‘Harvard Thinking:’ Are you getting enough sleep? Probably not.

Rebecca Robbins: In any other area, if we told someone we can increase your longevity, we can enhance the quality of your life, improve your health, your physical appearance — it’s healthy sleep. But so many people push back against that.

Samantha Laine Perfas: The National Sleep Foundation estimates that six out of 10 adults in the U.S. aren’t getting enough sleep. In the short term, this affects things like our mood, energy, and memory. Long-term, it can lead to serious health consequences and take years off your life.

So how should we go about getting more, and better, sleep?

Welcome to “Harvard Thinking,” a podcast where the life of the mind meets everyday life. Today, I’m joined by:

Tony Cunningham: Tony Cunningham and I’m the director of the Center for Sleep and Cognition, and the Director of Behavioral Sleep Medicine Clinic in the psychiatry department at Beth Israel Deaconess Medical Center and Harvard Medical School.

Laine Perfas: His primary research focus is understanding the role of sleep and sleep loss, and emotion and memory processing. Then:

Matthew Weaver: Matthew Weaver. I’m an associate epidemiologist at Brigham and Women’s Hospital and instructor at Harvard Medical School.

Laine Perfas: He’s also a member of the Harvard Work Hours Health and Safety Group and the Sleep Matters Initiative at Brigham and Women’s Hospital. And finally:

Robbins: Rebecca Robbins. I’m an assistant professor of Medicine at Harvard Medical School and associate sleep scientist at the Brigham and Women’s Hospital.

Laine Perfas: She has a joint faculty appointment at Harvard Medical School and the T.H. Chan School of Public Health. She also co-authored the book “Sleep for Success: Everything You Must Know About Sleep but Are Too Tired to Ask.”

Laine Perfas: And I’m your host, Samantha Laine Perfas. I’m a writer for The Harvard Gazette. Today we’ll explore some of the barriers to getting enough sleep, and how we might better set ourselves up for quality rest.

I think a good place to start for our listeners would be: Why is sleep so important?

Cunningham: I’ll kick things off here. I like to think of sleep as the great multiplier. Sleep affects every part of your being, every physiological process, every biological process, every psychological process. And it doesn’t do it in isolation. It does help your immune system, but it’s not just helping your immune system. It doesn’t just help your motivation. It doesn’t just help your recovery after a workout. It’s affecting all of those systems together. It’s one of those things where the total is greater than the sum of its parts.

Weaver: To pick up where Tony left off, we are very poor judges of our own sleep quality. You can get into a rut where you feel you’re sleeping five, six hours a night and you think you can get by on that, and that sort of becomes your new normal very quickly. And once you start to implement better sleep practices and achieve better sleep, you start to feel some of these benefits that Tony was describing, and it becomes this positive feedback loop where you see how much better that you’re able to feel and function during the day, and it motivates you to continue better sleep practices.

Robbins: Sleep is one of the most powerful predictors of our health and our well-being today, tomorrow, and well into the future. But what’s so interesting is that sleep is also, despite being so vitally important and a significant contributor to so many areas of our waking success, it’s forgone by so many in our population. Only 30 percent of Americans report consistently getting enough sleep. So the data reveal that many Americans are falling short of their biological need for sleep and leaving so much on the table when it comes to their potential performance.

Laine Perfas: What happens to our bodies if we don’t get enough sleep, both physically and mentally? What are some of the consequences?

Robbins: Virtually every aspect of our waking life suffers under conditions of sleep deprivation. When we’re falling short of some of the targets for healthy sleep — broadly defined, again, duration and consistency and quality are some of those ingredients — we wake up and our mood is one of the first things to go. So our mental health is intimately related to our sleep health. Without enough sleep, we’re more prone to feelings of anxiety and feelings of depression that, when unchecked, can snowball into longer-term diagnoses of anxiety or depression, or worse — suicidal ideation. We also see associations between sleep health and cardiovascular health. So our heart health is directly impacted by our sleep. When we’re not getting enough, our blood pressure goes up. We’re at greater risk for heart attacks, for stroke, and our cognitive health is also intimately linked to our sleep health. When we’re not getting enough sleep or getting good quality sleep, we wake up and we’re more likely to feel feelings of fogginess. We’re more likely to take longer to do tasks than when we’re well-rested. So our productivity suffers. Our creativity suffers. Our ethical decision-making also suffers. In the longer term, we also see an increased risk in the cognitive health category for neurocognitive decline. So those that are not getting enough sleep or chronically suffering from sleep difficulties are at greater risk for Alzheimer’s disease and related dementia and early mortality.

