Why sleep matters now more than ever Matt Walker
great to be here with everyone it a
really important conversation today I
think because I don’t know about you
Whitney but they’ve been Knights in the
last couple weeks where I just haven’t
slept that well right there’s just a lot
of stress there’s a lot of worry that’s
a lot of uncertainty and and so forth
and that meet with you ask absolutely I
feel like my sleep has been a little
less than ideal lately for sure probably
for a lot of you out there too I’d
imagine
yeah no indeed so though we’re very
lucky to have with us today like the
perfect speaker for this he’s professor
of neuroscience and psychology at
Berkeley in California and director of
the center for human sleep science
author of a book three years ago why we
sleep and last year gave a TED talk
who’s been seen nearly ten million times
now so it’s a it’s a treat to invite ya
Matt Walker thanks Whitney
you’ll be back right Whitney I’ll be
back with questions from from your in a
bit hello Matt how are you I am good
Chris and how are you doing and thank
you so much for having me on well thank
you it’s very good to have you here I
mean I guess I guess that’s going to be
the first question on top of people’s
minds is you know is there a case that
sleep matters now more than ever I think
firstly it’s important for me to to not
necessarily feed into people’s anxiety
regarding sleep I know as you mentioned
there asleep is difficult for some
people when anxiety is high and of
course that’s never more so at present
so what I would say is that if anything
that we’re talking about feels as though
it’s a trigger feel free just to come
back at a time that feels better in
terms of that anxiety level
in terms of sleep and covered 19 right
now we don’t necessarily have any
evidence to suggest that there is some
kind of a link between those two but
certainly what we know is that there is
a very intimate relationship between
your sleep health and your immune health
I’ll give you just a couple of examples
and there was a study some years ago
that demonstrated that individuals who
reported getting less than seven hours
of sleep and had almost a three-fold
increase likelihood of becoming infected
by the rhinovirus which is what we all
think of as the common cold relative to
those who are getting eight hours of
sleep or more there was another study in
over 50,000 women and what they found
was that individuals who were getting 5
hours of sleep or less had a 70%
increased risk for developing pneumonia
which is a respiratory lung infection
relative to those who are getting 8
hours of sleep or more um but I think
perhaps one of the most striking results
in this relationship between sleep and
immune health was a study where they
demonstrated if you’re not getting
sufficient sleep in the week before you
get your flu shot you produce less than
50% of the normal antibody response
therefore rendering that vaccination
significantly less effective do I think
particularly actually on that last point
at some point we will develop a vaccine
for kovat 19:00 and then the question
becomes is the same thing true if you’re
not getting the sleep that you need in
the week before you get your Co vid shot
will that immunisation become
significantly less effective I actually
think that’s an important question that
we will need to answer in the future ok
so no specific evidence how could there
be this is a fairly there’s a new threat
to humanity but given that you know in a
way the you know if someone gets
infected there follows this sort of epic
battle between a virus and their immune
system it’s it’s obvious common sense to
give your immune system every shot it
can and every chance it can and in many
other cases sleep is known to
do that so they haven’t really met
matters now it’s up there I think it I
think certainly from immune health
perspective we know that sleep
essentially sharpens every tool in that
box sleep essentially restocks the
weaponry in your immune Arsenal giving
you the greatest chance to fight off
infection and I think as of at least
April 2020 we don’t have that evidence
yet I know that there are a number of
studies however that are looking at that
even some of the sleep tracking
companies are trying to rally efforts
around that and examine this right now
so we will have the data I’m sure well a
little later in this interview we’re
going to dig into how to sleep better I
know you’ve got a lot of interesting
advice in that regard but before we go
there let’s let’s spend a bit more time
thinking about the different ways that
it can be really helpful now because
paradoxically and we actually many of us
have in theory at any rate more time to
sleep that we’ve ever had and so boy if
we could put that to use how else how
else could it help us just during our
waking day and the things that we’re
having to focus on now
sleepers seems to provide a benefit to
almost every major organ system in the
body and many of the operations of the
mind and perhaps I’ll just give two
examples within the mind one of the
things that we know sleep is essentially
incredibly beneficial for is learning
memory and even creativity and when it
comes to memory sleep is important in
perhaps at least three ways firstly we
know that you need sleep before learning
to actually prepare your brain a little
bit like a a dry sponge ready to
initially absorb new memories and lay
down those new memory traces but that’s
not enough you not only need to sleep
before learning to imprint those
memories into the brain
you also needs leave after learning to
essentially cement those new memories
into the neural architecture of the
brain so that you don’t forget um and
certainly there’s very good evidence for
that in fact sleep almost performs a
file transfer mechanism where it takes
memories and shifts
them from a sort of a short-term
vulnerable reservoir to a more permanent
long-term storage site within the brain
and that’s what we used to think that
sleep was beneficial for taking
individual memories and holding onto
them as it were future proofing that
information but we’ve since discovered
that sleep is actually much more
intelligent than that leap will actually
take new memories and start to integrate
and associate them with pre-existing
stores of information so it’s almost a
little bit like memory alchemy at night
so that you wake up the next day with a
revised mind wide web of associations
and that leads to remarkable states of
creativity there’s lots of good examples
for this that he’s in that laboratory
showing that um sleep can inspire almost
a three-fold increase in creative
insights and it’s probably the reason
that you know you’ve you’ve never been
told to stay awake on a problem but
instead you’re you’re told to sleep on a
problem and I think that phrase seems to
exist in almost every language that I’ve
inquired about today which means that
this creative benefit of sleep
transcends cultural boundaries comment
