Thank you very much. Well, I would like to start with testicles.
非常感谢。额，我想先说说睾丸。
Men who sleep five hours a night have significantly smaller testicles than those who sleep seven hours or more.
那些每晚只睡五个小时的男性相比每晚睡够至少七个小时的男性，有着更小的睾丸。
In addition, men who routinely sleep just four to five hours a night will have a level of testosterone which is that of someone 10 years their senior.
除此之外，习惯性只睡四到五个小时的男性，他们的睾酮水平和比他们年长十岁的人差不多。
So a lack of sleep will age a man by a decade in terms of that critical aspect of wellness.
所以，从睾酮这一关键的健康指标来看，缺乏睡眠会让男性老十岁。
And we see equivalent impairments in female reproductive health caused by a lack of sleep.
我们在女性的生殖健康上也看到了由缺乏睡眠导致的同等损害。
This is the best news that I have for you today.
这是今天我给你们准备的最好的消息。
From this point, it may only get worse.
从现在开始，事情只会变得更糟。
Not only will I tell you about the wonderfully good things that happen when you get sleep,
我不仅会告诉你们在你们睡觉时，会发生的美妙的事情，
but the alarmingly bad things that happen when you don't get enough, both for your brain and for your body.
还会告诉你们当睡眠不足时，发生在你们大脑和身体上的非常糟糕的事情。
Let me start with the brain and the functions of learning and memory,
让我从大脑以及学习和记忆的功能开始讲起，
because what we've discovered over the past 10 or so years is that
因为我们在过去十年的研究发现，
you need sleep after learning to essentially hit the save button on those new memories so that you don't forget.
在你学习完后，应该睡觉，以按下新记忆的保存按钮，这样才不会遗忘。
But recently, we discovered that you also need sleep before learning to actually prepare your brain,
但是最近，我们发现在学习之前你也需要睡眠，来准备好自己的头脑，
almost like a dry sponge ready to initially soak up new information.
就像是一块干海绵，准备好开始吸收新的知识。
And without sleep, the memory circuits of the brain essentially become waterlogged, as it were, and you can't absorb new memories.
没有睡眠的话，大脑的记忆回路就像是被堵塞住了，而你将不能吸收新的记忆。
So let me show you the data. Here in this study, we decided to test the hypothesis that pulling the all-nighter was a good idea.
让我向你们展示一下数据。在这个研究中，我们测试了这么一个假设，即熬夜到底是不是不错的做法。
So we took a group of individuals and we assigned them to one of two experimental groups: a sleep group and a sleep deprivation group.
我们招募了一组被试，然后将其分为两组：睡眠充足组和睡眠不足组。
Now the sleep group, they're going to get a full eight hours of slumber,
睡眠充足组的被试可以睡够八个小时，
but the deprivation group, we're going to keep them awake in the laboratory, under full supervision.
而睡眠不足组的被试则在实验室中，在全程监控下，不断地被我们叫醒。
There's no naps or caffeine, by the way, so it's miserable for everyone involved.
顺便说一句，他们没有小睡或咖啡因的支持，所以确实很痛苦。
And then the next day, we're going to place those participants inside an MRI scanner
第二天，我们把这些被试放进MRI扫描仪，
and we're going to have them try and learn a whole list of new facts as we're taking snapshots of brain activity.
让他们试着学习一整列的新知识，同时记录下他们的大脑活动情况。
And then we're going to test them to see how effective that learning has been.
然后，我们测试他们，来看看他们的学习到底有没有效。
And that's what you're looking at here on the vertical axis.
这就是你们所看的纵轴。
And when you put those two groups head to head, what you find is a quite significant,
当把这两组被试比较时，你们可以发现
40-percent deficit in the ability of the brain to make new memories without sleep.
没有充足睡眠的大脑在储存新记忆的能力上有40%的显著差距。
I think this should be concerning, considering what we know is happening to sleep in our education populations right now.
