[APPLAUSE]
SOPHIE BOSTOCK: Thank you.
Thank you so much.
It's always very
dangerous advertising
a talk for people who
are sleep deprived
because the odds
of them turning up
a somewhat lower than
those more energized
members of the public.
But thank you very, very
much for making the effort
to turn up.
As Richard says, my job
title is a sleep evangelist.
I'm very fond of that title
because if I do come and do
a talk, it really
takes the pressure off.
Because if while I'm
talking you do sort of
feel your eyelids getting
heavy, now is the time.
I will take it as a compliment.
But we are recording today.
So if you could keep the
snoring to a minimum,
that would be excellent.
So I thought just to start off.
Before you have a quick nap.
I'm actually going to
get you to stand up.
This is very deliberate.
It means extricating yourself
from your laptop or phone
for a very short period of time.
It's going to be OK.
And what I'd like
you to do is when
you see a statement on the
screen, which is true for you
most of the time, I'd
like you to sit down.
OK.
So firstly, I rely on an
alarm clock to wake up.
Sort of mostly.
[LAUGHTER]
I fall asleep within five
minutes of getting into bed.
I use caffeine to keep
me going through the day.
I can doze in long
meetings or talks.
I sleep for longer at
the weekends to catch up.
And there are a few people
standing, which is excellent.
The vast majority of you
have come to the right place.
For you guys, hopefully, you
will still learn even more.
Please have a seat.
It may not surprise
you to know that these
are all indicators of potential
sleep deprivation, which
from the looks of
things affects most
of the people in this room.
So experts have
kind of got together
to come up with a consensus
of how much sleep we actually
need.
Now, sleep is a
biological characteristic.
There is a lot of
natural variation.
But when they collated
loads of studies
together, what they
came up with is
that seven hours
is the recommended
minimum for optimal
health and functioning.
Now, most of us actually
lie in a broader range
between seven and nine hours.
But you can anchor the
scientific recommendation
on a minimum of seven
hours for most people.
But most studies that look
around the world at how much
sleep people are getting--
this one's from the RAND
Corporation--
show that at least
40% of the population
in developed countries
is short of sleep.
So Japan, here,
hitting the sleepless
ranks very highly
followed by the US.
And even in the UK, at
least one in three of us
are short of sleep.
But what I tend to find
when I come and speak
to people about sleep
at a corporate setting
is that probably the proportion
is considerably higher.
And this is pretty extraordinary
because you're all really quite
clever savvy people.
Yeah.
All of you.
And you've probably
heard an awful lot
about why sleep is
important, not just from me,
but from some other more
established sleep evangelists.
So you've got some phenomenons
sort of books and speakers,
people who are going
out and telling you
just how important sleep is.
So if I could get you to
raise your hand if you have
either read one of these
books or perhaps watched
a talk, perhaps a Talks at
Google on the topic of sleep
and how important sleep is in
the last three or four years.
OK, so once again,
quite a lot of people
in the room, which means that
if I was to spend the next 30
minutes telling you about all
the things that could happen
to you if you don't get
enough sleep, some of these
are going to be quite familiar.
Now, you could probably take
any single one of these and go,
do you know what?
This is really important to me.
If one of these is
important to you,
you it might want to
make you get more sleep.
But all of them together
collectively, surely the case
for good sleep is overwhelming.
And yet, time and time
again, we turn up tired.
We turn up with enough sleep.
And really, what I want
to spend the next half
hour talking about is why.
Not why we sleep, but why
we're not getting enough sleep.
And hopefully, by understanding
the behavioral science
and the neuroscience, which is
actually preventing a lot of us
from getting enough
sleep, we can then kind of
give some recommendations
which will
help you to get better
quality out of the time
that you are sleeping.
So in order to do this, we
need to go back in time.
For many of you, not so long.
For me, about 21 years,
give or take, to you
were a baby, when
you were a newborn.
Thank you, Richard,
for laughing.
So when we are born,
nobody teaches us to sleep.
We have an innate
ability to sleep.
It is not a learned behavior.
It's something that
is very natural.
It's driven within us.
And when you are a newborn,
it's really pretty simple.
The longer you've
been awake or the more
activity that you've done, the
greater the pressure to sleep.
So remember that.
Sleep pressure builds up the
longer that you're awake.
And we still have this
influence influencing our sleep
as adults.
But as we get older, it's get
considerably more complicated.
So around about
three months old,
our body clocks
start to kick in.
And I'll cover a bit more
about those a little bit later.
But the other thing that
happens as we get older
is that to we're able to
consciously override sleep.
Those parents in
the room will know
that this happens
with, unfortunately,
a lot of frequency.
But we're able to kind of kick
in this conscious override
switch which enables us to
prevent sleep from occurring.
Now, I'm very, very interested
in why this could possibly
be the case.
Let's face it.
From an evolutionary
perspective,
if sleep provides all
of those values, all
of those kind of brilliant
protective influences
on our health and
well-being, then why
can we prevent sleep
from occurring?
And for that, you kind of
need to go back even further.
So our conscious
brains evolved probably
around about 200,000
years ago, give or take.
And while our ancestors
were out on the savanna
hunting and gathering,
that manual override switch
was really helpful.
So I mean if you went
back to our hunter
gatherer days,
what type of things
would have kept
you awake at night,
would have made you kind of be
able to stay awake at night?
