The power of sleep
Renowned DJ/producer Tom Middleton, who is now a sleep science coach too, shares his knowledge on how important sleep is to our mental health — and gives pointers about how to sleep better
Hands up who’s tired today? How many hours sleep do you get on average? Less than seven, or ideally seven-point-five hours, is considered to be bad for your overall health. We’ll come on to why later. Around 65 per cent of us only get six-point-five hours’ sleep. Elite athletes aim for 10-12 hours’ sleep. Anyone with chronic sleep problems, like insomnia or sleep apnea? Fact: one in nine people have insomnia — that’s around 40 million people. Sleep is as essential as water, food and air for survival.
The main problem
We’re over-stimulated by a noisy, always-on digital world of screens, gadgets, relentless notifications and addictive platforms. We can’t switch off and deliberately stay awake. This leads to anxiety, stress, burnout, sleep deprivation, depression... and worse. I love this quote from Professor Matthew Walker, Director of the Center For Human Sleep Science, and author of the best-selling bible on sleep science, Why We Sleep, which beautifully summarises all the reasons why we should take our sleep more seriously.
“Scientists have discovered a revolutionary new treatment that makes you live longer. It enhances your memory, makes you more attractive. It keeps you slim and lowers food cravings. It protects you from cancer and dementia. It wards off colds and flu. It lowers your risk of heart attacks and stroke, not to mention diabetes. You’ll even feel happier, less depressed and less anxious. Are you interested? It’s free and it’s called sleep.”
This is going to be a little dive into the world of sleep science, how sleep quality and duration affects our health, daily performance, mood and energy. And more importantly, why it’s so vital to try and get between seven-point-five and nine hours’ sleep to build resilience and live long, healthy, disease-free and happy lives.
In my career as a touring DJ, producer and artist, I’ve travelled and performed to millions across 50 countries in clubs and at festivals. My curiosity about the science of sound grew during these touring years, as I quietly observed how we perceive and experience music, and how it affects our emotions, cognition, psychology, physiology and behaviour. I later discovered these areas of sound science are known as neuro-musicology and psychoacoustics. It’s a relatively new area of academic research, under the main headings of neuroscience and psychology of music.
I also became a dad and experienced the many challenges of juggling a professional career in the music industry that involved relentless touring, leaving me jetlagged, suffering from chronic insomnia, stressed, and at times burnt out, depressed and grumpy. These are actually mild negative outcomes compared to some people, as I will later explain.
Having been on the road touring for many years, I knew full well what it was like to suffer from jetlag due to bouncing between time-zones, staying up all night to DJ, carrying on to an after-party, being the last man standing or in my case, typically DJing extended seven- hour sets. Often I’d return to the hotel to pack, and I hadn’t even used the room, feeling utterly alone and empty, depleted of serotonin and dopamine from being in that state of natural high all weekend. Let’s face it, we know all too well the temptations for DJs to be on more than just natural highs. Alcohol and drugs could also be part of the mix.
Realising the lifestyle was unsustainable without some major interventions into supporting mental, physical and emotional health and wellbeing, I became interested in sleep as a rest and recovery tool. In 2007, I was hired as the global sound architect for Yotel. This led to creating scientifically designed playlists and soundscapes to help induce relaxation and help guests sleep. I was also test-driving content to help my own kids sleep.
Can we sleep better?
The question was, could I also learn to hack my own sleep to be happier and healthier, to be a better dad and a more productive producer? To help inform me about the processes going on when we sleep, I decided to train as a certified sleep science coach. In 2018, I released the world’s first scientifically designed sleep album, ‘Sleep Better’. Combining soundscapes that intentionally slow heart and respiration rates to below resting heart rates, this activates the parasympathetic nervous system, the ’rest and digest’ or relaxation mode. Learning about sleep science was both fascinating and frightening. I have come to realise just how crucial quality sleep at the right duration really is. Sleep is a biological necessity we require in order to rest, recover, repair, heal and grow, and to process and store memories and information. Think of it as your own free personal total health insurance, plus data back-up.
All creatures and plants sleep. You may have noticed plant leaves folding up at night. Interesting fact: some species sleep with one half of the brain and one eye still switched on to be aware of predators. Others sleep while still moving. Wouldn’t that be handy? Our sleep-wake cycle or circadian clock is set by the Supra Chiasmatic Nucleus (SCN) ‘body clock’, that resides either side of the hypothalamus behind the optic nerves in the middle of the brain.
