tag:theconversation.com,2011:/fr/topics/sleep-93/articlesSleep – The Conversation2024-03-14T08:30:05Ztag:theconversation.com,2011:article/2252982024-03-14T08:30:05Z2024-03-14T08:30:05ZWhy do we usually sleep at night? What happens when we don’t sleep? Expert insights into this essential part of our lives<p><em>Sleep is as essential to our health as food and water. It is important to a number of brain functions, including how nerve cells communicate with each other. We sleep for a third of our lives and there are many restorative processes going on during sleep that are needed to stay healthy.</em></p>
<p><em>Why do we usually sleep at night? What happens when we don’t sleep? On World Sleep Day, Nadine Dreyer asks a group of experts to tell us more about this essential part of our lives.</em></p>
<h2>Why do we need sleep and why do we sleep better at night?</h2>
<p>We sleep for a third of our lives, yet it is only when we cannot sleep or when we experience poor quality sleep that we really start noticing it. </p>
<p>During sleep, our muscle activity drops, our breathing slows down, and our heart rate and blood pressure decrease. At the same time our brain actively clears toxins, which cause neurodegenerative diseases.</p>
<p>It also consolidates memories, wiping out “useless” ones during deep sleep, known as <a href="https://www.sleepfoundation.org/stages-of-sleep/slow-wave-sleep#:%7E:text=During%20slow%2Dwave%20sleep%2C%20electrical,sleep%20in%20slow%2Dwave%20sleep.">slow wave sleep</a>. </p>
<p>All this allows us to start afresh the following day. </p>
<p>Our lives are organised around our sleep-wake schedule. As we’re a <a href="https://www.merriam-webster.com/dictionary/diurnal#:%7E:text=%3A%20of%2C%20relating%20to%2C%20or%20occurring%20in%20the%20daytime">diurnal</a> species, our master clock in the brain, which maintains many of our 24-hour rhythms, schedules our period of activity with daylight, and our period of rest with the night.</p>
<p>In some other animals, like rodents, evolutionary pressure has pushed those species to become nocturnal, which allows them to scurry and feed outside the view of their <a href="https://www.merriam-webster.com/dictionary/diurnal">diurnal</a> (daytime) or <a href="https://dictionary.cambridge.org/dictionary/english/crepuscular">crepuscular</a> (twilight) predators. </p>
<p>Not sleeping at the right time has been associated with poor health. Some of the side-effects are poorer cognitive performance, lower energy and worse mental health. </p>
<p>There’s also a higher risk of developing neurodegenerative diseases such as Alzheimer’s and a higher risk of developing high blood pressure and diabetes. </p>
<p>After a poor night’s sleep, we try to get on with our lives but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674220/">research</a> has shown this is not so easy. During the COVID-19 pandemic and the strictest lockdown, South Africans rated their sleep quality as poorer, with more insomnia symptoms. These were were both in turn associated with worse levels of depression and anxiety. </p>
<h2>What happens when we don’t sleep?</h2>
<p>Sleep is a state of vulnerability where a “rest and digest” state dominates over the “fight and flight” state when we are awake. </p>
<p>Our early sleep “scans” the environment before allowing us to dive into deeper stages of sleep. </p>
<p>When a rupture in this consolidated bout of sleep happens, we will start complaining “I haven’t slept enough” or “I slept really badly last night”. </p>
<p>Such ruptures include those induced by specific sleep disorders like sleep apnoea or insomnia.</p>
<p>Sleep apnoea leads to unconscious sleep interruptions due to upper airways obstruction and can lead to hypertension and increased risk of diabetes. </p>
<p>Research in rural Mpumalanga province in South Africa found one out of three older adults had <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.9214">moderate to severe sleep apnoea</a> and this was associated with a higher risk of cardiovascular disease. Yet there is no treatment in the public health system for this common sleep disorder. </p>
<p>Certain situations disrupt sleep: parents tending to their young children, doctors being awake while on call, loud generator noises during night-time electricity cuts, mosquitoes, or worse, gunshots or sounds of violence waking us up from our slumber, signalling danger.</p>
<p>Sleep health inequity in South Africa is also driven by socioeconomic status. </p>
<p>A recent study on sleep in men and women living in the urban township of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864334/">Khayelitsha</a> in South Africa’s Western Cape province showed that poor sleep quality was associated with fear of falling asleep in a violent environment. Sleep was disturbed by strange noises, fear of attacks and dreams about past traumatic experiences. </p>
<h2>Electronic devices make it difficult to sleep. Why?</h2>
<p>Even though our biology is meant to make us sleep at night, several societal, technological changes have progressively decreased our sleep opportunity. </p>
<p>Our sleep timing is controlled by our <a href="https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx">master circadian clock</a>. This clock is exquisitely sensitive to light, so exposure to bright light and blue light such as that emitted from electronic devices such as smartphones shifts our bedtime to a later time.</p>
<p>In our recently published study of <a href="https://www.sciencedirect.com/science/article/pii/S2352721823002668">adolescent sleep in Nigeria</a>, adolescents in urban areas slept less and sleep quality was worse. </p>
<p>Sleep duration was shorter, due to bedtimes being later but waking times in the morning similar to those of adolescents in rural areas. The use of electronic devices at night by urban Nigerian adolescents was associated with shorter sleep duration. </p>
<p>This is one example of a growing body of research that highlights the negative consequences of nocturnal tech use on sleep, even in African societies.</p>
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Read more:
<a href="https://theconversation.com/insomnia-how-chronic-sleep-problems-can-lead-to-a-spiralling-decline-in-mental-health-224131">Insomnia: how chronic sleep problems can lead to a spiralling decline in mental health</a>
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<h2>What are key habits to help people sleep better?</h2>
<p>The most important habit is to take sleep as seriously as a healthy diet and regular exercise. </p>
<p>We advise the following: </p>
<ul>
<li><p>Keep regular wake times and bedtimes. This helps us sleep at the best time with respect to our master clock’s rhythm. This in turn helps ensure a consolidated bout of sleep.</p></li>
<li><p>Aim for an average of 7 to 9 hours of sleep each night.</p></li>
<li><p>Avoid <a href="https://www.pnas.org/doi/full/10.1073/pnas.1418490112">watching screens</a> one hour before normal bedtime. If this is unavoidable, choose the lowest brightness and add the orange night screen setting. Rather read a book under a bedside light.</p></li>
<li><p>Get outdoor light during the day to strengthen the master clock’s circadian (near 24-hour) rhythm.</p></li>
<li><p>Do some form of physical activity once a day. This helps build sleep pressure and also strengthens the master clock’s rhythms.</p></li>
<li><p>Avoid alcohol before bedtime as this is associated with disrupted sleep.</p></li>
<li><p>Avoid caffeine and stimulants after noon.</p></li>
<li><p>Try to sleep in a quiet, cool and dark or dimly lit environment.</p></li>
</ul>
<p><em>For more information please visit <a href="https://sassh.org.za/">the South African Society for Sleep and Health</a>.</em></p><img src="https://counter.theconversation.com/content/225298/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karine Scheuermaier receives funding from National Institutes of Health (Bethesda, MD, USA), South African Medical Research Council, South Africa's National Research Foundation, and the Wellcome Trust (London, UK). She is affiliated with the South African Society for Sleep and Health and the World Sleep Society.</span></em></p><p class="fine-print"><em><span>Dale Rae works for Sleep Science and is currently funded by the Wellcome Trust UK. She is affiliated to the South African Society for Sleep and Health, World Sleep Society and European Society for Sleep Research</span></em></p><p class="fine-print"><em><span>Gosia Lipinska receives funding from the Wellcome Trust and the National Research Foundation. She is affiliated with the South African Society for Sleep and Health and the World Sleep Society.</span></em></p><p class="fine-print"><em><span>Jonathan Davy receives funding from Wellcome Trust. He is affiliated with the South African Society for Sleep and Health and the Ergonomics Society of South Africa. </span></em></p><p class="fine-print"><em><span>Dr Joshua Davimes receives funding from the National Research Foundation. He is affiliated with the South African Society for Sleep and Health. </span></em></p><p class="fine-print"><em><span>Dr Nomathemba Chandiwana has received research funding from Unitaid, USAID, Shin Poong Pharm, Merck, ViiV Healthcare, Gilead Sciences, Johnson & Johnson and is currently receiving research support from the Bill and Melinda Gates Foundation,, Novo Nordisk and Merck</span></em></p><p class="fine-print"><em><span>Oluwatosin Olorunmoteni receives funding from the Obafemi Awolowo University, the Consortium for Advanced Research Training in Africa, Uppsala Monitoring Center, Norwegian Agency for Development Cooperation, the Wellcome Trust and the UK Foreign, Commonwealth & Development Office.
</span></em></p><p class="fine-print"><em><span>Alison Bentley and Francesco Xavier Gomez-Olive Casas do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sleep is an essential part of life. What happens when we don’t get enough sleep and how do we ensure that we do?Karine Scheuermaier, Associate Professor in Physiology, Chair of Science Committee, South African Society for Sleep and Health, Member of the World Sleep Society, University of the WitwatersrandAlison Bentley, Honorary Lecturer in Family Medicine, University of the WitwatersrandDale Rae, Director of Sleep Science and associate professor at the Faculty of Health Sciences, University of Cape TownFrancesco Xavier Gomez-Olive Casas, Research Manager at MRC/Wits Agincourt Research Unit, University of the WitwatersrandGosia Lipinska, Associate Professor, University of Cape TownJonathan Davy, Senior lecturer, Rhodes UniversityJoshua Davimes, Senior Lecturer in Anatomical Sciences, University of the WitwatersrandNomathemba Chandiwana, Principal Scientist at Ezintsha,, University of the WitwatersrandOluwatosin Olorunmoteni, Neurodevelopmental Paediatrician, Obafemi Awolowo UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2245972024-03-04T13:36:47Z2024-03-04T13:36:47ZCould the days of ‘springing forward’ be numbered? A neurologist and sleep expert explains the downside to that borrowed hour of daylight<figure><img src="https://images.theconversation.com/files/579007/original/file-20240229-24-zwzuqp.jpg?ixlib=rb-1.1.0&rect=16%2C8%2C5557%2C3648&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">While that 'extra' hour of sunlight in the evenings can be exhilarating, it comes with significant health trade-offs.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/daylight-saving-time-notepad-with-text-spring-royalty-free-image/1365468815?phrase=daylight+saving+time&adppopup=true">Anna Blazhuk/Moment via Getty Images</a></span></figcaption></figure><p>As people in the U.S. prepare to set their clocks ahead one hour on Sunday, March 10, 2024, I find myself bracing for the annual ritual of <a href="https://www.inquirer.com/news/standard-time-daylight-saving-time-clock-change-sleep-20201031.html">media stories</a> about <a href="https://qz.com/1114163/daylight-saving-time-dst-is-incredibly-disruptive-heres-how-to-reset/">the disruptions to daily routines</a> <a href="https://doi.org/10.5664/jcsm.8780">caused by switching from standard time</a> to daylight saving time. </p>
<p>About one-third of Americans say they don’t look forward to these twice-yearly time changes. And nearly two-thirds <a href="https://today.yougov.com/topics/politics/articles-reports/2021/11/04/daylight-saving-time-americans-want-stay-permanent">would like to eliminate them completely</a>, compared with 17% who aren’t sure and 21% who would <a href="https://docs.cdn.yougov.com/etwjvohrxx/Daylight_Saving_Time_Toplines_Crosstabs.pdf">like to keep moving their clocks back and forth</a>. </p>
<p>But the effects go beyond simple inconvenience. Researchers are discovering that “springing ahead” each March is connected with serious negative health effects, including an uptick in <a href="https://doi.org/10.3390/jcm8030404">heart attacks</a> and <a href="https://doi.org/10.5664/jcsm.4938">teen sleep deprivation</a>. In contrast, the fall transition back to standard time is not associated with these health effects, as my co-authors and I explained in a <a href="https://doi.org/10.1001/jamaneurol.2019.3780">2020 commentary</a>.</p>
<p>I’ve studied the pros and cons of these twice-annual rituals for more than five years as a <a href="https://scholar.google.com/citations?user=ZddlKEoAAAAJ&hl=en">professor of neurology and pediatrics</a> and the director of Vanderbilt University Medical Center’s sleep division. It’s become clear to me and many of my colleagues that the transition to daylight saving time each spring affects health immediately after the clock change and also for the nearly eight months that <a href="https://www.cnn.com/2022/11/06/health/permanent-daylight-savings-health-harms-wellness/index.html#">Americans remain on daylight saving time</a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/NnlhgasgQYc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Washington is one of the states where legislators are pushing for permanent standard time.</span></figcaption>
</figure>
<h2>Why our bodies are thrown off by DST</h2>
<p>Americans are split on whether they <a href="https://today.yougov.com/topics/politics/articles-reports/2021/11/04/daylight-saving-time-americans-want-stay-permanent">prefer permanent daylight saving time</a> or <a href="https://apnorc.org/projects/dislike-for-changing-the-clocks-persists/">permanent standard time</a>. But a <a href="https://savestandardtime.com/current/">growing number of states</a> are supporting permanent standard time. </p>
<p>However, the two time shifts – jolting as they may be – are not equal. Standard time most closely approximates natural light, with the sun directly overhead at or near noon. In contrast, during daylight saving time from March until November, the clock change causes natural light to be present one hour later in the morning and one hour later in the evening according to clock time.</p>
<p>Morning light is essential for helping to set the body’s natural rhythms: It <a href="https://doi.org/10.1038/s41598-018-36791-5">wakes us up and improves alertness</a>. Morning light also boosts mood – light boxes simulating natural light are prescribed for morning use <a href="https://doi.org/10.1001/archpsyc.55.10.890">to treat seasonal affective disorder</a>.</p>
<p>Although the exact reasons why light activates us and benefits our mood are not yet known, this may be due to light’s effects on <a href="https://doi.org/10.1080/10253890.2020.1741543">increasing levels of cortisol</a>, a hormone that <a href="https://doi.org/10.1038/s41574-019-0228-0">modulates the stress response</a>, or the effect of <a href="https://doi.org/10.1038/s41598-018-36791-5">light on the amygdala</a>, a part of the brain involved in emotions.</p>
<p>Adolescents also may be <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">chronically sleep-deprived due to school</a>, sports and social activities. For instance, many <a href="https://nces.ed.gov/pubs2020/2020006/index.asp">children start school around 8 a.m.</a> or earlier, which means that during daylight saving time they get up and travel to school in pitch darkness.</p>
<p>The body of evidence makes a good case for adopting permanent standard time nationwide, as I testified at a <a href="https://democrats-energycommerce.house.gov/committee-activity/hearings/rescheduled-hearing-on-changing-times-revisiting-spring-forward-fall">March 2022 Congressional hearing</a> and argued in a <a href="https://doi.org/10.1093/sleep/zsac236">recent position statement</a> for the Sleep Research Society. The American Medical Association recently <a href="https://www.ama-assn.org/press-center/press-releases/ama-calls-permanent-standard-time">called for permanent standard time</a>. And in late 2022, <a href="https://www.timeanddate.com/news/time/mexico-abolishes-dst-2022.html#">Mexico adopted permanent standard time</a>, citing benefits to <a href="https://thehill.com/policy/international/3708301-mexicos-senate-votes-to-end-daylight-saving-time-for-most-of-the-country/">health, productivity and energy savings</a>. </p>
<figure class="align-center ">
<img alt="An illustration of two clocks depicting Daylight Savings Time changes: Fall backward, and spring forward." src="https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In 2024, clocks spring forward one hour at 2 a.m. on Sunday, March 10. They fall back at 2 a.m. on Sunday, Nov. 3.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/daylight-saving-time-fall-backward-and-royalty-free-illustration/1356689682?adppopup=true">iam2mai/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>The biggest advantage of daylight saving time is that it provides an extra hour of light in the late afternoon or evening, depending on time of year, for sports, shopping or eating outside. However, exposure to light later into the evening for almost eight months during daylight saving time comes at a price. This extended evening light delays the brain’s release of melatonin, the hormone that promotes drowsiness, which in turn interferes with sleep and <a href="https://doi.org/10.1093/sleep/zsac236">causes us to sleep less overall</a>.</p>
<p>Because puberty also causes <a href="https://www.neurologylive.com/view/teenage-circadian-rhythm">melatonin to be released later at night</a>, meaning that teenagers have a delay in the natural signal that helps them fall asleep, adolescents are <a href="https://dx.doi.org/10.5664/jcsm.4938">particularly susceptible to sleep problems</a> from the extended evening light. This shift in melatonin during puberty lasts into our 20s.</p>
<h2>The ‘western edge’ effect</h2>
<p>Geography can also make a difference in how daylight saving time affects people. One study showed that people living on the western edge of a time zone, who get light later in the morning and later in the evening, <a href="https://doi.org/10.1016/j.jhealeco.2019.03.007">got less sleep</a> than their counterparts on the eastern edge of a time zone. </p>
<p>This study found that western-edge residents had higher rates of obesity, diabetes, heart disease and <a href="https://theconversation.com/breast-cancer-risk-higher-in-western-parts-of-time-zones-is-electric-light-to-blame-85803">breast cancer</a>, as well as lower per capita income and higher health care costs. Other research has found that <a href="https://doi.org/10.1158/1055-9965.EPI-16-1029">rates of certain other cancers are higher</a> on the western edge of a time zone. </p>
<p>Scientists believe that these health problems may result from a combination of <a href="https://doi.org/10.3389/fphys.2019.00944">chronic sleep deprivation and “circadian misalignment</a>.” Circadian misalignment refers to a mismatch in timing between our biological rhythms and the outside world. In other words, the timing of daily work, school or sleep routines is based on the clock, rather than on the sun’s rise and set. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/84aWtseb2-4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">This video takes a deeper dive – all the way back to 1895 – into the history of daylight saving time.</span></figcaption>
</figure>
<h2>A brief history of daylight saving time</h2>
<p><a href="https://blogs.loc.gov/teachers/2017/03/world-war-i-and-daylight-savings-time/">Congress instituted year-round daylight saving time</a> during World War I and World War II, and <a href="https://www.mercurynews.com/2016/10/30/the-year-daylight-saving-time-went-too-far/">once again during the energy crisis</a> of the early 1970s. But the popularity of year-round daylight saving time fell from 79% to 42% after it went into effect in January 1974, largely due to <a href="https://www.washingtonian.com/2022/03/15/the-us-tried-permanent-daylight-saving-time-in-the-70s-people-hated-it/">safety concerns about children going to school in the dark</a>. </p>
<p>The idea at that time was that having extra light later into the afternoon would save energy by decreasing the need for electric lighting. This idea has since been <a href="https://doi.org/10.1016/j.jebo.2014.03.012">proved largely inaccurate</a>, as heating needs may increase in the morning in the winter, while air conditioning needs can also increase in the late afternoon in the summer.</p>
<p>After World War II, designating the start and end dates for daylight saving time fell to state governments. Because this created many railroad scheduling and safety problems, however, Congress passed the <a href="https://www.transportation.gov/regulations/time-act#">Uniform Time Act in 1966</a>. This law set the nationwide dates of daylight saving time from the last Sunday in April until the last Sunday in October. In 2007, <a href="https://www.bts.gov/geospatial/daylight-savings-time">Congress amended the act</a> to expand the period in which daylight saving time is in effect from the second Sunday in March to the first Sunday in November – dates that remain in effect today.</p>
<p>But the Uniform Time Act does allow states and territories to opt out of daylight saving time. Arizona and Hawaii are on permanent standard time, along with Puerto Rico, the U.S. Virgin Islands, Northern Mariana Islands, Guam and American Samoa. </p>
<h2>A shifting landscape</h2>
<p>As of March 2024, <a href="https://savestandardtime.com/current/">17 states have passed laws</a> to adopt year-round daylight saving time. But federal law requires that they need to wait for Congress, and in some cases also neighboring states, to act. More than two dozen states <a href="https://www.sleepfoundation.org/sleep-news/latest-updates-daylight-saving-time-legislation-change#what-is-the-status-of-state-level">introduced legislation related to the clock change in 2023</a>, but no laws were passed. </p>
<p>Meanwhile, proposed legislation and resolutions for <a href="https://savestandardtime.com/current/">permanent standard time have increased</a> from 15% in 2021 to 37% in 2024. </p>
<p>In March 2022, the U.S. Senate <a href="https://www.congress.gov/bill/117th-congress/senate-bill/623">passed the Sunshine Protection Act </a> in a bid to <a href="https://www.reuters.com/world/us/us-senate-approves-bill-that-would-make-daylight-savings-time-permanent-2023-2022-03-15/">make daylight saving time permanent</a>. But the House did not move forward with this legislation. Florida Sen. Marco Rubio <a href="https://thehill.com/homenews/nexstar_media_wire/3880009-bill-to-make-daylight-saving-time-permanent-reintroduced-in-congress/">reintroduced the bill</a> on March 1, 2023, but <a href="https://www.congress.gov/bill/118th-congress/senate-bill/582/all-info#">this bill has not progressed</a>. </p>
<p>The spike in activity among states seeking to break from these twice-yearly changes reflects how more people are recognizing the downsides of this practice. Now, it’s in the hands of legislators to decide whether to end the time shift altogether and to either choose a full year of having clocks more aligned with the sun or to artificially extend the day for more than half the year, for better or for worse.</p>
<p><em>This is an updated version of an article <a href="https://theconversation.com/why-daylight-saving-time-is-unhealthy-a-neurologist-explains-175427">originally published on March 10, 2022</a>.</em></p><img src="https://counter.theconversation.com/content/224597/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Beth Ann Malow is the Sleep Research Society representative to the Coalition for Permanent Standard TIme. </span></em></p>Americans have long been divided over adopting permanent standard versus permanent daylight saving time. But support for permanent standard time grew dramatically between 2021 and 2024.Beth Ann Malow, Professor of Neurology and Pediatrics, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2232812024-03-03T14:27:58Z2024-03-03T14:27:58ZHow art and literature can help us rethink our problems with sleep<figure><img src="https://images.theconversation.com/files/576267/original/file-20240216-26-wl1pyc.jpeg?ixlib=rb-1.1.0&rect=0%2C24%2C1280%2C981&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Noon - Rest from Work (after Millet) by Dutch painter Vincent van Gogh, 1890. </span> <span class="attribution"><a class="source" href="https://www.wikiart.org/en/vincent-van-gogh/rest-work-after-millet-1890">(Van Gogh)</a></span></figcaption></figure><p>With the arrival of <a href="https://www.ctvnews.ca/canada/time-change-when-do-we-set-clocks-forward-this-year-1.6787346">Daylight Saving Time</a> soon, losing that hour of sleep in the morning might be front of mind for many people. Troubles with sleep have become something of a public obsession. <a href="https://www.theglobeandmail.com/life/style/article-sleep-crisis-canada/">Up to half</a> of the population in Canada reports <a href="https://www150.statcan.gc.ca/n1/pub/82-003-x/2022003/article/00001-eng.htm">trouble sleeping</a>, and the global sleep industry is valued at <a href="https://www.polarismarketresearch.com/industry-analysis/sleeping-aids-market">US$67 billion</a>.</p>
<p>Consumer products like sleep trackers and scented pillow sprays imply that sleep loss is a matter of personal responsibility, something for individuals to solve with quick tips and gadgets.</p>
<p>Media reports and self-help articles also tend to treat imperfect sleep as an individual problem, a failure that people <a href="https://www.verywellhealth.com/the-10-worst-ways-to-ruin-your-sleep-3014992">need to fix</a> by changing <a href="https://www.yalemedicine.org/news/sleep-training">their habits</a> and <a href="https://www.linkedin.com/pulse/1poor-sleep-hygiene-killing-you-your-career-dr-travis-bradberry">lifestyle</a>. But if we think about sleep as a cultural issue, we can rethink our relationship with slumber and recognize how sleep exposes competing agendas.</p>
<p>Works of literature and art, for example, can teach us to challenge dominant visions of sleep, allowing us to see sleep as a place where values are formed and cultural debates are shaped.</p>
<h2>Sleep inequities</h2>
<p>There are many ways that <a href="https://link.springer.com/book/10.1057/9780230305373">sleep functions culturally</a> as a form of inequity and power. The inequitable nature of <a href="https://www150.statcan.gc.ca/n1/pub/82-003-x/2018012/article/00002-eng.htm">troubles with sleep</a> is visible through the poor sleep of <a href="https://www.cbc.ca/news/canada/british-columbia/uvic-physiological-nursing-study-1.5894709">medical workers</a>, the sleep loss tied to <a href="https://www.thestar.com/news/canada/fort-mcmurray-residents-plagued-by-sleepless-nights-study-finds/article_0d9bb466-c831-5c20-8271-24aabfc72da0.html">climate</a> <a href="https://vancouver.citynews.ca/2021/06/27/bc-heat-wave-sleep/">disasters</a> and uneven rates of <a href="https://www.cbc.ca/news/canada/new-brunswick/seniors-sleeping-pills-study-new-brunswick-1.5910922">sleeping pill use</a>. </p>
<p>While some people enjoy their luxury bedding at night, others are being <a href="https://theconversation.com/encampment-sweeps-in-edmonton-are-yet-another-example-of-settler-colonialism-221676">evicted from their homes</a>, unsure where or how they’ll get a night’s rest.</p>
<p>Seeing sleep purely as a personal responsibility ignores how it is tied to social values and <a href="https://www.hachettebookgroup.com/titles/tricia-hersey/rest-is-resistance/9780316365536/">forms of oppression</a>. No amount of weighted blankets, blue-light blocking glasses or aromatherapy candles can solve inherently systemic problems. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man lying awake in a bed." src="https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/575848/original/file-20240215-26-p01yfv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Trouble sleeping is often seen as an individual problem, but there are many societal issues that contribute to sleepless nights.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2><em>Dear Scarlet</em></h2>
<p>Literature and art have always played a key role in cultural debates. <a href="https://link.springer.com/book/10.1007/978-3-319-75253-2">Creative works</a> can teach us to see sleep in <a href="https://www.hachettebookgroup.com/titles/benjamin-reiss/wild-nights/9780465061952/?lens=basic-books">unexpected ways</a>, revealing the <a href="https://www.writingsleep.com/">meanings of sleep</a> in diverse contexts. They can also help us develop a critical literacy of sleep by teaching us to question the dominant cultural visions of slumber that circulate around us.</p>
<p>Writer and cartoonist Teresa Wong’s illustrated memoir <em><a href="https://arsenalpulp.com/Books/D/Dear-Scarlet">Dear Scarlet: The Story of My Postpartum Depression</a></em> shows how sleep loss for new parents can be tied to problematic cultural norms. As Wong battles overwhelming hopelessness after the birth of her first child, doctors and friends dismiss her concerns, telling her that she will get over the <a href="https://theconversation.com/new-treatment-for-postpartum-depression-offers-hope-but-the-stigma-attached-to-the-condition-still-lingers-213499">baby blues</a>. Sleep deprivation makes the situation worse. Wong lies awake, filled with anxious self-doubt, and eventually thinks that her baby would be better off without her.</p>
<p>In one nighttime scene, the baby’s crying leads Wong to think that she hates her baby. But she decides, “I didn’t hate you. I hated myself.” This spiral of dark thoughts shows how sleep deprivation can be linked to misery for new parents, especially in the absence of support.</p>
<p>The starkness of Wong’s drawings reflects her blunted senses, as her inner world is drained of detail and colour. In the final panel of the sequence, Wong’s body is composed of just thirteen or so lines of ink, a bare representation that reflects her desolation. The minimal artwork conveys a big message, showing how sleep loss is tied to cultural problems around <a href="https://www.womenshealthmag.com/uk/health/sleep/a40230166/sleep-feminist-issue/">gender</a>, health care and <a href="https://doi.org/10.1007/s41105-022-00378-5">social isolation</a>.</p>
<h2>Fiction and poetry</h2>
<p>Works of fiction and poetry can also reflect the links between sleep loss and societal issues. David Chariandy’s novel <a href="https://www.penguinrandomhouse.ca/books/26281/brother-by-david-chariandy/9780771023330"><em>Brother</em></a> follows the lives of Michael and Francis, the children of Trinidadian immigrants in Toronto. The brothers are trapped in a world of poverty and violence, and they often relive trauma in the moments when they are falling asleep.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A book cover featuring a electricity poll and power lines in front of a dark blue sky." src="https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=925&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=925&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=925&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1162&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1162&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578766/original/file-20240228-22-mnuihk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1162&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Brother by David Chariandy.</span>
<span class="attribution"><a class="source" href="https://www.penguinrandomhouse.ca/books/26281/brother-by-david-chariandy/9780771023330">(Penguin Random House)</a></span>
</figcaption>
</figure>
<p>Michael notes that Francis would “be on the edge of sleep when some terror would visit him. He’d wake screaming a deep body scream.” Of himself, Michael says, “on the edge of sleep, the shootings return to me with an attack of panic and wild vertigo.” The repeated image of the “edge” of sleep brings to mind a precipice or, perhaps, the blade of a knife that penetrates the mind.</p>
<p>Sleep is usually associated with peaceful rest, but by linking sleep with trauma, <em>Brother</em> changes what sleep means. The brothers’ nighttime panic reflects how sleep loss can be tied to social inequality and poverty, issues that go far beyond matters of personal sleep habits.</p>
<p>Writer Dionne Brand’s poetry considers the difficulty of sleeping when disasters are affecting others. In her book <a href="https://www.penguinrandomhouse.ca/books/17471/thirsty-by-dionne-brand/9780771016448"><em>Thirsty</em></a>, she writes:</p>
<blockquote>
<p> “if it is late at night and quiet…
<br> you can hear someone’s life falling apart
<br><br> Most people can sleep through a siren. I can’t…
<br> Even at a great distance
<br> you sense its mortal discoveries.”</p>
</blockquote>
<p>Sleeping through an ambulance siren can be a necessary skill in the city, but for Brand, such a sleep shows callousness toward the suffering of others. And in her poem <a href="https://www.penguinrandomhouse.ca/books/17468/inventory-by-dionne-brand/9780771016622"><em>Inventory</em></a>, these anxieties extend far beyond the street outside one’s bedroom window. The speaker in this poem lies awake because people in distant places are being killed by bombs and guns: “a sleep, no, / sleep would be forgiving.”</p>
<p>In these poems, the cruelty of sleep is that it requires us to become skilled at indifference. Sleep is not just an everyday act. It is also a form of meaning, a contradictory symbol of anxiety and rest.</p>
<p>If we want to be compassionate people during our waking hours, we need to enjoy restful slumber at night. Whether or not we sleep more soundly than the people in these books, works of literature can help us understand why sleeping well is about more than buying the right mattress or debating the merits of Daylight Saving Time.</p>
<p>The humanities can teach us <a href="https://www.mqup.ca/restless-in-sleep-country-products-9780228020394.php">how to see sleep as a place where values take shape</a>. And literature and art can help us decide what sleep means, or ought to mean, within the systems of power and care that shape our lives. </p>
