Sleep report opens eyes
A lack of shut-eye is costing lives and dollars.
Sleep deprivation is costing the United States hundreds of billions of dollars each year. So say the experts behind a report that highlights this burgeoning and oft-ignored health problem.
Round-the-clock television and lengthening work days mean that many people spend less time in bed. Although everyone is aware that not getting enough sleep can have ill effects, doctors and researchers are just beginning to realize the toll on our health.
To estimate the size of society's sleep problem, and find ways to solve it, a group of sleep-research organizations asked the Institute of Medicine to study the issue. Its 14-person panel released their report yesterday1.
The panel says that the impact of poor sleep is "shocking" even to experts in the field. They say that some 50 million to 70 million Americans are suffering from a sleep disorder and countless more from sleep deprivation.
Many sleep specialists say that a good night's kip is just as important for health as diet and exercise. The problem "is underappreciated and probably underestimated", says Harvey Colten of Columbia University in New York City, who chaired the panel.
Most people are thought to need seven to nine hours' slumber each night, and anything less than that starts to cause mental and physical slip-ups. But many fail to heed this advice. "People take it very lightly," says Charles Czeisler of Harvard Medical School in Cambridge, Massachusetts, and head of the Sleep Research Society.
At the more severe end of the spectrum are disorders with clear clinical definitions, such as chronic insomnia, narcolepsy and sleep apnea, a common condition in which sufferers temporarily stop breathing at night.
The results can be serious. Some 20% of serious car-crash injuries are linked to sleepy drivers. And a growing number of studies link poor sleep to an increased risk of major killers such as obesity, diabetes and heart disease, though the reasons for this link are so far unclear. "What's being appreciated now is that sleep is integrated with many other fields of medicine," Czeisler says.
It is difficult to tot up the true costs of these problems. According to one estimate listed in the report, US businesses lose roughly $150 billion a year because tired employees skip work, have accidents or are less productive. On top of this are the costs of increased medical visits and accidents.
Experts say that many sleep problems can be solved by cleaning up sloppy habits, for example, by cutting down on caffeine and not watching television in bed. To diagnose more serious problems, the report suggests, it would be good to develop cheaper monitors that could be used to measure brain waves during sleep at home rather than in the lab.
Further study is needed into why the body needs sleep in the first place, the panel adds, and how exactly lack of sleep can lead to disease. These tricky questions have so far proven difficult to answer.
The authors recommend a public-health campaign to help teach both doctors and patients about the importance of good sleep and the serious health consequences suffered without it. "This could have a tremendous impact," says Lawrence Epstein, president of the American Academy of Sleep Medicine in Westchester, Illinois.
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- Colten H. R.& Altevogt B. M. . Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem (Natl Acad. Press, 2006)(2006). http://www.iom.edu/CMS/3740/23160/33668.aspx
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