across the globe that is one of the most
mind-boggling things to hear about how
you can be worried about something or
puzzled about something and you wake up
in the middle of the night and suddenly
you know possibilities pop into place
the answer is there and that the fact
that you look in one way it’s kind of
knowing because it means your
unconscious mind has been there somehow
you know with I guess pre associating
and doing things that you were supposed
to do all by yourself and it’s not fair
but in other ways it’s this is it’s
super core and so you’re saying that
there’s like how the three times the
creative output very curious as to how
that’s measured but I mean that that’s
that’s an amazing pain if you if you
have enough if you have enough sleep
yeah so there’s a lovely study done by
some German researchers a couple of
years ago and the way that they did this
they gave people a series of problems
that had a hidden embedded rule into it
and they never told them about that rule
but through exposure perhaps gradually
you can divine that hidden insight that
is sort of locked into that problem and
then they bring them back and then they
test them at some point later to see if
the lightbulb moment has gone on for
those individuals and they’ve defined
that sort of creative solution that
hidden rule and you can do that after
being awake or you can do that after
being asleep and that’s how they can
start to tease apart is it just time
that the brain needs for creativity is
it time awake or instead is it time
asleep and it was time asleep that
seemed to give to the brain this sort of
creative genius ability and I think
something else you mentioned there
that’s interesting too it’s not just
creativity but sleep can also I think
change our emotional and mood state sort
of feeling better the next day and
that’s what we’re now starting to learn
is is another function of sleep for the
mind that sleep and provides almost a
form of overnight therapy that sleep
will take those difficult stressful
situations or problems and sleep almost
acts like a nocturnal soothing balm just
sort of taking the sharp edges off our
emotional experiences so that we come
back the next day and we don’t feel as
challenged or as triggered by those
events anymore um so it’s not
necessarily I think time that heals all
wounds it’s time with a night of sleep
that provides that form of emotional
convalescence and that’s perhaps
particularly important in this modern
era I think there’s a lovely quote by
the American entrepreneur Joseph E
Cosman and he said the best bridge
between despair and hope is a good night
of sleep and I think that’s particularly
prescient right now I mean you could let
me imagine that a lot of people right
now wrestling with various mental health
issues that are possibly exacerbated by
the day that we’re in and I guess what
I’m here saying is don’t forget the
simplest therapy of all which is just
enough that that that in itself
yes sleep I think we’re learning
performs a form of emotional first aid
as it were and it reminds me actually of
another lovely phrase by charlotte
brontë who said that a ruffled mind
makes for a restless pillow and i think
we’ve all had that experience of feeling
that have triggered that that day and we
just know that sleep isn’t necessarily
going to come at night it’s probably
also the reason sorry just gone no
you’re going yeah I was just going to
say I think it’s it’s part of the the
reason that we’re finding that sleep is
so tied into psychiatric disorders and
mental health conditions in the past 20
years for example we’ve not been able to
discover a single psychiatric condition
in which sleep is normal so I think
sleep has a very powerful story to tell
in our understanding and probably
treatment of serious mental illness I
mean there’s another issue that I
suspect a lot of people are wrestling
with right now is that a lot of people’s
response to being isolated and feeling a
bit stressed is to imagine more and more
delicious things to eat and cook people
you know we will we go to comfort food
is is and so some people you know what
if they’re they wrestle with weight
issues even more now they’re normal
I think you’ve argued that sleep has a
role to play in in the battle against
gaining weight it does and you know I
think very understandably right now that
that may also be relevant
we know that helpless mechanism plays
out where if were not sleeping well we
can start to gain weight the first piece
of evidence concerns hormones and to
specific hormones that control our
hunger levels those two hormones are
called leptin and ghrelin and I often
say that they almost sound like hobbits
but I promise you they’re not they’re
actually sort of real hormones now
leptin when it’s released is the signal
to your brain to say you’re full you’re
satiated you don’t want to eat it
anymore
whereas ghrelin does the opposite it
says you’re not full you’re not
satisfied with your food you should eat
more and when we start to understand in
opposite directions we lose the signal
that says you’re full and you’re
satisfied with your meal which is leptin
but we increase the hormone that says no
you’re actually hungry even though
you’ve just eaten you you should eat
more and so as a consequence people who
are underslept can start to eat
somewhere between two to four hundred
extra calories per day when you look at
some of these studies umm it’s not by
the way just that you start to eat more
it’s also that when you are under slept
your preference for different food
groups actually shift and so you start
to desire more heavy-hitting
carbohydrates and more simple processed
sugary foods rather than those more
healthy macro ingredients which also
sort of sets you on a path towards a
more we call obesogenic profile but it
also actually changes how your brain
operates in response to food and we did
a study a couple of years ago where we
give people good night of sleep or we
kept them awake for a night and then we
place them inside an MRI scanner and we
showed them different types of food
groups and things that were very
desirable ice cream chocolate etc or an
sort of healthy leafy greens and what we
found is that when people were not
getting the sleep that they needed the
sort of the deep hedonic centers of the
brain were actually ramped up in
response desire to desirable foods and
they started to want those more
unhealthy foods and this in part was
because the the frontal lobe in their
brain which almost acts like this sort
of CEO of the brain regulating and
controlling our impulses and our our
emotions that was actually switched off
by a lack of sleep and so now you start
to reach for those unhealthy food
choices but I think we can think of that
more positively and say perhaps sleep
can actually be a tool in your box that
can enable you to
manage your weight more efficiently
incorrectly and so getting that extra
sleep should lead to and that’s what we
see in the data hopefully a profile of
body weight yeah I suspect speaking
