21st Century Epidemic:
Sleep Deprivation

By Anton Kidess, MD

Sleep deprivation is a common problem that affects the life and well-being of millions of Americans. Inadequate sleep and widespread sleep disruptions are contributing factors to the many problems and frustrations that have become part of the American way of life. The National Sleep Foundationęs 2002 Sleep in America poll found that 47 million adults may be putting themselves at risk for injury, health and behavior problems because they aren't meeting their minimum sleep need. Excessive sleepiness reduces your alertness and performance. It can affect your attention span and causes memory difficulties. In 1997 a research study found that being awake for 18 hours produced impairment equal to a blood alcohol concentration of .08, which is the legal limit for alcohol. After 24 hours of being awake, it jumps to .10.

Research has shown that even losing one or two hours of sleep can impair your ability to drive. The U.S. National Highway Traffic Safety Administration (NHTSA) cites drowsiness as a factor in 100,000 police-reported crashes annually, involving 76,000 injuries and 1,500 deaths. Public surveys, however, suggest an even higher rate of drowsy driving. In one survey, 55% of those answering said they had driven while drowsy in the past year. Over their lifetime, 23% said they had fallen asleep driving but had not crashed, 3% had fallen asleep and crashed, and 2% had crashed when driving while drowsy.

These staggering numbers reflect the 21st century epidemic. Sleep is not just a time to get away from daily life, and it is not a time off. It is an active state that is important for renewing our mental and physical health each day. The body requires water, food and sleep. Sleep is just as important as water and food for our bodies. Several factors affect or can cause drowsiness. Our body has an internal clock which signals for us to be sleepy twice a day; in the evening at bedtime and about twelve hours later during the –siesta” time of the afternoon. The sunlight and darkness cycle helps our body coordinate the internal clock with the external environment. Although each personęs sleep needs and times vary, an average adult requires about eight hours of restful sleep each night. If you do not get enough sleep, you become sleepy. The longer and the more prolonged the sleep deprivation, the sleepier a person is. This can affect your mental as well as your physical health.

Teenagers are especially at risk. Research indicates that teenagers need more sleep than adultsăclose to nine hours every night, on average. Yet, a survey of teens shows that only 15% actually get that amount of sleep regularly. That means 85% of todayęs teenagers are not getting enough sleep. About 26% are only getting six or fewer hours of sleep on good nights.

Our society makes it more difficult for teens to get enough sleep at night. Early school start times often prevent teenagers from getting the sleep they need. Teenagers experience a shift in their internal clock that doesnęt allow them to fall asleep until later at night. However, they are unable to stay sleeping late because of early morning school. Other pressures such as school and familyăincluding part-time jobs, family chores and schoolwork add stresses and constraints to a teenageręs sleep schedule. In addition, teenagers are liable to give in to peer pressure and make poor decisions such as staying out late at night, smoking, drinking alcohol, and using drugsăall of which could disrupt sleep. Parents should be aware of the signs for sleep deprivation: such as, consistently has trouble waking up in the morning, is irritable in the afternoon, and is falling asleep easily during the day or is sleeping extra long periods on the weekends. Other signs may include trouble concentrating, mood swings, hyperactivity or aggressive behavior. You should remind your teen that he or she should never drive when feeling tired and make sure they have an alternative way of getting home if they are too tired.

There are other disorders of sleeping and waking that can lead to a lower quality of life and reduce a personęs health. Sleep disorders can include problems falling asleep or staying asleep, difficulties staying awake or staying with a regular sleeping cycle, excessive sleepiness or sleep apnea.

SIGNS OF DROWSY DRIVING

• You canęt remember driving the last few miles.
• You drift from your lane or hit the rumble strip.
• Your attention is weakened and your thoughts wander.
• You find yourself yawning frequently.
• You are unable to focus or keep your eyes open.
• You tailgate or miss traffic signs.
• You catch yourself nodding off and have trouble keeping your head up.

• Maintain a regular wake time even on days off work and on weekends.
• Try to go to bed only when you are drowsy.
• If you are not drowsy and are unable to fall asleep for about 20 minutes, leave your bedroom and engage in a quiet activity elsewhere. Do not permit yourself to fall asleep outside the bedroom. Return to bed when, and only when, you are sleepy. Repeat this process as often as necessary throughout the night.
• Use your bedroom only for sleep and sex.
• Avoid napping during the daytime. If you nap, try to do so at the same time every day and for no more than one hour. Mid-afternoon (no later than 3:00 p.m.) is best for most people.
• Establish relaxing pre-sleep rituals such as a warm bath, light bedtime snack, or ten minutes of reading.
• Exercise regularly. Confine vigorous exercise to early hours, at least six hours before bedtime, and do mild exercise at least four hours prior to bedtime.
• Keep a regular schedule. Regular times for meals, medications, chores, and other activities help keep the inner clock running smoothly.
• While a light snack before bedtime can help promote sound sleep, avoid large meals.
• Avoid ingestion of caffeine within six hours of bedtime.
• Donęt drink alcohol when sleepy. Even a small dose of alcohol can have a potent effect when combined with tiredness.
• Avoid the use of nicotine close to bedtime or during the night.
• Sleeping pills should be used only conservatively.
• Do not drink alcohol while taking sleeping pills or other medications.

References: American Academy of Sleep Medicine: www.aasmnet.org ; National Sleep Foundation : www.sleepfoundation.org

For more information, call Eau Claire Medical Clinic Ž 715.839.9280