WSAZ Investigates: How lack of sleep is harming your health

HUNTINGTON, W.Va. (WSAZ) -- Those nights where you toss and turn, or just don't get enough sleep in general -- they could be doing more damage than you think. Studies are showing lack of sleep is being linked to more long-term medical issues.

Dr. William R. Beam at St. Mary's Neurophysiology Sleep Disorders Center defines sleep deprivation as insufficient sleep for an organism to function normally during its normal activity cycle.

"Our sleep needs vary with age," said Beam. "In our pre-school years we need 11 to 13 hours or so of sleep. When we start school, so 6 or 7 years old, it drops down about an hour or so. Teenagers need more sleep than adults. They really should be sleeping 8 to 10 hours. Adults typically need 7 to 9 hours of sleep per evening."

Cutting back on sleep, he says, people will not be able to function at a high level. Things like judgment, concentration, reaction time, and memory begin to decline. Lack of sleep can also impact a person's mood -- making them irritable or emotional.

Ability to do physical tasks worsens, as well.

"There are very clear studies that if we are awake for 18 hours or longer, we function as if we have a blood alcohol level of 0.05 percent which is legally impaired," said Beam. "If we are up for 24 hours, we function as if we have a blood alcohol of 0.1 percent -- legally drunk. There is a strong similarity between sleep deprivation and the effects of alcohol on the brain."

Beam says the longer you go without sleep, the more pronounced those changes are.

"If you think you're going to make a drive from here to Florida on vacation and not stop and sleep, by the time you get to Florida, you're an impaired driver," Beam said.

Biologically speaking, sleep is necessary. However, Beam feels like that is not emphasized enough.

"If we sleep deprive an organism, it will die," said Beam. "Sleep deprivation is a torture technique."

He says an observation several years ago also showed that car accidents go up during Daylight Saving Time when we spring forward and lose an hour of sleep, and go down when we fall back and gain an hour.

Recently, sleep deprivation or insufficient sleep has been linked to several medical conditions, Beam said, including hypertension, cardiovascular disease, diabetes, and obesity. He says there has even been some association between lack of sleep and the eventual development of dementia. It has also been known to affect the immune system, Beam said, which is why people can be more susceptible to illnesses when they aren't sleeping enough.

"I only need four hours of sleep or I only need five hours of sleep," Beam said. "Well maybe for one night or so you can get by with that, but you're kidding yourself if you think you're going to function at a high level."

Sleep loss has also been linked to changes in hunger and how much we eat. People who aren't getting enough sleep tend to overeat and gain weight, according to Beam.

If you aren't getting enough sleep, within a few days, you will be prone to sleep attacks and micro-sleeps (i.e. driving down the road and you miss your exit and you don't know why.)

"I do think lack of sleep is contributing to poor health in probably a large societal way because of all the different conditions," Beam said. "There are very subtle, but long-term effects of sleep deprivation and there can be some acutely crisis-provoking events with acute sleep deprivation."

That's why the first thing Beam wants people to do is simply respect their need for sleep. Some societies have siestas in the middle of the day. Beam says our brains actually have a biologic rhythm that makes us sleepy in the afternoon. He says some cultures follow that rhythm while western society de-values it.

"For optimal health, for good health, we need to respect our need to sleep," Beam said. "In my view, sleep has been de-valued in western society. We fill our time with work and family obligations and recreation and the last thing that we consider for our health is sleep, and that's a wrong-headed idea."

Our lives get busy, but Beam says if sleep is taking a back seat, you need to re-evaluate your priorities. Otherwise, you will likely harm your health down the road, he says.

"Unfortunately, the development of computer screens is having an impact on people's quality of sleep," said Beam.

The blue light from screens, he says, can disrupt that natural rhythm and disrupt sleep.

Keeping electronics out of the bedroom is critical, he says, for a good night's sleep. That means no TV, computers and keeping cell phones out of the bedroom.

We need time to wind down, Beam says. He suggests having a standardized bed time and not exercise or do anything vigorous prior to going to bed. Beam says that is counterproductive.

Taking a warm bath or shower before bedtime can be helpful. Beam says the temperature drop is a signal to the brain that it's time to sleep.

So you've made it to bed, but parents with young kids are probably familiar with interruptions during the night.

"Insufficient sleep can be from too little duration of sleep or it can be due to fragmentation of sleep," Beam said. "Sometimes these things are unavoidable: Crying babies in the middle of the night, my beeper goes off, I need to answer a phone call, but we should protect ourselves from that as much as possible."

