America: Land of the Sleep-Starved

Effective therapies exist to treat insomnia, experts say

SUNDAY, July 17, 2005 (HealthDay News) -- Millions of Americans are getting fewer than the recommended seven to nine hours of sleep they need each night, causing irritable behavior, concentration problems and daytime drowsiness.

In fact, a recent poll by the National Sleep Foundation found 54 percent of Americans experience at least one symptom of insomnia a few nights a week or more. More than a third of the 1,500 adults surveyed said they wake up feeling unrefreshed. Thirty-two percent reported waking up a lot during the night.

What's causing the nation to lose so much sleep?

"The simple answer is, it's physiological," said Dr. William C. Dement, professor of psychiatry and sleep medicine at Stanford University in Palo Alto, Calif., and director of the Stanford Sleep Disorders Clinic.

People's sleep-deprived condition is mostly voluntary and imposed by the environment, he explained. In other words, people are staying up too late doing things they like to do and working incredible hours to meet the demands of necessities like school or work.

Beyond causing sluggishness during the day, insufficient sleep can have serious health and safety consequences, the sleep foundation poll indicates. One in four is at risk for sleep apnea, a disorder associated with hypertension and stroke, the poll found. Sixty percent of adults licensed to drive reported feeling drowsy over the past year, and 4 percent have had an accident or near-miss on the road because of drowsiness behind the wheel.

"Yes, the statistics are stunning and getting worse," agreed Dement, who has lobbied Congress to establish a sleep education institute whose focus would be to create a "sleep-aware" society. People are largely unaware of their individual sleep requirements and the toll that lack of sleep exacts on their lives, he explained.

But could reports of a sleepless America be overblown?

"I'm not sure we are so sleepy," said Michael Perlis, associate professor of psychiatry and psychology at the University of Rochester in New York, and director of the university's Sleep Research Laboratory and Behavioral Sleep Medicine Service. "This is bandied around a lot in the absence of good data," he asserted.

Occasional bouts of acute insomnia actually can be a blessing, Perlis insisted, particularly for people who have a ton of stuff to do. "Don't sweat it; it's a gift of time," he said.

It's when sleeplessness becomes chronic that it becomes a curse, he added. Anyone who experiences insomnia three or more days a week for more than two to four weeks should see his or her doctor. Not only can it be a problem in itself, but it also can be a risk factor for other illnesses.

"If you have chronic insomnia, you are at between three and 12 times increased risk of new onset or recurrent depression," Perlis added.

Fortunately, there are some very good and safe sleep aids available. One of them, Sepracor Inc.'s Lunesta, is the first on the market without a seven- to 10-day use restriction, meaning physicians may prescribe it for longer-term use. The only immediate problem with Lunesta is that it was cleared by the FDA for marketing early this year and may not yet be available throughout the United States.

Cognitive behavior therapy for insomnia, a type of intervention that teaches patients to modify their sleep behavior, also works extremely well, studies show. At the moment, only a handful of sleep centers have trained specialists who can offer this service, but the American Academy of Sleep Medicine is working hard to get more clinicians certified, Perlis noted.

In the meantime, if you're having difficulty going to sleep or staying asleep, Perlis has this advice:

  • Don't go to bed earlier, don't sleep in and don't nap. While it might sound counterintuitive, the goal is to reestablish a normal sleeping pattern. Think of it this way: if you snack all day before a banquet, you're not going to be hungry when dinner arrives. If you nap, you won't be sleepy at bedtime.
  • Don't drink yourself to sleep. People who use alcohol as a sedative often find themselves waking up at 3 or 4 a.m. It's not an effective sleep aid.
  • When you can't sleep, leave the bedroom. Spend your wakeful time somewhere. You don't want your body to automatically associate the bedroom with feelings of dread and anxiety that come with insomnia.

More information

The National Sleep Foundation can tell you more about insomnia.

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