To sleep, perchance to dream

Today, 19 March 2021, is World Sleep Day. Yesterday, I did something at work that I've never done before. I attended a presentation on sleep. The presentation, by Dr. Andres Fonseca, CEO and co-founder of Thrive, Ericsson's mental wellbeing partner, was all about sleep. What was unusual about this was that I've never worked for a company that took an interest in whether I slept well or not before. However, at the end of the presentation I understood so much more about the importance of sleep, its impact on my mental and physical wellbeing, and how to improve my sleep patterns. I was so impressed I wanted to share what I'd learned.

Quick takeaways

There are a few important things I took away from the presentation:

1. I don't get anywhere near enough sleep...I blame children, cats and Netflix etc.
2. Less than 6 hours sleep a night can cause physical health issues
3. Less than 6 hours sleep a night can cause mental health issues
4. Some people are "early-birds" and some people are "night-owls" and if you can adapt your work patterns to match your natural rhythm
5. Listen to your natural rhythms. When you start yawning go to bed
6. Create a sleep routine and stick to it

Sleep is really, really important

I think deep-down we all know how important sleep is and that its important that we get enough sleep and enough of the right kinds of sleep. I didn't realize quite how important sleep is and how a bad night's sleep affects me.

If you are regularly getting less than 6 hours sleep per night it can have a detrimental effect on both your mental and physical health.

Mental Health Impacts of <6 hours sleep

• Risk of depression
• Risk of anxiety
• Risk of dementia

Dr. Fonesca cited that both Margaret Thatcher and Ronald Regan, famed for their short sleep cycles (Margaret Thatcher claimed to need less than 4 hours sleep per night), both developed dementia later in life. He also noted that there are recognized links between bipolar disorder and reduced need for or ability to sleep.

Physical Health Impacts of <6 hours sleep

• Increased risk of obesity
• Increased risk of heart disease
• Increased risk of sleep apnea
• Increased risk of diabetes
• Increased risk of infection
• Increased risk of infertility
• Lower sex drive

Worryingly, sleep apnea, cessation of breathing during sleep, unsurprisingly leads to a very unrestful sleep. If your sleep patterns are really bad you can stop breathing. The link between lack of sleep and obesity was very interesting. Lack of sleep inhibits the secretion of Leptin, the hormone responsible for inhibiting hunger. Lack of Leptin means you don't feel full and means you often eat more than you should.

It became apparent to me that lack of sleep really is a bad thing.

Getting a good night's sleep

We talk about, "getting a good night's sleep" but what does that really mean? It became apparent during the presentation that not all sleep is equally good.

A good night's sleep is 8 hours. Typically babies and children need more, teenagers need a lot more and older people need less. However, its not enough to have 8 hours sleep in four 2-hour blocks during the day because there are three different types of sleep and it takes time to move into the third type, REM, sleep.

Sleep types

1. Light sleep - Non-REM
2. Delta Sleep - Non REM
3. REM sleep - REM

REM, not the US indie rock band fronted by Michael Stipe, stands for Rapid Eye Movement, the type of sleep associated with dreaming. You normally have to go through light sleep (non-REM) and delta sleep (non-REM) to get to REM sleep. Each of the sleep phases has an important role.

Light Sleep

During light sleep, which lasts around 20 minutes, your body temperature drops, your breathing and heart rate becomes more regular.

Delta Sleep (Deep non-REM sleep)

This is your deepest sleep and is used by the brain for memory consolidation taking the day's information, sorting it, discarding what's not important and filing it in long-term memory. If you don't get enough deep or delta sleep you may experience problems with concentration the next day. Its as if your short-term memory storage is full.

REM sleep

During REM sleep your muscles relax almost to the point of immobilization, but your brain becomes incredibly active. This is when creativity and problem solving takes place. You ideally need 1/2 -2 hours of REM sleep per night.

A good night's sleep ideally consists of all 3 types of sleep and you start to see why short naps or siestas aren't enough. Short naps give you light-sleep or even deep non-REM sleep but because it takes some time to get to REM sleep these short sleep patterns or "power-naps" are not really good enough to qualify as "good sleep".

The impact of sleep deprivation

I seemed to spend a lot of my Army career sleep deprived either in training or on operations. The army taught me to be able to sleep anywhere and through anything, but it didn't really teach me to have "good sleep".

Sleep deprivation can be very dangerous. Sleep deprivation drives the need for "micro-sleep" which in the Army we called "nodding-dog syndrome" where you can literally fall asleep standing up. Micro-sleep is exceptionally dangerous if you're driving a car or operating heavy machinery as its effectively a period of unconsciousness where you have no control. If it starts happening while driving you need to stop right away and have a proper sleep. In fact Dr Fonesca made the frightening point that if you drive under the influence of alcohol your reactions are severely impaired, but if you drive sleep deprived you potentially have no ability to react at all.

Dr. Andres Fonesca - CEO and Co-founder of Thrive

It is more dangerous to drive sleep deprived than it is to drive intoxicated.

Sleep deprivation can be a major issue for people forced to work shifts with constantly changing sleep patterns.

