On sale April 5, 2016, The Sleep Revolution: Transforming Your Life, One Night at a Time is a comprehensive, scientifically rigorous, and personal look at sleep from one of the nation’s most well-known sleep health advocates. Publisher Harmony Books provides the following Q&A.
What led you to write The Sleep Revolution?
As I went around the world talking about my last book, Thrive, I found that the subject people wanted to discuss most—by far—was sleep: how difficult it is to get enough, how there are simply not enough hours in the day, how tough it is to wind down, how hard it is to fall asleep and stay asleep, even when we set aside enough time. And since my own transformation into a sleep evangelist, everywhere I go, someone will pull me aside and, often in hushed and conspiratorial tones, confess, “I’m just not getting enough sleep. I’m exhausted all the time.” Or, as one young woman told me after a talk in San Francisco, “I don’t remember the last time I wasn’t tired.” By the end of an evening, no matter where I am in the world or what the theme of the event is, I’ll have had that same conversation with any number of people in the room. And what everyone wants to know is, “What should I do to get more and better sleep?” So I decided I wanted to take a fuller look at the subject because it’s clear that if we’re going to truly thrive, we must begin with sleep. It’s the gateway through which a life of well-being must travel. From the moment we’re born until the moment we die, we’re in a relationship with sleep. I wrote The Sleep Revolution to examine this ancient, essential, and mysterious phenomenon from all angles, and to explore the ways we can use sleep to help regain control over our out-of-kilter lives.
Why are you so passionate about the power of sleep?
For one thing, sleep is something we all have in common—it’s one of humanity’s great unifiers. It binds us to one another, to our ancestors, to our past, and to the future. No matter who we are or where we are in the world and in our lives, we share a common need for sleep. And right now, we’re in a sleep crisis.
At the same time, in the last four decades, science has validated much of the ancient wisdom about the importance of sleep. We’ve made incredible discoveries about all the things going on in our brains and our bodies while we’re sleeping, and these findings have fueled a sleep renaissance, in which the power of sleep to profoundly affect virtually every aspect of our lives is beginning to be recognized.
You say that sleep deprivation is the “new smoking.” How so?
Unfortunately, the comparison is apt, both in terms of the dangers and our attitude. Everywhere you turn, sleep deprivation is glamorized and celebrated, from “You snooze, you lose” to highly burned out people boasting, “I’ll sleep when I’m dead.” The combination of a deeply misguided definition of what it means to be successful in today’s world—that it can come only through burnout and stress—along with the distractions and temptations of a 24/7 wired world, has imperiled our sleep as never before.
It’s a long list. To name just a few things we lose, there’s creativity, memory consolidation, our ability to learn and solve problems, our ability to manage stress and anxiety, and a wellfunctioning immune system. Yet the myth persists that we can do our jobs just as well on four or five or six hours of sleep as we can on seven or eight. It’s a delusion that affects not
only our personal health but our productivity and decision making. In other words, we may not have as many good ideas as we would have otherwise had, we may not be as able to come up with creative solutions to problems we’re trying to address, or we may be shorttempered or waste a day (or day after day, or year after year) going through the motions. And in some occupations—in our hospitals, on our highways, or in the air—lack of sleep can be a life-or-death matter.
An Australian study found that after being awake for seventeen to nineteen hours (a normal day for many of us!), we can experience levels of cognitive impairment equal to having a blood alcohol level of .05% (just under the legal limit in many US states). And if we’re awake just a few hours more, we’re up to the equivalent of 0.1%—legally drunk.
Sleep deprivation affects our health—in a big way. The incidence of death from all causes goes up by 15% when we sleep five hours or less per night. A 2015 article based on the latest findings by the American Academy of Sleep Medicine, provocatively titled “Sleep or Die,” discussed the connection between lack of sleep and an increased risk of heart attack, stroke, diabetes, and obesity. In other words, getting enough sleep really is a matter of life and death.
