Brain Health FM with Dr Sui Wong

You forget a name in a meeting. You walk into a room and can't think why you're there. And a quiet worry starts: is my memory going? Is this just age, or something worse?
In this episode, consultant neurologist Dr Sui Wong explains why most everyday forgetting isn't decline at all. Through the story of one patient who arrived convinced she had dementia, you'll learn what's really happening when memories don't stick, how to tell ordinary forgetting from the kind worth getting checked, and why so much of what we blame on ageing is within your reach to change.

In this episode
0:00 The patient who was sure she had dementia
2:14 The two fears inside "is my memory going?"
3:08 The doorway effect
4:05 How a memory is made: the librarian
5:18 Jennifer: when a busy mind stops recording your life
6:46 The three things "ageing" really means
8:33 Quick-fire: names, rooms and brain fog
10:38 One small thing to try tomorrow
11:16 What feels like ageing is often within your reach

Key takeaways 
Most everyday forgetting is an attention problem, not a memory one. You can't recall what you were too distracted to encode in the first place.
Some word-finding slips are a normal part of ageing. What's worth checking is different: things you genuinely attended to that vanish, getting lost somewhere familiar, or other people noticing a change before you do.
Persistent brain fog is worth a visit to your doctor, because simple, treatable causes (such as an underactive thyroid, low vitamin B12 or iron-deficiency anaemia) can be picked up on a blood test.
Stress, poor sleep and a divided mind can produce the whole feeling of being older than you are, and that is reversible.

Thursday Tips
Get my free Thursday Tips: a short weekly newsletter of brain-performance tips, plus a form to send in questions for future episodes: https://brainhealth.fm/

References
Craik FIM, et al. (1996). The effects of divided attention on encoding and retrieval processes in human memory. J Exp Psychol Gen. DOI: 10.1037/0096-3445.125.2.159 · PMID: 8683192
Shafto MA, et al. (2007). On the tip-of-the-tongue: neural correlates of increased word-finding failures in normal aging. J Cogn Neurosci. DOI: 10.1162/jocn.2007.19.12.2060 · PMID: 17892392
Radvansky GA, et al. (2010). Walking through doorways causes forgetting: environmental integration. Psychon Bull Rev. DOI: 10.3758/PBR.17.6.900 · PMID: 21169587
Radvansky GA, et al. (2011). Walking through doorways causes forgetting: further explorations. Q J Exp Psychol. DOI: 10.1080/17470218.2011.571267 · PMID: 21563019
Kramer ES, et al. (2025). Evaluation of Suspected Dementia. Am Fam Physician. PMID: 41533411

Brain Health FM with neurologist Dr Sui Wong
Energy, focus and performance: a neurologist's practical guide.
New episodes every Tuesday.
Free weekly brain-performance tips for consistent energy and focus: join the Thursday Tips newsletter at drwongbrainhealth.com
Send in your questions/ topic suggestions: www.BrainHealth.fm
Dr Sui Wong is a consultant neurologist and neuro-ophthalmologist who has spent more than 25 years helping tens of thousands of patients. An active clinician-researcher, she also holds qualifications in mindfulness, yoga, movement and lifestyle medicine. She brings what she sees in clinic and what the research shows to the question of how high achievers can get their energy, focus, and clarity back.
This podcast is for educational purposes only, not individual medical advice. For concerns about your own health, please speak with your doctor.
Stories shared in this podcast do not refer to a specific person (unless stated otherwise with the person's permission), but are a representative amalgamation of the patients or patterns seen in Dr Wong's clinic, shared in a storytelling format for educational purposes only.

You finally get away. And within a few days of being back, you're saying it again: "I need another holiday." Everyone laughs, and everyone means it. The rest you had fades so fast it feels like months ago, not days.
In this episode, consultant neurologist Dr Sui Wong looks at what the research shows about why the benefit of a holiday disappears so quickly after you return, why people who drive themselves hardest feel both the high and the crash most sharply, and why a fortnight away can't make up for a year with no gaps in it. You'll hear how to move from rest as an escape to rest as a rhythm, three things she builds into her own week, and why some people always seem to get ill on holiday.

