by Matthew Walker, PhD, 2017
Incredibly “eye-opening” book about the importance of sleep! Wayne’s tennis buddy, Andrew, recommended it. I wasn’t going to read it – I got it from the Library for Wayne – but I’m so glad I did. Wow! Sleep is so incredibly important all throughout life and our modern world has decimated good sleep, all throughout the life span, and we are reaping the consequences. Every single physical disease, every single mental illness, every single health challenge, and many of our social problems (drowsy driving deaths, addictions) can result from too little sleep. And we just don’t listen. We don’t teach good sleep habits (like we do nutrition and exercise) and the bad habits just get passed on to the next generation. We think sleep is a sign of laziness, but lack of sleep causes laziness, in addition to memory issues, poor learning and poor grades, bad judgment, lack of social skills, infertility, obesity, high blood pressure, heart disease, stroke, cancer, dementia, Alzheimer’s, diabetes, depression, anxiety, suicide, schizophrenia, ADHD, Autism, and on and on. It’s so important to get a good night’s sleep, at least 7 to 8 hours a night as an adult, far more for children and teens.
I read something amazing on almost every single page. This book should be required reading for everyone!
Here are some tidbits: First and foremost, the myth of sleeping pills. “Sleeping pills, old and new, target the same system in the brain that alcohol does–the receptors that stop your brain cells from firing–and are thus part of the same general class of drugs: sedatives…The electrical type of “sleep” these drugs produce is lacking in the largest, deepest brainwaves.” They cause daytime grogginess, so people drink more coffee, compounding their sleeplessness, take more pills, are groggier during the day, more coffee, etc. A vicious cycle and then when you go off, you have rebound insomnia – “When individuals stop taking these medications, they frequently suffer far worse sleep, sometimes even worse than the poor sleep that led them to seek out sleeping pills to begin with. The cause of rebound insomnia is a type of dependency in which the brain alters its balance of receptors as a reaction to the increased drug dose, trying to become somewhat less sensitive as a way of countering the foreign chemical within the brain. This is also known as drug tolerance. But when the drug is stopped, there is a withdrawal process, part of which involves an unpleasant spike in insomnia severity.” Studies have found that “Ambien-laced sleep became a memory eraser, rather than engraver.” “Should similar findings continue to emerge, including in humans, pharmaceutical companies may have to acknowledge that, although users of sleeping pills may fall asleep nominally faster at night, they should expect to wake up with few(er) memories of yesterday.” Sleeping pills are dangerous for pregnant women – the babies are at risk for dependency. Also, they should not be given to children, teens – they damage their sleep when they need it for their developing brains and their learning.
“There are now more than fifteen such studies from different groups around the world showing higher rates of mortality in those who use sleeping pills.” Some of the causes: higher rates of infection (good sleep boosts immune systems and, “Older adults are far more likely to suffer from infections. Alongside newborns, they are the most immunologically vulnerable individuals in our society.”) Also, sleeping pills increase the risk for fatal car accidents, falls at night, and there are higher rates of heart disease and stroke, and cancer. “Individuals taking sleeping pills were 30 to 40 percent more likely to develop cancer within the two-and-a-half year period of the study than those who were not.” Why aren’t these risks common knowledge? “Consider that the original Star Wars movies–some of the highest-grossing films of all time–required more than forty years to amass $3 billion in revenue. It took Ambien just twenty-four months to amass $4 billion in sales profit, discounting the black market.”
Instead of sleeping pills, he recommends this: Cognitive Behavioral Therapy for Insomnia, and “reduce caffeine and alcohol, remove screen technology from the bedroom, have a cool bedroom, establish a regular bedtime and wake-up time, go to bed only when sleepy and avoid sleeping on the couch early/mid-evenings, never lie awake in bed for a significant time – get out of bed and do something quiet and relaxing until the urge to sleep returns, avoid daytime napping if you are having difficulty sleeping at night, reduce anxiety-provoking thoughts and worries by learning to mentally decelerate before bed, and remove visible clock faces from view.”
