WEBVTT

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Our next speaker is Major Alison Brager .

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She serves as an army neuroscientist

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and the Chief science officer at the US

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Army John F . Kennedy Special Warfare

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Center and School . Doctor Bra's

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research examines resiliency to extreme

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stress and extreme environments at the

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level of genes , brain and behaviors .

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Please welcome Major Brager .

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It's really an honor and a privilege to

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be here and to close out the morning

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session . Uh And I apologize , I know

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I'm holding you up between lunch . Uh

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But I hope you learn a thing or two

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about sleep uh before you go and have

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your lunch . Um It's also really an

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honor to follow in the footsteps of uh

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my mentor and former commander ,

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General Deirdre Tahan . Um as well as

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Doctor Kelly Starrett . Uh I've known

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Kelly for the last decade when I was

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competing in the crossfit games . Um He

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truly was the difference between having

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some lifelong injuries , potential

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surgeries . Um So the one thing I will

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say , it pays to be a Sub Leopard and

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it pays to do that 10 minutes on the

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roller or use a lacrosse bowl at night

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before you go to sleep . And I can

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promise you , it will help you fall

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asleep too . So I'm here today to talk

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about some of the principles and

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practices of the sleep readiness domain

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of H two F and how we have done a

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wonderful job integrating these

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principles and practices into the force .

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Uh But before I get started , I would

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like to give credit , your credit is

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due and that is to my amazing teammates

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back at rare . Um They are truly a

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world-class team of scientists and

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physicians who are leading the way with

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sleep health . And the current state of

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sleep science , not just for the army ,

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but across the dod . So to

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open up , um I am a member at present

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of the army Special Forces community

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and in our community , we live by

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certain truths . The number one truth

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of special forces is that humans are

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more important in hardware . And truly

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this is what makes up H two F um

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as you heard earlier today from General

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Deirdre Tehan , as well as the Ss Ma

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yesterday . It's first about the human ,

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secondly , about the equipment , but

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it's the equipment that you put on the

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human . And I really hope to get this

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message across today . So when I was at

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rare , leading the sleep research

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Center , we spent a lot of time

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figuring out how to capture sleep

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metrics of health wellness and

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performance for the H two F curriculum .

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And when we started to think about

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military relevant populations that we

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wanted to study . Uh we came to a

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unanimous decision that it had to be

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the college athlete , not the

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professional athlete , the college

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athlete . If you think about college

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athlete , the college athlete has

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competing demands of being an academic

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scholar , with the competing demands of

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being the best in their sport ,

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traveling across the country ,

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traveling across the world , having the

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pressure to perform and win , but then

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also the pressure to stay on the team ,

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to stay healthy , to not get injured ,

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to not lose their scholarship . So we

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spent a lot of time at rare ,

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collecting sleep health data and elite

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collegiate communities . Some of the

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collaborations we formed over the years

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was with Ls U's football team . And we

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also formed collaborations with Towson

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University's lacrosse program , which

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is one of the best in the country . Uh

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Some of the success stories we've had

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over the years was actually with LSU a

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few years ago . Uh So we were actually

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involved with the remodel of their

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locker room leading up to the 2018 ,

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2019 season . Um Essentially , this is

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an area where the players could go ,

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they could sort of reset before they

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had practice uh that day . They could

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also take a nap . And that year , Joe

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Burrow , and that's actually his

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sleeping napping mental reset pod right

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there , led the team to the national

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championship and they ended up winning

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the national championship that year .

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So go Tigers . Um , we also have done

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some work with the army's world class

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athlete program . I was fortunate

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enough after my time at rare to spend

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two years , part of the world class

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athlete program , uh , competing around

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the country in the world in crossfit .

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Um , some of the work we've done with

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these collegiate athletic teams and the

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world class athletes we've worked with ,

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um , really helped shape the future for

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understanding what baseline sleep looks

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like in our soldier populations . Some

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of the more surprising findings we had

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from our research . Um First , we found

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that sleep health and sleep issues are

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really pervasive in individuals that

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are otherwise healthy and also some of

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the fittest athletes in our country .

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Uh in the football players we were

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working with at Towson University as

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well as some of the lacrosse players .

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Uh We found that at least 60% of their

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varsity roster fit the diagnosis for

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some sleep disorder , whether it's

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sleep apnea or insomnia . We also did a

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little bit of work with the NFL as well .

