Life Kit - Life Kit Presents: CNN's Chasing Life

Episode Date: August 14, 2021

Hi Life Kit listeners! We want to share an episode from another podcast we think you'll really enjoy. It comes from our friends at CNN's Chasing Life. It's hosted by Dr. Sanjay Gupta and it helps listeners find balance in their lives. This episode is all about something very important — getting a good night's sleep. Dr. Gupta talks with experts about why we sleep in the first place, the latest research about sleep and how we get a full night's rest. Hope you enjoy!Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Hey, Life Kit listeners. We want to share an episode from another podcast that we think you'll really enjoy. It comes from our friends at CNN's Chasing Life. It's hosted by Dr. Sanjay Gupta, and it helps listeners find balance in their lives. This episode is all about something very important, getting a good night's sleep. Dr. Sanjay Gupta talks with experts about why we sleep in the first place, the latest research about sleep, and how we get a full night's rest. Hope you enjoy! For me, if I get eight hours of sleep, it physically hurts. But waking up after four

or five hours of sleep feels like I've been fully rested and it's just another normal day. For as long as he can remember, Cliff Luther has had a leg up on other people. In the sixth grade, I was asked to be a jester in the medieval fair that they were holding because they were studying the Renaissance in social studies. And I didn't just want to dress up. I wanted to really bring something to the performance. So I taught myself to juggle overnight. I think I went to bed about two in the morning,

and then I got up at six, and I was still just normal Cliff, normal myself, ready to take on the day. And I did juggle as part of being a jester. As he's gotten older, Cliff has used this ability to amass greater and greater accomplishments. He earned three graduate degrees and worked on a doctorate, all while working a full-time job and co-parenting his three young children. But recently, he started to wonder if this sleep superpower comes at a cost.

It seems like there's a societal perception that eight hours of sleep a day is what everybody should get. And knowing that I was already getting less than everybody is almost a little scary because most of these sleep studies out there say that getting only a few hours of sleep frequently affects the brain. It certainly concerned me that this could be detrimental to my health. So he decided to look into his unusual sleep patterns and got in touch with a sleep researcher. It turned out Cliff has a rare sleep condition. He's one of just a small segment of the population who gets less sleep than the average person, but functions just as well as someone getting the recommended seven to eight hours. I think Cliff's story is so interesting because it demonstrates all the mysteries, all the exciting unknowns that still surround sleep on a regular basis.

We all know intuitively, even as children, that sleep is important. When we don't get enough of it, we're cranky, we're depleted. We also now know that getting enough sleep plays an important role in protecting us from many kinds of diseases. But why we sleep and what regulates the amount of sleep we need are still not very well understood. So on today's show, we're going to take a look at some of the latest research on these medical mysteries and explore how we can harness the power of sleep to live better and longer lives. So puff up your pillow, set your thermostat nice and low. It's time to start chasing life. You know, even before the pandemic, Americans struggled with getting enough sleep.

Back in 2016, the CDC found that more than a third of Americans were regularly getting less than seven hours of sleep. When the pandemic hit, some researchers hoped COVID-19 restrictions and more time at home would help us reset our sleep patterns and give us more time to rest. And at least initially, that did seem like what was happening. One study found that around the world, people were sleeping an estimated nearly 14 minutes more in March of 2020 and 22 minutes more by April of 2020. That was compared to March and April of 2019. But as time went on and stress about the pandemic built, our sleep patterns were thrown even more out of whack. At the start of the pandemic, often I would lay awake in bed at night having this deep anxiety for things that were very likely unfounded,

but it led to pretty consistent insomnia. I'm 42 years old and have spent my whole life as a sound sleeper until the pandemic. Now I can fall asleep easily, but I'm awake in the middle of the night for hours. I think I'm sleeping a lot more during the pandemic. I'm sleeping in a bit later because I'm not commuting to work, even if I go to bed earlier. I've been waking up early, actually. It's weird. I used to really struggle to get up, and now I'm ready to go by 6 a.m., no matter what time I went to sleep the night before. During the pandemic, while I've been working from home, I find myself curling up

on the couch for a 15-minute nap in the afternoon. And it's weird, because that's not something I've ever done since I was like in preschool. So many people have struggled with getting a good night's sleep during the pandemic. The researchers now even have a name for it, coronasomnia. And even now, as restrictions are relaxing in many parts of the world and vaccination rates are increasing, a lot of people are still struggling. That includes people unlucky enough to have gotten sick with COVID-19, some of whom developed short or long-term sleep problems as a result. So to get us back on track and talk about what we can all do to improve our sleep, I spoke with Rebecca Robbins. Sleep is a really new field. And so the truth is, it makes it an exciting area