Cunningham: Like Rebecca was saying, if you’re not getting good enough sleep, you’re more likely to experience negative mood symptoms and all the downstream clinical and psychiatric effects that has in store for you. And, to give some concrete examples of what we think is going on there is that there are emotional centers of your brain. There’s the amygdala, which is thought to be the emotional center of your brain. And what we see is, if people are deprived of sleep, that emotional center becomes hyperactive. So even things like emotional stimuli that they saw the day before, they’ve had time to process. Normally, across the night of sleep, you are less reactive to it. Those areas of the brain are less responsive to it. But if you take somebody and you deprive them of sleep, their brains actually become more reactive than the first time that they experienced it. They become hyperactive in that situation. And what we think, beyond that, is going on is that there are actual areas of our brain that are important for executive function, which is important for decision-making, things like that. It’s called the frontal regions of our brain, or frontal lobe. And we think regions of that area of our brain help to put the brakes on the emotional centers of our brain. And effectively, when we don’t get enough sleep, the brakes get cut and we are just unable to as effectively put the brakes on our own emotional centers of our brain, and that’s when things can start to spiral out of control on us.

Laine Perfas: Could you talk a little bit more about the connection between mental health and sleep?

Cunningham: There’s definitely a relationship between serious mental health and sleep. And I think the way it really expresses itself, for the most part, is within recovery and within severity. If you’re treating somebody with depression and you don’t treat their sleep symptoms, even if they recover from the depression symptoms, they’re much more likely to relapse later if they’re still having sleep issues after the treatment. And then in other disorders, specifically one study I know about, in patients with psychosis, the patients that had comorbid sleep disorders had much higher severity symptoms of their psychosis than those that did not have a comorbid sleep disorder.

Weaver: There is such a tight relationship between mood and our sleep. And for example, medical residents in their first year of training experience very challenging schedules and have a limited opportunity for sleep. And we’ve seen a linear relationship with increasing adjusted odds of depression with increasing work hours in that setting. Police officers who screen positive for sleep disorder are much more likely to report burnout. They’re rated as being more difficult to get along with by their colleagues. They have more citizen complaints lodged against them, more likely to make errors in simulation studies of shoot or don’t shoot situations, alluding to that risky behavior. Sleep deficiency has a pervasive impact on all aspects of our life.

Laine Perfas: Yeah, that’s really interesting to think about, and it does seem to me that some people seem to be better at sleeping than others. I am thinking about my husband, and he’s one of those people where he can lay down and within a minute he’s out and he’s out for the night. And I’m on the other side tossing and turning, and I can’t sleep. I’m so tired, but my brain just won’t shut off. But it makes me wonder if some people just have a predisposition to sleep better or if they’re naturally able to fall asleep faster, sleep longer, or sleep shorter than other people.

Cunningham: I’d love to jump on this one because this is like a personal mission, that I feel like I need to help get the message out about this, because to answer your question, yes, there are individual differences in both — the ease with which people fall asleep, but also the amount of sleep that people need. And I’m not sure everybody will agree with me. I’m not sure everyone in the sleep field will agree. But sleep is normally distributed, which means the largest number of people out there need about eight hours of sleep. That’s still only between 25 to 35 percent of the population that biologically, physiologically need eight hours of sleep. That means there’s a lot of the population on either end of that spectrum. Where I see people tend to struggle when they come and see me because of clinical sleep issues very frequently, it’s because there are people on the lower end of the spectrum that are trying to get eight hours of sleep and they just don’t need it. They may only need six, six and a half hours of sleep, and that’s fine for them. That’s all they physiologically and biologically need. Now, I’m going to immediately speak out of the other side of my mouth and say a lot more of us think we’re those people, a lot more of us think that we’re six-, six-and-a-half-hour sleepers when we’re not really. But if you are striving on a nightly basis to hit that eight-hour number and it is not coming, and you’re starting to get stressed about it, and it’s starting to actually impair your ability to fall asleep because you’re getting so stressed about it, it might be worth talking to somebody to see if you can take the gas off a little bit and shoot for a lower number, get the best quality six and a half hours of sleep that you can get, and then, maybe worry about duration after that.

While eight hours is the most common number, it is not the only number. And so it’s really important to figure out what your number is.