What are you trying to
prevent from occurring
if you're staying awake
in that sort of setting?
AUDIENCE: Getting
eaten by lions.
SOPHIE BOSTOCK: Getting
eaten, absolutely.
Predators.
Anything else?
AUDIENCE: Weather.
SOPHIE BOSTOCK: Weather.
It could be awful storms.
We were not protected
by a lovely building
like this back in those days.
I mean basically, it was all
about threats to survival.
We needed to be able to
stay awake because we
were defending ourselves.
It was absolutely
protective from
an evolutionary perspective.
So our brains evolved to
learn that not sleeping means
that we are under threat.
That's really important.
So inside the brain, threats
switch on this highly
honed response to boost our
survival called the stress
response.
You probably come across
this, either called
the stress response or the
fight or flight reflex.
And what happens is
when we sense something
that we're afraid of,
this little red bit
almond shaped bit in the
middle, the amygdala,
switches on this
cascade of reactions.
So it pushes adrenaline
into the bloodstream.
We get the heart pumping faster.
Blood pressure raises.
Muscles tense up.
Over time, we also produce
the stress hormone cortisol.
All of these things are
getting us raring to go,
ready to either fight or flight.
Very useful defensive response.
The problem is these
days sleep deprivation
may not be due to a
threat to our survival.
We've all been there.
Just one more episode.
Just one more drink.
Just 10 minutes more
on that presentation.
It's not going to hurt.
It's only 15, 20 minutes.
We deliberately keep
ourselves awake past the time
that our bodies are telling
us that we're sleepy,
not realizing that we are
guilty of sleep sabotage.
So evolution is simply
not ready for Netflix.
By deliberately keeping us
awake and making ourselves
over tired, we kick start
this stress response.
We become hyper-vigilant,
hyper-aroused.
And it's much harder
to get off to sleep.
And even if we do
sleep, we actually
enter a little sleep
because there's
part of our brain
going, I don't want
to be eaten by
saber tooth tiger.
So we miss out on some of
that deep restorative sleep.
To make things even worse,
in this survival mode,
while our brain is busy
prioritizing what's
going on in the amygdala,
it's switching off,
turning down the amount
of energy it sends
towards another part of our
brain, our prefrontal cortex,
the bit that controls
self-regulatory capacity,
our logical thought, our
goal directed behavior.
The more short of sleep
you are, the less likely
you are to be able
to stick to the goal
that you meant to
make to fall asleep.
It's literally a vicious cycle.
So what can we do
to tackle sleep self
sabotage, the over-tires brain?
m it sounds very, very
obvious, if you are getting
at least seven hours
sleep a night, hopefully,
you're going to enter
that state less often.
But I think what's key
here is whether or not
you're getting seven hours
or a little bit less,
make it a routine.
Reduce the cognitive load,
that decision making that says,
shall I go to bed now or not?
If you know that at
11:00 PM without fail,
you are going to
sleep, well, it kind of
doesn't give you
as many options.
So it's about sticking
to a plan, making a plan
and sticking to a plan.
And then in the time before
bed, obviously, there
are going to be times that
you have to stay up late.
You've got stuff to finish.
There's a really,
really good series on.
Whenever you are ready to switch
off, don't just get into bed
and switch out the light.
Your brain is still active.
You owe yourself a period
of time to wind down.
Now, in an ideal world, this
is quite a kind of routine
that you go through.
Maybe it takes an hour
on a typical night.
So you might
declutter your room.
You might put your clothes
out for the next day.
You might lock the
doors in the house
to make yourself
sort of feel secure.
You might have a hot
shower, read a book.
Whatever you do, if you do it
in the same order each night,
when you tune into that routine,
there's a pattern recognition.
The body recognizes that
you are safe and secure
and you're going
to unwind for bed.
If you repeat that on
enough days of the week,
when it comes to
being sleep deprived,
you can tap into a small
part of that routine
and the brain kicks in.
It goes, I know I'm safe.
I know I'm secure.
I can relax, wind down,
and be ready for bed.
Finally, develop the
skill of relaxation.
So I was at yoga this
morning developing
my skill of relaxation.
And the yoga
teacher said, you've
got to put some effort
in, when we were just
sort of lying now on
the ground breathing.
And I thought, really?
I mean surely relaxation
is just relaxation.
Relaxation is actually
an effortful procedure.
It's not just about lying down
worrying about the presentation
that you've got to give in a
few hours time it's actually
about focusing your attention,
focusing your attention
on the breath,
making sure that you
are slowing the breath down.
The technique that you
use doesn't really matter,
whether it's
mindfulness meditation,
yoga, any form of relaxing
activity, progressive muscle
relaxation.
All of these things will help
the mind to detach and the body
to relax.
You're trying to reset
that stress response.
I front loaded quite
a lot of science
there in case some of you fell
asleep a little bit later on.
So we'll move on to
the second reason
that I believe that a lot of
us don't get enough sleep.
And I like to call this
blissful ignorance.
So a lot of you
walked into the room
knowing that you
want more sleep,
knowing that you're
not getting enough.
But I suspect that you
are underestimating just
how harmful the impact
is on your daily life.
Why do I say this?
Well, there have
been a few studies
looking at the impact of
a certain amount of sleep
on both objective performance
and subjective performance,
which I'll explain.
So this particular study,
they got some volunteers
and they split them
into four groups.