Cognitive Behavioral Therapy for Insomnia (CBT-I) is so effective and has no safety risks. The Annals of Internal Medicine has determined: “CBT-I must be used as the first-line treatment for all individuals with chronic insomnia, not sleeping pills.”
Secondly, here is why our doctors work such horribly long shifts during residency and then even continuing for doctors and nurses working in hospitals: “All of us know that nurses and doctors work long, consecutive hours, and none more so than doctors during their resident training years. Few people, however, know why. Why did we ever force doctors to learn their profession in this exhausting, sleepless way? The answer originates with the esteemed physician William Stewart Halsted, MD, who was also a helpless drug addict.
“Halsted founded the surgical training program at Johns Hopkins Hospital in Baltimore, Maryland, in May 1889. As chief of the Department of Surgery, his influence was considerable, and his beliefs about how young doctors must apply themselves to medicine, formidable. There was to be a six-year residency, quite literally. The term “residency” came from Halsted’s belief that doctors must live in the hospital for much of their training, allowing them to be truly committed in their learning of surgical skills and medical knowledge…To Halsted, sleep was a dispensable luxury that detracted from the ability to work and learn. Halsted’s mentality was difficult to argue with, since he himself practiced what he preached, being renowned for a seemingly superhuman ability to stay awake for apparently days on end without any fatigue.
“But Halsted had a dirty secret that only came to light years after his death, and helped explain both the maniacal structure of his residency program and his ability to forgo sleep. Halsted was a cocaine addict. It was a sad and apparently accidental habit, one that started years before his arrival at Johns Hopkins.” (This would make an excellent movie – The story of this one doctor who has influenced the medical profession so profoundly, and so negatively, for 135 years and counting.)
You can tell he is very strongly against the medical profession continuing this dangerous practice of sleep deprivation. There was a slight change made for first year residents, after “Facing government threats that would apply federally enforced work hours due to the extent of damning evidence, the Accreditation Council for Graduate Medical Education made the following alterations. First-year residents would be limited to (1) working no more than an 80-hour week (which still averages out at 11.5 hours per day for 7 days straight), (2) working no more than 24 hours nonstop, and (3) performing one overnight on-call shift every third night. That revised schedule still far exceeds any ability of the brain to perform optimally.” Even worse, the Accreditation Council only made the changes for first-year residents, stating “that data proving the dangers of insufficient sleep had only been gathered in residents in their first year of the program. As a result, they felt there was no evidence to justify a change for residents in years two to five…”
“This entrenched pomposity, prevalent in so many senior-driven, dogmatic institutional hierarchies, has no place in medical practice…” They try to justify these horribly damaging hours by saying it takes so much time to train all the material, but other countries don’t do this and their medical systems are more highly rated than ours.
Chernobyl nuclear power disaster and the Valdez oil tanker spill were two tragedies which were the result of sleep-deprived operators.
Here are his 12 tips for healthy sleep:
- Go to bed at the same time and wake up at the same time every day. “If there is only one piece of advice you remember and take from these twelve tips, this should be it.”
- Exercise at least 30 minutes every day but not 2-3 hours before bedtime.
- Avoid caffeine and nicotine.
- Avoid alcohol before bed. Alcohol robs you of REM sleep.
- “Avoid large meals and beverages late at night.” “Drinking too many fluids at night can cause frequent awakenings to urinate.”
- Avoid medicines that delay or disrupt sleep, such as heart, blood pressure, asthma.
- “Don’t take naps after 3 p.m.”
- “Relax before bed.” Read or listen to music.
- “Take a hot bath before bed.”
- “Dark bedroom, cool bedroom, gadget-free bedroom.” Have a comfortable bed and pillow. No clock faces.
- Sunlight exposure 30 minutes to an hour each day in the morning.
- “Don’t lie in bed awake.” Get up after 20 minutes and do something relaxing until you feel sleepy, rather than laying there being anxious about not sleeping.
