Fast Asleep: Improve Brain Function, Lose Weight, Boost Your Mood, Reduce Stress, and Become a Better Sleeper

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INTRODUCTION

Sleep is something we all do; in fact, we spend around a third of our lives in this strange, unconscious state. And yet until recently we understood very little about what sleep is for, how much we need, and the role that dreams play in improving our mental health.

The good news is that over the last 20 years there has been a revolution in our understanding of sleep and just how important it is. Not so long ago it was fashionable to brag that you hardly slept at all, and the mark of a successful businessperson or politician was their ability to get by on very little shut-eye. Former British prime minister Margaret Thatcher was held up as a shining example of someone who could operate without much sleep (which turned out to be a carefully cultivated myth), while I remember being told by a grizzled medical consultant, when I complained about the impact that lack of sleep was having on my empathy and judgment, that sleep is for wimps. Or, as another put it: There’s plenty of time to sleep when you are dead.

Our current attitudes toward sleep are very different. Thanks to recent research, we know that too little sleep can devastate your body, brain, and microbiome (gut bacteria), dramatically increasing your risk of developing a range of chronic conditions such as obesity, type 2 diabetes, and dementia.

And, when it comes to sleep, it’s not just about quantity, but about quality, too. We have learned, through extensive sleep studies, that if you don’t get enough of the right sort of sleep, you increase your risk of depression and memory problems. Which is all very worrying, particularly if, like a third of the adult population, you suffer from insomnia.

Fortunately, there are surprising and highly effective ways to improve your sleep quality, ensuring you fall asleep rapidly, get plenty of deep sleep, and wake up feeling refreshed. This, in turn, should boost your happiness, creativity, and even life expectancy.

The reason I particularly wanted to write this book is because I am obsessed by sleep and have been for many years, not just from a science perspective, but also on a deeply personal level. For the last 20 years, I have suffered quite badly from intermittent insomnia, to the point where I was in real despair. I wanted to find out what I was doing wrong and, of course, I wanted to find out what I could do to make it better.

I wasn’t always a poor sleeper. When I was a teenager, I could sleep anytime, anywhere. I once slept in a photo booth (I had missed the last train home). Another time I slept in a telephone kiosk. I never worried about going to sleep or staying asleep, because that came naturally.

I didn’t always get a good night’s sleep, but that was my choice. Like most teenagers, I was keen to burn the candle at both ends. As a medical student, I often stayed up partying, then went straight into some feverish last-minute cramming. Which I now realize was wildly counterproductive. You need sleep to consolidate your memories, as I will explain in this book.

As my medical training progressed, sleep became ever more precious. I found I just couldn’t function any longer on a few hours’ sleep a night. I became intensely irritable and I’m sure that both my judgment and my empathy were impaired. But, even so, I could still go to sleep and stay deeply asleep for hours when I was given the chance. Despite the disruption to my sleep pattern caused by the irregular hours I had to work, I never had any problem drifting off.

Then, as I entered my late twenties, everything changed. By then I was married and I had started a new career in television. The hours were long and unpredictable, though nothing like as bad as in medicine. At this time my wife, Clare, was working as a junior doctor and regularly working 120 hours a week. It was not unusual for her to be on duty for three or four days with only a few hours of broken sleep a night, which blunted her thinking. She told me that after one particularly grueling week, she briefly fell asleep standing, during an operation. Fortunately, she woke up before anyone noticed.

Not only did work absorb almost every waking hour, it also began to intrude on our sleep. On the occasions that Clare was actually sleeping at home, she would regularly wake me up in the middle of the night to help her look for patients, which in her sleep-deprived state she was convinced were lost in the cupboards or waiting for her downstairs. Clare has parasomnia, a quite common set of sometimes bizarre nocturnal behaviors, which include a tendency toward sleepwalking and sleep talking.

By the early 1990s, we had started to have children, and that, of course, resulted in many nights of disrupted sleep. In fact, we went on to have four children, which meant that a full decade was dominated by babies.

By the time we entered our forties, Clare was a GP and working more regular hours. Our children were also sleeping through the night. But by then I had begun to show classic signs of insomnia. I had difficulty going to sleep and kept waking up at three in the morning with thoughts rushing through my head. I would lie there for what felt like hours, and going to bed, which was once a real pleasure, was something I began to approach with a sense of unease. Would this be a good night or a bad night? Would I get up feeling shattered or would this be one of those rare nights when I would sleep through until morning?

Naturally enough, I wanted to understand what was going on and what I could do to get back to the days of blissful, effortless sleep. I made what was to be the first of many popular television programs examining the mystery of sleep. Making these programs introduced me to lots of sleep scientists and a whole new, fascinating world of sleep research.

