1
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Thank you very much.

2
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Well, I would like
to start with testicles.

3
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(Laughter)

4
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Men who sleep five hours a night

5
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have significantly smaller testicles
than those who sleep seven hours or more.

6
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(Laughter)

7
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In addition, men who routinely sleep
just four to five hours a night

8
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will have a level of testosterone

9
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which is that of someone
10 years their senior.

10
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So a lack of sleep
will age a man by a decade

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in terms of that critical
aspect of wellness.

12
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And we see equivalent impairments
in female reproductive health

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caused by a lack of sleep.

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This is the best news
that I have for you today.

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(Laughter)

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From this point, it may only get worse.

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Not only will I tell you
about the wonderfully good things

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that happen when you get sleep,

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but the alarmingly bad things
that happen when you don't get enough,

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both for your brain and for your body.

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Let me start with the brain

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and the functions of learning and memory,

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because what we've discovered
over the past 10 or so years

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is that you need sleep after learning

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to essentially hit the save button
on those new memories

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so that you don't forget.

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But recently, we discovered
that you also need sleep before learning

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to actually prepare your brain,

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almost like a dry sponge

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ready to initially soak up
new information.

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And without sleep,
the memory circuits of the brain

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essentially become
waterlogged, as it were,

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and you can't absorb new memories.

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So let me show you the data.

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Here in this study, we decided
to test the hypothesis

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that pulling the all-nighter
was a good idea.

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So we took a group of individuals

38
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and we assigned them
to one of two experimental groups:

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a sleep group
and a sleep deprivation group.

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Now the sleep group, they're going to get
a full eight hours of slumber,

41
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but the deprivation group,
we're going to keep them awake

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in the laboratory, under full supervision.

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There's no naps or caffeine, by the way,
so it's miserable for everyone involved.

44
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And then the next day,

45
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we're going to place those participants
inside an MRI scanner

46
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and we're going to have them
try and learn a whole list of new facts

47
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as we're taking snapshots
of brain activity.

48
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And then we're going to test them

49
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to see how effective
that learning has been.

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And that's what you're looking at
here on the vertical axis.

51
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And when you put
those two groups head to head,

52
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what you find is a quite significant,
40-percent deficit

53
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in the ability of the brain
to make new memories without sleep.

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I think this should be concerning,

55
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considering what we know
is happening to sleep

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in our education populations right now.

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In fact, to put that in context,

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it would be the difference
in a child acing an exam

59
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versus failing it miserably -- 40 percent.

60
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And we've gone on to discover
what goes wrong within your brain

61
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to produce these types
of learning disabilities.

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And there's a structure that sits

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on the left and the right side
of your brain, called the hippocampus.

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And you can think of the hippocampus

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almost like the informational
inbox of your brain.

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It's very good at receiving
new memory files

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and then holding on to them.

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And when you look at this structure

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in those people who'd had
a full night of sleep,

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we saw lots of healthy
learning-related activity.

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Yet in those people
who were sleep-deprived,

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we actually couldn't find
any significant signal whatsoever.

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So it's almost as though sleep deprivation
had shut down your memory inbox,

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and any new incoming files --
they were just being bounced.

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You couldn't effectively
commit new experiences to memory.

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So that's the bad that can happen
if I were to take sleep away from you,

77
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but let me just come back
to that control group for a second.

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Do you remember those folks
that got a full eight hours of sleep?

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Well, we can ask
a very different question:

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What is it about the physiological
quality of your sleep

81
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when you do get it

82
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that restores and enhances
your memory and learning ability

83
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each and every day?

84
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And by placing electrodes
all over the head,

85
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what we've discovered
is that there are big, powerful brainwaves

86
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that happen during
the very deepest stages of sleep

87
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that have riding on top of them

88
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these spectacular bursts
of electrical activity

89
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that we call sleep spindles.

90
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And it's the combined quality
of these deep-sleep brainwaves

91
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that acts like a file-transfer
mechanism at night,

92
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shifting memories from a short-term
vulnerable reservoir

93
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to a more permanent long-term
storage site within the brain,

94
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and therefore protecting them,
making them safe.

