Ep 199 Sleep Part 2: Predictably unpredictable

Now that we know just how critical sleep is, we’re all making sure we get the amount we need, right? Unfortunately no. One-third to one-half of Americans are not getting enough sleep, according to public health guidelines. Why is that? Hypotheses abound, but many point the finger of blame at different aspects of modern society such as screen time, artificial light, a sedentary lifestyle. These narratives suggest that sleep in industrialized societies today is not just different but worse than in centuries past. Is that the truth? How did humans sleep in yesteryear, and what can that tell us about sleep today? In the conclusion to our sleep two-parter, we explore the many ways that humans sleep and the wide array of consequences when we don’t get enough (or too much) of it.

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Episode Transcript

Speaker 1 (00:00):
Hi. My name is Kelly. I'm a big fan of
the podcast, so it's a real treat to be here
sharing my story about sleep, or, in my case, lack
of it. I was nearing the end of my final
quarter at college, and I'd spent my finals week living
off caffeine pills and no sleep in an effort to
cram for my tests. The day after my last presentation,
I decided to go cold turkey on the caffeine to

(00:22):
spend a few hours at my internship and then head
home for some uninterrupted napping. My internship, I could feel
the heaviness of my week of all nighters pulling at me,
so I asked to leave early and got in my
car to battle the early developments of rush hour traffic.
As I sat in my car, the stop and go
movement slowly lulled me to sleep, and the next thing

(00:43):
I knew, I was jolted awake by a thud as
my car had rolled forward and struck the jeep in
front of me Because we were going so slow, The
only damage done to the jeep was a cut in
his wheel cover. The driver was so nice and checked
on me to make sure I was okay, and then
drove off than being incredibly embarrassed. I was fine, but
my car, Betty, the cute little blue car I'd had

(01:05):
since I was sixteen, had damaged to her frame and
was totaled. Now that I'm older, I'm incredibly cautious of
driving fatigued. I was so lucky my wake up call
didn't hurt anyone except poor Betty.

Speaker 2 (02:03):
Wow, I mean, what a harrowing. What a harrowing and
also like relatable.

Speaker 3 (02:07):
I know who.

Speaker 4 (02:08):
Hasn't stayed up way too lately, many nights in.

Speaker 3 (02:11):
A row too often?

Speaker 4 (02:13):
Yeah, I know, terrifying. Glad you're okay. I'm sorry about
your car.

Speaker 2 (02:17):
I know, I know.

Speaker 4 (02:19):
Kelly. Thank you so much for sharing your story with us.

Speaker 3 (02:21):
We really appreciate it. We do. Thank you so much.

Speaker 4 (02:23):
Thank you. Hi. I'm Aaron Welsh.

Speaker 2 (02:26):
And I'm Eron Alman Updike And this is this podcast
Will kill You.

Speaker 3 (02:29):
Welcome to Sleep Part two.

Speaker 4 (02:31):
Sleep Part two.

Speaker 2 (02:33):
If you didn't listen last week or watch, you should
because it's really great.

Speaker 4 (02:39):
You know, there's a lot of criep out of it. Absolutely.

Speaker 2 (02:43):
A last episode we discussed sort of like what is sleep?
What are the different stages of sleep? A little bit
about what sleep does for us, for us and how
we fall asleep, et cetera. We talked about sleep and animals,
very cute stuff in hemispheric sleep and Love to Sleep yep.
And this week we're going to go in more into
how humans have slept over history and also like what

(03:06):
sleep disruption means, what sleep quality means.

Speaker 4 (03:09):
And what are the consequences of not getting enough sleep.
There's a lot of them. There's a lot.

Speaker 3 (03:14):
We'll get into all of it.

Speaker 4 (03:16):
We will, but first it's.

Speaker 3 (03:18):
Quarantiney plusy perrita time.

Speaker 4 (03:20):
It is. What are we drinking this week?

Speaker 3 (03:23):
We're still drinking.

Speaker 4 (03:24):
We are pillow talk.

Speaker 3 (03:25):
Pillow talk.

Speaker 4 (03:26):
Should we do the whole episode in a whisper.

Speaker 3 (03:28):
Yeah, so that everyone I can fall asleep. It's Camma
meal tea Camra meal tea ginger, ginger, honey, and a lemon.
I can't do it.

Speaker 4 (03:39):
I'm going to lose it. That's enough for me.

Speaker 2 (03:44):
We will post the full recipe for pillow talk on
our social media at the very least, and uh maybe
on our website, which is where you can also find.

Speaker 5 (03:55):
So many things that you really really want trust trust,
like merch. Yeah, we've got that. We've got transcripts from
all of these episodes. We've got a good Reads list,
a bookshop dot org affiliate account. We've got links to Bloodmobile,
who does the music for every one of our episodes.
We've got sources from them all. We have a contact
us form and a first hand account form, and much more,

(04:18):
much more.

Speaker 4 (04:19):
I don't even know.

Speaker 2 (04:20):
I honestly don't even know, because I kind of zoned
out when you were talking too, I know, while we're
discussing it.

Speaker 3 (04:26):
Yeah, this podcast will kill you dot com.

Speaker 2 (04:29):
This is a YouTube video that you are like, we're
filming this.

Speaker 4 (04:33):
We are in the exactly right studios. It's really cool.

Speaker 3 (04:36):
Thank you for having us, Yes.

Speaker 4 (04:37):
Thank you.

Speaker 2 (04:38):
And so if you would like to watch the full
thing it is there that is impossible to do.

Speaker 3 (04:42):
Thank you. If you are watching it, yeah, and.

Speaker 2 (04:44):
If you're not, you know, you can always rate reviews,
subscribe on various platforms.

Speaker 3 (04:48):
All the platforms, yeah, that you like to use.

Speaker 2 (04:51):
God, it's like, we this is our first time doing this,
every single time, every time.

Speaker 3 (04:55):
So on that note, break time, I need one already.

Speaker 2 (05:02):
Let's take a quick break, and when we get back,
there is so much to discuss about Sleep in Humans.
That was great, thank you, I said a lot for
the book club.

Speaker 4 (05:10):
Oh with that? Yeah really?

Speaker 2 (05:12):
Oh no, not really, okay, okay, okay, break time starting now.
Earlier this year, I bought myself a smart watch.

Speaker 4 (05:34):
I know that, you do know that, and.

Speaker 2 (05:36):
I started wearing it overnight. When I woke up in
the morning, I would check out how my watch that
I slept right, how many hours did I get? How
much deep sleep? What was my percentage? How many wake ups?
Oh gosh, only six and a half hours of sleep?
Only five percent deep sleep? Oh yep, that's when I
woke up because my dog was licking himself excessively. Always,

(05:57):
no wonder, I'm so tired today. And on the rare
occasion that I hit my eight hour sleep goal, my
phone would send a little congratulatory notification.

Speaker 4 (06:07):
Like yay, does it really? You did it?

Speaker 2 (06:09):
You hit your goal, and I would be I would
like got. I started to get really annoyed, like I
don't know why, but I was just like, yeah, I
hit it today. Once every two months, thank you for
reminding me what a failure I am when it comes
to sleeping. My god, and a little bit like I'm exaggerating,
I know, but still, but it would just be like, oh,

(06:29):
you hit it today, and I was like, what about
yesterday when I got seven hours?

Speaker 4 (06:33):
Like was that okay?

Speaker 3 (06:35):
Clearly is not good enough, right Siri?

Speaker 2 (06:37):
And then I was like, okay, am I actually tired?
Or it was my watch sort of creating this self
fulfilling prophecy where I convinced myself that I was more
tired just because I had X number of wake ups
or I didn't hit.

Speaker 4 (06:50):
Eight hours or whatever. Yeah, and I kept wearing it.

Speaker 2 (06:53):
But then I was like, you know what, I'm not
going to check what it recorded until later in the day,
just to see, like how tired am I to die?

Speaker 4 (07:00):
I feel?

Speaker 3 (07:00):
Before I have the watch tell me how I should feel.

Speaker 2 (07:02):
One hundred percent? Right, And it didn't always align. Of course,
this is all anecdotal. This is an end of one.

Speaker 4 (07:09):
I love it.

Speaker 2 (07:10):
This is my personal introduction to the story, right, And
I know that these watches, like you talked about last week,
they are not substitutes for professional sleep devices, and they
can be very inaccurate. And what mine did for me
was kind of, in a way increase my sleep anxiety,
or like the anxiety that I feel about not getting
enough sleep or not getting quality sleep. According to my watch,

(07:31):
I was rarely getting quote unquote enough sleep, Like what
does enough mean? It was from public health guidelines seven
to nine hours. And also alarmist headlines also would talk
about how much sleep you should be getting. And these
headlines every day are always proclaiming some new connection between

(07:52):
a lack of sleep and chronic disease or mental health
issues or dementia or poor life satisfaction or just sudden death.

Speaker 3 (08:00):
It's true.

Speaker 4 (08:00):
Yeah, I know, I know, believe me.

Speaker 2 (08:04):
And even when I try to go to bed early
and practice good sleep hygiene, I rarely hit that solid eight.
What was wrong with me? Oh, I was sleeping myself
into an early grave or not sleeping.

Speaker 4 (08:17):
Or not sleeping.

Speaker 2 (08:18):
Yeah, I was awaking myself into an early grave. But
one third to one half of American adults aren't getting
enough sleep according to those guidelines. Okay, fifty to seventy
million Americans have a sleep disorder.