personally there’s no amount of sleep I
could have that could make me lust after
broccoli but actually chargrilled was a
bit of olive oil and salt it’s not so
bad
so someone listen to this I mean if you
were trying to take a positive stance of
this isolation time or whatever thought
you know I’m gonna make this a time of
learning and of creativity and so forth
I mean that’s a possibility of someone
what what you’re saying is don’t forget
you’re gonna do that don’t forget to
make sleep a key part of that program
that’s gonna help on every account
that’s right it is a time like no other
were I think we have in some ways more
sleep opportunity time and in fact there
was a recent report out and it’s not a
scientific report so we have to be
careful not to over interpret it and
they looked at 68,000 Americans and
using sleep tracker data sort of
wearable track of data and they looked
at the change in sleep since March 13th
which was when the president mandated a
national state of emergency and what
they demonstrated or suggested was that
since then there’s actually been almost
a 20% increase in sleep time on average
as a nation here in the United States
now again I think we have to be very
careful it could be that people are just
sort of sitting in bed and you know
working or watching television in the
evening but even if it’s half that
amount I think what it may tell us is
that this time is very strange era that
will appear again right now as unmasked
what is otherwise a chronic persistent
debt in our sleep and finally you know
when you remove the breaks on sleep you
can see that sleep flourishes in return
now I’m not suggesting that that’s true
of everyone I think when we look at that
data more closely we’ll probably see two
clouds of data one
out of data where people are perhaps
sleeping more but then there will be
this opposite cloud where people
actually are sleeping significantly less
because of the things that we’ve spoken
about anxiety about the virus itself
concerns for example about whether they
all hold their jobs and people of course
magically have lost their job and so I
think we’ll see shifts but that seems to
be an interesting trend it’s interesting
I was having a conversation with friends
last night about how surprising the
final health statistics coming out of
this whole thing may look because if
people they have mostly be being
isolated so they’re not catching all the
other diseases they might be getting I
think I think flu stats are way down
compared to a typical year at this point
probably because of the isolation less
road deaths less who knows what else I
mean just possibly the there’ll be some
compensation for the horrifying death
rates that we’re going to see from kovat
but it’s you know it’s so interesting
trying to put those pieces together and
here’s here’s what is also interesting
to me like one of the key symptoms of
this virus is to make people incredibly
tired like a fever and incredibly tired
and I I’ve like it’s striking to me that
in principle we see those things as this
is awful things that happen that though
those are the viruses weapons actually
that in a way they’re not right there
are bodies weapons to try to beat the
virus we have a fever to try and burn it
off you I think that’s medically correct
that’s the body’s natural response with
a lot of hydrogens and home and with
sleep
should we just view like if you if
you’re having symptoms and you’re
feeling really tired
does it help at all to say this isn’t
the bug this is me and to listen to your
body into it and so just and to get or
the sleep you down more can I think it’s
a beautiful example and it’s another
demonstration of that relationship that
we spoke about I think everyone knows
that when you get sick or you get a
common cold what you really want to do
is just curl up in bed and and sort of
sleep sleep it off as it were and in
fact we understand that relationship
that when you
I’m infected there are a set of change
the immune factor that only go to were
to try and fight these infections but
they actually will signal to sleep that
sleep in it’s in in terms of its
duration is needed in greater amounts in
fact there are immune factors that are
sleeps stimulating factors because the
body knows that the best effort sort of
the most empowered custom that it can
call up in its weaponry defense against
infection is this thing called sleep and
that’s why we actually feel as though we
want to sleep more it’s not just because
we’re at home and we’re not at work and
we have the chance to sleep more it’s
that your immune system is actually
co-opting and bringing sleep into the
equation to help fight that infection
because sleep is so powerful in that
regard they’re given all these reasons
why we need more sleep now than ever
behaves talk to us about how how to get
it what are you’re putting on top tips
on how someone can get a really great
night’s sleep
yeah I think beyond the typical what we
call sleep hygiene factors such as
controlling your light in the evening
making your room a cool place also being
mindful of caffeine and all like give
three tips for what to do if you’ve had
a bad night of sleep and then if you’re
still struggling with sleep three tips
for perhaps how to better manage that um
so firstly if you’re coming off a bad
night of sleep the first thing and this
may sound counterintuitive particularly
coming from someone like me is not to
sleep in the next day you resist the
urge to sleep in wake up at your normal
time and there are two reasons for that
firstly your body has a 24-hour clock
and it expects regularity and it thrives
best on regularity and if you start to
change your wakeup time you will confuse
that 24-hour clock so try not to confuse
it wake up at the same time even a
a bad night of sleep the other reason is
that if you sleep in late you’re
probably not going to feel sleepy until
later that following evening so once
again you start to drift forward in time
the second piece of advice that relates
to that don’t necessarily go to bed any
earlier than you would otherwise
because sometimes if you do that even if
you’re feeling quite sleepy you can then
lie in bed and you can start to toss and
turn so try to push through until your
standard bedtime that following evening
the final piece of advice after a bad
night of sleep is resist the urge to nap
during the day now if you are healthy
good sleeper and you can nap regularly
then naps are just fine but if you are
struggling with sleep and have had a bad
night of sleep
try not to nap especially late in the
afternoon because you can think of naps
in that situation almost like snacking
before a main meal if you have a snack
you’re not going to have the same
appetite to try and sort of consume that
main meal and the same is true if you
start to snack with a nap just before
your main sleep so try to resist that
what to do if you are still struggling
with sleep I think the first thing is if
