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Wellbeing

Why We Sleep: Quotes and Notes

Below are my complete quotes and notes from Matthew Walker’s book—Why We Sleep.


Granted there are many different factors that make for a good or bad night of sleep, but temperature is very much one of them.
21/03/2020 – p. 325


It is clear that a tired, under-slept brain is little more than a memory sieve, in no state to receive, absorb, or efficiently retain an education. To persist in this way is to handicap our children with partial amnesia. Forcing youthful brains to become early birds will guarantee that they do not catch the worm, if the worm in question is knowledge or good grades. We are, therefore, creating a generation of disadvantaged children, hamstrung by a privation of sleep. Later school start times are clearly, and literally, the smart choice. One of the most troubling trends emerging in this area of sleep and leaky brain development concerns low-income families-a trend that has direct relevance to education. Children from lower socioeconomic backgrounds are less likely to be taken to school in a car, in part because their parents often have jobs in the service industry demanding work start times at or before six a.m. Such children therefore rely on school buses for transit, and must wake up earlier than those taken to school by their parents. As a result, those already disadvantaged children become even more so because they routinely obtain less sleep than children from more affluent families. The upshot is a vicious cycle that perpetuates from one generation to the next-a closed-loop system that is very difficult to break out of. We desperately need active intervention methods to shatter this cycle, and soon.
20/03/2020 – p. 314


The Stanford psychologist Dr. Lewis Terman, famous for helping construct the IQ test, dedicated his research career to the better ment of children’s education. Starting in the 1920s, Terman charted all manner of factors that promoted a child’s intellectual success. One such factor he discovered was sufficient sleep. Published in his semi nal papers and book Genetic Studies of Genius, Terman found that no matter what the age, the longer a child slept, the more intellectually gifted they were. He further found that sleep time was most strongly connected to a reasonable (i.e., a later) school start time: one that was in harmony with the innate biological rhythms of these maturing brains.
20/03/2020 – p. 310


One of the more paradoxical CBT-I methods used to help insomniacs sleep is to restrict their time spent in bed, perhaps even to just six hours of sleep or less to begin with. By keeping patients awake for longer, we build up a strong sleep pressure-a greater abundance of adenosine. Under this heavier weight of sleep pressure, patients fall asleep faster, and achieve a more stable, solid form of sleep across the night. In this way, a patient can regain their psychological confidence in being able to self-generate and sustain healthy, rapid, and sound sleep, night after night: something that has eluded them for months if not years. Upon reestablishing a patient’s confidence in this regard, time in bed is gradually increased.
19/03/2020 – p. 291


The obvious methods involve reducing caffeine and alcohol intake, removing screen technology from the bedroom, and having a cool bedroom. In addition, patients must (1) establish a regular bed time and wake-up time, even on weekends, (2) go to bed only when sleepy and avoid sleeping on the couch early/mid-evenings, (3) never lie awake in bed for a significant time period; rather, get out of bed and do something quiet and relaxing until the urge to sleep returns, (4) avoid daytime napping if you are having difficulty sleeping at night, (5) reduce anxiety-provoking thoughts and worries by learning to mentally decelerate before bed, and (6) remove visible clockfaces from view in the bedroom, preventing clock-watching anxiety at night.
19/03/2020 – p. 291


Waking up at the same time of day, every day, no matter if it is the week or weekend is a good recommendation for maintaining a stable sleep schedule if you are having difficulty with sleep. Indeed, it is one of the most consistent and effective ways of helping people with insomnia get better sleep. This unavoidably means the use of an alarm clock for many individuals. If you do use an alarm clock, do away with the snooze function, and get in the habit of waking up only once to spare your heart the repeated shock.
19/03/2020 – p. 280


Knowingly or not, you have probably used this proven temperature manipulation to help your own sleep. A luxury for many is to draw a hot bath in the evening and soak the body before bedtime. We feel it helps us fall asleep more quickly, which it can, but for the opposite reason most people imagine. You do not fall asleep faster because you are toasty and warm to the core. Instead, the hot bath invites blood to the surface of your skin, giving you that flushed appearance. When you get out of the bath, those dilated blood vessels on the surface quickly help radiate out inner heat, and your core body temperature plummets. Con sequently, you fall asleep more quickly because your core is colder. Hot baths prior to bed can also induce 10 to 15 percent more deep NREM sleep in healthy adults.*
19/03/2020 – p. 279