Speaker 3 (08:31):
Yeah, I have that same stat.

Speaker 2 (08:32):
And one in five Americans aged nineteen to thirty use
alcohol or cannabis as a sleepaid.

Speaker 4 (08:38):
One to five. That's a problem. One in five.

Speaker 3 (08:40):
Yeah, this is not medical advice, but that's a problem.

Speaker 4 (08:44):
It's bad news.

Speaker 2 (08:46):
We are struggling though, like all of this speaks to
a desire for sleep and not getting enough of it,
And so many aspects of our modern society are blamed
for bad sleep. Our screens, artificial lighting, stress, diet, lack
of exercise, and bad sleep has been in turn blamed
for everything. If only we could turn back time and

(09:09):
sleep the deep, unbroken, RESTful sleep of our ancestors. They
must have been so refreshed just laying down to sleep
when the sun dipped below the horizon and gently awakening
as the first rays of light softly caress their faces.

Speaker 4 (09:27):
If only that.

Speaker 2 (09:28):
Were true, If only, But what do we actually know
about how our ancestors slept and what bearing might that
have on our relationship with sleep today?

Speaker 4 (09:40):
Sleep, since it's.

Speaker 2 (09:41):
Behavior, unfortunately does not leave behind a fossil trace, learn
as I learned, I mean, even poop leaves behind.

Speaker 4 (09:48):
A fossil trace.

Speaker 2 (09:49):
We love a copper light, We do love a crop
re lite, crop re lighte crap.

Speaker 4 (09:54):
O, my god.

Speaker 2 (09:55):
But there are a couple of ways that we can
speculate about what sleep might have been or might have
looked like for pre industrial humans.

Speaker 4 (10:01):
Okay.

Speaker 2 (10:02):
One way is by asking how modern day, pre industrial
humans sleep like certain hunter gatherer groups right. And another
is by searching historical writings for mentions of sleep or
the nighttime experience.

Speaker 4 (10:13):
I love this so much. Okay.

Speaker 2 (10:16):
In eighteen seventy eight, a twenty seven year old Robert
Louis Stevenson, still a few years away from his from
Treasure Island and fame. Okay, he was hiking through southern
France with his donkey Modestine as his only companion.

Speaker 3 (10:28):
Oh my gosh, sorry, I love that.

Speaker 4 (10:31):
He was just like, I'm gonna take a gap here,
take my donkey.

Speaker 3 (10:34):
How do you just have a donkey? Just to think
you had?

Speaker 4 (10:37):
You can buy a donkey today. I know that, but
you might have a donkey.

Speaker 3 (10:41):
I couldn't have a donkey. I really like donkeys.

Speaker 4 (10:43):
Don't think my landlord would allow it. We met a
donkey recently.

Speaker 3 (10:46):
It was lovely.

Speaker 2 (10:47):
We have more to talk about with donkeys than I anticipated.
So as Stevenson crossed across the land with his donkey,
he set up camp wherever he felt like, I'm done
for the day, I'll just camp here, he noticed something unusual. Quote,
there is one stirring hour unknown to those who dwell
in houses, when a wakeful influence goes abroad over the

(11:09):
sleeping hemisphere, and all the outdoor world are on their
feet at what inaudible summons.

Speaker 4 (11:14):
Are all these sleepers thus recalled.

Speaker 2 (11:17):
In the same hour to life. Even shepherds and old
country folk, who are the deepest red in these arcana,
have not a guess as to the means or purpose
of this nightly resurrection. Towards two in the morning, they
declare the thing takes place, and neither know or inquire
further end quote.

Speaker 3 (11:34):
So He's like, everyone's awake at two am, bro, did
you know that?

Speaker 4 (11:37):
Did you know that? No one knows why, but it happens.
Everyone's sleeping in the country, everyone in the country. Everyone
is doing it. Everyone's doing it.

Speaker 2 (11:46):
But in fact, this midnight awakening or two am awakening
was only unusual to Stevenson and his contemporaries that were
living in rapidly industrializing areas Okay. For centuries before, many
societies across the globe slept in two chunks, separated by
about an hour or so, by phasic or segmented sleep.

Speaker 5 (12:06):
I learned that Aaron in researching this, and I want
to know everything.

Speaker 2 (12:11):
I can tell you a lot give it to me.
Not everything, Wow, I can tell you a lot.

Speaker 4 (12:15):
No one knows everything. No.

Speaker 2 (12:18):
So evidence for this segmented sleep comes from a huge
variety of sources, and there's of course a bias towards
English language sources, but there is evidence for this beyond
just the British Isles, which is where most of the
sources are concentrated. And many of these references are made
in passing, right, like not about the sleep itself. They're
not like we sleep in this way, right, because who

(12:40):
talks about that, right, Like it's not.

Speaker 4 (12:41):
A part of it's just it's just okay.

Speaker 2 (12:45):
But there would be writings like after my second sleep,
after my second sleep, or after my first sleep, you know,
things that showed that it wasn't particularly noteworthy or like interesting.

Speaker 4 (12:56):
It wasn't like oh I need to highlight this, and
it was like like.

Speaker 5 (12:59):
Hey guys, just so you know, oh I'm sleeping in
two chunks. It was just like like first breakfast, second breakfast.

Speaker 4 (13:05):
Yes, even after my.

Speaker 2 (13:06):
Second breakfast, yeah I went to mordor yeah exactly, yeah,
thank you, you're welcome. The first sleep was often called
something like first sleep, duh or dead sleep.

Speaker 4 (13:19):
Oh well.

Speaker 2 (13:19):
The second was second sleep or morning sleep. Oh, interesting,
and they were split pretty evenly. But I think it's
interesting dead sleep because that's when deep sleep, deep sleep
is happening. We learned last episode.

Speaker 3 (13:29):
We check it out.

Speaker 2 (13:30):
If we did, we did, and the intervening break was
referred to as watch or watching. In the Canterbury Tales,
a character sleeps soon after evening fell and woke up
in the early morning after her first sleep. And then
there was a sixteenth century book called a Treatise of Ghosts.

Speaker 4 (13:47):
Which like why, I want to know more and more?

Speaker 2 (13:50):
Yeah, that refers to quote about midnight when a man wakes.

Speaker 4 (13:54):
From his first sleep.

Speaker 3 (13:56):
Interesting.

Speaker 4 (13:57):
Yeah.

Speaker 2 (13:58):
Even medical books made reference to first and second sleeps.
They recommended that on your first sleep you lay on
your right side, and on your second sleep lay on
your left side.

Speaker 4 (14:09):
I don't know why, I don't. So typical of a
medical textbook to be.

Speaker 2 (14:13):
Like, this is what must be done. You have to
do this, yes on what I know?

Speaker 4 (14:17):
I know it's your feelings.

Speaker 6 (14:19):
Yeah, sorry, I just we know based on science, we
know period the end, okay, But waking up in the
middle of the night, it seems to have been like
a routine thing.

Speaker 2 (14:30):
I mean, if you woke up at two am. Nowadays,
would you be like, oh, okay, well I've gotten my
first sleep, might as well do some dusting and sock mending.

Speaker 3 (14:39):
Sock mending, no one does. Wouldn't know where to begin.

Speaker 4 (14:43):
I doubt it.

Speaker 2 (14:43):
Yeah, I don't know how to sock mend. But that
is exactly what it seems like many people used to do.
Maybe they would lay in quiet reflection, they would get
up to use the bathroom, they would smoke a pipe,
they would start some bread dough, do the washing, even
visit neighbors.

Speaker 5 (14:56):
I'm sorry, the idea of starting bread dough is genius,
I know, right, Like I could have biscuits every morning,
and if I just had a double two sleep regimen, yep,
I might be changing my life after this episode.

Speaker 4 (15:06):
I think you could.

Speaker 2 (15:07):
I think you are entitled to do that, okay. A
text from the seventeen hundred says that students should study
after the first sleep so they're more refreshed, which sounds like.

Speaker 4 (15:18):
A literal nightmare.

Speaker 2 (15:20):
It's not happening, no, no, no, so side note, though,
segmented sleep might help explain why today many people have
sleep maintenance insomnia, where you wake.

Speaker 4 (15:30):
Up in the middle of the night and you're like,
I can't fall back into sleep.

Speaker 2 (15:32):
It's like might be a remnant. People think it's a
remnant of segmented sleep.

Speaker 4 (15:37):
I love this.

Speaker 3 (15:38):
I know I'm gonna have so much more to say
about this.

Speaker 2 (15:40):
Eluginary origins of sleep disorders. Okay, so these by phasic sleepers,
were they going to bed super early in order to
get all the sleep?

Speaker 4 (15:49):
It doesn't seem like it, Okay.

Speaker 2 (15:51):
I think there's this idea that like, oh, suns down,
nothing to do but sleep, right in the olden days,
and it's possible that some people could not afford the
same amount of can or oil lamps as the wealthier classes.

Speaker 4 (16:02):
But like you, most people had a hearth to provide light, and.

