Courtney is joined by Brian Quigley from the Carruth Center for Psychological and Psychiatric Services to talk about everyone’s favorite thing – SLEEP!


Welcome everyone to Wellbeing Wednesdays. I am your host, Courtney Weaver. I'm the director over at Well WVU here at West Virginia University. Uh, once again, we're a recording from the comfort of our own homes as opposed to our cozy studio over on campus due to our self-isolation and mandates from the federal and state government, so we're keeping in line with those public health guidelines. Just super important. Um, by guest today, his name is Brian Quigley from the Carruth Center. And Brian, why don't you introduce yourself a little bit, tell us about your role at the Carruth Center.

So I'm the medical director at the Carruth Center. I'm a psychiatrist, and so that means I went through medical school and yeah, I went to the University of Washington for medical school and then came to Morgan town to WVU to do my residency in psychiatry. And then after I completed that, I've been a part of the cruise center since 2000. Seven or thereabouts. Um, and yeah, work as a psychiatrist, both seeing college students at WVU.

And then also I work, um, within the WVU school of medicine, department of behavioral medicine. And, um, so see patients, uh, some at, at, uh, WVU medicine and work with psychiatry residents. Um. Do a little bit of forensic psychiatry. Not much these days. Yeah, that's it. Okay. We're gonna start offline about forensic psychiatry.

I'm a true crime fanatic. So your description is way cooler. Like forensic psychiatry is not as cool as like true crime stuff. Well. Yeah, this is for another day. So we're actually here today and we're going to talk about a. Basic fundamental need that every human being has. And that's about sleep and the yes and all the things that we should be doing. And many of us probably aren't. So let's talk about some sleep basics to start us off.

So Brian, how many hours of sleep should the typical college student or average adult be getting every night? Yeah, that's a so average adult. That's a great way to frame it. And, and the thing that I think all of us have heard is eight hours. And so I was glad you mentioned it as an average, right? Cause it's not everybody that needs eight hours.

Some people do better with nine, some people do better with seven. Um, do better with sex. Uh, it's, it's, there's a range and when you add all of them up and average them, that it's about eight and most, most adults, and I'm glad that you mentioned it's, it's, it's adults. It's different depending on the stage of life.

It's different for an infant compared to a college student. Um, but yeah, eight is the average. And so that's kind of the air that's the place to begin the conversation with. Um, I thought, I was like, you know, I had like, I wanted to be superhuman when I was in medical school, and I was like, Oh, I only need like four.

Um, and I could train myself to just need four. And that was, that was a disaster. I can imagine. Failed experiment. I need 8.5 I wish. I wish I could get 8.5 hours of sleep every day. So could you describe what the typical sleep cycle is for those who don't know. Yeah, no, that's great. So yeah, that's the, both the sort of colloquial term sleep cycle as well as the clinical one.

And so it really, um, speaks to the fact that our sleep, how's the cycle? It has a cyclical pattern. The most obvious part, right, is most people feel tired in the evening sleep when it's dark, and then awakened when it's light out. And then the cycle. It goes back again, that's called the circadian rhythm.

That's more than like, like this basically on a 24-hour cycle. But within that period of time that we're sleeping, there are some rhythms within that, some sort of Metta rhythms. Um, and it really, it just kind of starts off as like light sleep. Um, so it's really easy to wake up. Like, let's say you fall asleep 10 minutes after your head's on the pillow, and then maybe over the next 30 minutes, it's kind of this light sleep where if somebody nudges, you know.

Wake back up and then that slowly merges into deep sleep, which is maybe, you know, for a lot of people around the, I don't know, 40 minute Mark or something like that, where the brain kind of starts to do something completely different than light sleep and, and a whole bunch of brain processes are happening.

Probably the most important one to deep sleep is that's when the majority of human growth hormone is made. And that has a lot of important sort of physical, restorative properties. Um, so you get this big bolus of, of human growth hormone. And then that transitions into REM sleep in the first cycle of REM sleep, usually cruise from about 90 minutes after you've fallen asleep.