<p>We need to recognize sleep as a matter of culture so that we can think critically about the forms of power tied up with it. Every sleep tells a story, and by learning to read these stories carefully, we can help each other rest a little easier.</p><img src="https://counter.theconversation.com/content/223281/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul Huebener does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Troubled sleep is often seen as a personal problem, a failure individuals need to fix. However, literature and art can help us question the cultural and systemic issues keeping us up at night.Paul Huebener, Professor of English, Faculty of Humanities and Social Sciences, Athabasca UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2228542024-02-29T21:48:23Z2024-02-29T21:48:23ZBetter sleep is a protective factor against dementia<figure><img src="https://images.theconversation.com/files/573581/original/file-20240117-23-vqzz7m.jpg?ixlib=rb-1.1.0&rect=60%2C0%2C6720%2C4456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Lack of sleep, or poor quality sleep, is one of the risk factors for developing Alzheimer's disease. Fortunately, there are ways to improve sleep.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Dementia is a progressive loss of cognitive abilities, such as memory, that is significant enough to have an impact on a person’s daily activities. </p>
<p>It can be caused by a number of different diseases, including <a href="https://alzheimer.ca/en/about-dementia/what-alzheimers-disease">Alzheimer’s</a>, which is the most common form. Dementia is caused by a loss of neurons over a long period of time. Since, by the time symptoms appear, many changes in the brain have already occurred, many scientists are focusing on studying the risk and protective factors for dementia. </p>
<p>A risk factor, or conversely, a protective factor, is a condition or behaviour that increases or reduces the risk of developing a disease, but does not guarantee either outcome. Some risk factors for Alzheimer’s disease and dementia, such as age or genetics, are not modifiable, but there are several other factors we can influence, <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">specifically lifestyle habits and their impact on our overall health</a>.</p>
<p>These risk factors include depression, lack of physical activity, social isolation, high blood pressure, obesity, diabetes, excessive alcohol consumption and smoking, as well as poor sleep.</p>
<p>We have been focusing our research on the question of sleep for over 10 years, particularly in the context of the <a href="https://www.nhlbi.nih.gov/science/framingham-heart-study-fhs">Framingham Heart Study</a>. In this large community-based cohort study, ongoing since the 1940s, the health of surviving participants has been monitored to the present day. As researchers in sleep medicine and epidemiology, we have expertise in researching the role of sleep and sleep disorders in cognitive and psychiatric brain aging. </p>
<p>As part of our research, we monitored and analyzed the sleep of people aged 60 and over to see who did — or did not — develop dementia. </p>
<h2>Sleep as a risk or protective factor against dementia</h2>
<p>Sleep appears to play an essential role in a number of brain functions, such as memory. Good quality sleep <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2793873">could therefore play a vital role in preventing dementia</a>.</p>
<p>Sleep is important for maintaining <a href="https://www.science.org/doi/10.1126/science.1241224">good connections in the brain</a>. Recently, research has revealed that sleep seems to have a function similar to that of a garbage truck for the brain: <a href="https://doi.org/10.1016/j.mad.2023.111899">deep sleep could be crucial for eliminating metabolic waste from the brain</a>, including clearing certain proteins, such as those known to accumulate in the brains of people with Alzheimer’s disease. </p>
<p>However, the links between deep sleep and dementia still have to be clarified.</p>
<h2>What is deep sleep?</h2>
<p>During a night’s sleep, we go through several <a href="http://ceams-carsm.ca/en/a-propos-du-sommeil/">sleep stages</a> that succeed one another and are repeated. </p>
<p>NREM sleep (non-rapid eye movement sleep) is divided into light NREM sleep (NREM1 stage), NREM sleep (NREM2 stage) and deep NREM sleep, also called slow-wave sleep (NREM3 stage). The latter is associated with several restorative functions. Next, REM sleep (rapid eye movement sleep) is the stage generally associated with the most vivid dreams. An adult generally spends around 15 to 20 per cent of each night in deep sleep, if we add up all the periods of NREM3 sleep. </p>
<p>Several sleep changes are common in adults, such as going to bed and waking up earlier, sleeping for shorter periods of time and less deeply, and waking up more frequently during the night.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=279&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=279&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=279&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=350&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=350&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=350&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sleep stages, and the role of deep sleep for brain health.</span>
<span class="attribution"><span class="source">(Andrée-Ann Baril)</span></span>
</figcaption>
</figure>
<h2>Loss of deep sleep linked to dementia</h2>
<p>Participants in the <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2810957">Framingham Heart Study</a> were assessed using a sleep recording — known as polysomnography — on two occasions, approximately five years apart, in 1995-1998 and again in 2001-2003. </p>
<p>Many people showed a reduction in their deep slow-wave sleep over the years, as is to be expected with aging. Conversely, the amount of deep sleep in some people remained stable or even increased. </p>
<p>Our team of researchers from the Framingham Heart Study followed 346 participants aged 60 and over for a further 17 years to observe who developed dementia and who did not. </p>
<p>Progressive loss of deep sleep over time was associated with an increased risk of dementia, whatever the cause, and particularly Alzheimer’s type dementia. These results were independent of many other risk factors for dementia.</p>
<p>Although our results do not prove that loss of deep sleep causes dementia, they do suggest that it could be a risk factor in the elderly. Other aspects of sleep may also be important, such as its duration and quality. </p>
<h2>Strategies to improve deep sleep</h2>
<p>Knowing the impact of a lack of deep sleep on cognitive health, what strategies can be used to improve it? </p>
<p>First and foremost, if you’re experiencing sleep problems, it’s worth talking to your doctor. Many sleep disorders are underdiagnosed and treatable, particularly through behavioural (i.e. non-medicinal) approaches. </p>
<p>Adopting good sleep habits can help, such as going to bed and getting up at consistent times or avoiding bright or blue light in bed, like that of screens. </p>
<p>You can also avoid caffeine, limit your alcohol intake, maintain a healthy weight, be physically active during the day, and sleep in a comfortable, dark and quiet environment.</p>
<p>The role of deep sleep in preventing dementia remains to be explored and studied. Encouraging sleep with good lifestyle habits could have the potential to help us age in a healthier way.</p><img src="https://counter.theconversation.com/content/222854/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrée-Ann Baril received funding from the Sleep Research Society Foundation, the Alzheimer Society of Canada, the Canadian Institutes of Health Research, Banting Postdoctoral Fellowships, the Fondation de l'Hôpital du Sacré-Coeur de Montréal, the Université de Montréal and speaking fees from Eisai.</span></em></p><p class="fine-print"><em><span>Matthew Pase received funding from the National Health and Medical Research Council of Australia, National Institute on Aging, Dementia Australia, Alzheimer's Association, National Heart Foundation of Australia, Australian Research Council, Stroke Foundation, Brain Foundation, Alzheimer's Drug Discovery Foundation, Rebecca L Cooper Medical Research Foundation, and Bethlehem Griffiths Research Foundation.</span></em></p>Sleep appears to play an essential role in a number of brain functions, such as memory. So good quality sleep could play a vital role in preventing dementia.Andrée-Ann Baril, Professeure-chercheure adjointe au Département de médecine, Université de MontréalMatthew Pase, Associate Professor of Neurology and Epidemiology, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2238952024-02-28T13:12:00Z2024-02-28T13:12:00ZSleep and circadian rhythm problems linked with poor mental health – new research<figure><img src="https://images.theconversation.com/files/577905/original/file-20240226-17-7n74le.jpg?ixlib=rb-1.1.0&rect=48%2C8%2C5435%2C3604&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The more severe sleep and circadian disruptions are, the worse a person's mood may be.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-cant-sleep-night-because-her-172728239">Ground Picture/ Shutterstock</a></span></figcaption></figure><p>Every cell in the body has a circadian rhythm. This rhythm follows a near 24-hour cycle that is synchronised to day and night. These <a href="https://www.ncbi.nlm.nih.gov/books/NBK519507/#:%7E:text=The%20regulation%20of%20sleep%20is,light%20changes%20in%20our%20environment">circadian rhythms</a> are critical for health and wellbeing.</p>
<p>But our circadian rhythm can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142605/">become disrupted</a> when our lifestyle does not correspond with this natural day-and-night cycle – for example, if we work night shifts or experience jet lag. Factors such as ageing, genetics and certain medical conditions (such as <a href="https://pubmed.ncbi.nlm.nih.gov/37565922/">autoimmune diseases</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338075/">Alzheimer’s disease</a>) are also linked with long-term circadian rhythm disruptions.</p>
<p>Sleep and circadian rhythm disturbances can also predict the onset and relapse of certain <a href="https://cms.wellcome.org/sites/default/files/2022-07/MH-Sleep-Report-Wellcome-07.2022.pdf">mental health disorders</a> – including depression, anxiety, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505194/">bipolar disorder and schizophrenia</a>. The more severe the sleep and circadian disruptions are, the worse a person’s mood, risk of relapse and mental health treatment outcomes are.</p>
<p>But despite evidence showing this link, why it exists remains largely unknown. This is what research conducted by myself and my colleagues sought to understand.</p>
<p>We found that sleep and circadian rhythm disruptions appear to <a href="https://www.pnas.org/doi/10.1073/pnas.2214756121">trigger or worsen a range of mental disorders</a> – including bipolar disorder and depression. We also uncovered some of the specific biological mechanisms which may underpin this link.</p>
<p>Our review assessed all research published in the past ten years on different mental disorders – including depression, anxiety and psychosis. We mainly focused on adolescents and young adults. </p>
<p>We found that the majority of young people diagnosed with a mental health condition also had sleep problems – such as insomnia (trouble falling asleep and staying asleep), delayed sleep timing and worsened daytime alertness. We also found that one-third of people with bipolar disorder (and other mental disorders) had a disrupted circadian rhythm, where they go to sleep and wake up later than usual.</p>
<p>Our study also pinpointed some of the mechanisms that may explain the link between sleep problems and mental health disorders. Among these mechanisms are an increased vulnerability at the genetic or molecular level to circadian rhythm disruption. </p>
<p>We also found that some participants experienced changes in their brain activity caused by chemical signalling problems that can affect sleep and mood levels. Inappropriate light exposure (such as getting too little natural daylight or too much artificial light at night) and eating too late in the evening or at night may also trigger sleep and circadian rhythm problems. </p>
<figure class="align-center ">
<img alt="A young man uses his laptop at night while sitting on his bed." src="https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577906/original/file-20240226-20-bm4d01.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Getting too much artificial light at night may be one of the mechanisms behind circadian rhythm disruption.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-teen-front-laptop-computer-on-226752055">junpinzon/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Importantly, we showed that most studies to date have only looked at the effect of sleep on mood or the effects of circadian disruption on mood separately. Both were rarely studied in conjunction, as assessing sleep is far more common (and easier) than assessing circadian rhythms. This is one of the current key research limitations that needs to be addressed in future studies. </p>
<h2>Circadian misalignment</h2>
<p><a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health">One in seven</a> ten to 19-year-olds experience a mental disorder worldwide. <a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health">Depression and anxiety</a> are among the leading causes of illness and disability among adolescents, with suicide being the fourth leading cause of death among 15 to 29-year-olds. Moreover, not addressing adolescent mental disorders can cause these problems to extend into adulthood.</p>
<p>Adolescence is not only a particularly vulnerable time for developing mental disorders – it’s also a time when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136689/#:%7E:text=Indeed%2C%20insomnia%20during%20adolescence%20is,particular%20life%20period%20%5B17%5D">sleep and circadian rhythms change</a>. Adolescents often sleep later, due to a delay in their circadian rhythm caused by their development, but have to wake up early due to school. As a consequence, they often experience shorter sleep than needed, which can further <a href="https://www.nature.com/articles/s44159-022-00074-8#:%7E:text=A%20meta%2Danalytic%20review%20of,depression%2C%20negative%20affect%20and%20anxiety">worsen their mental health</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/investigating-insomnia-our-research-shows-how-chronic-sleep-problems-can-lead-to-a-spiralling-decline-in-mental-health-224131">Investigating insomnia: our research shows how chronic sleep problems can lead to a spiralling decline in mental health</a>
</strong>
</em>
</p>
<hr>
<p>Our review highlights how important it is to pay attention to circadian rhythm disruptions in young people – especially when it comes to risk of certain mental health problems. Our review also highlights the need to consider sleep and circadian problems when someone experiences mental health problems. By addressing such problems, it may be possible to improve one’s mental health and quality of life.</p>
<h2>Sleep and circadian interventions</h2>
<p>At the moment, treatments for sleep problems (such as insomnia) involve <a href="https://academic.oup.com/sleep/article/43/9/zsaa034/5777024">cognitive behavioural therapy</a> and <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00683-9/fulltext">sleep restriction</a>. These focus on improving sleep – while mental health problems due to circadian rhythm disruption are not directly addressed.</p>
<p>Our review highlighted treatments that may help improve mood and sleep quality and align circadian rhythms. This included timing medication intake, exposure to natural daylight (and reducing nighttime light) as well as eating and being physically active during the day. More research will be needed, however, to better understand the benefits of these treatments in real-world settings.</p><img src="https://counter.theconversation.com/content/223895/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Chellappa does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Depression, bipolar disorder and anxiety have all been linked to problems with sleep and a disrupted circadian rhythm.Sarah Chellappa, Associate Professor, Cognitive and Affective Neuroscience, University of SouthamptonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2241312024-02-26T17:24:36Z2024-02-26T17:24:36ZInsomnia: how chronic sleep problems can lead to a spiralling decline in mental health<figure><img src="https://images.theconversation.com/files/577722/original/file-20240224-24-su6ra5.jpg?ixlib=rb-1.1.0&rect=21%2C142%2C3629%2C2310&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1965734296">APIMerah/Shutterstock</a></span></figcaption></figure><blockquote>
<p>I’ll often lie awake until three or four in the morning, before drifting off for just a few hours. Then comes the dreaded alarm clock. My mind and body are exhausted all the time – there’s always this knot of anxiety in my chest, doing away with any hope of a good night’s sleep.</p>
</blockquote>
<p>Simon* is a NHS mental health nurse who, like millions of people in the UK, suffers from insomnia: a sustained difficulty in initiating and maintaining sleep. His job is to support the recovery of people with severe mental illness, but his own sleep problems have had a profoundly negative impact on his mental health.</p>
<p>Most of us experience a bad night’s sleep from time to time, but can usually get back on track within a night or two. People suffering from insomnia, by contrast, have sleep problems that last for months or years at a time, taking a major toll on their health and wellbeing.</p>
<p>Around <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.26929#:%7E:text=a%20cognitive%20system.-,CONCLUSION,%2C%20social%2C%20and%20physical%20domains.">a third</a> of people will experience insomnia at some point in their life, with women and older people more often affected. Nearly 40% of sufferers <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772563">fail to recover within five years</a>. People with insomnia have an increased risk of diabetes, high blood pressure and <a href="https://www.sciencedirect.com/science/article/abs/pii/S1556407X22000182?via%3Dihub">cardiovascular disease</a>. Insomnia is also a major risk factor for <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13628">mental illness</a>, and often co-occurs with mood disorders such as depression and anxiety.</p>
<hr>
<p><em>Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. <a href="https://theconversation.com/uk/topics/tackling-the-mental-health-crisis-147216?utm_source=TCUK&utm_medium=ArticleTop&utm_campaign=MentalHealthSeries">In this series</a>, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.</em></p>
<hr>
<p>Many different life events can increase your chances of sustained sleep deprivation. Both the financial burden and confinement arising from the COVID-19 pandemic were associated with <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14048-1">greater risk</a> of insomnia, which is in turn likely to have led to a <a href="https://www.sciencedirect.com/science/article/pii/S1389945721004196?via%3Dihub">rise in mental health problems</a>.</p>
<p>And yet, very little is known about why and how a prolonged absence of sleep gives rise to mental illness. Our team at the University of York has pioneered research into whether sleep deprivation <a href="https://www.sciencedirect.com/science/article/pii/S1364661321000577">disrupts the brain’s ability to suppress intrusive memories</a> and distressing thoughts – classic symptoms of psychiatric disturbance. </p>
<p>It has also led us to ask whether it might one day be possible to treat mental illness while patients are sleeping – for example, by using sounds to normalise irregular patterns of brain activity during rapid eye movement (REM) sleep.</p>
<h2>Why are some people so badly affected?</h2>
<blockquote>
<p>They put their hand over my face so I couldn’t breathe. Now I can’t wear anything that covers my mouth or nose for fear of reliving [that experience]. Mask wearing was a big problem for me during the pandemic – and it was always worse when I slept badly. Just the sight of other people wearing masks could bring it all back.</p>
</blockquote>
<p>Helen* is a domestic abuse survivor who suffers from post-traumatic stress disorder (PTSD), a debilitating condition characterised by flashbacks, nightmares and severe anxiety. She told us her symptoms would always get worse after a bad night’s sleep – a pattern reported by other PTSD sufferers we spoke to.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of woman in bed covering her face with her hands" src="https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=439&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=439&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=439&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=552&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=552&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577724/original/file-20240224-26-m8ngfp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=552&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/insomnia-concept-young-woman-sitting-her-625713866">Randoms/Shutterstock</a></span>
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</figure>
<p>We can all sometimes encounter intrusive and unwanted thoughts, usually in response to reminders – for example, seeing a former partner and being reminded of an unpleasant breakup. While unsettling, these thoughts are infrequent, short-lived and, usually, quickly forgotten. This is in stark contrast to the highly lucid, distressing thoughts experienced by people with PTSD. Sufferers often engage in avoidant behaviour, such as not leaving home to reduce the likelihood of having to confront reminders of their trauma. </p>
<p>However, the symptoms of PTSD can also partly be explained by a breakdown of the brain mechanisms we rely on to push such intrusive thoughts out of conscious awareness. Because intrusive thoughts arise from unpleasant memories, another way people ward them off is by suppressing the offending content from their memory. But PTSD sufferers often <a href="https://journals.sagepub.com/doi/10.1177/0956797615569889">exhibit a deficit</a> in their ability to engage in this process of memory suppression, resulting in persistent unwanted patterns of thinking.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288776/original/file-20190820-170910-8bv1s7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
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<p><strong><em>This article is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.</em></p>
<hr>
<p>And what if lack of sleep reduces our ability to suppress unwanted thoughts and memories? This could lead to a downward spiral of more persistent and frightening intrusive thoughts, severe anxiety, and chronic sleeplessness – culminating in psychiatric disturbance.</p>
<p>Although a <a href="https://www.nature.com/articles/nrn.2017.55">wealth of research</a> has shown that sleep deprivation leads to psychological instability, <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">our study</a> was the first study to examine how an inability to control intrusive thoughts might underpin this relationship. For this reason, we worked with young adults without a diagnosed mental health disorder, allowing us to determine how even healthy brain processes go awry when people do not get enough sleep.</p>
<h2>How sleep deprivation affects our brain</h2>
<p>Our group of young adults (aged 18–25) were asked to memorise face-image pairs, comprising a male or female face with a neutral expression next to a unique scene. They would memorise each pair over and over again, so that any face presented in isolation would serve as a powerful reminder of the scene it was paired with – in the same way a reminder of an unpleasant event in the real world can trigger a distressing thought.</p>
<p>The face-scene learning took place late in the evening – after which half the participants went to sleep in our laboratory, and the other half stayed awake for the entire night – watching movies, playing games and going for short walks outside. They could eat and drink, but psychological stimulants such as caffeine were strictly prohibited. We would wake anyone in this group who nodded off.</p>
<p>Next morning, all participants were shown the faces only, in random order, with the following instructions. If the face was inside a green frame, the participant should allow the associated scene to come into their mind. A red frame meant they should engage in memory suppression to block out the scene – in the same way we sometimes purge unwanted thoughts from our conscious experience.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Explanation of face-image sleep and memory suppression experiment." src="https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577966/original/file-20240226-24-8ldt9l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sleep and memory suppression experiment.</span>
<span class="attribution"><a class="source" href="https://www.epoc-york.com/research">Scott Cairney/University of York</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Our sleep-deprived participants reported having more “intrusions” (failed memory suppression attempts) than those who had slept normally. And only well-rested participants got better at suppressing the unwanted memories over time. This suggests that sleeplessness does long-term harm to our ability to suppress intrusive memories and, hence, unwanted thoughts.</p>
<p>What’s going wrong inside a sleep-deprived person’s brain? To address this question, we <a href="https://www.biorxiv.org/content/10.1101/2023.11.07.565941v1">repeated our study</a>, but this time with participants undergoing <a href="https://www.ndcn.ox.ac.uk/divisions/fmrib/what-is-fmri/introduction-to-fmri">functional magnetic resonance imaging</a> (fMRI) – a powerful neuroimaging technique that allows us to determine which brain regions are engaged during particular cognitive operations (in this case, keeping intrusive memories at bay).</p>
<p>Memory suppression <a href="https://www.sciencedirect.com/science/article/pii/S1364661314000746?via%3Dihub">relies on a brain region</a> known as the right <a href="https://en.wikipedia.org/wiki/Dorsolateral_prefrontal_cortex">dorsolateral prefrontal cortex</a> (rDLPFC). When a reminder triggers retrieval of an unwanted memory, the rDLPFC inhibits activity in the brain’s memory processing centre, the <a href="https://en.wikipedia.org/wiki/Hippocampus">hippocampus</a>, to push that memory out of the person’s mind.</p>
<p>Our fMRI study showed that, when participants were attempting to suppress unwanted memories, activity in rDLPFC was reduced after a night of sleep deprivation relative to a night of restful sleep. Moreover, activity in the hippocampus was stronger after sleep deprivation than restful sleep, suggesting that a breakdown of control by rDLPFC had allowed unsolicited memory operations to emerge with impunity, opening the door to intrusive patterns of thinking.</p>
<h2>Can better sleep improve our mental health?</h2>
<p>REM sleep, discovered by <a href="https://www.science.org/doi/10.1126/science.118.3062.273">Eugene Aserinsky and Nathaniel Kleitman</a> in 1953, is a unique stage of sleep characterised by rapid movement of the eyes and a high propensity for vivid dreaming.</p>
<p>As the brain enters REM sleep, it undergoes dramatic changes that are thought to play an important role in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890316/">regulating our mental health</a>. For example, levels of the neurotransmitter <a href="https://www.britannica.com/science/acetylcholine">acetylcholine</a>, which modulates the processing of disturbing memories, are markedly increased in REM sleep relative to other sleep stages, mirroring levels seen in wakefulness. Abnormalities of REM sleep are <a href="https://www.annualreviews.org/doi/10.1146/annurev-clinpsy-032813-153716">linked</a> to various psychiatric mood disorders including PTSD, and associated with the intense nightmares experienced following trauma.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">A short history of insomnia and how we became obsessed with sleep</a>
</strong>
</em>
</p>
<hr>
<p>So, could the brain mechanisms that allow us to control intrusive memories be especially influenced by the amount of REM sleep we obtain over the course of a night? To investigate this, our fMRI study included <a href="https://pubmed.ncbi.nlm.nih.gov/31277862/">polysomnography</a> – a sleep monitoring technique that enabled us to identify when participants were in REM sleep, based on both their eye movement and discrete brainwave patterns.</p>
<p>Among our participants who slept, those who had more REM sleep showed stronger engagement of their rDLPFC when suppressing unwanted memories the next morning. This suggests REM sleep may indeed support mental health by restoring the brain systems that help to shield us from unwelcome thoughts.</p>
<h2>The emotional intensity of our memories</h2>
<p>When we think back to a traumatic or painful life event, we get a sense of the unpleasant feelings, such as sadness or anger, that accompanied the original experience. However, the intensity of these feelings is usually much reduced, allowing us to draw on past events without being consumed by negative emotions.</p>
<p>Suppressing unwanted thoughts has been shown to <a href="https://elifesciences.org/articles/71309">weaken the memories</a> that lead to them, meaning they are less likely to intrude into our consciousness in the future. This relates not only to the content of the memories (the “what, when and who”) but also <a href="https://www.jneurosci.org/content/37/27/6423.long">their emotional charge</a> – the intensity of the emotions we felt at the time. In other words, memory suppression helps us move on from prior adversity by gradually cleansing our memories of unpleasant experiences, and the negative emotions associated with them.</p>
<p>Conversely, failing to suppress an unwanted memory is likely to cause its emotional charge to linger, meaning that emotional responses to future reminders will remain more intense. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of exhausted man in bed, suffering with insomnia" src="https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=425&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=425&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=425&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=534&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=534&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577728/original/file-20240224-16-qbm7dc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=534&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1819333274">APIMerah/Shutterstock</a></span>
</figcaption>
</figure>
<p>We tested this by showing our participants scenes that were either emotionally negative (such as a car crash) or neutral (such as a forest). In the morning, after completing the memory retrieval and suppression task (with green and red-framed faces), participants were then asked to give intensity ratings for the negative and neutral scenes again.</p>
<p>Our findings were clear – and corroborated by further tests using an objective index of emotional arousal, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695635/#:%7E:text=The%20skin%20conductance%20response%20(SCR)%20is%20an%20indirect%20measure%20of,emotional%20valence%20(Bradley%20et%20al.)">skin conductance responses</a>. Among participants who had slept, emotional responses to the suppressed negative scenes became less intense over time. But among the sleep-deprived, emotional ratings for negative scenes remained elevated, regardless of whether the scenes were suppressed or not. This suggests that a breakdown of memory suppression mechanisms after sleep loss prevented participants from being able to “deal with” these negative emotions.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">Insomnia and mental disorders are linked. But exactly how is still a mystery</a>
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<p>In the context of psychiatric mood disorders that co-occur with chronic sleep disturbance, failure to suppress memories of emotionally disturbing events, together with an inability to reduce the unpleasant feelings embedded within those memories, could contribute to a strong tendency of mood-disordered individuals to focus on negative interpretations of the past.</p>
<p>Furthermore, anxiety arising from intrusive memories may also obstruct the sleep that is needed for recovery, leading to a vicious cycle of emotional dysregulation and sleeplessness.</p>
<h2>The importance of forgetting</h2>
<p>In the film Eternal Sunshine of the Spotless Mind (2004), the main characters have their memories of their turbulent relationship erased. Far from improving their quality of life, this leads to further complications, serving as a cautionary tale. </p>
<p>However, there are situations where aiding the forgetting process may help. For example, people who have experienced traumatic experiences can struggle to cope with unwanted memory intrusions. In these extreme cases, where the usual brain processes that allow for forgetting aren’t functioning properly, it could be beneficial to induce forgetting.</p>
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<p>Generally, forgetting is thought of as “bad”, with people worrying about forgetting where they put the car keys, or when their wedding anniversary is. But far from being a problem, this is how <a href="https://theconversation.com/why-forgetting-is-a-normal-function-of-memory-and-when-to-worry-223284">memory is supposed to work</a>. Sometimes, we want to just forget information that isn’t relevant to our daily lives, to prevent it from interfering with our goals. And sometimes, we want to forget embarrassing or emotionally scarring events.</p>
<p>Ultimately, the purpose of a functioning memory system is to make sensible and accurate decisions in the present, based on our past experience. The “adaptive” nature of forgetting allows us to get rid of irrelevant memories, making sure the memories that remain are as relevant to future decisions as possible. From this perspective, forgetting is as important as remembering. Simply put, forgetting is a feature of memory, not a bug.</p>
