The Extra Scoop: Sleep 101

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0:59Welcome to The Extra Scoop, our expert-led bonus episodes, giving you the need to know on the topics everybody is talking about. That's right, from gut health to sleep, hormones to skin, we are cutting through the noise with top experts, so there is no fluff, just facts. Exactly, it's all quick, practical, evidence-based advice to fit into your busy lives. So this is The Extra Scoop, let's get started.

1:28As our listeners probably know by now, our Extra Scoop episodes It's all about taking those topics that feels everybody's talking about and just breaking them down for you so that you are left with expert led insights that leave you feeling informed and empowered when it comes to your well-being. And this week we are talking about something we all do every night or hopefully do, but many of us still struggle with, and that is sleep. And there is just so much advice out there on how to get better rest from sleep cycles to smart rings, blue light blockers. it can be very overwhelming, hard to know what really makes a difference.

2:04How much sleep do we actually need? What's more important, total hours or REM sleep? And we needed someone to help us separate fact from fiction. So we are joined today by Dr. Lindsay Browning, a chartered psychologist, neuroscientist, and sleep expert with a doctorate in insomnia from the University of Oxford. So welcome, Lindsay. Thank you so much for joining us. No, it's brilliant. Thank you for having me. Oh, no, it's such a pleasure, Lindsay. We've been looking forward to this episode as people that don't always get the sleep that we need and not by our own doing, it's really helpful to have you on today.

2:36So let's start with that golden question you must get asked all the time. How many hours of sleep do we actually need? So for a working age adult, the recommendations are according to science, that getting somewhere between seven to nine hours a night is what we need to be getting regularly. But of course, what's really important is that's a range. It's not that everyone needs to get eight hours. And I hear this all the time. People think they should be getting eight hours, but that's just the average. Just like we're not all the same height. We're not all the same weight. We don't all have the same sleep needs.

3:09So generally speaking, people who get somewhere between seven to nine hours sleep a night tend to be healthier and happier. So that's the kind of range we're trying to aim for. I guess you must be kind of thrilled in your line of work that sleep has become such a hot topic. It must be sort of music to your ears to hear us say sleep is everywhere. And it does feel over the last five to 10 years, something that I think we all took for granted that was pretty unsexy has become pretty cool, pretty fashionable, quite a trend. And it's quite odd to say sleep's a trend, but I think it is a trend. We could probably all agree.

3:42I guess it would be helpful to understand in your opinion, why are we all talking about it? What are the top line benefits of getting that amount of sleep? So if you think about it, when we fall asleep, it's a waste of time, or at least that's what people think, because we could be getting things done. So sleep really needs to be important. Otherwise, why do we do it? Why has humankind evolved? Why do we sleep? And actually, with growing research and over recent years, the overwhelming science has proven how massively important sleep is. It is not a waste of time. When we sleep is when our body repairs, we regulate hormones, process emotions, and people who don't get enough sleep just have such poorer health and mental wellbeing that it's really, really important.

4:31We need to be prioritizing getting a good night's sleep in the same way that we prioritize eating well, exercising well, and doing all those other things that we are now as well as sleep, realizing are important as well. I mean, obviously it helps you perform your day-to-day task with a spring in your step. I know I certainly feel when your head is heavy and you don't feel like you're performing your best that it can be extremely tricky. But are there any, I don't want to go too morbid on the second question going in, but I worry, Lindsay, because I see things everywhere. It must be my algorithm, probably because I am sleep deprived a lot of the time because of my children at the moment, that I'm aging faster, that years are being knocked off my life because I'm not getting the sleep I need.

5:17I mean, what element of, I don't know if I dare ask, what element of truth is there? And that's a really great point because obviously my entire job is to help people sleep well, but as happy as I am that the sleep is now mainstream and it's, you know, every magazine newspaper going is talking about sleep. And that on the one hand is fantastic, but if you're not sleeping well, either because you have insomnia or because of your lifestyle. You have children, you've got caring responsibilities, you've got a really busy job. You can't get enough sleep. And being sort of thrown down your throat, all this negativity can just make your anxiety huge and just make everything seem worse.

