November 4, 2024 • 32 mins
Tossing and turning, racing thoughts of revision and exams... most of us know what it feels like to struggle with our sleep when we're preparing for a big challenge. And it can be tempting to sacrifice sleep when we're under time pressure, even though we know it's good for us. It's a real catch 22.
This week, we sit down with Professor Russell Foster from the University of Oxford. He's been studying sleep for decades, so together we dig into what's happening in our brains when we sleep, why it's so important for our health and wellbeing, and how we can prioritise our sleep to help us cope with stress.
This is On Your Marks. Because you’ll never know until you try.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
In sleep, I was having a lot of trouble.
Speaker 2 (00:05):
If I go to bed with things whirling in my
brain, it definitely takes me longer.
Speaker 1 (00:10):
I work late all the time. So normally I will start studying after the kids are in bed. Sometimes 1 A.M.
Speaker 3 (00:16):
I normally sleep between five and six hours a night, and then I have
another one hour nap after work.
Krutika Adatia (00:24):
Hello, I'm Krutika Adatia and I'm a Chartered Accountant. I now support accountancy students through their
training and as an educator, I'm regularly up close and personal
with some of the common issues people face while studying
for and sitting their accountancy exams. So in this series
for the ACCA, I'm chatting to experts about strategies we
(00:46):
can all use when facing some of life's challenges. This
week we're looking at sleep. Why is our sleep so
often disrupted in times of stress? What happens in the
brain when we sleep and how can we work with
our body clocks to get the best rest possible? This
is On Your Marks because you'll never know until you
(01:07):
try. We all know how important sleep is for survival,
but lucky for me, I've always loved it. As a
kid, I was never the one complaining about bedtime. In
fact, I actually looked forward to an early night and
for as long as I can remember, I've been an
early riser too. I'm that person that wakes up before their
(01:28):
alarm even goes off. But like most of us, when
I'm stressed, my sleep definitely takes a hit. Whether it's
tossing and turning before finally drifting off or waking up
feeling like I could use a few more hours, it
really makes me wonder what is it about sleep that's so
essential? So to dig into how sleep works, I'm joined
(01:49):
by Professor Russell Foster from the University of Oxford. He's
an expert in body clocks and sleep. So Russell, I'm
going to open with a personal question. How did you
sleep last night?
Professor Russell Foster (02:02):
Well, actually very well. I woke around about three o'clock in the morning as many
people of my age do, but I went back to
sleep within 10, 15 minutes. One of the strategies I use
a lot is listening to Radio 4 Extra, and I
usually get five or six minutes of something In Our
Time often and then fall asleep again. So the key
thing is you stay unstressed in the knowledge that you
(02:25):
almost certainly will get back to sleep. It's where you've
sort of wake up and think, " Oh my God, look
at the alarm clock," and then get really stressed, and
that's what you've got to avoid at all costs.
Krutika Adatia (02:36):
I'm glad you mentioned that you sort of put something
on to listen to because I like listening to audiobooks
and that often puts me to sleep.
Professor Russell Foster (02:42):
One of my favorites is In Our Time, as I
mentioned, but also that wonderful series Lord Peter Wimsey. That's
very wonderful and non- threatening.
Krutika Adatia (02:51):
Brilliant. For me it's Harry Potter because I've read the
books and I've watched the movies, so it's familiar and
it'll just...
Professor Russell Foster (02:56):
I think that's a good point because it is familiarity with
something that's non- threatening and gentle.
Krutika Adatia (03:01):
Why is it that we need sleep?
Professor Russell Foster (03:04):
Well, of course, for so long, sleep was disregarded as
sort of an indulgence and a luxury and almost as
an illness that needs a cure. And what's emerged over
the past 20 years or so is that sleep is
an absolutely essential part of our biology. The quality of
our waking day is defined more or less by the
(03:25):
quality of the sleep that we get. So it's an
essential part of our biology and I think so many
of us marginalize it. Sleep is always the first victim
in squeezing more and more and more in to an
over packed day. So we need to embrace it and
not treat it as some sort of luxury.
Krutika Adatia (03:43):
I'm glad you've mentioned that because I'm just thinking about
our listeners who might be students and cramming or potentially
working late into the night and often sacrificing their sleep,
what we're saying is that that shouldn't be the case.
Professor Russell Foster (03:57):
Absolutely. If we think about some of the things going
on within the brain whilst we sleep and what's emerged
again fairly recently is that sleep is a time when
we consolidate our memory. All that information is rushing in
during the day and we don't have time to process
it effectively. And so whilst we sleep, we can consolidate
memory. But the other thing, it's not just the retention
(04:19):
of facts. There's a wonderful study from Germany which looked
at the solving of problems. So this experiment was quite
a complicated task. It was introduced to individuals in the
morning, so they became familiar with the task and one
group performed it that afternoon and only 20% of the
group actually solved the problem. The next group introduced in
(04:40):
the morning, familiarized with the task, performed it the following
afternoon, but they were deprived of sleep. Again, about 20% of
the group solved the problem. But the really interesting group,
of course is introduced in the morning, performed at the following
afternoon, but with a full night of sleep, 60 to 70% of
the group solved the problem. It's a brilliant example of
(05:03):
how we're processing information. We're coming up with novel solutions
to complex problems, and that's just one reason why students
or all of us need to take our sleep very seriously.
Krutika Adatia (05:15):
So we need that sleep to help with the consolidation,
the sort of memory form, which is obviously important for learning.
Professor Russell Foster (05:19):
And the answering of questions. So it's not just the
retention of facts, it's the processing, it's the manipulation of
that information, which I think is so amazing.
Krutika Adatia (05:29):
That is incredible. I mean, this is probably a question
that's sort of how long is a piece of string,
but how many hours of sleep does an average person need?
Professor Russell Foster (05:39):
Well, that's a really good question and it's part of
the reason I wrote this book called Lifetime because I
was fed up with the sergeant majors of sleep screaming, "
You must get eight hours." The healthy range according to
the National Sleep Foundation is between six hours and some
people may need up to 11 hours and it's all
about defining what you need and then defending your sleep.
(06:03):
And so that's the key thing. Seven to eight hours
is an average, but it would be wrong to impose
an average value on everybody. It's like shoe size. You
wouldn't dream of making everybody wear the same shoe size
and we shouldn't dream of making everybody's sleep or expecting
them to sleep exactly the same length. And the key
thing is defining if you're tired or not and how
(06:27):
much sleep do you need? Well, if are feeling that you are
not firing all cylinders during the day, if you don't
feel as though your brain isn't working accurately and precisely,
that's a good indication you're not getting the sleep at
night. If you oversleep on free days at the weekend,
for example, if you need an alarm clock to drag
you out of bed or somebody else, if you're craving
(06:50):
caffeinated drinks to wake you up, if you're feeling sluggish
during the day. And importantly if you or your friends
and family note behavioral changes. You're more irritable, you're less
empathetic, you're failing to pick up those sorts of signals
from friends and family and you're doing stupid and unreflective
things. This is all telling you you're not getting the
(07:10):
sleep you need and you need to take a refresh
and think, " Right, I'm going to go to bed a
bit earlier and get a bit longer sleep."