<p>While forgetting is a catch-all term we use for the loss of a memory, it isn’t a single process in the brain. Memories can be forgotten via active processes, such as memory suppression. But this can also happen via passive processes including “decay”, where the physical trace of a memory in the brain breaks down over time, or “interference”, where new memories that are similar to previous ones lead to confusion-impaired retrieval. For example, if you park your car in a new location in the supermarket you often visit, you might forget this new location because the usual place you park comes more readily to mind.</p>
<p>Forgetting is a complex phenomenon that unfolds over different timescales and via different processes, both while awake and asleep. While some memories can fragment, others are forgotten as a whole, so that all aspects of the memory are <a href="https://psycnet.apa.org/fulltext/2019-38883-001.html">no longer accessible</a>. </p>
<p>That forgetting is likely to occur during sleep has been underappreciated by psychologists, because research on sleep has largely focused on the role it plays in strengthening memories. But <a href="https://learnmem.cshlp.org/content/29/11/401.long">we</a> and <a href="https://www.jneurosci.org/content/37/3/464">other researchers</a> have recently reasoned that if forgetting is a fundamental part of a functioning memory system, then sleep should play as much of a role in forgetting as it does in retention.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of sleep-deprived man in bed, covering his head with pillows." src="https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=509&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=509&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577727/original/file-20240224-16-ist89m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=509&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p>Previous <a href="https://www.science.org/doi/10.1126/science.1179013?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">research</a>, including <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(18)30153-2">our own</a>, has shown that the presentation of specific sounds during sleep can boost memory. If you were to learn the location of a cat on a computer screen, and during learning we played a “meow” sound, the presentation of the same sound during sleep would lead to better location memory following sleep. This selective boosting of a specific memory during sleep is called “targeted memory reactivation”.</p>
<p>We have <a href="https://learnmem.cshlp.org/content/29/11/401.long">recently shown</a> that this technique can also be used to induce “selective forgetting”. We asked our participants to learn pairs of words or names before going to sleep. We used famous names, location and object words to allow participants to create vivid images in their minds for each pair, so they would be more likely to remember them after a night’s sleep.</p>
<p>But we also made sure the pairs overlapped by sharing one common word. When people learn these overlapping pairs, they compete against each other, and this competition can lead to <a href="https://psycnet.apa.org/record/1995-04358-001">forgetting</a> some of the words. We thought a similar forgetting effect might be seen by using targeted memory reactivation when participants were sleeping. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-forgetting-is-a-normal-function-of-memory-and-when-to-worry-223284">Why forgetting is a normal function of memory – and when to worry</a>
</strong>
</em>
</p>
<hr>
<p>We found the presentation of the word during sleep caused reactivation and strengthening for one pair, but this had a disruptive effect for the other pair. This suggests we could use targeted memory reactivation to selectively strengthen and weaken memories during sleep, presuming we can create interference between two memories. This could be beneficial in the case of people whose brain processes aren’t functioning properly, not allowing them to “healthily forget” disturbing and intrusive memories.</p>
<p>Although such a treatment is still a long way off, our work raises the possibility of using sound cues during sleep – in combination with psychological techniques such as cognitive behavioural therapy – to decrease the crippling emotional grip a particular memory has on a patient.</p>
<h2>Modifying REM sleep to improve mental health</h2>
<p>Given the strong link between REM sleep and mental health disorders, REM sleep may represent a powerful therapeutic target for treating and preventing various psychiatric conditions. By delivering sounds in synchrony with naturally occurring brain rhythms, it is possible to modify patterns of brain activity that are associated with memory processing in REM sleep.</p>
<p>In <a href="https://academic.oup.com/sleep/article/44/4/zsaa227/5960115">one study</a>, we used a computerised algorithm to track rapidly emerging patterns of brain activity in real time while people were asleep (based on polysomnography data). When the algorithm detects the emergence of a particular brain rhythm, it delivers short bursts of sound to increase the intensity of that brain rhythm (akin to pushing a swing as it reaches the highest point of its cycle).</p>
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<p>We have showed this technique can be used to modify distinct brain rhythms in REM sleep. In future, such auditory stimulation could potentially provide a means of renormalising aberrant patterns of brain activity in REM sleep to treat psychiatric disturbance. For example, by integrating this technology with devices that are already available for people to monitor their sleep at home, the playing of particular sounds while someone is sleeping could provide a simple and cost-effective therapy for reducing mood disturbance.</p>
<p>However, this is a long way from being a reality, and many studies would be required to evaluate the feasibility of such an approach before it could be used as a therapeutic tool.</p>
<h2>Targeting sleep in psychiatric hospitals</h2>
<blockquote>
<p>High-risk patients undergo routine observations, sometimes as regularly as every ten minutes, all night and every night. Torches are shone into their rooms – to check they’re breathing – and there’s a lot of noise as doors are open and closed. It has a terrible impact on their sleep.</p>
</blockquote>
<p>Heather* is a consultant forensic psychiatrist who works on a secure mental health ward in the North of England. She describes how the ward regime (in this case, routine welfare checks on high-risk individuals performed throughout the night) impact on patients’ sleep.</p>
<p>A number of people with severe mental illness receive treatment in secure inpatient units. Although the goal of these psychiatric hospitals is to provide a therapeutic setting to support the improvement of mental health, many features of the inpatient environment, such as noise at night or the ward regime, can worsen patients’ sleep disturbances – intensifying the symptoms of their illness, including low mood, impulsivity and aggression.</p>
<p>At the same time, chronic sleeplessness often reduces patients’ engagement with psychological therapies (due to them sleeping in the day or lacking motivation), lengthening their admission and recovery time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of a man sitting up in bed, suffering with insomnia" src="https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577726/original/file-20240224-22-trso72.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-insomnia-cannot-sleep-hand-drawn-1964955184">APIMerah/Shutterstock</a></span>
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<p>In a recent international scoping review, we found that only a small number of non-pharmacological sleep interventions had been tested in psychiatric inpatient settings, despite <a href="https://www.medrxiv.org/content/10.1101/2023.03.03.23286483v1">clear evidence</a> that these improve both sleep and mental health outcomes.</p>
<p>New digital technologies can give a clear indication of patient welfare without the need for the noise and disruption Heather describes, providing an environment that is more conducive to healthy sleep. Future studies could test the potential for integrating these digital technologies with sleep-based therapies to speed up recovery times.</p>
<p>Achieving this goal is not only contingent on more research, but also on the capacity for carrying out scientific studies at scale. For example, all of the studies we have described were performed in tightly controlled laboratory environments, usually involving large and expensive pieces of equipment (for example, polysomnography systems). Though <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">recent efforts have shown promise</a> in the feasibility of moving these techniques into people’s homes, much more work needs to be done outside of the lab before digitised, sleep-focused interventions for mental illness become a reality.</p>
<p>We envisage a future in which sleep is a routine target for reducing or preventing symptoms of mental illness, both in psychiatric inpatient settings and in people’s homes. Although there is much work still to do, sleep research is at an exciting juncture between bench and bedside, and offers a viable solution to the growing global burden of mental illness.</p>
<p><em>*Some names in this article have been changed to protect the anonymity of the interviewees.</em></p>
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<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/the-brain-is-the-most-complicated-object-in-the-universe-this-is-the-story-of-scientists-quest-to-decode-it-and-read-peoples-minds-222458?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">The brain is the most complicated object in the universe. This is the story of scientists’ quest to decode it – and read people’s minds
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<li><p><em><a href="https://theconversation.com/unlocking-new-clues-to-how-dementia-and-alzheimers-work-in-the-brain-uncharted-brain-podcast-series-194773?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Unlocking new clues to how dementia and Alzheimer’s work in the brain – Uncharted Brain podcast series
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<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/224131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Scott Cairney has received funding from the Medical Research Council</span></em></p><p class="fine-print"><em><span>Aidan Horner receives funding from the Economic and Social Research Council and the Leverhulme Trust. </span></em></p>We envisage a future in which sleep is a routine target for reducing or preventing symptoms of mental illness, both in psychiatric settings and people’s homesScott Cairney, Associate Professor of Psychology, University of YorkAidan Horner, Associate Professor in Psychology and Neuroscience, University of YorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2235182024-02-15T12:14:29Z2024-02-15T12:14:29ZAs we dream, we can listen in on the waking world – podcast<figure><img src="https://images.theconversation.com/files/575451/original/file-20240213-16-qozdpv.jpg?ixlib=rb-1.1.0&rect=178%2C41%2C6811%2C3950&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research has opened windows of connections between the waking world and dreamers.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/imagination-surreal-art-man-cloud-head-1774713266">Jorm Sangsorn via Shutterstock</a></span></figcaption></figure><p>Humans spend about one third of our lives asleep and while most of us dream regularly, some people remember their dreams more than others. But scientists still know surprisingly little about why or how we experience dreams. </p>
<p>In this episode of <a href="https://theconversation.com/uk/topics/the-conversation-weekly-98901">The Conversation Weekly</a> podcast, we find out about new research from a sleep lab in France that has unlocked a way to find out more by communicating with people as they dream. </p>
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<p><iframe id="tc-infographic-561" class="tc-infographic" height="100" src="https://cdn.theconversation.com/infographics/561/4fbbd099d631750693d02bac632430b71b37cd5f/site/index.html" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>It’s hard to study people when they’re dreaming. While researchers can tell quite accurately when somebody is asleep using electrodes to sense their brain activity, there are no neural markers for dreams. That means you just have to ask someone about their dreams when they wake up. It’s impossible to know when they actually had the dream, or really what was going on, as they may have forgotten the details. </p>
<p>Dream researchers realised back in the 1980s that one special group of people could help open a window into the dream world: lucid dreamers. These people have the ability to realise that they’re dreaming and still remain asleep, and they can sometimes control what happens in their dreams. <a href="https://journals.sagepub.com/doi/abs/10.2466/pms.1981.52.3.727">Experiments with lucid dreamers showed that</a>, during REM sleep, they could move their eyes from side to side to indicate to researchers that they were having a dream. </p>
<p>Researcher Başak Türker and her colleagues at the Paris Brain Institute wanted to see if lucid dreamers could go one step further: to receive information and respond to it while they were dreaming. </p>
<blockquote>
<p>We thought maybe they would be also conscious of the environment in which they’re sleeping and maybe they would be able to receive information at the same time. </p>
</blockquote>
<p>They recruited a lucid dreamer from the institute’s sleep lab to do some experiments, and <a href="https://www.cell.com/current-biology/pdfExtended/S0960-9822(21)00059-2">their theory worked</a>. He was able to communicate with them: he smiled when they asked if he liked chocolate, and frowned when they asked if he liked football. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-study-of-dreams-scientists-uncover-new-communication-channels-with-dreamers-220492">The study of dreams: Scientists uncover new communication channels with dreamers</a>
</strong>
</em>
</p>
<hr>
<p>Then they went on to do further experiments with non-lucid dreamers to see if anybody can communicate with the waking world while they’re dreaming. And it turns out <a href="https://www.nature.com/articles/s41593-023-01449-7">that they can</a>. </p>
<p>To find out more about dream communication listen to an interview with Başak Türker, and Lionel Cavicchioli, health and medicine editor at The Conversation in France, on <a href="https://pod.link/1550643487">The Conversation Weekly</a> podcast. </p>
<p>A <a href="https://cdn.theconversation.com/static_files/files/3073/Dream_Communication_Transcript.docx.pdf?1709027765">transcript of this episode</a> is now available.</p>
<p><em>This episode of The Conversation Weekly was written and produced by Katie Flood, with assistance from Mend Mariwany. Gemma Ware is the show’s executive producer. Sound design was by Eloise Stevens, and our theme music is by Neeta Sarl. Stephen Khan is our global executive editor, Alice Mason runs our social media and Soraya Nandy does our transcripts.</em></p>
<p><em>You can find us on X, formerly known as Twitter <a href="https://twitter.com/TC_Audio">@TC_Audio</a>, on Instagram at <a href="https://www.instagram.com/theconversationdotcom/">theconversationdotcom</a> or <a href="mailto:podcast@theconversation.com">via email</a>. You can also subscribe to The Conversation’s <a href="https://theconversation.com/newsletter">free daily email here</a>.</em></p>
<p><em>Listen to The Conversation Weekly via any of the apps listed above, download it directly via our <a href="https://feeds.acast.com/public/shows/60087127b9687759d637bade">RSS feed</a> or find out <a href="https://theconversation.com/how-to-listen-to-the-conversations-podcasts-154131">how else to listen here</a>.</em></p><img src="https://counter.theconversation.com/content/223518/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Başak Türker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Dream researcher Başak Türker explains how she was able to communicate with people while they were dreaming. Listen to The Conversation Weekly podcast.Gemma Ware, Editor and Co-Host, The Conversation Weekly Podcast, The ConversationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2206412024-02-09T13:33:00Z2024-02-09T13:33:00ZAds, food and gambling galore − 5 essential reads for the Super Bowl<figure><img src="https://images.theconversation.com/files/574506/original/file-20240208-18-ge9cxl.jpg?ixlib=rb-1.1.0&rect=203%2C54%2C4074%2C2881&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Christian McCaffrey and the San Francisco 49ers will try to stop the Kansas City Chiefs from winning their third Super Bowl in five years.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/christian-mccaffrey-of-the-san-francisco-49ers-rushes-news-photo/1976854646?adppopup=true">Michael Zagaris/Getty Images</a></span></figcaption></figure><p>On Sunday in Las Vegas, the Kansas City Chiefs will be looking to win their second straight Lombardi Trophy, while a San Francisco 49ers victory would give the team its first Super Bowl <a href="https://en.wikipedia.org/wiki/Super_Bowl_XXIX">since 1995</a>, when <a href="https://www.pro-football-reference.com/players/Y/YounSt00.htm">Steve Young</a> was under center.</p>
<p>I didn’t get a pass to media day, so I didn’t get a chance to ask Chiefs head coach Andy Reid about how he tends to <a href="https://www.dailymail.co.uk/sport/nfl/article-12961001/Chiefs-coach-Andy-Reid-mustache-FREEZES.html">his mustache</a>.</p>
<p>But my colleagues and I were able to ask an all-pro lineup of scholars to write about a range of football-related topics, from the partisan food divide to the numbers behind the biggest gambling bonanza in league history.</p>
<h2>1. Flag, you’re it</h2>
<p>The Pro Bowl, the NFL’s version of the all-star game, usually gets scant attention. That’s because it happens the weekend before the Super Bowl – absent many of the stars playing in the big game – and the players seem most concerned about avoiding injuries, not winning the game.</p>
<p>A year ago, league officials decided to shake up the annual showcase. It would no longer be a tackle football game. <a href="https://www.nfl.com/news/nfl-announces-the-pro-bowl-games-to-replace-tackle-game-with-flag-football-skill">It would be a flag football match</a>. The thinking went that if the league’s stars didn’t have to tackle one another, they might play harder, be more likely to showcase their athleticism and, importantly, have more fun. </p>
<p>As West Virginia University sociologist Josh Woods explains, <a href="https://theconversation.com/could-flag-football-one-day-leapfrog-tackle-football-in-popularity-222349">the NFL’s promotion of flag football is a big deal</a>, particularly for an emerging sport that’s somewhat obscure outside of Florida, Georgia and New York, where roughly 80% of high school flag football players live. Its inclusion in the 2028 Summer Olympics will only further bolster its profile.</p>
<p>But Woods points to a gender divide and a political divide that could end up clouding the sport’s future.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/could-flag-football-one-day-leapfrog-tackle-football-in-popularity-222349">Could flag football one day leapfrog tackle football in popularity?</a>
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<figure class="align-center ">
<img alt="Young man runs holding a football and waving his finger mid-stride." src="https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574505/original/file-20240208-24-e030ed.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Miami Dolphins wide receiver Tyreek Hill runs for a touchdown in the first quarter of the 2024 NFL Pro Bowl in Orlando, Fla.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/tyreek-hill-of-the-miami-dolphins-and-afc-reacts-as-he-runs-news-photo/1985984027?adppopup=true">Mike Ehrmann/Getty Images</a></span>
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<h2>2. X’s, O’s and Z’s</h2>
<p>In 2011, former NFL cornerback Sam Shields was a rookie playing for a Green Bay Packers team that had made the Super Bowl. The night before the big game, he tossed and turned.</p>
<p>“I had stomach aches, using the bathroom, but I didn’t have to use it,” <a href="https://www.si.com/nfl/2019/01/31/super-bowl-2019-nfl-players-sleep-rams-patriots-atlanta">he told Sports Illustrated in 2019</a>. “It felt like Christmas too, when Christmas is the next day you can’t sleep.”</p>
<p>I’ve wondered whether I would get a wink of shut-eye if I were scheduled to pitch in the World Series. Something tells me I’d be a lot like Shields. And as if the Chiefs and 49ers players and coaches aren’t feeling enough pressure, it turns out that getting a good night’s sleep is one of the most important things an athlete can do before a big game, meet or match.</p>
<p>University of Pittsburgh sleep medicine specialist Joanna Fong-Isariyawongse highlights reams of studies showing how <a href="https://theconversation.com/sleep-can-give-athletes-an-edge-over-competitors-but-few-recognize-how-fundamental-sleep-is-to-performance-221403">a poor night’s sleep can effect performance and decision-making</a> while making you more likely to get injured.</p>
<p>In fact, she writes, “Sleep deficits have been linked to decreased performance in every cognitive measure.”</p>
<hr>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/sleep-can-give-athletes-an-edge-over-competitors-but-few-recognize-how-fundamental-sleep-is-to-performance-221403">Sleep can give athletes an edge over competitors − but few recognize how fundamental sleep is to performance</a>
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<h2>3. Going all in on gambling</h2>
<p>Did you bet on the 49ers to cover the spread? Perhaps you’re <a href="https://www.wikihow.com/Play-Football-Squares">playing squares</a>. Or maybe you’re betting on Reba McEntire’s national anthem <a href="https://www.foxsports.com/stories/nfl/2024-super-bowl-lviii-odds-how-long-will-reba-mcentires-national-anthem-be">to last longer than 90.5 seconds</a>.</p>
<p>If you’ve wagered on some aspect of the big game, you’re one of roughly 67 million American adults who have done the same, according to a Morning Consult survey conducted in early February. That would make another new record, shattering 2023’s record, which shattered the mark from 2022. The country’s gambling mania has been aided, in part, by the Supreme Court’s 2018 ruling that <a href="https://www.nytimes.com/2018/05/14/us/politics/supreme-court-sports-betting-new-jersey.html">overturned a federal ban on sports betting</a>. </p>
<p>Gambling and the Super Bowl have always gone hand in hand. To University of Iowa sports media scholar Tom Oates, what makes the developments of the past few years so remarkable is <a href="https://theconversation.com/the-super-bowl-gets-the-vegas-treatment-with-1-in-4-american-adults-expected-to-gamble-on-the-big-game-222370">the NFL’s stunning reversal on its own attitudes toward betting</a>.</p>
<p>Gone are the quaint days of league officials lobbying Congress to put restrictions and guardrails in place. The NFL has gone all in on its embrace of gambling, <a href="https://sports.yahoo.com/nfl-inks-nearly-1-billion-212312677.html?_fsig=UXLu7VdB0Sg8Wcfmd7USNw--%7EA">forging billion-dollar partnerships</a> with the country’s top sportsbooks.</p>
<p>“But this infusion of extra cash comes with a substantial social cost,” Oates writes. “Gambling addictions are at an all-time high, likely spurred by the ease with which people can place bets from their phones.” </p>
<p>So if you want to get in on the action, gamble responsibly and don’t let your emotions get the best of you. </p>
<p>That being said, a little birdie told me that Reba <a href="https://www.facebook.com/watch/?v=696443244813036">can really hold her notes</a>. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-super-bowl-gets-the-vegas-treatment-with-1-in-4-american-adults-expected-to-gamble-on-the-big-game-222370">The Super Bowl gets the Vegas treatment, with 1 in 4 American adults expected to gamble on the big game</a>
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<img alt="Woman with red hair and silver dress holds microphone and smiles." src="https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=510&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=510&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574593/original/file-20240209-31-9fdvn2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=510&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Country music singer Reba McEntire will be singing the national anthem at Super Bowl LVIII.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/reba-mcentire-performs-at-madison-square-garden-on-april-15-news-photo/1482508270?adppopup=true">Theo Wargo/Getty Images</a></span>
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<h2>4. At least they aren’t serving donkey meat</h2>
<p><a href="https://jacobin.com/2022/01/hyper-politics-annie-ernaux-moralism-identity-media-individualization">Everything is politicized</a>, so the lament goes. And even the Super Bowl – <a href="https://thedaily.case.edu/the-super-bowl-is-a-cultural-moment-but-why/">one of the few communal events left</a> in a polarized, atomized nation – can’t avoid the creep of partisanship. </p>
<p>In recent years, some of the country’s most iconic food brands – <a href="https://www.nytimes.com/article/bud-light-boycott.html">Bud Light</a>, <a href="https://www.nytimes.com/2020/07/10/business/goya-boycott.html">Goya</a>, <a href="https://www.businessinsider.com/papa-johns-cuts-ties-with-the-nfl-after-national-anthem-protests-2018-2">Papa John’s</a>, <a href="https://nypost.com/2021/02/23/coca-cola-diversity-training-urged-workers-to-be-less-white/">Coca-Cola</a>, <a href="https://www.vox.com/politics/2023/5/31/23742373/chick-fil-a-boycott-controversy-conservative-backlash">Chick-fil-A</a> – have been excoriated by partisans on both sides of the aisle. </p>
<p>So food spreads can color every Super Bowl party with a tinge of “red team,” “blue team.”</p>
<p>“What you serve at your Super Bowl party, or what the host serves at the event you attend, can now be interpreted, or twisted, through a partisan lens,” write political scientists Joshua J. Dyck and Shanna Pearson-Merkowitz.</p>
<p>One possible way to bridge the divide: Unite in a bipartisan celebration of Taylor Swift. Actually, <a href="https://theconversation.com/why-taylor-swift-is-an-antihero-to-the-gop-but-democrats-should-know-all-too-well-that-her-endorsement-wont-mean-its-all-over-now-222437">scratch that</a>. </p>
<p>Maybe you could just serve salmon – a food that, according to Dyck and Pearson-Merkowitz’s research, is “resistant to partisan cues.”</p>
<p>Grim times, indeed.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/super-bowl-party-foods-can-deliver-political-bite-choose-wisely-222687">Super Bowl party foods can deliver political bite – choose wisely</a>
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<h2>5. ByeDaddy</h2>
<p><a href="https://apnews.com/article/super-bowl-poll-commercials-halftime-1f65969d3ec56a5c3eca3ba386428d6a">According to an Associated Press-NORC Center for Public Affairs Research poll</a>, 22% of Americans planning to watch the Super Bowl are most excited about the commercials.</p>
<p>That’s one reason companies are willing to fork over so much cash for a coveted slot – as much as US$7 million for a 30-second spot. </p>
<p>However, as Auburn University scholars Linda Ferrell and O.C. Ferrell point out, many regulars on the airwaves of the Super Bowl, such as GoDaddy and Ford, are <a href="https://theconversation.com/super-bowl-ads-its-getting-harder-for-commercials-to-score-with-consumers-222269">missing from this year’s lineup</a>.</p>
<p>What gives?</p>
<p>“Gen Z, in particular, is not impressed by Super Bowl ads,” they write, “and complicating the matter is their lack of interest in broadcast TV.”</p>
<p>So as a millennial who’s spent years listening to how <a href="https://knowyourmeme.com/memes/millennials-are-killing">my generation has killed</a> everything from paper napkins to mayonnaise, I take great pleasure in typing: Gen Z killed the Super Bowl ad.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/super-bowl-ads-its-getting-harder-for-commercials-to-score-with-consumers-222269">Super Bowl ads: It's getting harder for commercials to score with consumers</a>
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<p><em>This story is a roundup of articles from The Conversation’s archives.</em></p><img src="https://counter.theconversation.com/content/220641/count.gif" alt="The Conversation" width="1" height="1" />
Oh, yeah, and there’s a game, too.Nick Lehr, Arts + Culture EditorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2215362024-02-02T16:35:54Z2024-02-02T16:35:54ZThere are benefits to sharing a bed with your pet – as long as you’re scrupulously clean<figure><img src="https://images.theconversation.com/files/573096/original/file-20240202-19-bguuni.jpg?ixlib=rb-1.1.0&rect=50%2C7%2C4848%2C3759&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Should your dog share your bed? Some owners have better quality sleep alongside their furry friends</span> <span class="attribution"><a class="source" href="https://www.gettyimages.co.uk/detail/news-photo/small-boy-asleep-with-his-pet-dog-circa-1950-news-photo/110169318?adppopup=true">Keystone View/FPG/Getty Images</a></span></figcaption></figure><p>When heading off for a night’s slumber, does your pet follow? Perhaps the cat curls up at the end of your bed. Maybe the dog dives under the duvet or pops their head on your pillow. Alternatively, your pet might have their own devoted sleeping space.</p>
<p>But if you do share your bed with Fluffy or Fido, what what does science suggest is best practice?</p>
<p>Pets increasingly have new roles and expectations in society. Dogs, cats and a multitude of other companion animal species have become <a href="https://doi.org/10.1080/08927936.2019.1621516">family members</a>, a role far removed from their original purposes as <a href="https://docs.lib.purdue.edu/paij/vol1/iss1/6/">protectors, hunting partners</a>, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0171593">pest-exterminators</a> and in some cases, <a href="https://link.springer.com/article/10.1007/s10460-021-10272-4">food sources</a>.</p>
<p>Owners now spend much more time in close contact with their pets, which <a href="https://doi.org/10.3390/ijerph17124300">confers many benefits</a>. Positive associations with pets are linked with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1295517/">improved health</a>, <a href="https://doi.org/10.1371/journal.pone.0122085">social contact</a>, <a href="https://doi.org/10.3389/fpubh.2023.1196199">physical activity</a>, and decreased perceptions of <a href="https://doi.org/10.1007/s00127-022-02332-9">loneliness</a>.</p>
<p>While people typically share living spaces with their pets, sharing beds is a much more intimate proposition. Nevertheless, <a href="https://wwwnc.cdc.gov/eid/article/17/2/10-1070_article">research shows</a> that of the estimated 90 million European households who own a least one pet, 45% of dogs and 60% of cats are allowed on the bed – and 18% of dogs and 30% of cats sleep with their owner inside the covers. </p>
<p>While it might be enjoyable and relaxing to share resting time with your pet, it could come with risks to pet and human health, not to mention impacts on sleep hygiene and human relationships too.</p>
<h2>Disturbed Sleep</h2>
<p>One challenge of sharing your bed with your pet could be <a href="https://doi.org/10.1016/j.mayocp.2017.06.014">disturbed sleep</a>. The movement of sleeping partners (two or four-legged) may lead to reduced sleep efficiency, although a bed large enough to accommodate all can mitigate this. </p>
<p>Encouraging your pet to sleep elsewhere, but within the bedroom could also be beneficial if sleep disturbance is affecting your wellbeing. Our pets also need <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163620">quality sleep</a>, so their own sleeping space might be good for them too.</p>
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<p>But shared sleeping areas can have positives. Many owners like to <a href="https://www.sciencedirect.com/science/article/abs/pii/S2352721820303053">sleep with their pets</a>, who can offer companionship, security and even warmth. More than 80% of dogs examined in studies preferred to be <a href="https://www.mdpi.com/2076-2615/10/7/1172#B3-animals-10-01172">close to people at night</a>, suggesting a mutual benefit. Different species of pets also appear to <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237822">spend time resting together</a>, so if you have a multi-pet household, all might enjoy shared sleeping.</p>
<h2>Bed bugs</h2>
<p>Pets sometimes bring unwanted guests into our homes such as fleas, ticks, mites and lice. These ectoparasites might <a href="https://onlinelibrary.wiley.com/doi/10.1111/zph.12369">hop from our pets to us</a> and either cause transient or more prolonged irritation. In extreme cases, they can transmit other, potentially serious diseases such as <a href="https://academic.oup.com/jid/article-abstract/136/4/489/2189513?redirectedFrom=fulltext&login=false">plague</a> or <a href="https://journals.asm.org/doi/10.1128/jcm.34.8.1952-1956.1996">“cat scratch disease”</a>, an infection caused by bacteria in cat saliva.</p>
<p>Pets often also harbour <a href="https://wwwnc.cdc.gov/eid/article/17/2/10-1070_article#r2">internal parasites</a> such as the roundworm Toxocara canis – a parasite that affects both cats and dogs – some of which can be passed to humans, resulting in illness. Microscopic eggs that can cause infection can be <a href="https://www.sciencedirect.com/science/article/abs/pii/S0304401709002003?via%3Dihub">carried on the fur of our pets</a> and close contact increases the potential of spread between pets and people.</p>
<p>The potential for other disease-causing organisms including bacteria, viruses and fungi to spread between our pets and us is also of concern, especially <a href="https://academic.oup.com/cid/article/36/2/e26/317343?login=false">antibiotic-resistant bacteria</a> such as <a href="https://www.mdpi.com/2076-0817/11/10/1110">MRSA</a>. Indeed, we can even share infections with our pets – <a href="https://link.springer.com/article/10.1007/s11357-020-00248-3">including COVID-19</a> – so it’s not all one-sided.</p>
