Tell Me More with Kelly Corrigan

Welcome to "Tell Me More."

I'm Kelly Corrigan.

I'm a writer, a podcaster, and a mom.

This season, number 7, is unlike anything you've seen from us before because everyone who works on this show is reading the same headlines.

There is so much unsettling news about how people are actually feeling, so we have recruited the best scientists and researchers to separate fact from fiction and surface a set of practices we can all live by.

Join us for a 10-part conversation on wellness-- how do you get it, and how do you keep it?

Mental health issues can cause sleep problems.

Sleep problems can lead to mental health issues.

It is a dynamic interrelationship.

Corrigan: This is Dr. Matthew Walker.

He teaches neuroscience and psychology at UC Berkeley.

He also wrote a book called "Why We Sleep," and he is the founder and director of the Center for Human Sleep Science.

If I've only slept for 5 hours, there's just, like, a limit on how good I'm capable of feeling.

Corrigan: This is Dr. Maya Shankar.

You may recognize her.

She was a guest on "Tell Me More."

She's a cognitive scientist.

She was an advisor to the Obama White House on behavioral science.

She's also the creator and producer and host of a podcast called "A Slight Change of Plans."

Well, first I'd have to give my kids up for adoption... Corrigan: Right.

Yeah.

and then I'd be talking about some good sleep.

Then I could really apply all this.

Yeah.

Yeah, yeah.

Corrigan: This is W. Kamau Bell, who you might also recognize from "Tell Me More."

He was a guest in our second season.

He's a stand-up comedian, a director, producer, and a dad.

For 7 seasons, he was the host of the 5-time Emmy Award-winning CNN docuseries "The United Shades of America."

He's also written several books and is active on the boards of Donors Choose, Live Free, and the ACLU.

Scale of 1 to 10, are you a good sleeper?

How would you describe it?

Uncompromising about sleep.

Restlessly, intermittently, not well-ly.

That's nice.

Thanks.

For my sleep, I would say in one word prioritization.

So how does sleep interact with mood and mental health?

Walker: Intimately.

In the past 20 years, we've not been able to discover a single psychiatric condition in which sleep is normal... Wow.

and I think that tells us everything that we need to know.

Mental health issues can cause sleep problems.

Sleep problems can lead to mental health issues.

It is a dynamic interrelationship.

And is there some kind of sleep that is really the culprit, like if you don't have enough REM sleep or if you don't have enough type one sleep or--?

Different types of sleep are related to different psychiatric conditions.

There is a set of different features that we can see, "Ah, this looks like a depressogenic profile of sleep problems," versus someone, let's say, who has anxiety.

It's also about what we would call the continuity of their sleep.

Some types of psychiatric disorders just have a type of sleep that is littered with all of these awakenings, and what's interesting is that psychiatry for maybe 50 years, often thought that the sleep problems that come with psychiatric conditions were a symptom.

Now we're realizing it's an underlying cause.

Now, it's not simply a unidirectional street going in the opposite direction.

It's two-way.

It's bidirectional.

It never is.

Yeah.

Shankar: My husband's always said that he feels like there's a cap on how happy you can be when you're sleep-deprived.

He's like, "I could get the best news in the world, Maya, "but if I've only slept for 5 hours, "there's just, like, a limit on how good I'm capable of feeling..." "Yay."

"Really?

Ohh."

"I won the lottery by myself, huh?

That's great."

It's how we torture prisoners.

Shakar: Yeah.

You know, I had panic attacks right around the time I turned 30, and I went to see this therapist, and the first thing she said is, "How much do you sleep?"

and then she said, "Before we discuss anything about your mother and your childhood..." Shankar: It's like, "Get back to sleeping."

"I want you to go to bed every single night "this week at the same time, and I want you to wake up at the same time every morning."

Transformational, and, to your point, a lack of sleep will just bring down a veil on your affective view of the world, and it will take the rose very quickly out of the tint of your worldview glasses.

It's almost like a pair of emotional windscreen wipers, and you can start to see clearly, you know, and you wake up with a different set of psychological clothes that you're wearing.

Have you ever had a terrible sleep stretch?

[Laughter] Since, let's see-- My oldest daughter was born in 2011.

Uh-huh.

It's been bad since then?

I would say it's been bad at least since then, yeah.

Has it affected your mental health?

