A cornucopia of sleep research

Jon Sutton talks to Jim Horne, Director of the Sleep Research Centre at Loughborough University, about a varied and productive career

Why have you devoted a career of psychological research and practice to ‘the dark third’ of life?
Sleep is not ‘oblivion’ or ‘non-behaviour’ as many seem to think, but a complex behaviour involving many separate systems within the brain, able selectively to suppress most other behaviours. When we go without sleep, the effects on most forms of waking behaviour are fascinating. Sleepiness masks many other subtle consequences of sleep loss, and therein still lies a treasure trove of potential discovery. When I was starting out as a PhD student it was an area wide open to exploration, and it still is.

Colleagues outside the field of sleep say how lucky I am to work in this field, as it invokes much interest from all walks of life, lay and professional alike, particularly the media, commerce, industry, and the legal professions. But one can make any research topic interesting for the layperson if it is presented in plain English in an enthusiastic style. Anyone who doubts this potential should read the scientist J.B.S. Haldane’s collection of newspaper articles, in his book On Being the Right Size.

Your research has led to widely adopted guidelines for the identification of sleep-related road crashes and to practical countermeasures, including the ‘Tiredness kills – Take a break’ signs on motorways, changes to the Highway Code, and the setting of legal precedents concerning driver liability. In the early days did you ever dream of such important, real-life impacts?
No – it evolved from realising that many motorway crashes occurring in the early hours of the morning must be due to sleepiness, given that drivers were forgoing sleep, were at their circadian trough and driving on a dull monotonous road. At that time the Department for Transport [DfT] and Highways Agency were sceptical about this as a major cause of road crashes, and attributed most of these simply to ‘driver inattention’.

Our subsequent work has been quite an adventure with its obstacles and fortuitous events. It also demonstrates the value of applying laboratory findings to the real world, and the importance of ‘applied psychology’, which is an area often demeaned and still shunned by many psychologists. Let me give you a brief story to illustrate what can be achieved. Working initially with Leicestershire Constabulary and some enthusiastic police officers we showed that these periods of ‘driver inattention’ actually lasted for at least 15 seconds. Of course, no driver would take their eyes off the road for this duration whilst travelling at 70 mph, and fail to brake or swerve. We also discovered that tyre blow-outs, another apparent cause of these crashes, seemed to peak in the early hours. Either we had discovered a unique property of tyre rubber, or that blow-outs were in fact tyre blow-ins as a result of an impact. Further forensic analyses of these tyres showed the latter to be the case.

I wrote a feature article about our findings, in New Scientist, which attracted attention, and it came to light that some prominent people had probably died in such ‘accidents’. We were able to persuade several influential MPs, particularly Tam Dalyell, to raise the issue in Parliament, and he subsequently championed our cause. With Leicestershire Police we asked the Highways Agency to erect ‘Tiredness Kills, Take a Break’ signs on our local section of the M1. They took some persuading, but eventually realised that the signs were worthwhile, and paid for hundreds more to be erected over the country.  Subsequently, we have worked well with the DfT who have funded much of our research into various aspects of falling asleep at the wheel. Our detailed analyses of many road crashes, using confidential police records from much of the UK, has shown that about 10 per cent of all road crashes are sleep-related, with double this for motorways. The DfT have endorsed this finding and use it frequently. We have published our findings extensively in the scientific literature, and this has led to changes in the Highway Code concerning what sleepy drivers should do when taking a break (i.e. caffeine followed immediately by a short nap). We have shown that drivers who fall asleep at the wheel do have adequate warning beforehand and are responsible for the crashes, which are not ‘accidents’. Also, whilst overhead lighting on motorways does reduce sleep-related night-time crashes somewhat, as drivers can see further ahead, they will drive faster. Consequently, if they do fall asleep, the outcome is more likely to result in death and serious injury, and so the overall outcome is that lighting doesn’t reduce these fatalities. Our guidelines for UK police forces on what to look for when investigating these crashes have been tested in many courts, and were instrumental in the Selby rail crash investigation, where I was the expert witness for the Crown. We become involved in national campaigns, and fronted the first DfT ‘Think Road Safety’ promotion on driver sleepiness. The new corporate manslaughter law helps us to persuade employers who encourage their employees to drive whilst sleepy to think again, as the boss may well share the blame of any subsequent crashes. We also work with several global companies in these respects who, in response, have changed their fleet strategies.

