HoldsUp

Michael Grandner

Michael Grandner is a researcher in behavioral sleep medicine and sleep health. His published research investigates the relationships between sleep, circadian rhythms, cardiovascular health, and cognitive decline. Additionally, his work explores the social determinants of sleep disparities, insomnia chronicity, and interventions to improve sleep apnea treatment adherence.

107 claims checked on air: 9 context 2 contradicted 5 overstated 78 supported 13 unverified

What they said on air - context

3 citing their own research

0:26:40needs contexthighWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

In the original publication describing sleep restriction therapy, the intervention was called restriction of time in bed rather than sleep restriction therapy.

"if you actually look to the original publication, they didn't, they didn't even call it sleep restriction therapy. They called it restriction of time in bed, which is really what it is." (said at 0:26:40)

In the seminal 1987 paper describing the intervention by Arthur Spielman and colleagues, the article was titled 'Treatment of chronic insomnia by restriction of time in bed', emphasizing that the technique curtails time spent in bed rather than physiological sleep. However, contrary to the assertion that the original authors did not call it sleep restriction therapy, they explicitly introduced and used the term 'sleep restriction therapy' in the original publication and its abstract.

0:34:55needs contexthighWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

CBT-I removes sleep barriers in approximately 85% of cases.

"What it does is it removes some of those barriers about, again, about 85% of the time, not 100%." (said at 0:34:55)

Cognitive behavioral therapy for insomnia (CBT-I) is widely recognized as the first-line treatment for insomnia and demonstrates strong efficacy across systematic reviews and randomized controlled trials. Clinical response rates for CBT-I typically fall between 70% and 80%, with session completion rates for individual in-person CBT-I reaching approximately 84%. While an approximate 85% figure aligns well with the general magnitude of clinical benefit and high completion rates of structured CBT-I, exact response and remission percentages vary depending on the delivery format (e.g., individual vs. automated digital CBT-I) and the specific outcome criteria used.

1:01:06needs contextmoderateWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

Arousal thresholds are higher during slow-wave deep sleep than during stage 2 sleep or REM sleep, making it easier to awaken from stage 2 and REM.

"and that's also why it's easier to wake up out of stage two and REM than deep sleep." (said at 1:01:06)

The claim is broadly accurate for stage 2 sleep and tonic REM sleep, but requires qualification regarding REM sleep substates. Polysomnographic arousal studies show that auditory arousal thresholds (AATs) are significantly higher during slow-wave sleep (stage 3/4 deep sleep) compared to stage 2 sleep, making stage 2 easier to awaken from. However, arousal thresholds during REM sleep vary substantially by substate: during tonic REM sleep, arousal thresholds are low and comparable to stage 2 sleep, whereas during phasic REM sleep (episodes with rapid eye movements), arousal thresholds are elevated to levels comparable to slow-wave deep sleep.

1:56:35needs contextmoderateWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

Bringing a new pharmaceutical drug to market costs approximately $2 billion and takes at least 10 years.

"why drugs are so expensive because it costs about $2 billion to bring a drug to market in 10 years at least." (said at 1:56:35)

Estimates of pharmaceutical R&D costs and timelines vary substantially based on methodology, therapeutic class, accounting for failed pipeline candidates, and the cost of capital. A systematic review found published capitalized R&D cost estimates ranging from $161 million to $4.54 billion per new molecular entity. A comprehensive study in JAMA analyzing FDA approvals from 2009–2018 estimated the median capitalized cost at $985.3 million and the mean at $1.34 billion, with certain therapeutic areas like oncology exceeding $2.77 billion. The average development timeline from discovery through approval typically spans 10 to 15 years. Thus, while ~$2 billion and ≥10 years represent commonly referenced benchmarks reflecting fully capitalized industry estimates (including failed drugs), actual R&D investments vary widely by drug class and study methodology.

2:42:12needs contextmoderateWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

Wrist-based movement detection can determine whether someone is awake or asleep minute-to-minute with over 90% accuracy relative to EEG brain wave activity.

