It is possible to extol the virtues of sleep. However, that would be too easy. What is difficult is to talk about the consequences of not. They range from pathology, and physical ailments, to psychological disorders. However the most poignant are the ones where the consequences are more instantaneous, and more damaging. If you are easily upset, and do not wish to read this, then please move on to the later stages of this article.

In 2006, a school bus in Florida was stopped at a junction. There were 9 children on board. Behind it, a car carrying 7 people pulled up behind this bus and stopped. Further up the road, an 18 wheel truck was travelling down the road towards the junction. It didn’t stop. It hit both the bus and car. The truck driver, and the children in the bus sustain serious injuries. Three of which were thrown completely out of the bus on impact. The car, was crushed, underneath the truck and burst into flames. It was carrying teenagers and children. 5 of which were from the same family, and the youngest was just 20 months old. It was later discovered that the truck driver had been up for over 30 hours straight.

If you take nothing else from this article, and from my reading, if you’re drowsy while driving, please pull over. It can take just 2 seconds to veer into an oncoming lane, and that’s usually how long a micro sleep lasts. No tactic of windows down, radio on, will work effectively. Find somewhere to pull over, and have nap, or get to sleep for the whole night.

Sleep and Emotions

Children, when given a good nights sleep, behave well, are well mannered, and fun to be around. Given a broken or poor nights sleep, and they become tantrum throwing little so so’s. The same is still true for adults, just not to ‘quite’ as much to the same degree. It seems that when measuring brain scans, of participants, viewing an emotional range of pictures, the well rested brain shows a modest reaction to such images (emotionally benign being a piece of driftwood, to more upsetting such as a burning house or a snake about to attack), the other group who stayed up an entire 24 hours, showed a 60% increase in the use of their ‘irrational’ centre of the brain, the amygdala. In this case, what was found, was that our dopamine (linked to impulsiveness and reward) receptors in the brain, had become hyperactive once being deprived of sleep. What is interesting, is that when underslept, it’s more likely that we become more emotional, in both positive and negative ranges and can more easily switch between the two.

Sleep and Alzheimer’s 

Two diseases which many fear in the developed world; Cancer and Alzheimer’s. Both of which are linked to inadequate sleep. Alzheimer’s disease has been linked to a build up of toxic proteins within the brain called beta-amyloids. Amyloid plaques are poisonous to surrounding neurons. What is fascinating is the it was only until recently that we didn’t know how this build up occurred. It has been discovered that the brain has an equivalent lymphatic system called the ‘glymphatic system’. In deep NREM sleep this system flushes out these amyloid proteins from the brain, and disposes of them, using cerebrospinal fluid which bathes the brain. The glymphatic cells or Glials shrink in size by up to 60% during NREM sleep to allow this fluid to remove these amyloid build ups.  At the same time, other harmful proteins called tau, are also removed during NREM sleep.

As is said in the book, wakefulness is low level brain damage, and sleep is brain sanitation. The tragedy, is that as these build ups occur, in greater quantity through lack of sleep, the harder it is for the damaged cells to achieve restful deep sleep. The over-riding message, more and more is that by focusing and prioritising a good nights sleep, you will be protecting yourself (and those around) from having to deal with the brutal and degenerative disease.

Sleep and Muscle Memory

When trying to learn new movements, sleep is imperative. Matthew walker describes how after a lecture he was met by a professional pianist. They described how after practising a great deal during the day, he would having not been able to get a particular part correct, and in the morning miraculously be able to play it perfectly.
What then happened was Matthew went back to lab, and three years later, he had confirmed what this pianist had empirically discovered:

Practice, with sleep, made perfect.

What was interesting, is that sleep enhances practices work. With equivalent studies being conducted on participants who slept while learning a number sequence, and participants who practised in the morning, and then practised in the evening. The sleep group was the winner.

The implications are extremely important when it comes to exercise.

