Ask the Expert: Tips and answers to FAQ’s about sleep

Answers to FAQ's about sleep - written video transcriptions

Video 1 – Can we plan for a good night's sleep?

Mark:  It’s always struck me as fascinating that it’s one of the most important parts of our life, and yet it’s the one part of our life we don’t plan for. We plan our finances, we plan our careers, or at least many people do, we plan our goals and all the rest of it, but we don’t actually do anything when it comes to sleep. Interestingly enough, Aviva did a survey about five years ago and identified…so that was pre-pandemic, and they identified that about…more than 50 per cent of adults in the UK recognised that they had a sleep issue. But only a quarter ever planned to do anything about it.

So it’s about like I want to go on a diet and lose some weight or I want to get fit, and I want to do this and I want to do that. If you don’t see a plan in place, nothing ever happens, and that essentially is what appears to be happening from that survey. A good starting point is to start looking at your own sleep habits, what you tend to do. What do you currently do, and what do you do that works, and what do you do that doesn’t? We kind of know, I guess common sense will tell us at least some of the things that might help and what will get in the way, and maybe adopt a little bit more of how we treat children.

There’s a pre-bed routine that probably runs at least an hour before you go to bed, there are things you do and things you don’t do, reading a book might fit into that for them. And yet we don’t do that. We kind of work until we drop, and even if we’re not doing work work, we’re doing other tasks. We’re doing whatever else we’ve got to get done that night, and then we just expect to get into bed and go to sleep, and it doesn’t really work like that.

Video 2 – What impact might the pandemic have had on sleep quality? 

Mark: Concern, financial concern and future employment and everything to do with health in the pandemic, but I think there’s a couple of other things that are fairly clear as well. One is simply we were doing less as human beings, we were stuck in our houses, we were less active, and probably to a degree, many people remain less active than we were two and a half years ago. Not going to work anymore, working from home more, less going on socially, so we were more sedentary, and so less exercise, less activity is more likely to make it harder to sleep at night.

And secondly, the other thing that happened and continues to happen, and it has been a trend before the pandemic, but the pandemic accelerated it markedly was the trends towards IT equipment, so phones and tablets and everything else. And the need to do everything online. And that has had, I think, a number of links that impacts on sleep. One is the exposure to the light, the blue light that’s given off by the machines generally, particularly if we’re using them late in the evening.

Collapse of work life boundaries for many people, we have been using these things later on, and possibly using them socially as well later on. And secondly, IT equipment tends to promote multitasking and juggling things to a greater degree than we did when we were going from meeting to meeting and dealing with people face to face. And multitasking does tend to link into our brain becoming overactive, and a lot of people reporting that they’re kind of waking up in the night and their brain’s buzzing, that sort of thing, is perhaps a symptom of that.

So I think it’s had a couple of specific impacts in addition to the wider concerns about health. People sending emails at inappropriate times, there’s a whole work-related issue that has impacted in that area, but I mean, I do remember just being online all the time, even socially, you were Zooming friends at night. It’s almost like everything went on to those sort of platforms as well, whereas previously you might have made a phone call to somebody, you now weren’t making a phone call to them, you were going online.

It’s very clear that the brain associates blue lights instinctively with sunrise, daylight, blue sky, being alert, so it’s no surprise that we’re struggling to sleep after that.

Video 3 - The news is very negative at the moment, any practical tips on reducing its impact on sleep? 

Mark: 24-hour news, if anything, is even worse than your normal scheduled bulletins, because they do tend to hover around bad news all the time, and links to that, I guess, social media too. Many people use social media for their news, and that also tends to gravitate towards bad news, controversy, and if we’re getting ourselves all emotionally caught up, again late in the evening, that’s going to have an impact too. So yes, I think watch the news once, watch it early, would be my general advice, and then move on and do something else.

Video 4 - What are the implications of sleeping badly?

Mark:  In the United States, the average adult definitely gets a lot less sleep now than in the 1930s/1940s, by about an hour and a half, and the UK appears to be roughly comparable to that. We haven’t evolved in that time, in that 60 year period, to need an hour and a half less sleep, we’re just getting an hour and a half less sleep. That’s coming at a cost to us, and maybe that’s another thing, just the awareness of the potential implications of not getting a good night’s sleep and consistently getting one. There’s some very, very real health implications now that are very clear, much clearer than they were even 20 years ago or ten years ago.

Video 5 - Are there any surprising effects of sleep for our health?

Mark:  A good example, and this is fairly recent research, is that during the process of sleep, we go through a sleep cycle that typically lasts about an hour and a half to go through it, plus or minus a bit of time, and during that cycle, we literally…our brain gets a car wash. Effectively during the day, there’s a build up of waste material in the brain called toxic amyloid.

It’s a leftover residue from how our brain works during the day, and sleep cleanses that out at night, and so we need to get sufficient sleep to give it effectively a good wash, if you like. And there is a lot of research now related to toxic amyloid build up in the brain with later onset of dementia and Alzheimer’s in particular, and there is a clear link there.

Famously two politicians in the 1980s both boasted a lot about not sleeping or not needing to sleep a lot, Ronald Reagan and Margaret Thatcher. Both of those two died from Alzheimer’s, so there’s very clear links, I mean, they boasted about it, they thought they were light sleepers, they didn’t think they needed very much of it. Well, they did, actually.

