Speaker 1: I'll get a team. It's Harps and Melissa and it
Speaker 1: is the prof. It is as I record as we
Speaker 1: start right now, it's three minutes past seven Tuesday night.
Speaker 1: Spent a big day and I mean listening to the
Speaker 1: prof wax lyrical with another smart bloke and Melissa. I
Speaker 1: was just wondering after listening to him whether or not
Speaker 1: at seven three in the PM, my cognitive function is
Speaker 1: somewhat less than seven o three in the am. What
Speaker 1: do you think? What do you think? You spoke to
Speaker 1: me earlier and you're speaking to me late. Am I dumber?
Speaker 2: I do not think that is the case. But I
Speaker 2: was intrigued before. And this goes to show what you've
Speaker 2: been learning and doing over the last few years in
Speaker 2: that your first thought is to turn to studying it.
Speaker 2: So you did say maybe you should do an IQ
Speaker 2: test in the morning, in an IQ test in the evening,
Speaker 2: and see.
Speaker 1: Well, I know we don't hold a great deal of
Speaker 1: kind of you know, value in IQ tests. You know
Speaker 1: they have a place, I guess. But firstly, Professor russ
Speaker 1: All Foster, welcome to the You Project, sir.
Speaker 3: Thank you, Craig. Really delighted to join you.
Speaker 1: I feel like you're a little bit too sophisticated and
Speaker 1: smart for us. But we'll just hang in there.
Speaker 3: Do you think, no, No, it's just a thin veneer.
Speaker 3: You can pietrate that ven I don't worry.
Speaker 1: You can't. You can't bullshit A bullshit A good sir. Now,
Speaker 1: if I took a typically, if I took an IQ
Speaker 1: test at seven am and seven pm, would I be
Speaker 1: slightly dumber? Or does it depend on a few other variables?
Speaker 1: Or would I be about the same.
Speaker 3: It depends on many variables. I mean, Craig, are you
Speaker 3: a morning type or an evening tape?
Speaker 1: Oh, that's a good question. I'm probably Melissa. What do
Speaker 1: you I reckon? I'm probably more mourning, but I'm like,
Speaker 1: I'm okay. But when I'm not okay, I hit the wall,
Speaker 1: like like after I get off this. So at seven
Speaker 1: o five now I reckon. By eight point thirty, I'll
Speaker 1: be sliding into a coma.
Speaker 3: Well. On average, adults peak cognitive performance, you know, our
Speaker 3: ability to process information and do mathematical tasks and all
Speaker 3: the rest of it, on average is between eleven am
Speaker 3: and twelve noon, and then it drops slowly throughout the
Speaker 3: afternoon to get to a really low point at around
Speaker 3: about four o'clock in the morning, four five o'clock in
Speaker 3: the morning. Now that will shift left or right depending
Speaker 3: whether you're a morning person or an evening person, but
Speaker 3: it's worth bearing in mind. Drew Dawson from Australia did
Speaker 3: a wonderful study comparing cognitive abilities at four o'clock in
Speaker 3: the morning and how bad you are at performing those
Speaker 3: tasks with the impact of alcohol. And he showed in
Speaker 3: this famous study that our ability to process information at
Speaker 3: four o'clock in the morning is worse than if we
Speaker 3: consume sufficient alcohol to make us legally drunk. So I
Speaker 3: mean you know, to your listeners, you know, if you
Speaker 3: happen to be driving at four five o'clock in the morning,
Speaker 3: your ability to drive that car is worse than if
Speaker 3: you consumed sufficient alcohol to make you legally drunk. It's
Speaker 3: that's the level of impairment the morning. It really is remarkable.
Speaker 1: And also, listeners, if you're driving at four am and
Speaker 1: your ship faced double that because which is the case,
Speaker 1: you clearly.
Speaker 3: Know, my listeners, doc, that's really bad.
Speaker 1: But also like what other things that we wouldn't think of,
Speaker 1: so obviously sleep, you know, the time of day driving,
Speaker 1: as you said at four am, is going to be
Speaker 1: analogous to you know, having alcohol in our system. But
Speaker 1: also dehydration impacts cognitive like significant dehydration impacts cognition.
Speaker 3: Yeah, yeah, absolutely, and brain glucose levels. I mean, if
Speaker 3: you if you're really running on empty, then then memory
Speaker 3: formation and just processing information becomes really much worse. But
Speaker 3: you know, it's a bit like it's a bit like
Speaker 3: not getting enough sleep. I mean, it's really incredible if
Speaker 3: you think about it. Poor sleep will produce fluctuation, fluctuations
Speaker 3: in mood. The tired brain actually remembers negative experiences but
Speaker 3: forgets the positive ones, So our whole worldview is changed.
Speaker 3: If you have a tired brain, you're more irritable, you
Speaker 3: show greater levels of anxiety. You've got lots of empathy,
Speaker 3: so picking up those social signals from your friend's, family,
Speaker 3: colleagues is reduced, and you know you can't interact as well.
Speaker 3: You much more inclined if you've if you're tired, to
Speaker 3: use stimulants and fueling the day with lots and lots
Speaker 3: of coffee and then in the evening thinking, goodness, I've
Speaker 3: got to get to sleep. What am I going to do,
Speaker 3: and then you start taking loads of alcohol or sedatives,
Speaker 3: which in fact disrupts some of the important things going
Speaker 3: on in the brain when we sleep. So yeah, there's
Speaker 3: a lack of sleep. Is not just the sort of
Speaker 3: the inconvenience of feeling tired at an inappropriate time. It
Speaker 3: has big impacts upon our ability to process information. And
Speaker 3: that's just just the short term stuff. We can get
Speaker 3: onto the long term stuff later on.
Speaker 1: I was amazed too. I should have known this, but
Speaker 1: I didn't know this, So I'm going to be honest.
Speaker 1: I was amazed to find out recently that the brain
Speaker 1: uses about twenty percent of our daily calorie expenditure and
Speaker 1: what is at one point two to one point four
Speaker 1: kilos or something.
Speaker 3: Yeah, yeah, absolutely, So you know, I suppose maybe no
Speaker 3: great surprise on the top of our head is the
Speaker 3: most complicated structure in the no universe, So using twenty
Speaker 3: percent of our calories isn't that bad. But yeah, you're
Speaker 3: quite right. And of course, you know, if you're in
Speaker 3: cold conditions, loss of heat from the head, because of
Speaker 3: course the blood flow to the breed could be quite serious.
Speaker 1: The other day I went on the other day was
Speaker 1: probably a month ago I went to the gym to
Speaker 1: lift stuff because I'm massive. I'm just kidding. And I
Speaker 1: went to the gym and outside the gym, on an
Speaker 1: aFrame proft was a sign that said excuses don't burn
Speaker 1: Making excuses doesn't burn calories. And I thought, that's actually
Speaker 1: not true, because it's a cognitive process. You've got to
Speaker 1: come up with some bullshit. So I went inside and
Speaker 1: told them, actually, making excuses does burn calories, so you
Speaker 1: might need a new message.
Speaker 3: And the more creative of the excuses, the more calories
Speaker 3: were burnt. I mean, certainly, that's what I find with
Speaker 3: my students. They come up with amazingly creative excuses.
Speaker 1: That's funny, big calorie burning excuses, you could call those.
Speaker 1: So I guess when we get onto the sleep more
Speaker 1: in a minute, but I guess so even people thinking
Speaker 1: about you know, the brain runs on glucose, right, so
Speaker 1: people who go I'm going to go paleo, their brain
Speaker 1: must almost be non functional for the first week or
Speaker 1: so until they start to adapt.
Speaker 3: Right. Well, I'm not sure about that. I mean, it
Speaker 3: depends if they're eating their protein. I mean, you know,
Speaker 3: if it isn't just a lot of meat and they're
Speaker 3: cooking that meat, they're releasing all of those calories, and
Speaker 3: of course what the body does, the energy currency of
Speaker 3: the brain is glucose, So no matter whether you're eating carbs, protein, fats,
Speaker 3: it's all converted into the basic currency of glucose. So yeah,
Speaker 3: it might take a few days, I guess, to adapt,
Speaker 3: but I think we'd adapt pretty quickly. I mean, one
Speaker 3: of the most extraordinary things you're talking about the brain
Speaker 3: is that the invention of fire, which allowed us to
Speaker 3: cook meat for the first time, which released so much
Speaker 3: more energy because you know, half the digestion, as it were,
Speaker 3: was done because the fire sort of cooked it and
Speaker 3: sort of made it easier to digest, is associated with
Speaker 3: a big leap in brain size. And so the invention
Speaker 3: of fire and cooking our meat has been associated with
Speaker 3: increasing brain size. And so you see a quite sharp
Speaker 3: rise in brain size in the fossil record on the
Speaker 3: basis of the size of the cranium where the brain
Speaker 3: sits in the skull.