you’re in bed and you’ve been awake for
let’s say 20 or 30 minutes perhaps the
advice is take a break stop trying to
fight sleep because typically the harder
that we try to force ourselves to sleep
the more stressed and anxious that we
become and the further that we push
sleep away from us and you know it’s
it’s a little bit like trying to
remember a name where you’re sort of the
harder you think the the less likely it
is that you are to recall that name
don’t try to step away from that again I
think the advice here would be you would
never sit at the dinner table waiting to
get hungry so why would you lie in bed
waiting to get sleepy and the answer is
that you shouldn’t I’ll just get out of
bed go and do something different in dim
light read a book listen to a podcast
only return to bed when you’re sleepy
and that way you’ll read
the association that your bed is the
place of sleep refusing listen to a few
TED Talks I will put you to sleep okay
yeah yeah my voice I think and my inane
words are usually the best sort of
soporific name known to err to women and
men and I think the last two pieces of
advice beyond and that really is a
powerful one is is just please stop give
yourself a break and stop trying that
can be really helpful because you know
otherwise if you’re in bed you’re
stressed and ruminated you’re teaching
your brain that this thing called the
bed is the place with where instead we
train it to when you return understand
that the bed is the place where you
always sleep when you have confidence in
sleeping the last two pieces of advice
have a winddown routine I think many of
us have this idea that’s the perhaps
should be like a light switch that we
get into bed and we can just go from a
one to a zero that it’s a binary that we
can just switch off and instantly fall
asleep the typically is not like that
sleep is much more like trying to land a
plane that you’ve got to gradually give
it time to descend down onto that terra
firma of good sleep and the faster that
you’re going in terms of the mind the
longer that you need to give and the
mind to sort of gradually come back down
into sleep do the Wow meditation is
useful also taking a hot bath or a
shower having some kind of ritual and
that’s useful by the way not just
because a hot bath will relax you but we
also have this science and sleep called
the warm bath effect where as you come
out of the bath and although the blood
has come to the surface of your skin and
when you get out you radiate all of the
heat out of your body so your core body
temperature actually drops and that’s
actually good for sleep it helps you
fall asleep faster and stay asleep and
more deeply the last quick point I would
make if you are struggling with sleep
and it’s a simple tip that can be
effective remove all clock faces from
the bedroom it’s fine to have an alarm
clock but try to
take away any information about time
because if you’re struggling with sleep
knowing that it’s 2:15 a.m. or 4 a.m.
it’s not going to help you so remove
those from the bedroom the last thing I
would note by the way is that if these
things are not working well for you and
this is tip from a wonderful sleep
clinician called Michael grander 5
minute an athletic coach trying to give
you tips for improvement but you have a
sprained ankle
then nothing I can tell you is going to
be useful until you fix that that
sprained ankle and what I mean here is
that if these things aren’t working for
you it could be that you have an
underlying sleep disorder and if that’s
the case these tips really aren’t going
to be effective until you go and connect
with the doctor and see if you have an
underlying sleep disorder that has been
undiagnosed Whitney oh there are a lot
of people chiming in with questions all
over the world and like there are a
number of our viewers who are really
appreciating what you’re saying and are
struggling with sleep themselves and and
one of the questions we’ve seen is
around stress as it relates to our sleep
cycles and our dreams also just what
impact can stress have on the kinds of
dreams we have and and are our sleep
cycles in general so stress within the
body causes a number of different
changes one of the things that stress
will do is elevate a hormone called
cortisol which it’s often thought of as
not just an activating hormone but also
a stress-related hormone and typically
as we try to fall asleep
cortisol should actually be decreasing
beautifully and it should fall to almost
its lowest point right around the time
when we’re trying to fall asleep and so
if were stressed and if you in fact look
at the disorder of insomnia people start
to decline in their cortisol like a
healthy sleeper would do but just around
the bedroom period where you’re starting
to think about going to sleep cortisol
actually starts to spike back up again
and that can prevent people from falling
asleep it’s what we call sleep onset
insomnia
cortisol is one of the ingredients that
can impact our sleep in our sleep cycles
the other factor is the nervous system
in the body and in fact we have two
branches of your automatic nervous
system we have the fight-or-flight
wrench and then we have the more calming
what we call the rest or digest branch
of the nervous system and when we become
stressed and anxious we shift over more
into that sort of fight or flight
situation of the nervous system and we
also know that that means the depa
am pinned down in order to stay asleep I
think some people have had that
experience were that if mentally or even
in your eyes you feel tired and you know
that you’re tired but there’s just
something about you know your heart rate
and just the bodily stress despite the
mind being tired that is preventing your
body from falling asleep how do we think
about changing those well as I mentioned
you know the hot bath effect can help
meditation they’ll has also been proven
to be very useful meditation that
actually tries to shift you over into
that more quiescent state of the nervous
system and in people with insomnia and
mindfulness meditation techniques have
proven useful it reduces the time it
takes them to actually fall asleep so
those are some of the ways that we can
think about both how the stress impacts
our sleep and perhaps how we can try to
combat it and and to the point about
dreams do you find that stress also has
an impact on the types of dreams that we
have it does seem to have a relationship
and perhaps the best demonstration of
this is an extreme form of that which is
a condition called PTSD or
post-traumatic stress disorder where
people have incredibly difficult
traumatic experiences and stress and
what we commonly see there is a
consequence of repetitive nightmares
in fact it forms part of the diagnostic
criteria for you to receive a diagnosis
of PTSD so there is certainly some think
about our emotional waking life that
sort of bleeds over it’s almost the red
thread narrative that transitions into
our sleeping life and specifically our
dreaming life
