Hey, Adam, do you remember when we were talking with doctor Wendy Troxel in our first episode I Do and how she.
Mentioned that guys.
Who only get four to five hours of sleep per night have testosterone levels of someone ten years older.
How can I forget that? It was terrifying.
Well, guess what. The news isn't any better for women.
Researchers at Duke University found that women who reported unhealthy sleep are at an elevated risk for type two diabetes, heart disease, and even depression.
Oh wow, that is also terrifying.
Yeah, Adam, it's like, if we want to enjoy our later years, we need to get good sleep. Now, it's just science. Hi, I'm Katie.
Low's and I'm Adam Shaviro.
And this is Chasing Sleep, a production of Ruby Studios from iHeartMedia in partnership with Mattress Firm. This episode is about sleep and age when it comes to longevity and quality of life. Study after study shows that the better you sleep, the better your overall quality of life. We're also going to look at how our sleep changes as we get older.
Doctor Jennifer L.
Martin has done extensive research on sleep and aging. Just this year she studied how best to treat insomnia among older veterans.
She co authored the.
Definitive statement on the recommended amount of sleep healthy adults should get?
How much should we get? What is?
Hold on?
Hold on, Adam? We can just ask her. Yeah, hello, doctor Martin, Hi.
Thanks so much for having me here.
Thanks for being here.
Also joining the conversation is Sarah Brown. She spent most of her health care career working with seniors, first as a nurse and then as the executive director of Emperi Systems home care in Minnesota. While Sarah was there, she introduced a revolutionary program to help nursing home residents get more and better sleep.
Sarah, welcome to Chasing Sleep.
Thank you so much for having me. And I just want to give credit where credits do. I was part of a team that did the sleep program. Can't take all the credit for myself.
Awesome.
I can't wait to hear about that. That sounds absolutely amazing.
Okay, doctor Martin, you wrote the book on this. How much sleep should we get?
The magic number is at least seven every day, every day, Katie, not just once in a while.
I'm curious, does the amount of sleep that you need actually evolve with age. So like, let me toss out an age and you tell me.
Oh, yeah, let's just throw out a couple numbers.
Thrown out numbers, Yeah, Like, how much should a sixteen year old get?
A sixteen year old probably needs somewhere between eight and ten hours of sleep. Anyone out there with the high school kid knows how hard that is. But through development, kids need less sleep over time until really early adulthood, and then it's pretty consistent from there on out. So from now on, when you throw out a number, I'm probably just going to say seven.
So thirty five seven, seven, fifty five seven, okay, three, forty three seven, okay, cool?
What about eighty fives?
So it's really interesting. There was a bit of a myth floating around when I first started my training a long time ago that as people get older they need less sleep, and that was based on studies where they didn't account for the fact that older people take more naps.
Oh interesting, So the other.
Thing that happens with aging is the quality of our sleep changes, so it's harder to get that full night of sleep. I think our best estimate now is that if you, let's say, you feel really good on seven and a half hours of sleep when you're thirty five. By the time you're eighty, maybe seven hours and ten minutes, So maybe your biological need drops by say twenty minutes or so, but it's not really a big difference, Like, Oh, I used to need seven and a half and now
I'm great with five. Right, that's not really what happens with aging.
And what about is it a quality question or quantity? Which one is more important?
That's an impossible question to answer.
Stumped, you know, I'm kidding gay ladies and gentlemen.
If people like me and Sarah knew the answer, we'd have Nobel prizes, right, like, because not all sleep is the same. There are different types and stages of sleep, and the only way to get them all and the right amount is to sleep well.
Right, And I'd like to just add to that.
What with the sleep program that we found is that it wasn't time in bed or time of sleep like it's it was consolidated sleep. So someone listening might think you're saying consistently like every night seven hours, but really it's you want seven hours uninterrupted to allow your body to go through all the sleep stages and cycles. Without
that fragmentation. And I think with older adults, with all the napping they end up the time that there is sleep in a twenty four period might be higher, but the quality is really low because they never got into that deep, restorative sleep.
