‘Dreamland: Adventures in the Strange Science of Sleep’ by David K. Randall (W.W. Norton & Company; August 13, 2012)
*A podcast discussion of this book is also available via the following link:
**The podcast is also available for download on iTunes.
Table of Contents:
i. Introduction/Mini-Summary
PART I: THE BASICS OF SLEEP: FROM THE EVOLUTION OF SLEEP, TO REM AND THE SLEEP CYCLE, TO SLEEP DEPRIVATION, TO THE BENEFITS OF SLEEP, TO THE MEANING OF DREAMS
1. The Evolution of Sleep
2. Sleep-Deprivation
- a. Randy Gardner: World Record Holder
- b. Sleep-Deprived Subjects in the Lab
- c. Sleep-Deprived Rats in the Lab
- d. The Extremes of Sleep-Deprivation: Fatal Familiar Insomnia
3. REM and the 5 Stage Sleep Cycle
4. The Benefits of Sleep
- a. Recharging the Prefrontal Cortex
- b. Learning and Memory Formation
- c. Problem-Solving and Creativity
5. The Meaning of Dreams
PART II: NATURAL SLEEPING PATTERNS AND CIRCADIAN RHYTHMS & HOW SOME ORGANIZATIONS (INCLUDING SCHOOLS, BUSINESSES, THE MILITARY, AND SPORTS TEAMS) ARE APPLYING THE SCIENCE OF SLEEP IN THEIR OPERATIONS
Section 1: Our Natural Sleeping Patterns and Our Circadian Clock
6. The Two Sleeps
7. Our Circadian Rhythm (and the Naturalness of Napping)
8. How Our Natural Sleeping Pattern Changes as We Age
Section 2: How Organizations Are Applying the Science of Sleep in Their Operations
9. The Science of Sleep in Education
10. The Science of Sleep in Business
- a. Naptime at the Office
- b. The Fatigue Management Industry
11. The Science of Sleep in the Military
12. The Science of Sleep in Sport
PART III: SLEEPING ARRANGEMENTS: PUTTING YOUR KIDS TO BED, AND SLEEPING WITH A PARTNER
13. Putting Your Kids to Bed
14. Sleeping with a Partner
PART IV: SLEEPING DISORDERS AND REMEDIES: SLEEP APNEA, SLEEPWALKING AND INSOMNIA & IMPROVING YOUR SLEEP
15. Sleep Apnea
16. Sleepwalking
17. Sleeplessness: Difficulty with Sleeping and Insomnia
18. Improving Your Sleep
19. Conclusion
i. Introduction/Mini-Summary
We spend up to a third of our lives sleeping, and yet, unless we are not getting enough of it, and/or are experiencing a sleeping disorder of some kind, most of us hardly ever give our sleep a second thought (other than to rue over how much precious time it takes up). Science too largely neglected sleep for the longest time, treating it mainly as a static condition during which the brain was not doing much of anything interesting. However, ever since rapid eye movement (REM) was discovered in the 1950’s the science of sleep has really taken off, and the discoveries that have come out of it go to show that this unconscious period is more interesting than we ever could have imagined. It is these discoveries that writer David K. Randall explores in his new book ‘Dreamland: Adventures in the Strange Science of Sleep’.
Randall himself became interested in the world of sleep as the result of injuring himself when he ran into a wall while sleepwalking one night. The doctor he went to was unable to give him any straight advice with regards to preventing future bouts of potentially harmful somnambulism, and this got the author to thinking about other facets of sleep about which he had questions. This curiosity ultimately led Randall to do some investigating into the strange science of sleep, and the end result is this very interesting and informative book.
The book is split into 13 chapters, with each chapter (outside of the introduction and conclusion) exploring a separate topic in the world of sleep. In the book we learn about such basics as REM sleep and the 5 stage sleep cycle, as well as the benefits of sleep and the harmful effects of sleep deprivation. It turns out that sleep is instrumental in such things as muscle regeneration, long-term memory formation, skills acquisition, problem-solving, emotional control, and creativity. Dreaming, we find, plays an important role in many of these benefits, thus making it seem far less likely that Freud was correct in thinking that dreams are actually a manifestation of subconscious wish fulfillment.
We also learn that our natural sleeping pattern is set by our circadian clock, and that many of our routines in the modern world run somewhat against this natural pattern. As it turns out, these routines not only have a negative effect on our sleep, but on our waking lives as well. Fortunately, many organizations are now beginning to take these lessons to heart, and are modifying their policies and practices to help ensure that their members are better-rested, so as to lessen the negative effects of fatigue. For instance, high schools are starting later; businesses are allowing their employees to take naps, and hiring on fatigue management consultants to help eliminate the effects of under-rested employees; sports teams are hiring trainers to ensure that their players are getting enough sleep, and to manage the difficulties of inter time-zone travel; and the military is allowing its soldiers more rest during peace time, and also monitoring and managing sleep during combat.
We also learn about the difficulties of, and the controversy surrounding putting your children to bed, and how the practice of co-sleeping (sleeping in the same bad with your infant) is making a come-back. At the same time, the tradition of sleeping in the same bed as your partner is taking a hit, as more and more couples experiment with sleeping in separate beds—and even in separate bedrooms.
Last but not least, we learn about sleeping disorders such as sleep apnea (continual waking up due to blockage of the windpipe), and the billion dollar business of treating and controlling this very distressing (and potentially deadly) disorder; sleepwalking, and the bizarre phenomenon of crimes committed while sleepwalking (including child molestation, rape, and even murder)—as well as how the justice system is dealing with these very troubling cases; and also insomnia, and the sordid history of sleeping pills—as well as the latest techniques in fighting sleeplessness, including cognitive behavioral therapy.
Fortunately, we also learn that there are several ways to improve our sleep other than with pills or therapy, such as avoiding coffee, alcohol and bright light before bed; getting some regular exercise; turning down the room temperature before bedtime (and/or taking a cool shower); and practicing some breathing techniques to help us fall asleep.
What follows is a comprehensive summary of David K. Randall’s Dreamland: Adventures in the Strange Science of Sleep.
PART I: THE BASICS OF SLEEP: FROM THE EVOLUTION OF SLEEP, TO REM AND THE SLEEP CYCLE, TO SLEEP DEPRIVATION, TO THE BENEFITS OF SLEEP, TO THE MEANING OF DREAMS
1. The Evolution of Sleep
Most of us spend about a third of our lives asleep. Indeed, the average person requires about 1 hour of sleep for every 2 hours awake (loc. 110), and your body takes specific measures to ensure that it is in fact getting its quota, as “each hour of missed sleep one night will result in deeper sleep the next, until the body’s sleep debt is wiped clean” (loc 110).
And we’re not the only species who displays the need for sleep, of course. As Randall notes, every animal on the planet requires sleep, though the amount that each needs does vary quite a bit (as we shall see in a moment).
For something as time-consuming and seemingly necessary as sleep, you might think that its evolutionary value would be obvious, but sleep actually presents quite a conundrum in terms of its adaptive function. Indeed, as Randall points out, “sleep interferes with other more biologically pressing needs, such as procreating, finding and gathering food, building shelter, and anything else you might do to ensure that your genetic line lives on” (loc. 107). What’s worse, the author continues, “a sleeping animal must lie still for long stretches at a time, all but inviting predators to make it dinner (and not in a good way)” (loc. 97).
Given that the danger of lying vulnerable for long spells is much more of a problem for prey species than for predators, you may think that the former would have evolved a way to get by on less sleep than the latter (loc. 102), yet no such general rule holds. Indeed, as Randall points out, “lions and gerbils sleep about thirteen hours a day. Tigers and squirrels nod off for about fifteen hours. At the other end of the spectrum, elephants typically sleep three and a half hours at a time, which seems lavish compared to the hour and a half shut-eye that the average giraffe gets each night” (loc. 103).
While species lower down on the food chain do not necessarily sleep less than those higher up, several species have evolved a way to limit the danger posed by sleep, and that is by resting with only half of their brain sleep at a time. Indeed, this strategy is employed by several species of birds and also dolphins: “a dolphin, for instance, will sleep with half of its brain awake at a time, giving it the ability to surface for air and be on the lookout for predators while the other half is presumably dreaming. Birds, too, have adapted the ability to decide whether to put half of their brain to sleep or the whole thing” (loc. 97).
Certainly, sleep must be doing something very important for us, but the fact is that the true biological function of sleep still remains a bit of a mystery (loc. 93). Having said this, though, exploring the benefits of sleep, and just what happens to you when you are deprived of it, does help shed light on the issue.
2. Sleep-Deprivation
a. Randy Gardner: World Record Holder
The world record for staying awake is 264 hours (11 days), and belongs to Randy Gardner, an American from San Diego who was a high school student and just 17 years old when he performed the feat in 1965. A team of sleep researchers from Stanford University happened to read about Gardner’s attempt in a local newspaper and decided to show up to document the trial (loc. 113). Here’s how Randall describes the event: “for the first day or so, Gardner was able to remain awake without any prompting. But things went south quickly. He soon lost the ability to add simple numbers in his head. He then became increasingly paranoid, asking those who had promised to help him stay up why they were treating him so badly” (loc. 116). When Gardner did eventually go to sleep, he slept for over 14 hours straight, and apparently much longer than usual for the next week. As Randall notes, though, “a few weeks later he was as good as new” (loc. 116), and no long term effects have been noted from the experiment.
b. Sleep-Deprived Subjects in the Lab
Sleep researchers conducting sleep-deprivation experiments with subjects in the lab have uncovered similar (though much more detailed) findings to those mentioned above. Here is Randall explaining the experience of a typical sleep-deprived subject: “within the first twenty-four hours of sleep deprivation, the blood pressure starts to increase. Not long afterward, the metabolism levels go haywire, giving the person an uncontrollable craving for carbohydrates. The body temperature drops and the immune system gets weaker. If this goes on for too long, there is a good chance that the mind will turn against itself, making a person experience visions and hear phantom sounds akin to a bad acid trip. At the same time, the ability to make simple decisions or recall obvious facts drops off severely” (loc. 143).