Not only that—we wear our lack of sleep on our faces. An experiment in the UK tested the effects of sleep deprivation on a group of thirty women. Their skin was analyzed and photographed after they slept for eight hours and then again after sleeping six hours for five nights in a row. Fine lines and wrinkles increased by 45%, blemishes went up by 13%, and redness increased by 8%.
How are cultural attitudes about sleep hurting us?
Our cultural assumption that overwork and burnout are the price we must pay in order to succeed is at the heart of our sleep crisis. The method (or cheat code) we use isn’t a mystery: feeling that there aren’t enough hours in the day, we look for something to cut. And sleep is an easy target. In fact, up against this unforgiving definition of success, sleep doesn’t stand a chance. Indeed, in much of our culture, especially in the workplace, going without sleep is considered a badge of honor.
For far too long, too many of us have been operating under the collective delusion that burning out is the necessary price for accomplishment and success. Recent scientific findings make it clear that this couldn’t be less true. Not only is there no tradeoff between living a well-rounded life and high performance, performance is actually improved when we make sleep a priority.
There’s the macho habit of people bragging about how little sleep they get. Can you talk about how misguided this is—and how detrimental to true success it can be?
To me, this is the ultimate indicator of our sleep crisis—not only are we dangerously misguided in our attitude toward sleep, but we are bragging about it!
My favorite—or least favorite—perpetrator of spreading this delusion is Thomas Edison, who went so far as to call sleep “an absurdity, a bad habit” and declared that “there really is no reason why men should go to bed at all.”
Today, so many of us fall into this trap of sacrificing sleep in the name of productivity. But, ironically, our loss of sleep, despite the extra hours we put in at work, adds up to more than eleven days of lost productivity per year per worker, or about $2,280. This results in a total annual cost of sleep deprivation to the US economy of more than $63 billion, in the form of absenteeism and presenteeism (when employees are present at work physically but not really mentally focused).
What role does technology play in the sleep crisis? How can our nightly routines, and taking our phones out of our bedrooms at night, help us sleep better?
The ubiquity of technology and its addictive nature have made it much harder for us to disconnect and go to sleep. With technology, we can now carry our work with us—in our pockets and purses in the form of our phones—wherever we go. The problem is that our relationship with our devices is still in that honeymoon phase where we just can’t get enough
of each other—we’re not yet at the stage where we’re comfortable being apart for a few hours or taking separate vacations. In fact, a 2015 survey showed that 71% of Americans sleep with or next to their smartphones.
But the blue light emitted by our phones is like an anti-sleeping drug or a stimulant—something few of us would willingly give ourselves each night before bed, especially when so many of us are using sleeping pills or other sleeping aids in a desperate effort to get some sleep.
Our houses, our bedrooms—even our beds—are littered with beeping, vibrating, flashing screens. It’s the never-ending possibility of connecting—with friends, with strangers, with the entire world, with every TV show or movie ever made—with just the press of a button that is, not surprisingly, addictive. Humans are social creatures—we’re hard-wired to connect. Even when we’re not actually connecting digitally, we’re in a constant state of heightened anticipation. And always being in this state doesn’t exactly put us in the right frame of mind to wind down when it’s time to sleep.
You write that we are living in “a golden age of sleep science.” What are the most compelling recent scientific findings?
We are absolutely living in a golden age of sleep science, with new findings coming out practically every day testifying to sleep’s benefits. Scientists are confirming what our ancestors knew instinctively: that our sleep is not empty time. For me, one of the most important recent findings is about sleep and brain maintenance—that sleep is essentially like bringing in the overnight cleaning crew to clear the toxic waste proteins that accumulate between brain cells during the day. Dr Maiken Nedergaard, of the University of Rochester, has studied the mechanism underlying these cleaning functions. “It’s like a dishwasher,” she said. Just as we wouldn’t eat off dirty dishes, why should we settle for going through the day with anything less than the full power and potential of our brains?
Sleep is also time of intense neurological activity—a rich time of renewal, memory consolidation, brain and neurochemical cleansing, and cognitive maintenance. Properly appraised, our sleeping time is just as valuable a commodity as the time we are awake. In fact, getting the right amount of sleep enhances the quality of every minute we spend with our eyes open.