我觉得这一发现令人担忧，考虑到我们的受教育人群在睡眠上正在经历的事情。
In fact, to put that in context, it would be the difference in a child acing an exam versus failing it miserably -- 40 percent.
事实上，说的具体些，就是学生在考试中得高分和考砸了之间的差距--40%。
And we've gone on to discover what goes wrong within your brain to produce these types of learning disabilities.
我们进一步研究大脑中到底哪里出错产生了这种学习障碍。
And there's a structure that sits on the left and the right side of your brain, called the hippocampus.
在大脑的左侧和右侧，有着这么一块区域，叫做海马体。
And you can think of the hippocampus almost like the informational inbox of your brain.
你们可以把海马体想成大脑的信息收件箱。
It's very good at receiving new memory files and then holding on to them.
海马体很擅长接收新的“记忆文件”，并保留这些文件。
And when you look at this structure in those people who'd had a full night of sleep, we saw lots of healthy learning-related activity.
当你们观察那些睡了一整晚的被试的海马体时，我们看到的是许多健康的与学习相关的大脑活动。
Yet in those people who were sleep-deprived, we actually couldn't find any significant signal whatsoever.
但是在那些睡眠不足的被试身上，我们基本上找不到任何明显的信号。
So it's almost as though sleep deprivation had shut down your memory inbox, and any new incoming files -- they were just being bounced.
这就好像睡眠不足关闭了记忆收件箱，任何新进的文件--都被退回了。
You couldn't effectively commit new experiences to memory.
你不能有效的将新的经历转化为记忆。
So that's the bad that can happen if I were to take sleep away from you, but let me just come back to that control group for a second.
这就是假如我剥夺你的睡眠时，会发生的糟糕事情，但容我稍微讲一下对照组。
Do you remember those folks that got a full eight hours of sleep?
你们还记得那些睡够了八个小时的被试吗？
Well, we can ask a very different question:
我们可以问一个非常不同的问题：
What is it about the physiological quality of your sleep when you do get it that restores and enhances your memory and learning ability each and every day?
让你每天睡眠时恢复和提高你的记忆力和学习能力的生理质量是什么样的？
And by placing electrodes all over the head,
通过在头部放置电极，
what we've discovered is that there are big, powerful brainwaves that happen during the very deepest stages of sleep
我们所发现的是，在睡眠的最深阶段会产生巨大而强大的脑电波，
that have riding on top of them these spectacular bursts of electrical activity that we call sleep spindles.
这些脑电波之上会有我们称之为睡眠纺锤波的壮观的电活动爆发。
And it's the combined quality of these deep-sleep brainwaves that acts like a file-transfer mechanism at night,
正是这些深度睡眠脑电波的综合作用，在夜间起到了文件传输机制的作用，
shifting memories from a short-term vulnerable reservoir to a more permanent long-term storage site within the brain,
将记忆从一个短期的易受遗忘的存储库转移到大脑中一个更永久的长期存储库，
and therefore protecting them, making them safe.
因此得以保存它们，使它们不至受损。
And it is important that we understand what during sleep actually transacts these memory benefits,
重要的是，我们要了解在睡眠中究竟是什么在发挥这些记忆的作用，
because there are real medical and societal implications.
因为这对医学和社会都有实际的影响。
And let me just tell you about one area that we've moved this work out into, clinically, which is the context of aging and dementia.
让我告诉你们我们已经把这项研究转移到临床的一个领域，即衰老和痴呆。
Because it's of course no secret that, as we get older, our learning and memory abilities begin to fade and decline.
因为随着我们变老，我们的学习和记忆能力开始衰退和减弱当然并不是什么秘密。
But what we've also discovered is that a physiological signature of aging is that your sleep gets worse,
但我们也发现的是衰老的一个生理特征是你的睡眠质量变差了，
especially that deep quality of sleep that I was just discussing.
尤其在我刚才谈到的深度睡眠质量中。
And only last year, we finally published evidence that these two things,
仅仅在去年，我们最终发表了证据表明这两件事，
they're not simply co-occurring, they are significantly interrelated.
