressed, your adrenal glands release
hormones like adrenaline and cortisol that flood
your system, raising your heart rate, increasing your
blood pressure, making your blood more likely to clot,
damaging your brain’s memory center, increasing
belly fat storage, and generally wreaking havoc on
your body. If the stressor is life-threatening, this
response is actually a good thing, because it causes
your body to prioritize one thing: survival. However,
feeling this way all of the time is clearly not good for
your health or your sleep. People with insomnia often
report trouble falling asleep due to worrying and
overthinking about stressors affecting them.
One issue with long-term stress is it can cause
chronically elevated cortisol levels. Now I mentioned
before that cortisol isn’t necessarily the bad guy, but
if you are experiencing constant stress and focusing
on the negative impact, the high levels or cortisol
can cause anxiety, depression, digestive issues,
headaches, weight gain, brain impairment, and
of course, sleep issues.
And unfortunately, people are living increasingly
stressful lives. It feels entirely unavoidable at times.
When you factor in how stressful it is to hear about
the damaging effects of stress, it can be overwhelming
and feel hopeless (making matters worse).
But I want to focus on a different approach, one you
maybe haven’t heard before. Reframing the stress.
I’ve already talked about the physiological response to
stress: our bodies release cortisol and norepinephrine
to stimulate epinephrine and your “flight or fight”
response. This includes increasing your blood
pressure, output of blood from the heart, increased
blood sugar levels (also shunts blood away from your
digestive system) and fatty acid levels, and alerts your
immune system. Essentially, during this time you are
supercharged with a boost of energy, speed, strength,
and even heightened senses—all good things.
Dr. Mark Hyman’s SLEEP MASTER CLASS Lesson 6: Exercise, Brain Health, Stress, and Sleep 4

Here are some other good things Sleep Better With Exercise
about cortisol: And A Healthier Brain
• Cortisol
 is also elevated during fun, excitement,
sporting events, and thrilling adventures—it is Exercise
responsible for enriching your experience. 1. T
 ry to incorporate 20 minutes of movement every
• C ortisol helps boost energy, make you feel more day. This can be walking, swimming, jogging,
alert, and reduces fatigue.
playing sports, wrestling with your kids, etc.“
• Y ou can experience a sense of calm following a
cortisol spike. “The moral of the story with exercise
• Cortisol
 can boost the formation of memories. is that consistency is super important.
• It can help to increase your focus, concentration, We need to give it a good shot over a
productivity, and brainpower.
prolonged period of time and we need to
• W hen you experience something really traumatic
or deep grief, cortisol can help ease the negative not overdo it. More is not always better
emotional response. but moderation is really what we should
be striving for.”
When you experience stress, your body also pumps
-Dr. Mary Pardee
out oxytocin. Normally, oxytocin is released when you
2. T
 ry to incorporate strength training into your
experience love, affection, touch, and happiness, and
exercise 3 times per week. You can work up to this.
helps strengthen relationships, enhance empathy,
Not going to the gym at all? Just aim for one day per
build strength and resilience, and compassion,
week and increase from there.
kindness, and the desire to help others. Yep, the
3. If you’re looking for a way to incorporate HIIT
“cuddle hormone” gets released during stressful
training, check out the 7 minute workout by the
events as a way to help you to seek support. It also is
New York Times.
cardioprotective (helps keep your heart healthy) and
anti-inflammatory—more good things. 4. G
 et outside and do something fun, every day.
What’s your favorite outdoor hobby?
If you change your perspective about stress, you are 5. T
 ry to exercise vigorously before noon and
less likely to experience the negative effects. When incorporate light yoga/stretching before bed. (But Pro tip:
you perceive a stressful situation in a positive light If you start your
don’t stress if you need to exercise later in the
and harness the good things that I listed, your body day with an aerobic
day. Any movement at all is more important than
activity outdoors—a
physically responds better. You literally do not feel the worrying about timing.)
bike ride, walk, jog, or
harmful effects as strongly or at all. Isn’t that amazing?
“Again, exercise when you can and make even rollerskate within
it a habit consistently, but if you’re trying the first 30 minutes
So, the next time you notice your body tightening up, of waking up, you get
or have concerns suffocating your mind, or have strict to really optimize things for longevity, for the added benefits of
deadlines that you’re struggling to meet, remember health purposes, there could be some early-morning light
that the cortisol, oxytocin, and stress response are exposure, vitamin D,
added benefit to doing your exercise in a
there to help you, make you rise to the occasion, make and a metabolism
you kick into overdrive, and make you reach out for fasted state in the morning.” boost!
support and connection. These are all good things, we -Mike Mutzel
just have to see their potential.
Dr. Mark Hyman’s SLEEP MASTER CLASS Lesson 6: Exercise, Brain Health, Stress, and Sleep 5

Brain Health Stress

1. B
 alancing your blood sugar is one of the most 1. R
 eframe how you look at stress. When you
impactful things you can do for your brain, encounter a stressful event, think about well-
hormones and neurotransmitters, and sleep. Focus equipped your body is to handle the situation and
on eating whole, real foods, mostly veggies, with a how advantageous it can be. Turn it to your favor.
serving of healthy fats and quality protein.
2. C
 lear your mind before bed. Keep a notebook
2. T
 ry to minimize overstimulation by setting limits on
by your bed and write down all of the things on
screens. Wait to check your emails, social media, or your mind.
news until at least an hour after waking up and turn
off these things at least an hour before bed. 3. P
 ractice gratitude. In the same notebook, make an
3. A
 sk your doctor if adding some supplements is right entry of the things you are grateful for that day.
for you.
4. R
 each out to your support system. Making
• L-theanine
connections with others, especially during stressful
• GABA
times, can help build relationships and calm your
• 5-HTP

stress response.
• Melatonin
5. P
 ractice a breathing exercise before bed. Pro tip: Pro tip:
Try the 4-7-8 technique from Dr. Judy Hinojosa. Try the 4-7-8
Breathe in through your nose for 4 counts, hold for technique from Dr.
7 counts, slowly breathe out through your mouth for Judy Hinojosa. Breathe
8 counts, repeat. in through your nose
for 4 counts, hold for 7
6. D
 elete social media off of your cell phone. (I’m not counts, slowly breathe
saying to never use social media, just consider out through your
setting boundaries on it.) mouth for 8 counts,
repeat.
Dr. Mark Hyman’s SLEEP MASTER CLASS Lesson 6: Exercise, Brain Health, Stress, and Sleep 6

Reflect On This:

What is my favorite way to play? Sports? Wrestling with the kids?

Surfing? How will I incorporate play into my day today?

Do I feel inundated with stimulation from social media?

How would I feel to set limits and not rely on the news or social media as much?

How do I respond to stressful situations? What’s my go-to method of coping? Is this healthy?
What ways could I reframe my thinking and approach?

What is one change to improve my sleep that I commit to today?

Exercise, brain health, and stress all go hand-in-hand with sleep—the more you prioritize movement and stress
management the better your sleep will be. And while lifestyle changes can make a significant impact on your
sleep, sometimes gadgets, devices, and supplements can be useful to help get your sleep back on track. Lesson
7 will take you through all of my favorites. I’ll see you there!
Dr. Mark Hyman’s SLEEP MASTER CLASS Lesson 6: Exercise, Brain Health, Stress, and Sleep 7

Disclaimer
This publication contains the opinions and ideas of the author. It is intended to provide helpful and informative
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professional should be consulted.

The author and publisher specifically disclaim all responsibility for any liability, loss, or risk, personal or
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