Why We Sleep: Unlocking the Power of Sleep and Dreams

by Matthew Walker

Routinely sleeping less than six hours a night weakens your immune system, substantially increasing your risk of certain forms of cancer. Insufficient sleep appears to be a key lifestyle factor linked to your risk of developing Alzheimer’s disease.

Inadequate sleep—even moderate reductions for just one week—disrupts blood sugar levels so profoundly that you would be classified as pre-diabetic. Short sleeping increases the likelihood of your coronary arteries becoming blocked and brittle, setting you on a path toward cardiovascular disease, stroke, and congestive heart failure.

Perhaps you have also noticed a desire to eat more when you’re tired? This is no coincidence. Too little sleep swells concentrations of a hormone that makes you feel hungry while suppressing a companion hormone that otherwise signals food satisfaction. Despite being full, you still want to eat more. It’s a proven recipe for weight gain in sleep-deficient adults and children alike.

But can we go so far as to say that a lack of sleep can kill you outright? Quite posssibly—on at least two counts. First, there is a very rare genetic disorder that starts with a progressive insomnia, emerging in midlife. Several months into the disease course, the patient stops sleeping altogether. By this stage, they have started to lose many basic brain and body functions. Few drugs that we currently have will help the patient sleep. After twelve to eighteen months of no sleep, the patient will die.

The physical and mental impairments caused by one night of bad sleep dwarf those caused by an equivalent absence of food or exercise.

This is especially true of a region called the prefrontal cortex, which sits above the eyes, and can be thought of as the head office of the brain. The prefrontal cortex controls high-level thought and logical reasoning, and helps keep our emotions in check. When a night owl is forced to wake up too early, their prefrontal cortex remains in a disabled, “offline” state. Like a cold engine after an early-morning start, it takes a long time before it warms up to operating temperature, and before that will not function efficiently.

For every day you are in a different time zone, your suprachiasmatic nucleus can only readjust by about one hour.

Caffeine works by successfully battling with adenosine for the privilege of latching on to adenosine welcome sites—or receptors—in the brain. Once caffeine occupies these receptors, however, it does not stimulate them like adenosine, making you sleepy. Rather, caffeine blocks and effectively inactivates the receptors, acting as a masking agent. It’s the equivalent of sticking your fingers in your ears to shut out a sound. By hijacking and occupying these receptors, caffeine blocks the sleepiness signal normally communicated to the brain by adenosine. The upshot: caffeine tricks you into feeling alert and awake, despite the high levels of adenosine that would otherwise seduce you into sleep.

Caffeine has an average half-life of five to seven hours. Let’s say that you have a cup of coffee after your evening dinner, around 7:30 p.m. This means that by 1:30 a.m., 50 percent of that caffeine may still be active and circulating throughout your brain tissue. In other words, by 1:30 a.m., you’re only halfway to completing the job of cleansing your brain of the caffeine you drank after dinner.

Other questions that can draw out signs of insufficient sleep are: If you didn’t set an alarm clock, would you sleep past that time? (If so, you need more sleep than you are giving yourself.) Do you find yourself at your computer screen reading and then rereading (and perhaps rereading again) the same sentence? (This is often a sign of a fatigued, under-slept brain.) Do you sometimes forget what color the last few traffic lights were while driving? (Simple distraction is often the cause, but a lack of sleep is another culprit.)

Of course, even if you are giving yourself plenty of time to get a full night of shut-eye, next-day fatigue and sleepiness can still occur because you are suffering from an undiagnosed sleep disorder, of which there are now more than a hundred. The most common is insomnia, followed by sleep-disordered breathing, or sleep apnea, which includes heavy snoring.

Throughout developed nations, most adults currently sleep in a monophasic pattern—that is, we try to take a long, single bout of slumber at night, the average duration of which is now less than seven hours. Visit cultures that are untouched by electricity and you often see something rather different. Hunter-gatherer tribes, such as the Gabra in northern Kenya or the San people in the Kalahari Desert, whose way of life has changed little over the past thousands of years, sleep in a biphasic pattern. Both these groups take a similarly longer sleep period at night (seven to eight hours of time in bed, achieving about seven hours of sleep), followed by a thirty- to sixty-minute nap in the afternoon.