Krutika Adatia (07:17):
So I guess you're alluding to this in your answer
that you've just given, but figuring out how many hours of
sleep you need is just being a bit more self- aware.
Professor Russell Foster (07:27):
Absolutely, yes. And as I said, we think we don't really need
sleep, so we work way into the night and I
certainly did as a student, but I don't think it
did me any good because I didn't get that consolidation
of memory and processing of information.
Krutika Adatia (07:42):
And so are we saying that maybe we might not
always need the same amount of sleep every day as
well? Could it vary?
Professor Russell Foster (07:49):
Sleep is a very dynamic part of our biology. It
changes as we age and due to external circumstances, we
may not get the same sleep every night, but essentially
it's trying to get the best sleep we can.
Krutika Adatia (08:01):
Now just moving on to another topic here, which I
know you also have a specialism in, and that's circadian rhythm. Can you
tell us what exactly is the circadian rhythm?
Professor Russell Foster (08:12):
If we step back and think about, well, what's our
biology? What does it do? Well, ideally it delivers the
right stuff at the right concentration to the right tissues
and organs at the right time of day. And this
circadian rhythm's internal biological clock provides the time structure to
allow us to do the right stuff at the right
(08:33):
time. And fine tune our physiology and behavior to the
very demands of the rest activity, the sleep wake cycle,
which of course has evolved as a result of sitting
on a planet that revolves once every 24 hours. And
so it's providing this essential time structure for life. So
in anticipation of going to bed, we see that core
body temperature drops, we see other factors, hormonal changes occur,
(08:58):
and then in anticipation of waking up in the morning
before we've even woken up, core body temperature rises, metabolic
rate increases, and we're mobilizing glucose and hormones underpinning energy
so that when we do wake up, we can exploit
that new environment, the dawn to our best of abilities.
So it's this wonderful device to anticipate predictable change within
(09:22):
the environment and allowing us to function optimally.
Krutika Adatia (09:25):
Right. And so are we saying everyone has the same
kind of biological body clock or does it vary from
individual to individual?
Professor Russell Foster (09:33):
It certainly varies, and that brings us really to the subject of chronotype.
And that sort of crudely means whether you're a morning
person, a lark, an intermediate dove, or a late person,
an owl. And there are three factors that contribute to
this. One is your genes. So we know that there
are subtle changes, very small changes in some of the
(09:54):
clock genes which underpin our circadian rhythms. And they can
make you get up earlier or make you get up
late. And so by essentially their contribution to our genes,
our parents are still telling us what time to go
to bed and get up. So there's that element which
is to some extent fixed. The other thing that changes
(10:15):
is how old we are. So from about the age
of 10, there's a tendency to want to go to
bed later and later and later peaking in the late
teens, early twenties. So there's a sharp rise in wanting
to go to bed later. And then there's a slow
return as you age to want to go to bed
earlier. So by the time you're in your late fifties, sixties, you're
(10:35):
getting up and going to bed at about the time
you got up and went to bed when you were 10,
11. But the key thing is that somebody in their
fifties, sixties will want to go to bed on average
two hours earlier than when they were going to bed
in their late teens and twenties. And that sharp rise
and slow move to a more morning chronotype is due
(10:57):
to the hormonal changes associated with puberty. So we've got
genes, we've got the sex hormones. And the third thing,
which is the thing we have some control over and
is often overlooked is when we see light. So morning
light advances the biological clock, makes us get up earlier
and go to bed earlier. Evening light, dusk light delays
(11:21):
the clock, we want to go to bed later and
get up later. We did some studies actually on university
students a few years ago all over the world, and
we found that the more owl- like they were, they
were missing the morning light, which will get them up
earlier, but they were getting lots of late afternoon evening
light, which would push the clock later. And so it's
(11:42):
a key point because if you're a late type, you
can set the alarm, either sit in front of a
light box. If it's sunny outside, go outside 30 minutes
and you can sort of nudge clock forward in time.
So there's three things, genes, age, development, and when you
see light.
Krutika Adatia (12:00):
What happens then to our sleep when students are stressed
or anxious?
Professor Russell Foster (12:06):
Well, this is the great enemy of sleep. Most people don't
have a sleep problem at all. It's dealing with anxiety
and stress and that can delay sleep onset. Or if
you wake up, it'll be very difficult to get back
to sleep again. And so what you need to do
is devise strategies that de- stress. First of all, embrace
sleep and enjoy the sleep that you get. Recognising that
(12:29):
your sleep pattern may be different from your partner or
whoever you share your life with. And we're going back
to defining how much sleep that you need. And so
at the end of the day, you need to wind
down. That may be relaxation therapy, for example. It may
be exercise. Don't exercise too close to bedtime because that
(12:52):
can raise core body temperature and that can actually delay
you getting to sleep. That's one of the interesting things
about sleep initiation. That's a drop in core body temperature.
The other thing I recommend is not talking about stressful
subjects. It's often the only time of the day when
you and a partner can actually talk about the stuff
that needs to talk about, but it's actually sometimes rather
(13:15):
stressful. And so I've certainly banned in our house any
mention of family finances while we're lying in bed at the end of the day.
Krutika Adatia (13:21):
That's a good idea.
Professor Russell Foster (13:22):
Just find a time but don't have it before you
go to sleep. So it is all about finding those techniques that
allow you to relax and wind down. Many people use
mindfulness, it doesn't work for everybody, but many people have
found that. Also, a relaxing bath for example. It's experimenting
and finding out what works for you. There will be
(13:42):
a solution. I think many people feel that sleep is
what you get, but actually as we've touched on, it's a
very dynamic behavior and we do have a lot of
control over it. And it's coming to terms with anxiety
and stress will absolutely improve your sleep.
Krutika Adatia (13:56):
And I like the point that you've mentioned about avoiding
stressful conversations, maybe even watching stressful things.
Professor Russell Foster (14:03):
Absolutely.
Krutika Adatia (14:03):
Because I know when I watch a show that's quite
emotionally charged or it's a bit upsetting, it takes me
a little bit longer to go to sleep.
Professor Russell Foster (14:12):
Well, I have to say I've become a coward. I don't watch the evening news
any longer. It's just too stressful. And so again, it's
identifying the things that do make you anxious and avoiding them.
Krutika Adatia (14:25):
And it's probably a nice segue talking about screens and
watching things. What impact does screen time and certain types
of light exposure have on scene?
Professor Russell Foster (14:36):
I'm so glad you mentioned this because there's an awful
lot of nonsense out there. It's another reason I wrote
Lifetime. There's a famous experiment that came out from the
states which was looking at a Kindle before you go
to sleep. And the press report says, looking at a
Kindle, it was called a light emitting book before you
go to sleep will disrupt your sleep. Well, you need
(14:57):
to look at the experiment. What people were asked to
do was look at their Kindle on its brightest light
setting for four hours immediately before sleep on five consecutive
nights. And what that did at the end of five
nights was delay sleep onset by nine minutes. It may
have been statistically significant, but biologically that's just meaningless. And
(15:19):
what's so interesting is that in those experiments, people were
kept under dim light prior to using the Kindle at
night. Another group repeated experiment essentially, but exposed people to
moderate levels of light during the day for about six
and a half hours and any subtle effects were completely
abolished. Showing why it's really important to get out during the
(15:41):
middle of the day, get some bright light exposure because
that will then desensitize the clock sensitivity to light in
the evening and reduce the chances of wobbling and moving
around the sleep wake cycle. So don't worry if a
Kindle is what relaxes you and you can get off
to sleep using one, do so. The thing to be
(16:02):
very careful about though is the content. Where we do
have good data is that if you're using your iPhone or
your tablet or whatever, and it can have an alerting
effect. It's not the light, it's what it's doing to
the brain to alert it. And again, it's all part
of that relaxation whereby you need to wind down and
(16:23):
yes, sure use a Kindle, but it may be a
few pages of Jane Austen, whatever, but it shouldn't be
some sort of Xbox frightening video thing.