A bedroom temperature of around 65 degrees Fahrenheit (18.3°C) is ideal for the sleep of most people, assuming standard bedding and clothing. This surprises many, as it sounds just a little too cold for comfort. Of course, that specific temperature will vary depending on the individual in question and their unique physiology, gender, and age. But like calorie recommendations, it’s a good target for the average human being.
19/03/2020 – p. 277


Thermal environment, specifically the proximal temperature around your body and brain, is perhaps the most underappreciated factor determining the ease with which you will fall asleep tonight, and the quality of sleep you will obtain. Ambient room temperature, bedding, and nightclothes dictate the thermal envelope that wraps around your body at night. It is ambient room temperature that has suffered a dramatic assault from modernity.

Your nocturnal melatonin levels are therefore controlled not only by the loss of daylight at dusk, but also the drop in temperature that coincides with the setting sun. Environmental light and temperature therefore synergistically, though independently, dictate nightly melatonin levels and sculpt the ideal timing of sleep.


Your body temperature needs to drop about 1 degree Celsius to help with release of melatonin
19/03/2020 – p. 275


what is the recommendation when it comes to sleep and alcohol? It is hard not to sound puritanical, but the evidence is so strong regarding alcohol’s harmful effects on sleep that to do otherwise would be doing you, and the science, a disservice. Many people enjoy a glass of wine with dinner, even an aperitif thereafter. But it takes your liver and kidneys many hours to degrade and excrete that alcohol, even if you are an individual with fast-acting enzymes for ethanol decomposition. Nightly alcohol will disrupt your sleep, and the annoying advice of abstinence is the best, and most honest, I can offer.


If you want good REM sleep and want to remember what you learn, it’s best to avoid alcohol altogether
19/03/2020 – p. 274


The overnight work of REM sleep, which normally assimilates complex memory knowledge, had been interfered with by the alcohol. More surprising, perhaps, was the realization that the brain is not done cessing that knowledge after the first night of sleep. Memories remain perilously vulnerable to any disruption of sleep (including that from alcohol) even up to three nights after learning, despite two full nights of natural sleep prior. Framed practically, let’s say that you are a student cramming for an exam on Monday. Diligently, you study all of the previous Wednesday. Your friends beckon you to come out that night for drinks, but you know how pro important sleep is, so you decline. On Thursday, friends again ask to grab a few drinks in the evening, but to be safe, you turn them down and sleep soundly a second night. Finally, Friday rolls around-now three nights after your learning session-and everyone is heading out for a party and drinks. Surely, after being so dedicated to slumber across the first two you nights after learning, you can now cut loose, knowing those memories have been safely secured and fully processed within your memory banks. Sadly, not so. Even now, alcohol consumption will wash away much of that which you learned and can abstract by blocking your REM sleep.
19/03/2020 – p. 274


This fits well with evidence we discussed earlier: that of the brain’s non-negotiable requirement for sleep the first night after learning for the purposes of memory processing.
19/03/2020 – p. 273


People consuming even moderate amounts of alcohol in the afternoon and/or evening are thus depriving themselves of dream sleep.
19/03/2020 – p. 272


Five key factors have powerfully changed how much and how well we sleep: (1) constant electric light as well as LED light, (2) regularized temperature, (3) caffeine (discussed in chapter 2), (4) alcohol, and (5) a legacy of punching time cards. It is this set of societally engineered forces that are responsible for many an individual’s mistaken belief that they are suffering from medical insomnia.
18/03/2020 – p. 265


We will never truly know if Edison was the short-sleeper that some, including himself, claim. What we do know, however, is that Edison was a habitual daytime napper. He understood the creative brilliance of dreamine and used it ruthlessly as a tool, describing it as “the genius gap” Edison would allegedly position a chair with armrests at the side of his study desk, on top of which he would place a pad of paper and a pen. Then he would take a metal saucepan and turn it upside down, carefully positioning it on the floor directly below the right-side armrest of the chair. If that were not strange enough, he would pick up two or three steel ball bearings in his right hand. Finally, Edison would settle himself down into the chair, right hand supported by the armrest, grasping the ball bearings. Only then would Edison ease back and allow sleep to consume him whole. At the moment he began to dream, his muscle tone would relax and he would release the ball bearings, which would crash on the metal saucepan below, waking him up. He would then write down all of the creative ideas that were flooding his dreaming mind. Genius, wouldn’t you agree?
17/03/2020 – p. 232


It should come as no surprise by now that those participants who took a nap showed superior memory performance on the maze task. They could locate the navigation clues with ease, finding their way around and out of the maze faster than those who had not slept. The novel result, however, was the difference that dreaming made. Participants who slept and reported dreaming of elements of the maze, and themes around experiences clearly related to it, showed almost ten times more improvement in their task performance upon awakening than those who slept just as much, and also dreamed, but did not dream of maze-related experiences.

