The Last Show with David Cooper
Dr. Orfeu Buxton: Sleep Quality, Not Quantity - January 16, 2026
17 Jan 2026
Chapter 1: 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.
Chapter 2: 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?
Chapter 3: 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.
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Chapter 4: 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. How did those influence cognitive performance on average?
So I know we're looking at older adults here, but I suppose the results could sort of be applied to everyone, at least in theory. How much does cognitive performance decline if they have a messed up night of sleep with lots of interruptions?
Well, on average, the people who sleep more poorly have worse cognitive function. A smaller difference was within a person. It was significant, but smaller than the between person difference. So you might have heard people are different.
I have. Yeah, yeah. That is a wild finding, but thank you for sharing it.
We rediscovered that for sleep and cognition. But what we also showed was day to day, there's an effect on processing speed the next day. And it's related to how many disruptions or interruptions there were. If they had more interruptions than their usual, than their average, then they had worse cognitive performance or processing speed than their average the next day.
processing speed being like the speed at which you do cognitive tasks, like writing an email, that kind of thing. Exactly.
Maybe a little fancier than writing an email, but yeah, a simple brain game.
I love that you did this within people's homes. Is it the watch technology that lets you do that? I know that a lot of sleep studies observe people like in a sleep lab environment. And to me, that's so wild because there's no way I could get a good night's sleep indicative of how I actually sleep at home in a lab. Maybe that's just me.
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