How Did You Sleep Last Night? Understanding the Fascinating Science of Sleep

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Text: Wednesdays with Woodward (registered trademark) Webinar Series. 

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JOAN WOODWARD: Hi, there. Welcome. Thank you for joining us. I'm Joan Woodward, President of the Travelers Institute, the public policy educational arm of Travelers Insurance. Welcome to our webinar series. As you know, we did the pandemic pivot like everyone else. And we're hosting these virtual sessions to try to bring very important and interesting issues, not only for your business, but for your personal life. 

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So before we get started, I'd like to share our disclaimer about today's program. 

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Slide, Wednesdays With Woodward (registered trademark) Webinar Series. How Did You Sleep Last Night? Understanding the Fascinating Science of Sleep. Logos. Travelers Institute (registered trademark). National African American Insurance Association. Insurance Association of Connecticut. Master's in Financial Technology (FinTech) Program at the University of Connecticut School of Business. MetroHartford Alliance.

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I'd also like to thank our partners today, so the National African American Insurance Association, the Insurance Association of Connecticut, the Master's in FinTech Program at UConn and the MetroHartford Alliance. Thanks for your partnership. 

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Slide, Forces at Work (service mark). Travelers Institute (registered trademark). Travelers. A bullet point list. Text: Workers' Compensation. Risk Management and Insurance. The Labor Market. Leadership and Management. Talent and Development. Employee Well-Being. 

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Today's session is part of a brand-new initiative at the Travelers Institute called Forces at Work. We launched this platform back in January to help all of us navigate the modern-day workforce and the issues that we face as leaders within our organizations. And you'll see a few of those issues here on the screen. 

One area of programming looks at how we can all lead healthier lives so we're able to bring our best selves to work and, more importantly, home to our families. We've completed programs on nutrition, exercise and stress in recent months, and today, we're adding to that list with sleep. Sleep is a topic that will be familiar to many of my colleagues here at Travelers.

About a year ago, our CEO, Alan Schnitzer, brought today's webinar guest into Hartford to speak to leaders across our company about sleep. And I think I can safely say that the learnings went well beyond what most of us probably would have imagined. So last Friday was World Sleep Day, which is an opportunity to promote sleep health.

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Slide, Speakers. Pictures, names, and titles. Text: Joan Woodward, Executive Vice President, Public Policy; President, Travelers Institute, Travelers. Dr. Matt Walker, Professor of Neuroscience, University of California, Berkeley. 

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To do our part, I'm so pleased to have Dr. Matthew Walker, a Professor of Neuroscience at the University of California, Berkeley, as my guest today. At UC Berkeley, Dr. Walker studies the impact of sleep on the human health and also about diseases. He's the author of The New York Times and international best-selling book, Why We Sleep, Unlocking the Power of Sleep and Dreams. Dr. Walker's Ted Talk, “Sleep is Your Superpower,” has garnered more than 20 million views. 

He's received numerous funding awards from the National Science Foundation and the National Institutes of Health. And in 2020, Dr. Walker was awarded the Carl Sagan Prize for Science Achievements. Dr. Walker, welcome to the program. We are so excited to have you here.

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Joan and Dr. Walker appear in a split screen on a video call. 

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MATTHEW WALKER: Joan, thank you so much for that kind introduction, and also just allowing me to speak the voice of sleep here to the audience. It's such a privilege. So, thank you. 

JOAN WOODWARD: Absolutely. All right, let's talk about some background first, then we're going to get into some tips and tricks. As you all know, I like to provide practical advice you can implement today and tomorrow in your lives. So we're going to talk about that a little later in the program. And we're going to take your questions. Feel free to put them in the Q&A. So to kick things off, Matt, how did you sleep last night?

MATTHEW WALKER: I could reach for my phone and actually check my sleep tracker. Last night was, I think, a pretty good night. I was adherent to my very maniacal regiment of regularity, and I woke up once throughout the night and fell back asleep fairly quickly. I did use, perhaps, some of the tips and tricks that we'll speak about regarding those 3:00 a.m. awakenings, but for the most part feel very well refreshed and fortunate to have had a good night of sleep.

JOAN WOODWARD: OK, so in your book, you call yourself, quote, "the accidental sleep researcher." What drew you into this field, and what's kept you here for 20 years?

MATTHEW WALKER: Yeah, I think many of us in the field are accidental sleep scientists. No one, when you were three or four and the teacher goes around the classroom and says, what would you like to be when you grow up? No one rockets their hand up and says, I would love to be a sleep scientist. It's just not what you do.

And for my Ph.D., I trained in medicine for five years then did a Ph.D. And I was trying to separate individuals on the basis of what type of dementia that they had very early in the course. And I was measuring their brain wave activity. And I was failing miserably. I was getting no good results whatsoever.

And then one weekend, I was reading about the dementias. And I realized some of them would eat away at the sleep centers, and others would not. They would leave those parts of the brain untouched. So I realized I was measuring my patients at the wrong time, which is when they were awake. I should be measuring them when they're asleep. Started doing that, got some fantastic results.

Then wanted to ask the question, I wonder if the sleep problems that these people were having, they're not maybe a symptom of the dementia. I wonder if it's an underlying cause of the dementia. And at that point, I read everything I could about sleep. I fell in love with this topic of sleep. It is a love affair that's lasted me over 20 years. I think it's the most beguiling topic in all of science, but I'm desperately biased. And I cannot imagine wanting to study anything else in science or medicine.

JOAN WOODWARD: Wonderful. By the way, there's a lot of us who accidentally fell into insurance and have stayed the rest of our careers. So we get it. Let me ask you a question around needing less sleep, because it seems like we should have evolved already to needing less sleep. And why haven't we?

MATTHEW WALKER: That's a great question, because when you think about it, sleep is arguably the most idiotic of all evolutionary behaviors. Because when you're asleep, you're not reproducing. You're not finding a mate. You're not foraging for food. You're not caring for your young. And worst of all, you're vulnerable to predation.