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Uh We tried to correlate the time at

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which a game was played with injury

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risk across the regular season . And

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from this , we actually found that West

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Coast teams have a distinct advantage

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during the regular season because they

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are playing games more aligned with

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their peak biological clock versus the

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East Coast teams . So again , just

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using all this data from a military

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relevant athletic community and now

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applying it to the principles and

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practices of H two F . One of the other

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projects we did actually involve taking

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a deep dive through what I think is one

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of the most underutilized but also most

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enriching documents on medical

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readiness that we have at our disposal .

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So this is a report that comes out

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every year and I uh encourage all of

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you to check this out because it is , I

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can't imagine the amount of manpower

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and work hours that go into the data

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analysis and data visualizations of

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this report . But the health of force

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report has a really accurate picture of

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the current state of sleep readiness ,

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physical readiness , mental health

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readiness , spiritual readiness , and

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all other aspects of medical readiness

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that is reported across our army

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installations , uh Conus and O Conus .

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So one of the things we found just

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looking at this right around the time

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that H two F started was that there are

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more bases in the United States that

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are Amber for sleep readiness . And

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what I mean by sleep readiness , it's

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the amount of uh soldiers who have been

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diagnosed with a sleep disorder . Then

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there are bases that are green for

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sleep readiness . You'll also see here

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that a majority of the bases that are

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red for sleep readiness , which means

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there are three standard deviations

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from the mean of sleep disorders are in

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the South . And this to us , this is

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interesting , right ? Because we're

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working with a transient soldier

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population , but yet it mirrors the

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heat maps that the CDC have reported

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for chronic health and disease . Well ,

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fortunately , we do see upward

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trends now . So this is a little

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analysis we did last year . Uh This is

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comparing the health of the forest

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report to 2017 with 2021 . Uh

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You could see that there still is a

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little bit red compared to 2017 .

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Uh but not nearly as much . And most of

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these units are trending towards Amber

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and there's far more units who are in

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the green since the implementation .

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And this idea of having uh a a

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total focus on health wellness and

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performance . I also want

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to give a shout out and some credit to

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the jag co because I really believe the

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Jag Corp is leading the way with the H

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two F curriculum in ways that many of

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you in the audience did not know . Um

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So back in Tober , I gave a sleep

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readiness brief to the staff judge

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advocate of the army and his team at

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Fort Belvoir . And it was from that

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brief that they decided that they could

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no longer ignore the poor sleep health

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that they had across their formation .

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Um And so since then , I've been

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traveling across the world to the

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different circuits of the Office of

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Trial Council and working with these

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young lawyers um who are at the

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pinnacle of their career and helping

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them protect their sleep health as much

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as possible during one of the most

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stressful times of their career . Um

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And this curriculum , it doesn't just

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focus on sleep health . It focuses on

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all the domains of H two F . So again ,

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just really special . Uh shout out to

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the jag corps . All right , let's pivot

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a little bit . And let's talk about ,

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about another truth that we abide by an

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army Special Forces . And this is

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quality being better than quantity .

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One of the ways that we can address

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this through H two F now concerns our

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equipment and arming our soldiers and

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our force with optimal equipment to

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help them perform even better . So this

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is an initiative that we have uh within

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SOCOM to date . It's very similar to

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the initiative that H two F and trade

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office is implementing and it has a

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really great name , the human

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performance data management system and

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what the human performance data

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management system is , is essentially

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providing the soldier with all

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different data points to track his or

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her physical performance , mental

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performance and spiritual performance

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throughout their entire career . And it

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includes the medical records , but it

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also includes what they're doing in the

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gym . Um When they go see a performance ,

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dietitian , how they eat , how they

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track what they eat . Uh What kind of

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mindset reset activities do they have ?

