Transcript: We Are Catastrophising Sleep! - Stephanie Romiszewski on Sleep in Midlife

INTRODUCTION

Stephanie Romiszewski: We need to stop worrying about poor sleep too much, because otherwise it creates this issue where many of us develop sleep anxiety, thinking, "Oh my God, this is so important."

The reality is, when you become too micro about these things and try to control them too much, you actually cause sleep problems. You’re actually causing sleep anxiety. Sleep anxiety is very different from having an actual issue with your sleep.

In order to be asleep, you actually need to spend time awake, which I think is really funny, considering how terrified we are of spending more time awake and dealing with sleep deprivation.

Many of us are very reactive when we have sleep problems. We start looking at our nighttime and evening routines, what we do, and even when we go to bed, not realising that unless you’ve got your wake-up routine nailed, none of that matters

Paul Sutton: Stephanie Romiszewski is a sleep physiologist and the founder of the Sleepyhead Clinic, which treats insomnia, and Re:Sleep, a sleep training programme. She also runs a BBC Maestro course called Sleep Better.

Stephanie believes that a lot of the current hype around sleep is unconstructive and that the short-term solutions we use to get a better night’s sleep can actually make things worse. She cites the fact that people who have no problems with sleep don’t do any of the things on a sleep hygiene list, for example.

So, with all this said and done, how important is sleep? How do our sleep patterns and requirements change as we age? And what should we be doing to ensure we wake up feeling refreshed and energised?

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PS: I'm Paul Sutton, and this is Middle Man, the show for midlife men and the people who love them.

EPISODE

PS: Stephanie, you describe yourself as a sleep physiologist, as opposed to what I would think of as a sleep psychologist. What’s the difference between those two roles, and what exactly is your role?

SR: So, physiology is much more to do with, I guess, the physical aspects of our body, to put it simply. You’ll often find physiologists working in fields like lung function, for example, conducting tests for patients. You’ll also find physiologists in sleep medicine, conducting tests such as sleep studies or sleep apnoea studies. Many people may be familiar with those. Physiologists also work in audiology and other areas where understanding the human body in detail is essential. Usually, physiologists are more involved in diagnostics.

I understand the confusion with psychology, though, because I’ve sort of blended the two disciplines. My first degree was in psychology, and my second was in behavioural sleep medicine. It makes me feel a bit more like a psychologist, but most of my work in the NHS, for example, was as a physiologist. I never actually got my doctorate in psychology because I was too busy learning about this fascinating world of sleep medicine.

As I progressed in my career, I realised we weren’t effectively treating common sleep issues. We were focusing on specialised conditions like sleep apnoea and narcolepsy, but people would come in all the time saying, "I just can’t sleep," or "I can’t get to sleep," or "I can’t maintain my sleep." There wasn’t much being done for those people. So, while I’m registered as a physiologist, I’ve ventured into behavioural sleep medicine, which isn’t as formally accredited as other areas in medicine.

PS: From what you’re saying, there’s clearly a significant crossover between the psychological and physical aspects of sleep, yes?

SR: Absolutely. For example, insomnia, which I specialise in, is very much a psychophysiological problem. The brain and body affect each other in a way that creates a disorder. A lot of the issues we have with sleep today are psychological, but that doesn’t mean there isn’t a physiological basis for many of them.

There’s a huge crossover in sleep medicine, and you’ll find specialists like me who have backgrounds in psychology or physiology, often blending the two. Historically, the focus has been more on diagnostics, which is why you’ll often see physiologists, or as we were called back in the day, medical technicians. It’s a broad field with a lot of overlap.

PS: How did you come to work in this field? Was it always an interest of yours, or did you, like some people, fall into it by chance?

SR: I would argue that most people fall into sleep medicine because there aren’t many accredited pathways to enter it—though there really should be. I was studying for a psychology degree when I had this wonderful opportunity to do a placement at Harvard Medical School. It was one of those sandwich courses where you gain practical experience. Stupidly, I should have done something more psychology-related to help me get my doctorate, as it’s such a competitive field.

Instead, I got sidetracked. I saw this opportunity to do sleep studies at Harvard Medical School, and I didn’t think I’d get it. But I did, and I thought, "Wow, this is fascinating." I happened to know someone who had done it the year before, so I picked their brains about it.