<h2>Allergies and injuries</h2>
<p>Sharing intimate contact with pets does raise the potential for <a href="https://doc.woah.org/dyn/portal/index.xhtml?page=alo&aloId=36892">increasing allergic responses or injury risk</a>. Minor, unintentional injuries such as scratches can occur. Contact with dust and dander from pet hair can be prolonged when in close proximity. This material can also <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1365-3164.2010.00882.x">accumulate in the environment</a>, potentially increasing the risk of allergic reactions.</p>
<p>Some pets may <a href="https://www.sciencedirect.com/science/article/pii/0168159195010084">develop behavioural concerns</a> such as separation-related behaviours as a result of sharing intimate spaces and prolonged contact with their human. Conversely, some owners choose to allow their pet access to sleeping areas to <a href="https://humanimalia.org/article/view/9930">reduce problem behaviours</a> such as door scratching or nighttime vocalising. Fair, <a href="https://www.nature.com/articles/s41598-021-97743-0">consistent training</a> and expectations between a pet and their owner can go a long way to mitigate any such concerns, no matter where a pet sleeps.</p>
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<h2>Keeping it clean</h2>
<p>If you do share your bed with your pet, good hygiene and regular cleaning is a must. Advice suggests that at <a href="https://www.bbc.co.uk/news/newsbeat-61259074">least weekly washing</a> of bed sheets is good practice. If you share your bed with pets, washing bedclothes <a href="https://www.sleepfoundation.org/best-sheets/how-to-wash-sheets">every three to four days</a> is suggested.</p>
<p>The fur and feet of our pets can be <a href="https://www.mdpi.com/2076-0817/11/10/1149">contaminated with dirt and pathogens</a> too. This leads to potential contamination “hotspots” in sleeping areas. Bacteria from faeces was <a href="https://www.mdpi.com/2076-0817/11/10/1149">isolated from the paws of 86% of dogs</a> in one study. Cleaning pet paws after being outdoors is a good strategy to reduce contamination risk. </p>
<p>Regular grooming and bathing (when appropriate) is <a href="https://www.frontiersin.org/articles/10.3389/fvets.2022.827348/full#B1">important for pet health monitoring</a> and wellbeing. It can also support a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0195561695501263?via%3Dihub">positive human-pet bond</a> and reduce the potential for spreading potential infection.</p>
<p>The use of <a href="https://www.bsava.com/position-statement/parasite-control/">anti-parasitic treatments</a> under veterinary advice can also minimise the carriage and spread of internal and external parasites to pet owners and other pets.</p>
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Read more:
<a href="https://theconversation.com/how-long-might-your-dog-live-new-study-calculates-life-expectancy-for-different-breeds-222446">How long might your dog live? New study calculates life expectancy for different breeds</a>
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<h2>It’s bedtime</h2>
<p>Whether you choose to share your bed with your pet depends on a number of factors, including lifestyle, health and even the relationship with your pet.</p>
<p>Balancing the potential downsides of sharing a bed with your pet, with possible benefits is important to assess whether it is a good choice for you or not. Indeed, sleep disruption due to bed-sharing with pets is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0025619615006746">not as detrimental to sleep quality</a> as often thought.</p>
<p>With good hygiene and management, the choice to share your sleep with your pet might just give you both a great night’s sleep.</p><img src="https://counter.theconversation.com/content/221536/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqueline Boyd is affiliated with The Kennel Club (UK) through membership, as Chair of the Activities Health and Welfare Subgroup and member of the Dog Health Group. Jacqueline is a full member of the Association of Pet Dog Trainers (APDT #01583) and she also writes, consults and coaches on canine matters on an independent basis, in addition to her academic affiliation at Nottingham Trent University.</span></em></p>While some people blanch at the thought of bed-sharing bed with a pet, others can’t sleep without their animal companions – an expert explains the pros and cons of sharing a bed with a pet (or two).Jacqueline Boyd, Senior Lecturer in Animal Science, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2214032024-01-31T13:36:42Z2024-01-31T13:36:42ZSleep can give athletes an edge over competitors − but few recognize how fundamental sleep is to performance<figure><img src="https://images.theconversation.com/files/571989/original/file-20240129-15-rvkoy3.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C2663%2C1778&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Sleep has been an underappreciated strategy for gaining an edge over an opponent at any level of athletic competition.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/ChiefsRavensFootball/47d36cdc32f2464d8b6aaed9cba32412/photo?Query=football%20playoffs&mediaType=photo,video,graphic,audio&sortBy=&dateRange=now-24h&totalCount=54&currentItemNo=44">AP Photo/Alex Brandon</a></span></figcaption></figure><p>In the adrenaline-packed world of professional sports, the power of sleep rarely gets adequate attention.</p>
<p>A healthy sleep pattern can be a stealthy game plan for athletes to gain an edge over their opponents. Only a <a href="https://www.cnbc.com/2018/12/21/lebron-james-reveals-the-nighttime-routine-that-sets-him-up-for-success.html">few top elite athletes</a> know the secret of early bedtimes for optimal performance.</p>
<p>Sleep is vital not only for keeping the mind sharp and body healthy but also for excelling in all fields in life – whether <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">in the classroom</a>, on the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5158299/">battlefield</a> or in <a href="https://doi.org/10.1093/sleep/zsab051">other professional arenas</a>. </p>
<p>As a <a href="https://www.neurology.pitt.edu/people/joanna-fong-isariyawongse-md-faes-faan">neurologist specializing in sleep medicine</a> at the University of Pittsburgh, I have devoted my career to understanding and advocating for the importance of sleep health. </p>
<p>Here are some key facts to understand why sleep matters.</p>
<h2>The critical role of sleep in performance</h2>
<p>Sleep is a complex, <a href="https://www.sleepfoundation.org/stages-of-sleep#">cyclical process</a> that progresses through several stages, each with distinct characteristics and functions. Initially, it begins with light sleep, <a href="https://www.ncbi.nlm.nih.gov/books/NBK526132/#">encompassing stages 1 and 2</a>, where the body starts to relax and brain wave activity begins to slow down. </p>
<p>These stages are followed by deep sleep, also known as <a href="https://www.sleepfoundation.org/stages-of-sleep/slow-wave-sleep#:">slow-wave sleep</a>, where the body undergoes significant restorative processes. The final stage is <a href="https://my.clevelandclinic.org/health/body/12148-sleep-basics">rapid eye movement</a>, or REM sleep, characterized by vivid dreams and increased brain activity. Typically, a person cycles through these stages four to six times each night, with each cycle lasting approximately 90 minutes. </p>
<p>Sleep is when our bodies heal. Deep sleep helps repair muscles and bones through several key mechanisms, including the release of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824213/">human growth hormone</a> – a protein produced in the pituitary gland – and various <a href="https://doi.org/10.1038/npp.2016.148">anti-inflammatory agents</a>. </p>
<p><a href="https://www.health.harvard.edu/diseases-and-conditions/growth-hormone-athletic-performance-and-aging">Human growth hormone is a key player</a> in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824213/">muscle development, tissue repair</a> and <a href="https://doi.org/10.1210/er.2008-0027">metabolism</a>, and is it vital for maintaining physical health. It significantly enhances the body’s capacity for self-repair, be it following an intense sports event or recovering from a sports-related injury. </p>
<p>In addition, sleep helps your brain to recalibrate through the waste-clearing <a href="https://doi.org/10.1016/j.sleep.2022.11.012">glymphatic system</a>, which is part of the central nervous system. Think of it as a dishwasher in your brain, flushing out waste products, including neurotoxic proteins such as <a href="https://doi.org/10.3389/fphar.2015.00221">amyloid-beta</a>, <a href="https://doi.org/10.1111%2Fj.1755-5949.2010.00177.x">abnormal tangles of a protein called tau</a> and <a href="https://doi.org/10.1101%2Fcshperspect.a009399">alpha-synuclein proteins</a>. </p>
<p>All three of those proteins have direct association with neurodegenerative diseases such as <a href="https://doi.org/10.1001/jamaneurol.2023.3889">Alzheimer’s dementia</a> and <a href="https://doi.org/10.1016/j.neubiorev.2017.08.016">chronic traumatic encephalopathy</a>, a disorder thought to be caused by repeated head injuries. For athletes, maintaining proper brain health and cognitive function is paramount.</p>
<p>In addition, deep sleep <a href="https://doi.org/10.1007/s00424-011-1044-0">strengthens the immune system</a> to help keep us healthy and free of illnesses.</p>
<p>REM sleep is the most active stage of sleep, the one in which we experience dreams. This contrasts with deep sleep, where the brain enters a state of synchronized slow waves, indicative of restorative rest. REM sleep is <a href="https://doi.org/10.1007/s11910-013-0430-8">essential for memory</a> and <a href="https://doi.org/10.3389/fpsyg.2019.00459">emotion processing</a>, which help with recall and reducing anxiety. </p>
<p>Athleticism by its purest definition and overall body control can often be linked to the benefits of Stage 2 sleep, which has been shown to play an instrumental role in the <a href="https://doi.org/10.1371/journal.pbio.1002429">consolidating of motor sequence memories</a> and physical skills learned during practice.</p>
<p>To fully benefit from these sleep cycles, adults need <a href="https://www.sciencedirect.com/science/article/abs/pii/S2352721815000157?via%3Dihub">seven to nine hours</a> of sleep per night. This duration ensures that they complete the necessary four to six sleep cycles, allowing their bodies and minds to fully experience the restorative effects of each sleep stage, which is essential for optimal health and performance.</p>
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<figcaption><span class="caption">Sleep is a performance enhancer, if you do it right.</span></figcaption>
</figure>
<h2>How sleep helps prevent injuries</h2>
<p>In professional sports, more training and higher pressure increase the chances of getting hurt. Research shows that collegiate athletes who sleep less than seven hours per night are <a href="https://doi.org/10.1249/JSR.0000000000000849">nearly twice as likely to get injured</a> when compared with those who sleep more than eight hours. In a game like football, where split-second decisions can lead to a touchdown or interception, a well-rested brain is the best tool for quick thinking and staying free of injury. </p>
<p>Good sleep also cuts down on the <a href="https://doi.org/10.1016/j.sleep.2019.03.008">risk of concussions</a>, which, sadly, are pretty common in sports. Up to <a href="https://doi.org/10.1097/00001199-200609000-00001">3.8 million cases</a> of concussions occur annually in the U.S. during competitive sports. Studies have shown that <a href="https://doi.org/10.1016/j.sleep.2019.03.008">sleepy athletes</a> are nearly three times more likely to suffer a concussion.</p>
<p>Sleep deficits have been linked to decreased performance in every cognitive measure, including <a href="https://doi.org/10.1093/sleep/zsab051">vigilant attention, spatial cognition</a> and tasks involving <a href="https://doi.org/10.1016/j.jadohealth.2013.12.034">inhibitory control</a>. On the sports field, this translates to sleepy athletes making more impulsive and risky decisions. </p>
<h2>Enhancing athletic performance through ample sleep</h2>
<p>Athletes of any level, even at the highest levels of competition, could gain a competitive edge by giving more attention to the value of sleep. Studies focusing on <a href="https://doi.org/10.1249/MSS.0b013e31820abc5a">sprinters</a>, <a href="https://doi.org/10.1016/j.physbeh.2013.07.002">tennis players</a> and <a href="https://doi.org/10.1249/MSS.0b013e31820abc5a">endurance athletes</a> have found that sleep can enhance the following four key abilities: </p>
<ul>
<li><p><a href="https://doi.org/10.1249/MSS.0b013e31820abc5a">Speed, strength and endurance</a>: More sleep can lead to faster sprint times, greater strength and <a href="https://doi.org/10.1007/s00421-009-1103-9">higher endurance</a>, which are crucial in sports where every second counts. Adequate sleep enhances muscle recovery and energy restoration, which are crucial for the strength and power needed in sprinting. </p></li>
<li><p>Accuracy and reaction time: One study found that tennis players who got more sleep showed better <a href="https://doi.org/10.1016/j.physbeh.2013.07.002">accuracy and faster reaction times</a>. Increased sleep enhances brain function by boosting cognitive processes such as focus, <a href="https://doi.org/10.1093/sleep/zsab051">decision-making</a> and sensory perception. Well-rested individuals also experience <a href="https://doi.org/10.1371/journal.pbio.1002429">better neuromuscular coordination</a>, essential for precise movements and quick responses. </p></li>
</ul>
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<figcaption><span class="caption">Sleep can make a critical difference when it comes to split-second decision-making.</span></figcaption>
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<ul>
<li><p>Cognitive skills and inhibitory control: Good sleep helps with <a href="https://doi.org/10.1093/sleep/zsab051">strategizing and decision-making</a> through improved recall and a clearer mind, thanks to the cleansing action of the glymphatic system. Sleep deprivation, on the other hand, can impair cognitive abilities, as evidenced in <a href="https://doi.org/10.1093/sleep/zsab051">research involving NASA recruits</a>. </p></li>
<li><p>Pain tolerance: More sleep can lead to <a href="https://doi.org/10.5665/sleep.1830">increased pain tolerance</a>, playing a vital role in the quality of life and recovery process following injuries or intense physical exertion. While the exact mechanisms are complex and involve a two-way relationship between sleep and pain, this benefit is particularly important in physically demanding sports. Improved pain tolerance can aid athletes not only in recovery but also in maintaining mental well-being, allowing them to focus on rehabilitation and training without being overly hindered by discomfort. </p></li>
</ul>
<h2>Essential sleep tips for peak performance</h2>
<p>Here are some practical and effective sleep tips tailored for athletes, designed to help them harness the power of sleep for top-notch performance in their respective sports: </p>
<ul>
<li><p>Consistency and quantity: A regular sleep schedule is crucial for peak performance. Athletes should make sure they’re getting eight to 10 hours of sleep, not just the day before a big game but every day throughout the competitive season. </p></li>
<li><p>Environment: A sleep-conducive environment – dark, quiet and cool – is essential to getting a restful night’s sleep.</p></li>
<li><p>Pre-sleep routines: Relaxing activities such as reading, stretching and meditation before bed can enhance sleep quality.</p></li>
<li><p>Screen limits: <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">Reducing screen time</a> before bed helps maintain natural sleep rhythms and the production of melatonin.</p></li>
<li><p><a href="https://theconversation.com/whats-the-best-diet-for-healthy-sleep-a-nutritional-epidemiologist-explains-what-food-choices-will-help-you-get-more-restful-zs-219955">Dietary considerations</a>: Avoiding caffeine, alcohol and heavy meals before sleep aids in restfulness.</p></li>
<li><p><a href="https://theconversation.com/short-naps-can-improve-memory-increase-productivity-reduce-stress-and-promote-a-healthier-heart-210449">Strategic napping</a>: Short, well-timed naps can be a valuable tool for recovery and achieving peak performance. </p></li>
<li><p>Sleep banking: To prepare for travel when you anticipate reduced sleep, consider sleeping longer beforehand. This can be achieved either through extra napping or by extending your regular nightly sleep. </p></li>
</ul>
<p>It’s important for any athlete to remember that sleep isn’t a weakness. Success as an athlete is about more than just physical training and tactical preparedness; it’s also about harnessing the power of sleep for optimal performance.</p><img src="https://counter.theconversation.com/content/221403/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joanna Fong-Isariyawongse does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Studies show college athletes sleeping less than 7 hours per night are almost twice as likely to be injured when compared with athletes sleeping more than 8 hours.Joanna Fong-Isariyawongse, Associate Professor of Neurology, University of PittsburghLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2221512024-01-31T04:58:36Z2024-01-31T04:58:36ZTurns out the viral ‘Sleepy Girl Mocktail’ is backed by science. Should you try it?<figure><img src="https://images.theconversation.com/files/572103/original/file-20240130-21-f4mjgk.jpg?ixlib=rb-1.1.0&rect=44%2C8%2C5946%2C3979&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/trendy-sleepy-girl-mocktail-popular-cherry-2311807805">Shutterstock</a></span></figcaption></figure><p>Many of us wish we could get a better night’s sleep. Wouldn’t it be great if it was as easy as a mocktail before bed? </p>
<p>That’s what the latest viral trend might have us believe. The “Sleepy Girl Mocktail” is a mix of tart cherry juice, powdered magnesium supplement and soda water. TikTok videos featuring the concoction have garnered hundreds of thousands of views. But, what does the science say? Do these ingredients actually help us sleep?</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://www.tiktok.com/@taaylorvictoriaa/video/7317809719945661742?is_from_webapp=1\u0026sender_device=pc\u0026web_id=7239513980711093761"}"></div></p>
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Read more:
<a href="https://theconversation.com/how-apps-and-influencers-are-changing-the-way-we-sleep-for-better-or-for-worse-211749">How apps and influencers are changing the way we sleep, for better or for worse</a>
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<h2>Tart cherry juice</h2>
<p>There is <a href="https://www.mdpi.com/2072-6643/12/4/936">research</a> to show including tart cherry juice in your diet improves overall sleep. <a href="https://ift.onlinelibrary.wiley.com/doi/full/10.1111/1750-3841.14952">Clinical trials</a> show tart cherry juice increases sleep quality and quantity, as well as a lessening insomnia symptoms (compared to a placebo). This could be due to the <a href="https://link.springer.com/article/10.1007/s13668-021-00362-4">presence of melatonin</a>, a sleep-promoting hormone, in cherries. </p>
<p>Tart cherry varieties such as Jerte Valley or Montmorency have the highest concentration of melatonin (approximately 1.35 micrograms of melatonin per 100g of <a href="https://www.liebertpub.com/doi/full/10.1089/jmf.2009.0096">cherry juice</a>). Over the counter melatonin supplements can range from 0.5 milligram to over 100 milligrams, with research suggesting those beginning to take melatonin start with a dose of 0.5–2 milligrams to <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/jpi.12782">see an improvement in sleep</a>. </p>
<p>Melatonin naturally occurs in our bodies. Our body clock promotes the release of melatonin in the evening to help us sleep, specifically in the two hours before our natural bedtime. </p>
<p>If we want to increase our melatonin intake with external sources, such as cherries, then we should be timing our intake with our natural increase in melatonin. Supplementing melatonin <a href="https://www.frontiersin.org/articles/10.3389/fneur.2010.00137/full">too close to bed</a> will mean we may not get the sleep-promoting benefits in time to get off to sleep easily. Taking melatonin too late may even harm our long-term sleep health by sending the message to our body clock to delay the release of melatonin until later in the evening. </p>
<h2>Magnesium – but how much?</h2>
<p>Magnesium also works to promote melatonin, and magnesium supplements <a href="https://www.mdpi.com/2072-6643/12/4/936">have been shown to improve sleep outcomes</a>. </p>
<p>However, results vary depending on the amount of magnesium people take. And we don’t yet have the answers on the <a href="https://link.springer.com/article/10.1007/s12011-022-03162-1">best dose of magnesium for sleep benefits</a>. </p>
<p>We do know magnesium plays a vital role in energy production and bone development, making it an important <a href="https://downloads.hindawi.com/journals/ije/2018/9041694.pdf">daily nutrient for our diets</a>. Foods <a href="https://bibliotekanauki.pl/articles/877044.pdf">rich in magnesium</a> include wheat cereal or bread, almonds, cashews, pumpkin seeds, spinach, artichokes, green beans, soy milk and dark chocolate.</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://www.tiktok.com/@courtneyscicluna/video/7327962156488477953"}"></div></p>
<h2>Bubbly water</h2>
<p>Soda water serves as the base of the drink, rather than a pathway to better sleep. And bubbly water may make the mix <a href="https://theconversation.com/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">more palatable</a>. It is important to keep in mind that drinking fluids close to bedtime can be disruptive to our sleep as it might lead to waking during the night to urinate. </p>
<p>Healthy sleep recommendations include avoiding water intake in the <a href="https://link.springer.com/article/10.1007/s10865-006-9047-6">two hours before bed</a>. Having carbonated beverages too close to bed can also trigger digestive symptoms such as <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2036.2010.04232.x">bloating, gassiness and reflux during the night</a>. </p>
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Read more:
<a href="https://theconversation.com/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">Don’t like drinking plain water? 10 healthy ideas for staying hydrated this summer</a>
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<h2>Bottoms up?</h2>
<p>Overall, there is evidence to support trying out the Sleepy Girl Mocktail to see if it improves sleep, however there are some key things to remember: </p>
<ul>
<li><p><strong>timing</strong>: to get the benefits of this drink, avoid having it too close to bed. Aim to have it two hours before your usual bedtime and avoid fluids after this time </p></li>
<li><p><strong>consistency</strong>: no drink is going to be an immediate cure for poor sleep. However, this recipe could help promote sleep if used strategically (at the right time) and consistently as part of a balanced diet. It may also introduce a calming evening routine that helps your brain relax and signals it’s time for bed </p></li>
<li><p><strong>maximum magnesium</strong>: be mindful of the amount of magnesium you are consuming. While there are many health benefits to magnesium, the recommended daily maximum amounts are 420mg for adult males and 320mg for adult females. Exceeding the maximum can lead to low blood pressure, respiratory distress, stomach problems, muscle weakness and mood problems </p></li>
<li><p><strong>sugar</strong>: in some of the TikTok recipes sugar (as flavoured sodas, syrups or lollies) is added to the drink. While this may help hide the taste of the tart cherry juice, the consumption of sugar too close to bed may make it <a href="https://academic.oup.com/advances/article-abstract/7/5/938/4616727">more difficult to get to sleep</a>. And sugar in the evening raises blood sugar levels at a time when our body is not primed to be processing sugar. Long term, this can increase our <a href="https://www.nature.com/articles/s41387-020-0109-6">risk of diabetes</a> </p></li>
<li><p><strong>sleep environment</strong>: follow good sleep hygiene practices including keeping a consistent bedtime and wake time, a wind-down routine before bed, avoiding electronic device use like phones or laptops in bed, and avoiding bright light in the evening. Bright light works to suppress our melatonin levels in the evening and make us more alert. </p></li>
</ul>
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Read more:
<a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">Nope, coffee won't give you extra energy. It'll just borrow a bit that you'll pay for later</a>
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<h2>What about other drinks?</h2>
<p>Other common evening beverages include herbal tisanes or teas, hot chocolate, or warm milk.</p>
<p>Milk can be especially beneficial for sleep, as it contains the amino acid tryptophan, which can <a href="https://link.springer.com/article/10.1007/s13197-020-04236-5">promote melatonin production</a>. Again, it is important to also consider the timing of these drinks and to avoid any caffeine in tea and too much chocolate too close to bedtime, as this can make us more alert rather than sleepy. </p>
<p>Getting enough sleep is <a href="https://theconversation.com/how-dangerous-is-insomnia-how-fear-of-what-its-doing-to-your-body-can-wreck-your-sleep-212248">crucial to our health and wellbeing</a>. If you have tried multiple strategies to improve your sleep and things are not getting better, it may be time to seek professional advice, such as from a GP. </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/reel/CzpbcaGMZCP/?utm_source=ig_web_copy_link","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
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Read more:
<a href="https://theconversation.com/on-your-back-side-face-down-mice-show-how-we-sleep-may-trigger-or-protect-our-brain-from-diseases-like-als-181954">On your back? Side? Face-down? Mice show how we sleep may trigger or protect our brain from diseases like ALS</a>
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<p><em>Correction: the approximate amount of melatonin in cherries has been updated due to a calculation error.</em></p><img src="https://counter.theconversation.com/content/222151/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Charlotte Gupta does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Unlike many viral wellbeing trends, this one may have some science to back it. But don’t drink too much too close to bedtime.Charlotte Gupta, Postdoctoral research fellow, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2215912024-01-24T00:16:27Z2024-01-24T00:16:27ZSome Australian Open matches run extremely late. How would that impact player sleep and recovery?<p>For many Australians, January is synonymous with late nights spent watching the Australian Open tennis tournament. These night matches are a great spectacle, and many players consider the prime time slot on centre court as a privilege and reward for their hard work.</p>
<p>An early highlight of this year’s tournament was the men’s third seed Daniil Medvedev playing out <a href="https://www.tennis.com/news/articles/daniil-medvedev-emil-ruusuvuori-australian-open-339-am">a five-set thriller</a> against unseeded Emil Ruusuvuori, with the match finishing at nearly 4am. Less than 48 hours later, Medvedev followed this up <a href="https://ausopen.com/articles/news/medvedev-eases-past-auger-aliassime-sets-borges-clash">by winning his next round match</a>. </p>
<p>In Medvedev’s <a href="https://apnews.com/article/medvedev-late-australian-open-tennis-708e79d5b03b1d8f042e4b23f183cc88">post-match interview</a>, he discussed recovery and preparation strategies after the previous late-night finish. This included ice baths, medical treatment and physio work before finally going to bed at around 7am, managing to get five hours of sleep.</p>
<p>Similarly, the first round match for women’s number two seed, Aryna Sabalenka, didn’t start <a href="https://womensagenda.com.au/life/sport/defending-womens-champion-plays-just-before-midnight-at-australian-open-raising-scheduling-questions/">until almost midnight</a>.</p>
<p>As sleep scientists, we know limited and disrupted sleep opportunities can impact the body. So what do these late nights and lack of sleep mean for players’ recovery and performance?</p>
<h2>Why a lack of sleep is bad for your muscles</h2>
<p>The function of sleep is still not well understood, despite us spending close to a third of our life asleep. While we do know that sleeping less than six hours a night is linked to the increased risk of several <a href="https://doi.org/10.2337/dc09-1124">chronic diseases</a>, there is still much to investigate.</p>
<p>Several recent studies we’ve worked on have demonstrated the importance of sleep for optimal muscle function. For example, one night of <a href="https://doi.org/10.14814/phy2.14660">sleep deprivation</a> (pulling an “all-nighter”) or <a href="https://doi.org/10.1113/JP278828">repeated nights of short sleep</a> actually impair the muscles’ ability to make new proteins, which is essential for repair and recovery.</p>
<p>Furthermore, other recent research suggests that a period of sleep loss (five nights, with four hours of sleep each night) can <a href="https://doi.org/10.1016/j.molmet.2020.101110">reduce mitochondrial function</a> within your muscles. Mitochondria are known as the “powerhouses of the cell” and are responsible for producing the energy needed to exercise – and win a tennis match.</p>
<p>Therefore, the lack of sleep tennis players experience after such late-night finishes may well impact their recovery and subsequent performance.</p>
<h2>Sleep loss directly affects athletic performance</h2>
<p>It is well accepted that sleep loss negatively impacts cognitive function and decision making. While the data is not definitive, there are also several studies that show sleep loss <a href="https://doi.org/10.1016/j.jsams.2018.01.012">impacts athletic performance</a>.</p>
<p><a href="https://doi.org/10.1249/mss.0000000000003000">A recent study</a> in healthy young women accustomed to resistance exercise found that when they performed their weights session after several nights of restricted sleep, the quality and volume of their performance was reduced. The effort it took to complete the session increased, too.</p>
<p>Losing sleep is also detrimental to anaerobic power and skill execution – both of which are critical for Australian Open hopefuls. One study <a href="https://doi.org/10.1016/j.physbeh.2013.07.002">found a decline in tennis serving accuracy</a> with only five hours of sleep, while another found a <a href="https://doi.org/10.1080/07420520802551568">decline in maximal power output</a>. </p>
<h2>Exercise can help you sleep – but it depends</h2>
<p>It is a widely held belief <a href="https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercising-for-better-sleep">that exercise improves sleep</a>. However, falling asleep shortly after completing an adrenaline-fuelled, high-intensity tennis match is not always easy.</p>
<p>Indeed, a recent study investigated the impact of <a href="https://doi.org/10.1093/sleep/zsad099">high-intensity exercise on sleep quality</a>. When the high-intensity exercise was performed in the early afternoon, deep sleep was improved. But when participants exercised shortly before bed, their sleep quality diminished.</p>
<p>However, this effect also depended on whether the person was a morning lark or evening owl (scientists call this a chronotype). The sleep quality of evening types was unaffected by exercise in the evening.</p>
<p>When it comes to tennis stars, a late-night finish can also affect their circadian rhythm. By the time Medvedev or Sabalenka would have got to bed, their natural, tightly regulated internal clock would have been readying them to wake up. Such a misalignment between the body’s circadian rhythm and the body’s drive for sleep tend to result in disrupted, insufficient sleep. </p>
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Read more:
<a href="https://theconversation.com/jetlag-hits-differently-depending-on-your-travel-direction-here-are-6-tips-to-get-over-it-196730">Jetlag hits differently depending on your travel direction. Here are 6 tips to get over it</a>
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<h2>Can players prepare to handle late-night matches?</h2>
<p>Some players have <a href="https://apnews.com/article/australian-open-late-matches-explainer-509cb3dab84762ae346a1c7fc7b3dfe4">voiced their concerns</a> regarding <a href="https://www.abc.net.au/news/2023-10-03/australian-open-extended-late-night-finishes-thing-of-past/102927520">late-night matches</a>. But other players suggest it’s just <a href="https://www.theage.com.au/sport/tennis/it-s-the-nature-of-the-beast-why-the-australian-open-can-t-avoid-late-nights-20240115-p5excn.html">part of the game</a>. So what can a player do to prepare for the sleep disruption?</p>
<p>Professional athletes have a number of strategies available. For example, <a href="https://doi.org/10.3390/ijerph17134650">napping has myriad benefits</a> for both cognitive function and physical performance.</p>
<p>A popular supplement, caffeine, has consistently been shown to improve physical performance and alertness. While endurance exercise has shown the largest performance benefits from caffeine, small to moderate improvements have been shown in muscle strength, sprinting, jumping and throwing performance.</p>
<p>However, caffeine can be detrimental to subsequent sleep. While athletes preparing for late matches might have an evening caffeine hit, the average Australian should avoid drinking coffee after 3pm.</p>
<p>Increasing sleep duration in the week leading up to late-night matches can also help. Studies have shown that sleep extension <a href="https://doi.org/10.1016/j.physbeh.2015.08.035">increases tennis serving</a> and <a href="https://doi.org/10.5665/sleep.1132">basketball free throw</a> accuracy almost 10%. Increasing sleep duration could really be the difference between hitting a winner or an unforced error. </p>