Interestingly enough, another link would be in the western world, so the developed world basically, we have this convention that in the spring, the clocks go forward by an hour, and in the autumn, they go back by an hour. So the day after they go forward, the incidence of heart attacks goes up by a quarter, and the day after they go back, the incidence of heart attacks goes down by a fifth.

So very clearly, more people are getting a bit more sleep on the nights that the clocks go back. It's having that impact, so that’s on a one night basis, a one off twice a year event, we have this immediate impact. We don’t factor this stuff in, it’s really important that we sleep well and sleep enough, and for most adults, the vast majority, it is seven to eight hours a night.

Video 6 - How much sleep do we need?

Mark:  There is another piece of research that indicates that the nearest percentage point, so rounding up or down by one per cent, zero per cent of the adult population can survive healthily on less than six hours a night. So anyone that suggests they can, statistically they’re almost certainly wrong. I tend to think this is a bit like height, human height, there’s a range of normal. Somebody can grow to five foot two, somebody else might get to six foot six, but you’re not going to get somebody growing to nine foot one and you’re not going to get somebody growing to three foot four, that’s not within the range of normal.

So someone who says, I can get by on less than six hours’ sleep, if that is true, it’s outside the range of normal. It’s an aberration, in short, and the same with the reverse. Someone needing more than nine, it may be there’s a sleep disorder in there somewhere, or there may just be something slightly different for them. But to all intents and purposes, anyone saying I can get by on less than six, well, you can get by, but it’s coming at a cost. It’s coming at a cost to your health, it’s coming at a cost to how you function, and maybe you’ve just got used to it.

There’s a grain of truth that some people sleep more easily than others, that is true, but there’s more than a grain of truth that the habits that we adopt in the day and our general approach to life, and in particular, how we behave in the evenings, if we were to put a time on it after eight o’clock in the evening, have a fundamental impact on how well we will go off to sleep, along with other environmental factors. And there’s a lot of those out there, how comfortable our bedroom is, is it dark.

We actually need far more dark than we realised. It needs to be dark. Even a neon light alarm clock interferes on some level with the quality of our sleep, so dark means dark, and we are relatively dark deprived now. We live in a very light society, and even whether we have partners who snore or someone else who goes to bed at the three in the morning, those things keep you awake as well. There’s other things out there, but a lot of it is about our habits and what we do that either helps or hinders our ability to sleep.

Video 7 - Do you have any thoughts as regards our sleeping routine?

Mark:  Again interestingly, the research would suggest that we thrive best on what’s called regularity, so broadly speaking, we go to bed at roughly the same time every night, and we get up at roughly the same time the next morning, and we tend not to do that, interestingly enough. Even the pandemic didn’t seem to change that, people still stayed up later on a Saturday night and a Friday night and got up later on the following morning.

Well, that’s not necessarily a healthy thing to do. We may have to do it, people who work shifts, for example, or if you’re really starting early in the working week, we have to factor that in, of course. But the closer we can get to consistency, generally the better.

Video 8 - Can you offer any do’s and don’ts regarding our behaviour and sleep?

Mark: There are definitely some dos and some don’ts. The don’ts, we probably know what they are, that’s one of them, caffeine, so try to knock that out, probably earlier in the day, actually, so none after mid-afternoon, try to stop the caffeine intake. Alcohol does tend to interfere with our sleep patterns as well.

Now, we’re not all going to stop drinking, that’s not going to happen, but being aware, I guess being more aware of, if I do this, it’s going to have an impact, rather than, it’ll help me sleep, actually, because it might, but you’re not going to sleep as well, the quality of sleep is not as good. Eating late is a bad idea, eating late and strong foods is an even worse idea, so curries and stuff like that will impact, so there’s some very clear don’ts.

The dos involve doing things that are a bit more relaxing, not overdoing the activity late on at night, so doing things that are a bit more calming, a bit like the child, same kind of routine. Late-night exercise or evening exercise can actually get in the way of sleeping.

Jan: Yeah, so it’s a balance because you’ve got to sort of tire yourself out physically, but not to the point where it’s too close to when you’re going to bed then.

Mark: Yeah, because the likelihood you will not sleep as well in that situation. Certainly extreme exercise does not go down well with sleep, if it’s late. Gentler exercise, maybe, body balance, yoga, that kind of thing might work better. Something that relaxes your mind is a good thing and isn’t too taxing. They’re probably the two things, so it could be light puzzles, jigsaw puzzles, that kind of thing might be an option.

You don’t want to be doing stuff that’s complex problem-solving necessarily, building a Meccano set or building an aeroplane or those sorts of things, or arts and crafts could be relaxing for some people. Listening to music for others, it's whatever works for you, really, and we all probably have some sense of what relaxes us. We need to do some of that.

There is a link between the ability to relax during the day as well at times and the ability to switch off at night, so building breaks into the day is particularly important as well.

Video 9 - Is there one tip you can offer regarding getting to sleep?

Mark: There’s a guy called Matthew Walker, who’s a sleep expert, he’s one of the foremost experts in this area, said that going to sleep at night is a bit like landing a plane. You don’t start thinking about landing a plane 30 seconds before you land it. There’s a kind of a process of coming in, and yeah, the engine’s calmed down and it descends. If you just hit the runway and think you’re going to sleep well, well, it isn’t going to happen like that, in all probability.