Everyone has this strange curiosity about sleep because it’s so mysterious to most of us. It’s like the forgotten area of medicine, and the less we know about it, the more intrigued we become—especially as it’s so hyper-personalised and unique to each of us. Naturally, I was completely sucked in.

At 19, I went to Harvard, learned so much about this area, and was trained by the best in the world as a technician. We were called "circadian technicians," just to show how much variation there is in what a physiologist can do.

When I came back, I thought, "What do I do now?" That led to a sleep physiologist role. I got a job at Guy’s and St Thomas’ Hospital in London straight away, and off I went, learning more clinical skills. At Harvard, the work was more research-based, dealing with healthy subjects and manipulating conditions to understand sleep better. But in the NHS, you deal with clinical cases, diagnosing and treating complex conditions.

It was a baptism of fire into sleep medicine, which I suppose many people still struggle to access now, as there isn’t a formalised accredited system yet. I feel incredibly fortunate to have had those experiences.

PS: It’s a fascinating area. Like you said, people probably have an innate curiosity about it. You know, about what goes on and everything. But this is going to sound like a very naïve and silly question, but let’s start with something top line: how important is sleep to us? I mean, what’s the real impact of poor sleep?

SR: I hate answering that question because it’s the most common one, but it’s not really the question we should be asking. The reality is that we literally cannot live without sleep. It doesn’t matter how bad or good your sleep is; you can’t exist as a human being without it.

So, that really emphasises why it’s so important—we need it to survive. But what we’re not emphasising enough is that we don’t have as much control over it as we’d like to think.

We need to stop worrying about poor sleep too much. Constantly hearing that sleep is so important creates this issue where many of us develop sleep anxiety, thinking, "Oh my God, I can’t live without sleep!" It’s true that sleep is fundamental to so many processes—your immune system, growth hormones, cell replacement, memory processing, emotional regulation, and so on.

Historically, we thought of sleep as a passive state, not worth studying. But now, thanks to technological advances, we know it’s an active state, where so many vital processes are happening. It’s brilliant that people are now talking about sleep’s importance, and that it’s become part of the cultural zeitgeist.

But there’s a downside. When we get too focused on controlling sleep, it can lead to problems like sleep anxiety. Sleep anxiety is very different from an actual sleep disorder.

Also, sleep varies throughout your life. It’s impossible to sleep eight hours every single night, even if you’re naturally an eight-hour sleeper—which not everyone is. Sleep changes as you go through different illnesses, life stages, time zones, and other factors. For example, when you’re ill, your sleep might change dramatically because of how it supports your immune system.

The expectation of perfect, consistent sleep every night is unrealistic and counterproductive. Sleep is supposed to adapt and flow with what’s happening in your life. Trying to control it too rigidly is what’s causing so many issues today.

PS: Specifically, with this show’s audience in mind, the reason I wanted to talk to you is that I get a lot of emails from men going through midlife transitions. Psychologically, they feel stuck or lost, and they might not have the most positive mindset.

That was me a year ago, to be honest. I wonder what role sleep plays in that. I’m not blaming negative mindsets entirely on poor sleep, but it makes sense to me that if you’re sleeping well, with good hygiene and routines, you’re likely to have a more positive mindset. Is that genuinely the case?

SR: It’s interesting you mention sleep hygiene, because I’d argue that many things on a typical "sleep hygiene" list aren’t necessarily going to help improve your mindset or sleep. The assumption is that these hygiene practices will fix your sleep, but that depends on what’s actually causing the problem.

Yes, poor sleep can affect your mood, behaviour, and how you feel during the day. But I’d also argue that much of this comes down to how we think about sleep. For example, if you wake up after a bad night’s sleep, you might immediately assume, "I’ll be tired all day," or "I’m going to mess up that meeting." These assumptions can create a self-fulfilling prophecy.

We often blame sleep for everything, but there are plenty of factors influencing how we feel in the morning—like what we do when we first wake up, or our nutrition. People fixate on their sleep and overlook the behaviours around it.

For example, when I work with patients with chronic insomnia, they often tell me how their sleep impacts their performance. But when I ask for specific examples, like how their work performance has been affected, they struggle to provide concrete instances. They feel it’s having a huge impact, but the actual effect might not be as dramatic as they believe.

This isn’t to downplay how they feel, but rather to highlight that our mindset and beliefs about sleep play a massive role.