<p>It remains to be seen if athletes like Medvedev and Sabalenka will overcome their disrupted sleep and prevail at this year’s Australian Open. But there’s certainly an advantage to having a good night’s shut eye.</p><img src="https://counter.theconversation.com/content/221591/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicholas Saner receives funding from the Victorian Medical Research Acceleration Fund. </span></em></p><p class="fine-print"><em><span>Olivia Knowles does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Night matches at the Australian Open are a great spectacle, but sleep disruption is likely to wreak havoc even on professional athletes.Nicholas Saner, Post-doctoral researcher in sleep science, Victoria UniversityOlivia Knowles, High Performance Manager, Hawthorn FC, and Researcher, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2199552024-01-17T13:37:48Z2024-01-17T13:37:48ZWhat’s the best diet for healthy sleep? A nutritional epidemiologist explains what food choices will help you get more restful z’s<figure><img src="https://images.theconversation.com/files/569476/original/file-20240116-23-j8753f.jpg?ixlib=rb-1.1.0&rect=12%2C0%2C2105%2C1409&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A balanced diet is one key factor in getting a restful night's sleep. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/freshly-woken-up-young-woman-enjoying-the-morning-royalty-free-image/1413633179?phrase=person+sleeping&searchscope=image%2Cfilm&adppopup=true">SimpleImages/Moment via Getty Images</a></span></figcaption></figure><p>You probably already know that how you eat before bed affects your sleep. Maybe you’ve found yourself still lying awake at 2 a.m. after enjoying a cup of coffee with dessert. But did you know that your eating choices throughout the day may also affect your sleep at night? </p>
<p>In fact, more and more evidence shows that <a href="https://doi.org/10.3390/nu12092830">overall dietary patterns</a> can <a href="https://doi.org/10.3390/nu14142998">affect sleep quality and contribute to insomnia</a>.</p>
<p>I am a <a href="https://sph.umich.edu/faculty-profiles/jansen-erica.html">nutritional epidemiologist</a>, and I’m <a href="https://scholar.google.com/citations?user=NwgRhPYAAAAJ&hl=en">trained to look at diets at the population level</a> and how they affect health. </p>
<p>In the U.S., a large percentage of the population suffers from <a href="https://www.gallup.com/analytics/390536/sleep-in-america-2022.aspx">poor sleep quality</a> and sleep disorders like <a href="https://www.nhlbi.nih.gov/health/insomnia#">insomnia</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK459252/#">obstructive sleep apnea</a>, a condition in which the upper airway becomes blocked and breathing stops during sleep. At the same time, most Americans eat far too much <a href="https://fns-prod.azureedge.us/sites/default/files/media/file/AverageHealthyEatingIndex-2020ScoresfortheUSPopulation.pdf">fatty and processed food, too little fiber and too few fruits and vegetables</a>. </p>
<p>Although it is difficult to determine whether these two trends are causally linked to one another, more and more <a href="https://doi.org/10.1146%2Fannurev-nutr-120420-021719">research points to linkages between sleep and diet</a> and offers hints at the biological underpinnings of these relationships.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Overhead view of colorful foods with high dietary fiber content arranged side by side on a countertop." src="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Most Americans consume far too little fiber and too few fresh fruits and vegetables.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/group-of-food-with-high-content-of-dietary-fiber-royalty-free-image/1457889029?phrase=high+fiber+diet&searchscope=image%2Cfilm&adppopup=true">fcafotodigital/E+ via Getty Images</a></span>
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<h2>How diet and sleep quality can be intertwined</h2>
<p>My colleagues and I wanted to get a deeper understanding of the possible link between sleep and diet in Americans who are 18 and older. So we analyzed whether people who follow <a href="https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines">the government’s Dietary Guidelines for Americans</a> get more hours of sleep.</p>
<p>Using a nationally representative dataset of surveys collected from 2011 to 2016, we found that people who did not adhere to dietary recommendations such as consuming enough servings of fruits, vegetables, legumes and whole grains <a href="https://doi.org/10.1016/j.appet.2020.104748">had shorter sleep duration</a>.</p>
<p>In a separate study, we followed more than 1,000 young adults ages 21 to 30 who were enrolled in a web-based dietary intervention study designed to help them increase their daily servings of fruits and vegetables. We found that those who increased their fruit and vegetable consumption over a three-month period reported better sleep quality and <a href="https://doi.org/10.1016/j.sleh.2021.02.005">reductions in insomnia symptoms</a>. </p>
<p>Research conducted outside the U.S. by my group and others also shows that healthier overall dietary patterns are associated with better sleep quality and fewer insomnia symptoms. These include the <a href="https://doi.org/10.3390/nu12092830">Mediterranean diet</a> – a diet rich in plant foods, olive oil and seafood, and low in red meat and added sugar – and <a href="https://doi.org/10.3390/nu15020419">anti-inflammatory diets</a>. These are <a href="https://doi.org/10.1016/j.appet.2021.105881">similar to the Mediterranean diet</a> but include additional emphasis on <a href="https://doi.org/10.1093/sleep/zsy158">certain components in the diet</a> like <a href="https://doi.org/10.3390%2Fmolecules25225243">flavonoids</a>, a group of compounds found in plants, which are shown to lower inflammatory biomakers in the blood.</p>
<h2>Parsing the foods and nutrients</h2>
<p>Within overall healthy diet patterns, there are numerous individual foods and nutrients that may be linked to quality of sleep, with varying degrees of evidence. </p>
<p>For example, studies have linked consumption of <a href="https://doi.org/10.5664/jcsm.3714">fatty fish</a>, <a href="https://doi.org/10.1016/j.advnut.2023.01.004">dairy</a>, <a href="https://doi.org/10.3389/fnut.2023.1079609">kiwi fruit</a>, <a href="https://doi.org/10.1097/mjt.0000000000000584">tart cherries</a> and <a href="https://doi.org/10.3390/nu15245115">other berries</a> such as strawberries and blueberries with better sleep. One of the common pathways through which these foods may affect sleep is by <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">providing melatonin</a>, an important modulator of sleep and wake cycles in the brain.</p>
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<figcaption><span class="caption">Walnuts and almonds, as well as fruits like kiwis and bananas, provide natural sources of melatonin.</span></figcaption>
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<p><a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">Fiber-rich foods</a> like beans and oatmeal and certain protein sources – especially those that are high in the amino acid tryptophan, such as poultry – are also associated with <a href="https://doi.org/10.1016/j.jand.2022.01.007">higher-quality sleep</a>. Individual nutrients that may be beneficial include <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/">magnesium</a>, <a href="https://doi.org/10.1016/j.tjnut.2023.11.030">vitamin D</a>, <a href="https://doi.org/10.1016/j.tjnut.2023.11.030">iron</a>, <a href="https://doi.org/10.1093/jn/nxz286">omega-3 fatty acids</a> and <a href="https://doi.org/10.1016/j.tjnut.2023.11.012">manganese</a>. Some foods like salmon are sources of multiple nutrients. </p>
<h2>Untangling the complexity</h2>
<p>One important caveat with a lot of the research on individual foods, as well as diet patterns, is that most studies cannot easily disentangle the direction of the relationships.</p>
<p>In other words, it’s hard to know whether the association is a result of diet affecting sleep, or sleep affecting diet. The reality is that it is likely a cyclical relationship, where a healthy diet promotes good sleep quality, which in turn helps to <a href="https://doi.org/10.1146/annurev-nutr-120420-021719">reinforce good dietary habits</a>. </p>
<p>With observational studies, there are also possible confounding factors, such as age and economic status, that may have important correlations with both sleep and diet.</p>
<h2>Foods to avoid for sleep health</h2>
<p>Aiming for higher intake of sleep-promoting foods isn’t necessarily enough to get better sleep. It’s also important to avoid certain foods that could be bad for sleep. Here are some of the main culprits:</p>
<ul>
<li><p>Saturated fats, such as that in burgers and fries and processed foods, could <a href="https://doi.org/10.5664/jcsm.5384">lead to less slow-wave sleep</a>, which is <a href="https://pubmed.ncbi.nlm.nih.gov/19998869/">considered the most restorative sleep</a>. </p></li>
<li><p>Refined carbohydrates, such as those in white bread and pasta, are metabolized quickly. If you eat these foods for dinner, they can result in <a href="https://doi.org/10.3389/fpubh.2022.931781">waking up from hunger</a>. </p></li>
<li><p><a href="https://doi.org/10.1016/j.alcohol.2014.07.019">Alcohol disrupts sleep quality</a>. Although the sedative effects of alcohol can initially make it easier to fall asleep, it disrupts sleep patterns by shortening the amount of <a href="https://www.webmd.com/sleep-disorders/sleep-101">REM, or rapid eye movement</a>, sleep in the first part of the night and leads to more night awakenings.</p></li>
<li><p>Caffeine consumed even six hours before bed can <a href="https://doi.org/10.5664/jcsm.3170">make it difficult to fall asleep</a> because it blocks the hormone adenosine, which promotes sleepiness. </p></li>
<li><p>The consistent overconsumption of calories can lead to weight gain, one of the <a href="https://doi.org/10.1016/j.smrv.2023.101838">strongest predictors of obstructive sleep apnea</a>. Having excess weight is a factor because it can put additional pressure on the diaphragm and lungs, and can also lead to a narrower airway if fat accumulates around the neck and throat.</p></li>
</ul>
<p>Interestingly, our group has recently shown that toxicants in food or food packaging, <a href="https://doi.org/10.1186/s12889-021-12014-x">like pesticides</a>, <a href="https://doi.org/10.1016/j.envres.2020.110216">mercury</a> and <a href="https://doi.org/10.1007/s11356-023-26833-5">phthalates</a> – chemicals used to manufacture plastics – can affect sleep. Since toxicants can be found in both healthy and unhealthy foods, this research suggests that some foods can contain a mix of components that are both beneficial and harmful for sleep.</p>
<h2>Timing of meals and gender considerations</h2>
<p>The timing and consistency of eating, known as “chrononutrition” in the sleep research field, also very likely help to explain associations between healthy diets and good sleep. </p>
<p>In the U.S., eating at conventional meal times as opposed to random snacking <a href="https://doi.org/10.1017/S136898001000296X">has been associated with better sleep</a>. In addition, late-night eating is typically associated with unhealthier food intake – such as processed snacks – and could <a href="https://doi.org/10.1017/s0007114521003597">cause more fragmented sleep</a>.</p>
<p>A final and very interesting piece of this puzzle is that associations between diet and sleep often differ by gender. For example, it appears that the associations between healthy diet patterns and insomnia symptoms <a href="https://doi.org/10.1016/j.sleh.2021.02.005">could be stronger among women</a>. One reason for this could be gender differences in sleep. In particular, <a href="https://doi.org/10.3389%2Ffpsyt.2020.577429">women are more likely than men to suffer from insomnia</a>.</p>
<h2>Keys to a good night’s sleep</h2>
<p>Overall, there is not one magic food or drink that will improve your sleep. It’s better to focus on overall healthy dietary patterns throughout the day, with a higher proportion of calories consumed earlier in the day. </p>
<p>And, in addition to avoiding caffeine, alcohol and heavy meals in the two to three hours before bed, the last few hours of the day should include other <a href="https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/">good sleep hygiene practices</a>. </p>
<p>These include disengaging from technology, reducing light exposure and creating a comfortable and relaxing environment for sleep. Moreover, allowing enough time to sleep and maintaining a consistent bedtime and wake time is essential.</p><img src="https://counter.theconversation.com/content/219955/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erica Jansen receives funding from the National Heart Lung Blood Institute (NHBLI) through a K01 award (K01HL151673). </span></em></p>A growing body of research is finding a robust link between diet and sleep quality. But it’s not just the usual suspects like caffeine and alcohol that can get in the way of restful sleep.Erica Jansen, Assistant Professor of Nutritional Sciences, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2193902023-12-24T20:54:28Z2023-12-24T20:54:28ZRelax – having different sleeping arrangements over the holidays probably won’t wreck your child’s sleep routine<figure><img src="https://images.theconversation.com/files/564133/original/file-20231207-25-tzvzwq.jpg?ixlib=rb-1.1.0&rect=0%2C7%2C4743%2C3145&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/little-boy-jumping-on-bed-bedroom-1024614475">Shutterstock</a></span></figcaption></figure><p>Sleep, along with diet and physical activity, is one of the three pillars of good health. Good sleep makes it easier to grow, learn, perform, be happy, stay in our best weight range and generally be in the best mental and physical health. This is true for all humans but is particularly important with children.</p>
<p>Regular sleep patterns are important for good sleep. But children and their families often stay with relatives or in holiday accommodation around this time of year. Parents may anxiously wonder: will changing sleeping arrangements during school holidays sabotage good habits formed and maintained during the school term? </p>
<p>For over 20 years, I have researched and treated children sleep problems. The research suggests changing sleep patterns over the summer break does not have to be a problem. And there’s a lot you can do to manage sleep issues during and after the holidays.</p>
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<a href="https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5184%2C3453&q=45&auto=format&w=1000&fit=clip"><img alt="A dad kisses his daughter on the head at bedtime as she lies in the bottom bunk." src="https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5184%2C3453&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564130/original/file-20231207-21-63vsqc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Changing sleep patterns over the summer break does not have to be a problem.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/father-kissing-goodnight-daughter-bedtime-627688967">Shutterstock</a></span>
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Read more:
<a href="https://theconversation.com/should-i-loosen-up-on-the-kids-bedtime-these-holidays-or-stick-to-the-schedule-tips-from-a-child-sleep-expert-192727">Should I loosen up on the kids' bedtime these holidays – or stick to the schedule? Tips from a child sleep expert</a>
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<h2>Sleeping as a skill</h2>
<p>In Australia, as in many western industrialised countries, parents often (but not always) expect their children to <a href="https://jcsm.aasm.org/doi/full/10.5664/jcsm.6284">sleep alone</a> in their own room and in their own bed. </p>
<p>Up to <a href="https://pubmed.ncbi.nlm.nih.gov/20582760/">40% of families</a> use behavioural sleep strategies to teach their child sleep alone. While such strategies are generally successful in achieving this, it can be hard work for all the family.</p>
<p>Many parents worry that having children share a room or even a bed with their parents over the holidays will become the habit during term time, too.</p>
<p>However, the science says once children have learned a skill, such as sleeping alone, they have a “<a href="https://eclass.uowm.gr/modules/document/file.php/NURED263/Pound%20How%20Children%20Learn_%20Educational%20Theories%20and%20Approaches%202014%20book.pdf">neural understanding</a>” of that skill. That means their brain has registered, recorded and filed the “memory” of sleeping alone and this is stored for quite a long time.</p>
<p>Short relapses or interruptions to using that skill will not eradicate it in the brief time of a holiday. The child will still know how to sleep alone. </p>
<p>However, <a href="https://theconversation.com/is-there-such-a-thing-as-too-old-to-co-sleep-with-your-child-the-research-might-surprise-you-188145">they may not want to</a>.</p>
<p>Children may may realise sleeping with parents or siblings is actually pretty great (for them). It may be less fun, however, for the parents (who may not necessarily want to share a bed with a wriggly child, or feel frustrated by seeing siblings who don’t normally share a room, muck around when they should be asleep).</p>
<p>Like many aspects of parenting, it helps for parents to remind their children of the rules at home and guide them back to their regular sleep pattern.</p>
<p>Helping children to understand the co-sleeping or room sharing arrangement may be temporary is helpful. Children can and do learn sleeping arrangements can be different in different places, but the rules stay the same at home.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two children peek out from a bunk bed." src="https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564137/original/file-20231207-23-tzvzwq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sometimes, being on holidays means sharing a room with your sibling or cousins for the first time.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-happy-young-boy-brother-lying-140064361">Shutterstock</a></span>
</figcaption>
</figure>
<h2>What if my child won’t sleep at the holiday accommodation?</h2>
<p>This is a problem not just because it keeps parents and others from a good night’s sleep. It also deprives the child of sleep.</p>
<p>For some children, particularly sensitive or anxious children, changing sleep routines and particularly sleep environments can really throw them off. These children <a href="https://pubmed.ncbi.nlm.nih.gov/29302831/">may find any change very difficult</a>. </p>
<p>When these children are faced with an unknown sleeping environment, they may keenly feel the separation from their parents (who make them feel safe). It can be very difficult and sometimes impossible for them to adjust quickly. </p>
<p>The result may be a child taking a longer time to get to sleep, or long and unsettled overnight wakings. Parents may need to mentally prepare and adjust their expectations.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A young girl touches the light switch of a lamp on her bedside table." src="https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564136/original/file-20231207-31-8fzvvl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Like many adults, some children struggle to sleep in an unfamiliar environment.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/asian-child-girl-resting-on-bedturning-1847058961">Shutterstock</a></span>
</figcaption>
</figure>
<p>It may help to prepare the child for the changes. Find out information about sleeping arrangements, <em>before</em> you go to your holiday accommodation. Talk to the child about the sleep set up, who will be there, look at pictures and share the excitement of a new place with the child. </p>
<p>Discuss being scared and anxious with the child and learn some strategies together to help them be brave and calm such as “You will have your favourite bunny with you. And we will just be in the next room”? Or, “We can take our night light from home?” Practise these before leaving on the holiday.</p>
<p>Encouraging and helping your child to be brave rather than expecting them to be brave alone is more likely to result in a <a href="https://psycnet.apa.org/record/2015-24314-010">smoother transition</a> from home to holiday and back again. Don’t shame them for feeling scared, but try to gently and empathetically help them learn some strategies to cope. Facing a difficult challenge such as changing sleep environments will also teach them resilience.</p>
<p>So parents don’t need to fear any negative repercussions from changing sleeping environments during the summer holidays. Bring on summer and enjoy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-parents-use-melatonin-gummies-to-help-children-sleep-so-how-do-they-work-and-what-are-the-risks-190129">Many parents use melatonin gummies to help children sleep. So how do they work and what are the risks?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/219390/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Blunden does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>For over 20 years, I have researched and treated children sleep problems. The research suggests changing sleep patterns over the summer break does not have to be a problem.Sarah Blunden, Professor and Head of Paediatric Sleep Research, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2188742023-12-18T13:20:32Z2023-12-18T13:20:32ZStudents could get more sleep and learn better if school started a little later<figure><img src="https://images.theconversation.com/files/564471/original/file-20231208-27-k39utf.jpg?ixlib=rb-1.1.0&rect=23%2C11%2C3916%2C2280&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">About 58% of middle schoolers and 73% of high schoolers do not get enough sleep.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-is-tired-and-sleeping-at-the-desk-in-classroom-royalty-free-image/1503343198?phrase=students+sleeping+in+class">JackF via iStock / Getty Images Plus</a></span></figcaption></figure><p>Nearly three-quarters of high school students do not get enough sleep on school nights, according to the <a href="https://www.cdc.gov/healthyschools/features/students-sleep.htm">Centers for Disease Control and Prevention</a>.</p>
<p>The National Sleep Foundation recommends that teens sleep for <a href="https://doi.org/10.1016/j.sleh.2014.12.010">eight to 10 hours per night</a>. But various factors hinder this, including early school start times and <a href="https://doi.org/10.1093/sleep/16.3.258">shifts in adolescents’ circadian rhythms</a> – the biological internal clock that regulates the sleep-wake cycle and repeats roughly every 24 hours. <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">Healthy sleep is crucial</a> for teens’ physical, cognitive and emotional development. When teens don’t get enough sleep, it can have lifelong impacts. They range from <a href="https://doi.org/10.1111/j.1365-2869.2011.00934.x">poor mental health</a> to <a href="https://doi.org/10.5664/jcsm.10156">lower attendance and graduation rates</a>.</p>
<p>As a neurologist <a href="https://scholar.google.com/citations?user=sTqquL0AAAAJ&hl=en">specializing in sleep disorders</a>, I have studied the profound importance of sleep in optimizing the body and mind. I believe insufficient sleep among adolescents is a public health crisis. This is why I reached out to my local state representative in Pennsylvania, <a href="https://www.legis.state.pa.us/cfdocs/legis/home/member_information/house_bio.cfm?id=1951">Rep. Jill Cooper</a>, a member of the House Education Committee, in October 2023 and pushed for legislative change. The resulting <a href="https://legiscan.com/PA/bill/HB1848/2023">proposed bill</a> would mandate that middle and high schools start no earlier than 8:15 a.m. by the 2026-27 school year.</p>
<p>While parents, educators and school administrators cannot alter biology, they can change school start times to allow students to obtain sufficient sleep for academic success and physical and mental well-being. In fact, the American Academy of Pediatrics <a href="https://doi.org/10.1542/peds.2014-1697">recommends pushing back school start times</a> to 8:30 a.m. or later.</p>
<p>Around the world, <a href="https://worldpopulationreview.com/country-rankings/average-school-day-length-by-country">school start times vary considerably</a>, from 7 a.m. in Brazil to 9 a.m. in Finland. While I’m not aware of any global dataset or research on the relationship between school start times and academic performance, Finland was ranked No. 2 on the list of <a href="https://worldpopulationreview.com/country-rankings/education-rankings-by-country">best educational systems</a> in the Global Citizens for Human Rights report in 2020. Canada, where the average school day begins at 8:30 a.m., was ranked No. 4.</p>
<h2>Sleep and the teenage brain</h2>
<p>Parents may notice that their kids, who were once early birds, start to sleep later and later as they hit their teen years. This is not just due to typical teen behavior like playing video games late at night, but rather it’s a <a href="https://doi.org/10.1093/sleep/16.3.258">biological response</a>.</p>
<p>During adolescence, changes in hormone levels, along with physical and brain maturation, lead to natural shifts in the circadian rhythm. The body tends to delay the release of melatonin, the hormone responsible for bringing on drowsiness at night. </p>
<p>Consequently, teens often find it <a href="https://doi.org/10.1016/j.pcl.2011.03.003">challenging to fall asleep early</a>, leading to a later bedtime. This delayed circadian rhythm also results in a preference for waking up later in the morning. These changes clash with societal and cultural expectations such as early school start times, often contributing to sleep deprivation among teenagers.</p>
<figure>
<iframe src="https://player.vimeo.com/video/694426344" width="500" height="281" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe>
<figcaption><span class="caption">Changes in hormones and the circadian rhythm make it difficult for teens to fall asleep and wake up early. Healthy Hours via Vimeo</span></figcaption>
</figure>
<p>More than 80% of public middle and high schools across the United States <a href="https://nces.ed.gov/pubs2020/2020006/index.asp">start before 8:30 a.m.</a>, with 42% starting before 8 and 10% before 7:30. Consequently, bus pickup for some children can be as early as <a href="https://www.orlandosentinel.com/2015/04/18/5-am-bus-rides-630-walks-to-school-all-too-early/">5 a.m. in some districts</a>. What follow are four negative outcomes associated with early school start times.</p>
<h2>Hindered academic success</h2>
<p>Numerous studies have linked early school start times to poorer performance on <a href="https://doi.org/10.1542/peds.2014-1697">academic tests</a>. </p>
<p>One study looked at <a href="https://doi.org/10.5664/jcsm.10156">school start times, graduation rates and attendance rates</a> for 30,000 students in 29 high schools across seven states. It found a significant improvement in attendance rates, from 90% to 93%, and graduation rates, from 80% to 90%, four years after delaying school start times to 8:30.</p>
<p>Sleep deprivation has been shown to worsen <a href="https://doi.org/10.1093/sleep/zsab051">memory, learning ability, attention span</a>, <a href="https://doi.org/10.1016/B978-0-444-53702-7.00007-5">creativity</a>, <a href="https://doi.org/10.1177/019263650208663302">school attendance</a> and <a href="https://doi.org/10.1001/archpediatrics.2010.96">first-period tardiness</a> – a perfect storm for poor academic performance. </p>
<h2>Poorer mental health</h2>
<p>A recent <a href="https://www.hhs.gov/sites/default/files/sg-youth-mental-health-social-media-advisory.pdf">advisory from the U.S. surgeon general</a> raised the alarm on the harmful impacts of social media on youth mental health. Researchers have unearthed mounds of evidence on the negative effects, including <a href="https://theconversation.com/mounting-research-documents-the-harmful-effects-of-social-media-use-on-mental-health-including-body-image-and-development-of-eating-disorders-206170">poor body image</a>. In these discussions, however, a simple yet powerful solution for improving mental well-being is often overlooked – the profound impact of sleep. </p>
<p>During REM sleep – or the dream state – our memories consolidate and we process emotions. Insufficient sleep increases the risk of <a href="https://doi.org/10.1111/j.1365-2869.2011.00934.x">depression</a>, <a href="https://doi.org/10.1542/peds.2014-1696">anxiety</a> and <a href="https://doi.org/10.1093/sleep/27.7.1351">suicide</a> among adolescents. One study showed that for every extra hour of sleep among adolescents, their <a href="https://doi.org/10.1016/j.smrv.2018.07.003">risk of suicide decreased</a> by 11%. </p>
<h2>Impaired physical health and social behavior</h2>
<p>Sleep is fundamental for physical well-being. For both children and adults, it plays a key role in essential bodily functions. During slow-wave sleep – or deep sleep – our bodies restore themselves: Our <a href="https://doi.org/10.1007/s00424-011-1044-0">immune system strengthens</a> to keep us healthy. And our waste-clearing glymphatic system <a href="https://doi.org/10.3389/fnins.2021.639140">eradicates neurotoxic proteins</a>, which are linked to diseases like Alzheimer’s. </p>
<p>Sleep deprivation is associated with higher rates of <a href="https://doi.org/10.1155/2012/476914">obesity</a>, <a href="https://doi.org/10.5664/jcsm.6288">diabetes, cardiovascular problems, chronic health conditions</a>, <a href="https://doi.org/10.1016/j.sleep.2019.03.008">physical injuries</a> and weakened immune function. Sleep-deprived students are more likely to fall asleep when sedentary, such as when driving a car. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603528/">Motor vehicle accidents</a> related to driving while drowsy are especially prevalent among teen drivers.</p>
<p>Sleep-deprived students are also more likely to demonstrate aggression, struggle with social communication and engage in risk-taking behaviors. One study found that the amount of sleep that high school students get is directly related to their <a href="https://doi.org/10.1001/jamapediatrics.2018.2777">engagement in unsafe behaviors</a>, such as substance abuse, risky driving, aggressive behavior and tendency toward self-harm. </p>
<h2>An economic cost</h2>
<p>The economic ramifications of this crisis may not be immediately obvious, but they are undeniable. Contrary to <a href="https://lacomadre.org/2019/10/beyond-students-late-school-start-times-could-impact-parents-and-transportation-budgets/">concerns that delayed school start times might increase transportation costs</a> by changing bus schedules, a 2017 study conducted by the nonprofit RAND Corp. found that the economic benefits <a href="https://doi.org/10.7249/RR2109">far outweigh the expenses</a>. </p>
<p>The study showed that a universal shift to 8:30 a.m. school start times would result in an $8.6 billion gain in the U.S. economy over two years. Investing in delayed school start times, therefore, isn’t a drain on resources. Instead, it contributes to a healthier future for generations to come.</p><img src="https://counter.theconversation.com/content/218874/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joanna Fong-Isariyawongse does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Most teens aren’t getting enough sleep, leading to poorer academic performance. Early school start times combined with natural changes in hormones and the circadian rhythm could be to blame.Joanna Fong-Isariyawongse, Associate Professor of Neurology, University of PittsburghLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2168342023-12-14T23:40:30Z2023-12-14T23:40:30ZChristmas drinks anyone? Why alcohol before bedtime leaves you awake at 3am, desperate for sleep<figure><img src="https://images.theconversation.com/files/564156/original/file-20231207-21-eolo35.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C666&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/new-year-christmas-celebration-champagne-front-1534963964">fornStudio/Shutterstock</a></span></figcaption></figure><p>You’ve come home after a long day at work, you have dinner, put the kids to bed, and then you have your usual nightcap before drifting off to sleep. Or, perhaps you’re at the pub for the work Christmas party, and you think you’ll just have one more drink before heading home.</p>
<p>That last drink might help you fall asleep easily. But your nightcap can also wreck a good night’s sleep. How could it do both?</p>
<p>Here’s what’s going on in your body when you drink alcohol just before bedtime. And if you want to drink at the Christmas party, we have some tips on how to protect your sleep.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">How can I get some sleep? Which treatments actually work?</a>
</strong>
</em>
</p>
<hr>
<h2>What happens to my body when I drink?</h2>
<p>Soon after you drink, alcohol enters your bloodstream and travels to your brain.</p>
<p><a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1530-0277.1998.tb03695.x">There</a>, it affects chemical messengers known as neurotransmitters and <a href="https://pubmed.ncbi.nlm.nih.gov/2700603/">slows down communication</a> between nerve cells. </p>
<p>Certain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040959/">regions of the brain</a> are particularly vulnerable to the effects of alcohol. When alcohol interacts with cells in these regions, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826822/">overall effect</a> leads to those characteristic feelings of relaxation, lowered inhibitions, slurred speech, and may induce feelings of drowsiness and lethargy. </p>
<p>Alcohol can also have immediate effects on the heart and circulatory system. Blood vessels widen, resulting in a <a href="https://link.springer.com/article/10.1007/s11906-021-01160-7">drop in blood pressure</a>, which can make you feel dizzy or lightheaded.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-different-drinks-make-you-different-drunk-88247">Do different drinks make you different drunk?</a>
</strong>
</em>
</p>
<hr>
<h2>What happens soon after a nightcap?</h2>
<p>Drinking alcohol before sleeping is like flipping a switch. At first, alcohol has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826822/">sedative effect</a> and you will probably feel <a href="https://pubmed.ncbi.nlm.nih.gov/23347102/">more relaxed</a> and <a href="https://www.nature.com/articles/s41598-020-62227-0#:%7E:text=In%20this%20large%2C%20population%20based,sleep%20(cross%20sectional%20analyses).">drift off easily</a>.</p>