Speaker 1: Any idea as to the mechanism behind and that duck.
Speaker 3: No, I mean, I guess you know, as we evolved
Speaker 3: and we became sort of bipedal running around on two
Speaker 3: legs and that freed up our hands and our arms
Speaker 3: to use tools. Of course, we could become more sophisticated.
Speaker 3: We were faster on two feet, so we became more flexible,
Speaker 3: and we could then capture meat for the first time
Speaker 3: rather than just scavenge. And then of course by cooking
Speaker 3: that we released all of those incredible calories, and that
Speaker 3: may be one of the really important steps in human evolution.
Speaker 3: But Crane, I'm talking about evolution, not sleeping Cicadian rhythms.
Speaker 3: So now I have a comfort zone here.
Speaker 1: Yeah, I know that's what I'm doing. I'm just trying
Speaker 1: to stretch it because I've heard you on other shows.
Speaker 1: You get a little comfy, You're a little familiar with
Speaker 1: the subject matter. I just want you to keep learning
Speaker 1: and evolving. Profits You're welcome. So now lifetime your body
Speaker 1: clock and its essential roles in good health and sleep.
Speaker 1: When did you write this?
Speaker 3: During lockdown? So I was I wrote a few articles
Speaker 3: for one of the newspapers in the UK, and a
Speaker 3: bunch of people said, oh, you should write a book,
Speaker 3: and I thought, well, you know, I'm never going to
Speaker 3: have time. And then COVID hit and so I thought, well,
Speaker 3: I'm never going to have you know, this this opportunity.
Speaker 3: So I used the time constructively and so really enjoyed it.
Speaker 3: And I worked with Penguin and it's interesting, I've written
Speaker 3: previous books, but what they allowed me to do was
Speaker 3: was they said, we want to hear your voice. And
Speaker 3: of course, as a scientist, that's exactly what you suppress.
Speaker 3: You know, you don't have anecdotes, you don't have the stories.
Speaker 3: And they said, no, no, that's great, and I sort
Speaker 3: of threw a few in and they said more of that,
Speaker 3: and so the feedback I got was make it as
Speaker 3: accessible as possible. So each of the chapters starts with
Speaker 3: a sort of a little story about whether it's Einstein
Speaker 3: and Salvador Daly and their cognitive abilities and their sleep more,
Speaker 3: whether it's you know, the chapter on metabolism introduces the
Speaker 3: sugar trade and slavery. Yeah, so it was fun to
Speaker 3: go outside with my comfort zone. So yeah, it was
Speaker 3: a lockdown project.
Speaker 1: I love that. You know. It's like, we've had a
Speaker 1: lot of academics on the show, and I'm a shudo academic.
Speaker 1: I'm more a pro academic, but that it's like, and
Speaker 1: I mean this in a loving and caring way, because
Speaker 1: my proper Well, this is my proper job these days,
Speaker 1: but also my other half of my proper job is
Speaker 1: corporate speaking. And you know, you've got to obviously, whatever
Speaker 1: idea or message or piece of data or truth or
Speaker 1: insight you want to share, it needs to be consumer
Speaker 1: friendly listener friendly. And there are not how do I
Speaker 1: say this about getting in trouble, there's not a huge
Speaker 1: percentage of academics that can stand in front of a
Speaker 1: non academic audience and create connection. And I'm not pissing
Speaker 1: in your pocket. That's an Australian term, prof But you're
Speaker 1: very good at it. That you're very good, and so
Speaker 1: you know that ability to go. This is the model
Speaker 1: that I use with would be speakers or even academics.
Speaker 1: I say, all right, what's the thing that you want
Speaker 1: to tell them? What's the idea? What's the piece of information?
Speaker 1: You know what? Firstly, what's that? Now? Secondly how do
Speaker 1: you share that in a story? And then thirdly why
Speaker 1: does this matter? And lastly how do we apply it
Speaker 1: or how do we integrate it into our operating system?
Speaker 1: And when I tell them that, they're like, oh, I go,
Speaker 1: so what do you want to talk about? Subjective reality? Cool? Well,
Speaker 1: tell them, give them an example, a practical example, or
Speaker 1: whatever it is. And it just because all the knowledge
Speaker 1: is there, it's just finding the language of the audience
Speaker 1: or the reader.
Speaker 3: Yeah, yeah, but you have to understand most of us
Speaker 3: are trained from the word go to suppress all of that.
Speaker 3: You know, we write in a very formal way and
Speaker 3: a formal language, and so maybe it's very kind of
Speaker 3: your say, so, perhaps I'm just a little bit disinhibited,
Speaker 3: and so I feel as though I can indulge that
Speaker 3: other other dimension of my personality.
Speaker 1: Well, you can step out of one world. And it's
Speaker 1: the opposite for me because I've written seven books and
Speaker 1: none of them are academic, right, They're just all, you know, conversational.
Speaker 1: I've also published with Penguin like you, but now I'm
Speaker 1: writing academic papers and it's a steep learner. I need
Speaker 1: to ring you up. It's a steep learning curve. Anyway,
Speaker 1: let's get into the topic at hands. I've got some
Speaker 1: really specific questions. I'm going to start with a question
Speaker 1: that I literally have only asked one other time in
Speaker 1: nine hundred and seventy five episodes, and it was yesterday,
Speaker 1: and I'm going to ask it again. Today, Why are
Speaker 1: we so crap at sleeping?
Speaker 3: Well, it's an interesting question. So if we think about
Speaker 3: the way we've viewed sleep, if we go back to
Speaker 3: the nineteen eighties, not getting sleep was a badge of honor.
Speaker 3: People used to come into work and see, I've I've
Speaker 3: done another or nightem people say, oh, yeah, fantastic, and yeah,
Speaker 3: well done, you know, pat on the back. And it
Speaker 3: was part of the fact that we didn't understand the
Speaker 3: value of sleep. We didn't appreciate that whilst asleep we
Speaker 3: consolidate memory and it's not just laying down the facts.
Speaker 3: I think the most awesome thing is that when we're asleep,
Speaker 3: we're actually asking questions of ourselves. We're processing information. A
Speaker 3: night of sleep has been shown scientifically to allow us
Speaker 3: to come up with innovative solutions to complex problems. So
Speaker 3: from the nineteen eighties we've kind of learnt that sleep
Speaker 3: is really important. So by the turn of the century
Speaker 3: people are thinking, yeah, you know, maybe I should start
Speaker 3: to pay a bit more attention about sleep. And then
Speaker 3: in the last twenty years and particularly the last five years,
Speaker 3: we've become incredibly anxious about our sleep, you know, and
Speaker 3: there's actually a condition called sleep anxiety, where people are
Speaker 3: so anxious they can't get to sleep and if they
Speaker 3: wake up, they can't get back to sleep. And I
Speaker 3: think that's been driven by several factors. APPS which are
Speaker 3: really bad at at telling us what our sleep is. So,
Speaker 3: for example, they're okay for telling us roughly when we
Speaker 3: went to sleep, roughly when we got up, and how
Speaker 3: many times you work up at night, But when they
Speaker 3: start telling you, oh, you had a good night's sleep
Speaker 3: or you didn't get enough for m sleep, that's just nonsense.
Speaker 3: But people get really anxious about it. Oh yeah, and
Speaker 3: we're also the sergeant majors asleep are screaming you must
Speaker 3: get eight hours. Well, that's also complete nonsense. The healthy
Speaker 3: the healthy range for sleep in adults is between six
Speaker 3: hours and ten to eleven APPS. And the key thing
Speaker 3: for all of us is that we define the sleep
Speaker 3: that we need and then adopt behaviors that defend that sleep,
Speaker 3: and you know, stop being frightened of sleep, embrace the
Speaker 3: sleep that we get. Sleep is very different between individuals,
Speaker 3: and of course it changes as we age. I mean,
Speaker 3: so many you know, people in there sort of post
Speaker 3: retirements will say, oh God, I wish I had the
Speaker 3: sleep that I had when I was sort of in
Speaker 3: my twenties. Well, it's going to change. And I know
Speaker 3: lots of elderly people who say, oh, no, it's fantastic,
Speaker 3: best sleep I've ever had. I don't have to worry
Speaker 3: about the kids, I don't have to worry about getting
Speaker 3: out for work, I don't have to worry about anything.
Speaker 3: And certain family members make it very clear that we're
Speaker 3: not to call before eleven o'clock in the morning. And
Speaker 3: I think that's it. You know, you adopt the sleep
Speaker 3: that works best for you. I mean. The serious point is,
Speaker 3: of course, that we've never taken sleep seriously up until
Speaker 3: very recently, because it's not part of a medical curriculum.