它们不是简单的同时发生，它们是显著相互关联的。
And it suggests that the disruption of deep sleep
这表明深度睡眠的中断
is an underappreciated factor that is contributing to cognitive decline or memory decline in aging,
是导致衰老时认知能力和记忆能力衰退的一个低估因素，
and most recently we've discovered, in Alzheimer's disease as well.
最近我们还发现，老年痴呆症也是如此。
Now, I know this is remarkably depressing news.
我知道这个消息是如此令人沮丧。
It's in the mail. It's coming at you. But there's a potential silver lining here.
它在邮寄途中，正在走向你。但也有一线希望。
Unlike many of the other factors that we know are associated with aging,
跟其他我们已知跟衰老有关的因素不同的是，
for example changes in the physical structure of the brain, that's fiendishly difficult to treat.
比如大脑物理结构的改变，这是非常难以治疗的。
But that sleep is a missing piece in the explanatory puzzle of aging and Alzheimer's is exciting
但睡眠是解释衰老和阿尔茨海默症谜题中缺失的一块倒是令人兴奋，
because we may be able to do something about it.
因为我们也许能想出点什么对策。
And one way that we are approaching this at my sleep center is not by using sleeping pills, by the way.
在我的睡眠中心解决这个问题的方法之一不是使用安眠药，顺便说一句。
Unfortunately, they are blunt instruments that do not produce naturalistic sleep.
不幸的是，安眠药是钝器，不能产生自然主义的睡眠。
Instead, we're actually developing a method based on this. It's called direct current brain stimulation.
反之，我们基于这个原理开发了一个方法。叫做脑直流电刺激方法。
You insert a small amount of voltage into the brain, so small you typically don't feel it, but it has a measurable impact.
你在大脑中注入少量的电压，小到你基本上感受不到，但却具有可衡量的影响。
Now if you apply this stimulation during sleep in young, healthy adults,
现在如果你在年轻，健康的成人睡眠时采用这种刺激，
as if you're sort of singing in time with those deep-sleep brainwaves,
就好像你在用那些沉睡的脑电波唱歌一样，
not only can you amplify the size of those deep-sleep brainwaves,
你不仅能够放大这些深度睡眠脑电波，
but in doing so, we can almost double the amount of memory benefit that you get from sleep.
而且这样做，我们可以增强从睡眠中获得的记忆好处的两倍。
The question now is whether we can translate this same affordable,
现在的问题是我们能否将这经济实惠、
potentially portable piece of technology into older adults and those with dementia.
潜在的便携技术应用到老年人和老年痴呆群体中。
Can we restore back some healthy quality of deep sleep, and in doing so, can we salvage aspects of their learning and memory function?
我们能否恢复深度睡眠的健康质量，并且通过这样做，我们能否挽救他们的学习和记忆功能？
That is my real hope now. That's one of our moon-shot goals, as it were.
这是我目前真实的希望。可以说，这是我们的登月目标之一。
So that's an example of sleep for your brain, but sleep is just as essential for your body.
所以这是大脑睡眠的一个例子，但睡眠对你的身体也同样重要。
We've already spoken about sleep loss and your reproductive system.
我们已经讨论过睡眠不足和生殖系统的关系。
Or I could tell you about sleep loss and your cardiovascular system, and that all it takes is one hour.
或者我可以告诉你睡眠不足和你的心血管系统，而这只需要一个小时。
Because there is a global experiment performed on 1.6 billion people across 70 countries twice a year,
因为有一个全球性的实验每年在70个国家的16亿人身上进行两次，
and it's called daylight saving time.
这个实验叫做夏令时。
Now, in the spring, when we lose one hour of sleep, we see a subsequent 24-percent increase in heart attacks that following day.
现在，在春天，当我们少一个小时睡眠时，我们看到接下来的第二天心脏病发作会增加24%。
In the autumn, when we gain an hour of sleep, we see a 21-percent reduction in heart attacks.
