Get Hip to Sleep
Is your life making you crazy? Go to bed.
Illustration by Serge Bloch
So there’s a big writing assignment, 15 other ongoing work projects, a six-year-old daughter with the energy of a circus acrobat, a husband who’s away indefinitely because of a family illness, a big, fat mortgage payment that keeps coming due, a cat needing frequent pep talks so he won’t lick the fur off his stomach, a parakeet who will eat only junk food, and a car that needs to go into the shop because some little rat keyed it. ¶ Okay, I’m a wreck. We all are. And how do we fight back? ¶ We cut back on sleep. We even consider it a point of pride not to have enough time to sleep. We walk around like blow-up versions of ourselves, our eyes blank and glassy, bragging about how little time we spend lazing around in bed because we have so many really important things to get to right away.
Well, here’s a news flash. According to the latest research, sleep is really important. It makes you smarter. It brightens your outlook. It helps keep you from getting sick. It helps you maintain your weight and may even improve your sex life.
Yep, getting a good night’s sleep is going to be the next new thing, and the trend is gaining momentum right here in our own backyard—in community workshops, in doctors’ offices, and in research labs. If you’re one of those four-hours-a-night-and-a-quick-triple-espresso-and-you’re-good-to-go types, you are about to become decidedly passé.
After about a decade of investigation, UC Berkeley sleep researcher Matt Walker has demonstrated beyond any sane doubt that, just as your mother told you, you need eight hours. In studies at UC Berkeley’s Sleep and Neuroimaging Laboratory, Walker and researchers from Harvard Medical School discovered that well-slept humans are far better at learning, developing skills, and achieving intellectual insights than the sleep deprived. They also found that people who were short on sleep tended to react more emotionally and less rationally to negative images, as well as to recall negative memories much better than anything positive.
Walker says his research “puts the empirical data behind the common wisdom” that, for instance, if we need a solution, we “sleep on it.” Similarly, we tell each other to put worries aside until tomorrow, “as if sleep changes our emotional compass,” Walker says.
Walker, who is an assistant professor as well as the director of UC Berkeley’s sleep lab, appears very well rested, to put it mildly. With his British accent dressing up his speech quite nicely, he conducts his class lectures with the buoyancy of a talk show host. He has a thick pelt of reddish brown hair and the body of an 18-year-old. Unless Walker has liquid adrenaline in the venti-sized cup he tends to sip before his 4 p.m. lectures, he’s definitely getting his eight hours.
Walker started doing sleep research while studying brainwave abnormalities associated with dementia for his Ph.D. from the Medical Research Council in London. Considering whether these abnormalities were more pronounced at night during sleep, Walker realized that we still didn’t know why healthy people sleep—that is, exactly what functions the sleeping brain performs—so he decided to answer that question first. “That was 10 years ago,” he says. “I’m still trying to figure it out.”
And making considerable progress, it seems. Walker and his research into why people sleep have found their way into stacks of science journals, including the specialized ones such as Cognitive Brain Research and Neuron, as well as the biggies such as Science and Nature. Actually, Walker has become a bit of a celebrity, appearing on CBS’s 60 Minutes and PBS’s Nova. He was even mentioned on The Colbert Report in October. Stephen Colbert said Walker’s research demonstrating that lack of sleep can make a person more emotionally ragged “is just another excuse for the pillow huggers to sleep in.”
Real detractors of Walker’s research have been few. The main objection has been that the sleep-related processes that he’s found improve learning and memory could also occur during waking hours, but Walker quickly offers why he thinks sleep is king. “The biology of the brain is radically different during sleep,” Walker says, adding that the brain flows with a different “chemical cocktail” and parts of the brain connect in different ways than during waking hours. “There’s something unique and special and privileged about the state of sleep.”
Explaining his findings about the connection between sleep and memory, Walker says that research subjects who were kept up all night were able to remember 40 percent less of what they learned the next day, compared with those who’d had a good night’s sleep. In other words, the study showed you need to sleep before you learn. “You need sleep to lay down new memories,” Walker says. If you haven’t slept, “it’s like your e-mail inbox is full,” and you can’t take in more until sleep sorts out what’s already in there.