If we are learning complex gymnastic or weight lifting movements, then our brain will never be as plastic if we are tired and under slept as we are, when we are chronically well rested and well slept. My argument is that in order to make the most out of your own training, then getting a good nights rest is imperative to your success.

Since getting better sleep, it took me two weeks, of sleep emphasis (i.e. getting a good 8.5 hours in bed each night), with virtually no alcohol intake, to reach a normal which I have not had in years. As the book describes, that we are not fully aware of how tired we are, the truth was iterated by my own experience. Not only that, but my training performance has hit a new peak, and I will put it down entirely to getting a much better nights sleep.

The interesting part of this, is that in 2015, the international Olympic committee, published a statement saying that all athletes both male and female need to sleep well consistently to aid their athletic development. This often run’s counter to many athletes balancing a full training schedule with work and family commitment, which realistically isn’t always possible.
Matthew Walkers work with professional sports teams supports this claim, and has over 750 studies to prove it.

In fact, rather frighteningly, if we only obtain 6 hours of sleep a night:
* Time to physical exhaustion drops by 10-30%.
* Aerobic output drops.
* Vertical leap and limb extension force drops.
* Proclivity for injury goes up.

In teenagers, a study was conducted, and one of the key measurements was sleep and chances of injury. At just 6 hours of sleep a night, an athlete’s chance of injury was over 70%. With 9 hours sleep, their chance of injury dropped to under 20%. This finding has some major ramifications, when considering that many teenagers are under slept, and playing a large amount of sport.
In team sports, especially contact sport, sleep plays a huge role after a game, in limiting and removing inflammation away from troubled joints, stimulates muscle recovery, and helps restock cellular glycogen.

Similarly, those who have had strokes, it was found the motor control came back, in greater quantity, following prioritisation of sleep as a therapy tool. It seems that this ‘magic cure’ can help do things, which doctors currently are unable to replicate.

Sleep For Creativity

The major part of the nights sleep, the we receive the greatest leaps in creativity is that of REM sleep. The majority of which is in the latter part of the night. It seems that, in REM sleep, our brain makes use of the vast stores of information, and will make use of seemingly non-obvious associations, that can help problem solve. In sleep, seemingly disparate pieces of information can be brought together, and help aid in the solution to a particular problem which we in waking life, might not be able to solve. This is yet another reason to prioritise sleep, over time on task. Your brain, is a truly amazing organ, if used in the right way, and given the conditions for success.

How Sleep [or lack thereof] Can Kill You

Drowsiness causes more accidents than does drinking and alcohol combined. It is also more dangerous within an accident. If drunk driving, we react late. Drowsy driving, we don’t react at all. Which means, that there is no loss of speed, no swerving, nothing, just a collision, and therefore they are far more deadly.

Each hour (albeit in the US), someone is killed on the roads, due to lack of sleep. Let that sink in. This is just one country.

It only takes 2 seconds for a car to veer into an oncoming lane, and that’s at 30 mph. Micro sleeps can happen usually, if we are chronically getting 7 hours or less of sleep a night. How many of people do you know get between 6 and 7 hours a night? Probably more than one.

This means that a micro sleep can really happen to anybody. It also is even more frightening, considering that new parents, who are lucky to get that much, suffer for months, in a state of sleep deprivation. The risk, based off of this fact, therefore, I believe to not be worth it. Driving tired simply is not worth the risk. If you are tired, pull the f”’ over.

In a study, where various groups were tested for their alertness given varying amounts of sleep, the people who had been given 6 hours of sleep a night, by day 10, performed as badly as those who had been awake for 24 hours. This study, was only 14 days long, and by the end of it, the impairment to their performance was still continuing to worsen.

In a similar study, published at the same time, participants were asked to subjectively discern how impaired their performance was, they consistently underestimated their level of impairment, similar to that of a drunk driver who believes that ‘they were fine’ when getting into their car after a session down at the local bar. ]

What also was interesting following the above study, was that even three days of ‘sleeping it off’ all the sleep deprived participants, were still impaired in their performance of basic tests, which means that the weekends are not sufficient to catch up, on a week of poor sleep.

