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Paying the Price of a Poor Night's Sleep

Posted Aug 24 2008 1:49pm
ANNOUNCER: Everyone wants to get a good night's sleep, but it turns out that can mean different things for each of us.

SAUL ROTHENBERG, PhD: Just like there are short people in the population, there are people who can get by with less than six hours. And just like there are tall people in the population, there are people who actually need-in order to be refreshed and alert-more than nine hours. So the middle is between six and nine and we assume that that's what most people need.

MICHAEL THORPY, MD: The sleep requirement reduces a little bit as we go into adulthood. And most adults need about the seven-and-a-half hours or eight hours of sleep. Maybe a little bit less in the elderly.

ANNOUNCER: And while sleep needs vary, the one constant is we all need that rest.

RAFAEL PELAYO, MD: Nobody really knows why we sleep. We can talk about how we sleep, but we know there's a reason that we sleep, but it's not really quite clear. The simplest thing is that sleep restores our body, restores our minds, it helps us think better.

ANNOUNCER: Experts feel that even while sleeping, the body is actually carrying on some important functions.

SAUL ROTHENBERG, PhD: Sleep is actually an elaborate, active physiological state. It's not a passive activity; your brain has mechanisms that drive you to sleep. At least one of the things that takes place during sleep is an active housecleaning by your immune system at the beginning of the night. And then the immune system has to be turned off at the end of the night to prevent the immune system from becoming too active.

ANNOUNCER: Without that rest, a host of problems can occur.

MICHAEL THORPY, MD: We're starting to learn about how it affects our metabolism, for example. We know it disrupts normal patterns of hormones and biochemical changes in the body. So sleep has an important role in regulating our body chemistry, keeping us alert during the day.

RAFAEL PELAYO, MD: The first thing that'll happen if you don't get enough sleep is that you'll have some problems with your memory. Usually word-finding difficulties, you can't get out the words exactly that you want to get. People get more irritable. People have trouble concentrating.

If somebody in the family does not sleep, it affects the entire family. When one person doesn't sleep well-and say it is the mother, for example-the children tiptoe around the house not to disturb the mother. She may feel bad, because she doesn't want to disturb the family. The family can maybe not make plans for the next day. They'll say, "Well, let's see how I sleep and then we decide." And the more they try to make the problem better, the worse it gets, the more frustration the family feels.

ANNOUNCER: Staying on top of the job can also be tough for people with sleep difficulties.

RAFAEL PELAYO, MD: We now think that the cost to society of sleep disorders is approximately $90 billion. That includes lost productivity, absenteeism at work, people getting into accidents-all these things have an impact and a cost to them.

ANNOUNCER: And while getting one restful night can feel refreshing, it doesn't make up for hours of lost sleep.

SAUL ROTHENBERG, PhD: One of the interesting things that we've learned about sleep deprivation is that it accumulates. So if a person needs seven hours of sleep a night, but only gets six, by the end of a normal workweek, having gotten one less hour of sleep per day, they would need five more hours of sleep on the weekend to catch up for the sleep deprivation that they missed during the week.

ANNOUNCER: Experts say changing bedtime behaviors can help.

MICHAEL THORPY, MD: One of the most important ones is controlling the time of going to bed and the time of getting up. But there are others, such as avoiding caffeine, avoiding smoking, not having a large meal before going to bed, exercising in the early evening, not late at night. Not napping during the daytime. Avoiding caffeinated products during the day, preferably. In the more serious and more difficult sleep problems, patients may then need to take medications.

ANNOUNCER: Improvements in prescription medications have minimized many unwanted side effects.

MICHAEL THORPY, MD: We initially started with the barbiturates, but they had a lot of problems with them and they had a lot of bad effects upon sleep stages and also they tended to be addictive. Then we moved to a new class called the benzodiazepines. These had some habit forming activities and tended to suppress sleep stages.

Even though people felt they were sleeping with the pills, their sleep was very different. Fortunately, the newer sleep medications don't do that. And what they do is they allow the normal stages of sleep to occur And what they tend to do is just reduce the awakenings that occur during sleep at night.

RAFAEL PELAYO, MD: The point is for you to fall asleep easily, sleep through the night, wake up refreshed, full of energy.

ANNOUNCER: Whatever the strategy experts agree that lack of sleep is a problem that has an answer.

MICHAEL THORPY, MD: I think it's important for patients to realize that no matter what type of sleep problem they have, they can always be helped. There is always something that can be done.

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