Freakonomics of Sleep 2

The Freakonomics of Sleep (Part 1)

Freakonomics of Sleep 2Over the last few years, a discussion on sleep has emerged into popular consciousness, largely due to an increasing literature base showing its importance, and the media’s willingness to write about these findings. Also, sleep science makes for great stories. People are fascinated by the subject, which makes complete sense: we spend one-third of our lives in this unconscious state, and when sleep is inadequate, there is a decisive and immediate price paid.

Back in May of this year, I had the honor to give a presentation entitled Sleep, Productivity, and Peak Performance at a CEO summit in Manhattan. Venture capital firm, Firstmark Capital, organized the summit for approximately 75 CEOs in their portfolio of funded companies, including greats like Dashlane, Shopify, Lumocity, and many others. I spoke first in the day and after me spoke Stephen Dubner of Freakonomics. He regaled the audience with his story of Takeru Kobayashi or “Kobi”, who smashed the world record for hot dogs eaten at Nathan’s Famous Hot Dog Eating Contest. It’s so much fun to listen to a great story teller do his thing. Here a short excerpt of it here:

The lessons taught by Dubner through his story are highly relevant to people (or companies) trying to solve any problem, including managing your health. When you’re trying to do something better or different than has ever been done before:

  1. Redefine the problem, or seek to ask the question in a different way. For example, don’t ask how you can eat more hot dogs, but rather ask how you can eat one hot dog most efficiently. How can you reframe the issue you’re working on?
  2. Find the barriers. As Kobi approached the problem of how to eat more hot dogs than ever before at this competitionnoun_91791, he gave no ‘mental allegiance’ to the previous record. He just focused on the process of how best to eat one hot dog, and then how to repeat that most efficiently. Some barriers are real, but some are perceived. Perceived barriers still have the ability to limit performance, so as you approach solving the issue, be mindful of how you consciously frame limits and restrictions in your mind.

We’ll discuss both these points in the next post when we talk about solving the problem of getting great sleep regularly. 

Dubner and I had the chance to connect before he left that day, and it just so happened that he was in the middle of producing a two-part podcast series on sleep. He invited me to be interviewed, and we recorded the very next week. True to form, the production crew did an excellent job assembling a great story from the various interviews they conducted, which you can hear in part 1 and part 2.

Part 1:

Part 2:

 

Sleep Deprivation + Cognitive Deficits

One of the interviews Dubner conducted was with David Dinges, PhD, who is the Chief of the Division of Sleep and Chronobiology in the Department of Psychiatry at the Perlman School of Medicine at the University of Pennsylvania. Dinges spoke to several things I discussed in detail in my Firstmark Capital presentation, particularly, the dose-response effects of sleep loss on neurocognitive functioning. In other words, the less sleep you get, the worse you’re likely to perform at a variety of cognitive tasks. Here is a direct excerpt from the interview:

DINGES: [After inadequate sleep] attention becomes unstable, we have trouble thinking fast, cognitiveThinker processing speed is markedly reduced. Short-term memory begins to fail. We can’t hold things in our memory as well as when we’re full alert. The less sleep we gave people at night, so if went from seven or eight hours a night down to six or five, the more we got this cumulative rate of build-up of these deficits. They got worse every day. When the sleep got very short, down to four hours or three hours, they got worse every day very rapidly and very dramatically. So there was a dose-response function. The less sleep you got chronically, the more rapidly you deteriorated.

Dinges then drilled down into how these sleep-deprived cognitive lapses affect our attention, and how we may try to compensate with our behavior.

So the two things you see first are you cannot sustain attention for very long. You compensate by becoming impulsive. So what happens with, paradoxically with chronic sleep restriction is people will be slow to respond, or lapse. And then they’ll be overly impulsive and maybe talk or interact a lot, and then suddenly be out of it again. And that instability in attention is the hallmark of sleep loss. But very close behind it, and equivalent to it, is your cognitive processing speed. You simply cannot think as fast and solve a problem as quickly when you’re sleep-deprived as when you’re not sleep-deprived.