= In this episode =
0:00   "I need another holiday": why the break doesn't hold
1:41   What the research shows: holidays help, then the effect fades
2:24   Fifty-four employees: how fast the benefit disappears
3:10   Why the hardest workers get the biggest crash
3:44   The same bowl, the same soup
4:18   What you come back to
4:48   Not deciding is a decision too
5:51   From escape to rhythm
6:25   Three things I build into my week
8:24   Why a fortnight away can't repair a year
9:13   Quick-fire Q1: What's the best type of holiday, restful or active?
10:15  Quick-fire Q2: Is it better to take one long break or several short ones?
10:53  Quick-fire Q3: Why do I always get ill on holiday?
12:28  One small thing: ten minutes between two meetings
12:56  What a holiday is really for
13:44  Before we close
14:19  Coming up next

= Key takeaways =
Holidays do help: research pooling seven studies found a small but real benefit to health and wellbeing. That benefit fades soon after returning to work, by roughly the same amount.
In a study of 54 employees, wellbeing rose during a long summer holiday and returned to baseline directly after going back. The rise and the fall were both greater in people who worked most compulsively.
A holiday can't make up for a year with no gaps in it. Build rest into the rhythm of your week instead: your hardest thinking when your focus is best, a short gap between meetings, and movement as a planned break.
"Leisure sickness", getting ill at weekends or on holiday, has been described but not yet explained. If symptoms keep coming back, don't just put it down to leisure sickness: speak with your own doctor.

= Thursday Tips &  Shape this Podcast =
Get my free Thursday Tips: a short weekly newsletter of brain-performance tips, plus a form to send in questions for future episodes: https://brainhealth.fm/

= References =
de Bloom J, et al. (2009). Do we recover from vacation? Meta-analysis of vacation effects on health and well-being. J Occup Health. DOI: 10.1539/joh.k8004 · PMID: 19096200
de Bloom J, Radstaak M, Geurts S (2014). Vacation effects on behaviour, cognition and emotions of compulsive and non-compulsive workers: do obsessive workers go 'cold turkey'? Stress Health. DOI: 10.1002/smi.2600 · PMID: 25100274
Vingerhoets AJ, et al. (2002). Leisure sickness: a pilot study on its prevalence, phenomenology, and background. Psychother Psychosom. DOI: 10.1159/000065992 · PMID: 12411765

Brain Health FM with neurologist Dr Sui Wong
Energy, focus and performance: a neurologist's practical guide.
New episodes every Tuesday.
Free weekly brain-performance tips for consistent energy and focus: join the Thursday Tips newsletter at drwongbrainhealth.com
Send in your questions/ topic suggestions: www.BrainHealth.fm
Dr Sui Wong is a consultant neurologist and neuro-ophthalmologist who has spent more than 25 years helping tens of thousands of patients. An active clinician-researcher, she also holds qualifications in mindfulness, yoga, movement and lifestyle medicine. She brings what she sees in clinic and what the research shows to the question of how high achievers can get their energy, focus, and clarity back.
This podcast is for educational purposes only, not individual medical advice. For concerns about your own health, please speak with your doctor.
Stories shared in this podcast do not refer to a specific person (unless stated otherwise with the person's permission), but are a representative amalgamation of the patients or patterns seen in Dr Wong's clinic, shared in a storytelling format for educational purposes only.

Eight hours at your desk. One meeting closes, the next one opens, Teams pings, emails land, and everything is urgent. No lunch away from the screen, no walk, just a coffee. By the end of the day you've been busy the whole time, and not much has actually moved.
In this episode, consultant neurologist Dr Sui Wong explains why a day like that keeps your stress response pressed like an accelerator while you sit in traffic. You'll hear what the research on breathwork does and doesn't show, how slow breathing reaches your autonomic nervous system, and a 90-second practice you can do at your desk without anyone noticing.

