This article is a long teaser for the best book I ever read on the topic of sleep. You will be surprised how much you don’t know about sleep, an activity we all spend 1/3 of our lives on.
過去三年來，我讀過三本跟睡眠有關的書，今天要介紹的是最近讀的、也是最棒的一本。
這篇推薦文很長，可以讓你滑很久，但我保證讀完以後，不管你是18歲還是81歲，不管妳是不是運動員，你應該不會覺得我浪費了您的時間。文中主要是我從書中篩選出來的三十段重點中文摘譯 (說是驚爆點 也許更貼切)。我敢說這30個重點裡的大部分，絕大部分的讀者讀完後大概都不會覺得 ”啊這個我早就知道了的啊”，而且越到後面，越可能讓你瞠目結舌。有些你可能會覺得作者似乎有點危言聳聽，語不驚人死不休… 因為我是在寫「摘」譯，無法詳述 (我的摘譯文字已經夠多了，再多下去可能會有侵犯版權的風險) ，進一步的理性闡述、實驗方法、及學術報告的引述，買整本書來讀你會更容易理解和相信，你就會跟我當初一樣，邊讀邊點頭(或搖頭)，偶爾可能還會擲筆興嘆！
(書本連結和作者簡介在本文最後，中文版連到博客來網路書店，那裡有更多的簡介)
(如果你覺得大叔的分享還不錯，請記得幫大叔的分享平台 防彈大叔 Coach Denys 按讚，這樣就可以持續讀到小編的分享。在這裡我順便也為我過去六個月裡發文遽減跟粉絲們道歉，因為全部心力都投入準備9/29的澎湖鐵人賽 Ironman Taiwan 2019。那天大叔以59歲高齡，花了16個小時順利完賽，正式取得IRONMAN頭銜，雖然很慢，但賽事中和賽後狀況良好，完全沒有運動傷害，也算是給我分享的養身健身方法多了一個背書。以後會更常執筆分享的，謝謝大家的支持～)
開始閱讀摘譯之前，先讓小編來個基本名詞解釋：
人在睡眠中，會在三種階段來回循環：
- Wake (醒著還沒睡著)。
- NREM (Non-REM) 這個階段又可細分為NREM Stage 1, NREM Stage 2, 和NREM Stage 3。Stage 3 就是 #深層睡眠 Deep Sleep, Stage 1 和 Stage 2 算是淺層睡眠；如果沒有特別區分Stage 只說NREM，指的就是深層睡眠。
- REM (Rapid Eye Movemen) 快速眼皮跳動期，在這個階段人們常會進入作夢的狀態。
現在我們可以開始了，請靠緊椅背、抓好椅子的手把，不要被嚇到摔到地板上…
Page 63: (以下頁數皆為英文版的頁數)
Regardless of the amount of recovery opportunity, the brain never comes close to getting back all the sleep it has lost. This is true for total sleep time, just as it is for NREM sleep and for REM sleep. That humans (and all other species) can never “sleep back” that which we have previously lost is one of the most important take-homes of this book.
沒有所謂的補眠這回事， 那是一個迷思，也是這本書最重要的訊息之一。睡眠不足(8小時)後，不管你花再多的時間去補睡，你的身體永遠沒辦法回復到如果有睡足那8小時後的狀態，這是一個科學結論，不論從整體睡眠時間來看，還是細分REM和NREM睡眠來看，都是一樣。
Page 82:
Alcohol is one of the most powerful suppressors of REM sleep that we know of.
最容易讓睡眠中的REM減少的原因之一就是喝酒 !
小編補充：針對這一點，個人最近一年裡親身驗證了大概十次，屢試不爽！即使我每次都只喝不到一罐的250cc小號台啤。量測睡眠品質數據使用的是目前全世界公認消費者等級裡最準確的Ouraring 戒指 https://ouraring.com
Page 85:
While the brain areas that generate sleep are molded in place well before birth, the master twenty-four-hour clock that controls the circadian rhythm—the suprachiasmatic nucleus—takes considerable time to develop. Not until age three or four months will a newborn show modest signs of being governed by a daily rhythm.
人腦裡頭掌管睡眠的部位雖然在出生前母親的子宮裡的時候就已經成形，但掌控生理時鐘最主要的機制需要更多時間才會成熟，所以大部分嬰兒都必須等到出生後三到四個月才會開始對晝夜的循環開始有些微的反應。
(小編補充：所以對新科的把拔馬麻來說，請做好頭三四個月晚上輪流睡通宵的心理準備吧)
Page 360:
Always put your child to bed when they are drowsy, rather than when they are asleep. In doing so, infants and children are significantly more likely to develop an independent ability to self-soothe at night, so that they can put themselves back to sleep without needing a parent present.
