The Science of Sleep | Holistic Cognitive Behavioral Strategies | Happiness Masterclass

Hey there, everybody, and welcome back to the Science of Happiness Masterclass. Today we're going to be talking about the science of sleep. I'm your host, Dr. Donnellice Snipes. In this video, we're going to define what quality sleep is and explore the research regarding the impact of quality sleep on health, mood, cognition, and indirectly, your relationships. Then we'll Finish by identifying 20 plus strategies to help you improve your sleep. Let's start out by defining what is quality sleep. Quality sleep is sleep that is restful and restorative. And for most adults and adolescents, that is seven to nine hours of good, solid sleep every night. What do I mean by solid? Yes, they actually do have parameters for this. So we can quantify whether sleep is quality or not. If you fall asleep in 10 to 20 minutes, that's good. If it's less than 10 minutes, that indicates that you're sleep deprived. So if you're one of those people who doze off in the car or fall asleep the minute you sit down in your easy chair, you're probably sleep deprived. If it takes you longer than 20 minutes to fall asleep, it may indicate that your circadian rhythms are out of whack or there is something else going on that's making it more difficult to fall asleep. And we'll talk about a lot of those things when we start talking about how to improve your sleep if you wake up less than twice per night. So once per night, according to the Sleep foundation, is okay. Ideally, when you're waking up, you're not waking up in order to get up and go to the bathroom and get yourself all, you know, awake. It's just you're cycling out of the deep and REM sleep cycles into that light sleep again. You're going through the whole sleep cycle and that can, you know, when you get into that light sleep may be a time when you wake up for a minute to flip over or to adjust your covers or something. When you do wake up, you want to be awake for less than 20 minutes during the night. And that's really important. If you wake up in the middle of the night and you're awake for an hour, hour and a half, two hours, then that is taking time off of your quality sleep. Yes, you may be in bed for seven hours, but if you're awake for two hours in the middle of the night, that means you only got five, five hours worth of sleep. You're supposed to be asleep at least 90% of the time that you're in bed. And you can do the math. We don't need to get super hung up on this particular number. If you're falling asleep in less than 20 minutes, you're not waking up more than once in a night and you're staying awake for less than 20 minutes, when you do wake up, then the chances are you are sleeping 90% of the time that you're in bed. Subjectively, when you wake up, do you feel energized? Are you waking up? You may not be like, oh goody, I get to go to work today. It may be more like, okay, I'm awake, let's get up and start the day. That's okay, that's sort of energized. Or do you wake up and you're like oh my gosh, did I even get any sleep? And you start heading for that, that coffee right away. Are you clear headed or are you foggy headed? And there's not another technical definition for this. Throughout the day, as you think, as you do things, a chemical called adenosine builds up in your brain. As adenosine levels get higher, we start to feel what they call slightly pressure. When we go to sleep and get into our deep sleep phase, that's when the adenosine is cleared out. Now if somebody is not getting into deep sleep, they're going to sleep and they have a light sleep and then they may go into REM sleep and then they wake up and then they go back to sleep and they go through that again, but they keep waking up before they get that good deep sleep. Then they may wake up in the morning and feel really foggy headed and start running for the coffee. Caffeine. Not that I'm recommending using it, but caffeine can temporarily displace some of that adenosine. So it helps to sort of mimic that deep sleep period. However, we are going to see in just a minute that chronic sleep deprivation is going to cause a myriad of problems in the individual. I want you to think for a second, you're probably an adult or an adolescent if you're watching this. When was the last time you had a good solid week? 2 weeks of getting 7 to 9 hours of sleep per night for most of us, you're going to be thinking back a long, long time. The National Sleep Foundation's Sleep in America poll found that by the 12th grade, less than 75% of students were getting adequate sleep. And as people's age goes up, as they go to college and then start working, that number gets even worse. So the majority of the U.S. population significantly chronically sleep deprived That's a problem. What is the impact of chronic sleep deprivation? And I want to emphasize what we're talking about here is chronic sleep deprivation. Not the one off where you didn't sleep very well because the baby was fussy or because your allergies were acting up or something else, but chronic, ongoing, multiple weeks in a row kind of sleep