Sleep affects our mental health every bit as profoundly as it does our physical health. Sleep deprivation has been found to have a strong connection with practically every mental health disorder we know of, especially depression and anxiety. “When you find depression, even when you find anxiety, when you scratch the surface 80 to 90% of the time you find a sleep problem as well,” says University of Delaware psychologist Brad Wolgast. In the Great British Sleep Survey, researchers found that sleep-deprived people were seven times more likely to experience feelings of helplessness and five times more likely to feel lonely.
Can more sleep really lead to more sex?
Yes! In a 2015 study, researchers measured the duration of women’s sleep and compared it to their level of sexual desire the next day. They found that every additional hour of sleep brought with it a 14% rise in the likelihood of having some kind of sexual activity with her partner. So more sleep is better—especially if you want more sex (or at least, if you want to make more sex more likely). Though we can’t say that improving our sleep will magically translate into a better sex life, it’s clear that when we’re sleep-deprived and exhausted, sex isn’t the first thing on our minds.
How does sleep—or lack of it—affect professional athletes?
The power of sleep is an increasingly badly kept secret in the sports world, and more and more athletes and teams at the leading edge have discovered that sleep is the ultimate performance-enhancing drug—one that comes with only positive side effects. And much of this is, of course, about recovery. “Just as athletes need more calories than most people when they’re in training, they need more sleep, too,” said sports medicine specialist Dr. David Geier. “You’re pushing your body in practice, so you need more time to recover.”
For elite athletes, the consequences of sleep deprivation become very obvious very quickly—they’re literally tallied up on a scoreboard. As Grant Hill put it, “People talk about diet and exercise,” but “sleep is just as important.” LeBron James swears by twelve hours a day when practicing. And Steve Nash believes that “napping every game day, whether you feel like it or not, not only has a positive effect on your performance that night but also a cumulative effect on your body throughout the season.” Professional triathlete Jarrod Shoemaker describes sleep as “half my training,” while Usain Bolt, the world’s fastest man, explains, “Sleep is extremely important to me—I need to rest and recover in order for the training I do to be absorbed by my body.” Volleyball player Kerri Walsh Jennings, a three-time Olympic gold-medal winner, admits that sleep “could be the hardest thing to accomplish on my to-do list, but it always makes a difference.” And tennis great Roger Federer trumps them all: before Wimbledon in 2015, he even rented two houses: one for his family to sleep in and one for him (and his training team), so the family activities wouldn’t wake him.
When the Golden State Warriors’ Andre Iguodala adjusted to a consistent eight hours of sleep a night, his playing time increased by 12% and his three-point shot percentage more than doubled. His points per minute went up by 29%, and his free-throw percentage increased by 8.9%. His turnovers decreased by 37% per game, and his fouls dropped by 45%. He was named the 2015 Finals MVP, and he Instagrammed a picture of himself holding the MVP award—credit where credit is due—while sleeping!
Why is sleep deprivation so dangerous when it comes to politicians?
Politics, of course, is the ultimate sleep-deprivation machine. Much of what our political leaders face is out of their control. But that is all the more reason to optimize the factors that are in their control. The most basic one is to improve their decision making by getting enough sleep. Will it instantly solve the world’s problems? Of course not. But will our leaders be better prepared to face those problems with more creativity and wisdom? Without a doubt.
Our political campaigns constantly feature candidates bragging about how little they sleep and all the long hours they put in. What they’re actually proclaiming with their burnout machismo is “Hey, vote for me—I structure my life so badly that my decision making is chronically compromised. If you want a leader who’s effectively drunk—all the time— I’m your man (or woman)!” It’s an under-the-radar double standard. “No politician would smoke in front of a camera,” says Till Roenneberg of Ludwig-Maximilians University, “but all politicians clearly declare—and show it in their faces—how little they have slept. We know how important sleep is, but they convey to the world that sleep deprivation is good.” And we all have to live with the consequences of all those suboptimal, sleep-deprived decisions.