Clearly, the dreaming brain was not simply recapitulating or re-creating exactly what happened to them in the maze. Rather, the dream algorithm was cherry-picking salient fragments of the prior learning experience, and then attempting to place those new experiences within the back catalog of preexisting knowledge. Like an insightful interviewer, dreaming takes the approach of interrogating our recent autobiographical experience and skillfully positioning it within the context of past experiences and accomplishments, building a rich tapestry of meaning. “How can I understand and connect that which I have recently learned with that I already know, and in doing so, discover insightful new links and revelations?” Moreover, “What have I done in the past that might be useful in potentially solving this newly experienced problem in the future?” Different from solidifying memories, which we now realize to be the job of NREM sleep, REM sleep, and the act of dreaming, takes that which we have learned in one experience setting and seeks to apply it to others stored in memory.
17/03/2020 – p. 230


The author John Steinbeck wrote, “A problem difficult at night is resolved in the morning after the committee of sleep has worked on it. Should he have prefaced “committee” with the word “dream”? It appears so. The content of one’s dreams, more than simply dreaming per se, or even sleeping, determines problem-solving success.
17/03/2020 – p. 230


It is sleep that builds connections between distantly related informational elements that are not obvious in the light of the waking day. Our participants went to bed with disparate pieces of the jigsaw and woke with the puzzle complete. It is the difference between knowl up edge (retention of individual facts) and wisdom (knowing what they all mean when you fit them together). Or, said more simply, learning versus comprehension. REM sleep allows your brain to move beyond the former and truly grasp the latter.

Some may consider this informational daisy-chaining to be trivial. but it is one of the key operations differentiating your brain from your computer. Computers can store thousands of individual files with precision. But standard computers do not intelligently interlink those files in numerous and creative combinations. Instead, computer files sit like isolated islands. Our human memories are, on the other hand, richly interconnected in webs of associations that lead to flexible, predictive powers. We have REM sleep, and the act of dreaming, to thank for much of that inventive hard work.


If you want to be creative feed your brain the information and have more REM sleep
17/03/2020 – p. 227


The two experiments of anagram solving and semantic priming revealed how radically different the operating principles of the dreaming brain were, relative to those of NREM sleep and wakefulness. As we enter REM sleep and dreaming takes hold, an inspired form of memory mixology begins to occur. No longer are we constrained to see the most typical and plainly obvious connections between memory units. On the contrary, the brain becomes actively biased toward seeking out the most distant, nonobvious links between sets of information.

—-
REM sleep is capable of forging more creative links between different sets of memories

17/03/2020 – p. 226


Deep NREM sleep strengthens individual memories, as we now know. But it is REM sleep that offers the masterful and complementary benefit of fusing and blending those elemental ingredients together, in abstract and highly novel ways. During the dreaming sleep state, your brain will cogitate vast swaths of acquired knowledge,” and then extract overarch ing rules and commonalities-“the gist.” We awake with a revised “Mind Wide Web” that is capable of divining solutions to previously impenetrable problems. In this way, REM-sleep dreaming is informational alchemy.
17/03/2020 – p. 220


Confirming the importance of the dream state, the better the quality of REM sleep from one individual to the next across that rested night. the more precise the tuning within the emotional decoding networks of the brain the next day. Through this platinum-grade nocturnal service, better REM-sleep quality at night provided superior comprehension of the social world the next day. But when those same participants were deprived of sleep, including the essential influence of REM sleep, they could no longer dis tinguish one emotion from another with accuracy.
16/03/2020 – p. 216


