Well, I would like to start with testicles.

謝謝大家。

(Laughter)

嗯，我想從睪丸說起。

Men who sleep five hours a night

（笑聲）

have significantly smaller testicles than those who sleep seven hours or more.

每晚睡眠五小時的男性的睪丸

(Laughter)

明顯比那些睡眠超過七小時的人小。

In addition, men who routinely sleep just four to five hours a night

（笑聲）

will have a level of testosterone

此外，經常只睡四五個小時的男人，

which is that of someone 10 years their senior.

他們的睪丸激素

So a lack of sleep will age a man by a decade

比較接近年紀比他們大十歲的人。

in terms of that critical aspect of wellness.

所以缺乏睡眠會讓男人 老個起碼十歲，

And we see equivalent impairments in female reproductive health

從這個健康方面來看的話。

caused by a lack of sleep.

缺乏睡眠同樣也對女性的生育能力

This is the best news that I have for you today.

有著同等的傷害。

(Laughter)

這是我今天帶給大家最好的消息。

From this point, it may only get worse.

（笑聲）

Not only will I tell you about the wonderfully good things

接下來只會愈來愈糟。

that happen when you get sleep,

我不只要告訴你，

but the alarmingly bad things that happen when you don't get enough,

當你擁有充足睡眠時 身體所能得到的好處，

both for your brain and for your body.

同時也會談到睡眠不足的問題，

Let me start with the brain

特別是你的腦部及身體。

and the functions of learning and memory,

讓我先從腦部

because what we've discovered over the past 10 or so years

還有學習及記憶的功能說起，

is that you need sleep after learning

過去十年左右的時間內 我們已經發現，

to essentially hit the save button on those new memories

人體在學習新知後需要借助睡眠

so that you don't forget.

去按下「儲存 」鍵把那些新的記憶

But recently, we discovered that you also need sleep before learning

記錄下來不致遺忘。

to actually prepare your brain,

可是最近的發現是 在學習前也需要睡眠，

almost like a dry sponge

將你的腦部準備好，

ready to initially soak up new information.

讓它像乾海綿一樣

And without sleep, the memory circuits of the brain

將新知吸收進去。

essentially become waterlogged, as it were,

缺乏睡眠的話，腦中的記憶迴路

and you can't absorb new memories.

會變得有點像塊濕海綿，

So let me show you the data.

無法幫你吸取新的記憶。

Here in this study, we decided to test the hypothesis

讓我給你們看一些數據。

that pulling the all-nighter was a good idea.

在這項研究中，我們針對海馬迴

So we took a group of individuals

去測試熬夜讀書是值得的理論。

and we assigned them to one of two experimental groups:

我們找了一群人，

a sleep group and a sleep deprivation group.

將他們分成兩個實驗組：

Now the sleep group, they're going to get a full eight hours of slumber,

一個睡眠組，一個不眠組。

but the deprivation group, we're going to keep them awake

睡眠組的人得到充分、 至少八小時的睡眠，

in the laboratory, under full supervision.

不眠組呢，我們則讓他們待在實驗室，

There's no naps or caffeine, by the way, so it's miserable for everyone involved.

保持清醒，全程監控。

And then the next day,

不能打盹也沒有咖啡因， 所以這組的人每個都很悲慘。

we're going to place those participants inside an MRI scanner

實驗的第二天，

and we're going to have them try and learn a whole list of new facts

我們再給他們做核磁共振掃描，

as we're taking snapshots of brain activity.

同時也給他們一張清單， 請他們記住上面列出的事項，

And then we're going to test them

過程中將他們腦部的活動拍攝下來。

to see how effective that learning has been.

之後我們再進行一個測驗

And that's what you're looking at here on the vertical axis.

看看他們學習的成效如何。

And when you put those two groups head to head,

現在螢幕上這個縱座標 就是實驗結果。

what you find is a quite significant, 40-percent deficit

而當把兩個實驗組對比來看時，

in the ability of the brain to make new memories without sleep.

我們看到一個很顯著的 40% 的落差，

I think this should be concerning,

因為被剝奪睡眠的腦部 無法儲存新記憶。

considering what we know is happening to sleep

我覺得這點發現很值得注意，

in our education populations right now.

因為我們已經知道睡眠對於

In fact, to put that in context,

處於學習階段的人腦部的影響。

it would be the difference in a child acing an exam

讓我舉例說明，

versus failing it miserably -- 40 percent.

有點像是小孩考試，差距是滿分

And we've gone on to discover what goes wrong within your brain

與不及格的 40 分那樣。

to produce these types of learning disabilities.