And that's, that's in those of us who are sleeping well and kind of have healthy sleep. And then it kind of goes back and forth between, you know, these different aspects of sleep, light sleep, deep sleep, REM sleep, and there's varying proportions of these, that kind of, um, progress throughout the night. And then usually when we wake up in the morning, the most recent cycle that we've had is a cycle of REM sleep, um, REM sleep.

It stands art, REM stands for rapid eye movement. Um, and that's because the characteristic kind of observation in that stage of sleep is that the eyes are darting back and forth, rapid eye movement. And you can see that even under the eyelids. Um, and then it can also, you can detect that eye movement pattern on a.

A, what's called an EEG or an electroencephalogram that measures brainwave activity. Um, often it can be measured, drink, sleep. And so yeah, that, that's, that usually we wake up and, and that's also, uh, a REM sleep is when we tend to dream. So sometimes when we wake up, we're like, Oh yeah, that was a crazy dream.

Or, Oh, that was, well, was Gordon D in my dream? I'm not sure. That was weird.

REM sleep. Yeah. REM sleep. Super important. We think that has a lot to do with the time of night when our brain kind of restored from an emotional standpoint and a cognitive standpoint. So memory functioning definitely appears to be really strongly related to REM sleep. So like, it's horrible. But like, um.

You know, the military has tortured people by selectively depriving them from REM sleep. And one of the OBS, one of the reasons they do that is because it trashes people's memory and makes them really emotionally vulnerable. And so, you know, somebody can fall asleep there, they get a little bit of sleep, but then their, as their eyes start moving back and forth there, Mmm.

They're woken up, and so they never really get that. And after a few days of this, it's really, really unsettling. So yeah, it's really important for emotional stability and memory stability and just general cognitive functioning, good cognitive function. Right. And that can also be an argument against pulling all-nighters that students tend to do on.

College campuses, definitely, definitely. And particularly S like finals week, having back to back all-nighters is hugely problematic for your, um, academic performance. And not that's, you know, I'm sure that sounds like a parent saying that, and now I have an apparent, and I bug my kids about that all the time.

But it's very true. It's, it's, it's. And if you could do an experiment, I don't recommend doing an experiment on herself. Just trust me. Your cognitive performance will not do well, but if you don't trust me, you know, you could try a cognitive experiment. And that cognitive decline is rapid after your, no.

And according to the national college health assessment on nationwide, sleep difficulties are usually within the top five. If nothing in the top six highest academic impediments that college students are reporting it's asleep, really does have a great impact on your academic performance. Yeah, and that's interesting.

That's from the student taking the surveys perspectives of the student is saying it's in the top five. No. If you asked me, is it a Docker of students? I put it in the top one. You know, across the board, like for every institution, stress is the number one academic impediment, but stress and sleep are so closely linked that students might have even realized that it could be built.

And I think just as general humans, you and I mean, I think it would be hard for any human to distinguish between stress. And, and, uh, a sleep problem that we're not totally aware of. You're getting seven versus eight and you've done that and your, your need is eight and you've been doing seven for a couple of weeks and then you're feeling more stressed cause there is more stress in your environment.

You may not say, Oh, it's because I'm actually cumulatively now eight hours behind over the last eight days and you're not going to attribute that to sleep. You're going to say it's that external factor that's. That's stressing me out. That's causing it. But, but really that that loss and sleep has made us more vulnerable to the external stresses and we interpret those stresses differently.

Yeah. Well, I've, I've heard this before where students might, either they're pulling all-nighters or they're really only sleeping a few hours a night, but then on the weekends they're like, well, I make up for it on the weekends and I sleep 10 12 hours. Now, are they actually making it that sleep up or what's the actual, what's your, I guess, opinion of that as a medical professional, as you can imagine, that would be really hard to definitively measure, but I think most people.