The first group got
no time in bed at all
and they had to try and
maintain that for three days.
The other groups, four hours
in bed, six hours in bed,
eight hours in bed.
So you know how much
sleep you regularly get.
You can kind of put yourself
into one of these groups,
whichever is closest.
And during the course of
the 14 day experiment,
they got people to test
their level of alertness.
And the way that they did
this is using something
called the psychomotor
vigilance task.
All that happens, you
sit looking at a screen
and some numbers flash onto it.
It's incredibly simple.
All you have to do
is press a button
when you see the
number occurring.
So you can make an error
by not pressing the button
or by pressing the button
when there is no number.
So it's very much
a very simple test
of alertness and concentration.
So this is what happened
to the number of errors
that people made over
the 14 day experiment.
So first of all,
we see the group
that got no time in bed at all
very rapidly increasing number
of mistakes that they made.
The eight hours in bed group,
not too much significant change
over time.
But what you can
see very clearly
is that there is this kind of
dose response relationship.
The less sleep that you're
getting, the more likely
you are to make mistakes.
But what's really significant is
that this builds up every night
that you are short of sleep.
The effects of
sleeplessness accumulate.
And this is what we
call a sleep debt.
This is something you
can build up over time.
This kind of makes sense.
But what's really
worrying is what
happened when we asked
people how sleepy they are.
So this is subjective
perception of your sleepiness.
So again, if you've got no
sleep, you know you're sleepy.
But the four hours and
six hours people, they
didn't report feeling any
different to each other.
And what's worse
is after 10 days,
they didn't really think that
their level of impairment
was any worse than it
was after three or four.
They are telling
themselves, like many of us
do, that they've
adapted, that they're OK,
that they're coping.
But the objective data tells
a very different story.
So we may well be
underestimating
the impact of sleeplessness.
Just to make it just a teeny
bit harder, as many of you
will know if you heard
Matthew Walker's talk,
sleep is absolutely essential
for learning and memory.
As you learn new
stuff during the day,
hopefully as you're
sitting here picking up
a few nuggets of
information, your brain
is actually expanding
with the knowledge.
It's like a sponge.
It can only suck up
a certain amount.
And sleep is the
process which returns
the kind of really interesting
emotionally resonant memories
into your long term memory.
And it also recharges
that short term memory,
allowing you to
learn new things.
So if you're not
sleeping terribly well
and it's having an impact
on your performance,
you might not
remember it tomorrow.
You'll probably tell
yourself that you're
going to adapt all over again.
And people can just
get in this cycle
where they're not actually--
they can't really remember
what it was like to sleep well.
They just tell themselves
that they're coping.
You've got to kind
of break this cycle
and remember what it's like
to have a good night's sleep.
So how do we do that?
Well, first things first, you've
got to repay that sleep debt.
The good news is you do not
need to repay it hour for hour.
The body is very adaptable.
It's very clever.
If you've had a really
poor night's sleep,
the next night it will
slip into a deeper sleep.
You'll have more of
the REM sleep, which
helps to recharge your
emotions and memories.
So there is an
adaptability there.
It's just that if you're
constantly short of sleep
you're not allowing
the brain to recharge.
So repay the sleep debt.
Take a vacation.
Make sure that you've
got several days
when you can actually sleep
for as long as you like.
And then you got
to work out what's
your natural sleep window.
So if you were to go to bed each
night when your eyelids start
to get tired and wake
up without an alarm,
how much sleep is that?
And some of you will go,
well, I do that on the weekend
and it's 10 or 11 hours.
I can't have 10 or 11 hours.
And that's because
you're repaying
some of your missing
sleep debt from the week.
You've got to give
yourself a chance.
Definitely, I would
recommend a vacation.
Always recommend that.
Once you have your sleep
window, first thing to do
is set a routine wake time.
Set your time that
you can get up
sort of 90% of the time
within an hour or so.
And once you've
started adapting that--
we'll talk in the next bit about
the body clock and how helpful
that can be--
but can you find a time where
your body wakes up naturally
so you're not constantly
reliant on an alarm?
That's a good indicator
to you that you
are getting enough sleep.
And if you can't get
that seven hours all
in one block at night,
do not be afraid to nap.
I know that Google is
renowned for having
invested in napping pods.
You've got some really great
environments in the workspace
where you can actually
go and take a power nap.
Now, a power nap is so called,
as many of you will know,
because roughly around about
20 to 25 minutes will get you
into a deep enough
sleep to restore
your cognitive functions, give
your mood a boost in terms
of sort of happiness
and well-being,
but it's not long enough
to drift into deep sleep.
Typically, after
about 45 minutes or so
you get into a deep sleep.
And if you wake up
from deep sleep,
you are properly out of it.
You've got this thing
called sleep inertia
and it can take you a full
hour to wake up again.
So if you're going to
nap, my advice would be--
as we'll see in a moment,
do it in the circadian
low after lunch and keep
it to 15 to 20 minutes.
OK.
So that's blissful ignorance
about lack of sleep.
Why else are we not
sleeping enough?
You heard it here first.
You've heard of the
obesogenic environment.
Now I would like
to propose to you
the sleeplessogenic
suggested environment, which
maybe doesn't rattle off
the tongue quite so well.
But I'm sure you can imagine
what I'm talking about.
So back on the savanna
as hunter gatherers,
before we had
watches and phones,
we used to rely on the sun
to tell us what time of day
it was.