Of course, when there’s a significant build-up of poor sleep, it can have a profound impact. But to get to that point, a lot of it comes down to our mindset and our approach to sleep. Education about sleep is crucial because it helps us understand what’s normal and what isn’t.

For example, since I started in this field nearly 20 years ago, I’ve learned not to worry about my sleep. People assume I must have perfect sleep hygiene or follow a strict routine, but I don’t. In fact, most of the things people think they "should" do for good sleep—I don’t do. The difference is that I don’t panic when I have a bad night’s sleep. I understand it’s normal to go through periods of variation.

Like anyone else, I experience ups and downs with my sleep, but I know how to manage fatigue and make myself feel better when I can’t rely on sleep as much. That’s the key: not getting stuck in the mindset that one bad night is a catastrophe.

We hear so much about the physical consequences of poor sleep—how it affects our health, our brain, our body. But I think we need more research to understand how significant these effects are in everyday life. When studies show that sleep deprivation has a "significant" impact, we often assume that means it’s catastrophic. But in research terms, "significant" could mean a small, measurable difference—not something that will drastically alter your life.

For example, people might worry that poor sleep will get them fired or destroy their relationships. But when we dig into these fears, we often find that the actual consequences are much less dramatic than people think.

That said, it’s true that sleep deprivation can make us grumpier, more irritable, or prone to arguments. But there’s always an element of choice and other contributing factors—like nutrition, physical health, and the behaviours you engage in throughout the day.

One area where I see this a lot is in "sleep behaviours." These are the actions you take around sleep, like what you do first thing in the morning or how you approach your day. Many people focus on their sleep itself, but it’s often their behaviours that are causing them to feel fatigued or unwell.

PS: This is really interesting because this isn’t the direction I thought this conversation would take. That’s a good thing, a really good thing. I don’t want to put words in your mouth, but it sounds like you believe we’re almost demonising sleep and blaming it for things that have nothing to do with it.

SR: Yes, I do. I really believe that’s started to happen. It’s not that I’m at the extreme end of the scale, believing sleep deprivation does nothing to us or that it’s not an issue. It’s just that we’ve swung so far to the other end of the spectrum, where we’re terrified of anything affecting our sleep. We’re tracking sleep to the nth degree, not realising that it’s probably making things worse in many ways.

We need to talk about sleep in a much more balanced way. It is true that sleep is a pillar of health, just like diet and exercise, but it’s not the be-all and end-all. It’s not the most important factor all the time. Sometimes, you’ll have to sacrifice sleep to function in other areas, like socially, for instance, and those things are important too. If you neglect one pillar of health to over-prioritise another, it can negatively impact your overall well-being.

We need to speak about sleep holistically. We can still rely on evidence-based science to understand its importance without scaremongering people into thinking, "Oh my God, I didn’t get eight hours of sleep—there’s something wrong with me."

As people get older, their sleep naturally changes, and yet there’s so much fear around that. This is something we wouldn’t have worried about in the past. Before the Industrial Revolution, there’s little evidence to suggest people were anxious about the duration or quality of their sleep. It was more natural—people woke with the light and did things they could manage without artificial lighting.

This anxiety around sleep is a relatively modern phenomenon. It wasn’t historically seen as a major epidemic. After the Industrial Revolution, priorities shifted, and sleep wasn’t considered worth studying compared to other medical issues that were more pressing, like diseases that shortened life expectancy. That delay in understanding sleep hasn’t helped us today, as people struggle to answer questions like, "What is sleep? Why is it important? When should I worry about it?"

Now, instead of proper sleep specialists, we’re getting advice from social influencers. That’s not inherently bad—it’s good to raise awareness—but the problem is that most medical science can’t be distilled into an Instagram post. There’s a lot of nuance in medicine that’s lost when we try to simplify it too much. People want hacks or black-and-white answers, but sleep is far more complex than that.

Sleep should be seen as a trusty old friend, not an enemy, but unfortunately, we’re treating it as the latter these days.

PS: You mentioned earlier that your sleep has changed as you’ve aged—mine has too—and that midlife people are the most frequent group seeking help with sleep issues like insomnia. Is it generally true that sleep becomes more disrupted as we age? How does it change?

SR: Yes, sleep does tend to change as we age. We all have something called a circadian rhythm, which is the 24-hour clock in our bodies that regulates many processes, including the sleep-wake cycle. As we get older, that rhythm becomes a bit "lazy." Our bodies love regular timing, but with age, those internal markers become less reliable.

