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Does your full schedule eat into how much you sleep at night? Are you frequently in noisy areas? Have you ever thought that maybe your sleep deprivation and surroundings (even if you can function well) are impacting your short-term performance and long-term health? Well, it is. And science can prove it.

Dr. Mathias Basner — an associate professor in the department of psychiatry at the University of Pennsylvania Perelman School of Medicine– who spent the past two decades researching how sleep and noise impact your cognitive functions (short-term performance) and long-term health, shares startling research findings that you might want to know.

Among other things, Basner’s research showed that at six hours of sleep per night, you will reach similar cognitive decline levels to those who do not sleep for a full night after 10-12 days, and at four hours per night, you will reach this level after five to seven days.

The brain, while sleeping, performs critical functions, including emotional processing and information triaging. Basner shared that one of the hottest theories right now is that sleep allows for brain plasticity, meaning your brain’s ability to modify its neural network connections or, in other words: rewire itself. If brain plasticity is impaired, you experience lowered ability to focus, memory problems, higher emotional instabilities, etc…

And that’s just the tip of the iceberg… think about how this affects your experience of life and effectiveness as a leader.

Tune in to get the full conversation and learn about:

• • • Clarity of the mind: effective leadership
    • Emotional Intelligence
    • The role of sleep in your life and for your body
    • How sleep deprivation may be impacting your ability to lead effectively
    • Short-term effects of sleep deprivation
    • How sleep impacts cognitive functions
    • Sleep deprivation research findings
    • How noise impacts your health short and long term
    • Research findings on brain plasticity
    • The trap (hint: blissful ignorance)
    • What is the optimum sleep amount per night
    • Key workarounds if you can’t get enough sleep

Dr. Mathias Basner’s biography:

Mathias Basner, MD, PhD, MSc is an associate professor in the department of psychiatry at the University of Pennsylvania Perelman School of Medicine. His primary research interests concern the effects of sleep loss on neurobehavioral and cognitive functions, population studies on sleep time and waking activities, the effects of traffic noise on sleep and health, and astronaut behavioral health on long-duration space missions. These research areas overlap widely. Basner has published more than 80 journal articles and reviewed articles for more than 80 scientific journals. He is currently on the editorial board of the journals Sleep Health and Frontiers in Physiology.

Between 1999 and 2008, Basner conducted several large-scale laboratory and field studies on the effects of traffic noise on sleep at the German Aerospace Center. For this research, Basner was awarded the German Aerospace Center Research Award in 2007 and the Science Award of the German Academy for Aviation and Travel Medicine in 2010. Basner developed an ECG-based algorithm for the automatic identification of autonomic activations associated with cortical arousal that was used in several field studies to non-invasively assess the effects of aircraft noise on sleep. He is currently funded by the FAA to obtain current exposure-response functions describing the effects of aircraft noise on sleep for the United States. Basner has been an advisor to the World Health Organization (WHO) on the effects of traffic noise on sleep and health on a number of occasions. He performed a systematic evidence review on the effects of noise on sleep for the recently published revision of WHO’s Environmental Noise Guidelines for the European Region.

Basner is currently President of the International Commission of Biological Effects of Noise (ICBEN) and member of the Impacts and Science Group of the Committee on Aviation Environmental Protection (CAEP) of the International Civil Aviation Organization (ICAO). He also represents the University of Pennsylvania in FAA’s Aviation Sustainability Center (ASCENT).

Connect with Dr. Mathias Basner:

• Website
• TED Talk

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Full Transcription:

Dr. Mathias Basner: It’s such a fundamental process. First of all, everybody’s doing it. I mean, we as humans are doing it. Dolphins are sleeping. The fruit fly is sleeping. Basically, life without sleep is impossible.

Tanya: That’s Dr. Mathias Basner, Associate Professor in the Department of Psychiatry at the University of Pennsylvania, TED speaker, and leading researcher on how noise and loss of sleep affect your health and cognitive functions. Dr. Basner has published and reviewed over 160 scientific journals. His research on the effective traffic on sleep at the German Aerospace Center won him the German Aerospace Center Research Award in 2007 and the Science Award of the German Academy for Aviation and Travel Medicine in 2010. More recently, his research, which is funded by the Federal Aviation Administration, or FAA, is focused on obtaining the effects of aircraft noise on sleep. Mathias, for somebody that spent an amazing amount of time studying how noise and sleep impacts health, I am dying to know in what environment do you live in. Do you live in a city or a really quiet, serene place?

Dr. Mathias Basner: I personally live in the suburbs of Philadelphia. Obviously, noise and the environment, in general, was one major driver for picking that location. We actually almost bought a house that was relatively close to a busy road. Then I said to myself with all the research I’ve been doing in the past, I really cannot buy this house because I know that it is affecting my health and the health of my children and my wife, of course. We decided against buying that house. Now we live in a house that is still very close to a lot of important infrastructure. The highway entry is just a couple of hundred feet away, but we don’t hear the highway. I believe we’re far enough away not to be affected by the air pollution that is generated by the traffic on the highway. That’s something that I generally suggest to people that they should make noise a priority whenever they pick a location where they either rent a place or even buy a place.

Tanya: Yeah, well, that’s going to be problematic because there’s studies that show that by 2050, two-thirds of the world population will live in urban areas.

Dr. Mathias Basner: Yeah, correct. There’s growing urbanization and it’s getting harder and harder to evade the noise, but I think this is why I, myself, and my colleagues were doing this research, basically showing what the negative health consequences are of irrelevant noise exposure. We’re hoping that not only politicians and regulators but also urban planners and architects, that they all take notice and that however we will be designing our urban environment in the future, that that is taking noise and also air pollution into consideration. They’re great examples. I mean, in many big cities, you will have blocks of houses, but then when you go through the house, there’s a beautiful courtyard basically in the back of all the houses, which is a refuge, which also means that if you place your bedroom on the back side of your apartment that is facing the courtyard, that noise is not such a big issue anymore. That is your own house is basically shielding you from the traffic that is going on on the front of the house. You have that refuge at the back of your house. You can basically make use of that.
Tanya: Yes. I mean, if you have that luxury, which is a huge luxury, yes, of course that’s great. Then also, for example, I have – so I live in New York City in a very, very busy area, I mean, not downtown, but still busy area right on a major street. I have double windows, which make all the difference. I’ve been in places where there’s not double windows, and my God, there’s constant noise. I just want to step back a little bit just so everybody knows, what area of research have you focused on?

Dr. Mathias Basner: I am very proud and happy that actually my research is not only in a single area, but it’s widespread. That developed naturally, I would say, but I think it’s a big advantage. Rather than being somebody who has been and is working, for example, just on a single calcium channel in the heart, I’ve been working on several areas that are all somewhat connected. Actually, when we were talking before this recording, it was mentioned it’s relevant in the sense that one area is sleep. Everybody’s sleeping. Everybody knows how detrimental it can be if you’re not getting enough sleep, either acutely or chronically. That’s sometimes a problem. Everybody, of course, thinks he or she is an expert in sleep because everybody’s sleeping and, of course, that’s not always true.

