Sleep is fundamental to our survival. It’s kind of like oxygen, yet most of us don’t view these essential functions through the same lens. In order to perform at our best, live long & healthy lives, and to explore our potential… we have to put the same value on sleeping that we do breathing.
Lucky for us, our guest today does exactly that – Dr. Aric Prather is a renowned professor, sleep scientist, clinical psychologist, and head of one of the world’s most successful sleep clinics at University of California, San Francisco (UCSF). Aric’s expertise lies in the fascinating world of sleep and its effects on our health and emotions. As the co-director of the UCSF Aging, Metabolism, and Emotions Center, and the clinician at the UCSF Insomnia Clinic, he has cracked the code to help restless sleepers achieve healing and restorative sleep.
With a robust research program supported by the National Institute of Health, Aric explores the causes and consequences of insufficient sleep. His work spans from large-scale population analyses to laboratory-based experiments, shining light on how poor sleep impacts mental health, immunity, and heart health – as well as – research driven solutions on how to sleep better.
In his latest book, “The Sleep Prescription: Seven Days to Unlocking Your Best Rest,” Aric offers a simple yet powerful plan to transform your sleep in just one week. Beyond the typical solutions, he shares surprisingly simple yet deeply effective techniques that will guide you in embracing the magic of restorative sleep.
In this conversation, you’ll hear about why sleep starts the moment you wake up; how sex plays a role in the quality of your sleep; the psychology of building habits around sleep; the ideal length for a nap; and so much more.
Whether you are someone for whom sleep seems elusive or you’re just trying to fine tune your sleep from “good” to “great”, Aric’s insights will guide you to that restful state where your body effortlessly does what it was built to do: sleep well.
“You don’t get to choose when you fall asleep. Sleep isn’t something that you make happen. Sleep is something that happens to you.”
In This Episode:
The need for better sleep
We know from the population level data that there’s a lot of people just struggling to get to sleep and to stay asleep. There was a huge uptick in this during the pandemic I think. Though, I would argue that over the last decade that I’ve been doing this and people around the country have been doing this kind of work, there’s become this thirst for understanding sleep. People are beginning to take notice, wake up to the importance of sleep, and so that’s really exciting, but there’s still a lot of need…oftentimes, I think people don’t recognize that the investment that you put in sleep actually puts you in a better position the following day and puts you in a better position to do all the things that you really want to accomplish. Some people just need some help in figuring out how to get that done.
The two main sleep challenges
If we were just kind of distilled to the two biggest drivers of sleep challenges in the United States, certainly it’s insomnia and obstructive sleep apnea, and then there’s people that get insufficient amounts of sleep. These are people that are just not getting the sleep they need. In some cases that’s due to insomnia or due to a clinical sleep disorder. Other times, it’s due to opportunity. We know across the population that sleep opportunity is not evenly distributed. There are segments of the population that don’t have an option to sleep as well as they could. They have to be night shift workers. Their jobs require that they keep these short hours or they have so many obligations and stressors in their lives that sleep kind of takes a backseat and they would get more if they could. I think that really seems to cover the broader perspective of what sleep health and sleep health challenges look like across the population.
Don’t worry, there’s some wiggle room
Though my bread and butter is talking about sleep and how important it is and making sure the message gets out, I also am not the fun police. I think there’s so much more to life, and I think I start from the perspective that we’re kind of built for sleeping. What I mean by that is your body will compensate. So your sleep was a little bit worse than it is usually. The trade-off was there. You knew the information, you knew what would probably happen and you made a decision and that’s fine. The good news is that tonight, assuming that you don’t drink the same amount of alcohol, you’ll likely be sleepy a little bit earlier, your sleep will be more restorative or deeper. It’ll be certainly likely more consolidated. There is this recovery mechanism that our body will do.
Build a wake-up routine
Particularly when you’re trying to build a habit, sometimes you need a carrot and ideally it’s something that’s meaningful for you. Think about myself, I have an 11-year-old and a seven-year-old, and they’re kind of great to be around, but not all the time. And so I love that hour before they wake up. I’m a big sunrise guy, so I like that kind of stuff. I mean, I can imagine for me, stabilizing my wake time, getting a cup of coffee, and watching the local news or being out by myself, not being on as in dad mode. But I’ve worked with lots of patients that have come up with creative things. Because we live in San Francisco, some people that I’ve worked with, they live near enough to the ocean and so they got into this habit of like, “Okay, well, I need to get up at seven or eight every morning, six every morning.” And they got up and then immediately got outside, did this walk on the beach that they didn’t do otherwise. And it was just a great moment for them to get some clarity, get themselves together, and it became this routine.
