Thank you very much. Well, I would like to start with testicles.
謝謝大家。 嗯,我想從睪丸說起。
(Laughter)
(笑聲)
Men who sleep five hours a night have significantly smaller testicles than those who sleep seven hours or more.
每晚睡眠五小時的男性的睪丸 明顯比那些睡眠超過七小時的人小。
(Laughter)
(笑聲)
In addition, men who routinely sleep just four to five hours a night will have a level of testosterone which is that of someone 10 years their senior. So a lack of sleep will age a man by a decade in terms of that critical aspect of wellness. And we see equivalent impairments in female reproductive health caused by a lack of sleep.
此外,經常只睡四五個小時的男人, 他們的睪丸激素 比較接近年紀比他們大十歲的人。 所以缺乏睡眠會讓男人 老個起碼十歲, 從這個健康方面來看的話。 缺乏睡眠同樣也對女性的生育能力 有著同等的傷害。
This is the best news that I have for you today.
這是我今天帶給大家最好的消息。
(Laughter)
(笑聲)
From this point, it may only get worse. Not only will I tell you about the wonderfully good things that happen when you get sleep, but the alarmingly bad things that happen when you don't get enough, both for your brain and for your body.
接下來只會愈來愈糟。 我不只要告訴你, 當你擁有充足睡眠時 身體所能得到的好處, 同時也會談到睡眠不足的問題, 特別是你的腦部及身體。
Let me start with the brain and the functions of learning and memory, because what we've discovered over the past 10 or so years is that you need sleep after learning to essentially hit the save button on those new memories so that you don't forget. But recently, we discovered that you also need sleep before learning to actually prepare your brain, almost like a dry sponge ready to initially soak up new information. And without sleep, the memory circuits of the brain essentially become waterlogged, as it were, and you can't absorb new memories.
讓我先從腦部 還有學習及記憶的功能說起, 過去十年左右的時間內 我們已經發現, 人體在學習新知後需要借助睡眠 去按下「儲存 」鍵把那些新的記憶 記錄下來不致遺忘。 可是最近的發現是 在學習前也需要睡眠, 將你的腦部準備好, 讓它像乾海綿一樣 將新知吸收進去。 缺乏睡眠的話,腦中的記憶迴路 會變得有點像塊濕海綿, 無法幫你吸取新的記憶。
So let me show you the data. Here in this study, we decided to test the hypothesis that pulling the all-nighter was a good idea. So we took a group of individuals and we assigned them to one of two experimental groups: a sleep group and a sleep deprivation group. Now the sleep group, they're going to get a full eight hours of slumber, but the deprivation group, we're going to keep them awake in the laboratory, under full supervision. There's no naps or caffeine, by the way, so it's miserable for everyone involved. And then the next day, we're going to place those participants inside an MRI scanner and we're going to have them try and learn a whole list of new facts as we're taking snapshots of brain activity. And then we're going to test them to see how effective that learning has been. And that's what you're looking at here on the vertical axis. And when you put those two groups head to head, what you find is a quite significant, 40-percent deficit in the ability of the brain to make new memories without sleep.
讓我給你們看一些數據。 在這項研究中,我們針對海馬迴 去測試熬夜讀書是值得的理論。 我們找了一群人, 將他們分成兩個實驗組: 一個睡眠組,一個不眠組。 睡眠組的人得到充分、 至少八小時的睡眠, 不眠組呢,我們則讓他們待在實驗室, 保持清醒,全程監控。 不能打盹也沒有咖啡因, 所以這組的人每個都很悲慘。 實驗的第二天, 我們再給他們做核磁共振掃描, 同時也給他們一張清單, 請他們記住上面列出的事項, 過程中將他們腦部的活動拍攝下來。 之後我們再進行一個測驗 看看他們學習的成效如何。 現在螢幕上這個縱座標 就是實驗結果。 而當把兩個實驗組對比來看時, 我們看到一個很顯著的 40% 的落差, 因為被剝奪睡眠的腦部 無法儲存新記憶。
I think this should be concerning, considering what we know is happening to sleep in our education populations right now. In fact, to put that in context, it would be the difference in a child acing an exam versus failing it miserably -- 40 percent. And we've gone on to discover what goes wrong within your brain to produce these types of learning disabilities. And there's a structure that sits on the left and the right side of your brain, called the hippocampus. And you can think of the hippocampus almost like the informational inbox of your brain. It's very good at receiving new memory files and then holding on to them. And when you look at this structure in those people who'd had a full night of sleep, we saw lots of healthy learning-related activity. Yet in those people who were sleep-deprived, we actually couldn't find any significant signal whatsoever. So it's almost as though sleep deprivation had shut down your memory inbox, and any new incoming files -- they were just being bounced. You couldn't effectively commit new experiences to memory.
