What can a sleep study diagnose
I want to start by asking you to imagine yourself in the following scenario: you are a high school senior or the parent of a high school senior, and you’re interested in a potential college, and so you arrange for a campus visit.
And you go on a campus tour, and everything looks great, and the people are friendly, but after a few minutes, something strange dawns on you: that this campus has a horrible smoking habit. Everybody you see is smoking outside; everybody smells like cigarette smoke. You go to have lunch in a dining hall, and students are bragging about how much they smoke.
One student says, “Yesterday, I smoked three packs all by myself!” And another student says, “Nice! I did that last week. High five!” And you think to yourself, “Well, this is strange. This is an otherwise great school, but they have a weird bad habit, and they’re oddly celebration about it. So I’m not sure I want to go here.” So imagine, you go on a second campus tour, and you look at a second college, and it’s very similar to the first: the campus looks beautiful, people are friendly Except this college has a bad junk food habit.
Everybody you see is eating junk food, there are junk food wrappers everywhere, there’s nothing nutritious to eat in the dining hall. And again, people are bragging about how much they’re eating. So, one student says, “Last night, I had a whole pizza by myself.” And another student says, “Nice! I did the same thing last week. High five!” So, if these two scenarios sound a little far-fetched, imagine a third scenario as you go visit another college.
And again, it looks great; the people are friendly, except that at this college, everybody looks tired. You see people falling asleep at their computers. You visit a class and people are dozing off in class, and it just seems like everyone could use a great nap, right?
So, what’s crazy to me about this is that I’ve never seen a campus full of people who are all smokers, or a campus full of people who are all sleep-deprived, but a campus full of people look tired and – or, sorry, a campus full of people who all eat junk food, but a campus full of people who are all sleep-deprived and tired describes every college and university I think I’ve ever seen, and most high schools, especially during later parts of the semester.
The effects of being sleep-deprived
What’s interesting is that the effects of being sleep-deprived all the time can be just as bad as smoking and just as bad as eating too much junk food, and yet lots of students would go to a college where everyone looks sleep-deprived because it looks like it’s a hard-working college, where people are very productive and achieving great things.
And so, as a sleep researcher, I’ve been fascinated by the biology and neuroscience of sleep for over a decade, and I have a lab at Williams College that studies mice. We look at what happens in the brain and the body during sleep. We look at how the neurons in the brain control sleep.
But I have to say, as a father, as a teacher, and as a colleague to a lot of hard-working colleagues, hard-working people, I have a new-found fascination for how we tolerate sleep deprivation as a society. And it’s not just students in our schools. It’s really everywhere. Whenever a ride public transportation, whether it’s a bus or a subway, I see people who just look exhausted.
And in fact, you can see people taking naps on their morning or afternoon commute and sneak them in. In our public life, it’s really not uncommon to see people dozing off, and in our public and professional lives, people just look exhausted. But something is even crazier than that to me, which is that not only are people fatigued, but some people be sleep-deprived and some people wear it as a badge of honour, right?
Because to be sleep-deprived, you must be hard-working, you must have a lot of essential things to do, and you must be very, very productive, or else why would you be sleep-deprived in the first place? I’ve been a part of job committees where job applicants will brag about the fact that they only get three or four hours of sleep a night.
And actually, just two months ago, I was looking at Facebook, and one of these memes that somehow only shows up in your feed for no reason, I read it – it had tens of thousands of lives, and it said, “No one looks back on their life and remembers the nights they had plenty of sleep,” the implication being that if getting plenty of sleep, you’re missing out on your life’s greatest potential and in all the things that you could be doing.
And so, this is interesting to me, and I wonder if people would brag about the fact that they’re not getting enough sleep if they knew that the health benefits of getting sleep were just as important as the benefits of not smoking or the benefits of eating good nutrition and not eating junk food. Sleep scientists have made so many great discoveries over the past 10 years, and I’m surprised that more people don’t know about them. So here are just two examples, and you must excuse me because I’m a biology professor.
So when you’re sleeping, your pituitary gland, which is right below your brain, surges its production of growth hormone. It releases growth hormone much more when you’re sleeping than when you’re awake, and growth hormone causes three effects: muscle growth, bone growth and fat metabolism.
How many people would take a pill that caused muscle growth, bone growth and fat metabolism? If there was a company that sold this pill, they’d make billions of dollars, and I imagine most consumers would pay a lot for this. And yet, we get it for free when we’re sleeping.
And it’s always odd to me when I see people working out at the gym, and they spend hours a day at the gym and then they say they don’t get enough sleep at night. It’s kind of funny thing to me: you know your muscles aren’t growing when you’re working out, or you’re not losing weight.
That all happens when you’re sleeping, and I don’t think most people know that. Here’s another example: the cells and the biochemistry – the biochemicals that make up your immune system and circulate through your bloodstream, they change when you’re sleeping compared to when you’re awake.
