Intro: [music] Welcome back to The Daily Utah Chronicle’s opinion podcast. I’m your host, Estella Weeks, and you’re listening to Point of View.

Steven Carlson: My name is Steven Carlson. I am a clinical psychology PhD student here at the University of Utah, and I am in the health psychology specialization, which means that my research, or my clinical work, focuses on the behavioral and biological processes that might undermine sleep health, as well as other kinds of medical issues. And so my research right now for my dissertation focuses on the role of bedtime procrastination, on circadian rhythms and Cardiometabolic Health, but really I am interested in all things sleep, and I'm really happy to be here.

Estella Weeks: Thank you. Okay, why don't we start with the basics? What is sleep like what does your body do during that time. What is your mind doing, and why do we need it? And like, why isn't it even important for us to sleep?

Steven Carlson: Sleep is really a unique process in that we often think of it as this kind of inert state where we just black out for, you know, seven or eight hours, nothing really happens, and we just wake up the next day and, you know, get on with our lives. But what we really know about sleep is that it's a really active process, and so we know that there are physiological and neurological processes that happen during sleep that really don't take place at any other time during the day, right? And so sleep is a really important process for us to be able to repair our bodies, prepare our minds for the next day, as well as to do a lot of really important processing of information that we may have learned over the past day, and so it's a really important time during our lives where we are preparing for our days, as well, as you know, repairing damage that we might have done to our to ourselves, to our tissues, to be able to preserve health and well being. It's quite a lot that happens during sleep. And so the question of, you know, what is it for? Why is it important? You know, it's really difficult to find something in our lives that isn't impacted by our sleep. You know, for better or worse.

Estella Weeks: So how long should you be getting sleep every single night? And does that have factors of like, age, gender?

Steven Carlson: Yeah, absolutely. So there, it's a really great question, and it's honestly not a very straightforward answer. So the National Sleep Foundation put together a consensus panel of sleep experts to try to determine what is the quote, unquote, correct amount of sleep. And so the experts came together in a panel to discuss, you know, what factors might influence recommendations for sleep duration. And what they concluded is that predominantly, age plays a really significant role in the recommendations that we might make for sleep duration. And that makes sense, right? We kind of have this intuitive sense that children and infants require quite a bit more sleep than adults do, and so their recommendations for adults. You know, through young adulthood and middle adulthood is about seven to nine hours per night. There is some evidence to suggest that older adults do tolerate sleep deprivation better than young young adults and middle aged adults. Do you know they have fewer lapses in attention or difficulties with reaction time or things like that after sleep deprivation than than younger adults do, and so you know it really varies across your lifespan, what your sleep needs are, but for most college students, the recommendation is seven to nine hours. 

Estella Weeks: What is the difference between a quality night sleep and sleep where you're waking up consistently throughout the night and you're not finishing those full cycles you mentioned earlier? Could you kind of explain that?

Steven Carlson: Yeah, and typically, I should say, when we are defining, you know, sleep quality, it's often, at least in a clinical setting, that we don't often think about sleep stages or getting enough of any particular kind of sleep stage. Generally, sleep stages are. Are conserved regardless of the duration of sleep that we get, but there does seem to be a correlation between the time that we spend in some sleep stages and sleep quality. And so to the question of what might distinguish between quality sleep and poor quality sleep typically are better at defining what is bad sleep or inadequate sleep or disordered sleep, then we are in defining what is quality sleep. But that being said, you know, there is a emerging kind of model of positive sleep health called the RU SATED or are R U SATED model? And it's it's an anagram so that it represents different dimensions of sleep health, because sleep is really kind of a complex process that has lots of different pieces to it. So, you know, the the R in the model, it stands for regularity. So, you know, sleep quality, we can say, is related to how consistently you are going to bed at the same time. So if you're going to bed and waking up within an hour each day, you know, we would consider that you know, good for your sleep quality. And then S is satisfaction. If you generally feel satisfied, feeling refreshed when you are waking up. That's a good indicator as well. Alertness is A, being able to stay awake through the day without dozing or falling asleep. And then T is the timing of your sleep and so generally we say that you know being asleep between 2 and 4 a.m. so not going to bed too late and not waking up too early, that's an indicator of good timing for your sleep. E is efficiency, so that is being awake for less than 30 minutes per night, so having difficulty falling asleep for longer than 30 minutes, or waking up and not being able to fall back asleep within 30 minutes. And then finally, is D, or the duration of sleep and so, once again, that recommendation of seven to nine hours of sleep per day. And so, you know, put putting that all together, it's way more than just duration, right? Because we can have someone who sleeps nine hours a day, but they're getting that nine hours of sleep in a 12 hour chunk where they're trying to sleep, their sleep is really fragmented. You know, they're waking up and they're feeling really unrefreshed, they're falling asleep during the day. That looks very different than someone who their sleep is more consolidated, and they're feeling better about their sleep.