Of a total of 299 dream reports that Stickgold collected from these individuals across the fourteen days, a clear rerun of prior waking life events-day residue-was found in just 1 to 2 percent. Dreams are not, therefore, a wholesale replay of our waking lives. We do not simply rewind the video of the day’s recorded experience and relive it at night, projected on the big screen of our cortex. If there is such a thing as “day residue” there are but a few drops of the stuff in our otherwise arid dreams. But Stickgold did find a strong and predictive daytime signal in the static of nighttime dream reports: emotions. Between 35 and 55 percent of emotional themes and concerns that participants were having while they were awake during the day powerfully and unambiguously resurfaced in the dreams they were having at night. The commonalities were just as clear to the participants themselves, who gave similarly confident judgments when asked to compare their own dream reports with their waking reports. If there is a red-thread narrative that runs from our waking lives into our dreaming lives, it is that of emotional concerns.
16/03/2020 – p. 204


Indeed, journaling your waking thoughts, feelings, and concerns has a proven mental health benefit, and the same appears true of your dreams. A meaningful, psychologically healthy life is an examined one, as Socrates so often declared.
16/03/2020 – p. 203


Thousands of genes within the brain depend upon consistent and sufficient sleep for their stable regulation. … Like a stubborn file that refuses to be transcribed by a printer, when you do not lavish these DNA segments with enough sleep, they will not translate their instructional code into printed action and give the brain and body what they need.

Insufficient sleep does more than alter the activity and readout of your genes; it attacks the very physical structure of your genetic material itself.

The less sleep an individual obtains, or the worse the quality of sleep, the more damaged the capstone telomeres of that individual’s chromosomes. These are the findings of a collection of studies that have recently been reported in thousands of adults in their forties, fifties, and sixties by numerous independent research teams around the world.
15/03/2020 – p. 188


If increasing your risk for developing Alzheimer’s disease, cancer, diabetes, depression, obesity, hypertension, and cardiovascular disease weren’t sufficiently disquieting, chronic sleep loss will erode the very essence of biological life itself: your genetic code and the structures that encapsulate it.
15/03/2020 – p. 187


The upshot of all this work can be summarized as follows: short sleep (of the type that many adults in first-world countries commonly and routinely report) will increase hunger and appetite, compromise impulse control within the brain, increase food consumption (especially of high-calorie foods), decrease feelings of food satisfaction after eating. and prevent effective weight loss when dieting.

[SS]
15/03/2020 – p. 178


South of the brain, we are also discovering that plentiful sleep makes your gut happier. Sleep’s role in redressing the balance of the body’s nervous system, especially its calming of the fight-or-flight sympathetic branch, improves the bacterial community known as your microbiome, which is located in your gut (also known as the enteric nervous system). As we learned about earlier, when you do not get enough sleep, and the hody’s stress-related, fight-or-flight nervous system is revved up, t triggers an excess of circulating cortisol that cultivates “bad bacteria” to fester throughout your microbiome. As a result, insufficient sleep will prevent the meaningful absorption of all food nutrients and cause gastrointestinal problems.*
15/03/2020 – p. 176


Ample sleep can therefore restore a system of impulse control within your brain, putting the appropriate brakes on potentially exces sive eating.
15/03/2020 – p. 176


In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep opportunity. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day. Impressively, it works both ways. In the autumn within the Northern Hemisphere, when the clocks move back and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after. A similar rise-and-fall relationship can be seen with the number of traffic accidents, proving that the brain, by way of attention lapses and microsleeps, is just as sensitive as the heart to very small perturbations of sleep. Most people think nothing of losing an hour of sleep for a single night, believing it to be trivial and inconsequential. It is anything but.
14/03/2020 – p. 169


I was once fond of saying, “”Sleep is the third pillar of good health, alongside diet and exercise.” I have changed my tune. Sleep is more than a pillar; it is the foundation on which the other two health bastions sit. Take away the bedrock of sleep, or weaken it just a little, and careful eating or physical exercise become less than effective, as we shall see. Yet the insidious impact of sleep loss on health runs much deeper. Every major system, tissue, and organ of your body suffers when sleep becomes short. No aspect of your health can retreat at the sign of sleep loss and escape unharmed. Like water from a burst pipe in your home, the effects of sleep deprivation will seep into every nook and cranny of biology, down into your cells, even altering your most fundamental self-your DNA. Widening the lens of focus, there are more than twenty large-scale epidemiological studies that have tracked millions of people over many decades, all of which report the same clear relationship: the shorter your sleep, the shorter your life. The leading causes of disease and death in developed nations-diseases that are crippling health-care systems, such as heart disease, obesity, dementia, diabetes, and cancer-all have recognized causal links to a lack of sleep. This chapter describes, uncomfortably, the many and varied ways in which insufficient sleep proves ruinous to all the major physiological systems of the human body: cardiovascular, metabolic, immune. reproductive.
14/03/2020 – p. 164