我覺得這點發現很值得注意, 因為我們已經知道睡眠對於 處於學習階段的人腦部的影響。 讓我舉例說明, 有點像是小孩考試,差距是滿分 與不及格的 40 分那樣。 我們又進一步地去研究 為什麼我們的腦部 會發生這樣的學習障礙。 在我們的腦部有個結構 叫做海馬迴,在腦的左右兩邊。 你可以把這個海馬迴想像成 你腦部用來接收資訊的收件夾。 它很強於接收新的記憶檔, 然後將之保存下來。 當我們察看實驗對象的海馬迴時, 那些整夜睡眠充足的人, 他們的海馬迴中 顯示出許多健康的 與學習相關的活動力。 可是在被剝奪睡眠的人腦中, 我們找不到任何明顯的信號。 幾乎就像是,睡眠被剝奪的同時, 你的記憶收件夾也被關掉, 任何新進的檔案,全數被彈回去。 任何新的學習或經驗 都無法有效地記錄下來。
So that's the bad that can happen if I were to take sleep away from you, but let me just come back to that control group for a second. Do you remember those folks that got a full eight hours of sleep? Well, we can ask a very different question: What is it about the physiological quality of your sleep when you do get it that restores and enhances your memory and learning ability each and every day? And by placing electrodes all over the head, what we've discovered is that there are big, powerful brainwaves that happen during the very deepest stages of sleep that have riding on top of them these spectacular bursts of electrical activity that we call sleep spindles. And it's the combined quality of these deep-sleep brainwaves that acts like a file-transfer mechanism at night, shifting memories from a short-term vulnerable reservoir to a more permanent long-term storage site within the brain, and therefore protecting them, making them safe. And it is important that we understand what during sleep actually transacts these memory benefits, because there are real medical and societal implications.
這就是如果睡眠被剝奪後 所可能發生的壞處, 讓我再講一下另外那組實驗。 記得那一組能睡滿八小時的人嗎? 嗯,針對這組,我們提出 一個完全不同的問題: 在你睡眠充足時,那個日復一日 讓你修復及提升記憶及學習能力的 優質睡眠, 它有生理學上的特質嗎? 藉由在頭上貼滿電極片, 我們發現有一些很大很強的腦波 發生在最深沉睡眠期, 在這些腦波之上, 這些奇特的電流活動 我們稱之為睡眠紡錘波。 正是這些深層睡眠的腦波 在夜晚扮演著檔案傳輸的功能, 將我們的記憶檔從暫存的記憶庫, 轉存至腦部另一個 長期記憶的儲存處, 確保它們被安全保存。 很重要的是,我們也了解到 在睡眠期間我們的記憶得以轉存, 有著醫療及社會化方面的正面影響。
And let me just tell you about one area that we've moved this work out into, clinically, which is the context of aging and dementia. Because it's of course no secret that, as we get older, our learning and memory abilities begin to fade and decline. But what we've also discovered is that a physiological signature of aging is that your sleep gets worse, especially that deep quality of sleep that I was just discussing. And only last year, we finally published evidence that these two things, they're not simply co-occurring, they are significantly interrelated. And it suggests that the disruption of deep sleep is an underappreciated factor that is contributing to cognitive decline or memory decline in aging, and most recently we've discovered, in Alzheimer's disease as well.