In this episode

0:00   John, and eight hours of busy
1:44   He came about his eyes; it was his nervous system
2:06   The accelerator stuck in traffic
3:49   Deep work versus fragmented attention
4:52   What your body is doing at the desk
5:52   "It's just life, isn't it?"
6:58   What the breathwork research shows, and what it doesn't
9:43   The 90-second practice: where you feel the breath
11:46  A safety note, then breathe along
12:44  Why the pauses matter
13:11  How breathing reaches your autonomic nervous system
14:46  Six breaths a minute and heart rate variability
16:24  One honest limit
16:54  Use the gaps you already have
17:29  Quick-fire Q1: What if my mind won't stop?
18:29  Quick-fire Q2: Is this the same as meditation?
19:17  Quick-fire Q3: Isn't the Wim Hof Method better?
20:35  One small thing: three slow breaths while the screen loads
21:05  If breathwork isn't for you
21:38  Before we close
22:17  Next time: why a holiday doesn't fix it

Key takeaways

The problem isn't hard work. It's constant switching: every ping and every jump between tasks presses the stress accelerator while you go nowhere.
Slow breathing has evidence behind it for lowering felt stress. The effects are small to moderate, not miraculous, and slowing the breath seems to matter more than the exact ratio of in-breath to out-breath.
Try three slow cycles in a gap you already have: in for 4, hold for 2 to 3, out for 6 to 8, hold for 2 to 3. If you're pregnant, or have uncontrolled high blood pressure, a heart or lung condition, or a history of panic attacks, leave out the holds and simply breathe slowly.
Fast, forceful breathing (such as Wim Hof style) activates the stress response, so it's not what you need at 4pm when you're already wired. If breathwork isn't for you, stand and stretch, look at something far away, or drink a glass of water slowly.

Thursday Tips

Get my free Thursday Tips: a short weekly newsletter of brain-performance tips, plus a form to send in questions for future episodes: https://brainhealth.fm/

Disclaimers

This podcast is for educational purposes only, not medical advice. If something about your health is worrying you, please see your own doctor.
Patient stories on Brain Health FM are not real individuals. Each is an amalgamation of the typical patterns Dr Sui Wong sees in clinic, shared in a storytelling way to illustrate what matters for your brain health.

References

Monsell S (2003). Task switching. Trends Cogn Sci. DOI: 10.1016/s1364-6613(03)00028-7 · PMID: 12639695
Tsubota K, Nakamori K (1993). Dry eyes and video display terminals. N Engl J Med. DOI: 10.1056/NEJM199302253280817 · PMID: 8426634
Lin F, et al. (2006). Effect of different sitting postures on lung capacity, expiratory flow, and lumbar lordosis. Arch Phys Med Rehabil. DOI: 10.1016/j.apmr.2005.11.031 · PMID: 16571389
Fincham GW, et al. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Sci Rep. DOI: 10.1038/s41598-022-27247-y · PMID: 36624160
Balban MY, et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. DOI: 10.1016/j.xcrm.2022.100895 · PMID: 36630953
Birdee G, et al. (2023). Slow breathing for reducing stress: The effect of extending exhale. Complement Ther Med. DOI: 10.1016/j.ctim.2023.102937 · PMID: 36871835
Lehrer PM, Gevirtz R (2014). Heart rate variability biofeedback: how and why does it work? Front Psychol. DOI: 10.3389/fpsyg.2014.00756 · PMID: 25101026
Hillebrand S, et al. (2013). Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: meta-analysis and dose-response meta-regression. Europace. DOI: 10.1093/europace/eus341 · PMID: 23370966
Lehrer P, et al. (2020). Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis. Appl Psychophysiol Biofeedback. DOI: 10.1007/s10484-020-09466-z · PMID: 32385728
Kox M, et al. (2014). Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proc Natl Acad Sci U S A. DOI: 10.1073/pnas.1322174111 · PMID: 24799686

Brain Health FM with neurologist Dr Sui Wong
Energy, focus and performance: a neurologist's practical guide.
New episodes every Tuesday.
Free weekly brain-performance tips for consistent energy and focus: join the Thursday Tips newsletter at drwongbrainhealth.com
Send in your questions/ topic suggestions: www.BrainHealth.fm
Dr Sui Wong is a consultant neurologist and neuro-ophthalmologist who has spent more than 25 years helping tens of thousands of patients. An active clinician-researcher, she also holds qualifications in mindfulness, yoga, movement and lifestyle medicine. She brings what she sees in clinic and what the research shows to the question of how high achievers can get their energy, focus, and clarity back.
This podcast is for educational purposes only, not individual medical advice. For concerns about your own health, please speak with your doctor.
Stories shared in this podcast do not refer to a specific person (unless stated otherwise with the person's permission), but are a representative amalgamation of the patients or patterns seen in Dr Wong's clinic, shared in a storytelling format for educational purposes only.