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Um And how do those influence the po uh

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performance ? That's what the goal of

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this program is . Another aspect of

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this program is arming each and every

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one of our soldiers in special forces

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with an aura ring to track sleep , as

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well as a garment watch to track

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physical cardiovascular readiness . And

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we've had some great success with this

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program today . So this comes directly

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from my own schoolhouse at the John F ,

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Kennedy Special Warfare Center and

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school . Um , one of our hardest

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courses at our school and quite

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honestly , it's one of the hardest

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courses in the army . I know there's a

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few uh combat divers out there . It's

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the army combat dive course . Uh So

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before they go down to Key West for the

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66 weeks of dive school , they spend

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six weeks in the pool getting familiar

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with the conditions of hypoxia and

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learning to be comfortable in the

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uncomfortable . One of the things we

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found giving these pre scuba students

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rings and watches is they made

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active positive changes in their

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lifestyle on their own . One of the

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biggest things we saw is that 70% of

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them were drinking less alcohol because

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they saw the direct impacts of alcohol

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on their sleep and on their performance ,

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they also stopped caffeine intake

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earlier . They were eating better

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quality nutritional foods and not

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eating so close to bedtime . And again ,

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this is with no intervention of our

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human performance and wellness staff .

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This is all stuff that they were doing

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alone on their own . Um And it's a

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program that we have continued to date

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and we do have 100% compliance with

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this program um and again , completely

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voluntary , but these students have

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been making really positive changes uh

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for their own benefit . So if we take

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this wearable data a step further , we

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go from the pre scuba phase and now we

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go down to the dive school in Key West

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where they are faced with some of the

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six hardest weeks of training of their

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life . Um We tried to use some

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sleep metrics that we commonly use back

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at rare to measure resiliency to sleep

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deprivation and see if these sleep

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metrics from the aura ring could

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predict performance at the dive school .

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So what you see here are the two

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metrics we care about . First , we care

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about lost sleep at night . This is

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especially concerning for this phase of

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dive school because at this stage , the

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students are only getting about a 5 to

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6 hour sleep opportunity and that's

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after they've been treading water for

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about 19 hours off and on in the pool

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the day prior . Um Another metric

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we care about is sleep onset . We want

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to see who is falling asleep quickly

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and who is staying asleep . Now ,

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you'll see here that there are two

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conditions that we're concerned about ,

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right ? Because we're trying to predict

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next day performance . There's no go

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and go . So the test we're talking

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about , it's called the 20 minute one

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man test of hypoxia basically , during

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this 20 minutes , the students are

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blindfolded . Uh , they descend 9 ft

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into the pool . They have open circuit

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scuba on the instructors toss them

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around , they disorient them for the

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first two minutes . And then they spend

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the next 18 minutes pulling the

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regulator out of the student's mouth ,

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tying it around their scuba gear . They

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have to untie it while they're

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blindfolded . Put it back in , they do

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this for another 18 minutes . A no go

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in . This circumstance is a shallow

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water blackout . So we're not talking

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about a student who just doesn't

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perform the test of standard . The no

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go is they have a shallow water

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blackout . And quite honestly , those

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of you who do have uh a combat dive

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badge know that it's , it's a rite of

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passage in the community . You have to

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be comfortable with the uncomfortable .

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But one of the things we find is the

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students leading up to this one man

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test who are able to get quality sleep

