Top Moment: The Real Reason You're Always Tired: Professor Guy Leschziner

In this moment, the world-renowned expert in Neurology and Sleep Medicine, Professor Guy Leschziner outline why sleep is crucial to every aspect of your life, and the biggest mistake people make when it comes to get a good night’s sleep. Humans spend a third of their lives sleeping, however science still understands very little about it. Guy says that sleep is of fundamental importance to humans otherwise evolution would have removed it. Despite its importance, Guy thinks that people underestimate the power of sleep. He’s says that too often people make lifestyle choices that ensure they will have the worst possible sleep, which can then impact everything from their immune system, cardiovascular system, and mental health. Listen to the full episode here - Spotify- https://g2ul0.app.link//HrQyIkjaIOb Apple - https://g2ul0.app.link//QMALvueaIOb Watch the Episodes On Youtube - https://www.youtube.com/c/%20TheDiaryOfACEO/videos Guy Leschziner: https://www.guyleschziner.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Steven Bartlett?

  Why sleep? Of all the things that you could commit so much of your time to, because it appears you've been really thinking and working on the subject matter of sleep for about 20 odd years, two decades roughly?

• 0:12Speaker 01

  Yeah, something like that, yeah.

• 0:14Steven Bartlett?

  Why?

• 0:15Speaker 01

  Well, I think the first thing is, is that we spend a third of our lives doing it, and yet, whatever people like me will tell you, we still understand relatively little about it. We understand relatively little about, you know, what it's for, what it does to our biology. Obviously, that's changing very, very quickly now. It has a great deal of overlap with the world of clinical neurology. So I also do, I do specialist clinics, specialist clinics in epilepsy, and I do specialist clinics in, in general neurology. So, and, and sleep and the brain intersect at every single level.

• 0:57Speaker 01

  Of course, you know, it's not me saying this, but a famous statement is, sleep is of the brain, by the brain, and for the brain. It's intimately linked to every aspect of how our brain works. So, one of the really exciting things is that because it's a relatively new area, our understanding of it is exploding in ways that are not paralleled across other areas of clinical medicine.

• 1:22Steven Bartlett?

  Is it important?

• 1:24Speaker 01

  Is it important?

• 1:25Steven Bartlett?

  Yeah.

• 1:26Speaker 01

  I, I think it is of fundamental importance. You know, the fact is that if sleep wasn't important, it would be a very stupid thing for evolution to create in us. The fact that we are essentially switched off from our external environment for a third of our lives. And actually, there's a whole host of evidence when you look at how certain animals have developed the ability to be able to sleep with only half their brain at a time, you know, animals like aquatic mammals or certain birds.

• 1:55Steven Bartlett?

  Dolphin.

• 1:56Speaker 01

  And dolphins, that very much suggests, well, you know, that must be of great importance if it's, if sleep is... Um. A risk for our survival, because if you're an aquatic mammal like a dolphin and you're sleeping and you're unable to surface or unable to see what predators are around you, that the, that the, the evolution has designed a system whereby it enables you to sleep with half of your brain at a time. So that in and of itself tells us it's important. The, the, the, the fact that the circadian rhythm, so that twenty four hour cycle that a whole host of biological rhythms have is so intrinsically linked to life itself

• 2:38Speaker 01

  that actually every single um life form exhibits features of this twenty four hour circadian rhythm. Tells us that this was something that was prioritised at a very, very early stage in life's evolution on earth. So, yes, it's important. And over the last few years, we've understa- understood precisely why it's important. I say precisely, but we know that it's important for pretty much every aspect of our waking lives, be it our immune system, be it our um cardiovascular system, our blood pressure, risk of diabetes, um, uh, mental health, so depression and anxiety, even how we perceive pain.

• 3:19Speaker 01

  So it really is fundamental to every system that we uh rely on during our waking lives.

• 3:26Steven Bartlett?

  Having seen, you know, thousands and thousands and thousands of people that struggle with sleep that have been sent to your centre, do you think the, the average person on the street over or underestimates the importance of sleep in their day to day life?

• 3:40Speaker 01

  Well, I think it's changing. I think it was not that long ago where, you know, comments like sleep is for wimps uh was heard fairly frequently and that there were some bragging rights associated with how little you sleep. I think that there has been a transformation over the last sort of fifteen or twenty years whereby people have become much more aware of how important asleep, asleep is and have started prioritising it a little bit.

• 4:06Steven Bartlett?

  So you think, where do you think we stand then? Overestimate, underestimate?

• 4:09Speaker 01

  I think that there is still in the general population an underestimation of how important sleep is. But I think there are certain segments of the population that are much more aware of it. And perhaps even, dare I say, overestimate it.

• 4:24Steven Bartlett?

  Overestimate?

• 4:25Speaker 01

  Yes, I think so. I think that there is a danger at the current time that we tend to obsessionalise about sleep and and think that it is the be all and end all. It's of course part of normal life for our sleep to fluctuate, depending on what's going on in our external and our internal lives. And I think the danger is that if you over emphasise the importance of getting eight or eight and a half hours of sleep every night, then you actually risk problems later down the line, exacerbating things like insomnia.

