[MUSIC] All right so summary short sleep duration is associated with an increased body mass index. Sleep deprivation increases hunger for high calorie foods, actually through multiple pathways and I think do I have to have this? I'm going to talk about another study too, so another study that was done, which I'm not showing you on a slide but I thought it was also really interesting. Which is they took a group of overweight people and they divided them up into two groups, they both had calorie restricted diets and one group was allowed to sleep more and another and the other group was sleep restricted. And the two groups lost about the same amount of weight, but the people who didn't sleep well or didn't sleep enough lost more lean muscle mass and less fat. And of course when you're on a diet you're trying to lose fat, you're not trying to lose your muscle mass. So sleep is really important for regulating, metabolic processes for hunger and appetite again, when we used to do studies, sleep depriving rats, the first thing that happens when you start sleep restricting a rat is that it starts eating like crazy. And so that's pretty much true across mammals, and it raises the issue that sleep duration could be a modifiable risk factor for obesity and we have a sleep deprived population, we have an obesity epidemic. And so one of the important things to do, is not only watch your diet and your exercise, but make sure you get enough sleep. And it's the problem is that we think about the first two things and we don't think about the 3rd one. All right, so I'm a psychiatrist, so I'm interested in mental health as well and there's a lot of data about the role of sleep in mental health and as well, hopefully just learned sleep is important for brain function and if your brain isn't functioning while your mental health is probably not going to be the greatest. And so people who have sleep problems, particularly insomnia, which is trouble getting to sleep and staying asleep have dramatically increased rates of eventually going on to develop depression. And there have been many, many studies of thousands of people that have shown this. There are also studies in adolescence, I'm not going to show this slide, but studies in adolescents showing that adolescents who don't spend enough hours in bed at night are at greater risk of developing depression. [COUGH] And so this was this is another study, actually that shows the same point, there were two studies I was referring to the other one, but this one is a study that was done in Japan, over 15,000 junior in high school students, and they looked at sleep deprivation or sleep duration and the presence of both symptoms of anxiety and depression. And here, these on the left are Males and on the right are females, and what we see here is the, the top row is grades 7-9, and this is grades 10-12 is that the rates of in some of anxiety and depression are much higher and they go up quite drastically as students report getting less and less sleep. So this is the left, most bars less than 5.5 hours, 5.5 to 6.5 6.5 to 7.5, and the the best amount in the males was 8.5 to 9.5 hours. In the females, it was 7.5 to 8.5 hours, but 8.5 to 9 was also pretty good so the idea is that if you don't sleep enough, you're going to be more likely to have anxiety, depression. The other studies show that if you don't sleep enough, you will be more likely to develop depression. And in general, what we know is sleep problems are more strongly associated with psychiatric disorders than there with any other medical disorders that insomnia, and also insufficient sleep predict new onset or recurrence of psychiatric disorders and they can persist. And another factor that I don't think I have in here is that, insomnia is also a risk factor for suicide, and this has been shown in adolescents and adults and older individuals is that it's an independent. So independent of how much depression there is people who have profound difficulty sleeping are more likely to have suicidal thoughts or engage in suicidal behaviors than people who sleep better. So, I'm going to finish up with this study. And this is a study that was done at Harvard, and published a couple of years ago and they took a bunch of Harvard students and they had them kind of keep track on sleep logs and with activity monitors of how much they were sleeping and when they were sleeping. And there were kind of four groups of subjects on the left side here and the dark bars are where people are sleeping and then the clear bars are where they're awake. So, and this is each day kind of stacked up. So you can see here on the left side, these are people who did not have regular sleep hours, they would go to bed sometimes late, sometimes early, they would take naps and some of them, this group were irregular with longer sleep duration, and these were irregular with short sleep duration. And then they had another group of subjects, students who had very regular sleep habits, they would go to bed and wake up at about the same time, and some of them were longer