盡量讓你的嬰兒在有了睡意但仍未睡著的時候就把他從你的懷裡放到嬰兒床上去睡，不要等到他完全睡著了才小心翼翼地把他放到床上去睡。這樣做可以幫助他們訓練在晚上自己入睡的能力，減少對父母的依賴。
Page 96:
The postadolescent stabilization of deep-NREM sleep in your early twenties does not remain very stable for very long. Soon—sooner than you may imagine or wish—comes a great sleep recession, with deep sleep being hit especially hard. In contrast to REM sleep, which remains largely stable in midlife, the decline of deep NREM sleep is already under way by your late twenties and early thirties. … Passing into your mid- and late forties, age will have stripped you of 60 to 70 percent of the deep sleep you were enjoying as a young teenager. By the time you reach seventy years old, you will have lost 80 to 90 percent of your youthful deep sleep.
青少年時期後，當你進入20出頭時，你的深層睡眠(deep NREM) 會開始變得不穩定(減少)，減少的速度遠比你的想像還要快；倒是REM睡眠會持續穩定，一直到中年後才開始減少。在你27~28歲和三十出頭時，深層睡眠會加速減少；到了45-49歲，你的深層睡眠相較於你青少年時期大概會減少了60-70%，這個減少幅度到你70歲時，會高達80%到90%。
Page 112:
(one) benefit of sleep for memory comes after learning… sleep protects newly acquired information, affording immunity against forgetting: an operation called consolidation… the interval of a single night will greatly increase the strength of the memory. . . . Whatever the cause, things which could not be recalled on the spot are easily coordinated the next day, and time itself, which is generally accounted one of the causes of forgetfulness, actually serves to strengthen the memory.
睡眠可以幫助大腦建立和維持記憶力，最明顯的成效就是在學習後的睡眠。睡眠具有一種整合腦中資訊的功能，可以保護你剛吸收到的新資訊，讓資訊免於遺失。
Page 125:
(In an experiment comparing the learning effects of two groups in a test that involves typing motor skills.) Half of the participants had learned the sequence in the morning and were tested later that evening after remaining awake across the day. The other half of the subjects learned the sequence in the evening and we retested them the next morning after a similar twelve-hour delay, but one that contained a full eight-hour night of sleep. Those who remained awake across the day showed no evidence of a significant improvement in performance. However, those who were tested after the very same time delay of twelve hours, but that spanned a night of sleep, showed a striking 20 percent jump in performance speed and a near 35 percent improvement in accuracy… In other words, your brain will continue to improve skill memories in the absence of any further practice. It is really quite magical. Yet, that delayed, “offline” learning occurs exclusively across a period of sleep, and not across equivalent time periods spent awake, regardless of whether the time awake or time asleep comes first. Practice does not make perfect. It is practice, followed by a night of sleep, that leads to perfection.
科學家找了兩組人來做實驗，比較他們練習打字後12個小時的學習效果，包括速度和正確性。第一組人是在早上上課，隔了12小時後在晚上考試，第二組人是在晚上上課，也是隔了12小時後再考試，但中間有睡眠8小時。考試的結果讓人驚訝：在速度上，第二組人超越第一組人20%；在正確性上，第二組人超越第一組人35%。也就是說，你的大腦會在技術上的學習後，即使沒有繼續練習(小編補充：因為在8小時的睡眠中)，也會持續改善學習後對技術的記憶力。這是很神奇的，想想看，這一段”離線”的學習只有在睡眠的狀態下才會發生，在醒著的時候是完全沒有發生的。所以結論是：持續的練習不會讓你的技術巔峰造極，睡個好覺後再繼續練習才會。
Page 127: (Athletes tune in here!)
The increases in speed and accuracy (in the learning of motor skills), underpinned by efficient automaticity, were directly related to the amount of stage 2 NREM, especially in the last two hours of an eight-hour night of sleep… it was the number of those wonderful sleep spindles in the last two hours of the late morning… that were linked with the offline (motor skills) memory boost… spindles.
It also brings to mind the prototypical Olympic coach who stoically has her athletes practicing late into the day, only to have them wake in the early hours of the morning and return to practice. In doing so, coaches may be innocently but effectively denying an important phase of motor memory development within the brain—one that fine-tunes skilled athletic performance.
The 100-meter sprint superstar Usain Bolt has, on many occasions, taken naps in the hours before breaking the world record, and before Olympic finals in which he won gold… Our own studies support his wisdom: daytime naps that contain sufficient numbers of sleep spindles also offer significant motor skill memory improvement, together with a restoring benefit on perceived energy and reduced muscle fatigue.