My career started actually at the German Aerospace Center. I wanted to become a – I studied medicine and I wanted to become a neurologist. I was interviewing and didn’t really find a good match with the department chairs. Then I saw that job opportunity at the German Aerospace Center. They were looking for somebody who had done sleep before. Actually, my dissertation was on sleep and I had worked in a clinical sleep laboratory, so I thought that was a good match. I was going to work there for 18 months and then go back in clinical medicine and I never did. I mean, I basically stayed there for 10 years before I moved over to the United States. They just started doing a study at the German Aerospace Center on the effects of aircraft noise on sleep. They were looking for somebody who knew the sleep part. This is basically how everything started. Then I already came with the sleep baggage, a little bit from my dissertation.

Once I came over to the United States, I did a deeper dive into the sleep area. Then I also expanded my research. At the German Aerospace Center, I mostly did affects – worked in aviation and looked at aircraft and traffic noise, but then here in the United States, I expanded my research into the space area. I’m very much interested in astronaut behavioral health and how we can succeed in sending a number of people, very likely four for the first flight, safely to Mars and actually bringing them back from Mars. The interesting thing is that sleep is a big issue in space flight as well. Noise is a big issue in space flight as well and, of course, noise affects sleep. There’s these three thematic areas are nicely overlapping. That makes it very interesting.

Tanya: I wouldn’t think of space as being a noisy place. I could get the sleep part. You’re in small confines with people. You’re floating, I mean, but a noise? Where’s the noise coming from?

Dr. Mathias Basner: The International Space Station is a marvelous machine, and there’s lots of pumps and mechanics and alarms. That is generating a lot of noise. I mean, it’s not up to the point where you would consider it dangerous for hearing, but it is pretty loud. It can definitely affect astronauts on their six month or even longer missions, and some of them even report that, that that can be very stressful.

Tanya: Yeah, actually, I was speaking with somebody, actually, on the Unmessable podcast that had been in the Navy for 32 years and spent 10 years at sea. For Navy people to be on a ship where there’s constantly things happening on a 24-hour basis where you get 3 hours or 2 hours of sleep, it’s brutal, and that’s a real issue. Okay, so one of the – a lot of your research is extremely interesting and pretty much touches everyone, but the one that I want to start with is neurobehavioral effects and cognitive function. You’ve studied the neurobehavioral effects of noise and sleep and how they affect cognitive functions. What is neurobehavioral effects and cognitive functions for people that don’t know?

Dr. Mathias Basner: We like to use the term neurobehavioral because it’s neutral, and it basically tells you everything you want to know. I mean, it’s, basically, neuro is the central nervous system, and behavior is what we’re interested in. It’s also what is basically what the central nervous system is doing. It’s like our brain is processing our environment and is eliciting our behaviors, so it’s a very neutral term that basically encompasses what we as human beings but also what many animals of course are doing. There’s so many different definitions of what cognitive means, of what psychologic means. We just like this term because it’s so nicely – just links our central nervous system to what we’re doing, behavior, and this is what I am very interested in. It’s the behavior. What are people doing? Why are they doing that? What is this doing – what is it doing to people in other ways that we could change that behavior that would lead to more healthy lifestyles?

Tanya: What are the effects of sleep loss on neurobehavioral and cognitive functions?

Dr. Mathias Basner: Oh, my, I mean, sleep is such a fundamental process. First of all, everybody’s doing it. I mean, we as humans are doing it. Dolphins are sleeping. The fruit fly is sleeping, so basically, life without sleep is impossible. We will notice very quickly after these typical 16 hours of being awake. Once you go beyond that, you will notice rapidly that you’re getting sleepy. You have the droopy eyelids. Really, it’s a very potent drive, this drive to wanting to go to sleep, which makes it also so dangerous. This is why about 20 to 25% of the traffic accidents – actually, sleep deprivation is considered the major cause of these accidents.

Tanya: Oh, wow! Twenty-five percent of the car accidents are due to sleep?

Dr. Mathias Basner: Yes.

Tanya: The need to want to sleep. Wow! I didn’t know that. That’s a big number.

Dr. Mathias Basner: Yes, this is actually why a world with self-driving cars, although many people are afraid of that, is going to be a much safer world in the end.

Tanya: Absolutely, 100%. Wow!

Dr. Mathias Basner: Also, these accidents tend to be more severe. Obviously, you’re falling asleep, and you’re driving towards a tree. There are no countermeasures because you’re basically having a micro-sleep. You’re not aware of your surroundings. Then you crash into that tree, and there’s a lot of fatalities, or people are permanently injured because of those accidents.

Tanya: Yeah, actually, sleep is a funny word. I mean, we all sleep, but I guess there’s different stages of it. If we take the car, for example, so many times I’ve been – I drove from one place to the other and had no recollection of the journey, which is frightening. That’s not a state of sleep, right? That’s just absentminded or something like that?

Dr. Mathias Basner: Yes, I would think and hope so. I mean, you made it home safely.

Tanya: Yeah.

Dr. Mathias Basner: Yeah, sleep is a very weird thing. Actually, 150 years ago, researchers thought that sleep is a very passive mechanism. It’s, basically, we’re shutting down. We’re conserving energy when quite the opposite is true. Sleep is an extremely active mechanism. Lots of things are happening in the brain. The sleeping brain consumes almost as much energy as the awake brain. Specific hormones are excreted exclusively during the night, and actually, the brain is still working on things that you experience during the day.

In fact, one of the hottest theories right now in sleep research is that sleep is the price we are paying for the brain’s plasticity so for the ability to change its wiring based on what we experience during the day. The idea is that, first of all, there’s limited space in our heads, right? I mean, what happens during the daytime, we gather new experiences, and that, basically, the neuron anatomical translation of that is that there are new neuronal connections made in the brain, or existing connections are actually enforced. That couldn’t go on forever because there’s only so much space in our heads. Basically, there has to be a time, and the idea is that that is sleep where we basically shut out the environment. We are looking at all these new information we gather during the wake period and compare that to already existing information, and then there’s a decision made whether, that connection, new connection that was made during the day, is it really worth keeping that connection, or should we make – get rid of that and make room for new experiences during the next day?

Actually, [00:16:49] and [00:16:50], who are the proponents of that theory actually termed sleep also as “clever forgetting.” It’s, basically, identify what you can forget and get rid of that. Of course, on the other hand, it’s memory consolidation, so basically, what we’ve learned, we want to consolidate that. The equivalent for would be like a computer scientist. Basically, getting it out of the temporary memory and writing it to the hard drive so that it is available for later retrieval.