sleepers, and some of them were shorter sleepers. And what they found was that, the students who had more regular sleep patterns had higher GPS than the ones with the irregular patterns. It was also the case that the ones with the more regular sleep patterns also had more regular exercise patterns. And so it sort of leads into this idea that regular exercise and regularly timed exercise helps your sleep and your sleep helps your exercise and they all help your brain function. Now, they didn't see such an effective sleep duration here, but most of the data really suggests that both having enough sleep in terms of how many hours you sleep and having regular sleep are critically important to get the best benefit from sleep and to have the best mental and physical health. And do we have some athletes in this class? A few athletes, so there's a whole area is not going to having worked with some of the athletic teams when I was at the University of Wisconsin, there's a whole field of sleep medicine related to athletic performance. And, there was a study done at Stanford showing that basketball players who got more sleep had better free throw averages than when they got less sleep. There are studies showing that, depending on which way you're jet lag is for professional sports teams, it's harder to get sleep when you travel east than it is when you go west. So all other things being equal, westward traveling teams do better. And again sleep duration is important for maximizing your ability to combine challenging mental and physical tasks. So, being coordinated while you're also in trying to deal with a like, how where do you throw the football when everybody's running around? You're going to do better if you are not sleep deprived. All right, so since we're all anteaters here, I like to finish up, this is peter the anteater or one of his relatives. And this is how anteaters sleep. They sleep curled up and actually they usually sleep with their tail over their face, but this was a picture without the tail over the face that we could kind of see that these are tales a blanket. So, what I want to get across to you today, the final thing is sleep to remember and remember to sleep. And, so I was told you need a little practice exercise of something to do. How many people here get at least seven hours in bed most of the time? Great so a lot of you do not. So what I want to suggest that you do is that you try as much as possible to get 7-9 hours in bed. The recommended amounts by the National Sleep Foundation, which surveyed a lot of experts is that adults between the ages of 18 and 65, should get about 7 to 9 hours. If you're younger than 18, you should be getting 8 to 10 hours, adolescents should get 8 to 10 hours at night. And if you can't quite get seven and eight hours, get, you can squeeze a nap in now. Sleep like diet and exercise is not something where we can be perfect every single day. And so what I like to remind people is even if, yeah, you've got to stay up late because you have a paper due or you're studying or whatever. The key to remember is you don't want to be sleep deprived night after night after night is to really try to schedule that, you're not going to go too many days in a row without getting your seven and 7-9 hours, hopefully not more than a day in a row. And so aim for and try to get an average of 7-9 hours. The next point is really important, and that gets into the regularity of your sleep, like from that Harvard study. Try to wake up at about the same time every morning. Now I know that's not necessarily realistic, but what we don't want is people to be waking up like at seven or 8:00 AM on the week days and then sleeping until two in the afternoon on the weekends. So try to have your sleep time more or less the same and try not to sleep in more than a couple hours extra on the weekend and try to go to bed earlier. And finally try to get at least 30 minutes of bright light exposure in the morning light is the most important signal to reset your clock to keep you on a 24 hour cycle. And we have our free California sunshine out here, so after you wake up, try to get outside, walk around, don't have super dark glasses on. If you can get that bright light signal in and that will help your sleep improved and it will help you feel more awake and alert. And then I'm going to stop there and we have a few minutes for questions, right? Questions anybody, yes. Okay, so that's a great question. Are there negative health effects for sleeping too long? And that sort of gets into what's too long, for someone your age, I mean I would we generally consider sleeping more than 11 hours a day, day after day after day as perhaps a bit on the excessive side. And that's probably something that should be checked out. And we there, epidemiologic studies in adults that are older suggesting that people who have longer sleep amounts may have health risks. But it's hard to distinguish whether that's because they're sleeping a long time or that they have health problems that make it difficult for them to get out of bed and