Chapter 1: What is the main topic discussed in this episode?
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Today on Conversations, it's all about sleep. And I think if you look at it from one angle, sleep is one of the strangest things that human beings do. Try this thought exercise. Just imagine the Earth is visited by a friendly group of extraterrestrials. When they get here, they're super interested in us and they have all these questions for the people that we've sent to meet with them.
Chapter 2: What makes sleep one of the strangest human activities?
But then sometime around midnight, the humans start yawning and they slip away to go to bed. And the aliens say, wait, wait, where are you going? And the humans say, we're off to bed to get some sleep. And the aliens say, what is sleep?
And the humans reply, well, it's this thing we do where we go into a darkened room, we lie on something comfortable, and then our conscious mind switches off and we watch these bizarre self-generated movies in our heads. And then, ideally, we wake up eight hours later and feel quite refreshed.
And I think it's at this point we'd be needing to put forward Associate Professor Dr Satapa Mukherjee to explain what's going on here. Sitapa is a sleep specialist. She's based at Flinders University's Sleep Health Institute in Adelaide, and she's the president of the Australasian Sleep Association.
This is exciting research because there's still so much we simply don't know about the business of falling and staying asleep. Hi, Sitapa. Hi. Take me through a night of sleep on a good night's sleep. What are the typical stages we go through as we go through that eight or so hours?
You're probably aware of this, that you usually can't fall asleep straight away when you jump into bed. So there is a time which is different for everybody, but it takes a good half an hour for a lot of people to wind down. So it kind of depends. Getting ready for a good night's sleep really starts...
in the evening and most people are trying to fall asleep during nighttime hours so that beginning of withdrawing from the world starts even before you get into bed and so you know we've all got little rituals that that help to tell our bodies that we're getting ready for sleep and part of that is trying to reduce stimulation and some some people dim the lights um
A lot of people hopefully switch off their phones. And then you finally get into bed. And as I said, you don't usually fall asleep immediately. Even then it might take 10, 15, 20 minutes for your brain to start to really relax. And what's happening as you go into that first stage of sleep is your brainwaves are actually slowing down. So one of the things that we do as sleep physicians and doctors
sleep researchers is we're constantly looking at the brainwaves because that really tells us when you're awake and when you're asleep and also what stage of sleep you're in. So your brainwaves start to slow down. What actually happens when we look at the EEG or the electroencephalogram is we can see sleep starts to intrude on wakefulness.
So we start to see a little bit of sleep and then people kind of go back into the more alpha waves, which are characteristic of wakefulness. And as you go off to sleep, you start to see more and more sleep appearing. And then you actually are asleep. And you go into stage one sleep, which is light sleep. And you can't just go from stage one to REM sleep, which is dreaming sleep.
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Chapter 3: What happens during the different stages of sleep?
One of the things your body does is it kind of gets you into bed. And you just need to lie there. And if you can sleep, you usually do feel better if you're unwell. So that's all a part of the body's process is to make us well and function as good as we can throughout the day.
All my creative decisions happen in the morning, I have to say. I have to find that there's only a finite quantity, a finite amount of decision-making ability I have in my head during the course of the day. By late afternoon, it's pretty well played out.
But in the morning when I've woken up, typically in the shower, this is I think what people say, they often get inspired in the shower, it's all been restored and I can suddenly make all these, easily make quite complex decisions that is a power that starts to dribble away by the end of the day.
Is this a subject you're interested in as a researcher, the refreshing nature of sleep and the way it can rebuild our power to make decisions at the start of the day?
I think, look, there are many researchers that are interested in this. And, I mean, it's been around for a long time. We all sleep. Most species of animals sleep. There is some form of sleep that's needed. And definitely, you know, the old proverb that, you know, if you've got a problem, sleep on it, and then usually you've got a pathway forward the next day.
So sleep really does help with processing complex information and and trying to help us see how we can move forward. And you're exactly right. A lot of people have great ideas in the shower after they've had a good sleep.
You mentioned the drop in brainwave activity that happens when we go to sleep. I have a very powerful sense that while I'm asleep or at some point during my subconscious mind is starting to get up and run around, quite a lot. And I think there's a bit of problem solving that's going on there by the subconscious mind as well. Can you detect that in brainwave activity?
Does it suddenly pick up again or in a different part of the brain once we're asleep?