(運動員這一點一定要知道！）
🏊🏼♂ ️🚴🏻♀ ️🏃🏻♂ ️🏌🏼♂ ️🚣🏻♂ ️🏋🏻♂️ 🧗🏻♀ ️🤾🏻♂️ 🏂
身體的自調性(automaticity)是運動技術裡速度和準確性的基石，這方面的提升跟我們睡眠中的第二階段NREM有直接的關聯性，尤其是晚上8小時睡眠裡的最後那兩小時… 可以很有效地幫助上面提到的那所謂在”離線”狀態下對動作技術記憶的提升。
這也讓我想起一些典型的奧林匹克鐵血教練，往往要求他的選手每天訓練到很晚，早上又得很早起床繼續訓練。用這種訓練方法的教練，雖不是故意，卻也無知地剝奪了選手們在訓練後容許大腦繼續整理強化動作技術記憶的黃金時段！
百米短跑超級巨星 尤賽恩．博爾特 (Usain Bolt) 就曾經有好幾次在他破世界紀錄和奪奧運金牌前的幾個小時被發現找時間短眠。我的團隊的實驗也證明他的方法是有效地：白天的短眠如果含有足夠的循環，可以幫助加強動作技術的記憶、減低對體力耗費的主觀感受、及減少肌肉的無力感。
(小編補充：鐵人三項選手們請注意 🏊🏼♂️🚴🏻♀️🏃🏻♂️ 👉🏼 所以說，每天早上四、五點就起床操練並非對每一位運動員來說都是最佳的作息模式)
Page 136:
YOU DO NOT KNOW HOW SLEEP-DEPRIVED YOU ARE WHEN YOU ARE SLEEP-DEPRIVED
When participants were asked about their subjective sense of how impaired they were, they consistently underestimated their degree of performance disability… With chronic sleep restriction over months or years, an individual will actually acclimate to their impaired performance, lower alertness, and reduced energy levels. That low-level exhaustion becomes their accepted norm, or baseline. Based on epidemiological studies of average sleep time, millions of individuals unwittingly spend years of their life in a sub-optimal state of psychological and physiological functioning, never maximizing their potential of mind or body due to their blind persistence in sleeping too little. Sixty years of scientific research prevent me from accepting anyone who tells me that he or she can “get by on just four or five hours of sleep a night just fine.”
當你睡眠不足的時候你自己不一定知道。(在一次針對這個議題的實驗裡)當實驗參予者(在睡眠不足的狀況下)被問自己有沒有感覺精神和體力上的不佳，所有人的回答都是很一致地低估了自己在體力和精神上表現的低落。如果是長達數月或數年的長期性的缺眠，當事人一定會在技術性的表現、機警度、和體能活力上達到最低點，然而這樣的長期低落狀態卻已經變成了這些人認定的常態。根據流行病理學的研究，有數百萬的人不自覺地在體能和精神上一輩子都在比他本能上應該有的狀態低很多的情況下度過，只因為他們盲目地相信自己每晚少睡幾個小時應該沒問題。60年以上的科學研究，讓我無法接受任何一個人告訴我說他或她每晚只睡四、五個小時身體狀況還是沒問題的。
Page 138:
After being awake for nineteen hours, people who were sleep-deprived were as cognitively impaired as those who were legally drunk (limit (.08 percent blood alcohol).
一個人在持續19個小時沒睡覺後，因為缺眠造成的認知神經減弱程度，和一個法律界定為酒醉開車的人的程度是完全一樣的(血液裡酒精濃度達0.08%)。
Page 138:
Operating on less than five hours of sleep, your risk of a car crash increases threefold. Get behind the wheel of a car when having slept just four hours or less the night before and you are 11.5 times more likely to be involved in a car accident. (Based on an extensive 2016 study of over 7,000 drivers in the US, tracked in detail over a two-year period, by the AAA Foundation in Washington, DC.)
晚上睡眠不到5小時就起床出門開車，造成車禍的風險會增加三倍；如果是少於四個小時，風險增加到11.5倍 （這是美國華盛頓的汽車協會AAA在2016年針對超過7000個駕駛兩年之間的資料統計出來的結果)
Page 140:
1.2 million accidents are caused by sleepiness each year in the United States. Said another way: for every thirty seconds you’ve been reading this book, there has been a car accident somewhere in the US caused by sleeplessness… vehicle accidents caused by drowsy driving exceed those caused by alcohol and drugs combined.