So on any one of those grounds, sleep should have been strongly selected against in the course of evolution. But sleep, as we've studied it, has been present in every species. What that means is sleep evolved with life itself on this planet, and then it has fought its way through, stoically and heroically, every step along the evolutionary path.

What that means is that sleep, despite all of those problems with it and those downsides, sleep, if it does not serve an absolutely vital function, then it's the biggest mistake the evolutionary process has ever made. And we now realize, looking at all of the brain and the body benefits, nature did not make a spectacular blunder in creating this thing called sleep. It's arguably, I would say, the greatest effort at immortality that we've seen so far.

JOAN WOODWARD: OK, so let's talk about what makes a good night's sleep. So what does a good night's sleep look like to you?

MATTHEW WALKER: For me, really, there are four macros of good sleep. So we know there are three macros of food-- fat, protein, carbohydrate. Well, there are four macros of good sleep. And you can remember it by the acronym QQRT-- QQRT. It stands for Quantity, Quality, Regularity, Timing-- QQRT.

Quantity-- seven to nine hours of sleep. There's a range. This myth of an eight-hour night of sleep for everyone, it's not true. There is a range. But you need seven to nine, somewhere in that range. Quality-- so quantity, quality is interesting. What I mean by this is the continuity of your sleep.

In science and in medicine, what we like to see is nice, long, continuous bouts of sleep with very few awakenings. However, if your night is littered with all of these awakenings and you're spending, let's say, 10 hours in bed to get just seven hours of sleep, that's very inefficient sleep. That's very poor quality of sleep because of those 10 hours in bed, you're spending three hours of that time awake.

So we like to see a sleep efficiency of at least 85%, meaning of the time that you're in bed, what percent of that time is asleep? Eighty-five or higher is great. If it's lower, let's have a conversation. The final two components, QQR, stands for regularity. And what they mean by that is go to bed at the same time, wake up at the same time, no matter whether it's the weekend or the weekday. Regularity is king.

And there was a great study that looked at over 60,000 individuals published about two years ago from the UK Biobank. They measured the regularity of people's sleep and the quantity, and then they looked at their all-cause mortality risk over time. Regularity predicted all-cause mortality, the most irregular people had a far higher risk, about a 43% higher risk, of premature mortality-- the lowest quartile versus the upper quartile.

They also had a higher risk of cardiovascular mortality, cancer mortality and also diabetes-related complications. But here was what was interesting. Because they measured quantity, they could then put quantity and regularity in the same statistical model and do a Coke/Pepsi challenge to see which one won out.

We all bet that it was quantity. We were wrong. It was regularity. Regularity was seemingly more important than quantity in predicting all-cause mortality. Now, you can't get away with short quantity of sleep. You can't say, well, then, I'm going to get four hours of sleep, but be very, very regular. You still can't cut free on that. So regularity is king.

The final one is timing-- QQRT-- T stands for timing. And you think, well, hang on a second. Timing sounds like regularity. No, timing is your chronotype-- morning type, evening type or somewhere in between. You don't get to decide.

All of the evening types who are listening right now, I have a message for you. It's not your fault because it is genetically determined. There are 22 different genes that dictate your morningness or your eveningness. It's very difficult to change. You can't train yourself out of it. And what we find is that when you sleep in harmony with your chronotype, your sleep is so much better in terms of its quantity and its quality.

So we will have people come to my sleep center and say, I've got terrible sleep onset insomnia. I go to bed at 10:00, and I'm wide awake for the first hour and a half. We do a chronotype test with them. We do a genetic test, but you can do the test online. It takes about three minutes. It's called the MEQ test-- MEQ. It stands for Morningness Eveningness Questionnaire, and it tracks your genetics very closely.

And what we determine is that that person is a night owl. They like to go to bed at midnight and wake up at 8:00. But because society is predilected towards the morning types, they're forced to get into bed at 10:00 and wake up at 6:00. They don't have sleep onset insomnia. They have a mismatch between when their biology wants them to sleep and when society forces them to sleep.

So to me, if you were to say, what about this new supplement on Amazon or the-- I would say, don't worry about all of that stuff. Focus on the four macros. If you get those straight, almost everything else will fall in line.

JOAN WOODWARD: Well, OK, so I just learned that about being a night owl and have a partner who might be a morning person. Is there a chapter in the book about how to live with someone who's not in your same timing?

MATTHEW WALKER: Yeah, I do speak about that, which is you've really got to try to find ways to risk mitigate the blast radius of your mismatched chronotypes, meaning that when someone goes to bed early, the night owl who wants to stay awake, just makes sure that you, for example, soundproof just about everything.

So for example, I'm mostly a neutral, about 11:00, 11:30 to 7:30 kind of guy. And my partner was much more of an early bird. She would go to bed at around 10:00 or so. So what I would do is I went around the house, and I put a little rubber sort of mat on the microwave, just in case I wanted to heat up a cup of tea, so it wouldn't bang on the glass.

I dismantled the microwave, and, James Bond-like, I found where the diaphragm was for the beep on the microwave, and I snipped those wires. And so-- now, this is the extreme. This is what happens when you live with a sleep scientist. But suffice to say that you can try to do that.

And then in the morning, the morning type needs to do the same type of accommodation. Otherwise, people just get upset and annoyed, and there's no reason to do that. Also, just try to make sure, how do you enter the bedroom as the night owl when the morning type is already fast asleep? And how do you exit and get yourself, brush your teeth, without disturbing the night owl in the morning if you're the morning type?

And again, night owls, embrace it. Don't be ashamed of it. I would say, yes, the early bird catches the worm. But I would also say that the second mouse gets the cheese.

JOAN WOODWARD: OK, good. Because society does-- favors the early bird people, and then the early bird people who actually work out before going to work. Anyway, I'm off topic. We got to get back on topic. So I want to talk about the consequences of sleep. So let's walk through the four dimensions that you lay out-- first, learning. What do we know about sleep and learning?