Yeah.

It has?

Yeah.

No.

I mean, you know, I always feel like-- Like, I always say to people, "I could take a nap at any time."

I have a kid who crawls into the bed most nights, which wakes me up, and then there's just the general sort of panic I feel as an American that keeps me sort of, like, always like, "Aah!"

My suspicion is that you're carrying what's called a sleep debt because those nights are consistently-- I owe sleep some money?

Yeah, exactly, so you're in arrears with the sleep bank, and even if you were to get, like, a solid 9 or 10, sometimes you wake up, and you feel almost like you have a sleep hangover where you feel worse than when you were getting 7, but instant napping during the day, that's usually one of the signs that we think of as excessive daytime sleepiness, and that's-- Well, first, I'd have to give my kids up for adoption.... Corrigan: Right.

Yeah.

add then I'd be talking about some good sleep.

Then I could really apply all this.

Yeah.

Yeah, yeah.

Firstly, it's very obvious that when you have kids, sleep will get tough.

You don't have to tell me.

I've done that study already.

You've been in that study since 2011?

2011, yeah.

Walker: When they are infants, take sleep whenever you can.

The very best thing for a child is a well-slept parent.

How common is that profile?

Like, are Americans in the 21st century, like, are we good sleepers, bad sleepers?

How do we compare to other countries?

There was a survey done by the National Sleep Foundation some years ago, and they looked at a number of different countries, and what they found was that, on average, Americans were getting somewhere around about 6 hours and 40 minutes, just 6 hours and 40 minutes of sleep every night.

Now, by the way, that's the average.

That means that there's a significant proportion of people who are getting less than that.

The CDC and the World Health Organization, they've typically recommended somewhere between 7 to 9 hours as the optimal sweet spot.

America was not necessarily the worst.

Japan was even shorter.

Human beings that can survive on less than 6 hours of sleep and not show any brain or body impairment is zero.

How long can you go, though, just so I can-- for a friend?

Yeah.

Ha ha!

Walker: After one night of short sleep, we can measure those impairments.

There was a great study done not by myself, but some colleagues over in the United Kingdom, and they took a group of individuals, and they limited them to 6 hours of sleep for essentially one week, and there were two key findings.

The first was that around 711 genes were distorted in their activity caused by that 6 hours of sleep.

Those genes that were actually increased in their activity were genes associated with the promotion of tumors, genes that were associated with cardiovascular disease and stress, and genes that were associated with long-term, chronic inflammation within the body, whereas those genes that were actually switched off or sort of turned down were genes that were associated with your immune system, and so, in other words-- Shankar: Oh, no pressure, Matt.

I know.

It's a sort of a, you know-- I'm already thinking about tonight.

It's so bad, isn't it?

It's terri-- I'm putting pressure on people, and I know-- Sleep or die.

We're a little bit too, you know, overt in that sense, but I think the point is this, that a lack of sleep will even erode the very fabric of biological life itself, which is your DNA genetic code.

I have a question.

Yes?

So you know how everybody has sleep apps?

Do you have an Oura Ring?

Do you do it?

Do you track everything like this?

No.

No.

OK. Is it helpful to all of us to have such sort of deep data on every single night of our sleep, or does it create kind of obsessive conditions that make it harder to have a lovely, effortless night's sleep?

I would say, for most people, if their sleep is normative and OK, then I think they are wonderful devices, but there is a slight potential downside here, which is, if I am not sleeping well, the last thing that I need is a device when I wake up to say, "By the way, Matt, you didn't sleep well."

Well, guess what?

I already knew that.

Another failure, Matt.

You're bad at sleeping.

Yeah, exactly, exactly.

By the way, it has now a medical term to it.

It is called orthosomnia, but I would say two things.

If you're suffering from that experience with your sleep tracker, either, A, take it off or, B, keep it on, keep tracking, but only allow yourself to look at your data at the end of the week.

People are so good at that, aren't they, not checking data too, too frequently?

Can I ask a follow-up question?

So, to Kelly's question, so one of the reasons I don't want to get the sleep measurement tracker thingamajigies is that I don't want it to distort my relationship with sleep, which is that it should feel like a pressureless experience, right?

I don't want to get too in my head about it.

How much can we trust our subjective assessment of how well we've slept?

