HEALTHY LIVING
05/12/2016 03:12 pm ET | Updated May 12, 2016

Sleeping With Technology: Harming Your Brain One Night at a Time

Here is an all-too-common scenario: Jeff and Mary put the kids to bed and settle down for the night to watch television. Jeff has his smartphone at his bedside and keeps checking email, social media, texts and the baseball scores while Mary checks her work emails, plays Words With Friends and checks her Facebook. At 11 they decide to turn out the lights and both of them place their phones next to the bed. Mary puts hers on silent but Jeff keeps his on vibrate in case he gets an important message during the night. Both have a tough time getting to sleep. John awakens several times during the night and checks his phone and answers an email or two. He has trouble falling back to sleep each time. They both awaken feeling exhausted. This goes on night after night after night. On the weekends they park the kids in front of the TV in the morning and try to sleep as long as possible but they are still tired come Monday.

We all know how important it is that we get a good night's sleep. What does that mean? Well, for young college-age adults the National Sleep Foundation recommends 7 to 9 hours per night. For younger children the recommendation is even more nightly sleep. For adults like Mary and Jeff the recommendation is usually around 7 to 8 hours per night.

Sadly, most children, teens and adults are not getting close to the recommended night's sleep and you can see this clearly in futile attempts to sleep in on the weekends to pay off our mounting "sleep debt."

Before I talk about why I feel this is happening and the role that technology plays in getting a bad night's sleep, it is important to understand what happens while you sleep. If you are a normal, well-rested person, your sleep is quite patterned. When you fall asleep you enter the first of several sleep cycles. In each cycle, which lasts about 90 minutes, your brain evidences four phases of deeper and deeper sleep until you reach a fifth stage called REM or rapid eye movement sleep. This is where your flickering eyelids indicate you are dreaming. The first sleep cycle dream is quite short and as the night progresses the REM phases get longer culminating in your last dream, which lasts about an hour, give or take. This is why, by the way, that most well-rested people wake up amidst a dream as that fourth sleep cycle is usually around hour 7 to 8 of sleep time.

During the night your brain is doing a variety of housekeeping functions including "synaptic rejuvenation" which involves consolidating information that you learned or experienced during the day and pruning away information that your brain feels is irrelevant or not worthy of consolidating and keeping. In addition, spinal fluid sweeps through your brain to wash out the sometimes-toxic by-products of thinking including bits of used proteins. Among these proteins are beta amyloids. If these beta amyloids are not removed they eventually build up into "plaques" which inhibit cell-to-cell communication and, sadly, are seen in abundance in the brains of Alzheimer's patients.

When you do not get a good night's sleep these phases do not proceed as they would if you were well rested. This means that your brain does not get to do its synaptic rejuvenation and other housekeeping actions including washing out toxic remains from a day's mental experiences. Add in days and days of poor sleep and you will soon have a a brain that does not function at its optimal level.

You can see the effects of lack of sleep by looking at what happens when you are so tired that you decide to take a nap. Naps are not inherently bad for you and in fact some research shows that they can be beneficial to your brain functioning. However, if you are exhausted you most likely lapse right into dreaming when you start your nap. This means you are skipping over the normal sleep phases where most of the housekeeping takes place.

My colleagues and I recently published a study where we tested a model that examined the role of technology in getting a good night's sleep. 734 college students [our college students were a bit older than the norm averaging nearly 26 years old] completed surveys that assessed sleep problems, smartphone use (both during a typical day and night as well as preference for multitasking as opposed to completing one task at a time), and two critical variables concerning our brain's performance: executive functioning and anxiety. Executive functioning encompasses how well you make decisions, avoid impulsive responses, work on problems, and attend to your world. Anxiety, in this study, was a special type of anxiety sometimes referred to as FOMO or fear of missing out. Our measure asked about how anxious you get when you do not have your phone or cannot access the Internet and also a personal assessment of how dependent you are on technology.

