E25: 7 Domains of Sleep

So it turns out that we spend about a third of our life. Sometimes in our life it's more than that and sometimes it's less, but we spend a lot of our time in sleep. And it affects every single part of our health, our wellness, our point of view. So we're going to be talking about the 7 Domains of Sleep.

And helping us do this today, joining us in the studio, is Dr. Christopher Jones. Dr. Jones is a neurologist and a board-certified sleep specialist, and the former director of the University of Utah Sleep-Wake Center. I really like the fact that when they named the sleep center they used both words, because people who have problems in the sleep domain have problems getting to sleep, and then they have problems staying awake.

Dr. Kirtly Jones: So, Dr. Jones, welcome to the "7 Domains of Women's Health" show.

Dr. Chris Jones: Thank you.

Dr. Kirtly Jones: In the interest of full disclosure, Dr. Jones has been watching me sleep for almost 50 years. Now, what has that been like, Chris? Do I snore?

Dr. Chris Jones: Wonderful.

Dr. Kirtly Jones: Wonderful? Oh, you said it so nicely. Do I snore?

Dr. Chris Jones: No, not that I recall.

Dr. Kirtly Jones: That was the appropriate thing to say. Would you tell me if I snored?

Dr. Chris Jones: Sure. Yes, I definitely would because snoring can be a clue that your sleep quality is not what it should be, and people who don't have optimal sleep quality can get irritable.

Dr. Kirtly Jones: Oh. And how would that affect you, honey?

Dr. Chris Jones: It would reflect my relationship with an irritable woman.

Dr. Kirtly Jones: Okay. Well, I don't want to be irritable, and I consider myself a great sleeper.

Dr. Chris Jones: You are.

Dr. Kirtly Jones: Thank you.

Dr. Chris Jones: As a general rule, yes.

Dr. Kirtly Jones: Thank you, thank you, thank you. But let's get down to a question. Do all animals sleep?

Dr. Chris Jones: When we think of animals, we automatically assume that we're talking about creatures that have nervous systems. Just like if you talk about animals that run around on the ground, you think about dogs and cats and little boys.

Dr. Kirtly Jones: Right. But anything that moves purposefully, that makes decisions, it seems, has a nervous system. So you talked to me a little bit about how there are some worms that have something that looks like sleep.

Dr. Chris Jones: Yes. Nematode worms have a very primitive, simple nervous system. There aren't very many nerves in a nematode worm, but there are a few, and there are times in the day when those neurons are less active and times when they are not.

Dr. Kirtly Jones: Yes, right. And these are underground, so it's not like it's a daytime-nighttime thing. They just need to shut down.

There are some animals, like elephants, elephants may sleep just two hours a day. Now, maybe they need to keep eating because they're big and they just eat vegetables. If you're that big and you didn't eat cheese or chocolate chip cookies and you're just eating vegetables, maybe you have to graze a lot.

Giraffes and horses actually sleep very little, but they may doze. So there are other animals that sleep, and their sleep patterns fit in with their evolutionary needs. Or not so much evolutionary needs, but the needs of their day-to-day behavior. So if you're a prey animal, if somebody comes to hunt you and eat you, then you may sleep a little less all at once.

Dr. Chris Jones: Yes. And if you see a horse down, all the way down on the ground, he's either dead or he's in REM sleep.

Dr. Kirtly Jones: Right. So horses don't sleep much, but during REM sleep, which is the dreaming stage, or rapid eye movement sleep, there's something called . . . We call it paralysis, but it's not exactly paralysis. There's muscle inhibition. Horses can stand for much of their sleep, but during REM they lay down.

Why do we need to sleep? If it's so important that we spend a third of our life doing it, and all animals do it, why bother?

Dr. Chris Jones: Because wakefulness is incredibly important, but it's hard to maintain wakefulness if you haven't had some neuronal restoration. The nerve cells in your brain need to recover, and the toxic metabolic compounds that are generated by very active brain cells, they need a time to flush out the toxic metabolic waste products that have been built up during a day, or if you're a night owl person, a lot of thinking and doing.

