Module 1: Introduction to sleep episode transcript.

 

Acknowledgement [00:00:00]

Medibank acknowledges the traditional owners and custodians of the land in which we record this audio file, the Wurundjeri Woi- wurrung and Bunurong peoples of the East Kulin Nations. We pay our respect to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

Dr Chris Robinson [00:00:20]

Did you know sleep can be a mood-boosting activity that's just as important to your overall health as diet and exercise? Get ready to learn about how to improve your sleep habits. I'm Dr Chris Robinson, Chief Medical Officer at Medibank, and with me is health psychologist and CEO of the Sleep Health Foundation, Dr Moira Junge. In this episode, we'll discuss the importance of sleep and its impact on your health.

Dr Moira Junge [00:00:46]

The thing about sleep tracking is that they get really anxious sometimes. I'm not getting enough X amount of quality sleep, but sometimes it's actually more the amount of awakenings that we have, and the restlessness is probably the biggest marker of quality of sleep.

Dr Chris Robinson [00:01:01]

Thanks so much for joining us today, Moira. Before we start, why don't you tell us a little bit about yourself and your background and how you found yourself working in sleep?

Dr Moira Junge [00:01:08]

Well, it's a long story, but the short version is that I am the CEO of the Sleep Health Foundation, and I'm a registered health psychologist, still practicing, just a little bit. And I was a nurse for the first 10 years of my career, and when I was studying to become a psychologist, the Alfred Hospital, they started a sleep disorder centre, and I got a job there doing the electrodes, and the sleep studies, and just really enjoyed it, just fell in love with sleep. And over the years, I’ve realised that prevention can be better than cure. And it’s just so important to me now to actually work for the rest of my career in the health promotion space, and the prevention space, to give people the tools and information and awareness that hopefully their sleep can be better with that awareness, there’s a lot of chronic conditions that people may not have had, or severe if they had the information earlier. So I'm just a big proponent of the importance of sleep. And I don't think we know enough about it at societal level yet. Like even though it's talked about a lot, people don't have a true understanding of its importance. I'm

Dr Chris Robinson [00:02:18]

so excited to unpack that a bit today. That's fantastic. What diverse experience. And I think that's going to put us in a really great place for today's conversation. Why don't we start with the basics? Why is sleep so important and why do we need it?

Dr Moira Junge [00:02:32]

It's an essential component of both our physical and mental health. We sort of see it as a core pillar alongside exercise and diet. We need it for our alertness, our memory, our energy, our ability to, you know, to learn and have productivity at work. With that, it also supports our immune system. And even during sleep, there's growth hormones secreted. And without it we know that we're at more risk or can be at more risk of certain chronic conditions. So that's why. So part of the reason we know how important sleep is, is because we see what sleep deprivation does. So people who are in a sleep deprived state actually have toxins built up in their brain in the same, it's called the lymphatic system. And it's a sort of a clearance system that's only been known about since 2012. That it's like the vacuum cleaner comes in and clears out the toxins that build up during the day. And that's why we feel so groggy and sort of not alert when we haven't had the sleep. So we know that it's clearing of toxins, laying down our memories. It keeps us safe, you know, in terms of accidents and injuries in the workplace, on the roads as well.

Dr Chris Robinson [00:03:43]

Yeah. Wow. And I think that's probably something we can all relate to is those nights where we've had disturbed sleep and then we try and lean into a busy meeting the next day or something like that. And we just can't fire on all cylinders. And so that that's from that, sort of that brain vacuum cleaner, as you described it, not getting rid of all those toxins.

Dr Moira Junge [00:04:02]

Yeah, absolutely. So it's just a, it's just a, it's a reset. I reckon it's our reset button. It's our control alt delete where we can actually just start to rejuvenate, recover. It's, I mean, there's lots of reasons why we sleep and it's just, yeah, it's just a crucial building block for, for all aspects of health.

Dr Chris Robinson [00:04:18]

That makes sense. Now you touched briefly on chronic disease and a lack of sleep. And I've read recently that about half of Australians, um, can, you know, they report having challenges with their sleep. Yeah. What impact is that having on our health, both on a day-to-day basis, but more importantly, what, what links are there between poor sleep and chronic disease?

