Too Stressed to Rest? What To Do When Anxiety is Keeping You Awake

Is the cost-of-living crisis keeping us up at night? HIF’s inaugural Sleep Index Survey found a clear link between poor health and lower disposable income, and quality of sleep.

In this episode, we talk to Dr Jemma King, a specialist in the field of behavioural and organisational psychology, about managing sleep and stress to optimise performance at work. 

Dr King holds a PhD in human behaviour and is an expert on psycho-physiological factors of effective leadership, stress, sleep, emotional intelligence and psychological safety.

To find out more about how a better night's sleep can assist your overall health and wellbeing visit www.sleep.hif.com.au

Transcript

00:00
HIF acknowledges the traditional owners and custodians of the land on which this podcast is produced. We pay our respects to Elders, past, present and emerging, and to all Aboriginal and Torres Strait Islander peoples. The following episode contains general information and discussion about sleep treatments and advice and is intended for informational purposes.

00:24
So we know that a good night's sleep starts the minute you wake up and that is by getting you know photon exposure or light exposure into your retinas, into your eyeballs and this sets off the system for the rest of the day. Getting light into your eyes will tell your body that in 16 hours you'll be getting natural sleep pressure and you should be going to sleep at that time. Welcome to Sleep Easy with HIF. I'm Guy Rollison.

00:53
And in this episode, we speak to Dr Gemma King, a specialist in the field of behavioral and organizational psychology, about managing sleep and stress to optimize performance at work. Dr. King holds a PhD in human behavior and is an expert on factors pertaining to stress, leadership, sleep, emotional intelligence, and psychological safety. Dr. King, welcome. And thanks for being on this episode of Sleep Easy with HIF.

01:22
Thanks so much for having me. Look, I was particularly excited to have you join us given the release of the inaugural HIF Sleep Index Survey, which uncovered quite a few concerning trends. And with so many listeners trying to navigate a balance between work demands and personal life, while also dealing with high stress levels, who better to speak with than an expert on all things dealing with stress? So tell us first of all about stress. What is it and what does it do to our body?

01:52
Yeah, this is a really important question. I think there is an epidemic of stress at the moment throughout society. And what stress really is, is the body's natural response to a perceived or actual real threat. And what happens, it triggers a complex series of biochemical reactions that gives your body the resources to either fight or flee from that stressful situation. Or if you get very overwhelmed, freeze, like play dead.

02:22
And the hormones that are involved are things like cortisol and adrenaline. Now stress is a really good thing. What the problem is, is the duration and the intensity of that stress. Now stress is good in the fact that it's kept us and our ancestors alive. It's a really important response that we do need. And in fact, there is good stress, which is eustress. But when it's...

02:49
prolonged and it's intense, that's when things go bad. So we tend to differentiate stress into either acute stress or in the moment stress, or chronic and long-term stress which can lead to burnout. Could you perhaps just expand on that a little more? Well, stress you may experience, say you're walking out down the street and you go to step across the road and a car pulls out and it nearly hits you. And you may get that tingling in your extremities, that's the adrenaline.

03:19
or your heart rate increases or your mouth goes dry. So they're just designed to keep you alive. Now chronic stress is where you have, your stress response system is activated again and again and maybe doesn't even get deactivated. And this may be, you know, Judy, you've got long-term health issues, you may have friction in your relationships, you're worried about a family member, you live in an unsafe environment.

03:49
or you have constant issues at work. And this chronic stress is incredibly detrimental, not only to your various health systems like your cardiovascular system and your immune system, but it also can lead to lots of mental health disorders. And to understand why this happens, it's a really good idea to go back in time and gain an understanding of how a stress response system works.

04:18
So how does the human stress response system function? Well, for humans, you know, we've been standing up as homo sapiens for about 250,000 years, which is not really that much time in terms of the evolutionary clock. So we still house a lot of the neural architecture and systems and responses that our, you know, hunter gatherer forebears had. And this,

04:47
One of them is the stress response system. It was very much designed to be adaptive to the types of stresses we had back then, which is the things like fear of predation, cold heat, getting chased by a saber-toothed tiger. But now, the types of stresses that we have to deal with on a day-to-day basis are often psychological or social, or things like paying tax, or worried about what our boss thinks of us, or...