As the last part of this quote makes clear, and as we might well expect, sleep deprivation drastically impairs cognitive functioning. To elaborate on this point, other experiments have shown that sleep deprivation slows down the firing of neurons in the prefrontal cortex (loc. 1569). Now, the prefrontal cortex is essentially the control center and executive decision-maker of the brain: “like a conductor in an orchestra, this part of the brain strives to hit the right balance between responses from the emotional parts of the brain and those from the areas responsible for higher thought. The outcome is a decision… It notices patterns, and when something novel pops up, it goes to work assessing how new information gels with what the brain already knows. It is responsible for a wide range of decisions, both conscious and unconscious, from the recognition that the person walking toward the car is your brother to whether investing in a condo in Phoenix is a good idea” (loc. 1552).
Since sleep deprivation slows down the prefrontal cortex, then, as we might expect, it makes a hash of our decision-making, and our ability to adapt to new situations. One sleep deprivation study presented subjects (who were MBA students) with a business venture and allowed them to develop strategies to grow their business (loc. 1558). Halfway through the experiment, though, the researchers altered the conditions and introduced competitors that threatened the market share of the original business venture (loc. 1560). Most of the subjects who did not have their sleep restricted were able to adapt to the new circumstances, and switched business strategies to respond to the new set of conditions. Sleep deprived subjects, on the other hand, were not able to adapt, and instead held on to their ineffective strategies as they watched their business go into the tank: “students who slept well watched their sales suffer when new competitors first entered their imagined marketplace, but most were able to recover quickly and adapt. Their counterparts didn’t fare nearly as well. After thirty-six hours, the sleep-deprived students were unable to cope with the unseen changes in the game. They continued to rely on what had worked before, not recognizing that these moves now cut into their bottom line. Soon, each was bankrupt” (loc. 1564).
Other sleep deprivation studies have found that cutting off sleep severely curtails the ability to learn and retain new information, and also corrodes emotional control (loc. 1211, 1398) (these points will be explored in greater detail below, where we cover the benefits of sleep). What’s more, it has been shown that these effects are even more pronounced in teenagers than in adults: “the lack of sleep affects the teenage brain in similar ways to the adult brain, only more so. Chronic sleep deprivation in adolescents diminishes the brain’s ability to learn new information, and can lead to emotional issues like depression and aggression. Researchers now see sleep problems as a cause, and not a side effect, of teenage depression” (loc. 2357).
c. Sleep-Deprived Rats in the Lab
While there are certain limits to how far researchers can push the boundaries of sleep deprivation in humans, they have been able to push past these limits when it comes to other animals—chief among the victims here being the poor lab rat. In the 1980’s, for instance, researchers at the University of Chicago decided to test what would happen to lab rats when they simply removed sleep as an option: “in but one of the many odd tests you will find in the history of sleep research, these scientists forced rats to stay awake by placing them on a tiny platform suspended over cold water. The platform was balanced so that it would remain level only if a rat kept moving. If a rat fell asleep, it would tumble into the water and be forced to swim back to safety” (loc. 120).
Here is Randall explaining how the rats fared: “as the rats went longer and longer without sleep, their bodies began to self-destruct. They developed strange spots and festering sores that didn’t heal, their fur started to fall out in large clumps, and they lost weight no matter how much food they ate” (loc. 127). From here things only got worse, and within two weeks all the rats were dead (loc. 123). When the researchers performed autopsies on the deceased rats “lo and behold they found nothing wrong with the animals’ organs that would lead them to failing so suddenly” (loc. 127). It appears that lack of sleep by itself had killed the poor animals (loc. 130). The same experiment was redone in the 1990’s (apparently, scientists just can’t get enough of torturing rats), and, of course, the same results were found (loc. 130). With regards to what actually caused the rats to die, “the best guess was that staying awake for so long drained the animal’s system and made it lose the ability to regulate its body temperature” (loc. 133).
d. The Extremes of Sleep-Deprivation: Fatal Familiar Insomnia
Again, no scientist has tried this experiment with humans (as far as we know), but there is every reason to believe that it would ultimately end in the same way. We know this because there is a rare genetic sleeping disorder called fatal familiar insomnia (FFI), whose main symptom is the increasing inability to fall asleep (loc. 201). As Randall explains, “within a year of the first signs of the condition, patients typically die after suffering through months of agony, beset by chronic migraines and exhaustion” (loc. 201). In other words, if you don’t sleep, you simply can’t survive.
Here is a short documentary about this devastating disease:
So much for the dangers of sleep deprivation. But what about the actual benefits of sleeping? Just what does it do for us? Studying the effects of sleep deprivation already gives us some clue as the purpose of sleep, but in order to gain a better picture of just what benefits sleep provides we will need to tackle this question more directly. Before we do, however, it will help to gain a better appreciation of the mechanics of sleep by way of looking at REM and the 5 stage sleep cycle.
3. REM and the 5 Stage Sleep Cycle
Before the 1950’s researchers payed little attention to sleep, as “until the middle of the twentieth century scientists thought that sleep was an unchanging condition during which time the brain was quiet” (loc. 157). In 1952, though, a landmark discovery was made out of the University of Chicago, as researchers there who were observing sleeping subjects discovered the stage of sleep known as rapid eye movement (REM), “so named because of the rapid movements of your eyes dancing against your eyelids” (loc. 163). As Randall explains, the researchers at first “believed that a malfunctioning machine created the appearance that a sleeping subject’s eyes were moving rapidly during the middle of the night. Unable to detect the cause of the problem, the researchers decided to go into the room and shine a flashlight on the subject’s eyes. They found that the eyes were in fact darting back and forth under the eyelids while the body lay still” (loc. 1002).
As scientists probed further, they found that REM is but one of five stages of sleep that we cycle through roughly every 90 minutes (loc. 157). Each of the first four stages is deeper than the one before, as the brain slips further and further away from consciousness (loc. 160). So, for instance, if you are woken up during the first stage of sleep, “you might not realize that you were sleeping” (loc. ), whereas if you are woken up during stage 4, “you will be disoriented, unable to answer basic questions, and want nothing more than to go back to sleep, a condition that researchers call sleep drunkenness” (loc. 163). Also, it appears that stages 3 and 4 are quite a bit deeper than the first two, as “your brain takes a long ride away from consciousness” (loc. 160) as it transitions into stage 3. This being the case, only stages 3 and 4 are considered deep sleep (loc. 160).
REM is the last stage of sleep, and, interestingly, this is when the brain emerges out of deep sleep, and “the brain is as active as it is when it is awake” (loc. 163). Of even greater significance is that this is the stage of sleep during which most dreams take place (loc. 166, 1002).
The following is a clip from a documentary that gives an introduction to the 5 stages of sleep (with a focus on REM sleep) (links to the subsequent parts of the documentary are available below the clip–these subsequent parts focus mainly on REM sleep and dreaming [topics that we will return to below]).
Now that we have a better familiarity with the stages of sleep, we are ready to launch into the question concerning its benefits.
4. The Benefits of Sleep
a. Recharging the Prefrontal Cortex
To begin with, we have already seen that the prefrontal cortex—the executive decision-maker of the brain—slows down as it is deprived of sleep. One interesting thing about the prefrontal cortex is that—unlike the other parts of the brain, which are only active part of the time during the day—the prefrontal cortex is always on: “unlike other parts of the brain, the prefrontal cortex gets no benefit from the time that the body spends in a relaxed environment. Even when you are swaying in a hammock sipping a cool beverage on a sunny afternoon, this part of the brain is constantly on alert, making sure you don’t topple over or spill your drink/ The prefrontal cortex is working every waking second” (loc. 1552/1547). The only time in fact that the prefrontal cortex is deactivated is during deep sleep (loc. 1945). Given that this is the case, then, and given that prolonged sleeplessness wares down the prefrontal cortex, it seems clear that at least part of the function of sleep is to give this vital part of the brain a chance to recharge. As Randall explains, “while science still doesn’t know exactly how this happens, the time we spend in deep sleep is when the prefrontal cortex recovers and reboots for the next day’s work” (loc. 1554). The end result is that sleep leads to improved decision-making and emotional control (loc. 1398, 1560, 1626-47, 1667).
b. Learning and Memory Formation
It was also mentioned above that sleep deprivation hurts learning and memory formation. Now, another way to put this, of course, is to say that sleeping plays a crucial role in learning and memory formation, and this has been made clear in numerous studies involving several different types of learning. For example, beginning with the very simplest form of learning, it has been shown that “subjects who have been allowed to take naps… remembered a longer list of words than their peers who hadn’t been allowed to doze off” (loc. 1398).