And we evolved our
level of activity
to be guided very
much by the sun.
So our alertness follows
this sort of pattern.
As we wake up in the morning,
our alertness sort of
boosts right up
until about midday.
After lunch, we have
this circadian low,
sometime between about
1:00 PM and 3:00 PM
where our energy levels dip.
That's just innate within us.
Then we pick up as it's
time to go home from work.
And as it starts to get dark,
our energy levels start to dip.
And that's when naturally
we feel more sleepy.
But the remarkable
thing about this pattern
is that even if you take
light, sunlight away,
this pattern persists.
So if you were to take
any cell from your body
and put it in a
Petri dish and put it
in a cupboard with all
the things that it needed,
it would actually operate
on a 24-hour rhythm.
Same thing would happen to
you if you went and lived
in a cave underground
for two months.
You might not think
this is a good idea,
but a French guy
actually went and did it.
And he was able to show that his
circadian rhythm persisted even
in the absence of light.
Now, the fact is circadian
rhythm ended up being about 24
and 1/2 hours.
So after a couple of
months, he was out of sync
with the external environment.
But it was through
exposure to light
that he was able to then, as he
returned to the outside world,
bring his body
clock back on track.
So we have literally
trillions of these body clocks
all around our body trying to
operate on a 24-hour rhythm.
Some of them are more
active during the night.
So growth hormone, for example,
gets produced during the night.
It's a really strong time
for growth and repair,
whereas obviously, our
conscious functions
are switched off at night.
We produce less urine.
Our blood pressure
goes down, for example.
So in order for the body
to work most efficiently,
we want all of our body
clocks to work in tune.
And you will know
if you've ever had
jet lag what happens when
your body clocks start
to be out of sync
with each other
and with the
external environment.
So light is an incredibly
powerful driver
for coordinating our body
clocks altogether, making us
work efficiently.
And darkness,
conversely, is what
enables the body to
produce melatonin,
the hormone that signals to the
body that it's time to sleep.
So we have this
alerting function,
which sort of gets
stronger and stronger
as the light gets brighter
and drops away at night.
And then I mentioned
earlier, as babies
we have this sleep pressure that
builds up the longer that we've
been awake.
So actually, as adults,
both of these two drivers
working to control
our level of alertness
at one time or another.
Now, interestingly for
this sleep pressure,
there is a way to block that.
Any ideas what will block
your sleep pressure?
AUDIENCE: Caffeine.
SOPHIE BOSTOCK:
Caffeine, absolutely.
So what's actually
happening there
is as sleep pressure
builds up, is
that you have this waste product
from activity called adenosine
that just builds up in the
brain and makes you feel drowsy.
And caffeine
basically muscles in
and masks the
adenosine receptors.
So you don't actually feel
that same level of drowsiness.
At the same time, it's
upping your stress hormones,
making you feel light
and jittery and alert.
But when the caffeine degrades,
the adenosine is still there.
It hasn't gone anywhere.
And so you can get this wave of
tiredness, this caffeine crash
from all the adenosine
that's been building up.
But you've been
masking its effects
so you didn't realize how
tired you really were.
So the environment that
most of us now work in,
this is not the savanna.
This might well be YouTube
or Google or pretty much
any office around the world.
What can you see here that might
interfere with either your body
clock or your sleep drive?
AUDIENCE: Lights.
[INAUDIBLE]
SOPHIE BOSTOCK: Lights.
Lots of light,
lots of technology.
So it turns out that the
brilliant designers of laptops,
phones, they
typically like to use
the same wavelength of light,
blue light, which mirrors
the midday sun, the
strongest alerting
signal that you can get.
And you've also got
sort of caffeine.
You've also got people
grazing through the day.
One of the things the body
clock likes is routine.
It likes to know the times
where you can actually
sit and rest and digest a meal.
It is going to depower
your stress response system
because you're forcing
it to kind of properly
stop, rest, and digest.
If you graze, you don't
have those same intervals
through the day.
The sleeplessogenic environment.
So what can you do if
you are out of sync
with your body clock?
I know I've already
mentioned having a routine.
But this really is incredibly
important to help your body.
If your routine is haphazard--
so sometimes you go to bed
at 11:00, sometimes 1:00--
your body doesn't know
when to produce melatonin.
So it just doesn't.
It just kind of holds back.
Whereas if you have
a regular routine,
your body can anticipate
what's going to happen.
It can help.
It will make you feel tired
at the same times each day.
We've mentioned lights.
One of the best things
is just to go outside.
I'm sorry that I'm keeping
you inside this lunchtime.
Hopefully, we'll finish
a little bit early
and you can go out and soup up
a lot of nice natural sunlight
to keep you going.
Caffeine, obviously, I've
said masks your sleep drive.
So I'm not saying don't use it.
It could also be really
good for alertness.
But use it strategically.
Be aware that the half life
of caffeine is six hours.
So six hours later,
you've still got
half of the kind
of virulence, half
of the power of that cup of
coffee in your bloodstream.
The recommendation
in this country
is you shouldn't have
more than 400 milligrams
of caffeine in a day.
That's about two or three
cups of filtered coffee or two
Starbucks, I think.
So just be really aware
of how much you're having.
And if you need pepping
up, try sunlight
or try other natural energizers.
So exercise actually tends
to kickstart the body clock.
Social interaction.
Stop and have a chat.
