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    The Most Important Thing Most Americans Misunderstand About Insomnia

    enApril 25, 2023

    Podcast Summary

    • Historically, many societies practiced segmented sleepConsider exploring segmented sleep as an alternative to improve rest if experiencing middle-of-the-night insomnia, as it was a common practice historically

      Our modern sleep patterns may not align with the natural way our bodies want to rest. Historically, many people practiced segmented sleep, or biphasic sleep, which involves breaking up sleep into two parts. This practice was common until the Industrial Revolution, when factors such as artificial light, caffeine, clocks, and work schedules led to the norm of one continuous 8-hour sleep. A historian named Roger Ekirch discovered references to this segmented sleep pattern in various societies throughout history, including Europe, Africa, the Middle East, and South Asia. A study by the National Institute of Mental Health in the 1990s even showed that when male subjects were deprived of electricity at night, their sleep naturally reverted back to the segmented pattern. So, if you're experiencing middle-of-the-night insomnia, it might not be a personal failing, but rather a sign that your body is trying to follow its natural biphasic sleep pattern. Consider exploring this sleep pattern as an alternative to help improve your rest.

    • Diverse Sleep Patterns Among Humans and AnimalsDifferent bodies have unique sleep requirements, and it's essential to discover what works best for each individual to improve sleep quality without medication.

      Sleep patterns vary greatly among different species, and humans are no exception. While industrial capitalism may have pushed us towards a monolithic sleep schedule, studies show that various tribes and animals have diverse sleeping habits. For instance, some hunter-gatherer communities enjoy one long sleep, while others, like cows, chew and sleep at the same time. Elephant seals sleep for only a few hours a day, and frigatebirds even fly while they sleep. These findings suggest that different bodies have unique sleep requirements, and it's essential to discover what works best for each individual. Dr. Jade Wu, a behavioral sleep medicine specialist and researcher at Duke University School of Medicine, emphasizes the importance of sleep and offers strategies to improve sleep quality without medication. As Derek Thompson, the podcast host, noted, sleep is crucial for our health, but an obsession with it can hinder our ability to fall asleep. Therefore, finding a balance and understanding our unique sleep needs is vital.

    • Understanding Sleep Deprivation and InsomniaSleep deprivation and insomnia are distinct conditions. Sleep deprivation is external, caused by lack of opportunity to sleep. Insomnia is internal, caused by inability to sleep. Both have different consequences. Public health messages should address both.

      Sleep deprivation and insomnia are not the same thing. Sleep deprivation is when one doesn't have enough opportunity to sleep, often due to external factors like work or study demands. Insomnia, on the other hand, is when one has enough opportunity to sleep but is unable to due to internal factors like anxiety or poor sleep hygiene. It's important to understand this distinction, as the consequences of each are different. Sleep deprivation, which can lead to high sleepiness, is associated with greater health risks, while insomnia, which is more common, is often linked to anxiety. Therefore, public health messages about sleep should aim to reduce anxiety around sleep while also acknowledging the importance of getting enough sleep. Additionally, demographic differences exist, with younger people and minorities being more likely to experience sleep deprivation due to external factors like early school start times and shift work.

    • Understanding the Differences Between Sleep Deprivation and InsomniaImproving insomnia through therapy may lead to better health outcomes, but it's challenging to definitively prove insomnia causes health issues.

      Sleep deprivation and insomnia are not the same thing, and both have different impacts on our health. Sleep deprivation refers to not getting enough sleep, while insomnia is the struggle with sleep, even when getting the recommended hours. Insomnia can interfere with daily functioning, leading to irritability, crankiness, and an inability to engage in activities that promote physical and mental well-being. While there is evidence linking insomnia to cardiovascular and metabolic issues, it's challenging to determine if insomnia is the cause or the effect. Research methods, such as longitudinal studies, make it difficult to establish a clear cause-and-effect relationship between insomnia and health problems. However, ongoing research suggests that improving insomnia through cognitive behavioral therapy may lead to better blood pressure regulation, indicating a potential positive impact on health.

    • Understanding the Impact of Insomnia on Mental and Physical HealthInsomnia can negatively impact mental and physical health, causing anxiety and interfering with daily life. Keeping consistent sleep and meal patterns, as well as exposure to natural light, can help maintain circadian health and keep biological rhythms in sync.