Sharing the bed
A majority of adults share the bed with another person. And as we age, our sleep can change, our preferences can change. And my experience has been people that have severe insomnia, they strangely have paired themselves with someone who sleeps like a rock. So now every night they’re wide awake and they’re looking at their partner who has been sleeping like the dead. And I always raised that the good news is that we don’t typically choose a mate based on their sleeping preferences. Presumably there are other things that attracted you to them, and we just need to figure out how to make this work. And you really want to keep the bed for sleep. It’s like a shrine to sleep. Like I said, we say sleep and sex because the bed plays such an important environmental trigger role in bringing on the feeling of sleepiness.
Sleep and sex
One would potentially make the argument that sex may have sleep benefits. So that is what people have suggested. And particularly orgasm. So the notion is that some of the neurochemical effects of orgasm can provide a relaxation response and help people sleep better. And there are kind of research studies, not as rigorous as maybe you’d want, to suggest that when people have sex, they may sleep better that night than if they didn’t.
Safety
It’s a really common experience. I mean, it’s basically known as the first night effect. It happens in the laboratory, it happens in a hotel. For most people when they sleep, unless they’re very sleep-deprived or they’re so excited about this, even if they are, I mean, it’s this new environment, it’s really hard to turn all the way off. It’s kind of like this idea of sleeping with one eye open or one ear open because you’re in this new environment and it’s really adaptive to be able to have this mix of crappy sleep for safety purposes.
Sleep rituals and stressors
We do a lot of work on measuring people’s stress during the day and how it affects their sleep, and then measuring their sleep and seeing how it affects how they respond to stress and that kind of stuff, and we, and many other sleep groups, find that when people get bad sleep, they’re much more sensitive to stressors during the day. But it doesn’t always work the other way. People can have all these things happen to them during the day and their sleep is fine. And I think it’s because there are so many behavioral rituals that protect us against the daily experiences that help us sleep. Now, there are, of course, caveats, like when something really terrible happens and it’s this ongoing stressor, or if it’s something that happens really close to bedtime, then all bets are off. But in general, the daily slings and arrows don’t really feed into our nights as much as we might think, because of these rituals.
Sleep policies
Policies can and should be put in place to protect the sleep of individuals. This is true in people that have shift work, this is true in people that have to have multiple jobs, the overworked, underpaid population. And I feel like there are opportunities for different industries to invest in the sleep of their communities, knowing that, in all likelihood, their employees will become better, more efficient, more productive workers. All of the literature that we have on sleep seems to show that, when people get the sleep they need, we’re the best versions of ourselves. We’re more creative, we’re more productive, we’re better leaders, we’re more empathetic, we’re better parents, we’re better partners, we’re more capable in regulating our emotions and dealing with the stressors of the day. All of those things are net positive.
Sleep aids
They all create a psychological dependency. I mean, melatonin does. Sleep masks do. I used to have a patient that I was working with that she used a weighted blanket, and she carried it everywhere, and it got so bad that when they went on trips with their friends, the friends would take turns paying for the extra luggage to carry this giant heavy blanket, because she couldn’t go anywhere without it. And I was like, there’s nothing wrong with a weighted blanket until something like that. And it’s hard not to be, clearly we need to work on this. You can’t go around with a weighted blanket for the rest of your life. Maybe you can, but it seemed challenging.
Transitioning into sleep
Getting back to the safety piece, one thing that I think is fundamental for people to put themselves in the best position for a good night’s sleep is to really create a robust transition. I think a lot of times what gets in the way is people think that… They act like they’re computers, where they can just shut down, but our bodies aren’t set up for that. And so it’s really important to be able to build in some me time to allow you to transition, and build in those rituals that we were talking about earlier. And so we suggest two hours before bedtime, really closing up, closing the book on whatever the day was. So, stop replying to that email. Stop engaging in things that are going to be arousing for your brain. And that doesn’t mean, okay, now you need to sit in quiet, and meditate for two hours, though, for some people that might work great. But for many of us it’s like things like relaxing things that we enjoy doing. It’s totally fine to watch TV, and be with your loved ones, but we’re really trying to hit the sweet spot of low arousal, slightly positive things for you.
Good sleep makes you happier and healthier
On a night where they get better sleep, they tend to experience more positive emotion in the morning, and more positive affect across the day. Population level data suggests that people who get sufficient amounts of sleep tend to report higher wellbeing. And then the health thing is indisputable, like people who get better sleep are more likely to have better health habits around nutrition, around physical activity. And it seems to compound, and have gains in physical health outcomes like heart disease, metabolic conditions, and the undisputed king of health outcomes, mortality.