在美國，因愛睏(缺眠)造成車禍的數目，每年高達一百二十萬次。換句話說，當你正在讀這本書的時候，每30秒就會在美國某個地方發生一次因為愛睏造成的車禍。因為缺眠造成車禍的數目比因為酒醉和嗑迷幻藥造成的車禍數目加起來還多。
Page 161:
Inadequate sleep and the pathology of Alzheimer’s disease interact in a vicious cycle. Without sufficient sleep, amyloid plaques build up in the brain, especially in deep-sleep-generating regions, attacking and degrading them. The loss of deep NREM sleep caused by this assault therefore lessens the ability to remove amyloid from the brain at night, resulting in greater amyloid deposition. More amyloid, less deep sleep, less deep sleep, more amyloid, and so on and so forth. From this cascade comes a prediction: getting too little sleep across the adult life span will significantly raise your risk of developing Alzheimer’s disease… Parenthetically, and unscientifically, I have always found it curious that Margaret Thatcher and Ronald Reagan—two heads of state that were very vocal, if not proud, about sleeping only four to five hours a night—both went on to develop the ruthless disease.
睡眠不足和阿茲海默症的病理現象會造成一種惡性循環。當睡眠不夠的時候，澱粉樣蛋白老化斑(Amyloid plaques，阿茲海默症患者腦部主要的一種病態組織)就會越來越多，尤其是在大腦裡主導深層睡眠的部位，於是深層睡眠就會減少；深層睡眠減少，你的大腦細胞就更無法排除澱粉樣蛋白老化斑。結果就是越來越多的澱粉樣蛋白老化斑，越來越少的深層睡眠，越來越多的澱粉樣老化班… 所以在成年時期，你的睡眠越少的話，年紀大後得到阿茲海默症病的風險就越高。在這裡我忍不住順便要講一個不能算有任何科學根據的推想：我一直很好奇為什麼英國前首相柴契爾夫人和美國前總統雷根這兩位元首在生前一直都不諱言(就算不是在吹噓)自己每晚只睡四、五個小時，最後兩人都是得到很嚴重的阿茲海默症。
Page 169:
In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep opportunity. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day. Impressively, it works both ways. In the autumn within the Northern Hemisphere, when the clocks move forward and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after. A similar rise-and-fall relationship can be seen with the number of traffic accidents, proving that the brain, by way of attention lapses and microsleeps, is just as sensitive as the heart to very small perturbations of sleep. Most people think nothing of losing an hour of sleep for a single night, believing it to be trivial and inconsequential. It is anything but.
在北半球，有些國家在三月開始實行日光節約時間，造成了大部分人失去了一個小時的睡眠機會。如果你跟研究人員一樣去理出很多醫院裡數百萬以上的醫療紀錄，你就會發現，這一天這樣一個看來似乎沒什麼大不了的睡眠減少，卻造成隔天心臟病發作率驚人的飆升！讓人驚嘆的，這種效果是雙向的，當北半球來到秋天，日光節約時間停止那天，人們多出了一個小時的睡眠時間，隔天心臟病發作率就劇降！同樣的升降變化也發生在車禍肇事率上，這證明了人腦和心臟一樣，也會因為睡眠時間的突然減少而造成注意力延遲和打瞌睡。大部分的人都覺得一個晚上少睡一個小時沒什麼大不了的，但事實證明絕非如此。
Page 171:
Chronic sleep deprivation is now recognized as one of the major contributors to the escalation of type 2 diabetes throughout first-world countries… How does a lack of sleep hijack the body’s effective control of blood sugar? Was it a blockade of insulin release, removing the essential instruction for cells to absorb glucose? Or had the cells themselves become unresponsive to an otherwise normal and present message of insulin? As we have discovered, both are true.
長期性的睡眠不足已經被認定是造成先進國家民眾第二型糖尿病升高的主要原因之一。缺少睡眠怎麼會使人體失去控制血糖的能力呢？是因為睡眠不足造成胰島素釋放不足，導致細胞沒有收到應該去吸收血糖的訊息？還是睡眠不足造成細胞失去了接收胰島素發出來的訊息的能力？我們的發現是：兩者皆是。
Page 171:
When your sleep becomes short, you will gain weight. … Inadequate sleep decreased concentrations of the satiety-signaling hormone leptin and increased levels of the hunger-instigating hormone ghrelin.
睡眠不足會造成體重增加，為什麼呢？睡眠不足會造成人體內一種讓你感覺到飽足感的荷爾蒙 leptin 降低，也會增加另一種讓你感覺飢餓的荷爾蒙 ghrelin.
Page 178:
Experiment with two groups of individuals on a strict, low-calorie diet for two weeks in the hopes of losing fat… When given just five and a half hours of sleep opportunity, more than 70 percent of the pounds lost came from lean body mass—muscle, not fat. Switch to the group offered eight and a half hours’ time in bed each night and a far more desirable outcome was observed, with well over 50 percent of weight loss coming from fat while preserving muscle.