      Insomnia, despite having subtler biological health effects, can significantly impact a person's mental and physical wellbeing if it leads to anxiety and interferes with daily life. Moreover, the anxiety surrounding insomnia can itself cause physical symptoms. The most underrated aspect of sleep science is circadian health, which involves our biological clocks regulating our sleep-wake cycle and other bodily functions. Our bodies naturally run on rhythms longer than 24 hours, and maintaining consistent sleep and meal patterns, as well as exposure to natural light, can help keep these rhythms in sync. Natural variation in circadian rhythms within the population is beneficial for species survival, with younger people tending to have later rhythms and older people having earlier ones. While we don't have a definitive answer, it's possible that this variation has evolutionary advantages.

    • Understanding our circadian rhythms and their influence on our energy levels and productivityOur circadian rhythms, regulated by melatonin, determine whether we're morning people or night owls, and can change over our lifetimes and be influenced by external factors. Awareness of this can help optimize our energy and productivity.

      Our biological clocks, or circadian rhythms, play a significant role in determining whether we are morning people or night owls. This is not just a matter of personal preference, but is influenced by the natural rise and fall of the hormone melatonin in our bodies. Melatonin helps regulate our sleep-wake cycles, and for some people, it starts rising earlier in the evening, making them more likely to be morning people, while for others it starts later, making them night owls. This melatonin curve can change over our lifetimes and can also be influenced by external factors such as work or family obligations. However, it is possible to make deliberate efforts to shift our circadian rhythms, as shown in a study where people were taken camping and exposed to natural light and dark cycles, resulting in everyone becoming more of a morning person. So, understanding our circadian rhythms and being aware of how they influence our energy levels and productivity can help us make the most of our days.

    • Understanding Our Circadian Rhythm for Optimal PerformancePaying attention to our melatonin curve and energy levels can help us identify our chronotype and tailor our activities accordingly, while respecting our bodies' needs is essential for productivity and overall health.

      Our ability to adapt to our environment, including our sleep patterns, is essential for our survival and productivity. Our circadian rhythm, primarily influenced by light, determines our energy levels and optimal performance times. By paying attention to our melatonin curve and energy levels, we can identify our chronotype and tailor our activities accordingly. However, not everyone has the luxury of flexible schedules, and shift work can have detrimental effects on both cognitive functioning and overall health. Contrary to popular belief, the notion of thriving on minimal sleep is largely a myth, as sleep deprivation can lead to significant health issues and decreased performance, even if not immediately apparent. It's crucial to respect our bodies' needs and advocate for accommodating work schedules when possible.

    • Sleep's impact on self-perception and health during perinatal periodRecognize sleep's importance for accurate self-assessment and overall well-being, especially during pregnancy when caffeine's half-life increases, potentially disrupting sleep.

      Sleep plays a crucial role in our perception of our own performance, and a lack of sleep can lead to overconfidence and inaccurate self-assessment. Furthermore, new parents often accept the conventional wisdom that sleep will be poor during the perinatal period, but there are steps they can take to improve it. For instance, they may not be aware that the half-life of caffeine can increase during pregnancy, leading to longer-lasting effects and potential sleep disturbances. By recognizing these factors and taking proactive measures, individuals can enhance their sleep quality and overall well-being. In summary, sleep is essential for accurate self-assessment and optimal health, especially during the perinatal period.

    • Syncing sleep schedule with natural circadian rhythm for better pregnancy and postpartum sleepPrioritizing circadian health during pregnancy and postpartum can lead to improved well-being for mothers and better sleep patterns for babies. Syncing sleep schedule with natural rhythm and leveraging benefits of breastfeeding can help achieve better sleep quality.

      During pregnancy and postpartum, prioritizing a mother's circadian health can significantly improve both her own well-being and her baby's sleep patterns. The speaker, a sleep researcher and mother of two, shared her personal experience of struggling with sleep during her first pregnancy despite her professional background in sleep research. She emphasized the importance of syncing one's sleep schedule with their natural circadian rhythm, rather than sacrificing sleep or trying to force an unsustainable schedule. Additionally, breastfeeding can enhance deep sleep, making it a potential benefit for mothers who are concerned about sleep loss. Overall, prioritizing circadian health can lead to better sleep quality, improved mood, and even earlier establishment of healthy sleep habits for infants.

    • New parents: Prioritize sleep routines for better sleep qualityNew parents should maintain consistent sleep schedules, trust interruptions for feeding, and establish a nap routine to regulate circadian rhythm and improve sleep quality. Cognitive behavioral therapy for insomnia (CBTI) can significantly enhance sleep for individuals dealing with insomnia through personalized, data-driven, and homework-based practices.

