Wendy Troxel: Sleep Science for Everyone

Sleep, along with movement, nutrition, and de-stressing, is one of the four key pillars we feel are essential to live a long, healthy life. Oddly, it can be the one that is most troublesome while simultaneously most pooh-poohed. We tend not to really dwell much on this one-third of our lives we spend sleeping, assuming that not much goes on there. The reality is that a ton of stuff is going on while we sleep, and that the other two thirds of life simply would not happen if it wasn’t. It is essential.

Wendy is a sleep scientist. If one were to conjure an image of what that would look like, it would perhaps be a gnomelike human existing in a dark room with a lot of monitoring gadgets, pondering the deep secrets of darkness. That person may exist, but it is about as far away from Dr. Troxel as one can imagine. The reality is an energetic, outdoors- and animal-loving person who just happens to be deeply curious about sleep. More than just the science of what happens when we sleep, Wendy is interested in the social aspects of sleep. Say what? Social sleeping? Like a cuddle huddle? Well, we are programmed to sleep with others, and the quality of our sleep has social implications. Bad sleep=grumpy life partner.

Sleep, like most all human activities, is social in origin — meaning we tend to sleep with other people, which brings many benefits. It is also true that many of our sleep disturbances are social in nature: snoring, too much movement, non-aligned sleep times with our bedmates. This is what animates Wendy Troxel — and, of course, the joy of running in the snow with her dogs. 

Where are you from and where are you based?
I am from Columbia, MD. I have lived in Park City, UT for the past 9 years. 

Who are you working for these days? What is that about?
I am a Senior Scientist for the RAND Corporation, which is an independent, non-profit, research institution (aka “think tank”) that conducts research on policy-relevant topics, including, in my case, health and healthcare. I also have a small, clinical private practice where I treat individuals, couples, and families facing sleep problems. 

Why are you interested in sleep?
Sleep is absolutely fascinating. It is something that we all do, and yet there remains so much mystery around why we sleep, the functions of sleep, and what we can do to optimize sleep across the lifespan. Sleep science is a relatively “young” science as it has only been around as a field for about 70 years. So it is very exciting to be in a field where we are constantly discovering and helping to teach the public about sleep, because many people are still literally in the dark about why sleep is so vital for our health, our wellbeing, our relationships, and even our survival.

“There are parts of the brain that are actually more active during sleep than during wakefulness!”

How do you study sleep? Do people sleep in a lab?
Since I am interested in how people sleep in the “real-world” and in their natural environments, most of my research involves ambulatory assessments of sleep that can be conducted in peoples’ own homes, including wrist-worn sleep trackers, which provide an objective measure of sleep, as well as daily diary assessments of their perceived sleep quality and sleep habits.

You’re an internationally recognized sleep expert. What do most people get wrong about sleep?
One of the biggest misconceptions about sleep is that it is sort of this “dead space” where the brain shuts down and nothing happens. I think this woefully misinformed conception contributes to the widespread cultural tendency to undermine the importance of sleep, as many people think of sleep as wasted space or the thing to do when everything else gets done. This couldn’t be further from the truth. Sleep is actually a highly active and dynamic state. There are parts of the brain that are actually more active during sleep than during wakefulness! This includes activity of the glymphatic system which is essentially responsible for flushing out toxins that build up in the brain. These very toxins are associated with the development of Alzheimer’s disease and other forms of dementia. I don’t say this to scare people, but rather as a wake-up call, that the functions of sleep are absolutely vital for health and functioning, so chronically sacrificing sleep for the other demands of living, or simply by choice, has real consequences.

Quick Tips for Better Sleep

If you could give us 3 tips for better sleep, what would they be?
1. Wake up at the same time of day every day of the week.

2. If you struggle to fall asleep or if you wake up in the middle of the night and can’t fall back to sleep for a half hour or more, get out of bed, go do something relaxing but distracting, like reading a book, and only return to bed when you feel sleepy again.

3. Exercise every day.

What are 3 things not to do before sleeping?
1. Use your phone or computer.

2. Drink excessive alcohol or any caffeine.

3. Engage in any activity that is too stimulating or distressing, like watching the news (these days) or TV shows that end with a cliffhanger and are designed to entice you to binge-watch.

Mattresses wear out. How does one pick a new one?
The general rule of thumb is that mattresses should be replaced about every 10 years. We spend roughly one-third of our lives asleep, so it is worth putting a premium on the comfort of your sleeping arrangement. Spend what you can afford within your budget, but don’t skimp out on this luxury, as you are going to be spending a lot of time in it. The key is that it is about comfort for you and your partner so, to the extent possible, it is best to get to try out your mattress first. Many mattress companies offer generous return policies so that you have the opportunity to test it out and don’t have to feel stuck if you ultimately decide that mattress doesn’t suit you or your partner.

