‘Insomnia is not bad itself. You can lie awake and think,’ wrote Muriel Spark in A Far Cry from Kensington.
It’s a sentiment that’s been much on my mind over the last few years. A multi-billion pound sleep industry has done its very best to make us fear for our lives if we’re awake for more than a few minutes. The result? People are more anxious than ever. This new anxiety even has a name – orthosomnia. Meaning an unhealthy obsession with getting perfect sleep.
And yet my own personal and anecdotal research indicates a far more complex sleep landscape. After all, monks and nuns woke every three hours throughout the night to pray and sing. Many of these were very long-lived. Even Hildegard of Bingen died just short of 81 back in the 12th century! I’m half way through writing a blog post on the remarkable longevity of nuns – watch this space.
So you can imagine my relief when last week a highly credible study found that being awake in the middle of the night appears to reduce our chances of dementia. Indeed people who woke during the night and then spent time awake (sleep researchers call this sleep maintenance insomnia) were 40% less likely to get dementia than people who slept solidly all night long.
This study was initiated by Roger Wong, assistant professor of Health and Preventative Medicine, at New York’s SUNY Upstate Medical University, who decided to investigate after his father started experiencing chronic sleep disturbances during COVID.
‘I was concerned that this would affect his cognition in the future,’ explained Dr Wong, who had read the existing literature on sleep and dementia and found it surprisingly contradictory. Dr Wong’s investigations involved 6,300 people over the age of 65, across a ten-year period.
And no one was more surprised to find that sleep maintenance insomnia – perversely and counter-intuitively – actually reduced the chances of dementia, than Dr Wong himself.
Researchers speculate that it’s all to do with the theory of cognitive reserve. When we lie awake at night, in peace and quiet, most of us listen to an audio book, or a podcast. Many of us read a book. Some of us think, reflect, imagine. Artists dream up paintings. Writers put together plots (I do this, as did Virginia Woolf on her sleepless nights). My mother listens to BBC Radio. Which is to say, we are working our brains, gently and calmly. As the bemused researchers explained: ‘Greater engagement in activities that preserve or increase cognitive reserve may thereby decrease dementia risk.’
Other people potter around. I often take a turn in the fields. Some of my friends do yoga. Which is to say, we are very gently exercising our bodies. And so researchers have suggested that this extra time awake at night might also have benefits because we may be moving.
Perhaps a little more worrying is an inability to fall asleep in the first place (known as sleep initiation insomnia). Dr Wong found that people who took longer than 30 minutes to fall asleep had a 51% greater chance of dementia. But before we start fretting about the other night when it took us hours to fall asleep, understand that all these figures need untangling. Researchers call this process ‘adjusting.’ I got in touch with Dr Wong who very kindly explained that ‘after adjustments’ the 51% fell to pretty much nothing. So failing to fall speedily asleep is unlikely (on its own) to cause dementia.
What about people using sleeping pills?
This study found that people using sleep meds increased their risk of dementia by 30%. Again, Dr Wong kindly explained that once adjustments had been made (removing all those already at risk due to other factors), this fell to 8%. Which wasn’t statistically significant. So sleeping meds, on their own, probably won’t cause dementia either.
This is an important study suggesting that, for people in reasonable health (and without other dementia risk factors), poor sleep is unlikely to lead to dementia. Especially if our wakeful hours at night are put to good use.
All this was confirmed by another report published last week that found quality of life was closely correlated, not with length of sleep, but with perceived quality of sleep. As I wrote recently on this blog (LINK), quality of sleep is my goal however it comes (which may be in two short blocks).
When it comes to quality of sleep, I like a light-blocking sleep mask. So I was also pleased to see this report, published last week, on the benefits of wearing a sleep mask at night. This study of 18-35 year olds found that sleeping in a mask resulted in being more alert and having better recall the following day. The researchers speculated that incoming light was disrupting slow wave sleep, even if participants weren’t aware of this. Participants spent longer in deep slow-wave sleep on nights when they wore an eye mask than on nights without.
