April 19, 2014
   
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Something to Lose Sleep Over — Sleep Loss and Your Health
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Something to Lose Sleep Over — Sleep Loss and Your Health

 
Professor of Medicine, University of Chicago School of Medicine, Chicago, IL.


Few of us take it seriously. Many of us even brag about not getting enough. We are talking about sleep.

Sleep — or the lack of it — is not usually thought of as an important health issue, but it certainly can be when we do not get enough for long enough. The occasional all-nighter is no big deal, but long-term sleep loss can cause or contribute to a wide range of physical and psychological problems, which is why sleep deprivation is used as an interrogation tool and has been a topic in recent policy debate in the United States over the definition of torture.

Adequate sleep has long been considered to be important for the brain but not for the rest of the body. Now, there is growing evidence that sleep loss or poor quality sleep may increase the risk of obesity and diabetes, as well as compromising the immune system.

Sleep Loss and Modern Times
Modern society often views sleep loss as harmless or even as a sign that someone is hard-working and efficient. The increasing demands of many jobs and our around-the-clock access to leisure and work have also shortened sleep times. In industrialized societies, roughly 20% of the work force is engaged in shift and other work schedules that tend to lead to substantial sleep loss. People lose sleep for a variety of reasons. Sleep loss can occur simply because we choose to go to bed late and get up early, or because of a physical or psychological problem. Whatever the cause, sleep loss is increasingly common in modern society.

Now, there is growing evidence that sleep loss or poor quality sleep may increase the risk of obesity and diabetes, as well as compromising the immune system.

This did not happen overnight. In 1960 the average person got 8.0-8.9 hours of sleep per night.(1) By 2002 the average American slept 6.9-7.0 hours.(2)(3) In 2004, more than 30% of adult men and women between the ages of 30 and 64 years reported sleeping fewer than 6 hours per night.(4) And a recent study evaluating sleep duration using an electronic device rather than self-reporting found the average to be 6.1 hours.(5)

Children and adolescents are no exception; and for them, the stakes are higher. Adolescents need for sleep has been estimated to be around 9 hours. But they only get about 6.9 hours a night as 12th graders, decreasing steadily from 8.4 hours as 6th graders.(6) A surprising 28% of high school students admitted falling asleep at school at least once a week.

The effects of all this sleep loss may be far more serious than simply being tired. The dramatic increase in obesity and diabetes has occurred at the same time as this decrease in sleep. The two trends mirror each other over the second half of the 20th century.(7) Is one causing the other? It is too soon to say, but the association between the two phenomena is undeniable.

Sometimes, chronic sleep loss is a known symptom of a number of conditions, including insomnia and obstructive sleep apnea (OSA) in which people stop breathing repeatedly during their sleep, often for a minute or longer and up to hundreds of times during a single night. Insomnia becomes more common with age. Today, with the aging of the U.S. population, chronic insomnia is estimated to affect 10-15% of the public population.(8) In middle-aged adults, OSA affects about 24% of men and 9% of women.(9) Data from the 2005 Sleep in America poll by the National Sleep Foundation indicate that as many as one in four adults, and more than 50% of obese adults, are at high risk for OSA. While OSA causes sleep fragmentation, respiratory disturbances and hypoxic stress (low levels of oxygen in the body) along with sleep loss per se, reduced total sleep time is a common symptom.

Taken together, sleep loss, either behavioral or disease-related, affects millions of individuals in our modern society. Recent laboratory and epidemiologic studies indicate that sleep loss may damage your health. These studies have focused on sleep deprivation's role in:
  • blood glucose levels and diabetes risk
  • appetite regulation and obesity risk
  • immune function.
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