Do I have that right, doctor Martin?
That's perfect, Sarah.
Can you tell us a little bit about the research and the work you've done at Impira.
Yeah.
The resortive sleep program actually stemmed from a falls program in which we were trying to identify the root cause of falls and one of the things that kept coming up is that these residents were reporting they were tired, or staff were reporting they were weak or tired.
So we're like, well, maybe they need more sleep.
So Pierre I was able to get a grant from the Department of Health to look at residents over twenty five different nursing homes. What we did is we went and got tigraphy watches, which is a gold standard for measuring sleep, and we measured the amount that residents were sleeping. And the more we learned about sleep is where we really learned that they weren't sleep deprived, they had sleep fragmentation, and that the sleep fragmentation was actually more harmful than the sleep deprivation.
We thought they had.
You know, one of the big things we found is sleep is all about your twenty four hour cycle. It's not just when you sleep at night, but what you do during the day to help get that resortive sleep at night. And from that we were able to create what we called a sleep program or a sleep initiative that really involved every department.
Everything we did.
Had an impact on someone's sleep, because again, it was at twenty four hour day, so it was like looking at things of signing contracts with vendors, all the labs want to come in and draw labs first thing in the morning for residents before they go to the hospital. We looked at shift change, we looked at meal times, we looked at activities throughout the day, we looked at napping, and we looked at the mattresses on the bed. So how can we let them sleep longer uninterrupted. So that's
kind of like a snapshot of it. Really, sleep was the fountain of youth or the foundation of healing and restorative Sleep was a basic human need.
That's the line of this episode.
Yeah, the felt like my drop right there, Sarah.
Once you pulled all of this research together. What was the big takeaway for you? What needed to change for seniors in your care?
I think the big summary of it is that people need a night and a day care plan.
Right in long term care nursing home.
It's so easy to just create the care plan based on what you do as a nurse on the day shift, who made the care plan, and then the night shift comes and it's their daytime really or they're awake time, so they're still turning and repositioning every hour, every two hours, toying rounding every hour, waking residents and following that exact same care plan. And that's just not good for our bodies, you know.
I think it's so interesting, Sarah, because I also got interested in sleep, actually studying sleep in nursing homes like in the early nineteen nineties.
Oh, that's very cool.
And the interesting thing is the napping is not napping. It's not like, oh, we have lunch and then everyone goes in their room and puts their head on their pillow and they have this sweet little afternoon siesta. Sure what happens in nursing home. And Sarah, you pointed this out so eloquently is that like sleep is just distributed all over the twenty four hour day.
So when you say connected seven hours of sleep, do you mean for all of our listeners out there, do you mean I fall asleep at ten and I don't see anything, remember anything. I don't get interrupted to p or be with my kids or anything like that until you know, five thirty six am.
Not quite that perfect, Okay.
But okay, so it might it might be a wake up and a head and go back down, but it's short wake up. It's not like and we're up in our brain spinning for an hour.
Correct.
Katie's a big napper. God, I love a napp But are those naps fragmenting her sleep too much?
You know?
Is she getting too long of a nap in the afternoon so that when she does go to sleep at night. It's why she's not getting the same kind of connective, restorative sleep.
If napping is part of the plan and you do it at the right time of day, which biologically for us is in that afternoon time, it's great. But most people don't have a life in the US at least where they can protect that time. Most people have kind of a nine to five ish gig going on, and so being able to protect the time is a big problem.
Right, So I'm a weekend napper because I'm so used to being on a more kids schedule.
I just want to go back to and ask doctor Martin to clarify because when I was heavy in the research, really we saw that napping, like that siesta kind of nap what could be healthy. But that was like we would recommend less than thirty minutes because if you sleep longer than that, what happens is you start to get into your deeper stage sleep and then you kind of rob from your nighttime sleep bag. Is that still an accurate statement?