To try to understand the impact of severe sleep deprivation, I decided to see how long I could stay awake with a man who holds the unofficial world record. He can go days on end with no sleep without appearing to suffer. What was the secret to his success? Why could he just keep going, while I couldn’t?

Since then I have spent many nights in sleep labs with electrodes attached to my head and body. I’ve taken drugs to put me to sleep and drugs to keep me awake. I have interviewed hundreds of people, ranging from firefighters to doctors, astronauts to police officers, about their sleep. I have also begun to look at the impact of food on sleep and test out different ways to improve sleep quality.

The Structure of the Book

You may be someone who is desperate to get a good night’s sleep. Or you may simply be interested in what happens to you when your eyes close and you drift off into the land of Nod.

The first part of this book is all about the science of sleep: the research that has led to our current knowledge and how this has given us rich insights into a previously undiscovered land. What are common sleep disorders and how do they arise? What really happens to your brain and body when they are chronically sleep deprived? Why are dreams so important and how can you make the most of them?

I will use my own sleep adventures to illuminate the journey and I will, of course, provide plenty of scientific studies to justify my more surprising claims.

All of this lays the groundwork for the second part of the book, which is primarily aimed at helping you sleep better. After all, I suspect that many of you are reading this book because you suffer from occasional insomnia, or you know someone who does.

I will take you through the best that modern science can offer with a sleep program that should, within a few weeks, set you on a better path.

One of my key goals is to help you improve your sleep efficiency, which is a measure of how well you’ve slept. Your sleep efficiency represents the amount of time you spend in bed fast asleep, as opposed to trying to get to sleep or lying in bed wide awake, fretting. You should be aiming for a sleep efficiency of 85%. More on that later.

As for the Fast Asleep program, it has been put together based on well-tested scientific principles. Yet at its heart are two novel and surprising elements, both based on the latest scientific research.

The first thing that might surprise you is that the most effective way to cure insomnia is to reboot your brain by putting yourself through a short course of Sleep Restriction Therapy. It is called Sleep Restriction Therapy because, paradoxically, it demands that you cut back on your sleep. Yes, I am going to help you sleep better by asking you to cut the amount of time you spend in bed. This can be demanding and is not an approach that is going to be appropriate for everyone, so if you have any health issues or are concerned about your suitability, then do talk to your doctor before beginning.

One of the classic mistakes people who have problems sleeping make is to try to spend more time in bed—when, for most people, lying in bed not sleeping isn’t restful, it is very stressful. It also sets up a really bad behavior pattern where your brain comes to associate being in bed with being awake, fretting.

Studies have shown that sleep restriction is more effective than anything else, including drugs, and that the results last, long-term.

The second novel thing about my program is the emphasis I place on food, particularly the sorts of foods that have been shown to improve the quality of sleep. Forget all those stories about turkey or cheese. It turns out that eating more legumes and fiber-rich foods, and fewer late-night sugary snacks, is one of the most effective ways to boost your levels of deep sleep and improve your mood.

That’s, in part, because fiber-rich foods feed the trillions of good bacteria that live in your gut, which, in turn, produce chemicals that have been shown to reduce stress and anxiety. I will take you on a fascinating guided tour of the science.

On a more practical level, my wife, Clare, along with food writer Justine Pattison, has created a range of tasty recipes that are packed with the sorts of ingredients that those good bacteria will really love, and that you will love, too.

I do hope you enjoy this book and, most of all, I hope it puts you to sleep. Fast.

1.

HOW WE WOKE UP TO SLEEP

As I pointed out in my introduction, it is astonishing that despite the fact that we spend up to a third of our lives—about 25 years—asleep, until relatively recently we knew very little about what went on during that time. A hundred years ago, most people thought that the brain simply switched off, like a light bulb, when you went to sleep.

The American inventor Thomas Edison, who manufactured the first light bulbs, and whose invention did more than any other to disrupt our sleeping patterns, thought that sleep was a waste of time. He claimed to need less than five hours’ sleep a night and said that having more was just greedy. As he put it: Most people overeat 100%, and oversleep 100%, because they like it. That extra 100% makes them unhealthy and inefficient.

As we’ll see, he couldn’t have been more wrong. One reason we knew so little about sleep was that until the early 20th century we had no means to probe it. Scientists like being able to measure things, and sleep was all too intangible. It was like trying to make sense of the movements of the planets before we had the ability to properly study the heavens.

The man who made the first major breakthrough in the science of sleep was a peculiar German psychiatrist named Hans Berger.

Reading the Sleeping Mind

Hans Berger’s contribution was the invention of electroencephalography (often abbreviated to EEG), the ability to record human brain waves by attaching electrodes to a volunteer’s skull.

