Thank you very much.
Well, I would like to start with testicles.
(Laughter)
Men who sleep five hours a night
have significantly smaller testicles than those who sleep seven hours or more.
In addition, men who routinely sleep just four to five hours a night
will have a level of testosterone
which is that of someone 10 years their senior.
So a lack of sleep will age a man by a decade
in terms of that critical aspect of wellness.
And we see equivalent impairments in female reproductive health
caused by a lack of sleep.
This is the best news that I have for you today.
From this point, it may only get worse.
Not only will I tell you about the wonderfully good things
that happen when you get sleep,
but the alarmingly bad things that happen when you don't get enough,
both for your brain and for your body.
Let me start with the brain
and the functions of learning and memory,
because what we've discovered over the past 10 or so years
is that you need sleep after learning
to essentially hit the save button on those new memories
so that you don't forget.
But recently, we discovered that you also need sleep before learning
to actually prepare your brain,
almost like a dry sponge
ready to initially soak up new information.
And without sleep, the memory circuits of the brain
essentially become waterlogged, as it were,
and you can't absorb new memories.
So let me show you the data.
Here in this study, we decided to test the hypothesis
that pulling the all-nighter was a good idea.
So we took a group of individuals
and we assigned them to one of two experimental groups:
a sleep group and a sleep deprivation group.
Now the sleep group, they're going to get a full eight hours of slumber,
but the deprivation group, we're going to keep them awake
in the laboratory, under full supervision.
There's no naps or caffeine, by the way, so it's miserable for everyone involved.
And then the next day,
we're going to place those participants inside an MRI scanner
and we're going to have them try and learn a whole list of new facts
as we're taking snapshots of brain activity.
And then we're going to test them
to see how effective that learning has been.
And that's what you're looking at here on the vertical axis.
And when you put those two groups head to head,
what you find is a quite significant, 40-percent deficit
in the ability of the brain to make new memories without sleep.
I think this should be concerning,
considering what we know is happening to sleep
in our education populations right now.
In fact, to put that in context,
it would be the difference in a child acing an exam
versus failing it miserably -- 40 percent.
And we've gone on to discover what goes wrong within your brain
to produce these types of learning disabilities.
And there's a structure that sits
on the left and the right side of your brain, called the hippocampus.
And you can think of the hippocampus
almost like the informational inbox of your brain.
It's very good at receiving new memory files
and then holding on to them.
And when you look at this structure
in those people who'd had a full night of sleep,
we saw lots of healthy learning-related activity.
Yet in those people who were sleep-deprived,
we actually couldn't find any significant signal whatsoever.
So it's almost as though sleep deprivation had shut down your memory inbox,
and any new incoming files -- they were just being bounced.
You couldn't effectively commit new experiences to memory.
So that's the bad that can happen if I were to take sleep away from you,
but let me just come back to that control group for a second.
Do you remember those folks that got a full eight hours of sleep?
Well, we can ask a very different question:
What is it about the physiological quality of your sleep
when you do get it
that restores and enhances your memory and learning ability
each and every day?
And by placing electrodes all over the head,
what we've discovered is that there are big, powerful brainwaves
that happen during the very deepest stages of sleep
that have riding on top of them
these spectacular bursts of electrical activity
that we call sleep spindles.
And it's the combined quality of these deep-sleep brainwaves
that acts like a file-transfer mechanism at night,
shifting memories from a short-term vulnerable reservoir
to a more permanent long-term storage site within the brain,
and therefore protecting them, making them safe.
And it is important that we understand
what during sleep actually transacts these memory benefits,
because there are real medical and societal implications.
And let me just tell you about one area
that we've moved this work out into, clinically,
which is the context of aging and dementia.
Because it's of course no secret that, as we get older,
our learning and memory abilities begin to fade and decline.
But what we've also discovered
is that a physiological signature of aging is that your sleep gets worse,
especially that deep quality of sleep that I was just discussing.
And only last year, we finally published evidence
that these two things, they're not simply co-occurring,
they are significantly interrelated.
And it suggests that the disruption of deep sleep
is an underappreciated factor
that is contributing to cognitive decline or memory decline
in aging, and most recently we've discovered,
in Alzheimer's disease as well.
