Associate Professor Lauren Hale Sounds a Wakeup Call About Sleep as a Social Justice Issue
It pays to stay awake during lectures — just ask Lauren Hale, an associate professor of preventive medicine, Program in Public Health, at Stony Brook University. When Hale was close to completing her PhD in Public Policy and Population Studies at Princeton University in 2003, she attended a lecture by Harvard University Professor Robert Stickgold, who spoke about the importance of sleep for learning and cognition. At the lecture’s conclusion, Stickgold stated that little was known about the role socioeconomic status plays in sleep quality. Hale, who knew her expertise could fill a gap in the literature, decided right then and there to make sleep demography the focus of her work.
As Stony Brook’s czarina of sleep health, Hale recently spoke about sleep as a social justice concern, gave the latest “snooze news” and offered a glimpse of how sleep — or lack of it — affects her family life.
Please explain the “demography of sleep” and why this is an area that merits further study.
It’s long been known that inadequate sleep has negative consequences on health, cognition, mood and public safety, but my interest from the beginning has been in the social patterning of sleep. What has been widely observed is that people with more education, income, security and stability and those who are able to make choices for themselves have better health outcomes. There’s a whole field of social epidemiology that studies these different health patterns. We’re finding that socioeconomic factors also matter for sleep. For example, we’ve observed that black men exhibit a pattern of being both shorter and longer sleepers, which means they aren’t sleeping the optimal amount. Additionally, people who live in urban areas are more likely to be short sleepers, perhaps because there are more safety concerns or they experience income insecurity, in addition to noise or light pollution conditions. These are just a few examples of how socioeconomic status is associated with sleep.
What don’t we know about sleep that you want to research?
There is a great deal about sleep — genetically, physiologically and behaviorally — that we still don’t understand. Even from an evolutionary perspective, we are still trying to figure out why we sleep. As a demographer, I’ve learned that teenagers have one of the highest risks for not meeting their sleep needs. I’m trying to understand which factors among teenagers matter most (e.g., screen time, family environment, schoolwork, school start times, caffeine and energy drinks) for determining their sleep, and the consequences of their sleep patterns on their physical and mental health. We would like to identify interventions or policies that help to improve the sleep of our teens and thus improve their health and safety outcomes.
What’s the greatest sleep challenge affecting people today?
It is our 24-7 culture of being connected to a screen. Whether a phone or tablet, work computer, television or DVD entertainment, we have enormous dependency on screens for various aspects of daily life, and that is increasing. Most of us have a hard time turning off our screens. About 90 percent of Americans use some sort of a screen before bedtime and our children are exposed to screens throughout the day for learning and entertainment activities, but often at a time of day that interferes with the ability to fall asleep. It’s easy to get sucked into the psychological excitement of whatever is on the screen, whether it’s social media, a video game, or just watching a movie or television program. Both the light and psychological effects of the exposure alter people’s ability to fall asleep, and here’s the conflict: We want to do something while we’re awake, but we also need to sleep. We need to start setting better boundaries for ourselves as adults and for our kids, because we’ll all suffer if we don’t get enough sleep.
You are the inaugural editor of Sleep Health, the National Sleep Foundation’s new journal. How will the publication be positioned?
We are appealing to social scientists, policymakers, anthropologists, social workers and the transportation management community to address larger-scale issues, such as how sleep relates to health and society. We will publish studies on the epidemiology of sleep patterning and health outcomes, focusing on topics such as depression, physical health, safety, shift work, occupational hazards and cognitive outcomes. What I’m most excited about is addressing issues like school start time or policies that relate to hours of work and school. Sleep Health will be an interdisciplinary, academic publication. All of our articles are peer-reviewed, and though our audience is primarily a scholarly one, we hope that the public will be interested in the topics we highlight. Hopefully that publicity will help to generate personal, social and policy changes that will ultimately improve sleep and health.
The National Sleep Foundation has reported on the importance of naps — and they’re not just for children. Do you think everybody would benefit by taking a midday nap?