"You can predict with about 90% accuracy using movement alone. And this was analog devices with that were on a tape backup or eventually 64 kilobytes of memory on the whole watch. With that level of technology, you could get over 90% accuracy minute-to-minute: were you awake or were you probably asleep relative to brain wave activity?" (said at 2:42:12)

Wrist actigraphy validated against polysomnography (PSG, which utilizes electroencephalography/EEG) reliably demonstrates overall minute-by-minute epoch accuracy of approximately 85% to 90% in identifying sleep versus wake states. However, this high overall accuracy requires qualification: it is primarily driven by very high sensitivity for detecting sleep (typically 90% to 96%) during the sleep period, whereas the specificity for detecting wakefulness—particularly quiet, motionless wakefulness—is substantially lower (often 35% to 60%), leading to frequent misclassification of quiet wake as sleep.

3:34:09needs contextmoderateWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

The average person wakes up 10 times or more during the night.

"Remember what I said: the average person will wake up 10 times a night or more." (said at 3:34:09)

Polysomnographic sleep studies in healthy adults demonstrate that spontaneous brief nocturnal awakenings and transient micro-arousals occur routinely throughout normal sleep, frequently numbering 10 or more per night. However, this claim requires context: the vast majority of these nocturnal awakenings are brief physiological transitions lasting only seconds and are not consciously remembered upon waking.

3:35:15needs contextmoderateWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

Reducing systemic inflammation in the body improves perceived sleep quality.

"Reduce systemic inflammation in your body, your sleep will feel better." (said at 3:35:15)

A robust body of evidence links systemic inflammation with sleep quality, but the relationship is predominantly established through observational and bidirectional associations. A comprehensive systematic review and meta-analysis of 72 studies (n > 50,000) found that sleep disturbance is significantly associated with higher circulating levels of systemic inflammatory markers, specifically C-reactive protein (CRP; effect size 0.12, 95% CI: 0.05–0.19) and interleukin-6 (IL-6; effect size 0.20, 95% CI: 0.08–0.31). While chronic low-grade inflammation correlates with disturbed sleep, stating definitively that lowering systemic inflammation directly improves subjective sleep quality simplifies a complex, bidirectional neuroimmune relationship that often depends on the underlying health condition and intervention type.

5:19:43needs contextlowWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

Drivers who obtain only 5 or 6 hours of sleep are three times more likely to nod off behind the wheel, even if they report feeling fully well-rested.

"Like even if you say you're fully well-rested, if you're getting five or six hours of sleep, you are three times as likely to nod off behind the wheel even if you say, 'I am 100% well-rested.'" (said at 5:19:43)

Epidemiological and laboratory studies demonstrate that sleeping fewer than 6 to 7 hours significantly increases the risk of drowsy driving and falling asleep behind the wheel, and that subjective perceptions of alertness become uncoupled from objective vulnerability to sleepiness during chronic sleep restriction. However, the specific claim of an exact threefold increased risk of nodding off specifically among drivers who report feeling '100% well-rested' is an overstatement of the exact point estimate, even though the underlying phenomenon (increased risk of falling asleep despite lack of perceived sleepiness) is documented in observational driver surveys.

5:25:32needs contextmoderateWhy You Can’t Sleep (and How to Fix It) | Dr. Michael Grand

Restricting semi-professional tennis players to 5 hours of sleep impaired their serving accuracy by approximately 35%, and caffeine only recovered about one-third of that lost accuracy.

"there's this great study where they did in tennis players, semi-pro tennis players serving. When they took them down to 5 hours of sleep, it impaired their serving accuracy by, if I remember correctly, something like 35%. It recovered—about a third of the loss was recovered when they caffeinated, but not all of it" (said at 5:25:32)

A randomized crossover study by Reyner and Horne (2013) evaluated the effects of 5 hours of sleep restriction on serving accuracy in semi-professional tennis players. The authors confirmed significant impairments in serving accuracy following sleep restriction. However, contrary to the claim that caffeine recovered about one-third of the lost accuracy, the trial found that an 80 mg dose of caffeine had no statistically significant beneficial effect on restoring serving accuracy.

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