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I really personally believe that many psychological
disturbances are the result of inadequate sleep. I did something stupid a while ago. I was pulling out
of the Starbucks parking lot on a Saturday morning, and somehow my foot was
on the gas instead of the brake as I put the car in reverse. It lurched
backward about 8 feet before I processed what was happening and hit the
brake. I’ve been driving for two decades. My record is
spotless. I’d never slipped up navigating the simple spatial
relationship between foot and pedals like that before. It took several
minutes to even believe it happened, then a few more minutes to realize how
lucky I was that nobody had been standing behind my car in the small, busy
lot. My almost-2-year-old had been sick for a few days
right before that. He’d been particularly restless at night.
I’d figured that, as a busy mom, I was more or less accustomed to
inconsistent sleep. But sitting there halfway out of the parking space,
heart rate spiking from near-shock, picturing the disaster that might have
occurred, there was no denying that waking up six or seven times a night
for three nights in a row had taken a pretty serious toll, and a
“grande drip with room” wasn’t going to fix anything. I was more sleep-deprived than usual that day, but
even when my son sleeps through the night there’s usually a list of
things on my list to accomplish during the late hours that are more urgent
than sleep, and I’m apparently in the majority on this one. It seems
as though no one sleeps that well anymore. It seems as thought we’re
not even supposed to sleep well: We’re burning the midnight oil, be
it by necessity or by habit — or just because “it’s the
right thing to do.”
I started wondering what’s so great about
aiming for less sleep — and whether we’re doomed to resign
ourselves to being a society of insomniacs. I checked in with two neurologists from local
sleep-disorder centers and asked them what’s keeping everybody awake.
It turns out that our need for Z’s is competing against some deeply
entrenched societal expectations.
DEMAND VS. SUPPLY
Dr. Aditya Bhargava is director of the SpectREM Sleep
Medicine Center, affiliated with the University of Nevada School of
Medicine. “Sleep is a state that we acquire during the
night where we lose perception of our surroundings and our body and our
mind are supposed to relax and rest and rejuvenate for the next day,”
he says, sorting through words to boil down a series of physical and
neurological processes into a layperson-friendly definition. “Ordinarily, when we sleep at night, we go
through what I like to think of as one-and-a-half-hour chunks of
sleep,” says Dr. Bill Torch, neurologist and medical director of the
Washoe Sleep Disorders Center in Reno, Nev. Each 90-minute chunk involves a cycle of five stages,
culminating in REM (rapid eye movement) sleep. “That’s the stage where we see real
creativity, some solution of problems. Emotional issues are worked out in
the dream state. A lot of invention occurs during that state of
sleep,” Torch says. Ideally, he continues, we need six of those
90-minute cycles each night to function optimally. That would be nine hours
of sleep. The average American adult sleeps about seven hours.
WHAT’S KEEPING YOU AWAKE?
The American Academy of Sleep Medicine lists 84 kinds
of sleep problems and disorders. Some are associated with medical,
neurological, or psychological problems, but the doctors I spoke with
stressed that many problems are environmental and lifestyle-based, too. One oft-cited reason we stay awake is because we can.
During the 19th century, before electricity, people spent the dark hours
between sunset and sunrise sleeping. The average nighttime slumber back
then lasted nine hours. “That’s the way sleep occurred for the
last 100,000 years,” Torch says. “We changed all the
rules.”
The change happened pretty suddenly, after 1913, when
the electric light bulb, under development for about a century by then,
became efficient enough to mass-market. That made it possible for factories
and households to run as late as they found it useful to do. Thomas Edison, one of a long line of inventors who
improved on the light bulb but who’s often singled out for full
credit, asserted that a few hours of sleep was all a person needed. He
claimed to thrive on four or five hours a night. Edison “profoundly changed the psychology of
the modern world. It was his desire to be known as the man who finally
eradicated the waste of human potential represented by all those hours
spent in ‘unproductive sleep,’ ” writes Stanley Coren in
his 1996 book The Sleep Thieves. He suggests that Edison would be pleased to know that
his enthusiasm for productivity caught on. On the basis of Coren’s
estimate — that the average American sleeps seven-and-a-half hours a
night, as opposed to the pre-incandescence-era nine hours — each of
us now has 500 extra hours a year to devote to getting things accomplished
(seven-and-a-half hours is a liberal figure; far more studies conclude that
it’s seven hours), or at least 500 extra hours to devote to something. Torch and Bhargava
each sound sounds a little frustrated when they point out that many people
habitually stay awake after they’re tired to watch television, use
computers, and play video games. “It’s a 24-hour culture, whether
it’s work or play,” says Bhargava. He refers to a study
conducted in the Midwest during which people on a camping trip were
monitored for sleeping activity. Without electronic distractions, they
slept an hour more than they tended to sleep at home. But most people aren’t out camping. We’re
in the middle of busy lives, with jobs and school and kids and social
obligations, plus we have that deeply ingrained Protestant work ethic to
maintain.
“This is why, I believe, we have a very
addictive society,” Torch says. “It has to do with the work
ethic, the social pressures that people feel in this society.” He
attributes the Starbucks — and caffeinated sodas and energy drinks
— to the need to keep working and playing when we should be resting. “[Caffeine] has become a required vitamin to
function in this very dysfunctional society that we live in,” he
says. He adds that other chemical stimulants occupy a similar role in a
frenzied culture.
