• Worries about COVID and a lack of routine can fuel insomnia. 
  • If you are sleeping less than 7-8 hours a night, the negative health consequences build up.
  • For better sleep, relearn to associate the bed with relaxation and rest instead of tossing and turning.  

Video Transcript

[MUSIC PLAYING] JOHN WHYTE: Hello. I'm Dr. John Whyte, chief medical officer at WebMD. I bet you're all having some trouble sleeping nowadays. There's a lot of stress, a lot of anxiety. So to help provide tips as to how to get a good night's sleep and how important that is, I've asked an expert to come by and share her insights.

I'm delighted to be joined by Dr. Sonia Ancoli-Israel, Professor Emeritus of Psychiatry at UC San Diego. Dr. Ancoli-Israel, thanks for joining me today.

SONIA ANCOLI-ISRAEL: Thanks so much for having me.

JOHN WHYTE: Let's start off with, what are all the factors that are causing problems with sleep right now?

SONIA ANCOLI-ISRAEL: Yeah. This is a very strange time in our lives, and there's a lot of anxiety going on. You know, suddenly, people find themselves at home. They're not-- they don't have their regular routine. There are a lot of things they're worried about. Am I going to get sick?

Are my loved ones going to get sick? Am I going to lose my job? Can I pay my rent? How do I handle teaching my kids at home? So-- so there are a lot of things going on that rightly so cause anxiety. And unfortunately, that tends to then also affect how we react at night-- that is, when we're trying to sleep.

JOHN WHYTE: And many people dismiss the importance of sleep. As a physician, I don't often talk to people about sleep. But we've learned more over the years about the association of sleep with high blood pressure, heart disease, other issues. Can you help explain to viewers why sleep is so important, and that when they compromise on their sleep, they actually may be making their health worse?

SONIA ANCOLI-ISRAEL: Yeah. Sleep-- and one of my favorite expressions, sleep touches everything. You know, I'm a sleep doctor, so I see everything from the perspective of sleep.

JOHN WHYTE: OK.

SONIA ANCOLI-ISRAEL: But it really does touch everything. When we are sleep-deprived, whether because we have a sleep disorder that's disrupting our sleep or we're just not in bed long enough to get the sleep that we need, we are compromised. Our cardiovascular system is compromised, and the metabolic system. Our cognition-- performance

decreases, concentration is worse, memory gets worse. So really, anything you can imagine gets worse when you don't get enough sleep. And partial chronic sleep deprivation, what that means is it's not like you're just staying up all night once every few weeks.

But if you're sleeping less than seven to eight hours, which is what adults need, if you're sleeping less than seven to eight hours a night, night after night after night, those negative consequences build up, and then you're-- you're compromised even more.

JOHN WHYTE: I want to ask you about those consequences, because I've been reading a lot of your work. And I saw a very interesting study that talked about the relation of sleep and cancer in terms of natural killer cells, and that's not something we think about. So what's the relationship between sleep and cancer?

SONIA ANCOLI-ISRAEL: It's very clear that not getting enough sleep or having disrupted circadian rhythms-- circadian rhythms are our biological clock-- when that's out of sync, that could increase the risk for a lot of things, cancer being one of them.

JOHN WHYTE: And you say it's seven to nine hours for most people. Is that right?

SONIA ANCOLI-ISRAEL: It's seven to eight hours for most people, and that includes older adults. You know, there's this myth out there that as we get older, we need less sleep, and that's not true. Older people have a harder time getting the sleep that they need, but they still need seven to eight hours. Teenagers, on the other hand, adolescents need nine to 10 hours. They need much more sleep.

JOHN WHYTE: Do you believe in sleeping pills?

SONIA ANCOLI-ISRAEL: I believe in anything that works best for the person who needs to sleep. The behavioral treatments such as getting out of bed when you can't sleep are the most effective treatments we have. We call that cognitive behavioral therapy for insomnia.