在秋季，当我们获得一个小时的睡眠时，我们看到心脏病发作会减少21%。
Isn't that incredible? And you see exactly the same profile for car crashes, road traffic accidents, even suicide rates.
是不是让人难以置信？你会看到同样的情况发生在车祸，交通事故，甚至自杀率上。
But as a deeper dive, I want to focus on this: sleep loss and your immune system.
但为了更深入些，我想要专注这个：睡眠不足和你的免疫系统。
And here, I'll introduce these delightful blue elements in the image.
这里，我将介绍图片中这些明亮的蓝色元素。
They are called natural killer cells, and you can think of natural killer cells almost like the secret service agents of your immune system.
它们被称为自然杀伤细胞，你可以把自然杀伤细胞想象成你免疫系统中的特勤局特工。
They are very good at identifying dangerous, unwanted elements and eliminating them.
它们非常擅长识别危险和无需的物体并消灭它们。
In fact, what they're doing here is destroying a cancerous tumor mass.
事实上，它们正在做的是摧毁一个癌变的肿瘤团块。

So what you wish for is a virile set of these immune assassins at all times,
所以你一定时刻希望拥有这群有能力的刺客，
and tragically, that's what you don't have if you're not sleeping enough.
但悲剧的是，当你睡眠不足时，你不能拥有它们。
So here in this experiment, you're not going to have your sleep deprived for an entire night,
所以在这个实验中，你不会整晚都被剥夺睡眠，
you're simply going to have your sleep restricted to four hours for one single night,
你一个晚上的睡眠将会被限制在4个小时，
and then we're going to look to see what's the percent reduction in immune cell activity that you suffer.
然后我们来看看你的免疫细胞会受到多大比例的影响。
And it's not small -- it's not 10 percent, it's not 20 percent.
这并不是个小数目--不是10%，不是20%。
There was a 70-percent drop in natural killer cell activity.
自然杀伤细胞的活力下降高达70%。
That's a concerning state of immune deficiency,
这是个令人担忧的免疫缺陷状态，
and you can perhaps understand why we're now finding significant links between short sleep duration and your risk for the development of numerous forms of cancer.
你可能能够理解我们现在发现的短睡眠时间和你患多种癌症的风险之间存在重要联系。
Currently, that list includes cancer of the bowel, cancer of the prostate and cancer of the breast.
目前，这一名单包括肠癌、前列腺癌和乳腺癌。
In fact, the link between a lack of sleep and cancer is now so strong
事实上，睡眠不足和癌症之间的联系是如此紧密，
that the World Health Organization has classified any form of nighttime shift work as a probable carcinogen,
以致世界卫生组织将任何形式的夜班工作列为可能的致癌物质，
because of a disruption of your sleep-wake rhythms.
因为你的睡眠-觉醒节律被打乱了。
So you may have heard of that old maxim that you can sleep when you're dead.
你可能听过这句老话，你死后自当长眠。
Well, I'm being quite serious now -- it is mortally unwise advice.
我现在是认真的--这是极其不明智的建议。
We know this from epidemiological studies across millions of individuals.
我们从数百万人的流行病学研究中了解到这一点。
There's a simple truth: the shorter your sleep, the shorter your life. Short sleep predicts all-cause mortality.
事实很简单：睡眠越少，生命越短。睡眠不足预示着全因死亡率。
And if increasing your risk for the development of cancer or even Alzheimer's disease were not sufficiently disquieting,
如果让你增加患上癌症或者甚至老年痴呆症的风险还不足够让人不安的话，
we have since discovered that a lack of sleep will even erode the very fabric of biological life itself, your DNA genetic code.
我们还发现，缺乏睡眠甚至会侵蚀生物生命本身的结构，你的DNA遗传密码。
So here in this study, they took a group of healthy adults and they limited them to six hours of sleep a night for one week,
所以在这个研究中，他们找来一群健康的成年人，在一周内限制他们每晚的睡眠时间在6小时，
and then they measured the change in their gene activity profile relative to when those same individuals were getting a full eight hours of sleep a night.
