Leading neuroscientist Matthew Walker on why sleep deprivation is increasing our risk of cancer, heart attack and Alzheimers and what you can do about it
Matthew Walker has learned to dread the question What do you do? At parties, it signals the end of his evening; thereafter, his new acquaintance will inevitably cling to him like ivy. On an aeroplane, it usually means that while everyone else watches movies or reads a thriller, he will find himself running an hours-long salon for the benefit of passengers and crew alike. Ive begun to lie, he says. Seriously. I just tell people Im a dolphin trainer. Its better for everyone.
Walker is a sleep scientist. To be specific, he is the director of the Center for Human Sleep Science at the University of California, Berkeley, a research institute whose goal possibly unachievable is to understand everything about sleeps impact on us, from birth to death, in sickness and health. No wonder, then, that people long for his counsel. As the line between work and leisure grows ever more blurred, rare is the person who doesnt worry about their sleep. But even as we contemplate the shadows beneath our eyes, most of us dont know the half of it and perhaps this is the real reason he has stopped telling strangers how he makes his living. When Walker talks about sleep he cant, in all conscience, limit himself to whispering comforting nothings about camomile tea and warm baths. Its his conviction that we are in the midst of a catastrophic sleep-loss epidemic, the consequences of which are far graver than any of us could imagine. This situation, he believes, is only likely to change if government gets involved.
Walker has spent the last four and a half years writing Why We Sleep, a complex but urgent book that examines the effects of this epidemic close up, the idea being that once people know of the powerful links between sleep loss and, among other things, Alzheimers disease, cancer, diabetes, obesity and poor mental health, they will try harder to get the recommended eight hours a night (sleep deprivation, amazing as this may sound to Donald Trump types, constitutes anything less than seven hours). But, in the end, the individual can achieve only so much. Walker wants major institutions and law-makers to take up his ideas, too. No aspect of our biology is left unscathed by sleep deprivation, he says. It sinks down into every possible nook and cranny. And yet no one is doing anything about it. Things have to change: in the workplace and our communities, our homes and families. But when did you ever see an NHS poster urging sleep on people? When did a doctor prescribe, not sleeping pills, but sleep itself? It needs to be prioritised, even incentivised. Sleep loss costs the UK economy over 30bn a year in lost revenue, or 2% of GDP. I could double the NHS budget if only they would institute policies to mandate or powerfully encourage sleep.
Why, exactly, are we so sleep-deprived? What has happened over the course of the last 75 years? In 1942, less than 8% of the population was trying to survive on six hours or less sleep a night; in 2017, almost one in two people is. The reasons are seemingly obvious. First, we electrified the night, Walker says. Light is a profound degrader of our sleep. Second, there is the issue of work: not only the porous borders between when you start and finish, but longer commuter times, too. No one wants to give up time with their family or entertainment, so they give up sleep instead. And anxiety plays a part. Were a lonelier, more depressed society. Alcohol and caffeine are more widely available. All these are the enemies of sleep.
But Walker believes, too, that in the developed world sleep is strongly associated with weakness, even shame. We have stigmatised sleep with the label of laziness. We want to seem busy, and one way we express that is by proclaiming how little sleep were getting. Its a badge of honour. When I give lectures, people will wait behind until there is no one around and then tell me quietly: I seem to be one of those people who need eight or nine hours sleep. Its embarrassing to say it in public. They would rather wait 45 minutes for the confessional. Theyre convinced that theyre abnormal, and why wouldnt they be? We chastise people for sleeping what are, after all, only sufficient amounts. We think of them as slothful. No one would look at an infant baby asleep, and say What a lazy baby! We know sleeping is non-negotiable for a baby. But that notion is quickly abandoned [as we grow up]. Humans are the only species that deliberately deprive themselves of sleep for no apparent reason. In case youre wondering, the number of people who can survive on five hours of sleep or less without any impairment, expressed as a percent of the population and rounded to a whole number, is zero.