“There are so many sleep challenges couples face”

What is your advice for couples who don’t have the same sleep schedule or just have trouble sharing a bed?
There are so many sleep challenges couples face, ranging from a snoring spouse to differences in sleep-wake preferences (she’s a morning lark, he’s an evening owl) to children (or pets) who weasel their way into the bed, making it a little too close for comfort, let alone good sleep! Regardless of the reason, the first step for couples is to have an open and honest conversation about what’s working and what’s not working when it comes to their sleeping arrangements. Couples have so many assumptions about the meaning of the “marital bed” and this often keeps them stuck in a situation that is not conducive to healthy sleep for either partner! My message is: there is not a one-size-fits-all sleeping strategy that will work for all couples. Rather than get stuck on what society says or what they think they should do, couples should really prioritize getting healthy sleep, as the science clearly shows that when people get the sleep they need, they are happier, healthier, better communicators, and even funnier — all of which can make a big difference in relationship quality! For many couples, it is the time spent together before falling asleep that is most important for connection and intimacy so, for couples who sleep on different schedules or who choose to sleep apart, I still recommend that they preserve and hold sacred that critical time spent together before either falls asleep.

Circadian Clocks and Age

Why do teenagers always want to sleep in? How did that work with your kids?
Around the time of puberty, teenagers show a biological delay in their circadian clocks, which govern sleep-wake cycles. This is driven, in part, by a delay in the release of the hormone melatonin. Teenager’s bodies wait to start pumping out melatonin until about 2 hours later than what we see in adults or younger children, and their bodies keep pumping out melatonin well into the morning hours. As a result, teenagers are biologically programmed to stay awake later and sleep in later. They are not just lazy! In fact, forcing a teenager to wake up at 6 am (given how excessively early middle and high schools start), is the biological equivalent of waking an adult up at 4 am! I don’t know about you, but if you woke me up at 4 am, I’d be cranky, sleepy, in a brain fog, and probably barely competent to drive a car! I witnessed this terrible conflict between early school start times and teens’ biology with my own children, which prompted me to become an activist to use my expertise in sleep science to try to advocate for policy change in school start times across the country. We still have a way to go and, unfortunately, I was unsuccessful in making the change happen in my own community, but we have had successes elsewhere, including the recent implementation of a statewide mandate in California which requires that most high schools start at 8:30 am or later.

Why do older people seem to wake up earlier?
As opposed to adolescence where we see a circadian phase delay which results in a shift towards later bedtimes and later wake-up times, in older age we often see a circadian “advance,” meaning a shift towards earlier bedtimes and earlier wake-up times. This is partly due to the fact that we see a dampening of circadian rhythms during older age, including less robust production of melatonin. Other factors also contribute to the tendency to wake up early with the inability to fall back to sleep as we age, including an increase in the prevalence of sleep disorders, such as insomnia and obstructive sleep apnea; other health issues, such as pain; and hormonal changes, particularly in women as they go through the menopausal transition.

Favorite place to sleep? Is there a city/country you sleep in best?
Believe it or not, some of my best nights of sleep have happened while camping in northern Utah with my family. The combination of the quiet, the dark, the escape from the “real world,” and the coziness of cuddling up while sleeping outdoors, is a recipe for great sleeping conditions for me.

Jet-Lag Strategies

Jet lag! Yuk. What is your solution?
I do a lot of travel for my work, including a 10-day speaking tour for my book in India this past summer, so I’ve really had a lot of opportunities to dial-in my jet-lag strategies. Here are my top tips.

1.​ Use light to your advantage. Getting sunlight in the morning is one of the best things you can do to help set your circadian rhythm to the new local time zone. Outside/ natural light is best, so I always make sure to go for a walk or a run in the morning when I am traveling east. By the same token, light at night can keep you awake, so try to avoid bright light in the evenings if traveling east, but get some light exposure in the evening if trying to stay awake when traveling west.

2.​ Adjust your schedule as quickly as possible to the new time zone — that means set your clock on your phone, watch, computer to the new time zone and try to switch as quickly as possible to having meals at the appropriate time, as meal times are also a powerful cue to set our internal biological clocks or circadian rhythms.

3. ​Use caffeine, but wisely. Caffeine is a stimulant and can be helpful in promoting alertness/reducing jet lag, but can also powerfully disrupt sleep if consumed too late in the day. The general rule of thumb with caffeine is to consume little amounts and often in the morning hours (about a cup of coffee every two hours, not exceeding 3 – 4 cups) to maximize the alerting benefits while minimizing potential side effects.