讓我再告訴你們另一個領域的進展, 我們已經將這部分的工作推展到 老年及失智症的臨床實驗中。 當我們老化,一個眾所周知的事實是 我們的學習及記憶能力開始退化。 我們同時所發現的是 睡眠品質下降正是 老化在生理學上的典型特質, 特別是之前提到的深層睡眠的品質。 就在去年,我們發表的資訊證明了 老化與失智症並不僅是並存的關係, 兩者有更緊密的關聯。 證據顯示深層睡眠的中斷 是一個之前被低估 造成老化過程中的認知力下降 及記憶力退化的因素。 這點也在我們最近 對阿茲海默症的研究中被確認了。
Now, I know this is remarkably depressing news. It's in the mail. It's coming at you. But there's a potential silver lining here. Unlike many of the other factors that we know are associated with aging, for example changes in the physical structure of the brain, that's fiendishly difficult to treat. But that sleep is a missing piece in the explanatory puzzle of aging and Alzheimer's is exciting because we may be able to do something about it.
我知道這真是令人沮喪的壞消息。 而且已經發表了,迎面而來。 還好,不幸中的大幸是, 與其他那些與老化相關的症狀相比, 例如腦部實體上的改變 這種無法治療或改變的因素, 我們發現睡眠原來是我們之前 對老化以及阿茲海默無解的那一塊, 原來我們或許能從睡眠下手。
And one way that we are approaching this at my sleep center is not by using sleeping pills, by the way. Unfortunately, they are blunt instruments that do not produce naturalistic sleep. Instead, we're actually developing a method based on this. It's called direct current brain stimulation. You insert a small amount of voltage into the brain, so small you typically don't feel it, but it has a measurable impact. Now if you apply this stimulation during sleep in young, healthy adults, as if you're sort of singing in time with those deep-sleep brainwaves, not only can you amplify the size of those deep-sleep brainwaves, but in doing so, we can almost double the amount of memory benefit that you get from sleep. The question now is whether we can translate this same affordable, potentially portable piece of technology into older adults and those with dementia. Can we restore back some healthy quality of deep sleep, and in doing so, can we salvage aspects of their learning and memory function? That is my real hope now. That's one of our moon-shot goals, as it were.
值得一提的是,在我們的睡眠中心, 我們不用安眠藥, 因為安眠藥不會幫人自然入眠。 但是我們用同樣的理論 發展了一個方法── 直流電刺激術。 藉由給腦部少量的電流刺激, 電流量少到你沒有感覺, 卻對腦部有相當程度的影響。 如果在年輕健康的成人睡眠時 用同樣的電流刺激, 則像是與深層睡眠的腦波同聲合唱, 不僅是深層睡眠的腦波被倍數放大, 那些睡眠期間的記憶效益 也同時倍增。 現在的問題是,我們是否能將 同樣的好用又經濟的方法 運用在老年人及失智症患者上。 我們有辦法幫他們恢復 健康的深層睡眠, 同時也能挽回他們在學習 以及記憶方面的功能嗎? 這是我現在最大的希望, 有點像是登上月球之類的 遠大志向吧。
So that's an example of sleep for your brain, but sleep is just as essential for your body. We've already spoken about sleep loss and your reproductive system. Or I could tell you about sleep loss and your cardiovascular system, and that all it takes is one hour. Because there is a global experiment performed on 1.6 billion people across 70 countries twice a year, and it's called daylight saving time. Now, in the spring, when we lose one hour of sleep, we see a subsequent 24-percent increase in heart attacks that following day. In the autumn, when we gain an hour of sleep, we see a 21-percent reduction in heart attacks. Isn't that incredible? And you see exactly the same profile for car crashes, road traffic accidents, even suicide rates.
所以這是睡眠之於腦部的例子, 但睡眠對你的身體也同等重要。 前面已經提到缺乏睡眠 對生殖能力的影響, 我也可以說說缺乏睡眠 與心血管系統的關聯, 關鍵就只是一個小時的差別。 全球有 70 個國家 16 億人口 每年兩次被當做 所謂「日光節約時間」的實驗品。 春天,當我們少掉一個小時的睡眠, 隔天早上心臟病發的人數 就上升 24 個百分比 。 秋天,當我們多了一個小時的睡眠, 心臟病發的比率下降約 21 個百分比。 不可思議,對嗎? 而且同樣的數字也呈現在 車禍及其他交通事故, 甚至自殺率上。
But as a deeper dive, I want to focus on this: sleep loss and your immune system. And here, I'll introduce these delightful blue elements in the image. They are called natural killer cells, and you can think of natural killer cells almost like the secret service agents of your immune system. They are very good at identifying dangerous, unwanted elements and eliminating them. In fact, what they're doing here is destroying a cancerous tumor mass. So what you wish for is a virile set of these immune assassins at all times, and tragically, that's what you don't have if you're not sleeping enough.