The world of sleep science is still relatively small. But it is growing exponentially, thanks both to demand (the multifarious and growing pressures caused by the epidemic) and to new technology (such as electrical and magnetic brain stimulators), which enables researchers to have what Walker describes as VIP access to the sleeping brain. Walker, who is 44 and was born in Liverpool, has been in the field for more than 20 years, having published his first research paper at the age of just 21. I would love to tell you that I was fascinated by conscious states from childhood, he says. But in truth, it was accidental. He started out studying for a medical degree in Nottingham. But having discovered that doctoring wasnt for him he was more enthralled by questions than by answers he switched to neuroscience, and after graduation, began a PhD in neurophysiology supported by the Medical Research Council. It was while working on this that he stumbled into the realm of sleep.
The film industry has a long and unhealthy obsession with the weight of its female stars. The more who speak up like Moretz did this week the more chance there is of change
This week, 20-year-old actor Chle Grace Moretz said she had been body-shamed by a male actor on set when she was 15. He was her co-star at the time, in his 20s, cast in the role of her love interest, and he said he would never date her in real life, because she was too big. It was a comment that drove her to tears. Moretz is the latest in a string of Hollywood stars who are prepared to be more open about their experiences of sexism in the industry, from Jennifer Lawrence to Emma Watson. Like the late Carrie Fisher, who revealed she was asked to lose weight before appearing in the new Star Wars series, Moretz touches on something particularly troubling: the pressure on women on screen to maintain a body size that may be unrealistic or unhealthy.
Unfortunately, this is nothing new. Silent-film expert Pamela Hutchinson cites the example of Greta Garbo. Louis B Mayer hired her for MGM in 1925, when she was already a success in Europe, with the caveat that In America, we dont like fat women. Garbo ate nothing but spinach for three weeks and then dieted, rigorously, for the rest of her Hollywood career. There were even more extreme measures. An actor called Molly ODay had her excess weight cut away by a surgeon. In 1929, Photoplay magazine explicitly blamed the death of comic actor Katherine Grant on the Hal Roach studios demands for her to lose weight.
The long read: More and more singers are cancelling big shows and turning to surgery to fix their damaged vocal cords. But is the problem actually down to the way they sing?
I dont even know how to start this, Adele wrote in an online letter to fans on 30 June. The previous night, she had played the second show of a sold-out, four-night residency at Wembley Stadium. These dates, in front of audiences of 98,000, were supposed to be the triumphant conclusion of her record-setting, 123-date world tour. But on stage, something had just felt wrong.
Ive struggled vocally both nights, she wrote. I had to push a lot harder than I normally do. I felt like I constantly had to clear my throat. After the second show, Adele went to see her doctor, who told her she had damaged her vocal cords and had no option but to cancel her remaining shows. The most powerful young voice in the music business had fallen silent. To say Im heart broken would be a complete understatement, she wrote.
Though only 29, Adele had been here before. Six years earlier, she had suffered a haemorrhage to her vocal cords after singing live on a French radio program. In order to repair the injury, she underwent an incredibly delicate, high-risk medical intervention: vocal cord microsurgery. In this operation, the surgeon wields miniature scalpels and forceps attached to foot-long poles that are guided down the throat to excise whatever damaged tissue is robbing the vocal cords of their elasticity, and depriving the voice of its natural timbre, range and clarity.
Adeles surgeon, Dr Steven Zeitels, was after a nasty polyp that had formed under her epithelium, the thin outer layer of the vocal cord. Zeitels carefully snipped the layer with a scalpel, and then, with a forcep, pulled back the tissue like a flap, exposing the polyp below. With a second forcep he pulled out the gooey, infected mass, and zapped the remaining haemorrhaged surface with a laser to stop the bleeding and prevent scarring.
The margin for error in such surgeries is measured in fractions of a millimetre. You cant let the instruments touch any healthy tissue. Dig too deep, Zeitels knew, and he would risk damaging the superficial lamina propria, the soft, pliable underlayer of Adeles vocal cords. If he pierced that, he told me, there would be no way to preserve the power and suppleness of her voice.