Early to bed, early to rise

The COVID pandemic has led to a significant change in working patterns, but not so much to hours of work. The "normal" 9-5 working day only suits about 30% of the population. Not everyone has the same circadian rhythms and people do fall into a spectrum of natural waking and sleeping patterns that can be characterized as "Early birds" (About 40% of the population) through "normal" to night-owls (about 30% of the population).

Many "early birds" find their best working hours are first thing in the morning, they may choose to have an early start but often feel that despite being at their desks at 7am they are expected to work until "normal" finishing time of 5pm. This makes for a long day, with a very unproductive 2-3 hours at the end as the early risers flag.

For "night owls" 9-5 office hours mean rising early than their body dictates, often not really getting into their stride until close to lunchtime. Perversely they are at their most productive after most people have gone home at the end of the "normal" working day.

One of the opportunities we face in the post-pandemic world is potentially the ability to adjust working hours to more closely match your bodies natural rhythms. This would probably drive productivity in the workforce.

How to get a better nights sleep?

While its great to understand more about sleep itself, I was keen to understand how to get a better nights sleep. During lockdown last year we got two kittens to keep our geriatric cat company. Between the three of them I get woken up any time between 4 am and 6 am most mornings. They've worked out that licking my face or clawing my toes is a very effective way of waking me up and getting them an early breakfast. Unfortunately, I'm both a "night-owl" and a light sleeper and this early morning awakening really impacts on my sleep.

So what practical steps can I follow to get a better nights sleep? Not surprisingly eating late at night, drinking alcohol, and watching Netflix on my tablet are not the best start for a relaxing night's sleep. Electronic screens generate "blue light" which inhibits melatonin secretion making it harder to get to sleep.

Also those of you how are temporarily working from home and using your bedroom as an office are also making things hard for yourself. You start to associate the bedroom with work, and activity so your body finds it harder to "switch-off" in an office-cum-bedroom. If you can work from home in a separate room from the room you sleep in.

There were four key takeaways for me:

1. Routine
2. Temperature
3. Light
4. Noise

Routine

The first, and hardest for me, is creating a bedtime routine. Ideally, you should go to bed at the same time each night. You should have a regular bedtime routine to help you wind down. Have a hot, non-caffeinated, non-alcoholic drink and Read a book, but not on an electronic device. This routine signals to your body that its time to go to sleep.

To be honest this is an area I'm going to find very hard to follow, but if you manage it, well done!

Temperature

Being toasty warm in bed isn't good for a good nights sleep. Ideally the bedroom should be between 18-20 degrees, you should wear comfortable sleeping clothes and not get too hot with a 100 TOG duvet. Counterintuitively, a warm shower before bedtime stimulates the body and helps you cool down. This could become part of a regular bedtime routine.

Light

Perhaps unsurprisingly, we sleep best in a darkened room. Avoid artificial light and recognize fluorescent light is really bad for sleep. Avoid electronic screens in the bedroom and ideally at least an hour before sleep.

If you can't get your room dark enough with blackout curtains, or like us your children insist on having the landing light on to aid night-time trips to the bathroom, consider wearing a comfortable eye-shade. Yes, you'll look silly but who cares if you get a good night's sleep?

Noise

Water is wet, the sky is blue and high noise levels interfere with your ability to sleep. If you live near a busy road, railway or airport or you have lots of students living near you, you may want to consider earplugs.

Music isn't really recommended to go to sleep, particularly music with lyrics as it tends to make you concentrate. Much as I like The Clash, I really wouldn't recommend trying to sleep through White Riot or London Calling before going to bed. However, some people swear by listening to "white noise" or nature sounds. Amazon's Alexa offers a series of bedtime sounds which my youngest daughter loves to listen to as part of her bedtime routine.

When sleeping becomes a problem

If sleeping becomes a problem then you should seek professional, medical, help. Sleeping tablets don't really help you to get the right mix of sleep types that your body needs. Many people who take sleeping tablets complain of "not being refreshed" when they wake.

One reason many of us have trouble sleeping is because of stress and anxiety, and the key to a good nights sleep may be in managing that stress. One simple but effective approach is to start a "worry-diary" where you right down your problems and concerns before going to bed. The process of writing them down helps you to not think about them when you try to sleep.

There are also a series of mediations and cognitive-behavioral therapy (CBT) techniques that can help you. I've found that Headspace, which everyone in Ericsson has access to through a corporate program, has some great meditations to help you sleep or go back to sleep. My favorite is to count slowly backward from 10,000 to zero. I've never got below 9,800 before I fall asleep. Do experiment to find what works for you.

What's the point of sleep?

I've always known that sleep was important, but I didn't realize quite how important it is to our physical and mental wellbeing. If you're getting less than 6 hours sleep a night you're not doing yourself any favors and you need more.

There are lots of simple things you can do to help yourself get a better nights sleep but if they don't work to seek professional help. Sleep is important and a good nights sleep not only benefits you but also your family, colleagues and work. Make time for sleep, it is time well spent!