My friend swears by her Drowsy eye mask (‘complete blackout and really comfortable, pure silk and adjustable Velcro… feels like a bit of luxury’). I have a cheap version of the Drowsy – but it’s large, silk, padded and attachable with Velcro.
For those of you interested in better quality sleep, I recommend this podcast featuring sleep scientist, Dr Gina Poe. Why? Because Poe explains that growth hormones (vital for immunity and physiological rejuvenation) are released in our first sleep cycle. If we miss this, we don’t get any growth hormone. These vital hormones, she says, are released at the same time every night. So if you usually fall asleep at 10pm, your growth hormone release time will be approximately 10 – 11.30pm.
But if you go to bed at midnight, there’s no growth hormone. You simply miss the window for its release. Poe says we need to keep to the same bedtime as often as we can.
My view on this? It’s probably sensible to take Poe’s advice. But don’t forget that socialising, moving and building your brain with a thought-provoking book are also important. So if you need to stay up late every now and then (and who doesn’t?) don’t worry.
So what should we do to build our Cognitive Reserve while we’re awake at night? You could self-reflect (not ruminate, you want to avoid ruminating at all costs). A study published last summer linked self-reflection with better brain health in later life.
The researchers found that people who engaged in more self-reflection had better cognition and improved glucose metabolism, as revealed by brain imaging. The lead researcher commented that ‘a self-reflective thinking style leads to a more adaptive stress response, with evidence even showing improvements in inflammatory responses to stress and better cardiovascular health.’ She’s essentially saying that self-reflectors are probably calmer and so less liable to stress.
I suspect that people who self-reflect probably reflect on what they eat, how they move etc and may be healthier in general, thus lowering their lower dementia risk. But I could be wrong. And it’s very easy (and free) to ponder life as you lie in the still silence of night. Gina Poe suggests praying – arguably a form of self reflection. Louise Bourgeois used to write, doodle and draw spirals, which she found very soothing. Many people I know write or journal.
Whatever you do, you needn’t worry about dementia. Despite recent headlines, it seems that other things are more important when it comes to keeping dementia at bay. Like self-discipline.
Prof Li-Huei Tsai, a neuroscientist who focuses on dementia and runs The Picower Institute for Learning and Memory, says that keeping our brains sharp is just down to self-discipline. ‘I think people actually know what they should be doing to stay healthy and to preserve their memory,’ she said yesterday. The usual advice – exercise, socialise, be intellectually active, eat sensibly, don’t smoke, no or very limited alcohol – is all it takes. ‘I think that if you just keep a routine… you do it… that’s the only way to do it.’
Intellectually active, according to the study Tsai was commenting on, includes reading books and writing. Perfect for those sleepless nights…
What do you do when you wake up in the Hour of God? Please use the comment box to share your experience of the quiet hours of night (nothing too intimate obviously!). We’re particularly interested in any tips for self-reflection (or for avoiding rumination, for that matter). Thank you!
And thanks to everyone who entered our Instagram giveaway. Two copies of 52 Ways to Walk have been posted to the winner and their walking friend. There’s another chance to win two copies (of the paperback, published yesterday) on Instagram @annabelabbs
Annabel (and thanks to Matisse for the painting!)
Thank you so much for this article. It is very interesting.
I tend to listen to a podcast when I am awake at night and very often I will find sleep again quickly.
Yes, podcasts are great. I like the BBC Natural History series because it has no music… just gentle voices! And sometimes some birdsong or wind…
So reassuring to read the insomnia report. I have long stopped stressing about waking in the middle of the night and thank the universe for audiobooks with a sleep setting – they get me out of my head and I enjoy a short time (or an hour or 2) listening to books. The biggest fear I have is getting a pressure sore in my ear from falling asleep with my AirPods in and rolling on my side😂.
Indeed – thank goodness for audiobooks!