Tanya: I mean, what you just talked about where the brain is doing all of these functions and triaging information and reinforcing current information while we’re sleeping is something completely new to me. I had no idea the brain was doing this, but the one thing that came up is it’s doing this subconsciously. There’s no conscious thought around triaging and doing all this stuff. It’s like your brain has a life beyond what you are aware of when you’re awake but also when you’re asleep. That’s fascinating.

Dr. Mathias Basner: Absolutely, there is so much happening in the brain, and we’re only aware of a tiny percentage. Actually, the brain is problem solving. There was a very clever study done by a colleague of mine, Jan Born. He was in Lübeck at the time. He basically had a task for subject. It was an arithmetic task. There was actually a very easy pattern behind that, and once you knew the pattern, you could go through the task very quickly. He basically gave that task to, I don’t know, 100 people, and 30 figured it out that were out of the study. The remaining 70, some of them were allowed to sleep, and the other half, they were not allowed to sleep. Then they both got a recovery sleep, but it turned out that, those people who had the sleep opportunity, way more of the subjects found that trick behind the arithmetic task the next time they did it. That is the brain – during the sleep episode, the brain was basically working on that problem, and those who did get the sleep opportunity then had that insight whereas the other people who didn’t have the opportunity to sleep over it – and this is why we say that, oh, you better sleep over it, makes a lot of sense because the brain is…

Tanya: Anecdotally, yes.

Dr. Mathias Basner: Yeah, absolutely, the brain is still working. Another very important thing why you should sleep over things is that sleep is extremely important for emotional processing. Actually, during REM sleep, what is happening is that, many of the emotional responses we had during the day, the memory of that is decoupled from the physiological arousal, and that’s actually a big problem in post-traumatic stress disorder.

Tanya: What do you mean is decoupled from the physical arousal?

Dr. Mathias Basner: The PTSD example is a good one. That if you have – let’s say you have a traumatic event, and of course, you have physiological arousal. Stress hormones are being excreted. Your heart rate rises. You basically have a panic attack, so what happens during sleep is that you – that this physiological arousal is decoupled from the memory of that event. Basically, the next day you could think about the event, but you don’t have that response anymore, right? That is what’s going wrong in post-traumatic stress syndrome. This is why many sleep researchers today believe that, if somebody had a traumatic event, you need to try to get that person to go to sleep and get that important REM sleep so that, actually, the physiological arousal can be decoupled from the memory of that event so that that person is not reliving not only the event over and over again but also the physiological arousal that is associated with the event.

Tanya: Oh, my God, that is so fascinating. Okay, so going back to some of the core research, what does sleep loss effects have on your body and on your health and on your cognitive function? Specifically, I’m thinking about – I mean, everybody goes without sleep if you have kids, if you have an intense job like lawyer consulting. I do consulting. We have pulled all-nighters. I’ve done 16, 18 hour days. Medical students that are doing their residency or fellowship, I mean, those are – that’s scary stuff. Those are extreme cases. On the lower spectrum, what’s the impact, and then on the higher spectrum, what’s the impact?

Dr. Mathias Basner: Yeah, so before I forget it, actually, sleep is also very important for sound decision making. A lot of the time, actually, politicians will pull an all-nighter, and then they step in front of the negotiation doors at 4 AM in the morning and present their decision or whatever. That may not be the best decision because of the sleep deprivation they engaged in. Fundamentally, yeah, we already talked about the neurobehavioral consequences. I mean, one thing that is early on affected and strongly affected is what we call vigilant attention, so just the ability to attend to a stimulus is very early on affected. Of course, that is the prerequisite for many of the more complex cognitive tasks. You cannot attend to your screen, for example. You will never be able to write your dissertation or whatever. A lot of the other more complex cognitive functions, like we already talked about memory, abstract reasoning, working memory, executive function, they are all, at some point, affected by sleep. Of course, that translates to that people who are sleep deprived are more prone to make errors, and that often translates into accidents. We already talked about the traffic accidents, but also, if you’re working at a nuclear power plant, for example, you don’t want to be sleep deprived, or if you’re just working the factory with heavy machinery, it’s more likely that you’re making errors and having accidents.

Aside from that, sleep also has metabolic consequences. There have been a number of studies, acutely sleep depriving people, also chronically sleep depriving people, which means not getting enough sleep on a chronic basis, that have been shown – these studies show consequences for blood pressure regulation, glucose tolerance but also for appetite stimulating hormones. These are all, basically, precursors for manifest diseases like high blood pressure, obesity, diabetes. There is good biological plausibility that if you are acutely sleep deprived multiple times or chronically sleep deprived that the likelihood for these metabolic diseases increases. Lo and behold, there’s – so on the one hand, we can do these experimental studies looking at what happens acutely to people. Then there’s also a host of epidemiological studies that basically asks people how much sleep do you get on a regular basis? Then they either follow them up or do that cross-sectionally, look at the health outcomes. There’s tons of studies out there showing that people who get either less than seven or less than six hours of sleep that they’re much more likely to have a much higher risk for these negative health consequences of diseases I just mentioned.

Tanya: That’s six to seven hours per night.

Dr. Mathias Basner: Yeah, that’s actually a big problem. It was actually the National Institutes of Health who approached the Sleep Research Society and the American Academy of Sleep Medicine and said, hey, guys, we’ve been funding you for 40 years. You still cannot tell us how much sleep people need? They took that task, basically, and got together a group of experts. They were tasked at looking at all the literature on sleep deprivation. Basically, looking at all the diverse literature, they came to the conclusion that adults should get on average seven hours of sleep or more per night to promote high levels of cognitive performance and health in the long run.

Now, obviously, there’s inter-individual differences. We’re not all the same. There are people who truly get along with six hours. There are people who truly need eight hours. If somebody tells you, though, that he or she is getting along with four hours, I would not believe that. That is definitely not enough to promote cognitive performance and health. A good ballpark estimate for the average person is 7 hours per 24 hours to promote optimal performance and health.

Tanya: Let’s say you’re a resident doing your residency in the hospital, and you have to pull a 24-hour shift. If you sleep let’s say 14 hours the next day, is that a cancellation of the negative effects that happened before, or it really has to happen every 24-hour period?

Dr. Mathias Basner: You know what? We don’t know a lot about that. We and others have done studies trying to find out what is this recycle rate. What’s happening a lot in our society, not even talking about physicians who have to do – there’s a lot of other occupations who have to do 24-hour shifts.

Tanya: Yeah, absolutely.