How is the sleep revolution transforming the workplace? Do you believe we’re moving toward a business culture that embraces sleep?
The sleep revolution is finally hitting the workplace. It’s not in full swing yet, but you can see the evidence all around. The business world is waking up to the high cost of sleep deprivation on productivity, health care, and ultimately the bottom line. It becomes much easier to change our sleeping habits when we have supportive workplace policies and a business culture that embraces sleep. From offering nap rooms to encouraging more flexible work hours, companies are exploring new ways to help employees make sleep a priority. I expect the nap room to soon become as universal as the conference room.
The good news is that pressure to change is coming both from employees, who are realizing that they are actually more productive when they don’t drag and drug themselves through the day like workplace zombies, and from employers, who are realizing that healthy employees make for a much healthier bottom line.
Some of the positive changes in the business world may be motivated by the increasing competition for recruitment and retention, while others are coming from business leaders who simply want their companies to succeed while creating a culture that allows their employees to thrive. But whatever the motivation, the result is that sleep makes us better at our jobs while simultaneously reminding us that we are more than our jobs.
Can you give some examples of companies that are encouraging their employees to treat sleep and renewal as a performance-enhancement tool?
HuffPost is one. I must admit there was skepticism when we first installed nap rooms in our New York offices in 2011. HuffPosters were reluctant to be seen walking into a nap room in the middle of a bustling newsroom in “the city that never sleeps.” But now they are perpetually full, and we’re spreading nap rooms around the world, starting with our London office. And more and more companies are installing nap rooms, including Ben & Jerry’s, Zappos, and Nike.
Brian Halligan, the CEO and founder of HubSpot, a maker of marketing and sales software, installed a nap room at the company’s office and credits some of his best ideas to napping: “In a given month, I do a lot of very mediocre stuff, but once in a while I come up with a really good idea. Maybe I’ll come up with two in a month. Those two inevitably happen when I’m either falling into a nap, or coming out of a nap, or waking up slowly on a Saturday morning. I’m trying to engineer more of those in my life.”
There’s also Hootsuite, a leading social-media management dashboard (which I use to schedule tweets and Facebook posts when I’m traveling so I can stay connected back home without having to stay up late). CEO Ryan Holmes has installed a nap room, with cots perfect for a midday rest, and he says he sees progress in terms of sleep even among his fellow techies: “Many of the same tech start-ups so notorious for workaholic culture are taking the lead in ensuring employees get adequate shut-eye.” This is quite a departure in the tech world, where part of the mythology of start-up narratives is about the endless sleepless nights considered a necessary part of the road-show story.
What are some of the industries and fields where the benefits of sleep are being rediscovered and put to use?
The medical field is one that’s discovering the power of sleep. You’d think, given the connection between sleep and health, that this would be one industry that would have alwaysappreciated sleep, but, as anybody who’s been in a hospital knows, getting sleep in one isn’t easy. But fortunately that’s changing as more hospitals are finding creative ways to put sleep into their top-line medical arsenal. St. Luke’s Hospital in New York City, for example, launched a noise-reduction program in response to low patient-satisfaction scores on sleep.
At Johns Hopkins Hospital, doctors and staff made a concerted effort to reduce nighttime noise in the ICU with a checklist for staff, which included things such as dimming hallway and room lights, more thoughtful scheduling of nighttime medical visits to the rooms, and turning off televisions. In 2009, Stanford Hospital launched the “SHHH” system, which stands for Silent Hospitals Help Healing, with each floor assigned a “noise champion” to reduce noise in the area, while the “Too Loud” initiative at Newark Beth Israel Medical Center in New Jersey offers a Noise Hotline that patients can call when noise levels are excessive.
Hotels are also finally getting the message. Options for sleep-obsessed travelers now go well beyond the classic request to be on a high floor and away from the elevators. One of the most innovative establishments on the sleep front is the Benjamin Hotel in New York City. The Benjamin has a sleep concierge and has brought in Cornell University sleep researcher Rebecca Robbins to give the hotel’s staff seminars on how to provide guests with the best sleep possible. “We’re in the business of sleep,” Robbins says. And for an additional fee, she offers personal sleep consultations.
