Sleep: The most overlooked and undervalued recovery tool for high performance w/ Dr. Steven Lockley

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Key Takeaways

• Steven Lockley, PhD is an Associate Professor at Harvard Medical School and a Neuroscientist working in the Division of Sleep and Circadian Disorders
• Sleep splits up into two main parts:

1. Deep Sleep — restorative cycle (recovery)
2. REM Sleep — memory forming cycle (learning)

• “These two types of sleep cycle every 90 minutes, or so.”
• Sleep Tracking Devices are useful. “These devices are useful for looking at a change in sleep over time, or a pattern of sleep.” In other words, we can assess whether something is getting better, or getting worse.
• A sleepy brain is a drunk brain. Staying awake for 16+ hours can be equivalent to levels of impairment similar to alcohol impairment.
• “This macho attitude of ‘I’ll sleep when I’m dead’, or ‘I’m wasting time, if I am sleeping’ Is really old fashioned and wrong.” You aren’t morally superior because you get up early
• Young adults have a body clock that is shifted later than older adults. “Early training times virtually guarantee sleep deprivation and the accumulation of chronic sleep debt.”
• “If you’ve had enough sleep during the night, then you shouldn’t even be able to nap. The fact that so many athletes rely on naps is a sign that they are consistently sleep deprived.”
• “So many coaches and staff think that this can be overcome by motivation, or “it is what it is, we just have to get over it — what’s the big deal — it’s just sleep”, which is again, just such an old school view. What’s funny is that we are willing to do whatever it takes to improve performance when it comes to exercise, diet, training, & preparation, but we ignore something like sleep, which effectively determines how alert you are and what your body clock time is. Ignoring this is a wasted opportunity to improve performance with very little effort.

Sleep: The Basics

• Circadian Rhythms are also known as 24-hour rhythm’s
• Steven works a lot in applying circadian/sleep principles in real world settings: the lives of firefighters, police officers, doctors, students, etc. in the hopes of better understanding the link between work hours, sleep loss, fatigue, errors, mistakes, and accidents.
• Every animal sleeps. “Even cockroaches and fly’s sleep… And I think that just goes to show how important it is to our physiology.”
• “Sleep is really the time where we clean out the brain, we restore and repair the body, we form memories during sleep, it’s a really key part of our physiology. Without sleep, we very quickly go downhill.”
• Sleep splits up into two main parts:

1. Deep Sleep (Non-REM — Rapid Eye Movement)
2. REM Sleep

• “These two types of sleep cycle every 90 minutes, or so.”
• We get more of the Non-REM sleep in the beginning of the night and then we get more of the REM sleep in the 2nd half of the night.
• Non-REM sleep, is sometimes called Deep Sleep.
• The amount of Deep Sleep (Non-REM) you get is typically based on how tired you are. So, the longer you have been awake prior to falling asleep determines how much of the Deep Sleep you end up getting.
• “Deep Sleep is the type of sleep that makes you feel refreshed when you wake up. That’s what recovers the alertness levels in your brain.”
• REM Sleep is key for forming memories and learning.
• “We need Deep Sleep in the beginning of the night to help us recover and feel fresh when we wake up and we need REM Sleep to help long term memory and learning.

Sleep Tracking Devices

• Although Daily Wellness Questionnaires are popular, they aren’t very accurate when it comes to assessing sleep quality and quantity. “Part of the problem with asking people ‘how well they slept’ is we typically do a poor job of self-assessment.”
• It is much more accurate to use objective markers of sleep using sleep tracking devices, than asking athletes how they slept using a daily wellness questionnaire.
• “None of the devices on the market are perfect, but they all tell you something.”
• Basically, the devices on the market use a variety of different means of measuring various physiological characteristics aimed at tracking two basic things.

1. Whether you are asleep or not
2. How deep you are sleeping

• “These devices are useful for looking at a change in sleep over time, or a pattern of sleep.” In other words, we can assess whether something is getting better, or getting worse.
• “No device is perfectly accurate at telling you how much Deep Sleep, or how much REM sleep you’ve had.”

Keys to a good Sleep Tracking Device:

Duration: The minimum recommendation for number of hours of sleep per night for adults is 7 hours. “But, we recommend more than that.” A good tracker should tell you the number of hours slept using some sort of physical motion scanner to recognize the moment sleep begins and ends.

Timing: We want to fall asleep at the same time every day. “A stable sleep pattern is advantageous and something you can assess with a device.”

Type: “We want to know how much Deep Sleep we are getting and how much REM sleep we are getting.”

• A good sleep tracking device can be helpful in providing feedback about the quality and duration of your sleep, but it can also be useful for noting the efficacy of any interventions. If you want to know if a certain drink before bed is helpful, or hurtful, you can look at the data concerning duration, timing, and type to get a rough sketch of how useful or harmful an intervention is.