Speaker 2 (16:05):
So you could like read, you could you had to
take care of your entire home mending, spinning, read, praying,
other activities by the fireplace. We humans, we are a
social species, and so there was also socializing at taverns
or gathering halls or just at your neighbor's house. So
this is a painting from the eighteen hundreds called Evening

(16:26):
in the Village, and it's like it shows kind of
like this is what evening was like there was. It
was a boisterous time. Often it wasn't just like, oh
the sun's down, time to turn to turn out the lights.
But it's not like people stayed up all hours of
the night. They valued their sleep very much. Sleep was
written about as like a peaceful respite from the worries

(16:48):
and the pain of waking life. A diary entry from
Sarah Cowper in the late seventeenth century said that, with
few exceptions, quote, this family goes to bed between nine
and ten. Yeah, okay, and then this I'm gonna get
this and hang this in my house. There was an
inscription over the parlor of a Danish pastor's like in yeah,

(17:09):
over his parlor in his room, from in the house
of a Danish pastor and from around the same time,
late seventeenth century that said stay till nine you are
my friend. Till ten that is all right, But if
you stay till eleven you are my enemy.

Speaker 4 (17:26):
I love that so much. It's like you got it
go please like you you don't know how quickly yes
this could turn.

Speaker 2 (17:36):
There is an Italian proverb bed is a medicine, and
another proverb that was one hour's sleep before midnight is
worth three after fascinating, And there's a Welsh saying that
men thrive by sleep, not long but deep.

Speaker 4 (17:53):
What is long?

Speaker 5 (17:54):
Like?

Speaker 2 (17:54):
Recommendations on how much sleep to get back then, you know,
historically varied but echo a lot of what we hear today. Okay,
six to eight hours is usually what I've seen. Eight
during the summer and nine during the winter. One guy
recommended a mere three, and you can always you can
already see them moralizing in another guy's belief that quote
nature requires five, custom takes seven, laziness nine, and wickedness eleven.

Speaker 4 (18:19):
Oh mg, Like, calm down, like dude, it's sleep, bro
It's okay.

Speaker 2 (18:28):
But it seems clear that unless you were in the
wealthier classes, you were lucky to get seven hours of sleep. Okay,
that was like a pretty like a norm, okay, and
everyone seemed to do the most that they could to
make their sleep as RESTful as possible. By the sixteenth century,
the bed became the most expensive piece of furniture.

Speaker 4 (18:45):
In the home.

Speaker 2 (18:46):
Oh wow, yep ornate softer ornamented with pillows, the first
thing that newlyweds bought, and the most desirable item in
a will.

Speaker 4 (18:56):
Like if you were left the bed, you were the
first favorite child around me.

Speaker 3 (19:01):
Nephew, yep, Oh wow, that's fun.

Speaker 4 (19:03):
Oh yeah, who's gonna get the bed?

Speaker 2 (19:05):
Who's gonna get the bed? Bedtime ritual was also a
big deal. It might involve removing flies or lice or
bedbugs from bedding and clothes. Like, there's another painting that
I didn't put in here, but it's I'll show you.

Speaker 4 (19:17):
It's very cute.

Speaker 2 (19:18):
It has like they're hunting for either fleas or bedbugs
or whatever.

Speaker 3 (19:22):
Around the bed, around the bed.

Speaker 2 (19:24):
Yeah, the beds were warmed with hot coals or stones
wrapped in rags. Windows were shuttered, and curtains were drawn.
You washed your feet, you combed your hair, and you
set out or had your servants set out your chamber pot.
You donned your nightgown and nightcap if you could afford
one to avoid catching your death from the cold. And

(19:47):
maybe you had a little dream of whiskey or a
few drops of laudanum to help.

Speaker 4 (19:51):
You sleep on the way back then all the way
back then.

Speaker 2 (19:54):
And finally, the head of the household would lead everyone
in nighttime prayers. It seems like a recipe for a
really wonderful, RESTful sleep, right, Like everyone was gonna get
really great sleep. I'm obviously leading you to say no,
I can guess no. I mean, like they must have
slept so much better than today, with like our screens

(20:16):
and our stressful jobs.

Speaker 5 (20:17):
Yeah, but also they're picking lace out of their bed
bro exactly, yeah, exactly, men.

Speaker 4 (20:22):
Their beds are made of what like hey, if you
even had that right? Yeah.

Speaker 2 (20:26):
Many descriptions of sleep from this era use words like
restless or troubled. People across the board were less healthy
than we are today. Trying to get a good night's
sleep when you're sick, or you're injured, or you have
a chronic disease, it can be really challenging. There's a
painting by the artist William Hogarth from seventeen fifty called
Francis Matthew Shuts in his Bed. It features a man

(20:49):
sitting up in his bed vomiting into a chamber pot, Like,
was he commissioned to paint this?

Speaker 1 (20:56):
Like?

Speaker 2 (20:56):
I love that he like Francis Matthew Shuts, was like,
please paint a painting of hatred.

Speaker 5 (21:02):
I'm gonna pay barfing Yeah yeah, I mean we had
a barf bowl growing up next to we had a
barf bucket.

Speaker 2 (21:08):
Yeah, I hated it. But even the sight of it,
it was a popcorn bowl. That's a no. No, I
don't like that very much.

Speaker 4 (21:19):
No, thank you.

Speaker 3 (21:20):
Oh maybe I shouldn't mention that.

Speaker 4 (21:22):
It's in there. We are not cutting that, sorry, mom.

Speaker 2 (21:26):
But France is here. He was lucky to have his
own bed. Yeah, many many it was a It was
a rare luxury. Many of the poor classes couldn't afford
good blankets or comfortable beds, and so the whole family
would sleep in one bed, sometimes with animals.

Speaker 4 (21:40):
Not a great way to get sound sleep.

Speaker 2 (21:42):
I mean, my dog sleeps in my bed, and he's
sometimes really a lot.

Speaker 5 (21:46):
Yeah, Oh my gosh. If the cat or the dog
gets in there, it's a disaster. Though the toddler is
the worst, I will say, I love him.

Speaker 4 (21:53):
I believe that. Yeah, yeah, yeah.

Speaker 2 (21:56):
And this is also like the fact that people people
did not get sleep is evidenced by frequent references to
daytime napping.

Speaker 4 (22:03):
Ah.

Speaker 2 (22:05):
And I think that people did probably get RESTful sleep
from time to time. But I think that, you know,
like we've talked about with the Food of yesteryear, people
tend to romanticize sleep in the past, like oh before
screens before social media, before this, and that there must
have been such unbroken You just had so many hours
a night to sleep.

Speaker 3 (22:24):
What else were you going to do?

Speaker 2 (22:25):
Right, And it sues that's not the case. But with
the Industrial Revolution and the introduction of artificial light, shift
work well lit streets, and the growth of cities and
nighttime entertainment and socializing, segmented sleep began to fade from
memory interesting, and by the turn of the twentieth century
it was a relic of the past, Like Stevenson was like,
I've never heard of this, that's common in the countryside.

(22:48):
And then that just started to slowly fade more and
more and more. How interesting, and this eight eight eight
rule became dominant.

Speaker 4 (22:56):
Eight hours for work, eight for sleep, eight for yourself.

Speaker 2 (23:00):
That was after shifts kind of shrank from like twelve
to eight, twelve to eight. And then it was like,
I honestly I tried to find like more of an
origin than that, Like, was there a scientific guidance that
led with this eight eight eight, And I don't. I
don't think that there was, Okay, I think it was
just like this seems like a nice.

Speaker 4 (23:17):
Easy division, Okay.

Speaker 2 (23:19):
Yeah, And so it was really only much later, like
we forgot about segmented sleep, and it was only in
the nineties and two thousands that people kind of rediscovered it.

Speaker 5 (23:29):
Do we know if when people were getting segmented sleep,
how many total hours they were getting?

Speaker 4 (23:34):
Well, that's what I think.

Speaker 2 (23:35):
I think it was around six, like seven, six to seven, set,
six to.

Speaker 4 (23:39):
Eight, okay, roughly?

Speaker 5 (23:40):
Ok?

Speaker 2 (23:40):
Yeah, yeah, yeah, but it was just like hurts a lot,
it was broken up, right, yeah, yeah, but yeah. So
in the nineties and two thousands is when this idea
of segmented sleep kind of returned, ok the surface with
work especially by Roger Ekirch two thousand and five book
At Day's Close, and there's like an earlier paper two
Seek we have.

Speaker 4 (24:00):
Lost I think.

Speaker 2 (24:02):
And so then these this research led a lot of
people to wonder, you know, is segmented sleep the true
ideal for humans? Has it just been stolen from us
by industry and artificial light?

Speaker 4 (24:14):
Should we be sleeping in chunks?

Speaker 3 (24:15):
Should we?

Speaker 4 (24:16):
Should we?

Speaker 3 (24:16):
Should we?

Speaker 4 (24:18):
The answer is yes, and the answer is no.

Speaker 2 (24:23):
I mean, it seems clear based on a wealth of
historical evidence that segmented sleep and daytime napping was commonplace
throughout much of pre industrial Europe, and in the nineteen nineties,
research psychiatrist Thomas Weir conducted an experiment where he deprived
people of artificial light at night for a few weeks,
over which time their sleep did become segmented.

Speaker 3 (24:44):
I saw that. I saw that people lay in.

Speaker 2 (24:45):
Bed for a bit, sleep for four hours, wake for
a couple and sleep for another four Yeah, but is
it universal segmented sleep?

Speaker 4 (24:53):
What about among humans? Among humans? Yeah?

