The Diary Of A CEO with Steven Bartlett - Matthew Walker: The World’s No.1 Sleep Expert (The 6 Sleep Hacks You NEED!)
Episode Date: March 9, 2023You know how important sleep is just from the personal experience of making it through the day after a bad night’s sleep. But what if you were told that sleep was the single most important thing you... could do for your physical and mental health? It affects everything from your sex hormones, immunity, bloody sugar and even how you form memories. Dr. Matthew Walker has dedicated his life to tackle the global sleep loss epidemic we are all living through, as this wakefulness personally costs us our health, it costs businesses productivity and it costs countries billions of dollars a year. In this enlightening episode, Dr. Walker discusses the science of how and why we sleep, how modern life is effecting our shut eye and the tricks to getting the best night’s rest. Considering that sleep makes up a third of your life, this is a conversation you can’t miss. Matthew: Instagram - https://bit.ly/3YsK1f6 Twitter - https://bit.ly/3yI60V7 Website - http://bit.ly/41ZEgss Follow me: https://beacons.ai/diaryofaceo
Transcript
Discussion (0)
Quick one. Just wanted to say a big thank you to three people very quickly. First people I want
to say thank you to is all of you that listen to the show. Never in my wildest dreams is all I can
say. Never in my wildest dreams did I think I'd start a podcast in my kitchen and that it would
expand all over the world as it has done. And we've now opened our first studio in America,
thanks to my very helpful team led by Jack on the production side of things. So thank you to Jack
and the team for building out the new American studio. And thirdly to to Amazon Music, who when they heard that we were expanding to the United
States, and I'd be recording a lot more over in the States, they put a massive billboard
in Times Square for the show. So thank you so much, Amazon Music. Thank you to our team. And
thank you to all of you that listened to this show. Let's continue. When you're struggling
with sleep in the middle of the night, and you're wide awake, in the last hour before bed, try this experiment.
I'm sold.
Matthew Walker.
Neuroscientist and best-selling author.
And one of the world's leading researchers in sleep science.
It's going to blow your mind.
There is a global sleep loss epidemic shaped by this thing called the modern world.
What society wants is that you're either producing or you're consuming. In fact, the CEO of Netflix, his statement was that we are to commit
war against sleep. We have this mentality in business. Less sleep equals more productivity.
That is just not true. Insufficient sleep costs most nations about $4 billion dollars. Your rates of obesity, cardiovascular disease, mental health conditions,
all of these things escalate.
If that wasn't bad enough,
if you're not getting sufficient sleep,
then 60% of all of the weight that you lose
will come from lean muscle mass and not fat.
Not the muscle.
How would you redesign society to help us to sleep better?
So first I would... It feels like caffeine is a miracle drug with no apparent cost.
Was I wrong or was I right? Wrong. Caffeine will hurt your sleep in three ways most people
are not aware of. So if you have a cup of coffee at midday what happens is that matt i have spent the longest time trying to sit down with you on this podcast i'm very very happy
to spend some time with you today.
And that is because your work is now world renowned. And it's very, very important work.
But as is the case with a few of the recent episodes on this podcast, I wanted to start by asking you, in your view, what is it you do? And why is it so important in your mind that you do it?
Well, firstly, thank you so much for having me here and having this conversation. It's
an incredible privilege to sit with you. Why do I do what I do and why do I think it's important?
Sleep, I would argue, is the single most effective thing that you can do to reset your
brain and body health. And I don't say that flippantly. It's not as though I'm dismissing
exercise or diet. Those two things are absolutely critical. But if I were to take you, the individual
and deprive you of exercise for a day, deprive you of food for a day, deprive you of water for a day, or deprive
you of sleep for a day, 24 hours. And I were to map your brain and body impairments. It's not even
a competition. That one night of lost sleep relative to those other things, it dwarfs.
The only thing I lose out against is oxygen. If I deprive you of oxygen, you're going to pop out of existence a little bit quicker than you will with a lack of sleep. So sleep to me, I think, is the elixir of life. It is your life support system. And as best we can tell, I would argue it's Mother Nature's best effort yet at immortality. And so in that regard, that's why I,
when I look across all of the studies and all of the data, it's so compelling to me.
And part of the reason I think it's, I've desperately tried and I haven't done a good
job, but I've tried to offer some public mission of reuniting humanity with the sleep that it's so
bereft of is because it does appear that there is
a global sleep loss epidemic. If you look at the numbers, people are struggling so desperately
with their sleep. So we have all of this knowledge, this incredible knowledge of sleep and how
important it is. And it's a perfect storm colliding with this great sleep depression
in modern society. And for that reason, I just felt
as though, what can I do to try to help offer this voice and this science? And I am but a scientist
and I stand on the shoulders of all of my colleagues and all of these giants in the field.
I'm just a researcher. So that's a little bit about, I guess, who I am, but more about why I do
it and why i think it's
important if i were to try and define your sort of and this i hate doing this because it requires
the application of some kind of narrow label if i was to try and define what your title is
in your own words what would that be so i'm just a professor of neuroscience of brain science at
the university of california berkeley um Berkeley. I am not a medical doctor,
just FYI for all of the things that we will talk about in this conversation. So I'm just a PhD.
Just a PhD. Yeah. You know, that's incredibly humble of you, but I would assert that you're,
without a shadow of a doubt, the leading author, scientistator voice as it relates to the topic of sleep
and my my question from that is where did that begin like where did that start in your life
in the journey of your life when did sleep become the thing it occurred to me or happened to me i should say when i was doing my phd i was studying people with
dementia and we were trying to understand what type of different dementia that they had very
early on in the course of their disease and we were looking at patterns of brainwave activity
so i was placing electrodes all over the head and I was measuring them and I was trying to differentially diagnose them very early on. And I was getting no good data whatsoever. It was
miserable. Nothing was landing. And one day I went home at the weekend and sort of with all of my
printed journals and I go to my doctor's residence and have this sort of igloo of journals around me
that I would sit and read at
the weekend. And I was, which probably tells you everything about my social life at the weekend,
if that's what I was doing. But so I was reading these journals and it occurred to me that some of
these dementias were eating away at the sleep centers in the brain and others would leave them
untouched. And at that moment I realized I'm measuring my patients at the wrong
time. I'm measuring them when they're awake. I should be measuring them when they're asleep.
Started doing that, got amazing results. And at that point, I wanted to ask the question, well,
I wonder if the sleep problems are not simply a symptom of the dementia. I wonder if it's a potential cause of the dementia.
And at that point, I started to think, well, so then what is this thing called sleep?
And what I learned is that some of the greatest minds in the past 100 years had tried to answer
a very simple question. Why do we sleep? And, you know, 30 years 30 years ago in fact the crass answer was that we
sleep to cure sleepiness which tells you nothing about you know it's like saying i eat to cure
hunger well no you that's not the right answer now 30 years later we've had to upend the question
and we now have to ask, is there any physiological
system in your body? Is there any operation of your mind that isn't wonderfully enhanced when
you get sleep or demonstrably impaired when you don't get enough? And the answer seems to be
to be no there. So my journey into the science of sleep really was an accident. But at that moment in time, when I started reading about sleep, I utterly fell in love with the topic.
And it is a love affair that has lasted me over 20 years.
I think it is the most beguiling topic in all of science.
I'm biased, of course.
And I will never study anything different.
I know that now.
I'll study it to the end of my career and until the end of my life.
Wow.
I've never heard anybody say to me on this podcast that they would study the same topic for the rest of their life.
And you're a young man.
You've got a long way to go.
Especially the amount you've been sleeping.
That's very kind of you to say.
I wish I'm moving into the foothills of middle age uh rapidly but no i i'm so fortunate in what i do um to have
found it or for it to have found me you know if i won all of the money in the world tomorrow
i would genuinely genuinely not do anything different.
I am so fortunate.
Well, I'd probably start trying to fly like business class or first class.
That would be nice.
But other than that, I would do nothing different.
And I am very mindful of that because that sounds very privileged.
And I know a lot of people enjoy what they do for a living rather than enjoy what they do for a living
and i know how lucky i am so i don't mean to be dismissive of people in that regard i just know
how much i love what i do you you asked a question there which is um you you posed a question which
many people have tried to answer you gave the the answer from 30 years ago about you know why do we sleep um and it dawned on me as you said that that i've never
asked myself that question i've never even pondered the thought of why i sleep i mean i know what
happens when i sleep but do i know why my body can't just find another way why can't my body
stay awake for the 24 hours i know some animals they sleep half their brain and then the other half kind of has a nap and whatever why why why do we sleep it's a
puzzling question because when you think about it from an evolutionary perspective it makes no sense
whatsoever sleep is utterly idiotic because when you're sleeping firstly you're not finding a mate you're not
reproducing you're not foraging for food you're not caring for your young and worst of all you're
vulnerable to predation now on any one of those grounds but especially all of them as a collective
sleep should have been strongly selected against during the course of evolution.
But from best we can tell, sleep evolved with life itself on this planet, and it has fought
its way through heroically every step along the evolutionary path. And what that has told us is
that sleep must be essential at the most basic of biological levels. And now we
understand that mother nature didn't make a spectacular blunder with this thing called sleep.
Sleep, for example, will restock the weaponry in your immune arsenal and it will make you a more
immune sensitive individual. So you're more immune robust when you wake up. We also know that
it regulates your blood sugar levels. It controls your appetite hormones. It also regulates your
sex hormones, testosterone, estrogen. Sleep upstairs within the brain will fixate memories
and help you learn and remember. Sleep will deescalate anxiety. It will reduce your emotional
difficulties and traumas. Sleep will actually cleanse away the Alzheimer's toxic proteins that
build up in the brain. You know, the list is endless. These are all of the reasons that we need
to sleep. But why can't I just do what those animals do where they half of their brain falls
asleep half of the brain stays awake is that at all linked to the fact that we we live in tribes
so we are essentially although we're you know there might be 10 people in the tribe we're
all 10 of the tribe so we can rest at different times and kind of cover each other's backs or
gosh yeah so actually there are two nested very insightful questions there
the first is this notion of what you're describing which is what we call unihemispheric sleep which
is just a fancy way of saying you can sleep with one half of your brain and the other half is wide
awake now there are only a few species that can do this um For example, aquatic mammals, dolphins are a great example. We can
place actually electrodes on their heads. And you can see that one half of their brain will be
fast asleep. It will be in deep, deep non-REM sleep. The other half of the brain will be frenetic,
wide awake. And in part for them, the reason is because they need to maintain aquatic mobility. You know,
they need to keep surfacing for air. Otherwise, you know, that's not going to be a good outcome.
We also know that birds or many avian species will have unihemispheric sleep. And you can
actually see this. There's some great YouTube videos online where they will film one half of the sort of the side of the bird's face
and the eye is closed.
And what it means is that the other half of the brain,
because the brain is actually,
the left half controls the right side,
the right side controls the left side.
So that left side is now fast asleep,
which is the right eye closed.
And then you kind of pan around
and all of a sudden the other eye
is wide awake and it's clearly looking about. Now this is obviously not for aquatic surfacing to
gain air. This is for a different reason. What happens is that in a flock, a bunch of birds will
all land on a branch. Now all of the folks in the middle, they get to sleep with both halves of
their brain. They can sleep with both halves or just one half. All of the folks in the middle, they get to sleep with both halves of their brain. They can sleep
with both halves or just one half. All of the folks in the middle, they get to sleep with both halves.