There are so many children diagnosed with ADHD and given speed (Ritalin and Adderall) who may simply be sleep-deprived. The symptoms of sleep deprivation and ADHD are so similar.
Night Owls and Early Birds are largely determined by genetics. Forcing a Night Owl to be an Early Bird is detrimental to their well-being. They really need to go to bed late and sleep late to be at their optimum. Because our society works best for Early Birds, Night Owls are forced to burn the candle at both ends and they end up with higher rates of depression, anxiety, diabetes, cancer, heart attack, and stroke.
Regarding Melatonin: It’s not a sleep aid in and of itself, unless you are jet-lagged. For a normal person, it is simply a placebo, which is fine, although the levels of Melatonin can vary widely, being much higher or much less than what are listed on the label, because it is not regulated. Melatonin is a hormone that builds up in the brain when it’s dark, so it signals the body that sleep is to happen, but it doesn’t cause it to happen.
Shift workers, pilots, cabin crew, those that routinely travel through time zones or have their sleep disrupted, are considerably more forgetful and have higher rates of cancer and type 2 diabetes.
Two factors determine wake and sleep: a person’s 24-hour circadian rhythm, and the chemical adenosine, which starts building up when you wake up and after 12 to 16 hours of being awake, this sleep pressure is at its highest. Caffeine can blunt it. Caffeine occupies the adenosine receptors tricking your brain into thinking it’s not sleepy. The half-life of caffeine is 5 to 7 hours. Decaf has 15 to 30 percent of the caffeine of regular coffee; it is not caffeine-free. Caffeine is also present in teas, dark chocolate, ice cream and some drugs. Caffeine is often the culprit behind poor sleep – keeping people from falling asleep and then not sleeping soundly once they do. Once the caffeine is finally burned up, you have a massive hit of adenosine because it is no longer held back and has been building up the entire time you’ve been awake. He showed pictures of spider webs and the spiders on caffeine built the most discombobulated, chaotic, useless webs–the worst webs of all, even worse than the webs of the spiders that were on LSD, Speed, or marijuana.
There is a questionnaire called SATED that will help determine your sleep fulfillment. It’s on an NIH website.
During REM sleep, your body is paralyzed. This is when you are dreaming and it is life-saving that the body is paralyzed while dreaming, except your eyes, which move rapidly back and forth, which is why it is called Rapid Eye Movement. He explains how it works: Seconds before you enter REM sleep, your voluntary muscles go completely limp so you are completely paralyzed. Your involuntary muscles continue working. It’s called “atonia” and is caused by a powerful signal from your brain stem down the full length of the spinal cord.
Aquatic mammals, like whales and dolphins, have to swim from birth to death, so they sleep with half a brain only. One half of their brain is in deep NREM (non-REM) sleep, while the other half is wide awake. Once one half has gotten its fulfillment of sleep, it switches on and the other half sleeps.
Humans used to nap in the afternoon, we are hardwired for it. Our modern world prevents us from doing so. The true pattern of sleep is a long period of continuous sleep at night, followed by a short nap in midafternoon.
REM sleep helps humans navigate socioemotional signals (facial expressions, body language, mass group behavior). REM sleep also helps us control our emotions throughout the day. The late morning REM sleep is critical for this. NREM sleep helps transfer and store new information, but REM sleep takes this new information and incorporates it into the store of memories and information already gathered. REM sleep is critical for creativity. REM sleep has enabled humans to go to the moon, create computers, develop vaccines. Chimpanzees and the great apes don’t have the rich REM sleep that we do. He posits that going from tree branch sleeping, to sleeping on the ground, allowed humans to evolve and develop rich REM sleep that enabled us to advance the way we have – our emotional gifts firstly, and the creativity REM sleep inspires.
He “humbly” attributes all of human advances to evolution. Yes, evolution exists, but man is the “very good” creation of an Almighty, All-Loving God, and I believe we started out with these deep and intricate, marvelous characteristics, including our sleep.