I mean, I think now we talk about there's two ways to nap. There's that short kind of power nap where you don't get into deep stages of sleep. And then there are people who do well with like a long nap like hour and a half, but then they spend less time in bed at night. So again, if you add it all together, and you know, it's a consolidated a bout of sleep in the afternoon, not like dozing off in your car, you know, or in front
of your television. It's like a planned sleep cycle. But in general, most people feel that little burst of energy, just as Sarah said, with a short nap like thirty minutes. So you asked a great question to start with, which is how much sleep do you need? And I said seven hours? And that number actually is based on health outcomes,
things like development of type two diabetes, heart disease. There's actually some evidence that because sleep has anti inflammatory properties, that if you're chronically sleep deprived, that inflammation might even make its way to your brain and increase your risk of Alzheimer's disease later in life. Oh wow, Sure, he's kind of still out on that one. I don't want to overstate it, but there is a plausible physiological mechanism
for that. And when we look at research with animals that have risk for Alzheimer's disease, that's what we're seeing.
I think it's your overall entire health, not just like Alzheimer's and heart disease, but pretty much any chronic condition. There's research to back that sleep has a contributing factor. And if you think about sleep at its core, what is it doing is sleep is really our body's medicine and our body's opportunity to let the body do what it's supposed to do to heal, to regenerate, to balance hormones, to process memories, to process stress.
So you know, I think it's not irreversible, but fix it now.
So, Sarah, both you and doctor Martin have worked a lot with seniors. Let's talk about chronotypes. I have heard of those early bird larks and night owls, you know, I mean early bird special That's a thing we've all heard about. Do we all turn into early birds as we age? How does that work?
I could nerd out on this for like the rest of the time.
Let's do it. That's what the podcast is for.
I love this, I absolutely love this. So there's this funny thing about humans. First of all, our circadian timing system is genetic, and like I feel like I'm calling myself old. But I remember when like the first genes related to circadian timing were discovered, and it would like blew our minds because we didn't really know how all of this worked. But we did know that these German scientists who went and lived in caves away from time cues didn't have a twenty four hour sleep cycle. It
was about twenty four hours and twenty minutes. So we need the sun to like reset us every day.
We're all diurnal.
It means diurnal that we should be up during the day and sleep at night. And so nobody can really flip and become a nocturnal.
Like an owl.
So whether you are more of an early riser or a night owl or somewhere in between, there all still our body does best when we sleep when the sun goes down.
So Sarah mentioned like night owls, that is a genetic thing. And some people are on the far extremes, so you can tell them go to bed early and get up early, and it is impossible for them to do that.
That's my husband.
That's my husband, that is me right there, right now.
Most people are in the middle. That's where the vast majority of people, probably well over like ninety ninety five percent of people have some ability to adjust. There is this age related change where during adolescence we become more night owl ish and as we age we become more lark ish. So if we take out those people on the far extremes, there is this pretty consistent age related adjustment, which is why senior dinner specials are at five and
why again high school shouldn't start at seven. O'clock in the morning. So your chronotype is your internal tendency, and I always say the best thing in the world is to respect your clock.
One thing that we had learned and we usually advise people is like, when you're twenty five years old and you're in your healthy time, when you can go to bed at will and wake at will and wake up and feel refreshed, how many hours is it?
And kind of pay attention to that.
So I think we just have a lot of segments of society where we try to get people to do something that messes up their sleep, and then we just like kind of shrug our shoulders and say, gee, why can't they get it back on track. We just publish a paper recently looking at people in the military where they're followed over time. There's a large study called the Millennium Cohort, And what we saw actually is that sleep problems pre date things like post traumatic stress disorder and depression.
So it's a predictor if you're not sleeping well that after you're exposed to some kind of a traumatic event, that you'll go on to develop mental health symptoms later.
Wow.