MATTHEW WALKER: Yes, sleep is incredibly powerful for learning and memory, and it's probably useful in at least three different ways. The first is that we need sleep before learning to actually prepare the memory structures in the brain, almost like a dry sponge ready to initially soak up new information. And without sufficient sleep, those memory centers will effectively become waterlogged, as it were. And you can't absorb new information. You can't lay down new, fresh memories.

So let's say that we've had a good night of sleep before, and we've formed and we've retained all of that information that we've been studying. You then need sleep not just before learning, but you also need sleep now, after learning, to effectively hit the save button on those new memories so that you don't forget. So sleep after learning is going to future-proof that information within the brain. It solidifies it into the neural architecture of the brain, almost like setting a fly in amber. It just locks it tight.

The third and final way that sleep is important is really a new discovery. Sleep is much more intelligent than we ever believed possible. Sleep doesn't just simply strengthen individual memories. Sleep will then intelligently start to cross-link and associate new memories together so that you wake up the next day with a revised mind-wide web of associations.

And this is the reason that no one has ever told you, gosh, you should really stay awake on a problem. Instead, they tell you that you should sleep on the problem. And it's because of this highly associative, interconnected smarts that sleep does. And I would say that that's the difference between knowledge, which is learning the individual elements of the information, versus wisdom, which is knowing what it all means when you fit it together. That's the power of sleep in the third dimension.

JOAN WOODWARD: Wonderful. So what does this tell us-- the learning part-- what does this tell us about the debate around school start times and children? Do you have a view on that?

MATTHEW WALKER: I do, and it is rather strong, I would say, based on the evidence that when we've studied school systems where they've changed their school start times, the data is unequivocal. What we see is that academic grades increase, truancy rates decrease, psychological and psychiatric referrals also decrease.

But then something else interesting happened. The life expectancy of these students also increased. And you think, well, hang on a second, how is that possible? That doesn't make sense. The No. 1 leading cause of death in late-stage adolescent teens is not suicide. That's second. It's car crashes. And here, sleep matters enormously.

So there was a great study done in Teton County in Wyoming. They shifted their school start times from 7:35 in the morning to 8:55 in the morning. The only thing more impressive than the extra one hour of sleep that those kids reported getting was the change in car crashes that following year. When they looked in individuals 16 to 18, that following year, there was a 70% drop in vehicle accidents-- 7-0.

Now, to put that in context, the advent of ABS technology in cars, anti-lock brake systems, that dropped accident rates by about 20% to 25%, and it was deemed a revolution. Well, here is the simple fact of giving our kids the sleep that they need that will drop accident rates by up to 70%.

So I think if our goal as educators truly is to educate and not risk lives in the process, then we are failing our children with this incessant model of early school start times. When you look at the data, when sleep is abundant, minds flourish. And when it's not, they don't.

JOAN WOODWARD: Excellent. Well, as a night owl, I fully endorse later sleep times for school starts. OK, next up is emotional well-being. So what do we know between the link between sleep and emotional well-being?

MATTHEW WALKER: Yeah, it's very strong. It's probably one of the strongest links in terms of sleep and brain function. We've done a lot of work in sleep and mental health. What we've discovered is that sleep, and particularly dream sleep, or rapid eye movement sleep, it acts almost like a nocturnal, soothing balm. That REM sleep provides, at night, a form of emotional first aid, and it takes difficult or painful experiences that we've had during the day, and it just sort of smooths the rough edges off them so that you come back the next day and you feel better about them.

So what you have now, the next day, after a good night of sleep, is a memory of an emotional event, but it's no longer emotional itself. You don't regurgitate the same visceral reaction that you had at the time of the exposure. And so we certainly know that sort of REM sleep acts almost as this capacity to divorce the emotion from the memory. It almost strips the bitter rind from the informational orange, as it were, of the emotion.

If you flip the coin and you look at the insufficient consequence of sleep, there, what we see is levels of anxiety increase dramatically. We did a study where we took people who had no signs of any anxiety disorders whatsoever, and we prevented them from sleeping for one night. The next day, we saw really quite a ballistic increase in the amount of anxiety that they were experiencing, as well as looking at brain scans.

And, in fact, based on the next morning-- and it was just literally an extended period of, at that point, 21 hours-- the anxiety level had increased so dramatically that over 50% of them would now be clinically diagnosed as having an anxiety disorder and requiring medication. That's how quickly it can happen.

So there is-- I think Emily Bronte once said that a ruffled mind makes for a restless pillow and vice versa, as well. And there's a wonderful quote by an American entrepreneur, E. Joseph Cossman, that basically summarizes all of our work in this space. He once said that the best bridge between despair and hope is a good night of sleep. And that's exactly what we're finding.

JOAN WOODWARD: Wow. So the link really is between stress, anxiety, depression and getting that good night's sleep.

MATTHEW WALKER: And it's bidirectional, too, Joan, that when you are stressed, you're anxious-- anxious, sorry-- and you are experiencing strong emotion. It will markedly disrupt your ability to fall asleep. Or if you fall asleep and you wake back up, it's hard to get back to sleep.

And conversely, if you may not be emotionally distraught but you have a bad night of sleep before, it can lead you to become more emotional the next day. In fact, we looked at brain scans, and the next day when you haven't slept well, your prefrontal cortex, which controls your emotions, that goes down and is deactivated. So you become all emotional accelerator pedal and too little regulatory control brake.

JOAN WOODWARD: OK, great. Next up, we want to talk about the consequences of sleep on aging. And I know a lot of us on the phone are very focused on aging and retiring. And so tell us about that connection.

MATTHEW WALKER: Yeah, the connection there is probably the other largest research program we have at the center on sleep, aging and Alzheimer's disease. What we know is that across the lifespan, as we get older, one of the classic cognitive markers of aging is that our learning and memory starts to fade and decline. What we don't really fully acknowledge in science and medicine is that a physiological sign of aging is that our sleep gets worse, and particularly the deep sleep that seems to fixate those new memories.