Dr. Mathias Basner: Just the standard population, we all have typically a five-day workweek, and we tend to sleep deprive ourselves during this workweek. The idea is that we then catch up on the weekend, right? There’s a number of studies out there now showing that, actually, oversleeping on the weekend, that that is not enough to get off – to get rid of the sleep that we basically accumulated during the week. I mean, in general, it’s, though, we have done studies looking at the question about does it matter how sleep is distributed across a day? At least the few studies out there right now do suggest that it doesn’t really matter whether you get eight hours at night or whether you get two hours during the day and then six hours during the night. It’s, basically, total sleep time that matters and not necessarily how you distribute it over the day.

The problem is, though, that there is something that we call sleep inertia in sleep research. It basically means that our brain needs some time to transition from the sleep to the wake state, very much like it takes some time to transition from the wake to the sleep state, so typically, when you go to bed, you don’t fall asleep right away. It takes a couple of minutes. I myself, I fall asleep after three minutes. My wife may take 20 minutes. Other people need 30 minutes, but it takes the brain some time to transition from being awake to being asleep.

The same is true in the morning when you get up. It’s not like a switch, and you’re performing at 100%. It takes up to an hour or sometimes even longer to get to that 100% performance level. That is why, distributing your sleep over multiple sleep periods, that may be a bad idea because you always have these transitional periods, and that can affect you. This is why we often suggest that, if you’re taking a nap and you know it’s going to be a short nap, probably actually have a cup of coffee before you take the nap. It will take some time for the caffeine to kick in, and actually, it will help you get over that sleep inertia after you wake up after the nap.

Tanya: Oh, my God, that’s a revolutionary idea that I have never heard before. I love that.

Dr. Mathias Basner: Yes, somebody actually called the term nappuccino.

Tanya: Nappuccino, that’s brilliant. Okay, so this is interesting. Okay, studies have shown that, on average, depending on the person, you need about seven hours of sleep within a 24-hour period, and you may or may not put it all in one chunk. Two things come up. One, sleep quality has to play a part in this. This is a huge part of your study as well is how does noise impact sleep? While you might think that you had a really good night of sleep – actually, on your brilliant TED Talk, which I recommend everybody to really go check out, you share a lot of great information. Some of the studies that you were monitoring didn’t necessarily doc the best quality of sleep.

It’s interesting because I have three kids under 3, and I have two dogs who bark at night when one kid gets up or hears anything. Even if there’s just a fly on the wall, they’ll bark. It’s horrendous, and so quality of sleep is a real big thing in my house. I could get up once. On a good night, I don’t get up. On a regular night, which is more often than not, I have one or two kids getting up, crying, dogs barking, and so it could be one to two to three times a night. I wake up, and I’m exhausted. Even if I have let’s say cumulatively seven hours of sleep, I am wiped, and my cognitive function is not as sharp. I can’t think quickly. It takes more effort to do things whereas if I have quality or what I think of quality I feel much better. What’s the story behind that?

Dr. Mathias Basner: Yeah, these awakenings that you mentioned are only those where you’re consciously – or you regain your waking consciousness, and it takes about two to three minutes for the brain to basically make you aware, consciously aware of yourself and your environment again. There may be many more briefer awakenings or what we call arousals that you may not even be aware of. I mean, first of all, it’s absolutely correct that it’s not only about sleep duration. We always say you need high quality sleep of sufficient durations, so there’s really these two qualities to the sleep, the sleep quality and the sleep duration. The sleep field has a little bit problems, though, of what is a good way of defining sleep quality? One major problem is that sleep is not very well accessible to subjective assessments. Typically, a lot of the things researchers do is hand out surveys and ask people how they feel or what they did, and sleep is this strange period where we know we are unaware of ourselves and our environment.

I mean, a very good example is the studies on the effects of traffic noise on sleep that I myself and my colleagues did at the German Aerospace Center. We put all these electrodes on people to measure their sleep, and then they get up in the morning. You ask them, oh, how was it last night? They say perfect. I feel asleep right away, and then you woke me up. I had a wonderful night. Then when you actually look at the electrophysiological data, you can see what’s actually going on with the brain. In some of them, we saw these numerous arousals. Basically, the brain not getting the rest it needs.

As we alluded to earlier, sleep is not a uniform process. There’s different sleep stages. There’s light sleep and deep sleep, and then there’s the rapid eye movement sleep or REM sleep. Basically, every 90 minutes you cycle through these different sleep stages but what is very important for sleep recuperation is continuity. That is that you have a longer bout of deep sleep, for example. If you have noise intruding into your sleep and waking you up out of that bout of deep sleep, then you have to find your way back into deep sleep, and then there may be another noise event and waking you up again. Actually, this is what we found in many of our studies. The amount of the different sleep stages is probably not even that much affected. I mean, there are small effects, but just this fragmentation and disturbing this natural process that sleep is going through, that is just so detrimental for what is happening in sleep.

It’s a colleague of mine, [00:35:23]. He had a very nice example just in terms of not getting enough sleep. He always has the example of a washing machine where you would never put your clothes in a washing machine. Then start the process, and then take everything out after half an hour. Everything is still dirty and wet, and the whole thing needs to go through the whole process before you have the finished product. The same is true with sleep as well.

Tanya: How would someone know if they’re getting enough sleep and enough quality of sleep if they’re investing seven hours or so per night? Like you mentioned, some people have even said that they feel great, but effectively, it wasn’t enough sleep.

Dr. Mathias Basner: Right, aside from if you’re as lucky as I am and you have access to measurement equipment, right? I just recently measured my own blood oxygen saturation overnight just to make sure I don’t have obstructive sleep apnea, which is this sleep disorder where your airway collapses, and then you’re not really breathing. Then the oxygen saturation falls in your blood, and that wakes you up. Again, this is one of the examples. There are lots of people with that disease, and they have no insight whatsoever. They think they slept perfectly because their sleep pressure at that point is so high because their sleep is not recuperative that they – after each event, they will fall asleep right away again, which means they’re not consciously aware of what’s happening to them, but they still have this massive sleep fragmentation that is basically ruining the whole recuperative value of their sleep.

The only chance you really have is if their sleep quality is very low and you’re not getting enough high quality sleep. That will have affects. You may feel foggy. You may not be able to concentrate, or you’re actually falling asleep in situations where you shouldn’t fall asleep. I mean, obviously, the car is a good example. Also, you want to watch a movie at night, and you fall asleep in front of the TV, or you’re in a lecture, or you’re in a meeting, and you’re falling asleep. That is very good and important sign telling you, hey, you are not getting enough high quality sleep.

Now, what the reason for that is, of course, it could be manifold. You could have a sleep disorder, not knowing about, and obstructive sleep apnea is just one out of many. You could be somebody who needs – even if you get seven hours of sleep, you could be somebody who just biologically needs more, or perhaps you are in the situation like you where you have three kids and two dogs. You’re having fragmented sleep. Not even having the insight into that your sleep is fragmented. I mean, this is – that’s really the only thing outside from measurement equipment and cognitive testing, which is not available for everybody. That is the best sign that you’re not getting enough sleep.

