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The war on the night: why bad sleep harms your health

Loss of empathy, memory impairment and higher risks of cancer are all linked to lack of sleep. So why don’t we turn in earlier?

At 4.02am on 2 November 1892 near Thirsk railway station in Yorkshire, an express train crashed into a goods train. Ten people were killed and 39 injured. Nearly 100 years later, at 1:23am on 28 April 1986, the No 4 reactor at the Chernobyl Nuclear Power Plant exploded, killing two people instantly followed by multiple deaths from radiation. Highly radioactive fallout was sent into the atmosphere and the long-term cancers are still being assessed. Understanding how these seemingly unrelated tragedies are connected requires an understanding of biological time.

Our lives are ruled by time. But the alarms that drive us out of bed in the morning or tell us that we are late for a meeting are recently-arrived chronometers. Life answers to more ancient beat that probably started to tick early in evolution. Embedded within our genes are the instructions for a biological or “circadian clock” that regulates our sleep patterns, alertness, mood, physical strength, blood pressure and much more. Normally we experience a 24 hour pattern of light and dark, and this signal is used to align our day to the Earth’s rotation. The clock is then used to anticipate this rotation and fine tune physiology and behaviour in advance of the changing conditions. Temperature, blood pressure, cognitive performance all decline in anticipation of sleep. Before dawn, these processes are slowly reversed in anticipation of the new day.

The daily cycles of sleep and waking are the most obvious of these rhythms. While asleep we don’t eat, drink, make money or have sex. Such apparent pointlessness has relegated sleep to a lowly position on our list of priorities. At best, we grudgingly tolerate sleep and at worst we regard it as an illness that needs a cure. Such attitudes are not only wrong, but dangerous.

Although sleep may be the suspension of most physical activity, the brain is consolidating memories and solving problems; it coordinates the removal of toxins;  promotes cell division and tissue repair; and rebuilds metabolic pathways. In short, without sleep our performance and health deteriorate rapidly.

Our species has declared war on the night and sleep has been the victim. The unintended consequences of cheap electric light are twofold. More light at night, combined with entertainments including social media, have eroded sleep time by up to two hours every night. On top of this, many of us are trying to sleep at the wrong time. Night shift workers work when they are sleepy and try to sleep when they are not. The body clock fails to adjust to the nocturnal regime and remains synchronised to the natural light/dark cycle.

Shortened sleep, along with working against biological time, has been linked to multiple health problems. These include lapses in attention and uncontrollable micro-sleeps; impulsivity and loss of empathy; memory impairment and reduced creativity; immune suppression; higher risks of infection and cancer; increased cardiovascular disease, type two diabetes; weight gain; and the susceptibility to depression, anxiety and mood instability are all associated with disrupted sleep.  

In our quest for instant gratification, it is unlikely that we are going to stop doing what we like when we like. However, understanding the consequences of bad sleep will surely help us to reprioritise sleep. Perhaps one day, the self-inflicted tired will be viewed with the same contempt as smokers huddled outside a building. Employers need to recognise that employees with disrupted sleep will be less productive and more likely to become ill. Why not introduce higher frequency health checks and provide advice for those at risk? As night shift workers are more likely to have heart disease, type two diabetes and be obese, why not provide food that reduces these risks? Finally, why not use emerging technologies to alert an individual that they are falling asleep both in the workplace and during the drive home?

So what happened at Thirsk railway station in 1892 and Chernobyl in 1986? These disasters, and many other like them, were linked to excessive tiredness, people working at the wrong biological time, and a break-down in procedure. Tiredness and circadian disruption do not cause such tragedies; they simply make them much more likely. James Holmes was the signalman at Thirsk. The day before the crash he had been awake for 36 hours, caring for his daughter who subsequently died, trying to find a doctor and looking after his grief-stricken wife. He reported to the stationmaster that he would be unable to work the next night, but no replacement was sent and he was forced to do his shift. Holmes fell asleep, and forgot that the goods train was on the line when he allowed the express through. After the crash, Holmes was charged with manslaughter and found guilty, but given an absolute discharge. The railway company was blamed for ignoring Holmes, and for failing to use procedures that would have detected he had fallen asleep. 

Professor Russell Foster CBE, FRS is Professor of Circadian Neuroscience, Chair of the Nuffield Laboratory of Ophthalmology, Director of the Sleep and Circadian Neuroscience Institute and Fellow of Brasenose College at the University of Oxford, and co-author of the new book “Circadian Rhythms: A Very Short Introduction”.

Russell will give the keynote speech “Sleep – Freedom to Think” at the BBC Radio 3 Free Thinking Festival at Sage Gateshead on Friday 17 March, broadcast that day at 10pm on BBC Radio 3

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Andy Burnham and Sadiq Khan are both slippery self-mythologisers – so why do we rate one more than the other?