And when you’re sleeping, they’re good at seeking viruses, bacteria and other microorganisms to stop infection and disease. And therefore, when you don’t get enough sleep, you’re much more prone to getting sick, and that’s why, when you’re sick, the best thing you can do is to get a good night’s sleep.
And so, besides these health benefits of sleep, people who don’t get enough sleep are at a higher risk for high blood pressure, heart disease, diabetes, obesity. Psychologically, people are at a much higher risk of anxiety and depression.
We all know that when you are sleep-deprived, you lose focus; you lose the ability to pay attention, and it’s been estimated by the National Sleep Foundation that over $60 billion is lost in the United States annually just because of unproductive workers because they’re so sleep-deprived.
And all of this is important, but I think it also ignores something that we all know, everybody in this room knows to be accurate, which is that it sucks to be sleep-deprived, right? It feels so awful to be sleep-deprived and try to keep your eyelids open.
They’re suddenly so heavy. You do things, like, when you’re a speaker at an event like this, where you do that head bob thing, you’re trying to keep your head awake and fall asleep for a second, and some distant part of your brain is like, “Not now! Not now!” You’re trying to keep yourself awake. And I know this just and anyone else. This is the worst picture of me ever taken.
It’s also the most ironic picture of me ever taken because I was so tired I fell asleep in the middle of the day because I had spent the entire night working on a talk about the benefits of sleep. So – I did not do that last night.
So, I know this just and everybody else, and it’s just awful to be sleep-deprived, but here’s where there’s good news, because the good news is that the opposite is also true, the opposite being that people who are chronically slept-deprived, when they develop habits to get a regular amount of sleep every single day, they suddenly feel like years have been taken off their life.
They’re suddenly alive and awake and have the energy of someone much younger, and they just feel great, and they wonder why they didn’t do it before. But there’s also a lot of sleep science to back this up. One of my colleagues ran lots of studies on varsity athletes at Stanford University. And she recruited varsity athletes for sleep studies in which they were essentially forced to get a good night’s sleepover several weeks.
And what she found was that compared to players who didn’t take part in this sleep study, everything about these athletes who slept in improved: their speed improved, their strength improved, the number of mistakes and errors they made went way down, their chances of getting a concussion went way down, and they were much better at the sport.
The same thing happens in the classroom. When students were recruited for sleep studies where they get much more sleep, their creativity increases, their problem-solving increases, their test scores increase and their grades increase. And so, it just seems that everything gets much better once someone declares themselves that they will get a good night of sleep every single night, very consistent.
And the greatest paradox in this is that the people who don’t get enough sleep because they’d like to accomplish more during the day find that they’re more productive when they get more sleep and not less productive, because even though they’re not awake as long, they’re much more productive when they’ve gotten enough sleep.
There are lots of measured studies on this, that you’re able to get more done when you get a good night’s sleep, not less. So, why are we so bad at this? If this is all true, then why, as a society, are we not good at this? And this is actually where I feel like the analogy between sleep deprivation, junk food and smoking goes down.
It’s because when people smoke or have junk food, they’re doing it for the short-term reward. It’s immediately satisfying when people do those things. But there’s nothing satisfying about sleep deprivation like we’ve already talked about. So why people do it? And I ask my colleagues this, I survey students all the time and the same three answers come up again and again and again.
One, we have busy lives and we’d like to get more done. Two, we’re stressed. Stress and anxiety keep us awake sometimes, and there are lots of stressors in our life. And three – and this is a very new trend – is that we’re addicted to our gadgets at night. We love looking at our smartphones, tablets, computers, and there are many apps now that just occupy our time before we go to bed.
There’s email, Facebook, Twitter, Instagram, not to mention YouTube, Netflix, and a long list of great TED Talks that we can see. So what do we do about all of this? And this is where I get some insight from the mice we study in our lab because it turns out that all animals need sleep, all animals get the same benefit of sleep that humans do, but it’s easy to keep a mouse awake. To sleep-deprived a mouse, you don’t have to do very much. If you want to stress out a mouse a little, you can give him a new roommate.
Giving him a new roommate will keep him awake for a little while. Or you can move him to a different cage that he’s not used to, and the stress of going to a new home will keep him awake hours past his bedtime. You might ask, “What is the mouse equivalent of watching YouTube or being addicted to email?”
And it turns out we can duplicate this as well with something as putting a paper towel in a mouse’s cage – We wad up a paper towel, give it to the mouse, the mouse is entertained by this for hours. It’ll explore the contours of the paper towel, it’ll kick it around, it’ll play with it, and again, it’ll stay up hours past its bedtime.
So, the take-home point from this is that we’re hard-wired to need sleep, but we’re also hard-wired to be sleep-deprived at a moment’s notice based on stressful things and exciting things happening in our lives. And it turns out when the mouse is playing with the paper towel, a surge of dopamine is being released in its brain.
And the same thing happens when we scroll on a smartphone. Every time you swipe up on a Facebook post or email or anything else, we get a little surge of dopamine in our brains, and that surge of dopamine keeps us awake.
