A few decades back, people didn’t care as much about sleep. Margaret Thatcher led by example, getting only four hours a night. But over recent years, there’s been pushback on the narrative that sleep doesn’t matter. It does. Anyone who has worked night shifts, had their nights disrupted by a newborn baby or delved into gruesome historical literature about sleep will agree.
In the 1960s, a high-school student in the US, Randy Gardner, was kept awake for 11 days for a study on the impact of sleep deprivation. He experienced symptoms including delusions, irritability and a lack of coordination. More recently, scientific literature has highlighted links between the way we sleep and our mental and physical health. This has all led to the realisation that sleep matters, and it becoming a particular focus of the wellness industry. There are sleep trackers, podcasts, influencers, supplements and smelly sprays to help. Sleep dismissal appears to have now been replaced by sleep hysteria.
In 2017, sleep scientists coined the term “orthosomnia”, which means “straight or correct sleep”. This is the phenomenon of people becoming fixated on obtaining “perfect” sleep. It can come about because of advice about the way we “should sleep” and information from sleep trackers about how we “actually sleep” – and perhaps a gulf between the two. Some people have started worrying about their sleep and are finding going to bed a miserable experience.
A couple of years ago, the leading clinical psychologist Prof Roz Shafran got in touch with me to discuss an increasingly problematic trend. Some people who were missing out on sleep because of factors outside their control (caring for others; dealing with a chronic health condition; insomnia; shift work) were becoming increasingly distressed – not so much because of how disrupted sleep made them feel during the day, but because of fear of the perceived consequences. Would their sleepless nights lead them to develop cancer or Alzheimer’s? Would they die early?
Shafran wanted to explore what could be done. With Prof Allison Harvey, we coined the term “sleep privilege” as a starting point for an overdue discussion of this topic. We wanted to flag that people differ in their sleep opportunities, and that advice needs to stop ignoring this.
This topic fits within my research expertise, but is also close to my heart as a parent of a teenager living with type 1 diabetes (a condition that regularly sees me getting up and down during the night). Interestingly, despite having read thousands of scientific papers about sleep over the years, I was not too worried about my own disrupted nights. Much of the science I had read revealed small effects and did not show causal links – and thinking back to Randy Gardner, he was by all accounts still alive. This emphasised to me how the messaging around this topic had become exaggerated, distorted and unhelpful.
Take, for example, “the eight-hour myth” – the idea that we all need this much sleep to function well. Anyone who has lived in close proximity to others will know this is wrong. Perhaps you need more sleep than your partner but less than your child. Expert panels agree with this, noting that sleep-length requirements change, both between individuals and throughout the course of our lives. Yet this seemingly harmless fable can do real damage as people try, but struggle to get, more sleep than they need. My colleague Prof Jason Ellis explains this well by likening sleep to a lump of dough: if we stretch it out too much (and try to sleep for more than we need), holes quickly appear (we wake up during the night).
Challenges also come from monitoring sleep. Some of us now track it using watches, rings, videos and mobile phone apps. But the act of tracking sleep can impact it, and monitoring can lead to sleepless nights: we lie in bed willing ourselves to get enough “core sleep”, or another aspect of sleep that most sleep scientists have never even heard of.
Sleep trackers initially developed by scientists have now found permanent residence in homes and even hospitals – and this can create real problems. A recent BBC article described how video monitoring technology (which can monitor sleep as well as activity) was reported to contribute to paranoia and illness in mental health wards. Not only do these devices appear to affect our sleep, but some of them lack accuracy too, meaning that they are likely making us worry over nothing.
Of course, sleep problems are real – and where they occur, help is at hand. My colleague Prof Colin Espie co-founded the company behind Sleepio, a digital therapeutic that delivers the first-line treatment for insomnia, cognitive behavioural therapy, via a medical-grade smartphone app. Sleepio is the first app of its kind to be recommended by health watchdog Nice and is available for free on the NHS in Scotland, with England hopefully soon to follow. There are also other helpful treatments that your GP can recommend. But for those without serious sleep challenges, perhaps we need to go back to the start. We should peel away the unhelpful layers that have built up over time – whether that’s paying too much attention to advice about sleep or tracking it. Perhaps returning to “natural sleep” should become the next health trend you haven’t yet heard of.