On 12 February 2012, three months after her surgery, Adele swept up six awards at the Grammys, including album of the year and song of the year. In her acceptance speech for best pop solo performance, she thanked Zeitels for restoring her voice. To most observers, it was a cheering comeback story, but for a handful of medical specialists it was a watershed moment. For years, vocal cord microsurgery had been considered risky. (In 1997, an unsuccessful surgical procedure left Julie Andrews already damaged voice beyond repair.) More than the physical risk, though, singers feared the damage to their careers that could follow if word got out. In the world of showbusiness, it was safer to be seen as a singer with a healthy young voice than as a one-time great with surgically repaired cords.
Now, Adele had suddenly swept away the stigma. In the years since, Zeitels business has boomed, along with those of many of his peers. They have no shortage of patients: there is an epidemic of serious vocal cord injuries in the performing arts. In addition to his work on Adele, Zeitels, who directs the Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, has repaired the cords of more than 700 performing artists, including Sam Smith, Lionel Richie, Bono and Cher. Michael Bubl, Keith Urban, Meghan Trainor and Celine Dion have also had to quit touring to get their cords surgically repaired. In a mark of how attitudes to surgery have changed, both Smith and Bubl broke the news of their surgeries to their fans via Instagram.
There is no precise data on the number of performers who have gone under the knife over the years. But several surgeons told me they estimate that vocal cord surgery has been performed on thousands of pop, rock and classical singers, as well as on theatre and stage musical stars. Cancelled shows reverberate across social media and hit a struggling music industry hard. When Adele pulled out of her remaining two Wembley shows this summer, nearly 200,000 tickets had to be refunded. Its unclear if she will ever tour again.
After Adeles 2011 surgery, Zeitels became something of a celebrity. Occasionally, a reporter asked him if Adele was cured for good. He made no assurances, but told Channel 4s Jon Snow that her surgically repaired voice sounds smoother now than before.
While the media was celebrating this miracle surgery, one woman in the music industry raised a dissenting voice. According to Lisa Paglin, a former opera singer turned voice coach, Zeitels had simply found a temporary fix; in the not too distant future, Adele would once again be forced off the stage and back into the operating theatre. It was a prediction that Paglin and Marianna Brilla, her coaching partner, were willing to stake their reputations on. The rash of vocal injuries silencing our most promising young talents, they argued, is too big a problem to be solved by microsurgery.
How many surgeries would Dr Zeitels consider performing on Adele? Or on anyone? After surgery, unless a singer makes major changes, return to performing means a return to the vocal abuse that put her/him on the operating table in the first place, Paglin wrote, in the small trade publication Intermezzo. Concerts injury surgery rest concerts injury surgery. Is this the life of a professional singer?
When Adele cancelled the final nights of her recent tour, Brilla and Paglin felt saddened but vindicated. For more than a decade, they have been pushing for a revolution in the way that almost every modern performer has been taught to use their voice. After years of painstaking research in musical archives, early scientific journals and the classroom, Brilla and Paglin say they can deliver what medical science has failed to: a permanent fix for vocal burnout.
Their solution requires the revival of an all-but-vanished singing method that is not just beautiful to the ear, but also easy on the throat. Some of their ageing and beleaguered clients described it to me as a kind of fountain of youth. But their cure is not without controversy. It is based on a provocative theory that has been gaining ground among a small cadre of international talents: that we have all been singing completely wrong even Adele.
Singing is a rough business. Every vocal performance involves hundreds of thousands of micro-collisions in the throat. The vocal cords also known as vocal folds are a pair of thin, reed-like, muscular strips located inside the larynx, or voice box, in the throat. They are shaped like a wishbone, and contain the densest concentration of nerve tissue in the body.
When we are silent, the cords remain apart to facilitate breathing. When we sing or speak, air is pushed up from the lungs, and the edges of the cords come together in a rapid chopping motion. The air causes the cords to vibrate, creating sound. The greater the vibration, the higher the pitch. By the time a soprano hits those lush high notes, her vocal cords are thwacking together 1,000 times per second, transforming a burst of air from her lungs into music powerful enough to shatter glass.
Beautiful singing requires lithe cords, but all that slapping together can wear down their fine, spongy surface and lead to tiny contusions. Over years of heavy use, nodules, polyps or cysts form on the vocal folds, distorting the sound they create. For a singer, the first sign of trouble is often the wobble. His pitch fluctuates on and off key because his ragged cords have lost their natural vibrato their ability to resonate properly. Then theres the hole, a point on the scale where a singers vibrating vocal cords fail to produce the proper tone. Try as he might, those notes will exit his mouth flat or, worse, as a barely audible gasp.