deprivation. Physically we see a slowing of response time, which can be dangerous when you're driving. It can be dangerous if you have any sort of balance problems because you may not be as quick to put your hands out to catch yourself. It can also be dangerous if you're working any sort of heavy machinery or heck, even, even in the kitchen when you're using your own little butcher knives. It can start increasing the risk of making a mistake. When you're chronically sleep deprived, you're probably going to feel fatigued. Additionally, chronic sleep deprivation is associated with increased inflammation. So let's talk about this for a second. When we are sleep deprived, our body registers that as a stressor. Our body's saying, hey, we didn't get to rest and restore and rebalance, so we're at a loss. Think about that factory that I've talked about before. If the factory doesn't shut down at night and let the cleaning crew come in and get rid of all the garbage and crap that's in the worker's way, then the workers can't be as efficient and can't get their job done as efficiently. So the manager may start to get a little bit fussy, may start to get a little bit stressed because the manager knows that it's going to be more difficult to get the job done. So translate that to our bodies. Our bodies recognize that when we can't restore and rebalance, then we are out of sync for the next day. That's a stressor. So, so it kicks off our threat response system. That good old HPA axis secretes a bunch of cortisol, adrenaline, glutamate, all those excitatory neurochemicals. It's sort of like your body's way of giving it a shot of natural stimulant. Well, that's fine in the short term, but in the long term, when that happens chronically, the cortisol loses. It loses its anti inflammatory capabilities and we start seeing an increase in oxidative stress because all the garbage is building up because it's not getting cleaned out. And we start to see a reduction in cortisol's ability to act as an anti inflammatory. We also see a strong correlation between chronic sleep deprivation and the increased risk of cardiovascular disease, impaired immune functioning, obesity and diabetes, these are all huge issues for people. Cardiovascular disease kills hundreds of thousands of people every year. We know that diabetes and obesity can contribute to systemic inflammation and are worsened by systemic inflammation. And of course, we don't want our immune system impaired. We also see with chronic sleep deprivation, decreased parasympathetic or vagal tone. Remember, the vagus nerve is our main trigger, if you will, for the relaxation response. As we get more sleep deprived, we become more stressed. As we become more stressed and that HPA axis gets into command, then the vagus nerve starts losing its ability to effectively help us relax. So we stay more high strung and have more difficulty winding down and there's reduced muscle injury recovery. This is an interesting thing to note. Even if you're not a fitness enthusiast, anything you do uses your muscles. And whether it's cleaning out your garage or planting in your garden, or doing whatever you're doing, if you feel sore afterwards, not injured, but sore, that indicates that you have some micro tears, some micro injuries in your muscles, which when they repair, is going to help them be stronger. But if you're not getting good enough sleep, then it actually may work against you and those micro tears won't heal as quickly. And we may even see loss of muscle in people who are chronically sleep deprived. In terms of your affect or your mood, chronic sleep deprivation is associated with a significant increase in depression and anxiety. Let's go back to the HPA axis. Chronic sleep deprivation is associated with increased inflammation. Increased inflammation is associated with increased depression. Chronic sleep deprivation is associated with chronic activation of that stress response system. So, and chronic activation of that stress response system is associated with increased anxiety. So we can see how this would work in the chronic phase. But what about acute? And I'm not recommending sleep deprivation, but it is interesting to note in the research that people who were depressed felt some symptom relief after brief acute sleep deprivation period. So one night, two nights of acute intentional sleep deprivation actually improved their mood. Why might that be? Well, at this point, the sleep deprivation may be triggering that HPA axis, that threat response system. And what does it do? It secretes a bunch of excitatory neurochemicals like norepinephrine, which is somewhat antidepressant in nature, as well as cortisol and glutamate. So people start feeling more, more focused, more energized, and it may improve their overall perception of their mood in the short term. But like I said, you can't keep doing this because eventually the sleep deprivation, the body's not going to respond to the same way. And all of those positive attributes, if you will, are going to end up causing problems. Cognition. Some aspects of higher level cognition are higher order thinking. And they found that the