Dr. Kirtly Jones: So our brains are probably one of these most metabolically active parts of our body. Most cells in our body have a time during a day or during an hour when they are not so busy, when they actually take that time to clean themselves out and dump metabolic waste products. But when we're awake, our brains are very, very busy and they can't do that. So it looks like, and this isn't some new science, really, that during a part of our sleep, the very important part of our sleep, we actually do clean our brain out.

Dr. Chris Jones: Yes. And the intensity of sleep can be measured with brainwaves. And it's shown that, in sleep, the very big, slow brainwaves are associated with very deep, non-dreaming sleep.

Dr. Kirtly Jones: That's what we call deep sleep, or Stage 4 sleep. And that's the sleep that, when you are sleep deprived, it's what you tend to get first. It's what we need to live, that stage of sleep.

Dr. Chris Jones: Yes. The deep non-dreaming first. It isn't until way into the second half of the sleep schedule that you start seeing little episodes of REM, and then more and more until you wake up.

Dr. Kirtly Jones: Well, let's talk about the REM sleep, because the REM sleep is pretty active, isn't it? Active brainwaves. A lot is going on during REM sleep.

Dr. Chris Jones: Oh, absolutely. How that gets manifested as dreams, I have no idea. But clearly there's some consciousness-like activity. And we can remember those dreams, so there is some metabolic cost even to dreaming sleep.

Dr. Kirtly Jones: Right. And babies in utero, you can watch their eye roll so it looks like they're REMing even though I don't know whether they're dreaming. And there's some suggestion that maybe REM sleep in infants and in babies allows them to practice some motor programs.

Dr. Chris Jones: Yes, definitely. An awake mother will see twitching of the extremities, the hands or feet, or there may be even some vocalizations in that stage of sleep.

Dr. Kirtly Jones: As if they're practicing some things that they'll use later, maybe. So we've got deep sleep and we've got REM sleep. And then there are some transitional kinds of sleep in between that. What's drowsiness?

Dr. Chris Jones: That's what happens in the medical student auditorium.

Dr. Kirtly Jones: Right. I'd like to say that none of my students ever were drowsy or fell asleep during my lectures, but I know they did. During the years when I was working over 100 hours a week and was on every-other-night call, I know that when I sat down for an afternoon lecture after lunch it was deadly. I just could not stay awake if I sat down. I was very sleep deprived, but if I was awake and doing things, I think I kept my personality intact. And I know that I operated well. But if you gave me a minute to sit down in a quiet place, I was unconscious.

Dr. Chris Jones: Right. And that, going to sleep easily, is another way of suggesting that the non-dreaming sleep is really important and we really need to stop doing anything and just get some sleep.

Dr. Kirtly Jones: Well, I think about people who are driving on interstates and it's a little boring, and it's pretty straight, and they're sleep-deprived. Just as I did fall asleep in an auditorium listening to a lecture, they might be falling asleep at the wheel if they're drowsy.

Dr. Chris Jones: Yes. Unfortunately, drowsy driving accidents do happen. It's not just intoxication, for example.

Dr. Kirtly Jones: Right. Well, I've seen videos of babies . . . YouTube has way too many videos, but you can watch videos of babies that are trying to eat but they're sleepy and they blink a lot, and they nod. So nodding off is when your head starts to drop and then you pull it back up and then you blink a little bit. Wynken, Blynken, and Nod.

Dr. Chris Jones: And nod.

Dr. Kirtly Jones: One night. So people start blinking more and their head nods, and those are signs of a drowsy state. The things that happen when we sleep include the deep sleep that we need, and our immune system . . . we heal actually during a deep sleep.