對兩組人做嚴格的低熱量飲食實驗，目標是降低脂肪。第一組人每晚只給睡五個半小時，結果減少的體重裡超過70%是肌肉，不是脂肪。第二組人每晚給睡8個半小時，結果是減少的體重裡超過50%是脂肪。
Page 179:
men who report sleeping too little—or having poor-quality sleep—have a 29 percent lower sperm count than those obtaining a full and restful night of sleep, and the sperm themselves have more deformities. I sually conclude my response with a parenthetical low blow, noting that these under-slept men also have significantly smaller testicles than well-rested counterparts (testosterone affects energy level, brain focus, libido, bone density, and muscle mass).
睡眠不足的男人，相較於睡眠充足的男人，精蟲數量少29%，而且有較多的精蟲變形。在講到這個議題的時候，通常我都會再補上一句：睡眠不足的男人睪丸一般也都比較小（睾酮素會影響男人的體能、腦力、性慾、骨骼密度、和肌肉量）
Page 179:
Routinely sleeping less than six hours a night results in a 20 percent drop in follicular-releasing hormone in women—a critical female reproductive element that peaks just prior to ovulation and is necessary for conception…report that brought together findings from studies over the past forty years of more than 100,000 employed women, those working irregular nighttime hours resulting in poor-quality sleep, such as nurses who performed shift work had a 33 percent higher rate of abnormal menstrual cycles than those working regular daytime hours. Moreover, the women working erratic hours were 80 percent more likely to suffer from issues of sub-fertility that reduced the ability to get pregnant. Women who do become pregnant and routinely sleep less than eight hours a night are also significantly more likely to suffer a miscarriage in the first trimester.
根據過去40年來針對十萬名職業婦女的多篇研究報告，經常性地每晚睡不到六小時，會使女人的促卵泡激素降低20%，那是一種在排卵前會大量釋放的荷爾蒙，對女人受孕率有關鍵性的影響。報告裡指出，像是護士這種輪值大夜班常常睡眠時間不定的女人，經期不正常的比率比其他不必值夜班的職業婦女高出33%，受孕率降低的機率也增加80%。已懷孕的女人如果經常性每晚睡不到8小時，在懷孕期頭三個月流產的機率也明顯升高。
Page 183:
Natural killer cells are an elite and powerful squadron within the ranks of your immune system… Natural killer cells will effectively… (kill) cancerous cells and inject a protein that can destroy the malignancy. What you want, therefore, is a virile set of these immune cells at all times. That is precisely what you don’t have when sleeping too little. Dr. Michael Irwin at the University of California, Los Angeles, has performed landmark studies revealing just how quickly and comprehensively a brief dose of short sleep can affect your cancer-fighting immune cells. Examining healthy young men, Irwin demonstrated that a single night of four hours of sleep—such as going to bed at three a.m. and waking up at seven a.m.—swept away 70 percent of the natural killer cells circulating in the immune system, relative to a full eight-hour night of sleep.
人體內有一種天然殺手細胞(Natural killer cells)，有點像是你的免疫系統裡的精英海龍部隊。當體內出現危險的癌細胞時，這些天然殺手細胞會注射一種特殊的蛋白質到腫瘤細胞裡，殺死這些可能會變成癌細胞的腫瘤細胞。所以隨時保有大量的天然殺手細胞很重要。可是當你嚴重缺眠時，這種細胞會大量的減少。加州洛杉磯大學的麥可歐文博士做過一系列非常具有歷史意義的研究，發現即使只是短短的缺眠，也會全面快速地減少這種防癌細胞。在他針對一群健康的年輕人做的的實驗裡，歐文博士示範了只要單一一個晚上只睡4小時，譬如說凌晨三點才睡然後七點就起床，這些人體內的天然殺手細胞立即減少了70%(相較於睡8小時的夜晚）。
Page 184:
A large European study of almost 25,000 individuals demonstrated that sleeping six hours or less was associated with a 40 percent increased risk of developing cancer, relative to those sleeping seven hours a night or more. Similar associations were found in a study tracking more than 75,000 women across an eleven-year period.
在歐洲有一個針對25,000人做的大型研究顯示，每晚睡不到六個小時的人，相對於每晚睡七個小時以上的人，得到癌症的機率增加40%（這只是相關性而不是因果性，但也值得參考）。另外也有一個類似的研究顯示出很多相同的相關性，那個研究是針對75,000個女人歷時11年的觀察。
Page 186:
the scientific evidence linking sleep disruption and cancer is now so damning that the World Health Organization has officially classified nighttime shift work as a “probable carcinogen.”