5:57So yes, sleep is important, just like eating well and exercising. But if you are having, I'm sure, new parents, they don't get the time to eat as healthily as they maybe did before children. They don't have the time to exercise as regularly. And we don't freak out about those things. So we want to understand that if we can prioritize our sleep, we want to choose to do so, but not to become so stressed and anxious that we have to get seven to nine hours sleep. Otherwise, you know, crisis will befall us because that's just not helpful. And the truth is, yes, sleeping well is good for you. But as humans, we have evolved to survive with little amounts of sleep for periods of time.

6:37Otherwise, every new parent on the planet would have cancer and dementia and diabetes and heart disease and all those things. So we need to see it in the realms of context. And like I said, if you are in charge of your schedule and you're not prioritizing your sleep and you're just scrolling through your phone for an hour or two before bed, I really want to encourage those people to not do that because go to bed early and you're going to humongously benefit from that. But if you can't go to bed early because you have to put your kids to bed and do all the other things you have to do, that's okay.

7:10We'll just survive. And when we can change our lifestyle and we have time to prioritize our sleep, we can improve it then. I love that take on it. I think that's incredibly constructive. And in terms of looking at that positive spin on it, I would love to get a bit more specific on why sleep is good for you. What are those core bits of research of evidence on those health benefits, that motivation for people tonight to put their phone away an hour early and get that extra bit of sleep? You can't argue with science. People who get enough good quality sleep, so people who regularly sleep seven to nine hours per night, tend to have a reduced risk of depression and anxiety.

7:50They tend to have a lower risk of heart disease, stroke, certain types of cancer, dementia. They have a lower risk of diabetes, obesity. Their immune system is going to be stronger and their memory is going to be improved. Just every aspect of your life. If I was here to be selling a supplement that you could all buy that had all these benefits, everyone would want to buy that supplement. But the great thing is I'm not selling anything. Sleep is free. You just need to go to bed and sleep and you're going to do all of this great, good stuff to your body. It's so interesting. And something that I find in the nutrition line of work a lot as well over the years has definitely been what foods are there that link to my sleep?

8:32And is it true there's melatonin and cherries? All these sorts of headlines that you see. What elements of truth are there within this? Yeah. So if we don't have enough magnesium, for example, our sleep is likely to not be so great. If we have any kind of deficiency, basically, iron deficiency, vitamin D deficiency. If we don't have the right amount of nutrients and vitamins, then our brain can't do the processing it needs to do at night, especially magnesium, for example, is really topical. Just taking a generic magnesium supplement, if your magnesium levels are low, is going to help. And with food, so things like tryptophan, we use tryptophan to turn into melatonin.

9:15Melatonin is our sleep hormone, helps our body to know that it's time for sleep. And yes, tart cherry juice tends to contain melatonin, certain types of nuts. Milk contains tryptophan, as does smoked salmon, turkey. So all of these things, they contain an ingredient which is helpful for sleep. However, the quantities that they contain isn't likely to be hugely significant for our sleep. If you have chronic insomnia, for example, the solution isn't going to be having a tart cherry juice drink or having a turkey sandwich, but those things, they may be beneficial somewhat. They're certainly unlikely to be harmful, but we need to look at what's really causing the problem and fix the main issue rather than just looking for little easy tweaks around the side.

10:06It's just like if you want to lose weight, you kind of have to have a calorie deficit and maybe do some exercise, but no one wants to hear that. We all want to hear, oh, well, is there not just a cream I can buy and rub on my tummy and then I'll get a six pack? That would be great. And the same with sleep. Like we need to put the effort in, we need to do the right things. And there aren't really any quick fixes to getting a good night's sleep. It's doing the good stuff that's most important. That's such wise advice. And I think it's so interesting when we're talking about a whole range of totally different topics, the advice is so often the same, which is there is no quick fix.

