"We are not going to work ourselves to death, we are going to wake ourselves to death"
- Michelle Olaithe (Talk for Growth Faculty, Mental Health Week)
For the video to this talk, please visit:
"Once upon a time…" begins every good bedtime story, except in this one the big bad wolf is a little more subtle and something you will welcome into your life in the name of fun and productivity, the poor lambs that will suffer are your mental and physical health, and the heroine, well, she’s your sleeping brain.
Full disclosure, this is largely a choose your own adventure story, but before we meet the villains and the sleep choices you have, let’s talk a little about why this bedtime story is important to you and examine the superpowers of your sleeping brain.
Healthy sleep, about 7-9 hours of relatively undisturbed sleep for adults, is an active state, not just some semi-catatonic laziness that separates one busy moment in your life to the next.
Sleep Foundation link for information about sleep and sleep health - www.sleepfoundation.org/sleep-hygiene
To name a few benefits to this brain state, healthy sleep will lower your risk of heart disease, diabetes, and car accident (5), and it is more likely your marriage will work out. Over sleeping and under sleeping are linked to a higher risk of death (4).
We know healthy sleep is an active and dynamic state, because if we put electrical pads on your skull and watch your brain activity while you sleep, we notice amazing things.
While your body appears to be doing very little, your brain is actually doing gymnastics. These gymnastics show up as different wave forms, denoting separable sleep states. Today, I’m going to focus on two sleep states: deep sleep and rapid eye movement sleep, also called dreaming sleep. Deep sleep shows up on these electrical measurements as beautiful big wave forms, let’s liken these to the tidal waves of your brain, and dreaming sleep looks largely like wake, that is to say the wave forms are small and erratic.
Several of my favourite happy endings gifted to us from these neuronal gymnastics are improved memory, better mood, and greater productivity. Let’s look at these a little closer:
Improved memory - With just a 30-minute nap you are more likely to do better on a test. In fact, you are more likely to have greater alertness, clarity of cognition, and recall. A 20-30-minute nap is also not likely to dip you into deep sleep and so it is unlikely to interfere with your night-time sleep.
Better mental health - Sleep and mental health are intimately and bidirectionally intertwined (1). Traditionally sleep problems have been seen as symptoms of mental health problems, but we now know that sleep disruption wreaks havoc on levels of neurotransmitters and stress hormones, impairing thinking and emotional regulation. Sleep appears causally related to the experience of mental health difficulties (10). Sleep disruption is one of the earliest signs of an on-coming mental health episode. Studies show that greater improvements in sleep quality lead to greater improvements in mental health.
Greater productivity - The cost of poor sleep is a loss of workplace productivity. It is so recognised that companies including Nike, Proctor & Gamble, Facebook, Ben and Jerry's, and Zappos have built in rooms for naps. In her book, Thrive, Arianna Huffington speaks to the need to reward self-care and downtime in employees to increase creativity.
And we think you get these benefits due to a couple of sleep super powers. Two of my favourite sleep superpowers are that sleep is the way your brain “clears house” and rewires itself.
Let’s talk about that first point, “clearing house”. During deep sleep, your brain
activates its dedicated waste removal system. This is your glymphatic system, your brains twin to the body’s immune system and is largely composed of a special cell called a glial cell (which is a pretty star like cell).
Because you work your brain so hard each day and your nervous system is acutely sensitive to changes, you need to clear it of metabolic wastes each night.
There are tiny pores all through this beautiful starry network that open when you sleep, and the flexible walls pulse in time with your vascular system, to flush waste out of your brain and bring in new energy supplies. When this system doesn’t work properly either through lack of sleep, older age, or cardiovascular issues, we accumulate waste.
Those who don’t sleep well, and accumulate waste, have a 7-27% higher risk of cognitive disorder, including dementia (3).
Pruning your brain at night
Okay, let’s shift gears, my other favourite sleep super power is the rewiring that occurs at night, and that occurs during another restorative sleep state, dream sleep, or REM sleep. It is so name, REM or Rapid eye movement sleep, because we shift our eyes left to right rhythmically. Another interesting fact, also a misunderstanding is that naming this phase “dreaming sleep” is a bit incorrect, because we dream during all stages of sleep, it’s just probably that stage of sleep when the dreams are more story-like.