Now, I know this is remarkably depressing news.
It's in the mail. It's coming at you.
But there's a potential silver lining here.
Unlike many of the other factors that we know are associated with aging,
for example changes in the physical structure of the brain,
that's fiendishly difficult to treat.
But that sleep is a missing piece in the explanatory puzzle
of aging and Alzheimer's is exciting
because we may be able to do something about it.
And one way that we are approaching this at my sleep center
is not by using sleeping pills, by the way.
Unfortunately, they are blunt instruments that do not produce naturalistic sleep.
Instead, we're actually developing a method based on this.
It's called direct current brain stimulation.
You insert a small amount of voltage into the brain,
so small you typically don't feel it,
but it has a measurable impact.
Now if you apply this stimulation during sleep in young, healthy adults,
as if you're sort of singing in time with those deep-sleep brainwaves,
not only can you amplify the size of those deep-sleep brainwaves,
but in doing so, we can almost double the amount of memory benefit
that you get from sleep.
The question now is whether we can translate
this same affordable, potentially portable piece of technology
into older adults and those with dementia.
Can we restore back some healthy quality of deep sleep,
and in doing so, can we salvage aspects of their learning
and memory function?
That is my real hope now.
That's one of our moon-shot goals, as it were.
So that's an example of sleep for your brain,
but sleep is just as essential for your body.
We've already spoken about sleep loss and your reproductive system.
Or I could tell you about sleep loss and your cardiovascular system,
and that all it takes is one hour.
Because there is a global experiment performed on 1.6 billion people
across 70 countries twice a year,
and it's called daylight saving time.
Now, in the spring, when we lose one hour of sleep,
we see a subsequent 24-percent increase in heart attacks that following day.
In the autumn, when we gain an hour of sleep,
we see a 21-percent reduction in heart attacks.
Isn't that incredible?
And you see exactly the same profile for car crashes, road traffic accidents,
even suicide rates.
But as a deeper dive, I want to focus on this:
sleep loss and your immune system.
And here, I'll introduce these delightful blue elements in the image.
They are called natural killer cells,
and you can think of natural killer cells almost like the secret service agents
of your immune system.
They are very good at identifying dangerous, unwanted elements
and eliminating them.
In fact, what they're doing here is destroying a cancerous tumor mass.
So what you wish for is a virile set of these immune assassins
at all times,
and tragically, that's what you don't have if you're not sleeping enough.
So here in this experiment,
you're not going to have your sleep deprived for an entire night,
you're simply going to have your sleep restricted to four hours
for one single night,
and then we're going to look to see what's the percent reduction
in immune cell activity that you suffer.
And it's not small -- it's not 10 percent,
it's not 20 percent.
There was a 70-percent drop in natural killer cell activity.
That's a concerning state of immune deficiency,
and you can perhaps understand why we're now finding
significant links between short sleep duration
and your risk for the development of numerous forms of cancer.
Currently, that list includes cancer of the bowel,
cancer of the prostate and cancer of the breast.
In fact, the link between a lack of sleep and cancer is now so strong
that the World Health Organization
has classified any form of nighttime shift work
as a probable carcinogen,
because of a disruption of your sleep-wake rhythms.
So you may have heard of that old maxim
that you can sleep when you're dead.
Well, I'm being quite serious now --
it is mortally unwise advice.
We know this from epidemiological studies across millions of individuals.
There's a simple truth:
the shorter your sleep, the shorter your life.
Short sleep predicts all-cause mortality.
And if increasing your risk for the development of cancer
or even Alzheimer's disease
were not sufficiently disquieting,
we have since discovered that a lack of sleep will even erode
the very fabric of biological life itself,
your DNA genetic code.
So here in this study, they took a group of healthy adults
and they limited them to six hours of sleep a night
for one week,
and then they measured the change in their gene activity profile
relative to when those same individuals
were getting a full eight hours of sleep a night.
And there were two critical findings.
First, a sizable and significant 711 genes
were distorted in their activity,
caused by a lack of sleep.
The second result was that about half of those genes
were actually increased in their activity.