of study because we're virtually pulling the covers back on some of the benefits of sleep. Rebecca is a sleep scientist at Brigham and Women's Hospital. She's also an instructor in medicine at Harvard Medical School. She says part of prioritizing a good night's sleep means shifting our societal expectations and reminding everyone how essential sleep is to our happiness, our health, and our productivity. What we do know now, without a shadow of a doubt, is when we're cutting our sleep short, getting six or a few hours of sleep, our mood is likely to suffer. We're more prone to negative mood and lashing out at friends or loved ones or colleagues. And then there's also just a general brain fogginess. We all know this all too well.

After a night of insufficient sleep, you wake up and it's just harder to focus. Also concerning is we're much more likely to make unethical decisions. So if you're the CEO of a company, I would want to try my hardest to get my employees to make sleep a priority. That's really interesting. So the types of decisions you may make morally or ethically could be affected by your sleep as well. Indeed, it's more compromised. And we're more likely to be riskier and actually less ethical than when we're well-rested. But we're also uncovering are some of the really compelling longer-term consequences of insufficient sleep and chronic insufficient sleep. So we published a paper. It came out this February, and this was a cohort of older adults.

And we found those individuals who report insufficient sleep were at many-fold risk for Alzheimer's disease and dementia and early mortality than those who are getting sufficient sleep. And so what that literature is starting to uncover in my field is some of the longer-term implications of our insufficient sleep tonight for our disease risk, our health, our well-being, many years down the line. I will fully admit that I did not always prioritize sleep. I thought that it was a third of my life going into non-productive time, frankly. That's how I thought about sleep. And it is really just a fascinating phenomenon to just think about it. I've often thought if I was like an alien

coming to visit Earth and these creatures go into this slumber-like state and I wasn't familiar with sleep, it would seem like this very odd behavior. But there's a reason for it, right? Physiologically. Do we have a better idea of why we really sleep? This is a great question. For many years, we knew we had the lymphatic system in the body,

tissues and vessel to remove toxins. You know, go to the doctor and they'd feel your lymph nodes, part of that whole lymphatic system, but there weren't any tissue or vessels, you know, in the system, in the brain. What we're seeing in the laboratory experiments is that during sleep, what happens is the glial cells in the brain start to expand. And those cells and that expansion allows for increased and accelerated flow of neural toxins through the brain. And so that rushing of these toxins through the brain and excreting them out is really vital because we see this clearance of brain toxins, which is one of the main benefits that sleep can provide in terms of cognition in the longer term. So those floodgates just open up at a greater level

or a greater pace during sleep than during wakefulness. What about sleep and weight, managing our weight? How do you describe it to people? Great question. Now, when we're depriving ourselves of sleep, we're not getting enough. Our weight management abilities are simply thrown out of whack. And there's a molecule that lines the belly of the stomach called leptin, sends a signal to the brain that we've had enough to eat. And when we're sleep deprived, we just see that leptin about 20% thrown off balance. And so what that does is that sends a slower signal to the brain that I've had enough to eat. So if you wake up and you're sleep deprived, that signal to the brain that, you know, oh, to the brain that I've had enough to eat. So if you wake up

and you're sleep deprived, that signal to the brain that, you know, oh, I'm good, I've had enough is simply slower. And so in laboratory settings, when we see individuals sleeping five or fewer hours, they eat on average about 200 extra calories because of this kind of molecular imbalance. Are there certain populations that are just more likely to be affected by poor sleep in this country? That's a great question. And I will say one of the groups that really struggles the most are older adults. Our sleep systems just simply start to decay with age. We're most fit and have the most effective sleep system when we're in our early 40s or late 30s. And unfortunately, things can start to decline from there. And then we do see gender differences as well. So women generally have slightly lower sleep quality than do men.

And we believe there's kind of an evolutionary argument there where is women in their 30s and 40s are, from an evolutionary standpoint, able to hear a baby cry and have a slightly lower depth of sleep. And for that reason, do report often in our studies lower sleep quality as compared to men. Does it break down by income at all? I mean, lower income, underserved communities. Are certain communities more likely to have poor sleep? Unfortunately, sleep is patterned along socioeconomic lines. So that lower income groups do unfortunately have lower sleep quality and shorter sleep duration. And there are sometimes environmental barriers there at play, noisy, unsafe neighborhoods, low certainty about where

you're going to sleep that night if resources are really a major concern. So insufficient and poor quality sleep on the lower end, but interestingly, also on the higher end, because of some of the things that you touched on, this kind of machismo about in our society, unfortunately, about sleep deprivation. Too often you ask someone how they are and they say, oh, you know, I'm exhausted. And so hopefully in our lifetime we can change that so that, you know, really collectively we're looking at sleep as this crucial part of our day to fuel our success. You know, you're absolutely right about the whole sort of badge of honor, sort of, you know, people would wear that and brag about not getting enough sleep.