Beyond just helping to retain factual information (otherwise known as declarative memory), sleep has also been shown to help with learning procedural information, such as how to drive a car or play a sport (loc. 1261). For instance, in 3 separate studies subjects were asked to perform a procedural skill, including the video game Tetris, the first person shooter game Doom, and a manual typing routine (loc. 1309, 1319, 1355). In each of the studies, some of the subjects were allowed to sleep before trying the task a second time, while others were not, and in each of the studies the subjects that were allowed to sleep ended up improving more than their non-sleeping peers (loc. 1316, 1322, 1356). What’s more, those who were allowed to sleep longer improved more than those who were allowed to sleep less (loc. 1366).
Interestingly, it appears to be dreaming in particular that is responsible for the improvement in procedural skills. This proves to be the case because it was observed that those subjects who were allowed to sleep between trials ended up dreaming of themselves performing the task in question (loc. 1312, ), and those subjects who dreamt more in this way improved more than those who dreamt less like this (loc. 1319, 1320, 1342).
One popular theory has it that the way that sleeping and dreaming may improve learning and memory is by wading through the information that the brain is exposed to during the day, and filtering out the less important information, and assimilating the more important information into long-term memory. The theory runs as follows: “when we learn something new—whether it is declarative, such as the facts of what happened at work last Wednesday, or procedural, like how to drive a car—the information flows through a part of the brain called the hippocampus. Storing all of this information into long-term memory not only is impractical but also could slow our brains down from finding something important when we need it. The brain picks and chooses what it keeps and what it tosses, so that information that isn’t essential is forgotten to make way for what is coming the next day” (loc. 1264).
Some scientists believe that a large part of this organizing process may take place during REM sleep in particular (which is when we dream), and that the images in our dreams may just be the result of this process at work (loc. 1264). If this is the case, then the peculiar way that the brain goes about this process may well “account for the randomness of dreams” (loc. 1264) (more on dreams below).
c. Problem-Solving and Creativity
Beyond learning and memory, it appears that sleeping and, again, dreaming in particular, may play an important role in problem-solving and creativity. Indeed, who among us has not, at one time or another, woken up feeling that we had solved a problem that we had been thinking about, or come to a decision we had been fretting over—or, better yet, dreamt up an epiphany? There are numerous stories of famous discoveries and problems being solved in this way as well. From Jack Nicklaus regaining his lost golf swing in a dream (loc. 1205); to August Kekule discovering the structure of benzene after he “woke up from a dream with a vision of a snake eating its own tail” (loc. 1219); to Samuel Taylor Coleridge waking up with 300 lines of ‘Kubla Khan’ in his head (loc. 1225); to Paul McCartney waking up with ‘Yesterday’ “just all there” (loc. 1228); to Stephanie Mayer dreaming up the idea for her immensely popular ‘Twilight’ series (loc. 1235) etc.
The contribution that sleep makes to problem-solving has been witnessed in the lab as well. For instance, in one study, researchers presented subjects with number puzzles of a particular kind—which puzzles had a significant, though not immediately apparent, shortcut (loc. 1274). None of the subjects were able to figure out the shortcut in their first attempts at the puzzles (loc. 1276). However, of those subjects who were given an opportunity to sleep between their first and second cracks at them, almost all of them were able to figure out the shortcut (loc. 1287); on the other hand, only 1 in 4 of the subjects that were not given this opportunity found the shortcut (loc. 1287). When it came to the sleepers, “sometime in the night, their minds were able to construct a novel approach to a problem they had faced while awake” (loc. 1290).
Just how does the brain do this? It appears as though sleeping and dreaming contribute to problem-solving and creativity by way of taking newly acquired information and mixing and matching it with previously held knowledge. Scientists suspect this for the following reasons: To begin with, it has been observed that the further on in the night you go, the more removed your dreams are from the objects and activities you have experienced during the day. For instance, subjects in the lab that had been made to play the kinetic video game Alpine Racer 2 (which has the player assume the role of an alpine skier), were woken up at various times during REM sleep throughout the following night. The researchers found that while the subjects dreamt of skiing early on in the night, the further on in the night they went, the more removed their dreams were from the act of skiing. So, for instance, “subjects began to say they were dreaming of things like moving quickly through a forest as if on a conveyor belt” (loc. 1345). It was as if the dreaming brain was taking the act of skiing and connecting it with things that were similar to, but further and further removed, from the act itself: “the literal replay of new information had started to evolve into analysis. Once an initial phase of dreaming passed, the brain began finding connections and associations with the data embedded on its memory cards” (loc. 1345). In other words, “the open interplay of emotions, facts, and fresh information allows our brains to see things in a new way,” thus opening up the opportunity for problem-solving and creativity.
Interestingly, if the sleeping brain does in fact stretch further and further to make connections as the night progresses, this may help explain why the dreams that we experience later in the night (which are the very ones that we remember the most) are so often disjointed and strange (loc. 1348).
5. The Meaning of Dreams
Up to this point we have considered dreams mainly in terms of their role in long-term memory formation, and creativity. However, there are certain dreams that do not seem to fit so easily here. I’m talking about narrative-driven dreams that are emotionally-charged (nightmares included), and that seem to capture our innermost hopes and fears—some of which dreams are eerily prophetic. Indeed, as Randall points out “most cultures, and nearly all religions, have regarded dreams as omens at one time or another” (loc. 938), and it is precisely these types of dreams that can make us see why.
In terms of the scientific community, up until the twentieth century the few scientists who had considered dreams were much more skeptical about just how meaningful they are, and they treated them instead mainly as meaningless gibberish (loc. 945). In 1900, however, the great psychologist Sigmund Freud changed all of this when he published his enormously influential The Interpretation of Dreams (loc. 946). Freud believed that dreams represent unconscious hopes and wishes that had been suppressed by the conscious mind, but which were allowed to come out in sleep as the conscious mind let down its guard (loc. 946). Even in sleep, though, these unconscious hopes and wishes remain hidden behind the symbols of the dream world (loc. 949). In order to discover the true meaning of a dream, Freud believed, these symbols had to be interpreted by a qualified therapist (loc. 949).
Freud believed that many of our suppressed unconscious desires were sexual in nature, and therefore, he thought that many of the images and objects that we encounter in our dreams represent sexual organs and/or acts. As Randall explains, “one review of Freudian literature found that by the middle of the twentieth century, analysts had identified 102 stand-ins for the penis in dreams and ninety-five symbols for the vagina. Even opposites—flying and falling—were called symbols for sex. Freudians pointed out fifty-five images for the act of sex itself, twenty-five icons of masturbation, thirteen figures of breasts, and twelve symbols for castration” (loc. 977).
Freud also believed that our affinity for certain objects and activities in our waking life bespoke repressed desires. Despite Freud’s infatuation with symbols, however, it appears as though he did allow for the possibility that certain objects, in at least some circumstances, represent nothing beyond themselves. For instance, Freud was an avid cigar smoker, and became famous for the following proclamation:
Freud’s theories remained very influential up until the 1950’s (loc. 988), but as scientists learned more and more about dreaming (including the fact that fetuses and even animals experience it [loc. 1020-22]) they began to seriously question the whole idea that dreams represent repressed hopes and wishes (loc. 1019).
The psychology professor Calvin Hall catalogued and studied dreams for over 30 years, and became convinced that dreams really don’t have any hidden meaning at all. Rather, he believed that dreams are simply an extension of our waking thoughts, jumbled up by the strange neurology of the night (loc. 1040). In other words, “the plot may not follow any logical order and characters may have strange requests, but the dream world isn’t that far from reality” (loc. 1043). On this view, if someone encounters a bridge in their dream, it is much more likely that they pass over a bridge every day on their way to work, than that the bridge represents something less literal—like a transition in life (loc. 1082).
One peculiar thing that Hall did find is that most dreams tend to be negative and/or frightful, and “the average dream is filled with characters who [are] aggressive, mean, or violent” (loc. 1046). This got the cognitive scientist Antti Revonsuo to thinking that maybe our dreams have evolutionary value. That is, perhaps “negative, anxiety-filled dreams were simply an ancient defense mechanism, letting us experience bad things in order to train our brains to react in case something similar happened while we are awake. Dreams, in this view, are the brain’s dress rehearsals” (loc. 1050).
Other scientists remain skeptical about this theory, however, and believe instead, somewhat like Hall, that we simply dream about the things that we care and/or are concerned about (loc. 1103), and that our dreams are but an “accidental by-product of our ability to think and have an autobiographical memory” (loc. 1106). In other words, “we dream about negative things… simply because we spend a lot of time worrying” (loc. 1106).
The following is an excellent documentary about the many facets of dreaming:
Whatever the truth about the meaning of our dreams may be, we will now turn our attention away from the dreamworld and towards out natural sleep-patterns and circadian rhythm—and how the modern world tends to make a hash of both.
PART II: NATURAL SLEEPING PATTERNS AND CIRCADIAN RHYTHMS & HOW SOME ORGANIZATIONS (INCLUDING SCHOOLS, BUSINESSES, THE MILITARY, AND SPORTS TEAMS) ARE APPLYING THE SCIENCE OF SLEEP IN THEIR OPERATIONS
Section 1: Our Natural Sleeping Patterns and Our Circadian Clock
6. The Two Sleeps
If you are like most people living in the industrialized West (or anywhere else industrialized, for that matter), you probably get your daily sleep all in one chunk, during the night. And, until recently, scientists had no reason to believe that this was anything but entirely natural. However, recent investigations have revealed that this sleeping pattern is actually somewhat removed from the one that nature assigned us, and that the pattern we now follow is largely the result of industrialization, and artificial light in particular.