Impulsiveness, inattention, and cognitive impairment are a powerful combination that anyone who is striving to meet a health goal or set up healthy habits would want to keep in check.  It makes sense that sleep would have a profound effect on sustaining an effective daily health pattern.

 

We’re Not So Great at Knowing How Much We Sleep

It turns out that people are not very good at knowing and reporting how much they sleep, according to Diane Lauderdale, Ph.D., an epidemiologist at the University of Chicago.

It’s quite difficult to get accurate information about people’s routine sleep behavior.  The obvious one is to ask people, “How much sleep do you usually get at night?” And that seems like it should be a great way to find out about sleep, just like if you ask people, “How tall are you?” or “How much do you weigh?” you get a pretty good answer. It turns out though, that sleep is hard. People don’t actually know the answer to that question… You’ll know that it took you awhile to go to sleep, but you might not be at all good at estimating how long it was, whether it was five minutes or 40 minutes. In addition, for many people, routines vary day-to-day. And so there’s not only the problem of not knowing on any one particular night how much sleep you got, but in answering a question about routine sleep behavior, not really having a good sense of how to average behaviors over days when in fact you don’t know how much you actually slept on any of them. One approach people in surveys unfortunately often resort to is just giving an answer which they think will be a well-accepted answer to the person interviewing them.

This is an interesting point from a research perspective, but it’s also supportive of the idea that tracking sleep via sleep monitoring devices is highly useful in developing and maintaining a restorative sleep practice.  Tracking certain behaviors around sleep helps you understand whether you’re currently making the best lifestyle choices to facilitate restorative sleep night after night. Also, tracking can provide objective information on what you’re actually doing versus what you think you’re doing, and the difference between these two can be large.

 

Is “Sleep-shaming” a Fading Trend?

Dubner refers to the “sleep is for suckers” mentality that some people seem to hold, and Diane Lauderdale elaborates in her interview.

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I’m not lazy!

There was a period, in the 80’s, 90’s when Margaret Thatcher, Bill Clinton bragged about only needing four hours or five hours of sleep.  And there was this period when being short sleepers was held up as evidence that you were leading an important life.

Admitting how little sleep you get can also be viewed as a form of bragging. A person is essentially aiming to signal genetic fitness by demonstrating performance during a handicap: “look how good I’m performing during these challenging conditions. Think about how well I’d do if I was at full capacity!

As Dubner points out, we have all known people like this, who say things like “I’ll sleep when I’m dead” and are sleep-shaming the rest of us.  However, Diane Lauderdale thinks this is a fading trend.

I think far fewer people brag about how little they’re sleeping. They’re more likely to be complaining about how little they’re sleeping and valuing sleep.

As the social stigma around sleep loss spreads, there will increasingly be a reluctance to brag about it. No one wants to be seen as slow, unreliable or a safety hazard.

With that being said, people who value sleep still say well-intentioned things like “I wish I had time to sleep well like you do,” to people who manage to consistently prioritize good sleep.  I know from personal experience that good health patterns around sleep, eating, exercise, etc. don’t happen by accident—they happen from conscious, sometimes creative, and completely do-able actions that we decide to take for ourselves.  So I think the sleep-shaming trend is moving in the right direction. More so than ever before, the social perception is that it’s smart to get sleep, which is accurate. Soon, bragging about sleep loss will be equivalent to bragging about poor hygiene, and  that social stigma might actually help people do right by themselves.

In the next part of this blog, I’ll discuss points I make in my interview, and give more details on the action plan I use to engender excellent sleep in my own health practice.

 



  • Viola Kay ケイラ

    As I’m reading this, it is clear to me that I am sleep deprived. If we want to be an i7 processor, I’m functioning at an i3 speed. I find myself acting impulsively and distracted easily. I also read very slowly because I keep re-reading sentences.

