The other evening, Susan and I were lamenting our threadbare sleep. Whenever I’m out with a friend, we discuss our sleep. Yesterday I spent the day walking with a friend who had just mailed some sort of antihistamine crossed with an opioid (only available in the US apparently) to a desperately sleepless friend.
Actually, my sleep isn’t quite so bad these days: I’ve learnt to make use of – and enjoy – my wakeful episodes and I’m no longer beset by fatigue after a bad night. Indeed, I’ve written all about this (and other sleep/night related subjects) in my upcoming book, titled Sleepless. The subtitle in the US is Unleashing the Subversive Power of the Night Self, and in the UK it’s a slightly more subdued Discovering the Power of the Night Self.
I interviewed many researchers in the three and a half years it took to write Sleepless. I also scoured letters and journals going back hundreds of years in a bid to understand how women of the past slept, survived and thrived, often on very limited and broken sleep (all those babies, sick and dying family members, lice, fleas, straw mattresses, cold etc). More importantly, Sleepless explores the way our brain changes at night and the therapeutic nature of darkness. It’s also a highly personal account of my ‘recovery’ following a series of bereavements, and the healing role played by night, darkness and (perhaps counterintuitively) insomnia.
You can pre-order now (UK) or here (US) or from any bookshop. Publication day is January 17th in the UK/Australia/NZ and February 13 in the US/Canada. Susan and I will be holding an online launch via zoom for our Age Well community on the evening of Wednesday 31st January. More to come nearer the time.
Or you can catch me talking live at the Sevenoaks Bookshop (Kent) on the afternoon of Sunday 28th January, or at The Bookshop, East Grinstead (Sussex), on the evening of Thursday 1st February or at the Stony Words Festival in Milton Keynes on Saturday 3rd February. Follow the links for tickets. More dates\events to follow.
To whet your appetite, I’ll share a couple of studies that arrived too late for the book but are indicative of some of the (many!) areas I cover:
Let’s start with the misleading headlines about disrupted sleep causing Alzheimer’s… Poor quality sleep has long been linked to Alzheimer’s although it was never clear whether Alzheimer’s caused our sleep to splinter or whether shortened splintered sleep led to Alzheimer’s. In a recent study, researchers used brain imaging technologies to investigate the relationship between sleep disturbances, amyloid plaque deposits (thought to cause Alzheimer’s) and brain connectivity. They found that one particular neural network was affected by sleep deprivation, but only in participants who already had significant accumulations of amyloid plaque.
This suggests that short sleep doesn’t cause the build-up of sticky amyloid plaques, but that plaque disrupts sleep by interfering with a particular brain network. Or as the researchers put it: ‘Sleep disturbance was associated with hyperconnectivity, only with the presence of Amyloid plaques…. Sleep disturbance may lead to altered connectivity …when Amyloid is accumulated in the brain.’
So there’s no need to lie awake worrying that our lying awake worrying will cause dementia. It (probably) won’t. Of course, we still need to sleep. And one of the most significant things I discovered in the course of writing Sleepless is just how important complete darkness at night is.
According to Dr Samer Hattar, one of the world’s preeminent experts on this topic, bright light between 10pm and 4am is particularly disruptive. Hattar speculates that exposure to light and dark at the wrong times of the day and night does more than disorder our circadian rhythms – it affects our mood and memory. Too much darkness during the day and too much light at night – regardless of how much, or when, we sleep – threatens to throw much of our brain off balance. He believes the light/dark cycle affects us more than we think, comparing its pivotal role in our health and wellbeing to that of movement and exercise. In other words, it’s as important to get our light/dark right, as it is to exercise every day.
A study published last month goes even further. Of the 86,770 participants involved, those who spent the most daylight hours outside had the best mental health – they were happier, calmer and more resilient. But – crucially – researchers also found that darkness at night was as important for our wellbeing. ‘Getting darkness at night is as important as getting bright light in the day. These signals are what we evolved under and they help to organise our physiology optimally,’ author and researcher Dr Sean Cain told me. ‘Regular and clear light/dark signals lead to a strong internal clock that’s better able to keep our entire bodies aligned the way they should be.’
Cain suspects that our focus on screens might be a bit of a red herring. ‘It’s likely that our home lighting does far more [damage] than our screens,’ he said. ‘We should be using very dim, warm light at night, but preferably darkness. Certainly we should be in darkness while sleeping.’
In fact, Cain suggests radically turning down the lights three hours before we want to sleep. LED lights seem to be particularly problematic because of their high blue (and green) content. I’ve switched to twilight red bulbs, which contain no blue or green light, for my bedside lamp. But I’m also partial to candle-lit evenings, using bees-wax candles to avoid pollutants.
Unfortunately we’re all so accustomed to bright light and so determined to be as productive as possible for as long as possible, that I rarely find anyone happy to sit with me in candlelight for three hours before bed. But on the occasions when I’ve done it, sleep has come sooner, lasted longer and felt more deeply satisfying. If you decide to try very low-lit evenings, please let us know how you get on and whether it improved your subsequent slumber.
