Audio long read: How to get the best night’s sleep — what the science says

0:02This is an audio long read from Nature. In this episode, how to get the best night's sleep. What the Science Says Written by Lynn Peoples And read by me, Benjamin Thompson From TikTok videos touting mouth tape and weighted blankets To magazines ranking insomnia-curbing pillows Sleep advice is everywhere And it's no wonder People all over the world complain of insomnia And not getting enough sleep Driving a market for sleep aids worth more than US$100 billion annually. But scientists warn that online hacks and pricey tools aren't always effective. And failed attempts to remedy the situation could have negative effects, says Andrew McHill, a circadian scientist at Oregon Health and Science University in Portland.

0:57It could discourage people from finding help, and things could get worse, he says. Instead, researchers point to the lessons coming from circadian science, which, over the past five decades, has exposed a network of biological clocks throughout the body. This timekeeping machinery ensures that physiological systems are primed to do the right things at the right times, such as defend against pathogens, digest food and sleep. But circadian clocks don't cycle precisely on their own. To stay in sync and function optimally, they need regular calibration from sunlight, daily routines and other cues.

1:43Modern life doesn't often cooperate. People spend much of their time indoors. They eat late into the night. They shift sleep schedules between workdays and weekends, effectively jet-lagging themselves. The toll is steep In the short term, circadian disruption and insufficient sleep can reduce cognition, mood and reaction time In the long term, they can increase risks of infections, diabetes, depression, dementia, cancer, heart disease and premature death For better sleep and overall health, Mackell and other scientists emphasise three basics Contrasting light and dark consolidating mealtimes and keeping sleep times consistent.

2:31Simply taking a walk outside during the day and reducing our light exposure in the evening could have great effect, says Mach Hill. Light provides the most powerful signal to the circadian system. Blue wavelengths are especially potent. That is not a coincidence. Humans evolved outdoors under the sky, and the midday sky is rich in blue light. Still, common advice about avoiding blue light at night captures only part of the story. In the 1990s and 2000s, a string of discoveries proved the existence of light-sensitive cells in the eye that are not directly involved in seeing. Rather, these cells synchronize body clocks.

3:20They detect both intensity and wavelength with input from rods and cones, and relay those data to a circadian pacemaker in the brain. The circadian system requires bright light to operate properly. But we're pretty bad at determining how much light we're getting, says Jamie Zeitzer, a sleep and circadian scientist at Stanford University in California. Typical home lighting of 100 to 250 lux might feel like a lot to the eye. But the blue-rich daylight that the circadian system is primed to detect shines orders of magnitude brighter, upwards of 10 ,000 lux, even on an overcast day. Timing matters too.

4:09Bright blue light during the daytime synchronises circadian rhythms and supports the nightly surge of melatonin, the hormone signal that tells the body it's time to sleep. It can also boost alertness and cognitive performance. The same illumination at night, from artificial lights and glowing screens, confuses the circadian system. Blue light is the strongest disruptor, but enough photons of any colour at night can shift rhythms, suppress melatonin levels and hinder sleep. Exposure in the middle of the night, such as with a flip of a toilet light switch, is most disruptive, says Zeitzer. The circadian system's sensitivity peaks near the midpoint of sleep when it least expects light.

5:00Studies show that even a dim light, such as a hallway bulb, can raise overnight heart rate and impair sleep. Ultimately, scientists say, what matters most is contrast. Bright days and dark nights. In fact, light during the day can buffer against the potential harms of light at night, says Mariana Figaro, director of the Light and Health Research Centre at the Icahn School of medicine at Mount Sinai in New York City. Mounting research links greater daytime light exposure with stronger circadian rhythms and higher sleep quality. One study of college students found that their total hours of light exposure during the day better predicted their bedtimes and wake times than did light exposure after dusk.

5:50The more light you get during the day, the better you'll sleep at night, says Figaro. Too little daylight and too much night light could even shorten life expectancy. A UK study of nearly 90 ,000 people found that the 20 % with the poorest light exposure patterns were predicted to die around five years earlier than were the 20 % with the healthiest habits, even after accounting for factors such as income and physical activity. Andrew Phillips, a sleep health scientist at Flinders University in Adelaide, Australia, and an author of the study, pins the explanation on circadian rhythms. Quote, they regulate every aspect of your physiology.

6:36End quote. Unfortunately, achieving this daily contrast is difficult in the modern world. Indoor lighting leans on green wavelengths that serve vision but not circadian signaling. Energy usage codes limit how bright those fixtures shine. Daylight entering through windows gets quickly diluted, and energy-efficient window glass and blue light-blocking spectacle lens coatings further reduce how many circadian-stimulating photons reach the eyes. Aging compounds the problem. People's lenses become more yellow over time and filter out more blue light. Circadian science's prescription, spend more time outdoors, sit near windows and use daylight mimicking light-emitting diode lamps during the day.

7:27In the evening, lower the brightness of lamps and power down screens, or use apps that dim or shift screens to a warmer spectrum, and consider a low-intensity amber nightlight for the toilet. Scientists note that the precise prescription is personal. Even people of the same age can vary considerably in how they respond to the same light, possibly because of characteristics such as sex or eye colour. And when light comes from screens, the content can matter as much as the light itself. If you're on an iPad at 11 at night, then the light exposure might have some effect, says Zeitzer. But if you're doing something relaxing that might outweigh the effect.