Speaker 2 (24:55):
What about quote you know pre industrial societies today, like
certain hunter gatherers or a hunter horticulturalist groups, do they
have by phasic sleep?

Speaker 4 (25:03):
Do they? Research is mixed.

Speaker 2 (25:07):
Some groups do seem to have segmented sleep, while others
include So the ones that were studied in this one
paper that I read were living in Namibia, Tanzania, and Bolivia,
so like quite distributory globally. Yep, they don't show any
segmented sleep or frequent napping.

Speaker 5 (25:23):
Okay, So they're just sleeping in one chunk, one chunk,
how many hours be talking?

Speaker 1 (25:26):
Hey?

Speaker 4 (25:26):
Okay?

Speaker 2 (25:27):
So there was a study in twenty fifteen by yeddish
at All and it was published that upset this assumption
that everyone used to sleep in segmented chunks. They found
that the three groups that they observed slept on average
five point seven to seven point one hours of sleep.

Speaker 3 (25:44):
Interesting.

Speaker 2 (25:46):
People went to bed at varying hours, but woke up
roughly the same time.

Speaker 3 (25:50):
Interesting, that they.

Speaker 2 (25:51):
Slept an hour longer in the winter than in summer,
and that they stayed up about three hours after the sunset.

Speaker 5 (25:58):
Okay, so that's why they're getting a little more in
winter because of some I'm going down a little earlier,
down a little earlier.

Speaker 2 (26:02):
Okay.

Speaker 4 (26:03):
Yeah.

Speaker 2 (26:03):
Much of those evening hours were spent socializing, and people
stayed up as long as they found something interesting going
on or they wanted to participate in, like storytelling or
singing or whatever it was. If they went to bed
and something caught their attention, they would get back up, okay,
like they you know, oh i'm gonna I'm not going
to sleep yet. There was no enforced bedtime for children. Interesting,
nor was there shushing if people were loud while others slept, Like,

(26:26):
there was no anxiety about like you're going to wear
them up.

Speaker 4 (26:29):
They're sleeping. It's their sleep time. Interesting, Okay.

Speaker 2 (26:32):
And it's important to remember that these you know, small
scale subsistence societies they're not living history, right, but they
along with these historical sleep analyzes, can provide some interesting
insights into the effects of industrialization on sleep, insights which
I think force us to question some of our current assumptions,

(26:52):
like artificial light negatively affecting sleep duration. If pre industrial
societies living without artificial light or sleeping five point seven
to seven hours a night, what does that mean for
artificial light? Is that the problem? Is it a contributing problem?
Is it a problem in some situations and not others?
But there's these like blanket statements that like it is evil, yeah,

(27:13):
and it's just are destroying You're destroying your sleep?

Speaker 4 (27:17):
Yeah, maybe they are.

Speaker 2 (27:19):
Is it the screens or is it the content that
you're doing? We talked about that scroll. But if we
are sleeping similar amounts as pre industrial societies, both historical
and modern, what's the issue? Like?

Speaker 4 (27:35):
Are we all sleep deprived?

Speaker 2 (27:36):
Have we as a species been sleep deprived for millennia?
I mean, but like really maybe? I mean, when you
consider what we know about sleep in humans, segmented, non
segmented go to beds soon after sunset or later in
the evening. There's one thing, there's one rule that comes out.
We are predictably unpredictable sleepers.

Speaker 4 (27:58):
That's it.

Speaker 2 (27:59):
Flexibility is built into our sleep, especially when it comes
to sleep timing, and that is key to what makes
us human.

Speaker 4 (28:08):
Oh yes, okay.

Speaker 2 (28:10):
Over our species evolutionary history. We spent those evening hours socializing, storytelling,
exchanging ideas, building relationships, philosophizing, becoming more human. Research has
shown that the topics of nighttime conversations tend to be
more abstract and creative.

Speaker 4 (28:28):
Oh, that's so weird and interesting.

Speaker 2 (28:30):
Using things like storytelling. I mean, like think about when
you're like sitting around a fire.

Speaker 5 (28:34):
Right, the weirder things get the longer you're awake. Huh,
even when there's not alcohol.

Speaker 2 (28:39):
Involves even but during the day, the topics are more
you know, they are more like practical immediate concerns.

Speaker 4 (28:47):
How do we solve this problem? Right now?

Speaker 3 (28:49):
What are we going to eat for dinner?

Speaker 4 (28:51):
Exactly? Not like what does dinner mean?

Speaker 3 (28:54):
What is the meaning of life?

Speaker 4 (28:56):
Yeah?

Speaker 2 (28:59):
And maybe in the winter months we wanted to turn
in early, and in the cool summer evenings we hut
around a fire. We stay up late one night and
squeeze in a nap the next day. We have different chronotypes.
We have daylarks and night owls. This is probably a
part of this. It was beneficial to have people sleeping
and awake at times offset from one another in continuous

(29:20):
predator watch, childcare things like that. As a species, as individuals,
we are flexible sleepers, but that flexibility is no longer
serving us well because we live in an inflexible society.

Speaker 5 (29:34):
You have to be at school at seven twenty am
or you're getting a tarty slip yep.

Speaker 2 (29:39):
And this in the society, we are also constantly told
and constantly feel that we are not getting enough sleep,
that it is the source of all of our mental
and physical health issues, and we need to prioritize sleep.
Even though many of us work eight to five or
longer and need to commute and need to find time
for family and friends and self care and healthy home

(30:00):
cooking and exercise and taxes and home maintenance and a
second job, sleep is often the first thing to go,
especially since sleeping long hours is seen.

Speaker 4 (30:10):
As such a moral failing.

Speaker 2 (30:11):
It is yeah so Echoing the tech bros of today
was Thomas Edison, who wrote at the turn of the
twentieth century quote most people over sleep one hundred percent
because they like it that extra.

Speaker 4 (30:25):
Yeah, dare you like it to sleep? Oh my god,
that extra.

Speaker 2 (30:31):
One makes them unhealthy and inefficient. For myself, I never
found need of more than four or five hours sleep
in the twenty four I never dream it's real sleep. Like,
oh my god, Edison, I know, I know. We are
always hearing people talk about loss of sleep as a calamity.

(30:52):
They better call it loss of time, vitality and opportunities.

Speaker 4 (30:55):
God, yeah, I'm so over him.

Speaker 2 (30:58):
Okay, but the thing is he had cots in every
room of his office building so he can do it.

Speaker 4 (31:04):
All the time.

Speaker 5 (31:05):
Are you serious? Because he was only sleeping four or
five hours a night, bro.

Speaker 2 (31:09):
Right, and he was getting the other four or five
around his office.

Speaker 4 (31:14):
Yeah.

Speaker 2 (31:15):
But it is like that sentiment is such an American
business industrial sentiment with Protestant roots, Like if you aren't
working or praying, your commuting with the double for sure.
There's so much toxicity surrounding competitive sleeplessness, like oh, I
only need to get this many hours, And I think
that sacrificing sleep has not only become normalized but idealized,

(31:39):
Like we can function on this, But what is the
truth is that we are set to fail right from
the beginning. Who genuinely feels most days that they are
getting enough sleep and have enough time to do everything
that they want and need to do, all while not
feeling utterly exhausted.

Speaker 4 (31:56):
No one, does anyone feel that way?

Speaker 3 (31:59):
Someone might.

Speaker 2 (32:01):
The medicalization of sleep, where sleep became an object to
be managed or optimized or treated, rather than the restorative
process it once was. This happened over the course of
the Industrial Revolution, and it is in full swing today.
During the eighteen hundreds, sleep grew more interesting to those
titans of industry who wanted to maximize worker productivity and sleep. Capitalism, labor,

(32:24):
and medicine all became intertwined. Medical discussions of sleep took
on a more industrial tone. So it would be like,
the more act of the mind, the greater the necessity
for sleep. Just as with a steamer, the greater the
number of revolutions the engine makes, the more imperative is
the demand for fuel. Okay, it's like, let's talk about trains, steamers.

Speaker 4 (32:45):
Whatever, because that's what we are. Machines. Yeah.

Speaker 3 (32:48):
Yeah.

Speaker 2 (32:49):
Sleep transformed from a personal issue to a matter of
public health, something unruly to be brought to heal. Interesting
you're staying up too late, you're sleeping in too long,
you are going to bed too early, You're wasting It's
the video games, it's the cell phones, it's the you know,
the books.

Speaker 4 (33:07):
Oh, the books.

Speaker 2 (33:08):
Yeah, yeah, although I do I have stayed up way
too late reading books.

Speaker 3 (33:12):
Okay, but when they're really good, you have to.

Speaker 2 (33:16):
And then with the development of the EEG in the
nineteen thirties, it became something that you could objectively measure.
You could assess sleep duration before, of course, but like
this was a whole new dimension, and with that came conflict.
How do you determine sleep quality? Is it based on
the EEG or how well rested someone feels? Is it

(33:38):
based on their duration or whether they feel like they
got enough sleep?

Speaker 4 (33:42):
How do you.

Speaker 2 (33:43):
Define insomnia sleeping less than the recommended amount, or wanting
to sleep more but not being able. To the medicalization
of sleep, which continued over the twentieth century, it led
to this very narrow picture of normal sleep, and with
that in place, medicine could now number one identify pathological

(34:04):
deviations from that norm, and two develop treatments or therapies
with the aim of returning someone to quote unquote normal sleep.
At the same time, the EEG had shown a sleeping
person to be really a world unto themselves, not influenced
by environmental stimuli, meaning that interventions needed to be at

(34:26):
the personal level. They were someone's personal responsibility.