For example, many older adults find they can fall asleep fine, but maintaining sleep becomes more difficult later in the night. Some stages of sleep, like REM (rapid eye movement) sleep, tend to become more fragmented.

REM sleep is a lighter stage of sleep where we process memories and emotions, and it’s when most of our vivid dreams occur. Because it’s such a light stage of sleep, it’s easier to wake up during it. As we age, there are more internal and external factors—like illnesses or the general effects of ageing—that can interrupt this stage of sleep.

Does this mean we need less sleep as we age? Not necessarily. Some people still get the same amount of sleep, but it may feel more fragmented. In trying to "fix" their sleep, people sometimes end up reducing it or disrupting it further.

For most of us, sleep will change as we age. We’re likely to become more "morning types," meaning we’ll wake up earlier and feel the need to go to bed earlier. The second half of the night also tends to become lighter.

Is this something to worry about? Not usually. It’s when people start worrying about these changes and making drastic behavioural adjustments to try and "fix" their sleep that they run into trouble. That’s when they might develop chronic insomnia.

In clinic, I often see people who’ve unintentionally shifted their baseline. They perceived a problem, tried to fix it, and ended up creating a real issue. The goal is to help them return to a healthier baseline—not necessarily what their sleep was like at 25, but something much better than their current state.

PS: That baseline you’re talking about—is that to do with regulating your sleep times? Because one of the things I’ve read and seen a lot about, which we mentioned earlier with sleep hygiene, is that it’s more to do with when you wake up rather than when you go to bed. In other words, if you keep a regular wake-up time, your body is more likely to adjust, and you’ll get the quality of sleep you need rather than just focusing on the length of sleep. Is there truth in that?

SR: Yes, there’s a lot of truth in that. Essentially, your sleep starts in the morning. It’s interesting because many of us are very reactive when we have sleep problems, so we focus on our nighttime routine—what we do in the evening, when we go to bed, or what we do during the night. But the reality is, unless you’ve got that wake-up time nailed, none of that matters. It literally doesn’t matter. You won’t get any meaningful influence from it.

If you regulate your wake-up time consistently, everything changes. Now, when you wake up will vary from person to person, depending on your lifestyle. For instance, I wake up fairly early because I have a lot to fit into my day, and I’ve essentially turned myself into a morning person. Whether I was biologically a morning person, I’m not sure, but since I was 19 and started learning about sleep, I’ve been following these principles.

When you regulate your wake-up time, you’ll notice your sleep quality and duration become far more predictable. That’s because the pressure to sleep starts in the morning. To be asleep, you actually need to spend time awake—which is ironic, considering how terrified we are of being awake for too long and experiencing sleep deprivation.

When you get up at a consistent time, you build a predictable sleep pressure. That pressure builds throughout the day and eventually needs to be alleviated, which is when you start to feel sleepy in the evening. Eventually, you won’t be able to keep your eyes open. This process becomes more regular and reliable when your wake-up time is consistent.

For people who want to go to bed at the same time every night, it’s not something you need to force. That will often happen naturally as a result of having a regular wake-up time. The key is to go to bed when you feel sleepy, not when the clock says you should.

The other significant change you’ll notice is that your sleep quality improves, and the window of your sleep becomes more consistent. Your brain starts to understand when you want to sleep and adjusts accordingly.

One of the biggest benefits of a consistent wake-up time is that you stop feeling the need to lie in or hit the snooze button. Many people think lying in or snoozing is about catching up on sleep or improving its quality, but actually, the less you do this, the better your overall sleep regulation will be. You’ll wake up more naturally and feel ready to start your day without that horrible slog to get out of bed.

This doesn’t mean you need to wake up early to experience these benefits. Whether your wake-up time is 6:30, 8:00, or 9:00, as long as it’s consistent and suits your lifestyle, it will elicit the same positive effects. You don’t have to be perfect—I’m not asking you to act like a robot. Even I lie in occasionally. But if you’re consistently snoozing and lying in, you’ll struggle to get on top of your sleep.

PS: Let’s take me as an example. I have to get up at 6:30 Monday to Friday to get my kids to school. On Saturday and Sunday, I don’t need to, so I might naturally sleep until 7:30. Over the Christmas holidays, I’ve been sleeping until 8:30, but it’s been consistent at 8:30 every day. My body seems to adjust. Should I be allowing myself that extra time at the weekend, or is it actually doing more harm than good?