睡眠不足和癌症的相關性已經罪證明確到讓世界衛生組織正式公佈把 「值大夜班的工作」列為可能的致癌物。
Page 187:
Sleep deprivation affects gene expression
Thousands of genes within the brain depend upon consistent and sufficient sleep for their stable regulation. Deprive a mouse of sleep for just a day, as researchers have done, and the activity of these genes will drop by well over 200 percent… when you do not lavish these DNA segments with enough sleep, they will not translate their instructional code into printed action and give the brain and body what they need.
睡眠不足會影響基因呈現 (白話就是基因的運作)…
大腦裡有數千種基因，它們正常穩定的運作必須靠持續的足夠的睡眠。
研究人員發現，讓實驗裡的白老鼠一個晚上失眠，白老鼠大腦裡的這些基因的活動性立即降低200%。所以當你睡眠不足的時候，你大腦裡的很多DNA是無法把指揮很多生理運作的訊息正確有效地傳達到身體各部位的。
Page 208:
the process of REM-sleep dreaming accomplishes two critical goals: (1) sleeping to remember the details of those valuable, salient experiences, integrating them with existing knowledge and putting them into autobiographical perspective, yet (2) sleeping to forget, or dissolve, the visceral, painful emotional charge that had previously been wrapped around those memories… the dream state supports a form of introspective life review, to therapeutic ends.
REM快速眼皮跳動睡眠對腦部相關的生理和心理健康有兩個關鍵的作用：(1)去記住白天裡那些鮮明又有價值的經歷，然後把它們跟原本已經存在大腦裡的知識和經驗整合成像是自傳一樣的記錄，(2) 把發生過的一些比較痛苦的、負面情緒的記憶從腦部記憶細胞裡化解掉… REM睡眠狀態中常會出現的做夢其實是一種生命內省的形式，在腦神經心理醫學上，具有療癒的功效。
Page 214:
Accurately reading expressions and emotions of faces is a prerequisite of being a functional human being (and a critical capability that affects our social life)… There are regions of your brain whose job it is to read and decode the value and meaning of emotional signals, especially faces. And it is that very same essential set of brain regions, or network, that REM sleep recalibrates at night… Deprive an individual of their REM-sleep dreaming state, and the emotional tuning curve of the brain loses its razor-sharp precision… You begin to mistake friends for foes. (Hence a tendency to perceive the world around you as more negative and hostile.)
能夠正確地解讀別人臉部的表情和情緒其實是人類有別於其他動物的一種很基本的能力(也是一種關鍵的社交能力)… 你的大腦裡有一些特定區域的主要工作就是解讀他人的情緒訊息，尤其是從臉部傳達出來的。而負責維護和調理腦中那些特定區域的就是「REM睡眠的作夢狀態」… 所以一個人的REM睡眠如果被減少，大腦對於情緒的調理就無法保持精準… 你就可能會開始把朋友當成敵人（結果就是一種容易以敵對心態把周遭所有的事情看成負面的傾向）
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After allegedly having not slept for three days and three nights, (Mendeleev, 1834-1907, a Russian chemist, the inventor or discoverer of the periodical table in chemistry) had reached a crescendo of frustration with the challenge… Succumbing to exhaustion, and with the elements still swirling in his mind and refusing organized logic, Mendeleev lay down to sleep. As he slept, he dreamed, and his dreaming brain accomplished what his waking brain was incapable of. The dream took hold of the swirling ingredients in his mind and, in a moment of creative brilliance, snapped them together in a divine grid, with each row (period) and each column (group) having a logical progression of atomic and orbiting electron characteristics, respectively. In Mendeleev’s own words: “I saw in a dream a table where all the elements fell into place as required. Awakening, I immediately wrote it down on a piece of paper. Only in one place did a correction later seem necessary.”
發現化學週期表的俄國化學科學家門捷列夫(Mendeleev)據說起初因為兜不出周期表熬了三天三夜沒睡覺以後，挫折到不行… 筋疲力倦後，他也只好投降，乖乖地去睡，那些化學元素還在他的腦海裡亂轉，就是不呈現任何邏輯性。睡著後，他做夢了，在夢裡他的大腦完成了他醒著的時候無法做到的事：他的夢把ㄧ堆亂轉的化學元素給兜了起來，在充滿驚人創造力的一瞬間，將這些化學元素堆疊到一個神奇的表格裡，每一行和每一列都根據圍繞著每個原子旋轉的電子特性展開！門捷列夫自己的說法是：「在夢裡我看到所有的元素有條有理地被放在表格裡，我一醒過來就馬上把這個表格抄寫在一張紙上，後來重新檢查時發現需要修改的只有一個小地方。」
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Paul McCartney’s (a member of the Beetles) origination of the songs “Yesterday” and “Let It Be” came to McCartney in his sleep. In the case of “Yesterday,” McCartney recounts the following:
“I woke up with a lovely tune in my head. I thought, “That’s great, I wonder what that is?” There was an upright piano next to me, to the right of the bed by the window. I got out of bed, sat at the piano, found G, found F sharp minor 7th—and that leads you through then to B to E minor, and finally back to E. It all leads forward logically. I liked the melody a lot, but because I’d dreamed it, I couldn’t believe I’d written it. I thought, “No, I’ve never written anything like this before.” But I had, which was the most magic thing!