The first sign that something was amiss came when the history professor Roger Ekirch kept coming across strange references in old books regarding two sleeps: a first sleep and a second sleep. Mention of the two sleeps came in every format from novels to medical books. For example, “a fifteenth-century medical book… advised readers to spend the ‘first sleep’ on the right side and after that to lie on their left. And a scholar in England wrote that the time between the ‘first sleep’ and the ‘second sleep’ was the best time for serious study” (loc. 267).
Further research revealed that, indeed, people once naturally split their sleep into two segments over the course of the night: “every night, people fell asleep not long after the sun went down and stayed that way until sometime after midnight. This was the first sleep that kept popping up in the old tales. Once a person woke up, he or she would stay that way for an hour or so before going back to sleep until morning—the so-called second sleep” (loc. 274).
The time between the two sleeps was an expected and cherished time, and people spent it in various ways, such as “praying, reading, contemplating [their] dreams, urinating, or having sex” (loc. 274). This last option was apparently most popular, and at least one French physician outright recommended it, as he “concluded that laborers were able to conceive several children because they waited until after the first sleep, when their energy was replenished, to make love. Their wives liked it more, too, he said. The first sleep let men ‘do it better’ and women ‘have more enjoyment’” (loc. 278).
Just as Ekirch was making his discovery, a psychiatrist named Thomas Wehr—who worked but 300 miles from Ekirch, at the National Institute of Mental Health in Bethesda, Maryland—was beginning to have suspicions that artificial light may have some unknown effect on sleeping patterns. In order to test this hypothesis, Wehr set up an experiment whereby he deprived subjects of artificial light for up to 14 hours a day, “in hopes of recreating the lighting conditions common to early humans,” (loc. 288).
Interestingly, the subjects spent the first few weeks of the experiment sleeping a lot more than usual. It appeared as though they were catching up on a huge backlog of missed sleep that they had “accumulated from staying out late at night or showing up at work early in the morning” (loc. 288). By this time in the experiment, the subjects were feeling better-rested than they had ever felt in their lives (loc. 288). But then something else unusual started to happen: when they slept, “the subjects began to stir a little after midnight, lie awake in bed for an hour or so, and then fall back asleep again” (loc. 292). In other words, the subjects started to exhibit a new sleeping pattern that was uncannily similar to the segmented sleep that Ekirch had recently discovered in pre-industrial books.
Remarkably, “the experiment [had] revealed the innate wiring in the brain, unearthed only after the body was sheltered from modern life” (loc. 295). And, indeed, further investigation revealed that people living in non-industrialized parts of the world continue to sleep in two segments in the night (loc. 302).
Interestingly, Wehr’s subjects described the time between their first and second sleep as being incredibly relaxing, and, in fact, “close to a period of meditation” (loc. 301). When Wehr ran tests on his subjects between their first and second sleep, he found that their brains were releasing an increased amount of the hormone prolactin, “a hormone that helps reduce stress and is responsible for the relaxed feeling after an orgasm” (loc. 301). In short, “the results showed that the hour humans once spent awake in the middle of the night was probably the most relaxing block of time in their lives. Chemically, the body was in a state equivalent to what you might feel after spending a day at a spa” (loc. 298). Unfortunately, living in the industrialized world has robbed of this very enjoyable experience.
7. Our Circadian Rhythm (and the Naturalness of Napping)
This was not all that scientists found about our natural sleeping patterns, however. Sleeping patterns are part and parcel of a larger system known as the circadian rhythm—a daily cycle of wakefulness and fatigue that virtually all plants and animals have: “somewhere inside the cells of most living things is what amounts to a fairly accurate twenty-four-hour clock, known as the circadian rhythm, which tells an organism when it is time to perform an important activity and when it is time to rest” (loc. 2103). In our species, the cells that control our circadian clock are located in a brain structure behind our eyes known as the suprachiasmatic nucleus (SCN). Our SCN takes its cue from exposure to light, and in turn controls our circadian rhythm by way of manipulating body temperature (loc. 2109), and directing the release of the hormone melatonin, which makes us sleepy (loc. 2196).
It has been found that the human circadian rhythm runs as follows: “most of us tend to perk up around nine o’clock in the morning and stay that way until around two in the afternoon, which is when we start thinking about taking a nap. Around six in the evening, the body gets another shot of energy that keeps us going until about ten at night. After that, our body temperature starts to fall rapidly, and we get sleepy if we don’t turn to coffee or another form of caffeine” (loc. 2116).
As we can see, then, our circadian clock seems to lend itself to a nocturnal sleeping pattern. Interestingly, though, our circadian clock also seems to lend itself to an afternoon nap. It is not known exactly why our circadian rhythm favors a lull in the afternoon and a boost of energy in the early evening, but “the best guess is that the early-evening pick-me-up was advantageous to early humans who needed energy to make a fire or find their way back home after a long day of foraging for food” (loc. 2116).
8. How Our Natural Sleeping Pattern Changes as We Age
Now, it was mentioned above that our natural sleeping pattern seems to involve a first and second sleep over the course of the night. However, it has also been discovered that our natural sleeping pattern changes over the course of our lives. Indeed, while the average adult naturally starts to shut down around 10 o’clock and perk up around 9 a.m., both the average teenager, and the average elderly person has a slightly different natural pattern (the average child is another story still, but we will wait until the section on putting your kids to bed to discuss it).
Beginning with the adolescents first, it has been discovered that the circadian rhythm of the average teen forces their nocturnal sleeping pattern forward a few hours: “studies of teenagers around the globe have found that adolescent brains do not start releasing melatonin until around eleven o’clock at night and keep pumping out the hormone well past sunrise. Adults, meanwhile, have little-to-no melatonin in their bodies when they wake up” (loc. 2336). In other words, a teen’s reluctance to wake up (or go to bed) at a reasonable hour may have more to do with biology than sheer irresponsibility.
When it comes to the elderly, on the other hand, their circadian rhythm goes through an even bigger change than that experienced by the average teenager, and also tends to move in the opposite direction. As Randall explains, after the age of forty “the brain begins a process of readjusting its sleep pattern and devoting more time to the lighter stages of sleep… These changes, a decade in the making, often become more apparent once someone turns fifty. By the time a person reaches sixty-five, he or she usually settles into a pattern marked by falling asleep around nine o’clock at night and waking up at three or four in the morning” (loc. 2832).
Just as with our natural tendency to experience a lull in the afternoon and a jumpstart in the early evening, evolutionary anthropologists, such as Carol Worthman, suspect that the fact that our sleeping patterns change over the course of our lives may have originally had adaptive value. Here is Randall to explain: “sleeping patterns that change as we age show that our brains expect us to be sleeping in a group, Worthman says… These overlapping shifts could be a way to ensure that someone in the family is always awake and keeping watch, or at least close to it. In this ancient system, it makes sense that older adults who are unable to move as fast as the rest of the family are naturally jumpy, never staying in deep sleep for long, simply because they were the most vulnerable to the unknown” (loc. 2843).
Whatever the reasons may be that explain our natural sleeping patterns, it is clear that the modern world—with its artificial light, early school starts, 9 to 5 work day etc.—is making a mess of these natural patterns. However, in light of what scientists have recently discovered about our natural sleeping patterns, some organizations (including schools, businesses, sports teams and even the military) are beginning to make changes that give greater due to these natural patterns. In the next section we will learn about some of these organizations, and the measures that they are taking.
Section 2: How Organizations Are Applying the Science of Sleep in Their Operations
9. The Science of Sleep in Education
As mentioned in the previous section, the circadian rhythm of the average teenager is different from that of the average adult, in that their natural nocturnal sleeping pattern is pushed forward somewhat. As a result, “teenagers who are forced to be awake before eight in the morning are often barely alert and want nothing more than to give in to their body’s demands and fall back asleep” (loc. 2339). But this poses a particular problem for their education, for many high schools (especially in America) have traditionally begun their morning classes at 8:00 a.m., or even earlier (loc. 2348). And sure enough, as an indication that there was in fact a problem with this arrangement, one study found that “most students earned higher grades in classes that started later in the day for the simple reason that they were more likely to stay awake for the entire lesson” (loc. 2353).
In response to these discoveries, several schools have now begun experimenting with later start times. Take the school district in Edina, Minnesota, for instance. Historically, the first bell at Edina’s high schools rang at 7:25 a.m., but when the board’s executives caught wind of the research on teenagers sleeping patterns, they figured it was high time for a change. Accordingly, they decided to advance their first bell to 8:30 a.m. (loc. 2362).
Now, at first, the parents of Edina weren’t so sure that this was such a great idea. Indeed, they worried that their teens would only stay up even later than before, and that the later school day would cut into their extra-curricular activities (loc. 2366). Nevertheless, the school board decided to go ahead with its plan, and “Edina’s teenagers started the 1996-1997 school year on the new, later schedule” (loc. 2371).
So, how did it go? Pretty well actually. The entire experiment was followed very closely by one Kyla Wahlstrom, a researcher who looks at the effects of school policies on students (loc. 2369). Wahlstrom found that “despite the fears of some parents, teenagers did in fact spend their extra hour sleeping, and reported that they came to school feeling rested and alert. At the same time, the number of on-campus fights fell, fewer students reported feeling depressed to their counselors, and the dropout rate slowed. Coaches pushed back practice times until later in the afternoon, and participation in sports didn’t suffer” (loc. 2377). Even the SAT scores shot up. For instance, for the top 10% of students, the average went from 1,288 out of 1,600 to 1,500 out of 1,600 (loc. 2381).