Rough practical guide for recommended sleep duration for athletes of various ages

• “None of us really get enough. 7 hours isn’t the target, we should be trying to get more than that, especially in younger people.”

Survivorship Bias of Sleep:

• Survivorship Bias is a bias in human thinking and decision making coined by World War II Statistician Abraham Wald.
• As the story goes, the military were studying planes that returned from missions and taking note of the areas that were hit by the most enemy fire (red dots in image above). The logic that they applied was that the areas suffering the most damage should be manufactured with “extra” protection
• However, the flaw in their thinking was that they only looked at the planes that survived, not the planes that didn’t return.
• What they should have done is the exact opposite of what they did. They should have added extra protection to those areas not hit by enemy fire as those were the areas that were most likely to cause a plane crash
• Steven Lockley argues that we have done the same thing with sleep. We pay attention to those people that are successful and don’t get a lot of sleep and ignore all of the people that get plenty of sleep and are also successful.
• “Unfortunately, there is more attention paid to the people that claim they are short sleepers and successful, rather than those that get a lot of sleep and are also successful.”
• People point to someone like Margaret Thatcher, who apparently slept 4 hours per night and was very successful, but then there also people like Albert Einstein who slept 10+ hours per night. “And he had a pretty successful career J”
• “This macho attitude of ‘I’ll sleep when I’m dead’, or ‘I’m wasting time, if I am sleeping’ Is really old fashioned and wrong.”
• You aren’t morally superior because you get up early
• Diet, Exercise, and Sleep are the 3 pillars of health and if you don’t get all of those things, then you cannot be fully healthy.
• “Short sleepers have a much higher incidence of diabetes, cardiovascular disease, depression, cancer, etc.”

Body Clock’s

• Young adults have a body clock that is shifted later than older adults.
• Therefore, asking a 16, 17, or 18-year-old to go to bed at 10PM is like asking me to go to bed at 7PM. “It’s no surprise that they can’t go to sleep at that time.”
• The problem is, our schedules don’t take body clock into account.
• School start times, class times, or training times are early in the morning, which require them to be up and ready to go at 6 or 7 in the morning, but their brains won’t let them fall asleep until 1, 2, or 3 in the morning, “which guarantees sleep deprivation.”
• The sad thing is that it isn’t their fault. There is a legitimate biological reason that they can’t fall asleep until later and most adults meet that with a comment like, “Come on, get up — you’re just being lazy.”
• Social media, cell phones, and laptops are also effective at shifting our body clocks later because they emit blue light. So, culturally, we have started to shift most of our body clocks later because we have cultural habits of working up until bed time and social habits of checking social media while lying in bed. “The good thing is that we can stop that. We can change it.”
• We can change it by creating a space between work and bed time where we take time to relax and unwind from our workday.
• Some things that can help fill that space between work and bed time are as follows:

— Breathing exercises

— Relaxation

— Meditation

— Yoga

— Warm Bath

— Reading a real book (not kindle)

• These all help to calm the brain down and get it ready for bed. And, if you can do that each and every day — you will get used to that schedule and you will have a much more consistent sleep pattern over time.

Internal Clock’s: Larks & Owls

• Some people have a biological clock that runs slightly faster than others and these people tend to be more “morning people” or larks.
• Other people have a slower biological clock that runs slightly slower and these people tend to be more “evening people” or owls.
• “If I took 100 people off of the street and measured their biological rhythms, I would actually find a 5-hour variation in their rhythm’s even if they were sleeping on the same schedule.”
• This means determining whether you are a morning type, or an evening type is a really good starting point for developing good sleep habits.
• Most teenagers and young adults are evening types
• “Everyone’s clock is a bit different, but there are 2 ways you can figure out your clock:”

1. First — Taking note of when you start to feel tired/sleepy each day is usually a good indication. For example, if you are consistently ready for bed at 9PM, then you are probably a lark. If you are wired until after midnight, then you are probably a lark.
2. Second — If you could sleep in tomorrow without restriction, what time would you get up? The later you would wake up, the more indicative you are an owl; the earlier you would wake up, the more indicative you are a lark.

• Steven makes a really good point in regards to the second way of determining your natural sleep rhythm. “Keep in mind that if you sleep in until whenever you like, you are initially paying off a huge sleep debt, so the first few days don’t really reflect your natural sleep rhythm. It takes a few days before you will find your natural, consistent rhythm.”

Practical Takeaways:

Training Time:

Ignoring the importance of WHEN you choose to train is a wasted opportunity to improve performance with very little effort.