Dreaming sleep is a crucial sleep stage implicated in reshaping your brain each night. When you are awake you process hundreds of thousands of events. These waking events prime circuits and synapses for further processing during sleep. It is during sleep when those primed synapses create proteins allowing for structural changes in your brain, crucial for long-term information storage (7). Furthermore, the neurons you don’t use are pruned and cleaned away. Each night you can change your brain for good health.
Despite these sleep superpowers and the benefits to your waking day, as a society we do not largely understand this and globally, we are facing, what the World Health Organisation have labelled a sleep epidemic.
In a study by Sleep Cycle, no country around the world manages to sleep 8-hours a night (6).
Sixty years ago, the nightly average was 8-hours of sleep, now we average about 6.5-hours.
This places us at a greater risk of mental health disorders and chronic health problems than we’ve seen before.
We are not going to work ourselves to death. We are going to wake ourselves to death.
"...however, you can also sleep yourself well"
This is when we dip into the choose your own adventure component of sleep. And, when I talk about sleep, I am not talking about perfection. Your brain can handle a little bit of loss, it has a range of ways to compensate, cat naps and plunging you into restorative sleep states quicker and for a greater percent of the night. In fact, waking 3 or 4 times in a night is completely normal and healthy.
I’m going to share with you three villains of sleep that you will welcome into your story in the name of false productivity and fun, and the three pathways that lead to sleeping yourself well.
Villain 1. Dirty bedtime habits.
In 1890, a behavioural scientist, Pavlov, took some dogs, rang a bell and presented some meat. Each time they would salivate to the meat. With enough pairings of the stimuli, the bell, and the reward, the meat, the dogs would salivate to just the bell.
Similar to these dogs, we are creatures of behavioural learning and habit. With enough pairings of feeling sleepy and going to bed, eventually just the bed, the stimuli, is enough to make you feel sleepy. But this means you need clean pairings and a clean routine.
Path 1. Clean your routine.
By keeping a solid routine, you teach your body that bed is about sleep. You teach your body to release melatonin at night to feel sleepy and cortisol in the morning to wake you up. But you must keep a clean routine.
When thinking about a routine, think babies. What would you do to get a young child to sleep well?
You’d give them a light but satisfying meal, warm bath or shower, make the bedroom dark, quiet, comfortable, cool (19-20 degrees Celsius), read a relaxing book, and stick to the same time each night.
For adults, sex is the only other activity you should add to this routine. Research tells us that you’ll get into a deeper more restful sleep.
Villain 2. Overthinking.
Overthinking, or rumination and worry, is one of the key factors that will destroy your sleep. Even though a somewhat normal habit for humans when we go into stress or fight/flight, it is largely not a helpful thinking style.
Your brain actually doesn’t work well at night. Think about if you’ve ever had the experience of having a thought at night, and gone ‘Brilliant!’ or ‘Ah! Disaster!’, only to wake in the morning and realise it was waffle? This is because your executive functions, a system in your brain responsible for shifting your attention quickly, making judgements, and problem-solving novel issues, is not completely online at night. This is why we are more likely to make poor decisions at night. This is why, as a population, we have a higher incidence of self-harm and suicide at night. You simply shouldn’t buy into your thinking at night.
However, it’s also why we sometimes have flashes of brilliance and creativity. When our executive functions go off-line our brain is not being regulated or controlled to think in a structured way. Either way, note it down if need be and come back to it in the morning when your executive functions are back online.
One of the systems that is often online at night is our Default Mode Network (9), an interconnected set of brain areas that come online when we are at rest, not doing a lot, or in a “default” mode. This system engages in self-reflection, reminiscing, or daydreaming.
If you’re feeling relaxed because you are engaging in self-care to ensure your fight/flight is down-regulated then likely when this system comes online you stew on positive things. However, if you’ve had a rough day or you’re feeling stressed about an event the next day, this system is going to pick apart interactions and your environment hunting for threat. Largely, your brain is a threat detection system, designed to keep you safe, It is doing it’s job to find whatever it is that has trip the alarm.
So, the alarm is tripped and the thoughts start “Oh, why did I say that?” “What if they ask that tricky question?”. Sound familiar?
Unfortunately, as far as I know, no-one has invented a time machine for you to go back and correct what you think you may have done, or a crystal ball so you can decide if one decision is more fruitful than another, so this thinking is pointless. You gain nothing but stress.