I just want to share one kind of little thing that we had learned so in long term care, if you look at the manifestations of sleep deprivation, sleep fragmentation, and they line up perfectly with psychosis and the reasons that we're putting people on antipsychotics. So we had this huge aha that like these people came into the nursing home, they were not psychotic their whole life. They didn't have these mental health disorders, and all of a sudden, they're
all having them. We have to look at the systems around them and what we're doing to actually cause psychosis, and it was the sleep fragmentation.
Yeah, this is a complete reversal about again what I learned in my training, which is sleep problems are a symptom. And I think, Sarah, what you're getting at is we have to change our mindset and start thinking about the role that sleep plays now at any point in life, if you chronically sleep deprive yourself, it changes your body.
This is a fascinating discussion and we are not done more to come.
Welcome back to chasing sleep. We're all getting older and we all want to stay healthy as we do. So we're talking about sleep and aging with doctor j Jennifer Martin and consultant for senior healthcare providers, Sarah Brown.
What about sex, Katie, No, I'm just sorry. Was that totally out of the blue. I just was thinking about this.
No, not at all.
We've been Yeah, we've been headed in that direction for a while.
And is the rumor true working in senior facilities, the rumor is that everyone's having sex in those places.
I'm not answering that question. I don't know if Sarah will either.
I've heard I'll answer it by saying, you're still a human when you're older.
It doesn't matter what age you are.
Good.
I'm giving so many collaps for that.
But if you're not sleeping, well, can it contribute to having a poor sex life?
So, yeah, you know, this is an area where so there is a sleep disorder called sleep apnia, which is a condition where people have a hard time breathing when they sleep. These people snore, they stop breathing. It's very common, especially in men, and it contributes to high blood pressure, and it contributes to a rectile dysfunction, both directly and because then people end up on anti hypertensive medications and
that can affect create problems with the rectile dysfunction. So that specific sleep disorder is directly linked to problems with sexual health.
I just can't believe every single woman I know who's in a heterosexual relationship with a man at a certain age is complaining to me about how bad they're snoring is keeping them up, and the older they get, the snoring is the worst, and the sleep apnea.
I mean, I think it's also when we are sleep deprived, we over interpret negative experiences emotionally and we under interpret positive experiences emotionally. So I think in your relationship, kind of think about that, like, what's the probability that you'll be interested in sex with your partner if you're sleep deprived, because again, all those positive emotions tend to be kind of blunted.
So one of the things you mentioned earlier, how do you see what you learned in these studies with older veterans to the average person and how we age.
Let's think about the military culture as a subset of society. So what I hear a lot from the folks that I work with and in my research is that they are trained to stay awake all the time except when they can sleep, and then they're supposed to fall asleep at the drop of a hat, that's not how life really is. So a lot of folks have to relearn
how to sleep well. So one of the myths that we're also trying to get past is that just because someone is older, that doesn't mean if they have insomnia disorder sleep apnea, that we should just leave it alone, like, oh they'll be okay.
Yeah, it's a wash. We actually look, that's your thing, that's your narrative.
You know, yeah, no, it's I mean, older pe respond just as well to treatment of sleep disorders as younger people, so age shouldn't be a factor.
Oh that's good to know. I've always wanted to ask this question. Every time I have a really early flight and I don't get a lot of sleep. I'm talking like two hours, three hours, and then I'm up and I'm heading towards the airport. I get a really bad cold for like twenty four hours after that, Katie, that doesn't really happen to you, But like I every time get a really bad cold if I don't get a lot of sleep before flight, why what is that?
Sarah? Do you want to with your nursing background, if like you're the one to talk about the immune system.
Well, so really, our immunities are built during sleep, so tearing, you know, breaking down your immune system by withholding sleep and not giving that restoration to your immune system definitely makes you more susceptible. And then traveling you're more exposed to people's germs.
All kinds of yucky stuff.
Wow.