Presently, we are investigating obesity-related, undiagnosed obstructive sleep apnoea in truck drivers, and immersing ourselves in psychological issues behind why young men risk driving whilst knowingly very sleepy, but deny the likelihood of falling asleep. Is it macho foolhardiness, or related to phenomena of sleep loss, particularly some impairment to frontal lobe function, with decision making becoming less risk averse, coupled with an optimistic, mild euphoria?

There does seem to be an overvaluing of wakefulness these days, along with attempts to create it artificially with drugs like Provigil.
Sleep is a very complex process within the brain, involving numerous neuropeptides and other brain mechanisms. To assume that these can be harmlessly overridden on a chronic basis, by a single drug, is just whimsy. We don’t know what the long-term consequence might be – early dementia perhaps? Besides, I suspect that with longer waking hours Parkinson’s Law will apply and people would not achieve much more, but simply spread their normal activities inefficiently into a longer day!

I like to get my eight hours – more if possible! But you have suggested that the idea that we all need this – and that people these days get less sleep – is nonsense.
Yes it is – the historical evidence usually cited to support current claims that our great-grandparents used to sleep for longer, for around 9 hours a day, stems from a misquoted study of schoolchildren, not adults. Nowadays, we forget that the average person a hundred or so years ago worked an arduous 12- to 14-hour day, six days a week, had to walk to and from work, then eat, etc., and would be lucky to get six hours sleep. Moreover, they would sleep under impoverished conditions in a damp, cold noisy bedroom, in a bed occupied by coughing children, bed-bugs and fleas. Maybe I exaggerate this somewhat, but in many respects we are comparatively lucky, today, with reduced work hours, comfy beds, fluffy duvets, warm bedrooms, etc. We spend much more time in leisure activity, and it is this which is more likely to intrude into our sleep – especially for children, where I think there is indeed a case for a worsening ‘sleep debt’. Too many kids are not getting enough sleep, and for them, sleep loss does not always lead to sleepiness but to hyperactivity and learning impairment, even being mistaken for mild ADHD.

How did it feel to have your work turn up in CIA memos in support of the claim that sleep deprivation for up to 180 hours is not torture?
Shock-horror! Recently, hitherto secret CIA documents were released by the Obama administration, to reveal that the CIA had cited what I had written in my book Why We Sleep to justify the use of sleep deprivation as a ‘painless coercive technique’ for use with suspect terrorists. It was written as an academic text without any thought of ‘coercive techniques’ in mind, and based on otherwise undemanding and benign laboratory studies using sleep-deprived volunteers who led an otherwise cosseted existence, able to withdraw whenever they liked. In such circumstances, the ‘body’ copes well, whereas brain and behaviour are obviously affected – not only by sleepiness but by those subtle changes whereby individuals can no longer think for themselves and become more like automatons. Sleep loss makes us more vulnerable to other stresses, and with additional ‘coercive techniques’, the situation for the sleep-deprived victim becomes deplorable. Whereas physical pain may still not be particularly apparent, the mental pain would be all too evident, and arguably worse than physical pain. Even if one were pragmatic and claimed that this form of sleep deprivation produced ‘desired results’, I would doubt whether the victim’s state of mind would be able to produce credible information, unaffected by delusion, fantasy or suggestibility.