Your internal chatter has a huge impact on the way you feel about yourself. Listen in, says Gary John Bishop
You stumble through the door into your morning coffee ritual. As you make your way through a maze of chairs, tables and outstretched legs you finally arrive at your space at the end of the queue, and the deliberation begins
Maybe Ill have something different this time, hmm, let me see Iced cranberry lemon tea? Nah, I need the jolt, Ill get my usual. Good, now what else What about one of those muffins? Nah, Im piling it on, theres about 6,000 calories in one of those Bagel? Ugh no, Ill stick to the coffee.
Your turn comes, the server asks: How can I help you? and you confidently declare: Vanilla latte with a shot of espresso please.
It all happens in seconds, this mass of deliberation, reasoning and decision making, and its never ending. While the coffee shop scenario might not be quite your thing, youll have your own version. This is how your mind works. Its how all of our minds work, going constantly back and forth, every moment of every day of our lives.
Sometimes its quiet, sometimes its loud, but its always there, that little voice in our head. We all know the one, the internal dialogue that filters life, categorises people and hears what it hears to give life that ever-so-familiar ring to it.
Studies show that we have more than 50,000 thoughts per day. While we have little or no say in those automatic and reactionary thoughts, we have a massive say in which of those thoughts we attach significance to.
Your emotional state, your moods, your ways of being and acting are in a dance with your internal dialogue. Your experience of yourself, of being you, is intricately woven into existence in the way that you speak to yourself and others. Its not only what you talk about but, more importantly, how you talk about it.
Most people believe that they have certain feelings first, followed by a thought to themselves about how they feel. Not quite. The language you use has a direct and powerful in-the-moment impact on your feelings. The German philosopher, Martin Heidegger, said: Language is the house of being, while his compatriot, Hans-Georg Gadamer, insisted: Without language nothing exists.
Look at your own life where you use terms like This is impossible, I cant, Im confused, This is too much or Im trying. Each of these (and a litany of others), gives rise to certain emotional states (anger, frustration, resentment, hopelessness, etc), all of which work against you in your endeavour. How does feeling hopeless help in that job search, or being frustrated help in healing your relationship, or feeling incompetent get you that promotion? It doesnt. It weighs you down and dampens your enthusiasm.
As a simple example, changing Its impossible to I havent worked it out yet has a remarkable impact on the way in which you deal with certain problems. Your emotional state shifts.
In very real terms, how you talk about what you are dealing with either works for or against you.
Next time youre feeling suppressed, frustrated or worn down, check yourself. Go over that internal chatter a few times and see if you can connect how youre describing it to yourself to how you feel. Ask yourself: Am I using the kind of language that is building something or destroying something? Is this in my favour or working against me?
Language really is that important. After all, you are what you speak.
The Netflix drama, which stars Lily Collins, leans on some outdated tropes. But only a handful of novels and films have evoked the reality of the illness, or explained why so many women turn their unhappiness on themselves
No talk about food. Its boring and its unhelpful, announces Keanu Reeves playing (hold on to your hat) a doctor specialising in eating disorders in To the Bone, the much-discussed upcoming film about anorexia, starring Lily Collins and distributed by Netflix. And this is excellent advice, but it can be hard to see beyond the surface issues when you are dealing with someone who is literally starving themselves to death: the shoulder blades jutting out like birds wings, the food hidden under place mats, the limbs so wasted you can circle them with your fingers. It is even harder if a part of you is turned on by skinny, self-destructive women, as the movies invariably are, and this one definitely is.
Its not easy to make a good movie about anorexia, which is why almost almost none exist. How to depict a mental illness that unlike, say, schizophrenia or bipolar disorder has such a well-known and hard-to-fake physical manifestation? To the Bones writer-director, Marti Noxon who based the movie on her own experiences with the illness got around this by getting Collins, who has spoken about her own struggles with eating disorders, to lose an astonishing amount of weight so that she looks credibly anorexic on screen. Given how thin female actors now have to be just to look slim, your heart breaks at the thought of how much weight she must have lost to look so painfully ill.