Yeah, I have to tell you my own personal rule. For work, I do not fly overnight and I do not take a six am flight out of lax Yep. Now for fun, I do whatever a lot, but I just kind of made this decision that I like, I have to respect what I'm telling everybody else and I'm not going to stay up all night to catch a flight to go talk about sleep.
That sounds like a good policy. Doctor Martin, what would you say to those of us who are pulling all nighters? I mean, we've all done that at some point. What is the impact on our overall health? Can we get away with pulling it on it?
Yes? So we're fine, Like we can cope with a little bit of variation. Always say you can have cake on your birthday, you can't have it every day, three times a day. The problem is what a lot of students do is they get six hours of sleep every night, so they're super sleep deprived, and then they pull an all nighter on top of it. And that's where we see,
you know again, dangerous levels of sleepiness, mood alterations. You know, we have a long conversation in this country about suicide, right, it turns out that poor sleep is a pretty potent predictor of thinking about and attempting suicide across ag.
I have been jaw dropped multiple times. And Sarah, this is like one of my favorite questions about sleep and aging, and Sarah, you touched on this. I have a grandfather that passed away of Alzheimer's and a grandmother that passed away with dementia. And I'm curious, as we get older and we have a lot more life experiences that we store in our brains, how does sleep affect our memories and our memory.
When it relates to memories, my answer would be, it doesn't matter how old you are. If you're not sleeping, you're going to have a harder time accessing executive function in your brain, no matter what age you are, because your body is under stress, and when we're under stressed, we can't access that higher level of executive functioning so some of the memory recall might get harder, our sharpness, mental sharpness might be harder. We might be more confused or forgetful for all ages.
Right, But knowing all of this, how should younger sleepers approach their sleep now to improve their quality of life and ensure high quality life well into the later years of your life.
So one of the big things I think with younger people is going to bed with your smartphone and that being exposed to that blue light that's going to disrupt our melatonin production and also just it's stimulating our brain, so it's harder for us to fall asleep.
So staying off with tablets.
And how long should we stay off them before bedtime?
At least a half an hour, but like two hours before bed would be great.
Yeah, Adam, you screwed.
I mean that's when I look at the gram. Is it weird that I kissed my iPhone good night?
Is that? Is that? Am I too close with my iPhone at that point?
Yes, that's very unhealthy. But if you're going to bed, you know, be in a dark room or amber red light that wavelength is better for your melatonin production as well, and then move your body during the day like, I can't emphasize enough how much our sleep is tied to our full twenty four hours. If you can learn to meditate the younger you are, or you know, just quiet
reflection time is helpful and to calm that silence. Because I look back in my younger twenties, before I like had a family, and if I could have started to practice like that, calm down, just things to calm down my mind, calm down my body for me, like I take warm bath or warm shower before bed.
That temperature regulation can be helpful.
Oh that's what I do.
That's nice, really really insightful and helpful. Final cueue, how do we encourage parents or even grandparents of the importance of good sleep?
So I think the most promising development in terms of sleep and aging is that we now know that one of the ways to age successfully is to take care of your sleep. I mean, I did a lot of things with my sleep that I wouldn't do now. And I have to say that I feel really good that my kids, one of whom is a college student and one is a high school student, like they they do pay attention to their sleep and think about their schedules
and their activities. In ways that we just didn't know, and I would I would just add that, you know, if we think about what we spend on a car versus what we spend on a mattress, where we spend a third of our lives, I think maybe we should think about some priorities. And at the same time, I also have to recognize that not everyone can afford to go out and buy a very expensive mattress. But the surface on which we spend a third of our lives is not something to take like lightly. There's no like
magic bullet. Everyone has their own preferences. I'm the kind of person when you go to a hotel and you're like, oh, I really like that, Like what kind of mattresses is? Why did I like it? What was so great about it? And the other kind of less expensive option is really nice betting. So if you can't afford to replace your mattress right now, you know, what about some really nice pillowcases or something that just makes your bed an inviting
place to be. But like I said, I think for most people really spending some time thinking about the investment that you put into your sleep environment and again remembering that you're going to spend seven eight hours of each twenty four hour day right there. And if you have a sleep disorder like sleep apnea or you struggle with chronic insomnia, that getting treatment still benefits people regardless of their age.