Headaches most days. A tight neck and shoulders. Thinking that has gone slow, and waking at 4am with the day already running in your head. Sarah searched her symptoms late at night and landed on the worst answer: a brain tumour. Her tests were normal. Then she asked the question this episode is about: "If it's not a tumour, what is it? Because something is wrong with me."
 
In this episode, consultant neurologist Dr Sui Wong explains what running wired can cost you, while the work still gets done and nobody else notices. You'll hear how your two stress systems work, why a stress system that never switches off can leave you exhausted and wide awake at the same time, what that does to memory and sleep, and the honest answer to "Have I already damaged my brain?"
 
In this episode
 
0:00 Sarah, and the fear she hadn't said out loud 1:44 The cost nobody else sees 3:09 11pm: the only time that belongs to her 4:40 Your two stress systems 5:19 The smoke alarm that never switches off 7:11 Why the day keeps running while you sleep 7:49 Sleep is the brain doing a different job 8:11 Not every headache is stress 8:34 A filing problem, not a memory problem 9:16 Overnight housekeeping, honestly weighed 10:28 Have I already damaged my brain? 12:24 Quick-fire 1: Is stress actually bad for you? 13:38 Quick-fire 2: Does a glass of wine help me sleep? 14:35 Quick-fire 3: Can stress damage your eyesight? 16:11 One small thing: a piece of paper before bed 16:51 When it might be more than stress 17:32 Coming up next
Key takeaways
 
Running wired often shows up quietly first: names coming more slowly, small errors in emails, a shorter fuse at home. The work still gets done. It just costs more to produce.
 
Irritability under chronic stress is physiology, not a character flaw. A brain that isn't sleeping properly, on a stress system that never switches off, has less capacity for patience.
 
What looks like a sleep problem is often a stress system still running at night. That is why you can spend eight hours in bed and wake as if you've been at work all night.
 
This is not a one-way door. Sleep, stress hormone rhythm and thinking can improve when conditions change. If you have headaches that worry you, a change in your central vision, or low mood most days, please see your own doctor.
 
Thursday Tips
 
Get my free Thursday Tips: a short weekly newsletter of brain-performance tips, plus a form to send in questions for future episodes: https://brainhealth.fm/
 
 
Disclaimers
 
This podcast is for educational purposes only, not medical advice. If something about your health is worrying you, please see your own doctor.
 
Patient stories on Brain Health FM are not real individuals. Each is an amalgamation of the typical patterns Dr Sui Wong sees in clinic, shared in a storytelling way to illustrate what matters for your brain health.
 
References
 
Fries E, et al. (2009). The cortisol awakening response (CAR): facts and future directions. Int J Psychophysiol. DOI: 10.1016/j.ijpsycho.2008.03.014 · PMID: 18854200
 
Miller GE, et al. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychol Bull. DOI: 10.1037/0033-2909.133.1.25 · PMID: 17201569
 
Vgontzas AN, et al. (2001). Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. J Clin Endocrinol Metab. DOI: 10.1210/jcem.86.8.7778 · PMID: 11502812
 
Bonnet MH, Arand DL (1998). Heart rate variability in insomniacs and matched normal sleepers. Psychosom Med. DOI: 10.1097/00006842-199809000-00017 · PMID: 9773766
 
Perlis ML, et al. (2001). Beta/Gamma EEG activity in patients with primary and secondary insomnia and good sleeper controls. Sleep. DOI: 10.1093/sleep/24.1.110 · PMID: 11204046
 
Diekelmann S, Born J (2010). The memory function of sleep. Nat Rev Neurosci. DOI: 10.1038/nrn2762 · PMID: 20046194
 