prefrontal cortex is very susceptible to sleep deprivation. So some aspects of higher level cognition or thinking remain impaired by sleep deprivation despite restoration of alertness with sleep stimulants. I think this is really important to note. You may feel like you're more alert, you may feel like you're more energized, but your thinking doesn't respond the same way to caffeine or stimulants. So your thinking process is still impaired even if you feel wide awake. People who are chronically sleep deprived have reduced attention, impaired encoding and retrieval of memories. Think about students, they're trying to learn and if they are not getting adequate quality sleep, guess what? What they learn is not being encoded and stored away as efficiently. And it's more difficult for them when they need to on the test during class to retrieve that information. But to add insult to injury, not only do we have more difficulty encoding and retrieving memories, people have also been shown to experience fragmented memory loss as a result of chronic sleep deprivation. So there may be memories kind of floating around in there that you can't kind of can't put your finger on anymore. Several studies, many studies have shown an increased risk of dementia with chronic sleep deprivation. When people are sleep deprived, even acutely, there is reduced beta amyloid plaque clearance from the brain. Now, in the very short term, like I said, if it's a one off night, that's probably not going to be a big deal. But when it's free, frequent, when it happens frequently, then you may start seeing these plaques build up, which contributes to an increased risk of dementia. Chronic partial sleep deprivation experiments demonstrate that profound neurocognitive deficits accumulate over time in the face of subjective adaptation to the sensation of sleepiness. Which again, is a really wordy way of saying you may feel like you're not sleepy. You may have, quote, trained yourself to get by on less sleep than you're supposed to get. However, just because you've trained yourself to be more alert doesn't mean you're not experiencing the negative effects of chronic sleep deprivation. And that chronic sleep deprivation is additive, is accumulating over time environmentally. And when I talk about environment, I'm talking about safety, productivity, your ability to hold your job. People have increased errors. They've shown this repeatedly with Medical students as well as physicians that are on long on calls. But they've also shown it in long distance truckers and other occupations where people may have some sleep deprivation. And there's a significant uptick in errors when people are sleep deprived. Another interesting thing that I found was that when we are sleep deprived, our coordination is reduced. People have reduced gait control, which can lead to increased falls. This is especially important for people who are frail or elderly. And think about it, a lot of times, at least when I was growing up, my grandparents used to say, oh, we only sleep four hours a night because that's all we need. Well, the research says different. The research says that they probably need more than that. However, other factors are at play that are preventing them from getting adequate quality sleep. But it is important to recognize that especially if you've got a person in your, in your family who is chronically sleep deprived because of dementia or something else, that it's important to note that they're at a much greater risk of falls and impaired educational and occupational attainment. They went back and they looked at people who are chronically sleep deprived and found out that, yeah, their grades were worse than people who weren't sleep deprived. And their occupational attainment, their ability to get their promotions and those sorts of things often were also hindered partly because of increased errors and increased difficulty keeping up pace when they started to become chronically fatigued. So what can you do? Hopefully. I've presented the case that sleep deprivation is a big, big problem. And we need to do what we can to improve our sleep quality as well as sleep quantity. Strategy 1. Get a physical. Why am I saying this? Because things like an enlarged prostate or a thyroid that is malfunctioning can contribute to sleep problems. And there are treatments that are available that can help reduce sleep. Some of that circadian rhythms are really important. Circadian rhythms are set more than just by when the light, when the sun comes up and when the sun goes down. They're actually set by light levels as well as activities that you do. Which is why keeping a bedtime ritual is really important. It doesn't have to be a long, drawn out ritual. It can be, you know, doing the same things 15 minutes before you go to bed, but it cues your body. Think about children when they're younger. They go to school, they get out at 3:30 or something, then they come home and play, or they go to after school care, whatever. Then they're picked up, they eat dinner, they take a bath, they read a story, and then they go to Bed, that is their routine. So as soon as