我們又進一步地去研究 為什麼我們的腦部

And there's a structure that sits

會發生這樣的學習障礙。

on the left and the right side of your brain, called the hippocampus.

在我們的腦部有個結構

And you can think of the hippocampus

叫做海馬迴，在腦的左右兩邊。

almost like the informational inbox of your brain.

你可以把這個海馬迴想像成

It's very good at receiving new memory files

你腦部用來接收資訊的收件夾。

and then holding on to them.

它很強於接收新的記憶檔，

And when you look at this structure

然後將之保存下來。

in those people who'd had a full night of sleep,

當我們察看實驗對象的海馬迴時，

we saw lots of healthy learning-related activity.

那些整夜睡眠充足的人， 他們的海馬迴中

Yet in those people who were sleep-deprived,

顯示出許多健康的 與學習相關的活動力。

we actually couldn't find any significant signal whatsoever.

可是在被剝奪睡眠的人腦中，

So it's almost as though sleep deprivation had shut down your memory inbox,

我們找不到任何明顯的信號。

and any new incoming files -- they were just being bounced.

幾乎就像是，睡眠被剝奪的同時， 你的記憶收件夾也被關掉，

You couldn't effectively commit new experiences to memory.

任何新進的檔案，全數被彈回去。

So that's the bad that can happen if I were to take sleep away from you,

任何新的學習或經驗 都無法有效地記錄下來。

but let me just come back to that control group for a second.

這就是如果睡眠被剝奪後 所可能發生的壞處，

Do you remember those folks that got a full eight hours of sleep?

讓我再講一下另外那組實驗。

Well, we can ask a very different question:

記得那一組能睡滿八小時的人嗎？

What is it about the physiological quality of your sleep

嗯，針對這組，我們提出 一個完全不同的問題：

when you do get it

在你睡眠充足時，那個日復一日

that restores and enhances your memory and learning ability

讓你修復及提升記憶及學習能力的

each and every day?

優質睡眠，

And by placing electrodes all over the head,

它有生理學上的特質嗎？

what we've discovered is that there are big, powerful brainwaves

藉由在頭上貼滿電極片，

that happen during the very deepest stages of sleep

我們發現有一些很大很強的腦波

that have riding on top of them

發生在最深沉睡眠期，

these spectacular bursts of electrical activity

在這些腦波之上，

that we call sleep spindles.

這些奇特的電流活動

And it's the combined quality of these deep-sleep brainwaves

我們稱之為睡眠紡錘波。

that acts like a file-transfer mechanism at night,

正是這些深層睡眠的腦波

shifting memories from a short-term vulnerable reservoir

在夜晚扮演著檔案傳輸的功能，

to a more permanent long-term storage site within the brain,

將我們的記憶檔從暫存的記憶庫，

and therefore protecting them, making them safe.

轉存至腦部另一個 長期記憶的儲存處，

And it is important that we understand

確保它們被安全保存。

what during sleep actually transacts these memory benefits,

很重要的是，我們也了解到

because there are real medical and societal implications.

在睡眠期間我們的記憶得以轉存，

And let me just tell you about one area

有著醫療及社會化方面的正面影響。

that we've moved this work out into, clinically,

讓我再告訴你們另一個領域的進展，

which is the context of aging and dementia.

我們已經將這部分的工作推展到

Because it's of course no secret that, as we get older,

老年及失智症的臨床實驗中。

our learning and memory abilities begin to fade and decline.

當我們老化，一個眾所周知的事實是

But what we've also discovered

我們的學習及記憶能力開始退化。

is that a physiological signature of aging is that your sleep gets worse,

我們同時所發現的是

especially that deep quality of sleep that I was just discussing.

睡眠品質下降正是 老化在生理學上的典型特質，

And only last year, we finally published evidence

特別是之前提到的深層睡眠的品質。

that these two things, they're not simply co-occurring,

就在去年，我們發表的資訊證明了

they are significantly interrelated.

老化與失智症並不僅是並存的關係，

And it suggests that the disruption of deep sleep

兩者有更緊密的關聯。

is an underappreciated factor

證據顯示深層睡眠的中斷

that is contributing to cognitive decline or memory decline

是一個之前被低估

in aging, and most recently we've discovered,

造成老化過程中的認知力下降 及記憶力退化的因素。

in Alzheimer's disease as well.

這點也在我們最近

Now, I know this is remarkably depressing news.

對阿茲海默症的研究中被確認了。

It's in the mail. It's coming at you.

我知道這真是令人沮喪的壞消息。

But there's a potential silver lining here.