10:40We all wish there was. How brilliant would that be? There's a few things I wanted to pick up on from what you were just saying, Lindsay, but one of them was, what are those core ingredients to helping our body, our brains get a good night's sleep? Well, in order to sleep, we need to be a couple of things. We need to be calm and relaxed, and we need to be tired. So those are two things that we can really work on during the day. So if we are stressed and anxious, and I'm sure we've all had periods of time when we've been stressed and anxious, and if you have an exam tomorrow or you've got some health worry, you're unlikely to sleep as well.

11:16Because when we are anxious, our body becomes physically increased cortisol, adrenaline. Our heart might be racing. Our brain might be worrying, thinking of all these worries. And when we are anxious, it's much harder to sleep because when we are asleep, in essence, we're kind of vulnerable. When we were cavemen and we were asleep, we were very, very vulnerable at that point. So in order to sleep soundly, we need to feel like the world is okay, that we are safe. And if we feel anxious and stressed, then our brain isn't really going to let us fall asleep as easily because it's wanting to stay awake to deal with the problems.

11:54So making sure that you are calm and relaxed. And you can do that in many ways. You might've heard about yoga, slow, deep breathing, reading a calming book, basically anything, anything at all that you find relaxing is going to be beneficial for sleep. And of course, if you have a big life stress and that goes away, your sleep's probably going to resolve. Maybe after that exam's happened, your sleep will go back to normal. So that's one part. And the second part is being tired. And this is where, especially when someone's struggling to sleep well, they can start to self-sabotage without realizing it.

12:29So if you haven't slept well the night before, you might be tempted to not get up at your intended time and sleep in late or go to bed really early or have a long nap to make up for sleep. And all of those things are going to take away from your sleep drive, your sleep hunger, which means actually then you won't sleep as well the next night. So being active during the day, getting outside, getting natural daylight to help your circadian rhythm know the difference between night and day and having a sort of regular bedtime wait time will help you to feel tired enough and ready for sleep at night.

13:04So we need to be relaxed and we need to be basically tired and sleepy enough for us to sleep well. It makes so much sense. Everything you've just said is like a reminder to why was I feeling like an insomnia last night? Oh, I had a lot on my mind. I'm sure lots of people can relate to that listening or what's confusing there is you hear about naps and things. And also there's lots of headlines at the moment, ones that I kept sending to Ella saying, look, it says women need more sleep than men. What's the truth? Oh, you're nodding. Great. What is the truth behind that? So that's really interesting because, you know, there's a lot of I'm sure in your field as well.

13:39We know as people in the sort of well-being and health industry, there is a big disparity often between women and men. So women do tend to, according to science, need a bit more sleep than men, which is interesting. Studies say between like sort of 11 minutes, 10 to 20 minutes, something like that, that women actually do genuinely probably need a bit more sleep than men. However, women tend to have more insomnia than men. We tend to have poorer sleep than men. So despite the fact that we need a bit more sleep, our sleep often is worse. And that's for a number of reasons. Women are 40 % more likely to have insomnia than men, studies have shown.

14:17One thing is hormonal fluctuations. As women, we have hormonal fluctuations when we are menstruating every month, our hormones change. Before that, we go through puberty or when we get pregnant, when we stop being pregnant, when we go through the menopause and all of these hormonal changes can affect sleep. And also women society at the moment, we're still in a place where women do tend to have more caring responsibilities, either for children or for older family members than men do typically. Of course, that's going to add a level of stress and also a level of perhaps not being able to get to sleep and have that wind down time, relaxed time before bed that we want to have.

15:00Yes, as women, be proud. Go to bed a little bit earlier than your partner and don't feel guilty about it because science shows you probably do need a little bit more sleep than men. And yeah, and all the hormonal stuff we just have to deal with, really. It's the fun of being a woman. I'm going to use that every night to my husband. I'm like, you know, the jobs of just like checking on the kids or putting stuff in the backpack for school the next day, etc. That we do before bed, I'm going to say, sorry, I can't. I actually just scientifically need a bit more sleep than you. So yeah, that was handy.

