1
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Thank you very much.

2
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Well, I would like
to start with testicles.

3
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(Laughter)

4
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Men who sleep five hours a night

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have significantly smaller testicles
than those who sleep seven hours or more.

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(Laughter)

7
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In addition, men who routinely sleep
just four to five hours a night

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will have a level of testosterone

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which is that of someone
10 years their senior.

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So a lack of sleep
will age a man by a decade

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in terms of that
critical aspect of wellness.

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And we see equivalent impairments
in female reproductive health

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caused by a lack of sleep.

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This is the best news
that I have for you today.

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(Laughter)

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From this point, it may only get worse.

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Not only will I tell you
about the wonderfully good things

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that happen when you get sleep

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but the alarmingly bad things
that happen when you don't get enough,

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both for your brain and for your body.

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Let me start with the brain

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and the functions of learning and memory,

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because what we've discovered
over the past 10 or so years

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is that you need sleep after learning

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to essentially hit the save button
on those new memories

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so that you don't forget.

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But recently we discovered

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that you also need sleep before learning,

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and now to actually prepare your brain,

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almost like a dry sponge

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ready to initially soak up
new information.

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And without sleep,
the memory circuits of the brain

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essentially become waterlogged,

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as it were,

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and you can't absorb new memories.

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So let me show you the data.

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Here in this study, we decided
to test the hypothesis

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that pulling the all-nighter
was a good idea.

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So we took a group of individuals

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and we assigned them
to one of two experimental groups:

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a sleep group,

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and a sleep deprivation group.

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Now, the sleep group, they're going to get
a full eight hours of slumber,

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but the deprivation group,
we're going to keep them awake

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in the laboratory under full supervision.

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There's no naps or caffeine, by the way,
so it's miserable for everyone involved.

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And then the next day
we're going to place those participants

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inside an MRI scanner

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and we're going to have them
try and learn a whole list of new facts

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as we're taking snapshots
of brain activity,

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and then we're going to test them

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to see how effective
that learning has been.

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And that's what you're looking at
here on the vertical axis.

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And when you put
those two groups head to head,

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what you find is a quite significant
40 percent deficit

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in the ability of the brain
to make new memories without sleep.

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I think this should be concerning,

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considering what we know
is happening to sleep

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in our education populations right now.

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In fact, to put that in context,

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it would be the difference
in a child acing an exam

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versus failing it miserably,

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40 percent.

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And we've gone on to discover

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what goes wrong within your brain

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to produce these types
of learning disabilities.

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And there's a structure that sits

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on the left and the right side
of your brain called the hippocampus.

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And you can think of the hippocampus

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almost like the informational
inbox of your brain.

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It's very good at receiving
new memory files

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and then holding onto them.

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And when you look at this structure

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in those people who had had
a full night of sleep,

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we saw lots of healthy
learning-related activity.

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Yet in those people
who were sleep-deprived,

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we actually couldn't find
any significant signal whatsoever.

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So it's almost as though sleep deprivation

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had shut down your memory inbox

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and any new incoming files,
they were just being bounced.

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You couldn't effectively
commit new experiences to memory.

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So that's the bad that can happen
if I were to take sleep away from you,

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but let me just come back
to that control group for a second.

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Do you remember those folks
that got the full eight hours of sleep?

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Well, we can ask
a very different question:

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what is it about the physiological
quality of your sleep

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when you do get it

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that restores and enhances
your memory and learning ability

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each and every day?

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And by placing electrodes
all over the head,

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what we've discovered is that
there are big powerful brainwaves

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that happen during
the very deepest stages of sleep

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that have riding on top of them

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these spectacular bursts
of electrical activity

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that we call sleep spindles.

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And it's the combined quality
of these deep sleep brainwaves

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that acts like a file transfer
mechanism at night,

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shifting memories from a short-term
vulnerable reservoir

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to a more permanent long-term
storage site within the brain,

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and therefore protecting them,

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making them safe.

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And it is important that
we understand what during sleep

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actually transacts these memory benefits,

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because there are real medical
and societal implications.

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And let me just tell you about one area
that we've worked out into clinically,

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which is the context of aging

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and dementia.

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Because, it's of course no secret
that, as we get older,

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our learning and memory abilities
begin to fade and decline.

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But what we've also discovered

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is that a physiological signature of aging

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is that your sleep gets worse,

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especially that deep quality of sleep
that I was just discussing.

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And only last year,
we finally published evidence

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that these two things,
they're not simply co-occurring,

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they are significantly interrelated.

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And it suggests that
the disruption of deep sleep

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is an under-appreciated factor

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that is contributing
to cognitive decline or memory decline

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in aging, and most recently
we've discovered,

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in Alzheimer's disease as well.