Sarah, do you have any REX on how to help people If you have.
A loved one who is in a nursing home or that you're providing care for, I would really just advocate that you would advocate for your loved one or yourself to say, my care plan should read that I want uninterrupted sleep. Like in nursing homes, the mattress can make all the difference in the world. A high density film mattress where you don't need to be turning and repositioning
the body has protective mechanisms while we're sleeping. So nursing homes struggle though, because there's so much litigation that you've got to kind of say I want this, and I want you to go outside your norm and I will sign in a formed consent, but sleep is very important to us, and we want you to update the care plan to reflect that. Without doing that, it's unlikely that the nursing homes are going to vary from their standard practice. We've been getting the message out for years, but culture
change and practice change takes years. So if you have a loved one even in the hospital too and a short hospitals say ask like we want it in their care plan, leave them uninterrupted.
That's great to know that that's something that we can advocate for. Well.
Growing up, I used to tell my friends sleep when you die, and I was kind of the life of the party. And right now seeing that short term and cumulative effective poor sleep, it really is your best medicine.
Thank you both so much, doctor Martin and Sarah Brown. Thank you so much for all the work you were doing around sleep your studies. And I'm so I like I said, I if we were seeing this, I spent most of this episode with my mouth completely agape.
I have learned so much.
From both of you, and I'm so appreciative of your time.
Thank you so much.
Thank you for coming on Chasing Sleep.
Thanks thanks for having us.
It's been a lot of fun, Adam, I learned so much from that conversation. I mean, can you believe what they said about Alzheimer's and dementia.
Yeah, it really brings into focus just how important good sleep really is.
Yes, we we talked about sleep deprivation.
I love that that sleep deprivation is actually can be used as a as a predictor for other mental conditions as opposed to, oh, these mental conditions are hurting the person's sleep.
We can use sleep.
Not only as sleep our medicine, but sleep is like this great predictor.
Of what might be coming down the road.
How about our personal you and me, Adam, were you so pumped to finally ask why you get sick?
That's been something that's been bothering me forever.
Why why when I wake up, you know, after three hours of sleep to get on.
A flight, Because we learned today lack of quality of sleep harms our immune system, leaving us more susceptible to disease. How about this banger getting off the phone and other screens at least thirty minutes, but I'm pretty sure she said two hours, Adam.
That well, that's a huge thing for the young people too, because healthy sleep habits now that are going to you know, have them be successful healthy sleepers. Later, it's time to start getting off those screens before bedtime.
Oh boy.
We also we need to add that sleep dot com is also a great resource for information on nearly every aspect of sleep. Great resource and the last huge mic drop, we need to go shopping. Think about what people are willing to spend other mattresses. Considering that you spend a third of your life laying on your mattress, I feel like we need to put more emphasis on that when we are looking for a mattress.
Let's go shopping baby.
On our next episode, we are talking about sleep and creativity.
I am excited about this.
I've always used this as an excuse as to why I have to sleep late like my whole life.
Right you totally yeah.
I hope that this backs my theory that I need my sleep in the morning and in the meantime. We'd love to hear what you think about the podcast right now, go to your podcast player and rate and review Chasing Sleep please, or.
You can also find us at our socials on the Insta.
I'm Katie q.
Lows and I am Shabby Shafts.
And don't forget to follow or subscribe so you never miss an episode until next time.
I hope you're living your best while sleeping your best.
Chasing Sleep is a production of Ruby Studios from iHeartMedia in partnership with Mattress Firm. Our executive producer is Molly Sosha.
This show was written and produced by Sound That Brands, Dave Beeson, Jason Jackson, and Michelle Rice.
This episode was hosted by Katie Lows and Adam Shapiro. Thank you to our partners at Mattress Firm.