Krutika Adatia (16:33):
That's really interesting. So ideally, I don't want to be
doom scrolling social media.
Professor Russell Foster (16:37):
No, no, I think that doom scrolling is exactly right,
and I think we all are tempted, but we mustn't
because it's again, the great enemy of sleep.
Krutika Adatia (16:44):
I know we spoke a little bit about this earlier in terms of
what we might be able to do to try and
get a better sleep, but is there a specific environmental
setup that students might want to have in place before
they go to sleep to help them sleep better?
Professor Russell Foster (17:00):
Certainly. I think that to make the bedroom or the
place where you sleep a place of calm, and it's
very difficult because many bedrooms are also offices and this
of course is what happened during Covid. But if you
can possibly take away the work space from the sleep
space, then that's really good. Make sure there's street lights,
(17:23):
have good blackout curtains, make sure the bedroom isn't too
warm because many bedrooms are overheated and if it's too
hot, it's much more difficult to drop that core body
temperature, which was one of the triggers that helps you
get off to sleep. So that's really important. I also
think, and I think we Brits might be a bit
cheap about this, is that we don't invest in decent
(17:44):
mattresses and pillows and duvets. I think there's a huge
resistance to do that, and yet we spent a third
of our lives in bed, so why not have a
decent pillow and a decent duvet? And so make sure
that's right. Other people will define the sleeping space with
a distinctive smell. It may be lavender, it may be
whatever. The evidence that it actually works above placebo isn't
(18:09):
strong, but I think there's a psychology here. Which is
you go into that space, you associate it with sleep,
and it can then put you... It's part of that
adjustment, that winding down, " I'm now in the sleeping space."
And that's reinforced by a distinctive smell. So those would
be things for the bedroom. But it's also important that
during the day you stop drinking coffee at around about
(18:31):
two, three o'clock in the afternoon. Some people are really
sensitive to coffee, and what you often find is this
sort of cycle of stimulation and then sedation. So you've
driven the working day with endless cups of coffee, so
you're wired, then you want to approach sleep time. You think, "
My goodness, I'm fully awake. What am I going to
do?" So you take a few slugs of glasses of
(18:54):
wine or alcohol of some sort, or even worse, which
are prescription drugs. And what they do is that they
are sedatives. They do not provide a biological mimic for
sleep. And in fact, alcohol can actually damage some of
the wiring, which is consolidating sleep and giving you an
(19:15):
improved ability to consolidate memory and actually find solutions to
complex problems. So don't use sedatives either, other people's prescriptions
or things like alcohol or indeed antihistamines. Which of course
some antihistamines, the drowsy ones, you often see people dosing
up with those really trying not to try and allow
(19:36):
natural sleep to take its course. So yes, I think
that's really important.
Krutika Adatia (19:41):
You've mentioned some really interesting things and a couple of things
I resonate with. So you mentioned the duvet, the pillow, not underestimating
that, and I'm just thinking about it is helping me
understand perhaps my own behavior and emotions that when I
do sometimes go to hotels or holidays and I'm not
able to sleep, it's probably because the pillow is not
comfortable or I'm just used to my home bed.
Professor Russell Foster (20:03):
So we go back to smell. And so you might
want to take a small amount of your partner's aftershave
or perfume or the lavender that you've defined your bed
with a few drops on the pillow. Again, it provides
that familiarity which makes you feel you are at home
and it'll be easier to sleep.
Krutika Adatia (20:20):
And the interesting point about coffee, I mean, I'm not a coffee drinker, but I
do drink tea, but just interesting to know and be
mindful of when you have that last cup of coffee.
Professor Russell Foster (20:30):
And tea. We've switched in our house to decaffeinated tea
for many, many years now, and I do think it makes
a difference. One of the other problems that many people
face is a partner who snores and you need to
check that they don't have obstructive sleep apnea, which is
the cessation, the stopping of breathing and then this sort
(20:51):
of waking up sort of thing. That's dangerous and then
you need to see your GP. That's actually really important.
But if it's just snoring, then what do you do
about it? Well, there are earplugs, but many people can't
deal with that. It is absolutely no shame if you
can sleep in an alternative sleeping space to go there.
So many people say, " Oh, I couldn't possibly do that.
(21:12):
It's the end of a relationship." And I say, " No,
absolutely not." It's the beginning of a new relationship because
you're going to get a decent night's sleep and then
the time you'll have together will be more empathetic, you'll
have more fun, you'll be less resentful. And so many
people, in fact, a 25- year- old came up to me
the other day and said, " How old do you have
to be before you can sleep in several rooms?"
Krutika Adatia (21:31):
Brilliant.
Professor Russell Foster (21:31):
Again, it's horses for courses. What works for you?
Krutika Adatia (21:37):
So Russell, you've obviously mentioned natural sleep and ways that
we can think about meditative techniques to unwind. There's obviously
a lot out there in terms of medication or supplements
that we can take. What are your thoughts and views
about that?
Professor Russell Foster (21:52):
Well, of course sleeping tablets, ideally you shouldn't use them long-
term. The occasional sleeping tablet, just to sort of correct
the whole situation is fine. And I think most GPs
now will only give you five or seven days supply,
and I think you shouldn't push it beyond. So avoid
sleeping tablets if you possibly can. A couple of other
(22:12):
drugs. So one is magnesium, and I saw some recent
data on magnesium, which looked really promising. I wouldn't say
that we've got the complete data yet, but magnesium may
help some people get off the... It's very difficult because
there's always a placebo effect with these issues. But anyway,
(22:33):
magnesium may be something you want to try. I don't
know of any adverse effects, but obviously you have to
be careful. And if you do take magnesium and you're
on other medications, you must let your GP know so
there's no possibility of a conflict. And I guess melatonin,
which is what many people are familiar with. Melatonin can
be prescribed by your GP. And of course many of
(22:56):
us passing through an airport see endless shelves full of
melatonin. So what's the facts? Melatonin is emphatically not a
sleep hormone. There are people who don't produce any melatonin
because they're on beta blockers, for example, and their sleep
is barely affected. So what we do have is some
data suggesting that if you take three milligrams of melatonin
(23:19):
prior to bed, it can reduce the time it takes
to get to sleep, but it won't keep you asleep.
But it can reduce the time to get to sleep
by about 10 minutes, maybe 20 minutes. And it doesn't
work for everybody. About 70% of people has some sort
of effect ranging from 20 minutes too much, much lower.
In the experiments that had been done, the most efficacious use
(23:42):
of melatonin reduced sleep timing by I think 15 minutes
or so. So it's not a big effect, but it
might help as long as you don't use it routinely.