Speaker 4 (34:30):
Ah, this is a you problem. It's a problem. It's
not an US problem.

Speaker 2 (34:34):
Forget the inflexible eight to five. Forget capitalism wanting to
extract every drop of productivity out of their workers. Forget
the moralizing over too much sleep, Forget the extremely narrow
definition of what ordered sleep feels like. If you don't
fit that picture, you either need to change something about
yourself or get a special lamp or take meds or something.

Speaker 4 (34:53):
But it is you.

Speaker 3 (34:54):
It is on you.

Speaker 2 (34:55):
Yeah, And the sad reality is that society is unlikely
to change to accommodate human sleep flexibility, the non pathogenic
variation within our species.

Speaker 4 (35:05):
We have variation.

Speaker 2 (35:06):
It does not mean that you are wrong or broken
or disordered. Yes, and there is disordered sleep, oh, definitely,
not saying that there isn't. Yeah, But what I'm saying
is that like we have do we feel like we
have to fit ourselves into that rigid structure of going
to bed at ten waking up at six feeling super
well rested, not having any naps, because who needs naps?

Speaker 4 (35:26):
Naps are for the lazy, right, I.

Speaker 3 (35:27):
Can't wait to talk more about naps.

Speaker 2 (35:30):
I mean they're also like I didn't get into this,
but there are like there was a big push for
certain companies to adopt like napping flexibility to increase productivity.

Speaker 7 (35:39):
Of course, productivity, yeah, yeah, but also I think it
did have a relationship so much good data that allowing
increases productivity.

Speaker 4 (35:49):
Yes, yes, just like working from home. Yeah.

Speaker 2 (35:55):
But when we when we fail to get that solid
eight hours uninterrupted sleep, when we feel tired, when we
struggle to fall asleep, we might feel like a failure.
And the medicalization of sleep has been a great thing, right.
It has helped us to diagnose and treat people who
are suffering from disordered sleep. It's allowed us to define
what disordered sleep is, and it gives people solutions when

(36:18):
they are especially desperate to actually get some sort of rest.
It's been a real lifesaver when it comes to sleep apnea,
for example. Huge It has helped us to better understand
the negative consequences of sleep deprivation, which are very real
and serious and the importance of getting adequate sleep, but
it has also given us this very narrow definition of

(36:39):
normal sleep, leading us to overpathologize and overtreat, especially with
a direct to consumer marketing of sleep medications that convince
us that we're all over tired or not getting enough sleep.
What even is excessive daytime sleepiness?

Speaker 4 (36:54):
Anyway?

Speaker 3 (36:55):
It actual definition?

Speaker 2 (36:57):
I know that it does, but it's like the commercials
don't say what it is. They're just like, are you tired,
yeah by this medication?

Speaker 4 (37:03):
Ask your doctor about Yeah?

Speaker 2 (37:05):
Exactly, Yeah, I know, exactly, I know. And we start
our obsession with sleep from a very young age, Like
what proportion of kids books are about sleep and needing
to sleep?

Speaker 5 (37:14):
I've read so many of them, so many Hello, I
was tracking my child's sleep yep, yeah yeah.

Speaker 4 (37:19):
And so it consumes it's consumed.

Speaker 5 (37:23):
The parents of newborns, especially right now because there's such
a marketplace, so there's such.

Speaker 3 (37:27):
A baby's weak window, et cetera.

Speaker 4 (37:30):
It makes me like viscerally upset.

Speaker 2 (37:33):
Well, I think because sleep is and should be a
RESTful thing. It's a restorative process, but now it has
become a stressor rather than a stress reliever, and it
creates the cycle where the more that we worry about sleep,
the worst sleep we get.

Speaker 4 (37:49):
Yep. And it's clear that.

Speaker 2 (37:50):
Many people around the world struggle with sleep, myself included.
And maybe those issues are the result of our genetics,
our individual choices, our life stage, our stress levels, are
inflex society, or all of the above. But I feel
like one thing that I really took away from this
and found helpful is that achieving society's definition of ideal sleep.
Quote it night after night after night. It's probably a

(38:14):
losing battle. And variation is normal. It is the norm.
The average is not necessarily the ideal. Just like how
few people actually have twenty eight day menstrual cycles? Who
actually gets eight hours of sleep on average a night
with this much deep sleep and this much rem and
so on and so forth erin maybe you'll tell me

(38:36):
the answer, Well, no, Well tell.

Speaker 4 (38:41):
Me some things anyway.

Speaker 5 (38:42):
I can't wait to especially to get more into naps
and split sleep and how we define good What is
quality sleep?

Speaker 4 (38:50):
What is it? Let me tell you? Who gets to
say that?

Speaker 3 (38:54):
Let me tell you.

Speaker 5 (38:56):
Okay, Since the nineteen eighties, it's estimated that, on average

(39:17):
in the US, sleep duration has declined from closer to
an average of seven and a half hours per night
to just over seven hours, so we've lost half an
hour of sleep in that same time period. The prevalence
of adults who report sleeping less than six hours per
night has increased from twenty two percent to thirty two

(39:41):
percent between nineteen eighty five and twenty seventeen. So more
people are sleeping less than six hours a night, and
on average, we're sleeping thirty minutes less than we used to.
And like you mentioned at the top, as of twenty twelve,
at least it's estimated that between fifty and seventy million Americans,
which if you extraply that out globally, is billions of

(40:01):
people worldwide are estimated to have some type of chronic
sleep disorder. But is that true globally, I don't know,
because there was a paper from the UK that actually
suggested that we haven't changed or at least there they
haven't really changed much in their sleep duration between the
nineteen seventies and now. If anything, sleep duration maybe increased

(40:25):
by a few minutes on average, what is that sleep
duration around that seven and a half hour mark, seven
and a half still around that seven and a half
hour mark, but studies out of Finland and Sweden are
slightly more in line with US numbers that maybe over
the last thirty forty years we've lost a few minutes
of sleep on average per night. Sleep duration is getting
quote unquote worse rather than quote unquote better. Now, there

(40:46):
is no doubt, and I don't want to under emphasize this,
that there are substantial individual and public health consequences of
a lack of sleep.

Speaker 4 (40:54):
Absolutely.

Speaker 5 (40:55):
So you were asking, like, what do we like, why
is this eight hours? Why is this and magic number?
It's really I think it mostly comes from the data
that we have that when people get consistently less than
seven hours of sleep per night, they have some negative
consequences in both the short term and the long term.

(41:16):
But this is a U shaped curve, so we see
that people who are consistently sleeping less than seven hours
or more than eight or nine hours all have long
term health consequences.

Speaker 2 (41:30):
But Aaron like, what about what is normal for one person?

Speaker 4 (41:34):
You know what I mean, It's going to depends exactly.

Speaker 5 (41:37):
And that's why it's always also arranged like it is
all of the literatures like it is arranged. Oh, I know,
And it's a lot of the data on like people
who are getting short duration sleep, the people who are
getting short sleep are actually usually getting less than five hours,
even though they then lump them with people who are
getting less than seven hours. If that makes sense, Yes,
so they get lumped together as this less than seven hours,

(41:59):
but most of them actually getting less than five.

Speaker 2 (42:03):
I mean, I okay, I understand all that, but it
like it again, we are like a last episode, you
talked about how how much sleep one individual person needs
is highly variable and is very an individual the lifetime
and lifetime and blah blah blah. But we're still making
as like these public health guidelines that are like, if
you are getting more than eight or nine hours of sleep,

(42:24):
that's bad for you. But what if someone like there
are people who is that what they need well at
an individual level or in their life stage.

Speaker 5 (42:32):
That's also that also is we think that a lot
of that, especially when it comes to long sleep, like
people who are sleeping longer than nine hours on average,
is that actually reverse causation. Is there something going on
that is a health consequence and the sleep is a
consequence of that health like problem or whatever, rather than
the sleep being the causes of any of these health problems. Yeah,

(42:55):
so we don't really know, but there has even been
studies that have shown just an increase risk of all
cause mortality with sleep less than five hours and with
sleep more than nine hours.

Speaker 4 (43:05):
I mean less than five is very short.

Speaker 5 (43:07):
It's very short exactly, but again they often lump it
is less than seven or less than five, so they
like in these studies, they kind of cruit them in.

Speaker 4 (43:14):
That way, big boxes.

Speaker 5 (43:17):
Acutely, we know that twenty four hours of sleep deprivation
is equivalent to a blood alcohol level of like one
hundred milligrams per DESTO leader, which is like a point
one on a breathalyzer. A reminder that legal limit in
the US is point eight, and you are impaired at
like point oh five for the most part. But the
long term effects are also very serious. So I want

(43:38):
to kind of get into a little bit of what
we see these like, what are these? Okay, I said
there's negative health effects of short sleep, what are they really?
We definitely see increases in fatal accidents, especially car accidents,
but also workplace accidents, whether that's like making mistakes at
work that put other people at risk, or getting your

(43:59):
arm cut or like having an accident in your workplace,
and these are largely driven by impairment in performance and
awareness that comes with this sleep deprivation. Right, we talked
about how it affects your ability to react to things.