然后测量他们的基因活动与每晚睡足8小时的人对比的变化。
And there were two critical findings.
这个研究有两个重要的发现。
First, a sizable and significant 711 genes were distorted in their activity, caused by a lack of sleep.
首先，一个数量相当大且显著的711个基因的活动因为缺乏睡眠而被打乱。
The second result was that about half of those genes were actually increased in their activity. The other half were decreased.
第二个结果是一半的这些基因活动确实增加了。另一半则减少了。
Now those genes that were switched off by a lack of sleep were genes associated with your immune system,
因睡眠不足而关闭的基因是跟你免疫系统相关的基因，
so once again, you can see that immune deficiency.
所以再一次，你会看到免疫缺陷。
In contrast, those genes that were actually upregulated or increased by way of a lack of sleep,
相反，那些因睡眠缺乏而上调或者活动增加的基因，
were genes associated with the promotion of tumors,
是那些促进肿瘤相关的基因，
genes associated with long-term chronic inflammation within the body, and genes associated with stress,
与体内长期慢性炎症相关的基因，与压力相关的基因，
and, as a consequence, cardiovascular disease.
还有因此导致心血管疾病相关的基因。
There is simply no aspect of your wellness that can retreat at the sign of sleep deprivation and get away unscathed.
你的健康没有任何方面可以在睡眠不足的迹象下安然无恙。
It's rather like a broken water pipe in your home.
这很像你家中的水管破了。
Sleep loss will leak down into every nook and cranny of your physiology,
睡眠不足会渗透到你身体的每一个角落，
even tampering with the very DNA nucleic alphabet that spells out your daily health narrative.
甚至会篡改你日常健康状况的DNA核酸字母表。
And at this point, you may be thinking, "Oh my goodness, how do I start to get better sleep? What are you tips for good sleep?"
此刻，你可能在想，“老天，我怎样才能得到更好的睡眠？你有没有睡个好觉的提示？”
Well, beyond avoiding the damaging and harmful impact of alcohol and caffeine on sleep,
除了避免酒精和咖啡因对睡眠的有害影响之外，
and if you're struggling with sleep at night, avoiding naps during the day, I have two pieces of advice for you.
如果你晚上睡眠不好，白天避免打盹，我有两点建议给你。
The first is regularity. Go to bed at the same time, wake up at the same time, no matter whether it's the weekday or the weekend.
首先是规律。准时上床，准时醒来，不管是工作日还是周末。
Regularity is king, and it will anchor your sleep and improve the quantity and the quality of that sleep.
规律为王，它会固定你的睡眠并且提升你睡眠的数量和质量。
The second is keep it cool.
第二点是保持凉爽。
Your body needs to drop its core temperature by about two to three degrees Fahrenheit to initiate sleep and then to stay asleep,
你的身体需要把核心温度降低2到3华氏度来开始睡眠和保持睡眠，
and it's the reason you will always find it easier to fall asleep in a room that's too cold than too hot.
这也是为什么你会发现冷的环境要比热的环境容易入睡。
So aim for a bedroom temperature of around 65 degrees, or about 18 degrees Celsius.
所以卧室的稳定要控制在65华氏度左右，或者大约摄氏18度。
That's going to be optimal for the sleep of most people.
这是大多数人睡眠的最佳选择。
And then finally, in taking a step back, then, what is the mission-critical statement here?
然后最终，退一步说，这里的关键任务是什么？
Well, I think it may be this: sleep, unfortunately, is not an optional lifestyle luxury.
我想也许是这个：不幸的是，睡眠并不是一个可选的奢侈的生活方式。
Sleep is a nonnegotiable biological necessity.
睡眠是一个不容置疑的生理需要。
It is your life-support system, and it is Mother Nature's best effort yet at immortality.
它是你的生命支持系统，它是自然母亲对永生做的最大努力。
And the decimation of sleep throughout industrialized nations is having a catastrophic impact on our health, our wellness,
工业化国家睡眠量的大量减少对我们的健康，我们的幸福，
even the safety and the education of our children.