The experiment worked so well in fact that the school board in Minneapolis decided to follow Edina’s lead, and “pushed its high school starting time from 7:15 to 8:40” (loc. 2385). Once again, Wahlstrom sat in on the experiment, and she was particularly interested in the results this time around, because the student body in Minneapolis was much different from that in Edina. Specifically, “Edina is an affluent town in which 90 percent of the students are white. In Minneapolis, most students were minorities, and three out of every four teenagers in a classroom came from families whose incomes were low enough to qualify them for subsidized school lunches” (loc. 2385).
Lo and behold, the results in Minneapolis were just as impressive as they had been in Edina: “just like their suburban neighbors, Minneapolis students posted better grades, dropped out less frequently, and attended first-period classes more often following the shift to a later schedule” (loc. 2391). Since these experiments in Minnesota, numerous other school boards across the U.S. have switched to later start times, and the results has been universally positive (loc. 2393-2407). In addition to the positive effects mentioned above, the later start times have also been credited for a decrease in the number of adolescents involved in car accidents (loc. 2394), as well as a decrease in bullying behavior (loc. 2398).
10. The Science of Sleep in Business
a. Naptime at the Office
Just as with the traditional school schedule, it appears that the traditional workday schedule also runs afoul of our natural sleeping pattern. Unlike the school schedule though—which interferes with a teenager’s sleeping in—the work schedule interferes with an adult’s nap time. Indeed, as mentioned above, the circadian clock of the average adult starts to slow down in the early afternoon. This is when many of us start to feel tired, and, if given the opportunity, head off for a nap. However, the workaday world frowns upon such non-sense, and therefore, most of us learn to go without.
It has not always been thus, though. As Randall points out, while “midday naps are most closely linked with Spain and other Latin cultures, they were once popular throughout Europe, Africa, and Asia” (loc. 413). As the developed world became increasingly industrialized and commercial, however, the afternoon nap became one of the casualties along the way. Some countries managed to hang on to the nap longer than others, though. In Spain, for instance, the government’s policy of giving civil servants 3 hours for lunch was only cut back in 2006. At that time it was decided that lunches would be shortened to 1 hour, “in hopes that private businesses would follow. The idea was to keep Spaniards at their desks at the same time that the rest of Europe was in the office” (loc. 419).
As the findings in sleep research are starting to gain attention, though, this trend is beginning to be reversed. As Randall explains, naps are now “being used to provide a competitive advantage. Companies such as Google, Nike, Proctor & Gamble, and Cisco Systems have installed designated napping areas in their offices. The idea is that naps may allow engineers and designers to arrive at creative solutions more quickly than they would by staying awake all day” (loc. 1403).
b. The Fatigue Management Industry
The introduction of nap rooms at certain companies is part of a larger trend in the business world towards appreciating and accommodating the body’s need for sleep. Indeed, while you may never have heard of the fatigue management industry (I hadn’t), it may not be long before it’s a household name, for it is in fact currently growing in leaps and bounds (loc. 439, 1402). As we speak, “consultants from companies with names like Alertness Solutions charge thousands of dollars to educate corporate managers and their employees on the importance of sleep and managing fatigue levels while on the job” (loc. 1405).
Take Martin Moore-Ede’s company, Circadian, for instance. As Randall explains, “more than half of the companies in the Fortune 500, and a Super Bowl-winning team, have asked Moore-Ede’s company… to develop working environments for their businesses that allow a worker’s body to function at high levels despite the demands of sleep and exposure to artificial light” (loc. 440).
As a testament to the efficacy of Circadian’s business model, consider the following story: Circadian took on a transportation company that had been spending “$32,000 in accident costs per every million miles its workers and equipment traveled” (loc. 460). To help address the issue, Moore Ede’s company developed a staffing strategy that “restricted long work shifts and required workers to pass awareness tests to prove that they weren’t in danger of falling asleep on the job” (loc. 463). The result was that the transportation company reduced their accident costs from $32,000 per million miles to $8,000 per million miles (loc. 463), and “overall, the company’s return on investment was greater than ten to one” (loc. 463).
And, of course, accidents due to fatigue do not only cost money, they cost lives. In one incident at an oilfield in Texas City, near Houston, fatigue was blamed for an explosion at one of the oilfield’s refinery towers in which 15 workers were killed, and another 170 were injured (loc. 470). The oil industry took the incident as a wake-up call, and “in 2010, the giant international oil companies agreed to install a fatigue management system at every major plant that will reduce mandatory overtime, train supervisors to recognize when an employee is close to nodding off, and give employees a chance to admit fatigue without worrying that they will lose their jobs” (loc. 481).
Given the benefits yielded by well-designed sleep management systems (and the fact that governments around the world are beginning to recognize these benefits, and legislate accordingly [loc. 447]), the sleep management industry stands to be a major growth sector moving forward. Moore-Ede himself predicts that “fatigue management officers will soon be a common position in human relations departments at multinational corporations around the world” (loc. 481).
11. The Science of Sleep in the Military
Given the importance of proper sleep in education and business, you can well imagine how crucial it is where life and death is the name of the game—in the military. Up until very recently, though, the US military treated sleep more as a luxury than a vital necessity. Indeed, even in peace time, a soldier’s schedule allowed him or her but 6 hours of rest per night, “or about three quarters of what most adult bodies need to maintain an alert brain” (loc. 1456). In battle things are even worse, as the exigencies of combat displace every facet of normal life—sleep included. To take just one example, in the Gulf War, by February 25 of 1991 the American military had pushed Iraqi forces out of Kuwait and had caught up to them in southern Iraq (loc. 1412). By the time the ensuing battle began, “over each of the last five nights, the men had slept less than three hours” (loc. 1422). And this type of sleep schedule in battle is by no means unusual (loc. 1443-50, 1464-71, 1572-99).
In order to counteract the effects of sleep-deprivation both in peace-time and in combat, American soldiers are accustomed to consuming large quantities of stimulants, especially caffeine. As Randall explains, “soldiers guzzle the stuff, starting in boot camp. As they move up the ranks, most graduate from high-caffeine, high-sugar drinks such as Red Bull, Jolt, and neon-green Mountain Dew and turn to super-caffeinated coffee” (loc. 1475). The military is largely compliant with this solution, and, by 2001 in the Afghanistan war, even issued soldiers caffeinated gum as part of their standard kit (loc. 1482). The military has also experimented with other ways to keep soldiers awake and alert without having to resort to sleep. Indeed, as Randall explains, “the military spent millions of dollars testing theories, such as whether it would be possible to put half of the human brain asleep at a time, essentially allowing a person to sleep like a dolphin” (loc. 1506). Unfortunately, none of these theories panned out, and it was finally acknowledged that “the only way to recover form lost sleep was to get more of it later” (loc. 1506).
As you may suspect, then, even when soldiers are hopped up on caffeine, this is no replacement for sleep, and eventually mistakes are going to be made. And mistakes were made. In 1996, for instance, “a time of relative peace, crew fatigue was blamed for thirty-two accidents that destroyed American military aircraft, including three F-14 jetfighters that cost $38 million each” (loc. 1460). More importantly, though, accidents due to fatigue have also cost lives. To begin with, it has been established that ¼ of all American combat deaths in the Gulf War were the result of friendly fire (loc. 1438); and, when the investigators had finished their probing into why, “one truth stared at them, a conclusion that was as obvious as it was radical: soldiers simply weren’t getting enough sleep. The skills and training built up over hundreds of hours of preparation were lost on the battlefield amid the sleep deprivation of combat” (loc. 1449).
Given the stark truth of these findings—and given that the military had already found that they could not find a way to stint on sleep without serious side-effects—they finally gave in and decided to direct their efforts towards ensuring that their soldiers were actually getting an appropriate amount of sleep. For instance, during peace time, “sleeping periods were extended by more than an hour, with lights out at 9:00 p.m. and wake-up at 5:30 a.m.” (loc. 1512). The results thus far have been very positive, with one drill sergeant conceding that “it has been great for morale… A soldier’s happiness is directly proportional to the amount of sleep he gets” (loc. 1512). And, of course, a well-rested soldier is not only a happier soldier, but is also much less likely to make mistakes that end up injuring or killing himself and/or those around him.
In addition to this, a soldier’s job now more than ever requires him to interact with civilians (loc. 1624, 1678), and getting the right amount of sleep can be the difference between establishing a positive relationship with these civilians, or turning a community against him and the rest of the military (loc. 1668). For instance, in the latest war in Iraq, it has been established that “twenty percent of the men who are sleeping less than four hours a night have reported an altercation with a civilian… [while] only 4 percent of men who are sleeping eight hours a night have” (loc. 1665). The reason is simple: “grumpy, tired soldiers have less control over their emotions and are therefore more likely to get into a fight with civilians” (loc. 1665). With the military now paying more attention to ensuring that their soldiers are getting enough rest (including with technology that allows commanders to monitor how much sleep their soldiers have been getting [loc. 1695]), the number of altercations with civilians, friendly fire incidents, and accidental injuries and deaths should only go down.
12. The Science of Sleep in Sport
While sport and athletics is not a matter of life and death the way that war is, athletes rely on the fitness of their brains and bodies just as much as soldiers, and therefore, it should be no surprise that the science of sleep applies just as much as here as it does in the military.
The first significant discovery in the science of sleep having to do with the world of sport came when sleep researchers started looking into the effects of inter time-zone travel on performance. As mentioned above, our circadian clock dictates that we perk up around 6 o’clock in the evening and start to shut down after 10 p.m. This brings up an interesting scenario when a sports team from the East Coast is required to travel across the country and face a West Coast team in Pacific prime time. If the game were to start at 8 o’clock Pacific Time, for instance, then it would already be 11 o’clock out east. As such, while the West Coast players would be firmly into their evening circadian spurt during the game, the East Coast players would already be shutting down for the evening. This should have a significant effect on performance, and hence the result of the game.