In Sleep Before Birth, I learned that the fetus’s brain has developed the neurons for NREM and REM sleep by 23 weeks, however not the body-paralyzing mechanism. So when a baby dreams in utero, there is nothing holding back the movement of arms and legs. Babies in utero sleep almost constantly: 6 hours of NREM sleep, six hours of REM sleep, and 12 hours of intermediary sleep state. In the final trimester, the baby starts to have real awake times, but just 2-3 hours per day. In the last trimester, total sleep time decreases but REM sleep increases. The last 2 weeks of pregnancy, a baby will have 12 hours a day of REM sleep. No other time of our lives are we dreaming as much as we did the last few weeks in utero. REM sleep is vital for the brain to mature. “Dazzling bursts of electrical activity during REM sleep stimulate the lush growth of neural pathways all over the developing brain, and then furnish each with a healthy bouquet of connecting needs, or synaptic terminals.”
“This phase of development, which infuses the brain with masses of neural connections, is called synaptogenesis, as it involves the creation of millions of wiring links, or synapses, between neurons. By deliberate design, it is an overenthusiastic first pass at setting up the mainframe of a brain. There is a great deal of redundancy, offering many, many possible circuit configurations to emerge within the infant’s brain, once born…”
“Worryingly, if you disturb or impair the REM sleep of a developing infant brain, pre- or early post-term, there are consequences.” He describes experiments on rats that disturbed their REM sleep and their brain development came to a halt and, although it did restart once sound sleep was restored, the brain never fully recovered what it had lost. The same has been found in other mammals.
Then he talks about Autism: “Our current understanding of what causes autism is incomplete, but central to the condition appears to be an inappropriate wiring up of the brain during early developmental life, specifically in the formation and number of synapses–that is, abnormal synaptogenesis.”
Alcohol is very damaging to a baby. “Alcohol is one of the most powerful suppressors of REM sleep that we know of.” It readily crosses the placenta and into the baby. There is a link between mothers who drink while pregnant and psychiatric illnesses such as Autism in children. Don’t drink while pregnant or while nursing. The alcohol passes to the infant and they don’t sleep well-their REM sleep is lessened and their sleep is more fragmented.
Childhood sleep is multi-phasic – many short sleeps throughout the day and night with many awakenings. The circadian rhythm takes time to develop. Signs of it are there at 3 or 4 months. By one year old, the child is waking up less and less during the night. By 4, the child’s circadian rhythm is about set and children at that age will have a long nighttime sleep and one nap during the day. Their 14 hours of sleep at 6 months old are spent as half REM and half NREM sleep. As they age, the amount of REM sleep decreases and the NREM sleep increases until it is eventually 20% REM and 80% NREM by the late teens and on through early and mid-adulthood.
Adolescents and young adults with schizophrenia are found to have reduced NREM sleep, and the NREM sleep they do have doesn’t exhibit the normal brainwave patterns of NREM sleep in healthy individuals. “Faulty pruning of brain connections in schizophrenia caused by sleep abnormalities is now one of the most active and exciting areas of investigation in psychiatric illness.”
Young children need lots of sleep, falling asleep early and waking up early. Adolescents, on the other hand, turn into night owls – their circadian rhythm is shifting forward – so they aren’t tired until very late, but then they still need lots of sleep. Our society is harming teenagers by early school start times. Teens need to sleep in: “…lest we wish our own children to suffer developmental brain abnormalities or force a raised risk of mental illness upon them.”
“No child needs caffeine,” Dr. Mary Carskadon.
Older adults experience a decline in deep NREM sleep, which actually starts in the late twenties and early thirties. Many health problems can be attributed to poor sleep. “…elderly individuals fail to connect their deterioration in health with their deterioration in sleep, despite causal links between the two having been known to scientists for many decades.” “…far more of our age-related physical and mental health ailments are related to sleep impairment than either we, or many doctors, truly realize or treat seriously.” Do NOT use sleeping pills – they are harmful to deep sleep and only make the problem worse. Seek out “scientifically proven non-pharmacological interventions.”