How can we go about making sleep a priority—even when we’re busy or traveling?
I get asked all the time, what do you do when, for whatever reason—a sick toddler, a bad cold, jet lag, a project deadline, or a late night out—you just can’t get the recommended seven to eight hours of sleep? Fortunately, in those instances in which you really can’t get enough sleep at night, there’s a great remedy to that problem: the nap. Naps are a cheap and readily available way to enjoy what the National Sleep Foundation calls “a pleasant luxury, a mini-vacation.”
In fact, as it turns out, naps are great for us even when we are getting good sleep at night. According to David Randall, the author of Dreamland, even a short nap primes our brains to function at a higher level and more easily come up with solutions. While chronic poor sleep can have long-lasting effects on our health, naps can help mitigate some of those effects. Short of time travel, a next-day nap may be the closest we can get to a second chance at a good night’s sleep.
Some people are actually trying to get more sleep but can’t fall asleep. What advice do you have for them?
When I’m really having trouble sleeping, or wake up with thoughts crowding my mind, I’ve found meditation to be a great remedy. Instead of stressing out about how I’m staying awake and fearing I’ll be tired the next day, I prop a few extra pillows under me and reframe what’s happening as a great opportunity to do something else—in my case, practice my meditation. If it’s in the middle of the night, I remind myself that that’s precisely when many avid meditation practitioners, like the Dalai Lama, wake up to get in two or three hours of meditation; this both takes the stress out of my wakefulness and adds an extra layer of gratitude to my practice. Just by reframing it from a problem to a blessing that allows me to go deeper without a deadline or any distractions, I find that I both have some of my deepest meditation experiences and, inevitably, drift off to sleep at some point.
What are some tips, tricks and techniques for getting better, more restorative sleep?
When we walk through the door of our bedroom, it should be a symbolic moment that marks leaving the day, with all of its problems and unfinished business, behind us. When we wake up in the morning, there will be plenty of time for us to pick up our projects and deal with our challenges, refreshed and recharged. I treat my transition to sleep as a sacrosanct ritual. Before bed, I take a hot bath with epsom salts and a candle flickering nearby—a bath that I prolong if I’m feeling anxious or worried about something. I don’t sleep in my workout clothes as I used to (think of the mixed message that sends to our brains) but have pajamas, nightdresses, even T-shirts dedicated to sleep. Sometimes I have a cup of chamomile or lavender tea if I want something warm and comforting before going to bed. Think of each stage of your bedtime ritual as designed to help you shed more of your stubborn daytime worries.
Why do you strongly believe that sleeping pills aren’t a long-term answer?
There are, of course, times in our lives—a traumatic experience, the death of a loved one—when we might need some temporary help getting to sleep. But it’s important to make a distinction between turning to sleep aids at such moments and turning to them as an everyday cure for sleeplessness.
Sleep difficulties can turn into serious medical problems. For the vast majority of us, however, sleep difficulties are a lifestyle problem. Yet we tend to treat all our sleep-related woes the same way: with a pill. This is hubris on the scale of Greek mythology. We expect, as if by magic, to wrestle sleep into submission. This isn’t accidental. Combine the marketing power of the modern pharmaceutical industry with a client market that includes, potentially, every fatigued and burned-out worker—which is to say nearly every worker—and you’ve got the makings of the juggernaut that is the modern sleep-aid industry.
The potential dangers of sleeping pills don’t stop at your being turned into a mindless zombie. There are also longer-term health hazards to go along with Night of the Living Dead—like misadventures. Researchers have discovered that the use of benzodiazepines (such as Xanax and Restoril), usually taken for anxiety or as a sleep aid, increases the risk of developing Alzheimer’s by 32% after being used for three to six months. Taking these drugs for more than six months raises the risk by 84%.