To the Bone has been wildly praised since it debuted at Sundance in January, and I can only assume this is because critics get weirdly overexcited when actors undergo physical transformations. The truth is To the Bone is not a good movie about anorexia. In fact, it is a bad one. We could talk all day about the ethics of hiring a young woman who is known to be vulnerable to eating disorders, and then telling her to lose weight to look anorexic, but lets give Collins the benefit of the doubt and say she is an adult woman who is free to make her own career choices. Instead, lets talk about To the Bones real problem, which is that it is shallow, sexist and sick.
The only justification for making a movie like this is that it is going to provide some insight into a much-discussed if little understood problem, a requirement Netflixs earlier and similarly exploitative foray into self-destructive young women, 13 Reasons Why, notably failed to meet. But from the very first scene it is obvious that To the Bone leans on some wearily outdated tropes. We first see Ellen (Collins) in an in-patient unit, in which she and her fellow anorexia patients are beautifully styled in the universally recognised signifiers of crazy-but-sexy young women: heavy kohl eyeliner and mascara, Tank Girl-esque distressed clothing and biker boots. We have gone from 1999s Girl, Interrupted to 2017s Meal, Interrupted.
From there on, the anorexia stereotypes are ticked off with the regularity of hospital mealtimes. The movie disregards its own advice almost immediately about not focusing on the food and does so with voyeuristic intensity, without ever asking why so many women feel so unhappy, and why they then turn this unhappiness on themselves. All the anorexia patients, with one male exception, are young, attractive, middle-class white women, when the illness affects a far broader demographic. Reeves, as Ellens psychiatrist, Dr Beckham, is a self-described unconventional doctor, who proves his unconventionality by swearing occasionally and insisting his methods are totally different from anyone elses (theyre not: they rely on therapy and healthy eating, as almost all eating-disorder treatments do). He also clearly enjoys his power over his mainly female patients and a braver, less conventional film would have explored this more. Instead, To the Bone merely accepts the doctors version of himself as the brilliant, patriarchal medical professional who can fix women.
I am going to show my cards here and say that I am undoubtedly biased on this issue, because I had a doctor similar in some regards to Beckham during my first three hospitalisations: Dr Peter Rowan, then based at the Priory in Roehampton. I was only 14 when I first met him but even then it seemed to me that he revelled too much in his authority over a ward of vulnerable women, who in turn viewed him as god-like. In 2011, 18 years after we parted ways, he was struck off when it emerged he had what was described as a blurred and secretive relationship with a female patient, who left him more than 1m in her will.
Now, clearly, there are plenty of excellent male psychiatrists who work with eating disorders, and my experience was an outlier. But given that anorexia is often a form of rebellion against gender norms, with female and male sufferers rejecting, respectively, sexualised femininity and macho masculinity by starving themselves, it is ironic that a movie should re-enact such gender cliches. The doctor is a man, the nurse is a woman, the women in Ellens life (her mother, stepmother and her mothers girlfriend) are all self-obsessed and bitchy, her father is absent but hard-working. The one male anorexia patient is wise and selfless in a way none of the female patients are, and spoiler alert he, along with the male doctor, helps to save Ellen. Many brilliant women are now the leading lights in eating-disorder treatment, not least the woman who treated me through my last three hospital admissions, Professor Janet Treasure, now the director of the Eating Disorder Unit at the Institute of Psychiatry at Kings College, London. So the idea that all that these hysterical female anorexia patients need is a couple of calm men to save them from themselves is, to put it mildly, grating. The film even tacks on a frankly ludicrous romantic subplot, and anyone who thinks patients with eating disorders are making out with one another on hospital wards has clearly never bothered to Google what starvation does to a persons libido.