So we have different kinds of activities linked to deep sleep. And interestingly enough, during sleep, most people have their temperature that's linked to their sleep. So we drop almost a degree of heat during sleep, and that may affect your sleep and affect your bed partner. Some women have hot flushes at night. But we also have temperature instability during REM sleep.

Dr. Chris Jones: Yes. In addition to the twitching of REM sleep and the dreaming, there's also much more loss of muscle tone, especially pertinent in the throat where you need to keep your airway open.

Dr. Kirtly Jones: So people snore in REM?

Dr. Chris Jones: Well, worse than that is that you're less sensitive to your oxygen levels going down. Now, this is something that men do much more frighteningly than women. Women might snore a little here and there, and they're back into non-REM sleep and their oxygens are great. But guys, their oxygen levels . . . we've seen patients in the sleep center, they drop to 80% saturation, 70% saturation.

Dr. Kirtly Jones: That's really low.

Dr. Chris Jones: Sixty-five percent saturation.

Dr. Kirtly Jones: Oh, my gosh. That's practically dead.

Dr. Chris Jones: Well, that's why we have sleep technicians to put a little nasal oxygen, nasal cannula on.

Dr. Kirtly Jones: So we always assume that we're going to go to sleep and . . .

Dr. Chris Jones: Come back.

Dr. Kirtly Jones: We're going to come back. This magical thing is going to happen. We're going to disappear and then we're going to come back. There are some people with profound sleep apnea who get so hypoxic at night that their heart develops an arrhythmia. They can die in their sleep because their oxygen level was so low.

Dr. Chris Jones: We really don't see it very often because the patient never comes back.

Dr. Kirtly Jones: Right. They don't come back to the sleep lab. And in the sleep lab, you wake them up when they get so desaturated.

Dr. Chris Jones: Yes.

Dr. Kirtly Jones: The risks of sleep apnea include . . . And this is people who stop breathing. They're snoring or they're not oxygenating, or they actually stop breathing. Sleep apnea means you're asleep but you're not breathing. Apnea means not breathing.

So there are people whose not breathing lasts for long enough that they can develop an arrhythmia. Their heart can be so hypoxic and they can die in their sleep. And that's one of the risks of untreated sleep apnea, is dying in your sleep.

And that is a sleep disturbance. Sleep apnea is a sleep disturbance. And we usually wake after we go to sleep, but some people with severe sleep apnea don't wake up.

And then, of course, there are people who either have a stroke or have a heart attack or have a brain aneurysm. There are things still going on, and in some situations, particularly during REM sleep, blood pressure can be quite variable. If people are hypertensive and they're going through this variable blood pressure time during their sleep, they may actually have a stroke or they may bleed into their brain and not wake up.

One of my favorite authors died in her sleep from a brain aneurysm and she was in her 50s, Ellen Meloy, a beautiful, wonderful, fit, strong, creative, and courageous woman. Didn't wake up because something happened when she slept.

But in general, not waking up is usually a function that's related to this sleep apnea. That's why we encourage people who are gasping, whose bed partners notice that they gasp in the middle of the night, to seek an evaluation by a sleep specialist because we need those people to get treated.

Dr. Chris Jones: And sometimes it's very subtle. Central apnea is without the gasping and loud snoring, but still, it's mostly men who do this and just don't have a regular, frequent breathing pattern and, gradually, the oxygen level drops enough.

Dr. Kirtly Jones: Right. Well, we sleep a third of our life and it's a pretty interesting active process, whether you're snoring or whether you're up all night. But often, because we're social, other people's sleep affects us. So snoring is one of the biggest social interrupters, I think, of the sleep domain. One person is snoring and the other person is wide awake thinking evil thoughts.

There are some animals that sleep with half their brain. Now, that's been known in birds that migrate huge distances and are in the air. They can't afford to drop out of the air in the ocean, so they sleep with half their brain. And dolphins sleep with half their brain, so half their brain is awake and half their brain is asleep. And it's been suggested that humans in a stressful situation, like sleeping in the sleep lab for the first time, actually may sleep with half their brain.