05:16
you know, sort of more complex stresses, which this system was not designed for. So this is why it's really hard to turn off this system, because our brain has a hard time differentiating between what's really life-threatening and what's just potentially, you know, socially threatening. And so we're left with this overactive stress response system.

05:47
Well, we have lots of different changes in the body. One of them is our immune system gets shut down because our brain thinks there's some really serious things going on out there. We could be getting chased by a marauding tribe. And so I don't really have time to scavenge for cancer cells or scavenge for bacteria cells. And all those sort of housekeeping duties get housed when we're under stress.

06:15
So that's why your immune system shuts down. Another system that shuts down is your digestive system because it actually takes energy to digest food. And so if you're very, very stressed, your body will repel you from wanting to eat food or it will stop your digestion. You may get that sick feeling, that feeling like you're going to vomit or need to go to the toilet. That's just a natural, ancient response to stress. And what we find is

06:44
really interesting. So in the moment that acute stress, your appetite goes, but if you've been stressed, the next day you're more likely to be hungry for salty, fatty, sugary foods. And that's because your brain thinks, okay, you're in a dire situation, you're going to need some really available nutrients to run or to fight.

07:10
And so what we see is the next day after being stressed, or if you eat while you're very stressed, have prolonged stress, your body will suck out 200 more calories out of that food source than if you were eating exactly the same food, not stressed. So yeah, there's some things that does your physiology. It also really negatively impacts your hormones, like your

07:38
testosterone and estrogen and we know that low levels of these hormones can have psychological effects. Low levels often mimic the signs of depression or anxiety, you know low levels of energy and just feeling a little emotionally unstable. Could you explain then the physiology and the psychological mechanisms through which anxiety and stress interfere with sleep?

08:08
This is a great question. It's probably one of the questions I get asked the most is, you know, how can I sleep better? And why is, you know, stress so terrible for my sleep? Well, what happens is when you're stressed, you produce a stress hormone where I spoke about before cortisol. Now cortisol typically rises in the morning, and that's a good thing because it gives you the resources you need to get through your day.

08:37
But hopefully over the day, your cortisol levels should be dropping and before you go to sleep, they should be quite minimal. But if you're stressed out and thinking about stressful things or doing stressful things, your cortisol levels will be quite high at night. And the last thing your body will wanna do if it's under stress is go to sleep because that puts you in a vulnerable, precarious position where potentially a predator could eat you.

09:07
So anxiety causes this sort of hyper arousal. And so what we see is this downward negative spiral because if you're not sleeping properly, you actually wake up feeling stressed in the morning, feeling overwhelmed. And we know if you don't sleep, the next day you actually produce more cortisol. And so you'll find yourself with, you know, racing thoughts and worries and rumination,

09:37
is keeping you awake at night, then you can't sleep, then you wake up in the morning feeling unrefreshed, so then you're more likely to drink coffee or have stimulants, energy drinks to keep you awake. And those things in themselves create high blood pressure and they also increase your cortisol. So yeah, it's a pretty sad story. I think a lot of us have been in when you're tired and you just can't get out of that negative downward spiral.

10:08
Which immediately leads me to ask, how does inadequate sleep impact someone's cognitive and emotional abilities? Yeah, so sleep deprivation pretty much impacts every single system in the body, for every single physiological system, every cognitive and emotional psychological system. So sleep is incredibly important. You know, we spend, we should spend seven,

10:36
and a half to eight hours a night doing it. So therefore it's very important because that's a lot of hours that we're lying down not being productive and being vulnerable to predators. And so there's many functions within the sleep architecture that have different functions for your daily life. So we get into bed, we go down to light sleep, then we go down eventually hitting deep, slow wave sleep.

11:06
Now deep slow wave sleep is an incredibly important part of your sleep in that it engages all of your physical replenishment processes. So this is where you produce your testosterone and estrogen, a lot of your blood sugar regulating hormones get produced then, your cetacean and hunger hormones. So

11:32
What we find is when people aren't getting into that deep, slow-wave sleep, they have dysregulated eating. As I said, you're probably more hungry the next day. And we know that you're more likely to put on weight or not be able to manage your weight. And there's a recent study that showed overweight people sleep on average 70 minutes less than normal-weighted people. And the potential, there is a...