The model we tested proposed that after controlling for all demographic characteristics of our sample, the cognitive issue (executive functioning) and the affective variable (anxiety/FOMO) would predict overuse of technology and multitasking which, in turn, would predict sleep problems. Before talking about the how the model worked it is important to point out that half the participants kept their phone close by while they slept (nearly all with it on vibrate or ring) and 49% checked it during the night for something other than the time at least once (32%) or two or more times (17%). Not surprisingly our students averaged only 6.68 hours of sleep per night over the previous four weeks with two-thirds averaging 7 or less hours of nightly sleep.

So, how did we do in predicting sleep problems? Poor executive functioning predicted sleep problems and also predicted more nighttime awakenings, which, in turn, predicted sleep problems. Anxiety, however, was the stronger predictor. People anxious about missing out on technology used their smartphone more each day, preferred to multitask more, and awakened more often to check their phone. Each of those predicted a poor night's sleep.

So what do we think is happening? There are two ways to look at this: biochemically and psychologically. Both are relevant. Biochemically, when you awaken in the morning your brain sees blue wavelength light, which releases small amounts of the hormone cortisol, which serves to slowly awaken you. At the other end of the day, when you approach dusk your eyes take in more red wavelength light which then allows melatonin to be released over a period of several hours which eventually leads to sleep. Technological devices emit light at multiple wavelengths to produce the white light you see with a substantial amount in the blue wavelength part of the light spectrum. This blue wavelength light serves to increase the secretion of cortisol (and wake you up) and inhibit the release of melatonin (which makes you not sleepy). Luckily, light at all wavelengths dissipates by the inverse square law which means that as long as you keep your device a substantial distance from your face you are not getting much blue light. How far away do you keep your phone or your iPad? The Mayo Clinic says that if you are planning to use a device in bed that you hold it 14 inches away from your face and dim the brightness which further reduces the blue wavelength light from reaching your retina. The National Sleep Foundation goes one giant step further and recommends that you not use any device within an hour of attempting to fall asleep. Given their research showing that 90% of American adults use their electronic devices within an hour of bedtime at least a few nights a week, this may be difficult.

Psychological issues are quite a different story. Remember that both executive dysfunction -- primarily poor decision-making and lack of ability to attend -- and FOMO anxiety predicted a poor night's sleep. These are fixable. First, we need to learn to practice metacognition by gaining a better understanding of how our brain works. If we know that we are not making good decisions about using technology prior to bedtime that is the first step to being metacognitive; if we can make behavioral changes that is even better. One metacognitive change would be to recognize that we are all responding to alerts and notifications like Pavlov's dogs and realize that at a minimum we should silence our phone or turn off all alerts. An even better metacognitive change would be to put our phone away an hour before bedtime but if that is too extreme consider starting small by putting the phone and tablet in another room 15 minutes before bedtime. Then when you get used to 15 minutes of time away from your devices start increasing the time until you get to an hour.

The impact on sleep of FOMO -- anxiety about missing out on technology use, particularly communication-based technologies like email, texts, social media, etc. -- was pronounced in our study (and has been shown to be a strong predictor of problematic behavior in other studies). The first step is metacognitive in that you will need to understand what this anxiety is doing to you, your brain and your body. We are not meant to be a bubbling pool of anxiety-laden chemicals. Their constant presence can lead to mental and physical health issues. Once that information becomes part of your understanding of the impact of technology on sleep you must begin the process of uncoupling the alerts and notifications with a knee-jerk response model.

Just because you got a text message does not mean you have to respond a.s.a.p. The problem with our obsessive behavior has been building for a long time and will not go away quickly. I suggest starting small again and alerting people in your virtual worlds -- those you regularly text, email, and connect with through social media -- that you are going to be learning how to not be such a quick responder. We know that this is difficult as a slow or nonresponse to a message leads to assumptions about the other person ("he must not like me or he would text right back" or "she must be angry with me" are common reactions to a delayed response). It will help if you use the auto respond function wherever you can to remind people that you may take a bit of time to get back to them. Start by waiting for 15 minutes to respond to messages and when that is working start increasing the time until you can get to at least 30 minutes. If you have trouble ignoring the alerts you can silence your phone during that time or use one of the many smartphone apps that will only allow calls or messages from certain people (in case of emergencies).