SR: Based on the research and having treated over 10,000 people, I’d say this is quite individual. If you have a problem with your sleep—and you’ll know if you do—then yes, being consistent with your wake-up time is one of the most influential things you can do to improve it.

However, if you don’t have a sleep problem and your sleep is working well for you, there’s no need to overthink it. If you don’t feel overly tired, don’t get those Sunday night blues (which often come from an irregular sleep pattern), and generally feel refreshed, then there’s nothing wrong with what you’re doing.

The research does show that the more we deviate from our regular wake-up time, the more it can affect our sleep. But it’s not a one-size-fits-all rule. Clinically and anecdotally, I’ve found that some people need to be stricter with their wake-up time to get good sleep, while others can get away with being more flexible.

For you, it depends on how you feel overall. If your sleep serves you well, you don’t need to change anything. But if you were to follow textbook science, then yes, you’d aim to wake up at around the same time every day. Over time, you likely wouldn’t feel the need to lie in as much because your sleep quality would improve, your sleep pressure would become more predictable, and your body would naturally establish a consistent window of sleep.

That said, life is about balance. Sometimes you have to sacrifice sleep to enjoy yourself or prioritise other aspects of your life, and that’s okay too.

PS: Yeah, absolutely. You talked a bit about balance earlier, and that really resonates with me. It’s one of the ways I’ve been thinking about things recently. This whole series of podcast episodes I’m doing on well-being is intended to take quite a holistic look at things. We’re talking about nutrition, alcohol, physical exercise—all of those aspects. To me, sleep fits into that in a holistic way. I don’t expect myself, or anyone else, to have perfect sleep, perfect nutrition, or perfect physical exercise. To my mind, all these things fit together. I’m assuming, from what you’ve said, you firmly believe that too?

SR: For sure. I think when it comes to looking after all these different pillars of health, it’s important to be mindful of which area might need the most attention. If there’s one area that’s not working for you, I’d recommend looking at that more in-depth first, because you’re starting from a place where something is broken. It’s the same with sleep.

The reason I’m emphasising this is that, while health and well-being are absolutely holistic and interconnected, I do worry when people start focusing on one area to try to "fix" another, without clear evidence that it’s effective. For example, people might change their diet to try and improve their sleep, but at the moment, the science doesn’t support the idea that there’s anything in your diet—unless you have a significant dietary problem—that will have a major impact on your sleep.

This highlights a broader issue: because sleep education is so far behind, many people don’t focus on the most influential things they can do to improve their sleep. Instead, they get caught up in these indirect approaches, which might not make a real difference.

That said, if your sleep is currently working for you, there’s no need to overthink it or make unnecessary changes. If you maintain balance across all the pillars—sleep, nutrition, exercise, mental health—you’re much more likely to continue feeling good.

So yes, it’s all about balance, and a holistic approach is essential. But with sleep, my experience and understanding suggest that it often needs to be prioritised. Ironically, even in the medical field, sleep problems are frequently treated as a symptom of something else, and that’s a real issue.

Take insomnia as an example—a very common issue. Many of your listeners might have experienced this. When people go to their GP describing insomnia, the first step is often to rule out other potential causes, which is important. But when the problem has become chronic—lasting more than three months, occurring four or more times a week, and significantly impacting life—it’s classified as chronic insomnia.

At that point, whether it’s primary insomnia (existing on its own) or secondary (linked to another condition), the focus needs to be on treating the sleep issue itself. Unfortunately, because medical education on sleep is still lacking, doctors often misattribute insomnia to something like depression. They’ll say, "I think you’re depressed," and send the patient away with that diagnosis.

This is hugely frustrating for most people, especially if they know they’re not depressed. Even worse, if the sleep issues started before any mood changes, the misdiagnosis can make things worse. It doesn’t fix the sleep, and it can negatively affect someone’s mental health.

So while a holistic approach is important, we also need to recognise that sleep deserves direct attention in its own right. And yes, if everything is working well for you, that’s great—maintain it! But the problem with sleep is that there’s so much misinformation and confusion around it.

For example, you mentioned sleep hygiene. It’s such a broad term that many people don’t even know what it actually involves. And the truth is, there isn’t an exact list of sleep hygiene rules—it’s turned into this endless checklist of things you’re "supposed" to do. But here’s the thing: most good sleepers—myself included—aren’t doing all of those things. In fact, we don’t care about them that much!