The occasional use of melatonin, I mean, I tried it
when I was flying to Australia. I found it didn't
work at all for me. So again, occasional use, fine.
If it works for you again, fine. I suspect there's
a big placebo effect. But those are the two sort
(24:05):
of things on the market at the moment. Magnesium and
melatonin. As I say, melatonin, you can't buy over the
counter in the UK, but of course you can get
it all over the place.
Krutika Adatia (24:13):
That's great. And obviously you've given some great examples of
an environment we could create our sleep more, but there might be listeners or
students watching or listening to this thinking, " Oh God, I
have irregular sleep pattern." And they might be having it
often. Could you just sort of spotlight, what kind of
impact is that having on their ability to learn?
Professor Russell Foster (24:33):
Well, it may have no impact. Again, there's lots of
variation between individuals, but if you're waking up and you're
not getting back to sleep, it's almost certainly, again, going
back to the anxiety and the stress. And it may
well be that you'll want to leave the sleeping space
and go to somewhere else, keep the lights low, read
something, listen to music that is relaxing, and then you
(24:55):
will feel tired and then go back to sleep again.
The key thing is we do have a condition which
is now called sleep anxiety, which is the terror of
not falling to sleep or if you wake up, you
can't get back to sleep. One trick incidentally is if
you've got one of those illuminated digital alarms by the
bed, cover it up. Because if you wake up and
(25:17):
you glance, you think, " Oh my goodness, I've only got
two hours before the alarm goes off." That completely stresses
you out and makes many people say, " Oh, well that's
it. Might as well get up, drink coffee and do emails."
And actually that two hours can be very valuable. So's
it about staying calm and then going back to sleep
again. It's the ability to use things like mindfulness, other
(25:38):
relaxation techniques to get you back to sleep.
Krutika Adatia (25:41):
So Russell, what is the impact of lack of sleep
on cognition and brain health?
Professor Russell Foster (25:46):
In terms of one's emotional responses, you see that even
a couple of nights of no sleep, one's mood fluctuates
quite significantly. Irritability increases, anxiety, loss of empathy, the failure
to pick up those social signals from friends and family. Risk-
taking and impulsivity. This is extraordinary and there's some great studies
(26:07):
on this. And so, " Yes, I know I can get
through the traffic light before it turns red." No, you
won't. And if you weren't tired, you'd never think of
doing that sort of thing. Negative salience, and I think
this is really important because some lovely studies have been
done, which shows that the tired brain remembers negative experiences
(26:27):
but forgets the positive ones. So one's whole world view
is dominated by this negative salience. So that's a really
important effect of not getting enough sleep. And of course
we've talked about the use of stimulants and sedatives, but
one has to be careful because that can lead into
sort of illegal drug use, and that's always a major
(26:50):
worry. So that's sort of our emotional responses. Let's think
about our cognitive responses. Well, overall one's ability to process
information is affected. One area I think is really interesting
is the ability to multitask. So what we're constantly doing
is being bombarded with information and we have to extract
the salient bits and pay attention to that and ignore
(27:13):
everything else. And when we're tired, that sort of focus
of attention can be very much disrupted. Our ability to
multitask, it goes down. We've talked about the memory consolidation,
the processing of information, our communication skills, decision- making skills,
our creativity, productivity, all of the stuff that makes us...
(27:34):
Even our sense of humor. All the wonderful things that
make us human are very much affected by even short-
term sleep disruption. Now, I don't want to make people
more anxious, but I think that it's worth being sensitive
to the fact that this is, if you find you're,
for example, sliding towards depression, then not getting the sleep that you
need can actually nudge you down that path. Long- term
(27:57):
sleep disruption, as you see in night shift workers is
associated with a whole range of physiological issues, changes in
immune response as even in long- term night shift nurses,
higher rates of cancer. It's very interesting. The World Health
Organization has now classified night shift work as a probable
carcinogen because of the data. So it's really important. Also
(28:18):
driving. So there's a study a few years ago showing
that 57% of junior doctors had either had a crash
or a near miss on the drive home after the
night shift. Now, most of your students won't be doing
night shift work, but it does illustrate the fact that
if you're tired, you're going to experience these micro sleeps,
which means you could fall asleep at the wheel. And
(28:40):
I think if you're vulnerable to mental health issues, then
poor sleep can nudge you in that direction, can make
it worse.
Krutika Adatia (28:47):
That's great. It seems like sleep is really integral to so much
of our being.
Professor Russell Foster (28:52):
It is, absolutely. It defines really the conscious state.
Krutika Adatia (28:56):
I sort of touched on this already, but what are
some of the practical tips that we might want to
give our listeners and our students who are struggling to
stay asleep and fall asleep?
Professor Russell Foster (29:07):
Well, there are lots of things we can do, as
I say, and of course it's a matter of finding
out what works for you. But on the rule of
thumb, it's that morning light which sets the body clock,
which means you can stabilize the sleep wake cycle. And
so stick to a regime, ideally don't oversleep at the
weekend. You can catch up a bit, but you never
(29:27):
do completely. So it's far better to get a stable
sleep wake across the seven days of the week rather
than massive oversleeping at the weekends. And of course, that oversleeping at the
weekend will mean you miss the morning light, which means
that you're not going to get that steady thing. So
many students, for example, will have shortened sleep during the
week, massively oversleep at the weekends. They don't get the
(29:50):
morning light, but they get afternoon and evening light that delays
the clock. So it's more difficult to get up on
that Monday. And so that's one thing. We've touched on
make sure the bedroom isn't too warm, make sure you've
got the right bedding. Try and make the sleeping space
a place of haven and calm. Don't get stressed if
(30:10):
you wake up. Chances are if you stay calm, you
will get back to sleep again.
Krutika Adatia (30:14):
Thank you for all your useful insights and those golden
nuggets. I've learnt loads as well that I'm going to
take on board. But finally, three top tips from our
conversation today that you want to make sure listeners think about.
Professor Russell Foster (30:28):
Well, I think that we need to embrace our sleep.
We've got to absolutely realize, as I said right at
the beginning, the quality of our sleep defines the quality
of our waking state. It is not an indulgence, it's
a critical part of our biology. So much of our
ability to function depends upon it, so take it seriously.
The second is most people don't have a sleep problem.
(30:49):
They have an anxiety issue. So it's finding ways to
wind down to relax and not to make sleep (inaudible)
to become terrified and worried about sleep. And if
you wake up, your chances are you will get back
to sleep. So it's all about staying calm. And what
were the third thing? I think it would be to
(31:11):
be aware that there's an awful lot of variation in
our sleep. It's a very dynamic part of our biology. One
size does not fit all, and so it's all about
defining what our individual needs are and then defending them.
I mean, you struggle because you're a morning person, then
you had to go out late on a Friday. And
sometimes you just have to be strong and say, " I'm
(31:33):
sorry, I'm going to be a bit of a party
pooper." Obviously not too often, but it's about defining what's
good for you.
Krutika Adatia (31:41):
Thank you so much, Russell. That's been a great conversation. That's it from
this episode of On Your Marks. Thank you Russell for
chatting with me today. For more information about ACCA exams,
you can go to www. accaglobal.com forward/ exams. And to watch
the video version of this podcast, check out the link
(32:03):
in the show notes. I'm Krutika Adatia and this has been On
Your Marks. On Your Marks is a fresh air production
for ACCA. Its lead producer is Eva Higginbotham and its
executive producer is Annie Day. The videographer is Yohan Forbes,
and the sound engineer is Basil Oxtoby. See you next time.
