Americans aren't getting enough sleep and it's killing us

Americans don’t respect sleep. As much as 40 percent of us say that we don’t sleep enough, according to Gallup. Perhaps we have too much to do or work more than one job, preventing a normal sleep routine. Whatever our reasons, sleep is often not a high priority. We shouldn’t take it so lightly: there is a growing mountain of compelling evidence that our casual disregard of healthy sleep is downright dangerous.

A meta-analysis published in the journal Sleep, found that too little sleep leads to an “unambiguous and consistent pattern of increased risk of dying.”

A recent study in the European Heart Journal — the latest to draw the connection between too little sleep and cardiovascular disease made news. Looking at data from 21 countries, researchers found that those who usually slept six or fewer hours increased their risk of death by stroke or heart failure by nearly 10 percent over a 7.8-year period. On the positive side, the study found that among those who under slept, daytime naps may compensate and mitigate these risks: more on naps to follow.

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The Centers for Disease Control (CDC) defines inadequate sleep less than 7 hours for a healthy adult, 18+ years old, but some researchers define it at 6 hours or less. For decades, researchers have known that sleep deprivation can lead to a variety of serious health issues. These include weight gain, Type 2 diabetes and increased inflammation, as well as behavioral and cognitive problems: depression, anxiety, substance abuse and impaired memory function.

Researchers at the University of Colorado, Boulder found in a study published in the current issue of “Current Biology” that the body’s metabolism has a very hard time recovering from sleep deprivation, with study subjects put on five pounds after five days of sleeping for only five hours a night. All-nighters push anxiety to clinical levels and even modest sleep reductions are linked to increased feelings of social isolation and loneliness. What can we do about it?

Shortcuts won’t work. While it seems like we should be able to “make up” lost sleep on weekends, that myth has been put to rest. Sleeping-in won’t erase the negative health effects of sleep deprivation during the week and irregular sleep patterns can compound health problems. You can’t trade hours of sleep and not increase your health risks.

While weekend catch-up doesn’t work, you can make up sleep on a daily basis through napping. Several studies show that an inadequate night’s sleep can be supplemented through short, daytime naps, which benefit long-term memory and can improve functioning. We are just starting to understand how naps might affect regulation of emotion: a University of Michigan study found that after waking from a 60-minute midday nap, people were less impulsive and had greater tolerance for frustration than people who watched an hour long nature documentary instead of sleeping. The benefits of napping for memory and learning are well described: a 90-minute nap confers the same benefits to test takers as an eight-hour night’s sleep. Despite the positives, napping during the day, especially at work, is still accompanied by a stigma.

What else can you do to ensure that you are getting the right amount of healthy sleep? The CDC’s sleep hygiene approach from Tips for Better Sleep recommends:

  1. Be consistent.

  2. Go to bed at the same time each night and get up at the same time each morning, including on the weekends.

  3. Make sure your bedroom is quiet, dark, relaxing and at a comfortable temperature.

  4. Remove electronic devices, such as TVs, computers and smartphones, from the bedroom.

  5. Avoid large meals, caffeine and alcohol before bedtime.

  6. Exercise: Being physically active during the day can help you fall asleep more easily at night.

Skimping on sleep or sleeping too long is like cheating at solitaire: it only hurts you. While fixing our own sleep hygiene is one issue; fixing the cultural sleep problem, another. The vast amount of new research is beginning to change policy in some areas, with school officials, for example, considering whether to push back school start times to better match teenagers’ sleep cycles.

Congress is entertaining proposals on making Daylight Savings Time run year-round in order to avoid the spike in sleep-related cardiovascular events that accompanies the time changes each year. Some states have already made this move.

A growing number of scientists, not normally known for being advocates, are bringing evangelical zeal to the message that lack of sleep is an escalating public health crisis that deserves as much attention as the obesity epidemic.

Jonathan Fielding, M.D., is a professor of public health and pediatrics at the University of California, Los Angeles.