The unfortunate girl or guy who sort of lands at the end, the far end, they will actually sleep
with one half of their brain. So one half of the flock, the entire flock, has one eye, 180 degrees of sort of half panoramic view
out. The other bird on the other end will have the other half of the brain asleep,
with the other eye awake, giving the other 180 degree view of protection vision. And therefore,
the entire tribe has a 360 degree assessment.
Now you would think in furnace
that once those guys or girls at the end
have done their duty,
they get to move into the middle
and they get to sleep with both halves.
No, that's not what happens.
What they will do after a while
is that they will stand up,
they will turn around 180 degrees,
sit back down and switch the other sides of the brain.
So to just be clear, the complexity of wiring and architecture that has to happen for one half of
the brain to be deep in sleep and the other half to be wide awake is astronomically hard. I mean,
it's incredibly difficult to create that wiring.
What that tells me is that if sleep was dispensable, if it was negotiable, then mother
nature would have just found a different way for us to get all of these brain and body benefits
and not gone to all of the evolutionary trouble of figuring out this fancy wiring for half-brained sleep. In other words,
you just can't get away from sleep. You have to sleep. But your second question, I think,
is even more fascinating, which is, us as a tribe, because we are a tribe species.
Now, there is something else that we call your chronotype. Are you a morning type,
evening type, or somewhere
in between? And by the way, you don't get to decide. It's not your choice. You know, this
notion of these go-getter type A's who say everyone has to be awake at five in the morning.
You know, you go to the gym, you blast out a workout for an hour and you're at the desk by
6am. You have no choice. If you're an evening
type, you're an evening type. It's hard-coded. We know that right now there's at least 22 different
genes that dictate what you are, morning type, evening type, or somewhere in between. And it's
about a third-third split across the population. Why is it a split? Why are we nicely spread out
across our chronotypes?
For exactly the reason you described.
Because when we're in a tribe, if we all sleep at the same time, we're all vulnerable for eight hours.
But if you were to insert some genetic variability into when people have a desire to sleep,
you've got the morning types who maybe go to bed at 9 p.m. and are waking up, let's say, at 5 a.m.
And then you've got all of the extreme evening types who are going to bed at 2 a.m. and waking up at maybe 11 or midday.
So that way, everyone gets their eight hours of sleep.
But the entire tribe, the nucleus of this group of Homo sapiens themselves, is only vulnerable for maybe just two or three hours.
So it's a clever solution that Mother Nature has come up with to say everyone gets their eight hours.
But as a species, you're only going to be vulnerable for two to three hours max when everyone, at least as a collective, is sleeping.
Absolute genius.
I used to think it was a load of nonsense,
this chronotype thing.
It was actually on this podcast where I learned about its existence.
And then I went on YouTube to learn more
and your video came up if you're explaining it.
Because I thought, I always pondered why my partner
goes to bed super early, wakes up super early.
I go to bed late, wake up late.
I'm going to ask you this question actually, because I i've wondered this in that situation where i'm sleeping in bed with a partner that has
a different chronotype yeah it can have an impact on my sleep right because of the way that our
sleep cycles work and the rem sleep in the stage one deep sleep etc etc if she's waking up when i'm
pulling into rem sleep i if she's waking up at 5 a.m but at 5 a.m
because i've gone to bed later my REM sleep has just begun that has quite a significant impact
on me right if she is waking you up yeah if she's waking if she wakes me up then it's non-trivial
and likewise if you're waking her up as you're getting into bed on the front end of sleep so it's very difficult one of the things that couples will
cite if they break up firstly is usually about a third of them will cite sleep difficulties or
sleep issues really as a as a cause of their their breakup or at least as a contributing factor to
that breakup one third yeah that it's one of at least one of the factors when you go then in
and when you double click to say okay then what it is about this sleep kind of tension between
the two of you one of those things is a mismatch in chronotype and you can see this when you know
people i think this you know on dating profiles, someone was telling me people even say like, I'm a morning type or I'm an evening type.
As if you're stating up front, this is part of my identity.
And just FYI, be forewarned, because maybe it's been an issue for them in the past.
This is why I often speak about the notion of what's called a sleep divorce to prevent a real one.
Now, it's not for everyone. A sleep
divorce is where you sleep in separate locations. And when we've surveyed people, both from the
Sleep Council in the United Kingdom and also the National Sleep Foundation here in America,
the data is about the same. One in four people will say that they sleep in different locations with their partner. So almost a quarter of people in relationships will sleep in different locations. We think it's potentially an underestimate because if you survey people anonymously, then a third of them will report waking up at least in a different location the next morning.
And part of the reason that it's a taboo is because people think, well, if we're not sleeping
together, then we're not sleeping together. The exact opposite is true, that when a couple is
sleeping well, we know that the sex hormones are improved, testosterone in men, estrogen, and
luteinizing hormone in women. We also know that your desire to be intimate with your partner is
increased. What we found is that for an hour of extra sleep, if a woman gets an hour of extra sleep, her libido desire to be intimate with her partner
increases by 14%. Now, to give you some context, the FDA drugs for improving or increasing libido
in women, drugs such as Vialisi here, clinical drugs, they will increase it by about 24%. And
that's a pharmacological agent. But here, just the added non-pharmacological benefit of
one hour of extra sleep will get you more than 50% of the way there. So I want to just remove
that notion of the stigma of that if you're not sleeping together, you're not asleep. It's
usually quite the opposite. I would say that part of the the challenge though is
that if we look at all objective measures if i measure your sleep and the sleep of your wife
if when you're sleeping separately versus when you're sleeping together it's very likely that
objectively you will both be sleeping worse when you're sleeping together, it's very likely that objectively you will both be sleeping worse when
you're sleeping together. That's what the science tells us. However, what's interesting is that
when you survey people and say, how satisfied are you with your sleep, which is a subjective
measure, people will say, I'm actually more satisfied with my sleep when I'm with my partner
than when I'm sleeping alone. So there's a mismatch here.
Objectively, your sleep is better, but subjectively, you still prefer that. And of course,
it's natural. There is safety, there's security in co-sleeping. There is this sort of connection
that we get. You can approach it if you want. Just be honest with yourself and be honest with your
partner. And you can start by saying, look, this isn't forever. I just want to say, let's do an
experiment for a week, 10 days. Let's just try it and see how it goes. It doesn't need to be
permanent because what you actually miss are the bookends of sleep.
For the most part, the two of you are not conscious
for most of the experience of sleeping together.
It's really getting into bed
and sort of having a kiss or a cuddle
and sort of waking up together in the morning
and sort of, now, obviously,
when you're mismatched chronotype,
that's also can be a challenge too.
So you can still have a sleep divorce but you
can set up a system where you will go in and you'll say your good nights and you'll kind of get into
bed have a kiss and cuddle and then you retreat to a separate location and you can repeat that
same process um so i i don't want to sort of belabor the point of a of a sleep divorce but
um people can certainly explore.
There is something called a halfway house, which is called the Scandinavian method, which sounds
far more salacious than it actually is. It's simply that you buy two beds and you put them
side by side in the same room. And therefore the amount of disruption, physical disruption that
happens by way of sheets and movement
is decreased. But that doesn't solve it all. Sometimes there is snoring, sometimes there is
sleep talking. Those things are not obviated by the Scandinavian method. When you think about where
society is, I was going to ask you, you know, you said you wanted to do the work you're doing now
for the rest of your life. So do you think the work you're doing now for the rest of your life um so do you think the work
you're doing now is going to become increasingly more important and relevant i.e is the problem
going to get worse or is it going to become less significant and less relevant based on the
trajectory of society as you see it you know i'm mixed i think when I wrote the book, I started writing a book that was called Why We Sleep back in probably about 2014 or 15. And at that point, sleep was the neglected but there was no voice of sleep. And I was so sad about that because I could see so much disease and suffering that was coming
so clearly by way of a lack of sleep, but it wasn't there on the public buffet menu for
consumption of knowledge. And so that was part of the motivation for trying to write the book. So I would say now, and this is not because of me or the book or anything like that, but is sleep more of a conversation in this day and age than it was six or seven years ago?
I think I would say yes, there is a greater awareness of sleep. But with that awareness, I think one can still question the pragmatics, meaning
just because we're talking about it more does not mean that people are still failing to either get
the sleep that they need or that they are unable to get the sleep that
they need. And those two things are different. One is that you are healthy and you can generate the
sleep that you need, but you don't give yourself the opportunity, time or life, I should say
sometimes, because it's sometimes not your choice. Life does not give you the chance to get sleep.
And if only you had the chance, you could sleep. one version the second version is no I'm giving
myself the right opportunity to sleep but because I'm anxious or because of other issues I am not
able to generate sleep I suffer from insomnia and sleep problems so those two things I don't see
having changed since you know I think this public movement, this increasing movement of sleep
conversation came on the table. So in that regard, I'm more pessimistic than I am optimistic. And I
think it will only get worse. If you look at rates of insomnia, for example, they're only increasing,
they're only escalating. Rates of anxiety disorders, the very same thing. And those two things are intimately
intertwined. So I think, I wish I, my mission was extinguished within the next couple of years
because society started sleeping wonderfully well. I don't think that's going to be the case.
So I think I've got my work cut out for me, um, to try and help people with better sleep.
Um, is it, so it's getting, we're getting worse at sleeping. my work cut out for me to try and help people with better sleep.
So we're getting worse at sleeping?
I think modernity is making it so much more difficult for us to sleep.
Modernity? I think when you think about, we often think about sleep as a biological process and it very much is and but also it's so
environmental as well as biological meaning when you were to say you know how did you sleep last
night think about all of the external factors that changed it well i had to be up at this time
i had to catch a flight this time my partner went to bed at this time had to be up at this time. I had to catch a flight this time. My partner went
to bed at this time and she woke up at this time. There was this noise that sort of happened. I'm
now sleeping in a hotel room. You know, there are countless externalities and those externalities
are shaped by this thing called the modern world. And in the modern world, if I could really be
cynical and I'm not someone, I'm very optimistic
and I'm very non-cynical, but you could argue from a capitalistic standpoint that society does not
want you sleeping. Because what society wants from a capitalistic point of view is that you're either
producing or you're consuming. And when you're sleeping, you're neither producing and you're neither consuming.
And so there are lots of ways that I think society and the modern world has conspired, willfully or not, conspiratorially or not, to decrease and try to diminish sleep. In fact, I think the CEO of Netflix several years ago,
and I'm sure that YouTube comments will correct me if I'm wrong here, but I believe his very statement was that we are deciding to commit war against sleep. That was their goal. And it just
stunned me that, you know, that we're going to go to war with sleep. We're going to
remove you from your sleep. So there are lots of ways in which I think society does not help us.
Light is another good example. We are a dark, deprived society in this modern era because
we're exposed to light. We are not giving ourselves the right temperature cues. You know,
we go into an office where it's,
you know, 20 degrees, 70 degrees Celsius, whatever it is, stock stable. Then we come home and we
regulate our temperature at home to be the same thing. We take on board probably too much caffeine
in this day and age, although I am actually an advocate of drinking coffee and I can explain why too. But anxiety, as I said, is a huge issue.
All of these things are preventing and classic roadblocks to sleep.
How many of us are getting the sort of recommended daily allowance of sleep as a percentage?