15:35No, but jokes aside, there's obviously, as we said, sleep so trendy at the moment. And as a result, it's become this enormous industry. And you've got all your kind of sleep tracking devices, for example. What is your take on the commercialization essentially of sleep? Do you think there's benefit in obsessing over those numbers and data points? Sure. So yeah, like I said, I'm thrilled that sleep is mainstream and that people are starting to take it seriously because lots of people before were actively ignoring sleep, fighting sleep and sacrificing it, thinking it was pointless. But the commercialization of sleep does worry me a lot because in my field, I work with people all the time who are desperately unhappy and stressed about their lack of sleep and they are vulnerable and they are spending a lot of money on anything that promises to improve their sleep.

16:27And most of these things aren't necessarily scientifically proven to help sleep. And if you've got money to burn and you want to try out the latest gadget, then go for it. However, if you don't, then you're just going to get even more stressed and anxious because you're like, oh my goodness, I've spent so much money on all these things and my sleep is still bad. And with sleep trackers. So on the one hand, they can be really great because they can be sort of an independent way of tracking your sleep duration and your patterns and giving you a bit of an insight into, okay, what is my sleep really looking like at the moment?

17:03Just like having a set of scales can help you to sort of give a general gist of your way if you're wanting to pay attention to that. However, if you have an eating disorder, weighing yourself really regularly is really unhelpful and it's going to cause huge anxiety. And the same thing with sleep trackers. If you are really worried about your sleep, then paying so much attention to these sleep trackers can just cause you to be so anxious about trying to perfect your sleep. It's even got a name, it's called orthosomnia. And orthosomnia is an insomnia caused by obsessing about sleep through tracking your sleep.

17:37And I want people to understand that sleep trackers, whatever ones you get, they use movement data and heart rate data, generally speaking, to track if you're awake or asleep, but they are not infallible. When they tell you which stage of sleep you're in, because we have light sleep, deep sleep, REM sleep, these sleep trackers, they're just not as precise as polysomnography, which is used in clinical studies of sleep. If you are basing your worry about the fact that, oh my goodness, last night I only got 53 minutes of deep sleep, according to my wearable sleep tracker, it is highly unlikely that that was actually diagnostically true.

18:18But as a gauge, comparing night by night, it can give you a little bit of feedback that might be interesting. But if you're starting to worry, oh my goodness, I'm not getting enough deep sleep because my sleep tracker says so, it's really unlikely to be that accurate and you might start worrying about something that frankly isn't even true. It's such a common thing that we see. And I think the reliability of the data is really important to question. Ella and I actually both went to a health scan a few weeks ago, which I think was actually pretty accurate. But it's just like at the gym, you get those things you stand on, or they scan you and they'll say, oh, look, you're this percentage of body fat, or you're this.

18:56They're all bound to be off to quite a large degree, probably, in accuracy. But I think something that people are using this tech for now is also to try and understand the sleep cycles. So there's a lot of talk about REM sleep and how much of it we actually require. Is it rapid eye movement? Yeah. Yeah. So REM sleep, REM sleep stands for rapid eye movement for sure. And that's because at that particular part of sleep, and we have different parts of sleep and they have kind of different jobs and our brain looks different in these different parts of sleep. And REM sleep is where your eyes, beneath your closed eyelids, will move rapidly.

19:34So if you see somebody, if your partner is in bed and they're asleep and you want to look at them, which might be weird, but anyway, if you look at their eyelids, you can see if they're in REM sleep because you can see the eyeball itself moving sort of fairly rapidly from side to side beneath the closed eyelid. And REM sleep tends to typically be when we dream. Our brain is most active in REM sleep. It looks very much like an awake brain. Your sleep trackers, they can make fairly good guesses. Now, heart rate tends to be a little higher and a bit more erratic, for want of a better word, when we're in REM sleep because our brain is probably having dreams and that kind of thing.