There is one caveat, though, and this is also, basically, one of the major findings of studies that my colleague who is five offices down, Dr. David Dinges, did a number of years ago. Basically, a lot of the knowledge that we have on sleep deprivation is based on what we call acute total sleep deprivation, basically not allowing somebody to sleep for a full night. However, that’s not what society is doing. We’re talking chronic sleep restriction. People are not getting enough sleep on a chronic basis. These studies are much harder to do, and this is why not many people have done them in the past. This was the first and largest one. Basically, putting people in the sleep lab and only giving them six hours or four hour sleep opportunity, and then having a controlled group of people who are allowed to get eight, and then see what’s happening to them.

The interesting thing there was that – basically, the cognitive performance, especially that attention component I talked about earlier, that that was affected very early on, and it just got worse and worse and worse. Actually, in the four hour group, after one week, you were as bad on this cognitive performance test as people who didn’t sleep for a full night, and after two weeks, you were as bad as somebody who hasn’t been sleeping for two full nights.

Tanya: Wow!

Dr. Mathias Basner: Now, the interesting thing is, in that study, they also had people fill out questionnaires. They were asking them how sleepy do you feel? After the first two nights of sleep restriction, there was an increase in sleepiness, but then it basically leveled off and stayed constant for the rest of the time. That basically suggests that we as humans are getting used to feeling sleepy.

Tanya: Yes, that’s the scary part, actually.

Dr. Mathias Basner: Right, and we don’t know how good we could feel and how well we could perform and how creative we could be and what great decisions we could make if we only would get enough sleep because we’re just used to feeling shitty. That is one of the major insights of that study. This is probably why, actually, 35 to 40% of the population are not getting that seven hours of night that we typically need to perform optimally.

Tanya: Yeah, it’s interesting. As you’re speaking, one other thing that’s coming up for me and I’m sure other people can relate to this whether or not they have kids, if they work a lot, is I’m in my mid-30s, and I have noticed a decrease in health. I have a few aches here and there. My back hurts, and my wrist does some funny stuff. I can’t put pressure on it. I’m wondering what part did my lack of sleep and me getting used to it and not even know about it play in my body’s ability to stay healthy and recover from small things that I didn’t have to deal with before.

Dr. Mathias Basner: Yeah, absolutely. I mean, many people, including us, we’re concentrating on the brain because that is, of course, the most important organ. A lot of things are, obviously, generated and controlled from the brain, but sleep is recuperative for the whole body. I mean, if you have a small ache or if you injure yourself, you will recuperate much faster if you’re getting enough sleep. This is why noise in the hospital is so detrimental.

Tanya: Oh, my God, I know.

Dr. Mathias Basner: This is the place where people need to recuperate and get enough sleep. If you have a flu, what do you do? You lie down and sleep. The body is basically trying to get the sleep to be able to fight the infection, and so this is why it’s so bad that our hospitals are so loud and that there are so many alarms and everything.

Actually, I can’t see it outside my window, but the University of Pennsylvania is just building a brand new hospital. They want it to be the hospital of the future. They consulted with many people including ourselves here just trying to make that the best experience for the patient and try to generate an environment where the patients heal optimally. This hospital will only have single-patient bedrooms. There will be actually a window that, with a switch, you can make that see-through or not see-through, so the nurses can actually check from the outside on the patient without having to enter the room, making noise, waking the subject up. You can refill the cabinets from the outside, so you don’t have to go inside the room. The whole idea is – the light system is changing its intensity and the spectral composition.

I actually was going as far as saying we actually have to have separate floors, floors for larks and for owls. You may know that we all have a different circadian preference. Many people like to go to bed early and like to get up early, and other people can only go to bed late. They would like to get up late, but then society’s often preventing them from doing that, which is what we call social jet-lag I thought it was a pretty cool idea to actually have a lark floor where the nurses start with preparations for the night on that floor, and then they switch the light off at 10:30 or 11. These patients are woken up at 5 AM. They don’t care. They’re up anyway because this is what their circadian system is dictating. Then, once you’re done with them, you go over to the other side of the floor where all the owls are, and you get them ready. Then you wake them up much later.

I think this is what personalized medicine is all about. You want to basically tailor your therapy to the patient. I think this could be part of it.

Tanya: You know what? I so love that idea. My identical twin girls were born at 28 weeks. I had a pregnancy complication that was called twin-to-twin transfusion syndrome, and we had to take them out. One of my twins was in the NICU at Mount Sinai on 95th and 5th Avenue in Manhattan for 180 days and the other one for 129 days.

Dr. Mathias Basner: Oh, wow!

Tanya: What you’re talking about – some of the doctors were telling me that 90% of their healing is going to happen when they’re sleeping and especially true for fetuses that really shouldn’t even be out of the womb, and so with metal garbage cans and beeping alarms and this 24-hour hustle and bustle factory of people coming in and out, I mean, it was – it is so incredible to see that there are hospitals taking into account some of the incredible research that you’re doing to really leapfrog the recovery process for patients and, ultimately, decrease the cost of care.

Dr. Mathias Basner: Absolutely, yeah.

Tanya: Yeah, so there’s a financial motivation.

Dr. Mathias Basner: Yeah, it’s a win-win.

Tanya: Absolutely, yeah. No, that’s great. Okay, so shifting to daytime noise because, my God, we have a lot of that. It’s interesting because you have a very specific definition of what noise is. What is that?

Dr. Mathias Basner: Yeah, so noise is defined as unwanted sound, and that makes it a very strange animal. Actually, the sound itself, there’s a physical component, which is the sound, and decibels play a role. How loud is that sound, and what kind of sound is it? Then there’s also the psychological component that is, basically, the circumstance that makes the sound unwanted. My boilerplate example is always the rock concert. Obviously, the people attending the rock concert, it can be 90 decibels or even – actually, I was at a concert with my 12-year-old daughter, and I measured 104 decibels. I mean, obviously, me being in this profession, I brought sound protection.

I guess that 95% of the people didn’t have that, and they must’ve had a very bad ringing on their ears the next day. Still, for them, it wasn’t noise. I mean, that’s the point I’m trying to make. I mean, they paid $200 for the ticket to see the band. They like the band. They like the music. They enjoyed themselves greatly. Even though the physical sound was very loud, it’s not noise to them because they just enjoy themselves in that situation.

Then there could be somebody who’s living three blocks away from the concert hall just sitting there trying to sleep or trying to read a book, and that is impossible because they’re still hearing the music from the concert hall or arena. Although the noise levels or the sound levels are much lower, it’s still noise in that situation. It’s annoying. It’s interfering with an intended activity, and that person thinks of that music as noise at that point and actually can trigger reactions that in the long run may have health consequences.

Tanya: What are the consequences or health consequences of what I guess you refer to as noise pollution, that undesired noise?