Speaker 3: In a five year training, a medic may get one
Speaker 3: or two lectures on sleep. And of course, you know,
Speaker 3: if you're a general practitioner, it's been estimated that thirty
Speaker 3: percent of the questions you're asked, thirty percent of the
Speaker 3: health issues are either directly or indirectly related to sleep.
Speaker 3: And the problem is, of course, what's the response, Well,
Speaker 3: here's a sleeping tablet, and that that is often not
Speaker 3: the best way forward. We've got to ap sort of
Speaker 3: measures which and they're very simple. I mean, the thing
Speaker 3: is the great thing about this whole area is there's
Speaker 3: a whole bunch of stuff we can do to make
Speaker 3: ours sleep better. It's not you know, so many people think, oh,
Speaker 3: you get the seat that you get. That's not true.
Speaker 3: I mean, clearly it's guided by our genes and our
Speaker 3: behavior and all the rest of it. But we can
Speaker 3: also modify that behavior.
Speaker 1: Yeah. Yeah, it's so interesting. As you said, eight hours
Speaker 1: sleep and you know, eight glasses of water a day,
Speaker 1: and how tall are you and how much do youigh? Oh,
Speaker 1: you should have twenty eight hundred and forty three calories
Speaker 1: a day. I'm like, well, what if one day I'm
Speaker 1: chopping down trees and running up mountains and the next
Speaker 1: day I'm writing my book and sitting for fourteen hours
Speaker 1: at might what about then? You know, it's like it
Speaker 1: just these kind of dogmatic, arbitrary numbers that get wheeled
Speaker 1: out that people use as rather than a very vague guideline,
Speaker 1: perhaps they use as some kind of gospel that needs
Speaker 1: to be followed despite all the variability of their behavior
Speaker 1: and their lifestyle and the weather and calories in and out.
Speaker 1: Like it's so it's so I would. I would posit
Speaker 1: professor that not only do sleep requirements Do you like that, Melissa?
Speaker 1: I did, thank you.
Speaker 3: I'm looking at looking up as we speak. What does
Speaker 3: it mean, Molnissa, Yeah, don't be ridiculous.
Speaker 1: You know what it means. You know what it means.
Speaker 1: I would posit Professor. I'm going to say it again, Comma,
Speaker 1: that not only do sleep requirements vary from person to person,
Speaker 1: but would they not vary from us day to day
Speaker 1: a little bit depending on what we've done in the day.
Speaker 1: Like if I have a massive day of energy expenditure
Speaker 1: and I'm physically working hard all day, would I need
Speaker 1: the same amount of sleep as a normal day or.
Speaker 3: It's pretty much. It is fairly similar, even even after
Speaker 3: vigorous exercise. But you're right, it is very dynamic, and
Speaker 3: the key thing is not to get anxious about it.
Speaker 3: If pre lockdown, I gave a talk and somebody came
Speaker 3: up to him and said, I don't get eight hours
Speaker 3: of sleep every night. Am I going to die?
Speaker 1: Ah?
Speaker 3: I said, well, well, I said, yeah, you're going to die.
Speaker 3: But it may have nothing to do with the fact
Speaker 3: that you're not getting eight hours of sleep. I mean,
Speaker 3: you know this is the kind of anxiety that we're
Speaker 3: finding at the moment rather than you know, embracing the
Speaker 3: sleep that we get.
Speaker 1: You know, what you should have done when they said
Speaker 1: am I going to die? You should have said yes
Speaker 1: and then just finished there and as they walked away dejectedly,
Speaker 1: you should have gone.
Speaker 3: But not from that, Craig, that would have been mean
Speaker 3: as well.
Speaker 1: You know, all right, I've got some specific questions, and
Speaker 1: some of these are very fundamental, but bear with me.
Speaker 1: What's a circadian rhythm? Or talk to us about you know,
Speaker 1: the different rhythms or body clocks, like what does what
Speaker 1: does that mean?
Speaker 3: Yeah, a Cicadian rhythm you can think of as an
Speaker 3: internal biological day. It really is one of the great
Speaker 3: I think advance is in science of biological science over
Speaker 3: the past twenty years of actually understanding that we have
Speaker 3: an internal clock. In fact, we have a master clock
Speaker 3: within the brain, which is about fifty thousand cells called
Speaker 3: the supra chismatic nuclei or the SCN, which is this
Speaker 3: master Then it's coordinating essentially billions of individual clocks in
Speaker 3: the cells of the body, which you're organized of course
Speaker 3: in the organ systems. So we've got this whole hierarchy
Speaker 3: of time, and what's it for. Well, what it does
Speaker 3: is fine tune our biology to the very varied and
Speaker 3: complicated demands of rest and activity. So if you think
Speaker 3: about consciousness versus sleep, it's a completely different physiological state,
Speaker 3: and that's all underpinned by changes driven by this internal clock.
Speaker 3: So if you know that in three hours time you're
Speaker 3: going to be up, walking around and active, then in
Speaker 3: anticipation of that, blood glucose levels rise, blood pressure rises,
Speaker 3: metabolum metabolism starts to increase, cortisols starts to go up.
Speaker 3: So but the time we actually wake up, we have
Speaker 3: a body that is physiologically prepared for activity. And in
Speaker 3: the same way, at the end of the day we
Speaker 3: start to change our physiology in preparation for sleep. So
Speaker 3: there's a drop in core body temperature, and indeed that
Speaker 3: small dropping core body temperature is associated with going to sleep.
Speaker 3: If you block that dropping core body temperature, it's more
Speaker 3: difficult to get off to sleep. So we've got this
Speaker 3: internal time structure which is fine tuning everything that we
Speaker 3: do to the varied and complicated demands of the twenty
Speaker 3: four hour revolution of the Earth and the light dark cycle.
Speaker 3: And we know at a fundamental level what makes us tick.
Speaker 3: So a bunch of genes have been identified which are
Speaker 3: turned on. They then make proteins. Those proteins then interact
Speaker 3: go into the nucleus of the cell and then turn off.
Speaker 3: Those genes are those clock chins, and then those proteins
Speaker 3: are degraded, and so the clock genes can then turn
Speaker 3: on once again. So you have this twenty four hour
Speaker 3: cycle of protein production and then degradation, and that's fundamentally
Speaker 3: the nature of the biological clock. It truly is an
Speaker 3: awesome process. And I think you know, in the past
Speaker 3: twenty twenty five years. I've been in a business really
Speaker 3: in this area in biological time for almost forty years,
Speaker 3: but it's over the past twenty years where we've seen
Speaker 3: this extraordinary revolution. And of course in twenty seventeen, the
Speaker 3: Nobel Prize was given to russ bash Hall and Young
Speaker 3: who identified in flies, not humans, not even in mice,
Speaker 3: but how this clock ticks in flies one of the
Speaker 3: great I think achievements of sort of biological endeavor. And
Speaker 3: I was privileged enough when I worked in the States
Speaker 3: to work to know these guys, and they are extraordinary.
Speaker 3: I talk about a bit of eyebat in the book.
Speaker 1: No Pressure, but I expect a Nobel prize from you
Speaker 1: and the five to ten. So if you can lift
Speaker 1: your game a little bit.
Speaker 3: It won't be in clocks. But the thing that we've
Speaker 3: been doing has been trying to understand how those internal
Speaker 3: clocks are set to the external world. So there's no
Speaker 3: good having this sort of ability to anticipate and fine
Speaker 3: tune unless the internal day and the external day are aligned.
Speaker 3: Classic mismatches jetlag. We actually get over jetlag primarily as
Speaker 3: a result of exposure to the environmental light dark cycle.
Speaker 3: And what we discovered is that, of course you need
Speaker 3: the eyes. If you have no eyes, the clock keeps
Speaker 3: on ticking. And we work on individuals who've lost their eyes,
Speaker 3: so they're completely blind and they essentially have unremitting jet
Speaker 3: lack for the rest of their lives. But we're working
Speaker 3: on that. But what we discovered is that the eye
Speaker 3: is not using the cells which we use for vision,
Speaker 3: the visual cells, the rods and the colors, but there's
Speaker 3: a third there's a third light sensor within the eye,
Speaker 3: so you can be visually blind if you've still got
Speaker 3: these other light sensors. Within the eye, you can regulate
Speaker 3: the clock. So the eye is this It's just amazing.