Not a ‘partnership’ you sought or wanted then. But you have certainly been very successful in taking psychology beyond the ivory towers ­– have you got any tips on working with commercial partners?
They can be a shrewd lot who can take academics for a soft touch. Only go for such partnerships you feel will be really worthwhile – not just a potentially easy source of money, as they will see through you, and may turn the tables by making further demands. Be credible and don’t blind them with science but demonstrate from their perspective (not yours) how you can be of help. Find out about the organisation beforehand, and the actual roles of the representatives you meet and, if possible, what they really want from you. Show that you can deliver the goods on time. Having done all that and convinced them of your desirability, and you find the proposal an interesting challenge, then don’t undercharge for your services – be professional. By the way, here, I’d go for research assistantships – not research studentships.

You’ve also attracted a lot of research funding over the years. What’s the secret to a good grant proposal?
My own recipe, which may not be appropriate for others, is to pick a relatively unexplored topic, make a well-argued case with what little evidence there might be, show that the topic has relevance to the real world, find some pump-priming money for a short pilot study to demonstrate that the proposed project study is feasible (but be prepared to abandon the idea), and if all looks good, then go all out for the real funding

Unfortunately, many academic institutions simply judge the worth of a project in terms of the size of the monetary overheads – the more the better. It’s like judging the quality of a cake by the cost of its ingredients rather than by its taste! Many younger researchers are unwittingly driven by these rather too-pragmatic and short-sighted views, and then go on to generate far more data that can ever effectively be analysed or anyone is really interested in. One’s international reputation is built on the quality of the product – good publications, and benefit to society at large, not simply by size of research income. Of course, one can’t do research without adequate funding, but money for money’s sake is not the way ahead. Institutions are usually quick to announce new research grants, but not the outcomes unless they are newsworthy. We are in a climate of overproduction of poor research, published in unimpressive journals, with too many papers that will never be read beyond their abstracts and never cited – what a waste of human time and effort. As a journal editor having to reject 80 per cent of manuscripts, I saw too much of this lamentable and worsening state of affairs. I suspect it will all implode sooner or later.

Where next for Jim Horne and the Sleep Research Centre?
I try and devote half my academic reading to articles outside my discipline, and often come across interesting findings that could cast a different light on what sleep might be about. Some have certainly been very worthwhile for us to pursue. So, I hope I can keep my wits about me and continue doing this.

Sleep research suits me as it is multidisciplinary: I’m as much a biologist as psychologist by background, and I’m rather a ‘jack of all trades, but master of none’. I have hopped around within the field of sleep. Moving from topic to topic keeps me from going stale, and provides a broad perspective, allowing me to interact in an informed way with the many other different specialist disciplines within the field, especially in medicine. Working as the Editor in Chief of the Journal of Sleep Research, which is both a medicine and science-based journal, enabled me to keep abreast of many aspects of sleep. Some colleagues regard me as an irritant as I tend to have an unconventional approach to sleep research, and to re-interpret various published findings from a different perspectives. It can liven things up, and it gets people grudgingly to think about accepted dogma.

I suspect that the functions of sleep change in subtle ways over the sleep period, from being directed towards cortical recovery, to preparations for wakefulness, and I’ve been arguing that REM sleep is loaded towards the latter. I go as far to say that REM is not really true sleep but a state of ‘non-wakefulness’, with wakefulness just switched off, rather like ‘screensaver’ mode on a computer. Recently discovered brain neuropeptides, common to the regulation of feeding behaviour and REM sleep, provide more clues, as do the well-known but perplexing phenomena of REM sleep, to the extent that I’ve a strong hunch that mammalian REM sleep is also involved in the regulation of waking energy balance, as well as in influencing appetite and satiety, and in determining the locomotor effort (energy cost) in obtaining food. This notion has little to do with the current overblown hyperbole about lack of sleep causing obesity and metabolic syndrome. And, I don’t think that REM has much to do with memory consolidation either! As for dreams – they’re the ‘B-movies’ of the mind – entertaining, but best forgotten.

 

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