Sleep: A Necessity, Not a Luxury

SUNDAY June 8, 2008 -- The pace of life gets faster and faster, and people try to cram more and more into every minute of the day.

As things get more hectic, sleep tends to get short shrift. It's seen as wasted time, lost forever.

"For healthy people, there's a big temptation to voluntarily restrict sleep, to stay up an hour or two or get up an hour or two earlier," said Dr. Greg Belenky, director of the Sleep and Performance Research Center at Washington State University Spokane.

"But you're really reducing your productivity and exposing yourself to risk," Belenky added.

That's a message doctors are trying to spread to Americans, including the estimated 40 million people who struggle with some type of sleep disorder each year.

Before Thomas Edison invented the light bulb in 1880, people slept an average of 10 hours a night. These days, Americans average 6.9 hours of sleep on weeknights and 7.5 hours a night on weekends, according to the National Sleep Foundation.

"The group of people getting optimal sleep is getting smaller and smaller," said Dr. Chris Drake, senior scientist at the Henry Ford Hospital Sleep Disorders and Research Center in Detroit. "When a person's sleep drops to six hours or less, that's when a lot of things become very problematic."

While experts recommend seven to eight hours of sleep each night, the amount needed for an individual can vary.

But lack of sleep affects a person in one of two ways, Belenky said. First, sleeplessness influences the day-to-day performance of tasks.

"The performance effects are seen immediately," he said. "You short-change yourself of sleep, and you see the effects immediately. You can make a bad decision. You can miss something. Have a moment's inattention, and you're off the road."

The longer-term effects of sleep deprivation involve a person's health. Doctors have linked lack of sleep to weight gain, diabetes, high blood pressure, heart problems, depression and substance abuse.

"Hormones that process appetite begin to get disorganized," said Drake, who's also an assistant professor of psychiatry and behavioral neuroscience at the Wayne State University School of Medicine. There's a decrease in the amount of leptin, an appetite-suppressing hormone, when a person gets too little sleep. At the same time, ghrelin -- a hormone that stimulates appetite -- increases with a lack of sleep.

Too little sleep also interferes with the body's ability to regulate glucose and can cause inflammation leading to heart problems and a rise in blood pressure. "There's a stress response to being in a sleep loss," Belenky said.

The types of people not getting enough sleep also break down into two groups. First, there are those who make the conscious choice to go without enough sleep.

"It's sort of part of the culture," Belenky said. "People pride themselves on getting little sleep. You'll hear people bragging, 'I only need six hours a night.' So there's a macho element here."

On the other hand, there are people who are suffering from sleep disorders. These disorders include:

  • Insomnia, an inability to go to sleep or stay asleep.
  • Sleep apnea, or breathing interruptions during sleep that cause people to wake up repeatedly.
  • Restless legs syndrome, a tingling or prickly sensation in the legs that causes a person to need to move them, interrupting sleep.

Someone suffering from any of these problems should visit their doctor or see a sleep specialist, Belenky said.

Sleep apnea, the most prevalent sleep disorder, can have particularly serious long-term effects if left untreated. "You're waking up out of sleep to breathe. You can't sleep and breathe at the same time," Drake said. "It's a risk factor for developing major cardiovascular health effects."

Some people who have trouble sleeping will resort to mild sedatives like Ambien and Lunesta.

The U.S. Food and Drug Administration recently asked the makers of these sedative-hypnotic drugs to strengthen their warning labels. This action followed reports of dangerous allergic reactions, as well as a host of bizarre behavioral side effects that include sleep-driving, making phone calls, and preparing and eating food or having sex while asleep.

Drake and Belenky both consider sleeping pills to be fine for the short term if taken properly.

"Sleeping pills are a temporary solution," Belenky said. "If you're upset about something or have situational insomnia, or you're trying to sleep at the wrong time of day because you've traveled across time zones, they are effective."

But, both doctors noted the pills will do nothing to help a chronic sleep problem. "They don't address the pathology of their sleeplessness," Drake said.

The U.S. National Institutes of Health offers these tips for getting a good night's sleep:

  • Stick to a regular sleep schedule.
  • Avoid exercising closer than five or six hours before bedtime.
  • Avoid caffeine, nicotine and alcohol before bed.
  • Avoid large meals and beverages late at night.
  • Don't take naps after 3 p.m.
  • Relax before bed, taking time to unwind with a hot bath, a good book or soothing music.
  • If you're still awake after more than 20 minutes in bed, get up and do something relaxing until you feel sleepy. Anxiety over not being able to sleep can make it harder to fall asleep.

Posted: June 2008


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