Speaker 3: The eye is this organ of space vision, but it's
Speaker 3: also the organ of time because of the way it
Speaker 3: sets the internal clock to the external world. And so
Speaker 3: this is a big chunk of what we're doing. I mean,
Speaker 3: you know, if you think about it, we've discovered a
Speaker 3: completely new light sensing system within the eye. And certainly
Speaker 3: when we proposed this in the nineties and around about
Speaker 3: the turn of the century, I remember I was at
Speaker 3: a seminar and said, you know, these data are consistent
Speaker 3: with the discovery of a new receptor system within the eye,
Speaker 3: and somebody at the back of the auditorium stood up
Speaker 3: and looked at me and just shouted bullshit and then
Speaker 3: walked out. I mean, the idea that we have been
Speaker 3: studying the eye for one hundred and fifty years and
Speaker 3: then missed an entire light sensing system was so insulting
Speaker 3: to this community that, you know, it was a tough decade.
Speaker 1: Well, academics, we know academics are very open minded.
Speaker 3: Yeah, well, yes, it's a it's a real it's very
Speaker 3: complicated because you know, being conservative with a with a
Speaker 3: small C is good because you know, want a whole
Speaker 3: bunch of nonsense, you know, keep on changing, so they're
Speaker 3: very resistant to change. And what we had to do,
Speaker 3: and the scientific approach is you just carry on doing
Speaker 3: better and better experiments to overwhelm the skeptics with the
Speaker 3: data set that you know makes it completely incontrovertible.
Speaker 1: So even if someone is blind as in they can't see,
Speaker 1: they can't make out, they can't read, they can't make out,
Speaker 1: they can't define things, but they they can open their
Speaker 1: eyelids and sense light or dark, then their internal clocks
Speaker 1: will function as normal.
Speaker 3: Yeah, we studied two individuals, one in one in the UK,
Speaker 3: one in the States, and the subject I know best.
Speaker 3: She said she had no conscious light detection at all, right,
Speaker 3: and so but we we asked it to to perform
Speaker 3: a test when the lights are on or off. And
Speaker 3: we said, look, we're going to force you to give
Speaker 3: us an answer to tell us if the lights are
Speaker 3: on or off. And she said, no point in doing
Speaker 3: this because I can't see. I absolutely have no light detection.
Speaker 3: When we forced her to make a decision, she got
Speaker 3: it right every time, and that is really cool. And
Speaker 3: what it shows is, of course these receptors are not
Speaker 3: only regulating the clock, and we've discovered that they're regulating
Speaker 3: part of our pupil constriction, they're regulating sleep, but they're
Speaker 3: also providing an unconscious awareness of light. And you know,
Speaker 3: we're just finding out really what all the roles of
Speaker 3: this receptor is new receptor in the eye doing so,
Speaker 3: for example, it looks as though they're important in alertness.
Speaker 3: So you know, the brighter the light, the more alert
Speaker 3: we are, and it's probably via these receptors. So yeah,
Speaker 3: it's a new and unexplored receptor system which we're appealing.
Speaker 3: We're trying to understand, feeling back information on it.
Speaker 1: How did that lady respond prof when she realized she
Speaker 1: could detect light and dark?
Speaker 3: She was really quite shocked and surprised because of course
Speaker 3: she'd been told and she you know, had adapted to
Speaker 3: the fact that she has no light detection. She is
Speaker 3: completely by and it raises a really important issue, of course,
Speaker 3: because there has been a tendency in ophthalmology departments, and
Speaker 3: I'm head of the Nuffold Laboratory of Ophthalmology in Oxford
Speaker 3: and that you know, when I talk to my clinical colleagues,
Speaker 3: I think, God, we never really thought of that before,
Speaker 3: and so if eyes are very badly damaged, there's a
Speaker 3: tendency to say, well, do you know that you can't see,
Speaker 3: you've lost your vision. There are going to be a
Speaker 3: source of infection you can't see to look after them.
Speaker 3: It will be much simpler if we remove them, but
Speaker 3: a proesthetic in and then you know, it'll be easy
Speaker 3: for everybody. And of course in the process they've already
Speaker 3: lost a sense of space, but inadvertently you could take
Speaker 3: away their sense of time. And so you know, I've
Speaker 3: been working very closely with my clinical colleagues to try
Speaker 3: and find out, you know, how severe particular eye diseases are,
Speaker 3: and what's their impact. Obviously on vision, that's their job,
Speaker 3: but mine is to assess, you know, what's their impact
Speaker 3: on their cicadian regulation and their sleepwake regulation, because if
Speaker 3: that's still intact, then those eyes have to be saved
Speaker 3: at all costs. Otherwise, as I said, you'll have unremitting
Speaker 3: jet lag for the rest of your life. And when
Speaker 3: you talk to individuals who lost their eyes, it's really poignant.
Speaker 3: I mean, we work with blind veterans UK and these
Speaker 3: are extremely robust individuals. You know, they're dealing with this
Speaker 3: traumatic loss of their eyes. And you know, I remember
Speaker 3: chatting to one chat and he said, well, do you
Speaker 3: know I'm determined. I know I cut the lawn on
Speaker 3: a Friday, and so he woke up and he went
Speaker 3: downstead and he worked out a way of getting this
Speaker 3: the moa out of the shed and how it was
Speaker 3: going to work and all the rest of it. And
Speaker 3: he was cutting the lawn and his wife came down
Speaker 3: and said, it's three o'clock in the morning. Disturbing. You're
Speaker 3: disturbing the navy. And you know what they say is, look,
Speaker 3: I feel constantly tricked by my body clock. And that's
Speaker 3: the problem because it's ticking, it's drifting through time, but
Speaker 3: it's not aligned with the external world. And so, you know,
Speaker 3: a lot of the work that we're doing at the
Speaker 3: moment is on the basis of our understanding of how
Speaker 3: those new receptors are regulating the masterclock in the brain.
Speaker 3: Can we fool the clock that it's seen light by
Speaker 3: mimicking that pathway with drugs? And it's we're at a
Speaker 3: really exciting stage. We've done all the mousework. We've now
Speaker 3: got a drug that can fool the clock that it's
Speaker 3: seen light and we're now going into In fact, our
Speaker 3: first in human trials took place in Melbourne over Lockdown,
Speaker 3: and we're now ready to do the full blown clinical trials.
Speaker 3: I mean, if I can end my career by giving
Speaker 3: back a sense of time to people who have radical
Speaker 3: eye disease, I'll die happy. Man.
Speaker 1: Yeah, that's bloody brilliant, Melissa. Can I ask you a question?
Speaker 1: If ten out of ten is I'm a brilliant sleeper,
Speaker 1: I have no problem, I sleep great, and one is
Speaker 1: extremely troubled sleeping. What number are you typically?
Speaker 2: We have spoken about this before, and I'm not talented
Speaker 2: at many things, but sleeping would have to be up there.
Speaker 1: That's something I could actually do pretty well.
Speaker 2: So probably seven or eight in general, I would say.
Speaker 1: Now, okay, So I want to ask you something. Melissa
Speaker 1: works a long day. She starts early and works late,
Speaker 1: and spends most of her days correct me if I
Speaker 1: get any of this wrong in a chair looking. She
Speaker 1: goes to the gym every day. She's active, but spends
Speaker 1: a lot of time looking at screens as do I now,
Speaker 1: and obviously has fluoro lights over her head most of
Speaker 1: her life. If we put her in the bush in
Speaker 1: some alternate reality, and she had no fluorescent lights and
Speaker 1: no TV, no computer, no iPhone. We took her out
Speaker 1: of modernity and we put her in wherever what would
Speaker 1: and so she had to get up when the sun
Speaker 1: came up and go to bed or do whatever when
Speaker 1: the sun went down. What would happen to her body clocks?
Speaker 3: Well, those experiments have actually been done not by us,
Speaker 3: but by a chap called ken Wright in Colorado, and
Speaker 3: he monitored the sleepwaate timing of a bunch of students
Speaker 3: in their normal environment, you know, basically what Melissa was doing.
Speaker 3: And then he took them out camping to the Rocky
Speaker 3: Mountains for a week. And what was extraordinary is that
Speaker 3: their whole body clock advanced in time. When they were
Speaker 3: tuned into the natural light dark cycle. They ended up,
Speaker 3: on average getting up two hours earlier and going to
Speaker 3: bed two hours earlier than when they were experiencing artificial
Speaker 3: light in their home environment. So it's very likely that
Speaker 3: Melissa would probably get up a bed earlier and go
Speaker 3: to bed earlier.
Speaker 1: What's the relationship or what's the comparison between the clock
Speaker 1: on the wall hanging in the kitchen and our biological
Speaker 1: clock is it how close they related?
Speaker 3: Well, it's so we talked about the importance of light
Speaker 3: in these new receptors and light intensity. How much light
Speaker 3: you need is important, but also when you get it.