One sure thing is to drink less fluid at night so your weakened bladder doesn’t wake you up.
Poor sleep in adults can result in depression, lower energy, lower cognitive function, poor memory – forgetfulness.
A vicious cycle develops if you inadvertently take a nap in the evening. You’ve released your sleep pressure, then when you go to bed later, you can’t fall asleep, and then when you finally do, your circadian rhythm urges you to wake up early. One way to help is to get some bright light late in the afternoon. He also says: “Older adults may also wish to consult with their doctor about taking melatonin in the evening. Unlike young or middle-age adults, where melatonin has not proved efficacious for helping sleep beyond the circumstance of jet lag, prescription melatonin has been shown to help boost the otherwise blunted circadian and associated melatonin rhythm in the elderly, reducing the time taken to fall asleep and improving self-reported sleep quality and morning alertness.”
In the section, Sleep to Forget, he says: “…my real-world hope is to develop accurate methods for selectively weakening or erasing certain memories from an individual’s memory library when there is a confirmed clinical need, such as in trauma, drug addiction, or substance abuse.” (YAY!!!)
Under Sleep for Other Types of Memory, he says: “The term “muscle memory” is a misnomer. Muscles themselves have no such memory: a muscle that is not connected to a brain cannot perform any skilled actions, nor does a muscle store skilled routines. Muscle memory is, in fact, brain memory.”
The deep NREM sleep is what allows us to remember things. It is typically the sleep we have early in the night. REM sleep and lighter NREM sleep occurs late in the night, sometimes early morning. We can boost the deep NREM sleep using electrodes that send small electronic signals that mirror the deep NREM sleep waves. This increases the sleep spindles that are created and needed for memory retention. It’s possible this could be used for aging brains to help them get more deep NREM sleep and retain more.
The Guinness Book of World Records no longer accepts any sleep deprivation records and they have removed all that were once there, to prevent others from trying to break them on their own. Going without sleep is so damaging to the brain and body, the Guinness Book of World Records did not want to be responsible for “the dire and sometimes deadly consequences of inadequate sleep…”
“After sixteen hours of being awake, the brain begins to fail. Humans need more than seven hours of sleep each night to maintain cognitive performance. After ten days of just seven hours of sleep, the brain is as dysfunctional as it would be after going without sleep for 24 hours.”
Drowsy driving is one of the tragedies of too little sleep. “…Vehicle accidents caused by drowsy driving exceed those caused by alcohol and drugs combined.” “A person who experiences a microsleep or who has fallen asleep at the wheel does not brake at all, nor do they make any attempt to avoid the accident. As a result, car crashes caused by drowsiness tend to be far more deadly than those caused by alcohol or drugs. Said crassly, when you fall asleep at the wheel of your car on a freeway, there is now a one-ton missile traveling 65 miles per hour, and no one is in control.”
Drowsy truck drivers are even worse in this respect than drivers of cars. Most truck drivers are overweight or obese. They are at greater risk of sleep apnea which causes heavy snoring, resulting in poor sleep. When truckers crash and lose their life, they take 4.5 others with them, on average. Our governments need to spend more on combating drowsy driving.
The FAA instituted power naps for pilots, early in the night power naps, to help them be alert and awake during the critical time period of landing. But now, people think a power nap is all they need, and that is simply not true. “Power naps may momentarily increase basic concentration under conditions of sleep deprivation, as can caffeine up to a certain dose. But in the subsequent studies that Dinges and many other researchers (myself included) have performed, neither naps nor caffeine can salvage more complex functions of the brain, including learning, memory, emotional stability, complex reasoning, or decision-making.”
Regarding Alzheimer’s, they have found that “sleep disturbance precedes the onset of Alzheimer’s disease by several years, suggesting that it may be an early-warning sign of the condition, or even a contributor to it.”