“I’ve seen quite a number of meth addicts
who chose methamphetamine as their drug of choice because they would
otherwise fall asleep; they’re very tired.” He says that many
blue-collar workers rely on meth to stay awake. Even some legal — and reputedly relaxing
— substances, nicotine and alcohol, aren’t sleep-friendly,
Torch says. “Alcohol is bad because it interferes with your
normal sleep patterns,” he says. “It actually disrupts
brainwave activities. It acts as an anesthetic, as opposed to a sedative.
It’ll put you to sleep, but it’ll also disrupt your brainwave
activity and create very poor-quality sleep.”
Add all these factors together, and, as Torch puts
it, “We’ve created a mindset that staying up late is good and
going to bed early is bad. We tend to admire people in this society who
stay up late.”
Remember being sent bed early as a punishment when
you were a kid? Edison’s probably dancing in his grave.
WHAT’S THE DAMAGE?
If we’ve been able to create a culture where sleep
isn’t priority one and maintain it for more than a century, we must
be able to tolerate it — at least to some extent. Nancy Meyer has been a casino dealer for 29 years.
For the past few years she’s been working the graveyard shift, 2-10
a.m. She likes the hours. She likes having her days free, and because the
casino has fewer tables open in the morning, Meyer says, customers tend to
circulate among them instead of staying put, which is good for tips.
Usually she sleeps two or three hours right after
work, then another two or three right before the next shift. “As long as I can get two or three hours before
I go in, I can get through OK,” she says. As far as adjusting her circadian rhythm around her
job goes, she says, “I don’t know if you ever get used to
it.”
After four days of working, she transitions easily
back to sleeping through the night for the rest of the week. Meyer is one of many who’ve adjusted their
lives to a limited amount of sleep. “Some people have a lot of energy and
initiative, and they can function with four to five hours of sleep,”
Torch says. And there’s good news for those who
aren’t sleeping all night, every night. “As far as [long]-standing health effects of
acute sleep deprivation go, there don’t seem to be any,” says
Bhargava. That’s acute sleep deprivation, which is temporary, he says, as opposed to chronic sleep
deprivation, which lasts for longer periods of time and can have more
serious consequences. He’s quick to point out, however, that doing OK
on limited sleep doesn’t keep you at the top of your game. “It affects things like physical and mental
functioning. Acutely sleep-deprived people will be sleepy during the day;
they may be more irritable; they may not be able to perform as well as
their job,” Bhargava says. “If you have any mental problem, whether
it’s anxiety, depression, bipolar disturbances, those disorders will
be exaggerated even more so. If you have attention-deficit disorder, your
ADD will be worse,” Torch adds. “As a matter of fact, I really personally
believe that many psychological disturbances are due to inadequate sleep or
disturbed sleep that has not been diagnosed properly,” he continues. Both doctors mention the increased likelihood of car
accidents among sleep-deprived people. The National Sleep Foundation
reports that “drowsy driving” is responsible for 71,000
injuries and 1,550 deaths in the United States each year.
GET SOME SLEEP
The simple answer to fatigue? Get some sleep. “We advise people that it’s important to
get eight or nine hours of sleep if you’re an adult and, if
you’re a child or a teenager, progressively more,” Torch says. But what if that’s easier said than done? For
many people, budgeting nine hours of our precious 24 sounds impossible or
at least impractical. What’s a poor overworked, overstimulated
21st-century American to do? When patients who are experiencing stress-related or
lifestyle-related sleeplessness come to the SpectREM center, Bhargava tries
to look at the whole picture. “We try to use methods to change people’s
perception of how they’re feeling. There’s some psychological
retraining in terms of how to sleep better,” he says.
Muscle-relaxation techniques and stimulus control are two frequent
recommendations. He prescribes medicines for underlying depression or
anxiety, but he considers them a temporary fix to help while patients
acquire new habits and techniques. Torch looks at sleeplessness from a similar angle; he
also takes personal habits into consideration. “You have to decide what’s important in
your life,” he says. “Is television important in your life?
Should the television be on at night, to watch the late news, or can you
seriously turn off your television at 7:30 or 8 o’clock and stop
watching, ad nauseam, [all the] crap on the television?” The
conviction in his voice makes it clear that his questions aren’t
rhetorical. Both doctors acknowledge that changing one’s
habits takes more than the swoosh of a magic wand.
“You’re burdened with a lot of
schoolwork. You’ve got friends, you’ve got cell phones,
you’ve got televisions, you’ve got radios, you’ve got
computers now — all of the things that keep us
‘busy,’ ” Bhargava says. But, they agree, it’s worth the effort. “I believe we’d lead healthier lives, and
that we’d be more efficient in the waking hours, if we did get more
sleep,” says Torch. “[Not getting enough sleep] actually
creates more of a hassle, and it creates anxiety and stress that makes you
want to stay up late at night to finish the work that you didn’t
complete. It’s a vicious circle, and it has to be broken.”
As for Thomas Edison, who eschewed sleep in the name
of productivity, Coren writes: “[He] probably had such a strong work
ethic that he simply underestimated the length of time he spent napping to
make up for his shortened nighttime hours of sleep. The automaker Henry
Ford once made an unexpected visit to Edison’s lab. One of the
technicians stopped him from entering Edison’s private office, noting
that ‘Mr. Edison is taking a nap.’
“Ford thought that was a bit amusing and said,
‘I understood that Mr. Edison didn’t sleep very
much.’
“‘Oh, that’s true,’ said the
technician.
‘He doesn’t sleep very much at all, he just
naps a lot.’ ”
Kris Vagner writes for the Reno News & Review, where a
version of this article first appeared.
This article appears in Jan 4-10, 2007.