And only a couple of years ago now, we published evidence that these two things are not simply co-occurring in later life. They are significantly interrelated. And it suggests that the disruption of sleep in later life is an underappreciated factor that is contributing to what we call cognitive decline. Now, there is-- let me speak about or come back to one myth that I can bust. But I want to speak about maybe abnormal aging, which is the context of dementia.

And here, there is now a very strong link with insufficient sleep. You all know that your body has a cleansing system. And you know what it's called. It's called the glymphatic system. So this cleansing system in the brain called the glymphatic system is remarkable because it will wash away all of the metabolic detritus.

What's interesting, however, is that that cleansing system in the brain is not switched on all of the time. It only is switched on during sleep, and specifically, deep sleep. So essentially, it's sort of a good night's sleep clean. It's a power cleanse for the brain.

And you may be saying, well, hang on a second. What does this have to do with Alzheimer's? Two of the pieces of metabolic detritus that your brain washes away at night during deep sleep are beta-amyloid and tau protein, which are the two underlying culprits that lead to the cascade of Alzheimer's disease. So now we realize why there is such a strong link between people who are not getting sufficient sleep across the lifespan and an escalating risk of getting Alzheimer's disease in later life.

So there, I think, it's also a potential new therapeutic route, because we know that it's in midlife, in our 40s, when we start to see the decline in deep sleep. What if we can start to intervene with new technologies that boost deep sleep? Can we use this technology to go from a model of late-stage treatment to midlife prevention? Can I bend the arrow of Alzheimer's disease down on itself, and, in doing so, restore back some learning and memory function? That's one of the real hopes now. That's what some of our work is trying to do.

I should mention the one myth. Yeah, older adults don't need less sleep. Think about it like this. As we get older, our bones become weaker. But no one in medicine says, well, older adults have weaker bones, and therefore, older adults just don't need bones that are particularly strong. We don't say that. We medicate them with calcium, and we use resistance training to prevent that sarcopenia.

But now, there's this myth out there that, well, older adults sleep less later in life. And it must mean that older adults just don't need as much sleep. That's wrong. Older adults need just as much sleep. It's simply that the brain in later life cannot generate the sleep that it, nevertheless, still needs. So that's one of those classic myths out there.

JOAN WOODWARD: OK, great. And the last category, consequence is disease. So we just talked about dementia and Alzheimer's. So what about you talk about cancer and cardiovascular and other diseases.

MATTHEW WALKER: Yeah, cardiovascular disease, the link is really quite strong now. We know that insufficient sleep, firstly, raises your blood pressure. It speeds the contractility rate of your heart. It also-- and we are starting to understand now it seems to be through a pathway of inflammation-- it causes greater buildup of plaque in your arteries, which is what we call atherosclerosis, a hardening of the blood vessels and the development of these calcium deposits, what you would know of as a plaque in your arteries.

And there's a great study from Harvard some years ago now. They looked at a group of individuals who had to begin with no signs of cardiovascular disease. And they track them over five years. What they found is that the people in that cohort who were getting less than five hours of sleep had a 200% increased risk of developing calcification of the coronary artery.

The coronary artery is the major corridor of life for your heart. And if it gets blocked, you will hear someone say, gosh, it was tragic. They had a massive coronary. What they mean is that they had a coronary heart attack because that artery got clogged up with calcium deposits. That's exactly what they saw in that study.

Cancer is interesting. There are well over 200 different forms of cancer. And sleep, insufficient sleep, is not related to every single one. But there are a handful of cancers that sleep is related to in terms of increasing maybe 30%, 40%, some of which are almost doubling the risk. And you can ask, then, why is it?

Well, when we are under slept, critical anti-cancer fighting immune cells called natural killer cells, which you can think of-- they're a little bit like the Secret Service agents of your immune system. They're very good at identifying dangerous foreign elements and eliminating them. And one of the dangerous elements that they will eliminate is carcinogenic cells.

And so when you're not getting sufficient sleep, these critical cancer shields in your system, from an immune perspective, go down. And that's why we become more vulnerable to cancer diagnosis, because all of us today, we're all going to produce cancerous cells in our bodies. What prevents those cancerous cells from developing into the disease that we call cancer, in part, are these natural killer cells, which, essentially, require sufficient sleep across the lifespan.

JOAN WOODWARD: That is just fascinating. It really, truly is. I want to go to some audience questions now because they're coming in like crazy, and I want to get to one topic that is really important, actually important to me in growing up was dreaming. And in your book, I read that overnight-- you call dreaming overnight therapy.

And everyone in the questions are asking, why are dreams so important to our mental health? What do dreams mean? So if I'm dreaming something scary or not very positive, does that mean I'm going to have a negative day? Does it mean I have negative thoughts? If I dream something positive-- Talk about dreaming. And our audience specifically wants to know why you call it therapy.

MATTHEW WALKER: Yeah. Dream sleep or rapid eye movement sleep is a state like no other during the 24-hour period. What we see in the brain is that the emotional and memory centers become very active during REM sleep. But what's also interesting is that there's a chemical in the brain called noradrenaline, and it gets shut off during REM sleep. Why is that relevant?

Well, we all know of the sister chemical downstairs in the body, which is called adrenaline. Well, noradrenaline is adrenaline for the brain. And during sleep, that sort of adrenaline for the brain is essentially the spigot is completely closed off. So dream sleep is a time when you can reactivate the emotional and memory centers of the brain. In other words, you can bring back to mind all of those difficult experiences, but you're going to reprocess them in a quote, unquote "safe, neurochemical environment."

And as a consequence, that's the biological milieu that allows you to divorce the emotion from the memory and essentially get good and get over those events. And there's a fascinating study which comes on to the second part of your question, which is, does what we dream matter? And here, what I'm going to say is, does what we dream matter in terms of the functional benefit of that overnight therapy?