<p>At this point, you still have a high level of alcohol in your blood. But don’t be fooled. As your body <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">processes the alcohol</a>, and the night goes on, alcohol actually <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12621">disrupts your sleep</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man sitting on sofa, wearing pyjamas, holding glass of red wine, sparkling lights on floor" src="https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564151/original/file-20231207-29-tofekf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A nightcap might help you drop off, but there’s worse to come.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/man-check-pyjamas-holding-glass-red-1901882026">dabyki.nadya/Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">Why do I fall asleep on the sofa but am wide awake when I get to bed?</a>
</strong>
</em>
</p>
<hr>
<h2>And later that night?</h2>
<p>As your body processes the alcohol and your blood alcohol level drops, your brain rebounds from the drowsiness you would have felt earlier in the night. </p>
<p>This disturbs your sleep, and can wake you up <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">multiple times</a>, particularly in the second half of the night. You may also have
vivid and stressful <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">dreams</a>.</p>
<p>This sleep disruption is mainly to the deep, “rapid eye movement” or REM sleep.</p>
<p>This type of sleep plays an important role in regulating your emotions and for your cognitive function. So not getting enough explains why you wake up feeling pretty lousy and groggy.</p>
<p>Drinking alcohol before bedtime also tends to mean you <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775419/?source=post_page---------------------------">sleep less overall</a>, meaning important rest and recharge time is cut short.</p>
<p>There are also <a href="https://pubmed.ncbi.nlm.nih.gov/31234199/">long-term impacts</a> of alcohol on sleep. Moderate and heavy drinkers consistently have <a href="https://academic.oup.com/sleepadvances/article/3/1/zpac023/6632721">poor sleep quality</a> and more <a href="https://www.nature.com/articles/s41598-020-62227-0#:%7E:text=In%20this%20large%2C%20population%20based,sleep%20(cross%20sectional%20analyses).">sleep disturbances</a> over time.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/adele-called-herself-a-borderline-alcoholic-but-is-that-a-real-thing-215987">Adele called herself a 'borderline alcoholic'. But is that a real thing?</a>
</strong>
</em>
</p>
<hr>
<h2>How about the Christmas party then?</h2>
<p>If you plan to drink this holiday season, here are some tips to minimise the effect of alcohol on your sleep:</p>
<ul>
<li><p><strong>swap every other drink</strong>. Try swapping every second drink for a non-alcoholic drink. The more alcohol you drink, <a href="https://academic.oup.com/sleep/article/44/1/zsaa135/5871424?casa_token=okbJAuf8TXUAAAAA:ye_q-DACToxvj8H3IVaiKrjNkDhHZnl-LKJdds3iteaKyzJFuHUzitlRv45DqxNO-FraDRAlQMV53z8">the more</a> sleep disruption you can expect. Reducing how much you drink in any one sitting can minimise the effect on your sleep</p></li>
<li><p><strong>avoid drinking alcohol close to bedtime</strong>. If you give your body a chance to process the alcohol before you go to sleep, your sleep will be less disrupted</p></li>
<li><p><strong>eat while you drink</strong>. Drinking on an empty stomach is going to worsen the effects of alcohol as the alcohol will be absorbed <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-3010.2006.00588.x?casa_token=TQiCqcbasYAAAAAA:GbEvnTT82aB3_sPfmJLOQXIV3ivjnbZdIoP2_XZBa8IDZ0YLaPxNfE6DMHLgH7obnpA22VDsM4vyGZV4dQ">faster</a>. So try to eat something while you’re drinking</p></li>
<li><p><strong>ditch the espresso martinis and other caffeinated drinks</strong>. <a href="https://www.sciencedirect.com/science/article/pii/S1087079207000937?casa_token=NJsobF-C-vwAAAAA:opzPjrglPdZTwXEo7rHil5vm0a1K3KmXw9vp0Het-eRHZEWbfRAA40vgicU3Z5kC8x7uEJF39C8">Caffeine</a> can make it hard to get to sleep, and hard to stay asleep</p></li>
<li><p><strong>be careful if you have sleep apnoea</strong>. People who have sleep apnoea (when their upper airway is repeatedly blocked during sleep) can be even more impacted by drinking alcohol. That’s because alcohol can act as a muscle relaxant, <a href="https://academic.oup.com/sleep/article/5/4/318/2753287">leading to</a> more snoring, and lower oxygen levels in the blood. If you have sleep apnoea, limiting how much alcohol you drink is the best way to avoid these effects</p></li>
<li><p><strong>drink plenty of water</strong>. Staying hydrated will help you <a href="https://academic.oup.com/sleep/article/42/2/zsy210/5155420">sleep better</a> and will hopefully stave off the worst of tomorrow’s hangover.</p></li>
</ul>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-causes-hangovers-blackouts-and-hangxiety-everything-you-need-to-know-about-alcohol-these-holidays-127995">What causes hangovers, blackouts and 'hangxiety'? Everything you need to know about alcohol these holidays</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/216834/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Here’s what’s going on in your body when you drink alcohol just before bedtime. And if you want to drink at the Christmas party, we have some tips on how to protect your sleep.Madeline Sprajcer, Lecturer in Psychology, CQUniversity AustraliaCharlotte Gupta, Postdoctoral research fellow, CQUniversity AustraliaChris Irwin, Senior Lecturer in Nutrition and Dietetics, School of Health Sciences & Social Work, Griffith UniversityGrace Vincent, Senior Lecturer, Appleton Institute, CQUniversity AustraliaSaman Khalesi, Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2158082023-12-10T19:07:34Z2023-12-10T19:07:34ZI’m trying to lose weight and eat healthily. Why do I feel so hungry all the time? What can I do about it?<p>Benjamin Franklin, one of the founding fathers of the United States, famously said nothing is certain except death and taxes. But I think we can include “you’ll feel hungry when you’re trying to lose weight” as another certainty. </p>
<p>The reason is basic biology. So how does this work – and what can you do about it?</p>
<h2>Hormones control our feelings of hunger</h2>
<p>Several hormones play an essential role in regulating our feelings of hunger and fullness. The most important are ghrelin – often called the hunger hormone – and leptin.</p>
<p>When we’re hungry, <a href="https://pubmed.ncbi.nlm.nih.gov/11739476/">ghrelin</a> is released by our stomach, lighting up a part of our brain called the hypothalamus to tell us to eat. </p>
<p>When it’s time to stop eating, hormones, including <a href="https://pubmed.ncbi.nlm.nih.gov/8717038/">leptin</a>, are released from different organs, such as our gut and fat tissue, to signal to the brain that we’re full.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/chemical-messengers-how-hormones-make-us-feel-hungry-and-full-35545">Chemical messengers: how hormones make us feel hungry and full</a>
</strong>
</em>
</p>
<hr>
<h2>Dieting disrupts the process</h2>
<p>But when we change our diet and start losing weight, we disrupt how these <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">appetite hormones function</a>. </p>
<p>This triggers a process that stems from our hunter-gatherer ancestors. Their bodies developed this mechanism as a survival response to adapt to periods of deprivation and protect against starvation. </p>
<p>The levels of hormones <a href="https://pubmed.ncbi.nlm.nih.gov/23126426/">managing our hunger increase</a>, making us feel hungrier to tell us to eat more, while the ones responsible for signalling we’re full decrease their levels, intensifying our feelings of hunger.</p>
<p>We end up increasing our calorie consumption so we eat more to regain the weight we lost. </p>
<p>But worse, even after the kilos creep back on, <a href="https://pubmed.ncbi.nlm.nih.gov/22029981/">our appetite hormones don’t restore</a> to their normal levels – they keep telling us to eat more so we put on a little extra fat. This is our body’s way of preparing for the next bout of starvation we will impose through dieting. </p>
<p>Fortunately, there are things we can do to manage our appetite, including:</p>
<h2>1. Eating a large, healthy breakfast every day</h2>
<p>One of the easiest ways to manage our feelings of hunger throughout the day is to eat most of our food earlier in the day and taper our meal sizes so dinner is the smallest meal.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. </p>
<figure class="align-center ">
<img alt="Man spreads avocado" src="https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Prioritise breakfast over dinner.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/soft-focus-shot-man-having-delicious-759322450">Shutterstock</a></span>
</figcaption>
</figure>
<p><a href="https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00344-8">Another study</a> found the same effect. Participants went on a calorie-controlled diet for two months, where they ate 45% of their calories for breakfast, 35% at lunch and 20% at dinner for the first month, before switching to eat their largest meal in the evening and their smallest in the morning. Eating the largest meal at breakfast resulted in decreased hunger throughout the day.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> also shows we burn the calories from a meal 2.5-times more efficiently in the morning than the evening. So emphasising breakfast over dinner is good not just for hunger control, but also weight management.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/should-we-eat-breakfast-like-a-king-lunch-like-a-prince-and-dinner-like-a-pauper-86840">Should we eat breakfast like a king, lunch like a prince, and dinner like a pauper?</a>
</strong>
</em>
</p>
<hr>
<h2>2. Prioritising protein</h2>
<p>Protein helps contain feelings of hunger. This is because protein-rich foods such as lean meats, tofu and beans suppress the appetite-stimulating ghrelin and stimulate another hormone called <a href="https://www.sciencedirect.com/science/article/pii/S1550413106002713">peptide YY</a> that makes you feel full. </p>
<p>And just as eating a breakfast is vital to managing our hunger, what we eat is important too, with <a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">research</a> confirming a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. </p>
<p>But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado.</p>
<h2>3. Filling up with nuts and foods high in good fats and fibre</h2>
<p>Nuts often get a bad rap – thanks to the misconception they cause weight gain – but nuts can help us manage our hunger and weight. The filling fibre and good fats found in nuts take longer to digest, meaning our hunger is satisfied for longer. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/12791613/">Studies</a> suggest you can include up to 68 grams per day of nuts without affecting your weight. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-will-eating-nuts-make-you-gain-weight-108491">Health check: will eating nuts make you gain weight?</a>
</strong>
</em>
</p>
<hr>
<p>Avocados are also high in fibre and heart-healthy monounsaturated fats, making them another excellent food for managing feelings of fullness. This is backed by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567160/">study</a> confirming participants who ate a breakfast incorporating avocado felt more satisfied and less hungry than participants who ate a meal containing the same calories but with lower fat and fibre content. </p>
<p>Similarly, eating foods that are high in soluble fibre – such as <a href="https://pubmed.ncbi.nlm.nih.gov/24820437/">beans</a> and vegetables – make us feel fuller. This type of fibre attracts water from our gut, forming a gel that slows digestion. </p>
<figure class="align-center ">
<img alt="Couple cook together" src="https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fibre helps us feel fuller for longer.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/a-man-and-a-woman-preparing-food-in-a-kitchen-hQocGyy0unQ">Sweet Life/Unsplash</a></span>
</figcaption>
</figure>
<h2>4. Eating mindfully</h2>
<p>When we take time to really be aware of and enjoy the food we’re eating, we slow down and eat far less. </p>
<p>A <a href="https://pubmed.ncbi.nlm.nih.gov/28718396/">review</a> of 68 studies found eating mindfully helps us better recognise feelings of fullness. Mindful eating provides our brain enough time to recognise and adapt to the signals from our stomach telling us we’re full.</p>
<p>Slow down your food consumption by sitting at the dinner table and use smaller utensils to reduce the volume of food you eat with each mouthful.</p>
<h2>5. Getting enough sleep</h2>
<p>Sleep deprivation disturbs our <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945708700133">appetite hormones</a>, increasing our feelings of hunger and <a href="https://www.nature.com/articles/ncomms3259">triggering cravings</a>. So aim to get at least seven hours of uninterrupted sleep a night.</p>
<p>Try switching off your devices <a href="https://journals.sagepub.com/doi/full/10.1177/1477153515584979">two hours before bed</a> to boost your body’s secretion of sleep-inducing hormones like melatonin.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-our-brain-needs-sleep-and-what-happens-if-we-dont-get-enough-of-it-83145">Why our brain needs sleep, and what happens if we don’t get enough of it</a>
</strong>
</em>
</p>
<hr>
<h2>6. Managing stress</h2>
<p>Stress increases our <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">body’s production of cortisol</a> and triggers food cravings.</p>
<p>So take time out when you need it and set aside time for stress-relieving activities. This can be as simple as getting outdoors. A <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">2019 study</a> found sitting or walking outdoors at least three times a week could reduce cortisol levels by 21%. </p>
<figure class="align-center ">
<img alt="Person walks in house, next to grey dog" src="https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Take time out to reduce your stress levels.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/gray-dog-looking-at-the-person-qqpfqFwAyDQ">Evieanna Santiago/Unsplash</a></span>
</figcaption>
</figure>
<h2>7. Avoiding depriving ourselves</h2>
<p>When we change our diet to lose weight or eat healthier, we typically restrict certain foods or food groups. </p>
<p>However, this <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">heightens activity</a> in our mesocorticolimbic circuit – the reward system part of the brain – often resulting in us craving the foods we’re trying to avoid. Foods that give us pleasure release feel-good chemicals called endorphins and learning chemicals called dopamine, which enable us to remember – and give in to – that feel-good response.</p>
<p>When we change our diet, activity in our hypothalamus – the clever part of the brain that regulates emotions and food intake – <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">also reduces</a>, decreasing our control and judgement. It often triggers a psychological response dubbed the “what-the-hell effect”, when we indulge in something we think we shouldn’t feel guilty about and then go back for even more.</p>
<p>Don’t completely cut out your favourite foods when you go on a diet or deprive yourself if you’re hungry. It will take the pleasure out of eating and eventually you’ll give into your cravings. </p>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em></p><img src="https://counter.theconversation.com/content/215808/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>When we change our diet, we disrupt our appetite hormones. Here’s how it works – and how small changes to our diet can help us feel fuller for longer.Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2180032023-11-28T17:55:45Z2023-11-28T17:55:45ZLifestyle changes can reduce dementia risk by maintaining brain plasticity — but the time to act is now<figure><img src="https://images.theconversation.com/files/561624/original/file-20231125-24-4dpbbp.jpg?ixlib=rb-1.1.0&rect=0%2C704%2C5714%2C3742&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Lifestyle changes may be our best hope of delaying dementia or not developing dementia at all.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/lifestyle-changes-can-reduce-dementia-risk-by-maintaining-brain-plasticity-but-the-time-to-act-is-now" width="100%" height="400"></iframe>
<p>Walk 10,000 steps a day, cut back alcohol, get better sleep at night, stay socially active — we’re told that changes like these can <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">prevent up to 40 per cent of dementia cases worldwide</a>. </p>
<p>Given that dementia is still one of <a href="https://doi.org/10.1186%2Fs12889-023-15772-y">the most feared diseases</a>, why aren’t we pushing our doctors and governments to support these lifestyle changes through new programs and policy initiatives?</p>
<p>The truth, however, is more complex. We know that <a href="https://theconversation.com/got-health-goals-research-based-tips-for-adopting-and-sticking-to-new-healthy-lifestyle-behaviours-173740">making lifestyle changes is hard</a>. Ask anyone who has tried to keep their New Year’s resolution to visit the gym three times a week. It can be doubly difficult when the changes we need to make now won’t show results for years, or even decades, and we don’t really understand why they work.</p>
<h2>Taking control of your health</h2>
<p>Anyone who has watched a loved one <a href="https://alzheimer.ca/en/about-dementia/what-dementia/common-questions-about-dementia">living with dementia</a>, facing the small and large indignities and declines that leave them eventually unable to eat, communicate or remember, knows it is a devastating disease. </p>
<p>There are <a href="https://alzheimer.ca/en/whats-happening/events/new-dementia-drugs-therapies-what-canadians-should-know">several new drugs</a> making their way to the market for Alzheimer’s disease (one of the most common forms of dementia). However, they are still far from a cure and are currently only effective for early-stage Alzheimer’s patients.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lecanemab-experimental-drug-is-a-ray-of-hope-for-alzheimers-disease-196719">Lecanemab: Experimental drug is a ray of hope for Alzheimer's disease</a>
</strong>
</em>
</p>
<hr>
<p>So lifestyle changes may be our best hope of delaying dementia or not developing dementia at all. Actor <a href="https://www.vanityfair.com/hollywood/2022/11/chris-hemsworth-exclusive-interview-alzheimers-limitless">Chris Hemsworth</a> knows it. He watched his grandfather live with Alzheimer’s and is making lifestyle changes after learning he has two copies of the APOE4 gene. This <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/what-is-apoe4-how-does-it-relate-alzheimers-disease-2023-04-21/">gene</a> is a risk factor for Alzheimer’s, and having two copies significantly increases his risk of developing the same condition. </p>
<p>Research has identified <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">modifiable risk factors</a> that contribute to increasing the risk of dementia:</p>
<ul>
<li>physical inactivity</li>
<li>excessive use of alcohol</li>
<li>less sleep</li>
<li>social isolation</li>
<li>hearing loss</li>
<li>less cognitive engagement</li>
<li>poor diet</li>
<li>hypertension</li>
<li>obesity</li>
<li>diabetes</li>
<li>traumatic brain injury</li>
<li>smoking</li>
<li>depression</li>
<li>air pollution</li>
</ul>
<p>Our understanding of the biological mechanisms for these risk factors is varied, with some more clearly understood than others. </p>
<p>But there is a lot we do know — and here’s what you need to know as well.</p>
<h2>Cognitive reserve and neuroplasticity</h2>
<figure class="align-center ">
<img alt="Two older men on a park bench, on of whom is straining to hear the other speaking" src="https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561625/original/file-20231125-21-n964o8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">As a person‘s hearing decreases, it can make it difficult to socially engage with others, resulting in a loss of sensory input. The brain has to work harder to compensate for this.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p><a href="https://doi.org/10.1016/j.neurobiolaging.2019.03.022">Cognitive reserve</a> is the brain’s ability to withstand damage or neurodegenerative disease. If there is tissue or functional loss in one part of the brain, other brain cells (neurons) work harder to compensate. In theory, this means lifelong experiences and activities create a dam against the damages of disease and aging in the brain.</p>
<p><a href="https://doi.org/10.3928/02793695-20100302-01">Neuroplasticity</a> is the brain’s amazing ability to adapt, learn and reorganize, create new pathways or rewire existing ones to recover from damage. The key takeaway is that neuroplasticity can happen at any time and any age, which means learning and activities should be lifelong.</p>
<p>Many of the risk factors linked to dementia likely work in combination, which is why an overall lifestyle approach is crucial. For example, <a href="https://doi.org/10.1007/s11920-016-0721-2">studies have shown</a> that exercise, cognitive and social engagement stimulate your brain and maintain its plasticity by growing new neural connections and building cognitive reserve.</p>
<p>The mechanism behind this is a combination of factors: increased oxygen and blood flow to the brain, stimulating growth factors that keep neurons healthy and reduced inflammation.</p>
<p>The opposite is also true. Poor sleep, diet, social isolation and untreated depression are linked to <a href="https://doi.org/10.3928/02793695-20100302-01">decreased cognitive reserve</a>. </p>
<p>The same rationale applies to hearing loss, a key emerging risk factor for dementia. As a person‘s hearing decreases, it can make it difficult to socially engage with others, resulting in a loss of sensory input. The <a href="https://doi.org/10.1097%2FWAD.0000000000000325">brain has to work harder</a> to compensate for this, potentially drawing down its cognitive reserve and leaving it less able to withstand dementia.</p>
<h2>The role of stress and inflammation</h2>
<figure class="align-center ">
<img alt="Illustration of hand drawing a brain with multicoloured chalk on blackboard" src="https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=222&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=222&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=222&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=279&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=279&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561626/original/file-20231125-17-6hps66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=279&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Chronic or prolonged inflammation disrupts normal function and causes damage to the brain’s cells.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Stress responses and inflammation are the body’s complex answer to injury. Inflammation is an important component of the body’s immune system, helping defend against threats and repair tissue damage. While short-term inflammation is a natural and good response, chronic or prolonged inflammation disrupts normal function and causes damage to the brain’s cells.</p>
<p>For example, one of the commonalities between dementia and untreated depression is the <a href="https://doi.org/10.17219/acem/149897%22%22">inflammatory process</a>. Prolonged exposure to stress hormones can lead to chronic inflammation. Hypertension, physical inactivity, smoking and air pollution are also associated with chronic inflammation and stress, which can damage blood vessels and neurons in the brain.</p>
<p>In a newer area of research still being explored, <a href="https://globalnews.ca/news/10095898/loneliness-global-public-health-concern-who/">social isolation</a> has also been <a href="https://doi.org/10.1016/j.yfrne.2023.101061">linked to inflammation</a>. As we learned during the COVID-19 pandemic, the brain is wired to respond to social engagement as a means of bonding and emotional support, especially in times of distress. </p>
<p>With surveys showing more than <a href="https://www.thestar.com/opinion/contributors/we-have-a-loneliness-crisis-it-s-time-to-act/article_30e6c996-a9e2-588b-a776-58addc503762.html">one in three Canadians</a> feel isolated, the lack of social connection and loneliness can trigger the body’s stress response and neuroendocrine changes, and prolonged exposure to this inflammatory process can damage the brain.</p>
<h2>Similar pathways across multiple diseases</h2>
<figure class="align-center ">
<img alt="Three women walking in exercise clothes" src="https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561627/original/file-20231125-27-f0h7c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">While there are benefits to being physically and socially active at any age, some research shows the payoff from those gains can be higher after age 40 when the body’s metabolism slows, risk factors increase and cognitive reserve becomes even more essential to help protect against cognitive decline.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Several of these risk factors, and their biological pathways, cut across multiple chronic diseases. Accumulating evidence of <a href="https://doi.org/10.1016/S1474-4422(19)30087-0">decades of research</a> supports the concept of “what’s good for your heart is good for your head.” </p>
<p>This means that making these lifestyle changes not only reduces your risk of dementia, but also your risk of diabetes, hypertension and heart concerns. This highlights the complex nature of dementia but also offers a united strategy to deal with multiple health concerns that may arise as people age.</p>
<h2>It’s never too late</h2>
<figure class="align-center ">
<img alt="A man asleep in bed" src="https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561628/original/file-20231125-27-dyme8y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Factors like not sleeping enough, having a poor diet and lacking social and cognitive engagement can increase the risk of developing dementia.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>It’s never really too late to change. The human brain and body have a remarkable capacity for adaptation and resilience throughout life. </p>
<p>While there are benefits to being physically and socially active at any age, some research shows the <a href="https://doi.org/10.1016/j.smhs.2019.08.006">payoff from those gains can be higher</a> after age 40 when the body’s metabolism slows, risk factors increase and cognitive reserve becomes even more essential to help protect against <a href="https://doi.org/10.1212/WNL.0000000000007003">cognitive decline</a>.</p>
<p>If making lifestyle changes means you can watch your child navigate adulthood, stroll 20 blocks to your favourite café every day and continue to live in your own home, perhaps walking the daily 10,000 steps, changing diets and keeping your friendship network strong is worthwhile. At worst, you’ll be healthier and more independent with or without dementia. At best, you might completely avoid dementia and other major diseases and keep living your best possible life.</p><img src="https://counter.theconversation.com/content/218003/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Middleton receives funding from the Public Health Agency of Canada and the Canadian Institutes of Health Research.</span></em></p><p class="fine-print"><em><span>Saskia Sivananthan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Lifestyle-related dementia risks are complex, with factors like sleep, exercise, diet and social contact interacting with things like cognitive reserve, neuroplasticity and inflammation in the body.Saskia Sivananthan, Affiliate Professor, Department of Family Medicine, McGill UniversityLaura Middleton, Assistant Professor, Department of Kinesiology, University of WaterlooLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2141312023-11-23T23:39:00Z2023-11-23T23:39:00ZIs sleeping with your baby a good idea? Here’s what the science says<figure><img src="https://images.theconversation.com/files/549663/original/file-20230918-21-ueto34.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5552%2C3709&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Scientific evidence allows parents to choose the sleeping arrangement that's right for them and their family.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Sleeping with your baby is not life-threatening, but it’s not essential either. Rather, it’s a family choice that you should make with your partner. </p>
<p>However, in order to make the right decision you need to have access to reliable information. The choice of sleeping arrangements at the beginning of your child’s life depends on a multitude of factors. So-called co-sleeping has become a polarizing subject. The important questions surrounding the practice are often drowned out in a whirlwind of information and opinions. Parents can quickly find themselves struggling over the best choice.</p>
<p>As researchers at the Université du Québec à Trois-Rivières and experts in early childhood and the sleep of children and teenagers, we’ve surveyed the scientific studies on co-sleeping in order to show both sides of the coin.</p>
<h2>What do we mean by co-sleeping?</h2>
<p>To start with, co-sleeping is a sleeping arrangement. It is not a method used for falling asleep, <a href="https://sleeponitcanada.ca">although sleeping arrangements strongly influence this</a>. </p>
<p>There are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246529/">two types of co-sleeping</a>:</p>
<ol>
<li><p>Co-sleeping on a shared surface, as in sharing the same bed; and</p></li>
<li><p>Co-sleeping in the same room, which involves sharing the same sleeping area.</p></li>
</ol>
<p>A <a href="https://www150.statcan.gc.ca/n1/en/catalogue/82-003-X201900700002">recent Canadian study</a> reported that about a third of mothers co-sleep on the same surface, while 40 per cent said they had never co-slept at all. A <a href="https://www.jesuisjeserai.stat.gouv.qc.ca/publications/baby_no4.pdf">Québec study</a> in the late 1990s revealed that one-third of mothers co-slept in the same room.</p>
<p>The <a href="https://caringforkids.cps.ca/handouts/pregnancy-and-babies/safe_sleep_for_babies">Canadian Paediatric Society states</a>: “For the first 6 months, the safest place for your baby to sleep is on their back, in a crib, cradle or bassinet that is in your room (room sharing).”</p>
<h2>Two schools of thought</h2>
<p>After it came to light in the late 2000s that Canada had <a href="https://publications.gc.ca/collections/collection_2015/aspc-phac/HP35-51-2014-eng.pdf">high mortality rates among infants</a> (one per thousand), society adopted a rather alarmist view of co-sleeping. </p>
<p>The first school of thought focuses on the medical aspects of co-sleeping linked to the risks of sleeping with a baby, such as choking, crushing or <a href="https://www.canada.ca/en/public-health/services/health-promotion/childhood-adolescence/stages-childhood/infancy-birth-two-years/safe-sleep/safe-sleep-your-baby-brochure.html#">sudden infant death syndrome</a>. </p>
<p>The second school aims to facilitate the <a href="https://www.sciencedirect.com/science/article/abs/pii/S1087079216000265?via%3Dihub%5D">practice of breastfeeding and the inclusion of cultural and family values</a> and believes that co-sleeping promotes them.</p>
<p>These two main schools of thought coexist, which explains why the choice of sleeping arrangements in the early months can become so challenging for parents. </p>
<h2>Better for breastfeeding and communication</h2>
<p>Does co-sleeping promote breastfeeding during the night? Yes, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1087079218300844?via%3Dihub">according to scientific studies</a>. But it’s hard to say whether it’s breastfeeding <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163638319301237?via%3Dihub">that favours this practice or whether it’s the other way around</a>. In any case, breastfeeding is the main reason <a href="https://www150.statcan.gc.ca/n1/en/catalogue/82-003-X201900700002">why mothers choose shared-surface co-sleeping</a>.</p>
<p>However, no difference was found between breastfeeding at night <a href="https://academic.oup.com/ejo/article/44/1/110/6293736?login=false">and the two types of co-sleeping</a>. In other words, sleeping in the same room is just as conducive to breastfeeding as is sleeping on a shared surface.</p>
<p>The same applies to meeting the child’s needs. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163638319301237?via%3Dihub">According to a scientific study</a>, physical contact and proximity in the same room promote the synchronization of the child’s circadian rhythm with that of the parent. This helps the baby consolidate their sleep. This would make parents more alert to the infant’s signals in both types of sleep arrangement. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163497/">And that, in turn, would help communication</a> and <a href="https://link.springer.com/article/10.1007/s10995-014-1557-1">make it possible to respond easily and quickly to the baby’s needs</a>.</p>
<figure class="align-center ">
<img alt="A baby lying on a bed is held by a woman lying next to him" src="https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/548829/original/file-20230918-17-jublh5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Proximity would promote synchronization of the child’s circadian rhythm to that of the parent.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Less stress</h2>
<p>While co-sleeping is known to reduce a baby’s stress, it depends on the level.</p>
<p><a href="https://academic.oup.com/ejo/article/44/1/110/6293736?login=false">One study that asked parents about this subject</a> found that children who had experienced one of two co-sleeping arrangements had lower anxiety levels at preschool age compared with those who had co-slept for less than six months. </p>
<p><a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453011001065?via%3Dihub">Another study</a> showed that children who slept with a parent had a lower stress response at 12 months of age compared with those who did not. However, when comparing a higher stress situation (e.g. getting a vaccination) to a moderate stress situation (e.g. during bath time), the difference between the two groups was smaller. It should be noted that several variables still need to be tested in order to fully understand this relationship, and that the two types of co-sleeping arrangements were not compared.</p>