If you have trouble falling asleep at night, it might not be a good idea to take a nap during the day because it might further interfere with your ability to fall asleep. If you don’t have trouble falling asleep and you are extremely tired during the day, it would probably be beneficial to get a little nap in.
Some companies offer sleep pods or nap rooms as a perk to their employees. Do you envision a day where it’s completely acceptable — and maybe even encouraged — for people to take a sleep break on the job as a way to recharge?
Given the productivity push of most work environments, it is unlikely that many companies will move in that direction. However, there is evidence that when employers allow flexible work schedules, their employees can have better work-family balance and tend to get more sleep. So there is certainly an argument to pitch to employers to allow their workers to have more flexible hours.
Is the topic of sleep health getting enough publicity?
As a public health or social justice concern, which is how I view chronic sleep deprivation of the population, I don’t think we’re getting enough attention. There’s relatively limited funding for sleep research compared with some other areas. The general population is very interested in sleep, however, because it’s something that applies to everyone. Between 50 million and 70 million Americans are not getting enough sleep or have a sleep disorder. So if it’s not you, it’s somebody in your household or somebody that you know or care about who has trouble sleeping.
This year’s Flame Challenge — a yearly contest started in 2011 by actor and Stony Brook visiting professor Alan Alda that explains science to an 11-year-old — asks the question: What is sleep? What does it tell you about the significance of sleep in our society if sixth-graders are asking this question?
I think it is a perfect question for the Flame Challenge because the emphasis is on communicating complex ideas to a general audience. Sleep is certainly one of those very complex topics that people talk and think about all the time. I’m one of the initial screeners for the challenge. I’m looking forward to reading submissions to see how people answer the question; it’s a difficult one.
Are you leaving it to your sleep health colleagues to answer the Flame Challenge question?
As a screener, my job is to check for scientific accuracy. It’s a tough question, and I encourage my colleagues to try to tackle it.
What sleep advice do you have for all the hard-working faculty, students and staff at Stony Brook?
Try to maintain a regular schedule. That means going to sleep and waking up on weekends at approximately the same time you do on weekdays. If you return to a Monday morning schedule after sleeping in on Saturday and Sunday, your body gets very confused. So while it’s enticing to sleep in and make up lost sleep, it’s better to get enough sleep by going to bed at approximately the same time and waking up approximately the same time every day. Of course, not everybody can do that, but that’s the best strategy.
Knowing what you do about the importance of sleep, have you ever caught some shut-eye in the office?
I’ve certainly tried! I’m not sure I’ve actually fallen asleep. That’s hard to do when you’re not in a comfortable place. One of the funniest segments on the television show Seinfeld was when George tried to set up a sleeping spot on the floor under his desk. I’ve never gone that far!
How do your preventive medicine colleagues view you and your research on sleep health? Have they named you the Queen of Z’s?
No, they still call me Lauren! Seriously, my colleagues are great and we get along very well, especially those of us in the Program in Public Health. We’re a relatively young and productive group and we’re all very supportive of each other
You’re the mother of two sons — a newborn and a preschooler. Is a good night’s sleep just a pipe dream for you these days?
A good night’s sleep right now means only waking twice! So it’s safe to say that I’m not sleeping through the night and probably won’t be able to for a few months. I’m up and back asleep and up again every two to three hours, but it’s not as bad for me as it is for some people who can’t get their babies back to sleep, or for people who are driving trucks at night or working two and three jobs, including night shifts, etc.
How does your sleep expertise play out in your own household?
As preoccupied as I am with the topic of sleep, the challenge of getting my older son to sleep is much harder than the textbooks would indicate. He even stays awake during daycare naptime. While the other kids are sleeping, he lies on his mat and hugs his stuffed animal, Mr. Cow. He doesn’t fall sleep easily at night, either. He’s an evening person, and I was, too, as a child. I was also a very difficult child to get to bed. I fought it and fought it. After losing battles with my mom to leave my room, I’d still stay up late reading. All in all, it’s pretty ironic that I am out and about researching and talking about the importance of sleep and my own son does not like to sleep!
— Susan Tito; photos by John Griffin and Efal Sayed