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 I'm sold Matthew Walker

neuroscientist and best-selling author

and one of the world's leading

researchers in sleep science it's gonna

blow your mind there's 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 411 billion dollars

your rates of obesity cardiovascular

disease mental health conditions all of

these things escalate if that wasn't bad

enough oh my God 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

feels like caffeine is a miracle drive

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

before we get into this episode just

wanted to say thank you first and

foremost for being part of this

community

um the team here at the diver CEO is now

almost 30 people and that's literally

because you watch and you subscribe and

you um leave comments and you like the

videos that this show has been able to

grow and it's the greatest honor of my

life to sit here with these incredible

people and just selfishly ask them

questions that I'm pondering over or

worrying about in my life but this is

just the beginning for the day of this

year we've got big big plans to scale

this show and to every corner of the

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let's get on with it

[Music]

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 your work is

now world renowned

um and it's a very very important work

but

as is the case with a few of the recent

episodes in 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

um why do I do what I do and why do I

think it's important

um 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

deprived 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 oxygen you're going to Puff

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 unless 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 I am 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 um

incredibly humble of you but but I would

assert that you're without a shadow of a

doubt the leading

author scientist commentator 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's miserable nothing was

was Landing

and one day I went home at the weekend

and sort of with all of my printed

journals and I go to the my doctor's

residence and have this sort of igloo of

journals around me that I would sit and

read at the weekend

um and I was which probably tells you

everything about my social life at the

weekend if that's what I was doing but

um 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 patience at

the wrong time I'm measuring them when

they're awake 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 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 nother 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 that's a

you've got a long way to go actually the

amount you've been sleeping it's very

kind of you to say yeah I I wish I'm

moving into the foothills of middle age

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

um I I am so fortunate well I probably

start trying to fly like business class

or first class that would be nice but

other than that

um I would do nothing different and I

I'm very mindful of that because that

sounds very privileged and I know a lot

of people

endure 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 of people in

that regard I just know how much I love

what I do you you asked a question now

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 it

doesn't happen 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 your 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 de-escalate 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 their brain

falls asleep after 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

where

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 uni

hemispheric 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 ER

otherwise you know that's not going to

be a good outcome we also know that uh

birds or even many avian species will

have uni hemispheric 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 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 the unfortunate girl or guy who

sort of lands at the end to 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 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 hot 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 brain sleep in other

words you just can't get away from sleep

you have to sleep but your second

question I think is 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

um 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 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 00 pm and

are waking up let's say at 5 00 am and

then you've got all of the extreme

evening types who are going to bed at

2AM and waking up at maybe 11 or midday

so that way the 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 there 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 that this Chrono type

thing um 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 was pondered by

my partner goes to bed super early wakes

up super early I go to bed late wake up

late

um

I'm gonna ask you this question actually

because because 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 she's

waking up at 5am but at 5am 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 she's

waiting 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 it 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 now someone was telling me

people will 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 um a sleep divorce is where you

sleep in separate locations

and when we've surveyed people

um both uh use it in the from the Sleep

Council in the United Kingdom and also

in 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 I'm 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 men estrogen and

uh at least an icing hormone in women we

also know that your

um 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 percent

now to give you some context the FDA

drugs for improving or increasing libido

in women drugs such as violisi 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

percent 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 sleep it's usually quite

quite the opposite

um 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 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 you know we there

is safety there's Security in

co-sleeping there is this

sort of connection that we get you 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 let's just try it and see

how it goes it doesn't need to be

permanent because what you actually miss

are the book ends 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 instead of

having a kiss or a cuddle or and sort of

waking up together in the morning and

sort of now obviously when you're a

mismatched chronotype that's also it 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 so

I I don't want to sort of believe at 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

um disruption that happens by way of

sheets and movement is decreased but

that doesn't solve it all sometimes

there is snoring uh sometimes there is

sleep talking those things are not

obviated by the Scandinavian method

when you think about where Society is I

was I was going to ask you you know you

said you wanted to to do 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 gonna get worse or is

it going to become less significant and

less relevant based on the trajectory of

societies you see it

you know I'm

mixed I think when I wrote the book I

started writing uh

a book that was called why we sleep back

in probably about 2014 or 15 and at that

point sleep was the neglected stepsister

in the health conversation of that day

you know we were speaking a lot about

diet and exercise which was wonderful

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 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 of sleep

um

but with that awareness

I want 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

that's 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

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 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