In order to test this theory, a group of researchers out of Stanford University decided to take a look at the results of Monday Night Football games between East Coast and West Coast teams over the last 25 years (loc. 2144). They then compared the final scores in the games to the point spread that had been established in Las Vegas (loc. 2146). Lo and behold, the researchers found that “a West Coast team won 63 percent of the time, by an average of two touchdowns. The games were much closer when an East Coast team won, with an average margin of victory of only nine points. By picking the West Coast team every time, someone would have beaten the point spread 70 percent of the time. For gamblers in Las Vegas, the matchup was as good as found money” (loc. 2149).
Since this study was performed, similar studies have been done involving other sports, and the same results have been repeated: “the circadian advantage—or disadvantage, depending on your perspective—popped up in studies of figure skaters, rowers, golfers, baseball players, swimmers and divers” (loc. 2163).
Given the effect that the circadian advantage has, other sleep researchers have now begun probing into how the circadian disadvantage can be mitigated, and also how exposure to artificial light can manipulate the circadian clock to help maximize performance. The Canadian physician Charles Samuels, for instance, has spent the past decade studying the effects of light on the body’s performance. His research has helped shape the training routines of numerous Canadian athletes. For instance, “thanks to Samuels, the Canadian Alpine ski Team travels with fifteen to twenty light boxes, a type of oversize flat lamp that simulates natural sunlight” (loc. 2227). The skiers sit in front of the lamps at set times leading up to and during competitions in order to maximize their performance (loc. 2227).
While Samuels’ methods are becoming more and more popular in Canada, they have been largely ignored in the US to this point. Nevertheless, Samuels predicts that that the science of sleep will soon revolutionize sport, claiming that “ten years ago I would have been very reticent to say that light did this or that, but now we know that light improves alertness… I was around in the sixties when Gatorade was invented, and this seems like it has the same potential to affect performance” (loc. 2227).
The findings of sleep research have not been ignored entirely in the U.S. sporting scene, though. The Texas Rangers of professional baseball, for instance, brought in a head strength and conditioning coach named Fernando Montes with a unique interest in and approach to sleep. Montes developed a program that required Ranger pitchers to record the amount and quality of sleep that they were getting (loc. 2295); and also to come in to the stadium early on game day to make special preparations for the game by way of, you guessed it, taking a nap (loc. 2302). (To be fair, Montes also gave his pitchers several other tips in order to ensure that they were maximizing their sleep [loc. 2295-2309].) The players were, understandably, a little suspicious of Montes’ methods at first, “but after a week or so of the new sleeping routine, each player told Montes that he felt stronger and more energetic during games” (loc. 2309).
Soon enough, other players on the team were showing up at the nap room before game time (loc. 2312). In one particular game against the Minnesota Twins (following a gruelling double-header and overnight flight from Kansas city), “players who didn’t nap were out of sequence, missing what should have been easy defensive plays and struggling to connect at the plate. Those who arrived early at the ballpark to get extra sleep, meanwhile, performed about as well as they did any other night, and they demonstrated few of the side effects of the long night of travel and sleep deprivation that had accumulated from the grueling road trip” (loc. 2323). From this point forward, the entire team bought into Montes’ system, and “for the rest of the season, Montes’s (sic) napping room was crowded” (loc. 2323).
PART III: SLEEPING ARRANGEMENTS: PUTTING YOUR KIDS TO BED, AND SLEEPING WITH A PARTNER
13. Putting Your Kids to Bed
We move now from the public realm to the private, and will begin by way of discussing sleeping arrangements. First up: putting your kids to bed. Now, anyone who has ever had kids—and, indeed, anyone who has ever been around them for any length of time—knows that putting children to bed can be one of the hardest things about parenting. As Randall notes, “getting children to sleep is the first problem that parents are expected to solve, and yet it is also one of them most difficult. One study found that parents seek advice from their doctors regarding this issue more than any other health concern or behavior” (loc. 739). Complicating the matter immensely, particularly at the beginning, is that until an infant reaches 4 months old, their circadian rhythm is not yet set (loc. 739). Thus, “nighttime feedings may take place at one in the morning one day, and then at three in the morning the next, without any pattern or schedule beyond an infant’s capricious cries” (loc. 750).
Recently, it has been customary for an infant growing up in the West to sleep in a crib in a separate room from his or her parents. However, this is a far different arrangement than the one that had traditionally held sway in the West, and that continues to hold sway in most other parts of the world to this day. In the more traditional arrangement, the infant sleeps in the same sleeping area with, and often in between, his or her parents—an arrangement called co-sleeping or bed-sharing (loc. 719). Apparently, things began to change in the West between 1900 and 1925, when “noisy new inventions like radios and vacuum cleaners entered the home for the first time and gave parents a reason to segregate their children into a quiet place at night while adult life went on” (loc. 818).
However, the new arrangement continued to remain popular not just because of the convenience that it brought adults, but also because of the perceived benefits that it brought infants. For one, it was established that co-sleeping did incur the risk of one parent or the other rolling over onto the child and crushing it—injuring it, or even killing it in the process—“especially when that adult [had] had too much to drink” (loc. 732). For instance, “public health officials point to studies such as one conducted in Santa Clara… which found that twenty-seven infants over a five-year span died as a result of being placed in the same bed as a sleeping adult. More than half of those accidents were caused when the adult rolled over onto the child. The others were caused by suffocation” (loc. 743).
Aside from this danger, it was also hypothesized by some—including the well-respected pediatrician Richard Ferber—that allowing an infant to sleep in the same bed with his or her parents may hamper that child’s growth towards independence (loc. 785). What’s more, it was noted that co-sleeping could seriously disrupt the parents’ sleep—especially the mother’s—and that the resulting sleep deprivation could become very problematic (loc. 789). Ferber himself advocates what some consider to be a very harsh approach (popularly known as the cry-it-out method), which is to keep children in a separate room, and gradually increase the amount of time that you wait before checking on them when they start to cry (loc. 777).
Still, though, despite the dangers and drawbacks, many parents in the West have recently been experimenting with going back to co-sleeping. As Randall reports, “about one in fifteen parents admitted to sharing a bed with their child in a study published in 1993. By 2007, the number had grown to about one in three” (loc. 727). There are a couple of reasons for this trend. To begin with, many parents simply feel more comfortable having their young children right next to them at night. Referring to one such couple, and their experience with co-sleeping, Randall explains that “Abigail’s parents had come to enjoy what they saw as an intense bonding time with their child” (loc. 723).
Another factor that has contributed to the trend of co-sleeping is that several experts have recently come out in defense of it (loc. 804). The idea is that when full precautions are taken, the arrangement can be quite safe, and that, in addition to this, it can allow parents to be more responsive to their child’s needs (including breast-feeding), and can also encourage a sense of healthy attachment between child and parent (loc. 804-11). What’s more, it has been argued by these experts that this approach does not interfere with a child’s growth towards independence, pointing to the fact that, “eventually, almost all children decide to sleep in their own bed when they are given the option” (loc. 883).
Still, many health professionals are not convinced by these arguments, and continue to advocate against co-sleeping.The following is a very informative (and even-handed) news-clip covering the co-sleeping and bed-sharing debate.
Whatever arrangement you decide is best for yourself and your family, what seems less controversial is that it is important to stick with this routine through thick and thin. Indeed, studies comparing the different methods indicate that “when it comes to a children’s sleep, routine is a better predictor of quality than whatever choice the parent makes regarding co-sleeping. Consistently following the same nightly script makes bedtime less of a battlefield” (loc. 868).
Also without controversy is that napping is beneficial for children. One study found that both children who were made to nap and those who were given the choice to nap slept about 10 ½ hours per night, but that those who were made to nap “slept more, logging an average of two additional hours over a twenty-four-hour period compared with those with irregular naptimes” (loc. 759). The difference in the children’s behavior, and in their interactions with their parents and others was clear: “the outcome of the extra sleep was better interactions between parents and their children. The children in the napping group were ‘more fun to be around, more sociable and less demanding,’ researchers noted. With their longer attention spans and calmer dispositions, they were able to learn and adapt to changing circumstances. Children who didn’t sleep as much, meanwhile, were hyperactive and fussy, a result of missing out on the time spent in deep REM sleep that allowed the nappers to better react and respond to the world around them” (loc. 763).
14. Sleeping with a Partner
So, your children are sleep. Hooray! But now comes the next issue, which is how to negotiate sleeping with your partner. Again, trends here seem to be shifting. While it was once unquestioned that a couple would sleep together in the same bed, many couples are beginning to explore other options. And I’m not talking about the husband sleeping in the doghouse here: otherwise relatively happy couples are beginning to experiment with separate beds, and even separate bedrooms. For instance, “architects and construction companies surveyed by the National Association of Home Builders predict that by 2016 more than half of all new custom-built homes in the United States will have separate master bedrooms” (loc. 616).
And the reason for this trend is simple: many couples are finding that that they simply sleep far better when they have their own personal bed. And the studies seem to agree. For instance, one study found “someone who shared a bed was 50 percent more likely to be disturbed during the night than a person who slept alone” (loc. 506). Another study found that “subjects not only were less likely to wake up during the night but also spent almost thirty additional minutes in the deeper stages of sleep on nights when they had a room to themselves” (loc. 530). And these positive effects are much more pronounced in women than in men. Indeed, in one of nature’s cruel ironies, men are more likely to snore, while women tend to be lighter sleepers (loc. 638): “the result is a nightly farce that is one reason why wives… suffer from insomnia more often than their husbands” (loc. 638).