Sleep For Diabetes and Weight Gain

When trying to lose weight lack of sleep can be a big inhibitor. When subjected to restricted amounts of sleep, participants found that upon being restricted sleep, their bodies physiology was different to when they were well rested. In all told, we tend to eat an additional 300 calories per day, when getting just 6 hours of good quality sleep. The thing is that, in that state we often don’t realise we are doing it, because our body produces more hunger hormone ghrelin and less leptin (satiety hormone). This finding therefore means we are more susceptible when under slept to diabetes and weight gain. Sleep loss actually increases the blood levels of a endocannabinoids which are chemicals produced in the body, that are very similar to the drug cannabis.

They essentially give you the munchies!

For those who would say that being awake longer burns more calories, it is now proven that sleep is a highly metabolic activity. So much so, that the net increase of being awake for 2 hours longer in a 24 hour period is only 147 calories, which is about one and half brazil nuts worth. Hardly worth losing sleep over, and the additional calories that you’ll want to eat when sleep deprived outweigh the loss of calories from being awake longer. Furthermore, we often feel more tired and demotivated, and therefore will not be as likely to exercise as vigorously.

Lack of sleep is the perfect recipe for weight gain and diabetes. Higher calorie intake, lower calorie expenditure. When under slept, we will gravitate towards sugary processed foods, foods which a designed for weight gain and make it harder for us to avoid over consumption. It is a vicious circle with regards to calories in, and sleep out.

The amazing thing is also that during the 20th century, the rise in obesity, is in direct correlation to the demise of a good nights sleep, almost in direct proportion. A three year old who sleeps less than 10.5 hours a night, as opposed to 12 hours a night, has a far greater chance (45%) of developing obesity by age 7 (these figures are from the US but I still hope my three year old is reading this!).

Finally, if this isn’t bad enough, when it comes to being on a calorie restricted diet and getting enough sleep, or not enough. The groups that got enough sleep, lost fat mass first. The group that was deprived of sleep, lost mostly (70%) lean mass. What did getting a good night sleep render? More than 50% of the weight loss came from fat mass.

How much help do you think it will be then, if you decide to get to bed early for the next month on your fat loss goals if you have them?

Sleep Loss and Reproductive Health (For men: How to shrink your balls)

The very best news that lack of sleep has to offer is yes, smaller balls (if your male). Lack of sleep will lower testosterone output, lowers growth hormone production and effectively ages a male by 10 years in his hormone levels. This alone is reason to prioritise sleep. Lower testosterone is associated with lower energy levels, lack of focus, tiredness and dulled libido. Along with this, testosterone manages bone density, muscle mass and strength. If you want to maximise the benefit of your training, sleep is without a doubt just as important as eating right.

For Women the loss of sleep is also a major player in loss of reproductive health. Women who work shifts such as care works or nurses or doctors, suffer from abnormal menstrual cycles, and are more likely to suffer miscarriages. For a woman who is pregnant, the science is even more compelling that any alcohol consumed during pregnancy, will not only affect the mothers sleep (if consumed in the evening) but will also affect the faetus’ brain development because of the reduction is NREM sleep that alcohol causes.

In terms of attractiveness, we become less attractive when under slept. In a study, where photographs were taken of individuals ranging from ages 18 to 30, with no make up, and flat lighting, at the same time of day, but on two different occasions. One well rested, the other with just 5 hours sleep. Then, the public were asked to judge the participants attractiveness. The results were unanimous, that under slept, everybody in the entire study appeared less attractive. This also is not only skin deep as we are about to discover.

Sleep and the Immune System

What did you do the last time you were ill? did you just want to lie in bed and sleep? It seems that the body will often force you to take some rest if you get ill.
Sleep boosts the immune system with an almost miraculous effect. When given the common cold, those who were sleeping 7 hours or more per night received just an 18% infection rate. Those sleeping 5 hours, had a 50% infection rate. Sleeping badly does not help your immune system function.