4.​ Melatonin, if advised by your doctor, can be a useful jet-lag tool. Whereas there is no evidence that melatonin works as a sleep aid (which is unfortunately how most people are taking it), melatonin is intended for use as a “chronobiotic” (i.e., “time-shifter”), and therefore can be helpful to manage jet lag. Evidence suggests that lower doses of melatonin (0.5mg to 3mg) are most effective, and should be taken several hours before desired bedtime. It can be somewhat tricky to determine when melatonin should ideally be taken, so it is best to consult with a medical provider or use a jet lag management tool to determine when best to take it.

5.​ Get some physical activity to increase energy levels and reduce feelings of malaise. 

Napping

How do you feel about napping?
Naps can be very restorative and healthy, if you follow a few general rules of thumb. First, be mindful of why you feel the need to nap. If you are napping because you simply can’t stay awake during the day, then that is probably a sign that you aren’t getting enough sleep at night or your sleep quality is compromised. A nap is no substitute for good, nighttime sleep. Second, if you are going to nap, keep it short. Naps should generally be 20-60 minutes in length. If the nap lasts much longer, you are likely to fall into deeper stages of sleep, which makes it harder to wake up and you end up feeling groggy and unrefreshed (which defeats the purpose of the nap). Third, naps should be earlier in the day so that they don’t compromise nocturnal sleep. Taking a nap too late in the afternoon or in the early evening hours is a bit like having a snack before dinner — it can diminish your drive for sleep, which you want to be very strong when you are ready for bed to facilitate being able to fall asleep quickly and stay asleep.

Now that your parent duties have slowed down, what are you doing?
I have two children, one who is in college and one who will be in college as of next year, so my husband and I are about to embark on a very different chapter in our lives. I’d be lying if I didn’t say I am feeling some degree of trepidation and anxiety as we approach this chapter. It’s really a major identity transition, as being a parent has been the most important job of my life. But at the same time, I am also excited about what sort of new adventures my husband and I can have together as empty nesters. Thankfully, I really LIKE my husband. Of course I deeply love him too, but I am grateful at this stage that we honestly like each other and enjoy doing things with each other. We have already started to think about the fun and exciting things we can do when it’s just the two of us in the home. Lots of travel is definitely in the cards! Actually, I recently realized that we may not be quite as footless and fancy-free as we might have thought, given we still have two furry, four-legged “children” in the home, so we’ll have to manage that somehow!

Sharing the Covers

You recently wrote a book Sharing The Covers, a couple’s guide to better sleep. What was your writing process?
As a scientist, my primary job is to write — articles, grant proposals, etc., but Sharing the Covers: Every Couple’s Guide to Better Sleep was my first experience writing a book and it was a huge learning experience! The book is the culmination of my nearly 20 years of research and clinical practice focused on the coupled nature of sleep and how couples negotiate the night, so I had a lot of content to draw from. The challenge was really in translating the science into very relatable language and integrating the scientific evidence with case stories that would resonate with a broad audience, in order make it as impactful as possible. Also, as with every large task, the key for me was breaking down what often felt like an insurmountable task into small and manageable “bites.” For me, that meant that every day I committed to one to two hours of writing for my book. I had to really discipline myself to commit to this time every day and to be open to the fact that sometimes the writing might flow easily and other times it might be like pulling teeth but, regardless, every day I committed to the exercise of writing, which was essential to ultimately getting it done.  

We understand you are running, but you live in this snowy place. How does that work?
Whenever possible I try to run outside, as I am really not a huge fan of the treadmill. With the right gear (i.e., warm running clothes), I really don’t mind running outside in cold temperatures — in fact, running gives me an excuse to get outside and benefit from the fresh air when I otherwise might be inclined to hibernate indoors. So the big rate limiter to my outdoor running is really if we get too much snow and I can’t find a place with packed snow to run or if the roads/trails are too icy to run.

What other fitness stuff are you into?
I am an outdoor junkie and I am blessed to live in a place with so many opportunities to enjoy and explore the outdoors. Hiking, running, downhill skiing, snowshoeing, skate skiing are all my jam. Sadly, I have pitiful hand-eye coordination, so I avoid most organized sports, or anything involving a racquet, a ball, or golf club!

What are your three life non-negotiables? The things you can’t live without…
My family. Sleep. Exercise. Sunshine.

Wendy Troxel, PhD: Sleep scientist at the RAND Corporation, clinical psychologist, and author of “Sharing the Covers: Every Couple’s Guide to Better Sleep”

Images by David Harry Stewart