95
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And it is important that we understand

96
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what during sleep actually transacts
these memory benefits,

97
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because there are real medical
and societal implications.

98
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And let me just tell you about one area

99
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that we've moved this work
out into, clinically,

100
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which is the context of aging
and dementia.

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Because it's of course no secret
that, as we get older,

102
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our learning and memory abilities
begin to fade and decline.

103
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But what we've also discovered

104
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is that a physiological signature of aging
is that your sleep gets worse,

105
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especially that deep quality of sleep
that I was just discussing.

106
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And only last year,
we finally published evidence

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that these two things,
they're not simply co-occurring,

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they are significantly interrelated.

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And it suggests
that the disruption of deep sleep

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is an underappreciated factor

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that is contributing
to cognitive decline or memory decline

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in aging, and most recently
we've discovered,

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in Alzheimer's disease as well.

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Now, I know this is remarkably
depressing news.

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It's in the mail. It's coming at you.

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But there's a potential
silver lining here.

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Unlike many of the other factors
that we know are associated with aging,

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for example changes
in the physical structure of the brain,

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that's fiendishly difficult to treat.

120
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But that sleep is a missing piece
in the explanatory puzzle

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of aging and Alzheimer's is exciting

122
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because we may be able
to do something about it.

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And one way that we are
approaching this at my sleep center

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is not by using
sleeping pills, by the way.

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Unfortunately, they are blunt instruments
that do not produce naturalistic sleep.

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Instead, we're actually developing
a method based on this.

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It's called direct current
brain stimulation.

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You insert a small amount
of voltage into the brain,

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so small you typically don't feel it,

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but it has a measurable impact.

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Now if you apply this stimulation
during sleep in young, healthy adults,

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as if you're sort of singing in time
with those deep-sleep brainwaves,

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not only can you amplify
the size of those deep-sleep brainwaves,

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but in doing so, we can almost
double the amount of memory benefit

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that you get from sleep.

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The question now
is whether we can translate

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this same affordable,
potentially portable piece of technology

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into older adults and those with dementia.

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Can we restore back
some healthy quality of deep sleep,

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and in doing so, can we salvage
aspects of their learning

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and memory function?

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That is my real hope now.

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That's one of our moon-shot
goals, as it were.

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So that's an example
of sleep for your brain,

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but sleep is just
as essential for your body.

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We've already spoken about sleep loss
and your reproductive system.

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Or I could tell you about sleep loss
and your cardiovascular system,

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and that all it takes is one hour.

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Because there is a global experiment
performed on 1.6 billion people

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across 70 countries twice a year,

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and it's called daylight saving time.

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Now, in the spring,
when we lose one hour of sleep,

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we see a subsequent 24-percent increase
in heart attacks that following day.

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In the autumn,
when we gain an hour of sleep,

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we see a 21-percent
reduction in heart attacks.

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Isn't that incredible?

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And you see exactly the same profile
for car crashes, road traffic accidents,

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even suicide rates.

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But as a deeper dive,
I want to focus on this:

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sleep loss and your immune system.

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And here, I'll introduce these delightful
blue elements in the image.

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They are called natural killer cells,

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and you can think of natural killer cells
almost like the secret service agents

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of your immune system.

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They are very good at identifying
dangerous, unwanted elements

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and eliminating them.

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In fact, what they're doing here
is destroying a cancerous tumor mass.

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So what you wish for
is a virile set of these immune assassins

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at all times,

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and tragically, that's what you don't have
if you're not sleeping enough.

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So here in this experiment,

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you're not going to have your sleep
deprived for an entire night,

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you're simply going to have your sleep
restricted to four hours

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for one single night,

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and then we're going to look to see
what's the percent reduction

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in immune cell activity that you suffer.

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And it's not small -- it's not 10 percent,

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it's not 20 percent.

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There was a 70-percent drop
in natural killer cell activity.

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00:11:03,786 --> 00:11:07,840
That's a concerning state
of immune deficiency,

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and you can perhaps understand
why we're now finding

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significant links between
short sleep duration

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and your risk for the development
of numerous forms of cancer.