Your subjective assessment is not bad in terms of a match with the objective measurement that we have, meaning that when you come through to the kitchen in the morning to your significant other and they say, "How did you sleep?"

You'll say, "Ah, I slept pretty good," so we all have a subjective sense of that, and, in general, it's not a bad match, but I can't tell you how much REM sleep I had or how much deep sleep I was able to get and when during the night I had those features, so there is a layer of granularity that you get when you measure objectively that you just cannot subjectively perceive.

Does that make some sense?

Isn't part of this about also, like-- Have they ever studied economic privilege and sleep?

Like, I would imagine that people who make more money might get more sleep, maybe not better sleep, than people who make less money.

So it's a U-shaped function.

People who earn very little, who are on the border of poverty, do not sleep well.

It could be that it is the stressful environment that you're living in, locations that don't feel safe, so you've constantly got this threat detection in your brain and in your body, and no wonder you can't fall asleep well.

Alternatively, it could simply be that, "I've got two jobs," so there are so many different factors that collude in that specific environment that will take sleep and squeeze it like Vise-Grips in the middle of the night.

Sadly, I was going to guess that, like, the neighborhoods that suffered the most from lack of sleep would be urban environments, black and brown neighborhoods, and also, the fact is, like, as I learned years ago, that, like, your zip code predicts so much about your life...

I know.

and a lot of those neighborhoods are also in places that other people didn't want to live for either health factors or noise factors, so you're already sort of compounding the problem by we put the poorest people over here in places that aren't actually good for people to live generally.

Walker: Yeah.

People who are significantly more affluent than the mean, they typically don't sleep well, either.

Once you get past sort of economic comfort and you're not necessarily worrying, "Am I going to make rent?"

at that point, there is this sweet spot for sleep, but it is bidirectional.

It's strange.

I would have thought that, too-- more money, less problems, and, therefore, better sleep.

As we were taught in the nineties, mo' money, mo' problems.

Walker: And that's what the data seems to be.

We hear in popular culture about these so-called super sleepers, so, like, CEO types or these really high-achieving people say, "Oh, my gosh, not only do I only need 5 hours.

I thrive on 5 hours," and I want to, like, punch my TV because, of course, that's not been my personal experience, so are there some people who only need 5 hours and, like, have all the great stuff happen?

Or are they lying?

So here's how it works with what we call natural short sleepers.

It's highly unlikely that those people are truly surviving on 5 hours of sleep, and, even if they are, their sense of how well they're performing turns out to be a miserable predictor of objectively how they're performing, so think about it like, um-- And how enjoyable they are to be around, right?

Let's ask their spouses.

Let's ask their direct reports.

Walker: Well, there was a great study that was done looking at business leaders, and they tracked how much sleep the business leader was getting from one night to the next, the next, and then they asked their employees, "How charismatic would you rate your business leader from one day to the next?"

and there was a perfect correlation that when they weren't sleeping well, they rated them less charismatic, less inspiring, and they knew nothing about the sleep of the CEO, but it was evident in their behavior, but, to your question, there are now at least two genes that we've identified which seem to allow some individuals to sleep probably around about 6 hours, 6 hours and 50 minutes, and not show any impairment.

Wow.

Call that the jackpot genes.

Yeah, exactly.

You know, where can I sign up for that CRISPR, you know, to switch out.

I think our whole society's function around "the early bird catches the worm" is, like, that's because we used to be farmers.

Right, right.

Like, we're not farmers anymore.

Walker: Well, I would say that society has this terrible, I think, both opinion and bias towards the morning types.

In fact, at least a third of society is not like that.

It is genetically determined.

We know that there are at least 22 different genes.

You don't get to decide.

It's gifted to you at birth.

It's called your chronotype--morning type, evening type, or somewhere in between-- and if we don't sleep in harmony with our natural biological type, our sleep is that much worse, and when you fight biology, you normally lose.

That's so interesting because...

I agree with all of that.

well, there's this whole framing that we've been talking about throughout this series, which is, like, there's nature, there's nurture, and then there's all the choices that you make, but those choices are being made in a context, and so if our context is you can sleep when you die and the early bird gets the worm and every CEO that we admire goes around telling people they sleep 4 hours a night until, like, the spoon drops out of their hand and wakes them up, you know, like, all that mythology around how A-players succeed is part of the context in which we're choosing our behavior, and now you've layered on this genetic chronotypes, and that makes me think about the ways that we are missing this huge opportunity for greater well-being across society by marrying up systems and structures with what the data's telling us, so it should be OK for kids who have your chronotype to be successful, even if they're not at their cognitive best at 7:47 when the bell goes off.