而且已經發表了，迎面而來。

Unlike many of the other factors that we know are associated with aging,

還好，不幸中的大幸是，

for example changes in the physical structure of the brain,

與其他那些與老化相關的症狀相比，

that's fiendishly difficult to treat.

例如腦部實體上的改變

But that sleep is a missing piece in the explanatory puzzle

這種無法治療或改變的因素，

of aging and Alzheimer's is exciting

我們發現睡眠原來是我們之前

because we may be able to do something about it.

對老化以及阿茲海默無解的那一塊，

And one way that we are approaching this at my sleep center

原來我們或許能從睡眠下手。

is not by using sleeping pills, by the way.

值得一提的是，在我們的睡眠中心，

Unfortunately, they are blunt instruments that do not produce naturalistic sleep.

我們不用安眠藥，

Instead, we're actually developing a method based on this.

因為安眠藥不會幫人自然入眠。

It's called direct current brain stimulation.

但是我們用同樣的理論 發展了一個方法──

You insert a small amount of voltage into the brain,

直流電刺激術。

so small you typically don't feel it,

藉由給腦部少量的電流刺激，

but it has a measurable impact.

電流量少到你沒有感覺，

Now if you apply this stimulation during sleep in young, healthy adults,

卻對腦部有相當程度的影響。

as if you're sort of singing in time with those deep-sleep brainwaves,

如果在年輕健康的成人睡眠時 用同樣的電流刺激，

not only can you amplify the size of those deep-sleep brainwaves,

則像是與深層睡眠的腦波同聲合唱，

but in doing so, we can almost double the amount of memory benefit

不僅是深層睡眠的腦波被倍數放大，

that you get from sleep.

那些睡眠期間的記憶效益

The question now is whether we can translate

也同時倍增。

this same affordable, potentially portable piece of technology

現在的問題是，我們是否能將

into older adults and those with dementia.

同樣的好用又經濟的方法

Can we restore back some healthy quality of deep sleep,

運用在老年人及失智症患者上。

and in doing so, can we salvage aspects of their learning

我們有辦法幫他們恢復 健康的深層睡眠，

and memory function?

同時也能挽回他們在學習

That is my real hope now.

以及記憶方面的功能嗎？

That's one of our moon-shot goals, as it were.

這是我現在最大的希望，

So that's an example of sleep for your brain,

有點像是登上月球之類的 遠大志向吧。

but sleep is just as essential for your body.

所以這是睡眠之於腦部的例子，

We've already spoken about sleep loss and your reproductive system.

但睡眠對你的身體也同等重要。

Or I could tell you about sleep loss and your cardiovascular system,

前面已經提到缺乏睡眠 對生殖能力的影響，

and that all it takes is one hour.

我也可以說說缺乏睡眠 與心血管系統的關聯，

Because there is a global experiment performed on 1.6 billion people

關鍵就只是一個小時的差別。

across 70 countries twice a year,

全球有 70 個國家 16 億人口

and it's called daylight saving time.

每年兩次被當做

Now, in the spring, when we lose one hour of sleep,

所謂「日光節約時間」的實驗品。

we see a subsequent 24-percent increase in heart attacks that following day.

春天，當我們少掉一個小時的睡眠，

In the autumn, when we gain an hour of sleep,

隔天早上心臟病發的人數 就上升 24 個百分比 。

we see a 21-percent reduction in heart attacks.

秋天，當我們多了一個小時的睡眠，

Isn't that incredible?

心臟病發的比率下降約 21 個百分比。

And you see exactly the same profile for car crashes, road traffic accidents,

不可思議，對嗎？

even suicide rates.

而且同樣的數字也呈現在 車禍及其他交通事故，

But as a deeper dive, I want to focus on this:

甚至自殺率上。

sleep loss and your immune system.

再看深一點，我想強調的是

And here, I'll introduce these delightful blue elements in the image.

睡眠不足與免疫系統的關係。

They are called natural killer cells,

請大家看一下圖上這些 賞心悅目的藍色元素。

and you can think of natural killer cells almost like the secret service agents

它們被稱為自然殺手細胞，

of your immune system.

你可以把它們想像成

They are very good at identifying dangerous, unwanted elements

免疫系統中的情報局特工。

and eliminating them.

它們擅長辨識出危險 且身體不需要的元素，

In fact, what they're doing here is destroying a cancerous tumor mass.

然後將之消滅。

So what you wish for is a virile set of these immune assassins

在這張圖上，它們正在摧毀 一個具癌細胞的腫瘤。

at all times,

這正是我們的免疫系統 無時無刻所需要的

and tragically, that's what you don't have if you're not sleeping enough.

