Sleep Deprivation

A friend shared with me recently a hospital happening that you may remember having had yourself. She was sound asleep, only to be awakened by a nurse on her rounds. Why? To give my friend a sleeping pill, of course.

Hospitals make a serious mistake in showing little regard for the benefits of sleep. The worst part of this, of course, is the custom of putting medical interns to work when they are groggy from sleep deprivation. Research has shown that the error rate of such medical staffers is far greater than that of interns who have adequate rest.

This I learned from an enlightening article written by Craig Lambert in the current Harvard Magazine. There he draws on the work of experts, most of them Boston-area  physicians, who have studied sleep and have discovered other disturbing facts about its deprivation. Sleeplessness in this country amounts to an epidemic, with consequences the public has failed to recognize.

“Lack of sleep,” Lambert summarizes, “may be related to obesity, diabetes, immune system dysfunction, and many illnesses, as well as to safety issues such as car accidents and medical errors, plus impaired job performance and productivity in many other activities.”

This bad situation, far from improving, has worsened over the last few years. Sixteen percent of Americans now sleep less than six hours on weekday nights, as contrasted with 12 percent in 1998. And only 26 percent of us get eight or more hours of sleep a night.

Americans may not be the most sleep-deprived people on earth. However, we are right down there fighting for the title. Even worse, going without sleep has come to be regarded as highly virtuous. Adults who do not leave the office until late at night are seen as models. Many college students pride themselves on their “all- nighters” before exams, ignoring evidence that this habit may damage their health and actually harm their performance on exam questions that require critical thinking.

Lambert’s article has convinced me of the dangers of getting too little sleep and the advantages of adding more. I have now resolved to increase my nightly ration by another hour, bringing my total number to eight. My hope is for this experiment to relieve some of the fatigue I experience during the day.

My primary care physician wants me to go further. She urges me to take a sleep test, but thus far I am resisting. The prospect of sleeping overnight in a laboratory setting with electrodes attached to my body intimidates me. But, if my current experiment fails, it may come to that.

The older I get, the more I value a good night’s sleep. Shakespeare’s words in Act II of Macbeth often echo in my mind: “Sleep that knits up the ravell’d sleeve of care / The death of each day’s life, sore labour’s bath, / Balm of hurt minds, great nature’s second course, / Chief nourisher in life’s feast.”

The great Elizabethan expressed poetically something of what modern researchers say scientifically. Sleep is not a waste of time; rather it brings us into a therapeutic process. While we are becoming refreshed, our brain is also at work processing information.    

Many studies suggest the folly of trying to get along without sleep. Lambert quotes a Detroit-based researcher who says: “The percentage of the population who need less than five hours of sleep per night, rounded to a whole number, is zero.”

Yet, our culture and our economy both support habits that research shows to be counterproductive and harmful. No matter what the findings of science, hospitals continue to show little regard for the healing powers of sleep. Why do institutions that profess healing as their main purpose place so little value on the therapeutic effects of a good night’s sleep?

During two short hospitalizations this spring, I rediscovered the setting to be sleep aversive. Despite signs on the walls urging staffers to limit noise in the corridors, there was a constant din of chatter coming from areas near the nursing station. Attendants talk loudly at all hours of the night, making it almost impossible for patients to sleep. And, yes, they do wake people for routine procedures that could be done at other times.

“Sleep deprivation doesn’t have any good side effects,” says another Boston researcher.  By contrast, sleeping well promotes good health and may even extend our life span.

The habit of sleeping well, however, requires discipline. Respecting our daily cycles of light and dark counts as part of it. So does sensitivity toward our established patterns of successful sleep. In later life, especially, the opportunity for sustained sleep must be seized if we are to maintain the habit. Research suggests that such opportunities may become narrower the older we get.

Presuming you are with me at this point, I wish you success with your efforts to sleep well. With the zeal of a recent convert, I have a new vision of the world and the gift of sleep looms large in it.

Richard Griffin