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Now, I know this is
remarkably depressing news.

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It's in the mail. It's coming at you.

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But there's a potential
silver lining here.

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Unlikely many of the other factors
that we know are associated with aging,

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for example changes in
the physical structure of the brain,

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that's fiendishly difficult to treat,

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but that sleep is a missing piece
in the explanatory puzzle

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of aging and Alzheimer's is exciting

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because we may be able
to do something about it.

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And one way that we are
approaching this at my sleep center

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is not by using
sleeping pills, by the way.

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Unfortunately, they are blunt instruments
that do not produce naturalistic sleep.

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Instead, we are actually developing
a method based on this.

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It's called direct current
brain stimulation.

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You insert a small amount
of voltage into the brain,

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so small you typically don't feel it,

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but it has a measurable impact.

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Now, if you apply this stimulation
during sleep in young, healthy adults,

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as if you're sort of singing in time

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with those deep sleep brainwaves,

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not only can you amplify
the size of those deep sleep brainwaves,

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but in doing so, we can almost
double the amount of memory benefit

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that you get from sleep.

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The question now
is whether we can translate

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this same affordable,

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potentially portable piece of technology

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into older adults

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and those with dementia.

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Can we restore back
some healthy quality of deep sleep,

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and in doing so can we salvage
aspects of their learning

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and memory function?

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That is my real hope now.

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That's one of our moonshot goals,

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as it were.

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So that's an example
of sleep for your brain,

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but sleep is just
as essential for your body.

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We've already spoken about sleep loss

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and your reproductive system.

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Or, I could tell you about sleep loss

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and your cardiovascular system,

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and that all it takes is one hour,

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because there is a global experiment
performed on 1.6 billion people

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across 70 countries twice a year,

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and it's called Daylight Savings Time.

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Now, in the spring when we lose
one hour of sleep,

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we see a subsequent 24 percent increase

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in heart attacks that following day.

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In the autumn, when we gain
an hour of sleep,

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we see a 21 percent
reduction in heart attacks.

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Isn't that incredible?

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And you see exactly the same profile

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for car crashes, road traffic accidents,

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even suicide rates.

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But as a deeper dive,
I want to focus on this:

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sleep loss and your immune system.

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And here, I'll introduce these delightful
blue elements in the image.

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They are called natural killer cells,

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and you can think of natural killer cells

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almost like the secret service agents
of your immune system.

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They are very good at identifying
dangerous, unwanted elements

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and eliminating them.

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In fact, what they're doing here
is destroying a cancerous tumor mass.

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So what you wish for

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is a virile set of these immune assassins

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at all times,

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and tragically that's what you don't have

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if you're not sleeping enough.

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So here in this experiment,

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you're not going to have your sleep
deprived for an entire night,

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you're simply going to have your sleep
restricted to four hours

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for one single night,

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and then we're going to look to see
what's the percent reduction

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in immune cell activity that you suffer.

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And it's not small.

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It's not 10 percent.

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It's not 20 percent.

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It was a 70 percent drop
in natural killer cell activity.

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That's a concerning
state of immune deficiency,

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and you can perhaps understand
why we're now finding

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significant links between
short sleep duration

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and your risk for the development
of numerous forms of cancer.

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Currently, that list includes
cancer of the bowel,

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00:11:12,971 --> 00:11:16,565
cancer of the prostate,
and cancer of the breast.

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In fact, the link between a lack of sleep
and cancer is now so strong

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that the World Health Organization

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has classified any form
of nighttime shift work

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as a probable carcinogen

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because of a disruption
of your sleep-wake rhythms.

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So you may have heard of that old maxim

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that you can sleep when you're dead.

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Well, I'm being quite serious now.

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It is mortally unwise advice.

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We know this from epidemiological studies
across millions of individuals.

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There's a simple truth:

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the short your sleep,
the shorter your life.

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Short sleep predicts all cause mortality.

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And if increasing your risk
for the development of cancer

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00:12:08,702 --> 00:12:11,721
or even Alzheimer's disease

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00:12:11,721 --> 00:12:15,865
were not sufficiently disquieting,

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we have since discovered
that a lack of sleep will even erode

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00:12:19,484 --> 00:12:24,044
the very fabric of biological life itself,

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your DNA genetic code.

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So here in this study,

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they took a group of healthy adults

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and they limited them
to six hours of sleep a night

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for one week,

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and then they measured the change
in their gene activity profile

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relative to when those same individuals

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were getting a full eight hours
of sleep a night.

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And there were two critical findings.

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First, a sizable and significant
711 genes were distorted in their activity

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caused by a lack of sleep.

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The second result was that
about half of those genes

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were actually increased in their activity.