Speaker 3: So morning light makes you get up earlier, it advances
Speaker 3: the clock. Dust light delays the clock makes you get
Speaker 3: up later. We did a study all actually with students
Speaker 3: all over the world, Western Australia, Melbourne, Auckland, Oxford, Munich
Speaker 3: and Groningen in the Netherlands, and we found that the
Speaker 3: later the chronotype, the later the body clock type, the
Speaker 3: less morning light people got eye that would make them
Speaker 3: get up earlier, but they got lots of evening light
Speaker 3: which would make them get up later. So whilst our
Speaker 3: genetics and our will influence when we get up and
Speaker 3: go to bed are really critical and often forgotten about,
Speaker 3: is when we see light. So if you're a real
Speaker 3: late type and you've got to get up earlier, then
Speaker 3: you can set the alarm and then force yourself out
Speaker 3: of bed. And in Australia, of course you've got bright light.
Speaker 3: It's all fine, so you get outside, you get your
Speaker 3: bright morning light. In the northern Hemisphere in the winter
Speaker 3: you probably need a light box and that will advance
Speaker 3: the clock, shift it forward, and then make it easier
Speaker 3: to get up. And that, of course, behave yourself is
Speaker 3: self reinforcing. You get up earlier, you get the morning light,
Speaker 3: and you start to get up earlier. So when we're
Speaker 3: all agricultural workers, we got sort of symmetrical exposure to
Speaker 3: morning and dusk light, and we sort of more or
Speaker 3: less stayed on que. Now, because of industrialization we live
Speaker 3: most of our lives inside. That's become distorted. But we
Speaker 3: can regain that timing by you set as I say,
Speaker 3: setting a long clock and then exposing ourselves to natural light.
Speaker 3: It's really really important to do that. Interestingly, we need
Speaker 3: a lot of light, and I guess we'll come onto this, Craig,
Speaker 3: because there's been a lot of stuff in the literature
Speaker 3: about and in the media, Oh, if you look at
Speaker 3: a screen before you go to bed, you're gonna shift
Speaker 3: your body clock. Well, actually the evidence for that is
Speaker 3: really poor. We need bright light for a long duration.
Speaker 3: So there was a study from the States which got
Speaker 3: people to look at a kindle for four hours on
Speaker 3: its brightest intensity for four hours immediately built before bedtime,
Speaker 3: on five consecutive nights that delayed sleep on set just
Speaker 3: statistically by ten minutes, so it's a really minor effect.
Speaker 3: So yeah, I think we need to be quite careful. Clearly,
Speaker 3: the brighter the light before we go to bed, the
Speaker 3: more chance we're going to delay the clock. But under
Speaker 3: normal circumstances, and particularly if we're seeing bright morning light,
Speaker 3: its internal light is not going to have a huge
Speaker 3: impact upon us. Certainly, screens and all the rest of it.
Speaker 3: The big problem with iPhones and smartphones and stuff is
Speaker 3: that we're doing social media, we're doing our emails, and
Speaker 3: it's all that stuff that's increasing alertness and then delaying
Speaker 3: sleep on set. So it is good not to use
Speaker 3: them before we go to bed. Not so much the
Speaker 3: light issue, but it's because of the alerting effect it's
Speaker 3: having on the brain.
Speaker 1: That's so interesting and so contrary to what we've been told.
Speaker 1: All Right, I've got a million more questions and we
Speaker 1: don't have I don't know how long you have, but
Speaker 1: oh my god, how good is Emilissa? I know, amazing,
Speaker 1: I know, I know, I'm excited. All right, tell me
Speaker 1: about why you and Andrew Huberman, I'm sure you know
Speaker 1: who he is. Yeah, Professor Andrew Huberman, and you both
Speaker 1: kind of bang on about the importance of bang on
Speaker 1: in a nice way about the importance of early morning light,
Speaker 1: why we need it, and why it's good for us.
Speaker 1: One of them, it would tell us about that.
Speaker 3: We've touched on it briefly, but for about ninety percent
Speaker 3: of us, the human body clock is a little bit
Speaker 3: longer than twenty four hours, so under constant conditions, we
Speaker 3: get up later and later and later each day. So
Speaker 3: what we need to do to stay on track is
Speaker 3: to get that morning light exposure, to advance the clock,
Speaker 3: to nudge just forward in time so that that slightly
Speaker 3: longer clock is forced to be exactly twenty four hours.
Speaker 3: And that's why morning light is so important. And you
Speaker 3: know it's a no brainer. The data are absolutely clear,
Speaker 3: and and you know that's something that we can actually
Speaker 3: take possession of our light exposure parenthetically, which I think
Speaker 3: is absolutely fascinating. There was a study a few years
Speaker 3: ago saying that dog owners got better sleep for non
Speaker 3: dog owners, and I've always wondered whether it's because, of course,
Speaker 3: it's not so much the companionship, although it may be
Speaker 3: it's the fact you have to get up and take
Speaker 3: your dog out outside. First thing in the morning, you
Speaker 3: get your phone tom shower, which then gives you that
Speaker 3: morning light that keeps the clock on queue.
Speaker 1: That's hilarious. There's been other research done on longevity and
Speaker 1: pet owners. They seem to live a year or two longer.
Speaker 1: Melita will live till she's two hundred because she loves animals.
Speaker 1: When I was thinking about talking to you, and I
Speaker 1: was just I think I was making a cup of tea,
Speaker 1: and I was thinking about sleep in general, of which
Speaker 1: I know very little about the science. But it dawned
Speaker 1: on me that knowing the bit that I do about
Speaker 1: what inadequate, consistently inadequate sleep can do to a brain
Speaker 1: and a person and moods and mental health and all
Speaker 1: of that, it's a little wonder that they used, and
Speaker 1: have used sadly, sleep deprivation as a form of torture
Speaker 1: in the Wars.
Speaker 3: Yeah, yeah, absolutely, And in some sense we're using sleep
Speaker 3: as a form of torture today. I mean that's perhaps
Speaker 3: a bit exaggerated, but you know, it's worth bearing in mind.
Speaker 3: Who in society is not getting the sleep that they need. Well,
Speaker 3: it's poor people who are forced to work night shift work,
Speaker 3: and you know, we did a study in the UK
Speaker 3: a few years ago and we were looking at kids
Speaker 3: and we ask them, does anybody share your sleeping space? Thinking,
Speaker 3: you know, do you share your bedroom with any What
Speaker 3: we didn't ask is do you have a bed? And
Speaker 3: as a result of you know, these studies, we discovered
Speaker 3: that these kids, many of them, didn't have a bed.
Speaker 3: They were sleeping on the family sofa and so, you know,
Speaker 3: so they get screwed up sleep. They go to school,
Speaker 3: they're tired, they can't fully appreciate, you know, education. So
Speaker 3: without sleep, you know, you're on that track of being
Speaker 3: marginalized because of your educational attainment, and therefore you're on
Speaker 3: this still track. And I think that that in a sense,
Speaker 3: poverty and low as socioeconomic groups are aligned with poor sleep,
Speaker 3: and it's something that we haven't done anything about. And
Speaker 3: we've got to prioritize this because we're then sort of
Speaker 3: marginalizing a whole group of individuals, and this is wrong
Speaker 3: in my view.
Speaker 1: Do you think that I don't know the way that
Speaker 1: we live now, modernity and technology and the fact that
Speaker 1: we've got everything at our fingertips all the time, including
Speaker 1: bright light twenty four hours a day, if we want.
Speaker 1: It has that kind of disconnected us a little bit
Speaker 1: from our biology. You know that internal I call it
Speaker 1: biological sat nav. You know that that biological guidance system
Speaker 1: that we've all got but we seem not to pay
Speaker 1: attention to yet.
Speaker 3: No, you're completely right, and we have a sense divorced.
Speaker 3: You know. It's humans. We are such an incredibly arrogant
Speaker 3: species and it's been part of our success. But also
Speaker 3: you know, we've also created problems for ourselves. We think
Speaker 3: we can do whatever we want at what a time
Speaker 3: we choose, ignoring the fact that we are part of
Speaker 3: a biological evolution which is timestamped, literally timestamped our entire biology,
Speaker 3: and we can't do whatever we like whenever we choose.