Daylight is what resets the SCN, along with three key hormones that help us to know when to be awake and alert and when it’s time to rest, recover and sleep. We have a clock of around 24 hours and 15 minutes, but we’ve rounded it down to a more simple 24 hours. The main regulators of sleep are hormones called melatonin, adenosine and cortisol. But we are also affected by, a) food intake (late-night drinking and eating), b) exercise and movement (dancing), temperature changes (inside clubs) and social interactions (clubbing). If we think about weekend club culture, all of these factors are impacting our natural ability to switch off and sleep. We are in fact the only species that intentionally disrupts our natural circadian sleep and wake cycle to stay awake. Let’s start at the end of the day. Darkness is sensed by photoreceptors in the eyes, which cues the SCN to make the pineal gland start to release our switch off and sleep hormone, melatonin. Melatonin starts to be secreted between 8 and 9pm, peaks between 2-3am, and stops around 7-8am. Then when we are exposed to daylight, the body starts to produce cortisol to wake us up and make us active. We also have a dip in overall alertness around 2-3pm (ideal siesta/nap time). During the day, adenosine starts to build up a ‘sleep pressure’, which naturally helps us to feel the need for sleep. We will return to adenosine later, and how its natural effect is blocked by caffeine.
The other important factor in sleep is knowing your chronotype: your genetic predisposition to being a morning person or a night person.
Are you a lark or an owl? It could be even more specific, as Dr Michael Breuss believes there are four sleep chronotypes; wolves, bears, lions and dolphins. And he believes there is a particular set of natural patterns that can help you to plan your life, know when to exercise, when to have meetings and be at your most productive and creative. (There is an online test to help you establish what your choronotype is.) Dysania is the state of finding it hard to get out of bed in the morning. Typically, we have to adhere to the standard corporate and education global schedule of AMer/morning lark, even if we’re genetically predisposed to being PMers or owls. Not fair or reasonable, and those of us who like to get up later are penalised for this.
Sleep is divided into around 90-minute cycles made up of different stages that have various purposes. Non-REM is 80 per cent of our adult sleep.
Stage 1. Light sleep - Alpha - about five-10 minutes - typical state for naps.
Stage 2. Theta - about 20 minutes - ideal to awaken after a nap in this stage.
Stages 3 + 4. Deep restorative sleep - Delta or slow wave - slowest heart and breath rate - muscles fully relaxed - growth hormone released - build and repair time - hard to be woken up from this stage.
REM stage (dream sleep). You typically have five or six of these per night.
Essential for regulation of emotions, creativity, rationality, social skills and overall mental health. Arms and legs temporarily paralysed to prevent you acting out your dreams.
What happens if we don’t get enough quality sleep?
Weakens your immune system, and you are 50 per cent more prone to get colds and flu.
Doubles your risk of getting cancer.
Increases chances of heart attacks, stroke and developing heart disease.
Brain unable to flush out amyloid beta peptides (brain plaque), which leads to: Increasing the development of Alzheimer’s and dementia. Reduces life expectancy by up to 13%. Boosts inflammation. Increases stress hormone cortisol. Increases gastrointestinal problems. Impaired cognition. Makes you more forgetful. Reduces reaction time. Lowers your sex drive. Makes testicles smaller and lowers sperm count. Reducing virility to man 15 years your senior. Increases emotional reactivity, making you grumpy and moody. Fight or flight mode is triggered more easily. Increases hunger hormone ghrelin. Decreases your satisfaction/fullness hormone leptin. Impacts insulin resistance. Forty per cent less able to absorb and process glucose, so it’s stored as fat; this can lead to obesity. And a predisposition to type 2 diabetes.
Sleep and mental health
This is the area that is most worrying, considering the recent tragic losses to the industry of Tim Bergling (Avicii) and Keith Flint of The Prodigy.
I’ve also lost two friends in the last two years to suicide, in which there was a direct link to sleep deprivation, so this is a deeply heartfelt matter and an important campaign for me. I just don’t think there should be more casualties like this in the music industry, so collectively we have a duty of care to reach out to our mates, and check in with them if we spot any warning signs. And also, be educated about how to take better care of ourselves. Think about this; sleep deprivation is used as a real torture to get people to tell secrets. You start to hallucinate and are physically, mentally and emotionally compromised. You become moody, erratic, emotionally reactive and in permanent fight or flight mode. All of your systems eventually start to shut down, and it was reported that a man died after 11 days of sleep deprivation. We need to sleep or we die.
Why is the nightclubbing industry at risk?
This is a controversial subject. I’m not saying don’t go out and enjoy yourself. I’ve been in the industry long enough to know why dancing, listening and singing along to music as a tribe is part of our culture and actually deeply ingrained in our DNA. I still love the scene, and love to listen and dance. My position is to simply raise awareness around the well-documented dangers of intentionally compromising your sleep, and to help coach those with sleep challenges, and improve the quality and duration of their sleep with simple sleep hygiene tips and hacks.
There is a conclusive body of evidence that sleep deprivation has a significant negative impact on mental health, which will lead to psychiatric conditions to varying degrees of severity. It’s not quite a chicken and egg situation, but a lot of research indicates that sleep deprivation and insomnia is more often a cause, as well as a typical symptom, of: Anxiety. Mania. Burnout. Likelihood of major depression. Likelihood of bipolar disorder. Mood instability. Higher neuroticism. Subjective loneliness. Lower levels of happiness. Slower reaction times — dangers when driving or operating machinery. Suicidal ideation. Suicide.