And the answer is yes. There's a great study done by-- from the University of Chicago. And they studied people who were going through a very difficult time in life-- bereavement, a very painful divorce. And they studied their sleep, and they got dream reports from them.

And then they followed them up one year later, because at the time, those people, understandably, were very clinically depressed. Twelve months later, about half of those people had gained remission to their depression whilst the other half had not. They were still clinically depressed.

So then they went back retrospectively to that data, and they separated the dream reports based on the people who got clinical remission versus the people who still had it. What they found was interesting. Both of those groups were getting REM sleep or dream sleep. And, in fact, both of those groups were dreaming.

The difference, however, was that the group that gained clinical remission, they were dreaming of the difficult experience that they were going through. The people who had REM sleep, who were dreaming but didn't dream of the emotional events, they didn't go on to gain the clinical resolution. What that taught us was profound.

It's not just sufficient to have REM sleep. It's not just sufficient to be dreaming. You have to be dreaming of the emotional experiences to gain that overnight therapy. Now, don't worry, people who are listening. You may be thinking, well, gosh, I never remember my dreams, or I don't remember dreaming about the things that are challenging me right now. Our recollection of our dreams is very poor, so don't use your own self recollection as a barometer of thinking, oh my goodness, I need to be remembering more of what I was dreaming about, or I'm not going to get that overnight therapy that he's talking about.

Most of us are getting that. The extreme cases where we see people not doing that is in a disorder called PTSD, or post-traumatic stress disorder, and we've done a lot of work there, too. But I will stop there. I hope that answers some of the questions on dreaming.

JOAN WOODWARD: Yeah, my grandmother had a dream book. And so if I had a dream as a little kid, I'd go run and open her book. And I had it by my bedside all the time. And she always said there was nothing like a bad-- bad dreams mean you're processing things. So I don't know. This is a long, long time ago. But, anyway--

MATTHEW WALKER: Yeah, or prophetic wisdom.

JOAN WOODWARD: Yeah. Another question from the audience, there's always been a person who claims to be able to get by with no sleep or little sleep. Is that actually a thing?

MATTHEW WALKER: Yes, it is a thing. But I will offer an asterisk to that statement. It is a thing because what we've discovered is what we call genetic short sleepers. And these individuals-- and we've identified at least two genes that will allow this to happen. And these individuals seem to be able to get away with as little as six hours and 10 minutes of sleep and show no body or brain impairment that we can measure-- none whatsoever.

Now, a lot of people perhaps listening may be starting to think, gosh, I think I'm one of those genetic short sleepers. To put it in context, statistically, you're much more likely to be struck by lightning in your lifetime than you are to be one of those genetic short sleepers. You'll see the same thing plays out with [INAUDIBLE]. Based on the actual statistical number of people who are in this call right now, there may be a couple of the genetic short sleepers. But it's probably far less than any of us would probably like.

By the way, I should say this discovery, we've been trying to help with this in combination with folks over at the University of California, San Francisco. It teaches us something absolutely radical about sleep. And it comes on to one of your first questions from the evolutionary perspective. What this genetic abnormality or these genetic mutants that we call them-- not in quite that sense-- but what that teaches us is the following.

Somewhere there is a biological genetic code that allows us to act like a zip file for sleep. We can compress an eight-hour need down to as little as six hours. So to me, the more interesting part is not really that there are these people, it's that there is a biological mechanism that seems to be able to squeeze hyperefficiency and get done in six what usually takes seven to nine hours. And at that point, if I can tap into that, however many of these webinars I do or books I write, the genie of insufficient sleep in society is out the bottle, and it's not going back in any time soon.

So rather than me fight it, why don't I see if I can find a way, biologically, to at least help individuals to sustain good sleep, even at the level of six hours, rather than eight hours? My worry is that if I do that, now, four hours becomes the new six hours, and it's an ever-eroding battle with society. But I'll try and do my part.

JOAN WOODWARD: OK, staying on that for one more question-- and then we're going to go to tips and tricks and hacks for everyone to use and hopefully employ in your night’s sleep. So last question from the audience, I just heard you talk about seven to nine hours, and I get it. But for a lot of people, like new parents and students pulling all-nighters, busy managers, it's just out of reach. So let's be practical. What do you say to people who insist they cannot get that full night's sleep?

MATTHEW WALKER: Yeah, I would say if you know that you're going to go into a period of insufficient sleep, let's say that you've got a work project or you're a student and you've got to study, in some ways, sleep is not like the bank, that you can't necessarily accumulate a debt. And for all brain and body functions, you can't pay it off at the weekend.

There are some things that you can pay off at the weekend. So my first tip or trick would be for that, if you can sleep long at the weekend and you've been sleeping short during the week, definitely do it. It can help. As a young medical resident, I knew that I was about to go on call for three nights.

There's something called sleep banking, which is that you can't necessarily go into a debt and then try to pay it off with some credit later. But you can build up credit before the event and then use that credit to spend down the debt that you then face. Does that make sense? I know it's a contorted logic. But in one circumstance, pre-bank it. So it's pre-banking. And that does seem to work. And it softens the blow significantly.

For new parents, I get it. I would say two things. At that point, firstly realize, this, too, shall pass. I know it's bad. And it will never be as bad as it is now because the older your child gets, on average, the better and more stable their sleep will become. The second is whenever you get the chance to sleep, even if it's a nap, whatever it is, take that opportunity.

The best thing for a newborn is a well-slept parent. And new parents will often make the mistake of wanting to make sure that everything is good with their infant for sleep. Trust me, your infant, no matter what, will get the sleep that they need. You don't need to worry about them. You need to give yourself the gift of compassion to say, it's OK for me to ask. I need to get some sleep.

So if people come over and say, I'd love to come over and see the baby or I'd love to come over and bring you food, or is there anything I can do for you? My recommendation is to say, yes. Would you just come over for 30 minutes, watch the baby? I'd love just to take a 20-minute nap. If you could do that for me, that would be lovely. Ask for that permission, if you can.