Speaker 3: And we've got to embrace this again now having said
Speaker 3: that we are in a twenty four to seven society,
Speaker 3: it's no good saying, you know, we're going to stop that,
Speaker 3: it's not going to stop. But what we've got to
Speaker 3: do is use the science that we have at the
Speaker 3: moment to mitigate some of the problems. And of course
Speaker 3: those problems are the most acute in night shift workers
Speaker 3: and so for example of the study from the UK
Speaker 3: showing that fifty seven percent of junior doctors had either
Speaker 3: had a crash or a near miss driving home after
Speaker 3: the night shift. So why the heck are we not
Speaker 3: providing vigilance devices on the dashboard, you know, either on
Speaker 3: an app or some other sub clip on which can
Speaker 3: detect head roll or the fact that car is moving
Speaker 3: laterally set off an alarm and wakes you up. Now
Speaker 3: there's that's load loads of technology that could actually make
Speaker 3: or difference. It's been estimated that in the States at
Speaker 3: least between one hundred thousand and three hundred thousand crashes
Speaker 3: on the freeway are people falling asleep at the wheel
Speaker 3: in the early hours of the morning. Knowing that night
Speaker 3: shift workers have greater levels of obesity, diabetes to culinary
Speaker 3: heart disease, what type of food do we make available
Speaker 3: to our night shift workers. Well, it's high fat, it's
Speaker 3: high sugar, and what we should be providing is rich protein,
Speaker 3: easy to digest snacks throughout the night. To my knowledge,
Speaker 3: no employer anywhere is making provision for the appropriate sort
Speaker 3: of nutrition for those night shift workers. Knowing again that
Speaker 3: in some sectors the divorce rate is six times higher
Speaker 3: for night shift workers, compared to day shift workers. What
Speaker 3: are we doing about that? Why aren't we providing the
Speaker 3: education to those workers saying this is the risk that
Speaker 3: you've got to you know, you've got to be aware of.
Speaker 3: But also not you, but your family. They need to
Speaker 3: know that the job is going to make you less empathetic,
Speaker 3: more irritable, less lovable and reducing a sense of humor.
Speaker 3: We've got to get education in that area. And finally,
Speaker 3: I'm sorry I'm granting out, but this is this is
Speaker 3: easy to do stuff. Knowing that there's people with shortened sleep,
Speaker 3: primarily night shift workers. Our frontline staff often have high
Speaker 3: rates of heart disease, you know, diabetes, to all these
Speaker 3: cancer as well, Why aren't we doing high frequency health
Speaker 3: checks to catch these conditions in this sector before they
Speaker 3: become chronic. So yeah, I would. It would be absurd
Speaker 3: to say we're going to put the twenty four seven
Speaker 3: genie back in its bottle. But what we can do
Speaker 3: is mitigate some of the problems instead of burying our
Speaker 3: head on the sand and ignoring it. And that's what
Speaker 3: we I think all of us need to do up
Speaker 3: through our governments and hopefully well intentioned employers, towards their
Speaker 3: employees love it.
Speaker 1: All right, A few quick quikies, well, although take your time,
Speaker 1: I mean, from me, a few quickies. Number one, alarm
Speaker 1: clocks good bed indifferent.
Speaker 3: If you need an alarm clock to get you out
Speaker 3: of bed, you're probably not getting the sleep you need. However,
Speaker 3: realistically yeah, I mean, many of us need them, but
Speaker 3: be aware you're probably not getting the sleep need. The
Speaker 3: big thing about these alarm clocks is that if they're
Speaker 3: these digital ones with a lighted dial. Now, what happens
Speaker 3: is that you wake up in the middle of the night,
Speaker 3: and that's the norm. Incidentally, the normal human sleeping pattern
Speaker 3: is to wake up, probably fall back to sleep immediately.
Speaker 3: And if you don't fall back to sleep immediately, then
Speaker 3: you'll get back to sleep fairly, fairly quickly. That is
Speaker 3: the normal pattern of human sleep. Problem is most people
Speaker 3: don't know that, so they wake up and they think,
Speaker 3: oh my god, that's it. I'm never going to get
Speaker 3: back to sleep again. Start doing the email, start drinking coffee.
Speaker 3: Whereas if you stay calm, keep the lights low, do
Speaker 3: something relaxing, you will fall back to sleep again. The
Speaker 3: problem is people wake up, they see their illuminated dial thing,
Speaker 3: oh my goodness, I've only got an hour and a
Speaker 3: half before I've got the alarm goes off. They get
Speaker 3: all anxious, stressed, and then they can't get back to
Speaker 3: sleep again. So many people, you know, the important information
Speaker 3: is when the alarm goes off, not how many hours
Speaker 3: or minutes you've got before it goes off. So cover
Speaker 3: up the dial are those illuminated alarms.
Speaker 1: And the irony is that you wake up and then
Speaker 1: you think I've only got an hour and a half
Speaker 1: to go, and you get anxious and which you know
Speaker 1: all of the things that happen with that, and then
Speaker 1: you don't sleep well. But also the other side of
Speaker 1: that is when you don't sleep adequately, that increases anxiety
Speaker 1: through the day.
Speaker 3: Yeah, exactly. And in fact most people don't have a
Speaker 3: sleep problem, they have a stress and an anxiety problem.
Speaker 3: And so that's why it's really important towards the end
Speaker 3: of the day to step back and do something relaxing,
Speaker 3: whether it be it's interesting. I was very rude about
Speaker 3: mindfulness when it first surfaced. I sort of had it
Speaker 3: in the same box as crystal, But actually that was wrong,
Speaker 3: and I regret my arrogance over that, because in fact
Speaker 3: it's a great way of it's a relaxation technique and
Speaker 3: it's one of those things that many people find useful
Speaker 3: to wind down at the end of the end of
Speaker 3: the day. And those are the sorts of things we've
Speaker 3: got to be doing. It's been really difficult during lockdown because,
Speaker 3: of course the sleeping space has also been in many
Speaker 3: cases the office as well. So you've got stuffed in
Speaker 3: your bedroom all of those detracted you know, those things
Speaker 3: that will keep you awake, the computer. You know, I
Speaker 3: just checked my meme as before I go to bed,
Speaker 3: and all of that stuff. And really what we should
Speaker 3: be having is the bedroom is this wonderful haven where
Speaker 3: we can retreat to and embrace. Sleep has this wonderful
Speaker 3: enhancing behavior. I don't know about Australians, but the Brits
Speaker 3: are kind of a bit mean where it comes to
Speaker 3: bedding and pillows and all that sort of stuff. And
Speaker 3: you know, for a third of our lives we should
Speaker 3: indulge in a good rap, not indulge. We should buy
Speaker 3: a good mattress, good pillows, good douvet, and so make
Speaker 3: sure that the se sleeping space is optimized. You know,
Speaker 3: you feel comfortable and it's a wonderful place to be.
Speaker 1: All right, that makes sense, you know what you said
Speaker 1: about I mean, all of it makes sense. But I
Speaker 1: was just thinking then about stress and anxiety are the
Speaker 1: problem and likes. It's almost like sleep is the symptom.
Speaker 1: But if you treat the problem stress and anxiety, then
Speaker 1: the sleep will take care of itself.
Speaker 3: Right, Yeah, absolutely, And we've got to be very careful
Speaker 3: about distinguishing between sleep, sleepiness, and fatigue. So given the
Speaker 3: opportunity we can get rid of sleepiness by sleeping more,
Speaker 3: fatigue is something different. Fatigue is this lethargy, this again sleepiness,
Speaker 3: But given an extended opportunity to sleep, the fatigue doesn't
Speaker 3: go away. Classic, of course is long COVID people are
Speaker 3: incredibly fatigued even though they're sleeping more. And you've got
Speaker 3: to distinguish between sleepiness and fatigue because fatigue is usually
Speaker 3: some indication of an underlying health problem. And see got
Speaker 3: to see your general practitioner to make sure that there's
Speaker 3: no there's no sort of illness that you're aware of,
Speaker 3: that you're unaware of that's causing the fatigue. It's such
Speaker 3: an important issue.
Speaker 1: We spoke broadly before about the relationship between sleep and
Speaker 1: cognitive function. What about more specifically proft between sleep and dementia.
Speaker 1: Do we know anything about that?
Speaker 3: Yeah, that's a really interesting question, and it's one of
Speaker 3: those areas that's that's bloomed in the past past ten
Speaker 3: years or so. Whilst we sleep, there's a thing in
Speaker 3: the in the brain, in the central nervous system called
Speaker 3: the glymphatic system. It's like a waste disposal unit, and
Speaker 3: what it does is get rid of some misfolded proteins
Speaker 3: and other rubbish. But these misfolded proteins are the beta amyloids,
Speaker 3: and the beta amorloids have been associated with building up
Speaker 3: in the brain and causing dementia and Alzheimer's. And you know,
Speaker 3: one night of no sleep can you can statistically see
Speaker 3: an increased in beta amyloid within the cerebral spinal fluid
Speaker 3: and deposited within the brain. So another really important element
Speaker 3: of sleep is to get rid of these toxic compounds. However,
Speaker 3: what this may explain is the fact that poor sleep
Speaker 3: in the middle years increases your risk for Alzheimer's and
Speaker 3: dementia in the later years. So you know it's we
Speaker 3: are if by not taking our sleep seriously during the
Speaker 3: middle years and not defending it. We are sort of
Speaker 3: potentially in not everybody, it's going to be those individuals
Speaker 3: who are vulnerable are increasing their chances of these appalling,
Speaker 3: debilitating conditions later on. Interestingly, the generation coming through I
Speaker 3: always forget the numbers, whether the XYZ or whatever, but
Speaker 3: the thirty year olds are actually getting on average twenty
Speaker 3: to thirty minutes small sleep every night than the forty
Speaker 3: and fifty year olds. It looks as though the generation
Speaker 3: coming through are not prepared to put the same old
Speaker 3: sure and actually indulging, you know, not indulging, but they're
Speaker 3: actually embracing sleep sensibly. Good on you, youngsters.