they eat dinner, for a lot of them, that's their body's signal that, hey, okay, that whole sleep thing is getting ready to start pretty soon. Limit naps to under one hour. If you limit them to under one hour, you're less likely to get into that deep sleep. And I know you're going, well, if I didn't get the deep sleep at night, I'd like to have it during the day. Yes, but if you start getting deep sleep during the day, then that throws your circadian rhythms out of whack. So if you need to nap, limit them to under one hour. There were a couple of these studies that I looked at, meta analyses that found that people who were acutely sleep deprived, they missed, for whatever reason, they didn't get enough sleep one particular night. They found that those people did have increased focus attention and reduced errors if they took a short nap or a short relaxation period in the middle of the day, generally, like right after lunch. Nutrition Hydration is really important for your body to function. Hydration is important for your body to clear out all of the free radicals and reduce that oxidative stress and get at that adenosine and everything else. However, hydration right before bed is not a good idea. Each person is going to be a little bit different. But figuring out, when do you need to stop drinking fluids prior to bedtime? Now, you may have a cup by your bed where you, if you wake up and you've got a dry throat, you just take a little sip, but you're not gulping, you're not drinking 8, 16, 24 ounces worth of flu fluid. So when do you need to stop drinking? For a lot of people, it's about two hours before bed. For some people, it may be more than that. Carbohydrates, carbs, and tryptophan, which is an amino acid, which is part of a protein, can be helpful to improving sleep quality when it's eaten four hours before bed. So think about when you want to go to bed. If you want to go to bed at 10, then you should eat dinner no later than six. That gives the body a chance to take in that food, to break it down and then start using the nutrients. If you eat right before bed, then that's just gonna sit in your stomach and it's not going to do. It's not gonna be able to be broken down and be used efficiently. Natural melatonin like that that occurs in foods such as tart, cherry juice, raspberries, goji, Berries, walnuts, almonds and tomatoes can be really helpful for helping you get to sleep. Remember, serotonin is broken down into melatonin in order to help you get to sleep. And melatonin. I know there's a lot of over the counter supplements of melatonin. You need to take that up with your doctor whether it is safe for you to take melatonin supplements or not. But we do know that natural melatonin containing foods are associated with improved sleep quality. Caffeine is another bugaboo for a lot of us. And it's really important to note that depending on how well your liver works and how old you are and some of those other factors, it may take a little longer or a little less time for your body to clear caffeine. But generally caffeine is thought to have a six hour half life. So you what you drink at 12. For example, if you have coffee at 12, then it's going to take until six, until half of it's out of your system and then till midnight until it's all out of your system. Now that is a very rough estimate and it is important to recognize that in order to get caffeine out of your system, all of it has to be out. So if you were pounding back coffee all morning, then you have a whole bunch that your body still needs to get out. Reducing caffeine, ideally not having caffeine after lunch can be hugely beneficial to helping you get good quality sleep from the beginning of the night. Limit alcohol and definitely don't have any alcohol in your system before bed. Why? Well, alcohol, yes, it can help people relax, it may help them get a little bit sleepier, but when it starts to leave the body, it actually triggers the stress response. Drinking alcohol actually triggers the stress response to a certain extent because it's an inflammatory, it has some inflammatory aspects to it. So the recommendation is to have a blood alcohol level of 0.00 before you go to bed. Medications. Now, there was, has been and there continues to be a lot of research about antihistamines and anxiolytics in terms of their impact on your ability to get quality sleep and their contribution to developing dementia later in life. Antihistamines. In 2018 and 2019 studies found that that most antihistamines, like over the counter antihistamines, were likely not associated with a significant increase in dementia risk if they were not used consistently for long periods of time, like multiple years, every single night. Benzodiazepines. These are your anxiolytics or your Antianxiety medications. The short term benzodiazepines, think Xanax, are associated with a greater risk of developing dementia. But the longer term benzodiazepines are actually associated with improved sleep quality. Not saying what to do, this is something you got to take up with your doctor. However, it is important to recognize the difference that not all benzodiazepines