英國史上最有名的合唱團披頭士的成員之一保羅麥卡錫寫的兩首名曲 “Yesterday” 和 “Let It Be” ，據他自己說也是來自他睡覺作夢的時候。Yesterday 這首歌當時創作的情況，根據保羅自己回憶的說法是：「當我醒過來時，腦中有一段很優美的旋律。我就在想，太好了，但這是怎麼一回事呢？那時候床右邊窗戶前就有一台直立式鋼琴，我立即起床坐到鋼琴前面，找到G大調，找到F鋒利小七合絃，就這樣幫我帶到B大調然後e小調，最後又回到E大調。我被引導的整個過程感覺都很合理順暢。我非常喜歡這個旋律，但其實我是夢到的，我無法相信這是我自己寫的，感覺就是”不可能，我從來沒有寫過像這樣的曲子”，但我的確是寫出來了，這就是最神奇的事！」
Page 286:
In a 2012 study that compared more than 10,000 patients taking sleeping pills with 20,000 participants that were not taking sleeping pills, the finding was: Those taking sleeping pills were 4.6 times more likely to die over this short two-and-a-half-year period than those who were not using sleeping pills. Those individuals classified as heavy users, defined as taking more than 132 pills per year, were 5.3 times more likely to die over the study period.
2012年有一個研究報告，針對一萬多名有在吃安眠藥的實驗參予者和兩萬名沒有在吃安眠藥的參與者做比較，結果發現：在短短的兩年半裡，有吃安眠藥的這組人死亡的機率高過於沒有吃安眠藥的那組人4.6倍。進一步細分出重度用者的話(每年吃超過132顆安眠藥)，安眠藥重度服用者在這兩年半的期間內死亡的機率是不吃安眠藥的人的5.3倍。
Page 308 – 313: (On SLEEP AND EDUCATION 現代教育體制裡跟睡眠有關的重大問題）
The circadian rhythm of teenagers shifts forward dramatically by one to three hours (compared to adults). (This means while the ideal wakeup time for adults may be 6AM, that for teenagers are 7AM to 9 AM. Many studies support the conclusions that, with a later school start time, teenagers do much better in learning as demonstrated by their SAT scores, among others.)…
青少年的生理時鐘，相對於成年人，是必須往後(也就是更晚)一到三個小時的。(也就是說如果成年人理想的起床時間是早上六點，青少年的就應該是早上七到九點。已經有很多的研究報告指出，學校早上開課的時間如果越晚，青少年學生的學習效果根據SAT分數來看就會更好)
Yet something even more profound has happened in this ongoing story of later school start times—The leading cause of death among teenagers is road traffic accidents, and in this regard, even the slightest dose of insufficient sleep can have marked consequences, as we have discussed…
然而，有關青少年上學時間應該延後這個議題上，還有更嚴肅的問題 – 導致青少年死亡原因裡頭最高的是路上行車車禍；看起來也許只是少量的睡眠不足可能就會造成很嚴重的後果⋯
When the Mahtomedi School District of Minnesota pushed their school start time from 7:30 to 8:00 a.m., there was a 60 percent reduction in traffic accidents in drivers sixteen to eighteen years of age. Teton County in Wyoming enacted an even more dramatic change in school start time, shifting from a 7:35 a.m. bell to a far more biologically reasonable one of 8:55 a.m. The result was astonishing—a 70 percent reduction in traffic accidents in sixteen- to eighteen-year-old drivers.
當明尼蘇達州的馬拖米迪學區把早上學校開課的時間從7:30延後到8:00a.m.後， 16歲到18歲學生的車禍率降低了60%！懷俄明州堤登縣學區採取了更大的改變，把早上開課時間從早上7:35延後到從青少年生理上來看更適合的8:55 ，結果更是令人震驚 – 16到18歲之間學生的車禍率降低了70%。
To place that in context, the advent of anti-lock brake technology (ABS) reduced accident rates by around 20 to 25 percent. It was deemed a revolution. Here is a simple biological factor—sufficient sleep—that will drop accident rates by more than double that amount in our teens.