It's really-- it really
gets your body clock going.
It makes you feel
naturally alert.
OK.
Finally, the final reason
that I think a lot of us
really can't sleep.
And that's insomnia.
So most of those
other reasons, there's
at least a voluntary element.
We are making choices, which
are depriving us of sleep.
But for some of
you in the room, I
am sure you're sitting there
going, I've tried all this
and I still can't sleep.
Insomnia is a condition where
you can't get off to sleep,
you can't stay
asleep, or you wake up
feeling unrefreshed for at least
three nights a week or more
for three months or more.
So very much a
chronic condition.
And what tends to happen is
that just like many of us,
there's some sort of stress that
temporarily stops you sleeping.
But this lack of
sleep actually becomes
a source of stress and anxiety.
Often, people with insomnia even
going into their own bedroom,
they start to feel anxious.
So what do you do
if you're trying
to cope with a lot of
stress and anxiety?
There's usually some sort
of behavioral compensation.
For some of us, it's alcohol.
We need to relax.
And actually, alcohol--
yep, it does make
us relax in the short term.
Unfortunately, it totally
messes with your natural sleep
architecture.
You don't get the same
level of restorative sleep.
So you wake up
feeling unrefreshed.
Also messes with your memory.
So it makes people think
that they're coping.
But actually, it
makes the sleep worse.
And so then they
start to believe
that they'll never sleep again.
These very unhelpful thoughts
and cognitions, defeatism
around sleep, very
often insomnia
increases the risk of anxiety,
depression, as well as
a number of other
stress-related illnesses.
So you get into this state of
chronic physical and mental
hyperarousal.
If you put someone with
insomnia into a brain scanner
what you'll see is that
their brain is more active--
not just during the
day, but also at night.
So you've got to be able
to redress the balance.
I mentioned earlier this fight
or flight stress response.
So we have two arms
of this thing called
the autonomic
nervous system, which
controls all of our
unconscious functions
like breathing, and our heart
rate, and our digestion.
And in insomnia,
you've kind of got--
you're overloading this fight
or flight stress response.
And what you want
to do is wake up
this parasympathetic
converse action
of the body for rest and digest.
So what can you do?
Basically, you've got to tackle
both the thoughts associated
with insomnia-- the unhelpful
sleep thoughts-- and also
the behaviors that
are making it persist.
So there's a couple of quick
techniques I can give you--
a cognitive technique,
putting the day to rest.
This is very, very simple.
It's free.
And it involves a piece
of paper and a pen.
So when you are doing that
wind down routine before bed,
protect five or 10 minutes.
Sit down with a piece of
paper and your pencil,
and write down what's worrying
you-- just what's on your mind,
what you're thinking about
that you need to do tomorrow.
Make sure that you
commit it to paper
and put it next to your bed
so that if you are lying there
trying to get to sleep but
these thoughts keep popping
into your mind, you
can just tell yourself,
it's on the page.
It will still be there tomorrow.
You do not need to
think about it now.
It almost sounds too
simple to be effective.
But one trial found that even
this simple intervention alone
could increase, significantly,
people's ability
to fall asleep.
But there are behavioral
techniques as well-- so all
of the things that I've already
mentioned, plus some extras.
So there's one called
the Quarter Hour Rule.
If you are in bed unable to
sleep for more than 15 minutes,
get up.
Get out of your room,
go somewhere else
until you feel your eyelids
heavy and starting to close.
What you want to do is break
any sort of negative connection
between yourself,
and your bedroom,
and being unable to sleep.
Your bedroom should be this
haven for sleep and intimacy.
That's allowed.
And everything that I've been
talking about today-- all
the tips, all the science--
is actually part of a toolkit
that we call CBT, cognitive
behavioral therapy
for insomnia.
And it's actually the
recommended first-line
treatment for insomnia--
so tackling the
negative thoughts
and negative behaviors.
There is a little bit
of a problem with CBT
for insomnia, in that very few
people are actually trained
to deliver it at the moment.
If you can get it
on the NHS, it tends
to be a very long waiting list.
And it was this that
actually inspired the company
that I work for--
so a professor of sleep
medicine called Colin Espe,
had been a clinical
psychologist for 30 years,
seeing patients, helping
them with CBT for insomnia,
and knowing that he
couldn't possibly
help all the people
that needed help.
So he actually worked with
a former insomnia patient
called Peter Haynes to create an
online, digital version of CBT
for insomnia.
So essentially, it automates
all of the functions
that the therapist would
go through with you,
and teaches you the tools and
techniques to sleep better.
So if you find your
way to Sleepio,
you'll be able to do a very
quick online sleep test.
This takes less than
two minutes to fill in.
And it gives you a sleep
score, between naught and 10.
If you have 10 out of
10, congratulations.
If you do not, hopefully there's
more we can do to help you.
So you can sign up for a few
sort of evidence-based sleep
guides that you get by email.
But the main thrust
of the program
is actually a weekly session
with The Prof, your animated
sleep expert.
THE PROF: Hello there, Sophie.
I am The Prof.
And I'm here to do everything
I can to help you sleep better.
Now, you may be thinking,
why should I trust
you to tell me what to do?
Well, everything we
do here at Sleepio
is rooted firmly in
scientific evidence.
SOPHIE BOSTOCK: So you
meet The Prof each week,
and he teaches you
tools and techniques.
And you use a sleep diary
to track your progress.
