Sleep deprivation is a silent epidemic. Since the invention of the light bulb, we have obtained less sleep than our ancestors, prioritizing work, school, socializing, sports, screen time – just about everything – over sleep. Sleep is viewed as compressible, something that can be made up at any time, but rarely is. Most believe this poses little risk. Unfortunately, they could not be more wrong.
The truth is, an adequate amount of good-quality sleep is critical to good health. Lack of sleep leads to deadly crashes, reduces productivity, and harms quality of life. Insufficient or disordered sleep can increase risk for ADHD, depression, heart attack, stroke, arrhythmia, heart failure, and early death.
This Teach-Out can be your first step in doing something about sleep deprivation. Learn how sleep works, why it is important, and what bad sleep habits are. Hear solutions you can start tonight to sleep better for the rest of your life. Understand strategies to help family and friends improve their sleep. Learn to advocate for the sleep health of your community. This Teach-Out is intended to connect learners worldwide to the University of Michigan in conversation around sleep deprivation.
A Teach-Out is:
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-an opportunity – it is open for free participation to everyone around the world
-a community – it will be joined by a large number of diverse individuals
-a conversation – an opportunity to give and take ideas and information from people
The University of Michigan Teach-Out Series provides just-in-time community learning events for participants around the world to come together in conversation with the U-M campus community, including faculty experts. The U-M Teach-Out Series is part of our deep commitment to engage the public in exploring and understanding the problems, events, and phenomena most important to society.
Teach-Outs are short learning experiences, each focused on a specific current issue. Attendees will come together over a few days not only to learn about a subject or event but also to gain skills. Teach-Outs are open to the world and are designed to bring together individuals with wide-ranging perspectives in respectful and deep conversation. These events are an opportunity for diverse learners and a multitude of experts to come together to ask questions of one another and explore new solutions to the pressing concerns of our global community. Come, join the conversation!
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From the lesson
Sleep Deprivation: Habits, Solutions, and Strategies
Clinical Instructor of Internal Medicine and Sleep Medicine Department of Internal Medicine & Ann Arbor Veteran’s Affairs (VA) Medical Center
Ronald Chervin, MD, MS
Professor of Neurology and Michael S. Aldrich Collegiate Professor of Sleep Medicine Director, Sleep Disorders Center
Cathy Goldstein, MD, MS
Assistant Professor of Neurology Sleep Disorders Center and Department of Neurology, Michigan Medicine & Ann Arbor Veteran’s Affairs (VA) Medical Center
Louise O'Brien, PhD, MS
Associate Professor Sleep Disorders Center and Department of Neurology; Department of Obstetrics and Gynecology; Department of Oral & Maxillofacial Surgery, Michigan Medicine
Sonja G. Schuetz, MD
Clinical Assistant Professor of Neurology Sleep Disorders Center and Department of Neurology, Michigan Medicine
Anita Valanju Shelgikar, MD, MHPE
Assistant Professor of Neurology Sleep Disorders Center and Department of Neurology, Michigan Medicine
Hi, welcome back.
As you know, I'm Doctor Cathy Goldstein and I have a very
special colleague right now with me, this is Doctor Olivia Walsh.
So Olivia, if you could just start by telling us your background and
how you became interested in sleep.
>> Yeah, absolutely, so my training is in Mathematics.
I did my undergraduate work in Mathematics at the College of William and Mary.
I came to Michigan, I knew I wanted to do applied math,
I started working with a professor here, Danny Forger,
who studies the Mathematics of sleep and circadian rhythms.
And through working with him, I started making models of circadian rhythms and
apps to communicate these models to the world.
>> Is there anything personally that drew you to this kind of work?
>> Honestly yeah, as an undergraduate I did not sleep enough, it was very bad.
And as a result, I kind of don't remember what it was like in college.
I completely did not form new memories, [LAUGH], for a lot of that time.
And as a result coming to grad school, I first of all,
I was like I gotta start sleeping.
And secondly, I was really interested in understanding more about
something that's so important.
But that we often treat it like not only is it not important but
at it's macho to not get enough sleep.
>> Definitely, huge problem right now.
For learners, can you review a little bit about what circadian rhythms are?
>> Yeah absolutely, so
a circadian rhythm is anything in your body that repeats itself once a day.
That's a lot of things.
So okay yeah, you ca usually sleep once a day,
but you also have peaks in performance in so many different systems in your body.
So your grip strength has a circadian rhythm, your metabolism has a circadian
rhythm, your immune response had a circadian rhythm.
If you were in a bunker and had no access to light,
your clock, the thing controlling all of these things repeating itself,
would do that at a period of around 24.2 hours.
It wouldn't be a normal 24 hour day, but
we're kept in sync with our environment by light.
Light is the main input to your circadian clock.
>> Olivia, so can you tell me exactly how light affects the circadian system?
>> We didn't know for a long time, we knew that it wasn't the rods and cones.
So the traditional visual pathway is light comes to your eye,
it's picked up by rod and cone photo pigments.
Cones are what see color, rods are more light, dark,
they transmit that information through the retinal ganglion cells that talk to
the visual parts of the brain.
But in the early parts of the 1900's, people had noticed that blind mice,
mice that could not see still had circadian rhythms.
So these mice were missing rods and cones, but
somehow light information was still getting to their brain.
It was a mystery for a long time.
The early math models of the circadian clock didn't know what they were,
so they put in placeholder terms.
But in the early 2000s we figured it out.