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The other half were decreased.

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Now, those genes that were
switched off by a lack of sleep

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were genes associated
with your immune system,

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so once again you can see
that immune deficiency.

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In contrast, those genes
that were actually up-regulated,

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or increased by way of a lack of sleep,

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were genes associated
with the promotion of tumors,

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genes associated with long-term
chronic inflammation within the body,

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and genes associated with stress,

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and, as a consequence,
cardiovascular disease.

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There is simply no aspect of your wellness

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that can retreat at the sign
of sleep deprivation

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and get away unscathed.

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It's rather like a broken
water pipe in your home.

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Sleep loss will leak down
into every nook and cranny

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of your physiology,

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00:14:00,157 --> 00:14:04,269
even tampering with
the very DNA nucleic alphabet

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00:14:04,269 --> 00:14:07,660
that spells out
your daily health narrative.

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And at this point, you may be thinking,

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oh my goodness,

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how do I start to get better sleep?

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What are you tips for good sleep?

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Well, beyond avoiding
the damaging and harmful impact

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of alcohol and caffeine on sleep,

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and if you're struggling
with sleep at night,

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avoiding naps during the day,

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I have two pieces of advice for you.

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The first is regularity.

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Go to bed at the same time,
wake up at the same time,

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no matter whether it's
the weekday or the weekend.

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Regularity is king,

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and it will anchor your sleep

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and improve the quantity
and the quality of that sleep.

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The second is keep it cool.

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Your body needs to drop
its core temperature

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by about two to three degrees
Fahrenheit to initiate sleep

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and then to stay asleep,

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and it's the reason
you will always find it easier

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to fall asleep in a room that's too cold

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than too hot.

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So aim for a bedroom temperature
of around 65 degrees,

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or about 18 degrees Celsius.

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That's going to be optimal
for the sleep of most people.

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And then finally,
in taking a step back then,

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what is the mission critical
statement here?

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Well, I think it may be this:

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sleep, unfortunately,
is not an optional lifestyle luxury.

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Sleep is a non-negotiable
biological necessity.

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It is your life support system,

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and it is Mother Nature's best effort yet

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at immortality.

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And the decimation of sleep

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throughout industrialized nations

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is having a catastrophic impact
on our health, our wellness,

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even the safety and
the education of our children.

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It's a silent sleep loss epidemic,

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and it is fast becoming one of
the greatest public health challenges

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that we face in the 21st century.

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I believe it is now time for us
to reclaim our right

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to a full night of sleep,

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and without embarrassment

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or that unfortunate stigma of laziness.

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And in doing so, we can be reunited

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with the most powerful elixir of life,

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the Swiss army knife
of health, as it were.

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And with that soapbox rant over,
I will simply say, good night, good luck,

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and above all,

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I do hope you sleep well.

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Thank you very much indeed.

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(Applause)

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Thank you.

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Thank you so much.

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Moderator: No, no, no.
Stay there for a second.

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Good job not running away, though.
I appreciate that.

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So that was terrifying.

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Matt Walker: You're welcome.
Moderator: Yes, thank you, thank you.

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Since we can't catch up on sleep,

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what are we supposed to do?

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What do we do when we're, like,
tossing and turning in bed late at night

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or doing shift work or whatever else?

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MW: So you're right,
we can't catch up on sleep.

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Sleep is not like the bank.

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You can't accumulate a debt

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and then hope to pay it off
at a later point in time.

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I should also note that the reason
it's so catastrophic

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and that our health
deteriorates so quickly,

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first it's because human beings
are the only species

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that deliberately deprive
themselves of sleep

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for no apparent reason.

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Moderator: Because we're smart.

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MW: And I make that point because
what it means is that Mother Nature,

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throughout the course of evolution,

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has never had to face the challenge
of this thing called sleep deprivation.

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So she's never developed a safety net,

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and that's why when you under-sleep

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things just sort of implode so quickly,
both within the brain and the body.

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So you just have to prioritize.

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Moderator. OK. So,
but tossing and turning in bed,

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what do I do?

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MW: So if you are staying in bed
awake for too long,

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you should get out of bed
and go to a different room

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and do something different.

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The reason is because your brain
will very quickly associate your bedroom

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with the place of wakefulness,

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and you need to break that association.

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So only return to bed when you are sleepy,

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and that way you will re-learn
the association that you once had,

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which is your bed is the place of sleep.

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So the analogy would be,

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you'd never sit at the dinner table

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waiting to get hungry,

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so why would you lie in bed
waiting to get sleepy?

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Moderator: All right.
Well, thank you for that wake-up call.

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Great job, Matt.

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MW: You're very welcome.
Thank you very much.

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(Applause)