Robbins: Sleep is deeply psychological, and I think sometimes we can get into these ruts behaviorally and start to tell ourselves a story of, you know, I’m a bad sleeper, or I’m a good sleeper. We are all different; our personal sleep profiles are different. And I couldn’t agree more, Tony, that the public health message of get eight hours — while in many ways is beneficial to get the word out about how much we need — the truth is, many of us are far from that number and need to move at least — if you’re a five-hour sleeper, I think we can all agree at least need to move a little bit higher, such that the range for adults is somewhere between seven and nine hours. But we’re all different in a different place along that continuum. Sleep can be extremely personal in trying to find your thumbprint of your preferred fall-asleep time.

And by the way, that might be different than your partner’s. I think awareness is everything, and just the fact that we are all different. But I might also just add that one of the contributors to sleep difficulties can be differences in how we manage our worries or tasks or the things in our lives. We do have good data to show that women wear, often, one hat outside the home and another hat inside the home. And there are more of the small day-to-day tasks that women typically share than men. So I do hear from a lot of women in our studies and friends that, “My mind is buzzing when I want to be falling asleep, and then I’m doing all the wrong things. I know that I’m scrolling Instagram and I shouldn’t do that.”

Laine Perfas: Do you have any advice for people who fall in that category?

Robbins: If you are on the category of maybe feeling like you’re taking a little bit longer or struggling to fall asleep, really draw a lot of attention to your bedtime, wind-down routine. And I don’t think it has to be that hard. I think if you boil it down to maybe three things that calm you and soothe you, and if that’s writing about your day, if it’s maybe writing down some to-dos that are lingering in your mind. If it’s reading a couple pages in a book, taking a warm shower, whatever’s relaxing to you, try to think of those two or three things and rinse and repeat that night after night. And your body and your brain are going to start to understand that what comes after those things is sleep. And understanding that is all part of sleep. The bedtime process, we think, “Oh, all right, I’m done with my work, putting the kids to bed, all these things. My day’s done, now I can sleep.” And then we crawl into bed and then we’re frustrated because we can’t fall asleep. But we have to build in time to get ourselves set up for success when it comes to sleep.

Weaver: I love that. And related to this, also in terms of not beating yourself up when you feel like you’ve been sleeping poorly, there are multiple domains to sleep health. We’re increasingly recognizing that regularity may be just as important as duration. The quality of the sleep that you get matters a lot. I think about those other aspects of optimizing your sleep. We had recently collaborated with the National Sleep Foundation on a review concerning sleep regularity, and obviously found that regularity is very important. When you reduce your regularity, there’s an increased risk of metabolic disease and cardiovascular disease, worse mood, a variety of outcomes, but also among those who are not sleeping long enough during the week, specifically, if they’re sleeping five or six hours during the week, catching up on their sleep on the weekends by up to two hours was not found to be harmful. It was found to be actually helpful. So if you’re not getting enough sleep and you need to extend a little bit on the weekends, as long as you’re not overdoing it, that’s beneficial as well.

Laine Perfas: Tony, you mentioned that everybody needs different amounts of sleep. I was also thinking about how that can differ throughout your lifetime, like your sleep needs as a baby versus an 18-year-old versus a 60-year-old. How do our sleep needs ebb and flow throughout the course of our lifetimes?

Cunningham: It definitely evolves throughout our lifespan. And at least some evidence that I’ve seen, the first brain state in the womb is thought to be REM sleep, which is really interesting as one of the stages of sleep. Which makes sense when you start to learn that REM sleep is really important for brain development. It is actually like the structural development of your brain, and what’s called long-term potentiation, kind of making these new neural connections. And so that may actually be our first level of consciousness in this world. And from there we go from about 16 hours of sleep as a newborn — 16 hours of sleep, eight hours awake during the day, in which your time spent asleep is about evenly split between REM sleep and other stages of sleep. And then it just goes down from there, and both the structure of your sleep and the duration of your sleep change a lot throughout, especially puberty. So you go through different stages of puberty, and that’s where you see the structure of your sleep really make a lot of changes. And then it stabilizes to some extent once you hit adulthood.

And I will insert here, I love the concepts of giving yourself grace, as Matt and Rebecca have been talking about, if you are struggling with sleep because you enter those like, late twenties, thirties, forties when it’s busy. I know a couple of us have small children that really take our sleep for a bit of a loop. So giving yourself a little bit of grace during that time, but prioritizing it when you can. And then you enter older adulthood, where the recommendation for amount of sleep actually drops a little bit. Once you’re hitting those older adult years, like 60 plus, there are again more brain changes that might be affecting your ability to stay asleep and get the same level of sleep stages that you’ve got before. But it doesn’t mean you should settle for less. I see a lot of older adults in my clinic that think they could be doing better, and in most cases, they can.

