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Sleepless Hours Exact a Huge Toll

Posted - Dec. 31, 2003 at 7:20 a.m.



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Dec 31, 2003 (United Press International via COMTEX) -- Editors' Note: UPI surveyed 71 specialists for a series of articles examining the consequences and costs of the industrialized world's nightmarish sleep debt and ways to turn around the troublesome trend. Part 2 addresses sleep-related dangers and benefits.

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SAN FRANCISCO, Dec. 31 (UPI) -- Forget the age-old reproofs against sleeping; newfound evidence shows you lose -- in ways admonishers never dreamed of -- if you don't snooze.

An epidemic of the walking sleepless -- an estimated half the industrialized world's populace -- is exacting a nightmarish price in health and wealth, a United Press International survey of specialists indicates. Yet, for the most part, the growing problem has failed to rouse the interest -- or put to sleep -- an action-addicted public that considers slumber a yawner.

"Chronic sleep deprivation or chronic partial sleep loss is endemic in our population," stated neurologist Dr. Clete Kushida, director of the Stanford Center for Human Sleep Research in Palo Alto, Calif.

Scientists calculate the average person has shaved off at least an hour of needed shut-eye a night, ballooning the national sleep debt to 107 billion hours a year. The once common nine nightly hours under the covers have shriveled to seven and a half, or less, for a typical adult. Such chronic shortchanging of one of three fundamental human needs carries a host of costly implications, some of which scientists may not yet realize.

"Although for thousands of years, we have known the biological reasons for eating and drinking, we have been in the dark about the 'why' for the third biological need of sleep," noted Matthew Walker, instructor of psychiatry at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston.

"The new research is beginning to reveal the answer," said Walker, whose study, published in the Oct. 8 issue of the British journal Nature, linked lack of sleep to failed memory.

His tests, which disclosed sleeplessness can severely and irreversibly hamper the brain's ability to restore and retain information, and other research hint at the intractable implications of the swelling sleep debt.

"Often there is more denial with sleep loss than there is with alcohol abuse," Kushida pointed out, noting both can produce a similar effect on drivers. "It's almost easier, and certainly more widely practiced, to take the car keys away from a person who's intoxicated than one who's sleepy."

Yet, in the United States alone, drowsy drivers are implicated in more than 100,000 accidents a year, he noted.

Mounting scientific evidence also points to more direct, health-harming consequences of sleep deficits, including increased susceptibility to ulcers, a doubled risk of early death in healthy older adults, manic behavior in people with bipolar disorder and impaired learning and memory. Because research has shown sleep deprivation exerts a derogatory influence over metabolism and hormonal activity similar to that usually reserved for the aging process, scientists suspect skimpy slumber may exacerbate chronic conditions that go along with growing old.

"People who chronically get inadequate sleep may be ill more often and seem to be at increased risk of obesity," noted Dr. Susanna McColley, associate professor of pediatrics at the Feinberg School of Medicine at Northwestern University in Evanston, Ill.

The sleep-deprived also appear extra-vulnerable to cardiovascular disease, hypertension and depression, studies indicate. Particularly among the young, a sleep void can create a profound learning and behavior gap, researchers observed.

"I suspect that many children do not use their full brain capacities to learn and absorb information because of their chronic sleep deprivation," said psychologist Avi Sadeh of Tel Aviv University in Israel. " I'm even more worried that the increasing rates of attention problems (ADHD -- hyperactivity), youth violence and other forms of lowered frustration tolerance are related to this growing tendency to shorten sleep."

With its spreading claim to infamy, sleeplessness has awakened interest in the scientific and medical community both as a gateway and a signpost to disease.

A recent Stanford University School of Medicine study linked poor slumber and depression, showing the emotionally dejected and distraught are five times more likely to also suffer from a sleep disorder than are those in good mental health.

"Difficulty falling asleep or staying asleep can be due to medical problems, including depression and/or anxiety," McColley told UPI. "If you persistently have trouble sleeping, consult a physician."

Slumber difficulties also can go hand in hand with weight and blood pressure problems. Obesity is a risk factor for sleep apnea, a nighttime breathing disorder that affects 18-million Americans -- and doubles their risk for hypertension.

The slumber-shunners should realize good things come to those who sleep, including better physical and mental health, said Dr. Andrea Zabka, a comparative bioscientist at the University of Wisconsin in Madison.

Recent research, for example, has linked getting a good night's rest to improved memory, learning and performance -- by 20 percent in one motor skills study -- and averting or ameliorating run-ins with illness. A Stanford study, published in the October issue of the journal Brain, Behavior, and Immunity, even suggested proper sleep may be just what the doctor ordered, not only for preventing cancer but also for stymieing its progression.

"Adopting healthy eating and exercise habits, getting a good night's sleep, and finding good emotional and social support should be regarded as much a part of cancer treatment as chemotherapy or radiation," said study author Dr. David Spiegel, the Jack, Lulu and Sam Wilson Professor in Medicine.

In the long term, sleeping the night away could enhance mental function and prevent or decrease the severity of such age-related chronic health conditions as obesity, diabetes, cardiovascular disease and hypertension, observed Dr. Phyllis Zee, professor of neurology at Northwestern.

"Our research is based on the idea that adequate quantity and quality of sleep is important for successful aging," she told UPI.

Those who shut their eyes to their sleep needs, intending to pay up on the debt later, may be in for a rude awakening, scientists cautioned.

"Sleep deprivation, at least in terms of memory consolidation, is not like the bank," Walker told UPI. "You cannot accumulate a debt and hope to pay it off in a lump sum at a later date. It is an all or nothing event, and if you don't snooze, you lose."

Sleep deprivation can be deflected only to a certain extent, and attempts to recover the loss carry their own risks, researchers said.

"We can compensate and recover by sleeping more during weekends, holidays, etc.," Sadeh told UPI. "However, it does not compensate for the compromised functioning during the sleep deprivation period, and irregular sleep schedule (i.e., large weekdays-weekend differences) has been linked to poorer school performance and behavior problems."

Research suggests brief -- no more than 30 to 45 minutes -- daytime snoozing can refresh and re-energize some, though not all, sleepyheads. The findings have roused a number of companies to offer employees time and space for on-the-job "power naps."

"Naps can improve short-term cognitive functioning during the day and improve performance," said Shelley Tworoger of the Fred Hutchinson Cancer Research Center in Seattle. "However, naps should not replace adequate nighttime sleep."

Mid-afternoon siestas might be of particular benefit to shift workers unable to get in some winks during the night, said Dr. Harvey Moldofsky, medical director of the Sleep Disorders Clinic of the Centre for Sleep and Chronobiology in Toronto, Canada.

"Sleep is important," said Mary Amanda Dew, professor of psychiatry, psychology and epidemiology at the University of Pittsburgh School of Medicine and Medical Center. "It's OK to miss some occasionally, but don't do it often, and try to stick to regular sleep/wake times as much as possible. It's better than being grumpy and miserable because you're too tired."

Next: Running up a sleep debt? Blame Thomas Edison and, perhaps, your parents.

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E-mail Lidia Wasowicz at sciencemail@upi.com

Copyright 2003 by United Press International.

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