Insufficient sleep is only one among several risk factors associated with Alzheimer’s disease. Sleep alone will not be the magic bullet that eradicates dementia. Nevertheless, prioritizing sleep across the life span is clearly becoming a significant factor for lowering Alzheimer’s disease risk.
14/03/2020 – p. 163


Nedergaard’s findings completed the circle of knowledge that our findings had left unanswered. Inadequate sleep and the pathology of Alzheimer’s disease interact in a vicious cycle. Without sufficient sleep, amyloid plaques build up in the brain, especially in deep-sleep-generating regions, attacking and degrading them. The loss of deep NREM sleep caused by this assault therefore lessens the ability to remove amyloid from the brain at night, resulting in greater amyloid deposition. More amyloid, less deep sleep, less deep sleep, more amyloid, and so on and so forth. From this cascade comes a prediction: getting too little sleep across the adult life span will significantly raise your risk of developing Alzheimer’s disease. Precisely this relationship has now been reported in numerous epidemiological studies, including those individuals suffering from sleep disorders such as insomnia and sleep apnea.* Parenthetically, and unscientifically, I have always found it curious that Margaret Thatcher and Ronald Reagan-two heads of state that were very vocal, if not proud, about sleeping only four to five hours a nightboth went on to develop the ruthless disease. The current US president, Donald Trump-also a vociferous proclaimer of sleeping just a few hours each night-may want to take note.
14/03/2020 – p. 161


Alzheimer’s disease is associated with the buildup of a toxic form of protein called beta-amyloid, which aggregates in sticky clumps, or plaques, within the brain. Amyloid plaques are poisonous to neurons, killing the surrounding brain cells. What is strange, however, is that amyloid plaques only affect some parts of the brain and not others, the reasons for which remain unclear. What struck me about this unexplained pattern was the location in the brain where amyloid accumulates early in the course of Alzheimer’s disease, and most severely in the late stages of the condition. That area is the middle part of the frontal lobe-which, as you will remember, is the same brain region essential for the electrical generation of deep NREM sleep in healthy young individuals. At that time, we did not understand if or why Alzheimer’s disease caused sleep disruption, but simply knew that they always co-occurred. I wondered whether the reason patients with Alzheimer’s disease have such impaired deep NREM sleep was, in part, because the disease erodes the very region of the brain that normally generates this key stage of slumber.


What cause Alzheimer’s
14/03/2020 – p. 158


The two most feared diseases throughout developed nations are dementia and cancer. Both are related to inadequate sleep. We will addres the latter in the next chapter regarding sleep deprivation and the body Regarding the former, which centers on the brain, a lack of sleep is fast becoming recognized as a key lifestyle factor determining whether or not you will develop Alzheimer’s disease.
14/03/2020 – p. 157


In other words, if you don’t sleep the very first night after learning, you lose the chance to consolidate those memories, even if you get lots of “catch-up” sleep thereafter. In terms of memory, then, sleep is not like the bank. You cannot accumulate a debt and hope to pay it off at a later point in time. Sleep for memory consolidation is an all-or-nothing event. It is a concerning result in our 24/7, hurry-up, don’t-wait society.
14/03/2020 – p. 157


The very latest work in this area has revealed that sleep deprivation even impacts the DNA and the learning-related genes in the brain cells of the hippocampus itself. A lack of sleep therefore is a deeply penetrating and corrosive force that enfeebles the memory-making apparatus within your brain, preventing you from constructing lasting memory traces. It is rather like building a sand castle too close to the tide linethe consequences are inevitable.


It’s impossible to make new synaptic connections and memories when you are sleep deprived. The architecture of the brain responsible for doing that is weakened by lack of sleep

14/03/2020 – p. 155


Memories formed without sleep are weaker memories, evaporating rapidly.