Laine Perfas: There was some interesting research done during the pandemic that showed how sleep was affected during that period of time. What did we learn, and were there any takeaways?

Robbins: Dr. Weaver and I have published quite a bit on this, and our research showed at the beginning of the pandemic we saw, in a global sample, that there was an average 25-minute increase in sleep duration. We thought that was an overwhelmingly positive outcome of COVID-19; those that were able to work from home and shelter in place were able to benefit from a little bit more sleep. And what wonderful news, because we know that sleep is a really important part of a healthy immune system; amid exposure to pathogens, how wonderful that our population was able to get a little bit more sleep. And we saw that overall, that moved our global society from being in the red, as we’d say, below the recommended seven hours, to above that mark. So it was a positive outcome of the pandemic in the early weeks and months. But as the pandemic wore on, we started to see an increase in what we lovingly referred to as COVID-somnia. There were quite a few complaints of sleep difficulties, searches online for insomnia symptoms and sleep remedies, because one of the most important things for all of us when it comes to our sleep is feeling at peace as we fall asleep and feeling as though we’re certain about what tomorrow holds. And for a long time during the pandemic, we didn’t have that.

Weaver: I think this relates back to what Tony mentioned in the beginning about individual thumbprints of sleep needs that were all quite different. And in the context of the pandemic, we on average had more flexibility in our sleep timing. We could control our own schedules a bit more and sleep at the time that was biologically appropriate for us and wake up at a time that was the same. So that increased freedom. I think we did see a shift in sleep timing during the pandemic, that was a little bit greater than actually the difference in sleep duration that was observed overall. That individual freedom helps us set our own schedules that work for us. And I also think over the long term, if you’re thinking, culturally that we’re sleeping less than we used to years ago, we’ve had major cultural changes to our society and one of the things that facilitated them was the increasing accessibility or proliferation of artificial lights. Light’s the most powerful resetting signal for our circadian rhythms. It suppresses the release of the hormone melatonin. It shifts our bed timing later. So when you have access to self-selected lighting in your home, you tend to stay up later, go to bed later. And that’s been over the longer term, something that has enabled us to probably sleep less than we used to and harm our overall sleep practices.

Laine Perfas: I am also wondering if there’s a little bit of stigma associated with sleep. This, oh, if you sleep in, you’re lazy, you’ve got to get up, seize the day, get everything started pretty early. Do you think that plays a role in our quality of sleep?

Robbins: That’s a great question. I think for so many years we’ve worn sleep deprivation like a badge of honor, and we viewed sleep as the price we have to pay in order to succeed. But all of our data show that the opposite is true. It’s remarkable: In any other area, if we told someone we can increase your longevity, we can enhance the quality of your life, improve your health, your physical appearance, it’s healthy sleep. But so many people push back against that.

For so long, we as a society viewed sleep as a pejorative. Whenever you get enough sleep, you don’t really hear people talking about it. You only hear the opposite, which then can contribute to this idea that poor sleep is socially normative, and if you’re getting enough sleep, something’s wrong with you. And so I hope that in our lifetime we might see a reversal of that, such that sleep becomes viewed as an essential part of anyone who’s interested in high performance.

Cunningham: A particular group that I think gets pointed at with this blame is teenagers, and it’s really just not fair because not only are they at a time of their life where they really need a lot of sleep, but their circadian rhythms are shifting later. This is part of that pubertal development, part of that change of sleep that I mentioned earlier, is their bedtimes get shifted later and later. And guess what? School start times aren’t helping them out either.

They’re not really feeling tired until maybe midnight or 1 a.m., and then they have to be up at 7, 7:30. God forbid if they’re a swimmer, they’re up at 5 in the morning. And they’re really having to cut their sleep off on a fairly regular basis. And that’s one group in particular that I think we need to have more care for how is our society set up, especially at such a pivotal time of development.

Laine Perfas: Another group I think we need to give a little more grace to is parents of young children. As someone who is up every two to three hours currently to feed a baby, it’s brutal to then have to go into your day as usual when your sleep is interrupted so much.

Robbins: Totally, Sam, and I think we do a disservice to so many parents, because the sleep community has often said, “Oh, nap when your baby naps.” And I have two little ones. And I remember those days and being so frustrated with that advice.