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 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 at

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

any 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 it does that have

Geographic variants 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've

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 UK it's not much better 6

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

um that are actually sleeping much

better than that I think let me um

Mexico for example is

um is doing very well if you look at

Mexico City uh people are actually

sleeping and 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

um 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 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 we're

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

um

it's 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 instead

of all of the other dials the sort of

the red yellow orange green dots 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

which 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

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

it 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 were where 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 two percent of their GDP

so here in America that number was 411

billion dollars of lost profit caused by

insufficient sleep in the United Kingdom

it was over 50 billion dollars in Japan

it was over 120 billion dollars 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 out 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

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

the 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 yourself

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 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 move down to the level of medicine

then I would go to education because we

don't get taught about sleep in schools

and 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 the 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 will go into the

room of the teenagers they'll you know

pull open the curtains they will pull

the covers off and they say you're

wasting the day you know 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 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 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

problems 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 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

um hopefully if there are people

listening from governments which I'm

sure there are because you know I hear

about that sometimes which is quite

bizarre but um I

I'm sure they'll be getting in touch

with you very quickly going back to the

top of that that stag on the company

level so as a CEO or a CFO or an

employer whatever

um there are some companies that are

incentivizing their team members to

sleep right is there any data showing

the efficacy of that

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

um 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 performance

because the weakest link on any space

mission and we've done some work with

NASA

um 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 they found was that these naps

anywhere between 20 minutes to an hour

could increase productivity on these

different tasks by about 34 and

increased General alertness by over 50

percent 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 in 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 organized

but they just like companies like Google

or Facebook they understand the pounds

and pennies cents 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 um I did some work

uh Google uh during a sabbatical and

there on their campus they will have

these nap pods and they will have these

what are called

rooms 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 have 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 is 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've we can do these studies in the

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 in their

revenue

third that 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 uh 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 you know

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

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 uh 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 Health Care Resources

increases by about 80 percent so the

cost to either you the company here in

the US where your company is paying for

your health care or the cost of the

government for example in the United

Kingdom is astronomical

and also then the co what we call

comorbid diseases your rates of obesity

diabetes cardiovascular disease mental

health conditions all of these things

escalate as underslept employees

continue to get even more 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 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 sleeping deep

sleep and that happens a little bit

further on into my you know the 90

minute look at me trying to tell a Sleep

Experts well 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 minutes and 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 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 de-escalate negative

emotions and increase positive emotions

um so naps certainly are a good thing

but with a big caveat that I'll come

back to

um 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 cities 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 I might response to them is why do

you want to get more REM sleep and their

answer is what 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 Short change any of them but for

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 that's non-trivial

so um so the reason I would say

be careful with naps is for two main

um 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 snap for about 40 minutes you'll

probably go down into deep sleep and at

that point where 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

denosine 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 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 are 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 mentioned caffeine there a topic

I've modeled 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 a it's

another astute one which is

it would you know is it a miracle drug

with no cost

in biology and Medicine There is almost

no free lunch

um 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

um caffeine will hurt your sleep and

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 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 as

the equivalent of you know talking

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 that 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

um 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 00 PM 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 uh 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 p.m but now all of

a sudden that signal is blocked and a

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 the 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 a 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 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 100 150 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 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 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 the 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

uh caffeine is not because I'm so pure

technical I want to be the poster child

of good sleep I love the smell of

freshly ground coffee in the morning and

it's a great ritual it's just that I've

ruined my genetics and I am one of these

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

um why do I now favor coffee I was

actually quite

anti-caffeine and 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 today 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

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 is what's

got other things such as Cafe style 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 on 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 we're at

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 uh

decaffeinated coffee

I would love to drink a caffeinated

coffee too because I

you know 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 boost 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 so 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

as you might know the show's now

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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 I 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 there 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 cult 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 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

for 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 but 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-lar 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 you know 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 in so many conditions what exactly

is that therapy aiming to do what like

what does it do for for somebody

great question so in some ways that the

title 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 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 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 the

box let's just manage it that's just

because it's going to stress you out

right it's 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 one do the

prototypical recommendation is that

after about 30 minutes of time a week

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 and