12:01
bidirectional causality there where because you're not sleeping, you're overweight, and then if you're overweight, you're more likely to have sleep apnea and less likely to have good hearty sleep. And then we've got the other part of the sleep that's very important is REM sleep, rapid eye movement. So this is where you consolidate your memories, you make sense of the day, you make, you know,

12:30
emotional reasoning about what happened, which is incredibly important. It's like you're categorizing and filing what happened in your day. But what a lot of people don't realize is the REM part of your sleep has a very important forgetting function. So this is, you know, where you, I suppose, we call defrag your day. There's a lot of things throughout the day you actually don't need to remember. And if you are

12:58
don't have that part of your sleep, you're not actually binning a lot of memories and people can get quite anxious. And there's some theories that post-traumatic stress disorder is in part a sleep disorder because people will have got to sleep and they'll have scary dreams that wake them up and they don't actually process those dreams and defrag and delete the memories that they don't need. But it goes even further than that again, doesn't it? Yeah.

13:28
Another really important part of sleep, within the slow wave part of the sleep, is where the lymphatic system actually flushes away all of the metabolic byproducts of thinking. So this is what we basically call brainwash. And we know that if people don't have...

13:55
proper sleep or deep slow-wave sleep, they don't actually wash away these products. And one of the products is called Adenosine. Now Adenosine is a product that is pretty much Mother Nature's dimmer switch. It's the thing that builds up in your brain from, you know, it's a by-product of energy. And it's pretty much is the dimmer switch and it sort of makes you feel slow physically and cognitively.

14:24
So when this builds up, you feel sleepy, and it's mother nature saying, okay, go and have a good lie down and sleep. And the only way to clear away that product is through deep, slow-wave sleep. And this really does affect your cognition. And what's really interesting is that we did a really big study with McKinsey Consulting in their executive leadership program.

14:52
and we put biometric capture devices on leaders and we tested their sleep and then we tested their cognitive ability the next day. And what we found was those leaders that had 45 minutes of sleep deprivation actually had a reduction of mental control or IQ that was up to 10% the next day. So yeah, if they didn't sleep properly, they were 10% more stupid the next day, which is...

15:20
quite a significant amount when you live in a very competitive, you know, executive performance environment where you really need to be on your game. So there's a really good reason to get some good hearty sleep. Tell me then, what are the immediate and long-term consequences for those who have to deal with the lack of sleep? As I said before, there is not a system in your body that isn't impacted by sleep deprivation.

15:50
We know that if you have one night of poor sleep, you actually can cope quite well. And I think this is really good to remember because what we find is after one night of poor sleep, what is really detrimental is the sleep anxiety conflated with the sleep deprivation. So you're giving yourself a double whammy. It's really important if you have one night of bad sleep to say, okay, I'll be fine. I can do this.

16:20
And we find with the research, one night physically, cognitively, you'll be fine. But what we find though is, you know, after two days, three days, three days is actually when the sleep deprivation becomes really detrimental to your cognitive performance. So that is having about 60% of your sleep needs. So that's getting about 3.5 hours of sleep a night. Actually has...

16:48
a long term impact on your cognition. It also increases the propensity if you're having long term sleep deprivation, say you're a shift worker, it increases propensity for a whole lot of hormones, so a whole lot of cancers, particularly in females, breast cancer are more likely to have early onset menopause, prostate cancer.

17:14
and as I said breast cancer and in fact there was a report that the World Health Organization wants to classify shift work as a class 2 carcinogen because of the negative impact on physiology and psychology. We know that when people also

17:36
shift workers or not sleeping properly, they're much more likely to get divorced and have friction within their immediate and community relationships. And these insights and this knowledge can be especially important for managers and leaders, can't it? Yeah, I think this is incredibly important knowledge to know.

18:01
the impact of sleep deprivation, stress on your workforce, not only because, you know, out of a moral obligation that you should be good to your employees and you should care about the wellness and health and longevity, but also it is a huge performance decrement. You cannot have an efficient workforce. You can't be performing at your optimal levels when your workforce is...

18:31
and sleep deprived. And another part of the study that we did with McKinsey was really fascinating. We found that those leaders who were sleep deprived had lower levels of team psychological safety ratings in their meetings on the days that they were sleep deprived. Now, this was far statistically significantly greater than those...

18:59
leaders who actually slept well. So this is super fascinating, like never before have we seen research that links team psychological safety, which is basically another word of saying group trust, to the physiology of a leader. So it kind of makes sense but this is the first time it's been shown empirically. So I think that you know when a leader comes in or a boss and they're a little

19:29
dismissive, they don't have the capacity to listen to problems, it really does infiltrate and infect the team. And I know one leader of a very big manufacturing organisation that he will look at his biometric capture device and if he's in the red and has seen that he hasn't slept, he will actually avoid.