Well, imagine for teenagers, whose biological rhythms are shifted forward by about two to 3 hours as they're going through adolescence, some school start times will be around 7:30 in the morning.

That means that some kids are having to wake up at 5:00, maybe even earlier.

That's like asking an adult to wake up at 2 A.M. in the morning, come into work, learn efficiency, and act with good grace.

It's very unlikely that that would happen, but that's what we do.

I mean, I always say that to my daughters.

It's like, "Before we have this conversation "about the litany of things that are wrong in your life, "like, go sleep 5 nights in a row, and then let's have a conversation."

Walker: Sleep has a terrible image problem in society, and whoever the PR agent has been for sleep should be fired.

All right, so I have a little game, so I just want you to put these in 3 columns-- friend to sleep, enemy to sleep, and it depends.

OK.

Sex--immediate friend of sleep, and we have very good data.

Sex that accomplishes orgasm, it typically results in a far higher quantity as well as quality of sleep.

It works both ways.

For every extra hour of sleep that a woman gets, her desire to be physically intimate with her partner increases by 14%, which just brings me on to being a woman.

I would say it depends, so here, it depends because, firstly, women are far less likely to get one of the main prominent sleep disorders, which is called sleep apnea, or heavy snoring.

However, when you flip it to the insomnia category of sleep disorders, there, women are more likely to suffer from insomnia than men.

But doesn't, like, changes in your hormones that come with your menstrual cycle and also hot flashes and all that nonsense-- So that's the third component of "it depends."

I say it's over-- I agree.

I was going to ask whether the mechanism of action there with the insomnia is anxiety because anxiety rates are higher in women.

It absolutely is, and anxiety is one of the principal underlying models that we have that causes insomnia.

Booze, alcohol.

I'm putting it here.

Unfortunately, alcohol, booze is very much a potent enemy of sleep.

When I think about kids in college, which is such a time of, like, pronounced mental health pain, and then what they're living with is tons of booze, tons of disruption, tons of noise, tons of other people, bad mattresses, like...

Tons of anxiety.

the anxiety, like, it's just a terrible-- The frequency of use of what we call study drugs, which are usually sort of-- Adderall.

Adderall, it's almost a perfect storm.

I am looking back on my college years, and I was totally not the cool college kid.

I slept for 8 to 10 hours a night throughout college, and for the first time ever, I feel, like, so vindicated by you, Kelly.

Yes.

I am giving it to you.

I feel so great about myself.

You know what?

Maya Shankar gets the award.

Thank you, everyone.

All those missed parties were worth it, apparently.

Corrigan: Yes.

Exercise...

I'm not doing that.

very much a friend of sleep.

It is one of the most reliable ways that we've seen that people can improve both the quantity of sleep, how much I'm sleeping total, the quality of sleep, and also the depth of the sleep, the amount of deep sleep that they get.

The snooze button-- Can I guess?

Can I guess with that one?

That's bad.

It's got to be bad.

I mean, I use it, but it's got to be bad.

So overall, I would say it's bad.

There's a great study done back from a group in Japan about 10 years ago, and they woke people up with a skrill of an alarm versus just letting them wake up naturally, and the cardiovascular difference in terms of your blood pressure and your heart rate was very much different in ways that you would imagine, and imagine then saying, "OK. That happens once with an alarm clock"... Let's just make it happen again.

"but then I'm going to decide to repeatedly "shock my heart, maybe 3 or 4 times before I wake up," and I do that 7 days a week each month of each year, and I have been doing that for the past 20 years, then it's nontrivial.

It's a lot of hits.

OK. Coffee.

Did I tell you I'm unpopular?

Yeah.

[Imitates buzzer] The danger is that coffee-- or caffeine, I should say-- has a half-life of about 5 to 6 hours, which means about 50% of it is still in your brain after 5 to 6 hours, meaning if I have a cup of coffee at midday, then at midnight, a quarter of that is still in my brain, so everything in moderation.

Just try to cut yourself off about 10 hours, 12 hours before you expect to go to bed.