• 5:01Steven Bartlett?

  The average person that you've treated, worked with in your clinical practice that's struggling with sleep is at the heart of the issue, just poor sort of sleep hygiene, like you've said there?

• 5:12Speaker 01

  Yeah.

• 5:13Steven Bartlett?

  Because I've got so many friends that say to me that they struggle with their sleep. Many of them have struggled with it for years. And I doubt that there's some sort of genetic reason why this many people are struggling with sleep. So I imagine it's just some kind of behavioural reason.

• 5:29Speaker 01

  So I think that the genes that predispose to insomnia are pretty widespread. But obviously, you know, in pretty much all areas of medicine, there is an interaction between genetics and environment. And certainly, poor sleep hygiene, and that's a horrible term, I hate that term, but it's the term that is most widely used and understood, can certainly put in place certain aspects of behaviour that then can give rise to chronic insomnia in the long term. So if you've got very bad chronic insomnia, then suddenly putting good sleep hygiene in place is unlikely to fix it. But it may be that that poor sleep hygiene in the first instance

• 6:11Speaker 01

  gave rise, or at least predisposed you to developing insomnia.

• 6:15Steven Bartlett?

  And what is poor sleep hygiene? If I wanted to be the worst possible sleeper?

• 6:21Speaker 01

  Okay.

• 6:22Steven Bartlett?

  In the world, what would I have to do?

• 6:24Speaker 01

  So I think you would probably have to uh um set up your home office in your bedroom.

• 6:30Steven Bartlett?

  Okay.

• 6:31Speaker 01

  You'd have to have um you know, your TV on in your bedroom all the time.

• 6:35Steven Bartlett?

  Okay.

• 6:35Speaker 01

  Uh uh be surrounded by electronic devices, drink a lot of coffee late in the evening.

• 6:40Steven Bartlett?

  Alcohol?

• 6:41Speaker 01

  Uh drinks a little bit of alcohol. So alcohol in the short term, of course, is is quite sedating. It's a central nervous system depress uh depressant. But it does dramatically worsen the quality of your sleep and for various reasons, the direct chemical effect, the fact that you've got a full bladder, um the fact that you're probably snoring a little bit more. So alcohol's not a good thing. Um you know, not having a wind down period. So you know, gambling on the stock market until one AM, switching your laptop and then trying to go to bed, uh those kinds of things. So that's, you know, the quintessential very, very bad sleep hygiene.

• 7:18Steven Bartlett?

  What about when I eat?

• 7:19Speaker 01

  So uh you know, eating is perhaps less important, but avoiding a very large carbohydrate meal, carbohydrate-rich meal before you go to bed for two reasons. One is that we know that it can cause some fluctuations in terms of your blood sugar. And also, if you've got a bit of reflux, it can make that much worse.

• 7:37Steven Bartlett?

  Okay. What about sleeping in bed with somebody else?

• 7:41Speaker 01

  Well, I think that for some people, they've, and again, this goes back to no one rule for everybody. You know, if you've got a a a sleep trait termed sleep reactivity, which is where your sleep is very liable to your environment, then obviously, sleeping next to somebody who's snoring loudly or who gets up in the middle of the night two or three times to to to urinate can be can be very disruptive to your sleep. If you've got very little sleep reactivity, you may actually find it comfortable, more comfortable to sleep with somebody in the same bed as you.

• 8:12Steven Bartlett?

  I was um I was thinking the other day, cause where I've currently moved into, there's no blinds or curtains in my bedroom.

• 8:19Speaker 01

  Hmm.

• 8:19Steven Bartlett?

  And I was wondering if that might be a good thing. Because it at least means that in terms of my circadian rhythm, I'm waking up at the same time every day. Because I'm waking up when the sun comes up.

• 8:31Speaker 01

  Yeah, but the sun comes up at different times, on different days firstly. So if you were doing that routinely, you might find yourself really rather sleep deprived in the summer months. And also, there is some emerging evidence that exposure to light at night in your sleep is not very good for you. So there was a very recent study that implied that light exposure at night increases your risk of diabetes. So it certainly is not good for the quality of your sleep. And the likelihood is that you won't wake up as soon as it's light, you'll wake up at an hour or so after it's got light. But during that hour or so, it may have had a negative impact on the quality of your sleep.

• 9:16Speaker 01

  So having a dark bedroom is really part of good sleep hygiene, as is having a quiet bedroom that is not too hot or too cold.

• 9:26Steven Bartlett?

  What if you wear a sleep mask? Does that solve it?

• 9:29Speaker 01

  Yes, it does. I mean, I wear a sleep mask. I think it's, you know, particularly if you don't have good blackout curtains or blinds in your bedroom, using a sleep mask, particularly in the, in the summer months, is probably very helpful indeed.

• 9:42Steven Bartlett?

  Does that mean that the only light receptors we have are behind our eyes?

• 9:46Speaker 01

  Well, I think that there was a, there were some rumours on the internet that there were light receptors elsewhere, but certainly the only ones that we know to be of significance in terms of defining our circadian rhythm are the ones in our retinas.