and not all antihistamines are created equally. Exercise. Exercise has been found to improve sleep quality. However, if you're going to exercise in the evening, within four hours of bedtime, they suggest low intensity exercise. Why? High or moderate intensity exercise increases cortisol. It kicks off that stress response system, increases cortisol and glutamate, norepinephrine and adrenaline and all that stuff. Stuff which has to be removed from the system, if you will, before you go to sleep. Low intensity exercise, which is defined as between 40 and 50% of your target heart rate, an easy walk or gentle yoga, stretching, those things actually reduce cortisol levels and reduce your stress hormones. So if you must do something close to bedtime, something that is gentle for most people has found to be more beneficial. However, I will note because I know some of you are going, that's not me. There are some people who can exercise really intensely and it just wipes them out and they come home and they can go right to sleep. So there are no one size fits all recommendations. You need to figure out how your body works. Respiratory vagus nerve stimulation, that is deep diaphragmatic breathing, has also been found to improve sleep because it triggers the parasympathetic response. It triggers the vagus nerve to help you start relaxing. Deep breathing can be really helpful when you lay down in bed. Get comfortable, take a few deep diaphragmatic breaths to sort of clue your brain in that it's time to start relaxing affective, emotionally or cognitively. A lot of people struggle with getting to sleep because they can't shut their mind off or they have difficulty shutting their mind off. Journaling and or listing can be really helpful with this. When you journal, you're writing down all of your thoughts. And for some reason when you, when your brain thinks that, okay, I don't have to hold on to this anymore because we're going to remember it, it's down in black and white, then it's easier to let go. Sometimes you just have to get it out, as they say. Listing can be another thing if you have a lot of anxiety or if you keep popping up with things that you need to Remember to get at the store or do tomorrow or this or that. Writing down a list. Keep a notepad or your phone with a blue light blocker on it next to your bed so you can just jot it down really quick and go back to sleep instead of laying there thinking about it. Otherwise, you're going to lay there and keep thinking that I've got to remember to do this tomorrow. I can't forget to do this tomorrow. Those are two really helpful things. Suggestions for getting things out now. If you have a friend that you can call and talk it over with, if that's easier, that's fine. Or heck, talk to your dog, but somehow get it out. Positive focus is another strategy that can help you relax and potentially get better quality sleep. As you reduce your stress hormones, you you are improving your sleep quality. Positive focus means just spending 5, 10 minutes as you are getting ready for bed thinking about the things that went right that day, things that were good that day, things that you're looking forward tomorrow. That doesn't mean ignoring all the bad things the rest of the time, but it means ending your day on a positive note. Guided imagery can be really helpful. Some people use guided imagery of going to sleep. They see themselves laying down and quickly going to sleep. Other people use guided imagery that helps occupy their mind, which quiets a lot of the ruminations. It quiets a lot of the repetitive or intrusive thoughts. When you were a kid, your caregivers may have told you to count sheep, close your eyes and envision the sheep jumping over this fence. That's guided imagery. As adults, we can use guided imagery that's a little bit more ornate or elaborate. If we want, we can use our own guided imagery where we talk ourselves through a situation and we notice in our mind, we notice all of the different senses. Five things we see, four things we hear, three things we smell, two things we feel. Or you can actually get recordings, guided imagery recordings and somebody else is walking you through a particular scenario. Some people have difficulty staying focused through the narrative guided imagery. They prefer to do it themselves because. Because that occupies that verbal part of their brain. The verbal part of your brain is going to. What you're focusing on is going to drown out any other intrusive thoughts that try to come up. Or you can easily, a little bit easier turn your attention back to that scene. Avoid potential stressors two hours before bed, you know what your stressors are. The news, social media, email, or other input, as you define it, anything that is going to cause you additional or excessive stress don't do the bills two hours before bedtime and social media can be funny. It can be relaxing for some people in certain situations. However, the chances of running afoul and running into something that actually triggers your stress response are pretty high just based on the algos that social media uses. If you can avoid it, stay off of