Pulling an all-nighter to study for an exam is unwise – you will do better to sleep and go with what you know the next day
14/03/2020 – p. 154


just twenty months old. There are many things that I hope readers take away from this book. This is one of the most important: if you are drowsy while driving, please, please stop. It is lethal. To carry the burden of another’s death on your shoulders is a terrible thing. Don’t be misled by the many ineffective tactics people will tell you can battle back against drowsiness while driving.* (*Common myths that are of no use in helping to overcome drowsiness while driving include: turning up the radio, winding down the car window, blowing cold air on your face, splashing cold water on your face, talking on the phone, chewing gum, slapping yourself, pinching yourself, punching yourself, and promising yourself a reward for staying awake.) Many of us think we can overcome drowsiness through sheer force of will, but, sadly, this is not true. To assume otherwise can jeopardize your life, the lives of your family or friends in the car with you, and the lives of other road users. Some people only get one chance to fall asleep at the wheel before losing their life. If you notice yourself feeling drowsy while driving, or actually falling asleep at the wheel, stop for the night. If you really must keep goingand you have made that judgment in the life-threatening context it genuinely poses-then pull off the road into a safe layby for a short time. Take a brief nap (twenty to thirty minutes). When you wake up, do not start driving. You will be suffering from sleep inertia-the carryover effects of sleep into wakefulness. Wait for another twenty to thirty minutes, perhaps after having a cup of coffee if you really must, and only then start driving again. This, however, will only get you so far down the road before you need another such recharge, and the returns are diminishing. Ultimately, it is just not worth the (life) cost.


Make the simple commitment to never ever drive a long distance when you’ve had less than 7 hours sleep. If you are planning such a trip ensure you give yourself more than 7 hours sleep opportunity the night before.
13/03/2020 – p. 142


After thirty years of intensive research, we can now answer many of the questions posed earlier. The recycle rate of a human being is around sixteen hours. After sixteen hours of being awake, the brain begins to fail. Humans need more than seven hours of sleep each night to maintain cognitive performance. After ten days of just seven hours of sleep, the brain is as dysfunctional as it would be after going without sleep for twenty-four hours. Three full nights of recovery sleep (i.e., more nights than a weekend) are insufficient to restore performance back to normal levels after a week of short sleeping. Finally, the human mind cannot accurately sense how sleep-deprived it is when sleep deprived.

—-
You are sleep deprived if you’re getting less than 7 hours sleep per night
13/03/2020 – p. 140


In a disturbing later study, researchers in Australia took two groups of healthy adults, one of whom they got drunk to the legal driving limit (08 percent blood alcohol), the other of whom they sleep-deprived for a single night. Both groups performed the concentration test to assess attention performance, specifically the number of lapses. After being awake for nineteen hours, people who were sleep-deprived were as cog nitively impaired as those who were legally drunk. Said another way, if you wake up at seven a.m. and remain awake throughout the day, then go out socializing with friends until late that evening, yet drink no alcohol whatsoever, by the time you are driving home at two a.m. you are as cognitively impaired in your ability to attend to the road and what is you as a legally drunk driver. In fact, participants in the above study started their nosedive in performance after just fifteen hours of being awake (ten p.m. in the above scenario).

Operating on less than five hours of sleep, your risk of a car crash increases threefold. Get behind the wheel of a car when having slept just four hours or less the night before and you are 11.5 times more likely to be involved in a car accident.


Do not ever get behind the wheel of a car if you’re under-slept.
13/03/2020 – p. 138


Returning to Dinges’s study results, you may have predicted that optimal performance would return to all of the participants after a good long night of recovery sleep, similar to many people’s notion of “sleeping it off” on the weekends to pay off their weeknight sleep debt. However, even after three nights of ad lib recovery sleep, performance did not return to that observed at the original baseline assessment when those same individuals had been getting a full eight hours of sleep regularly. Nor did any group recover all the sleep hours they had lost in the days prior. As we have already learned, the brain is incapable of that.

You can not recover performance from sleeping off your previous sleep habits – contrary to what people say and do when they try and make up for missed sleep

13/03/2020 – p. 137


Similarly problematic is baseline resetting. With chronic sleep restriction over months or years, an individual will actually acclimate to their impaired performance, lower alertness, and reduced energy levels. That low-level exhaustion becomes their accepted norm, or baseline. Individuals fail to recognize how their perennial state of sleep deficiency has come to compromise their mental aptitude and physical vitality, including the slow accumulation of ill health. A link between the former and latter is rarely made in their mind. Based on epidemio logical studies of average sleep time, millions of individuals unwittingly spend years of their life in a sub-optimal state of psychological and physiological functioning, never maximizing their potential of mind or body due to their blind persistence in sleeping too little. Sixty years of scientific research prevent me from accepting anyone who tells me that he or she can “get by on just four or five hours of sleep a night just fine.”