OK. Blue light from screens, I would say enemy of sleep.

However... Oh, man.

less so than we thought.

Oh, interesting.

See?

See?

It's the fact that these devices-- our computers, our phones, our tablets-- they are attention-capture devices, and the way that they do that is by activating your brain.

If you absolutely need to take your phone into the bedroom, here's the rule of thumb, that you can only use your phone standing up, and at some point, if you think-- Well, that defeats the whole purpose then, Matt.

if you think, "OK.

I'm standing up," and then-- yeah, exactly; I know; that's exactly the reason why-- and you sit down, as soon as you sat down-- I'm sorry--that's it.

My snooze button is my phone falling on my face to wake me up.

There you go.

At that point, I'm saying, warning bells are ringing, my good friend.

We, again, need to chat very soon.

OK.

But I sleep like this.

My daughter sleeps with the phone in her hand.

Oh, no.

OK. Next one is napping.

I would say it depends.

Do you nap?

Do you nap?

You do?

Yeah.

I can't believe you nap.

Oh, yeah.

And did it change your mental health?

Well, it's just a total game changer.

It gives me, like, a whole second day.

Reset.

Yeah.

Corrigan: How long would you nap?

Maybe 20 to 30 minutes.

That's perfect.

20 minutes is about the optimal, so naps can have wonderful benefits.

We've done lots of studies.

When we've been awake during the day, we build up something called sleep pressure, which is a chemical called adenosine, and it weighs us down with healthy sleepiness, and then when we sleep, the brain gets the chance to clear out that sleepiness chemical, and then we wake up refreshed.

The danger with naps is that if you take them too late into the day and you nap for too long, it's a little bit like a pressure valve on a steam cooker, pshh, and you find it either harder to fall asleep or stay asleep.

Try to not nap after about 2 P.M. and make them about 20 minutes.

Overall, it's between friend to sleep, but there's a little bit of it depends.

All right.

Last one.

Weed.

Ah, I was waiting for that one.

[Laughter] People take gummies, and they think it's, like, totally helping them sleep.

So it's an enemy, and, certainly, when people smoke weed or take gummies, they do fall asleep faster, but there are two problems with weed at least.

The first is that you develop a tolerance and a dependency.

The second is that when you come off your use, not only do you go back to the bad sleep that you were having to begin with.

You are even worse, and you have what's called rebound insomnia.

Finally, weed, like alcohol but through a different mechanism, also blocks your dream sleep.

So if you were going to wave a magic wand and change society in any number of ways to honor what is true and what we know about this intersection between mental health and sleep, what would you do?

I would start at the government level.

I know of no first-world nation that has had a public health campaign regarding sleep.

Why not?

We've had them regarding drunk driving, safe sex, drugs...

The Surgeon Generals with loneliness.

food, diet, loneliness now, which is fantastic, I think.

Then the next step down, I would take it to medicine.

In the doctor's surgery, you see posters on the wall.

"Here's how you get good cardiovascular health."

There is no simple poster that is describing, "Here are the 5 steps to good sleep."

What are you going to do?

How are you going to change society?

Flexible work and school hours.

Shankar: Yes.

No Wi-Fi access in the bedroom.

The last thing I would say in addition to all these wonderful things, don't buy in to the stigma of getting sufficient sleep meaning that you are either lazy or that you're not busy enough, meaning that you're not important enough.

Mm-hmm.

He said, get your sleep when you can.

This has been fascinating... My work here is done.

but I'm trying to take good advice.

Thank you so much.

You're so welcome.

Thank you so much.

I love being with you.

This is so much fun.

Good night.

Sweet dreams, Kamau.

[Whispers] Thank you so much.

Good night.

Thanks.

Corrigan: Here are my takeaways from talking to Matt, Maya, and Kamau.

Number one--sleep issues upset mental health, and mental health upsets sleep.

Number two--we have to rebrand sleep.

Morning people are not superior.

Number 3--our ethos of "sleep when you die" is an unhelpful mythology.

Number 4--stop using your snooze button.

Number 5--if you want to use your phone in your bedroom, that's fine, but you can only use it standing up, and finally, number 6-- great sleep is like putting on fresh psychological clothes.

It makes everything feel better.

If you'd like us to send you this list, we're happy to do it.

Just send an email to [email protected].