and we do know however a study published
some years ago now demonstrating that if
people are dreaming are particularly
dreaming about some of those difficult
traumatic experiences it can actually be
beneficial that it leads to clinical
resolution of things such as depression
and trauma and bereavement so there is a
relationship between our waking life in
our Dreaming life when it comes to
emotional health and we do think that
sleep and particularly dream sleep plays
a form of a sort of mental health in
that regard and sort of dissipating and
removing some of that emotional stress
that definitely explains some of the
unusual dreams I’ve been having and I
imagine it’ll be helpful for some of our
viewers who have also been having odd
dreams so I’ll be back later with other
other questions that’s good
talk a bit Matt about just that the role
of greens on sleep and like so many
people the news is so interesting right
now your instinct is to take your phone
or whatever to your bedside you know
check it check out the news lastly at
night whatever is there evidence about
this about whether that’s advisable or
not so I think there is a feeling in the
sleep science community of course that
the invasion of technology into the
bedroom hasn’t necessarily been a good
thing technology has done wonderful
things for us is the enhancement and
improvement of our sleep one of them I
think at this stage it’s probably not I
think in the future it actually will be
but you mentioned the sort of the use of
of screens and phones in perhaps the
hour before bed or even once we get into
bed I don’t think that’s advisable
firstly there is a concern about the
blue light that comes from some of these
devices and that blue light will
typically stamp the breaks on the
release of a hormone that we call
melatonin and melatonin is a hormone
that signals to your brain and your body
that it’s nighttime that its darkness
and we need that signal of darkness
to enable the healthy timing of our
sleep and in some ways we are a dark
deprived Society in this modern era but
if you look at the evidence there is
some evidence that those screens can
actually change our sleep patterns but
more recently I think that that’s been
debated what I do think perhaps is the
greater impact of technology is less so
with the blue light coming from these
devices but more so the the the
activation the physiological activation
that these devices trigger and we know
firstly that if you’re using your phone
it can cause something called sleep
procrastination if it was actually a
thing where you get into bed you are
tired you’re sleepy you could easily
fall asleep but you think well I’ll just
am I’ll just check Facebook one less
time or I’ll just send that quick tweet
and I’ll just sort of go online and
order a few of those things that I need
and then you look up and it’s 30 minutes
later and now you’re deficient by half
an hour in terms of your sleep the other
thing that these devices can do though
is on the back end of sleep if we bring
those devices into the bedroom a lot of
us I think the first thing that we do
when we wake up in the morning is we
swipe right and then all of a sudden
this sort of tsunami of anxiety comes
flooding in and that trains our brain to
essentially expect that sort of stress
every single morning it’s what we call
anticipatory anxiety and I think a good
example of this would be if you have to
wake up for an early morning flight and
you know that it’s critical but you have
a job interview there’s just something
about your sleep not as it’s intrusive
and having your phone next to your bed
is a sort of a diet version of that and
sort of a li te version of that but it’s
still present and it still affects sleep
so if you can a good piece of advice is
try not to check your phone for let’s
say just the first five minutes of the
day if you can just sort of hold off and
you can push that distance of
a little bit further so you don’t train
your brain to think okay every night
when I go to bed the first thing I’m
going to be doing is receiving anxiety
in the morning you mentioned melatonin
some people are aware by it as a natural
remedy do recommend its use for some
people for anyway well man Onan isn’t
actually a sleep inducing chemical at
least so far looking at the data it’s a
sleep timing hormone so it helps us
regulate when the brain is told to go to
sleep to think of melatonin your to
consider let’s see the hundred meter
race at the Olympics melatonin is the
starting official that sort of begins
the gun that starts the great sleep race
but that’s starting official with the
sort of the starting pistol they don’t
participate in the sleep race itself
that’s a different set of chemicals so
if you’re transitioning between
different time zones
that’s certainly when melatonin can be
useful to help sort of give your signal
sorry give the brain the signal back of
when it should be night and day for most
people though melatonin isn’t
necessarily efficacious for improving
their sleep as we get older and the
amount of melatonin that we start to
release does actually decrease in total
across the night and that’s where I
think some of the evidence is actually
interesting it does seem to provide a
benefit the one thing I would note is at
least here in America what has to be a
little bit careful because melatonin is
not regulated by the FDA and because
it’s over-the-counter there was a study
that looked at different brand print
sort of vendors of Merit only if it is
that relative to what it said on the
bottle there was somewhere between
eighty percent less um or almost four
hundred and sixty percent more a
melatonin relative to what was suggested
so I think one needs to be a little bit
careful for that what would be the dose
well it’s usually a lot less
most people some people will take five
milligrams or ten milligram thinking
that more is better which is very
natural thing to do with with
supplements that’s not really the case
with melatonin that he’s have shown that
really the the effect if there is one is
best at something like point five
milligrams or even less than that though
okay Matt is that just two to four when
you’re changing time zones or is that do
you think that’s possibly effective for
someone to take regularly well I think
if you are perhaps someone who is a
night owl so what we have are what we
call chrono types there are you an
evening type are you a morning type are
you somewhere in between and in some
ways that’s actually quite genetically
determined so you don’t really get a
choice so much as to whether you’re a
morning type or an evening type now in
evening types I would like to go to bed
late and wake up late their melatonin
rise doesn’t normally start to begin
until let’s say ten eleven even midnight
so for those individuals who are trying
to drag themselves back if they have to
you know go to work early in the morning
and then they need to get to bed earlier
than they would otherwise one can try to
see if melatonin is beneficial but if