In the sleep field would tell you, no, you're not making it up. And it's really hard to make it up. It's like, it's like credit card debt or something. You know, you spend, you spend a, I dunno, 10 hours’ worth during the week by staying up and you sleep in an extra four, you're still down six units. Um, . You know, most people aren't gonna, you know, sleep 24 hours straight and to make it up in it.

And it probably doesn't even work that way physiologically. Cause like I said, there's this circadian rhythm that happens as part of all this and that that's dark and light. And so the sun doesn't stop, you know, doing its thing because we pulled success of all-nighters. It doesn't take a break and try to make our rooms like a cave, but there's still all the normal social rhythms.

And. A diurnal rhythms that occur. And so yeah, we probably never totally make that up. Okay, good to know. Uh, so what does the phrase sleep hygiene mean? Cause that's something that people, especially like in health promotion and in the medical field kind of throw around. So what's your definition of that?

Yeah, so the, um, I mean, I think the basic core of it is like, good sleep practices are good or behaviors that support sleep. Mmm. And so there, yeah, there's a number of those. They're sort of like internal factors and external factors. I think the big external factor for, for most adults and in particular college age adults would be alcohol, caffeine, as you.

Maybe take a shot there. Actually, don't drink coffee, so, alright, let's get a zoom on that and make sure,

okay. I believe you, but yeah, no, I mean, so yeah. Caffeine and all its various forms and alcohol are two big external variables that can have an impact on a person's sleep and can be a behavior specific behavior. That is modifiable that can improve a person's sleep. So alcohol, the way the alcohol works, it actually, it blocks your REM sleep.

So it's weird because you feel, uh, you know, if I, if I have a beer with dinner after dinner, you know, you kind of feel a little bit more relaxed and, and sometimes we feel more relaxed. It's like, Oh yeah. Those two, all-nighters is three. All-nighters are starting to catch up with me. I can really feel it. I can fall asleep really easy.

They feel like, okay, alcohol makes me sleep easier, but it's it. Although you may fall asleep easier what your brain is doing, it's blocking the REM sleep and so you're not getting quality sleep and that quality of the sleep. And I, I should have mentioned that earlier when we were talking about the amount, the quantity.

Eight hours is important, but even more important than that, the number of hours is the quality of that sleep and alcohol disrupts, absolutely wrecks the quality of sleep. Even small amounts, which isn't to say we shouldn't ever have a glass of wine or have beer. Uh, but you know it, even though it's small amounts, we'll, we'll, um.

Decreased. The quality of our sleep seeks, he ended up having to make kind of decisions. And that comes back to the hygiene, making healthy decisions. Um, caffeine, you know, in a different way. It makes it hard to fall asleep, um, and can make it easy to, to, to, uh, wake back up. Um, during the night. Internal factors would be a whole bunch of things like some mental health related, like anxiety, some stress related.

Um, there's a, there's a lot of things. There's the temperature of the room. There's, uh, how dark is the room, the sound outside, um, the time that you go to bed at the time that you wake up. There's a lot of different variables that all those things center around human behaviors that we can modify that.

Yeah. So let's talk about screen time because that's what we see a lot. Students are constantly on their phones. I mean, everyone's seems to be constantly on their phones. And what with the shift to folks staying inside their homes is that they may be using their bed for more than just sleep. So they, they might be on their phone, they might be on their computers doing their coursework.

Um, but how does screen time affect sleep? Yeah. Uh, just as you said. Um, so part of it is like now, especially during, I think, um, while we're self-quarantining or quarantining or going to be on devices more, that's kind of how we're able to get, how are we going to be able to maintain a physical distance but not social distance?

Um. And so yeah, for doing that in our bed now our brains start to equate sort of this old Burt state. Like you and I are pretty alert right now. Hopefully we're having a, a conversation. The social part of our brain is turned on and that's not really the part of the brain that we want turned on while we're trying to fall asleep.