Great blog thank you. I regularly walk at 4.30-5 am and struggle to get back to sleep. So I have a string of yoga mala beads by my bed and I do light slow deep (LSD- but the healthy kind!)breathing for every bead on the string. It’s a lovely form of meditation and stops me reaching for my phone and using a calm app or something similar and thus being stimulated to start scrolling etc. It’s worth trying and you can do it with the lights off. A great walk to start the day with meditation and the benefits that brings
Great idea – thank you for sharing! I like yoga nidra too (or a version of)…
I love this idea. Thank you for sharing.
This is a fascinating article, lots of new info for me to think about, thank you for all the time you’ve put into this.
Glad you enjoyed – thank you!
I imagine a life in an alternative world, where we care for each other and the planet. This involves imagining green ways of living with governments taking responsibility and what policies they could introduce for sustainability for food growth/ farmers, travel etc. Communities where we live peacefully and respect and look out for each other. It’s a nice place to be at 2am in the morning 😌
Oh what a lovely idea! I might try that too – it’s a prayer of sorts isn’t it? Thank you for sharing!
Thank you for that. With a maternal aunt, my mother and now my elder sister suffering with dementia, I believe there’s no way I can avoid it. It preys on my mind a lot. I also suffer from lifelong insomnia. But this article gives me some hope. I do all the alleviating things mentioned.
Louise Bourgeois – and many like her – had insomnia all her life and got to 98 with no memory problems at all… The other things appear to be of more importance so keep going!
Thank you for this interesting article Annabel. I tend to listen to a podcast if I wake at night and can’t get back to sleep. I usually choose a podcast where the subject matter is not too alarming! and where the speaker has a voice which is not too strident and intrusive and the rhythm of their speech is quite smooth without too many words being overly emphasized.
You’re so right about the voice. I like a low-ish slow-ish voice without too much intonation! Glad you found my piece interesting!
Annabel: Dr Wong cannot possibly have spent ten years researching AFTER / AS A RESULT OF his father’s problems during Covid!? Regards, AlanB
Hi Alan – yes, he went over ten years of records (ie records going back ten years. You can follow the link to the report to see the methodology (you being a marketing man!). I probably should have made that clearer …
What isthe difference between self-reflection and rumination? Thanks.
Briefly, rumination is when we go round and round a negative thought. Self-reflection is when we think, ponder and come to more of a positive conclusion – or acceptance at any rate. There’s no berating of ourself when we reflect!
Good to read. Thank you! I almost always wake in the night and my salvation is my Kindle (I’ve tried audio books and podcasts and they’re not really for me). When the book is really gripping, it’s like having a parallel life to dip into so being awake at silly o’clock is more a treat than a disaster. If I’m reading a hard copy book then a neck torch with dimmable lights, weird as it looks, helps.
I also recommend a red light. I have a red bulb I switch to if I’m writing at night. We continue to produce melatonin when the light is red. It’s blue-white light that appears to disrupt our sleep and halt melatonin production – our brain thinks it’s morning! Thanks for your comment and kind words…
Ah interesting. Thank you. I didn’t know that about a red light. Let me see if they do one that hangs round my neck – vampire vibe?!
They’re a bit pricey but you can also get cheap party bulbs – just screw it into the light fitting! Or a torch with a redlight setting…
Very interesting article. I lay awake worrying last night! Also the going to bed at midnight part, I rarely go to bed before 11.30 – midnight I know it’s a bad habit and I make endless resolutions to improve, which all fall by the wayside. However when I was on a fairly active holiday recently was often in bed by 10.30 and could barely read more than a page of my book, and woke up at 8.00 am and didn’t wake up n the middle of the night. I admit I felt much better for it, but was doing a lot of fairly strenuous hiking and was outdoors most of the day. Back here and into other things that keep you inside and otherwise occupied I’ve fallen back into the late nights, and waking in the night. What to do!
You’re so right about strenuous days, particularly outdoors – I suspect that’s the key to good sleep. Our ancestors had long days working the fields/foraging for millennia. Our brain hasn’t adjusted to our new sedentary, indoor lives! Keep going for good walks!