15:04.520 --> 15:06.742
within this five hours and they're able

15:06.750 --> 15:08.639
to fall asleep quickly . They are

15:08.639 --> 15:11.559
passing the one man at a much greater

15:11.570 --> 15:14.659
uh rate than those who aren't . Um

15:14.669 --> 15:16.940
Again , this is just one snapshot in

15:16.950 --> 15:18.719
time , but this is the type of

15:18.729 --> 15:20.890
performance data , performance

15:20.900 --> 15:23.669
prediction data that we can use in the

15:23.679 --> 15:26.250
future through the accessibility of

15:26.260 --> 15:28.760
wearables . I also want to point out

15:28.770 --> 15:31.289
another great study that was done by a

15:31.299 --> 15:33.799
friend of mine um from my athletic

15:33.809 --> 15:35.976
career in college . And that's Kristen

15:35.976 --> 15:37.809
Holmes . Uh , we used to compete

15:37.809 --> 15:40.031
against each other in college and now I

15:40.031 --> 15:42.253
guess we can compete against each other

15:42.253 --> 15:44.031
in science . She's also a sleep

15:44.031 --> 15:46.087
circadian biologist . Uh , she did a

15:46.087 --> 15:48.359
study with an army aviation brigade up

15:48.369 --> 15:50.635
in Alaska . And one of the things she

15:50.645 --> 15:53.325
found is that soldiers up there who are

15:53.335 --> 15:55.755
keeping very consistent and stable

15:55.765 --> 15:57.784
schedules in their rise time and

15:57.794 --> 16:00.755
bedtime , despite the constant days of

16:00.765 --> 16:03.155
darkness and light , they were better

16:03.164 --> 16:05.794
off when it came to measures of

16:05.804 --> 16:08.474
psychological well being than the

16:08.484 --> 16:10.744
soldiers who did not have consistency

16:10.755 --> 16:14.280
in their schedule . The last thing I

16:14.289 --> 16:16.559
wanna talk about before I open it up

16:16.570 --> 16:19.099
for some questions is another effort

16:19.109 --> 16:22.580
that I actually became knowledgeable on

16:22.669 --> 16:25.669
just a few weeks ago um through a

16:25.679 --> 16:27.735
strength and conditioning coach from

16:27.735 --> 16:30.020
the army National Guard . Uh So this is

16:30.030 --> 16:33.780
a great project where they are taking a

16:33.789 --> 16:36.700
clinical grade sleep tool and then

16:36.710 --> 16:39.460
applying the principles and practices

16:39.469 --> 16:42.340
of ruthless sleep hygiene in order to

16:42.349 --> 16:44.619
help the National Guard units here ,

16:44.869 --> 16:47.700
but also deployed . Um I've learned

16:47.710 --> 16:51.010
that this uh device has been used here

16:51.020 --> 16:54.280
in garrison in National Guard um units

16:54.289 --> 16:57.140
across six states soon expanding to 10 .

16:57.369 --> 16:59.669
Uh but it's also been used during

16:59.679 --> 17:02.080
deployed situations um down at the

17:02.090 --> 17:04.770
borders and some counterinsurgency and

17:04.780 --> 17:07.500
drug uh operations we're doing overseas .