There's a photo pigment in your eye called melanopsin, it was actually first
discovered in the skin of frogs, but it's also in your human retina.
The light coming to your eye hits melanopsin that's intrinsically
photosensitive retinal ganglion cells.
Those IPRGCs are what send the message from your eye to
the suprachiasmatic nucleus, the master clock of the body,
where controlling rhythms is the number one thing it does.
>> Very cool, so
if you're somebody that's being exposed to an abnormal light dark cycle.
For example, you're a night shift worker, or
you travel to another country and you get jet lag.
What happens to the clock then?
>> It gets completely confused.
Like I said, light is what's keeping us in sync with our home environment.
So if you get late at a weird time, the clock doesn't know what to think.
It might be expecting darkness, a burst of light comes in and it sends a signal that
updates the phase of your clock, the internal time of your body.
And if you adopt a new light schedule like for instance, if you cross time zones and
then just say okay I'm in Tokyo now, I'm gonna follow my normal schedule.
But in Tokyo you will adjust, it's this process called entrainment, but
is not necessarily the fastest way to adjust.
If you get late at the right times,
you can adjust yourself to a new time zone, faster.
>> And how did you guys use math to help speed up that process?
>> So the clock is a really nice system to model with math.
A lot of biology is really hard to do math on because it's so complicated.
But the clock is a relatively clean system, and
we know the most important input is light.
So over the course of decades now, people have been developing and
refining math models, that take as the input, light.
And then, they process it, and get, as an output, internal time.
And so, the internal time of a person
can be approximated if we knew the recent light history.
And this is based on lots and lots,
of experiments where people are in dim light or constant light conditions,
and they're getting lights flashed on them, they're spitting into tubes.
But through that, we can come up with math models.
And then once we have a math model,
we can do a kind of mathematics called optimal control theory.
And this is the same kind of math you would use if you were asking okay,
I want to have a ball and design for the best slide for
getting the ball from here to here as quickly as possible.
Most of the applications of control theory have been for physics, but
we took it and applied it to biology, specifically,
this really clean model of the biological clock.
>> That is unbelievable.
So we talked about this in kind of reference to shift workers and people
travelling across the world, but what about what all of us do on a weekly basis?
So I know that most people, come the weekend,
they push themselves to stay up later, and then they sleep in two to three hours.
Can that have relevance in shifting the clock?
>> Absolutely that's called social jet lag.
It's something that was coined by a researcher named Till Roenneberg.
The idea is you're basically crossing time zones if you wake up one time for
work and then you wake up three hours later on the weekend on your free day.
It's been correlated to a bunch of ill health effects like risk of obesity.
And the way to think about it, or how I think about it,
is imagine you're on a swing, you've got really nice amplitude going.
You are doing awesome on this swing.
This crossing of time zones, it's almost like somebody pushing you
at a point in that swing that isn't the best for your amplitude.
I don't know if you've ever had like a jerk on the playground,
who pushes you at the wrong time.
You lose amplitude on the swing because you're not able to get that full
oscillation.
And when you are changing time zones every week, it's kind of like you're on a swing
and somebody's just shoving you and you can't get that really strong rhythm going.
>> So it sounds like a lot of people are really messing up their clocks and that
this is just a widespread problem even if you're not an international traveler or
you're not a shift worker.
So can you tell me a little bit about the app that you developed
here at University of Michigan and train, and how that can help?
>> Yeah absolutely, so we were doing this research into the circadian clock,
the best presentation of light to shift a person in time zone A,
to time zone B as quickly as possible.
And we got a bunch of schedules that people could use to cross time zones.
And we didn't wanna just publish them in an academic paper and
have them be used by only us.
So I made an app where people could enter where they were starting from,
and where they were going to and also their normal lighting habits.
Cuz somebody who normally wakes up at four am has a very different circadian
oscillation over the course of the day than somebody who wakes up at 11 am.
So with those pieces of information,
we relaid the schedules, put it out there in an app.
This was actually my first ever app that I made, and it got a lot of attention.
And I think it's because people are starting to realize that the circadian
clock affects so many things, and that jet lag is
a major problem that affects everybody, not just travelers.
So the app was released, we gave people who wanted to,
the chance to opt in to submit their data back to us.
A huge number of people did where we're in to 10,000 now.
Which is great, because it's not just download numbers,
that's people who chose to send their data back to us.
And from this we can get a snapshot of how people sleep the world around.
>> That's fantastic, and if our viewers want more information about that app?
>> They can check out in train.org.
>> Perfect, so
if you had to tell everyone one thing to promote health of your internal clock,
which subsequently affects your sleep and your alertness, what would it be?
>> I would say keep a regular schedule.
Not just a weekend versus weekday, I would say over the course of the week,
as much as you can, try and keep a regular light dark schedule.
And I believe this because of the science, but I was also a subject
in a circadian study, where for five months I had to keep a regular schedule.
I had to go to bed at the same time every night and
wake up the same time every morning.
And I didn't have to fall asleep right away, it was just a matter of
controlling my light so that after 11}30 I was not getting light.
And I cannot tell you how healthy I was.
Those were the five months of maximum health in my life, and
ever since then its just been downhill, I've gonna get back to that.
Seriously, I know it's hard, but as regular schedule as you can,
get I think that's really great.
>> Well, I would definitely agree with that.
I thank you so much, Olivia, for this fascinating discussion
about the effects of the clock and how math can help us understand it.