19:54
difficult conversations or having those hard meetings on that day because he knows that his tolerance and his receptiveness to ideas is not the best. So I just love how there's many leaders who are really leaning into this kind of technology and using it to lead better and to sleep more. What then would be a normal sleep pattern or say sleep cycle?

20:25
You know, we have 90 minute sleep cycles. So hopefully you have around four or five of these 90 minute sleep cycles where you go from light sleep right down to deep slow way sleep, then back up to REM sleep, and then back down again. And what we find is those individuals who are sort of delaying sleep and going to bed later.

20:52
they aren't actually getting as much deep, slow-wave sleep than those people who sort of get into bed by 9.30, you know, ready to sleep by 10. The hours before midnight we see a much more replenishing and, you know, much more repair happens in the hours before midnight rather than post midnight. And that's why if you are a shift worker, you have to be incredibly careful.

21:20
about getting adequate sleep and napping so you get that deep slow wave sleep. This episode of Sleep Easy with HIF is brought to you by the Health Insurance Fund of Australia. What if your health insurer gave you the freedom to choose? So what are a few of the techniques you might suggest to help hijack stress response and improve sleep? Yeah, I think, you know, this is...

21:49
so important that people really understand their stress, their particular stress style, and know what helps their stress so they can improve their sleep. So we know that a good night's sleep starts the minute you wake up, and that is by getting, you know, photon exposure or light exposure into your retinas, into your eyeballs, and this sets off the system for the rest of the day. Getting light into your eyes will tell your body that in 16 hours,

22:18
you'll be getting natural sleep pressure and you should be going to sleep at that time. If you push past your natural sleep pressure, what we find is that your body gets confused because humans would only stay awake for two reasons, typically in our history. And those two reasons were either hunting or being hunted. And so if you push past your natural sleep pressure,

22:44
your body gets confused and thinks, oh, there must be something dangerous going on and will therefore produce adrenaline and cortisol, which I mentioned before will really impact your sleep. So what I suggest to do throughout the day, wake up, get light in your eyes for about 10 minutes, not too harsh if you live in Queensland, but get that light in your eyes. Also, I think it's really important to

23:12
punctuate your day with what I call nano-intermissions. So this is, you know, every 20 minutes, sit back, maybe do some resonant breathing, which is slow in and out-breath through your nose. We know if you breathe through your nose, you're more likely to produce something called nitric oxide, which is produced by enzymes in your paranasal sinuses. Nitric oxide is a fantastic,

23:41
vasodilator, it kind of calms the system and drops your heart rate. So I really suggest that, you know, you punctuate your day with just a few moments of taking those breaths and then what it does, it stops the accumulative effect of the build-up of the cortisol throughout the day, so then you're less likely to be wired at night or if what we see typically is you're exhausted, you may drink,

24:10
sleeping tablet full exhausted into bed. And then when your body starts to process those hormones, you end up waking up. So you have those waking up at 2 a.m. or having disrupted sleep. So nano-intermissions is a big thing. Also, it's really important to engage in cardiovascular exercise. Human bodies were meant to move.

24:36
Being sedentary is incredibly dangerous for our bodies. We really need to use it or we lose it. So walking, we know from a recent study out of Oxford, one of the best things you can do to reduce stress and improve performance is to walk in nature, where you see green, preferably where you can also see water. We know seeing green drops cortisol.

25:02
because our hunter gatherer brains love to see greenery, love to see water because that meant life, meant sustenance. But also what this study showed is if you walk together with someone with an active goal, shared goal is one of the greatest ways to improve or decrease cortisol. So the goal could be, let's walk to the bridge and back and then we'll have coffee together. Really, really good for your health.

25:31
It's also really important to be mindful of what you eat before bed. We know that if you eat heavy protein before you go to sleep, your body will prioritise digesting the protein over getting into deep, slow-wave sleep. They're both parasympathetic activations, so your body doesn't want a big chunk of meat in its digestive tract, so you will want to get rid of that. And it takes energy to digest food.

26:01
and it will be taken away from all of those repair functions that you get in deep slow wave sleep. So if you can eat protein during lunchtime and opt for vegetarian at night, when I use my biometric capture device, my wearable, the difference in my sleep quality is unbelievable by just changing that one thing. You know, make sure you hydrate, make sure you don't eat.