That’s a time of life that’s just fraught with sleep difficulties. And, you have very little control over your schedule. You’re so driven by caring for this beautiful little baby, but it’s challenging. And then you can’t abide by that advice to sleep when the baby naps because your house is a mess, right? You have laundry to do, you have bottles to clean. So I like much better the advice to when you can sleep and the baby’s down, to try to recoup some of the sleep loss.

Laine Perfas: So let’s say you are someone who recognizes, “I need more sleep. I need to prioritize my sleep.” You would think it would be as simple as then just get more sleep, or to go to what I lovingly call Dr. Google and ask, “How do I get more sleep?” Could you talk about some of the sleep myths that are out there or some of the suggestions that are actually counterproductive?

Robbins: We got together a list of the most common myths about sleep and published it in our journal of Sleep Health not too long ago. And there were quite a few. But number one, the myth that there’s some people out there that do great on less than seven hours. and they do exist, but they are extremely, extremely rare, and not well studied. Other myths are that alcohol is a good thing for sleep. And we do find that maybe, depending on your body mass, one dose of alcohol could maybe help you feel a little bit sleepy, reduce stress a little bit if consumed with food a little bit earlier in the day, but close to bedtime and consumed in excess is not going to be helpful for your sleep.

Another one of our myths is that your brain can learn to function on less sleep. I hear this from our students who are undergrads and going into finance all the time. They’re like, “I need to start training myself!” Unfortunately, that will only hinder your ability to be successful there. Other myths are adults sleep more as they get older. We see that we’re in the best sleep shape when we’re actually about the age 38 or maybe 40, and our sleep systems can start to decline after that. Do older adults need less sleep? No, but they unfortunately struggle a little bit more than younger adults in their ability, their fundamental ability to get good sleep. One of the other big ones was being able to fall asleep anytime, anywhere is the sign of a good sleeper. Falling asleep fast is not a sign always of good sleep. If you are starved for nutrition, you haven’t eaten for several days, you know, you’re going to sit down at a table and help yourself to as much food as possible. If you’re not getting good sleep, you’re going to be starved for sleep and fall asleep very quickly.

Weaver: I totally agree. We often talk with professionals in different occupations, like police officers, firefighters, and they’ll say, “I can drink coffee right up till the moment I go to bed. I can sleep instantly.” What that means is you’re chronically sleep deprived, and you need more sleep than you’re getting. There are many of us out there who think we can get by on four hours of sleep. As we mentioned earlier, we’re just not good judges of our own sleep deprivation. I think we all appreciate the increased attention that sleep is getting these days. And with that come a variety of hacks. I would say have a healthy level of skepticism for things that are suggested that seem a bit off the wall. Sleep hygiene tips are super basic, like we mentioned earlier in this conversation. It’s a cool, dark environment. It’s a healthy wind-down routine. It’s prioritizing it and allowing yourself enough time in that environment to fall asleep naturally. Those are the key things. There’s not like a magic pill that’s going to necessarily help you out.

Laine Perfas: What are the pros and cons of sleep supports like melatonin, magnesium, even medication?

Cunningham: When we talk about a treatment decision, right? When we see people clinically who are having chronic sleep issues and we’re trying to make a decision as to how we’re going to treat them. Do we want to do a behavioral intervention — I do cognitive behavioral therapy for insomnia, CBTI — that’s considered the gold-standard frontline behavioral treatment for insomnia symptoms. Now, one of the problems is there are not enough providers out there for the number of people who are having sleep issues.

There is definitely a place for medications and for melatonin. I think one of the problems is we want to use those things as acutely as possible. So if you’re having a specific period in which sleep is going be negatively impacted or going through a specific stressful time — you have a traumatic event, maybe something really has rattled you and sleep is going to be a priority for a while — that would be a time in which sleep physicians would be more inclined to use medications. If it’s more of a long-term chronic issue and you really want to be at the root of the problem, that’s when you’re going to want to get in line for a behavioral sleep medicine interventionist.

And then melatonin, I think my biggest issue with it is people don’t really take it correctly. What they end up doing is take a giant bowl of melatonin right before they’re going to bed, which is way more than you could possibly need, and it’s not giving it enough time to actually act. My understanding of melatonin is that it’s supposed to just kickstart your natural production. Basically, it becomes like a feedback loop where if you have a little bit of melatonin in your system, it will then kickstart your natural melatonin production. And so the ideal way of taking it is a much smaller dose a couple hours, potentially even two to three hours, before your determined bedtime to give your body the time to produce the melatonin that it needs.