In sleep, I was having a lot of trouble.
Speaker 2 (00:05):
If I go to bed with things whirling in my
brain, it definitely takes me longer.
Speaker 1 (00:10):
I work late all the time. So normally I will start studying after the kids are in bed. Sometimes 1 A.M.
Speaker 3 (00:16):
I normally sleep between five and six hours a night, and then I have
another one hour nap after work.
Krutika Adatia (00:24):
Hello, I'm Krutika Adatia and I'm a Chartered Accountant. I now support accountancy students through their
training and as an educator, I'm regularly up close and personal
with some of the common issues people face while studying
for and sitting their accountancy exams. So in this series
for the ACCA, I'm chatting to experts about strategies we
(00:46):
can all use when facing some of life's challenges. This
week we're looking at sleep. Why is our sleep so
often disrupted in times of stress? What happens in the
brain when we sleep and how can we work with
our body clocks to get the best rest possible? This
is On Your Marks because you'll never know until you
(01:07):
try. We all know how important sleep is for survival,
but lucky for me, I've always loved it. As a
kid, I was never the one complaining about bedtime. In
fact, I actually looked forward to an early night and
for as long as I can remember, I've been an
early riser too. I'm that person that wakes up before their
(01:28):
alarm even goes off. But like most of us, when
I'm stressed, my sleep definitely takes a hit. Whether it's
tossing and turning before finally drifting off or waking up
feeling like I could use a few more hours, it
really makes me wonder what is it about sleep that's so
essential? So to dig into how sleep works, I'm joined
(01:49):
by Professor Russell Foster from the University of Oxford. He's
an expert in body clocks and sleep. So Russell, I'm
going to open with a personal question. How did you
sleep last night?
Professor Russell Foster (02:02):
Well, actually very well. I woke around about three o'clock in the morning as many
people of my age do, but I went back to
sleep within 10, 15 minutes. One of the strategies I use
a lot is listening to Radio 4 Extra, and I
usually get five or six minutes of something In Our
Time often and then fall asleep again. So the key
thing is you stay unstressed in the knowledge that you
(02:25):
almost certainly will get back to sleep. It's where you've
sort of wake up and think, " Oh my God, look
at the alarm clock," and then get really stressed, and
that's what you've got to avoid at all costs.
Krutika Adatia (02:36):
I'm glad you mentioned that you sort of put something
on to listen to because I like listening to audiobooks
and that often puts me to sleep.
Professor Russell Foster (02:42):
One of my favorites is In Our Time, as I
mentioned, but also that wonderful series Lord Peter Wimsey. That's
very wonderful and non- threatening.
Krutika Adatia (02:51):
Brilliant. For me it's Harry Potter because I've read the
books and I've watched the movies, so it's familiar and
it'll just...
Professor Russell Foster (02:56):
I think that's a good point because it is familiarity with
something that's non- threatening and gentle.
Krutika Adatia (03:01):
Why is it that we need sleep?
Professor Russell Foster (03:04):
Well, of course, for so long, sleep was disregarded as
sort of an indulgence and a luxury and almost as
an illness that needs a cure. And what's emerged over
the past 20 years or so is that sleep is
an absolutely essential part of our biology. The quality of
our waking day is defined more or less by the
(03:25):
quality of the sleep that we get. So it's an
essential part of our biology and I think so many
of us marginalize it. Sleep is always the first victim
in squeezing more and more and more in to an
over packed day. So we need to embrace it and
not treat it as some sort of luxury.
Krutika Adatia (03:43):
I'm glad you've mentioned that because I'm just thinking about
our listeners who might be students and cramming or potentially
working late into the night and often sacrificing their sleep,
what we're saying is that that shouldn't be the case.
Professor Russell Foster (03:57):
Absolutely. If we think about some of the things going
on within the brain whilst we sleep and what's emerged
again fairly recently is that sleep is a time when
we consolidate our memory. All that information is rushing in
during the day and we don't have time to process
it effectively. And so whilst we sleep, we can consolidate
memory. But the other thing, it's not just the retention
(04:19):
of facts. There's a wonderful study from Germany which looked
at the solving of problems. So this experiment was quite
a complicated task. It was introduced to individuals in the
morning, so they became familiar with the task and one
group performed it that afternoon and only 20% of the
group actually solved the problem. The next group introduced in
(04:40):
the morning, familiarized with the task, performed it the following
afternoon, but they were deprived of sleep. Again, about 20% of
the group solved the problem. But the really interesting group,
of course is introduced in the morning, performed at the following
afternoon, but with a full night of sleep, 60 to 70% of
the group solved the problem. It's a brilliant example of
(05:03):
how we're processing information. We're coming up with novel solutions
to complex problems, and that's just one reason why students
or all of us need to take our sleep very seriously.
Krutika Adatia (05:15):
So we need that sleep to help with the consolidation,
the sort of memory form, which is obviously important for learning.
Professor Russell Foster (05:19):
And the answering of questions. So it's not just the
retention of facts, it's the processing, it's the manipulation of
that information, which I think is so amazing.
Krutika Adatia (05:29):
That is incredible. I mean, this is probably a question
that's sort of how long is a piece of string,
but how many hours of sleep does an average person need?
Professor Russell Foster (05:39):
Well, that's a really good question and it's part of
the reason I wrote this book called Lifetime because I
was fed up with the sergeant majors of sleep screaming, "
You must get eight hours." The healthy range according to
the National Sleep Foundation is between six hours and some
people may need up to 11 hours and it's all
about defining what you need and then defending your sleep.
(06:03):
And so that's the key thing. Seven to eight hours
is an average, but it would be wrong to impose
an average value on everybody. It's like shoe size. You
wouldn't dream of making everybody wear the same shoe size
and we shouldn't dream of making everybody's sleep or expecting
them to sleep exactly the same length. And the key
thing is defining if you're tired or not and how
(06:27):
much sleep do you need? Well, if are feeling that you are
not firing all cylinders during the day, if you don't
feel as though your brain isn't working accurately and precisely,
that's a good indication you're not getting the sleep at
night. If you oversleep on free days at the weekend,
for example, if you need an alarm clock to drag
you out of bed or somebody else, if you're craving
(06:50):
caffeinated drinks to wake you up, if you're feeling sluggish
during the day. And importantly if you or your friends
and family note behavioral changes. You're more irritable, you're less
empathetic, you're failing to pick up those sorts of signals
from friends and family and you're doing stupid and unreflective
things. This is all telling you you're not getting the
(07:10):
sleep you need and you need to take a refresh
and think, " Right, I'm going to go to bed a
bit earlier and get a bit longer sleep."
Krutika Adatia (07:17):
So I guess you're alluding to this in your answer
that you've just given, but figuring out how many hours of
sleep you need is just being a bit more self- aware.
Professor Russell Foster (07:27):
Absolutely, yes. And as I said, we think we don't really need
sleep, so we work way into the night and I
certainly did as a student, but I don't think it
did me any good because I didn't get that consolidation
of memory and processing of information.