For every hour of lost sleep the consequences are: * 23 per cent increase in substance abuse 38 per cent increase in hopelessness and sadness 42 per cent increase in suicidal thoughts 58 per cent increase in suicide attempts (*George Mason University - Fairfax County Youth Survey, 27,939 participants.)
This is where I am waving the red flag. We must acknowledge that sleep issues such as insomnia are an early warning sign of potential mental health disorders and mood problems. Parallels with night shift work The World Health Organisation has categorised shift work as a probable carcinogen. There are many studies on the negative health impact on shift workers due to circadian disruption, ie. shift work sleep disorder (SWSD).
I see many similarities, yet many greater challenges in relation to DJ/artists touring and clubbing. As well as the jetlag from jumping between time-zones, let’s think about the intense dopamine highs of DJing, performing or even raving. The temptations to keep the dopamine buzz going; alcohol, drugs, food, sex, then the drastic comedown back to normality. The blue Monday mood can extend well into the week. These oscillations can cause serious biochemical imbalances when the body is constantly working to recalibrate between these two states. This is where some mental health problems start.
So how do I sleep better?
I’ve pulled together the best expert and scientifically advised tips. The ‘Sleep Better’ album is designed to help you relax and wind down, recommended to be played in the hour before usual bedtime, and aiming for seven-point-five hours of sleep. There is an app version, which features a virtual orange/red spectrum sunset to avoid blue light emissions.
Sleep Hygiene Tips:
• Routine - establish a regular routine - aim for at least seven-point-five hours - nine hours = five or six complete 90-minute circadian sleep cycles.
• Daylight exposure (and vitamin D) - humans spend on average 90 per cent of their time indoors, and as a result, we are also becoming chronically vitamin D deficient. Exposure to daylight is essential in resetting the body clock for activity, and boosting the immune system. Note: indoor light is only 500 Lux, bright sunlight on a clear day is 100, 000 Lux.
• Exercise - stand up/move/exercise during the day. We weren’t designed to be sedentary.
• Diet - eat light at night, spices will stimulate, avoid caffeine after 2pm, it blocks adenosine sleepiness hormone, keep well-hydrated, 68 glasses per day — this also reduces snoring and sleep apnea. Alcohol disrupts REM and Slow Wave restorative sleep quality and depth.
• Chronotype - help plan a sleep/wake/move/ work schedule that is more natural for your type: Wolf, Bear, Lion or Dolphin. CF Dr. Michael J Breus thepowerofwhenquiz.com
• Digital detox - switch off gadgets an hour before bed and keep them out of the bedroom - we are ‘always on’, so make time to switch off.
• Breath-work - try relaxing breath-work, such as four x four box breathing or four, seven, eight patterns.
• Yoga for sleep - including ‘legs up the wall’ Viparita Karani pose - redirects lymph and blood flow, and really helps relax the body.
• Empty head - cognitive behavioural therapy - write down and ‘remove’ unwanted negative thoughts from your head, then write down a to-do list, and finally focus on three things you’re grateful for and smile.
• Chill out - practice meditation, listen to relaxing music, read a book, but avoid hyper- arousal from stimulating blue light-emitting screens and scrolling through social media feeds. • Travel + Sleep Toolkit - invest in custom-fitted medical grade silicone ear plugs that reduce unwanted sleep-disrupting noise by 36dB (you can still hear a baby crying or wake-up alarm) and a good quality eye mask. acscustom.com/uk/products/other/ sleepsound
• Air quality - an oxygen-emitting house plant, good ventilation, a pink salt crystal bedside lamp to naturally ionise the bedroom (and emits red orange light).
• Lights - use red bulbs or LED light to simulate sunset at night and prevent melatonin secretion being disrupted by blue/white cortisol- stimulating light. Use a red LED light in the bathroom and halls at night if you have to get up.
• Sleep Paleo - keep the bedroom like a cool dark cave. Sleep onset is helped by a 1° drop in body temperature. Ideally, keep your room on the cool side, around 60-65°F/16-18°C.
• Environment - keep the bedroom as a sleep sanctuary. Invest in a mattress and pillows that suit your level of support, and allergen-free high- quality bedding.
Tom Middleton is a member of the AFEM Health Group and co-chair of AFEM’s Global Health Group, runs a consultancy called SONUX, and uses the science of sound to design audio content for apps and platforms such as Calm and the Silentmode performance mask and Breathonics TM app, helping to address human problems such as stress, anxiety, depression and burnout. “This replaces the unhealthy, noisy world with meaningful music and soundscapes for mental, physical and emotional health and wellbeing, boosting focus, performance and productivity,” Tom says.
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