When you are trying to go to sleep and cannot, or when you wake up at 3am, you can feel very isolated and alone. But you are definitely not alone. Sleep deprivation is a national crisis that affects 1 in 4 American adults. 43% of Americans between 13 and 64 years of age say they rarely or never get a good night’s sleep during the week. 37.9% reported unintentionally falling asleep during the day at least once in the preceding month, and truly worrisome: almost 1 in 20 people (4.7%) said they had nodded off or fallen asleep while driving at least once in the past month.
A month without adequate sleep is all it takes to meet a diagnosis of chronic insomnia. And despite what you might think, you never “adjust” to getting an inadequate amount of sleep, even after years of sleeping too little. Each individual has a set minimum amount of sleep which is necessary to allow them to function at full cognitive capacity. For most adults, that minimum amount of sleep is 7-9 hours. The 2011 Sleep in America® poll by the National Sleep Foundation found that 63% of Americans said their sleep needs were not being met during the week, and 15% of American adults sleep less than six hours on weeknights.
Sleep is vital to the health of human beings, and chronic insomnia can result in serious health consequences. Sleep deprivation has been linked to multiple medical problems including obesity, diabetes, high blood pressure, cardiac illness, decreased ability to fight infection, depression, substance abuse, decreased work productivity, increased risk of accidents and impaired reaction time and judgment.
A recent area of interest for researchers has been the result of sleep loss on appetite and weight. Chronic sleep loss interferes with glucose metabolism, increasing the likelihood of insulin resistance which could lead to the development of diabetes. Sleep loss also increases the production of ghrelin, the hormone that increases appetite, and lowers leptin, the hormone that naturally curbs appetite. Sleep loss is also connected to poor food choices and irregular eating habits. All of these factors indicate that sleep deprivation can be related to obesity. There is data to support that the more sleep deprived you are, the more likely you are to be overweight.
Why are people not getting the sleep they need? Although we all can cite reasons like stress, a partner’s snoring, and late-night work or study, the 2011 Sleep in America® poll also revealed that people are plugged into technology at all hours of the day but also the night – 95% of all surveyed (ages 13 to 64) said they used some type of electronics such as a TV, computer, video or cell phone in the hour before going to bed. As research has found that artificial light exposure after dusk affects the body’s ability to prepare for sleep, logging off to go to sleep is becoming more and more difficult for many people.
There are lots of ways to take an active role in improving your sleep. As Jonathan Harland outlined in his blog post here, the most important involve changing your sleep behaviors, or “sleep hygiene.” Start to think about sleep as something you need to tend to and protect, like brushing your teeth. Making these changes to your sleep habits can improve your sleep and your health:
- Set a regular bedtime and wake time, and schedule 7-8 hours for sleep
- Avoid napping during the day
- Avoid stimulants such as caffeine, nicotine, and alcohol in the evening
- Exercise is best done in the morning – vigorous exercise too close to bedtime can make it difficult to fall asleep
- Avoid large meals close to bedtime
- Allow adequate exposure to natural light in the morning
- Relax before bedtime, avoid anything that promotes wakefulness like TV or upsetting conversations
- Use your bedroom only for sleep or sex – avoid watching TV, listening to the radio, or reading
- Keep your bedroom quiet and at a comfortable temperature
- Do not watch the clock
- Go to sleep only when you are tired
When to talk to your doctor:
- If you sleep problems continue even after making changes to your behavior.
- If you are feeling sleepy during the day, even when you are getting an adequate amount of sleep, it may be related to a sleep disorder or medical condition.
- If drugs and alcohol are causing problems in your life, they are likely disrupting your sleep too.
- If you have seen a change in your sleep pattern after starting a new medication, as some medication can interrupt sleep.
The first step is to speak to your Harvard Vanguard clinician about your sleep problems. We can help evaluate the factors contributing to your sleep problems, diagnosis relevant medical problems, and recommend helpful changes to allow you to get a good night’s rest. Sometimes, medication or cognitive behavioral therapy (CBT) may be recommended to help if you have significant sleep problems.
For problems that require a specialist, we are partnered with The Sleep Disorders Clinic at Beth Israel Deaconess Medical Center. This is a multi-disciplinary clinic, including neurologists, pulmonologists and psychologists, who use a range of diagnostic testing to evaluate and treat adults with a range of sleep disorders. You can get a good night’s sleep! Allow us to help.
Learn more about sleep problems:
National Sleep Foundation
The CDC website on Sleep and Sleep Disorders
Harvard Vanguard Healthwise Knowledgebase