Krutika Adatia (07:42):
And so are we saying that maybe we might not
always need the same amount of sleep every day as
well? Could it vary?
Professor Russell Foster (07:49):
Sleep is a very dynamic part of our biology. It
changes as we age and due to external circumstances, we
may not get the same sleep every night, but essentially
it's trying to get the best sleep we can.
Krutika Adatia (08:01):
Now just moving on to another topic here, which I
know you also have a specialism in, and that's circadian rhythm. Can you
tell us what exactly is the circadian rhythm?
Professor Russell Foster (08:12):
If we step back and think about, well, what's our
biology? What does it do? Well, ideally it delivers the
right stuff at the right concentration to the right tissues
and organs at the right time of day. And this
circadian rhythm's internal biological clock provides the time structure to
allow us to do the right stuff at the right
(08:33):
time. And fine tune our physiology and behavior to the
very demands of the rest activity, the sleep wake cycle,
which of course has evolved as a result of sitting
on a planet that revolves once every 24 hours. And
so it's providing this essential time structure for life. So
in anticipation of going to bed, we see that core
body temperature drops, we see other factors, hormonal changes occur,
(08:58):
and then in anticipation of waking up in the morning
before we've even woken up, core body temperature rises, metabolic
rate increases, and we're mobilizing glucose and hormones underpinning energy
so that when we do wake up, we can exploit
that new environment, the dawn to our best of abilities.
So it's this wonderful device to anticipate predictable change within
(09:22):
the environment and allowing us to function optimally.
Krutika Adatia (09:25):
Right. And so are we saying everyone has the same
kind of biological body clock or does it vary from
individual to individual?
Professor Russell Foster (09:33):
It certainly varies, and that brings us really to the subject of chronotype.
And that sort of crudely means whether you're a morning
person, a lark, an intermediate dove, or a late person,
an owl. And there are three factors that contribute to
this. One is your genes. So we know that there
are subtle changes, very small changes in some of the
(09:54):
clock genes which underpin our circadian rhythms. And they can
make you get up earlier or make you get up
late. And so by essentially their contribution to our genes,
our parents are still telling us what time to go
to bed and get up. So there's that element which
is to some extent fixed. The other thing that changes
(10:15):
is how old we are. So from about the age
of 10, there's a tendency to want to go to
bed later and later and later peaking in the late
teens, early twenties. So there's a sharp rise in wanting
to go to bed later. And then there's a slow
return as you age to want to go to bed
earlier. So by the time you're in your late fifties, sixties, you're
(10:35):
getting up and going to bed at about the time
you got up and went to bed when you were 10,
11. But the key thing is that somebody in their
fifties, sixties will want to go to bed on average
two hours earlier than when they were going to bed
in their late teens and twenties. And that sharp rise
and slow move to a more morning chronotype is due
(10:57):
to the hormonal changes associated with puberty. So we've got
genes, we've got the sex hormones. And the third thing,
which is the thing we have some control over and
is often overlooked is when we see light. So morning
light advances the biological clock, makes us get up earlier
and go to bed earlier. Evening light, dusk light delays
(11:21):
the clock, we want to go to bed later and
get up later. We did some studies actually on university
students a few years ago all over the world, and
we found that the more owl- like they were, they
were missing the morning light, which will get them up
earlier, but they were getting lots of late afternoon evening
light, which would push the clock later. And so it's
(11:42):
a key point because if you're a late type, you
can set the alarm, either sit in front of a
light box. If it's sunny outside, go outside 30 minutes
and you can sort of nudge clock forward in time.
So there's three things, genes, age, development, and when you
see light.
Krutika Adatia (12:00):
What happens then to our sleep when students are stressed
or anxious?
Professor Russell Foster (12:06):
Well, this is the great enemy of sleep. Most people don't
have a sleep problem at all. It's dealing with anxiety
and stress and that can delay sleep onset. Or if
you wake up, it'll be very difficult to get back
to sleep again. And so what you need to do
is devise strategies that de- stress. First of all, embrace
sleep and enjoy the sleep that you get. Recognising that
(12:29):
your sleep pattern may be different from your partner or
whoever you share your life with. And we're going back
to defining how much sleep that you need. And so
at the end of the day, you need to wind
down. That may be relaxation therapy, for example. It may
be exercise. Don't exercise too close to bedtime because that
(12:52):
can raise core body temperature and that can actually delay
you getting to sleep. That's one of the interesting things
about sleep initiation. That's a drop in core body temperature.
The other thing I recommend is not talking about stressful
subjects. It's often the only time of the day when
you and a partner can actually talk about the stuff
that needs to talk about, but it's actually sometimes rather
(13:15):
stressful. And so I've certainly banned in our house any
mention of family finances while we're lying in bed at the end of the day.
Krutika Adatia (13:21):
That's a good idea.
Professor Russell Foster (13:22):
Just find a time but don't have it before you
go to sleep. So it is all about finding those techniques that
allow you to relax and wind down. Many people use
mindfulness, it doesn't work for everybody, but many people have
found that. Also, a relaxing bath for example. It's experimenting
and finding out what works for you. There will be
(13:42):
a solution. I think many people feel that sleep is
what you get, but actually as we've touched on, it's a
very dynamic behavior and we do have a lot of
control over it. And it's coming to terms with anxiety
and stress will absolutely improve your sleep.
Krutika Adatia (13:56):
And I like the point that you've mentioned about avoiding
stressful conversations, maybe even watching stressful things.
Professor Russell Foster (14:03):
Absolutely.
Krutika Adatia (14:03):
Because I know when I watch a show that's quite
emotionally charged or it's a bit upsetting, it takes me
a little bit longer to go to sleep.
Professor Russell Foster (14:12):
Well, I have to say I've become a coward. I don't watch the evening news
any longer. It's just too stressful. And so again, it's
identifying the things that do make you anxious and avoiding them.
Krutika Adatia (14:25):
And it's probably a nice segue talking about screens and
watching things. What impact does screen time and certain types
of light exposure have on scene?
Professor Russell Foster (14:36):
I'm so glad you mentioned this because there's an awful
lot of nonsense out there. It's another reason I wrote
Lifetime. There's a famous experiment that came out from the
states which was looking at a Kindle before you go
to sleep. And the press report says, looking at a
Kindle, it was called a light emitting book before you
go to sleep will disrupt your sleep. Well, you need
(14:57):
to look at the experiment. What people were asked to
do was look at their Kindle on its brightest light
setting for four hours immediately before sleep on five consecutive
nights. And what that did at the end of five
nights was delay sleep onset by nine minutes. It may
have been statistically significant, but biologically that's just meaningless. And
(15:19):
what's so interesting is that in those experiments, people were
kept under dim light prior to using the Kindle at
night. Another group repeated experiment essentially, but exposed people to
moderate levels of light during the day for about six
and a half hours and any subtle effects were completely
abolished. Showing why it's really important to get out during the
(15:41):
middle of the day, get some bright light exposure because
that will then desensitize the clock sensitivity to light in
the evening and reduce the chances of wobbling and moving
around the sleep wake cycle. So don't worry if a
Kindle is what relaxes you and you can get off
to sleep using one, do so. The thing to be
(16:02):
very careful about though is the content. Where we do
have good data is that if you're using your iPhone or
your tablet or whatever, and it can have an alerting
effect. It's not the light, it's what it's doing to
the brain to alert it. And again, it's all part
of that relaxation whereby you need to wind down and
(16:23):
yes, sure use a Kindle, but it may be a
few pages of Jane Austen, whatever, but it shouldn't be
some sort of Xbox frightening video thing.