Speaker 1: Yeah, good on you youngsters. Now, I did hear with
Speaker 1: you chatting with I forget his name, he's British MD.
Speaker 1: I think do you remember him anyway, It doesn't matter.
Speaker 1: It was a podcast. He was great, you were great anyway,
Speaker 1: So clearly he made an.
Speaker 3: I never listened to them. It just whatever, I don't know.
Speaker 3: It just I feel cringe when I hear my own
Speaker 3: voice on the reader. So I the only when I
Speaker 3: did a Ted talk. It took me half about two
Speaker 3: weeks for I have the courage to watch this thing.
Speaker 1: I'm with you. I'm with you. I've done about nine
Speaker 1: hundred and seventy of these and I have not listened
Speaker 1: to one whole episode. I've listened to bits, but have
Speaker 1: I sat and listened start finished to me and I haven't.
Speaker 1: Now I did re coil with a modicum of alarm
Speaker 1: when I heard you say people who take blood pressure
Speaker 1: medication and maybe something else need to take it out right.
Speaker 1: Not in the morning now, thanks to my mum and dad.
Speaker 1: Shout out to Ron and Mary. Not because I drink
Speaker 1: or smoke, because I don't, or not because of any
Speaker 1: lifestyle behavior, but because of my genetics. I have to
Speaker 1: take blood pressure medication and forever I've been taking in
Speaker 1: the morning until tomorrow when I start or tonight. Well
Speaker 1: I can't take it tonight because they already taken Tell
Speaker 1: me about that. Why do people with was it just
Speaker 1: blood pressure or any other medication as well?
Speaker 3: Well, it's other medications as well, so aspirin for example,
Speaker 3: your proton pump inhibitors, your startings, these will all have
Speaker 3: a time of day effect and it's called chronopharmacology. And
Speaker 3: it can't and it makes sense, you know, we have
Speaker 3: this dynamic biology. So no surprise. Different drugs have different
Speaker 3: effects different times. Perhaps, you know. One of the early
Speaker 3: pioneers in this was Bill Hereski from the States, who
Speaker 3: was looking at anti cancer medications, and he showed that
Speaker 3: the same cocktail of chema therapy given at two different
Speaker 3: times resulted in over five years forty five percent survival
Speaker 3: from ovarian cancer in one group and ten percent ten
Speaker 3: percent survival in another group. So this is same drug,
Speaker 3: same concentration, different time, big effects. So cancer is a
Speaker 3: really interesting one. Childhood leukemia, for example, an old study
Speaker 3: showed that late afternoon early evening was much more effective
Speaker 3: than morning therapy, you know, and I think the fact
Speaker 3: was something like four point six Those kids having their
Speaker 3: chemo in the morning were four point six times greater
Speaker 3: risk than those that have it in the late afternoon
Speaker 3: early evening. If you invented a drug that changed those
Speaker 3: odds in that way you're talking about your Nobel price,
Speaker 3: you'd be off to Stockholm to get it. We can
Speaker 3: do that by timing, and so there's been over one
Speaker 3: hundred drugs with a shown time of day effect. Now,
Speaker 3: the anti hypertensis that you talk about, the data had
Speaker 3: a huge impact. So this study suggested that over. I
Speaker 3: think it was a twenty year period. Taking the drug
Speaker 3: before you went to bed rather than first thing in
Speaker 3: the morning, halved your chances of a stroke or heart attack. Now,
Speaker 3: what's really important and what is uncontrab what is absolutely
Speaker 3: shown by every group that studied it, is that there's
Speaker 3: a fifty percent greater chance of having a stroke between
Speaker 3: six am and twelve noon, and that's associated with a
Speaker 3: sharp rise in blood pressure driven by the clock and
Speaker 3: then activity, you know, to get all those nutrients and
Speaker 3: add oxygen to the tissues, but also plateleot stickiness. Blood
Speaker 3: stickiness is also at its peak at that time in
Speaker 3: the morning. So why taking a drug before you go
Speaker 3: to bed has it has a better effect than first
Speaker 3: thing in the morning when you know when it's the
Speaker 3: critical time? And of course it's called the pharmokinetics as
Speaker 3: it were, of the drug. Essentially the time you know
Speaker 3: you've taken it, the time it's got into the system,
Speaker 3: the time it's you know, become active, and it's half
Speaker 3: life how long it hangs around other critical agents. Now,
Speaker 3: if you take it in the morning, you're already halfway
Speaker 3: through that risk zone of stroke, and the drug with
Speaker 3: the time it gets the full efficacy is actually going
Speaker 3: to be several hours after the peak of the danger zone.
Speaker 3: So the argument is you take it and before you
Speaker 3: go to bed. The drug has a long half life
Speaker 3: and therefore is around when it intersects with that dangerous
Speaker 3: six am to twelve noon window. Now, I should say
Speaker 3: there's a study that's either just published or about to
Speaker 3: be published which suggests that that difference is not as
Speaker 3: as profound as the original study said. So I think
Speaker 3: it still makes sense if I were taking anti hypertensives,
Speaker 3: I take them before going to bed than first thing
Speaker 3: in the morning. One of the interesting ones is aspirin though,
Speaker 3: because aspirin is very good at reducing the stickiness. It's
Speaker 3: a blood thinner and many people take it but it
Speaker 3: it lasts in the body for a relative short period
Speaker 3: of time. Only you know, peak concentration is just a
Speaker 3: few hours. So again, how can taking aspirin before you
Speaker 3: go to bed be effective in reducing that dangerous six
Speaker 3: am twelve noon window. Well, the really cool live information
Speaker 3: is that the platelets which are causing this stickiness are
Speaker 3: made at night. When they encounter aspirin, their stickiness is eliminated,
Speaker 3: so that the drag is around when the new platelets
Speaker 3: are being made, so by next morning the blood is
Speaker 3: already less less sticky because the platelets have been effectively
Speaker 3: turned off. So there's lots of ways in which we're
Speaker 3: discovering that the timing of drugs is so important vaccination.
Speaker 3: I think this is a really interesting one. So for
Speaker 3: the flu vaccine, again, this is a twenty sixteen study.
Speaker 3: It showed that morning vaccination in a group of sixty
Speaker 3: five to seventy year olds was three times more effective
Speaker 3: than afternoon vaccination in generating an antibody response. And that's
Speaker 3: for the flu. People are looking at COVID now there's
Speaker 3: been a few studies. They're not randomized control trials, so
Speaker 3: it's a bit messy, so we don't really know what's
Speaker 3: going on with COVID. But there's a whole range of studies,
Speaker 3: you know, showing that our immune system is turn up
Speaker 3: during the day, and then towards the late afternoon, early
Speaker 3: evening it gets turned down and it is lower at night.
Speaker 3: And again that makes sense. It's turned up when we're
Speaker 3: encountering other encountering other people and most likely to encounter bugs.
Speaker 3: It's turned down when we're less likely to encounter people
Speaker 3: and bugs. So you could say, well, why isn't the
Speaker 3: immune system turned on at full throttle all the time.
Speaker 3: The problem, of course is autoimmune diseases, so it's probably
Speaker 3: we don't know the answer, but it's probably showing the
Speaker 3: circadian timing because it's turned up when it's needed and
Speaker 3: it's turned down when it's not needed quite so much
Speaker 3: to avoid the problems of autoimmune responses.
Speaker 1: Wow, I've never even i mean other than when they
Speaker 1: say take you know, take an anti in flame twice
Speaker 1: a day with food or something right, which is you know,
Speaker 1: indicative of when to take it. But that am versus
Speaker 1: PM versus afternoon. I've never even have you considered that, Melissa,
Speaker 1: not once? No, it's amazing, and like, that's excuse my language,
Speaker 1: that's fucking profound. Why is everybody not shouting this from
Speaker 1: the rooftops.
Speaker 3: Well, I think that's the really interesting issue. I mean,
Speaker 3: it's we've we in some cases we need more studies,
Speaker 3: but in other cases, and I've talked to my friends
Speaker 3: about this and they say, look, our healthcare services are
Speaker 3: running as fast as we can to stay where we are.