Lack of sleep causes emotional irrationality. Sleep deprivation resulted in the amygdala being 60 percent more amplified in emotional reactivity when viewing the same images as non-sleep deprived individuals. The pre-frontal cortex is the brake for the amygdala and sleep deprivation inhibits the ability of the pre-frontal cortex to put the brakes on the amygdala.
They have found that addictions are associated with sleep disturbances. Insufficient sleep in childhood “significantly predicts early onset of drug and alcohol use in that same child during their later adolescent years…”
This was not in the book, but HALT in addiction treatment stands for Hungry, Angry, Lonely, and Tired. When you are experiencing one of these, you will want to drink, or use the drug. Stop and solve what it is that you are feeling – if you are hungry, eat; if you are angry, find a way to cope; if you are lonely, contact someone; if you are tired, sleep.
“There is no major psychiatric condition in which sleep is normal.”
“By improving sleep quantity, quality, and regularity, Harvey and her team have systematically demonstrated the healing abilities of sleep for the minds of numerous psychiatric populations.”
Regarding Alzheimer’s: during deep NREM sleep, there is a cleansing process going on in the brain that rids it of amyloid and tau proteins, and stress molecules. “Getting too little sleep across the adult life span will significantly raise your risk of developing Alzheimer’s disease.” “Parenthetically, and unscientifically, I have always found it curious that Margaret Thatcher and Ronald Reagan–two heads of state that were very vocal, if not proud, about sleeping only four to five hours a night–both went on to develop the ruthless disease. The current US president, Donald Trump–also a vociferous proclaimer of sleeping just a few hours each night–may want to take note.” He is researching ways to increase deep NREM sleep. “Insufficient sleep is only one among several risk factors associated with Alzheimer’s disease. Sleep alone will not be the magic bullet that eradicates dementia. Nevertheless, prioritizing sleep across the life span is clearly becoming a significant factor for lowering Alzheimer’s disease risk.”
It’s better to get your flu shot after a good night’s sleep. If you have had a week of 4-6 hours a night before your flu shot, you will have less than half the normal antibody response.
To improve sleeping for Neonates, he advocates dim-lighting in NICUs during the day and nearly black-out conditions at night, so they can get the sleep they so desperately need to develop their brain and all their other organs. They should be sleeping the vast majority of the day and night. Here’s what happens with sleep deprivation in humans and rats: “a loss in the ability to maintain core body temperature, cardiovascular stress, respiratory suppression, and a collapse of the immune system.” In hospitals with NICUs designed to enhance sleep, they see “50 to 60 percent improvements in neonate weight gain and significantly higher oxygen saturation levels in blood were observed, relative to those pre-terms who did not have their sleep prioritized and thus regularized. Better still, these well-slept pre-term babies were also discharged from the hospital five weeks earlier!”
People who are sleep-deprived eat more, and eat more junk, have higher blood sugar, gain weight. “The upshot of all this work can be summarized as follows: short sleep…will increase hunger and appetite, compromise impulse control within the brain, increase food consumption (especially of high-calorie foods), decrease feelings of food satisfaction after eating, and prevent effective weight loss when dieting.” Two hormones, leptin and ghrelin, control appetite. Leptin tells you when you are full, Ghrelin tells you when you are hungry. Sleep deprivation decreases leptin and increases ghrelin. People in the studies who were limited to 5 hours a night ate more and ate more junk foods than those who had 8 hours a night of sleep.
Regarding sleep deprivation and cancer, “the scientific evidence linking sleep disruption and cancer is now so damning that the World Health Organization has officially classified nighttime shift work as a “probable carcinogen.””
REM sleep is critical to understanding the world and the people around us. Sleep deprived individuals “slipped into a default of fear bias, believing even gentle-or somewhat friendly looking faces were menacing. The outside world had become a more threatening and aversive place when the brain lacked REM sleep–untruthfully so.”
