FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

AN HOUR'S LESS SLEEP REDUCES ALERTNESS AS MUCH AS TWO BEERS

Question: I can't seem to get enough sleep because of the demands of work and family. Obviously, I'm tired at times, but I could get even more done if I didn't need to waste so much time with sleep. Do you have any suggestions on balancing sleep, work and family, or as an alternative, would you lengthen the day?

Answer: I've had a number of people express the view that it would be wonderful if they could use that "wasted" one third of their life spent in sleep to do something productive. Sleep is an important but mysterious portion of our lives. To characterize it as non-productive or "wasted," however, reflects our general lack of understanding of the sleep process. Perhaps this common view comes about because sleep -- like food or exercise -- can be neglected for a short period to accomplish some immediate gain. We know, however, that lack of adequate food and exercise over a period of time leads to illness.

The generally accepted view is that we adults need about eight hours of sleep every night. Unfortunately, since the dawn of the industrial revolution the sleep/wake cycle has been set by someone else rather than by our individual biologic needs. The demands of life today make it difficult for most of us to consistently get seven or seven and one-half hours of sleep. As a basis for comparison, in the last century before the widespread use of electric lights, most of our ancestors got about nine hours of sleep each night.

So what do we gain in compensation for the sleep we've lost when compared to our ancestors 100 years ago? Obviously, we gain an hour or more of awake activity. That time can be spent completing that report for work, cleaning the house, helping the kids with homework or spending quality time with family or friends. My personal view is that too much of it is wasted watching TV, but that is another story!

The cost of this lost sleep is difficult to tally. Inadequate sleep produces a number of subtle changes. It tends to make most people more irritable, although most don't recognize their lack of sleep as being the cause of their mood. Instead, it is easier to point to the stressful events of the day -- the boss, the spouse, the kids, the teacher, etc. Lack of sleep also has a negative influence on concentration. Sleeping just 30 minutes less than you need can adversely impact your learning and problem solving. This translates into decreased productivity at work or school. Shortening your night's sleep by one hour can produce as much impairment as drinking two alcoholic drinks. The consequences of this should be clear without additional explanations.

A simple clue to your sleep needs can be found from your answers to the following questions. Do you "crash" for 10 or 12 hours on the weekend or on vacation? Do you have sleepy spells during the day? Do you need an alarm clock to get you up in the morning? Do you find it difficult to concentrate on the task at hand? If you answered "yes" to any of these questions, then you probably aren't getting adequate sleep at night. I can't increase the number of hours in your day, but I think you will be pleasantly surprised at the changes getting more sleep can bring. The increased vigor and ability to concentrate that accompanies being well rested usually more than compensates for the additional minutes of sleep it takes to produce this state. The first thing I'd suggest you do is get that extra sleep on the weekend, then head to your library or book store for a copy of "The Promise of Sleep" by William C. Dement, M.D., Ph.D. Though Dr. Dement is a noted scholar in the field of sleep research, I think you will find his book quite readable and informative.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.