防禦殺手，

So here in this experiment,

可惜，如果你睡眠不足， 你就沒有這些防禦殺手。

you're not going to have your sleep deprived for an entire night,

在這個實驗中，

you're simply going to have your sleep restricted to four hours

被實驗的對象並非整夜不眠，

for one single night,

而是限制整晚睡眠

and then we're going to look to see what's the percent reduction

不超過四小時，

in immune cell activity that you suffer.

我們再去觀察免疫細胞的活動力

And it's not small -- it's not 10 percent,

下降了多少百分比。

it's not 20 percent.

我們看到的數目不小，不是 10%，

There was a 70-percent drop in natural killer cell activity.

也不是 20%。

That's a concerning state of immune deficiency,

自然殺手細胞的活動力 整整降低了 70% 。

and you can perhaps understand why we're now finding

這樣免疫力缺乏的狀態令人憂心，

significant links between short sleep duration

你就可以理解為什麼我們要尋找

and your risk for the development of numerous forms of cancer.

睡眠不足與多種癌症發生機率

Currently, that list includes cancer of the bowel,

兩者間的重大關聯。

cancer of the prostate and cancer of the breast.

目前的清單上包括大腸癌，

In fact, the link between a lack of sleep and cancer is now so strong

前列腺癌以及乳癌。

that the World Health Organization

事實上，缺乏睡眠 與癌症之間的關聯如此重大，

has classified any form of nighttime shift work

世界衛生組織

as a probable carcinogen,

已經將任何形式的夜班工作列為

because of a disruption of your sleep-wake rhythms.

可能的致癌因子，

So you may have heard of that old maxim

因為夜班工作完全打亂 正常的睡眠與清醒的作息。

that you can sleep when you're dead.

或許你有聽過那句老話，

Well, I'm being quite serious now --

你可以等你死了再睡個夠。

it is mortally unwise advice.

嗯，我要很認真地說，

We know this from epidemiological studies across millions of individuals.

這句話真的很不明智。

There's a simple truth:

我們從對數百萬人的 流行病學研究中得知

the shorter your sleep, the shorter your life.

一個簡單的事實：

Short sleep predicts all-cause mortality.

睡眠時間愈短，生命也就愈短。

And if increasing your risk for the development of cancer

睡眠短少也預告了各種可能的死亡率。

or even Alzheimer's disease

而且假如得到癌症

were not sufficiently disquieting,

或阿茲海默症的風險提高

we have since discovered that a lack of sleep will even erode

還不夠讓你憂心的話，

the very fabric of biological life itself,

我們還發現了 缺乏睡眠最終也會侵蝕

your DNA genetic code.

人體生理功能的結構──

So here in this study, they took a group of healthy adults

你的遺傳基因密碼。

and they limited them to six hours of sleep a night

這份研究中的實驗對象是 一群健康的成人，

for one week,

他們被限制每晚只能睡六個小時，

and then they measured the change in their gene activity profile

實驗持續一個星期，

relative to when those same individuals

之後我們測量了他們的 基因活動方面的改變，

were getting a full eight hours of sleep a night.

再與同樣這批人

And there were two critical findings.

每晚可以睡足八小時的數據相比。

First, a sizable and significant 711 genes

我們有兩個重要的發現。

were distorted in their activity,

首先，有總數多達 711 個基因的

caused by a lack of sleep.

活動力被扭曲了，

The second result was that about half of those genes

因為缺乏睡眠。

were actually increased in their activity.

第二個發現是， 那些基因中約有半數，

The other half were decreased.

活動力增強了。

Now those genes that were switched off by a lack of sleep

另一半則是削弱了。

were genes associated with your immune system,

那些因為缺乏睡眠而被關掉的基因

so once again, you can see that immune deficiency.

是與免疫系統相關的基因，

In contrast, those genes that were actually upregulated

你可以再次清楚看到那個免疫缺陷。

or increased by way of a lack of sleep,

相對來說，那些因為睡眠不足 而被迫提高活動力的基因，

were genes associated with the promotion of tumors,

或是總數增加的基因，

genes associated with long-term chronic inflammation within the body,

即是那些促進腫瘤形成的基因，

and genes associated with stress,

和體內長期發炎有關的基因，

and, as a consequence, cardiovascular disease.

還有那些與壓力相關的基因，

There is simply no aspect of your wellness

想當然爾，它們也與心血管疾病相關。

that can retreat at the sign of sleep deprivation

你的健康基本上完全不可能