20:15In deep sleep, our heart rate is the lowest. It's very, very slow. The sleep trackers can track which different part of sleep you're in. But the point is, A, it's not that accurate necessarily. And B, it doesn't really matter how much time you're spending in these different parts of sleep because there is very little we can do to influence that. The point is we can't just decide, oh, I want to get more REM sleep and not change the others because we can't, when we're asleep, just deliberately try and increase one particular a part of sleep. If we're not getting enough REM sleep, which to be fair, in order to know that for sure, you'd have to have a polysomnography to get the accurate data.

21:00The best way of increasing your REM sleep is just to get a bit more sleep. And people really start to worry about which is the best part. I should be getting more deep sleep or more REM sleep. But again, they are all important. I get calls all the time from people who want to see me to say, Dr. Browning, can you help me because my sleep tracker tells me I only get X amount of deep sleep. I only get X amount of REM sleep. How can I change that? They think that that's the only important part and it's not. They are all important. Light sleep, deep sleep, and REM sleep are all important. They all have different jobs.

21:37We can't know for sure which is the most important part really because frankly, we can't conduct studies when we remove one part of sleep because it's all, you know, if we stop people having REM sleep, we'll just stop them having sleep. So they'll be sleep deprived. So it's very difficult to know, you know, which is the most important part of sleep. And actually they're all important. They are all important. We need to get REM sleep and deep sleep and light sleep. And to get more of the sleep that you need, you need to sleep for longer. That's basically the easiest way of understanding it. I love that because I think one of the things that Ria and I talk about so much, I think it's probably the crux if you distill all the conversations that we have down into one thing is this focus on simple.

22:25And just like you're saying, sleep really matters and that's great. And it's so important, just like what we eat really matters, just like moving our bodies, managing our stress, they all really matter. But this obsession of kind of perfectionism we can get away from. And it's really distilling it down. Like you're saying, it's just keep it simple. Try and do things to actively de-stress before you go to sleep to help your mind and then try and go to sleep a little bit earlier. And it's almost as simple as that to some extent from what I'm taking from you. Yeah, definitely. And of course there are some sleep trackers can pick up some issues.

23:02Like for example, there's something called sleep apnea, which is where somebody repeatedly stops breathing during the night. Some sleep trackers can pick up on that. That's really helpful because if you do have sleep apnea, obstructive sleep apnea is when there's an obstruction and your throat closes up or your tonsils block the airway, and then you can repeatedly stop breathing through the night. Each time that happens, your brain has to wake you up with a gasp of breath to restart the breathing process, and then you go back to sleep again. And people with sleep apnea, they might be sleeping for eight, nine hours, 10 hours, but still wake up exhausted and they might not really understand why am I so tired?

23:42And it's because the sleep quality is terrible. So sometimes sleep trackers can identify things that we aren't aware of, but if your sleep is kind of normal and there isn't another sleep disorder going on, then we don't need to obsess too much about which proportion of the like we're spending in these different parts of sleep because there is very little, like I said, we can do to manipulate it. That's so reassuring to know. I think it's just focusing on trying to get the hours in that you possibly can and create the good sleep environment. It's interesting, my father actually has sleep apnea and he has a special box he has to sleep with.

24:16And I think it can be really worrying for people. There's so many different conditions, aren't there, that are linked to this sort of thing. And I wanted to very quickly, I know we're running out of time, but I just wanted to say caffeine just very, very quickly before we round off and finish this episode. A lot of people will report to us in the clinic, oh, I feel like I sleep absolutely fine, but I'm tired all the time. And sometimes we have found, I don't know if this aligns with your research, Lindsay, but they are having a lot of caffeine throughout the day and they don't realize it's impacting the quality of their sleep at night, but they feel like they sleep just fine.

24:52You know, like there's always that person that will have a coffee after dinner at 10pm. What really is the impact of caffeine and sleep in that way? So caffeine affects our sleep in a couple of ways. We have during the day, basically have a sleep drive that kind of builds up sleep pressure. And we produce adenosine. And throughout the day, we produce more and more and more of this, it kind of builds up and up and up. And the more we have, the more tired we feel. And when we have caffeine, if you have a double espresso, then what that does is it stops your brain from being able to tell how tired you are.