再看深一點,我想強調的是 睡眠不足與免疫系統的關係。 請大家看一下圖上這些 賞心悅目的藍色元素。 它們被稱為自然殺手細胞, 你可以把它們想像成 免疫系統中的情報局特工。 它們擅長辨識出危險 且身體不需要的元素, 然後將之消滅。 在這張圖上,它們正在摧毀 一個具癌細胞的腫瘤。 這正是我們的免疫系統 無時無刻所需要的 防禦殺手, 可惜,如果你睡眠不足, 你就沒有這些防禦殺手。
So here in this experiment, you're not going to have your sleep deprived for an entire night, you're simply going to have your sleep restricted to four hours for one single night, and then we're going to look to see what's the percent reduction in immune cell activity that you suffer. And it's not small -- it's not 10 percent, it's not 20 percent. There was a 70-percent drop in natural killer cell activity. That's a concerning state of immune deficiency, and you can perhaps understand why we're now finding significant links between short sleep duration and your risk for the development of numerous forms of cancer. Currently, that list includes cancer of the bowel, cancer of the prostate and cancer of the breast. In fact, the link between a lack of sleep and cancer is now so strong that the World Health Organization has classified any form of nighttime shift work as a probable carcinogen, because of a disruption of your sleep-wake rhythms.
在這個實驗中, 被實驗的對象並非整夜不眠, 而是限制整晚睡眠 不超過四小時, 我們再去觀察免疫細胞的活動力 下降了多少百分比。 我們看到的數目不小,不是 10%, 也不是 20%。 自然殺手細胞的活動力 整整降低了 70% 。 這樣免疫力缺乏的狀態令人憂心, 你就可以理解為什麼我們要尋找 睡眠不足與多種癌症發生機率 兩者間的重大關聯。 目前的清單上包括大腸癌, 前列腺癌以及乳癌。 事實上,缺乏睡眠 與癌症之間的關聯如此重大, 世界衛生組織 已經將任何形式的夜班工作列為 可能的致癌因子, 因為夜班工作完全打亂 正常的睡眠與清醒的作息。
So you may have heard of that old maxim that you can sleep when you're dead. Well, I'm being quite serious now -- it is mortally unwise advice. We know this from epidemiological studies across millions of individuals. There's a simple truth: the shorter your sleep, the shorter your life. Short sleep predicts all-cause mortality.
或許你有聽過那句老話, 你可以等你死了再睡個夠。 嗯,我要很認真地說, 這句話真的很不明智。 我們從對數百萬人的 流行病學研究中得知 一個簡單的事實: 睡眠時間愈短,生命也就愈短。 睡眠短少也預告了各種可能的死亡率。
And if increasing your risk for the development of cancer or even Alzheimer's disease were not sufficiently disquieting, we have since discovered that a lack of sleep will even erode the very fabric of biological life itself, your DNA genetic code. So here in this study, they took a group of healthy adults and they limited them to six hours of sleep a night for one week, and then they measured the change in their gene activity profile relative to when those same individuals were getting a full eight hours of sleep a night. And there were two critical findings. First, a sizable and significant 711 genes were distorted in their activity, caused by a lack of sleep. The second result was that about half of those genes were actually increased in their activity. The other half were decreased.
