Dr. Orfeu Buxton: Sleep Quality, Not Quantity - January 16, 2026
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What is the main topic discussed in this episode?
Where intellectual honesty gets witness protection from social prosecution. The Last Show with David Cooper. We are told to chase eight hours of sleep every night, but what if that is not quite the right goal? Well, there's new research on older adults that finds broken, fragmented sleep, not short nights, can slow mental processing the next day. A night slept the whole way through might be better than eight hours all broken up. I'm here with Dr. Orfeo Buxton, a professor of biobehavioral health at Pennsylvania State University, to discuss just this. He's done research in this area. Orfeo, welcome to the program. Thanks for having me. Good evening.
What is the difference between sleep quality and sleep quantity?
I hope you slept well. Thank you, Orfeo. I did, but maybe it was a bit fragmented last night. So let's get into the weeds here. When we say sleep fragmentation, I think it makes sense to most people. But what does that actually look like in the bed?
How does fragmented sleep affect mental processing speed in older adults?
Is it tossing and turning? Is it waking up briefly? Is it something else entirely?
well everyone wants to feel restored after they slept not tired and exhausted still but sharp ready to go and so one way that you know your sleep was disrupted or way too short is that you don't have that sense of that the sleep was restorative how people experience that can vary and it can vary night to night tossing and turning is a good way to put it this can be for long stretches or frequent interruptions during the night either internally generated by thinking and waking up to something or disruptions from the environment.
I can't tell you how many times I've woken up covered in sweat, worried that I missed the start time of my show. Stress dreams, waking up, and then my cat bothers me at night. And then I hear a noise, maybe it's the heater going off. I'm guilty of sleep fragmentation if I'm behaving the way that I just described.
You know, pets, especially cats, are not advised for sleep. They're not on the same schedule. They kind of don't care if you're getting good sleep or not. Might have to work on that.
You just picked a huge fight with my partner, my girlfriend. Yeah. She likes to sleep with the cat. Okay, the big takeaway, how you sleep mattering more than how long you sleep. This goes against most wisdom I've heard. So we think they're all important, right?
So the actual advice is to get seven or more hours a night. on a regular basis and it seems like the regular basis is maybe doing even more work it's a sleep is a habit just like exercise and diet you don't have three salads and wake up lean you don't go to the gym for six hours and wake up the rock sleep is a habit and so you need enough of it it needs to be on a regular basis but what we're showing here in this study in older adults is that it needs to also be relatively unbroken. So if you have very long interruptions or frequent interruptions, your cognitive performance is a little less than preferred.
Let's talk your study. What exactly did you look into? How do you set up an experiment like that?
Yeah, so this is very different from the controlled laboratory studies where we know that cognitive performance is influenced by how much you slept last night, the last week or two, how disrupted it was. This was looking at the role of day-to-day sleep in cognitive function in older adults in a real-world setting. So they were sleeping in their own bed, going about their usual daily activities. They had a sleep watch on their wrist for a couple of weeks. And during the day, they did six...
What does sleep fragmentation look like in practice?
brief brain games every day. And those brain games are on a study phone app, and they can evaluate various characteristics of cognitive processing, memory, processing speed, and so forth. So we did this in several hundred older adults in their 70s and 80s in Bronx, New York, as part of the Einstein Aging Study. And we examine multiple aspects of sleep. So duration, timing, quality, disruption, those kinds of things overnight and how day to day sleep influences cognitive performance the next day. And also on average, short sleep or lots of disruptions.
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