17:08.920 --> 17:11.199
What's really unique about this project

17:11.209 --> 17:13.439
that the National Guard is doing is

17:13.449 --> 17:15.910
that they're taking an at home sleep

17:15.920 --> 17:19.219
monitoring and sleep staging device

17:19.229 --> 17:21.579
that is FDA approved and also

17:21.589 --> 17:23.699
recognized by all major insurance

17:23.709 --> 17:27.209
companies . And they are giving these

17:27.219 --> 17:29.660
soldiers access to the nighttime sleep

17:29.670 --> 17:32.229
data from wearing this headband . And

17:32.239 --> 17:34.949
then through the practice of ruthless

17:34.959 --> 17:37.150
sleep hygiene to implement , for

17:37.160 --> 17:39.550
example , a principle called slant that

17:39.560 --> 17:41.449
we implemented at rare , which is

17:41.449 --> 17:44.140
essentially aligning your sleep

17:44.150 --> 17:46.630
environment to optimal conditions ,

17:46.810 --> 17:49.689
implementing that implementing strict

17:49.699 --> 17:53.520
bedtime , um possibly looking at some

17:53.530 --> 17:55.880
over the counter sleep aids , doing

17:55.890 --> 17:58.619
those ruthless hygiene practices before

17:58.719 --> 18:00.729
we're consulting uh a medical

18:00.739 --> 18:02.850
professional . I think this is just a

18:02.850 --> 18:05.260
great project that is out there . So

18:05.270 --> 18:07.326
really , I I , you know the learning

18:07.326 --> 18:10.670
lesson from this is to always um

18:10.680 --> 18:12.902
trust and believe that the strength and

18:12.910 --> 18:14.966
conditioning coaches and our H two F

18:14.966 --> 18:17.939
providers from the the active duty

18:17.949 --> 18:20.005
components in our National Guard and

18:20.005 --> 18:22.171
reserve components are out there doing

18:22.171 --> 18:24.369
the right things um taking care of the

18:24.380 --> 18:28.290
human first . So to go back

18:28.300 --> 18:30.300
again to this point of humans being

18:30.300 --> 18:32.522
more important to hardware . Um I wanna

18:32.522 --> 18:35.290
talk about my own personal story when I

18:35.300 --> 18:37.130
was a company commander in the

18:37.140 --> 18:39.362
recruiting command . And this goes back

18:39.362 --> 18:41.439
to General ta he's point about there

18:41.449 --> 18:44.699
being an off board or an annex for

18:44.709 --> 18:48.119
fatigue management in the board . Uh So

18:48.130 --> 18:50.979
about three years ago , remember I am a

18:50.989 --> 18:54.069
medical officer by trade . Uh but about

18:54.459 --> 18:56.459
three years ago , the recruiting

18:56.469 --> 18:59.020
command needed somebody to command a

18:59.030 --> 19:01.560
fleet of truck drivers that the

19:01.569 --> 19:03.736
recruiting command has . There's about

19:03.736 --> 19:06.540
2118 wheelers in this fleet . They

19:06.550 --> 19:09.449
basically deploy across the country for

19:09.459 --> 19:12.300
11 months a year . So this is a really

19:12.310 --> 19:15.229
hard command . Right . It's not so much

19:15.239 --> 19:17.239
the fact that they're driving an 18

19:17.239 --> 19:19.350
wheeler that can also kill everything

19:19.350 --> 19:21.461
and everyone on the road if there's a

19:21.461 --> 19:23.572
terrible accident . But it's also the

19:23.572 --> 19:25.739
fact that these soldiers for 11 months

19:25.739 --> 19:27.850
of the year from the first of January

19:27.850 --> 19:30.405
all the way until Thanksgiving or away

19:30.415 --> 19:32.255
from their families . Uh They're

19:32.265 --> 19:34.321
putting kids into the army , they're

19:34.321 --> 19:36.432
going to high schools , they're going

19:36.432 --> 19:38.654
to festivals , they're going to fairs .

19:38.654 --> 19:40.543
Um but on the flip side , they're

19:40.543 --> 19:42.321
missing their birthdays , their

19:42.321 --> 19:44.321
anniversaries , their kids softball

19:44.321 --> 19:46.209
games , uh their kids graduations

19:46.209 --> 19:48.321
because they're out there focusing on

19:48.321 --> 19:50.543
putting kids in the army . So the , one

19:50.543 --> 19:52.432
of the things I wanted to do as a

19:52.432 --> 19:54.599
company commander and in , um , you

19:54.609 --> 19:56.776
know , with one of the things I wanted

19:56.776 --> 19:59.199
to do and my first sergeant uh wanted

19:59.209 --> 20:01.920
to do was to protect the safety , the

20:01.930 --> 20:04.160
morale and the health fair and welfare

20:04.170 --> 20:06.400
of these soldiers as much as possible .

20:06.770 --> 20:09.469
So we thought that a fatigue management

20:09.479 --> 20:12.640
strategy and a company policy focus on

20:12.650 --> 20:14.910
fatigue management would be the best

20:14.920 --> 20:17.579
idea . Now , it wasn't welcomed with

20:17.589 --> 20:20.040
open arms . At first , quite honestly ,

20:20.050 --> 20:21.994
my brigade commander at the time ,

20:21.994 --> 20:24.217
called me an entitled medical officer .

20:24.217 --> 20:28.209
But over time , I won his good graces

20:28.219 --> 20:30.441
and I'm now one of his favorite company

20:30.441 --> 20:32.663
commanders . And the reason for that is

20:32.663 --> 20:34.886
because during my time , we didn't have

20:34.886 --> 20:38.030
a single accident in our formation ,

20:38.239 --> 20:41.400
unlike the 10 command teams before me .

20:41.619 --> 20:44.079
Um And again , it was just those simple

20:44.089 --> 20:45.510
things . Thank you .

20:49.280 --> 20:51.447
It was just those simple things making

20:51.447 --> 20:53.447
sure that they were adhering to the

20:53.447 --> 20:55.939
Department of Transportation rules of

20:55.949 --> 20:59.089
starting driving at sunrise , stop

20:59.099 --> 21:01.266
driving at sunset because we know that

21:01.266 --> 21:04.270
most , uh , motor vehicle accidents

21:04.280 --> 21:07.849
happen right after sunset . It was also

21:07.859 --> 21:09.970
giving them the opportunity to have a

21:09.970 --> 21:12.489
full day off on the road . Um , so

21:12.500 --> 21:14.611
before I got there , oftentimes their

21:14.611 --> 21:16.611
day off was a maintenance day where

21:16.611 --> 21:18.667
they took , took the trucks in for a

21:18.667 --> 21:20.778
car wash , right , because you got to

21:20.778 --> 21:22.722
keep it clean . You know , because

21:22.722 --> 21:24.778
we're putting kids in the army , you

21:24.778 --> 21:24.430
have to look as professional as

21:24.439 --> 21:27.829
possible . Uh , but it also was about

21:27.839 --> 21:29.950
getting the tires changed , doing all

21:29.950 --> 21:32.117
the routine maintenance that you would

21:32.117 --> 21:34.949
expect traveling 585,000 miles a year .

