Why We Sleep: Unlocking the Power of Sleep and Dreams

by Matthew Walker

Take away the bedrock of sleep, or weaken it just a little, and careful eating or physical exercise become less than effective,

the shorter your sleep, the shorter your life.

Adults forty-five years or older who sleep fewer than six hours a night are 200 percent more likely to have a heart attack or stroke during their lifetime, as compared with those sleeping seven to eight hours a night.

One night of modest sleep reduction—even just one or two hours—will promptly speed the contracting rate of a person’s heart, hour upon hour, and significantly increase the systolic blood pressure within their vasculature.

Making matters worse, growth hormone—a great healer of the body—which normally surges at night, is shut off by the state of sleep deprivation.

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 forward 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.

When your sleep becomes short, you will gain weight. Multiple forces conspire to expand your waistline.

From a metabolic perspective, the sleep-restricted participants had lost their hunger control. By limiting these individuals to what some in our society would think of as a “sufficient” amount of sleep (five hours a night), Van Cauter had caused a profound imbalance in the scales of hormonal food desire. By muting the chemical message that says “stop eating” (leptin), yet increasing the hormonal voice that shouts “please, keep eating” (ghrelin), your appetite remains unsatisfied when your sleep is anything less than plentiful, even after a kingly meal. As Van Cauter has elegantly described to me, a sleep-deprived body will cry famine in the midst of plenty.

A final comment on trying to lose weight: let’s say that you choose to go on a strict, low-calorie diet for two weeks in the hopes of losing fat and looking more trim and toned as a consequence. That’s precisely what researchers did to a group of overweight men and women who stayed in a medical center for an entire fortnight. However, one group of individuals were given just five and a half hours’ time in bed, while the other group were offered eight and a half hours’ time in bed. Although weight loss occurred under both conditions, the type of weight loss came from very different sources. When given just five and a half hours of sleep opportunity, more than 70 percent of the pounds lost came from lean body mass—muscle, not fat. Switch to the group offered eight and a half hours’ time in bed each night and a far more desirable outcome was observed, with well over 50 percent of weight loss coming from fat while preserving muscle. When you are not getting enough sleep, the body becomes especially stingy about giving up fat. Instead, muscle mass is depleted while fat is retained. Lean and toned is unlikely to be the outcome of dieting when you are cutting sleep short.

Sleep fights against infection and sickness by deploying all manner of weaponry within your immune arsenal, cladding you with protection. When you do fall ill, the immune system actively stimulates the sleep system, demanding more bed rest to help reinforce the war effort. Reduce sleep even for a single night, and that invisible suit of immune resilience is rudely stripped from your body.

At the end of the six days, everyone was given a flu shot. In the days afterward, researchers took blood samples to determine how effective these individuals were in generating an antibody response, determining whether or not the vaccination was a success. Those participants who obtained seven to nine hours’ sleep in the week before getting the flu shot generated a powerful antibody reaction, reflecting a robust, healthy immune system. In contrast, those in the sleep-restricted group mustered a paltry response, producing less than 50 percent of the immune reaction their well-slept counterparts were able to mobilize. Similar consequences of too little sleep have since been reported for the hepatitis A and B vaccines.

Examining healthy young men, Irwin demonstrated that a single night of four hours of sleep—such as going to bed at three a.m. and waking up at seven a.m.—swept away 70 percent of the natural killer cells circulating in the immune system, relative to a full eight-hour night of sleep.

Poor sleep quality therefore increases the risk of cancer development and, if cancer is established, provides a virulent fertilizer for its rapid and more rampant growth. Not getting sufficient sleep when fighting a battle against cancer can be likened to pouring gasoline on an already aggressive fire. That may sound alarmist, but the scientific evidence linking sleep disruption and cancer is now so damning that the World Health Organization has officially classified nighttime shift work as a “probable carcinogen.”

Nevertheless, the psychoanalytic method built on Freudian theory is nonscientific and holds no repeatable, reliable, or systematic power for decoding dreams. This, people must be made aware of.

The author John Steinbeck wrote, “A problem difficult at night is resolved in the morning after the committee of sleep has worked on it.”

The degree to which evening electric light winds back your internal twenty-four-hour clock is important: usually two to three hours each evening, on average. To contextualize that, let’s say you are reading this book at eleven p.m. in New York City, having been surrounded by electric light all evening. Your bedside clock may be registering eleven p.m., but the omnipresence of artificial light has paused the internal tick-tocking of time by hindering the release of melatonin. Biologically speaking, you’ve been dragged westward across the continent to the internal equivalent of Chicago time (ten p.m.), or even San Francisco time (eight p.m.).