When vaccinated, individuals who responded best to the vaccine were the ones who slept a sufficient amount (8.5 hours per night). If you were getting 6 hours a night, you may as well have not been vaccinated at all as your bodies immune system will not ‘remember’ sufficiently how to tackle an equivalent live virus. Those on shift work as particularly susceptible to this loss of immunity to the particular virus.

With each passing year, it seems that malignant tumours are being linked more and more to lack of sleep. 25,000 Europeans were studied, and individuals who slept less than 6 hours a night, had a 40% increased risk of cancer to those who slept 7 or more hours a night. Similar associations were found tracking 75,000 women across an 11 year time scale. The reasons for this are unclear, but the theories are that an agitated sympathetic nervous system shows an increased amount of inflammation, and suppresses effective immune system function. Cancers use inflammation to their advantage, and with lack of sleep being unable to reduce this inflammation it is logical to draw this conclusion. For instance sleep deprived mice suffered a 200% increase in cancer size and speed of growth. It didn’t get any better on postmortem examination of these mice, the cancers had spread far more rapidly and aggressively in the sleep deprived mice, to the well rested.

Sleep and Society

1 out of 2 adults does not get the necessary sleep this week in western society.

In business there is an economic cost to sleep – The UK loses £30 Billion a year due to sleep loss. Or put it more simply, that lack of sleep costs countries more than 2% of their GDP each year. Imagine if this was spent on education.

Nearly all our faculties are affected being under slept that makes us less useful to those around us –
creativity, motivation, effort, efficiency, effectiveness in a group, emotional stability, sociability, and honesty?!

CEOs affect entire companies. When they sleep less, they affect even well rested employees. They are less charismatic and a sleep deprived employee will find the CEO less inspiring if the CEO does not get enough sleep. Productivity and honesty are the name of the game when it comes to sleep.

Given less sleep, we tend towards easy and less challenging tasks.
Under slept employees tend not only towards lower levels of productivity, but unethical practices. Which when reputation is on the line, this poses a serious consequence to the success of the company. They are also more likely to blame other people for mistakes and take less ownership over their own short comings.
It’s fundamentally wrong with forcing people to work late and sleep little.

Sleep and Education

This is highly significant whether we are parents or students.
Adolescents typically will have a shift in their body clock to 1 to 3 hours later. This is a natural occurance and something which should be worked around. Given that REM sleep accounts for the majority of the brains emotional intelligence, when deprived of this sleep, which 80% occurs in the last 2 hours of an 8 hour sleep cycle, then students with a deprived amount of REM sleep are more likely to be unruly, disengaged and disruptive in class.
It seems that the school start times of 9 am are more beneficial to an adolescents concentration and school performance that we at first realised. Compound this over 5 days and the results can be quite alarmingly different to those who are under slept.

When it came to 16 to 18 year old drivers the changes to one county’s school start time, rendered a 70% reduction in road traffic accidents for that age bracket. Give that Anti-Lock Braking Systems achieved just a 20 to 25% reduction in road traffic accidents, then this natural life saver is not something to sniff at, being that its more than twice the man made technologies. Natures mechanism for improving driver decision making seems an obvious and utterly astounding fact that it perplexes me, as to why we aren’t taking the lack of sleep much, much more seriously.

Notwithstanding the effect that good sleep habits can have on children with ADHD.

Sleep and Healthcare

Having worked with people in the medical world, it’s become quite apparent that a large proportion of doctors (juniors especially) are a group of people who simply do not get enough sleep. The alarming fact that a large proportion of doctors do not get enough sleep, or are being each week forced to completely change their natural circadian rhythm by doing short stints of night shifts.

Key Thoughts and what to do about your sleep:

We’re currently only giving ourselves opportunities to sleep between 7 hours and 7.5 hours or thereabouts, but the sleep opportunity needs to be more than the desired sleep.

8.5 hours sleep opportunity is the necessary amount of time we need to plan to be in bed. Which therefore means, to get up at 5 am, we need to be in bed at 8.30pm to get an adequate amount of sleep.