“Now think of occupations that require individuals to be sleep-deprived, such as law enforcement and military personnel, doctors, nurses, and those in the emergency services–not to mention the ultimate caretaking job: new parents. Every one of these roles demands the accurate ability to read the emotions of others in order to make critical, even life-dependent, decisions, such as detecting a true threat that requires the use of weapons, assessing emotional discomfort or anguish that can change a diagnosis, the extent of palliative pain medication prescribed, or deciding when to express compassion or dispense an assertive parenting lesson. Without REM sleep and its ability to reset the brain’s emotional compass, those same individuals will be inaccurate in their social and emotional comprehension of the world around them, leading to inappropriate decisions and actions that may have grave consequences.”
Sometimes “sleeping on it” provides the solution to problems no amount of thinking and awake-time problem-solving can. Dmitri Mendeleev, February 17, 1869, dreamed the complete periodic table of the elements. He had been working on it for years with no success.
Paul McCartney dreamed the songs, “Let it Be,” and “Yesterday.”
Mary Shelley had a dream (nightmare) in Lord Byron’s castle which became “Frankenstein.”
He discusses sleep disorders:
Somnambulism – sleep walking. Nothing pathological about it. They think sleep walking is caused by an “unexpected spike in nervous system activity during deep sleep.” “Most somnambulism episodes (e.g., sleep walking, talking) are considered benign and do not require intervention.” It sounds like there are effective treatments if someone is concerned.
Insomnia – defined as difficulty falling asleep, staying asleep, and early morning waking; suffering significant distress or daytime impairment; happens 3 nights a week for at least 3 months; no medical conditions that would explain it. True insomnia requires a sleep specialist. Two most common triggers are emotional concerns/worries and emotional distress/anxiety. “Insomnia patients could not disengage from a pattern of altering, worrisome, ruminative brain activity.” There is much promise in Cognitive Behavioral Therapy for Insomnia. Sleeping pills are definitely NOT the answer, as discussed previously.
Narcolepsy – three core symptoms: excessive daytime sleepiness, sleep paralysis, and cataplexy (falling down seizure). Only about one in 2000 people suffer from narcolepsy. People who think they have it most likely are suffering from chronic sleep deprivation. The cataplectic episodes are triggered by strong emotions, either positive or negative. “A narcoleptic patient is banished to a monotonic existence of emotional neutrality.” “Despite wonderful work by many of my colleagues, narcolepsy currently represents a failure of sleep research at the level of effective treatments.”
The blue light of iPads and devices reduces melatonin. “Using LED devices at night impacts our natural sleep rhythms, the qualify of our sleep, and how alert we feel during the day.” His advice is to create dim, lower-light in the rooms you spend your evenings. And definitely to not use devices in the evenings or use the software that lowers the blue light of the devices.
Alcohol – it is completely untrue that alcohol helps you fall asleep easier or offers sounder sleep. Alcohol is a sedative. Sleep under alcohol is also very fragmented, “littering the night with brief awakenings. Alcohol-infused sleep is therefore not continuous and, as a result, not restorative.” “Second, alcohol is one of the most powerful suppressors of REM sleep that we know of.” “People consuming even moderate amounts of alcohol in the afternoon and/or evening are thus depriving themselves of dream sleep.”
In the section, Sleep to Forget?, he talks about how you can tell your brain to remember some things and forget other things and when you sleep, that will happen. “Counter to earlier assumptions in the twentieth and twenty-first centuries, sleep does not offer a general, non-specific (and hence verbose) preservation of all the information you learn during the day. Instead, sleep is able to offer a far more discerning hand in memory improvement: one that preferentially picks and chooses what information is, and is not, ultimately strengthened. Sleep accomplishes this by using meaningful tags that have been hung onto those memories during initial learning, or potentially identified during sleep itself.” Also, it was not REM sleep that accomplished this. “Rather, it was NREM sleep, and especially the very quickest of the sleep spindles that helped bend apart the curves of remembering and forgetting.”