social media two hours before bed. Environmentally, don't go to bed until you're sleepy. If you go to bed and you're wide awake and you start getting frustrated because you're not sleepy, that's triggering that stress response. Get up, do something else, and then go back to bed. When you start getting sleepy, reserve the bedroom for sleep and intimacy only. That's not where you go to fight with your significant other. It's not where you do your homework. It's not where you pay bills. It is for sleep and intimacy only. This keeps the bedroom from being associated with stressful memories. Keep it cool, dark and quiet. Your definition of cool may be different than other people's definition of cool, but in order to get sleepy when we trigger that relaxation response, it lowers our body temperature and we need to be able to assist ourselves in lowering our body temperature. Because our circadian rhythms are partly set by our pineal gland, it's important to keep it as dark as possible. And that includes night lights. That includes if I have an air purifier in my bedroom that for some unknown reason they decided to put a blue light on it to indicate that it's on. I'm like, why blue? Why not red? Red would have been much better. Eliminate as many sources of blue light especially, but get it as dark as possible. Wear a sleep mask if you're able to do that. And keep it quiet. That means quiet from road noise. That means quiet from your significant other or your dog snoring. That means don't have the TV on all night long. That means try to block out the neighbors if they're making a lot of noise. That's a big ask for a lot of people. There are noise canceling headphones. There are earplugs. Some people don't feel safe if they can't hear, so those aren't options for them. So it's important to figure out what works for you. White noise machines work for some people. Other people find white noise machines annoying. What works for you? Address allergens in the bedroom. If something is making it hard for you to breathe or making you cough throughout the night, you're not getting good quality sleep. So get those allergens out. Consider Aromatherapy, Valerian, valerian, lavender, chamomile. Those are three very common sedative essential oils. You can do more research to find essential oils that you find calming and relaxing. Avoid blue light two hours before bed. Now, blue light comes from the sun. Blue light comes from our televisions and any of our electronic devices. So avoiding blue light can be really difficult. Try getting blue light blocking glasses. They sell glasses now that, you know, look like reading glasses to. They're perfectly clear, but they block the blue light. So that is one strategy you can use during the day. You can get blue light blocking apps for your smartphone and your computer. You can get special screens that go over your television or your computer to also block the blue light. Consider changing your bulbs in your whatever room that you spend time in right before bed to 2000 Kelvin 25 watt bulbs. So you're making it dim and you're making it yellow. And a lot of the 2000 Kelvin bulbs are actually technically designed to be put in a porch light to repel moths and bugs and stuff. But they are plenty bright enough. You know, think about the old fashioned candles. They're plenty bright enough to illuminate the room without increasing your alertness during the day. However, you want to have 6,500 kelvin and 100 watt equivalent bulbs during the day and that makes it really bright. And it's important to remember that lux and lumens are a little bit different. The first further away the light is, no matter how much brightness it's putting out, it disperses. So you want to have those bright bulbs closer to you. Whether it's a desk lamp or an overhead chair lamp or something like that. Exposure to those bright white really bright bulbs during the day helps set circadian rhythms. Get bright natural light upon awakening. So that's that 6,500 kelvin or 100 watt equivalent if you've got to do it with bulbs. You know, like in the winter when we only have 12 hours of sunlight if we're lucky. Pay attention to your mattress ergonomics as well. If you're not sleeping in a comfortable mattress, if you're in pain, or if you're sleeping in a mattress that has a divot in it, then you're likely not going to get adequate quality sleep. If you're sleeping on a mattress that retains heat, like the old memory foam mattresses, that may contribute to poor sleep as well, it is definitely worth it to invest at least in a nice thick mattress topper and a good quality pillow in order to improve your sleep. Quality sleep is an essential part of restoration, repair, and maintaining your circadian rhythms. Sleep deprivation underlies the majority of health cognitive and mood related problems. Just kind of let that sink in. Think about all of the physical and mood and cognitive complaints you've got and identify how many of them might be being worsened by sleep deprivation. Just try it. Prioritizing quality sleep can be one of the most important things you can do for yourself in both the short and the long term.