      New parents should prioritize maintaining consistent sleep schedules, trust the sleep interruptions for feeding and nursing, and establish a regular nap routine. These practices can help regulate the circadian rhythm and improve overall sleep quality. Additionally, cognitive behavioral therapy for insomnia (CBTI) is a non-medication therapy that can significantly enhance the relationship with sleep for individuals dealing with insomnia. This personalized, hands-on therapy, which usually lasts 4-8 sessions, focuses on data-driven and homework-based practices to help patients sleep better and develop long-term skills for managing sleep challenges. For instance, a 36-year-old writer and podcaster dealing with insomnia, who is married, a workaholic, has moderate alcohol consumption, and occasional marijuana use, can benefit from CBTI by learning evidence-based strategies and techniques to improve sleep quality and cope with sleep disturbances.

    • Identify sleep patterns with a log and focus on sleep qualityInstead of forcing sleep, practice relaxation and improve sleep quality through consolidation before increasing quantity.

      CBTI (Cognitive Behavioral Therapy for Insomnia) begins with keeping a sleep log to identify patterns and gain useful data. CBTI also focuses on sleep consolidation, which involves making your sleep schedule smaller to improve sleep quality before increasing quantity. This counterintuitive approach can help reduce hyperarousal, or mental and physical restlessness, allowing for easier falling and staying asleep. The relationship with sleep is crucial, and trying too hard to force sleep can actually make it more elusive. Instead, practicing relaxation techniques and removing the pressure to sleep can lead to a healthier, more balanced sleep pattern.

    • Understanding the natural process of sleepApproaching sleep as a flexible, friendly relationship can lead to better sleep quality by embracing our natural sleep rhythms and recognizing middle of the night insomnia as normal.

      Approaching sleep as a friendly relationship rather than a rigid requirement can lead to better sleep quality. Our bodies naturally experience two halves of sleep, with the first half focused on deep, restorative sleep driven by our homeostatic sleep drive, and the second half driven by our circadian rhythm. Understanding this natural process can help us approach sleep with more flexibility and forgiveness, allowing us to let go of unrealistic expectations and find a sleep schedule that works best for us. Additionally, recognizing that middle of the night insomnia or waking up during the night is a natural part of our biological make-up can help reduce stress and anxiety around sleep. By embracing this natural rhythm, we can improve our overall sleep hygiene and build a healthier, more sustainable relationship with sleep.

    • Exploring Popular Sleep HacksWhile some sleep hacks may benefit certain individuals, everyone's sleep needs and patterns are unique. Sunlight exposure during the day, avoiding excessive reliance on sleep trackers, and considering biphasic sleep are potential solutions. However, be cautious with impractical hacks like lettuce water and long-term use of sleep aids.

      While some sleep hacks may work for certain individuals, it's essential to remember that everyone's sleep needs and patterns are unique. Here are rapid-fire thoughts on five popular sleep hacks: 1. Sleep trackers: While they can be helpful for identifying overall sleep patterns, they should not be overly relied upon or cause unnecessary anxiety. 2. Viewing sunlight early in the day: Exposure to sunlight during the day helps regulate our circadian rhythms, leading to better sleep quality and wakefulness. 3. Lettuce water: The idea of drinking lettuce water for sleep benefits is based on studies in mice, and the required amount for humans would make it an impractical solution for sleep. 4. Taking Adafil PM every night: Although it may help some individuals fall asleep, long-term use could lead to psychological dependence and decreased confidence in one's ability to sleep naturally. 5. Biphasic sleep: If waking up at unusual hours and feeling well, it's perfectly fine to embrace biphasic sleep, even if it goes against societal norms. Remember, there's no one-size-fits-all approach to sleep, and it's crucial to find what works best for you.

    • Establish a relaxing bedtime routine with a consistent activityFind a relaxing activity to help signal your body for sleep and make it a consistent part of your bedtime routine.

      Having a consistent sleep routine can be crucial for falling and staying asleep. The specific activity doesn't matter as long as it's relaxing and enjoyable for the individual. For some people, watching the same TV show before bed can be an effective sleep association. It's not about the enjoyment, but rather about queuing the beginning of the wind down process and taking up enough attention to prevent the mind from going to anxious places. The activity should not be boring to the point of being aversive. Instead, it can be something fun and enjoyable, even if it's something as simple as watching an episode of a favorite TV show. The key is to find what works best for you and make it a part of your bedtime routine.

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