Put your thinking to bed, when you go to bed.
I hear you say, easier said than done. But I did say I would give you the path out of danger.
Path 2. Put your thinking to bed.
Meditation and mindfulness have come out of the realm of the esoteric and are now heavily researched. These non-invasive and non-pharmacological techniques have been shown to boost immune function, decrease stress, and slow cognitive ageing. Amazing stuff. All health benefits you can have if you practice for 15-minutes a day.
With regard to sleep, meditation and mindfulness increase meta-awareness, a thinking ability that helps you be aware of your thinking and direct it to where you want it. Like putting a puppy on a leash, meditation puts your Default Mode Network on a leash, so you decide where to go, and it helps bring your attentional and executive systems back online.
Meditation and mindfulness are the anti-thesis to mind wandering at night.
There’s also a book I’ve read that gives a bunch of other techniques for mind chatter, titled “Chatter” written by psychologist Ethan Cross - tinyurl.com/2y9tyz8e
Here is an excellent blog that I have found valuable for clients, written by psychologist Nick Wignall that asks you to examine you values and reasons for rumination and worry - nickwignall.com/stop-ruminating/
Villain 3. Our technology is too smart for our biology.
We’re such a smart and innovative species. Think about just a few weeks ago, we’re now learning how to redirect giant space rocks away from our planet. It’s incredible. We’re incredible.
We’ve made lights so we can stay up late into the evening. We’ve invented tiny devices so that our friends can talk to us at one a.m. about the toasted sandwich they’ve just made. We’ve put mail into a digital format so that at 9pm, your Boss can let you know that the deadline has been moved forward to 8am tomorrow.
Unfortunately, while highly convenient, your biology, your animal, didn’t get the memo. Your body still senses threat from physical and social sources and will ramp up quickly and, the other factor, light is still our primary way to regulate our daily rhythms.
Let’s look at each of these a little more.
The first is that each of these innovations are highly stimulating and/or stressful. You will get a jolt of cortisol, a stress hormone, and you will put your bedtime off till later. Simple. Cortisol is the hormone your body releases to wake you in the morning. If you’re pumping it at night because you’re watching scary films, trying to meet deadlines, or because you’re doom scrolling on facebook your body won’t be sleepy.
The second, with equivocal evidence, is that the light from the devices, your laptop, some house lighting, your phone, is the same wavelength as daylight. This light hits the master clock, your suprachiasmatic nucleus, which sits behind your eye, and tells the rest of your body it is daytime.
Michael Gradisar has some amazing resources about his research in this area on his blog www.winksleep.online (in particular, posts 65-68)
Either way, we know that devices are linked with sleep procrastination and shorter sleep time.
Path 3. Let your biology do its job: Put down the device.
Set a reasonable time limit on phone calls, emails, and checking social media. Do not break your rule, even if you wake up in the middle of the night. Let other people know that you are setting healthy limits on these. Have a staff meeting, make it a work place
none on the weekend.
But don’t take my word for it, make it a workplace wide experiment, what happens if there is management support around healthy work/life balance routines? Test it over a month, see if KPIs increase.
Research tells us you’ll be more productive, if you work hard AND rest harder.
Be a role model. Encourage others to set these limits too.
So, three paths that lead to a happy ending:
1. Clean your routine;
2. Put your thinking to bed, and;
3. Put down the device.
"The final question I’ll leave you with…
In this choose your own adventure, which path will you take?"
1. Sleep and mental health: https://www.ncbi.nlm.nih.gov/books/NBK19961/
2. Sleep loss and blood alcohol level: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1739867/
3. Sleep and cognitive decline: https://jnnp.bmj.com/content/91/3/236
4. Sleep and all-cause mortality: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864873/
5. Sleep and health: https://www.sciencedirect.com/science/article/pii/S1087079217300278
6. Sleep around the globe: https://www.sleepcycle.com/
7. Sleep and memory: https://www.frontiersin.org/articles/10.3389/fnsys.2019.00002/full
8. REM and cortical synapses: https://advances.sciencemag.org/content/1/6/e1500105
9. The Default Mode Network: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466873/
10. Sleep and mental health: https://pubmed.ncbi.nlm.nih.gov/34607184/
11. Sleep and mental health: https://pubmed.ncbi.nlm.nih.gov/27416139/