Furthermore, Walker says, you also need to sleep after you learn something, in order to preserve it. His studies have shown that, getting back to the computer metaphor, sleep could also be compared to a process of making sure your files are backed up. “With no sleep,” Walker says, “memories are vulnerable and fragile, and susceptible to being overwritten.”
Especially fascinating is that Walker’s research subjects who learned a visual or motor skill comparable to hitting a ball or playing a tune on the piano got better at the skill by sleeping. They were taught the skill and tested. The next morning, after a good night’s sleep, they were tested again, and their performance improved. Similarly, subjects who were shown an arrangement of objects often didn’t understand the exact pattern until they’d had a night to sleep on it, after which their sleeping brains seemed to have discovered the overall logic of the arrangement.
Regarding the emotional effects of sleep deprivation, Walker and his researchers have seen on MRI scans that the part of the brain responsible for alerting the body to danger, the amygdala, goes Code Red in sleep-deprived research subjects. At the same time, the prefrontal cortex, which is in charge of logical reasoning, shuts down. The result is an inability to put emotional experiences into context and a propensity to go completely ballistic over relatively minor matters.
Walker says he sees the evidence of such effects all around him. He points to an increase in mental health disorders beyond what can be attributed to improved diagnosis, and increased incidence of irrational and antisocial behavior, such as road rage. “All those things tend to show an upward rise,”Walker says, “and the amount of sleep we’re getting is doing the opposite.” Americans slept about 8.25 hours a night in 1907, whereas the current average is barely seven hours, with the East and West coasts the worst off, according to a survey by the National Sleep Foundation. “The proportion of sleep that we’ve lost is catastrophic. It’s monumental,” Walker says. “We as industrial nations have lost our appreciation of sleep, I think, in dangerous ways.”
Let’s check in after a bad night’s sleep. Burst out laughing inexplicably at the grocery checkout? Yep. Teared up when the handyman said he couldn’t come over immediately to replace the water heater? A little. Pulled right in front of a car and almost caused an accident? Uh, check.
We know lack of sleep turns us into mush and don’t need to hear it from Matt Walker or from Michael Cohen, M.D., medical director of the Contra Costa Sleep Center. Still, Cohen, who treats people who wake up as many as 1,000 times a night because of a breathing interruption called apnea, brings the point home.
Some of Cohen’s patients come to him only after they’ve been fired from jobs for being unable to function or after they’ve been in a car crash. “That’s how they die,” Cohen says, referring to drivers with profound sleep deprivation due to untreated apnea. Asked in a follow-up question whether the drivers tend to fall asleep at the wheel or if they simply drive poorly, Cohen responds in a way that seems particularly grim in the shorthand of e-mail. “They FALL ASLEEP and then drive poorly … no skid marks, cross freeway, crash.”
Cohen points out that the pilot who steered his ship into the Bay Bridge recently, causing 54,000 gallons of oil to spill into the bay, had sleep apnea. News stories have focused on the chance that a stimulant he was on to keep him alert clouded his judgment, but Cohen says a better question is if his sleep apnea was being treated or whether he was sleep deprived.
Cohen, who looks a bit like Sean Connery, says helping people get a good night’s sleep has extended his career in medicine. His specialty of 35 years, before becoming a sleep specialist, was pulmonology, mostly dealing with patients who had emphysema and lung cancer. Frequently, he says, “there was no corrective therapy.” By contrast, people with sleep disorders who find their way to his sleep lab showing signs of irritability, lack of focus and attention, and bad memory function often find their lives are profoundly improved. “What I’ve been impressed with is the dramatic change in people’s lives after treatment,” Cohen says. “At first they come in and have all these terrible complaints. Then they come a month later, and they’re all smiles.”
Luckily, doctors in this part of the suburban East Bay are generally in agreement on the importance of a good night’s sleep and routinely refer patients to sleep specialists. If Cohen suspects a patient has a sleep disorder, he invites him or her to spend the night at his sleep lab hooked up to sleep and breathing monitors. “I think we’re way above the national statistic” in terms of assessing sleep habits as a potentially major factor in how a patient feels generally, he says.