There is currently a petition online demanding that Netflix pulls the show for two reasons. The first, that it might trigger sufferers, is a point I feel sympathy for but cannot agree with. Legislating against anything that might trigger the mentally ill or vulnerable is an impossible game of Whack-a-Mole. But the petitions other complaint, that it glamorises anorexia, will be less easy for the film-makers to dismiss. Contrary to what the character of Ellen might suggest, anorexia is not all thigh gaps and eyeliner. By the time I was admitted to hospital for the first time when I was 14, most of my hair had fallen out, I could barely walk because I was so cold and my knuckles bled constantly due to extremely dry and cracked skin. Instagram-ready, I was not. There is a line between rendering a complex subject filmable and sexing-up a serious illness, and To the Bone crosses it from the first scene. And when all a movie about anorexia tells you is that people with anorexia have issues with food, and that this makes them thin and unhappy, you have to wonder what the point of the movie is.
Anorexias physical manifestations distract even those of us who have suffered from it from grasping the internal issues. Indeed, that is the point of the starving: we dont have to think about the unhappiness that led us to this point. In one interview, Noxon said that being around Collins and the other actors who were losing weight was difficult for her. I started to need to turn to the other female producers quite frequently and say: Im going to need you to tell me that I dont need to lose weight, she said. When there is a part of you that still gets turned on by not eating, you will not be able to discuss anorexia properly, because you are still preoccupied by the surface symptoms.
From Alexander Fleming onwards, the lives of millions have been transformed and saved by treatments that scientists were not even looking for
When scientists in New Zealand discovered that a meningitis vaccine fortuitously protects against gonorrhoea, they were benefiting from an unpredictable force responsible for some of historys most striking medical breakthroughs: serendipity.
So many things have been discovered by chance. The German writer, scientist and all-round polymath Johann Wolfgang Goethe, a discoverer himself, wrote: Discovery needs luck, invention, intellect none can do without the other.
In pharmaceutical giant Pfizers laboratories in Kent, a failed treatment for angina accidentally became a billion-dollar erectile dysfunction blockbuster, and the worlds most famous blue pill.
During early clinical trials of sildenafil, now better known by its trade name Viagra, male volunteers taking the pills consistently reported unprovoked, long-lasting erections. After further investigation, it turned out that Viagra, designed to relax blood vessels around the heart to improve blood flow, was having the same effect on arteries within the penis. Since its commercial release in 1998, it has been used to improve the sex lives of millions of men worldwide.
Incidentally, the 2007 Ig Nobel Prize, awarded annually for that years most useless research, was awarded to three Argentinian scientists who discovered that Viagra helped hamsters recover faster from jet-lag.
Returning to work after a month-long Scottish vacation in 1928, pathologist Alexander Fleming made a discovery in a discarded culture dish, which he had unintentionally left open to the elements on a window sill in his laboratory at St Marys Hospital in London.
In Flemings absence, the dish, growing the dangerous bacteria staphylococcus aureus, had become contaminated with an air-borne mould a type of fungus. Fleming noticed that, near the blue-green strands of fungus, growth of the bacteria had been stopped in its tracks.
Fleming had inadvertently stumbled across the first antibiotic, which he called penicillin.
For his accidental discovery, he shared the Nobel prize for medicine in 1945 with Florey and Chain, Oxford chemists who perfected the process of penicillin mass production in time to treat infected battlefield injuries sustained in the second world war.
When I woke up just after dawn on 28 September, 1928, I certainly didnt plan to revolutionise all medicine by discovering the worlds first antibiotic, or bacteria killer, Fleming later recalled. But I suppose that was exactly what I did.
New York engineer Wilson Greatbatch invented the worlds first implantable heart pacemaker but he didnt mean to.
While trying to build a device to record heartbeats in 1956, he accidentally installed the wrong type of resistor into his prototype which promptly began to emit regular electrical pulses.
Realising these pulses were recapitulating the electrical activity of a normal heartbeat, Greatbatch immediately saw the potential of his device. After two years of refinements, his design for a pacemaker that could be implanted into the heart was patented in 1960 and soon went into production. Life-saving descendants of this first device now improve the lives of over half a million patients with slow heartbeats every year.
In the 1980s, two Australian doctors were ridiculed for suggesting that stomach ulcers were caused not by business lunches and stress, but by infection with a common bacteria. Barry Marshall, a gastroenterologist and his pathologist colleague in Perth, Robin Warren, noticed that stomach biopsies taken from their ulcer patients all contained the same spiral-shaped bacteria, called helicobacter pylori.