甚至安全以及孩子的教育有灾难性的影响。
It's a silent sleep loss epidemic, and it's fast becoming one of the greatest public health challenges that we face in the 21st century.
这是一种无声的睡眠缺乏流行病，它正在快速成为我们在21世纪面临的其中一个公众健康的最大挑战。
I believe it is now time for us to reclaim our right to a full night of sleep,
我认为现在是重申我们睡好整夜权利的时候了，
and without embarrassment or that unfortunate stigma of laziness.
放下尴尬和懒惰的耻辱。
And in doing so, we can be reunited with the most powerful elixir of life, the Swiss Army knife of health, as it were.
通过这样做，我们可以与生命中最强大的长生不老--瑞士军刀重聚。
And with that soapbox rant over, I will simply say, good night, good luck, and above all ... I do hope you sleep well.
说完这番激昂的演说，我只想说，晚安，祝你好运，最重要的是我真希望你们睡得好。
Thank you very much indeed. Thank you. Thank you so much.
衷心感谢各位。谢谢。非常感谢。
No, no, no. Stay there for a second. Good job not running away, though. I appreciate that. So that was terrifying.
别，别，别，呆一会儿。还好没走开，我感激这点。那真是很可怕。
You're welcome. Yes, thank you, thank you. Since we can't catch up on sleep, what are we supposed to do?
不客气。谢谢，谢谢。既然我们睡不着，我们应该做什么？
What do we do when we're, like, tossing and turning in bed late at night or doing shift work or whatever else?
当我们晚上在床上辗转反侧，轮班工作或因为其他事情时，我们应该做什么？
So you're right, we can't catch up on sleep. Sleep is not like the bank.
你说的对，我们睡不着。睡眠不像银行。
You can't accumulate a debt and then hope to pay it off at a later point in time.
你不能欠点债，然后希望在后面晚些时候还清。
I should also note the reason that it's so catastrophic and that our health deteriorates so quickly,
我还应该指出，这个如此灾难性的，我们的健康恶化得如此之快的原因，
first, it's because human beings are the only species that deliberately deprive themselves of sleep for no apparent reason.
首先，这是因为人类是唯一故意无缘无故剥夺自己睡眠的物种。
Because we're smart.
因为我们很聪明。
And I make that point because it means that Mother Nature, throughout the course of evolution,
我提出这一点是因为这意味着大自然母亲，在整个进化过程中，
has never had to face the challenge of this thing called sleep deprivation.
从来没有面临过剥夺睡眠的挑战。
So she's never developed a safety net, and that's why when you undersleep,
所以她从来没有建立安全网，所以这就是为什么当你睡眠不足时，
things just sort of implode so quickly, both within the brain and the body. So you just have to prioritize.
大脑和身体内部会奔溃得如此之快。所以你只需要分清轻重缓急。
OK, but tossing and turning in bed, what do I do?
但在床上辗转反侧时，我该做什么？
So if you are staying in bed awake for too long, you should get out of bed and go to a different room and do something different.
如果你在床上醒着太久，你应该下床，去另一个房间去做些不一样的事情。
The reason is because your brain will very quickly associate your bedroom with the place of wakefulness,
原因是你的大脑会很快把你的卧室和清醒的地方联系起来，
and you need to break that association. So only return to bed when you are sleepy,
你需要打破这个联系。所以只在你想睡的时候回到床上，
and that way you will relearn the association that you once had, which is your bed is the place of sleep.
这样你就会重新学习你曾经拥有的联系，也就是你的床就是你睡觉的地方。
So the analogy would be, you'd never sit at the dinner table, waiting to get hungry, so why would you lie in bed, waiting to get sleepy?
这就类比像你永远不要坐在餐桌前等待饥饿。那么为什么要躺在床上等待入睡呢？
Well, thank you for that wake-up call. Great job, Matt.
谢谢你的提醒。好样的，马特。
You're very welcome. Thank you very much.
不客气，谢谢大家。