Speaker 3 (44:13):
And all of that attentiveness exactly.

Speaker 5 (44:16):
But we also see big increases in risks of cardiovascular disease,
so that's heart attack, stroke, heart failure. We see increases
in high blood pressure, we see increases in diabetes. We
don't know the exact mechanisms of this, but we think
that it's related to effects on our metabolism as well
as insulin resistance, and then maybe something about like variations

(44:41):
in blood pressure and things that happen with sleep. So
if we're getting short sleep again that less than five
ish five to seven hours of sleep per night, we
see increases in risk of all of these diseases. We
talked in our Circadian Rhythm episode about the very strong
associations between shift work, which tends to result in sleep
deprivation and increased risk of cancers, and we don't really

(45:03):
know the mechanisms there, but we also see we know
that sleep has a huge effect on our immune system,
and so a lack of sleep can increase inflammatory markers
and things like that, and we see sleep affected in
a variety of ways in a variety of psychiatric and
neuropsychiatric disorders, including depression, bipolar, anxiety, and dementia. Sleep architecture

(45:27):
is hugely affected in dementia is a consequence exactly. We
have no idea, right, but we know that it's like
very involved.

Speaker 2 (45:36):
That's like, and that's what Yeah, there's like, ah, this
is where the headlines I feel like are really frustrating
because it's like, we know, for instance, in Perkinson's disease,
that sleep disruption is one of the earliest symptoms, yes,
and it's usually.

Speaker 4 (45:48):
Something that you only look back on and go, oh yeah.

Speaker 3 (45:51):
Yep, just like constipation actually.

Speaker 4 (45:53):
Just like constipation.

Speaker 2 (45:55):
But I feel like there are headlines that then suggest
that like if you aren't if you are getting sleep,
you are.

Speaker 4 (46:01):
At risk of these disorders.

Speaker 2 (46:03):
Right, And it's like, is that is that true? We
don't does it play right?

Speaker 4 (46:07):
Yeah?

Speaker 5 (46:08):
Yes, you're right, Like we don't really know, especially when
it comes to like causal versus consequence and things like that.
I also do want to just point out that there's
also a lot of data that shows, especially in the US,
that there's huge socioeconomic and racial disparities in who is
getting quote unquote enough sleep.

Speaker 2 (46:25):
Who's having to work two jobs, three jobs, and how childcare.

Speaker 5 (46:28):
It's like, right, yeah, so who is at risk for
sleep deprivation or having short sleep? And because we know
that short sleep is associated with a lot of the
same health outcomes that we see huge disparities in terms
of race and socioeconomics when it comes to things like
heart disease, diabetes, blood pressure, these things that are also

(46:49):
related to sleep. Like, you can't really disentangle those things
very easily. But there's a few big caveats, I feel
like to all of this, and you pointed out so
much any of them already in what you were talking
about first, is that whether we have this number of
seven to eight hours, because again that is what this

(47:09):
kind of large scale data all converges on that less
than seven ish hours, more than eight ish hours, we
see more negative health consequences. So that means that the
ideal for adults is seven eight ish hours. Does it
have to happen all at once or can a split
sleep schedule ken cs does or naps or repostas can

(47:30):
that count?

Speaker 4 (47:31):
And there's not a ton.

Speaker 5 (47:33):
Of data on this, but the data that has actually
looked at it, studies that have looked at like a
split sleep schedule or looking at naps, they absolutely count.
So it is not about getting seven uninterrupted hours of sleep.
It is seven total hours of sleep in a twenty
four hour period. And we know that, especially in the

(47:53):
cases of things like shift work where you can't avoid
the fact that you only have this number of hours
between work or whatever, that having naps can have a
huge increase in performance, decrease in accidents, like it really
improves outcomes. But the other thing is that if we
need seven to eight hours, it needs to be good

(48:15):
quality sleep too. But all of the data that we
have on the negative effects of sleep really rely largely
with a few exceptions, on total duration of sleep. It's
all about sleep deprivation, right where it's like, we know
that if you're not getting enough hours of sleep, you're

(48:36):
having these negative health income outcomes. We don't have nearly
as much data on what makes.

Speaker 4 (48:42):
Good sleep good.

Speaker 2 (48:43):
Sleep, Okay, but I have like just a question or
a thought to because we're talking about how sleep deprivation, duration,
et cetera. And I think that there's and you pointed
this out that there are people who are at risk
of sleep deprivation because of life, life circumstances, because of jobs,
because of et cetera, like all these different aspects. So

(49:03):
they are not able to achieve eight hours.

Speaker 3 (49:07):
Eight hours at least not eight hours continuously.

Speaker 2 (49:09):
Right, they like, let's say those eight hours are not
available to them. But there's a difference between that person
who's sleeping six hours or is there a difference, I
guess is my question between that person who can only
sleep six hours because of external life circumstances versus someone
who can only sleep six hours even though they want
to and have the space to sleep eight.

Speaker 3 (49:28):
That's a great question, Aaron.

Speaker 5 (49:30):
We don't have that level as far as I found
in the literature. We don't have that level of disentanglement.

Speaker 2 (49:35):
Because I feel like this is where some of it
comes into play. Whereas like not being able to achieve
those eight hours is it why?

Speaker 4 (49:42):
Right?

Speaker 5 (49:42):
Is it because you are dealing with insomnia and you
are trying to fall asleep but you cannot Or is
it because you get home at ten pm and your
next shift starts at five am?

Speaker 4 (49:51):
Yeah?

Speaker 5 (49:52):
Right, I don't know. We don't have it because again,
these are like, yeah, it's a really good question. It's
just so much because those are two different that is,
two different issues that we're dealing with, and yet the
outcome is the same. You are getting less hours of sleep.

Speaker 2 (50:05):
You're getting less hours. But is the consequence of that
outcome like does that.

Speaker 5 (50:09):
Might have the same effect as far as far as
we know on the big scale data, yes, just period,
it's like you're not getting enough hours.

Speaker 4 (50:16):
Ok, well, let's talk about quality. So how do we.

Speaker 3 (50:18):
Define quality sleep? According to Big Sleep.

Speaker 5 (50:21):
Just kidding, I just want to call that's the National
Sleep Foundation, but you know everyone's.

Speaker 3 (50:25):
Into Big so and so.

Speaker 5 (50:27):
Yeah, yeah, So according to the National Sleep Foundation, there
was a paper I think it was from twenty seventeen.
I'll have to check my notes, but they came out
with this big guideline basically on like how are we
going to define quality sleep?

Speaker 3 (50:39):
How do we actually do this? What counts as quality
good quality sleep?

Speaker 5 (50:44):
And I'm not going to go nitty gritty in the details,
but you can read the exact paper to really because
they go line by line on like what do you
need to have for this to be good sleep? Or
what metric would qualify as poor quality sleep. The gist
of it is like big scale, we should be falling
asleep relatively quickly, which means within fifteen to twenty minutes,

(51:05):
not too quickly, Like if you're falling asleep within two
to five minutes or less than eight minutes, that might
be a sign that you had sleep deprivation and so
your sleep drive is too strong, so you're falling asleep
too fast.

Speaker 4 (51:16):
I'm sorry, annoy it's just like I don't know.

Speaker 2 (51:19):
I just am still on the whole like should, should, should,
here's the ideal. You are wrong lett, you don't do this?

Speaker 3 (51:26):
What can we keep going? Because it's gonna get even better? Please,
meaning you're gonna get even.

Speaker 4 (51:29):
More I'm annoyed. Yeah.

Speaker 5 (51:32):
We we should be falling asleep relatively quickly. We should
not be waking up more than once per night. Certainly,
we should not be awake for more than twenty minutes
total after we fall asleep.

Speaker 3 (51:45):
Just let me finish and then we'll get into it.

Speaker 5 (51:48):
Our rem sleep. This gets a little more into sleep
architecture and who's able to measure this? Our rem sleep
should be about twenty to thirty percent of our total
sleep duration, and our deep sleep should be about fifteen
to twenty percent. Okay, fifteen to twenty fifteen to twenty percent. Now,
these are the consensus guidelines. This is the consensus. These
are the average that they came to. Even in this document,

(52:11):
they have these like graphs for each of these and
they have dotted like it's like a barograph where it's
like filled in versus dotted versus blank, and the dotted
area is the quote unquote disagreement. And that's like most
of these graphs, meaning that even among the experts they
could not agree on like should it be twenty percent
or should it be thirty percent? Should it be fifteen minutes?
Or should it be twenty minutes? Like we really don't know.

(52:33):
And yet they are trying to come up with these
guidelines on how what counts as good quality sleep? How
are we going to measure this in like clinical studies?
Not how should you be measuring it on your rings
and things?

Speaker 1 (52:45):
Right?

Speaker 2 (52:46):
Okay, okay, can I there's one more?

Speaker 5 (52:48):
There's one more, because this I think is so important
in the context of everything that you're talking about.

Speaker 4 (52:52):
Huh.

Speaker 5 (52:53):
According to these guidelines, if you are napping during the
day and you're not a baby, that is an indicator
of poor sleep quality, especially if you're napping for more
than like ninety two one hundred minutes aka one full
sleep cycle.

Speaker 4 (53:09):
Okay, okay, go ahead. So here's the thing. Uh huh?
Where do I begin?

Speaker 3 (53:18):
Where do you begin?