Weaver: Yeah, I agree. And melatonin in particular, it’s worth trying. It’s something that your body’s secreting naturally, but it may be secreting it at an inappropriate time, particularly if your sleep is irregular. So if you want to sleep at a different time than you usually do, it can be helpful. If you’re traveling, changing time zones, it can be helpful. As Tony mentioned, things to keep in mind are inappropriate dose. What is commonly sold at, say, Walgreens, CVS, are 3, 5, 10 milligrams. It’s not necessarily, it’s not regulated by the FDA. So, we would recommend making sure that you get a pharmaceutical-grade version of melatonin and take a small dose. We recommend starting at half a milligram and you can give it a try. It is quite safe.

Robbins: And just to underscore what Dr. Weaver just said, a half a milligram, and that’s far less than what you can find in a typical grocery store or drug store. It is many factors higher than that. And it’s not a better situation. I know this is a little bit of a myth that melatonin is a sleep aid. It really is a circadian rhythm intervention, and I think it’s unfortunately broadly labeled to consumers as a sleep aid.

Laine Perfas: As we wrap up, I had one last question, which is a little bit funny since Matt mentioned that he is suspicious of many sleep hacks, but I wanted to ask each of you if you had a favorite sleep hack, either that has worked for you personally or people that you have treated.

Cunningham: So the two I would go to, clinically speaking – and I’m going to call it recommendations, I don’t even want to call it a hack. You want your bedroom to be nice and cool temperatures. You want it to be dark, and you want it to be relatively quiet. I do like white noise. White noise is okay. But you don’t want a lot of background noise. You don’t want TV going, stuff like that. And then the other thing that, again, if I’m going to have somebody focus on one thing with regards to their sleep, timing and duration. It’s to try to keep as consistent of a rise time each day. It’s not just sleep duration, it’s sleep regularity. Like Matt said, there’s some room for flexibility, right, like catching up on sleep, or there’s also some research that you can sleep-bank ahead of time, too, and that will help if you know you’re going to have some issues. But on a long-term scale, if you are able to keep a consistent rise time each day, pretty close, will just help it make sure that you’re tired by your bedtime the next day.

Weaver: I totally agree, and I guess I’d call it a strategy more than a hack, but agree with all Tony’s points. Cool. Dark. Quiet. I also use white noise. I find that to be very helpful. And be conscious of the lighting in advance of the bedtime, so keep it pretty dim an hour before bed incorporated in your wind-down routine; reading from a physical book rather than your phone in general is helpful for me at least, is my own sort of hack. And one thing that is increasingly popular on social media is the importance of light in the morning. And there’s actually really strong evidence base for that. So I’m a big believer in bright sunlight early in the morning. It will help you sleep later that night and keep you on a regular sleep schedule.

Robbins: The good news, as you see in all of these suggestions, is small changes can go a really long way, and they start tonight. And I like this idea of, I am my own “n-of-one” experiment, and let me try these things and see what maybe I’m doing that is hurting my sleep and how can I change that? And then what might be helping, and how can I lean more into that? Earlier dinners are good, keeping your last time you’re eating pretty far away from your bedtime. And there’s like a constellation of things that really help surrounding sleep itself to set you up for success.

I think the only other thing I’d add is just the bedtime routine. Sam, as a parent, you’re very acutely aware of your child’s bedtime routine, and I think we all are, across our society, focused on kids and getting them on track. And then we forget that as adults we actually need that same routine. And again, we need to feel like we’re at peace and we can drift off into sleep. And I think it’s harder and harder to find that in today’s day and age, especially if you’re looking at your phone before bedtime. If you’re able to pick three things that soothe you and think about what really relaxes you the most — is that going to the spa? Then maybe pick up a hand cream that you find to be soothing. Do a little gentle massage of your cervical spine. Some gentle yoga that you find relaxing, an up-dog, a down-dog, and then find a comfortable seat. And maybe if you find that you have a busy mind before bedtime, practice a couple breathing exercises. And you can come back to being at peace in the present moment. And that is what sleep is all about, feeling at peace, and that’s how you drift off.

Laine Perfas: Thank you all for joining me today.

Robbins: Thank you for having us.

Weaver: Thank you.

Laine Perfas: Thanks for listening. If you’d like to see a transcript of this episode and to find all of our other episodes, visit harvard.edu/thinking. This episode was hosted and produced by me, Samantha Laine Perfas. Additional editing and production support from Sarah Lamodi, Max Larkin, Ryan Mulcahy, and Paul Makishima. Original music and sound design by Noel Flatt, produced by Harvard University. Copyright 2025.