21:35.219 --> 21:38.410
Um , and so I , what I would do is

21:38.420 --> 21:41.030
before the next quarter schedule came

21:41.040 --> 21:43.469
out , I would ruthlessly work with the

21:43.479 --> 21:45.689
Brigade Planning Cell and we would sit

21:45.699 --> 21:47.755
in a room for three days and meet in

21:47.755 --> 21:50.010
the middle where we could give , uh , a

21:50.020 --> 21:52.489
day off for every maintenance day and

21:52.500 --> 21:55.010
still accomplish the mission and none

21:55.020 --> 21:57.290
of the soldiers missed a single show

21:57.300 --> 21:59.530
during that time , it was able to be

21:59.540 --> 22:02.109
done , it just took deliberate planning

22:02.119 --> 22:04.819
and effort and ultimately , we didn't

22:04.829 --> 22:06.940
have any accidents during that time .

22:06.940 --> 22:09.051
And quite honestly , the safety , the

22:09.051 --> 22:11.349
morale and the welfare of the soldiers

22:11.699 --> 22:15.589
was benefited from it as well . And so

22:15.599 --> 22:18.589
with that , um these are some great

22:18.599 --> 22:21.489
resources on sleep out there . Um you

22:21.500 --> 22:23.389
know , team rare , they're really

22:23.389 --> 22:25.556
leading the , the way with some of the

22:25.556 --> 22:27.333
knowledge products and material

22:27.333 --> 22:29.611
solutions that we have at our disposal .

22:29.611 --> 22:31.611
Within H two F I know General Tahan

22:31.611 --> 22:33.667
showed that infographic earlier from

22:33.667 --> 22:36.250
Arctic operations . Um that team rare

22:36.260 --> 22:38.819
has , has now produced um you know ,

22:38.829 --> 22:40.890
take advantage of your army Wellness

22:40.900 --> 22:43.630
centers and all the many H two F

22:43.640 --> 22:45.584
resources available . You know , I

22:45.584 --> 22:47.696
shared that story with you about what

22:47.696 --> 22:49.862
the strength and conditioning coach of

22:49.862 --> 22:52.029
the Army National Guard is doing uh to

22:52.029 --> 22:54.959
improve soldier sleep . Um Just really

22:54.969 --> 22:57.420
trust your formation and leverage all

22:57.430 --> 22:59.569
your professionals and your resources

22:59.579 --> 23:02.219
within your footprint . Um So we can

23:02.229 --> 23:04.173
continue to win our nation's war .

23:04.173 --> 23:05.173
Thank you ,

23:15.329 --> 23:17.551
ma'am . We have a few questions for you

23:17.551 --> 23:19.718
here . So what tools can help soldiers

23:19.718 --> 23:21.607
that frequently change time zones

23:21.607 --> 23:25.119
quickly adapt ? So , uh I like to think

23:25.130 --> 23:28.959
of it as the uh trifecta . Um

23:28.969 --> 23:31.329
First , this is the only time you

23:31.339 --> 23:33.283
should be using Melatonin . So you

23:33.283 --> 23:35.283
should not be using Melatonin every

23:35.283 --> 23:37.395
night when you sleep . It should only

23:37.395 --> 23:39.617
be when you're shifting time zones , um

23:39.617 --> 23:41.617
exercise as soon as you get to your

23:41.617 --> 23:43.617
destination , increase blood flow ,

23:43.617 --> 23:45.783
help facilitate the process of falling

23:45.783 --> 23:48.819
asleep . Um And then this is also the

23:48.829 --> 23:52.410
time too um when you should use

23:52.420 --> 23:55.500
caffeine , right ? Um Those are I think

23:55.510 --> 23:59.329
are the big three is caffeine exercise .

23:59.479 --> 24:02.790
And Melatonin light is also , I would

24:02.800 --> 24:04.911
say that would be the fourth thing is

24:04.911 --> 24:07.449
light . Um But in terms of tools

24:07.800 --> 24:10.280
exercise , Melatonin caffeine ,

24:12.790 --> 24:14.679
ma'am , how is the soft community

24:14.679 --> 24:16.989
overcome soldiers' concerns security

24:17.000 --> 24:19.167
and career related that their wearable

24:19.167 --> 24:21.333
data is being tracked and presented to

24:21.333 --> 24:23.660
commanders . Oh yes , this is the ,

24:23.670 --> 24:26.260
this is actually the hardest uh and

24:26.270 --> 24:28.492
most challenging hurdle for getting the

24:28.492 --> 24:30.829
wearable efforts approved uh for us .