I remember doctors that I work with in the hospital, you know, people would wear that and brag about not getting enough sleep. And I remember doctors that I work with in the hospital, you can sleep when you're dead, was a common adage that we always heard. You know, I have been thinking about this issue for a couple of decades, and I have seen a cultural sort of change in how people talk about sleep. It has gained this sort of, this recognition as being important as we've learned more and more about it. What do you find, I guess this is what everybody wants to know, but what are the interventions that you have found work to help people get a better night's sleep? Anyone who has insomnia symptoms or disorder, those groups really benefit from something called cognitive behavioral therapy for insomnia, or CBTI is the acronym for that.

And essentially that kind of takes the healthy sleep hygiene kind of tips and strategies, but takes them to the next level. So one of the key components of that is relaxation training. And this is something that I'm actually very passionate about. And we find that individuals who are really good meditators actually need a little bit less sleep at night. Another key component is something called stimulus control. And basically that's a kind of a jargony term for helping people really look at the bedroom as a place for sleep and trying to do away with any unhealthy views of the bedroom environment. So for someone who has insomnia, they walk into their bedroom and their cortisol starts to spike and they suddenly become stressed and nervous, like, oh, sleep, it's not going to come again tonight. And so a lot of work with those individuals who really have those kind of maladaptive cognitions, we try to reframe and rewire how they look at the bedroom environment. And so we really discourage in those groups doing anything in bed but sleep.

Is there an ideal sleep environment? We hear about cool and dark. Is that pretty much the same for everybody across the board? I love talking about the bedroom because it's often, unfortunately, a lot easier to change things in our environment than change our behavior. Temperature really matters. A warm bedroom above 70 degrees, about Fahrenheit, has the risk of increasing your risk for nightmares. So individuals in warmer environments actually have more disruptive dreams or nightmares and just general sleep fragmentation, whereas a cooler temperature is better able to support our good sleep, pull us into deeper stages sooner and help us stay there. And furthermore, we really don't know a lot about mattresses in the population. So we actually have a fun study underway right now to understand people's general satisfaction, how long you've owned your mattress. But I have a hypothesis that by and large, people can't even

tell you when they bought their mattress. They've had them for way too long and their pillows aren't supportive. And we're more likely to buy ourselves a new pair of shoes than, you know, refresh elements in the bedroom environment. So think about when you bought your mattress, your pillows, these are elements that are truly the foundation of your bedroom environment and work within your budget. It doesn't have to break the bank. I'm curious now about the mattresses. I'm going to read your study when it comes out. But, you know, it's funny. I think about running shoes and, you know,

every six months or so, obviously depends how much you run. Is there an ideal amount of time when you should change your mattresses? A really good mattress will last you about eight to 10 years. But I'm always amazed how people just really aren't attuned to when they bought their mattress, how long they've had it, or, you know or really much around the purchase decision itself. Whereas I'm

with you. I mean, I'm spending copious amounts of time on my running shoes or my outfits for exercise, but far less attention, I think, as a population to sleep gear, so to speak, right? As soon as you said it, I, and I'm sure all the listeners are kind of like, when did I get my mattress? It's probably been a while. So I hadn't really thought about that. So that's a good note. Could I become sort of super athlete sleeper? You know, in the sense, could I train myself to need less? Oh, that's interesting that the superstar sleeper might be someone who is doing well on less sleep. And I do get this question all the time. We've presented our work to some kind of, you know, really type A, you know, finance types. And I'll never forget the question from our host. We've presented our work to some kind of, you know, really type A, you know,

finance types. And I'll never forget the question from our host. She said, we'd really like some information on how to get really good sleep and not spend a lot of time doing it. And I think that that really speaks to a question that we all have. I mean, that would in some ways be the holy grail. How do we consolidate all of the benefits of sleep into less time? But unfortunately, that treatment is not here yet. The old school is the best way to make time for it. The vast majority of adults need between seven and nine hours to support optimal health and wellness tomorrow and in the longer term. The one last thing I'll say is there's some really cool technology on the horizon that modulates brainwaves and might actually,

if coupled with those behavioral strategies that we talked about, could potentially reduce the amount of time. After the break, we'll talk more about this idea of efficient sleep and how the secret to becoming a super sleeper might actually lie in our genes. We're back with Chasing Life. Now, one of the most fascinating mysteries in sleep is what controls how much sleep we need. Dogs sleep about 9 to 14 hours a day. Cows sleep about 3 to 4 hours. So why do we humans need seven to eight? After studying sleep for more than 20 years, I'm convinced that sleep is one of the most important things for our survival. That's Ying-Wei Fu.