Remember that chronic sleep restriction is defined as less 6 hours per night or less.
Getting 6 hours or less over months and months, you lower your physiological baseline and get used to suboptimal level of mental and physical of functioning – that is a scary thought
13/03/2020 – p. 137


Most worrying from a societal perspective were the individuals in the group who obtained six hours of sleep a night-something that may sound familiar to many of you. Ten days of six hours of sleep a night was all it took to become as impaired in performance as going without sleep for twenty-four hours straight.
13/03/2020 – p. 136


My final discovery, in what spanned almost a decade of research, identified the type of sleep responsible for the overnight motor-skill enhancement, carrying with it societal and medical lessons. The increases in speed and accuracy, underpinned by efficient automaticity,. were directly related to the amount of stage 2 NREM, especially in the last two hours of an eight-hour night of sleep (e.g., from five to seven a.m., should you have fallen asleep at eleven p.m.). Indeed, it was the number of those wonderful sleep spindles in the last two hours of the late morning-the time of night with the richest spindle bursts of brain wave activity-that were linked with the offline memory boost.

Perhaps more relevant to the modern world is the time-of-night effect we discovered. Those last two hours of sleep are precisely the window that many of us feel it is okay to cut short to get a jump start on the day. As a result, we miss out on this feast of late-morning sleep spindles. It also brings to mind the prototypical Olympic coach who stoically has her athletes practicing late into the day, only to have them wake in the early hours of the morning and return to practice. In doing so, coaches may be innocently but effectively denying an important phase of motor memory development within the brain-one that fine-tunes skilled athletic performance. When you consider that very small performance differences often separate winning a gold medal from a last-place finish in professional athletics, then any competitive advantage you can gain, such as that naturally offered by sleep, can help determine whether or not you will hear your national anthem echo around the stadium. Not without putting too fine a point on it, if you don’t snooze, you lose. The 100-meter sprint superstar Usain Bolt has, on many occasions, taken naps in the hours before breaking the world record, and before Olympic finals in which he won gold. Our own studies support his wisdom: daytime naps that contain sufficient numbers of sleep spindles also offer significant motor skill memory improvement, together with a restoring benefit on perceived energy and reduced muscle fatigue.

Obtain anything less than eight hours of sleep a night, and especially less than six hours a night, and the following happens: time to physical exhaustion drops by 10 to 30 percent, and aerobic output is significantly reduced. Similar impairments are observed in limb extension force and vertical jump height, together with decreases in peak and sustained muscle strength. Add to this marked impairments in cardiovascular, metabolic, and respiratory capabilities that hamper an underslept body, including faster rates of lactic acid buildup, reductions in blood oxygen saturation, and converse increases in blood carbon dioxide, due in part to a reduction in the amount of air that the lungs can expire. Even the ability of the body to cool itself during physical exertion through sweating-a critical part of peak performance-is impaired by sleep loss.
13/03/2020 – p. 127


When I tested participants after a night of sleep, however, my ears heard something very different. I knew what was happening even before I analyzed the data: mastery. Their typing, post-sleep, was now fluid and unbroken. Gone was the staccato performance, replaced by seamless automaticity, which is the ultimate goal of motor learning: 4-1-3-2-4, 4-1-3-2-4, 4-1-3-2-4, rapid and nearly perfect. Sleep had systematically identified where the difficult transitions were in the motor memory and smoothed them out. This finding rekindled the words of the pianist I’d met: “but when I wake up the next morning and sit back down at the piano, I can just play, perfectly”.
13/03/2020 – p. 126


In other words, brain will continue to improve skill memories your in the absence of any further practice. It is really quite magical. Yet, that delayed, “offline” learning occurs exclusively across a period of sleep, and not across equivalent time periods spent awake, regardless of whether the time awake or time asleep comes first. Practice does not make perfect. It is practice, followed by a night of sleep, that leads to perfection.

Practice with sleep makes perfect.
Sleep improves even motor skills that are being learnt
13/03/2020 – p. 125


We had learned a subtle, but important, lesson: sleep was far more intelligent than we had once imagined. Counter to earlier assumptions in the twentieth and twenty-first centuries, sleep does not offer a general, nonspecific (and hence verbose) preservation of all the information you learn during the day. Instead, sleep is able to offer a far more discerning hand in memory improvement: one that preferentially picks and chooses what information is, and is not, ultimately strengthened. Sleep accomplishes this by using meaningful tags that have been hung onto those memories during initial learning, or potentially identified during sleep itself. Numerous studies have shown a similarly intelligent form of sleep-dependent memory selection across both daytime naps and a full night of sleep.