24:30.839 --> 24:32.979
But we , we accomplished it . Um It's

24:32.989 --> 24:36.060
about trust , right ? So uh we did

24:36.069 --> 24:39.729
create exceptions to the policy um for

24:39.739 --> 24:43.300
our skiffs . Uh But we also worked

24:43.310 --> 24:45.780
directly with the military liaisons of

24:45.790 --> 24:48.540
the two companies we um were working

24:48.550 --> 24:52.040
with so a a and garment to ensure that

24:52.050 --> 24:53.619
their encryption and their

24:53.630 --> 24:57.170
cybersecurity features um were up to

24:57.180 --> 24:59.430
our standards . And so yes , you can

24:59.439 --> 25:01.272
actually wear the A ring and the

25:01.272 --> 25:05.130
garment and our skiffs . Um because

25:05.140 --> 25:07.140
we were able to work with these two

25:07.140 --> 25:09.029
companies to make that possible ,

25:10.949 --> 25:13.116
ma'am . How can leaders best implement

25:13.116 --> 25:15.060
tenets of sleep , sleep health and

25:15.060 --> 25:17.099
basic training units , particularly

25:17.109 --> 25:19.220
with their drill sergeants at cadre .

25:20.119 --> 25:22.341
So to me , it's about cultural change .

25:22.390 --> 25:25.339
Um You know , I shared my story about

25:25.739 --> 25:28.869
command . And at first I had a few

25:28.880 --> 25:31.270
soldiers that were bought in , but 90%

25:31.280 --> 25:33.839
of my soldiers were not bought in . Um ,

25:33.849 --> 25:36.270
you have to have that one or two people

25:36.280 --> 25:38.630
who are truly bought in , but they also

25:38.640 --> 25:40.696
have to be the one or two people who

25:40.696 --> 25:42.584
are the unofficial leaders of the

25:42.584 --> 25:44.807
formation . I mean , sure , we have our

25:44.807 --> 25:46.862
first surgeons and we have our , our

25:46.862 --> 25:49.084
senior NC OS . But there also are those

25:49.084 --> 25:51.300
informal leaders in the formation that

25:51.310 --> 25:53.829
people look up to . Um if they're doing

25:53.839 --> 25:55.390
it , the rest is easy ,

25:58.329 --> 26:00.218
ma'am . We have time for one last

26:00.218 --> 26:02.162
question . Do you have any tips on

26:02.162 --> 26:03.885
helping someone with circadian

26:03.885 --> 26:05.885
dysregulation due to constant shift

26:05.885 --> 26:08.051
changes ? Yeah . So that's where those

26:08.051 --> 26:10.051
three tools really come into play ,

26:10.051 --> 26:12.530
right ? Exercise , melatonin caffeine

26:12.540 --> 26:14.979
and again , controlling light exposure

26:15.050 --> 26:17.750
using uh blue light to be wake

26:17.760 --> 26:19.982
promoting and then dampening down light

26:19.982 --> 26:22.430
exposure to be sleep promoting . Um

26:22.829 --> 26:24.996
Again , going back to team rare , they

26:24.996 --> 26:27.329
have some great infographics uh

26:27.339 --> 26:29.939
specifically for shift work and

26:29.949 --> 26:33.050
rotating shift work on their website .

26:33.099 --> 26:35.489
I highly encourage you to check out

26:35.500 --> 26:37.611
those infographics . That's something

26:37.611 --> 26:40.500
that general Tahan um really started

26:40.510 --> 26:42.621
and implemented and championed during

26:42.621 --> 26:44.232
her time at rare . And those

26:44.232 --> 26:46.288
infographics , they can basically be

26:46.288 --> 26:48.399
put in a bathroom stall , they can be

26:48.399 --> 26:50.621
put anywhere around the formation . And

26:50.621 --> 26:52.788
I'd like to think the more exposure to

26:52.788 --> 26:55.010
them , the more likely you are to adopt

26:55.010 --> 26:54.369
them