you’re young and you’re healthy
melatonin doesn’t necessarily seem to be
very effective in terms of helping your
sleep what about any other sort of quote
natural sleep aids from I don’t know
chamomile tea to alcohol and any other
suggestions so for camomile tea we don’t
have any good evidence people have
looked at this and it doesn’t seem to
necessarily benefit there may be some
ingredients in chamomile that could have
a benefit but right now no really good
strong evidence that at least I’ve seen
you mentioned alcohol and I’m glad you
did because alcohol is perhaps I’m the
most used sleep aid rather relative to
at least prescription sleep aids and
it’s very natural that people
have a nightcap and they’ll say it
really helps me fall asleep faster
unfortunately alcohol is the enemy of
sleep and alcohol will hurt your sleep
in at least 3 different ways but the
alcohol is a class of drugs that we call
the sedatives and sedation is not sleep
but when we have a drink in the evening
or a couple of drinks we mistake the
former for the latter and alcohol will
actually simply just numb the cortex so
you’re just sedating yourself if I were
to look at the electrical signature of
your sleep when you’ve had a normal
healthy night of sleep I’d compare it to
when you’ve had alcohol it’s not the
same it’s a different electrical profile
and the other two dangers regarding
alcohol and sleep is that firstly even
if you think you fall asleep faster you
typically will wake up many more times
throughout the night what we call sleep
fragmentation do you wake up the next
day and you don’t feel as restored by
your sleep because your duration of
sleep the quantity of sleep that you’ve
had may be quite similar but the quality
of that sleep in terms of its continuity
is actually significantly worse the
final thing about alcohol is that it’s
actually very good at blocking your
dream sleep what we call your rapid eye
movement sleep and we know that REM
sleep is in for number of different
funds including mental health and and/or
emotional stability so that’s really why
people if they are struggling with sleep
and they should re are away from trying
to use alcohol it’s not a sleep aid at
all it’s actually going to harm your
sleep and would you make the same
comments about sleeping pills is that
sedation not real belief inducing um it
is that is the case the the sleeping
pills typically that are prescribed
right now are a class of drugs that in
fact we call the sedative hypnotics once
again their action is they act on the
same receptor in the brain that alcohol
does now the way that they sort of
stimulate and tickle that receptor as it
were is a little bit different but
in general that’s what they’re doing -
they’re trying to sort of downscale the
activity in your cortex sort of knock
out your cortex as it were and what it’s
again you look at the electrical profile
is not the same as normal naturalistic
sleep that’s right you know sorry please
go on just go say that that’s the
mentioned prescription drugs and that’s
the same for over-the-counter sleep aids
that even if they they do get you to
sleep you you they’re just not I mean is
there any any value to them at all or
should you just shun them that they’re
just an illusion that they’re giving you
leave you’re not they’re not actually
giving you the beneficiary benefits of
sleep yeah I think that that seems to be
the case and it’s the reason that back
in 2015 or 16 the American College of
Physicians made really quite a landmark
recommendation they suggested that based
on the evidence looking at the magnitude
of the benefit that these sleeping pills
have relative to placebo and some of the
concerns the health and safety concerns
regarding these sleeping pills that they
must no longer be the first-line
treatment recommendation for people with
insomnia instead the suggestion was a
treatment called cognitive behavioral
therapy for insomnia or CBT I and it is
this remarkable behavioral and therapy
and cognitive therapy that’s been
developed over the past ten or fifteen
years and it seems to be if you put it
sort of head-to-head with sleeping pills
I’m almost like a Coke Pepsi challenge
and it is just as effective as sleeping
pills in the short-term but what’s
beneficial is that when you stop working
with that therapist and it can take
somewhere between six to eight weeks to
course-correct and retrain the brain to
good sleep it’s very effective i’m you
continue on with those benefits up to a
year recent studies up to five years
whereas when you are taking sleeping
pills and you stop not only do you
typically go back to the bad sleep that
you are having sometimes for some
patients you can have what’s called
rebound insomnia which is where your
sleep can be even worse - right now if
people are struggling with sleep they
should really seek out
this treatment called cognitive
behavioral therapy for insomnia
that’s the first-line recommended
treatment that we have to sleep
difficulties are related to insomnia
Whitney coming to your just a sec but
just to follow up on this I’m in it I
feel like there are still just
occasional circumstances where those
over-the-counter pills may be useful I
mean I you know when I’m hosting a TED
conference my mind when I go to bed is
though buzzy it’s like there’s no chance
I will sleep at all for hours and I’ve
certainly felt like anecdotally I found
it essential for a couple of those
nights to take an over-the-counter drug
and at least least get some tip you wake
up at least on the day feeling refresh
whereas when I haven’t done that I’ve
woken up feeling like I just cannot hope
is it are there any circumstances where
you also one of uses appropriate um
suddenly right now people in terms of
prescription sleep medications and there
is still a time in a place for those but
even there it’s really recommended for a
short term period nothing more than a
handful of weeks at best and then we
should look at alternative treatments
but certainly I do sort of sympathize
and and have empathy with that you know
I’ve experienced that myself and
particularly with things like jet lag I
certainly will use melatonin to see if I
can help and you know if things like
chamomile or melatonin and do make you
feel better than what I would say is
that perhaps the placebo effect is one
of the most reliable effects in all of
pharmacology so if you do feel as though
it’s working then perhaps and keep on
with that at least with the caveats that
we’ve spoken about regarding
non-regulated over-the-counter
supplements no more than half a
milligram
sounds like witness right there are some
questions online about technology and
the impact that can have on your sleep
specifically seeing a couple of
questions about artificial light and how
that might disrupt our sleep cycles and
then how we can use technology to
benefit our sleep like acts and that
sort of thing yes so we discussed a
little bit about this of blue and those
a study done at Harvard Medical School a