Do you know it seems to be about um one third of most modern civilizations
are failing to get the recommended seven to nine hours of sleep a night one third so roughly 30
35 33 roughly yeah and does that have geographic variance i in some countries it's worse in some
countries it's better i'm thinking about the uk versus the us or you know japan or whatever yeah it is and in fact you let me give numbers to the
three countries that you described uh here in the united states the average amount of sleep that
people are getting is uh six hours and uh 29 minutes in the, it's not much better, six hours and 49 minutes. Japan was the worst,
six hours and 22 minutes. Now, to be clear, that's the average. What that means is that there is
still a large proportion of that bell-shaped distribution of people getting even less than that amount. Now, there are some
countries that you look at that are actually sleeping much better than that. I think Mexico,
for example, is doing very well. If you look at Mexico City, people are actually sleeping
not too far off from eight hours. So there is variability,
and we can try to understand why. Which, by the way, just brings me back while I think about it
to your comment of, will my work be done? Not from the, because I'm a scientist and I do, I have a,
run a big sleep center at UC Berkeley, but the work I do as a, hopefully a public advocate for sleep why I don't think it's going to change anytime soon is because governments aren't really doing much about it and I've tried as best I can
and if there is any government out there that listens to this that wants to work with me I'd
be delighted I don't remember and maybe you can but any major first world nation government that has had a public
health campaign regarding sleep and it stuns me because those same governments have had public
health campaigns regarding you know eating regarding smoking regarding drunk driving
regarding risky behaviors safe sex sex. Loneliness. Loneliness, mental health, suicide.
Where is sleep in that equation?
And it's such a fundamental ingredient.
And in fact, almost all of those things
that I've just described
have an intimate relationship with sleep.
I mean, suicide, especially, we were starting to do a lot
of work with this, although it's been hard to get funding. But what we found is that insufficient
sleep is a precursor to suicide. That sleep disruption seems to predict both suicide ideation,
in other words, suicidal thinking, suicide planning, and tragically, suicide completion as well.
So if we were to try to have governments create a public health campaign to pull this Archimedes
lever on better sleep, there are so many other health benefits. You know, sleep is the tide that
rises all the other health boats. It's almost like a mixing deck in a studio,
you know, in those sound studios where you've seen it. And then there's that one button all
the way to the end, the white button, sort of that when you move it up, sort of all of the other
dials, the sort of the red, yellow, orange, green dials, they all move up at the same time as well.
There's this like sort of one mess, there's like one ring to rule them all sleep is that
archimedes lever so if governments could only execute on that the health benefits would be
manifold in terms of their consequences it begs the question you know if i were to make you today
president prime minister whatever of the world and you had to do you know just a few things to really fix the lack of sleep
epidemic there you go i've diagnosed it um what would those things be if you were in charge how
would you redesign society to help us to sleep better gosh it's such a good question and i've
thought a lot about this almost in reverse, which is to say,
why is it that we are struggling to get sleep? And there is no single answer. There are so many
different reasons. And that's why it's actually a very challenging problem to solve. I would go
through a descending level of steps. So first I would start at the government level and we would get those public health campaigns in order. Next, I would go to the professional level because there we have this
mentality in business that, you know, sleep is for the soft among us, that less sleep equals
more productivity. And that is just not true. And I can provide you with
all of the evidence. So we need to get rid of this sort of sleep machismo attitude in the
workplace where we wear our badge of honor of sleep deprivation on our arms. We need to get
companies to actually start embracing sleep. And I can guarantee you, and I can give you all of the evidence as to why if as a company, as a CEO, if you start prioritizing the sleep of your employees, you will be far better off as a company.
You will be more product based and you will be more profitable and revenue generating.
Sleep is the very best form of physiologically injected venture capital that you could ever wish
for. And in fact, the Rand Corporation, which is an independent survey corporation, what they found
is that at a national level, insufficient sleep costs most nations about 2% of their GDP.
So here in America, that number was $411 billion of lost profit caused by insufficient sleep. In the United Kingdom,
it was over $50 billion. In Japan, it was over $120 billion. If I could solve the sleep loss
crisis in the workplace, I could perhaps double the healthcare benefit for many of those countries,
or I could halve the education deficit in those countries. So the next level I would target is at business. Then next
step down would be medicine. Medicine is a classic demonstration here. We have junior doctors, or
here in America, they have doctor residency programs where people are working 20, 30 hour
shifts. And so already doctors are inculcated into the mindset of the uselessness of sufficient sleep.
Across numerous countries, and I think it was maybe over eight different countries,
we looked at the medical curricula and we asked how many hours of education do doctors get about
sleep? And what's strange is that, you know, often doctors, you'll go in and you'll have an
appointment, they'll say, okay, you know, how are you eating? And you know, what's going on with
the bathroom? How's the toilet? And then, you know, how are you sleeping? As if sleep is one
of these universal health barometers. But what we found is that most doctors will only be given
about an hour to an hour and a half of sleep education during their entire medical school education, which blows my mind
because it is one third of their patients' lives, but they're only given about 90 minutes of
education. So no wonder your doctors aren't treating your sleep problems, thinking about
your sleep problems, understanding your sleep. It's not their fault. And plus they're sleep deprived anyway, when they're being trained. Ironically, by the way, doctors, junior doctors who've worked
a 30 hour shift, when they finish that 30 hour shift and get back in their car, they are 168%
more likely to get into a car accident because of their lack of sleep and back up in the emergency room from where they were
just working, but now as a patient. I mean, this, the paradox, the irony just stuns me. So I next
moved down to the level of medicine. Then I would go to education because we don't get taught about
sleep in schools. I never got one of those special classes. You know, I got sort of, you know,
sexual education classes, classes about drugs. No one came in and told me about the benefits
of sleep. Why aren't we doing that? Then next I would move down into the family
because there is prejudice in families with sleep. It's this notion of parents of teenagers. And these teenagers, by the way,
it's not their fault. They have a shift in their chronotype, in their circadian rhythm, that when
they go through puberty, when they're going through adolescence, they get fast-forwarded in time.
So when they were eight or nine years old, they would be going to bed, you know, sort of early in
the evening. But now as teenagers,
they seem to be stubborn and they're staying awake, staying awake until midnight, 1am,
and they won't get into bed. It is not their fault because they have a biologically wired shift
in their tendency of when they want to wake up and when they want to sleep. Why am I bringing this up about this sort of mismanagement in the home?
Because parents at weekends, they'll go into the room of the teenagers,
they'll pull open the curtains, they will pull the covers off,
and they say, you're wasting the day.
And firstly, what they're doing is probably trying to sleep off a debt
that we've lumbered them with during the week
because of this incessant model of early school start times, which I'll come back to.
But within the home, if you ask parents of teenagers, what percent of parents think that
their teenagers are getting sufficient sleep? And about 70% of them will say, yes, my teenager is
getting sufficient sleep. When you look at the data, only about 15% of them will say, yes, my teenager is getting sufficient sleep. When you
look at the data, only about 15% of teenagers are actually getting the sleep that they need.
So what happens is a parent-child transmission of sleep neglect. They're saying, you're lazy,
you're slothful. So then what happens? Well, in 15, 20 years time, now that teenager has got a teenage child. What do they do? They go back in
the room, they rip the curtains open, they say you're wasting the day because that's what they
were told. So we need to break that down too. And then finally, we need to come to the individual
and we need to solve the individual's sleep problem. So it's a very long answer and I'm
desperately sorry to a very big question as to what I would do if I was off for a day.
But I hope that gives you some sense of the depth that I think we need to go to.
I've tried to think about the question a lot.
It's not particularly well executed.
I don't think I was very eloquent there, but I hope that gives a sense.
It sounded perfectly eloquent to me.
It sounded like a manifesto.
So hopefully if there are people listening from governments,
which I'm sure there are,
because I hear about that sometimes,
which is quite bizarre,
but I'm sure they'll be getting in touch with you very quickly.
Going back to the top of that stack,
on the company level,
so as a CEO or a CFO or an employer, whatever,
there are some companies
that are incentivizing their team members to sleep, right?
Is there any data showing the efficacy of that?
There is data that we have, and it's bi-directional, both the efficacy of when you increase sleep and also the detriment when you don't allow sleep.
So a great example was NASA back in the 1980s. They were looking at using naps
in the astronaut program, because when you're up and you're orbiting Earth, you will actually be
cycling Earth, you know, really quite quickly. And you will get to see, depending on the orbit,
maybe somewhere between 10 to 15 sunrises every 24 hours, which sounds, I mean, amazing and remarkable. But trust me, in terms of your sleep, it is very dislocating. So they were looking at
how to use naps strategically to improve improve performance because the weakest link on any space mission,
and we've done some work with NASA, is the human being themselves. And they can cause
catastrophic failure. Now, if you make an error at work and you're here terrestrially on the ground,
you know, it's probably non-trivial. Make an error when you're up in space,
it can be a big deal. So they were looking at that.
And what we found was that these naps, anywhere between 20 minutes to an hour, could increase
productivity on these different tasks by about 34% and increase general alertness by over 50%.
And in fact, the data was so powerful that it ended up being transmitted to
all of the terrestrial workers on the ground that NASA would start to, it was what was called NASA
naps. It was a NASA nap culture. Now, NASA isn't desperately compassionate by any means. It's a
great organization, but they just like companies like Google or Facebook, they understand the pounds and pennies sense,
you know, the dollars and the cents version of productivity. So anything that returns productivity,
they will invest in. And some of those companies, you know, I did some work at Google during a
sabbatical and there on their campus, they will have these nap pods and they will have these what are called shrooms
where you can go and you can take a nap.
So think about 20 years ago,
you would never imagine a company paying you
to sleep on the job.
If you were caught sleeping on the job,
you'd probably be fired.
Now companies are incentivizing it,
not because they are thinking compassionately or empathetically about the health or the wellness of their individuals.
It is because they understand that it transacts marked productivity.
So NASA was a good example.
When you give sleep, you get something back.
But I can go back to the reverse of that.
Why we think that a lack of sleep does not equal more productivity is for at least five reasons.
First, when you survey, and we can do these studies in the laboratory too, when you undersleep
employees, they will choose less challenging problems. So if you give them an array of work
problems, they will just simply, you know, check email, they'll listen to phone messages, they don't
dig into deep project work. Second,
of the problems that they do take on in their work, they will produce fewer creative solutions.
And after all, creativity and ingenuity are supposed to be the two engines that drive
businesses forward in terms of their productivity and their revenue. The third interesting finding that we've discovered
is that when underslept employees start working in teams,
they will slack off.
They won't do their work.
They will let other people do their work.
It's what we call social loafing.
So they ride the coattails of other people's hard work,
which won't breed a good atmosphere in your company.
You know, trust me.
The fourth thing that we found is that underslept employees are more deviant, that they're more likely to
fudge data in spreadsheets. They're more likely to falsely claim money for reimbursement. That
was inappropriate. The final thing is that a lack of sleep will go all the way to the top of the
business chain. What we found is that the more or less sleep that a business leader has had from one night to the next to the next,
the more or less charismatic that employees will rate that business leader from one day to the next to the next,
even though the employees themselves, they know nothing about the sleep
that that CEO has been getting.
It's evidential in how charismatic that CEO is.
So you can add all of these things up
and no wonder if you don't snooze,
you lose in the case of business in that regard.
That's why I can produce,
I think a non-trivial case for business.