This is where it gets exciting: “We are now exploring ways of harnessing this remarkably intelligent service of selective remembering and forgetting with painful or problematic memories. The idea may invoke the premise of the Oscar-winning movie Eternal Sunshine of the Spotless Mind, in which individuals can have unwanted memories deleted by a special brain-scanning machine. In contrast, my real-world hope is to develop accurate methods for selectively weakening or erasing certain memories from an individual’s memory library when there is a confirmed clinical need, such as in trauma, drug addiction, or substance abuse.”
There is another treatment they’ve discovered to cure the nightmares of PTSD patients: a drug called prazosin. It is a drug to lower blood pressure, but one of the benefits of it is that PTSD patients reported they were able to dream without having flashback nightmares. The drug lowered noradrenaline in the brain. That allowed the patients to get good REM sleep. Researchers have found it’s not enough to have REM sleep, we need to have REM sleep that involves “dreaming about the emotional themes and sentiments of the waking trauma. It was only that content-specific form of dreaming that was able to accomplish clinical remission and offer emotional closure in these patients, allowing them to move forward into a new emotional future, and not be enslaved by a traumatic past.”
“Through its therapeutic work at night, REM sleep performed the elegant trick of divorcing the bitter emotional rind from the information-rich fruit. We can therefore learn and usefully recall salient life events without being crippled by the emotional baggage that those painful experiences originally carried.
“Indeed, I argued that if REM sleep did not perform this operation, we’d all be left with a state of chronic anxiety in our autobiographical memory networks; every time we recalled something salient, not only would we recall the details of the memory, but we would relive the same stressful emotional charge all over again. Based on its unique brain activity and neurochemical composition, the dream stage of REM sleep helps us avoid this circumstance.”
“As the theory predicted, it was the dreaming state of REM sleep–and specific patterns of electrical activity that reflected the drop in stress-related brain chemistry during the dream state–that determined the success of overnight therapy from one individual to the next. It was not, therefore, time per se that healed all wounds, but instead it was time spent in dream sleep that was providing emotional convalescence. To sleep, perchance to heal.”
In the 1960s, researchers deprived some young adults of REM sleep for a week. It didn’t even take a week, by the third day, they were exhibiting signs of psychosis: anxious, moody, paranoid, hallucinations (seeing and hearing). The researchers conclusion: “REM sleep is what stands between rationality and insanity.” He argues long and convincingly, with lots and lots of proof, that we need later school start times for our children. “It is clear that a tired, under-slept brain is little more than a leaky memory sieve, in no state to receive, absorb, or efficiently retain an education. To persist in this way is to handicap our children with partial amnesia. Forcing youthful brains to become early birds will guarantee that they do not catch the worm, if the worm in question is knowledge or good grades. We are, therefore, creating a generation of disadvantaged children, hamstrung by a privation of sleep. Later school start times are clearly, and literally, the smart choice.”
“Research findings have also revealed that increasing sleep by way of delayed school start times wonderfully increases class attendance, reduces behavioral and psychological problems, and decreases substance and alcohol use. In addition, later start times beneficially man a later finish time. This protects many teens from the well-researched “danger window” between three and six p.m., when schools finish but before parents return home.”
Later school start time is also correlated with increased life expectancy, mostly attributed to fewer car crashes in teens. In Teton County, Wyoming, when they changed school start time from 7:35 a.m. to 8:55 a.m., the result was a 70 percent decrease in traffic accidents in 16 to 18 year olds.
His conclusion:
“…the decimation of sleep throughout industrialized nations is having a catastrophic impact on our health, our life expectancy, our safety, our productivity, and the education of our children.
“This silent sleep loss epidemic is the greatest public health challenge we face in the twenty-first century in developed nations…
“I believe it is time for us to reclaim our right to a full night of sleep, without embarrassment or the damaging stigma of laziness. In doing so, we can be reunited with that most powerful elixir of wellness and vitality, dispensed through every conceivable biological pathway. Then we may remember what it feels like to be truly awake during the day, infused with the very deepest plenitude of being.”