PS: With that in mind, then—this sleep hygiene list, which, as you said, varies so much depending on where you look—what are the core things you advise people to focus on to help train themselves, for lack of a better phrase, to achieve better sleep? We’ve already discussed regulating wake-up time as perhaps the most important, but what else should people look at?

SR: Before I get into specific advice, the most important thing I can do is encourage you to assess whether any sleep tip you’re given will actually work for you. Otherwise, it’s just another person—whether it’s me or someone else—adding more noise to the conversation.

Here’s a simple way to evaluate advice: ask yourself if the tip or method impacts the sleep systems. There are two main systems involved in sleep. First, there’s the homeostatic sleep drive, which is the sleep pressure I mentioned earlier—the sleep "battery" you build up during the day. Does the tip affect your sleep drive? Can it increase it? How does it do that?

Second, ask if it affects your circadian rhythm, which is the timing of your sleep and wake cycles. If a tip doesn’t influence one of these two systems, it’s unlikely to help. This simple understanding can save you from wasting time and energy on things that don’t work.

Take, for example, lavender sprays. They don’t impact the sleep systems directly. While you might associate the scent with relaxation—which is helpful for winding down—it’s not going to physiologically put you to sleep. The danger comes when people expect too much from these products. When they don’t work, anxiety builds, leading to reliance on the product and potentially creating sleep anxiety or even insomnia.

So, let’s go back to what really works. Regulating your wake-up time is the foundation. A consistent wake-up time makes your sleep drive more predictable.

Forget about forcing a bedtime, though. Your bedtime isn’t as important as your wake-up time because your sleep drive determines when you’ll feel sleepy. If you go to bed when you’re not sleepy, you’re setting yourself up for frustration.

Some people naturally get sleepy at the same time every night because their wake-up time is consistent, and their sleep drive aligns with it. But for others, going to bed without a strong physiological need to sleep can create a vicious cycle of anxiety. That anxiety increases your heart rate, raises cortisol (a wake hormone), and suppresses melatonin (your sleep hormone). It’s a recipe for lying awake, tossing and turning.

Sleep ebbs and flows depending on life stages, health conditions, and other factors. If you can’t sleep, it’s better to rest than to force yourself to sleep. Avoid doing daytime activities like work during the night, as this can confuse your circadian rhythm.

Don’t associate your bedroom with wakefulness. If you can’t sleep, get up and do something calming—read a book or watch light, non-stimulating TV. Avoid looking at your phone, as the light and activity can reinforce wakefulness. Return to bed only when you feel sleepy.

Napping is another important area. While short naps (20–30 minutes) can be helpful occasionally, napping too often or at random times can disrupt your sleep drive. Think of it like charging your phone: if you’re constantly topping it up without letting it drain or fully recharge, the battery won’t function properly. Napping should be a recovery tool, not a daily habit for compensating for poor sleep.

If you’ve had a bad night’s sleep, get outside into natural light as soon as possible. Light helps regulate your circadian rhythm and reduces fatigue. Movement or light exercise—even if it’s the last thing you feel like doing—can also help you feel better.

We’ve been led to believe that anything less than "perfect sleep" is a disaster, but that’s not true. Sleep is flexible, and your body is designed to adapt. A little sleepiness during the day isn’t something to fear—it’s just your body telling you it’s working as it should.

PS: You mentioned light exposure, which is something I wanted to ask you about. It’s quite widely written that it’s a good idea to get light in the mornings—when you’re up and about, getting some sunlight is supposed to be beneficial. I use a daylight alarm clock as well, which is obviously a different thing, but I wondered what your views on that were. And also, on the other side of things, you often hear that you shouldn’t use your phone within an hour or two before bed. What’s the whole story with light?

SR: Oh my goodness, it’s actually more complicated than you’ve described, which is a bit annoying because we could talk about it for hours, but I’ll try to keep it simple.

Light exposure is one of the most influential external timekeepers for our bodies. It helps align us with the planet’s cycles—day and night, the seasons, everything. Since the Industrial Revolution, things have gotten a bit wonky, but in some ways, it’s helpful because we can now use light to create consistency, depending on how we manage it.

