Rebecca Robbins: All right.
"Many adults need five hours of sleep or less."
Now, this is a myth.
"Loud snoring is annoying but mostly harmless."
David Rapoport: Loud snoring is actually a sign
that there is a blockage in your throat.
Robbins: "Your brain and body
will adapt to less sleep."
This is a myth.
I'm Dr. Rebecca Robbins.
I'm a postdoctoral research fellow
at the Brigham and Women's Hospital
and Harvard Medical School.
Rapoport: And I'm Dr. David Rapoport.
I'm a professor of medicine
at the Icahn School of Medicine at Mount Sinai,
and I run the research program in sleep.
Robbins: And we're here today to debunk
some of the most common myths about our sleep.
"Watching TV in bed is a
good way to relax before sleep."
Now, this is not something
that we would necessarily recommend.
If you turn the television on and if it's close to you,
that's a source of bright-blue light.
So, bright light is one of the strongest cues
to our circadian rhythm.
It kick-starts our body and our brain
to become awake and alert in the morning.
It's called a zeitgeber,
the strongest input to that circadian,
the awake phase of our rhythm.
Rapoport: "Drinking booze before bed
will improve your sleep."
So, this is a very commonly used tactic
for people who have trouble sleeping,
and they have a drink.
It's a drug.
It's very much like a sleeping pill.
And it is true that it will help you get to sleep,
as long as you don't drink too much.
One or two drinks, perhaps.
What you do, however, is it disrupts the normal sleep.
It suppresses REM sleep,
which is a normal part of your sleep
that comes on a little while after you go to sleep,
typically 30 to 60 minutes later.
And then, when it comes
that the alcohol has gotten out of your system,
then the REM comes back perhaps at the wrong time,
perhaps too strong, and it disrupts things.
And so basically it is not generally recommended
that alcohol be used as a sleeping pill.
"Lying in bed with your eyes closed
is almost as good as sleeping."
I think that one's pretty definitely not correct.
Sleep is a very specific process
that your body goes through.
The most common myth, if you will,
that we got rid of in the scientific field 50 years ago
is that sleep was like, you know, taking your car
and putting it in the garage and turning off the key
and leaving it there,
and then you come back the next morning
and it just is parked.
Sleep is not like that at all.
Sleep is a very active process.
When you go to sleep, you enter one stage.
A little while later, you enter another stage.
It gets progressively deeper.
You then have the REM sleep,
and then you wake up momentarily,
and that whole cycle takes an hour
to an hour and a half, and then it starts again,
and it happens three to five times in a night.
And if you disrupt any of that,
something happens, and the next morning you feel it.
You don't feel rested.
Now, we don't understand how that actually happens
or why that happens, but we do know it does happen.
So when you're lying in bed, none of that is happening.
If your eyes are closed and you're not asleep,
it just doesn't count.
Robbins: Next.
Rapoport: "If you can't sleep, you should stay in bed
and try to fall back asleep."
If you don't fall asleep,
we generally recommend that you not stretch it out
and stress yourself out by just trying.
And there's probably nothing
that can prevent sleep
as well as, "I've gotta go to sleep."
[Robbins laughs] "I've gotta go to sleep."
"I've gotta go to sleep." Robbins: "I need to!"
Rapoport: You can feel your pulse
and your blood pressure going up.
So what we try and do when
we work with somebody
who has this problem with insomnia
is exactly the opposite of that.
We try and tell them, relax, don't worry about it.
Stay in bed for a little while and see what happens.
But don't try to go to sleep, just relax.
And if you can't relax and if you don't go to sleep,
it's probably better to get up
so that you don't associate the bed
with a stressful situation.
Robbins: All right. "Many adults need
five hours of sleep or less."
Now, this is a myth.
We have scores of epidemiological data
and data from the sleep lab to show
that five hours is not enough
for the vast majority of adults.
There may be some individuals
that maybe do OK on six hours,
but much less than that really is a myth.
Now, you might hear people brag about this,
saying, "Oh I get five, I'm just fine."
But by and large, we do see those people
likely making up for lost sleep on the weekends
or in power naps, for instance.
So, for the vast majority of us,
the recommendation really is seven to eight hours.
Rapoport: This is a real problem
that the sleep field has been trying to address,
and that is that not sleeping has been perceived
as a macho thing.
It proves how great you are,
it proves how manly you are in some cases.
