SLEEP DEPRIVATION HAS become one of the most significant, unrecognized public health issues of modern times. If you're like me and most Americans, you've experienced the effects of sleep deprivation or know someone with a sleep disorder. Short cutting sleep by even a couple hours makes me inattentive, cranky and ravenous for the exact carb-dense junk foods my doctor tells me to avoid. But that's not all. What happens when a few nights of lost sleep multiply into weeks, months or even years? Lack of sleep is often chronic – due to the excessive social and work demands of daily life combined with poor sleep habits and sleep disorders, which are often unrecognized. Daytime sleepiness or fatigue is the primary result, but a host of other problems await, including poor concentration, inattention, irritability and decreased performance behind the wheel, in school and on the job. Even worse, emerging research tells us that chronic sleep deprivation and sleep fragmentation due to repeated nighttime wake-ups, as seen in sleep apnea and other sleep disorders, leads to serious health risks that might surprise you. According to a recent report, more than one-third of healthy adult Americans regularly sleep less than seven hours per night. (Seven to nine hours is recommended for young and middle-aged adults; seven to eight hours for older adults and even more for children and teens.) The 2018 National Sleep Foundation's Sleep in America poll found that only 10 percent of adults prioritize their sleep over other aspects of daily living, such as fitness/nutrition, work, social life and hobbies/personal interests. We pack our days with professional, extracurricular, family and social activities, and we teach our children to do the same, encouraging back-to-back after-school activities that book their free time well into the evening. Nighttime slumber is often shorter than expected, leading to the common habit of sleeping in on weekends to "catch up." Night shift workers are particularly affected. The negative impact of sleep deprivation has been studied for more than a century. Limiting sleep to four to six hours per night over one to two weeks causes significant impairments in mental performance and increases daytime drowsiness. These cognitive effects are equivalent to those produced by two nights of not sleeping at all. So be on guard, because many people are completely unaware of these issues. The U.S. Department of Transportation identifies fatigue as a top safety problem in transportation operations, costing billions of dollars and thousands of lives annually. Impairment in simulated driving tests after modest sleep loss is comparable to the impairment produced by alcohol. And the combined effect of sleep restriction and alcohol is a double whammy, even with low alcohol intake and alcohol concentrations below 0.08 percent, the legal intoxication level in most states. The impact of regular sleep loss on driving are further exacerbated by co-existing disorders like sleep apnea. Treating sleep apnea can reduce the risk of traffic accidents. Sleep is essential for biological recovery of the body and brain so it can function properly during waking hours. Beyond daytime functioning, chronic sleep deprivation contributes to numerous medical and psychiatric conditions, including high blood pressure, cardiac arrhythmias, diabetes, obesity, depression and substance abuse – to name just a few. Not getting your ZZZs prevents the recovery of cells in every organ system, promotes damage to the lining of blood vessels and increases pro-inflammatory biomarkers that underlie many chronic diseases. In fact, the 2003 Nurses' Health Study involving over 71,000 female registered nurses found sleeping less than seven hours per night increased risk of heart attack compared to those averaging eight hours. Both acute and chronic sleep loss affect hormones that control hunger and satiety – spiking levels of the appetite-stimulant ghrelin, while levels of the appetite-suppressing hormone leptin fall. Sleep loss elevates evening cortisol levels, a hormone that helps the body manage stress. Heard enough? Hot off the presses is a study published in May involving nearly 44,000 people over 13 years. Individuals under age 65 sleeping five hours or less during weekdays had a 52 percent increase in mortality compared to seven-hour sleepers. But the mortality rate among those with short sleep during weekdays and long sleep during weekends did not differ from the rate of the reference group, demonstrating the value of "catching up." You may wonder why sleep loss affects you but not your co-workers, partners or friends who seemingly can outperform despite burning the candle at both ends. New research confirms a genetic basis for differences in vulnerability to the impact of chronic sleep deprivation. Like other applications of precision medicine, we may, in the future, be able to predict one's ability to function well under a sleep-deprived state and target countermeasures accordingly. Wouldn't that have been convenient during my medical school and residency years! As a society, we are making progress. Measures to address the potentially devastating impact of the sleep-deprivation epidemic are cropping up everywhere. Examples include legislation against drowsy driving, delayed school start times and restriction of work hours for physician trainees, pilots and interstate truckers. These measures highlight the serious health and socioeconomic consequences of sleep loss in America and in most other industrialized countries. If you're reading this article, you or someone you love is probably suffering from the effects of inadequate or unrefreshing sleep. Maybe your partner snores horribly, keeping you up for hours. Or perhaps you lie awake each night for no apparent reason, unable to fall asleep despite feeling exhausted (I've done this myself many nights). Your child might complain of frequent nighttime awakenings, which affect performance in school or on the soccer field. And you may worry that sleep loss will eventually catch up to you. So tonight when the sun goes down and melatonin levels rise, think beyond what's on your plate in the coming days. Take time to wind down and clear your mind. Think about your future health and happiness, and go to sleep. Source