By the way, the other aspect that is hugely costly to businesses, and when I go and speak
to businesses about why they should value sleep, if you offer it on the grounds of, again, sort of
compassion or mental health, you probably don't want to listen. When you convert it into the cost
of the company and how much it's fleecing them in terms of their profits, then they start to pay attention.
Underslept employees will take on average about 11 more days, sick days throughout the year
relative to well-slept individuals. So you're essentially just paying people additionally for
11 days of
work that they will never give you when you are under sleeping them. Secondly, the utilization
of healthcare resources increases by about 80%. So the cost to either you, the company here in
the US where your company is paying for your healthcare, or the cost to the government, for example, in the United Kingdom, is astronomical.
And also then the what we call comorbid diseases, your rates of obesity, diabetes, cardiovascular
disease, mental health conditions, all of these things escalate as underslept. So there is no strong case that I've seen that leads me to
think businesses should foster the mentality of insufficient sleep, quite the opposite. So that's
hopefully an answer to your question. We can look at it bi-directionally. When we give sleep back,
do you get productivity? Yes. When you take sleep sleep away the things implode rapidly yes and is
it costly to your company very much so on that point of naps and you know google sleep pods naps
and things like that there was a point in my life where i because i learned about rem sleep and the
importance of rem sleep and deep sleep and that happens a little bit further on into my you know
the 19 minute look at me trying to tell a sleep expert no i love it
but you see what i mean like this is my very this is my monkey brain so i didn't understand the
subject matter very well still really don't to be honest but in the first it takes me a significant
amount of time to get to deep sleep into REM sleep how long on average would you say it takes
for it for some you know yeah so you will probably go into light sleep in
the first 10 to 15 minutes then you'll go down into deep sleep you'll stay there for about 30
40 uh minutes then you'll start to rise back up and you'll pop up and you'll have a short REM
sleep period and then you complete the non-REM to REM cycle after about 90 minutes and back down
you go again down into non-REM and up into REM so on average for human beings it's 90 minutes and back down you go again down into non-rem and up into rem so on average
for human beings it's 90 minutes so i therefore assumed that napping really does nothing because
i thought well it takes me so long to get to rem sleep and to deep sleep that there's if i've got
15 minutes 20 minutes to to nap it's just a waste of time right was i wrong or was i right you were understandably wrong okay good
i'm happy because i i've always rejected naps because i thought they don't matter
because it takes me so long to get to a restorative state anyway so so we've done
lots of different studies with naps we and other colleagues uh too and what we found is that naps
can transact some fantastic
benefits. They can improve cardiovascular health, lower blood pressure. They can improve your
learning and memory abilities. They can reset the emotional north of your magnetic compass in a good
way where you can deescalate negative emotions and increase positive emotions.
So naps certainly are a good thing, but with a big caveat that I'll come back to.
Yes, you're right in the sense that to get a full cycle of sleep and to get into REM sleep,
you would probably have to make that nap about 90 minutes. And in fact, a lot of the
studies that we do, we will use a 90 minute nap duration of time so that the brain can cycle
through all of those different stages of sleep. But you don't need to, nor would I suggest that
you do. What we found is that different stages of sleep perform different functions for the brain at different times of
night. There are actually four separate stages, stages one through four, increasing in their
depth of sleep. So stages three and four are those really deep stages of non-REM sleep. Stages one
and two, that's the lighter form of non-REM. And then you have rapid eye movement sleep,
or what we think of as dream sleep. And people will sometimes say to me,
how do I get more REM sleep? Or how do I get more deep sleep? And my response to them is,
why do you want to get more REM sleep? And their answer is, well, isn't that the good stuff?
And it turns out that there is no good stuff. It's all good stuff. You know, maybe with the
exception of that light stage one non-REM sleep, that's shallow sleep, and we typically don't like to see too much of that.
But stage two non-REM sleep, three and four,
they all have their different functions that we've discovered,
and REM sleep has its functions.
So you need all of them.
You can't shortchange any of them.
But for a nap,
what we found is that you can get nice benefits for things like your learning and your
memory, and it can even reduce some level of anxiety up to about 20 minutes. You can, in fact,
you can nap. I think the study, one of the studies, they brought a nap down to about nine minutes in
duration, and there was still some basic improvements for your sort of general level of
alertness and reaction time.
For example, if you're an athlete, that's non-trivial.
So the reason I would say be careful with naps is for two main sort of suggestions.
The first is try not to nap for about longer than 20 minutes.
Because once you go past 20 minutes, you really start to go
down into those deeper stages of non-REM sleep. And if you wake up after about 45 minutes or 60
minutes, it's not a problem. I'm not suggesting that you shouldn't or you couldn't. I'm just
saying be aware because when you come out of that deep sleep and you wake up from that deep sleep,
normally that's not how you wake up. You will usually wake up out of lighter stages of sleep
or out of REM sleep.
It's rare that we wake up out of deep sleep.
But if you nap and you nap for about 40 minutes,
you'll probably go down into deep sleep.
And at that point, if you wake up and your alarm goes off,
then you're going to feel almost miserable
and worse than you did before the nap
because you have what's called sleep inertia,
which is essentially a sleep hangover,
where the brain is still sort of pulled back into that deep sleep state.
And it can take you almost an hour before you feel like you're back up
to operating temperature and you're up to motorway speed.
So I would say keep it to 20 minutes and you don't suffer too much of
that inertia. You still get some nice benefits. Also don't nap too late in the afternoon.
Also the final part is if you are struggling with sleep at night, if you're someone who has
insomnia or sleep difficulties, do not nap during the day. It's the worst thing that you can be doing because when we're awake
during the day, we build up a sleepiness chemical in our brain. It's called adenosine. And the longer
that we're awake, the more adenosine that builds up, the more adenosine that builds up, the sleepier
and sleepier that we feel. And when we sleep, the brain gets the chance to clear away all of that adenosine,
all of that sleepiness. And somewhere between seven to nine hours after sleeping a full night,
the brain has evacuated all of that sleepiness chemical, all of that adenosine, so that then we
should wake up and we should feel refreshed and restored and not needing caffeine to function. Why is that relevant to naps? Well,
it's relevant to naps because when you take a nap, you're essentially, it's like a pressure
valve on a cooker. You're just releasing some of that healthy sleepiness that you've been building
up. And therefore, if you are struggling with sleep at night and then you nap during the day,
it's terrible because you're taking away all
of that healthy good weight of sleepiness that we've been trying to build up on your shoulders
to give you the best chance of a good night of sleep. That's why I would say if you are
suffering from insomnia, don't nap during the day. Also, even if you don't struggle with sleep at night, try not to nap after about 3 p.m. in the afternoon or 2 p.m.
Napping late in the afternoon or in the early evening,
it's a little bit like snacking before your main meal.
It just takes the appetite off your sleep hunger.
So try not to do that.
But naps, for the most part, if you don't struggle with sleep,
they are wonderful things.
Just keep in mind the 20-minute sort of idea. You you mentioned caffeine there a topic i've mulled over over and
over again on this show um because as i've said to maybe three or four of my guests now
it feels like caffeine is a miracle drug that comes with no apparent cost but when i think
about things like anxiety and i know shallow sleep
states i've always pondered that maybe caffeine is playing a role in that you said you you're
you're pro caffeine you're a caffeine drinker yourself so i am not a caffeine drinker myself
but i am pro coffee oh okay and i'm i'll tell you why i'm very thoughtful about my wording between caffeine and coffee there.
And to your point, it's another astute one, which is, you know, is it a miracle drug with no cost?
In biology and medicine, there is almost no free lunch.
And that is true when it comes to caffeine and sleep so perhaps I'll give the skinny on caffeine
and how it impacts your sleep but then circle back around to what seems an oxymoronic statement for
me which is why I'm still pro coffee caffeine will hurt your sleep in probably at least three ways some of which you most people
are not aware of the first issue is the duration of its action so caffeine has what we call a half
life of about five to six hours in other words after about five to six hours half of that caffeine
is still in your system what What that means is that caffeine
has a quarter life of somewhere between 10 to 12 hours. So if you have a cup of coffee at noon,
at midday, a quarter of that caffeine is still in your brain at midnight. So having a cup of coffee
at noon, and it's hyperbole in truth, probably, or it's a little bit hyperbolic but it's almost the
equivalent of a coffee at noon is the equivalent of you know tucking yourself into bed and just
before you turn the light out you swig a quarter of a cup of coffee and you hope for a good night
of sleep and it's probably not going to happen so that's the first thing to keep in mind is the
timing of caffeine the second is that caffeine is a stimulant.
Now, everyone knows this.
Everyone knows that caffeine can make you more alert and more awake.
By the way, how does it do that?
It comes back to adenosine, which is the chemical that we spoke about, the sleepiness chemical.
It's no coincidence that those two things sound the same at the end of the name, caffeine
and adenosine.
Caffeine will actually race into your brain and it will latch onto the adenosine receptors,
the welcome sites in your brain. And it has very sharp elbows and it will force away the adenosine from those receptors and it will hijack those receptors. Now, at this point, you may be thinking,
well, hang on a second. If it's latching onto those sleepiness chemical receptors, shouldn't caffeine make you more sleepy? And the answer is
no, because what it does is it just latches onto the receptor and it inactivates it essentially.
So it masks the receptor. What caffeine does then is race into your brain you've got all of this sleepiness at 9 p.m or 10
p.m you have an espresso because you're trying to power through and finish the report or you know
the presentation for your sort of your pitch deck for your startup company and that caffeine races
in it latches onto the adenosine receptors and blocks the signal of adenosine. So now your brain was thinking,
I'm starting to get tired. It's 10 PM. But now all of a sudden that signal is blocked.
And caffeine is like hitting the mute button on your television remote controller. It just
mutes the signal of sleepiness. So now you think, well, no, I don't feel sleepy anymore.
And here's the danger that even though, well, when the caffeine is in your system and it's
latched onto the receptors, that adenosine is still there.
It's not going away.
In fact, if anything, during the course of the caffeine in your system, it continues
to build and build.
And now when the caffeine finally gets metabolized and excreted out of your system, not only do you go back to
the sleepiness that you had many hours before, it's that plus all of the adenosine sleepiness
that's been building up during that time in between. So you get hit with this huge tsunami
wave of sleepiness, and that's what we call the caffeine crash. So one of the issues so that's sort of caffeine in terms of how it works in its timing
another issue is that it creates anxiety just as you said and anxiety is probably one of the
greatest enemies of sleep it's one of the principal reasons that underlies insomnia is a physiological
state of anxiety that your fight or flight branch of the nervous system is ratcheted up that's what
caffeine will do it needs to do the opposite for you to fall asleep. That's why you can have what
we call the tired but wired phenomenon, where you say, I'm so desperately tired. I am so tired,
but I'm just so wired that I can't fall asleep. It's because your nervous system is too amped up.
Caffeine will trigger that amping up. Then at that point, if you're struggling to fall
asleep because you've got too much caffeine on board, it is what we call anxiogenic. So now you
start to worry. And the last thing you need to do when your head hits the pillow for good sleep is
worry. Because when you start to worry, you start to ruminate. And when you ruminate, you catastrophize.