Krutika Adatia (16:33):
That's really interesting. So ideally, I don't want to be
doom scrolling social media.
Professor Russell Foster (16:37):
No, no, I think that doom scrolling is exactly right,
and I think we all are tempted, but we mustn't
because it's again, the great enemy of sleep.
Krutika Adatia (16:44):
I know we spoke a little bit about this earlier in terms of
what we might be able to do to try and
get a better sleep, but is there a specific environmental
setup that students might want to have in place before
they go to sleep to help them sleep better?
Professor Russell Foster (17:00):
Certainly. I think that to make the bedroom or the
place where you sleep a place of calm, and it's
very difficult because many bedrooms are also offices and this
of course is what happened during Covid. But if you
can possibly take away the work space from the sleep
space, then that's really good. Make sure there's street lights,
(17:23):
have good blackout curtains, make sure the bedroom isn't too
warm because many bedrooms are overheated and if it's too
hot, it's much more difficult to drop that core body
temperature, which was one of the triggers that helps you
get off to sleep. So that's really important. I also
think, and I think we Brits might be a bit
cheap about this, is that we don't invest in decent
(17:44):
mattresses and pillows and duvets. I think there's a huge
resistance to do that, and yet we spent a third
of our lives in bed, so why not have a
decent pillow and a decent duvet? And so make sure
that's right. Other people will define the sleeping space with
a distinctive smell. It may be lavender, it may be
whatever. The evidence that it actually works above placebo isn't
(18:09):
strong, but I think there's a psychology here. Which is
you go into that space, you associate it with sleep,
and it can then put you... It's part of that
adjustment, that winding down, " I'm now in the sleeping space."
And that's reinforced by a distinctive smell. So those would
be things for the bedroom. But it's also important that
during the day you stop drinking coffee at around about
(18:31):
two, three o'clock in the afternoon. Some people are really
sensitive to coffee, and what you often find is this
sort of cycle of stimulation and then sedation. So you've
driven the working day with endless cups of coffee, so
you're wired, then you want to approach sleep time. You think, "
My goodness, I'm fully awake. What am I going to
do?" So you take a few slugs of glasses of
(18:54):
wine or alcohol of some sort, or even worse, which
are prescription drugs. And what they do is that they
are sedatives. They do not provide a biological mimic for
sleep. And in fact, alcohol can actually damage some of
the wiring, which is consolidating sleep and giving you an
(19:15):
improved ability to consolidate memory and actually find solutions to
complex problems. So don't use sedatives either, other people's prescriptions
or things like alcohol or indeed antihistamines. Which of course
some antihistamines, the drowsy ones, you often see people dosing
up with those really trying not to try and allow
(19:36):
natural sleep to take its course. So yes, I think
that's really important.
Krutika Adatia (19:41):
You've mentioned some really interesting things and a couple of things
I resonate with. So you mentioned the duvet, the pillow, not underestimating
that, and I'm just thinking about it is helping me
understand perhaps my own behavior and emotions that when I
do sometimes go to hotels or holidays and I'm not
able to sleep, it's probably because the pillow is not
comfortable or I'm just used to my home bed.
Professor Russell Foster (20:03):
So we go back to smell. And so you might
want to take a small amount of your partner's aftershave
or perfume or the lavender that you've defined your bed
with a few drops on the pillow. Again, it provides
that familiarity which makes you feel you are at home
and it'll be easier to sleep.
Krutika Adatia (20:20):
And the interesting point about coffee, I mean, I'm not a coffee drinker, but I
do drink tea, but just interesting to know and be
mindful of when you have that last cup of coffee.
Professor Russell Foster (20:30):
And tea. We've switched in our house to decaffeinated tea
for many, many years now, and I do think it makes
a difference. One of the other problems that many people
face is a partner who snores and you need to
check that they don't have obstructive sleep apnea, which is
the cessation, the stopping of breathing and then this sort
(20:51):
of waking up sort of thing. That's dangerous and then
you need to see your GP. That's actually really important.
But if it's just snoring, then what do you do
about it? Well, there are earplugs, but many people can't
deal with that. It is absolutely no shame if you
can sleep in an alternative sleeping space to go there.
So many people say, " Oh, I couldn't possibly do that.
(21:12):
It's the end of a relationship." And I say, " No,
absolutely not." It's the beginning of a new relationship because
you're going to get a decent night's sleep and then
the time you'll have together will be more empathetic, you'll
have more fun, you'll be less resentful. And so many
people, in fact, a 25- year- old came up to me
the other day and said, " How old do you have
to be before you can sleep in several rooms?"
Krutika Adatia (21:31):
Brilliant.
Professor Russell Foster (21:31):
Again, it's horses for courses. What works for you?
Krutika Adatia (21:37):
So Russell, you've obviously mentioned natural sleep and ways that
we can think about meditative techniques to unwind. There's obviously
a lot out there in terms of medication or supplements
that we can take. What are your thoughts and views
about that?
Professor Russell Foster (21:52):
Well, of course sleeping tablets, ideally you shouldn't use them long-
term. The occasional sleeping tablet, just to sort of correct
the whole situation is fine. And I think most GPs
now will only give you five or seven days supply,
and I think you shouldn't push it beyond. So avoid
sleeping tablets if you possibly can. A couple of other
(22:12):
drugs. So one is magnesium, and I saw some recent
data on magnesium, which looked really promising. I wouldn't say
that we've got the complete data yet, but magnesium may
help some people get off the... It's very difficult because
there's always a placebo effect with these issues. But anyway,
(22:33):
magnesium may be something you want to try. I don't
know of any adverse effects, but obviously you have to
be careful. And if you do take magnesium and you're
on other medications, you must let your GP know so
there's no possibility of a conflict. And I guess melatonin,
which is what many people are familiar with. Melatonin can
be prescribed by your GP. And of course many of
(22:56):
us passing through an airport see endless shelves full of
melatonin. So what's the facts? Melatonin is emphatically not a
sleep hormone. There are people who don't produce any melatonin
because they're on beta blockers, for example, and their sleep
is barely affected. So what we do have is some
data suggesting that if you take three milligrams of melatonin
(23:19):
prior to bed, it can reduce the time it takes
to get to sleep, but it won't keep you asleep.
But it can reduce the time to get to sleep
by about 10 minutes, maybe 20 minutes. And it doesn't
work for everybody. About 70% of people has some sort
of effect ranging from 20 minutes too much, much lower.
In the experiments that had been done, the most efficacious use
(23:42):
of melatonin reduced sleep timing by I think 15 minutes
or so. So it's not a big effect, but it
might help as long as you don't use it routinely.
The occasional use of melatonin, I mean, I tried it
when I was flying to Australia. I found it didn't
work at all for me. So again, occasional use, fine.
If it works for you again, fine. I suspect there's
a big placebo effect. But those are the two sort
(24:05):
of things on the market at the moment. Magnesium and
melatonin. As I say, melatonin, you can't buy over the
counter in the UK, but of course you can get
it all over the place.