She's a professor of neurology at the University of California, San Francisco. And as you can probably tell, she's a total sleep evangelist. But she hasn't always been this way. In fact, she didn't even think about researching sleep until a colleague of hers reached out about a woman with a very unusual sleep schedule. And this woman usually had to go to bed right after dinner, like 6 to 7 p.m., and usually gets up about 1 or 2 a.m. And she felt that this was a very disruptive life pattern for her because in the evenings, her spouse would like to go to movies or do something interesting, but she never could do that because all she wanted to do was go to bed every day after dinner.

And she became very worried at that point because she started to see that her granddaughters also had the same thing. It was almost like this whole family's circadian rhythm was shifted up by four hours. Professor Fu's colleague wanted to know, was it possible that a genetic mutation was responsible here? Because this woman has such unusual sleep behavior, and she actually had a really large family with many people had this sleep patterns. So we were able to use a more traditional human genetics positional cloning method to look for the mutation. It took them three or four years, but they eventually found it. And it was the first time anyone has ever shown that a gene might actually dictate our sleep behaviors. I think before our first report, people probably would say, oh yeah, my parents are early risers,

so I'm early risers. It's kind of a general idea, but not really concrete idea about the genes actually have so much role in our sleep behavior. And I think after our first report, it really highlighted how important our genes are in terms of regulating our sleep behavior. After this discovery, Professor Fu and her team wanted to figure out what other kinds of genetic mutations might be connected to sleep. People would write to them about all kinds of unusual sleep patterns, and they'd start designing new studies. And one of the people who eventually wrote in was Cliff Luther. Being awake during the night and during the early parts of the morning, you do a lot of reading. So I happened upon a study by Dr. Fu that had discovered a mutation in a gene that seemed to be linked to needing less sleep. I was reading

through and suddenly I felt like maybe this would explain why I didn't need as much sleep as other people. And it was exciting to possibly get an answer to questions that I've had since I was a little kid. And it made me feel like there could possibly be some sort of relief. Professor Fu and her team analyzed the DNA samples from Cliff and dozens of other short sleepers and landed on a few common genetic mutations. When they bred mice to have those same genetic mutations, sure enough, they found the same behavior. The mice slept far fewer hours. The really surprising thing, though, was that those same mice, while sleep-deprived,

still performed better on memory tests than normal mice. The normal mice, if you train them a certain trait and you put them into sleep deprivation and then you test them the next day, a lot of them will forget what they learned before sleep deprivation. But for the short-sleeved mice, you can train them and sleep deprive them and they will test the same as if they didn't go through sleep deprivation. So their memory is not susceptible to sleep deprivation, which then gave us an idea that maybe these people, even though they sleep much less, their sleep efficiency is actually much better than people who sleep eight hours.

In other words, all the things that happen when you're asleep, the cleansing of neurotoxins, the memory consolidation, those things might be happening faster, more efficiently in short sleepers. Now, if we can know how under normal conditions our sleep is regulated, we can then compare to these efficient sleepers, their sleep regulatory mechanism, and therefore we can use that information to help everybody sleep more efficiently. And even beyond that, maybe we can figure out how to help people who have sleep problems to really be able to sleep better.

Maybe one day we'll be able to design a pill or use gene editing to help more of us get efficient sleep. But until then, the best thing you can do is follow the tried and true techniques for getting seven to nine hours, as Rebecca explained. Set a regular routine. Try to go to bed and wake up around the same time every day. Get regular exercise in your day. Avoid alcohol, avoid spicy foods, and avoid caffeine at least six hours before bedtime. And I think most importantly of all, this goes for everybody, you just need to prioritize getting rest.

I'm the first to admit, sleep is one of the first things to go when I have a deadline at work or I have to stay late at the hospital monitoring patients. But since I've started to study sleep, I've really changed my approach. I now try to give myself a full 30 minutes to wind down. I'll usually go spend time with the girls, lights out, room cool, telling them some stories. It's good for them, and it's good for me. So get the good sleep tonight, and you'll get the immediate benefits tomorrow.