而且假如得到癌症 或阿茲海默症的風險提高 還不夠讓你憂心的話, 我們還發現了 缺乏睡眠最終也會侵蝕 人體生理功能的結構── 你的遺傳基因密碼。 這份研究中的實驗對象是 一群健康的成人, 他們被限制每晚只能睡六個小時, 實驗持續一個星期, 之後我們測量了他們的 基因活動方面的改變, 再與同樣這批人 每晚可以睡足八小時的數據相比。 我們有兩個重要的發現。 首先,有總數多達 711 個基因的 活動力被扭曲了, 因為缺乏睡眠。 第二個發現是, 那些基因中約有半數, 活動力增強了。 另一半則是削弱了。
Now those genes that were switched off by a lack of sleep were genes associated with your immune system, so once again, you can see that immune deficiency. In contrast, those genes that were actually upregulated or increased by way of a lack of sleep, were genes associated with the promotion of tumors, genes associated with long-term chronic inflammation within the body, and genes associated with stress, and, as a consequence, cardiovascular disease. There is simply no aspect of your wellness that can retreat at the sign of sleep deprivation and get away unscathed. It's rather like a broken water pipe in your home. Sleep loss will leak down into every nook and cranny of your physiology, even tampering with the very DNA nucleic alphabet that spells out your daily health narrative.
那些因為缺乏睡眠而被關掉的基因 是與免疫系統相關的基因, 你可以再次清楚看到那個免疫缺陷。 相對來說,那些因為睡眠不足 而被迫提高活動力的基因, 或是總數增加的基因, 即是那些促進腫瘤形成的基因, 和體內長期發炎有關的基因, 還有那些與壓力相關的基因, 想當然爾,它們也與心血管疾病相關。 你的健康基本上完全不可能 在缺乏睡眠的狀態下 安然無恙,毫髮無傷。 就像是你家有個水管破了一樣。 缺乏睡眠的問題 就像水流至每個角落及裂縫, 造成你生理上的問題, 甚至竄改你 DNA 中的核酸字母, 將你的日常健康敘事重新排列組合。
And at this point, you may be thinking, "Oh my goodness, how do I start to get better sleep? What are you tips for good sleep?" Well, beyond avoiding the damaging and harmful impact of alcohol and caffeine on sleep, and if you're struggling with sleep at night, avoiding naps during the day, I have two pieces of advice for you.
講到這裡,你可能會想: 「我的天!那要如何開始優質睡眠? 你有什麼祕訣嗎?」 除了避免酒精與咖啡因這類 對睡眠有害無益的飲料外, 如果你本來就是晚上難睡的人, 盡量避免白天時睡覺。 我另外還有兩個建議。
The first is regularity. Go to bed at the same time, wake up at the same time, no matter whether it's the weekday or the weekend. Regularity is king, and it will anchor your sleep and improve the quantity and the quality of that sleep. The second is keep it cool. Your body needs to drop its core temperature by about two to three degrees Fahrenheit to initiate sleep and then to stay asleep, and it's the reason you will always find it easier to fall asleep in a room that's too cold than too hot. So aim for a bedroom temperature of around 65 degrees, or about 18 degrees Celsius. That's going to be optimal for the sleep of most people.
第一個是規律。 固定時間上床,固定時間起床, 週間週末都一樣。 規律是王道, 它能幫你的睡眠穩定下來, 同時改善睡眠的質與量。 第二個是涼爽的室溫。 你的身體核心溫度需要降低 大約華氏兩三度去啟動睡眠狀態, 之後繼續保持在睡眠狀態中, 這也就是我們總是覺得 臥室涼爽時會比在高溫時 容易入睡的原因。 所以盡量將房間的溫度 控制在華氏 65 度左右, 攝氏大約是 18 度。 對大部分的人來說 這是最理想的睡眠溫度。
And then finally, in taking a step back, then, what is the mission-critical statement here? Well, I think it may be this: sleep, unfortunately, is not an optional lifestyle luxury. Sleep is a nonnegotiable biological necessity. It is your life-support system, and it is Mother Nature's best effort yet at immortality. And the decimation of sleep throughout industrialized nations is having a catastrophic impact on our health, our wellness, even the safety and the education of our children. It's a silent sleep loss epidemic, and it's fast becoming one of the greatest public health challenges that we face in the 21st century.
最後,再講回來, 那我們關鍵任務的目標是什麼? 嗯,我想應該可以這麼說: 睡眠並不是奢華生活的選項。 睡眠是一個不容改變的生理需求。 它是你的維生系統, 也是大自然帶給人類 不老的最好方法。 工業化國家普遍面臨 睡眠大幅銳減的問題, 這正對我們的身心健康 造成災難性的衝擊, 甚至危及到我們 下一代的安全及教育。 這個悄然無聲的睡眠不足疫情, 正迅速成為人們在 21 世紀面臨的 公共衛生方面的最大挑戰之一。
I believe it is now time for us to reclaim our right to a full night of sleep, and without embarrassment or that unfortunate stigma of laziness. And in doing so, we can be reunited with the most powerful elixir of life, the Swiss Army knife of health, as it were.