So we have this term that we use, we sleep with one eye open. So that's a phrase that we use, at least in American literature or Western literature, I'm sleeping with one eye open. And that may actually happen in people who are anxious in a new situation, or moms with new babies. They can hear a tiny little whimper and part of their brain is asleep, but another part of their brain is awake.

Dr. Chris Jones: Monitoring.

Dr. Kirtly Jones: It's monitoring.

Dr. Chris Jones: Maternal monitoring.

Dr. Kirtly Jones: Monitor on all the time. So even if women are in a sleep lab, and you can show that they slept some of the time, their impression is they didn't sleep at all because part of their brain was awake, even though part of their brain was asleep.

Dr. Chris Jones: Right. It is much easier to remember little episodes of wakefulness than episodes of sleep.

Dr. Kirtly Jones: Right. Exactly. Can you sleep with both eyes open? Is that possible?

Dr. Chris Jones: Not that I know of.

Dr. Kirtly Jones: I don't think so. I could be crazy, but I don't think so.

Dr. Chris Jones: We would pick that up in a polysomnographic sleep study, but I don't think we ever saw it.

Dr. Kirtly Jones: There are times, though. Let's actually talk about that. You can. There's a time in childhood development at about 2 when kids have night terrors. When the mom hears the kid screaming and you run into the room and the kid's eyes are open, they are screaming, you pick them up, and you give them a hug and tell them they're going to be okay. But they keep screaming and they are not there. And some sleep studies suggest that they actually are asleep with their eyes open. These are night terrors.

Dr. Chris Jones: The night terror. That's actually the technical term.

Dr. Kirtly Jones: Night terror. Those kids, it sounds like they're terrified, their face looks like they're terrified, their eyes are wide open, but they do not respond to calming very well. They can't hear you or see you. They're asleep. Is it Stage 4? What sleep do night terrors arise out of, do you know?

Dr. Chris Jones: I think that that's non-REM, and it's a blood-curdling scream that comes out.

Dr. Kirtly Jones: Yeah. I remember you didn't wake up, by the way, honey. But I remember when our son had night terrors. And he didn't have too many, but it was very impressive to go in to a child who normally soothed easily to a little cuddle, who was just eyes open, but he was not there.

Dr. Chris Jones: Possessed.

Dr. Kirtly Jones: He was. My God, he was possessed. But eventually, I had to shake him a little to wake him up, and then he would look at me and he would just cry. And then he wasn't screaming anymore. Then he would just settle down and go back to sleep. But you missed that. Do you remember that?

Dr. Chris Jones: No.

Dr. Kirtly Jones: Okay. Of course, you don't. Well, would you consider night terrors a parasomnia?

Dr. Chris Jones: Sure.

Dr. Kirtly Jones: What's a parasomnia?

Dr. Chris Jones: Para, beside, and somnia, sleep. So it's something that's right next to sleep. So sleepwalking, for example. They're asleep to an extent, but the sleepwalker has no memory of it and is not making very good judgment about where they're going to walk. For example, I had a parent who caught his child as the child was leaning over the second-floor balcony.

Dr. Kirtly Jones: Oh, my God. So that's another situation where they are asleep but their eyes are open. Well, there's sleep-eating. And I know women do more sleep-eating than men.

Dr. Chris Jones: Yes, definitely that.

Dr. Kirtly Jones: I swear that's my problem. Those cookies that disappeared, I don't remember eating them. Actually, I don't sleep eat. But there are some women who sleep eat. So in a sleep state, they go and eat silly things out of the refrigerator.

Dr. Chris Jones: Yeah. Sometimes it's embarrassing. Like a couple of tablespoons of butter.

Dr. Kirtly Jones: They never go for the leftover kale salad, I'll bet.

Dr. Chris Jones: No.