<h2>More disturbed and fractured sleep</h2>
<p>Babies who co-sleep wake up more often than those who sleep alone at the beginning of life. <a href="https://journals.lww.com/jrnldbp/abstract/2022/01000/bed_sharing_in_the_first_6_months__associations.11.aspx">This is also true for parents</a>. </p>
<p><a href="https://academic.oup.com/sleep/article/41/2/zsx207/4753805">A study</a> measuring the amount of sleep at six, 12 and 18 months showed that the group of children co-sleeping on a shared surface or in the same room had more nocturnal arousals, measured by <a href="https://stanfordhealthcare.org/medical-tests/s/sleep-disorder-tests/procedures/actigraphy.html">actigraphy</a> at six months. They also had more arousals measured by the mothers’ sleep diaries at six, 12 and 18 months, compared with the group of children sleeping alone. </p>
<p>At 12 months, the solitary sleepers had a longer average sleep time. These results were obtained after controlling for type of feeding (breast or bottle). However, the study did not investigate whether sleep characteristics differed between the two types of co-sleeping. </p>
<p>Mothers who co-sleep on a shared surface report that their babies fall asleep more easily and quickly, but wake up more frequently. They say they choose this arrangement <a href="https://link.springer.com/article/10.1007/s10995-014-1557-1">to improve their family’s sleep</a>. </p>
<p>Mothers generally perceive <a href="https://www.jpeds.com/article/S0022-3476(22)00076-2/fulltext">no sleep difficulties in their babies</a>. But when mothers’ sleep is measured by actigraphy, it is <a href="https://academic.oup.com/sleep/article/41/2/zsx207/4753805?login=false">more fragmented and disturbed for the first 18 months</a> compared with those who opted for a solitary sleep arrangement. </p>
<p><a href="https://www.jpeds.com/article/S0022-3476(22)00076-2/fulltext">Another objective study</a> reveals that co-sleeping on a shared surface over the longer term (for the first two years of the child’s life) is associated with a shorter sleep duration at night, a greater need for naps during the day, and a higher proportion of difficulties falling asleep.</p>
<h2>Attachment: no clear answers</h2>
<p>Is co-sleeping on a shared surface associated with stronger attachment to the child? </p>
<p>This subject is controversial. </p>
<p>Some studies have reported a stronger attachment bond in babies who co-slept on a shared surface <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163638319301237?via%3Dihub">compared with those who slept alone</a>. </p>
<p>Others report no link, either positive or negative, between parent-child attachment and <a href="https://journals.lww.com/jrnldbp/abstract/2022/01000/bed_sharing_in_the_first_6_months__associations.11.aspx">sleep arrangement after the child’s first six months of life</a>. </p>
<h2>Parents’ choice</h2>
<p>This scientific data will help parents choose the sleeping arrangement that’s right for them and their family. The decision remains a parental choice. </p>
<p>If you opt for a co-sleeping arrangement, you can find the safety measures to put in place <a href="https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/cps-spc/alt_formats/pdf/pubs/cons/child-enfant/sleep-coucher-eng.pdf">on the Health Canada site</a> in order to make sure everyone gets a good night’s sleep.</p><img src="https://counter.theconversation.com/content/214131/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Evelyne Touchette has received funding from the Fonds de recherche du Québec and the Social Sciences and Humanities Research Council.</span></em></p><p class="fine-print"><em><span>Gabrielle Fréchette-Boilard ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.</span></em></p>Questions about co-sleeping are often drowned out in a whirlwind of information and opinions. But science can provide some answers.Gabrielle Fréchette-Boilard, Doctorante en psychoéducation, Université du Québec à Trois-Rivières (UQTR)Evelyne Touchette, Adjunct professor, département de psychoéducation, Université du Québec à Trois-Rivières (UQTR)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2164452023-11-15T02:02:29Z2023-11-15T02:02:29ZWhat is the PanaNatra line of painkillers and can herbal products effectively relieve pain?<p>In an era where <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201926/#:%7E:text=Globally%2C%20it%20has%20been%20estimated,pain%20each%20year%20%5B1%5D">chronic pain affects millions worldwide</a>, the search for effective and safe pain relief has never been greater. </p>
<p><a href="https://www.pananatra.com.au/products/">PanaNatra</a> is a line of herbal products from <a href="https://www.haleon.com/">Haleon</a>, the makers of Panadol. Haleon <a href="https://www.pananatra.com.au/products/">claims</a> the three PanaNatra’s products, made from plant extracts, help manage and provide relief from mild joint aches, mild muscle pain, and mild pain affecting sleep. </p>
<p>They contain different combinations of four plants:</p>
<ul>
<li><em>Boswellia serrata</em> (contained in the joint and muscle products) </li>
<li><em>Curcuma longa</em> (in the joint and muscle products)</li>
<li><em>Piper nigrum</em> (just in the joint product)</li>
<li><em>Withania somnifera</em> (just in the sleep product).</li>
</ul>
<p>These products are “<a href="https://www.tga.gov.au/products/medicines/non-prescription-medicines/listed-medicines">listed medicines</a>” in Australia. This means the ingredients are considered broadly low risk, have been used in traditional medicine, and are manufactured to a high standard. But the manufacturer has not provided evidence to the government regulator that they work. </p>
<p>So can herbal ingredients effectively and safely relieve different types of pain? </p>
<h2>What does the evidence say?</h2>
<p>Let’s consider the evidence for the four main ingredients.</p>
<p><strong><em>Boswellia serrata</em></strong></p>
<p>Indian Frankincense (<em>Boswellia serrata</em>) has been described in traditional Indian Ayurveda texts since the 1st century AD. Key active compounds derived from the gum resin of the tree called <a href="https://pubmed.ncbi.nlm.nih.gov/27671822/">boswellic acids</a> are thought to have anti-inflammatory effects. </p>
<figure class="align-center ">
<img alt="Boswellia serrata" src="https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559173/original/file-20231113-25-2pl3tb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"><em>Boswellia serrata</em> is also known as Indian Frankincense.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/boswellia-serrata-73147612">Shutterstock</a></span>
</figcaption>
</figure>
<p>The <em>Boswellia serrata</em> dry concentrate extract (Rhuleave K) used in the Muscle Pain product contains 50 mg of the herb per tablet, whereas the Joint Pain product includes 33.3 mg as a different formulation (Apresflex).</p>
<p>A review of various human clinical trials using a range of formulations of this herb <a href="https://www-ncbi-nlm-nih-gov.ezproxy.library.sydney.edu.au/pmc/articles/PMC7368679/pdf/12906_2020_Article_2985.pdf">supports its ability</a> to reduce some types of pain and improve function in osteoarthritis. But a key finding of the study was that improvement only begins when <em>Boswellia serrata</em> is used continuously for four weeks and at a dose of at least 100–250 mg per day.</p>
<p>In a <a href="https://pubmed.ncbi.nlm.nih.gov/21060724/">clinical trial</a>, 100 mg daily of a <em>Boswellia serrata</em> gum-based product was found to reduce pain and improve physical functions for people with osteoarthritis.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/9-signs-you-have-inflammation-in-your-body-could-an-anti-inflammatory-diet-help-210468">9 signs you have inflammation in your body. Could an anti-inflammatory diet help?</a>
</strong>
</em>
</p>
<hr>
<p><strong><em>Curcuma longa</em></strong></p>
<p>Turmeric (<em>Curcuma longa</em>) has been used in Chinese and Indian medicine for at least 2,000 years. It contains a well-known chemical called curcumin, a natural compound used for its anti-inflammatory properties, especially for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273926/">osteoarthritis</a>. </p>
<figure class="align-center ">
<img alt="Turmeric root (Curcuma longa)" src="https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559174/original/file-20231113-17-p914do.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"><em>Curcuma longa</em> is also known as turmeric.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/turmeric-root-curcuma-longaherb-plant-786438259">Shutterstock</a></span>
</figcaption>
</figure>
<p>Turmeric compounds such as curcumin are <a href="https://journals.sagepub.com/doi/10.1177/1759720X221124545">often combined</a> with <em>Boswellia serrata</em> compounds to improve their anti-inflammatory effects to reduce pain. </p>
<p>A <a href="https://pubmed.ncbi.nlm.nih.gov/33511486/">review of 16 different clinical trials</a> found turmeric extracts were effective for knee osteoarthritis. </p>
<p>A similar conclusion was drawn from a <a href="https://www.sciencedirect.com/science/article/pii/S0965229921001163">review of 11 clinical trials</a> which examined the use of curcuminoids (of which curcumin is one) for one to four months. It found curcuminoids had similar pain-relieving qualities as non-steroidal anti-inflammatory based drugs. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/these-5-foods-are-claimed-to-improve-our-health-but-the-amount-wed-need-to-consume-to-benefit-is-a-lot-116730">These 5 foods are claimed to improve our health. But the amount we'd need to consume to benefit is... a lot</a>
</strong>
</em>
</p>
<hr>
<p><strong><em>Piper nigrum</em></strong></p>
<p>Black pepper (<em>Piper nigrum</em>) contains the chemical <a href="https://www.mdpi.com/2076-3417/9/20/4270">piperine</a>, which has anti-inflammatory properties.</p>
<figure class="align-center ">
<img alt="Piper Nigrum (peppercorn)" src="https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559177/original/file-20231113-23-f91rga.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"><em>Piper nigrum</em> is also called black pepper.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pepper-piper-nigrum-peppercorn-common-1158781747">Shutterstock</a></span>
</figcaption>
</figure>
<p><em>Piper nigrum</em> is often added to curcumin products to improve the absorption of curcumin, as is the case with the PanaNatra Joint Pain product.</p>
<p>For musculoskeletal pain, a <a href="https://pubmed.ncbi.nlm.nih.gov/32664057/">preliminary human trial</a> that examined the effects of a 1,000 mg daily dose of Rhuleave K (the extract used in PanaNatra) found it was as effective as paracetamol. </p>
<p>But the study was not placebo-controlled and the dose of paracetamol given (1,000 mg per day) was below the recommended daily intake for pain relief.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/knee-pain-heres-why-it-happens-and-how-you-can-fix-it-211858">Knee pain: here’s why it happens and how you can fix it</a>
</strong>
</em>
</p>
<hr>
<p><strong><em>Withania somnifera</em></strong></p>
<p><em>Withania somnifera</em> (also called Ashwagandha) has been used in <a href="https://medlineplus.gov/druginfo/natural/953.html">traditional Indian Ayurvedic medicine</a> for thousands of years to reduce stress and ease inflammation. </p>
<figure class="align-center ">
<img alt="Withania somnifera plant, commonly known as Ashwagandha (winter cherry)" src="https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559178/original/file-20231113-21-zdguhr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ashwagandha, or <em>Withania somnifera</em>, is sometimes called winter cherry.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/withania-somnifera-plant-commonly-known-ashwagandha-2237392831">Shutterstock</a></span>
</figcaption>
</figure>
<p>One of the key chemicals appears to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705790/">withaferin A</a> which interferes with the inflammatory signalling pathway. </p>
<p>PanaNatra’s Pain and Sleep product contains 300 mg per tablet of a <em>Withania somnifera</em> extract called KSM66.</p>
<p>A <a href="https://pubmed.ncbi.nlm.nih.gov/32818573/">human trial</a> found a daily 600 mg dose of <em>Withania somnifera</em> extract improved sleep quality and helped in managing insomnia.</p>
<p><a href="https://assets.cureus.com/uploads/original_article/pdf/25730/1612429507-1612429503-20210204-18590-tdgx00.pdf">In a separate trial</a>, <em>Withania somnifera</em> was found to improve sleep quality, again when administered at a dose of 600 mg per day.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/from-ayurveda-to-biomedicine-understanding-the-human-body-85631">From Ayurveda to biomedicine: understanding the human body</a>
</strong>
</em>
</p>
<hr>
<h2>So what does this mean?</h2>
<p>Whether, and how well, a herbal medicine works is largely dependent on the formulation (how it’s made and the extract used) and the dose provided. The same herb used in one formulation may result in a different outcome than a different formulation containing the same herb. </p>
<p>It’s also important to note that effectiveness for one type of pain does not mean a product will work for other types of pain. </p>
<p>Overall, similar herb extracts to those that have been included in the PanaNatra products do have some evidence that they work for pain and sleep. Whether they work for you will depend on a number of factors including the effectiveness of the PanaNatra formulation, how much you take, and the extent of your pain.</p>
<h2>Are they safe?</h2>
<p>PanaNatra needs to be used carefully by some patients. </p>
<p>Overall, there is insufficient human data to recommend any of these herbal ingredients in pregnancy or lactation. In fact there is some evidence that <em><a href="https://www.sciencedirect.com/science/article/pii/S2210803321000142">Withania somnifera</a></em> may be unsafe to use in pregnancy, and other than the amounts commonly found in food, turmeric and its compounds are <a href="https://www.nccih.nih.gov/health/turmeric">not considered safe</a> to use in pregnancy either. </p>
<p>The herbs may also impact the effectiveness and safety of other medicines. For example, the blood levels of the cancer drug <a href="https://link.springer.com/article/10.1007/s00280-023-04504-z">tamoxifen may be reduced</a> when taken concurrently with turmeric supplements. </p>
<p><em>Withania somnifera</em> has been associated with drowsiness and cases of <a href="https://www.mdpi.com/1660-4601/20/5/3921">liver toxicity</a>.</p>
<p><em>Curcuma longa</em> products, including formulations containing curcumin and piperine, have also been associated with liver toxicity. As such, Australia’s Therapeutic Goods Administration has proposed <a href="https://consultations.tga.gov.au/medicines-regulation-division/low-neg-risk-2023-2024/user_uploads/tga---low-negligible-risk-annual-consultation-2023-2024---final.pdf">adding warning labels</a> to any products that contain those ingredients. But this discussion is ongoing and a decision won’t be made until next year. </p>
<h2>Bottom line</h2>
<p>While there is a long history of traditional use of the herbs in the PanaNatra products, there is limited high-quality scientific evidence for the effectiveness and safety for these specific products. </p>
<p>Pregnant and breastfeeding women should not take these products, and you should not exceed the daily dose recommended by the manufacturer. </p>
<p>If you have an underlying health condition, or are taking other medication, before you try them, consult your doctor or pharmacist to check if these products are suitable for you.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-you-know-whats-in-the-herbal-medicine-youre-taking-72726">Do you know what's in the herbal medicine you're taking?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/216445/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a Fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association, and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd a medical device company, and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design, and testing.</span></em></p><p class="fine-print"><em><span>Joanna Harnett is an academic University of Sydney’s Faculty of Medicine and Health Pharmacy School where she teaches and conducts research in the field of traditional, complementary, and integrative medicine (TCIM). She has received research funds from universities, organisations, and/or industry for TCIM research and education and received payments for providing expert advice about TCIM to industry, government bodies and/or non-government organisations, and/or spoken at workshops, seminars and/or conferences for which registration, travel and/or accommodation has been paid for by the organisers.
The institutes, centres and universities associated with the authors receive research grants, donations and endowments from foundations, universities, government agencies, individuals, and industry. Sponsors and donors have provided untied funding to advance TCIM education and research. This viewpoint article was not undertaken as part of a contractual relationship with any donor or sponsor.
</span></em></p>PanaNatra is a line of herbal products from the makers of Panadol. But can herbal ingredients relieve different types of pain?Nial Wheate, Associate Professor of the School of Pharmacy, University of SydneyJoanna Harnett, Lecturer (Complementary Medicines) Sydney Pharmacy School, Faculty of Medicine and Health, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2172682023-11-09T04:38:08Z2023-11-09T04:38:08ZWhy The Conversation lifted the (eye) mask on insomnia<figure><img src="https://images.theconversation.com/files/558256/original/file-20231108-21-nr1728.jpg?ixlib=rb-1.1.0&rect=5%2C5%2C992%2C992&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/statue-gold-sleep-mask-gypsum-david-1909455499">Shutterstock</a></span></figcaption></figure><p>Insomnia is an ancient preoccupation and modern obsession. Its effect on our mental health and wellbeing <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">can be dramatic</a>.</p>
<p>In Australia, the financial cost of poor sleep is an estimated <a href="https://treasury.gov.au/sites/default/files/2019-03/360985-Sleep-Health-Foundation-and-Australasian-Sleep-Association.pdf">A$26 billion a year</a>, mainly through lost productivity or accidents.</p>
<p>The pursuit of sleep is also a <a href="https://www.alliedmarketresearch.com/insomnia-market">multibillion-dollar</a> global business which is still getting bigger. Think sleep apps, sleep therapy, sleep influencers, sleeping pills, medicinal cannabis, and on it goes. </p>
<p>That’s why The Conversation commissioned a <a href="https://theconversation.com/au/topics/insomnia-series-144018">six-part series</a> to explore insomnia. We hear from sleep researchers, psychologists, a historian and a sociologist. Each has a unique take on sleep, the lack of it, and what it’s costing us.</p>
<h2>How we became obsessed with sleep</h2>
<p>The series begins with a <a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">short history</a> of insomnia, charting its rise as nations industrialised. Philippa Martyr, a historian from the University of Western Australia, writes that’s when things we now associate with insomnia became part of people’s lives – artificial lighting and clocks, more ambient noise, changes in diet and housing. So our sleep habits shifted as a result of this new way of living and working. </p>
<p>Sleeping pills followed, as did our obsession with caffeine. Now we go to bed with handheld devices – with their bright lights and constant dopamine hits that stimulate us and stop us sleeping.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">A short history of insomnia and how we became obsessed with sleep</a>
</strong>
</em>
</p>
<hr>
<h2>Insomnia in the movies, and why it’s a problem</h2>
<p>Next, we look at how fictional portrayals of insomnia in the movies can be misleading. Most movies tend either to minimise or, more commonly, to exaggerate symptoms. Psychological thrillers are among the biggest offenders.</p>
<p>Insomnia is rarely depicted as a treatable illness, <a href="https://theconversation.com/whats-insomnia-like-for-most-people-who-cant-sleep-youd-never-know-from-the-movies-211823">write</a> Aaron Schokman and Nick Glozier from the University of Sydney.</p>
<p>Why are they concerned? These portrayals have implications for the estimated <a href="https://www.sleep.theclinics.com/article/S1556-407X(22)00022-4/fulltext">one in three</a> of us with at least one insomnia symptom. These portrayals can perpetuate stereotypes about insomnia and who’s at risk, making it harder for people to seek care.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1720751088624672849"}"></div></p>
<h2>How dangerous is insomnia really?</h2>
<p>Insomnia has been linked to developing conditions such as dementia, obesity, diabetes and high blood pressure. No wonder people are concerned about their lack of sleep and its impacts. This concern, in turn, can worsen sleep.</p>
<p>But how bad is insomnia on your body, really? Leon Lack and Nicole Lovato from Flinders University <a href="https://theconversation.com/how-dangerous-is-insomnia-how-fear-of-what-its-doing-to-your-body-can-wreck-your-sleep-212248">show</a> how the evidence is less robust than we might think. Yet the scary headlines continue, making people worry even more. </p>
<p>Even if people don’t have insomnia to start with, all this unnecessary worry may lead them to develop it.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1714756257427370360"}"></div></p>
<h2>How about mental disorders?</h2>
<p>The evidence for insomnia’s link with mental disorders is much stronger, which we explore in the <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">next article</a> in the series.</p>
<p>As Ben Bullock from Swinburne University of Technology writes, the relationship between insomnia and mental disorders is complex. It’s not just a case of “which comes first, the insomnia or the mental disorder?” Insomnia and mental disorders are interrelated in ways we don’t fully understand.</p>
<p>And treating one often treats the other.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1715193491888701464"}"></div></p>
<h2>Which treatments actually work?</h2>
<p>Next, we look at treatments for insomnia – what works, what doesn’t, and what we might expect.</p>
<p>It turns out the most effective treatment isn’t a sleeping pill, <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">write</a> Alexander Sweetman and Nicole Grivell from Flinders University, and Jen Walsh from the University of Western Australia.</p>
<p>It’s a type of psychological therapy known as cognitive behavioural therapy for insomnia, or CBTi. About <a href="https://connect.h1.co/prime/reports/b/11/4/">70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://www.sciencedirect.com/science/article/abs/pii/S1087079218301965?via%3Dihub">at least a year</a>.</p>
<p>If that doesn’t work, there are sleeping pills, and newer drug therapies on the horizon.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1721830842761126336"}"></div></p>
<h2>There’s an app for that</h2>
<p>Insomnia is not just a personal issue that affects an individual’s health and wellbeing. It’s a public health issue, affecting public safety. It’s a socioeconomic issue, as poorer sleep is linked to a lower education and income. And, increasingly, it’s a commercial issue, <a href="https://theconversation.com/how-apps-and-influencers-are-changing-the-way-we-sleep-for-better-or-for-worse-211749">writes</a> Deborah Lupton from the University of New South Wales, in the final article in the series.</p>
<p>The global insomnia market is expected to reach <a href="https://www.alliedmarketresearch.com/insomnia-market">US$6.3 billion</a> by 2030, driven by increased diagnoses and therapy, as well as sleep aids, including sleep apps.</p>
<p>But not all sleep apps are accurate or useful. And fixating on the sleep data these apps generate won’t necessarily help you sleep. </p>
<p>Then there are social media “sleep influencers” who share their take on sleep and how to get more of it. Can any of this help us?</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1717783446972404007"}"></div></p>
<h2>If you can’t sleep</h2>
<p>We hope the series helps pull back the (eye) mask on insomnia – what it is, what it is not, and how to access treatment. But the series is also a reminder that not everyone can buy the latest technologies or can change their environment or lifestyle to help them sleep.</p>
<p>As Lupton <a href="https://theconversation.com/how-apps-and-influencers-are-changing-the-way-we-sleep-for-better-or-for-worse-211749">concludes</a>, a good night’s sleep shouldn’t be the preserve of the privileged.</p><img src="https://counter.theconversation.com/content/217268/count.gif" alt="The Conversation" width="1" height="1" />
How did you sleep last night? Our six-part series looks at why so many of us have insomnia, and what it’s costing us.Anna Evangeli, Deputy Health Editor, The Conversation Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2146412023-11-08T03:04:39Z2023-11-08T03:04:39ZSleep apnoea can be scary. But here’s what happened when First Nations people had a say in their own care<p>Obstructive sleep apnoea is about <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4623124/">twice as common</a> in First Nations people compared with non-Indigenous Australians.</p>
<p>But the truth is, this sleep-related respiratory disorder is significantly under-reported in First Nations communities.</p>
<p>A <a href="https://issr.uq.edu.au/article/2021/11/let%E2%80%99s-yarn-about-sleep">Let’s Yarn About Sleep</a> program in Queensland hopes to change that, by acknowledging the importance of sleep not just to physical and mental health, but to spiritual health. The program uses traditional knowledge as a key part of its culturally responsive model of care.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1698807144567668999"}"></div></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-first-sleep-health-program-for-first-nations-adolescents-could-change-lives-206286">The first sleep health program for First Nations adolescents could change lives</a>
</strong>
</em>
</p>
<hr>
<h2>What is obstructive sleep apnoea?</h2>
<p>In obstructive sleep apnoea the upper airway is repeatedly wholly or partially blocked during sleep, resulting in lower blood oxygen levels. The sudden drop in blood oxygen levels, and the body’s frequent waking to restart breathing, affects sleep. These also strain the heart and blood vessels.</p>
<p>People with sleep apnoea often wake up feeling unrefreshed and experience significant daytime sleepiness. Sleep apnoea also <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(22)00005-0/fulltext">increases the risk of</a> obesity, heart disease, cognitive problems, poor mental health, productivity loss and driving accidents.</p>
<p>We suspect there are significantly more cases in First Nations communities than currently reported. That’s partly because the proportion of First Nations people over 50 has <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/population-groups-of-interest/indigenous-australians">grown</a> in recent years and obesity is <a href="https://www.indigenoushpf.gov.au/measures/2-22-overweight-obesity">more common</a> in this population. Both obesity and increased age are risk factors for sleep apnoea.</p>
<p>Another reason why we suspect sleep apnoea is under-reported is the
<a href="https://healthbulletin.org.au/articles/the-tyranny-of-distance-mapping-accessibility-to-polysomnography-services-across-australia/">lack of specialist sleep services</a> in rural and remote areas. Long wait times, plus logistical and financial challenges in accessing services not available locally, means people are not being assessed, diagnosed and treated.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-is-snoring-anything-to-worry-about-68142">Health Check: is snoring anything to worry about?</a>
</strong>
</em>
</p>
<hr>
<h2>A growing awareness</h2>
<p>So community members have advocated for expanding the existing Let’s Yarn About Sleep program – which was originally set up to manage sleep problems in First Nations <a href="https://theconversation.com/the-first-sleep-health-program-for-first-nations-adolescents-could-change-lives-206286">teenagers</a> – to cater for people with sleep apnoea.</p>
<p>This builds on insights from community yarns about the impact of poor sleep. These highlighted that dreaming in First Nations culture is considered an important opportunity to connect with ancestors, Country and cultural knowledge. So, poor sleep, through its impact on dreaming, also affects spiritual health.</p>
<p>Let’s Yarn About Sleep project coordinator and Kalkadoon woman Roslyn Von Senden says:</p>
<blockquote>
<p>Dreams are an important part of our life, a medium to connect with our ancestors to be guided, foresee things, connect with others, and get inspiration and ideas to express our artistic talent. Sleep loss deprives us of opportunities to connect with our culture, our ancestors and who we are as traditional custodians of the world’s oldest surviving culture. That leads to poor emotional and mental health, affects our wellbeing and results in chronic conditions.</p>
</blockquote>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Sleep coach with program participant showing him how to use CPAP machine" src="https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=335&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=335&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=335&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=421&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=421&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557197/original/file-20231102-21-feolbl.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=421&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sleep coach Karen Chong talks about sleep apnoea with program participant Neil Dunne.</span>
<span class="attribution"><a class="source" href="https://stories.uq.edu.au/news/2023/better-sleep-to-improve-health-in-indigenous-communities/index.html">UQ/Let's Yarn about Sleep program</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>The program’s yarn with community members also highlighted the lack of culturally secure services, low awareness of sleep apnoea treatment options and stigma in accessing services as the key contributors to high rates of undiagnosed/untreated sleep apnoea in First Nations communities.</p>
<p>Uncle Neil Dunne, a Pitta Pitta man, who has sleep apnoea and was a member of the program’s community steering group, says: </p>
<blockquote>
<p>Sleep apnoea is very common in our community, but many of our mob don’t get tested. There is still shame in talking about sleep apnoea. Not many people know what it means and how it affects our health. I was tested for sleep apnoea, and the doctor told me I stopped breathing 13 times [per hour] in my sleep. This is scary. It is important to educate our community on how we can get help and why it is important to get help for sleep apnoea.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/my-snoring-is-waking-up-my-partner-apart-from-a-cpap-machine-what-are-the-options-188825">My snoring is waking up my partner. Apart from a CPAP machine, what are the options?</a>
</strong>
</em>
</p>
<hr>
<h2>So what does the program look like?</h2>
<p>The idea was to design a culturally responsive model for local diagnosis and management of, and education about, obstructive sleep apnoea in First Nations communities.</p>
<p>This has involved consultation with 12 First Nations communities, and training Aboriginal health workers and nurses to deliver the program.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1714853480308015614"}"></div></p>
<p>The Aboriginal health workers will educate community members about symptoms of sleep apnoea, its health impacts and pathways to seek clinical care. They’ll also screen for sleep apnoea in the community and start the referral process so people can be treated by GPs and nurses via their local community health service or Aboriginal medical service. </p>
<p>The program uses standard treatments for sleep apnoea, such as <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/cpap-continuous-positive-airway-pressure">continuous positive airway pressure</a> therapy, known as a CPAP machine. This includes a mask you wear at night to help open up your airway and help you breathe while sleeping. </p>
<p>But community Elders also guide the team to integrate cultural practices.</p>
<p>For example, the team will include didgeridoo sessions for men as part of the program. This Aboriginal musical instrument is not only an important part of cultural ceremonies, playing the didgeridoo <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/">reduces the severity</a> of sleep apnoea. It strengthens the muscles of the throat and the back of the tongue (key muscles associated with sleep apnoea).</p>
<p>Cultural protocols don’t support offering didgeridoo sessions for women. So we will seek guidance from community members to decide which other wind instruments can be used for women. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man playing didgeridoo outside" src="https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557193/original/file-20231102-19-m7ytdt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Playing the didgeridoo will be part of therapy.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/man-plays-didgeridoo-garden-697433446">Erich Haubrich/Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/friday-essay-the-remarkable-yidaki-and-no-its-not-a-didge-74169">Friday essay: the remarkable yidaki (and no, it's not a 'didge')</a>
</strong>
</em>
</p>
<hr>
<h2>Locally-led, culturally responsive</h2>
<p>It’s early days for us to see any results from the program. But it shows we can develop locally led and culturally responsive models of care.</p>
<p>By co-designing with community members, integrating cultural knowledge into how we manage sleep apnoea, and building the First Nations sleep health workforce, the program aims to transform diagnosis and management for First Nations peoples.</p>
<hr>
<p><em>Timothy Skinner, Professor of Health Psychology, La Trobe University, co-authored this article.</em></p><img src="https://counter.theconversation.com/content/214641/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Yaqoot Fatima is a member of the Australasian Sleep Association and is associated with the Sleep Health Foundation.