What of a petite bedside lamp? How much can that really influence your suprachiasmatic nucleus? A lot, it turns out. Even a hint of dim light—8 to 10 lux—has been shown to delay the release of nighttime melatonin in humans. The feeblest of bedside lamps pumps out twice as much: anywhere from 20 to 80 lux. A subtly lit living room, where most people reside in the hours before bed, will hum at around 200 lux. Despite being just 1 to 2 percent of the strength of daylight, this ambient level of incandescent home lighting can have 50 percent of the melatonin-suppressing influence within the brain.

One of the earliest studies found that using an iPad—an electronic tablet enriched with blue LED light—for two hours prior to bed blocked the otherwise rising levels of melatonin by a significant 23 percent.

Compared to reading a printed book, reading on an iPad suppressed melatonin release by over 50 percent at night. Indeed, iPad reading delayed the rise of melatonin by up to three hours, relative to the natural rise in these same individuals when reading a printed book. When reading on the iPad, their melatonin peak, and thus instruction to sleep, did not occur until the early-morning hours, rather than before midnight. Unsurprisingly, individuals took longer to fall asleep after iPad reading relative to print-copy reading. But did reading on the iPad actually change sleep quantity/quality above and beyond the timing of melatonin? It did, in three concerning ways. First, individuals lost significant amounts of REM sleep following iPad reading. Second, the research subjects felt less rested and sleepier throughout the day following iPad use at night. Third was a lingering aftereffect, with participants suffering a ninety-minute lag in their evening rising melatonin levels for several days after iPad use ceased—almost like a digital hangover effect.

Second, alcohol is one of the most powerful suppressors of REM sleep that we know of.

A bedroom temperature of around 65 degrees Fahrenheit (18.3°C) is ideal for the sleep of most people, assuming standard bedding and clothing.

Compare the physiological state of the body after being rudely awakened by an alarm to that observed after naturally waking from sleep. Participants artificially wrenched from sleep will suffer a spike in blood pressure and a shock acceleration in heart rate caused by an explosive burst of activity from the fight-or-flight branch of the nervous system.

Most of us are unaware of an even greater danger that lurks within the alarm clock: the snooze button. If alarming your heart, quite literally, were not bad enough, using the snooze feature means that you will repeatedly inflict that cardiovascular assault again and again within a short span of time. Step and repeat this at least five days a week, and you begin to understand the multiplicative abuse your heart and nervous system will suffer across a life span.

More than 80 percent of public high schools in the United States begin before 8:15 a.m. Almost 50 percent of those start before 7:20 a.m. School buses for a 7:20 a.m. start time usually begin picking up kids at around 5:45 a.m. As a result, some children and teenagers must wake up at 5:30 a.m., 5:15 a.m., or even earlier, and do so five days out of every seven, for years on end. This is lunacy.

Add this all up, and you see that investing in delaying school start times—allowing students more sleep and better alignment with their unchangeable biological rhythms—returned a net SAT profit of 212 points. That improvement will change which tier of university those teenagers go to, potentially altering their subsequent life trajectories as a consequence.

When the Mahtomedi School District of Minnesota pushed their school start time from 7:30 to 8:00 a.m., there was a 60 percent reduction in traffic accidents in drivers sixteen to eighteen years of age. Teton County in Wyoming enacted an even more dramatic change in school start time, shifting from a 7:35 a.m. bell to a far more biologically reasonable one of 8:55 a.m. The result was astonishing—a 70 percent reduction in traffic accidents in sixteen- to eighteen-year-old drivers.

Most people know the name of the common ADHD medications: Adderall and Ritalin. But few know what these drugs actually are. Adderall is amphetamine with certain salts mixed in, and Ritalin is a similar stimulant, called methylphenidate. Amphetamine and methylphenidate are two of the most powerful drugs we know of to prevent sleep and keep the brain of an adult (or a child, in this case) wide awake. That is the very last thing that such a child needs.

As the state of chronic sleep deprivation builds over time, the child will look ever more ADHD-like in temperament, cognitively, emotionally, and academically. Those children who are fortunate to have the sleep disorder recognized, and who have their tonsils removed, more often than not prove that they do not have ADHD.

Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder,

Don’t take naps after 3 p.m. Naps can help make up for lost sleep, but late afternoon naps can make it harder to fall asleep at night.