26:29
you know, have ingest caffeine after three or if you are insomniac, don't have caffeine you know after twelve. Really try to avoid sugary snacks before bed. We know that when people eat sugary snacks before bed they sleep on average 26 minutes less than those people who don't eat sugary snacks. It's because it's pretty much like putting fire in the

26:58
your resting heart rate. Another big no-no which I found very sad is alcohol. It is so bad for your sleep. You know as a stress researcher I always used to say you know it's a really good idea to just have a glass of wine, it's really helpful for your sleep. But when I looked at the data I was like oh no it's not good at all for your sleep. So if you do drink, try to avoid really sugary drinks and try to drink within you know...

27:27
not within two hours of bed. If you can, have a walk in between alcohol and sleeping. And of course, drink lots of water. Another thing to increase your sleep is to have a pre-sleep routine. So try to down-regulate the lights, any type of light in your eyes, any type of stimulating electronic devices, and maybe have a hot...

27:56
bath, a 40 degree hot bath has been found to be one of the best pre-sleep modalities. Make sure your room is cold, dark and quiet. And so people say, what does dark mean? Well, if you hold out your hand in front of your face and you can still see your hand, that is not dark enough. So you want anything under 80 lux. And you can get these, you know, lux.

28:23
meters on your phone for free and it kind of tells you how much light is in your room. So overhead lights, particularly those really bright artificial lighting is very very bad for your sleep. It really you know puts your circadian system out of whack. Now sleep quality as we all know varies greatly from person to person. Could you perhaps discuss a few key factors?

28:50
that influence sleep quality and how people can make positive changes to their sleep routines to improve say their professional performance? Yeah, people really do differ in the amount of sleep they need. I mean generally 7.5 to 8 hours is optimal. Anything over 9 hours we actually see.

29:16
is bad for you and it can be correlated with a whole raft of different, you know, conditions that create cognitive decline. Unless of course you're an elite athlete and nine hour sleep is great. But you really should be, you know, keeping your sleep between, you know, 7.5 to 8 hours. And I actually like using wearables because, you know, people often think, you know, I...

29:43
had a great sleep or I didn't have a great sleep. And not until you measure it, do you really know. And that's why I love having that objective data so I can wake up and look at my app and I can say, wow, I got three hours of restorative sleep, which is the deep, so we're sleeping the REM sleep.

30:03
I think it's important that if you want to change it, you have to be able to measure it. And there's a lot of people who are catastrophized. They say, I had a terrible sleep. When you actually look at their data, their sleep's quite good. Now there are some very, very lucky people that have a gene called DEC2, where they only need to sleep about four hours. But this is quite rare. I think it's about four in 100,000 people.

30:30
And interestingly, we see there's an over-representation of people with this DEC2 gene that are in high-stakes jobs like CEOs, generals, politicians, people who engage in startups often have this gene. And they're very fortunate because they only need to sleep for hours. It does no health byproducts. That's all they need.

30:59
but for most of us mere mortals, we do need a lot of sleep. But also I think it's really important, when I was talking before about stress and sleep, is that you have to match your rest or your de-stressing protocol to your types of stress. So we know that not all stress is equal. And I think a lot of us have had this, you know,

31:28
phenomena where you go away on holidays for two weeks and you're usually doing all the things you should be doing to de-stress and getting good sleep, but you come back to work absolutely still cooked. And that's probably because you still had these certain types of stresses and you didn't match your rest to your stress. So we have physical stress, we have emotional stress, we have sensory stress, we have comparative stress.

31:57
So that's the stress when you're looking at everyone else's lives and thinking, my life's so terrible. And then we also have creative stress. And so if you really want to down regulate, you need to on a holiday, and also financial stress. So you may be going away on this holiday, but you still have got to pay for expensive hotel room. You still may be arguing with your partner. You still may be doom scrolling on your device.

32:24
or you may be in a busy shopping and looking at lots of different shops or museums and you actually didn't get a sensory down regulation or you didn't get a break from that emotional relationship or you didn't actually get to lie around and do nothing. So make sure that you really identify what is the major driver of your stress and then match that stress to that protocol.

