The effects of Sleeping Pills Caffeine and Alcohol on Sleep

I want to come back to some of the optimal conditions and the things we should do, but you mentioned sleeping pills in your talk and I think you've said that they they absolutely don't produce natural sleep. We should keep away from them. Are there any kinds of natural, any natural pill or anything that you would say you can take before we can get your fantastic device? So we don't know of any pharmacological compounds that have been produced yet that produce a naturalistic sleep or B, really exceed anything that you see with placebo. And the fact that those sleeping medications come with a collection of deleterious effects led in America, for example, in 2016, the American College of Physicians made a landmark recommendation based on the weight of that danger relating to sleep medications and how little they truly benefit above and beyond placebo. They said sleeping pills must no longer be the first line recommendation for insomnia. The alternative, and we have a good one, is called Cognitive Behavioral Therapy for Insomnia or CBTI. So if anyone is interested in this, if you just go to the NHS website and type in CBTI or type in insomnia and look for Cognitive Behavioral Therapy for Insomnia, you will find it. They do a great job of introducing it. You can do a little sleep test to see how bad your sleep is. So we have a safe, psychological treatment for insomnia that is just as effective as sleeping pills in the short term. But what's great is that once you stop working with the therapist, you continue on with the benefit in terms of sleep improvement. Whereas with sleeping pills, if you stop them, not only do you go back to the bad sleep that you were having before, you actually have what's called rebound insomnia, which is that your sleep is even worse than it was when you started taking them. The other thing you say keep off is alcohol and caffeine. Altogether, when are you able to drink coffee and when alcohol and still be able to sleep? Yes. I mean, I'm generally an unpopular person, but these make me deeply unpopular. So let me sort of go through them. Alcohol is probably the most misunderstood sleep aid out there. It's not a sleep aid at all. People often turn to alcohol to help them with sleep, but it's a problem for three reasons. Firstly, alcohol is a class of drugs that we call the sedatives and sedation is not sleep. But when you drink in the evenings, you mistake the former for the latter. But alcohol is just knocking out your cortex and sedating you and that's not sleep. The second problem is that alcohol will actually fragment your sleep. So you'll wake up many more times throughout the night and that leads you to the next morning feeling unrefreshed by your sleep and unrestored. The third thing about alcohol is that it's very good at blocking your dream sleep, what we call rapid eye movement sleep or REM sleep for short. And REM sleep is essential for both brain and body just as much as deep sleep is essential. So on all of those three grounds, alcohol is to be avoided. Even one glass with dinner, we can demonstrate some of those effects. Now, I want to be clear, you know, life is to be lived to a degree and I don't mean to be puritanical. How you want to live your life is completely up to you. What I want to do, however, is empower you with the knowledge of sleep science so that you can then make an informed decision as to how you would like to live your life. I think the politically incorrect thing that I would never say in front of a large audience is that you should go to the pub in the morning and that way the alcohol is out of your system by the evening and that way no harm, no foul. But I would never suggest that in public. So that's alcohol. And the second is caffeine. I think everyone knows that caffeine kind of makes you more alert and makes you awake. Caffeine is a class of drugs that we call the psychoactive stimulants. And by the way, it's the only psychoactive stimulant that we readily give to our children without too much concern, which I think is an issue. But one of the other things that people don't know about caffeine is the duration of action. So caffeine has what we call a half-life of six hours. It has a quarter-life of 12 hours. In other words, if you have a cup of coffee at noon, a quarter of that caffeine is still swilling around in your brain at midnight. So if you have a cup of coffee at lunchtime, it's the equivalent of, at noon let's say, it's the equivalent of tucking yourself into bed at midnight and just before you do, you swig a quarter of a cup of coffee and you hope for a good night of sleep. And it's probably not going to happen. So that's one of the other issues with caffeine. The final issue with caffeine I would note is that some people say, I'm one of those who I can have a cup of coffee after dinner and I can fall asleep fine and I stay asleep. So it's no problem. There may still be a problem because if you give a person a standard dose of caffeine, about 160, 180 milligrams, which is a standard cup, and we've done some of these studies, and then you measure their sleep, that single cup of coffee will decrease and eliminate about 20% of your deep sleep. So to put that in context, to drop your deep sleep by 20%, I'd have to age you by about 20 to 25 years. Or you could just do it every night with a cup of coffee. I know I told you it makes me so uncomfortable. I'm so sorry. I'm such a downer.