讓我們從一個比較有意義的角度來看一下這兩個數據：當年汽車業發明了防鎖死煞車系統(ABS)的技術後成果是讓車禍率降低了20-25%，當時被認為是一個革命性的發明！而我們上面討論的一個很簡單的健康生理因素 – 足夠的睡眠 – 對青少年車禍率的降低卻是汽車工業界裡所謂革命性發明的兩倍！
Page 316-318: (On SLEEP AND HEALTH CARE 現代西醫醫療體制裡跟睡眠有關的重大問題）
Many medical schools used to require residents (住院醫師) to work thirty hours… that was thirty hours all in one go. Worse, they often had to do two of these thirty-hour continuous shifts within a week, combined with several twelve-hour shifts scattered in between. The injurious consequences are well documented. Residents working a thirty-hour-straight shift will commit 36 percent more serious medical errors, such as prescribing the wrong dose of a drug or leaving a surgical implement inside of a patient, compared with those working sixteen hours or less. Additionally, after a thirty-hour shift without sleep, residents make a whopping 460 percent more diagnostic mistakes in the intensive care unit than when well rested after enough sleep. Throughout the course of their residency, one in five medical residents will make a sleepless-related medical error that causes significant, liable harm to a patient. One in twenty residents will kill a patient due to a lack of sleep…
很多醫學院過去一直以來都要求住院醫師必須工作30個小時…而且是一次連續工作30個小時。更糟的是，這樣的連續30個小時的排班，每週兩次，之間還會穿插好幾次12個小時的值班。這種制度造成的傷害率可以說是罄竹難書。相較於每次排班工作不超過16個小時的醫師們，連續工作30個小時的醫師犯下嚴重醫療過失的次數增加了36%，像是開錯藥方或把手術工具忘了留在患者的體內。在急診病房，連續工作34個小時沒有睡覺的住院醫師犯下醫療過失的數字，比起有好好睡個覺再來上班的醫師們，多出了460%! 在住院實習期間，每五位住院醫師就有一位因為睡眠不足犯下嚴重的醫療過失傷害到病人。每20個住院醫師裡頭會有一位因為睡眠不足而導致病人死亡。
As (the author) writes this chapter, a new report has discovered that medical errors are the third-leading cause of death among Americans after heart attacks and cancer… Facing government threats that would apply federally enforced work hours due to the extent of damning evidence, the Accreditation Council for Graduate Medical Education (ACGME) made (some minor) alterations. (But the revised schedule) still far exceeds any ability of the brain to perform optimally.
我(作者)在寫書中這一章時，正好有一篇新的研究報告發表，發現醫生犯下的醫療過失在導致美國人死亡因素排名上名列第三，緊接在心臟病和癌症之後… 面對政府因為如此嚴重又明顯的傷害可能會強制執行聯邦工時法，研究生醫學教育認證委員會有做了一些輕微的調整，但調整後的住院醫師工時還是遠遠超過人腦可以在最佳狀態下運作所需的睡眠時數。
(Story behind the “6-year residency” imposed for all graduates from medical school) originated from the esteemed physician William Stewart Halsted, MD, who was also (later found out to be) a helpless drug addict. Halsted founded the surgical training program at Johns Hopkins Hospital in Baltimore, Maryland, in May 1889. (More of the dramatic and ridiculous story of the origin of the “residency” system can be found on page 316 to page 318 of the book. Unfortuantely, the “residency” system is still there to date, only with some minor adjustment from Halsted’s original schedule.)
(小編註：西醫教育體制裡規定的六年實習，起源於一位很有名的醫師 威廉.史都華.浩斯堤 早年的大力推廣，這位醫師後來被起底是一個很嚴重的毒品嗑藥者。1889年 5月，浩斯堤在馬里蘭州巴爾提摩市的約翰霍普金斯醫院首創「手術訓練課程」，後來有一段令人無法置信的情節，書中有更詳細的情節(英文版是在316～318頁裡。很不幸的，這樣的住院醫師規定目前還是存在，相較於當初浩斯堤定出的時數只有微小的調整。）
(小編註：在台灣，根據衛福部2017年3月的公告，“每次勤務連同延長工時不得超過28小時，但其間應有短暫休息，至於總工時以每4週320小時為上限”，連續不休息的住院執勤時數紙從以前的30小時減少兩小時。 https://www.mohw.gov.tw/cp-2736-8859-1.html)
Author: Matthew Walker, PhD, English scientist and professor of neuroscience and psychology at the University of California, Berkeley. His research focuses on the impact of sleep on human health and disease. Previously, he was a professor of psychiatry at Harvard Medical School. He has received numerous funding awards from the National Science Foundation and the National Institutes of Health, and is a Kavli Fellow of the National Academy of Sciences. He has published more than 100 scientific research studies and has been featured on numerous television and radio outlets, including 60 Minutes, Amanpour & Company, National Geographic, NOVA scienceNOW, The Joe Rogan Experience, NPR, The Drive with Peter Attia, and the BBC.