couple of years ago and what they found
was that
people who were using an iPad for one
hour before bed relative to someone who
is just reading a book in standard light
um firstly the use of that iPad I’m
delayed the release of melatonin that
darkness signaling hormone by two to
three hours it all also decreased the
amount of melatonin by about 50% v zero
it also seemed to disrupt the amount of
rapid eye movement sleep like those
people were getting and what was also
interesting in that study is that when
they stopped using the iPad before bed
there was almost a blast radius effect
where their sleep was still disrupted
for a couple of nights after it took
sort of a wild has almost wash out the
effect of that iPad use but as I said
there’s been some more recent reports
that seem to suggest that perhaps those
devices in terms of the blue light may
not necessarily be as powerful impacting
I think it’s more about the
psychological the cognitive activating
impacts that those devices have and
perhaps less so those the amount of blue
light and by the way I should note that
it is particularly light in the blue
part of the visible spectrum so if you
are going to have light in the evening
and the advice is by the way in the last
hour before bed not just about
technology and screens try to dim down
half the lights in your house and you’ll
be surprised at how sleepy that can make
you feel I think that’s one of certainly
the the pieces of advice not just
technology in terms of light it’s also
just the light that we have the
pollution that we have in her moment
itself I’ll come back
with last questions from the audience
that’s how much how much sleep should
people actually have is there a
prescribed our number do currently the
recommendation is for people to get
somewhere between seven to nine hours of
sleep and and there certainly is a range
it’s not necessarily a one-size-fits-all
very similar to perhaps you know the
standard recommendations for calories I
could say that you know it’s for the
average adult it’s two thousand or two
thousand five hundred calories a day but
depending on who you are your physiology
what you’ve been doing that day that
will vary but right now for the average
adult the suggestion is somewhere
between seven to nine hours I think the
CDC suggests that there is a minimum of
seven hours in terms of a requirement
but again it’s going to be different for
different people that will always be
those edge cases are sort of the tail
ends of the bell curve distribution as
it were but that’s a good I think range
to shoot for I mean do you think there
are outliers in other margaret
thatcher’s and my wife’s of this world
who only need five hours sleep there are
outliers and in fact there’s been some
recent work looking at what we call
these short sleepers and there are
specific genes there are a couple of
genes in fact that have now been
discovered that seemed to be related to
just innate short sleepers people who
sleep somewhere between five to six
hours a night and that really does seem
to be all they uni can play around with
the circumstances you can bring them
into the laboratory you can take away
technology you can take away light you
can take away all cues that could
otherwise influence their sleep and
really sort of strip away everything but
their natural sleep expression and still
even when you give them you know a 10 12
hour period of time in bears an extreme
example they still only sleep
consistently somewhere between five to
six hours a night so we definitely know
that there is a very small select
proportion of the population that is a
short sleeper of course
when I say that many people say well I
think I’m I’m probably one of those but
statistically the likelihood is is a hat
quite low if that’s that’s helpful
well I’m certainly relieved a bit to
hear at least that that’s a possibility
because I’m married to someone who seems
to never sleep anything like seven or
eight hours and and seems to be full of
energy on many days but I’ve been
worried about her since ever since I
heard your gentle thank you thank you
tried to encourage you to speak but this
is actually a paradox Matt in that some
of your findings are so you know
powerful on the the potential risks to
ask of not enough sleep but we haven’t
had time to talk about let’s help you
talk about risk of Alzheimer’s you know
risk of many other things can go up risk
of heart disease and so forth did so
that people could literally at line
awake lie awake worrying about what they
just heard from Matt Walker like how you
know you yourself have sometimes done
that right you’ve had these new you know
discoveries and have woken up in the
night and been worried about the fact
that not only what you discovered but I
am awake now and this may be affecting
me as does that happen
yeah it does you know and firstly I’m no
bit of cardboard cutout of sleep
perfection I’ve struggled with bouts of
insomnia during my life and I’m probably
the worst of all individuals knowing
what I know you know I’m sitting there
as you mentioned and I’m wide awake and
I’m thinking well you know my
dorsolateral prefrontal cortex is not
shutting down and not releasing you know
this specific sleep chemical I know that
you know Alzheimer’s proteins in my
brain may be building it and at that
point you know I almost become like the
Woody Allen neurotic of the sleep world
and I’m dead in the water for the next
two hours in terms of sleep so you know
I joke about that but you know I’ve
definitely had my bouts and
relationships with insomnia before so I
am very I’m very thoughtful about that
and how you give a message of the
importance of sleep understanding that
it could be triggering and I think you
know some of the information that can be
given in the talk or in the book could
almost be taken as a asleep or else a
scenario and that was never my intent I
think when I was writing the book
several years ago now I think if you
looked at the public there was still
this dense of sleep you know so what the
evidence was just so important that you
know I felt as though we were at a stage
where we thought of sleep as an
inconvenience and all I really wanted to
do was try to perhaps change some of
that belief to say leap is not an
inconvenience sleep is actually an
investment sleep is an investment in
your physical health as well as your
mental health and so that was really
sort of the goal I was trying to offer
but I understand that it can be
triggering I think you know I struggle
to to wrestle with those tensions I feel
as though it’s important that people
like the World Health Organization or
the CDC not be gun-shy in terms of
giving us the information regarding
risks in terms of our physical and
mental health and so I do feel it’s
important that the science of sleep is
is given to the public but I also
understand that it can be complicated
and triggering for some people there’s
someone who hears this right now and
wakes up tomorrow at 2:30 a.m.