JOAN WOODWARD: Wonderful. OK, that sounds like great advice. So you've convinced us now it's important to sleep and how to sleep. What are your tricks? So what is your best advice for improving our night's sleep? And then I want to get into sleep aids, so melatonin and other things that are on the markets. But first of all, let's talk about what's your advice for doing things without any of those items.

MATTHEW WALKER: Yeah, I would say probably my top two unconventional tips for sleep are the following. The first is that you have to have a wind down routine. Sleep is not like a light switch. We shouldn't expect it to be. It's much more like landing a plane, that it takes time to come down onto the terra firma of good sleep at night.

So here's the following suggestion. Do this experiment for one week. And at the end of the one week, ask yourself, did it make a difference? If it doesn't make a difference, throw it out. Say, that guy with a strange British accent, he's an idiot, doesn't know what he's talking about. But here's the study.

We have a wake-up alarm. But also, I want you to add a "to bed" alarm one hour before you expect to go to bed. Once that one hour goes off, your job is to turn down half of the lights, if not all of the lights in your home. Ideally, you'd also do a digital detox in that last hour, but I understand it's not going to happen for most people. That's fine.

But turn down half of the lights, if not all of them, in your home. You will be surprised at how sleepy that darkness makes you feel. So you're doing what you normally do now, which is the lights are on, and then you switch them all off and you jump into bed. I'm saying, one hour before bed, do this experiment for seven days.

Then don't just ask yourself, does it feel better? And do I sleep better having done that? I want you, at the end of the experiment, to go back to what you were doing before, which is leaving all of the lights on until you go to bed. So not only ask yourself, do things get better when I do the experiment? And secondly, do things get worse when I go back to doing what I was doing before? That's what we call the negative-positive-negative experiment, and it's much more bidirectional proof of concept.

The second thing I would probably suggest in terms of a sleep tip is find ways to distract your mind. Most people, the reason that they can't sleep and have insomnia absent a medical condition, is because when they get into bed, the Rolodex of anxiety begins, or they wake up at 3:00 a.m. and it starts. When that anxiety wheel starts to turn, you start to ruminate. When you ruminate, you catastrophize.

And at that point, you're dead in the water for the next two hours because, at least for me, and I don't know about people listening, everything feels twice as bad in the dark of night than it does in the light of day. And the problem that you're all experiencing-- and I do, too-- is that I can't get my mind off itself.

So how do I do that? I'll give you at least five different ways. The first is meditation. You can do a guided meditation. You can download apps on your phone. They're great. They work. And it's good for insomnia. If you don't like meditation, you can do box breathing. You can breathe in for a certain count, hold your breath and then exhale for a longer count.

Or you can do what's called a body scan. Start at the top of your head. Just feel sensations where the tension is. Relax the body. You can do that, too. Take yourself on a mental walk. So think about a walk that you do in vivid detail. Let's say I'm walking the dog. I will think about which leash am I going to take out the drawer? I'll take the blue one. I click the dog in with my right hand. I open the door with my-- it's that level of hyper-vivid detail.

What is common across all of those mechanisms, be it meditation, breath work, body scan or doing a mental walk, they are all getting your mind off yourself or off itself. Because sleep-- sleep is a little bit like trying to remember someone's name. The harder you try, the further you push it away. And as soon as you stop trying, the word comes back.

So when you use these techniques to fall asleep or get back to sleep, the next thing that you typically remember is your alarm going off in the morning. Why? Because you got your mind off itself.

JOAN WOODWARD: OK, get your mind off yourself. And you had the four techniques. I love that. And I've tried a few after reading the book. And I will tell you, they have worked. They have worked for me.

MATTHEW WALKER: Fantastic.

JOAN WOODWARD: What doesn't work is when I worry about things and I'm anxious and I'm stressed out. And you're right, things are always better in the light of day than in your dark bedroom. OK, let's move on to sleep aids. First, let me ask you about prescription drugs. What's on the market now? Are any of these helpful? And then, of course, OTC, what about melatonin, the most popular one people talk about?

MATTHEW WALKER: Yeah, I've typically not been a fan of the classic sleep medications, the gen one, they were the benzodiazepines, like Valium. And they're really not great. The gen two, also not really-- I favor them, things like Ambien, Lunesta, Sonata. Both of those classes, the kind of web 1.0 and web 2.0 of sleep meds, they are what we call sedative hypnotics. And sedation is not sleep.

Now, when you take an Ambien, I'm not going to argue you're awake. You're not. But to argue that you're in a naturalistic sleep is an equal fallacy. You're just sedated. And so I really don't favor them because they don't produce a naturalistic sleep. And if I show you the electrical signature, you would see how clearly different it is.

Then came web 3.0 when it comes to sleep medications. There's a new class of sleep medications that-- I mean, I'm not anti-medication. People thought I was. And I really favor these. They are called the DORAs drugs-- D-O-R-A small s-- DORAs. And it's a class of drugs. There are three FDA approved, things like Belsomra. Its chemical name is suvorexant, or Dayvigo, lemborexant.

What's interesting is that these medications, they work very differently. They go down towards your brainstem, and they act like a clever set of chemical fingers that dial down the volume button on wakefulness. And then they step back, and they allow the antithesis of wakefulness to come into its place, which is this thing that we call naturalistic sleep. So I favor these medications.

The problem right now is that many insurance coverers, health insurance coverers, will not reimburse you. They will try to push you to those cheaper, generic drugs. So it is a very expensive thing. Now, for some people, after a month of really bad insomnia, if I were to come along and say, right now, I can wave a magic wand, if you give me $300, and we can go back and I'll give you good, solid sleep for that entire month. Do you want to take the deal or not? Many people would. But I do find it very unfortunate right now that those drugs are just so expensive, because I do think they're very helpful.