And the nice thing
about being mobile
is that obviously at any
time of day or night,
you can be helped to
know what you should be
doing to optimize your sleep.
And The Prof mentioned evidence.
Now, I just wanted to make
you aware of one study
that you may or may
not be aware of.
This is a few years
ago, back in 2014.
We started speaking to
Google about Sleepio.
And they said,
well, you have got
a randomized
placebo-controlled trial.
And that's interesting.
But will it work for Google?
Because we are different.
So we did-- we did another
trial with 270 Googlers.
We randomized them
into two groups,
either using Sleepio
or just carrying on
with whatever they
were doing at the time,
followed them up
after eight weeks.
And then the group who used
Sleepio were able to continue
to use it they wanted to.
And the second group got access.
And we measured things like
sleep quality and well-being.
I'm just going to show
you one piece of data,
which is on well-being.
So here, you can see group
one, significant uplift
in well-being.
And this was things
like, I'm satisfied
with my overall well-being.
I'm able to detach from
work during non-work hours.
I'm able to cope effectively
with work-related stress.
And I feel that my
workload is manageable.
The improvements were
maintained three months later,
and the second group saw
very similar improvements
to the first.
And this just mirrors
what we've now
seen in eight randomized control
trials in over 6,000 people.
CBT for insomnia works.
And if you want to read more,
there's a fascinating paper
that you can find.
Since then, actually,
an awful lot of Googlers
have been using the program.
Over 550,000 have met The Prof.
And on average, they're getting
2 and 1/2 extra hours of sleep
each week.
And they're reporting less
stress and less anxiety.
So you could try it.
I don't know, it
might be helpful.
So just to sum up, I
haven't written a book.
I tried to come up with
some memorable acronym.
And I'm not sure
that I've succeeded.
But I was thinking harness
the power of sleep.
So P is for planning ahead,
prioritizing that seven hours.
O is for getting outdoors
as much as possible.
W is protecting that
wind down routine.
Whether you have 30
minutes or 60 minutes,
make that time work for
you in unwinding for sleep.
E is for energizing.
You still want to energize
your body during the day.
But do it as
naturally as you can.
And think about
limiting your caffeine,
switching out caffeine for
decaf where it makes sense.
And finally, R--
I've said this a
lot of times today--
routine, routine, routine.
That's really going to
help your body clock.
And set reminders on your
phone, remind other people
in your family that actually
you're going to try this
and commit to it because it
will be better for all of you.
That's it.
[APPLAUSE]
AUDIENCE: Hi, thanks
for the speech first.
And I have a question
regarding sleeping with light,
natural light, versus
sleeping in darkness.
Because I personally have
a problem with light.
So I wake up at 6:00 if the
natural light is there at 6:00,
or the same with every time.
So what is the suggestion?
Or is there kind of
a rule or something?
SOPHIE BOSTOCK: So
are you thinking
when it gets light
in the mornings,
it's disturbing your sleep?
You don't want to
get up at 6:00 ?
AUDIENCE: Yeah, yeah.
Like for example, if my
routine is seven to eight hours
and it starts at
midnight or at 11:00,
it doesn't work if
the sun rises at 5:00.
SOPHIE BOSTOCK: Absolutely.
And if you didn't
have to go to work,
and you were able to live on
the savannah quite happily,
you wouldn't mind.
And you would rise
naturally with dawn.
And that would be fine.
Your body clock would
adjust through the year.
But yes, we all have
other commitments.
So if you actually want to
sleep for longer, very easy.
Make sure that you
have blackout blinds.
Really try and
interfere, actually,
with that morning sunshine
if that's not what you want.
Sometimes you will say yes,
but my partner wants the sun.
What do I do?
There's a very
simple intervention
called a sleep mask--
a soft-- I know.
It's very, very cheap,
very, very simple.
Often, if you wear one for
a night or two, you're-- oh,
I don't know about this.
But actually, most people who
stick to it for three or four
nights, they're like
oh, actually this really
makes a difference.
And one of the advantages
of wearing a sleep mask
is if you go traveling,
it's something
you can take with you anywhere.
And if you are developing a
napping habit because actually,
you are unable to get enough
sleep during the night,
having a sleep mask
sort of with you,
it kind of creates a
little cocoon effect
that can be quite helpful.
So yeah, if light is disturbing
you, block out the light.
AUDIENCE: Yeah, thanks a lot.
So can you speak a bit
about using some medication,
say melatonin?
Because I know, for
instance, in the US
you can buy it in any pharmacy.
But here you can really--
you need to get prescription.
So is there a kind of
consensus about it?
SOPHIE BOSTOCK: Yeah, so
that's an interesting one.
melatonin is a natural
hormone, as we saw.
It definitely signals to the
body that it's time for sleep.
But what it doesn't do is
override your stress response.
So it's not a very
powerful hormone
in terms of tackling insomnia.
So the effects of using
melatonin on insomnia
are pretty much null.
They're not strong.
What melatonin can
be very helpful
for is if your body clock is out
of sync with the environment.
Because it's really something
that influences your body clock
more than anything.
So if you're jet-lagged,
actually very, very helpful
for adjusting over time.
There are some questions
about melatonin,
just like most other
natural hormones.
If you're taking it, does it
mean that your body is actually
going to produce less?
And I think that's
a potential concern.