pressing about the fact that they’re not
getting enough sleep and what that may
be doing to them give them some
practical advice what should you do if
you wake up consumed with anxiety in the
middle of the night so there again I
think it’s it’s Reavers case of firstly
try not to worry about it too much being
kind and giving yourself the break from
sleep not sitting there tossing or lying
there and tossing and turning just
understand that tonight is not my night
perhaps I can just step away from sleep
let me get up
let me not continue to reinforce to my
brain that almost like a dentist’s chair
when
go to a dentist sure I’ve typically
learned that things don’t usually go
well there and because it’s a
reinforcing sort of self-fulfilling
prophecy don’t let the same thing happen
to your bed and the way that you can
prevent that is if you are struggling if
you are tossing turning the best advice
is get out of bed do something different
only return when you’re sleepy and that
way gradually you’ll feel better you’ll
feel confident about your bedroom and
the bed being this place of restful
confidence ly rather than this trigger
for rumination anxiety and wakefulness
wonderful thank you Whitney
there are so many questions out there
are many of which we won’t get to but we
should find a way to to get some of
these great questions in front of you
mat so that you can answer them but I
think the the one that I just like to
ask here is about physical exercise
we’re seeing a lot of people just
wondering how they can use exercise to
help with their sleep
the relationship that I think is is
quite powerful we know that physical
activity during the day does seem to
have an improvement effect on your sleep
at night particularly in terms of the
quality of your sleep there is some
evidence that it can improve the
quantity of your sleep but physical
performance and physical activity or
even just necessarily it doesn’t have to
be that you need to go out for a 10-mile
run even lower level of physical
activity beyond sort of 20 or 30 minutes
deems to have a beneficial impact on
subsequent sleep at night by the way the
relationship is also present in the
opposite direction when you start to
sleep well your motivation to actually
go out and exercise the next day is
increased and also your ability to
physically perform exercise is also
improved at a number of different levels
as well so there is that relationship
and it’s actually bi-directional
wonderful and last question for me as
well I mean you started your TED talk
with a spectacular claim that lack of
sleep had a big impact on sexual
performance that if a man
does it go the other way is is good sex
also great for good sleep though there
is a little bit of evidence to suggest
that physical intimacy with your partner
in that regard can actually enhance your
sleep some of that I think is just
related to the relaxation that comes
after following that physical intimacy
that it ramps down the fight-or-flight
branch of the nervous system and you go
gradually into this more rep a sort of
relaxation stage of the nervous system
some of the hormones that are released
in to be beneficial things such as
oxytocin and we also know just that
people who are having physical intimacy
with themselves should we say has been
used as a technique for dealing with
insomnia though there is a little bit of
evidence in that regard and certainly I
think if it’s satisfying for all that’s
when we typically see a good benefit
well now let them tell you that ted
conversations aren’t practical delight
to have you here thank you so much for
this conversation and we may we may have
some other questions to put to you to
post on our blog or something like that
from from the many other people who had
questions but but really thank you thank
you so much you’re very welcome and I’d
be delighted to try and offer any
ongoing health and I can respond to more
questions and thank you again for
hosting me both here and on the Ted
stage last year thank you thank you
thank you Whitney who do we have
anything to say about the rest of this
week which I guess that’s right we have
one more one more day of interviews
tomorrow’s interview is with Elizabeth
Gilbert the acclaimed author and she’s
going to give us some tips on how we can
really work through feelings of
overwhelmed during this time which i
think is something that a lot of us
experienced at one point or another
perhaps in a sort of an ongoing way
depending on on what your circumstance
might be and so I think that’ll be
really a great help for us as we round
out the week
you know the very first episode of the
Ted interview was with Liz Gilbert and I
I just I found it to be astonishing that
like really astonishing as she said in
that interview I’m not her demographic
most of her books the targeted women or
seem to have been better but the way she
describes the emotional landscape we all
are facing I just found it so so
profound and so I actually cannot wait
for the conversation with with Liz
tomorrow she’s holed up by herself I
spoke with her a couple days ago
but she’s ready to come and many
thoughts on how to make use at this time
how to navigate it but I think you’re
really in for a treat and do do share
notice of of that conversation thank you
everyone for listening it means a lot to
us that you come spend this time with us
build community with us learn with us as
we said before we’ll say again we’re all
in this together
thank you madam Whitney thank you all I
carry one