Their obsessions with their childhoods have both become punchlines; but one of these jokes, it feels to me, is told with a lot more affection than the other.

Andy Burnham is a man whose policies and opinions seem to owe more to political expediency than they do to belief. He bangs on to the point of tedium about his own class, background and interests. As a result he’s widely seen as an unprincipled flip-flopper.

Sadiq Khan is a man whose policies and opinions seem to owe more to political expediency than they do to belief. He bangs on to the point of tedium about his own class, background and interests. As a result he’s the hugely popular mayor of London, the voice of those who’d be proud to think of themselves as the metropolitan liberal elite, and is even talked of as a possible future leader of the Labour party.

Oh, and also they were both born in 1970. So that’s a thing they have in common, too.

Why it is this approach to politics should have worked so much better for the mayor of London than the would-be mayor of Manchester is something I’ve been trying to work out for a while. There are definite parallels between Burnham’s attempts to present himself as a normal northern bloke who likes normal things like football, and Sadiq’s endless reminders that he’s a sarf London geezer whose dad drove a bus. They’ve both become punchlines; but one of these jokes, it feels to me, is told with a lot more affection than the other.

And yes, Burnham apparent tendency to switch sides, on everything from NHS privatisation to the 2015 welfare vote to the leadership of Jeremy Corbyn, has given him a reputation for slipperiness. But Sadiq’s core campaign pledge was to freeze London transport fares; everyone said it was nonsense, and true to form it was, and you’d be hard pressed to find an observer who thought this an atypical lapse on the mayor’s part. (Khan, too, has switched sides on the matter of Jeremy Corbyn.)

 And yet, he seems to get away with this, in a way that Burnham doesn’t. His low-level duplicity is factored in, and it’s hard to judge him for it because, well, it’s just what he’s like, isn’t it? For a long time, the Tory leadership’s line on London’s last mayor was “Boris is Boris”, meaning, look, we don’t trust him either, but what you gonna do? Well: Sadiq is Sadiq.

Even the names we refer to them by suggest that one of these two guys is viewed very differently from the other. I’ve instinctively slipped into referring to the mayor of London by his first name: he’s always Sadiq, not Khan, just as his predecessors were Boris and Ken. But, despite Eoin Clarke’s brief attempt to promote his 2015 leadership campaign with a twitter feed called “Labour Andy”, Burnham is still Burnham: formal, not familiar. 

I’ve a few theories to explain all this, though I’ve no idea which is correct. For a while I’ve assumed it’s about sincerity. When Sadiq Khan mentions his dad’s bus for the 257th time in a day, he does it with a wink to the audience, making a crack about the fact he won’t stop going on about it. That way, the message gets through to the punters at home who are only half listening, but the bored lobby hacks who’ve heard this routine two dozen times before feel they’re in the joke.

Burnham, it seems to me, lacks this lightness of touch: when he won’t stop banging on about the fact he grew up in the north, it feels uncomfortably like he means it. And to take yourself seriously in politics is sometimes to invite others to make jokes at your expense.

Then again, perhaps the problem is that Burnham isn’t quite sincere enough. Sadiq Khan genuinely is the son of a bus-driving immigrant: he may keep going on about it, but it is at least true. Burnham’s “just a northern lad” narrative is true, too, but excludes some crucial facts: that he went to Cambridge, and was working in Parliament aged 24. Perhaps that shouldn’t change how we interpret his story; but I fear, nonetheless, it does.

Maybe that’s not it, though: maybe I’m just another London media snob. Because Burnham did grow up at the disadvantaged end of the country, a region where, for too many people, chasing opportunities means leaving. The idea London is a city where the son of a bus driver can become mayor flatters our metropolitan self-image; the idea that a northerner who wants to build a career in politics has to head south at the earliest opportunity does the opposite. 

So if we roll our eyes when Burnham talks about the north, perhaps that reflects badly on us, not him: the opposite of northern chippiness is southern snobbery.

There’s one last possibility for why we may rate Sadiq Khan more highly than Andy Burnham: Sadiq Khan won. We can titter a little at the jokes and the fibs but he is, nonetheless, mayor of London. Andy Burnham is just the bloke who lost two Labour leadership campaigns.

At least – for now. In six weeks time, he’s highly likely to the first mayor of Greater Manchester. Slipperiness is not the worst quality in a mayor; and so much of the job will be about banging the drum for the city, and the region, that Burnham’s tendency to wear his northernness on his sleeve will be a positive boon.

Sadiq Khan’s stature has grown because the fact he became London’s mayor seems to say something, about the kind of city London is and the kind we want it to be. Perhaps, after May, Andy Burnham can do the same for the north – and the north can do the same for Andy Burnham.

Jonn Elledge edits the New Statesman's sister site CityMetric, and writes for the NS about subjects including politics, history and Daniel Hannan. You can find him on Twitter or Facebook.