And when you catastrophize,
you're dead in the water for the next two hours when it comes to sleep. Because we have this sense
that, you know, things at night in the darkness of night are so much bigger than they are in the
brightness of day. And we start worrying, you know, in this modern era, we're constantly on reception,
and very rarely do we do reflection. Unfortunately, the only time when we typically do reflection is when we turn off the light and our head hits the pillow, and that is the last time you want
to be doing reflection. So that's the second problem with caffeine. It's anxiogenic, and it
only makes you sort of almost like the Woody Allen neurotic of the sleep world.
The final part of caffeine is that it's very good at blocking your deep sleep.
So we've done a number of these studies where we'll give people a standard dose of caffeine,
let's say 150 milligrams, 200 milligrams, which is probably, you know, a cup and a half of good, strong coffee. And then we put you to bed and we look at the amount of deep sleep
and it will strip away your deep sleep by about somewhere between 15 to 30 percent
now to put that in context to drop your deep sleep by 30 percent i'd probably have to age you by about
40 years for zero or you could do it every night with an espresso with with dinner and that's one
of the problems that people will say dinner. And that's one of the
problems that people will say to me, look, I'm one of those people who I can have two espressos
with dinner and I fall asleep fine and I stay asleep. So no harm, no foul. Well, not necessarily
because even if you fall asleep and you stay asleep, you're not aware of the lack of the deep
sleep that you're not getting because of the caffeine. And so now you wake up the next day and you think, well, I don't remember having a hard
time falling asleep.
I don't remember waking up, but now I'm reaching for two or three cups of coffee the next morning
rather than my standard one cup of coffee because I don't feel refreshed and restored
by my sleep because I was lacking the amount of deep sleep.
And deep sleep, what does that rob us of?
The lack of deep sleep.
So lack of deep sleep, deep sleep is critical for regulating your cardiovascular system. It's the
time when we do replenish the immune system. It also regulates your metabolic system. So it
controls the hormones such as insulin that will regulate your blood sugar and you will become
blood sugar dysregulated without sufficient deep sleep. Upstairs in the brain, deep sleep will
strengthen and consolidate and secure new memories into your brain. They will prevent those memories
from being forgotten. Deep sleep is also the time when we cleanse the brain of metabolic toxins,
particularly the toxins that are related to Alzheimer's disease. So getting a lack of deep sleep is, I would say, a non-trivial thing in that regard.
But I don't want to be also puritanical here.
And this is where I'm going to change my title tune.
I am not here to tell anyone how to live their life.
I have no right to tell anyone how to live their life.
I'm just a scientist.
All I want to try and do is gift you the science and the knowledge of sleep so that you can make an informed
choice. And after all, and the same is true for alcohol too and sleep, you know, life is to be
lived to a certain degree. You know, no one wants to be the healthiest guy in the graveyard. I don't want to be that way too.
I want to live life just with moderation.
The reason I don't drink caffeine
is not because I'm so puritanical.
I want to be the poster child of good sleep.
I love the smell of freshly ground coffee in the morning.
It's a great ritual.
It's just that I've run my genetics
and I am one of
the slow caffeine metabolizers. So you can do these genetic kits online and they will tell you,
are you a slow metabolizer or a fast metabolizer? So that's the variability. That's why some people
say, look, I'm pretty immune to caffeine. Others will say, no, I'm not. Why do I now favor coffee? I was actually quite anti-caffeine in coffee when I first came
out with the book, just looking at the studies, but now the data is immensely compelling.
The health benefits associated with coffee are undeniable. Study after study after study,
and we can put them all together in this big, what we call a meta-analysis study.
And it is so strikingly clear that coffee,
drinking coffee is a good thing for you from a health perspective.
Two things to say about that.
The first is that it's got nothing to do with the caffeine.
And a lot of people have sort of rightly challenged me
to say, look, you say how problematic sleep can be when you're drinking too much caffeine. And a lot of people have sort of rightly challenged me to say, look,
you say how problematic sleep can be when you're drinking too much caffeine,
but yet coffee is associated with many of the same health benefits that sleep is associated with, but coffee is supposed to hurt your sleep. How do you reconcile those two, Matt Walker? And the answer is very simple, antioxidants.
Because it turns out that the coffee bean contains a whopping dose of antioxidants.
Things such as, it's what's got other things such as cathestol,
but it's got a bunch of incredible antioxidants.
Probably the most powerful of them in terms of the coffee bean
is something called chlorogenic acid. Now, don't worry, it's not chlorine, it's not chloride,
it's not bleach. Chlorogenic acid is very different. And what's happened in the modern
world is that we have and struggle with our diet so much because we don't eat enough whole foods etc so what's
happened is that the coffee bean has been now asked to carry the herculean weight of all of
our antioxidant needs on its shoulders and where most people get the majority of their antioxidants
is by way of drinking coffee. That's why coffee is
associated with so many health benefits. It's not the caffeine. Case in point, if you look at the
studies with decaffeinated coffee, you get very similar health benefits. Again, it's not the
caffeine, it's the coffee itself. So the bottom line here is drink coffee, but I would say the dose and the timing make the
poison. So try to limit yourself to about two cups of coffee, three cups of coffee maximum,
because if you look at the health benefits, by the way, it's a dose, it's not a dose response
where it's linear, where the more and more coffee you drink, the more and more healthy you become.
It peaks at about two to three
and then actually starts to go down
in the opposite direction
for lots of reasons that we can speak about.
So dose and the timing make the poison
when it comes to coffee.
So you drink decaf?
So I do drink decaf.
So I will drink coffee just because I love the smell
and I do enjoy the taste of it,
but I drink decaffeinated coffee.
I would love to drink caffeinated coffee too
because I'm sure it would be interesting
because I work out every day
and I work out every morning
and so many of the health coaches that I speak with
and health professionals say,
you know, you should definitely get a shot of caffeine
and it boosts your workout.
And actually the data on that is pretty clear too
that you're lifting for example in the gym and your metabolic activity is stronger when you've
had pre-caffeine doses but it's also stronger when you sleep but exactly and that's the problem so
and sleep is i would argue much more beneficial to health and if you're trying to work out or you're trying to
be an athlete or perform sleep will trump caffeine five ways till tuesday i mean sleep is probably the
very best legal performance enhancing drug that we know of that not enough athletes are abusing
one of the other sort of ongoing stereotypes that i've always wondered if it was wrong or right or whatever now i get a chance to ask you is about this culture of sleep medication
so i've got some friends who who might have i don't know prescribed sleep medication but i've
got a lot of friends also that use what they call sort of natural they always use the word natural
natural something so it's like natural sleep tablets yeah what's your perspective on
this culture of us of humans taking sleep tablets to get them to feel sleepy and go off to sleep at
night usually when people ask me that question personally the first thing i ask them is why is
it that you think you're not able to sleep and try to reverse engineer the question from there
before we even start thinking about sticking band-aids on wounds, I firstly want to ask what's causing the infection,
because we can keep bandaging it for all we like, but if it keeps festering, it's probably not going
to go away anytime soon. Is it a problem to keep bandaging it? It is a problem. Right now, we don't typically advocate sleeping pills as the first line defense agent against or for insomnia as a treatment. In fact, in 2016, the American call and again, this is me simply describing the science. This is me being descriptive of the science, not prescriptive in terms of medicine, because i'm not a medical doctor um but in 2016 the american
college of physicians they had a expert panel who surveyed all of the literature on classic
sleeping pills and what they suggested was that sleeping pills must no longer be the first line
treatment for insomnia it has to be cognitive behavioral therapy for insomnia or what we call CBTI,
which is a psychological intervention that we can speak about. But their recommendation was that
they found, I think their wording was small and of questionable clinical importance in terms of
the benefits of sleeping pills. Now, there is a time and a place in clinical medicine for sleeping pills, but usually as an
adjunct in combination with cognitive behavioral therapy, they are not advocated for long-term use.
So they're usually advocated for short-term use weeks. Most people have been on them for months,
if not years, these classic sleeping pills. And that's a problem because those sleeping pills are in a class of drugs that we call the sedative hypnotics.
And sedation is not sleep. For some subset of some people, there are some of these
quote unquote sleep supplements that may benefit. But overall, the studies are very clear. None of them are efficacious.
And when you think about it, it makes sense. If there was some cheap sleep supplement that you
could buy on Amazon, that was the Shangri-La of good sleep. That was this miracle sleep drug.
Don't you think that a pharmaceutical company would have patented it 20 years ago and be making
billions of dollars from it? That alone tells you all that a pharmaceutical company would have patented it 20 years ago and be making billions of dollars from it?
That alone tells you all that you need to know about, you know, these natural sleep supplements.
Cognitive behavioral therapy for insomnia, though, seems to be the kind of the front line of prescribed defense against a lack of sleep, insomnia conditions.
What exactly is that therapy aiming to do?
What does it
do for for somebody great question so in some ways that the title um tries to suggest what it what it
does but not particularly well perhaps so it focuses on cognitive aspects and it focuses on
behavioral aspects so for the cognitive aspects when we do cognitive behavioral therapy, working
with the patient, we'll try to focus on thoughts and beliefs and ideas around sleep. Do they have
anxiety around the bedroom? Most of them do. I can't sleep. Because I can't sleep. So every time
I walk into the bedroom, my bed is the enemy. And I look at the bedroom and I look at the bed
and I just know that that means
I'm going to have a bad night of sleep. So what's happened is that at that point, your sleep
controls you and you've lost all confidence in your ability to sleep. And we need to course
correct that. So one of the things we do in cognitive behavioral therapy is that we lower
that anxiety and we say, look, everyone has
a bad night of sleep, even a bad couple of nights of sleep. In fact, I will tell you, I don't sleep
perfectly well all the time too. I've had at least two very severe bouts of insomnia in my life.
We all have a bad night of sleep. It doesn't mean that tomorrow you're going to wake up with
depression or Alzheimer's disease. Don't worry, you're not going to get cancer, you know, just because you've had a bad night of sleep. So we start to change
people's misbeliefs about sleep. And we try to get them back from being catastrophic about this idea
of my not sleeping. So we, that's the cognitive aspect. We start to lower their anxiety around
the bed and the bedroom. We start to try to build confidence back. We start to lower their anxiety around the bed and the bedroom. We start to try to
build confidence back. We start to reduce their expectations about, you know, what is reasonable
sleep? Well, right now you're getting four or five hours of sleep and we can do better, but don't
start thinking that you need to get eight hours of sleep straight out of the box. Let's just manage
it. That's just because it's going to stress you out, right? only going to make matters worse right okay you know when you're struggling with sleep
in the middle of the night and you're wide awake you're laying in bed and you're thinking oh my
god i've got five hours left before i've got to go to work it's the last you know it's a little
bit like trying to remember someone's name the harder you try the further you push it away
so would you say and that's what do i do in that situation you it's 2 a.m in the morning you've got to be up at seven there's a flight you're getting on so whatever yeah what
should one do because from what i was reading in chapter 14 i was i was hearing that maybe i should
get out of bed or not just sit there and ruminate you know into the early hours of the morning or do
i stay in bed and do something what does does one do? The prototypical recommendation is that
after about 30 minutes of time awake, you should get out of your bed and you should just go to a
different room and do something like, you know, read a book or listen to a podcast. Don't eat
because it then trains your brain to wake up to do that. Don't stop working or getting in front
of a computer screen. You know, I said, listen to a podcast. Sure. You know, just make sure your phone's in,
you know, you don't start scrolling any more than that, but you can do relaxing things, stretch,
meditate. The reason is because if you start to spend a lot of time awake in your bed,
your brain is an incredibly associative device. And very quickly, it will start to learn that
this thing called your bed is this place where I'm always awake. quickly it will start to learn that this thing called your bed is this
place where I'm always awake and therefore you start to learn through this repeated loop of
behavior that I'm always going to be wide awake in bed and we need to break that association and
that's why we say get out of bed after about 30 minutes because you're just training your brain
to think that this thing called my bed is the place where I'm never asleep and we want to break that and only return to bed when you're sleepy and there's no time limit for
that and that way gradually it's much better because you will relearn the association that
your bed just as when you were young it was guaranteed that your bed is this place where
you will always be asleep the problem with that is many people don't want you know it's the middle
of the night it's dark it's cold I'm not I'm just not going to get out of bed so what's your other what else have you
got in your toolbox matt um at that point i would say okay that's reasonable the first thing i would
suggest is meditation you know i am a hard-nosed scientist. And when I was researching the book, I just thought,
this sounds all a bit woo-woo. And I live and work in Berkeley, California, which is kind of
the free speech, flower power movement, San Francisco, flowers and you have business.