To prove their hunch, Marshall deliberately downed a pint of foaming helicobacter broth that hed grown in his lab after isolating it from the stomach of one of his patients. Within a week, he had rampant stomach inflammation which was then completely reversed by taking antibiotics.
Their discovery has also meant the virtual eradication of a type of stomach cancer caused by helicobacter infection.
For their work (and presumably Marshalls bravery), Marshall and Warren were awarded the 2005 Nobel prize for medicine.
Several classes of antidepressants owe their discovery to chance, from iproniazid, which was initially used to treat tuberculosis in the 1950s, to the tricyclics of the 1960s, which stemmed from an experimental treatment for schizophrenia and the more recent breakthrough involving the use of ketamine.
The entry-level benzodiazapine was developed in the 1950s by a Polish immigrant in the US, Leo Sternbach, from discarded chemical compounds he had synthesised 20 years earlier in Poland when he was working on experiments to create new dyes.
The dyes were a failure. The benzodiazapines quickly became the most popular prescription drugs in the US.
People who felt they had a strong purpose in life suffer from less insomnia and sleep disturbance, says neurologist
The secret to a good nights sleep later in life is having a good reason to get up in the morning, according to US researchers who surveyed people on their sleeping habits and sense of purpose.
People who felt they had a strong purpose in life suffered from less insomnia and sleep disturbances than others and claimed to rest better at night as a result, the study found.
Jason Ong, a neurologist who led the research at Northwestern University in Chicago, said that encouraging people to develop a sense of purpose could help them to keep insomnia at bay without the need for sleeping pills.
More than 800 people aged 60 to 100 took part in the study and answered questions on their sleep quality and motivations in life. To assess their sense of purpose, the participants were asked to rate statements such as: I feel good when I think of what Ive done in the past and what I hope to do in the future.
According to Ong, people who felt their lives had most meaning were less likely to have sleep apnea, a disorder that makes the breathing shallow or occasionally stop, or restless leg syndrome, a condition that compels people to move their legs and which is often worse at night. Those who reported the most purposeful lives had slightly better sleep quality overall, according to the study in the journal Sleep Science and Practice.
Insomnia and some other sleep disorders become more common in old age, but Ong said that the findings were likely to apply to the public more broadly. Helping people cultivate a purpose in life could be an effective drug-free strategy to improve sleep quality, particularly for a population that is facing more insomnia, he said.
Age UK, a charity, advises people who sleep badly to go to bed and rise at the same time every day; establish a bedtime routine; and cut out caffeine, alcohol and nicotine in the evening. Not eating a heavy meal late at night; avoiding exercise before bed; cutting out daytime naps and banning TVs and computers from the bedroom helps too, they add.
Music is one of lifes great pleasures. But why, asks Adam Ockelford, does it affect us so profoundly?
Its a question that has intrigued thinkers across the ages from Socrates to Schopenhauer: why is it that abstract patterns of sound mean so very much to human beings?
We are more exposed to music than ever before, thanks to streaming from Spotify and YouTube to Mixcloud and downloading, and were bombarded with music via advertising, too. It is there to influence the way we think, feel and behave. As every filmmaker knows, music is unique in its power to stir the emotions. As music therapists work with dementia patients and autistic children has shown, music has the capacity to touch us and tap into memories that words alone are not able to reach. But how?
Defining what isnt music can help us to understand its powerful effect on us. There are those who believe that certain everyday sounds particularly the sounds of nature should be classed as music, such as Tennysons babbling brook. This may be regarded as music to a poets ear, but it doesnt communicate to us in the way music does. Music conveys meaning since all its constituent sounds notes elicit tiny emotional responses, and these are locked together in a coherent narrative through imitation. In this sense, rushing water or pattering rain fail the musical test.
How does music compare with the other uniquely human form of communication in sound: language? Unlike words, sequences of notes are free to convey pure emotion, unfettered by the need for semantic understanding. Hence music requires less mental processing power than language, and music in its simplest form the early vocal interactions between baby and caregiver precede language in human development. The miracle is that the structure and meaning of both music and language are grasped quite intuitively in the early years, merely through exposure. This is because the young brain is primed to search for patterns in sound explicit tuition isnt necessary.