我相信現在是拿回權力的時候了, 對每晚享有充足的睡眠 並不需要感到不好意思 也不要擔心招來被視為懶惰的恥辱。 這樣才能拿回生命賦予的 最強大的萬能藥, 就像是一把健康專用方面的 萬能瑞士刀一樣。
And with that soapbox rant over, I will simply say, good night, good luck, and above all ... I do hope you sleep well.
我在此登高一呼就到這裡為止, 最後祝各位晚安,好運, 更重要的是…… 祝大家都睡得好。
Thank you very much indeed.
非常謝謝各位。
(Applause)
(掌聲)
Thank you.
謝謝。
(Applause)
(掌聲)
Thank you so much.
非常謝謝大家。
David Biello: No, no, no. Stay there for a second. Good job not running away, though. I appreciate that. So that was terrifying.
比艾羅:等等,先別走。 謝謝留下來多講幾句話。 今天的主題太可怕了。
Matt Walker: You're welcome. DB: Yes, thank you, thank you. Since we can't catch up on sleep, what are we supposed to do? What do we do when we're, like, tossing and turning in bed late at night or doing shift work or whatever else?
馬特‧沃克:不客氣。 比艾羅:謝謝。 比:如果補眠是沒有幫助的, 那我們能做什麼呢? 例如,當我們晚上在床上 翻來覆去無法入睡, 或因為上夜班或其他因素 不能睡覺怎麼辦?
MW: So you're right, we can't catch up on sleep. Sleep is not like the bank. You can't accumulate a debt and then hope to pay it off at a later point in time. I should also note the reason that it's so catastrophic and that our health deteriorates so quickly, first, it's because human beings are the only species that deliberately deprive themselves of sleep for no apparent reason.
馬:你說對了,補眠不能解決問題。 睡眠跟銀行貸款不一樣。 你不能累積債務, 期望之後再來一次還清。 我應該也要指出問題之所以如此嚴重 以及健康惡化如此之快的原因, 首先,人類這個物種大概是唯一 會自己剝奪自己的睡眠 且沒有明顯的理由。
DB: Because we're smart.
比:因為我們很聰明。
MW: And I make that point because it means that Mother Nature, throughout the course of evolution, has never had to face the challenge of this thing called sleep deprivation. So she's never developed a safety net, and that's why when you undersleep, things just sort of implode so quickly, both within the brain and the body. So you just have to prioritize.
馬:我講這一點是因為大自然 在整個進化過程中, 從來沒有面臨過 「睡眠剝奪」的挑戰。 所以也沒有發展出安全網, 因此當你缺乏睡眠時, 你的腦部與身體 很快就崩潰無法招架。 所以你只能用輕重緩急 決定優先順序。
DB: OK, but tossing and turning in bed, what do I do?
比:好,可是當我在床上輾轉難眠時, 我能做什麼?
MW: So if you are staying in bed awake for too long, you should get out of bed and go to a different room and do something different. The reason is because your brain will very quickly associate your bedroom with the place of wakefulness, and you need to break that association. So only return to bed when you are sleepy, and that way you will relearn the association that you once had, which is your bed is the place of sleep. So the analogy would be, you'd never sit at the dinner table, waiting to get hungry, so why would you lie in bed, waiting to get sleepy?
馬:當你躺在床上很久仍了無睡意, 不如起床,去另一個房間 做點什麼不同的事。 不然你的大腦很快就會把你的臥室 跟清醒狀態連結在一起, 你必須打破那個連結。 當你睡意來了再回去臥室, 那樣子你才能重建以前的連結── 也就是床等於睡覺之處。 這也有點類似, 你不會去坐在餐桌等飢餓感, 所以你為什麼要躺在床上等睡意?
DB: Well, thank you for that wake-up call. Great job, Matt.
比:嗯,謝謝你的醒世之喚。 很棒的演說,馬特。
MW: You're very welcome. Thank you very much.
馬:不客氣。謝謝大家。