Deligkaris P, et al. (2014). Job burnout and cognitive functioning: A systematic review. Work & Stress. DOI: 10.1080/02678373.2014.909545 · PMID: not indexed in PubMed
 
Fultz NE, et al. (2019). Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep. Science. DOI: 10.1126/science.aax5440 · PMID: 31672896
 
Shokri-Kojori E, et al. (2018). β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proc Natl Acad Sci U S A. DOI: 10.1073/pnas.1721694115 · PMID: 29632177
 
Miao A, et al. (2024). Brain clearance is reduced during sleep and anesthesia. Nat Neurosci. DOI: 10.1038/s41593-024-01638-y · PMID: 38741022
 
Hauglund NL, et al. (2025). Norepinephrine-mediated slow vasomotion drives glymphatic clearance during sleep. Cell. DOI: 10.1016/j.cell.2024.11.027 · PMID: 39788123
 
McEwen BS, et al. (2016). Stress effects on neuronal structure: hippocampus, amygdala, and prefrontal cortex. Neuropsychopharmacology. DOI: 10.1038/npp.2015.171 · PMID: 26076834
 
Schmaal L, et al. (2016). Subcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group. Mol Psychiatry. DOI: 10.1038/mp.2015.69 · PMID: 26122586
 
Echouffo-Tcheugui JB, et al. (2018). Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study. Neurology. DOI: 10.1212/WNL.0000000000006549 · PMID: 30355700
 
McEwen BS, Morrison JH (2013). The brain on stress: vulnerability and plasticity of the prefrontal cortex over the life course. Neuron. DOI: 10.1016/j.neuron.2013.06.028 · PMID: 23849196
 
Ebrahim IO, et al. (2013). Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. DOI: 10.1111/acer.12006 · PMID: 23347102
 
Daruich A, et al. (2015). Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis. Prog Retin Eye Res. DOI: 10.1016/j.preteyeres.2015.05.003 · PMID: 26026923
 
Tsubota K, Nakamori K (1993). Dry eyes and video display terminals. N Engl J Med. DOI: 10.1056/NEJM199302253280817 · PMID: 8426634
 

Brain Health FM with neurologist Dr Sui Wong
Energy, focus and performance: a neurologist's practical guide.
New episodes every Tuesday.
Free weekly brain-performance tips for consistent energy and focus: join the Thursday Tips newsletter at drwongbrainhealth.com
Send in your questions/ topic suggestions: www.BrainHealth.fm
Dr Sui Wong is a consultant neurologist and neuro-ophthalmologist who has spent more than 25 years helping tens of thousands of patients. An active clinician-researcher, she also holds qualifications in mindfulness, yoga, movement and lifestyle medicine. She brings what she sees in clinic and what the research shows to the question of how high achievers can get their energy, focus, and clarity back.
This podcast is for educational purposes only, not individual medical advice. For concerns about your own health, please speak with your doctor.
Stories shared in this podcast do not refer to a specific person (unless stated otherwise with the person's permission), but are a representative amalgamation of the patients or patterns seen in Dr Wong's clinic, shared in a storytelling format for educational purposes only.

Why high achievers feel tired but wired
Brain Health FM with neurologist Dr Sui Wong
Energy, focus and performance: a neurologist's practical guide.
New episodes every Tuesday.
Free weekly brain-performance tips for consistent energy and focus: join the Thursday Tips newsletter at drwongbrainhealth.com
Send in your questions/ topic suggestions: www.BrainHealth.fm
Dr Sui Wong is a consultant neurologist and neuro-ophthalmologist who has spent more than 25 years helping tens of thousands of patients. An active clinician-researcher, she also holds qualifications in mindfulness, yoga, movement and lifestyle medicine. She brings what she sees in clinic and what the research shows to the question of how high achievers can get their energy, focus, and clarity back.
This podcast is for educational purposes only, not individual medical advice. For concerns about your own health, please speak with your doctor.
Stories shared in this podcast do not refer to a specific person (unless stated otherwise with the person's permission), but are a representative amalgamation of the patients or patterns seen in Dr Wong's clinic, shared in a storytelling format for educational purposes only.