He built the first working electroencephalograph in 1924, but for a long time his work was ignored. He was widely regarded as a crank. And that’s not surprising because Berger believed passionately in telepathy. In fact, the main reason he had created his EEG machine was to prove that humans can communicate with each other through psychic powers.

His obsession with telepathy began when he was a young cavalry officer. One day, while he was taking part in a military exercise, his horse suddenly reared and threw him into the path of a horse-drawn cannon. He wasn’t seriously injured, but he was very shaken. He later discovered that his sister, who was at home at the time, had had a sudden premonition that he was in deadly danger and forced their father to send him a telegram to see if he was alright.

Berger was convinced that during the accident, he had sent out a powerful psychic distress message, which his sister had somehow picked up. He was so convinced of this that he decided to retrain as a doctor, and then as a psychiatrist, just to prove that telepathy exists.

I personally don’t believe in telepathy, but Berger was absolutely right when he claimed that the human brain produces electrical signals that can be read by multiple electrodes placed on the scalp. Although modern versions of the EEG are far more sophisticated than Berger’s invention, in essence they do the same thing.

Dream Sleep

Berger had shown, in 1924, that his EEG machine could be used to study human brain waves, but it would be another 27 years before sleep researchers got around to using it in any meaningful way.

In December 1951, an impoverished student at the University of Chicago named Eugene Aserinsky decided to take his eight-year-old son, Armond, to his lab to take part in a novel sleep experiment. He scrubbed Armond’s scalp, taped on the EEG electrodes, and left him to fall asleep. Aserinsky then went next door to record what happened.

For Aserinsky this was a do-or-die moment. He was 30 years old and living with his newly pregnant wife in a converted army barracks. They were so poor he could barely afford the HP payments on his typewriter, let alone heat their home. He needed a breakthrough with his research, and soon.

Since no one else had yet bothered to use an EEG to study someone sleeping through an entire night, Aserinsky had decided he might as well begin with his young son.

Nothing very exciting happened for the first hour, but then he noticed that his machine had begun to record a sudden change in brain activity. On the machine, it looked as if his son Armond had woken up. But when Aserinsky went next door to check, Armond was clearly still deeply asleep. Nothing was moving except for his eyes, which were darting around under his eyelids.

Aserinsky woke the boy, who reported that he had been having an intense dream. This was amazing, groundbreaking stuff. The next day Eugene repeated the experiment, with the same results. A few hours after Armond fell asleep, the EEG recorded a sudden change in his brain activity, which coincided with rapid eye movements. Studies done with other, adult, volunteers showed the same thing.

Eugene Aserinsky had done something that would transform our understanding of sleep. He had sent the first exploratory probes into Planet Sleep and discovered that, far from being a dull, barren world where not much happens, it is a place where the brain undergoes some remarkable changes. Sleep research was about to become sexy.

However, despite having made this amazing breakthrough, Aserinsky soon lost interest in sleep. After publishing his findings in 1954, he went off to study electrical brain activity in salmon and later died in a car crash, very possibly because he fell asleep at the wheel.

So what does happen when we sleep?

I’ve spent many nights both being observed in sleep labs and, more interestingly, observing other people while they sleep. If you have never seen someone else go to sleep, or had yourself filmed while falling asleep, then I would recommend you give it a go. It is very entertaining.

As I mentioned earlier, we used to think of going to sleep as being like switching off a light bulb. You were either awake or asleep. We now know it is much more complicated than that.

Sleep involves three distinct states: light sleep, deep sleep, and REM (rapid eye movement) sleep. We sleep in roughly 90-minute cycles throughout the night, flipping between one state and another.

As you can see from the diagram opposite, during the first part of the night you get most of your deep sleep, while the second half of the night is dominated by REM sleep. Most people wake two or three times a night. If you are lucky (like my wife, Clare), you won’t even be aware of it. If you are unlucky, you will wake up and stay awake.

When you go to bed and close your eyes, you should soon start to drift off into light sleep (Stage 1). At this point you are drowsy, but easy to rouse. If the dog next door starts to bark or your partner starts to snore loudly, you might wake up.

After Stage 1 (which normally lasts about ten minutes), you begin a deeper dive into sleep.

When it comes to sleep, I like to see myself as a seal, plunging joyfully into the depths of the night. Some years ago, I made a film about free divers, people who swim to great depths without the aid of oxygen tanks, and it looked just beautiful, as they headed away from the bright light of the surface toward the dark of the ocean floor. That said, for some people, the act of falling asleep is frustrating rather than joyful.

The next stage, Stage 2, also counts as light sleep. As you enter it, your core body temperature (typically measured with a rectal thermometer), which began to fall even before you got into bed, drops even farther. Your heart rate slows down (I’ve recorded mine