8:14Calorie intake is also intricately linked with circadian rhythms and sleep. The human liver at 10am and the human liver at 10pm are very different organs. The same can be said for other parts of the body that process food. Hunger hormones, digestive enzymes and glucose-regulating insulin have rhythms too. Humans are simply not equipped to deal with food at all hours, says Emily Manugian, a circadian scientist at the Salk Institute for Biological Studies in San Diego, California. Late morning to early afternoon is when the body is usually most prepped for incoming calories. Eating late in the evening disrupts clocks and leaves key steps of digestion incomplete.

9:03It can also disrupt the gut microbiome, which could contribute to insomnia. What's more, late meals send blood to the gut and raise core body temperature, countering the natural night-time dip that promotes sleep. And they elevate glucose levels and uncouple liver and kidney clocks from the core clock in the brain, raising the chance of midnight toilet trips. Manoogian and others suggest reviving the old adage, eat like a king in the morning, a prince at noon, and a peasant at dinner. That last meal, they say, should fall at least three hours before bedtime, ideally with no subsequent snacks or caloric drinks.

9:49Food quality matters too. Diets high in sugar and saturated fat lighten and fragment sleep. Caffeine lingers for hours, and alcohol is deceptively disruptive. You might fall asleep, but the quality of your sleep will be quite poor, says Manougian. On the flip side, eating some plant-based foods during the day could improve sleep. Research shows that walnuts boost melatonin levels and sleep quality. Marie-Pierre Saint-Ange, a nutrition, sleep and circadian scientist at Columbia University in New York City, co-authored a study that links greater daytime intakes of fruit and vegetables with less fragmented sleep.

10:35If a bedtime snack is unavoidable, Saint-Ange recommends something light and easy to digest, such as yogurt or granola. Another option, if you can find it, cow's milk that has been collected at night contains more melatonin and lower levels of the stress hormone cortisol than does milk collected during the day Research confirms that similar fluctuations occur in human breast milk, suggesting that new parents might want to label pumped bottles with AM and PM to help their babies and themselves to sleep soundly Sleeping at the right time can be just as, if not more, important than getting lots of sleep.

11:20You're getting more bang for your buck, says Phillips. The circadian system regulates sleep in tandem with the sleep homeostat, a separate system that influences drowsiness through a molecule called adenosine. Adenosine builds up in the bloodstream while a person is awake and is broken down during sleep. but it alone isn't enough to initiate and maintain quality sleep. At 8am after an all-nighter, for example, circadian signals would be promoting wakefulness by raising body temperature and alertness, countering high adenosine levels. Aligning the homeostat with circadian signals means going to bed and waking up at consistent times, in tune with a person's biology.

12:10This optimal sleep window will differ for an early bird versus a night owl. So, inevitably, strict work and school schedules will conflict with someone's internal clocks. Perhaps the most glaring mismatch is that teenagers' rhythms naturally shift later, even as school bells ring earlier. Research estimates that at least 80 % of workers and students rely on alarm clocks, evidence that most are living in discord with their biology. Accumulated sleep deprivation over days of waking with an alarm causes many people to compensate by sleeping in on non-working days. Springing forward to daylight saving time and falling back to standard time adds further whiplash.

12:59The risks of misalignment and inconsistency go beyond poor rest. Phillips and his colleagues found that an unstable day-to-day sleep schedule alone predicted mortality better than did total sleep hours. Another study he co-authored showed that people with heart failure who had irregular sleep patterns had twice the risk of another medical event, such as hospitalisation or death, compared with regular sleepers. We need to reframe how we think about sleep, says Phillips. It's not just about hitting a daily quota. Focusing on any one factor can help the others fall into place, says Phillips. A regular eating schedule can anchor sleep timing, which, in turn, can make it easier to get morning light and avoid light at night.

13:51Still, adhering perfectly to the rules is not necessary to reap the benefits. People should adjust what they can, when they can, scientists say. Shift workers, for example, face barriers to all three, but compromise can get them closer. Eating meals during the day, even while working nights, could lower many of the risks associated with shift work, such as mood disorders and blood sugar problems. And people can use other behavioural clues, such as exercise. A hard morning workout promotes night-time sleep, says Saint-Ange. Life also calls for flexibility. Manoukian allows herself the occasional late dinner with friends, and people with a large sleep debt can benefit from an extra hour or two of catch-up sleep on non-working days.

14:44Although sleep gadgets might not cure sleeplessness, some tools could guide healthier habits. Wearable trackers and light sensors might prompt users with personalised feedback. Corey McLean, an engineer at Google in Cambridge, Massachusetts, and co-author of a paper on using large language models for personal health, imagines digital devices giving a nudge. Quote, if it sees you tend to go to bed at a reasonable hour on weekdays, but then you're much more variable on weekends, it could suggest that as an area for improvement. End quote. To read more of nature's long-form journalism, head over to nature.com slash news.