I am sure that many of you are wondering what you will do if you can't use your smartphone prior to bedtime. I suggest any activity that is repetitive and doesn't require communication. For example, most of your favorite television shows are fairly predictable so watching one can be calming to your brain as long as the device is not close to your face. Another option is to build a playlist on a device with only your absolute favorite songs, ones that you can sing in your sleep. If that device is a smartphone make sure you silence any alerts as even a slight vibration or beep will start the cortisol and stop the melatonin. Third, you might consider reading an actual [gasp] paper book, particularly if the author is one who you know well as the plots will often be predictable. Predictable means less activation of the neurons and biochemistry of your brain, which will allow you to fall asleep more easily.

The bottom line is this will not be an easy road but it is not too late to save your brain. I always prided myself on being able to be wide awake and productive with only 5 hours of sleep but over the years I see that that has taken its toll on my ability to process information. I have been following my advice in this post for about a year and already feel better and more prepared to be productive on a daily basis. You can do it, too!

REFERENCES:

S. K. Adams and T. S. Kisler, "Sleep Quality as a Mediator between Technology-Related Sleep Quality, Depression, and Anxiety," CyberPsychology, Behavior, and Social Networking 16, no. 1 (2013): 25-30.

A.-M. Chang, D. Aeschbach, J. F. Duffy, and C. A. Czeisler, "Evening Use of Light-Emitting eReaders Negatively Affects Sleep, Circadian Timing, and Next-Morning Alertness," PNAS (2014), http://www.pnas.org/content/early/2014/12/18/1418490112.full.pdf.

K. Custers and J. Van den Bulck, "Television Viewing, Internet Use, and Self-Reported Bedtime and Rise Time in Adults: Implications for Sleep Hygiene Recommendations from an Exploratory Cross-Sectional Study," Behavioral Sleep Medicine 10, no. 2 (2012): 96-105.

J. S. Durmer and D. F. Dinges, "Neurocognitive Consequences of Sleep Deprivation," Seminars in Neurology 25, no. 1 (2005): 117-129.

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M. Gradisar, A. R. Wolfson, A. G. Harvey, L. Hale, R. Rosenberg, and C. A. Czeisler, "The Sleep and Technology Use of Americans: Findings from the National Sleep Foundation's 2011 Sleep in America Poll," Journal of Clinical Sleep Medicine 9, no. 12 (2013): 1291-1299.

L. Hale and S. Guan, "Screen Time and Sleep among School-Aged Children and Adolescents: A Systematic Literature Review," Sleep Medicine Reviews 21 (2015): 50-58.

S. Lemola, N. Perkinson-Gloor, S. Brand, J. F. Dewald-Kaufmann, and A. Grob, "Adolescents' Electronic Media Use at Night, Sleep Disturbance, and Depressive Symptoms in the Smartphone Age," Journal of Youth and Adolescence 44, no. 2 (2014): 405-418

P. A. Lewis, The Secret World of Sleep: The Surprising Science of the Mind at Rest, New York: Palgrave Macmillan, 2013.

Mayo Clinic, "Are Smartphones Disrupting Your Sleep? Mayo Clinic Examines the Question," June 3, 2013, http://newsnetwork.mayoclinic.org/discussion/are-smartphones-disrupting-your-sleep-mayo-clinic-study-examines-the-question/?mc_id=youtube.

L. Rosen, L. M. Carrier, A. Miller, J. Rokkum, and Ruiz, "Sleeping with Technology: Cognitive, Affective, and Technology Usage Predictors of Sleep Problems among College Students," Sleep Health 2, no. 1 (2016): 49-56.

E. H. Telzer, A. J. Fuligni, M. D. Lieberman, and A. Galván, "The Effects of Poor Quality Sleep on Brain Function and Risk Taking in Adolescence," Neuroimage 71 (2013):

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