Interview with Dr. Amy Bender

In a recent interview with Dr. Amy Bender, she talks about the importance of improving the sleep of professional athletes.

Could you introduce yourself and tell us a little bit about what you work on?

I’m the Director of Clinical Sleep Science at Cerebra. We’re a sleep technology company focused on better diagnosis and treatment of sleep disorders, but also focused on work to help the everyday person sleep better. I lead our research department on initiatives related to those key areas of better diagnosis and treatment of sleep disorders and sleep improvement.

What got you interested in sleep in general, but also sleep and performance?

My aunt was a sleep technologist and she invited me out to her lab. She hooked up a patient with electrodes, and showed me the translation of those physiological signals onto the screen—I was instantly hooked. After that I pretty much called every sleep lab that I could when I got back home and found a place where I could volunteer.

As it turned out, the manager of the place I was volunteering at was on the hiring committee to hire the Director of the Sleep and Performance Research Center at Washington State University. So there was kind of a collaboration there already. They were looking for a sleep technologist, then ended up hiring me as a sleep technologist. At the lab we focused on sleep deprivation and the impact on cognition and the sleep EEG. I started off there for about 4 years as the sleep technologist and was fascinated by the science so I applied to graduate school.

I ended up getting into a dual Master’s PhD program focused on experimental psychology while continuing to work at the lab. Having the sleep technologist background that I do, I wanted to focus on the impact of sleep deprivation on the EEG. After my Masters and PhD I ended up doing a postdoc at the University of Calgary where I was focused on Canadian Olympic team athletes and how to improve their sleep. Because I was a former athlete myself (I played college basketball, Ironman, I did some mountaineering as well), there was kind of a love for sports and performance already. Doing that postdoc at the University of Calgary was like a combination of both of my passions. Since then I have worked with a number of college athletes, professional athletes, and Olympic athletes.

It seems like the importance of sleep for sports performance is getting more recognition these days. What shifts in perception have you seen in your career?

Well, I see more of an emphasis on sleep in sports teams for sure. Previously, the coach would only focus on things that they had control over with their players while at the facility. Things like sport-specific skills, conditioning, and strength. This has since expanded into nutrition on and off the field, sports psychology, and sleep. Once we started to realize how important sleep was for performance, I think the teams and athletes started listening. We still do have a long way to go, there’s only a handful of us out there working with teams and elite athletes and so I think it can certainly grow a lot more.

For example, Dr. Cheri Mah’s study on sleep extension in Stanford basketball players and how that impacted reaction time, mood, and sprint times—I mean people started to listen and I think we’re finally getting there. If a team or an athlete isn’t thinking about sleep, then they’re really missing out on a huge area of performance.

Our CEO actually wrote a blog post about this during the Olympics. Discussing how athletes can entrain to their new time zone and for their specific competition time.

Oh absolutely that is important, I recently went on a trip overseas, and it’s apparent. I tried to do all that I could to shift my rhythms earlier (I was traveling to Europe) so I was trying to get lots of light in the morning, get up earlier, block light at night, go to bed early, you know—just trying to shift my rhythms about three days before the trip. Even doing all that, being the sleep scientist that I am, I still had jet lag upon arrival. It was a quicker recovery, but still: people need to be thinking about If they’re traveling across time zones. They may bank on the fact that “I’ll get there a week ahead of time and I’ll be adjusted by the time the competition starts”, but I think the training leading into that competition is also important for being fresh and ready and alert. It’s definitely a factor for teams and athletes traveling across multiple time zones, and there’s a lot they can do ahead of time to help prepare for that.

We’re betting people ask you for sleep tips pretty regularly. Is there anything where you’re like “people still haven’t realized how big an impact this could have for them”?

You all are a circadian optimization company, and so one of the things is that light is so important. For example, I’m in my office right now in low light, it’s only between 100 and 200 lux, and so I think it’s important for people to understand that the indoor environment isn’t necessarily optimized for circadian optimization. Trying to get outside in the morning is key for me, even on a cloudy day where light could be up to 13,000 lux or so.

It’s important for people to get outside light and go on a walk in the morning to help entrain their circadian rhythms to be more on that normal schedule. Many people don’t realize it, they think that their office environment is perfect for light. But getting the right amount at the right time, starting in the morning, is very important. Then also trying to dim the lights at night and maybe wear blue light blocking glasses in the evening are good tips for people to follow.

There’s been some work looking at office lighting, having bright white light in the morning and then as the evening approaches kind of transitioning to more of that orange kind of sunset lighting. And they do find improvements in sleep, in performance, and even mood.

Like you mentioned, we’re a circadian rhythms company first and foremost, so we gotta ask: What do you think the future holds for circadian rhythms research in the world of elite performance? How about just overall health?

I think there’s a lot to uncover here, and in particular I’m really interested in the individual, their own chronotype, their own circadian rhythm, and optimizing training times based on when they would perform the best. For example, if they’re more of an early bird but they have evening competition, how can we optimize our circadian rhythms to shift more towards an optimal performance time in the evening? I think this is a fruitful area that has a lot to be explored, and there are hints of it in the research right now. I think we could do a lot more to shift circadian rhythms for optimal performance at a certain time.

A while back, there was a realization that strength and conditioning is important, and so sports teams would add a strength coach. Then there was a realization that nutrition is also important, so they would add a nutritionist to the team. Now (potentially) I think that you might see more sleep coaches helping out teams. There’s a lot of work out there that we aren’t necessarily taking advantage of and I think that could be an area where maybe more sleep coaches will pop-up for different teams and different athletes.

Any research you’re excited about or want to highlight?

At Cerebra, we’re working on developing a kind of a miniature EEG wearable device that you could potentially wear on the forehead or even measuring in-ear EEG with one of our partners that we are working with. We want to pair that with an app to be able to figure out for the individual what their triggers are for sleep quality. We have a way to measure sleep quality using ORP (which is a metric of sleep depth which micro-analyses the EEG). We did a study recently where we had 20 people do 20 nights with our current device while tracking their lifestyle factors such as, caffeine, exercise, alcohol use, and how much they got outside. We’re really seeing some interesting results with some of those lifestyle factors and how that impacts sleep quality, and also how that impacts next day performance. Additionally, we did a reaction time test for all those individuals, we’re just finding some really interesting results and I think we want to go way beyond the “general sleep hygiene” advice for people and make it more personal and individualized.

For example, I might be a high or a fast metabolizer of caffeine, and so a coffee at 1 p.m. won’t necessarily impact my sleep quality vs someone who may be more of a slow metabolizer – where it would impact their sleep quality. I think it’s really exciting for us to really try and personalize sleep optimization for different individuals.

Actually, I was listening to a recent podcast that Olivia (CEO of Arcascope) was a guest on, and she mentioned that sleep at night starts with what you do during the day. A lot of these activities, stressors, or anxiety that you experience during the day can then impact your sleep quality at night.

Actually, before I started working at Arcascope, I had no idea that what I did during the day impacted my ability to fall asleep and stay asleep. Having experienced sleeping troubles throughout my life, I wish I had this knowledge sooner!

For sure, that brings up an important point. If you are struggling with your sleep, and you have tried different things but it doesn’t seem to impact your sleep quality, try and get help from a sleep professional. If you’ve been struggling multiple times for weeks you’ve tried everything, don’t try and solve it on your own but really try and reach out to sleep professionals who can help.