'1/3 of life spent asleep impacts 2/3 spent awake'
Psychologist Alice Gregory, out with a new book on the evolution of sleep, explains how the pandemic has challenged our dozing patterns
Growing up, if there's one thing this writer disliked, it was bedtime. Somehow, it felt very adult-like to be up until midnight, and so, we always had an ammo of excuses to avoid hitting the sack anytime earlier. That's probably a bad idea, feels Alice Gregory, an expert on sleep, whose new book, Nodding Off: The Science of Sleep from Cradle to Grave (Bloomsbury Books) offers interesting insights into how sleep evolves throughout our waking life—from infancy to old-age—and the constant challenges to it.
Gregory, who has been researching sleep for more than a decade, and is currently a professor at Goldsmiths, University of London, got interested in the subject during her undergraduate degree at the University of Oxford. "I was attending a lecture by a sleep expert. She pointed out that sleep is often neglected, but is important for multiple aspects of our lives. The more I thought about it, the more this made sense and it left me surprised that I hadn't learned much about this before. I wanted to learn more and was left convinced that sleep should be given greater attention when we study psychology," she shares in an email interview.
Though we are always told to "get enough rest," alternative messaging like "sleep is for wimps", "I'll sleep when I'm dead" and "money never sleeps," has challenged this narrative one time too many. "Certain people in power are reported to get little sleep, including Angela Merkel and Donald Trump. Some people take away the message that if they want to get ahead in life, they should work longer days and sleep less, but this does not necessarily follow." In fact, she says, missing out on sleep can lead to difficulties.
The good thing is that the dialogue on sleep is now changing, thanks to scientific research.
Edited excerpts from the interview:
In the book, you point out how the number of hours of sleep that we need reduces significantly, as we grow older. So, while an infant requires nearly 12 hours, an adult would need seven to nine. Why is that, and what happens, if we don't get the required amount of sleep?
Sleep requirements do indeed change throughout the life-course as does the composition of our sleep. For example, the proportion of slumber spent in Rapid Eye Movement sleep (where we are most likely to have vivid dreams) reduces dramatically from birth to adulthood. There are other changes in terms of sleep timing and napping, too. Such changes provide hypotheses about the functions of sleep and in particular different stages of sleep. For example, it has been proposed that REM sleep (so plentiful in babies) is particularly important for the developing brain.
We all miss out on our sleep from time-to-time, myself included, and that is just the reality of life. It is also the case that certain people may need slightly more or less sleep than these average guidelines. Overall, however, if you find that you have not had the sleep that you need, it is important to acknowledge likely impairments to your functioning. For example, do not drive if you have missed out on sleep or are tired. Over time, it seems that the effects of missed sleep could accumulate and there are links between short sleep and a plethora of problems, even life expectancy.
The connection of sleep with bad behaviour and even attractiveness of an individual is quite fascinating. Does this mean that sleep dictates our lives in very significant ways?
The third of our lives spent asleep seems to impact greatly on the two third we spend awake. You have flagged some interesting examples including links with behaviour and attractiveness—but there are many others too—including our mental health, our weight, performance at work and even the functioning of our immune system, the latter being particularly noteworthy, given the current pandemic.
You write about how technology, especially the blue light-emitting smartphone, has disrupted sleep cycles.
I do think that certain types of technology are problematic when it comes to sleep. Blue light can indeed disrupt our melatonin, the hormone of darkness which gives our bodies a cue that it is time to go to sleep. Even when blue light is filtered from devices, bright light, noise and arousal associated with smartphones and other devices can be problematic. Guidelines differ, but I would recommend avoiding these devices for at least an hour before bed. I would also keep smartphones and other electronic devices out of the bedroom if possible, and especially for children and adolescents who may benefit from clear rules about this.
You've discussed how insomnia and depression are bedfellows. Do elaborate.
Insomnia and depression co-occur so frequently that the former is even considered a diagnostic criterion for the latter. That is not to imply that insomnia is just a symptom of depression, as sometimes it occurs on its own or even predicts the development of depression.
There are lots of reasons why insomnia and depression might be associated. These include shared genetic and environmental vulnerabilities. It is also possible that missing out on sleep makes us less likely to partake in positive activities that help to keep depression at bay. Lack of sleep might even change the way our brain responds to emotional stimuli, making us more likely to feel depressed. In fact, there is some research to suggest that treating sleep problems can indeed have a positive impact for associated mental health difficulties. Further research is required, but this approach holds promise.
Stressful events in our lives can trigger insomnia. You also point out to the "3P model of insomnia, which focuses on predisposing, precipitating and perpetuating factors". This pandemic appears to be one such event.
The 3P model of insomnia has been very influential over the years. The idea is that there can be predisposing factors (such as a genetic vulnerability) for the development of insomnia. There may then be a precipitating event (in your example here, perhaps the arrival of the pandemic) that can trigger the onset of insomnia.
Perpetuating factors, perhaps in this example, drinking more alcohol than usual to cope with the stress, or becoming overly worried about sleep, can maintain the problem when it arrives. It's not surprising that given the change in routine and possibly decreased exercise and light exposure as well as increased stress, so many people are complaining about their sleep.
How can we cope better, especially in these times?
Some of the advice provided for good sleep has been difficult to follow recently. For example, getting exercise and exposure to light and trying to avoid stress. However, with lockdowns around the world, this has been difficult to achieve. Nonetheless, other tips for achieving a good night's sleep are still possible. For example, relaxation techniques such as mindfulness and breathing exercises might be more useful than ever. It is helpful to avoid light and electronics at night. Caffeine can affect sleep, even when consumed early in the day, so give that a miss if sleep is proving evasive. Trying to stick to a consistent sleep-wake routine, despite the unusual circumstances, can also be very helpful.
Would you say that there is a connection between the pandemic, lack of sleep and the rise in mental health cases?
The pandemic is a relatively new situation, so there is a paucity of research on COVID-19, sleep and mental health although more research comes out each day. Some studies have indeed suggested a change in sleep over the recent months and an increase in mental health difficulties too. Based on what we know about the links between sleep and mental health, it seems likely that one difficulty could exacerbate the other, reminding us yet again, to look after our mental health as best we can and to prioritise a good night's sleep.
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