Dr Moira Junge [00:04:43]

Yeah. So we know that on any given night, um, yeah, about half of Australians say they don't sleep well and they'll have at least two symptoms of a sleep disorder. They may not have a sleep disorder. That's far less percentage of the population that have a sleep disorder. With poor sleep, there's an increased risk of several conditions. Um, we know, you know, certain dementias, some cardiovascular conditions, obesity, type two diabetes, uh, strokes, and of course, mental health conditions. So we also know that there's an increased risk of accidents, both on the roads and in the workplace when people don't get enough sleep.

Dr Chris Robinson [00:05:19]

So major impacts both on your health tomorrow, but also into the future. So it just highlights how important sleep is. Yeah. That's right. Let's talk more broadly about sleep. You hear kind of people throw around the idea that you need seven hours or eight hours, or when you get old, you need less. How much do we actually need? And does it differ as we age?

Dr Moira Junge [00:05:37]

Yeah, well, it changes a lot across the lifespan, like from tiny babies through to older people, there's a massive change over the lifespan. But once we get to adulthood, it's actually quite stable from about sort of 18 through to about 65. Even we say that most adults need roughly seven to nine hours of sleep per 24. It's such a guide, like there's an enormous variation. We also consider that anything between six hours and 10 hours is considered normal as well. So younger babies, you know, think it's a huge variation of, you know, anything from like 11 through to, you know, 19 hours or so. Um, and sort of adolescence children around sort of 14 to 17 require about eight to 10 hours of uninterrupted sleep per night. But we know that they're not getting that. If you do a show of hands around at the moment in schools, a lot, very, very few, are getting between eight to 10 hours per night. Um, but we know that part of the, the, the shift in teenage, teenage-hood is actually part of their, um, uh, hormonal changes, like their body, their body clock changes. They have a delayed sleep phase, which means that the time at which their melatonin comes out. And when they were little kids, they might have seen, when they were in primary school, they might've gone to bed pretty easily at eight, eight 30. And here they are sort of pushing the boundaries anyway, with a time with independence. But it's a time when there's a hormonal changes, you know, I mean, so yeah, they, they, it's part of it at least is this a delayed, uh, onset of melatonin. So therefore you don't feel as sleepy earlier. There's a lot of sort of pushback and, um, with, with, with teens and sleep. But as we get older, as I said, it's sort of quite stable. So even people over 65 years of age, recommendations worldwide is still to get say seven to eight, but it's a lot harder to get. There's sort of more aches and pains, more sort of condition, chronic health conditions. Um, it's important to note that doesn't have to be in one go that you can actually have a nap, you know, like, or a couple of small naps.

Dr Chris Robinson [00:07:34]

So my afternoon nap is okay?

Dr Moira Junge [00:07:36]

Absolutely. Which hopefully we'll get onto talking about napping later. Cause yeah, napping is absolutely okay with certain conditions apply to it. So we, um, we really important to remember though, when we're talking about duration of sleep and hours of sleep, that's only one dimension. It's, it's, it's not, it's, I mean, it's a very important one, but the really other important dimensions are quality of sleep, the timing of sleep and the regularity of sleep. Yeah ok. So people who don't sleep that well, at least you can try to be as regular as possible. Um, try to get quality sleep, um, and not fret too much about the hours.

Dr Chris Robinson [00:08:16]

And when we talk quality of sleep, is that referring to things like the amount of REM you might be getting or rapid eye movements?

Dr Moira Junge [00:08:22]

Yeah, absolutely. So in stages of sleep, rapid eye movement sleep, people have nearly everyone who's not even the sleep world knows about REM sleep now. So rapid eye movement, 80% of our dreaming occurs in that stage. And that's a good quality sleep, but, and stages three and four, like deep sleep is really good quality as well. We could slow wave sleep, but the, the brain waves are like Delta, they're called Delta waves. And they look like the Swiss mountains. They're sort of high, wide, slow complexes. And when we're awake, we have alpha waves, which is sort of just straight up and down lines, like soldiers to attention. Um, so, but all stages are good quality. Like they're all good. Like even light sleep, we have is good quality. So the thing about quality is mostly the amount of wakings we have, the disturbance and the restlessness of our body. So we'll get onto tracking later too. But the thing about sleep tracking is that people have been, because of the trackers, they, they get really anxious sometimes. I'm not getting enough X amount of quality sleep, but it's sometimes it's, um, it's actually more the amount of awakenings that we have. And the restlessness is, is probably the biggest marker of quality of sleep.