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00:11:21,892 --> 00:11:24,675
Currently, that list includes
cancer of the bowel,

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cancer of the prostate
and cancer of the breast.

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In fact, the link between a lack of sleep
and cancer is now so strong

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that the World Health Organization

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00:11:37,639 --> 00:11:41,829
has classified any form
of nighttime shift work

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as a probable carcinogen,

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00:11:45,059 --> 00:11:47,726
because of a disruption
of your sleep-wake rhythms.

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00:11:49,830 --> 00:11:52,560
So you may have heard of that old maxim

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that you can sleep when you're dead.

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Well, I'm being quite serious now --

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it is mortally unwise advice.

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We know this from epidemiological studies
across millions of individuals.

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There's a simple truth:

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the shorter your sleep,
the shorter your life.

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00:12:10,869 --> 00:12:14,424
Short sleep predicts all-cause mortality.

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00:12:16,940 --> 00:12:21,109
And if increasing your risk
for the development of cancer

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00:12:21,133 --> 00:12:23,377
or even Alzheimer's disease

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00:12:23,401 --> 00:12:27,577
were not sufficiently disquieting,

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00:12:27,601 --> 00:12:31,299
we have since discovered
that a lack of sleep will even erode

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the very fabric of biological life itself,

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your DNA genetic code.

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00:12:40,038 --> 00:12:43,974
So here in this study,
they took a group of healthy adults

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and they limited them
to six hours of sleep a night

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for one week,

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and then they measured the change
in their gene activity profile

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00:12:53,257 --> 00:12:55,700
relative to when those same individuals

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00:12:55,725 --> 00:12:58,272
were getting a full eight hours
of sleep a night.

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00:12:59,451 --> 00:13:01,267
And there were two critical findings.

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00:13:02,204 --> 00:13:07,275
First, a sizable and significant 711 genes

213
00:13:07,299 --> 00:13:09,627
were distorted in their activity,

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00:13:09,651 --> 00:13:11,093
caused by a lack of sleep.

215
00:13:11,923 --> 00:13:15,050
The second result
was that about half of those genes

216
00:13:15,074 --> 00:13:17,516
were actually increased in their activity.

217
00:13:17,842 --> 00:13:19,771
The other half were decreased.

218
00:13:20,448 --> 00:13:23,728
Now those genes that were switched off
by a lack of sleep

219
00:13:23,753 --> 00:13:27,242
were genes associated
with your immune system,

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00:13:27,266 --> 00:13:30,106
so once again, you can see
that immune deficiency.

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00:13:31,348 --> 00:13:34,420
In contrast, those genes
that were actually upregulated

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00:13:34,445 --> 00:13:36,817
or increased by way of a lack of sleep,

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00:13:36,841 --> 00:13:40,739
were genes associated
with the promotion of tumors,

224
00:13:40,763 --> 00:13:45,914
genes associated with long-term
chronic inflammation within the body,

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00:13:45,938 --> 00:13:48,740
and genes associated with stress,

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00:13:48,764 --> 00:13:51,793
and, as a consequence,
cardiovascular disease.

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00:13:53,171 --> 00:13:56,831
There is simply no aspect of your wellness

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that can retreat at the sign
of sleep deprivation

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00:14:00,146 --> 00:14:01,959
and get away unscathed.

230
00:14:02,912 --> 00:14:05,920
It's rather like a broken
water pipe in your home.

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00:14:05,944 --> 00:14:09,587
Sleep loss will leak down
into every nook and cranny

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00:14:09,611 --> 00:14:11,997
of your physiology,

233
00:14:12,021 --> 00:14:15,925
even tampering with
the very DNA nucleic alphabet

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00:14:15,950 --> 00:14:18,790
that spells out
your daily health narrative.

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00:14:21,866 --> 00:14:24,549
And at this point, you may be thinking,

236
00:14:24,573 --> 00:14:27,105
"Oh my goodness,
how do I start to get better sleep?