I mean, I think there are different researchers that have tried to look at that. But sleep's actually really hard to study because, I mean, obviously if we are monitoring someone's brainwaves, we can't have them in an MRI machine trying to see which part of the brain is lighting up because the noise of the MRI scan will stop them from sleeping.
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Chapter 4: What is the role of REM sleep in emotional processing?
Yeah. Yeah, yeah. And I think we've all experienced that. But these people with narcolepsy, I mean, obviously, if you get cataplexy as part of your narcolepsy, and not everybody does, that's also a fairly rare phenomenon. But if you do have cataplexy, then you do have to be really careful. And you know, you've got to let people know that you could fall down.
And obviously we don't want people to injure themselves. So there are medications that can help to moderate the cataplexy and stop that from happening. Because obviously if you were driving, for example, and you laughed while you were driving, that could be really dangerous. So there's a lot of different things that we can do to help to control the cataplexy.
And one of them is really just making sure that the people around you are aware and will look out for you in case you do have one of these episodes.
I just imagine this condition must really torment people who have a cataplexy particularly, to be constantly aware that any sudden outbreak of emotion might bring you crashing to the ground and might make you a kind of a public spectacle and also put you at risk of physical injury.
There are good treatments that we have now to help to moderate the impact of a cataplexy. And that's what we would definitely, if someone's having these episodes every few days or every week, we would definitely ask them to take medication to help them control it.
When people are having problems getting to sleep, and I do, I try to practice a kind of, I mean, I suppose it might be called mindfulness, but I try to exert as best I can some kind of mental discipline and try not to let the mind move into worrying things or dwelling on things, to try and get into a familiar story that I might already know.
Is this part of your work, this kind of, for want of a better word, mindfulness approach to getting better sleep?
It definitely is. And it's different for everybody because we have so many things in our lives that can impact our sleep. But we all have difficulty sleeping and I have the same issues from time to time. And I think one of the most important things is most of us can function quite well, pretty well, even if we haven't had a really good night's sleep.
If, say, you've only had a few hours sleep compared to your normal seven hours. So you can still go to work, you can still do most of the things and then the next night you just go to bed at your usual time and you'll probably go off to sleep faster. So trying to reduce that anxiety of, you know, it's 3 a.m.,
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Chapter 5: How does sleep deprivation affect our mental health?
you'll still be able to get through your day with only a few hours of sleep and then the next night you'll get a good night, is kind of reassuring and helps to take away that anxiety and hyper-arousal which then makes it really hard. to go back to sleep. So I think that's a really important thing.
And as you say, the mindfulness, so, you know, the counting sheep thing, try to do something that is pretty boring. You don't want to be doing anything particularly active because then that'll just make you stay awake more. Going into the other room, sitting, listening to something, just trying to meditate, all of those things will help to calm you down.
And then when you feel sleepy, go back to the bedroom.
I've got friends, and they are male friends, who seem to suffer from this more than women. It's after many years of poor sleep and grumpiness that they've only been able to realise that they've been suffering all along from a form of sleep apnea. Are people very often unaware that they have sleep apnea?
I think a lot of people are unaware. I mean, sometimes they come to us in the medical profession because of the snoring, which is disrupting their bed partner. But a lot of times people just assume that snoring and not sleeping well is just a part of getting older, but it definitely isn't. And a lot of people have sleep apnea who are not aware of it. We know that when we've done...
population-based studies that about, you know, 25% of the adult population have got sleep apnea and many of them are completely undiagnosed.
I was discovered to have had sleep apnea at one point and it was suggested to me it was probably some kind of mild allergy related, which was true. I treated the allergy and it's been fine since then. It's amazing. I was amazed that such a complex problem in my case, in any case, could be fixed so quickly and easily. Yeah.
Well, I think it's because physiologically you breathe through your nose and your mouth. If your nose is blocked for whatever reason, and maybe in your case it was allergies, then your mouth opens and then you're kind of relying on the back of your throat to remain open. And of course, your tongue can move backwards and just obstruct the airway quite easily.
So if you open the nasal passages and allow people to breathe well through their nose, then by treating the allergy in your case, then that restores the patency of the airway and the sleep apnea is treated. And that's a really interesting area because there's different people who have different factors which contribute to them having sleep apnea.
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