But I'm not sure
that the research
is being done long term to work
out whether actually taking
artificial melatonin
may in some way
disrupt your natural patterns.
So with most of these things,
I wouldn't take something
artificial for a long time.
It'd be much better to
sort your habits out.
But if you have a
short term stress,
like lots of travel and jet-lag,
I think very, very helpful,
perhaps.
AUDIENCE: Hi, I'm
just wondering--
thank you for the talk.
I'm just wondering what's your
view on the quantification
and measurement of other sleep
stats all the watches we have,
et cetera.
And second question is, any
tips for taking power naps?
Because sometimes it's very
difficult for me to fall asleep
after I'm awake.
SOPHIE BOSTOCK: Yes.
OK, so first question
about measurement.
So the only way to
know exactly what's
going on during the brain--
in the brain during
sleep, is to measure
the electrical impulses-- so
an electroencephalogram, which
will actually tell you the
different stages of sleep.
And I didn't show it
in the presentation.
We tend to have
around about sort
of three main stages of
sleep, and then a REM,
rapid eye movement, sleep.
So stage one, very light sleep,
can very easily get woken up.
Few people dipping
into stage one now.
And then stage two is
a kind of true sleep
where your body temperature
starts to go down,
blood pressure
starts to go down.
But stage three is where it's
very, very hard to wake you up
and you've got growth
hormone being produced.
And then you come back through
these cycles of REM sleep,
dream sleep, which is
so important for memory
consolidation and
emotional balance.
So basically, we sleep in
these five or six sleep cycles.
Most of the trackers
that you wear,
they used to just
rely on movement.
And it so happens
that during REM sleep,
your body is actually paralyzed.
So-- we think--
so that you can't
act out your dreams.
So they use an algorithm
based on your movement
to kind of predict ah, OK, that
was a period of not moving.
That must be the end
of the sleep cycle.
That's not a very good way
of estimating whether or not
somebody is awake or asleep.
Because we can all lie very
still and not be sleep.
The newer new age
kind of trackers,
which use heart rate
variability or pulse rate, those
seem to be better.
But there's been relatively
little published validation
to show that they are as
good as a polysonogram, where
you go into the lab and have
lots of things measured.
But I did see a
small study recently,
which was using one of the
Fitbit kind of new age--
which actually showed pretty
good sort of specificity
and sensitivity to sleep.
What you probably
don't want to do
is compare your sleep
to somebody else's sleep
using those trackers.
I think it's OK to use
it as a guide for you.
But then you've got to
ask, why am I using it?
The best measure
of whether or not
you are getting
good quality sleep
is how you feel during the day.
And your tracker can't
really help you with that.
The second question
was about naps.
Any top tips for naps?
So a lot of us will have
this very strong body clock.
And actually, we won't have a
very strong lull after lunch.
And it's quite
hard for us to nap.
If you don't feel
sleepy, don't nap.
That's one thing.
It is something to
adapt as a habit.
Your body clock learns.
So if you keep
trying and protecting
your 20 minutes after lunch
when you think you are probably
in need of a re-boost, even if
you're just sitting quietly,
maybe you're meditating,
it's probably still going
to have a restorative effect.
Because you'll
probably still be able
to up your parasympathetic
nervous system, your rest,
your digest, and start to
feel physically refreshed even
if you haven't done all of
the memory kind of recharging
in the brain.
So I think it's still
worth having a break
even if it's not a nap.
AUDIENCE: OK, I have
a quick question.
So first of all, thank
you for coming to Google.
This is really great.
I've really enjoyed it.
So thank you for that.
Quick question
about winding down.
So for instance,
I have the problem
of waking up really early.
So I try to go to bed early.
But because I'm always on--
like very switched on--
in the morning I'll wake
up like, 5:00, right?
And then I can't get back to
sleep until, let's say 6:30--
a reasonable time to get up.
So I'm wondering any tactics
for continuing to sleep, right?
If you've gotten, let's
say, six hours but you
wake up because
you're kind of wired,
how do you actually get
yourself, for another hour,
into sleep mode?
SOPHIE BOSTOCK: I'm sure
there's a lot of people probably
in the room who are interested
in the answer to that one.
And what interested me
there is that you've said,
you know, I wake up so
early in the morning,
so I try and go to
bed earlier at night.
And that's kind of your mistake.
You're waking up,
exactly as you say,
because you're a
bit sort of wired.
You are kind of in this
vigilant sort of state.
So there's a lot in terms of
the relaxation techniques,
and learning to detach from all
this exciting stuff going on
in life.
But there's also something in
increasing your sleep pressure.
So one of the things
that we do in CBT
is to use a technique called
sleep restriction, which
sounds very counter-intuitive.
But it actually involves
pushing your bed time back.
So if you normally
go to bed at 10, say,
but you're waking up at 5:00
in the morning despite the fact
that you wanted to sleep
until 7, maybe in that time
you're only getting
six hours sleep.
So by tracking your sleep over
a couple of weeks using a sleep
diary, the advice would be,
OK, try and go to bed at 1:00
in the morning.
Set your alarm
for 7:00, whenever
your desired wake-up time is.
You're going to get
incredibly tired
trying to keep yourself awake.
But you will build up a
stronger sleep pressure.
And you'll start to
sleep through the night.
And then as you start to
sleep through the night,
you can increase
your sleep window.
The other way to do
it is a slightly sort
of softer approach.