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00:14:27,129 --> 00:14:29,374
What are you tips for good sleep?"

238
00:14:30,080 --> 00:14:34,558
Well, beyond avoiding
the damaging and harmful impact

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00:14:34,582 --> 00:14:37,501
of alcohol and caffeine on sleep,

240
00:14:37,525 --> 00:14:39,962
and if you're struggling
with sleep at night,

241
00:14:39,986 --> 00:14:42,167
avoiding naps during the day,

242
00:14:42,191 --> 00:14:44,334
I have two pieces of advice for you.

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The first is regularity.

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00:14:47,942 --> 00:14:51,343
Go to bed at the same time,
wake up at the same time,

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00:14:51,367 --> 00:14:54,428
no matter whether
it's the weekday or the weekend.

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Regularity is king,

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and it will anchor your sleep

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and improve the quantity
and the quality of that sleep.

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The second is keep it cool.

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Your body needs to drop
its core temperature

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by about two to three degrees
Fahrenheit to initiate sleep

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and then to stay asleep,

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and it's the reason
you will always find it easier

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to fall asleep in a room that's too cold

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than too hot.

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So aim for a bedroom temperature
of around 65 degrees,

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or about 18 degrees Celsius.

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That's going to be optimal
for the sleep of most people.

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And then finally,
in taking a step back, then,

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what is the mission-critical
statement here?

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Well, I think it may be this:

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sleep, unfortunately,
is not an optional lifestyle luxury.

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Sleep is a nonnegotiable
biological necessity.

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It is your life-support system,

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and it is Mother Nature's
best effort yet at immortality.

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And the decimation of sleep
throughout industrialized nations

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is having a catastrophic impact
on our health, our wellness,

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even the safety and the education
of our children.

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It's a silent sleep loss epidemic,

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and it's fast becoming one of the greatest
public health challenges

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that we face in the 21st century.

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I believe it is now time for us
to reclaim our right

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to a full night of sleep,

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and without embarrassment

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or that unfortunate stigma of laziness.

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And in doing so, we can be reunited
with the most powerful elixir of life,

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the Swiss Army knife
of health, as it were.

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And with that soapbox rant over,

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I will simply say, good night, good luck,

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and above all ...

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I do hope you sleep well.

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Thank you very much indeed.

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(Applause)

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Thank you.

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(Applause)

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Thank you so much.

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David Biello: No, no, no.
Stay there for a second.

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Good job not running away, though.
I appreciate that.

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So that was terrifying.

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Matt Walker: You're welcome.
DB: Yes, thank you, thank you.

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Since we can't catch up on sleep,
what are we supposed to do?

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What do we do when we're, like,
tossing and turning in bed late at night

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or doing shift work or whatever else?

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MW: So you're right,
we can't catch up on sleep.

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Sleep is not like the bank.

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You can't accumulate a debt

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and then hope to pay it off
at a later point in time.

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I should also note the reason
that it's so catastrophic

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and that our health
deteriorates so quickly,

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first, it's because human beings
are the only species

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that deliberately deprive
themselves of sleep

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for no apparent reason.

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DB: Because we're smart.

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MW: And I make that point
because it means that Mother Nature,

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throughout the course of evolution,

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has never had to face the challenge
of this thing called sleep deprivation.

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So she's never developed a safety net,

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and that's why when you undersleep,

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things just sort of implode so quickly,
both within the brain and the body.

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So you just have to prioritize.

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DB: OK, but tossing and turning in bed,

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what do I do?

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MW: So if you are staying in bed
awake for too long,

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you should get out of bed
and go to a different room

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and do something different.

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The reason is because your brain
will very quickly associate your bedroom

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with the place of wakefulness,

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and you need to break that association.

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So only return to bed when you are sleepy,

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and that way you will relearn
the association that you once had,

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which is your bed is the place of sleep.

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So the analogy would be,

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you'd never sit at the dinner table,
waiting to get hungry,

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so why would you lie in bed,
waiting to get sleepy?

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DB: Well, thank you for that wake-up call.

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Great job, Matt.

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MW: You're very welcome.
Thank you very much.