It's been shown over and over again that if we change people's behavior, that's the best way to improve sleep. It's like, you know the expression, I can give a man a fish or I can teach him how to fish. I can teach you how to sleep or I can give you a sleeping pill to sleep. Teaching them how to sleep will-- will last forever. And then there are times where it's appropriate to give a sleeping pill.

JOHN WHYTE: So what are Dr. Ancoli-Israel's top tips for better sleep during the COVID pandemic?

SONIA ANCOLI-ISRAEL: I think the most important part is learning or relearning to associate the bed with sleep. If you're in bed, and you're anxious, and you're tense, and you're tossing, and you're turning, you're going to start associating the bed with being anxious, tense, and tossing, and turning.

And you're going to start going to bed at night, before you even get into bed, you're going to look at the bed and go, whoa, I'm not going to be able to sleep. So we want to recondition our brains to look at the bed and go, ah, sleep. And the best way to do that is to not do anything in bed other than sleeping.

So if you find that you get into bed, and you're tense, and tossing, and turning, get out of bed. And you do something that's relaxing for you. When you go out of the bedroom, let's say you want to read or watch TV. You want to try to keep the environment as dark as possible. Obviously, you can't read in the dark.

JOHN WHYTE: Yep.

SONIA ANCOLI-ISRAEL: Because light tells our brain to wake up. The other thing is you don't want to be reading or watching TV where it's going to suck you in. You know how you're reading and you go, oh, I'm really tired but I want to--

JOHN WHYTE: No news, no 24-hour news.

SONIA ANCOLI-ISRAEL: Who did it? I want to stay and keep reading. I want to see the end of the movie. Because the second you start getting sleepy, you want to go back to bed.

JOHN WHYTE: What other tips do you have for us?

SONIA ANCOLI-ISRAEL: So you know, in our very busy lives-- not just now, but always, even before this pandemic-- in our busy lives, the first moment we have to sit and think is when we get into bed at night. And that's the wrong time to start thinking.

JOHN WHYTE: Is it OK to have pets in your bed? Do they reduce anxiety and help sleep?

SONIA ANCOLI-ISRAEL: So we used to say absolutely not, because pets disrupt your sleep. But there's some new data to suggest that perhaps it would be soothing. So again, it probably depends partly on the individual, partly on the pet. If the pet is moving around a lot, and-- and snoring, and making noise that is disrupting your sleep, then that pet should not be in the bedroom.

JOHN WHYTE: Now, I'm sure viewers are wondering, as I have, about those earrings and about that [INAUDIBLE] So tell us what's on your ear. I'm sure people are being like, what's on-- what's on those ears? What do they mean, because I'm sure you have a story?

SONIA ANCOLI-ISRAEL: They're made out of flax. They're very light. They're from Mexico.

JOHN WHYTE: And those ornaments behind you, tell me about those.

SONIA ANCOLI-ISRAEL: Oh. I-- there are quite a few different ones, but I have a shelf full of sleeping figures, you know? I've been studying sleep for 40 years, and so I've collected a lot of little sleepy figures over that time. Anything that's-- that's asleep, I get.

JOHN WHYTE: And in 40 years, what has surprised you the most in what you've learned about sleep over that time? I'm sure lots of changes since what you first learned.

SONIA ANCOLI-ISRAEL: Yeah, a lot. Well, for one thing, we learned about behavioral techniques being so important, moving away from pharmacology and more towards behavior. We've learned about new sleep disorders, things that were probably going on but we never knew about. And there are more and more new treatments for them. We've looked so much more about the importance of sleep, uh, and how much sleep someone needs. Some of the work that I've done, I-- I specialized in aging and Alzheimer's. And the relationship between poor sleep, and cognition, and dementia, there's so much. And genetics, the genetics of sleep.

JOHN WHYTE: Well, Dr. Ancoli-Israel, I want to thank you for taking the time today to-- to share your thoughts and to share your tips about how we can all sleep better.

SONIA ANCOLI-ISRAEL: Thank you. It was my pleasure. And I wish you all a good night's sleep.

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