Last thing I would say, melatonin, it's not a particularly good sleep aid. When we look at the studies, melatonin will only increase the speed with which you fall asleep by an average of 3.9 minutes, and it only improves the efficiency of your sleep by 2.2%. That's the reason that if you go to the doctor and you say, I've got insomnia, they never prescribe you melatonin, because it's just not an effective sleep aid.

I would say that, for some people, there is a cluster for whom melatonin is effective. But for most people, I would say if you're getting a benefit, it's probably going to be a placebo benefit. But in truth, the placebo effect is the most reliable effect in all pharmacology, so no harm, no foul.

Just keep in mind two things. Most people take too much. They take 5 milligrams, 10 milligrams, maybe even 20. I would say max out at 5. Ideally, you would aim for 3 milligrams. The second is it's not regulated by the FDA. There's a study that looked at 20 different brands based on what you were swallowing versus what it said was on the bottle. It ranged from 83% less than up to 464% more than what it said on the bottle.

JOAN WOODWARD: Oh, wow. Wow.

MATTHEW WALKER: You don't know. You've got no sense because it's not regulated. It's the FDA. What was worse, by the way, if you read the fine print of that study, there was as much variability within any one vendor from one batch to the next to the next.

JOAN WOODWARD: But long-term use of melatonin, do you have a comment there? Is that not good for you? People who use it as a placebo, let's say, and use 3%-- 3 mgs.

MATTHEW WALKER: Yes. The argument has been in sleep science that, a little bit like testosterone replacement therapy for males, once you do that after about a year, depending on what type, the testes can shut down their own production of testosterone so that when you stop, they never restart producing testosterone again.

Now, we don't know that there's evidence in favor or against melatonin. There was a study that looked at dosing people for one month. And when they stopped, they started naturally releasing their melatonin just fine. And some people in favor of melatonin said, well, that's good evidence that, then, you don't have to worry. The problem is most people aren't taking melatonin for a single month. They're taking it for years. So we just don't have the data yet. So absence of evidence is not evidence of absence. And so for now, I would say the jury is out.

JOAN WOODWARD: OK, all right. Another question coming in from the audience. We have a lot on this. There are other supplements like magnesium, I was told, that can help me get to sleep or stay asleep.

MATTHEW WALKER: Largely, a fallacy, but I would, again, offer one asterisk. The data, if you dig into it, for magnesium being good for sleep is in people who are originally magnesium deficient, they had marked sleep problems. And when they dosed them with magnesium and made them magnesium normative, it restored their sleep.

That's very different than saying, well, I am magnesium normative, and I'm going to start taking magnesium to see if I can boost my sleep. That's like me saying, well, I've got this incredible new oxygen saturation machine. And you say, well, but my blood oxygen saturation is 99%. It doesn't matter how good your machine is, I can't go any further than ceiling. So keep in mind.

The other thing, most people are taking magnesium in a form that is incorrect. Most magnesium forms, magnesium citrate, oxide, they don't cross the blood-brain barrier, and sleep is generated by the brain. So how can they have an effect? There is one form of magnesium that does seem to cross the blood-brain barrier, and it's called magnesium l-threonate. And I think you can get it on Amazon. I have no association with them, something called Mag-T, Magtein. That does seem to cross the blood-brain barrier.

So I would say if you really do want to use magnesium, firstly, go and get a blood test, see if you're magnesium deficient. At that point, absolutely dose with magnesium. But if you are not magnesium deficient and you still want to give magnesium a try, use magnesium l-threonate. Otherwise, you're just-- how to say this diplomatically-- you're probably just creating very expensive urine, otherwise.

JOAN WOODWARD: OK, I've heard of that with people taking too many vitamins. All right, lastly, a big topic of my-- on the audience mind is alcohol. So a lot of people believe having a couple of glasses of wine at night or a Manhattan or tequila, whatever your choice is, helps them get to sleep faster. But I know in my own experience, you can also wake up in the middle of the night because you've had that glass of wine. Comment on that.

MATTHEW WALKER: Yeah, I mean, I'm desperately unpopular based on my personality in general, but this only makes matters worse for me, unfortunately. Alcohol is not your friend when it comes to sleep. Alcohol is also in a class of drugs that we call the sedatives. And so what you're experiencing when you have a nightcap, when you say, I fall asleep faster, you're just losing consciousness more quickly. You're not going into natural sleep.

The second problem with alcohol is just as you described. It is a central nervous system stimulant. So the metabolic byproduct of alcohol will activate the fight or flight branch of the nervous system. So you're much more likely to wake up many more times throughout the night. Remember the four macros of good sleep-- QQRT, Quantity, Quality, Regularity, Timing. We said quality was critical. Alcohol will fragment your sleep. That's poor quality of sleep.

The final thing is that alcohol is very good at suppressing your dream sleep or your rapid eye movement sleep. And we've spoken about the importance of dream sleep. Dream sleep isn't just for the brain, by the way. It's for the body. It's during dream sleep or REM sleep that we release our peak levels of testosterone in both males and females. Males and females both need testosterone just in log order amounts different.

So I would say to try to make myself at least a little bit less unpopular, I would never offer this in a webinar, but I would tell you, based on the evidence, you should go to the pub in the morning, and that way, the alcohol is out of your system, and no harm, no foul by the evening. But I would never recommend such a thing.

JOAN WOODWARD: Never, never, and certainly not during a workday. Maybe on the weekends we could try that experiment. You say to experiment. All right, so that's alcohol. Let's talk about exercise. A lot of people are asking this question. I'm not an exerciser. Would exercise help my sleep or hurt my sleep?

MATTHEW WALKER: Very much help your sleep. The evidence there, remarkably robust, particularly deep sleep. Do you have to worry about time of day and type of exercise? Not so much. Exercise of almost any time of day usually leads to a benefit for sleep.

Aerobic exercise, things like spin bike, going on a run, rowing machine, elliptical, those things typically have a slightly greater beneficial impact on your sleep than, let's say, weight training or lifting weights. But both of those are great for sleep.