Speaker 3: You know, it's the whole red Queen thing. If you
Speaker 3: then impose an additional layer of complexity on our treatment regimes,
Speaker 3: which is time. Then we're going to be completely We
Speaker 3: just don't have the bandwidth, the capacity to deal with it.
Speaker 3: And so I spoke to a young trainee medic. I said, okay,
Speaker 3: you know, we did a three week intensive module and
Speaker 3: at the end of it we did the debrief and
Speaker 3: I said, you know, okay, so you guys, you know
Speaker 3: you've seen the data. Are you signed up to this?
Speaker 3: Do you think it's important? And they everybody said yes.
Speaker 3: I said, well, how are we going to introduce it?
Speaker 3: You know, for the reason that we said the state
Speaker 3: healthcare systems overwhelmed it's just too much. And this kid
Speaker 3: said to me, well, it's obvious. You introduce it in
Speaker 3: the private healthcare sector, you show its efficacy and that
Speaker 3: provides the database which will then force the state health
Speaker 3: systems to take attempt to pay attention to this. So
Speaker 3: a very pragmatic view, I'm not sure. I mean, I
Speaker 3: think what we need is education throughout the sector, but
Speaker 3: both from the patients talking to their doctors and saying,
Speaker 3: well what time of day should I take this medication?
Speaker 3: And that will also encourage the doctors to try and
Speaker 3: make the time to be aware of this stuff. Part
Speaker 3: of the problem, of course, is that, as we've touched on,
Speaker 3: in a five year training a medic may only have
Speaker 3: two three lectures on sleeping clocks. And so that's why
Speaker 3: we've adopted within the Sleep in Cicadian Neuroscience Institute here
Speaker 3: in Oxford, the first, you know, fully online master's degree
Speaker 3: in Sleep Medicine. We've got a lot of people in
Speaker 3: Australia taking it, They're taking it all over the world
Speaker 3: where healthcare professionals can become aware of this data, the
Speaker 3: importance of sleep, how to achieve better sleep, what sleeps about,
Speaker 3: what are Cicadian rims about, and then use this science
Speaker 3: to advise individuals and deliver better medications.
Speaker 1: So when some it comes out and they've got their degree,
Speaker 1: their master's in sleep health, what are they? Are they
Speaker 1: a sleep health expert?
Speaker 3: What will I guess? Yeah, I guess you could. We
Speaker 3: haven't been thinking of it in that way. Essentially, we've
Speaker 3: just tried to sort of compensate for the lack of
Speaker 3: education in this space. And the people that are signing
Speaker 3: up to this course are saying, well, cracky, that's making
Speaker 3: I am now better as a healthcare professional because I
Speaker 3: know this stuff, and so that's the being the logic,
Speaker 3: and I think that's the motivation for most people. I'm
Speaker 3: not I'm not aware of people setting up after this
Speaker 3: master's degree a sort of sleep advisors other than within
Speaker 3: their sort of normal day job. And I think that's
Speaker 3: that's the exciting thing for us, us because it's providing
Speaker 3: that the framework for this this education that is lacking
Speaker 3: across most most medical education programs. It's just one last thing.
Speaker 3: It's worth bearing in mind that our drug test so
Speaker 3: quite rightly, we test our drugs first of all on mice,
Speaker 3: you know, to make sure that there's nothing really bad
Speaker 3: going on, and then we go to humans. But of
Speaker 3: course mice are night active animals and we are day
Speaker 3: active animals, and so our time biology is completely different.
Speaker 3: And there was a study done fairly recently showing that
Speaker 3: you know, people had gone in research has gone in
Speaker 3: in the morning given an anti stroke medication to mice
Speaker 3: who had an induced stroke, and this was given first
Speaker 3: thing in the morning, and it really improved the outcomes
Speaker 3: of that induced stroke. So they then took it to
Speaker 3: humans and they went in gave it to humans first
Speaker 3: thing in the morning and it had no effect at all.
Speaker 3: And so if you think about it, the mice were
Speaker 3: a beginning of their sleep phase, humans were beginning of
Speaker 3: their active phase, went back, gave it to mice in
Speaker 3: the beginning of their active phase. It didn't work. So
Speaker 3: there's a an argument that we may have sitting on
Speaker 3: the shelves around the world some incredibly powerful drugs for
Speaker 3: health which when they were initially screened in mice, were
Speaker 3: done at the wrong time, and therefore we've missed some
Speaker 3: incredible opportunities. There's an argument that, you know, we should
Speaker 3: go back and test these drugs, retest these drugs at
Speaker 3: different times and see if there's an important time of
Speaker 3: day effect.
Speaker 1: Oh wow, right. The last question is courtesy of my mother.
Speaker 1: She's eighty three. Her name's Mary Harper. Mary asks, oh,
Speaker 1: how I professor, She says. My mum used to say
Speaker 1: to me, I don't know if this is bullshit, so
Speaker 1: I need I need. It's bullshit, it's true or it's
Speaker 1: kind of true. The sleep that we get before midnight
Speaker 1: is like like an hour before midnight is worth two
Speaker 1: hours after midnight or something like that, like the sleeper
Speaker 1: is more valuable or something. Is that bullshit.
Speaker 3: I can't answer that, but what I can say is
Speaker 3: that there may be a basis for it, because, as
Speaker 3: you know, sleep is divided up into these deep sleep,
Speaker 3: slow wave sleep, and then sleep, and we have a
Speaker 3: series of these cycles depending on seventy to ninety minutes
Speaker 3: throughout the night. Now we have more deeper slow wave
Speaker 3: sleep during the first half of the night compared to
Speaker 3: the second half of the night. And it's been argued
Speaker 3: that deeper sleep is associated with memory consolidation and the
Speaker 3: processing of information. So it may not be completely daft,
Speaker 3: and there is you can think about it having some
Speaker 3: some relevance. I mean, but the studies haven't really been
Speaker 3: done right, all right.
Speaker 1: Well you're a gun. That's a good thing. You're a gun.
Speaker 1: The name of the Proft's book is called a Lifetime's
Speaker 1: written a bunch of Have you written a bunch of books, now,
Speaker 1: haven't you?
Speaker 3: I have? Yes. But this is the first sole author
Speaker 3: one and the first one which is truly I think,
Speaker 3: accessible for everybody.
Speaker 1: So this is a user friendly book. This is not
Speaker 1: your academic tomb that's going to blow your head off.
Speaker 1: It's called Lifetime. Your body clock and its essential roles
Speaker 1: in good health and sleep, Professor Russell Foster. Where else
Speaker 1: do you want to steer people, sir, Anything any website,
Speaker 1: any social media platform, or any anything that you want
Speaker 1: to point our audience towards.
Speaker 3: I mean, clearly, what I'd like to do is read
Speaker 3: Lifetime and really come away with the fact that there's
Speaker 3: a lot of really good science that they can use
Speaker 3: to improve their individual health and happiness. You know, as
Speaker 3: I sort of say at the end of the book,
Speaker 3: the stupid and the wise will die. In the end
Speaker 3: Circadian wise, you know, on average, will live live better,
Speaker 3: live longer, be healthier, and actually enjoy the company of
Speaker 3: others and the world and all the opportunities the world
Speaker 3: has to offer. So I just think I want people
Speaker 3: to embrace this area of science and not get frightened
Speaker 3: of it, and to use it to their best advantage.
Speaker 1: Was it liberating? Last question or promise? Was it liberating
Speaker 1: writing without having to be so bloody particular about referencing
Speaker 1: everything and bit like, just to be able to tell
Speaker 1: stories and speak from your own experience and observation. Was
Speaker 1: it liberating?
Speaker 3: Well, there's two parts to that, Craig, Because in fact,
Speaker 3: every bit of science is referenced, and what was interesting
Speaker 3: is that Penguin didn't kick back on the fact that
Speaker 3: there are nine hundred and twenty one references. So the
Speaker 3: key thing for me was that people could look up
Speaker 3: the science for themselves, but the text itself was accessible,
Speaker 3: and as soon as I began to feel comfortable writing
Speaker 3: in a different way, then it was great. It was
Speaker 3: a bit liberating. But for me, it's okay being accessible,
Speaker 3: but the science has got to be as rigorous as possible,
Speaker 3: and as I say, all of those scientific facts are
Speaker 3: referenced within the book.
Speaker 1: I'd expect nothing less. We will say goodbye to you
Speaker 1: officially off air, but for the moment, thanks so much.
Speaker 1: You're bloody brilliant. We think you're asin Thanks for being
Speaker 1: part of the You project for an hour.
Speaker 3: Well thanks Craig and Melissa. I really enjoyed it.
Speaker 1: Thank you sir, Thank you Melissa, Thank you everyone.