Speaker 2 (53:19):
They have different all of these different metrics.

Speaker 4 (53:21):
Uh huh.

Speaker 2 (53:22):
And this is what you should do, and this is
what you shouldn't do. Yes, And why shouldn't you do
those things? That means that you get bad sleep? What
does bad sleep mean? How is this measured? What about
the piece? What about the picture?

Speaker 4 (53:34):
All of all of these things together? Correct? Why is
napping bad?

Speaker 2 (53:38):
That feels very like industrial revolution more moralizing?

Speaker 5 (53:43):
And you should not be awake for more than twenty
minutes at night. So that means that a split sleep schedule,
a bi phasic sleep schedule, would be an indicator of
poor quality sleep according to these guys.

Speaker 2 (53:53):
Lass, I don't it just there's something about sleep that
makes me feel So I think maybe because like I
feel such anxiety about sleep that I am because all
of these things, like I'm not getting good quality sleep
on the center these metrics. But there are days when
I feel great and I feel super well rested. But
I'm like, but is this going to make me more
vulnerable to infections? Or am I going to get dementia

(54:14):
or whatever? All these different things, and it just feels
like so much pressure to do.

Speaker 4 (54:19):
The right thing.

Speaker 2 (54:20):
Yes, and there's no there's no solution. There's like very
few solutions, or there's solutions in the forms of pharmaceuticals
which like work for some people, don't work for.

Speaker 5 (54:29):
Others, and most of them are highly addictive where you
cannot then sleep without it. They're also altering our sleep architecture,
Like there's a lot of downsides of a lot of
the medicines that we use to help people sleep, and
most of them are not indicated to be used in
the long term.

Speaker 2 (54:45):
At the same time, like there is okay, at the
same time, many people aren't getting the sleep that they
should be getting, and part of that is maybe it's
individual choices, but part of it is also because because
of the had the way that sercie sience function. Yep,
and so's there is no solution, right, but it's so

(55:07):
I just think.

Speaker 5 (55:08):
That these guidelines in particular are so interesting if we
really pull back and look at this like big picture
of evolutionary context, and they still largely are driven based
on data about sleep deprivation and things, because we see
that like if people are sleep deprived or they're not
getting a lot of deep sleep or things like that
during a sleep, then they're going to have say an

(55:30):
increased or rather a decreased sleep latency, so like the
next night, they're going to fall asleep a lot quicker, right,
And so that is where it's not like this data
comes out of nowhere.

Speaker 4 (55:38):
They're not making it up, but it is.

Speaker 5 (55:41):
It's all very messy, and it's all based on how
we live today. And I read one paper that was like, honestly,
to look at how humans sleep today is like looking
at lab rats in a lab. It's not like looking
at natural rats in their habitat because we live in
labs basically, which I thought was so inter well, And.

Speaker 2 (56:00):
So much of the sleep treatments or how sleep disorder
is defined or characterized, or how people feel like they're
not getting enough sleep is because I can't fall asleep
at this time the way that I that everyone else
thinks I should, yes, right, And a lot of the
treatments then, like I was, I didn't talk about any
of this, but there was a book that I read
that discussed this and did a lot of case studies
and kids who like, there were a few kids that

(56:22):
were like I can't they could not stay awake during
the day, and their tactic was to make them go
exercise during that time. It would be like you have
to walk on a treadmill, you have to go on
this exercise bike instead of like letting.

Speaker 3 (56:35):
This kid take a nap.

Speaker 5 (56:36):
Oh my gosh.

Speaker 2 (56:37):
And same thing, like somebody was like I had to
quit my job and find a more flexible job because
I could not wake up or I could not sleep
it whatever, it is, right, But it's like in those
situations or like I was on this medication that allowed
me to sleep during these times when society was telling
me to sleep.

Speaker 4 (56:54):
Yep, that I had to sleep then.

Speaker 2 (56:55):
But it's just like it shows such a bias towards
what we diffrene is ideal sleep, right, the way that
medicine and and capitalism are.

Speaker 5 (57:05):
Yeah in hand in this oh one hundred yeah, it's
so it's so so so interesting, Like I I I
feel like this has changed the way that I think
about sleep totally.

Speaker 3 (57:16):
It was really interesting.

Speaker 5 (57:17):
But at the same time, at the same time, there
are quite a lot of sleep disorders. Yes, and again,
we do need sleep, and it seems that on average,
on average, we need somewhere between seven and eight hours
as adults.

Speaker 3 (57:32):
You could maybe say six to eight hours.

Speaker 4 (57:34):
I just find that so interesting.

Speaker 2 (57:35):
Yees, six six eight, But like historically and then you
know pre industrial societies today getting getting five to seven
or five point seven.

Speaker 4 (57:45):
Yeah, so that's pretty close to six to seven, but like.

Speaker 2 (57:47):
Six to seven today is like that would be low
I think in medicine.

Speaker 5 (57:52):
In medicine, that's usually considered pretty reap. But you were
talking about short sleep being less than seven. Well, again
because they lump most of them are getting less than five.
I feel like seven is the number that is most common.
So you're right, six would be probably considered.

Speaker 4 (58:05):
Not enough today. Yeah, but.

Speaker 5 (58:09):
It's all on average too, right, And if they're getting
more in the winter but we're not, because why is
it the fluoresza lights, I don't know. It's a little
bit of a mess. But there are a lot of
sleep disorders and they're all really important and they all
deserve their own episode, which we're not doing narklepsi.

Speaker 2 (58:24):
We will be doing insomnia, we will be doing sleepy,
We should do that one soon.

Speaker 5 (58:30):
We should because we can, like you're saying, kind of
group those those are three of the big categories really,
or they fit into three categories of sleep disorders. So
I'll mention a few of the biggest ones just so
that people know, like how we define these big scale
Insomnia is probably the first one that people think of
if we think of like sleep disorder. Maybe I don't
know a lot of people, and there's different ways to

(58:52):
define it. If you're dealing with, you know, a little
bit of insomnia, meaning like a cute insomnia jet lag
versus chronic insomnia, But usually it's either not being able
to fall asleep or not being able to stay asleep
once you're asleep, which again is so interesting in the
context of this idea.

Speaker 4 (59:06):
Of faces sep so omnia.

Speaker 5 (59:08):
Yes, yeah, And it's estimated that at least in the
US anywhere from ten to twenty percent of adults have
either chronic insomnia or intermittent issues with insomnia, so chronic
twenty percent, intermittent. We talked again in our Circadian Rhythm
episode about circadian rhythm sleep disorders, which is you know,
whether you whether it's just a mismatch between what your

(59:29):
job or your environment requires, or because you have to
do shift work, whatever it is, whether you're a teenager
and your school starts at seven am, but you have
shifted to be a night owl, So that that's a
whole nother set of sleep disorders. Then there are sleep
related breathing disorders like obstructive sleep apnea, which and this
is where I think we can get a lot of
data about sleep quality because sleep apnea is not necessarily

(59:53):
changing your sleep duration at all, but it results in
fragmented sleep because you are frequently arousing during sleep and
you're basically going from non rem sleep to awake for
very short periods. You might not even ever be aware
that you're doing it, but your brain is doing it
on top of the fact that you are not breathing,
so your body and brain are not getting oxygen alert alert.

Speaker 4 (01:00:18):
That's why you wake up.

Speaker 5 (01:00:20):
And so that has huge consequences, especially on things like
cardiovascular disease, high blood pressure, diabetes, metabolic syndrome, all those things.
So obstructive sleep apnea is a very serious disorder, and
it's estimated to effect close to fifteen percent of adults
in the US. Fifteen percent such a high I know number.
And then there's the opposite end of the spectrum, which

(01:00:41):
are disorders of central hypersomnia, like narcolepsy, which is the
most well known, and that results in sleep attacks during
the day and this interrupted more fragmented and less consolidated
sleep at night. We also see, especially with narcolepsy, we
see what's called cataplexy, where you have the muscle atonia.

Speaker 4 (01:00:59):
The we usually associate it with rem.

Speaker 5 (01:01:01):
Sleep that is associated by emotional arousal or sometimes just
happens randomly inappropriate times, meaning not while you are asleep.
And then we have there's other hypersomnias as well. And
then there's things like parasomnia's which we see with things
like Parkinson's, or we have sleep related movement disorders like
restless leg like. There are a lot of sleep disorders

(01:01:23):
that are affecting people's duration and quality of sleep, even
though we don't have great metrics to kind of look
at all of that. Yeah, and then what I think
is interesting is part of what you were saying, Aaron,
is that there's often a disconnect between what our watch
says and what we feel.

Speaker 2 (01:01:41):
What feels normal, and how we can I feel like
that is something that I struggle with sometimes, like, is
the tiredness I'm feeling excessive?

Speaker 4 (01:01:49):
Is it excessive daytime sleepiness?

Speaker 5 (01:01:50):
Or am I just like is it fatigue which is
different from sleepiness?

Speaker 2 (01:01:55):
Or am I just like you know it's a down
period or whatever?

Speaker 4 (01:02:00):
Yeah, there are so many things.

Speaker 2 (01:02:01):
Am I just sitting at my desk for twelve hours
a day? Right?