One of the local doctors who routinely inquires about his patients’ sleep habits is Walnut Creek psychiatrist Robert Picker. He says he has seen patients’ mental health problems diminish dramatically once they’re sleeping well. “Sometimes there’s a remarkable trickle-down improvement on the issues that are bothering them.”
Similarly, psychiatrist James Gracer screens his patients for sleep disorders because he’s found they can be the primary cause—without his patients suspecting it—for why they come to his Orinda office. If a doctor doesn’t ask directly about sleep habits, Gracer says, “you spend an hour focusing on what’s wrong, and it might never come up.”
Looking beyond his own practice, Gracer describes low-grade sleep deprivation as epidemic. When asked whether the people he knows around here seem to get enough sleep, he says, “No one does. People stay up late. They get up early. People are stressed with work, with kids. Very few people give themselves enough time to sleep.”
Maybe some of you don’t give a hoot if you could pass an exam. And maybe you figure it’s your business if you want to watch Letterman, even if you are crabby the entire next day. Even so, don’t go away mad. At least two other important facets of your life can be affected by sleep: your weight and your sex drive. (Your ability to fight off colds, flu, viruses, and cancer is also compromised by lack of sleep, studies say, but let’s get back to the big issues.)
East Bay health educator Valerie Keim has been in the sleep-deprivation trenches her whole life. A lifelong insomniac, at age 49 she has a thing or two to say about how to fall asleep and stay in its dreamy clutches. She recently presented a sold-out workshop called In Pursuit of Sleep, offered through the John Muir Women’s Health Center.
Keim is promoting sleep at the community level. Among the people she works with are single and working moms who routinely try to get by on four or five hours of sleep a night. The problems this presents include weight gain, Keim says. In scientific studies, sleep deprivation has been linked to both obesity and diabetes, but Keim’s informal research findings also speak to just wanting to keep off extra pounds. “If you want your diet to work, you’ve got to get enough sleep,” she says. “When you’re sleep deprived, your body grabs on to calories and your metabolism shifts dramatically.”
She’s got an equally blunt appraisal of sleep’s connection to sex drive. “Maybe you don’t need all these enhancements and hormones,” she says. “Maybe you just need to get enough sleep.”
Stress is probably the number one sleep killer these days, Keim says. Many of her sleep-promotion tips encourage relaxation to help undo the effects of the day’s fight-or-flight reaction, which floods our system with adrenaline and keeps our brains overly vigilant at night. Her dos and don’ts of getting a good night’s sleep also include making a cocoon of your bedroom with soundproofing curtains and rugs, and avoiding coffee, which can still be in your system at bedtime even if you’ve had it early in the day. Keim’s audience interacts with her enthusiastically, offering some of their own ideas for getting a good night’s sleep.
Still, her students aren’t quite on the sleep train yet and shuffle over to a coffeepot during their break. One woman mentions that they shouldn’t be having caffeine, but another waves the concern away. “You gotta stay awake somehow,” she says.
Exposed to professional sleep zealots as I reported this story, what could I do? I slept. At 10 o’clock every night, I said good night as politely as possible to the unfolded laundry completely covering the family room couch, our unorganized tax files, and the long list of people to whom I owed e-mails, who would no doubt feel neglected, abandoned, and maybe downright hostile because of my inattention.
When my cat cried outside my bedroom door at 3 or 4 a.m., I hissed at him in a way that said clearly, “I will lock you in the garage with nothing to sleep on but lint from the clothes dryer if you don’t shut up.”
I thought about what Matt Walker had told his students about a guy he saw while walking across the UC Berkeley campus. Surrounded by kids studying and typing on laptops, the young man in question was sleeping peacefully, on his back, with a book lying on his face. “My hope,” Walker said, “is that by the end of this semester, you would walk by that guy and say, ‘He’s probably going to ace the exam.’ ”
So, on mornings when I opened my eyes before the alarm went off, I immediately thought of that Einstein in training, shut my eyes again, and got back to it. None of this jumping up to get a head start on the day. That is for ninnies.
And, you know, it worked. Every morning after getting my recommended solid eight, I found that the big story assignment hanging over my head was “writing itself,” and I was constantly jotting down phrases that had organized themselves, seemingly, as I slept.