Rather than going straight
in for 1:00 in the morning,
you could just
compress a little bit.
And keep compressing if it's
not sort of working for you.
But that sleep
restriction idea gets
introduced in week three
of the Sleepio program.
It's probably the single most
powerful technique in CBT
for helping people reset that
sort of wakefulness early
in the morning issue.
So definitely give that a go.
AUDIENCE: Thank you.
AUDIENCE: I'll
sneak in a question
from someone who is not in the
room-- we have a Dory today.
So the question is, do alarms
based on the sleep cycle,
deep versus light, work?
SOPHIE BOSTOCK: So I think that
relates to the sort of tracking
question.
Unless your brain
is cued into a lab,
it's very difficult to know
what stage of sleep you're in.
I haven't seen a lot
of convincing evidence,
but that's probably because
a lot hasn't been published.
If it works for
you, I say use it.
And a lot of this kind of sleep
science, it's very individual.
If there's something
you find reassuring--
so for example, chamomile tea.
Some people swear by it.
The actual evidence
from scientific trials
is pretty equivocal--
probably doesn't
really do very much.
But there's a very
strong placebo effect.
Anything that makes you feel
like you are sleeping well
is probably a good idea
for you, personally.
Even if the science is
a bit kind of shaky.
AUDIENCE: Hi, what
do you recommend
for winding down at night?
The other question is if I
want to go to bed at 11:00,
is it a bad idea to go to the
gym like between 9:00 and 10:00
in the evening?
SOPHIE BOSTOCK: OK, I'll take
off at the gym one first.
It used to be thought--
the advice used to be
not to exercise late at night.
And the reason being because
it increases your body
temperature.
It really gets the body going.
And there was some
evidence that absolutely,
if your body is too
hot, you cannot sleep.
So one of the things I didn't
mention is to cool your room.
So an ideal room temperature
is 18 degrees, supposedly,
with air circulating
if possible.
So subsequent to
that, the advice
is actually some
people are really
quite effective at cooling down,
like mentally and physically,
after they've been to the gym.
So I would have thought that if
you're doing something highly
aerobic, it's going to take
you at least an hour if not 90
minutes to properly
calm down after that.
So you want to allow
enough time for that.
But this is about being
a scientist of yourself
and kind of experimenting.
You know, if you push that
exercise time a little bit
forward, does it make you
sleep better, and so on?
Because it will be different
for different people.
In terms of the
wind down routine,
you can ask parents what
they do for their kids,
and everyone's probably got
a slightly different pattern.
But they get into a pattern.
And that's what's important.
That's what gets reassuring.
It doesn't matter if you
have a bath or a shower,
or you read, or you meditate.
I know that Google's got
some really good resources.
I know you've got--
Headspace is
available if you want
to learn mindfulness meditation.
Just reading a book
that is not energizing,
sort of alerting,
light-filled experience,
watching TV so long as you are
far enough away that you're not
getting overstimulated
by the content.
I definitely wouldn't do
that right before bed,
but as part of an hour-long
wind down routine, that
might be fine.
It's just about psychological
and physical kind
of detachment from the day.
AUDIENCE: Yes, I wanted to
ask you about noise in the
because we talked about
light in the morning.
Like earplugs-- I
mean, maybe it's not
good to use them every night.
I'm wondering about other ways--
can you train yourself to not
be sensitive to noise,
or noise generators,
or what do you suggest?
SOPHIE BOSTOCK: Good question.
Some people definitely
find white noise machines
very useful.
This doesn't have to be
something very expensive.
It could be a fan.
I think Wayne
Rooney swore by it.
He said he couldn't
sleep without the noise
of the washing machine
or something like that.
There are certain noises
which block out other sounds.
So a fan and similiar
can be quite good.
An artificial noise
machine, absolutely fine.
There isn't any evidence that
so long as it's not too loud,
that that's going to
disrupt your sleep.
I also don't think
there are any issues
with using earplugs
long term, provided
that they're good quality.
But I wouldn't worry about
using earplugs as a negative.
I think, actually
it's quite sensible.
SPEAKER: Time for
one more question.
AUDIENCE: Oh wow, thank you.
We could go on.
So during the week, I
rarely get enough sleep.
And then on the weekend,
I do sleep longer.
Is that sufficient?
I mean, you talked about
the brain self-repairing.
SOPHIE BOSTOCK: Yeah,
so here's the thing.
It's better to sleep
than not to sleep.
So great that you're making
an effort to catch up
on sleep at the weekend.
But for every night
of short sleep,
you are feeling those effects.
On your Tuesday, your Wednesday,
your Thursday, and your Friday,
you are building
up that sleep debt.
So by Friday afternoon,
I hope you're not
operating heavy machinery.
But it's not ideal.
If you can find even just
an extra half an hour
during the week, what
you'll actually find
is that you have more weekend.
You've got more of
a life because you
don't have to worry about
catching up on your sleep.
The other thing is that
come Monday morning,
you're effectively
giving yourself jet-lag
if you have a different pattern
during the week to the weekend.
And there is some research
evidence that come out
suggesting that of
this sort of pattern--
we do call it social jet-lag--
could increase risks of high
blood pressure, of weight gain.
It's putting more pressure on
your body than is necessary.
So if you can find more
of a balance, great.
SPEAKER: All right,
thank you very much.
SOPHIE BOSTOCK: Thank you.
[APPLAUSE]