Of course, it has presumably always been the case that sleeping with a partner carries with it certain disadvantages, so the question becomes why the trend towards separate beds is catching on now. Several hypotheses have been advanced, including “busy work schedules, better and more open communication, or the fact that many people wait until they are older to get married and don’t want to give up the power of controlling their sleep environment” (loc. 610).
Still, whatever the advantages of sleeping in separate beds may be, most couples continue to prefer the one bed arrangement (loc. 526-33). There are a few reasons for this. For one, many people (especially women [loc. 679]) report that they simply feel safer in a bed with someone else. In addition to this, many couples feel that the only time that they truly get to be alone together is when they are in bed with one another (loc. 669)—which is especially important to them given that they find that the physical proximity draws them closer together emotionally (loc. 686). Also important here, particularly for men, is the sex. Indeed, one researcher who was involved with the studies on sleeping couples confirmed that “the change in a couple’s sex life after one moves to the room down the hall was so pronounced that men in his study couldn’t stop talking about it. ‘Some of the men were really grieving the loss of sexual access when they stopped sharing a bed,’ he [said]. ‘None of the women said that,’ he added” (loc. 690).
PART IV: SLEEPING DISORDERS AND REMEDIES: SLEEP APNEA, SLEEPWALKING AND INSOMNIA & IMPROVING YOUR SLEEP
15. Sleep Apnea
It was mentioned above that snoring (usually in men) is one of the main disrupters of a partner’s sleep. But it turns out that snoring is also a symptom of a disorder that leads to severely disrupted sleep in the snorer (loc. 2418). This sleeping disorder is known as sleep apnea. Sleep apnea is a condition wherein the throat of the sleeper “closes randomly throughout the night” (loc. 2422). This blocks air from reaching the sleeper’s lungs, until “the brain jolts awake, and the body gasps for air” (loc. 2425). At this point, the individual falls back asleep, only for the cycle to start up all over again. As Randall explains, “it is all so quick that it can happen more than twenty times an hour, all night long, without the sleeper remembering it the next day” (loc. 2425).
Of course, while the individual may not remember what has happened to them the next morning, they nonetheless feel the effects of the poor sleep that they have had. Indeed, the disorder often keeps the sleeper from going into deep sleep, and the benefits that deep sleep brings. Thus “patients with mild cases of sleep apnea complain of constant exhaustion, a result of never spending more than a few minutes asleep at a time” (loc. 2429). People with severe sleep apnea suffer even worse, as the condition can trigger both heart attacks and strokes. Indeed, “a 1992 report by the National Commission on Sleep Disorders estimated that sleep apnea was the cause of thirty-eight thousand fatal heart attacks and strokes in the United States each year” (loc. 2432).
A successful treatment for the disorder now exists, but this emerged only in the late 1970’s (loc. 2418)—largely a result of the fact that the disorder had only been identified for the first time a decade before (loc. 2418). The treatment’s inventor is one Colin Sullivan, who, at the time of his invention, worked as a physician at the Respiratory Unit at Sydney’s Royal Prince Alfred Hospital (loc. 2418). At the time, Sullivan was working with dogs; specifically, English bulldogs and pugs—which pushed-in-face breeds just happen to be “the only animals besides humans that experience sleep apnea” (loc. 2440). In order to treat his apneatic dogs, Sullivan developed a kind of reverse-vacuum device that “continuously pumped in air from the surrounding room, increasing the air pressure in the throat and preventing it from closing up” (loc. 2443).
Sullivan’s contraption worked marvellously with the dogs (loc. 2443), so he decided to try it out on some human patients (loc. 2443). The results here were just as spectacular. For instance, the first patient on whom Sullivan tried his device reported that “when he woke up the next day… he felt awake and alert for the first time in years” (loc. 2460). Further tests turned out to be just as promising, as patient after patient “told [Sullivan] that the improvement in their sleep was life-changing” (loc. 2463).
Despite some skepticism from other physicians (loc. 2467), Sullivan knew he had a winner, and so he soon started developing a model of his device for market—under a company named ResMed (loc. 2488). And what a winner indeed! As Randall reports, “the new company… introduced its first continuous positive airway pressure device, known as a CPAP, into the market in 1989. Within five years, the company was making $300 million a year in revenue” (loc. 2488). By the time Randall visited ResMed recently for the purposes of his researching his book, “four of every ten patients with sleep apnea in the United States were using a ResMed device,” and “ResMed… sales had grown to 1.1 billion a year” (loc. 2491, 2498).
Still, despite the success of the CPAP machine with many sleep apnea patients, many of these patients have trouble using the machine. It seems that many people simply can’t get comfortable sleeping with a mask on their face, or with air being forced down their throat (loc. 2532). Fortunately, there are other measures that one can take that go at least part of the way to helping with the disorder, such as “drinking less alcohol, cutting back on smoking, sleeping on one’s side instead of on the back, or doing exercises or playing musical instruments that build up the muscles in the throat” (loc. 2529). In addition, there are other treatments that can also help—such as certain special dental devices, and even surgery (loc. 2539)—but, unfortunately, none of the solutions tends to provide full relief, and all of them have their disadvantages .
16. Sleepwalking
Now, at first glance it may seem like sleepwalking, unlike sleep apnea, is a fairly benign sleeping disorder, but it turns out that it, too, can be fairly dangerous. To begin with, it should be mentioned that Randall himself is a bit of a sleepwalker. Indeed, the entire idea for his book ultimately came out of a misadventure that he experienced one night while sleepwalking (as mentioned in the introduction). Specifically, Randall injured himself walking into wall, and woke up in a good deal of pain, lying on the floor 30 feet from his bed (loc. 32-42).
As it turns out, sleepwalking is not all that uncommon—although it does seem to be something that is more prevalent among the young. Indeed, as the author mentions, “about one in five people will sleepwalk at least once in their lifetime, though most outgrow it by the time they are in middle school” (loc. 1786). The reason why most people don’t sleepwalk is because normally when someone is sleeping the parts of the brain that are responsible for movement and spatial awareness are shut down (loc. 1779). In a sleepwalker, on the other hand, these parts of the brain have failed to shut down as they should (loc. 1778). At the same time, the part of the brain that is responsible for consciousness remains quiet (loc. 1780). This means that “sleepwalkers can have their eyes open and react to the events going on around them, but have no conscious thought or memory” (loc. 1782).
Interestingly, a sleepwalker can perform any of the activities that a waking person can, “including talking, eating, driving, masturbating, and having sex” (loc. 1790). As you can well imagine, any one of these activities performed while sleeping could potentially pose a threat to the sleepwalker—and those around him. Indeed, even just walking while sleeping presents a danger, as the author himself found out the hard way when he walked into a wall. Sleepwalkers have caused far worse injuries to themselves than this, though. Indeed, some sleepwalkers have even been known to jump out of windows (loc. 174, 1805, 1818). This has caused some to “resort[] to literally tying themselves to the bedpost each night out of the fear that they will accidentally commit suicide” (loc. 173). And it gets worse: “in a study published by the Journal of Forensic Science in 2003, Cramer Bornemann detailed cases of people falling from hotel rooftops, getting hit by cars after marching into traffic, and picking up loaded guns and shooting themselves—all while sleepwalking” (loc. 1920).
And the potential danger to those whom a sleepwalker encounters can be just as acute. Indeed, sleepwalkers have been known to commit crimes, including such acts as child molestation, rape, and even murder (loc. 1917). In one of the more bizarre cases you will ever hear, a Canadian man named Ken Parks fell asleep one night and then proceeded to rise from his bed, go to his car, get in, start it up, drive 14 miles to his in-laws house, walk inside, kill his mother in-law, and attempt to kill his father in-law (loc. 1744-55).
Now, you may well ask just how we know that Parks was actually sleepwalking when he did all of this, of course, and the short answer is that we really can’t know for certain. However, virtually all of the evidence in this case pointed to the idea that Parks did in fact perform these acts while sleepwalking. For instance, aside from the fact that Parks was a confirmed sleepwalker, it was also the case that he got along reasonably well with his in laws and had no reason to kill them (loc. 1763). What’s more, Parks injured himself very badly at some point during the night’s proceedings—in that he cut his hands to the bone (loc. 1957). However, he showed no signs of pain until he came to at the police station hours later (loc. 1752, 1961). This is consistent with the fact that our pain receptors are shut down in deep sleep (loc. 1944), thus rendering someone in deep sleep incapable of feeling pain (loc. 1947).
The evidence in favor of Parks’ sleepwalking alibi was so compelling, in fact, that a jury found Parks not guilty of murder: “instead, Parks’s (sic) deeds were classified under a new category—officially called a non-insane automatism—that allowed him to walk outside of the courtroom a free man” (loc. 1863). Now, as you can well imagine, the potential of using sleepwalking as a valid defense is something that could throw a huge wrench into the justice system. The prosecutors in the case felt the same way, and “after the verdict… filed an appeal in hopes of preventing a surge of defendants claiming that they, too, had been asleep at the time of a crime” (loc. 1863). However, the decision stuck.