In addition to keeping the electronics out of the bedroom, Beam says you should make the room sleep-friendly by making it cool and dark.

He has also had patients who allow pets in the bedroom and wake up with the animals. That can be another issue.

"There are a lot of things we allow to interfere with our sleep sometimes and not realize how much it does interfere," Beam said.

If you are up frequently throughout the night or even just aroused throughout the night, that deteriorates the restorative quality of sleep. Beam says that mean you can sleep for eight hours, but if you are frequently disturbed throughout the night, you may wake up feeling like you only slept four hours.

"It's not only the duration of sleep, but the type of sleep we get and whether it is fragmented," Beam said.

Sleep disorders are common, according to Beam. About 4 percent of middle-aged men and about 2 percent of middle aged women have obstructive sleep apnea. That's about as common as having asthma, Beam says.

"These are very common problems that people often believe is part of the aging process," Beam said.

One of the biggest factors that gets in the way of sleep is work. Beam says that is especially true for shift workers and professions like medicine, police, fire, EMS and truck drivers.

Beam says employers should look into techniques for rotating shifts and time off between shifts that are important to minimize the effect of shift work on their employees.

Overtime can be potentially dangerous to a person's health, Beam says.

"Employees that are at a premium, police, try not to overtempt them extra shifts," Beam said. "There is a whole body of data on sleep deprivation and how it affects police because they tend to work shift work. They tend to work extra shifts. There's pretty clear data that it affects their performance on the job."

Several years ago, the number of hours physicians in training could work was reduced, Beam said. The hope was that this would improve not only the lives of the residents, but the safety of the patients.

While this change didn't show as much improvement as medical professionals were hoping for, Beam said, there are other factors including the hand off of patient care. Would you rather be treated by a doctor who knows every little detail about you, or one who is more well-rested but isn't as fine-tuned on your medical needs and history? That, Beam says, is a quagmire for the medical field.

"It's certainly I think right-headed not to ask people to work 36 hours straight and expect them to function the same as somebody who's just had eight or nine hours of good sleep," Beam said. "That's unrealistic."

There is an apparent issue for truck drivers, as well. Traveling through the dark hours of the night and having to drive long routes under pressure to make deadlines, falling asleep at the wheel is not uncommon, Beam says.

"If an 18-wheeler has an auto accident, it's often a million-dollar event in addition to whatever human tragedy goes with it," said Beam. "Eighteen-wheeler accidents are horrible. They crush cars. They're just horrible."

He says recently some of the criteria for truck drivers have been relaxed, but there is still a risk.

Beam points out that the Exxon Valdez oil spill, Chernobyl disaster, and other incidents were in some way due to sleep deprivation.

"There are real catastrophic consequences sometimes to chronic insufficient sleep or accute sleep deprivation," Beam said. "Basically you're putting a drunk person at the wheel of an oil tanker or controlling a nuclear power plant or simply driving an 18-wheeler."

On the other hand, there are techniques the employees can use as well. Controlling when you are exposed to light can be essential. Beam says your brain naturally wants to sleep when it is dark outside. Some employees might consider wearing sunglasses to block out as much sunlight as possible when leaving an overnight shift and trying to adapt to a daytime sleep pattern. Sleep aids like melatonin may also help employees adjust to unusual sleep schedules, he says.

So how about the tricks we play to stay awake?

I will nap or sleep more tomorrow night: "If you shorten your duration of sleep and try to make up for that the next night by extending your sleep time a little bit, you will pay back a little bit of that sleep debt," said Beam. "Although it probably won't be as high quality sleep as you would have gotten otherwise. On the other hand, sometimes people, shift workers particularly, become out of rhythm and even though they're paying back some of their sleep debt, because they're doing it at a time that's not in sync with their biologic rhythms, the sleep is not really high quality."

Caffeine boost: "It can be a short-term solution to somebody who is sleep deprived as a sort of band-aid on a situation," said Beam. "A college student that has been going on six hours of sleep for three or four days and is going to take a final may want to use caffeine to help keep them alert during the test. On the other hand, becoming dependent on caffeine to function in a day-to-day basis is probably wrong-headed. The other thing is caffeine lasts a lot longer in our bodies than most people think. It can last for up to 7 or 8 hours. So when you start to use caffeine after lunch, later in the day, you really are running a risk of having difficulty initiating sleep in the evening and having sleep fragmentation for the first part of the evening because the caffeine effect may still well be in effect."



 
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