Music is central to the notion of what it is to be human, and spans cultures, continents and centuries.
Many of the core cognitive traits required for musical understanding stem from an evolutionary need one being the ability to detect difference and similarity around us: what looks the same, smells and tastes the same, also sounds the same, and therefore is the same. It may be, as the human brain evolved, other purely musical abilities built on these cognitive survival skills above all, the ability to express oneself emotionally, and to understand others through abstract narratives in sounds. And these skills also became important to our survival.
Current thinking stresses the importance of music in early bonding between parents and infants, and the sense of cohesion within wider social groups it can provide. There is increasing recognition, too, of the potential role of music in the development of empathy, ie If I can copy the sounds you make, then I must in some respects be like you; the emotions that I experience as I make sounds like yours may be the same as the emotions that you experience. And the process is reciprocal, as in: If you imitate me, then to a degree you must understand me, must know how I feel.
My music, your music, our music can bind us together as families, as tribes and as societies in a way that nothing else can.
Comparing Notes: How We Make Sense of Music by Adam Ockelford is published by Profile Books at 20. Order a copy for 17 from bookshop.theguardian.com
Tranexamic acid could save the lives of a third of women who die in childbirth from excessive bleeding, which kills 100,000 a year
A cheap and widely available drug could save the lives of thousands of women who die in childbirth from excessive bleeding, one of the main killers of women worldwide.
The drug, tranexamic acid, is available over the counter in the UK to women suffering from heavy periods. In Japan and the far east, it is used as a skin whitener. But now a very large study of 20,000 women in 21 countries has shown it can stop a third of cases of bleeding to death after giving birth.
Haemorrhage after childbirth kills 100,000 women a year, mostly in low and middle-income countries. It is not only the women dying it is the impact on the child that has to grow up without a mother, children who might already be in the family and the husband, said associate professor Haleema Shakur from the London School of Hygiene & Tropical Medicine who led the trial.
This is of absolutely huge importance. While a single mother is dying, we need to keep fighting for them.
The drug has already been proven to cut the death toll from bleeding after accidents in a trial of similar size. The latest trial, published in the Lancet medical journal, recruited more than 20,000 women who either gave birth in one of 193 hospitals involved or managed to get there after starting to bleed. They were randomly assigned either tranexamic acid or a placebo.
The researchers found that tranexamic acid was most effective when it was given soon after the bleeding began. The trial was originally intended also to find out whether the drug saved women from having to undergo a hysterectomy the removal of the womb. But the scientists discovered that in many countries, where anaemia is common and blood supplies are limited, surgeons operated immediately as the surest way to save the womans life.
If all women who haemorrhage after childbirth were given the drug, the trial suggests that 30,000 lives could be saved a year. In practice, that will be more difficult. Tranexamic acid was given in an intravenous injection in the hospitals, as the quickest way to have an effect. Many women give birth at home and may not get to a hospital in time.
It is available in the form of a tablet for heavy periods, but absorption may take too long, said Shakur. They are now working on new ways to get it rapidly into womens systems perhaps as an injection in the arm muscle or as a capsule under the tongue. It is also possible that women deemed to be at high risk of haemorrhage could be given a tablet before they give birth. The trials have shown no side-effects, making the drug very safe.
Of the two-thirds of women who died in spite of being given the drug, Shakur said some arrived at hospital too late, while others had underlying illness including severe malaria and anaemia which may have been the cause of death.
It has taken a long time to show that the drug does work in the context it was designed for. Professor Ian Roberts from the London School, who co-led the study, said: The researchers who invented tranexamic acid more than 50 years ago hoped it would reduce deaths from postpartum haemorrhage, but they couldnt persuade obstetricians at the time to conduct a trial. Now we finally have these results that we hope can help save womens lives around the world.
There are many next steps, said Shakur. We have to make sure tranexamic acid is available wherever a woman gives birth and is at risk, she said. We must make sure doctors and midwives are aware of the results of the study. And we need health ministers to make sure that the drug is available in their country and is on their shopping list of essential medicines.