Is It Macho to Make Bad Decisions?

We train our children, from a very young age, to ignore a feeling of tiredness and work till late at night. They go on to college and all-nighters, consuming caffeine in every conceivable form to stay awake. Working hard equals staying up at night. Right?
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Imagine, for a few seconds, powerful businessmen and women sitting in a boardroom taking tough decisions; stock traders trading away busily; politicians discussing the nation's future; military leaders deciding on the best strategy. Now visualize a physician operating on you, in a critical life or death situation. Who amongst this group of chronically sleep deprived, stressed out individuals do you think will perform the best to save the world and your life?

Of course, the answer I am looking for is "none," because while these people are likely all very smart, the cream of the crop, high performing, high achieving, competitive individuals, what they often fail to learn is that lack of sleep changes how the brain perceives situations and makes decisions.

The numbers are out there and have been there for years. Over 20% of all U.S. workers have insomnia. According to the CDC, 50 to 70 million American adults don't sleep well. The cost of insomnia to the U.S. economy is estimated to be over $63 billion per year. The average American sleeps around 6 hours per night compared to about 7 hours over ten years ago and over 9 hours a century ago. Twenty-four hours of sleep deprivation equals being legally drunk, and so on.

More science, surveys, articles and news tell the same story. There is news almost every day about sleep deprived air traffic controllers, truckers, doctors, train drivers and pilots. Local newspapers often carry reports of single vehicle accidents caused by sleepy drivers.

Somehow, in spite of all this, it seems it is still macho to sleep less. There are still people who feel that to be successful in life you have not done the necessary work unless you have been consistently deprived of sleep and survived it. Some will even tell you that people who value their sleep are practically losers.

Therein lies a pervasive problem in society. We as a society do not value the need to feel charged up, refreshed and rested in order to perform at our best, no matter what science and numbers tell us. We train our children, from a very young age, to ignore a feeling of tiredness and work till late at night. They go on to college and all-nighters, consuming caffeine in every conceivable form to stay awake. Working hard equals staying up at night. Right?

As a sleep physician treating people of all ages, I grapple with the challenge to re-train and de-train their minds from how they have unfortunately been programmed during their lifetimes. I find myself recounting the scientific facts: Sleep is a necessary function of the body during which memories are organized and processed. The body goes through multiple metabolic processes tied to sleep onset and maintenance through the night to manage blood sugar, weight, fat content, blood pressure, aging and in case of children physical growth. Sufficient sleep means waking up on your own, not counting the hours. Sleep protects from the effects of stress. Anxiety and depression are common effects of chronic sleep deprivation. Sleep deprivation causes food cravings and increased weight. Insufficient sleep leads to impulsive, poorly thought through decisions and inaccurate control of muscles.

The people who come to see me in the physician's office are there often because some thing, some event or someone made them realize they have a problem.

I wonder what it will take for us as a society to start valuing our rest.

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