So, what do we do about all of this, especially when we have a life that’s much more complicated than that of a mouse? You know, a paper towel is bad enough for a mouse, but we have all these nice gadgets now that we didn’t have ten years ago to immediately give us all these things.
So it’s here where I feel like I have three ideas worth spreading, and we need to just completely embrace sleep as a culture. We need to treat this as healthy, and no job applicant should brag about only getting three or four hours of sleep, no student should high-five another student in the dining hall for pulling an all-nighter, and we should just be much more sleep-conscious as a society.
I went to a doctor two weeks ago, and when I showed up at the doctor’s office, I had to check a little form about healthy habits in my life. And there was a long list, and it was things like, “Do I have a smoke detector in my home?”, “Do I wear my seat belt?” “Take a daily vitamin?” I thought this was a great list, but nowhere on the list was, “Do I get 6 to 8 hours of sleep a night?” And I thought it was very odd.
Sleep As a Health Issue
We need to treat sleep as a health issue, just as much as smoking, or just as much as eating a balanced diet. Number two is we need to relearn how to go to bed. It’s amazing – You know who the best sleepers are in American society? It’s actually our kids, which is funny because it takes a while to get them to sleep. But once they’re asleep, they sleep soundly, and they have a nice quantity and quality of sleep. And I think that’s because we take the time to put them to bed properly.
We brush their teeth; we give them some water; we change their clothes into their pyjamas; we dim the lights; we read them a story, and this whole 30-minute, 40-minute process prepares them for a great night of sleep. And they sleep soundly once they finally go to sleep.
Can you imagine what it would be like to put our kids to sleep the same way that we put ourselves to sleep? If we gave our kids bright screens and said, “Play whatever you want for 30 minutes” – but maybe it’ll turn it in two hours – our kids would never sleep, and this would be detrimental.
And so we need to put ourselves to be mainly the same way. We need just to remember what we did when we were six years old. And I think this gets lost sometime around high school. We don’t, as parents, put our high schoolers to bed. And somewhere around the elementary school ages to high school ages, people forget how to go to bed, and we just magically assume that we’ll fall asleep after being worried and playing with our gadgets.
And so we need to dim the lights, to develop a nice habit, a nice night-time routine, and we need to take anything that has a screen on it and push it away 30 or 45 minutes before we go to bed and try not to look at it until we wake up the next morning.
Finally, kids are the best sleepers, but if you ask adults who are the best sleepers out of the adult community, what people find is that the best sleepers are the ones who embrace good wake habits. People who have good time management and productivity skills sleep better at night because they have such a well-balanced day.
And there are so many books written on productivity and time management, and lots of tips you can find online, but I tell students this can be something as easy as just knowing if you are a morning person or a night person, what time of day are you most productive and do your best work during that time of day, what time of day are you least productive and do the mindless tasks that you just need to get done of day – ask where you work best, how you work best – even just by asking students these kinds of questions, they discover the answers for themselves, and everyone is different.
Because really, you get a good night’s sleep not because sleep is fun, but because if you get a good night’s sleep, it makes you have a better day’s wake; it makes you more productive, more time-efficient, and you get more done.
But it’s reciprocal. If you have a better day’s wake and you get more done and you’re more productive, it causes you to have a better night’s sleep. And this is a reinforcing cycle, and it works great. And I’m a little disappointed in myself that I didn’t figure out these techniques into years in my life. I started studying sleep before I realised this good night’s sleep habits and these great productivity habits.
And when I think about that, I actually a kind of get a little frustrated, because when I was in school, I had sex education, nutrition education, drug awareness-resistance education, but no one ever told me how to go to bed and no one ever told me how I could get more done during the day. These are things I just picked up on my own. And I think these are so valuable things that we could teach high school kids and college kids.
And so just recently, at Williams College, we taught our first course called The Science of Sleep and the Art of Productivity, and I was afraid that no one would sign up for this class. And it turned out people were hungry for it. College students over enrolled in the class and we wound up getting a lot more people in than we initially intended. But it was amazing.
They loved learning about sleep habits; they loved talking about how they could get more done during the day, and it worked out really well. And now what we’re trying to do is take these messages and spread them across our campus and the community, to embrace a culture of sleep that everyone is proud of. Because it’s true: no one looks back on their life and remembers the nights they had plenty of sleep.
This is true. But the opposite is also exact: nobody looks back on their life and remembers the times they were exhausted, right? And I hate this picture of me, but the funny thing about this day is I don’t know a single thing about this day. The only reason I remember this is because they took a picture of me.
I remember the times I was awake and alert, and I had a life of good experiences when I was awake, not when I was exhausted. And I optimise those times now. I try to be awake as much as I can so I can enjoy those great experiences with my family and with my friends. So I think the take-home message is to get a good night’s sleep not because it’s fun, but because it makes you so much happier during the day.
And this is what I wish for all of you. I hope that everybody has a good night’s sleep for a better day’s wake and a better day’s wage for a good night’s sleep.