Recent news reports of a study of sleep duration in geographically isolated societies in Africa and South America suggest that Americans are actually getting plenty of sleep because members of these tribes spend about the same amount of time asleep each night as people in modern societies. These controversial findings will be debated, but are not relevant to the widespread sleep deficit and associated health consequences in more modern societies.
Americans are sleeping less and weighing more. Science tells us this is no coincidence. Inadequate sleep can contribute to weight gain in several ways, including altering levels of the hormones that control appetite and fullness and setting off a chain reaction of poor habits that can increase the risk of weight gain and obesity. Sleep is proving to be as important to health as good nutrition and regular exercise.
America is exhausted. A recent report from the CDC says that the percentage of adults sleeping fewer than 6 hours per night has increased by 31% since 1985. This sleep deficit not only leaves people tired, irritable, and less productive, but also increases the risk for some serious health problems, including high blood pressure, heart disease, diabetes, and even earlier death. Just how much sleep we need isn’t completely clear, although according to the available data, most people should aim for 7 hours of sleep each night. Simple lifestyle changes can help people meet that goal.
Do the long hours in the hospital, often with little sleep, make doctors in training more prone to making mistakes? Over the past decade, concerns regarding trainee doctors’ sleep loss and the potential for medical errors have brought about limits on the number of consecutive hours a resident can work in the hospital. Do the same concerns apply to fully licensed surgeons? A recent study in The New England Journal of Medicine suggests that the answer is no. Comparing the data on patients whose surgeons were on call the night before with that of patients whose surgeons were not working the night before showed virtually no difference in how well the patients did after surgery. It is not clear, however, whether these doctors anticipated the effects of being on call and compensated for them, or whether these results would be the same for less-experienced surgeons-in-training.
Many people with insomnia turn to sleeping pills, which often have unwanted side effects. Few of them know about an equally effective therapy that targets the root cause of insomnia without medications. Called cognitive behavioral therapy for insomnia, or CBT-i, this short-term talk therapy teaches people to change the unproductive thinking patterns and habits that get in the way of a good night’s sleep. While this therapy can’t “cure” insomnia, it does provide tools to better manage it. In a review article in this week’s Annals of Internal Medicine, researchers found that people treated with CBT-i fell asleep almost 20 minutes faster and spent 30 fewer minutes awake during the night compared with people who didn’t undergo CBT-i. These improvements are as good as, or better than, those seen in people who take prescription sleep medications such as zolpidem (Ambien) and eszopiclone (Lunesta). And unlike medications, the effects of CBT-i last even after the therapy ends.
Worrying about a problem or a long to-do list at bedtime can be a recipe for insomnia. Mindfulness meditation — a mind-calming practice that focuses on breathing and awareness of the present moment — can help, according to a report in JAMA Internal Medicine. Mindfulness meditation involves focusing on your breathing and then bringing your mind’s attention to the present without drifting into concerns about the past or future. It helps you break the train of your everyday thoughts and relax. In addition to calling on mindfulness meditation at night to fight insomnia, it’s a good idea to practice it during the day, too, so it’s easier to evoke the relaxation response at night when you can’t sleep.
Obstructive sleep apnea is a common cause of daytime sleepiness. It occurs when the muscles in the back of the throat relax too much during sleep. This lets the tissues around the throat close in and block the airway. People with obstructive sleep apnea can wake up gasping for breath scores of times a night, usually without knowing it. Obstructive sleep apnea can boost blood pressure and increases the risk of stroke. New guidelines from the American College of Physicians recommends an overnight sleep test to diagnose, or rule out, obstructive sleep apnea for individuals with unexplained daytime sleepiness. These are usually done in a sleep center, but home tests can also be done using a portable monitor.
When it comes to memory, sleep is a Goldilocks issue: both too much and too little aren’t good. Aim for “just right,” says a new report from the Harvard-based Nurses’ Health Study. Study participants who slept five hours or fewer per night or nine hours or more did worse on tests of memory and thinking skills that those getting seven to eight hours of sleep a night. The researchers estimated that undersleepers and oversleepers were mentally two years older than the women who got seven to eight hours of shut-eye a night. Although this study couldn’t prove that getting too little or too much sleep causes memory and thinking problems, it’s in line with other work showing the potentially harmful effects of poor sleep. Previous research has linked poor sleep with higher risks of heart disease and stroke, type 2 diabetes, and depression.
Sleep apnea—pauses in breathing while sleeping followed by snoring-like gasps for breath—can cause daytime drowsiness and mental fatigue. It can also boost blood pressure and the risk for developing heart disease. A new study suggests that treating sleep apnea by using a breathing machine during sleep can make a difference for people with hard-to-treat high blood pressure. Although blood pressure medications offer a bigger bang for the buck to reduce blood pressure, treating sleep apnea can help, and offers other benefits as well. Getting used to using a breathing machine, which delivers continuous positive airway pressure (CPAP), may take some work. One key is to find a mask that works, which may be a trial-and-error process.
Daylight Saving Time officially ends at 2:00 am this Sunday. In theory, “falling back” means an extra hour of sleep this weekend. But it doesn’t usually work out that way. Many people don’t, or can’t, take advantage of this weekend’s extra hour of sleep. And the focus on gaining or losing an hour of sleep overlooks the bigger picture—the effect of Daylight Saving Time transitions on the sleep cycle. This seemingly small one-hour shift in the sleep cycle can affect sleep for up to a week. It’s difficult to side-step the effects of Daylight Saving time on sleep. So be aware that it can take your sleep rhythms a week or so to get adjusted to the new clock.