32:53
So, you know, sensory stress, go and have a float, or physical stress, go and have a massage, or the comparative stress. Don't get on social media and compare yourself to other people. In our modern, often hyper-connected world, many people find it challenging to disconnect from technology and its demands, even during their downtime.

33:19
For listeners who may be unfamiliar with the term, could you perhaps explain what doom scrolling is and why it's becoming a topic of interest? Yeah, so as I've just said, doom scrolling is terrible for your brain, for your sleep and for your stress levels. So there's two factors at play here. Not only before bed, are you getting...

33:45
blue light into your eyes, into your retinas, which really dysregulates your circadian rhythm. You may have blue light blockers, but what we know is that your devices also emit purple and green parts of the light spectrum. And we don't actually know what they do. Probably the same thing as blue light. So just having blue light blockers on a screen, I don't think is sufficient to stop the impact of that.

34:14
that light, sensory light coming into your retinas. Also, it's not the color of light, just actually any type of light coming into your eyeballs really dysregulates your circadian rhythm. So if I'm going to sleep, what I typically do is hold my phone on my side and look at it from the side of my head. I have to look at my phone when I see what time it is, and that way I'm not getting that shock of the light into my eyeballs. Another thing we find is

34:45
What are you looking at while you're on your device? You may come across things about war, things about the economy, things about stressful things. Or you may see your friends have bought a boat or a bigger house. And what this does is you get this comparative stress. And so as I said before, your primitive brain can't differentiate between actually seeing something or imagining it or it being real.

35:14
And so if you're watching something violent or you're seeing something stressful about war or the economy or politics that upsets you, your brain has a better be safe than sorry policy and it'll start to produce stress hormones as if you're going to have to deal with that stressful situation. And so you could be lying in bed and you can start to feel your heart race and you can start to feel the adrenaline and cortisol surge through your system, which is terrible.

35:44
for your sleep and for your stress levels. So if you can, try to get off your phones or your devices, two hours before. If it's, we have a terrible dopamine addiction to these devices, because it really does hit that dopamine pathway. So what I do is I turn my phone that goes to black and white after a certain amount of time, and things look just a little bit less interesting. So I'm less inclined to just doom scroll through.

36:14
social media. And the tired but wired phenomena. When someone feels exhausted and they go to bed and can't sleep, what's happening there and what can we do about it? Yeah the tired but wired phenomenon is really interesting and this is um we've all experienced this. This is when you're lying in bed and you are so exhausted you've been thinking about hitting that pillow for you know all day.

36:42
And then you lie down and then you just do a quick think about what happened during the day, what did I say, what did they say, what have you got on tomorrow? And then all of a sudden you've got dinner plate eyes and you're totally wired and completely awake. And you're like, what happened? I was exhausted five minutes ago. Well, what happens is, as I said before, your brain cannot differentiate between seeing something and imagining it.

37:10
So if you're thinking about stressful things, stressful conversation, having to have that conversation with your boss, your body will start to...

37:20
gear up as if it's actually happening and you get the cortisol and adrenaline surging through your veins. We know that adrenaline is very short acting but cortisol has a 30 minute half-life. So if you're lying there and you secrete this cortisol and you're still awake a half an hour later and you start getting irritated, you think I've got to go to sleep, I've got a busy day tomorrow and then you get more cortisol secretion because you're upset about not being asleep and then before you know it,

37:48
It's two in the morning and you are just wired. So that's what we call the tide but wired phenomenon. So my recommendation for this is to be very disciplined about what you let run around in your head when you're horizontal. And so I recommend having a safe basket of thoughts. So you choose five thoughts that you are only allowed to think of when you're

38:16
laying down horizontal. You can write them down on a pad next to your bed. So these things that should be what we call interesting but repetitive, not emotionally evoking. It could be changing a chain on your bike.

38:36
It could be making spaghetti bolognese, something you can do a hundred times with your eyes closed. It could be just visualizing your running track. It could be doing your yoga asanas. But something relatively non-emotionally evoking that you think about that will keep your brain from getting dragged off into the drama. And so you don't ping pong back and forward. Yeah, I think it's really important to have those thoughts preempted because what happens is

39:06
If you say to your brain, don't think about that stressful thing, what do you do? You think about things. It's like don't think about a white bear and so you think about a white bear. You can never give up something, you have to take up something. It's like you can't give up smoking, you have to take up running or you can't give up drinking alcohol, you have to take up drinking kombucha. Just like you can't give up thinking a stressful thought, you have to take up an alternate technical, slightly boring thought.