I just thought, this is all a bit holding hands and singing kumbaya. This is not for me,
this meditation stuff.
I couldn't get away from the strength of the data. It was immensely powerful
regarding sleep and its benefits on insomnia and sleep. So I started meditating. And now I meditate
for 10 minutes before bed every single night. And I've been doing that for about four years.
So I would say if even
if it's in the middle of the night and if i wake up in the middle of the night i'll start to try
to walk myself through a meditation um you reference the listening to podcasts etc etc
you know doing something else to stimulate the brain i when i go to bed i have to have something
playing i say have to i shouldn't be that definitive i like to have something playing. I say have to, I shouldn't be that definitive. I like to have something playing,
some kind of sound or noise or whatever.
And much to my partner's dismay,
my content of preference is serial killer.
Podcasts or documentaries or just like something
which is really going to grab hold of my brain and focus me so something
like it has to be really interesting to me for me to be able to focus on it my partner is the
opposite again she likes um silence why do i listen to serial killers it's different for
different people's constitutions yeah yeah and psychologies uh and you know i can pathologize you all you like if
if you would wish me to but i would say it what's fundamentally going on here with meditation
and i'll come back to an alternative too but the reason why some meditation apps as well have now
started to do what's called sleep stories which in some ways is what you're doing a version of with your podcast,
is harks back to when we were kids. You know, for many parents, they would just read a book to their
kid, you know, the children's books, goodnight books, because you would read the child to sleep.
And for some reason, we, as we developed into adults, thought well we no longer benefit from having a story read
to us to help our sleep no it's not true we we benefit hugely in fact the the meditation company
calm you know was saved by the introduction of sleep stories into their app they were doing
pretty well as a meditation app but then they started to do sleep stories and it became a
unicorn company, um, in terms of its valuation, it broke a billion dollars and it was on the,
the back of sleep stories. And what they realized is that people were self-medicating their insomnia
by way of meditation. So they latched onto that. And then they found that these stories,
sleep stories were great. And you've got now wonderful people, people who you've interviewed on the show. So what you're doing and what those
sleep stories are doing and what meditation is doing, it's all the same thing, which is that
it is taking your mind off itself. Because when you are struggling to sleep or you've woken up
in the middle of the night, what you don't want to be
doing is focusing on either what you what you what did i do today what did i not do today what did i
do poorly oh my goodness what have i still got to do tomorrow and at that point things are just a
disaster you're wide awake what all of the things that we've just discussed do is they take your mind
off itself and at that point then you start to allow sleep to come back naturally that's why
one of the other suggestions is take yourself for a mental walk so don't count sheep by the way that
doesn't work a colleague of mine at UC Berkeley did the study. It actually takes you longer to fall asleep if you're counting sheep. What she found at Dr. Alison Harvey was
that if you just close your eyes and you think about a walk that you take frequently, let's say
it's a walk with the dog, and you think about it in high fidelity detail. So I close my eyes,
I go out the door, take a left down the steps, then I'm going to go up the street.
I take the first left past that pine tree.
That's the level of detail. If you just walk yourself on that mental walk,
sure enough, people fall asleep in about 50% less time,
half the time it takes.
This is the thing with sleep stories
and also my serial killer documentaries
or serial killer podcasts that I listen to, detail.
Exactly.
You get, even i've listened to
calm's sleep stories before and the attention to detail in that sort of descriptive nature of what
they're saying is so apparent they'll say things like the cold wet windowsill saw the raindrops
like um tapping against it one by one by one by one and that sounds very similar to my serial killer
documentaries when i hear about the serial killer coming in through the window yeah yeah yeah at
nighttime um and i wondered why the descriptive nature of it the detail matters for dozing us off
and because it prevents i mean you've got limited bandwidth in terms of cognitive capacity right and
if you're consumed and you saturate your bandwidth
with that level of detail, it's very hard for any of these other things called our worries
and our anxieties to start entering into our mind. The other thing I would note by the way, though,
is if you are, if none of these things are working for you, if the fictional notion of
serial killing is not working for you, if meditation is not working
for you, if going on a mental walk is not working for you, this is the final suggestion I have.
If you're lying there awake, firstly, by the way, if you're struggling with sleep, remove all clock
faces from your bedroom. It's one of the best pieces of advice I can give you. Knowing what
time of night it is, is no favor. So knowing now that it's 3.23 a.m. in the morning
and I'm still struggling to fall asleep. And then I look back at the clock and it's now 4.03 a.m.
and I've still been awake and now it's 4.27 and I've got to wake up at 6.30 a.m. Knowing that
has no utility for you. Remove all clock faces from your bedroom it is a gift
but coming back to the final suggestion if you don't want to get out of bed you don't want to
listen to a podcast the final thing i would say is just accept and say look it's okay tonight
is not my night it is not the worst thing in the world. And instead of trying to sleep,
all I'm going to do here is lie in bed and I'm just going to rest. Because wouldn't it be lovely
if someone came to you in the middle of your workday, you're just stressed and someone said,
by the way, just come into this room. There's a bed here. Just lie down and just rest for an hour wouldn't it be lovely just have
a good old rest for an hour just rest there and i would say that if you can't sleep just lie in bed
stop worrying about sleep and not being able to get it stop worrying about the next day
just lie in there and enjoy a nice good old rest and by the way usually what happens is that after you start
thinking okay i'm going to rest the next thing you remember is the alarm clock going off at 6 30
because finally you stop trying and sleep happens so of course you know prolonged one of the things
i've also i wonder if this is a if i'm wrong about this is i sometimes thought that you know i could
go monday to friday and kind of sacrifice my sleep this was specifically when i was really in the if I'm wrong about this is I sometimes thought that, you know, I could go Monday to Friday
and kind of sacrifice my sleep. This was specifically when I was really in the height
of like running big businesses, et cetera. And then on the weekend, I'll just make up for it.
So I thought, you know, I could go Monday to Friday. I'll sleep maybe sometimes two hours a
night, three hours a night, whatever. Then Saturday, you know, I'll just do a, you know,
11 hour sleep and I'll just make up for it yeah is that a good strategy the delightful laughter at the end of your sentence that um i think
probably tells you the answer that you know um unfortunately sleep doesn't work like that it
would be nice if it did sleep is not like the bank in other words you can't accumulate a debt
as you were doing during the week and then hope to try and pay it off at the weekend um so for
example let me take an extreme version of that experiment let me take you tonight i'm going to
deprive you of sleep for an entire night for let's say eight hours of sleep and then tomorrow night
i'm going to give you all of the recovery sleep that you want as much as you wish for. And then the next night you can have all of the
recovery sleep that you want. And even on the third night, will you sleep longer that first
recovery night after a night of no sleep? Absolutely. You will sleep longer, but across
those three or four recovery nights of sleep, will you get back
all of the sleep that you lost? Not even close. You'll maybe only sleep back about four, four and
a half of the eight hours that you lost. In other words, by that stage, you are four or three and a
half hours in overdraft on your sleep bank account. You went into debt and you only paid about 50% of it back.
So what's happening with you during the week is that you're accumulating this debt, you know,
of maybe 10 hours, you shortchange and you're only sleeping like six hours a night for the five
nights during the week. And then you binge on sleep and you try to maybe sleep 10 hours or 11 hours, that's only two or three extra hours. So some
total, that's only four to six hours of made up sleep relative to the 10 hours of debt.
So what happens is that that next week, you now carry forward four hours of your debt.
And then the next weekend, you try to sleep it back, but you're still four hours lost.
So now you've got eight hours of net debt. In other words, what develops is into a compounding
interest on a loan. It just starts to escalate ballistically across weeks, across years,
and across the lifespan. And then what happens in terms of health outcomes? So say that I did
that for a couple of years, say that I sustained that pattern of you know depriving myself of sleep throughout the week maybe catch up on saturday depriving
myself again the next week catch up on sunday deprive myself the next week and i did that
pattern for multiple years what would be the health implications so you can describe them
short mid and long term the first thing i would say though, is that the elastic band
of sleep deprivation will stretch only so far before it snaps. The short term, you know, probably
the most immediate short term consequence is that you are popped out in a driving related accident,
drowsy related accident. Because drowsy related accidents are non-trivial they make up a large proportion of
accidents on our streets in terms of human errorful driving when you say popped out out of the gene
pool okay so what happens is that when you are underslept you're at the wheel and you start to
have what we call micro sleeps where your eyelid will partially close now
you are not aware of it you have no awareness of it whatsoever and in fact parts of your brain seem
as though they're almost falling asleep like you're having this micro sleep and it lasts for
about a second or two seconds now if you're on the motorway and you're traveling at 70 miles an hour
and you have a two second micro sleep that's enough time for you to drift from one lane into
the next. If you're just in a two, on a two lane, you know, sort of back street where there's
oncoming traffic in the other direction and you're traveling at 40 miles an hour and you drift half
the way into that lane, that's oncoming traffic. So in other words words if you have a micro sleep at 60 or 70 miles an hour
at that point there's a two-ton missile traveling at 60 miles an hour and no one's in control
and that may be the last micro sleep that you ever have in your life
obviously all the other things you've mentioned would be implications things like performance drop
sort of memory relationships libido would all drop off so i
wouldn't be having as much sex i would you want all those things then midterm so midterm then
you're going to escalate those things into more disease state so for example if i were to take an
individual and uh people have done these studies not not we but um where you limit them to let's
say four or five hours of sleep for one week your levels of blood sugar are disrupted so significantly that your doctor
at the end of that one week would classify you as being pre-diabetic. So that's, you could almost
argue that short-term, not mid-term. You know, one, if you're a male and I limit you to four or
five hours of sleep, healthy young male for one week, I will drop your levels
of testosterone to that of someone who is 10 years older than you. So I can age you by a decade
just by short sleeping you for one week. We see equivalent impairments in female reproductive
health in estrogen, luteinizing hormone, and follicle stimulating hormone. So it's both men
and women. Your blood pressure will start
to creep up. Your systolic blood pressure in particular will creep up. Your heart rate in
terms of its contraction rate, in other words, the speed of your heart starts to increase.