• If your team finishes their game at 9 or 10 PM and they don’t get to bed until closer to 2 or 3 in the morning, asking them to come in for a 9AM recovery session “doesn’t make any sense.”
• If most athletes are young adults, and most young adults are owls, then most athletes are owls. Therefore, why do so many sports teams train in the early morning?
• “Shifting things a little bit later in the day, let’s say early afternoon — you will get the same amount of work done, but the quality will be so much higher because the players will be more rested.”
• The response from the athletes of the teams that Steven has worked with have been extremely positive. “The players are happier, they respond better, they have better quality training — it changes the atmosphere of inclusion because now you are responding to the needs of the players, not the preference of the coach because it works better for his schedule to get up in the morning.”
• “Even the companies I have worked with have shown amazing results. They have allowed for more flexible hours where people make their own schedules and we have seen improved productivity and employee retention in companies that have allowed for that.”
• Steven mentioned a natural study where a school had a change in start times from 8AM to 10AM and then back to 8AM. The 2 outcomes they looked at were exam results and sick days.
• During the period of a later school start time (10AM)

1. Exam results improved
2. Sick days reduced

• During the period of an earlier school start time (8AM)

1. Exam results got worse
2. Sick days increased

• The same principle applies to training times. If we move training times later, without doing anything else, we are increasing the probability that performance improves, injury rates go down, and illness rates decrease.
• If you play a game at 7 PM (or another time in the late evening) that doesn’t finish until very late at night, and your only option (due to facilities or field availability) is to do a recovery session the next day in the early morning (9 or 10 am) you are better off giving them the day off. “Sleep trumps any other recovery modality — the amount of sleep always takes priority when we are talking about recovery.”
• “There’s no such thing as too much sleep. More sleep is a good thing. Sleeping in is a good thing.”
• Sleep Inertia — the groggy feeling you get after waking up. This is normal and it takes around 2–4 hours to fully dissipate, therefore “you don’t want to be doing key things within an hour or two of waking up.”
• What time does your team train? If you train at 8AM, or 9AM, you are basically training during the period of sleep inertia. Training will be less effective, the training dose less potent, the adaptation less positive, and the long-term effect being a consistent under-training and under-performing, all due to the implications of a poorly selected training time.
• Science shows that peak performance occurs in the late afternoon — coinciding with our peak body temperature.
• The time between when you normally train and your game time can effectively be thought of as time zone differences. For example, “if you normally train at 5PM and you play at 8PM, that’s the same as traveling 3 time-zones even though you haven’t gone anywhere.”
• “So many coaches and staff think that this can be overcome by motivation, or “it is what it is, we just have to get over it ”, which is again, just such an antiquated view; we are willing to do whatever it takes to improve performance when it comes to exercise, diet, training, preparation, but we leave out something like sleep, which effectively determines how alert you are and what your body clock time is. Ignoring this is a wasted opportunity to improve performance with very little effort.”

Napping:

• “If you’ve had enough sleep during the night, then you shouldn’t even be able to nap. The fact that so many athletes rely on naps is a sign that they are consistently sleep deprived.”
• Steven mentioned that ‘how quickly you can fall asleep’ is a sign of sleep debt. So, if you can fall asleep at all (within 15–20 minutes), in the context of a nap, then you have some amount of sleep debt. Even more alarming — if you can fall asleep within 10 minutes during the daytime, then that is a sign of chronic sleep debt. Within 5 minutes, you are considered to be at the level of someone with sleep apnea. Within 1–2 minutes, that’s a very severe and serious level of sleep debt.
• This made me think of how many times I’ve seen my athletes fall asleep within minutes of sitting down on our chartered bus for an away game. Many times we haven’t even pulled away from campus before half the team is fully asleep. I now look back and realize that this is not a sign of “your classic college student”, but a sign of chronic sleep debt that the coaching staff is heavily responsible for creating.
• Napping too long can introduce the sleep inertia problem described earlier
• Therefore, you don’t want to nap too close to the game in case of sleep inertia
• Ingesting caffeine prior to the nap can help overcome this sleep inertia problem

Acute & Chronic Effects of Poor Sleep

• A sleepy brain is a drunk brain. Staying awake for 16+ hours can be equivalent to levels of impairment similar to alcohol impairment.
• Just as a drunk brain makes poor decisions, so does a sleepy brain.
• Consistently getting 6 hours of sleep per night on average for 2 weeks, you will perform at a cognitive level comparable to someone that has stayed up for 24 hours straight.
• Consistently getting 4 hours of sleep per night on average will see you hit the cognitive impairment level of someone staying up for 24 hours straight within just 1 week. If you get 4 hours of sleep on average for 2 weeks, your performance level is equivalent to someone that has stayed up for 48–72 hours straight.
• Steven also just did a study with more variability. For example, 10 hours of sleep with two consecutive nights of 3 hours of sleep, followed by 10 hours followed by two nights with 3 hours, etc. “This study showed that this pattern builds up sleep debt EVEN FASTER and MORE SEVERELY than a more stable sleep debt. Keeping a regular sleep schedule is vital.”

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