During learning, when you emphasise to yourself that something is particularly important to remember (i.e. tag it) sleep aids you in remembering that information and discarding the information which you do not deem as important.
13/03/2020 – p. 121


By transferring memories of yesterday from the short-term repository of the hippocampus to the long-term home within the cortex, you awake with both yesterday’s experiences safely filed away and having regained your short-term storage capacity for new learning throughout that following day. The cycle repeats each day and night, clearing out the cache of short-term memory for the new imprinting of facts, while accumulating an ever-updated catalog of past memories. Sleep is constantly modifying the information architecture of the brain at night. Even daytime naps as short as twenty minutes can offer a memory consolidation advantage, so long as they contain enough NREM sleep.*
12/03/2020 – p. 115


Having learned a list of facts before bed, participants were allowed to sleep a full eight hours, recorded with electrodes placed on the head. The next morning, participants performed a memory test. When researchers correlated the intervening sleep stages with the number of facts retained the following morning, deep NREM sleep carried the vote: the more deep NREM sleep, the more information an individual remembered the next day. Indeed, if you were a par ticipant in such a study, and the only information I had was the amount of deep NREM sleep you had obtained that night, I could predict with high accuracy how much you would remember in the upcoming memory test upon awakening, even before you took it. That’s how deterministic the link between sleep and memory consolidation can be.
12/03/2020 – p. 114


Of broader societal relevance, the concentration of NREM-sleep spindles is especially rich in the late-morning hours, sandwiched between long periods of REM sleep. Sleep six hours or less and you are shortchanging the brain of a learning restoration benefit that is normally performed by sleep spindles. I will return to the broader educational ramifications of these findings in a later chapter, addressing the question of whether early school start times, which throttle precisely this spindle-rich phase of sleep, are optimal for the teaching of young minds.
12/03/2020 – p. 112


Of the many advantages conferred by sleep on the brain, that of memory is especially impressive, and particularly well understood. Sleep has proven itself time and again as a memory aid: both before learning, to prepare your brain for initially making new memories, and after learning, to cement those memories and prevent forgetting.
12/03/2020 – p. 108


More generally, these and similar studies have confirmed that poor sleep is one of the most under appreciated factors contributing to cognitive and medical ill health in the elderly, including issues of diabetes, depression, chronic pain, stroke, cardiovascular disease, and Alzheimer’s disease.
12/03/2020 – p. 102


Furthermore, those older adults with the greatest loss of deep sleep showed the most catastrophic overnight forgetting. Poor memory and poor sleep in old age are therefore not coincidental, but rather significantly interrelated.
12/03/2020 – p. 102


It was a saddening confirmation of my theory: the parts of our brain that ignite healthy deep sleep at night are the very same areas that degenerate, or atrophy, earliest and most severely as we age.
12/03/2020 – p. 102


Older adults may also wish to consult with their doctor about taking melatonin in the evening. Unlike young or middle-age adults, where melatonin has not proved efficacious for helping sleep beyond the circumstance of jet lag, prescription melatonin has been shown to help boost the otherwise blunted circadian and associated melatonin rhythm in the elderly, reducing the time taken to fall asleep and improving self-reported sleep quality and morning alertness.*
12/03/2020 – p. 100


Inefficient sleep is no small thing, as studies assessing tens of thousands of older adults show. Even when controlling for factors such as body mass index, gender, race, history of smoking, frequency of exercise, and medications, the lower an older individual’s sleep efficiency score, the higher their mortality risk, the worse their physical health, the more likely they are to suffer from depression, the less energy they report, and the lower their cognitive function, typified by forgetfulness.
12/03/2020 – p. 97


Certainly, whẹn we sleep at night, and even when we wake in the morning, most of us do not have a good sense of our electrical sleep quality. Frequently this means that many seniors progress through their later years not fully realizing how degraded their deep-sleep quantity and quality have become. This is an important point: it means that elderly individuals fail to connect their deterioration in health with their deterioration in sleep, despite causal links between the two having been known to scientists for many decades. Seniors therefore complain about and seek treatment for their health issues when visiting their GP, but rarely ask for help with their equally problematic sleep issues.
12/03/2020 – p. 96


Of the many functions carried out by deep NREM sleep-the full roster of which we will discuss in the next chapter-it is that of synaptic pruning that features prominently during adolescence.
11/03/2020 – p. 89