Night Owls and Morning Larks

There are multiple, complex biological and environmental processes affecting our brains each day that slowly increases ‘sleep pressure’ and eventually allows most of us to drop off to sleep at some point during the mid to late evening. We all have a daily biological clock called our circadian rhythm that controls lots of basic, primitive body functions including sleep/wake cycles. Some of this physiological drive is likely to be genetically determined through natural variations in the timing of this clock, but other aspects are environmental (do we live in extremes of latitude where daylight hours fluctuate massively through the year?) as well as down to our individual lifestyle choices and comorbidities (are we stressed or anxious or are we over-weight and snore heavily?) We also know that this daily fluctuation in brain chemistry is not fixed but changes during different periods of our lives. It is normal, for example, that teenagers will tend to not feel ‘sleep pressure’ building until later in the evening or even early morning than when those same individuals were prepubescent. It therefore follows that they will also prefer to get up later. But herein lies the problem for many of us; society does not account for variation in our natural preferences, or stages of our development and we are all forced to work in a ‘one size fits all’, 9 to 5 world.

Most of us do not fall into a strict category of ‘night owl’ or ‘morning lark’ with these terms merely describing each extreme in the population with night owls shifting their sleep hours a little later in the night than morning larks. However, most people will identify with one of these categories more than another and are likely to be influenced through both their genes as well as their environments to develop certain sleep patterns during their lives.

Lack of sleep quality relates to poor health

Worryingly, research quite clearly shows that if you are one of those people who, for example, are either too busy or stressed, work night shifts or simply happen to be a teenager, and you fail to get the recommended 8 hours of sleep each night that is recommended for adults by the World Health Organisation (WHO), you are actually increasing the chances of dying early. A study last year involving more than 400,000 people demonstrated that, after adjustments were made for sex, socioeconomic status, smoking and other lifestyles factors, those who clearly fell into the morning lark camp were around 10% less likely to die early than those who burned the midnight oil.

Whilst some of this is down to lifestyle choice (or lack of choice), it is also genetically determined with the ‘night owls’ having a natural brain chemistry that drives their sleep/wake cycles to shift back a few hours compared with the ‘morning larks’.

Unfortunately for the night owls, it is also true that quality of life whilst they are still on this planet is likely to be inferior to those who get more, and better quality, sleep.

Quality not quantity

Importantly, it is not as simple as just making sure that you have set aside enough time for sleep of adequate duration, but that the sleep quality is good enough. There are questionnaires such as the Pittsburgh Sleep Quality Index that provide an objective score for this and allows you to track improvements in sleep quality over time. However, a more simple way to question if you are getting adequate sleep quality is to ask yourself, “Do you wake up feeling refreshed?” If the answer is “no”, it is quite likely that poor sleep quality is having an influence on everything

from learning capacity, creativity, physical ability, cardiovascular disease, virility and libido, appetite, mental health disorders, chronic pain, migraine, learning difficulties in children, cognitive decline in adults and metabolic diseases such as obesity and diabetes. If this list is not enough, research shows that there does not appear to be a single area of our physical and mental well-being that is not negatively affected by poor quality sleep.

The reasons for these relationships are certain to be complex but there can be no doubt that there is a relationship between ill-health and poor sleep quality and it is something that society cannot afford to ignore.

Is there anything we can do about this?

In light of this kind of research, as well as many other studies looking not just disease but also learning and success in our school systems, we must start asking ourselves how we can change these ‘stuck in the past’ society systems that are clearly damaging our health and that of future generations. Why can’t we ask employers, employees, teachers and students what they would prefer? It would not be impossible to have days that are staggered according to our natural chemical preferences and these changes would be very likely to dramatically improve work productivity, physical and mental health, school grades, behaviour and concentration as well as quality of life generally.

These are clearly huge society challenges but, in the same way as most of us now think it crazy that people were once allowed to smoke in public places, I believe that we will look back in the not too distant future and think, how on earth did we allow our children to suffer at school, have such poor productivity in an unhappy workforce and allow our parents to slip more easily into mental decline, just because we all had to get up at the same time each morning.

Reversing the harmful impact of sleep loss

In the meantime, there are numerous studies that are now showing just how effective ‘sleep behavioural modification’ is in reducing at least some of this health burden.

Sticking to simple evening and bedtime routines such as regular meal times, not having caffeine and alcohol past certain times of the day, not drinking too much water past a certain time, restricting screen use for a few hours before bed time and ensuring that your bedroom has black out blinds and timed daylight lamps so mimic more regular, year-round light/dark timing, all have a significant effect on improving sleep quality and health status even in those who are programmed to have a night owl preference.

A study just published by Australian and UK researchers showed that these kinds of sleep hygiene practices led to a shift in the circadian clocks of 21 “extreme” night owls after just 3 weeks showing that, although some of this is genetically determined, a considerable amount may be due to lifestyle choices which can be manipulated and controlled.

Poor sleep quality should be viewed as a medical problem and, as with any ‘medical’ problem, the most effective way of managing it is to look at it through a biopsychosocial lens. The reasons for each individual’s poor sleep quality will be as varied our fingerprints i.e. unique. This is why we cannot apply the same treatment regime to everyone who has sleep issues. Really understanding all the issues that affect our physical and mental health is the key to understanding this very real issue and therefore providing effective help for those people who suffer as a consequence of it.