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Just as Important as Exercise, Diet

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Dec 30, 2003 (United Press International via COMTEX) -- Editors' Note: UPI surveyed 71 specialists for a 3-part series examining the consequences and costs of the industrialized world's nightmarish sleep debt and ways to turn around the troublesome trend. Part 1 overviews their assessments and advice.


SAN FRANCISCO, Dec. 30 (UPI) -- Set on maximizing your health, wealth and youthfulness in 2004? Start by sleeping the night away, experts advise.

With the dawn of a new year, the growing ranks of slumber scrooges should awaken to the costly and, at times, fatal consequences of skimping on sleep, and resolve to give their mind and body a richly deserved rest, scientists urge.

"We live in a time of time famine," noted Dr. Harvey Moldofsky, medical director of the Sleep Disorders Clinic of the Centre for Sleep and Chronobiology in Toronto, Canada. "That is, because of societal/work obligations that increasingly occupy our time, there is insufficient time for addressing our obligatory bodily needs for sleep."

The slumber debt runs up a high tab in injury and death on the highway and on the job, poor performance and reduced productivity in school and at work and, some studies suggest, increased susceptibility to ulcers, heart disease, obesity, depression and a host of age-related ailments.

The numbers involved are staggering enough to keep scientists and policymakers awake nights.

Nearly half of Canadians begin each day bleary-eyed from lack of sufficient slumber, the nation's statistical agency reports. That means, every morning, an estimated 9-million rest-less drivers hit the road with compromised alertness, a suspected cause in some 35,000 collisions annually, researchers warn.

Across the southern border, the U.S. populace shuns shut-eye in equal measure.

"There are solid data that America is a very sleepy nation," stated Dr. William Dement, director of Sleep Research and Sleep Disorders Clinic and professor of psychiatry at Stanford University Medical Center in Palo Alto, Calif. "The National Sleep Foundation annual population surveys have documented this at least several times."

A recent NSF poll indicated a quarter of American adults -- 47 million individuals -- fail to get even the minimum amount of needed sleep. Of the 200-million vehicle operators on the nation's highways and byways, half drive drowsy, a condition equated with being drunk. A fifth, or 32 million, admit dosing off at the wheel.

More than half the U.S. workforce concedes sleepiness at work curtails the quantity of production, and 40 percent own up to a negative effect on the quality as well. At least two-thirds blame tiredness for slackened concentration and 66 percent for a lessened ability to handle stress on the job.

The study estimated sleeplessness takes a $92.5-billion to $107.5-billion bite out of the nation's economy annually, of which $15.9 billion is in direct health-care and medication expenditures, and the remainder in indirect costs associated with lost productivity and accidental injury and death.

U.S. law-enforcement officers implicate sleep deprivation in more than 100,000 car crashes a year, 1,500 of them fatal and 71,000 involving injuries.

"Most of us feel that at least 50 percent of the adult population has a troublesome amount of sleep debt," said Dement, whose half-century as a student and teacher of the basic and clinical aspects of slumber have earned him the nickname, Father of Sleep Medicine. "The industrialized nations are probably about the same."

Even more eye-opening are studies showing a mere one to one-and-a-half hours trimmed off a single night's rest slashes the next day's performance by one-third.

"Sleep is part of good health, as important as nutrition and exercise to overall well-being," asserted Rafael Pelayo, a Stanford neurologist who interprets the brain activity of sleepers and studies their snoozing patterns.

The amount of requisite slumber for a healthy individual varies as much as the optimal number of calories, but the average lounges at around eight hours nightly for an adult, nine to 10 for an adolescent, nine to 11 for a child and up to 15 for a toddler or infant.

"There are individual differences," pointed out Dr. Phyllis Zee, professor of neurology at Northwestern University in Evanston, Ill. "We know that less than six hours is associated with poor performance and perhaps (poor) health and increased mortality."

One means to determine how much is just right is to gauge the amount needed to feel rested on a vacation or under other circumstances devoid of time pressures.

"If you feel refreshed, alert, engaged and with a positive mood after sleep, you probably sleep enough," advised psychologist Avi Sadeh of Tel Aviv University in Israel. "If you feel drowsy, sleepy, tend to fall asleep in passive situations or feel very nervous and agitated, perhaps you are not getting enough sleep or suffer from a sleep disorder that makes your sleep inefficient."

An adult free of slumber-inducing medication who routinely nods off for unusually long periods may have a medical condition predisposing him or her to a stroke, cardiovascular disease or other disorders, scientists cautioned.

"Individuals who have to sleep more than nine hours a night to feel rested should speak with their doctor about the potential reasons they need more sleep," recommended Dr. Anne McTiernan, author of "Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer" (2000, St. Martin's Press) and member of the Fred Hutchinson Cancer Research Center in Seattle.

In a United Press International survey of 71 specialists, the experts suggested a number of steps that could lead to the land of the sleeping:

--Follow a routine of retiring and rising on a timeline that deviates by no more than two hours every day, even on weekends;

--Avoid caffeine, nicotine and alcohol, which suppresses deep sleep, within three to six hours, and heavy meals within three hours, of bedtime;

--Use your bed for resting or sleeping, not for doing extra office work, watching television or playing video games (unless it helps you to doze off);

--Exercise moderately for 30 minutes a day, but no later than three hours before lights out;

--Sip warm milk, herb tea or other non-caffeinated drinks before turning in for the night to raise body temperature and help transport you to dreamland;

--Nibble on bananas, turkey, peanut butter or other foods rich in tryptophan, a compound that produces a natural sedative effect;

--Refrain from naps when you get home from work or school because they can reduce "sleep pressure" and, hence, your subsequent ability to drift off for the night;

--Put work aside two to three hours before you go to sleep;

--If sleep fails to claim you within 20 minutes, get out of bed and read for a while, selecting soothing rather than stimulating material;

--Partake of massage, meditation, music, yoga, positive imagery, biofeedback, a warm bath or other techniques that help the brain kick back and unwind;

--Write out a "worry list" of bothersome matters half an hour before bedtime and deal with it before your head hits the pillow;

--Keep the room quiet, dark and cool, and wear socks to sleep to keep toes toasty;

--Consult a doctor before taking melatonin, which may produce insomnia if given at the wrong time, or other sleep aides, which may prove ineffective, unhealthy or habit-forming;

--Dim the lights two to three hours before bedtime and get out in bright sunshine for five to 30 minutes as soon as you arise to help set your brain's internal clock to your sleep-wake schedule;

--Have sex, which some studies have identified as a sleep facilitator;

--If slumber continues to elude you, consider a visit to a sleep specialist.

"No one can always stick to these principles and some would say it's boring!" conceded Dr. Susanna McColley, director of the Cystic Fibrosis Center at Children's Memorial Medical Center in Chicago. "(But) as is often said about exercise, we should budget or plan sleep in our lives."

Next: You don't snooze, you lose -- in ways you may not even imagine.


E-mail Lidia Wasowicz at

Copyright 2003 by United Press International.

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