Sleeping is actually good,
and you should sort of be proud of the fact
that you sleep to your need.
Robbins: "Your brain and body will adapt to less sleep."
Rapoport: That sounds like yours.
Robbins: No.
This is a myth.
We see that, just like good nutrition
or a great, healthy diet is so important,
we similarly have a diet that we need
our brains and our bodies to be at their best.
Rapoport: There are actual, formal studies
that have tested
how people perform with lack of sleep
and how they think they are performing.
And it turns out that we basically are really lousy
at saying how sleepy we are.
So you know you feel bad
when you haven't had enough sleep,
but you have no idea how bad you are,
and your performance keeps deteriorating
the more you don't sleep
or restrict your sleep over multiple days,
and you think, "Oh, I've settled in.
I have a little headache, and it doesn't really bother me.
I'm doing just great."
And what is actually happening is
you're performing less and less well
on the various things that we can test,
including driving simulators.
You're falling asleep for three or four seconds
continuously, without knowing it.
Robbins: All right. "It doesn't matter
what time of day you sleep."
Rapoport: If you look at our biology,
we have, inside our brain, a clock.
That clock is set to say,
"This is a good time to sleep."
And then at another time it says,
"This is a good time to be out."
Sleep is timed.
It doesn't just happen.
And even if you don't sleep for the whole night,
you'll be more and more sleepy all night long.
But in the morning, you'll get a second wind,
and that's because the clock says, "Up, time to be up."
It doesn't matter that you didn't sleep,
it's time to be up.
As Rebecca said, we've gained an incredible ability
to not abide by that rhythm.
And the problem is that people think
that they can get away with things
that our biology just won't let us do.
Nurses have been most studied for this,
and firefighters and emergency workers
and people who live on ships.
They all pay a price, epidemiologically.
We've shown higher heart disease,
more tendency to gain weight,
and a variety of malfunctions and difficulties
as time goes on.
You can do it, but it's gonna cost you.
Robbins: "Exercising within four hours of bedtime
will disturb your sleep."
Rapoport: What we give as advice is that
about an hour before sleep,
you wanna try and avoid active kind of things,
and exercise certainly is one of them.
On the other hand, there are people who exercise
close to sleep and do very well.
So I don't think we should say, you know,
if you're somebody who
exercises regularly in the evening
and you sleep beautifully
and you feel rested the next morning,
that you should give up exercise,
'cause I think that would be a bad bit of advice.
You'll gain weight,
you'll lose the toning that you've gotten,
so on and so forth.
On the other hand, if you haven't been doing it,
I probably wouldn't start exercising at night.
And if you're having trouble with sleep,
that's one of the first things we look at,
after drugs like caffeine, to try and get rid of.
Robbins: All right. "Remembering your dreams
is a sign of a good night's sleep."
Rapoport: I think that there is a huge variation
in how much people remember their dreams.
Some of it has to do with when you wake up.
If you wake up during REM sleep,
you almost always will remember a dream.
Some of us don't remember anything
at all about our dreams,
and it doesn't seem to harm them.
But it's not a true thing
that just because you don't remember your dreams,
that you're not having good sleep.
What tells you you're having good sleep
is how you feel the next day.
Robbins: Now, if you're waking up with nightmares,
that could be a simple sign
that maybe your bedroom is too hot
and you need to turn down the temperature.
'Cause a hot bedroom environment unfortunately
can create fragmented sleep
and cause you to wake up often from nightmares.
Now, "Eating cheese (or other food) before bed
causes nightmares."
Rapoport: I don't think I'm aware of any particular food
that will do that to everybody,
but it's very clear that being uncomfortable
will precipitate both bad sleep and waking up
and maybe even nightmares.
So, imagine somebody with irritable bowel syndrome
who knows that whenever they eat, whatever,
gluten or some specific food, spicy foods,
it upsets their stomach when they're awake.
Well, guess what?
If they eat it before they go to sleep,
it'll upset their sleep,
and it may show up as a nightmare.
Robbins: "Loud snoring is annoying
but mostly harmless."
Rapoport: Loud snoring is actually a sign
that there is a blockage in your throat.
The mildest form of blockage
just causes vibration, noise.
If you've ever played with a piece of grass
and you blow through it,
you know that if you blow through a tube
or a structure that can vibrate,
it starts to vibrate and make noise.
Many instruments are based on exactly that principle.
You're creating a vibration
by blowing through a partially blocked tube.
