Social Conditions Associated With Poor Sleep

America suffering from an epidemic of sleeplessness; National Center on Sleep Disorders Research, estimates that there are as many as 70 million problem sleepers in the United States.  According to one estimate, sleeplessness costs $15.9 billion a year in health care costs alone.
National Sleep Foundations 2005 Sleep in America poll shows that sleep-related issues are affecting the lives of most adults in America; they are affected at home, at work, on the road, and in their social relations. The sleep problems are widespread and costly.  According to NSFs poll finds 75% of adults frequently have a symptom of a sleep problem such as waking a lot during the night, or snoring.  Although they say they have these symptoms, most ignore them and few think they actually have a sleep problem.  

Quality sleep is missing for many adults.  Poor sleepers are more likely than good sleepers to say that their intimate relationships are affected because they are too sleepy.  Sleep problems are prevalent among these poor sleepers; 88% say they experience at least one symptom of insomnia and/or a sleep disorder (94%) at least a few nights a week. Additionally, poor sleepers are less likely to exercise, engage in leisure activities and eat healthy.

The 2005 Sleep in America poll shows that sleep is the great American divide.  Half of the country sleeps pretty well  the other half has problems. The data provides a compelling snapshot of how our lives are dramatically affected by the way we sleep. People who sleep well, in general, are happier and healthier. But when sleep is poor or inadequate, people feel tired or fatigued, their social and intimate relationships suffer, work productivity is negatively affected, and they make our roads more dangerous by driving while sleepy and are less alert.  This poll shows the sleepiness our society has serious consequences, and Americans poor sleep is creating a public health and safety crisis in need of immediate attention," says Richard L. Gelula, NSFs chief executive officer.

Accidents are another serious consequence of the insomnia epidemic. The National Highway Traffic Safety Administration (NHTSA) attributes over 100,000 automobile crashes per year to drowsy drivers, with 1,500 fatalities, 71,000 injuries, and a monetary cost of $12.5 billion.

A British study revealed that drivers who report moderate to severe daytime sleepiness (20 % drivers) are twice as likely to have been involved in a crash as other drivers. Yet 37 % of respondents to an NHTSA poll said they have fallen asleep behind the wheel, 8 % having done so in the last six months. But accidents don't occur only on the road.  Bhopal, Chernobyl, and Exxon Valdez - the sleep deprived workers were implicated in each of these industrial disasters. 

Our doctors, our police, our pilots, and our military personnel, all those charged with protecting our lives, are just as likely as the rest of us, perhaps more so, to suffer insomnia and sleep deprivation.  Sleep deprivation wreaks havoc with our physical, cognitive, and intellectual abilities. In fact, sleep deprivation found a general reduction in overall response speed, a decrease in the speed of the fastest responses, and an increase in "lapsing"-delays in responding to stimuli-which in turn produced further decreases in response speed. 
 Many pilots, policemen, and doctors admit to making errors in sleep-deprived states of consciousness Mark Rosekind, a consultant for industrial sleep hygiene says. According to his findings, cited in Business Week, 19 % of health care workers report worsening a patient's condition because of fatigue; 44 % of law enforcement officers report taking unnecessary risks while tired; and 80 % of U.S. regional pilots say they've fallen asleep in the cockpit.

Medical Conditions Associated With Poor Sleep

Many adults say they are often tired and fatigued.  They are not satisfied with the quality of their sleep, but most dont take steps to improve it. Some adults are able to say on most nights, "I had a good nights sleep."  One-half of those polled report feeling tired, fatigued or not up to par during their wake hours at least one day a week; 1 out of 5 says this happens every day or almost every day!  However, more people now say they are sleeping less than 6 hours on weekdays and weekends and this affects their function the next day.  
TSA poll shows a relationship between sleep and health. Adults diagnosed with at least one common medical condition (among them high blood pressure, arthritis, heartburn/GERD or depression) are less likely to say they frequently get a good nights sleep and are nearly twice as likely to experience frequent daytime sleepiness than those who dont have the conditions. 

Sleep-challenged people are irritable, inattentive, and accident prone. They are more likely to suffer depression, heart disease, or stroke than their well-rested peers.  A 1999 study reported in the journal Sleep notes that insomniacs suffer impaired concentration, impaired memory, a decreased ability to accomplish daily tasks, a decreased ability to enjoy interpersonal relationships, and an increased use of health care services. The Archives of Internal Medicine notes that insomnia sufferers are more likely to develop affective disorders, heart disease, and other adverse health outcomes. Another study indicates "Insomnia is predictive of cardiovascular and non-cardiovascular disease."

Numerous studies associate insomnia with reduction in immune function. Sleep deprivation evokes not only decreased function of the immune system, most clearly visible on the morning following the sleepless night, but also deterioration of both mood and ability to work, which were most prominent the following evening. 

NSFs new poll also confirms an epidemic of obesity in America.  Based on body mass index (BMI) measures, the poll finds: 

Nearly 64 %of respondents are overweight or obese, conditions that clearly impact sleep.

Those considered obese are more likely to get less than 6 hours of sleep on weeknights and frequently have daytime sleepiness.

Obese people are nearly 6 times as likely to be at risk for sleep apnea 

In conclusion, sleep is unquestionably the most effective stress-reduction technique we will ever know. The demands of daily life can overcharge the complex of the autonomic nervous system, triggering the mechanism that raises the mind and the body into a response to stress and keeping it there for prolonged periods. Sleep, effectively rebalances the system, giving the parasympathetic branch, which governs our ability to "rest and digest," a chance to assert itself. In this way sleep moderates the effects of stress and switches the body into self-healing mode.

Resource.:re information visit NSFs newly redesigned Web site, www.sleepfoundation.org for a Summary of Findings of the 2005 Sleep in America poll along with other sleep-related information and useful assessment tools.  
Why America Can't Sleep-Excerpted from The Insomnia Solution: The Natural, Drug-Free Way to a Good Night's Sleep
By Michael Krugman, MA, GCFP

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