Dr. Kirtly Jones: You don't see somebody coming back to bed with kale stuck between their teeth, probably not. People have sleep-kicking. So someone might get kicked in bed in the middle of the night if someone has restless legs, where their legs just seem to move on their own. So those kinds of behaviors can be very difficult in the social domain for the bed partner.

There are behaviors . . . so people might do things when they're in a sleep state with their eyes open, but their brain is not. Their forebrain, the part of the brain that actually controls your behavior, is not awake.

Dr. Chris Jones: Right. And I did it when I was a kid, much to the enjoyment of my brother, who was laughing hysterically.

Dr. Kirtly Jones: Well, I will tell you that during your internship, when you were in a particularly stressful rotation at the Massachusetts General Hospital, you did some sleep talking.

Dr. Chris Jones: Uh-oh.

Dr. Kirtly Jones: You thought I was your nurse and you were upset that I had not started an IV on this patient, so you were kind of yelling at me to start the IV on the patient. After I pat your hand gently and tell you everything is going to be fine, then you're asking me why I haven't started this IV yet. And I thought, "Oh, God, I'm glad I'm not on your service right now." But there you go.

For people who are cognitively engaged, they consider sleeping a waste of time. They just think, "I don't want to sleep. It's time when I can't study. It's time when I can't work." But actually, sleep is fundamental to cognitive excellence, to cognitive function. And I want to talk a little bit about the arctic squirrel. Because you told me this story about the arctic squirrel.

Dr. Chris Jones: Oh, yeah.

Dr. Kirtly Jones: It's this little squirrel who buries himself underground in the arctic, goes into hibernation, and lowers the body temperature down to almost freezing and his brainwaves are flat. It looks like he or she is in a coma. But every couple of weeks, this little squirrel actually spends a lot of energy to warm up and wake up so that then they can go to sleep so that they can clean up their brain. So when they wake up, they don't wake up and go hunting for food because there's no food. It's the middle of winter. They wake up and they go to sleep.

Dr. Chris Jones: This is a very important distinction you're making between coma and deep sleep. They really are different.

Dr. Kirtly Jones: Oh, right. So I remember an anesthesiologist told me that he was going to put me to sleep, and I looked at him and I said, "I hope not. You are going to put me in a coma."

Dr. Chris Jones: There you go.

Dr. Kirtly Jones: It's not sleep. So is good sleep necessary for memory?

Dr. Chris Jones: Actually, good memory recall is probably one of the most important things that sleep does, which is to go through all the memories of the last few days or weeks, or maybe even longer, but typically days or weeks, that they're not going to make that mistake again.

Dr. Kirtly Jones: So during sleep, you prune memories that aren't important to you.

Dr. Chris Jones: Yes.

Dr. Kirtly Jones: So you are allowed . . .

Dr. Chris Jones: And it's typically over the past week or so.

Dr. Kirtly Jones: Yeah. And sleep is important for cleaning up the brain for getting rid of toxins.

Dr. Chris Jones: Yes. There's a fascinating science article on the spinal fluid flushing out toxins specifically in the deeper stages of sleep.

Dr. Kirtly Jones: So there's some suggestion that good sleep helps protect the brain against Alzheimer's disease. People who sleep well have a lower rate of developing Alzheimer's than people who have a history of poor sleep. But it could be that people who have poor sleep, their brain isn't that happy anyway. Do you need a happy brain? Do you need a healthy brain to sleep?

Dr. Chris Jones: Yes, you do.

Dr. Kirtly Jones: I know that people, as they either have Parkinson's and move toward dementia or they have Alzheimer's and move toward dementia, often they don't sleep very well. They wander. They just can't organize their sleep as much.

Dr. Chris Jones: Yes. It takes a good brain to make good sleep.

Dr. Kirtly Jones: Yeah. So we should take care of our brains. Yeah.

Dr. Chris Jones: Yes.

Dr. Kirtly Jones: Well, people with insomnia are so frustrated, they're so sad, they're so depressed. Do women have more insomnia than men?

