[Matt]: And we’ve seen this, too.
that if you look at that emotional brain reaction signature that I just sort of described,
and you repeat that.
But with people who are high-anxious and low-anxious,
and we know some of the genes that are associated with being high anxious and low anxious
So we’re using anxiety as a sort of a proxy for perhaps a particular genotype here.
What you see is
that it’s those high-anxious people who are the most vulnerable to this impact of a lack of sleep.
Those who are low-anxious still have a bad outcome,
but it’s nowhere near as bad.
So there seems to be sort of interactions here between sleep loss and
your basic trait levels of being sort of nervous,anxious type to begin with.
– 这就说得通了 – 那些感到难受的人
– That makes sense.- And those are the people who are sadly,
the people who typically don’t get a good night of sleep.Anyway…
[Rhonda]:Right. So to say.
[Rhonda]: Anxiety is like one of the things that stops me from sleeping.
[Matt]:It’s the principal trigger of insomnia.
– 对 的确- 目前 它是失眠的外在表现
– Yeah really, true.- is the model of insomnia right now.
[Matt]: is that you get…And if you look at the nervous system,
[Matt]: that’s how we understand insomnia right now is that
is that… its principle is… I think
ultimately you’ll find that there are multiple flavors of insomnia, different forms.
We already categorized two of them.
We’ve got what we call sleep onset insomnia
and sleep maintenance insomnia.
Difficulty falling asleep, difficulty staying asleep.
They’re not mutually exclusive.
You can have both, or you can just have one or the other.
But coming back to it,
I think the overarching biological red thread narrative of insomnia
is an amplified “fight-or-flight” nervous system,
like your nervous system is split into these two branches,
what we call sort of the sympathetic and parasympathetic
parts of your autonomic nervous system.
The sympathetic is anything.
But sympathetic it poorly named.
It’s the fight-or-flight branch of your nervoussystem.
It ramps you up, charges you up, releasescortisol, adrenaline.
You constantly see an overactive, sympathetic nervous system in people with insomnia,
and when you measure their cortisol across the 24-hour period.
In most of us, just as we’re getting to our natural bedtime,
cortisol just starts to now drop down.
We start to see that cycling down of cortisol.
The opposite happens in people with insomnia.
You get a continued rise right around that bedroom period.
And it seems to be very predictive of sleeponset problems.
If you look throughout the night,
cortisol then starts to plummet, and it drops beautifully down.
It’s part of the reason why deep sleep
is the best form of natural blood pressure medication
that you could ever wish for.
Your heart rate drops down,
your vessels relax,
Cortisol drops down.
But in other insomnia patients,
we see this bizarre spike in cortisol in the middle of the night.
And it predicts nighttime awakenings.
It predicts sleep maintenance insomnia. [Rhonda]:
I have experienced…So I… That’s one of the problems that I actually have.
It’s much, much better now
that my stress level is, like,maintain
At graduate school,
I would get nighttime awakenings where my heart would start racing.
And I would wake up thinking
that there was a spider or some kind of threat.
And I would scream, and sometimes jump fly outthe bed.
就是说 你知道 就是……
I mean, you know, and just…
it would scare my husband, you know.
At the time, we weren’t married.
但是 我想说 这种半夜惊醒的经历
But,I mean, you know, these nighttime awakenings,
it was something that’s dated back for quite some time.
But really, it manifested during a very stressful period,
and that was graduate school.
– 那现在……- 已经好多了
– We see that… – Got much better.
[Matt]:But if you can think about that as sort of, you know,
a stress management component to insomnia, you know,
it’s part of what we call cognitive behavioral therapy for insomnia,
which is sort of dealing with that stress,you know, meditation.
There’s great apps out there, like Headspace,for example.
And the data on meditation and insomnia isvery very powerful.
You know, I’d known about it a little bit,
but I hadn’t read really all of the studies
until I started researching it for the book.
And I was so convinced that I started meditating.
And I haven’t stopped since.
Because it was, you know…Typically, I’mnot a bad sleeper.
I’m a light sleeper.
I’m a pretty good sleeper.
I found it hugely useful for times when I was under stress,
or when I was traveling and jetlag.
It’s very beneficial, too.
But that underlying theme, I think, as a message for insomnia,
it’s not the only cause of insomnia,
but it seems to be if there’s one common sort of rule
that binds many of the patients with insomnia together,
it’s this overactive fight-or-flightbranch of the nervous system.
And if you can settle that down,
– 就一定能提高睡眠质量- 没错
you are certainly on the path towards better sleep. [Rhonda]:Right.