It's a myth that you have to cut yourself off from exercise, let's say, three hours before bed. If you look at the data, you can actually exercise as close to one hour before bed, and it's not going to hurt your sleep. So overall, the message, I think, would be absolutely clear-- exercise, it's a fantastic sleep tool.

Thinking about getting daylight during the morning, getting darkness at night, keeping your bedroom cool, getting exercise during the day, and not eating too close to bedtime, if you do those five things, you don't have to worry so much about supplements. If you're reaching for supplements as your first kind of effort to improve your sleep, then you're stepping over dollars to pick up pennies. Focus on the critical foundations of sleep, and that way you're not going to be minoring in the majors and majoring in the minors.

JOAN WOODWARD: OK, good. So a couple of questions, more questions from the audience here. We understand we need to put away our phones and not be so connected to digital. But Denise Stevens at Marsh asks, is reading a book, an actual book that you could actually touch, with pages in it, is that helpful at all?

MATTHEW WALKER: That's actually great. Again, it's one of those things that gets the mind off itself. And, in fact, I can give you a great example. There was a meditation company called Calm-- and they still exist, a great, great-- Calm, I have no relationship with them. They were looking at the meditation statistics. And what they found was that people weren't meditating when they necessarily wanted them to, which was first thing in the morning. They were meditating right before bed.

They were self-medicating their state of insomnia. And then they realized something profound. As children, we loved to have books read to us, and it helped us fall asleep. They realized that, as adults, we're no different. So they started to create something called sleep stories. And it turned that company around, and they became a unicorn company. They had $1 billion valuation after just a year of having sleep stories.

And now, that's the reason they can afford to hire people like Matthew McConaughey and Harry Styles to do these. And occasionally, if you really dig into the bowels of the app, you can find a sleep story read by a very odd British sleep scientist. But they demonstrated that those, that exactly that, reading a book or having a book read to you, is a wonderful soporific. Why? Because it stops you thinking about your troubles and your worries.

JOAN WOODWARD: OK, I think our last question is coming from Canada. Kimberly Murray asked-- one of our big brokers up in Canada. How does diet impact sleep? Are there foods to avoid or foods that would help us induce our sleep?

MATTHEW WALKER: Yeah, a lot less work on this than there really should be, but there's probably two at least general themes. The first is that the best diet that we've found for good sleep seems to be the Mediterranean diet, if you want to pick one. And they've tried to pit different diets together and see which results in-- are associated with, at least-- it's not causal-- associated with the best sleep. And it does seem to be the Mediterranean diet.

What we also know from experimental causal manipulations is the following. Diets that are high in saturated fat, high in simple sugar and low in fiber, all lead to markedly disrupted sleep. So if you're trying to think about that, try to have a food intake that is rich in, let's say, monounsaturated fats, not saturated fat, that has high dietary fiber and has at least minimal simple sugar. That seems to be the best kind of dietary prescription that we found.

There is some evidence, interestingly, for individual food items. And I've looked at this data because I just thought, as a hard-nosed scientist, this is nonsense. This is just woo-woo kind of silliness. But it's reliable. Kiwi fruit and tart cherry juice are both demonstrated to improve your sleep. Why? Because they contain a strong dose of antioxidants, which seem to be beneficial for sleep.

So I'm still waiting-- the studies, I don't know why, I think I'm just still biased because it just seems too simple, but I actually think they do work. But I currently don't build into my regimen, my pre-sleep regimen, a quick glass of tart cherry juice. And I juggle three kiwi and then swallow them whole. I'm not there yet. But if you want to, those seem to be pretty good.

JOAN WOODWARD: Awesome. Awesome. Do you want to share with us your routine really quickly? Because we're at the end of the hour, flew by here. What is your routine?

MATTHEW WALKER: Yeah, sure. So one hour before bed-- well, let me start, your best night of sleep starts with the beginning of the day. So I usually wake up. I'll usually do some form of exercise. I usually do a spin bike for about 30, 40 minutes. I try to make sure that I either select a gym that has windows next to their cardio equipment or at home, I place my spin bike next to a window, so I get my daylight in combination with my exercise.

Then I'll try to cut myself off from caffeine after about 10:00 a.m., because I'm just someone who's sensitive to caffeine. Next thing I'll do is I will try to, in the evening, start to have a wind down routine at least two hours before bed. One hour before bed, almost all of the lights are off. Ten minutes before bed, I do a 10-minute meditation. And then I've got sound-- I've got earplugs. I've got a noise machine. I've got an eye mask.

I am just-- my partner, Nikki, I said that you come into the bedroom, you get eye masks, earplugs, all of this type of stuff. They look at you and think, God, I never wanted you more. It's a very strange sight. But anyway, that's typically my routine. And I am incredibly metronome-like regular with my sleep.

It's not to say that I don't have bad nights of sleep. I absolutely do. I'm not immune to having insomnia. I've had it twice in my lifetime. It's just that I usually know the tips and tricks to zip it very quickly and cinch it and prevent it from escalating into long term.

JOAN WOODWARD: Wow. Now thanks to you, all of our audience now know-- and by the way, we had almost 8,000 people join us today, so quite the turnout for this topic. Everyone, I think 100% of no matter where you are or what you sit, what your job is, are interested in this. So I cannot thank you enough. We really learned a lot.

We knew all the things-- eat right, exercise more, don't drink as much. We knew that. But you put the science behind it for us to really help us understand why these things are so important. So we're so grateful, and we're honored to have you, Dr. Walker.

MATTHEW WALKER: Well, the pleasure was mine, and the honor was mine, too. Everyone listening, this is 8,000 human hours that you could have done anything with. You chose to spend it with me. For that, I'm eternally grateful. Thank you so much again.

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So also in April, we're going to have different conversations around cyber insurance. And May 7, we're going to have a special guest on, my friend Anne Marie Colapietro, talking about living with a chronic disease. And she's sharing her story, journey of living with Parkinson's. So that'll be terribly informative and talking about risk and resilience in your own life. 

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