“In 20 years, people will look back on the sleeping pill era as we now look back on the acceptance of cigarette smoking,” UCLA’s Jerome Siegel told me. “Movies and TV glamorized smoking. Advertisements, often with doctors or actors posing as doctors, were used to sell cigarettes.” Only after many years and many studies linking cigarettes to lung cancer and other diseases did the government step in to regulate tobacco advertising. So we may have moved beyond the era of Joe Camel and advertisements proclaiming “More doctors smoke Camels than any other cigarette!” and “Give your throat a vacation . . . Smoke a fresh cigarette,” but as Siegel put it, “history appears to be repeating itself. The chronic use of sleeping pills is an ongoing public health disaster.”
The Sleep Revolution isn’t just a book; it’s also a movement. Talk about the #SleepRevolution college tour, the drowsy driving awareness campaign, and the other ways in which you’re working to spread this message.
This spring, we are launching the #SleepRevolution College Tour at 50 campuses—including Harvard, Georgetown, USC, UCLA, Ohio State, University of Georgia—to spark a national conversation about the importance of sleep and the dangers of sleep deprivation based on the latest science.
To help students embrace sleep as a performance enhancer rather than something to be avoided, we’ve partnered with major brands—including Sleep Number, Jawbone, JetBlue, Marriott, Spotify, and MetroNaps—to host “sleep fairs” to give students tangible tools to make changes in their lives and embrace better sleep habits. And we’ll also be providing them with plenty of sleep-related products—including pajamas, slippers, eye-masks, candles, dream journals, alarm clocks, and white noise machines—donated by those same brands. The tour will feature panels and conversations with the leading sleep experts, and we will be
featuring sleep-themed blog posts and videos from students and professors on The Huffington Post.
And we’re also working with Uber on a major campaign against drowsy driving. We’re creating content to educate drivers, giving away “sleep kits” to drivers and passengers, and working with companies to offer subsidized rides home to employees who work late. [Arianna will also be doing ride-alongs in which she will talk with Uber passengers and answer questions about their sleep.]
Now that we know that sleep has the potential to transform our lives, how can we put this knowledge into action?
I’m often asked a question that goes something like this: “Arianna, it’s great that you get all this sleep now, but would you have had the same career if you had done this earlier in your life?” And my answer isn’t just a categorical yes—I also believe that not only would I have achieved whatever I’ve achieved, but I would have done it with more joy, more aliveness, and less of a cost to my health and my relationships.
But if we’re going to truly restore sleep to its proper role in our lives, we have to look beyond all the tools and techniques, the lavender pouches, the blackout shades, the space-age mattresses, the rules about caffeine and screens. At the end of the day (literally), being able to do something as natural as going to sleep shouldn’t require chronically medicating ourselves or putting ourselves on a nightly war footing against all the screens, foods, and activities that stand between us and a good night’s sleep. Rather, it starts with something as simple as it is profound: asking ourselves what kind of life we want to lead, what we value, what gives our lives meaning.
To be able to leave the outside world behind each night when we go to sleep, we need to first recognize that we are more than our struggles and more than our victories and failures. We are not defined by our jobs and our titles, and we are vastly more than our résumés. By helping us keep the world in perspective, sleep gives us a chance to refocus on the essence of who we are. And in that place of connection, it is easier for the fears and concerns of the world to drop away.
For many of us, thinking this way is a big change. It certainly has been for me. After all, we live in a world that celebrates getting things done above all else. So who are we when we are not getting things done? If we stop emailing or texting or planning or doing, will we cease to exist? (It’s not hard to imagine a modern-day Descartes declaring, “I tweet, therefore I am.”)
To be sure, we can strive to get more sleep without asking these existential questions. But making the most of the third of our lives that we should be spending asleep and reaping all the benefits sleep offers in terms of our health, our clarity of thinking, our decision making, and our engagement in our lives requires reflecting on what matters most to us and then reprioritizing our days—and our nights—accordingly. As our days become more and more consumed by doing, by distractions and urgency, sleep, waiting for us every night, offers a surrender.