And so if you have a device in your bed and you're checking social media or whatever, you're turning on all these different neural networks in your brain that are not compatible with. What you're really trying to do, which is shut down neural networks. So sleep can sort of take over. So there's that piece, but then there's also the actual light that comes from the screen.

And you know, you usually, there's a lot of, um, blue lights that comes from computer screens and device screens and blue light. Is it a frequency that, um, the photo pigments in the retina. Pick up on and, and there's a special, uh, neural pathway that goes to the, uh, sort of sleep centers of the brain and, and really kind of messed that up.

So having blue light kind of, um, essentially makes it so your melatonin response is blunted or doesn't turn on like it's supposed to. And now it has this big cascade of effects on her. Circadian rhythm, which I referenced earlier. Yeah. So I think from two, two standpoints, the light itself and then the, the, the sort of the social brain and other parts of her brain, they get turned on with these devices.

Putting those both together in an environment that's ideally is for sleep alone is problematic. And part of the sleep hygiene. So how long before bed should folks turn their screens off? Um, I mean, it depends on who you ask. Um, I think, you know, the, the quick answers say an hour, um, uh, the quick answer is an hour, but like, let's say, you know, you've just been doing, like, you've been using your phone in bed.

And you've seen that as your main wind down for years and years to go from like every night to like a whole hour. Like, I'm not even gonna try that. That's that. That might be a big jump for people. So I think scaling back gradually. Okay. Work better for some people instead of like keeping a like exactly an hour.

Well, if you can't do an hour a year, terrible at it and might as well ditch it. Be PR, you know, be kind yourself. Make it progressive, you know, do it for 15 minutes before you go to bed. Have zero screen time. If you can manage that, okay. Then move it to 30 and maybe shoot for eventually getting to an hour.

Yeah. I think it depends too on our diff, all of us have different temperaments. I can be kind of wound tight and just kind of have some baseline anxiety myself. And so sometimes if I've been wound up all day, even sort of shutting down the devices an hour before isn't enough. You know, I still have enough well, momentum from the day that even an hour wind down period is quite enough and really two hours is better.

So you kind of have to sort of learn your own little idiosyncrasies and quirks and use those to help guide you. But roughly an hour is a good place to start. In this podcast, we like to do a little bit of a. A hot moment in popular culture or in current events related to wellbeing. And for the past couple of weeks, it's been supplied by our friend Covance 19, well, not really our friend, but, um, this pandemic that's happening.

So could you speak a little bit to how you think this pandemic might be impacting the quality of folk sleep? Yeah. You know, I, I guess I've only been thinking about it like, not. Super carefully, but now that you ask it and put me on the spot, give me hints earlier that you were going to go this direction.

I mean, yeah, you're right. We're, we're inside more. We're using this term social distancing, which some argue that's maybe not the best terms cause we're really trying to achieve physical distancing. Cause that's how the virus a primary way it's transmitted. But we can be in social contact through, uh, our devices in different electronic means.

And so there might be more, you know, we're, we're going to need our social fixes. And so yeah, there might be a tendency for that to begin to encroach. Into the evening hours and into the bedtime hours. So yeah, maybe the coronavirus pandemic might, yeah, we might be seeing more social outlets through the devices, which again, the light and the social network.

So social networks in the brain turning on right during sleep. You know, be something that could sneak up on all of us for sure. All right. Well, we're like way past our time, which is great. Um, so thank you so much, Brian, for taking time out of your busy day to chat with us about sleep. Maybe we'll have you on again because there are a bunch of stuff.

There's a bunch of questions that we actually didn't get to that I'm still like to explore, so yeah. Awesome. Yeah, it's, it's, it's been a good time, so I'm glad we can continue to do it even from home, which is really great. Um, so to all our listeners out there, thank you so much. Stay safe and we'll catch you next time on Wellbeing Wednesdays.