Dr. Mathias Basner: Yeah, basically, I mean, it is – what’s happening in the body, it’s a stress reaction. This is why the notion of something being unwanted plays a role. It’s more stress if it’s unwanted, and basically, what happens in the body, the body excretes stress hormones like adrenaline and cortisol. These stress hormones lead to changes in our physiology. Actually, there have been studies showing that the walls of our arteries are stiffer after a single night of noise exposure, but it’s also changing the composition of our blood, like cholesterol levels and also the blood clotting properties of the blood. All in a way that are consistent with an increased risk for cardiovascular disease in the long run.

Lo and behold, there are a number of epidemiologic studies out there showing that, if people are exposed to relevant noise levels over a prolonged period of time, that they have a higher risk of high blood pressure, myocardial infarction, also, potentially a higher stroke risk, and there’s the first few studies coming out now looking at other non-cardiovascular disease outcomes, for example, the risk for diabetes, obesity but also cancer. There’s all good biologic plausibility for these health outcomes. I mean, for these latter end points, we don’t have enough good studies yet, but I think most people would say that for cardiovascular disease there is – we have good enough evidence to suggest that if you’re exposed to relevant levels for prolonged periods of time that you’re cardiovascular disease risk increases. These risk increases are not crazy high. It’s not like your lung cancer risk in smoking, which is twice as high or something. It’s only a risk increase of a couple of percent per ten decibels.

The thing is, though, that so many people are exposed to, for example, traffic noise that because of that it’s a major public health problem. There was one study a number of years ago showing that if we could lower environmental noise exposure by 5 decibels that that would save $3.9 billion just in treatment for cardiovascular disease alone.

Tanya: Wow! The same way that we talked about there’s an unconsciousness about the quality of your sleep, like you could think you had a great night sleep and you actually didn’t if you were to be hooked up on monitors, can that be true for also your awareness of how your environment, for example, being in New York City and hearing the traffic, for that to cause on your body? Frankly, there is so much noise around me all the time that I think I’ve gotten used to it, and in fact, it actually doesn’t bother me. So many times I could see people visiting me, or we’ll be out on the street. I can focus, and I can have a perfect conversation and tune everything out. Other people are just wrecked by what’s happening around. While it doesn’t bother me in the moment, can it still have a negative impact on the health?

Dr. Mathias Basner: Yeah, I mean, we talked already about the concept of habituation or even adaptation in terms of sleep or chronic sleep restriction, and certainly, there is habituation also relative to noise in the sense that, at some point, you don’t realize the constant noise exposure any longer. I think it’s biologically a very plausible mechanism that’s going on in humans. Otherwise, we wouldn’t be able to function at all in that environment. However, it doesn’t mean that the noise is not affecting us anymore.

I think the best example is – it’s an anecdote, but I was at a conference in Japan, and oh, my God, I mean, it was so quiet there. I mean, first of all, Tokyo is a huge city, but it’s incredibly quiet. The conference was in Nara, which is a World Heritage Site. It’s beautiful. It’s so quiet, and actually, I didn’t realize that it was. I mean, I realized it first when I got to Tokyo. I said, oh, this is pretty quiet. Then, when I was in Nara, I didn’t realize anymore how quiet it was. Then I got back to Los Angeles airport. It was really this wall of sound was hitting me, and only then do you realize. Oh, my God, I’m exposed to this all the time?

Yeah, it is not good for your health. We really should seek out those quiet environments more, and again, this is why it’s so important trying to, A, find an environment where you live in that is quiet. If you don’t have that, seek out these environments as often as you can. This is why something like Central Park is so important.

Tanya: Yes. If you seemingly have adapted to the noise around you, does your body still perceive that as stress and, therefore, produce cortisone or other hormones?

Dr. Mathias Basner: It is still doing that, yes. It’s probably even worse if you’re also having the conscious component attached to it. I will get a lot of calls from people who are like fighting something. Somebody’s building something new in their vicinity, or something has built something like, I don’t know, a wind turbine, or there’s a new highway, or whatever, and they have been fighting that with the companies and regulatory bodies. At that point, it’s real stress. Obviously, you’re also somebody who is, well, at least somewhat sensitive to the noise. Otherwise, you wouldn’t be fighting it, and at that point, it is a major problem. The body is still reacting to it. We already had that example from sleep, noise exposure during sleep. We’re also not aware of it, but it’s still affecting us.

I mean, we did field studies in people’s homes, people who have been living in that environment for many, many years. Obviously, they are reacting at the same sound level with a lower probability relative to our laboratory studies, but they’re still reacting. I mean, it’s not what – they’re habituating, but they’re not adapting. Adapting would mean that there’s no reaction anymore. Our auditory system is special and unique in the sense that it has that monitoring function. It is constantly monitoring our environment. Anything happens, somebody slamming the door next to you, you will startle, and your attention will be directed to that door. Even more important during the night, this is our channel that tells us something about our environment. If there is a tiger approaching, or an elephant roaring next to us, or whatever – I mean, I’m not talking evolutionary perspective. This is the organ that tells us, hey, it’s time to wake up. This is a dangerous situation.

Quite honestly, sleeping is super dangerous, right? We’re unconscious of our surroundings, and we are easy prey for whoever wants to eat us or take advantage of us. Having the auditory system is super helpful and it has been super helpful in terms of survival in the past, but now it’s not that important for us anymore. We live in our safe buildings and everything, and there are not that many tigers around here.

Tanya: Luckily.

Dr. Mathias Basner: Yeah, luckily. It’s affecting us in different ways now. It’s still doing the job it has done so phenomenally over the past thousands of years. Its’ still waking us up. It’s still arousing us. It’s still alerting us. It’s still getting us ready to run away. It’s still secreting stress hormones to secure our survival, although it may not be that necessary nowadays.

Tanya: Okay, so that is very interesting. Now, what about desired noises? This is something that, gosh, everybody can probably relate to. You’re working, and you have music going. You’re in your home, and you have the TV in the background. You’re in your car. You have the radio or whatever, music. You go into the subway or a bus, and you put your earphones on. There’s always constant noise around, but it’s wanted. Does that have any impact on the health?

Dr. Mathias Basner: I think so. I mean, I haven’t done research in that area myself. I think we have – in general, we have a problem, and I’m not excluding myself. There is no down time anymore whatsoever. We’re not only talking the auditory system. We’re talking the central nervous system, basically. I mean, people are stepping into an elevator, and they’re looking at their cellphone.