Krutika Adatia (24:13):
That's great. And obviously you've given some great examples of
an environment we could create our sleep more, but there might be listeners or
students watching or listening to this thinking, " Oh God, I
have irregular sleep pattern." And they might be having it
often. Could you just sort of spotlight, what kind of
impact is that having on their ability to learn?
Professor Russell Foster (24:33):
Well, it may have no impact. Again, there's lots of
variation between individuals, but if you're waking up and you're
not getting back to sleep, it's almost certainly, again, going
back to the anxiety and the stress. And it may
well be that you'll want to leave the sleeping space
and go to somewhere else, keep the lights low, read
something, listen to music that is relaxing, and then you
(24:55):
will feel tired and then go back to sleep again.
The key thing is we do have a condition which
is now called sleep anxiety, which is the terror of
not falling to sleep or if you wake up, you
can't get back to sleep. One trick incidentally is if
you've got one of those illuminated digital alarms by the
bed, cover it up. Because if you wake up and
(25:17):
you glance, you think, " Oh my goodness, I've only got
two hours before the alarm goes off." That completely stresses
you out and makes many people say, " Oh, well that's
it. Might as well get up, drink coffee and do emails."
And actually that two hours can be very valuable. So's
it about staying calm and then going back to sleep
again. It's the ability to use things like mindfulness, other
(25:38):
relaxation techniques to get you back to sleep.
Krutika Adatia (25:41):
So Russell, what is the impact of lack of sleep
on cognition and brain health?
Professor Russell Foster (25:46):
In terms of one's emotional responses, you see that even
a couple of nights of no sleep, one's mood fluctuates
quite significantly. Irritability increases, anxiety, loss of empathy, the failure
to pick up those social signals from friends and family. Risk-
taking and impulsivity. This is extraordinary and there's some great studies
(26:07):
on this. And so, " Yes, I know I can get
through the traffic light before it turns red." No, you
won't. And if you weren't tired, you'd never think of
doing that sort of thing. Negative salience, and I think
this is really important because some lovely studies have been
done, which shows that the tired brain remembers negative experiences
(26:27):
but forgets the positive ones. So one's whole world view
is dominated by this negative salience. So that's a really
important effect of not getting enough sleep. And of course
we've talked about the use of stimulants and sedatives, but
one has to be careful because that can lead into
sort of illegal drug use, and that's always a major
(26:50):
worry. So that's sort of our emotional responses. Let's think
about our cognitive responses. Well, overall one's ability to process
information is affected. One area I think is really interesting
is the ability to multitask. So what we're constantly doing
is being bombarded with information and we have to extract
the salient bits and pay attention to that and ignore
(27:13):
everything else. And when we're tired, that sort of focus
of attention can be very much disrupted. Our ability to
multitask, it goes down. We've talked about the memory consolidation,
the processing of information, our communication skills, decision- making skills,
our creativity, productivity, all of the stuff that makes us...
(27:34):
Even our sense of humor. All the wonderful things that
make us human are very much affected by even short-
term sleep disruption. Now, I don't want to make people
more anxious, but I think that it's worth being sensitive
to the fact that this is, if you find you're,
for example, sliding towards depression, then not getting the sleep that you
need can actually nudge you down that path. Long- term
(27:57):
sleep disruption, as you see in night shift workers is
associated with a whole range of physiological issues, changes in
immune response as even in long- term night shift nurses,
higher rates of cancer. It's very interesting. The World Health
Organization has now classified night shift work as a probable
carcinogen because of the data. So it's really important. Also
(28:18):
driving. So there's a study a few years ago showing
that 57% of junior doctors had either had a crash
or a near miss on the drive home after the
night shift. Now, most of your students won't be doing
night shift work, but it does illustrate the fact that
if you're tired, you're going to experience these micro sleeps,
which means you could fall asleep at the wheel. And
(28:40):
I think if you're vulnerable to mental health issues, then
poor sleep can nudge you in that direction, can make
it worse.
Krutika Adatia (28:47):
That's great. It seems like sleep is really integral to so much
of our being.
Professor Russell Foster (28:52):
It is, absolutely. It defines really the conscious state.
Krutika Adatia (28:56):
I sort of touched on this already, but what are
some of the practical tips that we might want to
give our listeners and our students who are struggling to
stay asleep and fall asleep?
Professor Russell Foster (29:07):
Well, there are lots of things we can do, as
I say, and of course it's a matter of finding
out what works for you. But on the rule of
thumb, it's that morning light which sets the body clock,
which means you can stabilize the sleep wake cycle. And
so stick to a regime, ideally don't oversleep at the
weekend. You can catch up a bit, but you never
(29:27):
do completely. So it's far better to get a stable
sleep wake across the seven days of the week rather
than massive oversleeping at the weekends. And of course, that oversleeping at the
weekend will mean you miss the morning light, which means
that you're not going to get that steady thing. So
many students, for example, will have shortened sleep during the
week, massively oversleep at the weekends. They don't get the
(29:50):
morning light, but they get afternoon and evening light that delays
the clock. So it's more difficult to get up on
that Monday. And so that's one thing. We've touched on
make sure the bedroom isn't too warm, make sure you've
got the right bedding. Try and make the sleeping space
a place of haven and calm. Don't get stressed if
(30:10):
you wake up. Chances are if you stay calm, you
will get back to sleep again.
Krutika Adatia (30:14):
Thank you for all your useful insights and those golden
nuggets. I've learnt loads as well that I'm going to
take on board. But finally, three top tips from our
conversation today that you want to make sure listeners think about.
Professor Russell Foster (30:28):
Well, I think that we need to embrace our sleep.
We've got to absolutely realize, as I said right at
the beginning, the quality of our sleep defines the quality
of our waking state. It is not an indulgence, it's
a critical part of our biology. So much of our
ability to function depends upon it, so take it seriously.
The second is most people don't have a sleep problem.
(30:49):
They have an anxiety issue. So it's finding ways to
wind down to relax and not to make sleep (inaudible)
to become terrified and worried about sleep. And if
you wake up, your chances are you will get back
to sleep. So it's all about staying calm. And what
were the third thing? I think it would be to
(31:11):
be aware that there's an awful lot of variation in
our sleep. It's a very dynamic part of our biology. One
size does not fit all, and so it's all about
defining what our individual needs are and then defending them.
I mean, you struggle because you're a morning person, then
you had to go out late on a Friday. And
sometimes you just have to be strong and say, " I'm
(31:33):
sorry, I'm going to be a bit of a party
pooper." Obviously not too often, but it's about defining what's
good for you.
Krutika Adatia (31:41):
Thank you so much, Russell. That's been a great conversation. That's it from
this episode of On Your Marks. Thank you Russell for
chatting with me today. For more information about ACCA exams,
you can go to www. accaglobal.com forward/ exams. And to watch
the video version of this podcast, check out the link
(32:03):
in the show notes. I'm Krutika Adatia and this has been On
Your Marks. On Your Marks is a fresh air production
for ACCA. Its lead producer is Eva Higginbotham and its
executive producer is Annie Day. The videographer is Yohan Forbes,
and the sound engineer is Basil Oxtoby. See you next time.
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