Bright light in the morning is fantastic. Light alarms, for instance—I also have one—are a wonderful way to wake up. They gradually increase light levels, which gently seep through your sleep stages, nudging you awake in a natural and gentle way. This helps avoid the horrible sleep inertia that happens when a traditional alarm jolts you awake, often from a deep or REM stage of sleep. That’s why you can feel groggy or rubbish in the morning—it’s about being woken up from the wrong stage of sleep.

Light in the morning reduces melatonin levels, which is exactly what you need—it’s your sleepy hormone, and you don’t want it lingering around when you’re trying to wake up. It also helps with the rise in cortisol, which is necessary to alert your brain and kickstart all the processes your body needs to function.

We’re much more like plants than we realise. While we don’t use light in the same way, it’s still a form of energy for us. That’s why light is particularly important in winter, when we don’t get enough natural light. Natural light is always better than artificial, of course—it gives us more benefits, like vitamin D, which is crucial for mood. But even artificial light can help when natural light isn’t available.

When I was working at Harvard, we did sleep deprivation studies where participants weren’t allowed to sleep all night or even longer. Then we exposed them to bright light. While it didn’t completely mitigate the sleep debt or bring their cognitive performance back to the level of a well-rested person, it offset a lot of the negative effects. It tricked their bodies into thinking, “It’s morning, I’ve got things to do,” and that included regulating hormones like leptin and ghrelin (which control hunger and satiety).

As we move into the evening, the story changes. To prepare for sleep, our bodies need gradually lower light levels, and ideally, we should sleep in pitch darkness. Darkness helps initiate melatonin production, which is why many of us feel tired earlier in the evening during winter. Unfortunately, that can backfire if you end up nodding off on the sofa at 5 p.m., as it disrupts your sleep later.

Now, about phones and blue light. It’s true that looking at your phone can affect melatonin levels, but the degree to which it matters is a bit questionable when you look at the research. Flicking your phone on for a minute isn’t going to ruin your sleep cycle, but if you’re spending a lot of time on it, the light combined with the stimulating content can have a bigger impact. The stimulation—what you’re looking at or engaging with on the phone—often has a quicker and more noticeable effect than the light itself.

The general idea is that your mornings should be as bright as possible, and your evenings should gradually dim down. Sleeping in pitch darkness is ideal. But if you’re awake during the night, don’t stress too much about having low levels of light—it’s not going to completely sabotage your sleep process.

PS: Just to finish off, I think I know the answer to this question already—which is, don’t worry about it—but if someone is stressing about sleep, is there one thing they should focus on?

SR: Yes, I’d say the most important thing is to remember that even if your sleep is awful right now and it’s not serving you, your body is still resilient. You’re not going to drop down dead from a bad night’s sleep, I promise. The more you stress about it, the worse it will feel, and I’d argue that the stress itself is far more harmful in the short term than a poor night’s sleep.

Your body is fascinating. Even during periods of poor sleep, it will try to compensate. For example, if you’re only getting short bursts of sleep, your body will increase the amount of restorative REM sleep you get in those shorter periods to help make up for it. You can’t manually control or optimise this—it’s just how your body works. So, when your sleep tracker tells you you’re not getting enough of this or that stage of sleep, remember, those trackers are often highly inaccurate.

You can’t manipulate individual stages of sleep; you can only work on improving your overall sleep habits. If you’ve tried everything I’ve described for two to three weeks consistently and you’re still not seeing any improvement, that’s a good thing in a way. It means you’ve ruled out behavioural causes, and you can move on to seeking help from a professional.

Unfortunately, in the UK, access to insomnia services on the NHS is still limited, but they are becoming more common. Alternatively, you can find a sleep specialist—just make sure they’re qualified and experienced. Sleep is still an underdeveloped field, and we need clearer structures and pathways for care.

I hope this has been helpful and that people leave this conversation thinking, “Even if I do nothing else, I feel a bit better.” That’s the goal.

OUTRO

PS: You can find out more about Stephanie’s personalised sleep support at sleepyheadclinic.co.uk, or check out her online course at re-sleep.com.

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Next week, we’re addressing the loneliness epidemic among men.

David Robson: It really does matter as much as things like exercise, whether you're taking blood pressure medication, air pollution - you know, so much more important than something like air pollution for our health. Actually, the only thing that is comparable really does seem to be whether you smoke or not, or whether you drink excessively or not.

PS: See you then.