I still remember when I was growing up, and I’m a little older than you are. There was just taking a train to the next bigger city, and we would just sit there and stare out the window and talk to each other. Nowadays, as you say, everybody is listening to music; they’re looking at their phone. There’s really no downtime whatsoever. Obviously, a subway is still very loud, so you’re trying to drown that out with the music. The only way you can do that is making the music even louder, so it is dominating the background noise. I’m disclosing that I’m not making money from any of these companies. Noise-canceling headphones are such a brilliant idea to use them. Basically what we do, we adjust the noise level always relative to the background level. The best example – and this is also where they work best – is like a plane. You have a 60-decibel background noise level, so if you want to listen to the music, you have to crank it up to 80 decibels or whatever, and that’s where it’s starting to get unhealthy for your hearing.

However, if you’re able to lower the background noise by 20 decibels and you only have to listen at 60 decibels, that makes it much more healthy for your hearing. If you want to do something good with a Christmas present or a birthday present, that’s a great present to give somebody, noise-canceling headphones, and especially the adolescents and kids who are constantly exposing themselves to the music.

The problem is we, as humans, are really bad at assessing what we’re doing right now, how that is related to our long-term health. Obviously the kids say, “I don’t care. I don’t notice anything,” but they don’t realize that 10, 15 years down the road, they will start to get tinnitus or they will start to hear worse. It’s just something that is –

Tanya: It’s incremental over time.

Dr. Mathias Basner: Right, it’s accumulative stress on the auditory system, and at some point it will show. That’s 10, 15 years down the road and they just don’t realize. This is educational campaigns, giving them the noise-canceling headphones, all of that is very important, a very good idea, because otherwise we will – we’re already a nation of people with hearing disabilities, and it will only get worse if we are not paying attention.

Tanya: Yes, and actually I’m thinking about open floor plans at work. That was in tremendous fashion probably the last five years, ten years, something like that. That’s tough. Now it’s starting to not be as in fashion as it was, but that’s really an issue. One of my friends sent me an AI noise-canceling subscription that I can join that is hooked up to my computer that cancels out everything. I was like, oh, my God, that’s brilliant.

One existential, fundamental question: Why are we, as a society, so uncomfortable with silence or just empty space or empty time and have this amazing need to always fill int eh void with looking at the phone, or having music, or something?

Dr. Mathias Basner: I’m no expert in this. In terms of the silence and noise, it’s like there are these chambers that totally absorb all the noise, and people report feeling uncomfortable in these rooms because it’s really dead silence. I believe that is because – I mean, certain sound environment, that’s something we grow up in, and it’s typical. Even if you’re on a farm far away from any civilization, there’s a wind blowing, and there’s the leaves rustling in the wind, and there’s animals. That is all part of our natural environment, so completely getting rid of that feels very unnatural. That makes many people just feel uncomfortable because of that. That’s so true for everything in life. There’s something like a gold middle. If you have too much of something, it’s not good; if you have too little of something, it’s probably not good, either.

This is, again, just an anecdote. I had some of my best ideas just jogging through the woods, not listening to music, because that’s when your mind starts wandering. You’re starting to explore areas that you never thought about. If you’re constantly feeding input into your brain, there’s no time for doing that anymore. Your brain is constantly addressing the new information that’s coming in. I don’t know what it’s going to do.

I just introduced a cellphone and iPad-free Sunday in my family because I just couldn’t stand my kids constantly looking at the screen and doing nothing else.

Tanya: Mm-hmm, I like that.

Dr. Mathias Basner: Yeah, and I mean, it has only been one Sunday so far, but they actually went out and played tennis with each other. I felt rewarded right away that they did something together and something that didn’t involve technology.

Tanya: Yeah, there’s absolutely something in the world of parenting that we talk about, actually we’re starting to talk about a little bit more, and that is over-scheduling your kids. This Type-A personality, got to put them in tennis, and ballet, and this, and that, and gym, and karate, and school, and after-school activities, and early drop-off, and play-dates, and it’s all this structured activities that, like you said, doesn’t allow for sitting and wandering or creative thinking. That’s where some of the most connecting the dots happen and out of the box thinking occurs. That’s something that I’m really mindful as a parent and actually should apply that to myself.

Dr. Mathias Basner: Yes. Another big problem is talking about over-booking the children. I mean, my older son is in high school now, and they have crazy schedules. I mean, there’s a big movement now trying to postpone high school start times, and I think that makes very good sense. Neighboring school district has just done it, and we’re fighting that our school district is doing the same thing. There are some kids that like being picked up by the bus before 6 AM. Then we actually wrote an op-ed in the Philadelphia Inquirer and parents contacted us saying oh, my daughter is on the track team, and she has to get up at 4 AM in the morning to do practice before school. Do you think that this is healthy? Hell, no.

Tanya: Zero.

Dr. Mathias Basner: Adolescents need so much more sleep than adults do. Then the crazy amount of homework that they have, there’s literally no time for what we just talked about, winding down, just doing nothing. Every little bit of the day is filled. The other crazy thing is we went to a information hour just informing us what colleges are looking for. Basically these children have to build a portfolio that is very similar to what I have to build to being promoted to full professor. Basically you have to document everything; you have to show this and that area and that and that area. These are children! It’s really crazy.

Tanya: Yeah, it’s twisted. I know, it’s twisted. We’re thinking about public school and private school and what’s the process of doing that. We’re talking about kindergarten or pre-kindergarten.

Dr. Mathias Basner: Yeah, it starts earlier and earlier.

Tanya: Yeah, and my neighbor just went through that. She put in herself a solid 60 hours of essay-writing and all this stuff to get her two twins into – I mean, it’s twisted, and they’re 5.

Dr. Mathias Basner: It’s really nothing you should laugh about. It’s sick.

Tanya: It’s bad. Okay, so just to – if you were to look at all of the stuff that you’ve done in your life, what is the one thing that stands out, like a discovery or some type of research that you’ve found that just blew your mind?

Dr. Mathias Basner: That blew my mind?

Tanya: Blew your mind, like my God, I cannot believe that this is what we found.

Dr. Mathias Basner: Well, we had one finding, but we are still checking whether that is true. We talked a little bit about that, and that is the question whether we can recycle after a period of sleep restriction. What’s even more important is that actually the degree your cognitive performance is affected if you engage into a period of acute sleep deprivation, that that depends on how much chronic sleep loss you have on board. Whenever I lecture to students, I’m making sure I’m showing this one slide because basically, we did a study where we did this chronic sleep restriction for five nights, only four hours’ sleep opportunity, and we had a control group In the sixth night, we gave them different amounts of sleep opportunity, 12 hours, 10 hours, 8 hours, 6, hours, 4, hours, 2 hours, and then there was one group that was not allowed to sleep at all during that sixth night. You can nicely see how their performance changes. It’s a nice dose response function. The people who got 12 hours’ sleep opportunity of course recovered greatly and almost were back at the level of the control group. Then the less sleep they got, the worst they did on the cognitive test. Then looking at the group that didn’t get any sleep that night, they were off the chart. This slide is very powerful in the sense that at first, it only showed the groups that got two hours or more, and then you add the group that didn’t get any sleep and it’s off the charts bad.