Estella Weeks: So it sounds like from that a lot of students really would not fit into a healthy sleeping category. Based on all those factors. Is there some sort of correlation between, like, working hours, that your brain is, like, really on throughout the day, and like, a need for more sleep? Because I'm just thinking of students and why it would be important for them to maybe get more sufficient sleep than maybe someone who's not actively, like, working on an education. 

Steven Carlson: Yeah it's really good question. And so the research that we know about how sleep need develops, it really comes out of what we call the two process model for sleep regulation. And in this model, our sleep need, or homeostatic sleep need develops over the course of of the day. So the longer that we're awake, the more sleep need that we develop. And really, that sleep need is largely considered to be use independent. So what that means is that, you know, we don't typically think that it is dependent on how active we are. Rather it's just the consequence of kind of your base metabolic rate. So the longer that you are awake, the more sleep need that you have more we also call it sleep pressure, that you have. And typically, when we want to make sure that people are sleeping, well, it's about making sure that you're falling you're trying to sleep at a time when you do have enough of that sleep pressure, in terms of students who are very active, you know, using a lot of brain power in class, doing a lot of work, you know, and the various roles and responsibilities that students have between, you know, school and work and social lives and all those other things, internships, all of those other things. You know, oftentimes, you know, it's not uncommon to feel more tired on those days where you have a lot of responsibilities, you're really busy, but generally that is more of a subjective feeling of fatigue, rather than the objective tiredness or objective sleep, pressure or sleep need. 

Estella Weeks: What are some consequences of pulling those finals week all nighters, getting really bad quality of sleep and then waking up earlier, you know, drinking coffee or energy drinks to get through the day.

Steven Carlson: College is a time where. There, there's so many pressures on young adults, right? It's a really high stress environment. There's a lot of demands on students to be able to be really productive, to learn a lot and then perform the next day. And so, you know, there is this really strong drive to, perhaps sacrifice sleep to be able to study more, do more assignments, or, you know, pick up additional shifts at work and things like that. And so in the in the case of pulling an all nighter to study, you know, it can certainly make sense to try to do that to get that extra edge on your performance on your test the next day, for example. However, the acute effects of sleep deprivation can really undermine that attempt to study more during the night. And so just to kind of put this into perspective, you know, a night of complete sleep deprivation has a cognitive and like physical motor impact, similar to being legally intoxicated, so having a blood alcohol content of 0.1 and so, you know, it's a really tempting kind of Devil's bargain between I want to study more and be more prepared for this test, but you also have to ask yourself, Okay, but is it worth maybe taking that test with the cognitive level equivalent of being drunk? 

Estella Weeks: So it sounds like you should probably just go to bed instead of that all nighter? 

Steven Carlson: You should probably just go to bed instead of pulling that all nighter, yeah.

Estella Weeks: Good to know. So there is some sort of correlation between maybe better grades and better sleep, yeah. 

Steven Carlson: So there, there is some research on the impact of sleep and academic achievement. You know, we see this in research, both with college age students, but also with high schoolers and even elementary school students, where we see that generally, the better you sleep, the better you perform in school. And this makes sense, right? Because we know that sleep is really important, not just in your ability to perform academically, right, to remember the things that you've learned. You know, sleeping actually helps set you up to learn more more effectively. So it's both in making those memories for the important things that you're learning in class, and then being able to access those memories later on as well. So really, there are acute effects of sleep deprivation on on cognitive functioning, once again, like being drunk, if you're you know are completely without sleep, but most students probably won't be completely without sleep. And so it's more that chronic sleep deprivation that builds up over over the course of longer periods of time that might be more impactful on on grades.

Estella Weeks: You mentioned earlier that most of the time students who are like super sleep deprived, they're not going completely without sleep, and I think that kind of alludes to naps. Can we talk a little bit about if maybe a nap could replace a good night's sleep, or what are the negative consequences of that?