Dr. Chris Jones: Yes, they do. Statistically, that is true. Men can certainly have it, but for the most part, the interest and the investigations have all been about females.

Dr. Kirtly Jones: I don't know why this is, whether this is biologic or sociologic, but it could be that men put their troubles to bed, as it were. They go to bed and they deal with it tomorrow, and women may ruminate a little bit more. They worry more, and that might keep them awake more, because it's very hard to sleep if you're worried, and if you're worried about sleep you can't go to sleep.

Dr. Chris Jones: Right. It's a double dilemma.

Dr. Kirtly Jones: And maybe even this sleeping with half a brain, this business about being partly awake . . . So if you've got a teenager who's supposed to be in at 10:00, coming in from a date or something, and they're not home yet, or maybe they were going to be in at midnight, you may not be able to go to sleep until the kids are tucked in.

I'm only as happy as my least happy child. If my kids aren't tucked in, I can't go to sleep yet. So that kind of attention to the social domain might make it harder for people to sleep.

It's important to note that there are many single dads and there are many men who are very, very attuned to the social domain. I think you and I bore and bred one, and has insomnia because he's constantly working over things in the social domain all the time. So there are certainly men who can spend a lot of time in the social domain, and there are women who can put it aside, like Scarlett O'Hara, "Tomorrow is another day."

Well, I've had women who have insomnia and say, "I borrowed some of my friend's sleeping pills and it really worked for me. Will you prescribe them for me?"

Dr. Chris Jones: This is a loaded topic. We actually had a death here. Took one tablet of a benzodiazepine "anti-anxiety," or you could also call it a "sleeping pill," and she got addicted. And then she died.

Dr. Kirtly Jones: Yeah. Well, I'm thinking about Michael Jackson.

Dr. Chris Jones: Oh, there you go.

Dr. Kirtly Jones: And he struggled, struggled, struggled with sleep. He was kind of an activated guy and was using sleeping aids, and then he couldn't sleep, and found a physician who actually sedated him and put him into a coma with drugs that we use for anesthesia. And during one of those episodes, he died.

So what do you think about sleeping pills? Have you ever prescribed sleeping pills?

Dr. Chris Jones: No.

Dr. Kirtly Jones: As a sleep doctor, a whole career in sleep medicine.

Dr. Chris Jones: No.

Dr. Kirtly Jones: Right.

Dr. Chris Jones: Partly that's because we here at the University Health have, or at least I hope she's still there, a fantastic sleep psychologist. A good sleep psychologist is vital to any really good sleep center.

Dr. Kirtly Jones: Well, insomnia is usually the domain of the sleep psychologist. There are reasons to stay up because you have physical pain, or your bladder is full all the time, or you've got a big prostate and it leans on your bladder, or it's really noisy outside and you can't sleep. But people with chronic insomnia, the approaches tend to be behavioral. In fact, I think there is research that says that cognitive-behavioral therapy for insomnia, CBTI, is more effective over the long run than sleeping pills in helping people get back to a pattern of good sleep.

There are clearly behaviors, there are habits that we consider good for sleep. But there are people who make decisions about their work for financial reasons that completely conflict with their sleep, and these are people who work night shifts or who work swing shifts. So financially people often make decisions that actually can be a very adverse effect on their sleep.

Dr. Chris Jones: Shift work is really hard on sleep.

Dr. Kirtly Jones: And then there are those of us who were physicians, who were on call or were in the hospital every other to every third night and were up all night, and it wasn't a financial decision but it was clearly where our heart was. We wanted to be there. We didn't want to sleep because we were missing out on some really important cases and doing important things.

I think we've tried to change the culture in training medical residents, surgical residents, and OB/GYN residents so that they actually have a little bit more sleep time. But I think there's definitely a conflict with people who want to be awake for their work or their training and end up really disturbing their sleep patterns.

