Recently, a man came to our sleep center looking for help with a problem at work. A lawyer, he had been staying up half the night preparing defense arguments. Now his daytime performance was slipping. He was even nodding off on drives between courthouses.
He wanted a quick remedy, a prescription stimulant, anything to get him back on top of his game. What did I recommend?
I told him to go to bed earlier. I told him the restorative effects of sleep would do more to sharpen his thinking and reasoning skills than any knowledge he crammed into his brain in the middle of the night.
Did he believe me? Would you?
America is suffering a sleep crisis, and it's a problem of our own making. As a sleep doctor, I see it all the time. People are working longer and harder and sleeping less and less. Some have little choice. Maybe their jobs or their situation compels them to stay awake. But too many people deprive themselves of sleep because they believe that's what smart, successful people should do.
They are heading for a nightmare. The fact is, sleep is essential to both health and success and something we all need to start taking far more seriously. To know how well a patient is doing in life and at work, one of my first questions is always, "How are you sleeping?"
Recharging the batteries
When we sleep, we do not fall into a passive, coma-like state, as ancient thinkers speculated. Sleep is an active process, a state of neuro-restoration. Toxins are cleared from the brain as we slumber. Our blood pressure falls and our heart rests as our metabolism slows. Virtually every organ system in the body is reinvigorated. Talk about a good night's work!
Studies have confirmed that adequate sleep improves memory, stabilizes mood and enhances concentration and attention. But here's the bad news. A growing body of research points to the profoundly negative effects of too much wakefulness. Sleep deprivation is associated with stress, obesity, diabetes, heart disease and even dementia.
More obviously, a lack of sleep effects performance on the job and on the road, leaving us more prone to making mistakes and causing accidents, as the trucking industry knows well.
Yet still many of us strive to sleep as little as possible. We even brag about pulling an all-nighter to prepare for the exam or the big presentation. (Even though research shows that sleeping after studying yields higher test scores than studying right up until the test.) When did skipping sleep become a badge of honor?
Can't just blame the light bulb
Sleep deprivation is a rather recent development in human history. Before the invention of the light bulb, our ancestors went to bed when it got dark. They worked hard and they slept hard. We simply work hard.
Sleep's status was further dimmed by the Internet and our 24-hour online world. But my colleagues in the medical community are also to blame. When was the last time your doctor asked how you were sleeping?
Relative to other medical disciplines, sleep science is in its infancy. We have learned much since the discovery of REM sleep just over 60 years ago, but we have far to go toward understanding all of sleep's mysteries. Medical students receive only a few lectures on sleep during a four-year curriculum. Then they enter a profession where they are pushed to work long days attending to as many patients as possible.
The medical profession still does not take sleep seriously. And until it does, you have to make doubly sure you do.
Early to bed
On average, adults need 7.5 to 8.5 hours of sleep each night. Elementary school children need 9 to 11 hours. Lost sleep has a cumulative effect. Studies have shown that performance on vigilance tasks and reaction time after 17-18 hours of being awake is similar to trying to perform those tasks legally drunk.
Also, it takes several days to recover lost cognitive abilities after just a few consecutive nights of inadequate sleep. Thus do motor vehicle accidents spike on the Monday morning after the switch to Daylight Savings Time, as a result of only a one lost hour of sleep.
At Cleveland Clinic, we're taking steps we hope will elevate sleep to the status of a vital sign, along with pulse and heart rate, and create a better rested community. We're educating primary care doctors on the importance of sleep habits and detecting sleep disorders, we're hosting sleep symposiums, and we're surveying employees to discern their sleep habits.
As individuals, we need to take personal control and put sleep back in our lives. We need to go to bed at reasonable times, take naps to catch up, watch our caffeine, and start discussing sleep habits with our doctors.
My patient the lawyer was skeptical. But as he began sleeping more, he found that his mood improved and so did his alertness at work. He traded late night research for a new snap in his step. Now, when he feels himself growing tired, he goes to bed. Being awake feels better than ever.
Dr. Nancy Foldvary-Schaefer, a neurologist, is director of the Sleep Disorders Center at Cleveland Clinic and author of "The Cleveland Clinic Guide to Sleep Disorders."