    I’ve personally always prioritized sleep (not always at reasonable times) at the cost of a social life, jobs, and school (even in high school). It’s such a tug-of-war when it comes to balancing sleep, eating well, exercising, and not coming off “lazy” because you’re not productive. Though I suppose if you get efficient at all of those things, it actually helps productivity. How can we avoid these extremes?

    • danpardi

      @violakay:disqus

      I like this: “I am an i7 processor, but I’m functioning at an i3 speed.” I find myself acting impulsively and distracted easily. I also read very slowly because I keep re-reading sentences.

      Even with good intentions and a desire for good sleep, it’s still a constant battle, as you describe. There are so many things that want us to stay up later: friends, shows, apps, work, etc. It’s a nightly struggle for me too, but clear goals and tracking does help. Also, a reminder to myself of wanting to be my best the next day is effective for me to get my butt in bed. The next post will provide some very clear steps, and a sleep experiment, on how to get better sleep.

      • Vivek Menon

        Coming from the same position (prioritizing sleep, but as a constant & losing battle against cultural and social norms), I am keen to understand more…

        Reason being, it is far too easy for me to fall into a vicious sleep cycle, i.e. think I am rested and “normal” even when not, because I get used to that impaired state of being (slowly worsening over time).

        Knowing and having a simple tracker of good or bad performance would help break that cycle!

        • danpardi

          @madisonvm:disqus, a tracker for daily performance is an interesting idea. The next post will describe and online tool, not Dan’s Plan, where you’ll be able to assess vigilance.

  • As a dietitian when I work with people in a nutrition-setting of course I ask about their sleep, sleep hygiene, etc. I’ve noticed that similar to eating habits, people tend to defend and identify with their sleep habits even if they’re not great. Meaning, suggesting to change someone’s nighttime routine sometimes gets taken as crossing some ‘line of autonomy’ that people don’t wanna hear about. Not sure if I’m articulating that properly but maybe you catch my drift.

    • danpardi

      Hi @jeffrothschild:disqus, that’s interesting and not surprising. For many, health directives feels like an imposition on personal freedom and choice. Also, as work times and commute times extend, people will always need to find time for personal hobbies, interests, or even just to relax. Since personal time is limited by extending work and commute hours, something has got to give, and often, it’s sleep. This scenario can also stimulate motivated reasoning to prefer anyone show says that sleep is not that important, and who has a product that supposedly reduces sleep need. Nothing has even been shown to limit sleep need. Nothing. There are always consequences.

    • Ginny RoBards

      I think part of why people are resistant to feedback concerning their sleep hygiene is they perceive it as being less directly controllable than either nutrition or exercise. Due in part to external factors like Dan mentions (time constraints). But also to internal factors – you can’t just flip a switch and go to sleep spontaneously, even if you really really want to. I’ve personally experienced frustration when I for whatever reason can’t compel myself to fall asleep and remain asleep within the time window that fits my biological rhythms and professional/academic responsibilities, so I totally get that. 🙂

      I am hoping that as (non-intrusive) sleep monitoring technology is validated and made accessible to the public, more people will feel able to make changes. Being able to accurately measure both duration and intensity of sleep with some reliability on a nightly basis is a helpful starting place, especially since most of us are poor judges of that.

      • danpardi

        Great points, @ginnyrobards:disqus. Our next post will address some of this. It will be up this week.

  • Marie Pardi

    I remember very vividly being so sleep deprived with a sick baby that the fifth or sixth time I had to visit our pediatrician, he took one look at me and put out his hand and said, “Hi I’m Dr—-,” I shook his hand and said, “Hello ,I’m Marie,” the Dr turned to my husband and said , “I’m admitting your wife and daughter to the hospital immediately!” Sometimes you don’t even realize you are seriously sleep deprived, until someone else notices you are not functioning or thinking clearly. This is an excellent article for us to monitor our own sleep but also be aware of sleep issues of our loved ones, especially teenagers. Thanks Dan!