Speaker 5 (01:02:04):
And we can often see big disconnects in terms of
how much sleep someone is getting if we're measuring it,
and how much sleep they feel like they're getting, how
rested they feel in the morning. So, like, all of
that is is hugely important. And the less sleep that
we get actually, especially acutely, we know this more from

(01:02:26):
acute data. We are less good at recognizing our own deficits.
Much like with alcohol, Right, once you're drunk, you don't
realize how drunk you are. Once you are sleep deprived,
you don't necessarily realize how sleep deprived you are. Interesting, Yes, especially,
we have a lot of data on that in the
acute term.

Speaker 4 (01:02:45):
Can you say more about that?

Speaker 5 (01:02:46):
Yeah, So, like someone who has been sleep deprived for
let's say twenty four hours or something like that, we
know that they're like blood, It's like they are drunk, right,
But they think often that they are perfectly capable of
making sound and rational decision and that there is no
impairment in their decision making. And it's not because they
don't logically know that it that sleep deprivation affects them.

(01:03:08):
It's because in that moment there's like a disconnect. You
are not recognizing your own impairments, probably because of those impairments, right,
Like that's why you have to hide the bowl of
keys so that you even though you know you shouldn't
drink and drive, someone is going to grab those keys,
because once they are drunk, they're impaired in their.

Speaker 4 (01:03:26):
Decision make rational decision making, right.

Speaker 2 (01:03:29):
Okay, So I have a question about sleep deprivation and trends.

Speaker 4 (01:03:33):
So like one night is not.

Speaker 2 (01:03:35):
Sleep deprivation if you can get sleep the following like
it is, it's a cute sleep deprivation. But like, I
guess I'm wondering about, like what is chronic sleep deprivation
When we talk about, oh, you should be getting this
many hours of sleep and night, is that average over
months over you know?

Speaker 5 (01:03:49):
Yeah, it's a good question. I don't have a perfect
answer for that. We have I think more strict definitions
on that. If we're talking like insomnia, right, so like
chronic insomnia would be like there are months, there's like
certain thresholds, and like they're kind of arbitrary, but like
someone had to make a threshold, I guess, But yeah,
I don't. I don't have as much of like a
on average.

Speaker 4 (01:04:09):
It's just on average. Sorry, I know average is not ideal.
Blah blah blah.

Speaker 5 (01:04:16):
Yeah, yeah, so it is, it's all I mean, I
I think, what is my conclusion, Aaron, I don't know.

Speaker 4 (01:04:28):
Sleep?

Speaker 5 (01:04:28):
I think I think we learned from last week's episode
that sleep is quite essential. Yeah, and we know from
sleep deprivation and short sleep and these and these that
sleep is essential and maybe many of us aren't getting
enough of it. Maybe on average we're doing okay, But

(01:04:49):
a lot of this is probably not down to individual stuff.

Speaker 1 (01:04:53):
I know.

Speaker 4 (01:04:54):
It's I wish that.

Speaker 2 (01:04:57):
I had like spend more time trying to articulate this
because they're many different components.

Speaker 4 (01:05:01):
Question though, what is excessive daytime sleepiness? What's the threshold?

Speaker 5 (01:05:04):
Yeah, so there's like different scales that you can use
to kind of define it. So there's like the one
that I use most often, in clinic is called the
Epworth Sleepiness Scale, and so it's like a set of
questions that you ask on like how likely would you
fall asleep in these scenarios?

Speaker 4 (01:05:19):
And if you score I think it's like a ten
or greater.

Speaker 5 (01:05:23):
That's like that would be considered excessive compared to like
there are some scenarios like if you lay down in
the afternoon to take a nap and you are able
to fall asleep, that's not necessarily excessive sleepiness if that's
the only thing. But if you are like falling asleep
while you're stuck in traffic, and you could fall asleep
while you're reading a book, and you're going to fall
asleep no matter what. If you sit down to watch
a movie or you're a passenger in a car, Like

(01:05:44):
those are the kinds of things, And I think there's
other like thresholds in other ways to kind of define
it too. Then there's other tests that you can use,
like the multiple sleep latency test how quickly do you
fall asleep? Or the I forget the name of it now,
but it's like you sit in a quiet room and
how long can you stay awake for.

Speaker 4 (01:06:02):
Just by yourself? Yeah, boy, thank you?

Speaker 5 (01:06:05):
And so based on like time, you know, there's like
averages of what is typical versus what would be disordered.
So that's like kind of how you make those those distinctions.

Speaker 4 (01:06:14):
I just find that there's so much, like, ugh, there's
so much.

Speaker 1 (01:06:18):
I know.

Speaker 4 (01:06:18):
Also, John falls asleep in literally under ten seconds.

Speaker 3 (01:06:21):
I mean I maybe ten seconds, but I'm very fast.

Speaker 4 (01:06:24):
Yeah, it takes me a long time. I wish I
could nap. I can't. What does that mean? What does
that mean? Does that mean? But I mean I think
that it's all like I don't know, and.

Speaker 5 (01:06:34):
So much too goes into it, right, Like there's I
didn't even get into this, but there's like data on
like what you eat for dinner, what time you eat dinner,
the concentration of glucose versus fats versus this in your food,
how much caffeine you're drinking, what time you're drinking that caffeine,
how your individual body metabolizes that caffeine. Are you drinking alcohol?
Did you drink alcohol yesterday?

Speaker 2 (01:06:52):
There is so much like are you stressed, do you
have stressed?

Speaker 4 (01:06:57):
Do you live next to traffic?

Speaker 2 (01:06:58):
Like there are so many things that are working against us,
and at the same time, it's also like, I think
part of what's working against us is this emphasis on
like the right.

Speaker 5 (01:07:09):
Sleep, the right the quote unquote right. And I think
that that really does. I think that you're very right
that like when we blanket statement anything, which like in
some regards we have to from a public health perspective,
absolutely give this guidance sleep is a public health issue.

Speaker 4 (01:07:23):
It is.

Speaker 5 (01:07:23):
But does that mean that every single person needs to
be getting exactly seven hours every night?

Speaker 3 (01:07:28):
No, that's not what that.

Speaker 5 (01:07:30):
Means, right, But it's very hard because then that's an
individual level communication of like how how rested do you
feel in the morning, are you having sleepiness? Are you
having issues at work? Like how do you feel like?
And that's not something that you can do in a
set of public health guidance, right.

Speaker 2 (01:07:44):
I think it just it makes a further creates this
disconnect between being able to ask yourself how you feel
about the sleep that you're getting and what you are
comfortable with, and then also like what is the ideal
are you achieving? That you don't look like this picture
of normalcy? And it's this nonpathogenic variation, yes, human species
that does exist, and that also exists to our detriment

(01:08:07):
because of the way that society functions.

Speaker 3 (01:08:09):
Right, drop that mic.

Speaker 2 (01:08:14):
Tell them where they can learn more many places. Okay,
actually really there were some very interesting parts of the
book that I read called The Slumbering Masses, Sleep Medicine
and Modern American Life by Matthew Wolfmeier, and then that
at at Day's Closed Night in Times Past by Roger E. Kirsch,
And then that paper by yettish at Off from twenty fifteen,

(01:08:37):
Natural Sleep and its Seasonal Variations in three Pre Industrial Societies.
And then there's a paper by Schultz and Salzarulo twenty sixteen,
The Development of Sleep Medicine A Historical Sketch, and many
more on the website.

Speaker 4 (01:08:51):
Actually not that many more.

Speaker 3 (01:08:52):
For this one, I had a number of papers.

Speaker 5 (01:08:55):
One that I really liked was from two thousand and
seven from Cellular and Molecular Life Signs that was titled
Sleep and Sleep Disturbance, Biological basis and Clinical Implications. There
was one from Sleep Medicine Clinics from twenty twenty four
that was titled Sleep Deficiency, Epimiology and Effects. There's another
one that I actually really enjoyed from twenty twenty four
Nature Human Behavior that was titled individual sleep need is

(01:09:16):
flexible and dynamically related to cognitive function.

Speaker 4 (01:09:20):
How about that?

Speaker 3 (01:09:21):
How about that?

Speaker 4 (01:09:21):
But we have a lot.

Speaker 3 (01:09:22):
More on our website, this podcast will kill You dot com.

Speaker 4 (01:09:24):
Under the episode's tab, we do a.

Speaker 2 (01:09:26):
Big thank you to Kelly again for taking the time
to share your story with us. We really appreciate it.

Speaker 3 (01:09:31):
Yeah, we do, We really do.

Speaker 4 (01:09:32):
Thank you.

Speaker 2 (01:09:33):
Thank you to Bloodmobile for providing the music for this
episode and all of our episode.

Speaker 4 (01:09:37):
Yes, thank you so much, so much.

Speaker 5 (01:09:42):
To Boomer and Sabrina and Tom and Leanna and Brent
and Pete and everyone. I've read exactly right, Corey, Jessica, Christina,
There's too many, there's everyone, everyone.

Speaker 4 (01:09:53):
Thank you, thank you, thank you.

Speaker 2 (01:09:55):
I had a big thank you of course, to our listeners,
to our watchers, to anyone who enjoys this podcas as
in anyway or doesn't enjoy it and just has to
watch it for a class, thank you for watching it.
We really appreciate it. And a big thank you also
to our patrons. Your support really does mean the world
to us.

Speaker 4 (01:10:12):
Thank you. Well. Until next time, wash your hands, you
feel the animals, and get some sleep.

Speaker 3 (01:10:17):
Get some sleep.