The other half were decreased.
Now those genes that were switched off by a lack of sleep
were genes associated with your immune system,
so once again, you can see that immune deficiency.
In contrast, those genes that were actually upregulated
or increased by way of a lack of sleep,
with the promotion of tumors,
genes associated with long-term chronic inflammation within the body,
and genes associated with stress,
and, as a consequence, cardiovascular disease.
There is simply no aspect of your wellness
that can retreat at the sign of sleep deprivation
and get away unscathed.
It's rather like a broken water pipe in your home.
Sleep loss will leak down into every nook and cranny
of your physiology,
even tampering with the very DNA nucleic alphabet
that spells out your daily health narrative.
And at this point, you may be thinking,
"Oh my goodness, how do I start to get better sleep?
What are you tips for good sleep?"
Well, beyond avoiding the damaging and harmful impact
of alcohol and caffeine on sleep,
and if you're struggling with sleep at night,
avoiding naps during the day,
I have two pieces of advice for you.
The first is regularity.
Go to bed at the same time, wake up at the same time,
no matter whether it's the weekday or the weekend.
Regularity is king,
and it will anchor your sleep
and improve the quantity and the quality of that sleep.
The second is keep it cool.
Your body needs to drop its core temperature
by about two to three degrees Fahrenheit to initiate sleep
and then to stay asleep,
and it's the reason you will always find it easier
to fall asleep in a room that's too cold
than too hot.
So aim for a bedroom temperature of around 65 degrees,
or about 18 degrees Celsius.
That's going to be optimal for the sleep of most people.
And then finally, in taking a step back, then,
what is the mission-critical statement here?
Well, I think it may be this:
sleep, unfortunately, is not an optional lifestyle luxury.
Sleep is a nonnegotiable biological necessity.
It is your life-support system,
and it is Mother Nature's best effort yet at immortality.
And the decimation of sleep throughout industrialized nations
is having a catastrophic impact on our health, our wellness,
even the safety and the education of our children.
It's a silent sleep loss epidemic,
and it's fast becoming one of the greatest public health challenges
that we face in the 21st century.
I believe it is now time for us to reclaim our right
to a full night of sleep,
and without embarrassment
or that unfortunate stigma of laziness.
And in doing so, we can be reunited with the most powerful elixir of life,
the Swiss Army knife of health, as it were.
And with that soapbox rant over,
I will simply say, good night, good luck,
and above all ...
I do hope you sleep well.
Thank you very much indeed.
(Applause)
Thank you.
Thank you so much.
David Biello: No, no, no. Stay there for a second.
Good job not running away, though. I appreciate that.
So that was terrifying.
Matt Walker: You're welcome. DB: Yes, thank you, thank you.
Since we can't catch up on sleep, what are we supposed to do?
What do we do when we're, like, tossing and turning in bed late at night
or doing shift work or whatever else?
MW: So you're right, we can't catch up on sleep.
Sleep is not like the bank.
You can't accumulate a debt
and then hope to pay it off at a later point in time.
I should also note the reason that it's so catastrophic
and that our health deteriorates so quickly,
first, it's because human beings are the only species
that deliberately deprive themselves of sleep
for no apparent reason.
DB: Because we're smart.
MW: And I make that point because it means that Mother Nature,
throughout the course of evolution,
has never had to face the challenge of this thing called sleep deprivation.
So she's never developed a safety net,
and that's why when you undersleep,
things just sort of implode so quickly, both within the brain and the body.
So you just have to prioritize.
DB: OK, but tossing and turning in bed,
what do I do?
MW: So if you are staying in bed awake for too long,
you should get out of bed and go to a different room
and do something different.
The reason is because your brain will very quickly associate your bedroom
with the place of wakefulness,
and you need to break that association.
So only return to bed when you are sleepy,
and that way you will relearn the association that you once had,
which is your bed is the place of sleep.
So the analogy would be,
you'd never sit at the dinner table, waiting to get hungry,
so why would you lie in bed, waiting to get sleepy?
DB: Well, thank you for that wake-up call.
Great job, Matt.
MW: You're very welcome. Thank you very much.