Well, there are times in the environmental domain that the environment interrupts good sleep, or it makes it better. I'm a great sleeper in the winter when it's dark and cold. So having a cold room or a cool room is good for sleeping, having a dark room.

But I think about places where . . . let's say in Scandinavia, where it is light during June, and in May and June and July it's light all the time. What do people do when it's light all the time?

Dr. Chris Jones: They must get a lot done. I don't know. How do they do it?

Dr. Kirtly Jones: I think they go a little crazy.

Dr. Chris Jones: One nice thing about non-dreaming sleep, it doesn't hold to the same extent as dreaming sleep, but there is a severity that you can attach to sleepiness, more or less sleepiness. It's possible to fall asleep in the middle of the day.

Dr. Kirtly Jones: If you're sleepy enough.

Dr. Chris Jones: If you're really sleepy enough, yeah.

Dr. Kirtly Jones: There's a movie with Robin Williams called "Insomnia" where he's a detective or something and he has to go up to Alaska to hunt some evildoer. And he can't sleep and he gets a little crazier, as only Robin Williams can get crazy. He gets crazier and crazier because he can't sleep because the light is on all the time. So he keeps working all the time.

So I think that creating a space where it's cool, and it's really hard in a really hot summer to make a cool bedroom, and dark so that you can actually easily sleep. It's easier to sleep when it's not too hot, not too cold, not too dark. This bed is too hard. This bed is too soft. This bed is just right. Goldilocks and the three sleep disturbances.

There's a line from "Hamlet" that says, "To sleep, perchance to dream." There's this sense that this other space that we're in when we're sleeping is kind of mystical as we seem to close our eyes and we're someplace else. We've gone to another ZIP Code without having to travel. There's this other place that is magical, and some people feel that their dreams are quite spiritual.

There is a cultural norm of people saying their prayers before bed. Now, that could be just because people are activated. When you get up in the morning, you've got stuff to do. And although there are many cultures that pray throughout the day, multiple times throughout the day, at least in European cultures we tend to pray before we go to bed. "Now I lay me down to sleep, I pray the Lord my soul to keep." That's a little prayer that many of us learned growing up. "Now I lay me down to sleep, I pray the Lord my soul to keep. If I should die before I wake, I pray the Lord my soul to take."

One of our sleep psychologists, for people who have had nightmares, actually encourages people to try to have happy thoughts or to think calming thoughts before they go to bed, whether you're counting sheep, or doing just structured breathing, or trying to think happy thoughts before they go to sleep. She feels that you can direct your brain a little bit.

In fact, we use it cognitively to solve problems. We talk about sleeping on it, if you want to sleep on it. And there are some examples of famous scientists who solved difficult problems in math or in physics. They thought that it was unsolvable and they went to sleep, and they woke up, and they had solved it. So you can kind of direct some of your brain's work.

There are some people who suggest this, not everyone, but if you direct your work spiritually with prayers before you go to sleep, maybe you'll have a more spiritual sleep. Whether or not you are religious or you're spiritual without a religious format, there is the concept of letting your brain do some work while you're asleep.

And if you can direct how your brain is going to work, thinking some kinds of thoughts before sleep that calm your brain down a little bit more so that you will sleep a little bit more easily. As you mentioned, fighting about money is a good way to not go to sleep at night.

Dr. Chris Jones: Amen.

Dr. Kirtly Jones: So thank you very much for coming in to talk to us about sleep. You've been interested in it for as long as I've known you pretty much, so it's been most of your life you've been thinking about daytime-nighttime, things that go bump in the night, things people do during the day, and, of course, your 25-year career as Director of the Sleep-Wake Center. So thanks for coming in to do this with us.

Dr. Chris Jones: Thanks for having me.

We're going to end with a little haiku. This is "7 Domains of Sleep" haiku.

Eyes open. Eyes closed
Your brain does magic in sleep
Dreaming in color

Thanks for joining us in the "7 Domains of Women's Health."