Steven Carlson: You know, it's often a question, either with napping or sleeping in on the weekends, whether or not you can kind of catch up on missed, missed sleep opportunities. And so the question of whether or not you can catch up on sleep. And so what the research shows is that maybe in the short term, you know, a nap or catching up on sleep on the weekends might improve cognitive functioning and things like that. But really that kind of long term, kind of yo yo between not getting enough sleep and then trying to catch up. Not getting enough sleep and catching up, that still has a lot of kind of wear and tear on our ability to to solve complex problems, and, you know, has long term effects on our health as well. And so that kind of irregularity of not getting enough sleep and then trying to compensate on the weekends can be really impactful in terms of our cognitive functioning and our health. And in terms of naps you know, there can be times where taking a power nap, you know, like 20 to 30 minute nap, you know, before a test or something like that, if you are feeling a little bit tired, it can be helpful for improving, you know, your attention, your alertness. But it won't necessarily replace, you know, chronic sleep deprivation. And you know it is worth noting too that you know there might be some drawbacks from using naps as a way to try to compensate from poor sleep. Because it's kind of the situation where you are taking that nap, and you might be borrowing from tonight's sleep to take that nap. And so we talked a little bit about sleep need earlier, right? And so you can kind of think of sleep need as a rubber band. So the longer that you are awake, the more sleep need you have, the more tension there is on that rubber band. You need to have enough tension there to kind of snap into sleep. And so you can think of a nap as reducing that sleep need or having less tension on that rubber band. Or you can also kind of think of it as an appetite for sleep. And so if you have, if you take a nap, it's kind of like spoiling your dinner, and so you're kind of having this sleep snack that makes it harder for you, too to sleep later in the night. And so you know, napping can be something that might perpetuate sleep difficulties like insomnia and and other things like that. It definitely can be a disruption to your nightly sleep if you do have too much of a nap during the day, and that's why, typically, when we recommend these power naps, we really emphasize it being brief, right? 20 to 30 minutes. That way you're not borrowing from that sleep that night. We also tend to have some recommendations in terms of when you place that sleep, because just like appetite with for food, you know, if you have a big snack right, like, right before dinner. It's going to spoil your appetite more than if you had that snack, you know, two hours before. And so typically, we recommend that you have that power nap, you know, at the latest in, like the the early mid afternoon, so like 3 p.m. Of course, it depends on when you're going to bed normally anyway, but you know, we want you to have plenty of time to develop that sleep pressure, that sleep need before going to bed. So it's easier for you to fall asleep and stay asleep, and you know, have good, refreshing sleep that night. 

Estella Weeks: Speaking of bedtimes, what are some things that students can implement in their nightly routine, just to kind of get better sleep, so that you're able to have a better attention span the next day, be able to work harder, all the good things. What are some recommended bedtime routines? 

Steven Carlson: I just want to say once again, that students have such a difficult situation in that students are so overwhelmed, right? And so students often have to juggle a lot of different responsibilities between attending classes and then their actual homework, in addition to actually working jobs and having internships and all of the different things that students have to have to deal with, on top of developing a social life having personal time for yourself. So, you know, you really stack all of that up, and your your daytime disappears pretty quickly. It's really often difficult to find enough time to get all of that done during the day, and so sleep can often be one of the the first things to go when we're doing that kind of calculus, uh, trying to determine how to fit everything in during the day. What I would recommend for for most students, is to really have a plan and trying to stick to a plan where you are setting aside, you know, eight to nine hours in the evening for you to sleep, or during the night for you to sleep, and to be aware of the competition for your time, right? So for everyone that might be different, you know, that might be a late evening work shift, or that might be Netflix, right? Being aware of what's interfering with your sleep time and understanding how you might be able to build in the things that you need earlier in the day. So if you feel like that, you're delaying your sleep because you need that me time, trying to have some of that me time earlier during the day. I would typically recommend, and what might be my number one recommendation, is having a regular bedtime and wake time that you try to stick to every day, including weekends. It is, it is difficult, but you know, you don't have to be perfect, right? That's the good news. What I'd also recommend is, during the day, trying to be physically active, and especially being physically active outdoors. So we also, you know, know that in terms of actual bedtime routines, like things that you actually will want to do, we don't often have specific things like, you know, there there's a lot of things that people like doing. We don't want to be too strict on saying what is right and what is wrong, but generally doing things that are relaxing, avoiding things that are too stimulating or alerting. You know, certainly, you know, the time that we are recording this, looking at the news is pretty stressful. Recommend, generally not looking at the news. Or, you know. Work emails before going to bed, and doing things that you enjoy, that are, you know, relaxing, like reading and things like that can be really great things that kind of set aside the day and prepare for sleep. What really is important, beyond the specific things that you're doing, is having some consistency there, because it's kind of a cue for your body and your brain that, you know, if I am doing X, Y and Z, then it's time to wind down and go to sleep. So that could be, you know, painting your nails or reading a book, or, you know, checking in with your partner, as long as you're not talking about anything too distracting or too too distressing. You know, the specifics of the routine isn't as important as the consistency and making sure you're not doing anything that's too too alerting. Just as a general rule, the things that you know we recommend to our patients is, you know, give yourself at least a half hour where you can unwind, maybe disconnect from the device before, before going to bed. That's also a tricky recommendation for people to make. I...