The key contributors that affect your own sleep –

1. LED Light in the bed room – Just a 1 to 2 percent of strength of daylight, this ambient level of home lighting can suppress melatonin by 50%.
2. Stable temperatures – lack of temperature variability affects the release of melatonin.
3. Caffeine.
4. Alcohol.

LEDs and Sleep
Blue LEDs are twice as harmful as incandescent lights to our melatonin release.

iPad before bed – suppresses the release by over 50%, the results of which we lose REM sleep. As a result, we’ll feel sleepier during the day.
What’s scary is that we seem to experience a Digital hangover when coming off blue screens 90 minutes before bed. This rather unnerving affect carries on for more than 3 days in our brains ability to produce REM sleep.

Solutions – Limit the hangover by creating mood lighting in the evenings, and invest in blackout blinds.

Alcohol and Sleep

Alcohol can be likened to that of light aneasthesia. The effect the alcohol has on sleep, powerfully suppresses REM sleep. Which as we know effects our emotion centres in the brain, and limits our ability to temper our less rational part of the brain. In short of being completely boring, the science consistently points towards abstinence being the best bet for getting a good nights sleep.

Temperature Control and Sleep

The major issues with modern homes is that of temperature control throughout the day. Our body needs a reduction in temperature to aid the release of melatonin. Our body clock is linked to natural ambient temperature.
When blood vessels in our extremities vasodilate to improve heat loss our body begins the secretion of melatonin.

What they found is that the ideal temperature is 18.3 degrees for bedrooms and No lower than 12.5 Degrees otherwise they are too cold.

In a study participants before body cooling, had a 58 percent likelihood of waking up in the last half of night and struggling to get back to sleep. The classic hallmark of sleep maintenance insomnia. The number tumbled to just 5 percent likelihood when receiving the thermal help from the bodysuit that this science lab were testing. As a result the electrical quality of sleep specifically NREM sleep, had been boosted by the thermal manipulation in all individuals who conducted the study.

Hot baths can prior to bed induce a 10 to 15 percent increase in NREM sleep in healthy adults. In short to get a good nights sleep, start by having a hot bath or shower before bed, to aid the release of heat. You’ll also fall asleep much faster.

Some Parting Thoughts

Having read this, you may be shocked by the findings. I was. As a result, I felt very strongly that I had to do this information justice. Matthew Walkers presentation of this research is groundbreaking. Upon reading the book and studying it in detail, my own sleep habits have dramatically changed and improved. For the last few weeks, I have made sure that I’ve got to bed before the 8 and half hour window of when I need to be up. I’ve focused on having hot showers, and drink no alcohol in the evenings (although sometimes at lunch). As a result, what has happened to my own life has been astounding.

I’ve felt more energetic. More productive. I’ve been happier, and a nicer person to be around. Problems which I face, don’t have the same emotional tinge to them that they used to. My relationship with my wife and my kids has improved. I’ve become more creative (writing bed time stories for my boys for example). More relaxed. My workout performance has improved, and I find that during my coaching sessions, I’ve been able to deliver more energy and more focus towards my clients than I have done. Our entire household has improved routines now. My wife has been practicing piano on a regular basis. Our boys have been better behaved with less fights between them.

In actual fact, We feel like we’ve got back to a new normal. As Matthew writes, I didn’t realise how tired I was, until I really started getting a good nights sleep, and suddenly realised what I was missing out. One of the first questions I’ll now ask my clients is how much sleep they are getting, and the answer usually comes back “not enough”.

Having worked in health for a few years now, and constantly looking at ways to improve peoples everyday life, I can categorically say, that if you prioritise nothing else other than getting a truly good nights sleep, your life will change for the better, and the health and the goals you’ve wanted to achieve will seemingly start to become more and more possible, just because your mind and body, will be well rested, and the problems you face right now, will elegantly have solutions presented to you. You’ll know, because you’ll feel normal again.

Thanks for reading,

Archie Cunningham