Tanya: The cognitive function is off.

Dr. Mathias Basner: Cognitive function is off the chart. They’re basically disintegrated. This is what you know.

Tanya: What does that mean, disintegrated? Problems writing emails or problems formulating sentences?

Dr. Mathias Basner: This is a specific test where there are symbols on the screen, and they have a number code, and then you get a symbol shown and you have to find the number. It’s about complex scanning but also working memory and of course, the motor control. I don’t know if people typically in 90 seconds get 60 right. After that full night of sleep, they only would get 40 right. It was a major decrement in their performance.

In the last lecture before Spring Break, I tell students, “Don’t do that. You had all your exams. You all didn’t get enough sleep, which is a bad idea anyway,” which we talked about, “but if you then drive down to Florida during the night, that is a recipe for failure, chaos, death, whatever you want to call it.” They have the chronic sleep restriction on board. Then they’re engaging into acute total sleep deprivation and then driving during the night, which is when the circadian system is actually maximally promoting sleep and not wakefulness. These three components together – and especially then alcohol gets in the mix.

Tanya: That ends up as a statistic.

Dr. Mathias Basner: Yes, absolutely.

Tanya: Twenty-five percent, yeah, wow. Okay, so that’s amazing. I look forward to seeing if you’re going to pursue the studies and figure out if actually after all these terrible years of being at a loss of sleep or a lack of sleep if we can actually recoup. Hopefully the answer is yes at some point.

Dr. Mathias Basner: Yes, that would be nice. Again, there’s still a lot to be done. I think we need to step out of the laboratory and get more –

Tanya: Longevity studies, actual real-life studies.

Dr. Mathias Basner: Absolutely, yeah. What we haven’t talked about and is something that is just emerging but is emerging at a crazy pace is that neurodegenerative diseases like Alzheimer’s – it’s more and more clear that sleep deprivation is a major driver of that.

Tanya: Is it?!

Dr. Mathias Basner: Yeah.

Tanya: Is Alzheimer’s, for example, on the upswing? I keep hearing – I don’t know if it’s because the people that are around me are getting older and they’re are getting more – diagnosed with Alzheimer’s but is it just me or there’s been more cases as of lately?

Dr. Mathias Basner: I guess people are getting older in general. Obviously that disease is strongly associated with age. Also there is more awareness and maybe diagnosed more. It’s really hard to say whether it’s really on the upswing. I also have to admit I don’t know the literature as well as I could say whether it – there are truly science that it is increasing or not. One of the functions of sleep seems to be actually we have something like lymphatic space in the brain as well, and basically they open up while we’re sleeping and all the toxic, metabolic products that have accumulated during the wake period are flushed out of the system. It’s like a garbage disposal function. Those little proteins that are responsible for Alzheimer’s are also being transported away. If you’re not getting, again, enough sleep on a chronic basis, that may be the reason why these proteins are accumulating in your brain and then you may have a higher probability of acquiring Alzheimer’s and other neurodegenerative diseases. This is why getting enough sleep is so important.

The one thing I also want to stress, though, is we’re walking a fine line. On the other hand, we want to educate the population basically telling them hey, sleep is important Try to get enough sleep. Then you could also basically tell the story as a horror story. If you’re not getting enough sleep, you’re going to become fat, and get diabetes, and a heart attack, and Alzheimer’s, and everything. We don’t want to do it to a point where people are actually afraid of not getting enough sleep because that is one of the key symptoms of insomnia. People are worried that they’re not getting enough sleep and then all of a sudden, actually you’re lying in bed and you’re worried, and it basically triggers an arousal reaction and then you can’t fall asleep. We don’t want that, either.

It’s just making a few lifestyle adjustments. Exercise, we haven’t talked about exercise at all. Sleep and exercise go very well together. Exercise is promoting healthy, high-quality sleep. Getting enough sleep on a chronic basis is lowering injury risk. If you’re doing sports, that’s a very good thing to do. We also didn’t talk about sleep hygiene. There are so many ways you can promote a healthy sleep: a dark, quiet, adequately temperate bedroom; no TV in the bedroom, very important; don’t expose yourself to bright light during the night but seek out the outdoor environment during the day because no matter how bright your indoor light, it’s at best 600 to 800 lux. If you go outside on a cloudy day, it’s a 10,000 lux. If you go outside on a sunny day, it’s 30,000 lux. This is why we need the natural environment to really boost our circadian system and train is to the 24-hour days so we can fall asleep at the right time and get up at the right time in the morning.

Tanya: You bring up a really great marriage here between working out or exercise and then quietly sleep. Why do they go so well together as opposed to just exerting, let’s say, an as long of a day, let’s say an intense day, but not having that same effect as if you were to go work out?

Dr. Mathias Basner: I don’t really know. It’s just that the studies are showing this. Actually for the longest time, the sleep hygiene recommendations were do not exercise before you go to bed. There’s more and more studies showing that that actually doesn’t seem to be that detrimental for sleep or that it may actually be beneficial for sleep. I myself published a paper very recently, Analyzing Data of the American Time Use Survey basically where people were asked how they spend the 24 hours of a day. What we were interested in, what those people who were short sleepers, what waking activities are they trading their time for? Someone who sleeps six hours has two hours more spent awake than somebody sleeping eight hours, so what are they doing?

If I ask that question to students, most of them will say ah, watching TV, and that’s true, but work is actually the number one sleep killer, work time. We were asking what about exercise? I had the idea when a friend of mine told me she was getting up at 4 in the morning to go to the gym before she goes to work. I said, “Hey, that can’t be healthy in terms of sleep.” We looked whether exercise was stealing sleep time, and yes, actually that is true, but if you’re not exercising immediately before work and if you’re not overdoing it, then it’s actually compatible with each other. For that paper, I just read a lot of the literature and there’s a lot of the literature out there showing people who are exercising, that they have a better, longer sleep relative to those who do not exercise.

Tanya: I am inspired. I have to get back on the exercise train, which I haven’t been on for ten years, admittedly. I think that’s really going to help. I’m sure a lot of people with what you shared today, which I am so grateful and appreciative because I know for me, it made a difference. I know that if it made a difference for me, it’s going to make a difference to a lot of people. Thank you so very much for your time.

If people want to get in touch with you, how do they reach out?

Dr. Mathias Basner: Just by email. It’s Basner, my last name, and then @Upenn.edu. Thanks for having me. I’m always happy to spread the word and try to not educate people in a teacher kind of way but just getting the word out there how these different things can affect our health and whether there are things we can do to make sure these things don’t affect us and that we live a happier, longer, and healthy life.

Tanya: Absolutely, that’s so amazing. Thank you so very much for being on.

Dr. Mathias Basner: Thanks for having me.