The Lost Art of Sleeping

It's become something of a national epidemic. We're tired. We're dead tired. In a study published in a 1994 issue of the Annals of Internal Medicine, 25 percent of those polled reported feeling fatigued on a regular basis. Lack of energy is now one of the five complaints most frequently heard by physicians, according to Newsweek. The lifestyle of the typical American has accelerated steadily since the turn of the century, and we're paying the price. Two-career families are typical. Even kids have as tight a schedule as their parents (and may have a job, too). The pressures of jobs, extracurricular activities, and families can become overwhelming. Overtime hours are at an all-time high, according to the Labor Department, with work weeks ranging from 50 to 70 hours common. Often, when the schedule gets tight, the easiest thing to postpone is bedtime. Even when their heads are firmly planted on their pillows, many find themselves counting sheep instead of snoozing. In fact, according to the National Commission on Sleep Disorders, adults today get 20 percent less sleep than was typical when our grand-parents were young. Pop stars collapse on stage, public figures like Harvard president Neil Rudenstine and NBA coach Don Nelson succumb to exhaustion, and the world takes notice. But exhaustion has become pervasive, affecting white-collar and blue-collar alike. It is very much a cultural phenomenon, akin, when taken to extremes, to the Japanese "karoshi", or death from overwork, to which 30,000 Japanese men fall victim each year. The American state of perpetual busyness can be traced back to our Puritans, who prized the work ethic above almost all else -- and abolished most of the English holidays, leaving only Sundays as a day of rest. The Industrial Revolution etched the Puritan work ethic into corporate stone -- although unions fought to keep at least one day off for workers, and to limit the shift to an eight-hour day. (For a little perspective, compare the standard American one- or two-week vacation to the six to eight weeks most Western Europeans receive.) The corporate down-sizing of the '90s has instilled every worker with the fear that if he doesn't work a little harder than the next guy, he may end up on the unemployment line. The end result is a culture that lives on the edge, cramming more into every day than there's room for, and cutting back on sleep to make it all fit. The revolution in information technology has brought fax machines, PCs, cellular phones, E-mail, and beepers into many American households, making it easier to work almost 24 hours a day. Domestic services -- maids, personal shoppers, and companies that pick up your dry cleaning or ferry your children to soccer practice -- are thriving. And the Institute of Circadian Physiology, in Cambridge, Massachusetts, offers the ultimate service to busy executives and CEO wanna-bes -- training in how to survive on just several short naps. But can body and soul really thrive on just catnaps? Research would seem to say no. Most people seem to require between six and nine hours per night, with 7.5 hours the average. In one of many such studies, K. Opstadin reported in a 1994 issue of the European Journal of Endocrinology that total sleep deprivation (of several days' duration, in a military training exercise) resulted in irritability, blurred vision, slurred speech, memory lapses, and confusion. There are physiological repercussions as well. In a 1994 issue of the Journal of Clinical Investigation, Dave Dinges showed that short periods of sleep deprivation affect some specific indicators of immune-system competence, with the long-term outcome likely to be more serious. L.A. Toth, in a 1995 issue of Advances in Neuroimmunology, reports animal studies which indicate that sleep deprivation can, in fact, lead to an increase in the incidence of infectious disease. Sleep loss, often associated with stress in general, is also implicated in heart disease and stomach problems. And rodent studies have demonstrated that when rats are deprived of sleep indefinitely, they eventually die from lack of sleep. Why is sleep so vital to us? Generally, sleep occurs in two different forms. REM sleep (commonly known as dream sleep) is characterized by rapid eye movements, intense brain activity, and considerable physiological activity and body movement. Non-REM sleep (NREM) occurs in four stages, with brain activity decreasing and muscle relaxation increasing as the stages progress; stage 4 sleep consists of deep sleep, when an individual is very difficult to arouse. A sleep cycle typically consists of 90-minute NREM periods (in which stage 1 sleep deepens into stage 4 NREM sleep, then decreases to stage 1 NREM sleep again) followed by about 15 minutes of REM sleep. This cycle repeats itself regularly if an individual sleeps a normal amount of time. If the individual's sleep is disrupted several nights in a row, however, periods in REM and stage 4 NREM sleep are greatly increased when he or she is finally allowed to sleep undisturbed. These two are the restorative periods of sleep, in which sleep's actual functions are performed. Scientists have deduced that stage 4 NREM is the period in which the body physiologically rejuvenates itself: blood cells are replenished, tissue repaired, immune-system factors produced. Growth factors are released, organs are repaired, and new bone is laid down. REM sleep seems to help the brain restore itself -- mental acuity, disposition, and memory are all affected when REM sleep is repeatedly disturbed. M. Wilson, in a study published in a 1994 issue of Science, recorded the brain waves of rats as they learned their way through a maze, and then recorded the brain waves of the animals as they slept. The animals' brains displayed identical firing patterns to those exhibited while learning the maze, except that the firing was much more rapid -- in essence, the animals appeared to be replaying the tape over and over to lay down the memory onto the brain's circuitry. In a human experiment, reported by A. Karni in a 1994 issue of Science, retention of material learned was significantly decreased when REM sleep was disrupted after a training session. When dream sleep is deficient, people feel like they're living in a mental fog. Writer Ellen Szalinski describes how exhaustion forced her to drop one of her college courses. Unfortunately, she was so tired -- and her memory so clouded -- that she forgot, and continued to attend. For people living in a perpetual state of fatigue, there are several organic causes of fatigue that may need to be ruled out. Thyroid problems, anemia, diabetes, chronic-fatigue syndrome, and depression can all cause one to feel drained, lifeless, and devoid of energy for long periods. But those who get a clean bill of health from their doctors -- and chronically get less than six or seven hours of sleep -- may have to change their lifestyle. Make sleep a priority, and try to keep a fairly regular schedule. If you end up missing some sleep, try to get more the next night or on the weekend -- it probably won't help you feel much better in the short term, but it will help you avoid building up a long-term sleep debt. What if you're one of those people who faithfully climbs in bed on schedule, only to find that slumber eludes you? (The National Sleep Foundation estimates that one in three of us fall into this category.) The following tips may help you spend less time staring at the ceiling: * Exercise promotes the release of body chemicals that aid in stress management and relaxation, helping the insomniac fall asleep. But avoid vigorous exercise for an hour or two before bedtime. * Avoid caffeine, nicotine, and alcohol in the evening. * Make sure your environment is conducive to sound sleep. Keep it dark and quiet, wear comfortable nightclothes, and consider investing in a new bed if yours is too soft or too hard. If you share your bed with a sleeping partner who snores, steals the covers, or tosses and turns, sleep separately until you establish a good sleeping pattern. * Don't go to bed stuffed or starved. Either extreme will contribute to wakefulness. * Avoid using the bedroom to read or watch TV. Establish an association between the bedroom and sleep. * Take some time to wind down before going to bed. * Use sleep aids and sedatives sparingly, and only as a last resort. Sedatives alter the normal sleep cycle, and dream-sleep periods may decrease. If they're used repeatedly, one can wake up feeling tired even after "sleeping" the whole night. * What about taking melatonin? While it's being hailed as a miracle remedy for sleep problems, researchers are unsure regarding proper dosages and long-term effects, and it may actually causeinsomnia in some people. Talk to your doctor. Still can't get to sleep? Get up for a while. Read a light novel, listen to some music, eat a bowl of pasta, and drink some warm milk. (Carbohydrates and tryptophan, an amino acid in the milk, both help to induce sleep.) Take a warm bath. When you feel ready, try again. Stay relaxed. And sweet dreams.