Dr Chris Robinson [00:09:26]

Yeah. That's really fascinating. Okay. Should we worry about if we are getting less sleep than the recommended sleep here and there? So not, you know, say Monday to Thursday, you get, you know, your seven to eight, but then maybe, you know, the odd Friday or Saturday, whatever it may be, you're not getting as much sleep. Should we be worried about that if it's happening just here or there versus if it's happening every week? What, where do we start to worry?

Dr Moira Junge [00:09:51]

Yeah, it's a good question. I'm so glad you asked that because I don't want people ever worrying about sleep because the cruel irony about worrying about sleep. You don't sleep because you're worrying about sleep. The conscientious person who's trying to get their sleep better will not get better sleep once they're worried about it and hyper-focused on it. So yeah, we need to be, uh, we want people to get regular consistent sleep, but we understand we, I mean, we're all human. Life happens. Life happens. And we don't know, we don't have a metric yet for that. Like I can't say, you know, X amount is okay, but it's important to realise that we can cope. We've seen it all in ourselves. We cope, of course, from time to time. Without the recommended amount of sleep. It's just where if you are sleepy though, like feeling excessively sleepy and thinking, gee, I can't cope with that lack of sleep I've had to be very mindful of particularly things like road safety. Yeah. Okay. Um, and perhaps, you know, experimenting with short naps to just increase your alertness to get through the next few hours. You could have it, you know, so just being mindful of it rather than anxious about it, being, uh, alert, not alarmed about the importance of sleep.

Dr Chris Robinson [00:10:58]

Yeah. Okay. So general good patterns of sleep versus obsessing about one night's sleep.

Dr Moira Junge [00:11:04]

Yeah. And, yeah. And remembering that there's so much individual variation that some people remember that talking about the range is like six to 10 and that's just duration. We don't, you know, the quality is important. Sometimes you might make up for it in really great quality that when you, when you've had your, your poor sleep. So it's just, it's just general consistent, consistent, consistent is the key with sleep.

Dr Chris Robinson [00:11:25]

Yep. And I imagine finding what works for you. If seven and a half hours every night is what you can manage, and you wake up feeling refreshed and focused, then that’s a great amount of sleep for you, but you know, if you're different, you're different and sleep is such a subjective thing, isn't it?

Dr Moira Junge [00:11:39]

Very much so. And very important to be in the, in terms of timing, making sure that you go with your body clock as much as possible, because if, if your partner is a night owl or an early bird and you're trying to match each other, it's just probably not going to go so well. Yeah. It's going to increase the sort of cycles of, frustration of one or both parties. So wherever possible, try to just be true to your own body clock. But that's hard with our jobs. Like most people are masquerading as morning types and they're not, they've got to get up for the kids or the office or the pets.

Dr Chris Robinson [00:12:13]

Yeah. This is bringing back memories of night shift in the intensive care. Thank goodness those days are gone.

Dr Moira Junge [00:12:20]

It's probably why you're doing this job.

Dr Chris Robinson [00:12:21]

Yeah, indeed. It's been really great to have a bit of a conversation around some of the foundations of sleep challenges.

Dr Moira Junge [00:12:27]

My pleasure. It's always great to talk about sleep.

Dr Chris Robinson [00:12:29]

And in our next episode, we're going to start to dive a little bit deeper into those common sleep issues that we hear about, as well as start to learn how we can improve our sleep health. Thanks for joining us today. We hope you've learned more about the importance of sleep and its impact on your incredible body. Live better with Medibank.

Dr Chris Robinson [00:12:50]

Please note the content in this recorded discussion is general in nature and is not intended to replace individual health professional care. For people who have been diagnosed with a sleep disorder or have any other pre-existing medical conditions, please seek advice from a healthcare professional before participating in this challenge.