So snoring is just that.
And if that's all it was,
it wouldn't be all that bad for you.
But, unfortunately, it usually isn't just by itself.
And especially when, as they say on the question,
loud snoring.
That kind of snoring, and especially if it's associated
with gasps and snorts and pauses,
is actually a sign of a very common disorder
called sleep apnea.
And sleep apnea is when that blockage
gets a little bit worse than just causing vibration
and actually blocks the flow of air in.
And when that happens, you're actually choking.
And when that gets complete,
we call it an apnea,
"without breathing," from the Greek.
And your body defends itself against this blockage
by waking up, 'cause everything
gets normal when you wake up.
The trouble is that then you go back to sleep
and it happens again,
and it can happen every 30 to 60 seconds.
Robbins: "Hitting snooze bar
is better than getting up."
We often hear that people
have two, three, four, five alarms
set up before they get up in the morning.
Now, the best thing for all of us to do
would actually be to practice sleep hygiene
and have a consistent bedtime
and actually wake up with an alarm.
But of course that's a lot harder in actuality.
The best thing for us, by and large,
is to set your alarm clock
for the latest time that you can in the morning
to allow for as much sleep as possible
but that will allow you to go about your daily routine
and get to work on time.
Because if we're hitting several snooze bars
and waiting, I believe it's nine minutes,
and then another nine minutes,
all of that incremental sleep is very rarely that.
It's much more fragmented.
It's very light sleep, if anything.
And the majority of REM sleep is in the morning
right before we wake up.
So try to protect that as best you can
and set your alarm clock for the latest possible time.
"You can simply become a morning person."
Rapoport: So, the difference between
a morning and an evening person
appears to be influenced by lots of things
that are probably genetic.
And it's not something you can just change by training.
What you can do is trick your biology
into thinking that you live in Chicago
but you work in New York.
And that's what blue light does.
Robbins: With some blue-light therapy, actually,
using bright-blue light in the morning
can help shift those true evening people
a little bit earlier.
Rapoport: It basically tells you
that you're actually in a different time zone
from where you are, and that shifts you a little bit.
So that's the approach
we use when the problem is severe
and there's a need for that.
It's actually shifting when morning is
rather than shifting whether you work in the morning.
Robbins: So, "You can catch up on sleep
by sleeping in on the weekends."
Now, for the vast majority of us,
this is a very common practice,
this kind of sleeping in,
and unfortunately, in our society,
we term it as this luxury,
you know, "Oh, to sleep in."
And that's because most of us aren't
getting enough sleep during the work week
or adding bricks into our backpack of sleep debt.
Now, what sleeping in does
is it sends a cue to our circadian rhythm
that we're trying to change time zones.
So if we extend our rising time by more than an hour,
two, three, worse, four hours into the morning,
you might feel better than if you got up early,
but that sleep the next night is gonna be compromised.
Why? We call this social jet lag.
Our body is trying to adapt.
If you're a New Yorker, physiologically,
your body thinks you're in London
and you're trying to adjust to that time,
so you're gonna be fighting your physiology
come bedtime that next night.
So the best practice is
to keep a consistent bedtime schedule
and try to get as much sleep as you can.
Now, if you do have an excessive sleep debt
and you really need to pay that back on the weekends,
the best way without interrupting
your circadian rhythm
would be to do that with a nap in the afternoon
because that's not gonna change
your body's physiological circadian rhythm.
"Boredom makes you tired
even if you got enough sleep."
Now, yes, it is very true that a boring meeting or lecture,
especially in the afternoon, may be soporific.
But if you're in that environment
and sleep-deprived,
it is a bellwether sign
that you're not getting enough sleep.
So, when people say, "The airplane makes me tired.
I get in the plane, I fall right asleep."
Boredom alone, of course, is not a sleep-inducing state.
Rapoport: Boredom is a way of
unmasking your sleep tendency.
We, in fact, use that in testing.
We put people in boring situations
and see how long it takes them to fall asleep.
If they are fully satisfying their sleep need,
they don't fall asleep for at least 20 minutes.
Robbins: Sleep is so critical to our health
and our wellness and our well-being,
and every night does count.
In light of all the things that we've talked about,
remember that if it's not broken, don't fix it.
So do try to implement some of the strategies
or put some of the strategies to work
that we've talked about today
if you find that you have a problem,
because at the end of the day, small changes
do make a really big difference,
especially when it comes to our sleep.