Experts Say Sleep Is Vital to Our Well-being

ST. LOUIS - Sleeping five or six hours a night-and bragging about it?

You may think you're getting away with something, but your body knows better. Most people require at least eight hours of sleep each night for optimum functioning. If you're routinely staying up late to go online or out dancing, your body is paying a high price.

People in the sleep disturbance business say "chronic under-sleeping" increases the risk of accidents, may suppress immune function and could lead to heart disease, diabetes or other dangerous health conditions. All of that is in addition to less serious repercussions, such as decreasing your productivity, making you irritable and causing you to doze off at the weekly staff meeting.

You say you can live with that? Think again.

"We know that if we deprive rats of sleep, their body temperatures plummet and they die. That tells us that the body has an internal need for sleep," said Mark Muehlbach, clinical director of the Clayton Sleep Institute, an agency that tests people for sleep disorders.

Few people would deny that a good night's sleep makes them feel refreshed and restored. Some studies show that sleep may allow the body to remove toxins and restore damaged tissues. Others show that sleep may help us store memories in the brain and "get rid of nonsense." Some researchers are trying to determine the effects of sleep deprivation on the immune system. And at least one study has reported that people who drive while sleep-deprived cause as many accidents as people who drive drunk.

For years, sleep experts have recommended that adults get at least eight hours of sleep a night to function properly. Yet a poll conducted in 2000 by the National Sleep Foundation (www.sleepfoundation.org) found that "on average, adults sleep just under seven hours during the workweek" and that one-third of adults sleep only six and a half hours - or less - nightly. The foundation, a nonprofit organization that supports sleep- and fatigue-related education, research and advocacy, also learned that "a full 45 percent of adults agree that they will sleep less in order to accomplish more."

That's because many of us are under the impression that sleep is not as important as the other things we do, says Dr. Kimberly Zoberi, a family practitioner in Des Peres, Mo. "We live in a society that tells us we can do every single thing, and we really can't," she said. "Something's got to give, and unfortunately, it's often our personal well-being."

And every afternoon, when our eyes ache to close for just a few minutes, we lie about the seriousness of the situation.

Matt Uhles, a coordinator at the Clayton Sleep Institute, cited a poll conducted in 2002 by the National Sleep Foundation. "Fully 99 percent of participants admitted that a poor night's sleep will impact performance the next day," he said, "but 48 percent reported that they thought it was `normal' to be sleepy in the afternoon."

It's not. If we got enough sleep each night, we wouldn't feel sleep-deprived during the day. That's not to say that almost everybody doesn't experience a dip in the natural rhythm of the body in the afternoon.

"We do have a natural `sinking period' from 2 to 4 p.m. each day, a time when we should slow down," said Uhles. "Other societies have a siesta at this time, but we Americans refuse to take daily naps." If you are running on something close to empty, that natural dip will be harder on you.

Why don't people get enough sleep? Too many temptations.

"As a result of indoor lighting and around-the-clock entertainment, our sleep patterns have changed dramatically, even though our need for sleep has not," said Zoberi. "Now when the sun goes down, instead of ending the day as our ancestors did, we go to the movies, do household chores, watch TV or head for the mall."

Uhles agreed. "Most people sleep by default," he said. "In fact, a large portion of the population sees sleep as an unnecessary evil."

When questioned, most people claim they cannot possibly cut anything from their overly busy schedules in order to get to bed earlier. "It would be one thing if they would put sleep on their list of things to do," said Uhles, "but they don't."

Some sleep-deprived clients at the Clayton Sleep Institute openly reject the notion that they are responsible for that deprivation. Muehlbach said people who want to function well on four hours of sleep often insist there must be some other reason causing them to be tired during the day. "When I tell them to go to bed earlier, they actually say they would rather have something medically wrong, something that could be treated with drugs, than be told to get more sleep."

Some people, of course, suffer from sleep disorders. Earlier this year, the National Sleep Foundation released a report that said two-thirds of adults 55 and older experience frequent sleep problems, but only a small fraction - one in eight - say those problems have been diagnosed. That means most people deal with sleep disorders on their own, perhaps choosing an over-the-counter medication at the pharmacy or grocery. Zoberi isn't opposed to that solution, at least for a few days. "Over-the-counter medications are OK for very short-term use - maybe two or three days in a row," she said.

How do you know when sleep deprivation has surpassed being an occasional problem and developed into a disorder? If you've had trouble sleeping off and on for a month or longer, Zoberi suggests seeing your doctor.

Insomnia - the ability to fall asleep or stay asleep - is the most common sleep problem, and about half of older adults report frequently experiencing at least one symptom of insomnia. Insomnia itself may be a symptom of another sleep disorder, including sleep apnea, restless leg syndrome, involuntary leg jerks or narcolepsy, which is a disorder of the central nervous system. Depression or anxiety also may contribute to a loss of sleep.

"Most disorders are treatable, and usually we can put people back to sleep," said Muehlbach.

Some people do sleep - but remain adamant that they were awake all night long. "We train those people to relax, teach them to concentrate on breathing patterns or to focus on one image," he said. "Sometimes, a short trial of medication takes care of the problem."

A bed partner or pets that move around a lot also can disturb your sleep. Caffeine can keep you in a lighter level of sleep, one where you won't get the rest you need. Spending too much time in bed worrying about not sleeping often adds to anxiety about sleep deprivation.

Sometimes, people overlook a string of sleep disturbances during the week, figuring they will catch up on lost sleep over the weekend. Zoberi isn't buying that. "Our bodies do try to catch up, and if given the opportunity, you will sleep more," she said. "But does catching up erase the damage you did over the last five days? No. It's better to get the right amount of sleep, let your body have time to do its restorative functions, each night."

You may be thinking that naps are the answer. They aren't. A short nap does not provide the deep sleep your body needs. Also, a nap that lasts too long can interfere with sleep later that night. However, Zoberi said a 30- to 45-minute nap about the same time every day "can refuel you to get through the next set of challenges."

Even people reluctant to go to bed earlier or take short naps are likely to admit there is an innate attraction to the idea of personal downtime. "We tell people to think of sleep as a minivacation that you take every day," said Uhles. "You can't get around it, because you can't survive without sleep. It's in the top three, along with water and food. Your body must have it."

Why remains a mystery. In spite of the countless studies that show how sleep helps us, researchers do not understand precisely why we need sleep.

"That is the million-dollar question," Muehlbach said. "All research shows that if we go without sleep, we get tired, which is the body telling us we need to sleep - but we don't really know why. Still, since we spend about one-third of our lives sleeping, we would hope there is more than one single function that benefits."

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(c) 2003, St. Louis Post-Dispatch. Distributed by Knight Ridder/Tribune News Service.