The progression into obesity, diabetes, cardiovascular disease, mental health issues, anxiety, depression, suicidality,
all of these things, immune compromise, infection, all of those things can be termed, you know,
will be midterm. Now, all of those things have a longer term tail to them, which is this thing
called premature mortality. So using that sweet spot of seven to nine hours of sleep, you can
argue that there's a simple truth on the basis of the seven to nine hours of sleep, you can argue that there's
a simple truth on the basis of the data. The shorter your sleep, the shorter your life.
That short sleep will predict or cause mortality. Is that supported by data?
That's supported by data, yeah. Now, there's an interesting change there, which is once you get
past about nine or 10 hours, your mortality risk doesn't just keep going down and down. It will hook back up again,
as if almost too much sleep is a bad thing. And we can explain why that is the case as well,
and why it's probably not quite as simple as that. But the final long-term consequence that I would
say is Alzheimer's disease. Now, the two most feared diseases in developed nations are cancer
and Alzheimer's disease. Both of them have links to insufficient sleep, many of them causal. And this relationship between sleep and Alzheimer's
disease, this is where we actually do, I'd probably say almost 50% of the work that I do at my sleep
center is focused on sleep and Alzheimer's disease. And there the data is stunning. I would say
at this stage, insufficient sleep seems to be one of the more or one of the most significant
lifestyle factors that can develop or dictate the development of alzheimer's disease later in life
now that's a lifestyle factor there are other genetic factors but certainly we now know that
it's not just that insufficient sleep predicts a greater amount of Alzheimer's
pathology in your brain. So for example, people who on average are sleeping six hours or less
have a far higher magnitude of beta amyloid, which is the sticky toxic protein related to
Alzheimer's disease, and another protein called tau protein. These are the two protein culprits
of Alzheimer's. Both of those
are escalate the less and less sleep that you have. Now that's just associational. We also know,
by the way, that two sleep disorders, insomnia and sleep apnea, heavy snoring, both of those
are associated with a marked increased risk of your Alzheimer's disease, of Alzheimer's disease
later in life. That's simply associational. That doesn't prove causality,
but we now have the causal evidence, both in animal models and in human models. If I deprive
a human being of sleep for a single night, or I just deprive you of deep sleep for a single night,
the next day we can see an immediate increase in these Alzheimer's disease-related proteins
circulating in your bloodstream,
circulating in what we call a cerebrospinal fluid that bathes the brain, and using special brain scans, we can even measure it within the brain itself. So these are causal manipulations. It's
not associational. I manipulate this thing called sleep, and the consequence is that I manipulate
your Alzheimer's disease proteins. That correlation going to
causation, then the question is, well, mechanism. What is it about sleep when you get it that is
de-escalating Alzheimer's disease risk? In other words, when you don't get it, why would it
increase your Alzheimer's risk? And this was a stunning discovery made by a scientist called
Makan Nedegard at the University of Rochester here in America. And she found three things. First,
studying mice and rats, she found that the brain has a cleansing system. Now, we didn't
used to think that your brain had a cleansing system. Your body had one, and everyone knows
what it's called. It's called the lymphatic system. We didn't think the brain
had one, but she discovered that the brain has one. It's called the glymphatic system,
named after these glial cells that make it up. The second thing that she discovered is that that
cleansing system within the brain is not always switched on in high flow volume across the 24
hour period. It was expressly during sleep and particularly during
deep non-REM sleep when that sort of sewage system was put into overdrive and washed away
all of this detritus that built up during the day. And the final thing that she discovered,
and this is why it's related to Alzheimer's disease, is that two of the metabolic byproducts that build up during the day in our brain are beta amyloid and tau protein,
the two bad actors in Alzheimer's disease. So in other words, what she discovered is a system of,
you know, good night, sleep clean. That sleep is a power cleanse for the brain.
And if you're not getting your sleep every night, you know,
it doesn't mean that you're going to get Alzheimer's disease next week. It doesn't mean
that you're going to get Alzheimer's disease, you know, in a year's time. But night after night,
once again, it's like compounding interest on a loan. And that's why we now believe through this
causal mechanism that insufficient sleep is a risk factor for Alzheimer's disease.
Lots of people will say to
me, look, there are these individuals in society who claim that they, you know, didn't need very
much sleep, who didn't sleep a lot. You know, Margaret Thatcher has often quoted me, quoted to
me about that. You know, Ronald Reagan was apparently another short sleeper. I don't think it's coincidental that both Thatcher and Reagan
went on to die of the unfortunate disease of Alzheimer's.
I'm sold.
Sleep is important, I get it.
I'm sold.
How do I...
My question is, what are the things that in the modern society are standing
in the way of sleep we've touched on some of them loosely but some of the like big obvious things
the things that you would suggest doing very actionable things we could do straight away
to improve our chances of having that healthy um deep sleep that we need to be optimal in every regard of our health and performance.
There's probably, I think, five standard tips, what we call sort of sleep hygiene that you can
do. And then I'll come on to maybe just some unconventional tips that we've sort of touched
on. And we've spoken about many of these. The first thing I would recommend people to do,
this is why when some people say, what about this new sleep supplement? Or, you know, it's 40 quid for this bottle of these new sleep natural medications. I'm going
to give it a try. I would say, try these tried and true things first before you spend your money
on supplements. The first thing is regularity. Go to bed at the same time and wake up at the same
time, no matter whether it's the weekday or the weekend,
your brain expects regularity. It thrives best under conditions of regularity. When you give it regularity, you can improve the quantity and the quantity of your sleep. The second thing is
get some darkness at night. As I said, we don't get enough darkness in the modern world. And so
the trick I would offer, and I don't use it, I don't like
the word hack, but the sort of suggestion would be in the last hour before bed, try this experiment
for everyone listening for the next week, dim down half of the lights or switch off half of
the lights or even three quarters of the lights in your home in the last hour before bed.
All of the lights in every room.
In all of the rooms, you know, switch off almost all of the light. Now I'm not suggesting be
unsafe and walk around in the darkness in the last hour. That's not what I'm saying.
Just dimmed out, you know, switch off half of the lights. You will be surprised at how sleepy
that darkness will make you feel. And it's also an incredible behavioral
trigger to signal to your brain that it is time for sleep, that darkness is around me. That's the
second tip is darkness. The third tip is temperature. Most people sleep in an ambient bedroom temperature that is too high. And you
need to aim for a bedroom temperature of about 18, 18 and a half degrees Celsius, around about
65 to 68 degrees Fahrenheit, if I'm probably butchering the mathematics there on that. But
you need to get cool. Now you can wear thick socks, you can have a hot water bottle, that's fine, but the
ambient needs to be cold because you need to drop your core body temperature and your brain
temperature by about one degree Celsius to fall asleep and stay asleep. And it's the reason that
you will always find it easier to fall asleep in a room that's too cold than too hot. So make your bedroom cold make it dark like a cave the the fourth question would be sort of
what we've or fourth suggestion would be walk it out and we've spoken about this the 30 minute rule
you know get up do something different or meditate you know don't lie in bed awake for too long
then the final two things we've spoken about well we've spoken about caffeine
we haven't spoken about alcohol but let me just say as the kind of headline of it alcohol is not
a sleep aid many people use it as a sleep aid it is not your friend alcohol again is a sedative
so it knocks you out the second is that it fragments your sleep so you wake up your sleep
is littered with all of these small awakenings. Most of them you don't remember because they're too brief, but it makes for miserable, lousy quality sleep. And the final
thing is that alcohol is very good at blocking your REM sleep or your dream sleep, which we know
is critical for many other functions as well. So alcohol is not your friend. That's the sort of the
final tip. Again, you know, just every, if you're with friends, have a glass of red wine, just know,
okay, my sleep's not going to be great.
No, thank you, Matt.
I'm joking.
You know, I'm not, yeah, I'm, it's just, you know, live life too.
Of course, yeah.
I'm not saying that.
I was, I was thinking there about the other sort of behavioral things that we do that
harm our sleep as well.
We talked about coffee earlier on, avoiding that.
It's weird that people drink it after dessert in the evening so i never understood that i guess that's
an old tradition um but the other thing obviously that the modern generation are even more susceptible
to is to have a quick tiktok look at the social media account or something now i thought you know
there's a lot of different products out there that are trying to help with the the light that
comes from these screens that i think is the cause of what's keeping us awake but there's this
little button called dark mode on my ipad there's also one called night shift so if i just pop that
on bob's your uncle and this and i can crack on with my screen time true or false partly true oh good okay so i can just pop that on night mode in dark mode and then
i can carry on using my ipad partly true so it turns out that the blue light from screens does
have an impact on sleep so there's a great study done by harvard medical school by some colleagues
there and they showed that reading for an hour on an iPad just before bed,
relative to just reading a book in dim light. Firstly, it delayed the time with which people
fell asleep. So it took them a lot longer to fall asleep. Second, it reduced the total amount of
sleep that they had. Third, it decreased a sleep related hormone called melatonin. It delayed the
release of that melatonin and it reduced the amount of melatonin.
And finally, it reduced the amount
of rapid eye movement sleep.
So it had-
Significantly.
Significantly.
The melatonin point, how significantly?
So it delayed the release by about
somewhere between 90 minutes to two hours
across the individuals.
So in other words, your brain wasn't,
so what melatonin does,
it's called the hormone of darkness or the vampire
hormone just because not because it makes you want to bite into people's necks because it signals to
your brain that it's night time that it's darkness and so your brain needs the signal of melatonin
for it to understand when is it dark in other words it needs to understand by way of melatonin
when it is time to fall asleep and when you're bathed in electric light at night, and especially when you're getting
blue light from these devices, your brain is fooled into thinking it's still daytime. And when
there is light emitting through your retina coming into your brain, it signals to a part of your brain
to hit the brakes on melatonin and your brain will not release
melatonin. So what was happening with this iPad reading is that you were artificially telling the
brain it's still daytime and the brakes on melatonin was still shut on. And so melatonin
was not starting to be released until much later. And what was also interesting about the study,
by the way, is that when they stopped the iPad reading, the sleep disrupted pattern continued for several days later.
In other words, it was almost like a drug that it had a washout period that was a blast radius to it.
Now, there's been some great work by a wonderful sleep scientist in Australia, Michael Gradozar.
And he has added to this story.
And he said, it's not just the blue light these devices the principal
function of these devices is that they are attention capture devices just like you said
i'm just going to have a wee little tiktok before bed they are in the attention economy
and all they care about is capturing your attention for current currency and they make
a lot of money from it what that attention does is that it stimulates your brain and when your brain is
stimulated it's very difficult for you to fall asleep and it creates what we call sleep
procrastination where you're lying in bed and you could be perfectly sleepy and you could fall asleep
right now but then you sort of check social media and you think, oh, I'll just shoot that last email. Oh, then I'll order that last thing on sort of, you know, Amazon. And then you get a
text back from your friend and you start texting them. And then you look up and it's now an hour
later and you're an hour deficient on sleep. So it's the activation of your cerebral cortex by
these devices that is perhaps the more harmful aspect of them regarding
your sleep. Now here again I don't want to be finger wagging you know the genie of technology
is out the bottle and it's not going back in any time soon there's nothing that I'm going to say
as a sleep researcher that's going to change that. I don't take my phone into my bedroom. I put my phone out in the kitchen
and I don't see it until morning.
But lots of people do and fair enough.
But there's another rule
that I've stolen from another friend
called Michael Grandner,
who's here in America at the University of Tucson in Arizona.