Yaqoot Fatima is supported by funding from the NHMRC Partnership Grant, MRFF Indigenous Health Research Grant, MRFF-EMCR grant, Tropical Australian Academic Health Centre grant and Beyond Blue for sleep health research.
</span></em></p><p class="fine-print"><em><span>Daniel Sullivan is a member of the Australasian Sleep Association and the Australian Psychological Society. Daniel Sullivan receives funding from a Medical Research Future Fund Early-Mid Career Researchers grant. </span></em></p><p class="fine-print"><em><span>Romola Bucks is a member of the Australasian Sleep Association, and the Sleep Health Foundation. Romola has received funding or currently receives funding from sources including the NHMRC, the Tropical Australian Academic Health Centre Seed Funding Scheme, and Indigenous Health Research Fund: MRFF.</span></em></p><p class="fine-print"><em><span>Shannon Edmed receives funding from the National Health and Medical Research Council (NHMRC) 2021 Medical Research Future Fund (MRFF) Early to Mid-Career Researchers Grant.
Shannon Edmed's research is supported partially by the Australian Research Council's Centre of Excellence for Children and Families over the Life Course (Project ID CE200100025).
She has also previously received funding from Government departments such as the Commonwealth Department of Health and Aged Care and the Commonwealth Defence Science and Technology Group.
</span></em></p><p class="fine-print"><em><span>Roslyn Von Senden does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Poor sleep deprives First Nations people of the chance to connect with culture. So they co-designed a sleep apnoea program they’d actually use.Yaqoot Fatima, Associate Professor, UQ Poche Centre for Indigenous Health, The University of QueenslandDaniel Sullivan, Research Fellow, UQ Poche Centre for Indigenous Health, The University of QueenslandRomola Bucks, Pro Vice Chancellor (Health and Medical Science) & Director of the Raine Study (rainestudy.org.au), The University of Western AustraliaRoslyn Von Senden, Senior Project Officer, UQ Poche Centre for Indigenous Health, The University of QueenslandShannon Edmed, Research Fellow, Institute for Social Science Research, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2160582023-11-06T13:35:07Z2023-11-06T13:35:07ZWhat’s your chronotype? Knowing whether you’re a night owl or an early bird could help you do better on tests and avoid scams<figure><img src="https://images.theconversation.com/files/557337/original/file-20231102-21-hyagg8.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6000%2C1994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Owl chronotypes function better at night, while lark chronotypes are more energized in the morning.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/blue-owl-royalty-free-image/1164845949">The Photo Matrix/Moment, nomis_g/iStock via Getty Images Plus</a></span></figcaption></figure><p>Timing is everything. For early risers and late-nighters alike, listening to your internal clock may be the key to success. From the classroom to the courtroom and beyond, people perform best on challenging tasks at a time of day that <a href="https://doi.org/10.1177/17456916231178553">aligns with their circadian rhythm</a>.</p>
<p><a href="https://theconversation.com/your-body-has-an-internal-clock-that-dictates-when-you-eat-sleep-and-might-have-a-heart-attack-all-based-on-time-of-day-178601">Circadian rhythms</a> are powerful internal timekeepers that drive a person’s physiological and intellectual functioning throughout the day. Peaks in these circadian rhythms vary across individuals. Some people, known as larks or morning chronotypes, peak early and feel at their best in the morning. Others, known as owls or evening chronotypes, peak later in the day and perform best in the late afternoon or evening. And some people show neither morning nor evening preferences and are considered neutral chronotypes.</p>
<p><a href="https://psychology.cofc.edu/about/faculty-and-staff/may-cynthia.php">As a researcher</a> seeking ways to improve cognitive function, I’ve explored whether your chronotype affects your mental performance. Understanding the kinds of mental processes that vary – or remain stable – over the course of a day may help people schedule their tasks in a way that optimizes performance. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/UbQ0RxQu2gM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Your brain has an internal clock that influences how your body functions over the course of a day.</span></figcaption>
</figure>
<h2>Why your chronotype matters</h2>
<p>Chronotype can be measured with a <a href="https://pubmed.ncbi.nlm.nih.gov/1027738/">simple questionnaire</a> that assesses things like your perceived alertness, preferred rising and retiring times and performance throughout the day. Even without a questionnaire, most people have a sense of whether they are a lark or an owl or fall somewhere in between. Do you wake up early, without an alarm, feeling sharp? Are you mentally drained and ready for pj’s by nine? If so, you are likely a morning type. Do you sleep late and wake feeling sluggish and foggy? Are you more energized late at night? If so, you are likely an evening type. </p>
<p>People perform best on many challenging mental tasks – from <a href="https://doi.org/10.1016/0191-8869(90)90056-W">paying attention</a> and <a href="https://psycnet.apa.org/doi/10.1037/pag0000199">learning</a> to <a href="https://doi.org/10.1016/S0191-8869(02)00320-3">solving problems</a> and <a href="https://doi.org/10.1016/j.iree.2021.100226">making complex decisions</a> – when these actions are synchronized with their personal circadian peaks. This is known as the <a href="https://doi.org/10.1111/j.1467-9280.1993.tb00573.x">synchrony effect</a>. Whether you are an air traffic controller scanning the radar, a CFO reviewing an earnings report or a high school student learning chemistry, synchrony can affect how well you perform.</p>
<p>Much of the evidence for synchrony effects comes from lab studies that test both larks and owls early in the morning and late in the day. People with strong chronotypes are <a href="https://doi.org/10.1371/journal.pone.0088820">more vigilant</a> and better able to <a href="https://doi.org/10.1038/s41467-021-24885-0">sustain attention</a> at their peak relative to off-peak times. Their memories are sharper, with <a href="https://doi.org/10.3389/fpsyg.2016.01764">better list recall</a> and more success in <a href="https://doi.org/10.1080/13825585.2016.1238444">remembering “to-do” tasks</a> like taking medication.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Hand reaching out under bedsheets towards a blue alarm clock on a nightstand" src="https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557340/original/file-20231102-17-6nvix8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When you feel the urge to hit snooze may tell you something about your circadian rhythm.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/early-morning-royalty-free-image/626952608">eggeeggjiew/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>People are also less prone to <a href="https://doi.org/10.1525/collabra.57536">mind wandering</a> and less distracted at their optimal time. For example, a study I conducted gave participants three weakly related cue words (such as “ship,” “outer” and “crawl”). They were tasked to find another word that linked all three (such as “space”). When my team and I presented misleading words alongside the cue words (such as “ocean” for ship, “inner” for outer and “baby” for crawl), those who were tested at synchronous times were <a href="https://doi.org/10.3758/BF03210822">better at ignoring the misleading words</a> and finding the target solution than those who weren’t.</p>
<p>Synchrony also affects high-level cognitive functions like persuasion, reasoning and decision-making. Studies on consumers have found that people are more <a href="https://doi.org/10.1016/j.paid.2005.01.021">discerning</a>, <a href="https://doi.org/10.1007/s11002-013-9247-0">skeptical</a> and <a href="https://doi.org/10.1002/mar.20169">analytical</a> at their peak times. They <a href="https://doi.org/10.1016/j.ijresmar.2008.04.002">invest more time and effort</a> in assigned tasks and are more likely to <a href="https://doi.org/10.1016/j.jcps.2009.08.002">search for important information</a>. Consequently, people make <a href="https://doi.org/10.1016/j.jbusvent.2021.106165">better investment decisions</a>, are less <a href="https://doi.org/10.1111/j.1467-9280.1990.tb00226.x">prone to bias</a> and are <a href="https://doi.org/10.1007/s11002-013-9247-0">more likely to detect scams</a>. </p>
<p>At off-peak times it takes people <a href="https://doi.org/10.1016/S0191-8869(02)00320-3">longer to solve problems</a>, and they tend to be <a href="https://doi.org/10.1016/j.paid.2012.10.031">less careful</a> and more <a href="https://doi.org/10.1111/j.1467-9280.1990.tb00226.x">reliant on mental shortcuts</a>, leaving them <a href="https://doi.org/10.1007/s11002-013-9247-0">vulnerable to flashy marketing schemes</a>. Even ethical behavior can be compromised at non-optimal times, as people are <a href="https://doi.org/10.1177/0956797614541989">more likely to cheat</a> at their off-peak times.</p>
<h2>In the classroom and the clinic</h2>
<p>The basic mental abilities that are affected by synchrony – including attention, memory and analytical thinking – are all skills that contribute to academic success. This connection is especially significant for teens, who <a href="https://doi.org/10.1080/00221325.2010.535225">tend to be night owls</a> but typically start school early.</p>
<p>One study randomly assigned over 700 adolescents to exam times in the early morning, late morning or afternoon. <a href="https://doi.org/10.1177/0748730414564786">Owls had lower scores</a> relative to larks in both morning sessions, but this disadvantage disappeared for owls taking the exam in the afternoon. Early start times may put student owls a step behind larks.</p>
<p>Time of day may also be a consideration when conducting assessments for cognitive disorders like attention-deficit disorder or Alzheimer’s disease. Scheduling time may be particularly significant for <a href="https://doi.org/10.3389/fpsyg.2019.00003">older adults, who tend to be larks</a> and often show <a href="https://doi.org/10.1080/17470210902834852">larger synchrony effects</a> than young adults. Performance is better at peak times on <a href="https://doi.org/10.1080/13825585.2015.1028326">several key neuropsychological measures</a> used to assess these conditions. Failing to consider synchrony may affect the accuracy of diagnoses and subsequently have consequences for clinical trial eligibility and data on treatment effectiveness.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person writing on a piece of paper on a clipboard with a pen" src="https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557341/original/file-20231102-27-tovoh8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">What time of day you take a cognitive test may influence your results.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/woman-hand-writing-on-clipboard-with-a-pen-royalty-free-image/1434437996">Violeta Stoimenova/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>Of course, synchrony doesn’t affect performance on all tasks or for all people. Simple, easy tasks – like recognizing familiar faces or places, dialing a close friend’s phone number or making a favorite recipe – are unlikely to change over the day. Furthermore, young adults who are <a href="https://doi.org/10.1080/07420528.2023.2256843">neither larks nor owls</a> show less variability in performance over the day.</p>
<p>For those who are true early birds or night owls, tackling the toughest mental tasks at times that align with their personal circadian peaks could improve their outcomes. When small improvements in performance offer an essential edge, synchrony may be one secret to success.</p><img src="https://counter.theconversation.com/content/216058/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Cindi May received funding from the National Institute on Aging. She currently serves on the board for Disability Rights South Carolina.</span></em></p>Synchronizing your daily activities to your circadian rhythm could help you improve your performance on a variety of cognitive tasks − and even influence diagnosis of cognitive disorders.Cindi May, Professor of Psychology, College of CharlestonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2087012023-10-31T16:18:14Z2023-10-31T16:18:14ZBooks on toddler sleep can give inflexible advice – parents should be reassured that one size doesn’t fit all<figure><img src="https://images.theconversation.com/files/552067/original/file-20231004-17-6a6bk5.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C5751%2C3819&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/little-africanamerican-girl-toy-sleeping-bed-1577602816">Pixel-Shot/Shutterstock</a></span></figcaption></figure><p>If you are a parent of a young child, sleep may well have become an obsession for you. </p>
<p>Toddlers often wake frequently during the night. Sleep deprivation is a <a href="https://www.lullabytrust.org.uk/safer-sleep-advice/coping-with-sleep-deprivation-as-a-new-parent/">real problem</a> for parents. And parents are often asked – and judged – about how their child is sleeping. </p>
<p>It’s no wonder that there is a healthy industry providing parents with books of advice on how to get their children to sleep for longer. But these books also often offer contradictory advice. </p>
<p>In <a href="https://doi.org/10.1111/chso.12714">research</a> with my colleague Amanda Norman, I examined parenting “self-help” books aimed at parents with children aged between two and five. We looked at how parenting books address parents – and how books like this <a href="https://doi.org/10.21827/ejlw.12.38836">made us feel</a> as parents ourselves. </p>
<p>We found each of the books tended to give parents one approach for dealing with their child’s sleep, rather than a range of options. But these methods were polarised between <a href="https://static1.squarespace.com/static/55084b9ae4b022bff6dce256/t/569eeb2e5827c3cdcbf484c3/1453255472504/Gentle+Birth+Gentle+Mothering+Ebook.pdf">gentle parenting</a>, which focused on following the needs of the child, and “behaviourist” techniques that reward desired behaviour and prioritise routine.</p>
<figure class="align-center ">
<img alt="Sleeping toddler in dark room" src="https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/552068/original/file-20231004-16-p00xui.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Finally asleep.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cute-little-boy-yellow-pyjamas-sweetly-365694512">Smolina Marianna/Shutterstock</a></span>
</figcaption>
</figure>
<p>In our own parenting experiences, gentle approaches felt vague and left us unclear of a path forward. The behaviourist methods made us feel like failures because the advice was so rigid it made it hard to follow well.</p>
<h2>Instructing parents</h2>
<p>Books about children’s sleep often take an authoritative or moralising tone with parents: an expert telling them what to do rather than a peer discussing ideas to try to help with their children’s sleep. We found these in both behaviourist and gentle parenting approaches.</p>
<p>A routine-driven, behaviourist approach, such as that taken in psychologist Tanya Byron’s 2008 <a href="https://books.google.co.uk/books?hl=en&lr=&id=0SnUVwAflKcC&oi=fnd&pg=PA9&dq=tanya+byron+your+toddler+&ots=tn8poyjESE&sig=GVgnrAx4wsWPOuoulrb3Aw-TwsI&redir_esc=y#v=onepage&q=tanya%20byron%20your%20toddler&f=false">Your Toddler</a>, lays out how to respond to a child’s behaviour to get them to sleep through the night in their own bed. The book recommends that children who sleep through the night – the approved behaviour – should be rewarded, for example with a sticker. </p>
<p>In <a href="https://www.penguin.co.uk/books/343547/new-toddler-taming-by-green-dr-christopher/9781446459348">New Toddler Taming</a> (2011) a book which also takes a behaviourist approach, paediatrician Christopher Green suggests use of his “patent rope trick” to keep children in their bedrooms, though noting that “to some, if not most, parents it’s going to seem a little bit old-fashioned and a fair bit silly”: </p>
<p>“Take a length of rope and loop one end around the <em>inner</em> handle of the toddler’s bedroom door. Attach the other end to the <em>outer</em> handle of a nearby door. Carefully adjust the rope so that when the bedroom door is pulled open, the aperture is a little less than the diameter of the offending child’s head. As all of you who have had babies know, if the head is not going to get out, nothing is. The result is that the toddler is not locked in, they just cannot get out.” </p>
<p>He adds that a light should be left on outside the bedroom, so the child will not become frightened, yet at the same time the child is “very aware that bed is the place he is meant to be. He may resort to crying to break your resolve but once again this ploy will fail when you use the rope trick in conjunction with the controlled crying technique.”</p>
<p>Gina Ford, a former maternity nurse and author of bestselling infant sleep books, also takes a behaviourist approach in her book <a href="https://www.amazon.co.uk/Contented-Toddler-Years-Gina-Ford/dp/0091912660">The Contented Toddler Years</a>. This includes briefly comforting a crying child before putting them back in their cot or bed. But the assertion that this is unlikely to be necessary more than once or twice before the child goes to sleep can seem improbable when faced with a living, breathing toddler. </p>
<p>American paediatrician <a href="https://www.sterling.edu/sites/default/files/nighttime-parenting-how-to-get-your-baby-and-child-to-sleep-william-sears-8b83fca.pdf">William Sears’</a> book Nighttime Parenting: How to Get Your Baby and Child to Sleep takes a gentle parenting approach. Sears argues for a “lazy” method that meets a baby’s needs while also preserving the parents’ own sleep by sharing a bed. </p>
<p>Co-sleeping – children sleeping in the same bed as their parent – means that parents can meet their child’s needs during the night as they would be met during the day, by connecting with them and offering cuddles and being emotionally available. This approach, however, may not be particularly helpful to parents who struggle to get enough sleep when sharing a bed with a child, or who feel they need some time alone. </p>
<p>Constant availability from a parent – maintaining the “powerful biological connection between you and your baby” – is also recommended in <a href="https://www.pinkymckay.com/">Pinky McKay’s</a> 2006 gentle parenting book <a href="https://www.amazon.co.uk/Sleeping-Like-Baby-Solutions-Toddlers/dp/0143004522">Sleeping Like a Baby</a>. This advice comes alongside examples of the negative results of not responding to infant wakes for children later in life. In one quote, a mother says: “I feel devastated that I have betrayed my child.”</p>
<p><a href="https://doi.org/10.7765/9781847794161">Other research</a> that has looked at how mothering has changed since the end of the second world war found that overly strict advice often resulted in mothers feeling ambivalent about parenting books from “experts”. </p>
<p>This was our experience as parents. Our own feelings and experiences with managing – or failing to manage – sleep were very much entwined in the reading process. We tried to implement advice from parenting books, failed, and then found our own ways through. </p>
<p>As researchers, we also found that there was little space given in these books for individual contexts, such as the baby or parent’s temperament, or factors such as ethnicity, social class, or additional needs such as neurodiversity. There was no mention of the views of the children themselves.</p>
<p>The management of children’s sleep was treated as an issue with a one-size-fits-all solution. But children – and their parents – are individuals with their own needs. The blueprints offered in books offering advice on improving baby sleep should be read with caution; we cannot make a child sleep.</p><img src="https://counter.theconversation.com/content/208701/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexandra Scherer received funding from The British Academy for the start of this research project on sleep.</span></em></p>We found each of the books tended to give parents one approach for dealing with their child’s sleep, rather than a range of options.Alexandra Scherer, Lecturer in Childhood Studies, University of PortsmouthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2117492023-10-27T01:24:05Z2023-10-27T01:24:05ZHow apps and influencers are changing the way we sleep, for better or for worse<figure><img src="https://images.theconversation.com/files/554430/original/file-20231017-21-7t15ti.jpg?ixlib=rb-1.1.0&rect=1%2C0%2C997%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/worried-woman-watching-bad-online-content-1074562523">Shutterstock</a></span></figcaption></figure><p><em>This is the final article in The Conversation’s six-part series on insomnia, which charts the rise of insomnia during industrialisation to sleep apps today. Read other articles in the series <a href="https://theconversation.com/au/topics/insomnia-series-144018">here</a>.</em></p>
<hr>
<p>Insomnia is not just a personal issue that affects an individual’s health and wellbeing. It’s a <a href="https://treasury.gov.au/sites/default/files/2019-03/360985-Sleep-Health-Foundation-and-Australasian-Sleep-Association.pdf">public health</a> issue, affecting public safety. It’s a <a href="https://academic.oup.com/eurpub/article/33/2/242/7049369?login=false">socioeconomic</a> issue, as poorer sleep is linked to a <a href="https://www.annualreviews.org/doi/10.1146/annurev-publhealth-040119-094412">lower education and income</a>. And, increasingly, it’s a commercial issue.</p>
<p>The global insomnia market is expected to reach <a href="https://www.alliedmarketresearch.com/insomnia-market">US$6.3 billion by 2030</a>, driven by increased diagnoses <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12820">and</a> therapy, as well as sleep aids, including <a href="https://www.openpr.com/news/3228602/sleep-tech-devices-market-2023-driving-factors-forecast">sleep apps</a>.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">A short history of insomnia and how we became obsessed with sleep</a>
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</em>
</p>
<hr>
<h2>There’s an app for that</h2>
<p>There are <a href="https://www.jstor.org/stable/27213628">numerous</a> <a href="https://www.nature.com/articles/s41746-020-0244-4">digital devices and apps</a> to help people sleep better. You can buy wearable devices, such as smartwatches and smart rings or wristbands, to digitally monitor your sleep. You can download apps that record how long you sleep and where you can log your tiredness and concentration levels. </p>
<p>Some devices are designed to promote sleep, by generating <a href="https://theconversation.com/what-is-brown-noise-can-this-latest-tiktok-trend-really-help-you-sleep-188528">white or brown noise</a> or other peaceful sounds. You can also buy “smart” <a href="https://thegadgetflow.com/blog/smart-pillows/">pillows</a>, <a href="https://www.sleepfoundation.org/best-mattress/best-smart-mattress">mattresses</a> and a range of <a href="https://sleepspace.com/smart-lights-improve-perceived-sleep-quality/">smart light-fittings and lightbulbs</a> to help track and improve sleep.</p>
<p>Such technologies operate to “digitise” sleep as part of “<a href="https://www.amazon.com.au/Quantified-Self-Deborah-Lupton/dp/150950060X">the quantified self</a>”. They render sleep practices and bodily responses into data you can review. So these devices are promoted as offering scientific insights into how to control the disruption to people’s lives caused by poor sleep.</p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CqpQFLMAp-x","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<p>You can listen to “<a href="https://www.theguardian.com/lifeandstyle/2019/feb/08/rise-of-sleep-story-apps-talking-books-that-send-you-to-sleep">sleep stories</a>” – bedtime stories, music or guided meditations meant to help you sleep. Then there are the sleep <a href="https://blog.feedspot.com/insomnia_blogs/">blogs</a>, <a href="https://www.timeout.com/things-to-do/best-sleep-podcasts">podcasts</a> and social media content on <a href="https://www.tiktok.com/tag/insomnia?lang=en0">TikTok</a>, <a href="https://www.youtube.com/watch?v=i9sR_T76H34">YouTube</a> and <a href="https://www.instagram.com/p/CqpQFLMAp-x/">Instagram</a>. </p>
<p>Where there is social media content, there are social media “influencers” sharing their take on sleep and how to get more of it. These “<a href="https://influencers.feedspot.com/sleep_instagram_influencers/">sleep influencers</a>” have accumulated large numbers of followers. Some have <a href="https://www.bbc.com/news/technology-66524539">profited</a>, including those who live-stream themselves sleeping or invite audiences to try to wake them up – for a price.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1693353491161325720"}"></div></p>
<h2>Sharing and connecting can help</h2>
<p>There may be benefits to joining online communities of people who can’t sleep, whether that’s in an online forum such as <a href="https://www.reddit.com/r/sleep/?rdt=60835">Reddit</a> or a specially designed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861843/">sleep improvement program</a>.</p>
<p>Sharing and connection can ease the loneliness we know <a href="https://academic.oup.com/sleep/article/34/11/1519/2454670?login=false">can impact</a> sleep. And technology can facilitate this connection when no-one else is around.</p>
<p>We know social media communities provide much-needed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156131/">support</a> for health problems more generally. They allow people to share personal experiences with others who understand, and to swap tips for the best health practitioners and therapies. </p>
<p>So online sharing, support and feelings of <a href="https://www.psychologytoday.com/au/blog/the-science-of-fandom/202303/can-social-media-and-online-communities-be-good-for-us">belonging</a> can alleviate the stresses and unhappiness that may prevent people from finding a good night’s sleep.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/social-media-activism-trucker-caps-the-fascinating-story-behind-long-covid-168465">Social media, activism, trucker caps: the fascinating story behind long COVID</a>
</strong>
</em>
</p>
<hr>
<h2>What is this fixation costing us?</h2>
<p>But there are some problems with digitising sleep. A <a href="https://www.theguardian.com/commentisfree/2023/may/09/obsession-sleep-harm-drivers-legal-sleep-limit">focus</a> on sleep can create a <a href="https://theconversation.com/is-tracking-your-sleep-a-good-idea-190231">vicious cycle</a> in which worrying about a lack of sleep <a href="https://www.sciencedirect.com/science/article/abs/pii/S0005796717301638">can itself</a><a href="https://www.bps.org.uk/research-digest/misbelieving-youve-got-sleep-problems-can-be-more-harmful-actual-lack-sleep"> worsen sleep</a>. </p>
<p>Using sleep-tracking apps and wearable devices can encourage people to become <a href="https://theconversation.com/is-tracking-your-sleep-a-good-idea-190231">overly fixated</a> on the metrics these technologies gather. </p>
<p>The data generated by digital devices are not necessarily <a href="https://www.nature.com/articles/s41746-020-0244-4">accurate or useful</a>, particularly for groups such as <a href="https://mhealth.jmir.org/2021/6/e26462">older people</a>. Some young people say they feel <a href="https://journals.sagepub.com/doi/abs/10.1177/10949968221142806">worse</a> after using a sleep app. </p>
<p>There are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157780/">data privacy issues</a>. Some digital developers do not adequately protect the very personal information smart sleep devices or apps generate.</p>
<p>Then, there’s the fact using digital devices before bedtime <a href="https://www.sleepfoundation.org/how-sleep-works/how-electronics-affect-sleep">is itself</a> linked to <a href="https://www.sciencedirect.com/science/article/pii/S2352721823000347">sleep problems</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/are-sleep-trackers-accurate-heres-what-researchers-currently-know-152500">Are sleep trackers accurate? Here's what researchers currently know</a>
</strong>
</em>
</p>
<hr>
<h2>Are we missing the bigger issue?</h2>
<p>Other critics argue this intense focus on sleep ignores that sleeping well is impossible for some people, however hard they try or whatever expensive devices they buy. </p>
<p>People living in poor housing or in noisy environments have little choice over the conditions in which they seek good sleep. </p>
<p>Factors such as people’s income and education levels <a href="https://www.mdpi.com/2254-9625/12/8/80">affect</a> their sleep, just as they do for <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/bjop.12645">other health issues</a>. And <a href="https://www.sciencedirect.com/science/article/pii/S2352721823000864">multiple socioeconomic factors</a> (for instance, gender, ethnicity and economic hardship) can combine, making it even more likely to have poor sleep.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Plane flying low over houses" src="https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=478&fit=crop&dpr=1 754w, https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=478&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/554442/original/file-20231018-25-99hpyt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=478&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">People living in poor housing or in noisy environments have little choice over their sleep environment.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/heathrow-airport-london-9-september-british-114954946">Steve Heap/Shutterstock</a></span>
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<p>Sleep quality is therefore just as much as a <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/bjop.12645">socioeconomic</a> as a biological issue. Yet, much of the advice offered to people about how to improve their sleep focuses on individual responsibility to make changes. It assumes everyone can buy the latest technologies or can change their environment or lifestyle to find better “sleep health”. </p>
<p>Until “<a href="https://www.mdpi.com/2624-5175/5/1/13">sleep health inequalities</a>” are improved, it is unlikely digital devices or apps can fix sleep difficulties at the population level. A good night’s sleep should not be the preserve of the privileged.</p>
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Read more:
<a href="https://theconversation.com/counting-the-wrong-sheep-why-trouble-sleeping-is-about-more-than-just-individual-lifestyles-and-habits-210695">Counting the wrong sheep: why trouble sleeping is about more than just individual lifestyles and habits</a>
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<img src="https://counter.theconversation.com/content/211749/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Deborah Lupton receives funding from the Australian Research Council.</span></em></p>Fixating on sleep can make your sleep worse. But some people crave the connection online sleep communities provide.Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.