that they're just or contributing to their sleep problems. So if you feel if you worry that you're sleeping too long to check with your doctor and we have a sleep center here and we can check things out but, you may just be sleeping more than your colleagues who are not sleeping enough. Pardon? General question. Okay good, well people who think there again most people are not sleeping enough. So, yes in the back there shout. What about sleep aids, like melatonin is that the question? Okay so, we generally don't advise taking sleep aids. There are two kinds of sleep aids there's the ones that you can buy over the counter. I'll talk about melatonin separately because melatonin is not so much a sleep inducing agent, it's more of a rhythm setting agent. Most of the stuff that you get in the drugstore, like the Tylenol PMS or the Sominex or whatever those are anti histamines. They can make you really groggy the next day they don't help your thinking particularly and you can get tolerant to them really rapidly. So after a couple of days they're really not working but if you don't take them you're going to have more insomnia. Sleeping pills that are prescribed, we generally try to avoid using them or only use them for short term because there's not a lot of evidence that they're all that helpful. And on the other hand, there are behavioral therapies that can work really well for sleep that are quite effective and very safe. Melatonin, a lot of people take melatonin, they take it as they're going to bed. Melatonin might be helpful if you have trouble going to bed at the hour, you need to, so if you're like someone who like, I need to go to bed like a 10 or 11, but I can't fall asleep till three in the morning, taking melatonin an hour or so before your desired bedtime might be helpful to help your timing system. But some people find it makes them sleepy, but it's it's really more something that tells your brain to do what it should do at night. Other questions, yes. Good timing for a nap. >> How long should a nap be? >> How long should a nappy? Okay, so there's one of the things about sleep is we have something called sleep inertia. So when you wake up in the morning, it takes your brain about a half hour to fully boot up, it's like rebooting your computer, it doesn't just boom, go on, it has to go through all that stuff and your brain kind of does that too. So my, one of my personal anecdote, my one of my sons used to drive me nuts because he would tell me, he could get up 15 minutes before class and get there and I'm like, your brain isn't even awake, that, you're missing the first half of class. So, and the naps will cause sleep inertia if they're longer, so a shorter nap,, a half hour to 40 minutes is easy or to wake up and get going again, and I think we've all had long naps and you wake up and you feel like you've kind of been run over by a truck and it's really hard to get going. And that sleep inertia. So those naps take longer to wake up from. So it's not really bad to take a long nap if you're really sleep deprived, just be prepared for the consequences, so a short nap is not a bad thing. Some sleep is always better than no sleep. So, at least when I used to be in school, people would have the myth of like, well just pull it all night or don't sleep at all it's better to stay up all night. No, it's always better to get some sleep. Any other questions. Yes. [INAUDIBLE]. Right, okay, screen time. So there's two things about screen time, one of which is, it often has a lot of blue light in it and blue light is what gives your brain a signal to be awake. So there's an alerting effect of light and also it affects your circadian rhythm. So it, makes your brain think I shouldn't go to bed yet and I should be awake and alert. And then the other thing is that if you're engaging in screen time where you're interacting with stuff, you're aroused in awake. So, there have been some studies like with these blue light blocking, amber glasses or you can get programs for your computer that cut out some of the blue light and that's probably a good idea. But the important thing is like put the gadgets away and their studies that show that the more things you have in your room and this is true for parents as well as kids like TVs and computers and, iPads and phones and all that stuff, the less you sleep in the longer you stay up. Yes. [INAUDIBLE]. Yeah, okay so yeah so the question is if you sleep three hours one day in 11 hours the other day that is not a good thing to do is better to sleep like 7-9 hours almost every day. So if you're continuously sleeping three hours and 11 hours or three hours, three hours, three hours 11 hours, that's not good. There's something called social jet lag where, you have short sleep on school nights and then you sleep a lot on the weekends that's associated with poorer school performance and more mood problems. So again, the more regularly you can sleep both the timing and the amount the better. I think I do one more question if anybody has one, nope. All right well thank you all. [APPLAUSE]