Excellent post. This has put my mind at ease as I spend a lot of time awake, self reflecting and thinking that I am odd for doing it in the first place. I do need to work on going to bed earlier as I am never in bed before 1 am therefor am missing the growth period, which I hadn’t heard of. Really interesting post. Thank you for all your hard work and researching .
Doreen, if you habitually go to bed at 1am, that (1-2.30am ish) will be your growth hormone release period. You will only miss it if you go to bed at 3am – as I understand it. So it’s more about maintaining consistency over time. However, if you have always gone to bed at 11pm and recently shifted to 1am, then you will be missing that crucial period. Thanks for you kind comments!
I listen to Radio 4 or 4xtra.
Make tea and read a book/do a crossword.
Just lie and go through my day’s intake of food, plan next day day’s intake if previous has been REALLY
unhealthy!!
Oh, that sounds very brain-building! Thanks for sharing …
Thank you so much for clarifying that! I have always gone to bed late, even before I retired and was getting up early for work. But I will try to keep a consistent bedtime, albeit later than most people. So interesting!
This is a really great post – thank you! I, too, like many above, tend to wake up anywhere between 3:30 and 4:30am, and am awake for at least 1/2 hour but generally longer. The one thing I DON’T do anymore is panic that I am awake, thinking about how bad it is for my brain! I usually do my own version of yoga nidra, and find it generally works well. But I’m thrilled to hear that getting up and actually doing something is ok (even good) as well. I’ve always been concerned it would be too stimulating. I also loved reading everyone else’s strategies. Very helpful! Thanks again.
PS – As a wellness coach, I am doing a short presentation on sleep in early May, and my focus was going to be putting people’s minds at ease vs scaring them (aka Matt Walker, whom I have a great deal of respect for, but I find that telling people all the bad things that may happen isn’t all that helpful!). I will definitely refer to a couple of the studies referred to in your blog. Again, thank you.
Yes, I agree (actually so does Matt Walker, in hindsight!) we don’t need to be made scared and anxious, as that isn’t conducive to returning to sleep. Good luck with your presentation!
My mother in law used to wake up around 3 in the morning and she would pray her rosary.
Taking her inspiration I ask my body to wake up around that time and I meditate for half an hour and then return to sleep.
Perfect time to meditate! No distractions just darkness and no noise.
3am – that was the traditional hour of Matins. Perhaps the body knows? Thanks for sharing…
Wise words and reflections
Thank you
Aloha
Thank goodness to have something de stressing on this topic – but what do you mean by ‘ruminating’?
Ruminating is dwelling on a negative or distressing topic – regret, remorse, recrimination … and going round and round without resolution. Best avoided where possible (not always possible of course)…
Listen to a podcast or the radio. Occasionally get out my book and keep reading. Occasionally ponder life and the meaning of everything. Sometimes listen to white/green noise (or whatever sound the app is making – I like rain and thunderstorms). Glad to hear all of that is good for me!
Ah, good suggestions. I also listen to recordings of rain, surf, wind. Very relaxing – the sounds our ancestors would have fallen asleep to … Thanks for sharing!
I read a relaxibg book or magazine. Nothing which could induce anxiety.
Yes, that’s the key – whatever it is must be relaxing! Thanks for sharing…
Always love these blogs and eagerly await the next.
Re sleep, luckily I generally sleep pretty well. Often use a meditation app to go to sleep (Insight Timer).
Now and again , cannot easily get back to sleep if I wake during night, as mind buzzing, so use a go back to sleep meditation to help.
And/or breathe in for 4 and out for 7 several times.
Confession : drinking wine after 9 disturbs sleep.
Thanks for the comment and for sharing your tips. I think you’re right about wine. Interestingly a report dropped into my inbox a couple of days ago saying that coffee drinkers typically sleep for half an hour less, per night, than coffee abstainers – regardless of the time and quantity of their coffee consumption. It seems that some things just stick around!