While the landmark case has not exactly resulted in a surge of defendants claiming that they were sleeping while they committed their crimes, in the next 7 years 5 such cases did crop up in Canadian courts (loc. 1893). In addition, “around the world, cases of sleep violence were increasingly put before juries” (loc. 1897). The fact is, though, that the potential for abusing this alibi is so strong that the courts treat it such that there must be substantial evidence in its favor, and normally this is very difficult to establish. (loc. 1967, 2006) The result is that it is much more likely that someone who is genuinely sleepwalking while they commit a crime will be convicted, than that someone who is falsely using the defense will get away with their crime (loc. 1971, 2030).
17. Sleeplessness: Difficulty with Sleeping and Insomnia
We move now to a condition/sleeping disorder that is far more straightforward than previous ones, though, in a way, just as strange: difficulty with sleeping and insomnia. Now, on any given night up to 40% of adults in American have trouble sleeping (loc. 2640), but genuine insomnia takes this to the extreme. As Randall reports, “the National Institutes of Health identifies the condition as ‘difficulty getting or staying asleep, or having non-refreshing sleep for at least one month” (loc. 2683). While difficulty with sleeping is very common, insomnia (as it is defined here) is even less prevalent than sleepwalking, as only “about one in ten people in the United States suffer from it during their lifetime” (loc. 2683).
Historically, the modern drugs used to treat sleeplessness have been riddled with problems. The first of these drugs was called Veronal (after the sleepy city of Verona), and was released in 1903 (loc. 2702-10). The pill was a barbiturate, and did have some small capacity to aid sleep (loc. 2710), but it also incurred a tolerance on the part of the patient, “making a patient require progressively larger doses for it to work” (loc. 2714). Unfortunately, the drug was also lethal at sufficiently high doses (which really weren’t all that high), and “for the next sixty years, sleeping pills were blamed for countless accidental overdoses when patients took an extra pill or two in a half-asleep daze” (loc. 2714). What’s more, the easy availability of the drug made it a favorite among suicide attemptees—including several high profile actors, such as Grant Withers and Marilyn Monroe (loc. 2717).
In the 1970’s Veronal was replaced by Valium, Rohypnol and Halcion, all of which are benzodiazepines (loc. 2721). While these new drugs were much more difficult to overdose on, they did give the user a high, which made them much more likely to be abused (loc. 2724). What’s worse, it was later revealed that the drugs eventually led to memory loss (loc. 2723). For instance, Halcion sometimes caused a condition that came to be known as traveler’s amnesia. As Randall explains, “typical patients who experienced traveler’s amnesia would take a dose of Halcion while on a red-eye flight, to ease the adjustment to the time difference. When they woke up at their destination, however, their memory would be blank. Patients lost track of who they were, where they had landed, and why they were there” (loc. 2727). Because of these complications, the drug was eventually banned in several countries (though it remains legal in the US) (loc. 2731).
The next drug in line is called Ambien, and it was released in 1993. Finally, the pharmaceutical industry hit on a drug that was relatively clean in terms of its side effects. As a result, “Ambien quickly dominated the sleeping pill market and rang up more than a billion dollars in sales a year” (loc. 2734). Ambien reigned as king of the sleeping pill market until 2005, when a new drug called Lunesta was released. Lunesta works similarly to Ambien, but manages to eliminate side effects even more; so much so, in fact, that, unlike Ambien, “the FDA approved it for long-term use” (loc. 2738). As a result of this advantage (and a very aggressive ad campaign [loc. 2741]), Lunesta quickly came to be the leading drug in the sleeping pill market. And what a market! As an indication of this, consider that “by 2010, about one in every four adults in the United States had a prescription sleeping pill in their medicine cabinets” (loc. 2751).
Here’s the thing though: studies of both Lunesta and Ambien have shown that they actually have very little effect in increasing either the amount or quality of sleep (loc. 2753). For instance, “in one study financed by the National Institutes of Health, patients taking popular prescription sleeping pills fell asleep just twelve minutes faster than those given a sugar pill, and slept for a grand total of only eleven minutes longer throughout the night” (loc. 2754). Despite this, though, prescription sleeping pills remain very popular. So, what’s the story? It turns out that it may have to do with how these drugs work. As it happens, both Ambien and Lunesta “have the curious effect of causing what is known as anterograde amnesia. In other words, ingesting the drug essentially makes it temporarily harder for the brain to form new short-term memories” (loc. 2761). So, even though someone who is using the drug may be tossing and turning almost as much as they were before they started taking it, they simply can’t remember these episodes the next morning, and so end up feeling much better about their sleep (loc. 2761).
Given the shortcomings of sleeping pills, other methods have been developed to help address the problem of insomnia; and one of them, at least, has been shown to be relatively effective. The method is called cognitive behavioural therapy, and it has two parts. In the first part, the therapist helps the patient to identify and challenge the worrisome thoughts that are hindering them from falling asleep (loc. 2787). The second part requires the patient to visualize their life as a successful sleeper, and to record their actions so that they can monitor their progress (loc. 2787). In studies of the method, researchers have found that its effects take longer to set in than sleeping pills (loc. 2804), but that in the long run it is almost as effective in terms of increasing the amount of sleep one gets (loc. 2787), and even more effective in increasing sleep quality (loc. 2815). What’s more, cognitive behavioral therapy has been shown to yield long-term benefits, while sleeping pills lose their effectiveness the moment you go off them (loc. 2808). Given the success of the method, “organizations ranging from the National Institutes of Health to Consumer Reports [now] recommend therapy as the first step in treating insomnia” (loc. 2818).
18. Improving Your Sleep
Fortunately, sleeping pills and therapy are not the only way to improve your sleep. Indeed, there are several things that we can do to improve both the amount and quality of the sleep we get, and in this section we will address these measures. To begin with, you should know that there’s simply no evidence to indicate that the softness or firmness of your mattress has anything to do with how well you will sleep (loc. 2929-48). Being comfortable is important for falling asleep, of course, but study after study indicates that people are most comfortable with whatever type of mattress they happen to be sleeping on already (loc. 2929-32). In other words, you get used to what you sleep on (even if it’s a concrete floor [loc. 2945]), and are most comfortable with what you happen to become accustomed to.
One external factor that does make a difference, however, is the amount of light that you are exposed to on the run up to going to bed. Your body is designed to start shutting down for sleep when the light goes down, so you can help get yourself ready for bed by avoiding the artificial light of televisions and computers, and also dimming the lights in your house up to a ½ an hour before bedtime (loc. 2957-60). Your circadian clock also lowers your body temperature at night, so you can help it along by way of taking a cool shower before bed (loc. 2972), and also lowering the temperature in your house over night (apparently, maintaining a room temperature between 60 and 66 degrees Fahrenheit is best if you prefer pajamas and sheets, and a range of 86 to 90 degrees is best if you prefer to sleep in your birthday suit [loc. 2972-75]).
In terms of no-no’s, this should be a no-brainer, but coffee before bed is a big one (loc. 2948). Coffee is a stimulant and will do nothing but make it more difficult for you to fall and stay asleep. Alcohol before bed is also a no-no, for while it may make it easier for you to fall asleep, “as the body breaks down the liquid, the alcohol in the bloodstream often leads to an increase in the number of times a person briefly wakes up. This continues until the blood alcohol level returns to zero, thereby preventing the body from getting a full, deep, restorative sleep” (loc. 2952).
Regular exercise, on the other hand, is a big help. Indeed, studies indicate that “even a small increase in the amount of exercise a person gets leads to measurable improvements in the time that it takes to fall asleep and stay that way. This is particularly true for older adults” (loc. 2978). Aside from exercise, “yoga, acupuncture, and massage have all been linked with improved sleep, in part because they put both the body and the mind at ease” (loc. 3013).
And the importance of having a body and mind at ease simply cannot be overstated. Indeed, it has been found that two things simply must happen for a person to fall asleep. First, the mind must shut down its conscious thought. As Randall puts it, “the mind must put aside its focus on its immediate surroundings and daily concerns. This process requires a person to give up direct control of his or her thoughts” (loc. 2914). (Worrying that you are not falling asleep is therefore a perfect way to keep yourself awake, and it is often this that sets insomnia into motion, and allows it to persist [loc. 2653-60].) Simultaneously, your body must be comfortable enough that your brain essentially forgets that it is there (loc. 2914). If, and only if, these two things happen will you fall asleep. Breathing exercises are often very good at encouraging both, and they have in fact been found to be a very effective way of helping us fall asleep (loc. 3017). Here is the breathing exercise that is mentioned in the book: “as subjects laid on their back with their eyes closed each night, they were instructed to focus on their breathing by thinking the word in every time they inhaled and out with each exhalation” (loc. 3017).
(I have found that thinking in images also helps take my mind away from conscious thought, so I often imagine a huge wave [somewhat like the one below] swelling as I breathe in, and breaking as I breathe out—this works great for me.)
19. Conclusion
The discoveries that have come out of the science of sleep are certainly interesting and useful. However, the science is still very much in its infancy, and there is much that we don’t know, and a great deal yet to be discovered. As the science progresses, though, we can expect to learn much more of interest, and also a great deal more that will help us get a better night’s sleep. Good night, and sleep tight.
*Thank you for taking the time to read this article. If you have enjoyed this summary of David K. Randall’s Dreamland: Adventures in the Strange Science of Sleep or just have a thought, please free to leave a comment below. Also, if you feel others may benefit from this article, please feel free to click on the g+1 symbol below, or share it on one of the umpteen social networking sites hidden beneath the ‘share’ button.
Cheers,
Aaron,
The Book Reporter
New Books in Brief 