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You're getting sleepy...very, very sleepy

Back when we were still drawing on cave walls, people understood that if they laid low after nightfall, became silent and still, and brought their body temperature down, they would be much less likely to attract predators during their most vulnerable hours. And so they slept, awakening with the dawn’s early light, rested, refreshed, and still alive.

Today, sleep is less often used for concealment, but it remains paramount to the daily renewal of our mental and physical health.

Sleep is still about survival.

For some 70 million Americans, however, it’s not that simple. These are the legions for whom some kind of sleep disorder is interrupting their rest; and for 60 percent of them, it is a chronic problem.

The variety of reasons we don’t get enough sleep is staggering. In some cases, it is behavioral: we stay up too late or get up too early; we exercise or partake of other stimuli such as caffeine right before bed; we rise throughout the night to caretake the children or animals.  Sleep researchers call it “volitional chronic sleep deprivation.”  Whether or not it feels like a choice, our self-sacrificed sleep has become a lifestyle disorder.

Sometimes it has a mental basis:  we are too angry, too worried, or too excited to settle into sleep; we continue to work from our beds, planning, writing, calculating solutions; we are afraid, causing heightened listening, wide-eyed vigilance, or even nightmares.

In many cases, the problems are physical, rooted in respiratory disturbances, neurological distress, or musculoskeletal discomfort.

And for many, it is a combination of behavioral, mental, and physical factors that keeps us up at night.

The bottom line is that we are not getting enough sleep. And the consequences, both personal and social, are considerable. A recent report by the Institute of Medicine confirmed connections between sleep deprivation and increased risks for hypertension, diabetes, obesity, depression, heart attack, and stroke. That’s enough to keep anyone up at night.

Some scientists are also investigating the correlation between insufficient sleep and depressed immune systems.

“The true sleep disorders,” says American Board of Sleep Medicine diplomate Dr. Shirley Dickinson, “are more pathologic and not self-inflicted.  But without a doubt, the increased amount of stress in our society leads many to believe sleep is no longer necessary.”

Perhaps of more immediate concern than the tug-of-war between disease states and sleep deprivation are the functioning insomniacs, whose lack of sleep has them snoring their way through board meetings, making potentially dangerous mistakes or decisions on the job, and shifting their cars to autopilot on the way home from work.

What we save in sleep we just might sacrifice in safety. Internationally recognized incidents still under investigation for the role played by sleep deprivation include the Exxon Valdez oil spill and the nuclear power plant disaster in Chernobyl.

Despite the dynamic nature of recommendations about our health and well-being, sleep researchers have remained steadfast in their stance that most people require about eight hours of restful sleep to recover from the remaining 16 waking hours each day.

Yet, according to a 2005 survey conducted by the National Sleep Foundation, some 40 percent of Americans admit to fewer than seven hours of sleep per night.  People report getting a bit more sleep on weekends, but not enough to make up for sleep lost during the week. In fact, many authorities agree that, while we can lose sleep and even go into considerable debt, we can’t actually make it up.

The key, perhaps, is a return to our survival instincts where we invest in our sleep as if it were a matter of life or death.

“The true sleep disorders are more pathologic and not self-inflicted. But without a doubt, the increased amount of stress in our society leads many to believe sleep is no longer necessary.”

— Dr. Shirley Dickinson, American Board of Sleep Medicine diplomate