He has this great rule regarding technology
and it's the following,
that if you really must take your phone into your bedroom you can only use it standing up and what you'll find
is that after about six or seven minutes standing up you think i'm just gonna i'm just gonna sit
down on the bed and at that point as soon as your backside hits the bed you're done you've got to
put the phone away i think it's a great rule of thumb if uh if you need to take technology in the bedroom um i'm going to apply
that the other thing i wanted to ask was about sleep and weight loss i've had a lot of health
experts on this podcast recently but none of them have really talked to me about the role that sleep
or sleep deprivation plays in weight is there a relationship it's probably one of the most well defined relationships
that we know in all of sleep science and it is at least a three-part story so the first emerging
evidence came in terms of hormones so there are what we call appetite regulating hormones and the two principal ones
of concern here are something called leptin and ghrelin. Now leptin when it's released will signal
to your brain that you're satisfied with your food, you are satiated and you are no longer hungry.
Ghrelin does the opposite. When ghrelin is released, it says, no, you're not
satisfied with your food. You are not full. You still want to eat more. You are still hungry.
And some of the first studies, they started to just limit people, restrict people's sleep to
six hours or five hours or four hours. And what they found was that there was firstly that signal leptin that says,
no, you're satisfied with your food. You don't want to eat any more. You're full.
That signal of fullness, satiation, was decreased by 18%. If that wasn't bad enough,
ghrelin, which is the hunger hormone hormone that leapt up by 28 percent overall hunger levels rose by about
at 26 percent so firstly you are it's almost like double jeopardy that you are getting punished
twice for the same crime of not sleeping enough once Once by losing the signal of I'm full,
I don't want to eat anymore.
And once again for the, no, I'm much more hungry
and I'm just going to overeat, which is ghrelin.
So what that produces is a profile of increased eating.
So on average, underslept individuals
started to eat in those studies about three to four hundred extra calories at each sitting by way of insufficient sleep.
Then what they discovered is that it's not just that you want to eat more, it's what it is that
you have a craving for when you are underslept. And this is the problem.
What they found is that when you are underslept,
you eat more of everything, but you especially eat more
of these heavy hitting stodgy carbohydrates,
bread, pasta, pizza.
The next thing that you started to eat,
have a preference for was simple sugary foods,
sweets and chocolate.
And then finally you started to crave very salty food
and high sodium food intake
will increase your blood pressure.
So that was the first of the three mechanisms.
Then we did a study where we said,
perhaps it's not just the circulating hormones in the body,
the brain is the ultimate arbiter of your food decisions.
So what's going on in the brain? So we took a group of perfectly healthy individuals and we put them through the experiment
twice. Once when they'd had a full eight hours of sleep and once when we deprived them of sleep.
And then the next day we placed them inside an MRI scanner and we showed them images of lots of
different foods that range from being sort of, you know, very healthy to being very
unhealthy and sort of ice cream and, you know, chocolate and pizza and things to leafy salads
and nuts and greens and vegetables. And we asked them to rate how much they wanted that food for
each item. Now we did something a bit sort of dastardly to make it more ecologically correct so that they weren't just saying,
okay, they probably think I should probably say that's healthy.
We said, we're going to randomly select one of these images, these food images that you see.
And after you get out the brain scanner, we're going to give you that food and we're going to politely ask you to eat it all.
So it made it a bit more realistic.
So the choices were more, you know, as much as that we could. So what we found is that when they were sleep deprived, the deep hedonic centers, the emotional centers of the
brain, these desire centers, these reward centers, they ramped up in their activity in response to
these highly desirable, highly unhealthy foods. So these more basic sort of, you know, guttural parts of the brain, as it
were, these reward centers were lighting up much more strongly when you were sleep deprived. Worse
still, the impulse control regions in the front of the brain, what we call the prefrontal cortex,
they were shut down, they were taken offline. So as a consequence, you lost your impulse control.
And that's why you start to then
say, you know, when I'm sleep deprived at the food sort of buffet, I'm not going to do salad.
I'm just going to, that pizza looks awful good, or that pasta with the cream. I'm just going to go
into that, all go. So it's what we call a pattern in terms of brain activity in neuroscience of hedonic eating,
that your brain goes into this hedonic desire profile. So now we understood it's not just
hormones in the body, it's also changes in the brain. Then came the finding that there's another
chemical in the body that's responsible. And this comes on to cannabis when people um when people when people that you may
know have smoked cannabis they'll often say i get viciously hungry i get the munchies i get really
hungry that's no coincidence because cannabis will stimulate Now, we all have naturally occurring cannabis compounds in our brain and our bodies.
They are called endocannabinoids.
Endo meaning comes from insiders, whereas the cannabis that comes externally when you
sort of smoke it or take edibles.
So endocannabinoids do many things for the brain and the body, but one of the things
that they do is control your appetite and your hunger. And what we found is that when you sleep
deprived individuals, these naturally occurring endocannabinoids rocketed up by over 20%,
cranking up people's appetite. And so these three ways lead you to start packing on you know when insufficient
sleep is occurring when sleep gets short your waistline typically starts to expand and we now
understand the reasons if that wasn't bad enough it is bad enough the final yeah you just stop
honestly i've really uh the The last thing that we discovered
is that let's say that you're trying to be really careful and you're trying to diet and you're
trying to lose weight. If you're not getting sufficient sleep, then 60% of all of the weight
that you lose will come from lean muscle mass and not fat. Not muscle i know exactly so in other words when you are
dieting but you are underslept you lose what you want to keep which is muscle and you keep what you
want to lose which is fat so again it's i'm sold not an ideal situation my last question for you
in fact was of all the subject
matter we've talked about what is the most interesting thing we've missed in your view
the thing that you think is most pertinent or interesting or significant or
perks people up or sits them on the end of their chair when you discuss it
i think the only other area that fascinates people even more than sleep is dreaming.
So dreaming above and beyond the stage of which it comes from, which is principally called rapid
eye movement sleep or dream sleep. REM sleep provides a set of physiological and benefits,
but dreaming we've now discovered,
even above and beyond that, provides benefits.
And it provides at least two benefits.
The first is creativity.
I was telling you that during deep sleep,
you cement individual memories.
You grab memories and you shift them
from a short-term storage reservoir
to a long-term storage reservoir.
And you strengthen the circuit of those memories.
So you future-proof information. But that's individual memories. What we discovered is that sleep is much more
intelligent than you ever thought possible. That it's during REM sleep, and particularly during
dreaming, that we take all of the individual pieces of information that we've been learning,
and we start interconnecting them and associating them with all of our back catalog of stored information.
And so what dream sleep, one of the functions of dream sleep, is to cross-link and associate new memories together.
So you wake up the next day having, after dream sleep, with a revised mind web of associations.
And those are capable of divining solutions to previously impenetrable
problems. So think of dreaming as, it's almost like informational alchemy, that you start to
fuse things together that shouldn't normally go together. But when they do, they cause marked
advances in your thinking, in your productivity, in your ingenuity. And in that way, you go to sleep
with the pieces of the jigsaw,
but you wake up with the puzzle complete.
And I would argue that that's the difference
between knowledge,
which is remembering the individual pieces,
and wisdom, which is knowing what it all means
when you fit them together.
That's one of the functions of dreaming.
It's the reason, by the way, that you've never been told to stay awake on a problem.
The other function of dreaming that we know of is that dreaming provides a form of emotional first aid.
That we've done a lot of work and we came up with a theory that was called dreaming as overnight therapy.
And what we've discovered is that when we go into dream sleep, particularly based on its neurochemical profile and its physiological anatomy of the brain, the dreaming brain will
take difficult, painful experiences, sometimes traumatic experiences, and it will essentially
strip away the bitter emotional rind from the informational orange.
So let's take a step back.
What makes a memory emotional?
What makes a memory emotional is that at the time of the experience, that experience triggered
a strong visceral reaction.
And that visceral reaction is useful to the brain.
And it wraps that experience in this blanket of what we call emotion.
It red flags it and prioritizes it in the brain.
So now you've created a memory of an emotional event. In other words, you've created an emotional
memory. But what dream sleep does is then it takes that useful emotional memory and it will detox the
emotion from the memory. It strips the bitter emotional rind from the informational orange.
It's almost, and that's why we called it overnight therapy, so that the next day you come back and
now you feel better about those experiences. So you have a memory of an emotional event,
but it's no longer emotional itself. You don't regurgitate that same visceral reaction that you had at the time of learning.
So the brain has done this elegant trick
of stripping the emotion from the memory.
So that's the second benefit,
is that it provides,
it's not time that heals all wounds.
It is time during sleep,
and particularly during dream sleep,
that provides
emotional convalescence it's funny because there's a stereotype that we should never go to bed angry
at each other you will wake up far less angry as a consequence matt we have a closing tradition on
this podcast where the last guest asks a question for the next guest not knowing who they're gonna
ask it for um the question that's been left for you from our previous guests obviously they don't know who they're leaving it for but it's a very i
love these questions when they're challenging um what is the biggest way in which you are a
contradiction gosh i'm a contradiction in so many ways i think i'm a contradiction in the sense that within my profession with
this field of sleep, I feel very comfortable. I'm reticent to say confident, but I am very
comfortable to get on stage, you know, give a TED talk in front of a couple of thousand people
and my heart rate will be very stable. I probably, I probably don't feel, I feel more myself on stage alone in front of
thousands of people than I do at any other time in my life. That's where I feel most myself.
But yet I'm a contradiction because off stage I'm very insecure. I am very much an introvert. I'm very shy. Um, I don't like being
the focus of attention. And so those two things I've often wrestled with, but the more people
I've spoken to sort of now being out in the public sphere and sort of, sort of being more in the sort
of public intellectual realm, you start to meet, meet you know very famous people and you meet you know musicians and and what you learn is that they're very similar
that they say that they become this version of themselves on stage and then when they're off
stage they are a radically different person but i am such a contradiction in that sense. I feel very comfortable and very secure on stage
in front of thousands of people. And for many people, public speaking is one of the most
anxiogenic things you can ask anyone to do. But for me, heart rate is probably in the,
you know, mid forties, uh, very relaxing for me, but then put me in a in a room you know small room of a couple of people
my heart rate's probably through the roof and i've become very introverted so i'm a contradiction in
that sense um yeah matthew thank you thank you for for making the time today i've i've i've wanted
to speak to you for many many years and you absolutely never disappoint anybody so you're
it's very kind of you to say it's exceptionally important work and as you said at the start of
this conversation we often neglect the medicinal properties of a great night's sleep over things
like diet and medicine or exercise whatever whatever else it is but your your voice and the
the passion that sits behind it has led a a charge in society which is waking us up no pun intended to the um
the virtues and the power and the importance of having a great night's sleep but in a nice way
in a way that i find it really empowering and actionable and that's the most important thing
so thank you for that matthew thank you and thank you for saying that last part especially i i don't
think i can um lay claim to that sort of early on I think I'm doing much better as much better. I'm
doing a little bit better as a public communicator and being less puritanical and dictatorial in my
sleep message. I think I did a terrible job coming out. I'm learning and I'm being more sensitive,
but I'm always lovely to hear feedback from folks about what I'm not doing well, because
I would love to do this better and better if I can. But thank you for saying those kind words.
And thank you again for having me on, giving me this opportunity to speak.
I now will anoint you as a sleep ambassador from this point forward.
So thank you so much again, Stephen.
Thank you.