39:36
Another thing you can do when you're lying in bed and you can't go to sleep is name to tame or brain dump. So this is when you just dump out all of those things that are bothering you onto a notepad. And what I find is extra potent is that if you say, I'm gonna think about this problem tomorrow and in that list, you actually give yourself the time. I'm gonna think about my taxes at 10.15.

40:05
I'm going to think about that hard conversation I have to have with my kids at 2 o'clock. And so by putting the time down, it kind of placates the stress part of your brain and then you're more likely to be able to forget it and go to sleep. In high stress occupations such as frontline workers and first responders where 24, 48, even 72 hour shifts can present themselves.

40:32
sleep deprivation can become a significant concern. Could you perhaps elaborate on the unique challenges these professionals face in maintaining adequate sleep? And what strategies or policies can be implemented to mitigate the impact of sleep deprivation on their performance and wellbeing? Yeah, so shift work is becoming, increasingly becoming a global problem because, you know,

41:02
Organizations are globally connected. You may have to have meetings with people in different time zones. But also, with manufacturing, we now have people just working 24-7 around the clock. And we've just recently finished a big study with a manufacturer, a global manufacturer here. And we used biometric cap devices. And what we found was those shift workers were all very exhausted. And...

41:29
It was actually very disheartening to see just the level of suffering I think a lot of these people would be going through. Because of all the consequences we know that sleep deprivation cause. Mental health disruption, hormonal dysregulation, bad moods, always getting sick and just always feeling exhausted. And so this organisation has been really great getting on the forefront of

41:58
try and do something about it. And I think that one of the best things you can do is educate your workforce on all the things I've just been talking about, the importance of sleep, the parts of the sleep architecture you need, what happens in those parts of sleep, the deep, slow-way sleep, the REM sleep, and then all the things that interrupt you from getting into that deep sleep. And then having some pretty strict protocols or having the funds available so your employees can get dark.

42:26
curtains, can get eye masks, can get molded earplugs, can get sleep education, can get sleep apps, white noise apps, all those things that can really help them with their shifts. Also, when people are coming out of the shifts, you have human-centric lighting. So maybe in the parts of the factory, say, where they're getting changed to go home, there's not the really harsh overhead lights.

42:56
or in parts of the organisational factory where they are working, say, two o'clock in the morning or three o'clock, where is the most dangerous time for workplace accidents, have some mechanisms to have good lighting systems to wake them up, have psychomotor vigilant tests to see if people are having decrements in their motor skills. So just being really aware of it, being...

43:24
very on to it, being educated and just realising that not only morally leaders, managers should be caring about the employees but I do think that there is the potential for some very serious legal ramifications for organisations not attending to the sleep needs of their staff.

43:49
shift work or sleep deprivation increases cancer and increases a whole lot of health problems and if people aren't, organisations aren't attending to these issues, there could be the potential for class actions in the future. So I think leaders, organisations really need to make this a priority. For many organisations, the mounting costs directly related to stress has meant

44:17
a rapid trend towards stress monitoring and risk mitigation. What about sleep? Would you like to see more organizations putting emphasis on sleep as part of that? Yeah, I'm a very big proponent of, if you want to change something, you need to be able to measure it. So using biometric capture devices, using science, using AI, having the technology.

44:45
to really understand what is going on with your workers and doing this in a non-invasive way. I think when an organization's intentions are pure and they're actually engaging in research and monitoring for the benefit of the employee, I think it can just be a win-win situation. Employees are happier, they're more efficient, less workplace injuries, and, you know, which is good for everybody. So, you know, I would really...

45:14
advocate measuring sleep and getting sleep experts in and doing research and using all of the latest technology which in effect will become cheaper than having to deal with the legal ramifications, social and emotional and societal ramifications of not attending to the sleep needs of your employees.

45:41
Unfortunately, we do have to wrap things up, but thank you so much for your time today, as well as your depth of scholarship and the insights you've shared with us here on Sleep Easy with HIV. Thank you so much for having me. It was really great chatting to you. And if anyone ever wants to reach out and understand more about sleep and stress, you can find me on LinkedIn on Gemma King PhD. Thanks so much.

46:10
The content provided on this podcast is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have any sleep-related concerns or questions, we encourage you to seek advice from a licensed healthcare professional or sleep specialist based on your specific circumstances.