Cain’s study focused on mental health, concluding that ‘Greater night-time light exposure was associated with increased risk for major depressive disorder, generalized anxiety disorder, PTSD, psychosis, bipolar disorder, and self-harm behavior.’ But where the brain leads, the body follows. As NHS England points out on its website, those with poor mental health are at a much greater risk of poor physical health, dying on average 15-20 years earlier than the general population.
So turn off the overhead LED lights and keep your evenings in a dim amber glow. Spend as much time as you can getting natural light during the day. And ensure your nights are spent in complete darkness. It really is time to embrace the dark.
Thank you to Antoinette Koutsomihalis, an award-winning, Sydney-based astro-photographer, for this post’s picture. Antoinette is one of several utterly inspiring women who appear in Sleepless, sharing her journey of grief, darkness and the healing power of a night sky. She was a huge inspiration to me – and I salute her courage, creativity and sheer grit! You can see her stunning night shots on Instagram at @toni_kouts.
Looking forward to seeing lots of you online on the 31st January or at one of my upcoming events.
As ever, thank you for making it to the end of this post! I wish you a restful night of calming darkness…
Annabel
A very interesting summary. I love the bit about complete darkness at night, living as I do in Scotland that’s not a problem at this time of year! It’s dark almost the whole day too on these gloomy, cloudy days, which sounds as though it’s bad for us too. But in the summer it hardly gets dark. I assume our bodies also adjust to this. To be honest, and this is only an observation and my own point of view,( I’m certainly not qualified), it seems to me that it’s not terribly helpful to have these hard and fast rules, we can’t all adhere to them for many reasons, not least because of where we live.
Thanks Liza. Actually, I’m not sure our bodies do fully adjust to artificial light when it’s out of sync. Even outdoors and cloudy is much, much brighter than indoors – so their point is that we need outdoor light during the day and complete dark at night rather than overhead lights left on or street light pouring through thin curtains. Of course, we’re all different but there do seem to be problems with hospitals and old people’s home, for example, where LED lights are on all night and where people often don’t get out either during the day. We need the contrast – however we can get it! Yes, Scotland is wonderfully dark right now!
Too true Liza!
I’ve followed your posts for several years now, and always find them informative and positive. I’m particularly interested in the topic of post-menopausal sleep. I experienced terrible, chronic insomnia from 55-69. Some days I could barely function, and there were nights when I hardly slept at all. Prescription and over-the-counter meds either had no effect or left me feel drugged the next morning. Besides which, I didn’t want to rely on medication for what should be a natural part of the rhythm of dailylife.
I believed this to be related to consecutive life events – a stressful and responsible job; retirement + moving to a new part of the country; difficult adjustment to spending so much time with newly retired husband; husband’s cancer diagnosis and long decline; death of husband; house move to another new part of the country to be nearer my children.
But even when I began to settle into my new life, and to feel more content, my sleep didn’t improve. One day I had a ‘lightbulb’ moment. I had taken HRT from age 40-55 for early menopause. The insomnia had started soon after finishing HRT (old tablet formulation).
I had heard of Dr Louise Newson and knew that she considers post menopausal oestrogen loss to be a hormone deficiency. I booked a video consultation with one of her army of female GPs, and despite my age, she prescribed Oestrogel and a progesterone tablet specifically for my insomnia. In my working life I’d done a Masters in Public Health, so I know a bit about clinical evidence, and evaluating risk, and decided that in spite of there being very little evidence of using HRT post-70, this was a risk worth taking.
That was almost two years ago. The effect has been utterly transformational, and sustained. I now sleep from around 10.00 – 5.30, pretty much every night. This suits my natural body clock – I like to wake early. If I do wake in the night (rarely), I just drift off again. Night-time trips to the kitchen for hot chocolate and toast are a thing of the past – I haven’t done that once since starting HRT. I had forgotten what normal sleep feels like. This may not be ‘normal’ in that it clearly relates to my use of HRT, but it feels exactly like what sleep felt like in my younger life.
I do sometimes worry about possible increased risk of dementia (my mother had it over a terrible 10 year period) but this is a risk I’m prepared to take.
I’m sorry to have written so much, but having read about your work on insomnia, I thought you might be interested in my experience.
Please keep posting your work online – it’s valuable stuff!
Wonderful to hear about your dramatic return to sleep, Rose! Thanks for sharing … and keep enjoying those blissful sleep-filled nights!
Thanks Rose, interesting stuff!
Really interesting piece and it’s whet my appetite for the book.
The ‘complete darkness’ at night is not so much of a challenge for me here where I live in SW France. Thick wooden shutters shut out the light and I’m especially grateful for them when there’s a full moon. When I lived back in the UK, a full moon would have me tossing and turning all night.
When I visit friends in London, I find it really hard to sleep – even with curtains – because of the levels of light pollution at night.
Thank you! Yes, wooden shutters are wonderful things… most cities are excessively light-polluted now and, yes, full moons still cause problems, particularly in the run-up when the light is lower. We also produce less melatonin around the time of the full moon so it’s not just the light. Seems we’re biologically wired to be up and about on full moon nights!