America is chronically sleep deprived and Dr. Charles Czeisler wants to do something about it.
According to Czeisler, head of the Division of Sleep Medicine at Harvard Medical School, sleep is the third pillar of health, along with exercise and eating well.
But the public hasn’t yet gotten the message that adequate sleep is essential to good health.
“We are at the same place that the impact of smoking was on health 50 years ago,” he said, “when finally there was enough evidence that the surgeon general issued a report indicating that smoking was hazardous to people’s health.”
As happened with smoking, Czeisler believes we need a public-awareness campaign to educate people about the proven dangers of short-changing their sleep. Among them:
- Increased risk of heart disease, high blood pressure, diabetes, metabolic syndrome, and some cancers “The evidence suggests that functions of sleep touch nearly every system in the body,” said Michael Grandner, an instructor in psychiatry and a member of the Center for Sleep at the University of Pennsylvania. Studies have shown that short sleep can raise blood pressure and impair how people regulate blood sugar.
- Immune health People who sleep less than seven hours a night are about three times more likely to develop cold symptoms, researchers have found. And a lack of sleep could make vaccines less effective.
- Maintaining a healthy weight Obesity has been linked to lack of sleep, and when you diet while exhausted, your body burns muscle, not the fat you want to lose. This link between obesity and health appears highest among young adults, Grandner said. Lack of sleep can also alter hormone levels associated with appetite.
- Mental health Many people with mental health and mood disorders also have insomnia. Adding insomnia therapy to depression treatment doubles the chance of recovery, according to a new report from Ryerson University in Toronto. “For good mental health, sleep is important,” said Colleen Carney, director of the sleep and depression lab and associate professor at Ryerson.
- Longevity One 2010 study showed that men who slept fewer than six hours per night were more likely to die prematurely.
In addition to correlations to disease, lack of sleep can affect performance as well:
- Learning and memory consolidation Research shows that a good night’s sleep after learning something will help you better retain the information.
- Athletic performance Stanford University basketball players sprinted faster and increased their 3-point shooting record by 9 percent when they stayed in bed for at least 10 hours a night during a research study.
- Public safety Driving while exhausted is nearly as dangerous as driving drunk. “The more hours awake you are, the more impaired you are,” said Russell Sanna, executive director of Harvard’s Division of Sleep Medicine.
Without adequate sleep, Sanna said, “you get sick, fat, and stupid.”
Czeisler, Sanna, and their colleagues have begun developing plans for a campaign to inform the public about the importance of getting enough sleep. While they like to compare their efforts to the anti-smoking campaign, they acknowledge some key differences.
Spreading the message about the importance of sleep is more complicated because not everyone needs the same amount. You may be perfectly fine with seven hours in bed, while your spouse needs a full eight. And while it’s clearly unhealthy to consistently sleep fewer than six hours or more than nine hours a night, there hasn’t been much research on the consequences of getting more than six hours but less than your particular body requires, Grandner said.
The anti-smoking campaign also had an obvious enemy — the cigarette companies — while there is no single entity keeping us from sleep. We usually put off sleep because of responsibilities at work, school, and home. Focusing on long-term health fades in the face of so many short-term competing interests, Grandner said.
But there are also some parallels between a pro-sleep and an anti-smoking campaign.
As with smoking, the decision to get less sleep isn’t entirely a personal one; society also conspires against us getting a good night’s rest. Employers expect workers to be responsive at all hours, the light from TVs and electronic devices can mess up our circadian rhythms, and work and school schedules are often out of synch with our body’s internal clock.
As with smoking, there are many corporations that benefit from sleeplessness, he said. While we’re sleeping, we can’t be shopping or working. And what would happen to sales of coffee, energy drinks, and sleeping pills if we all suddenly started getting adequate sleep?
“Our consumption-oriented economy profits more when people are awake longer,” Czeisler said.
Tackling a problem this entrenched and complicated will require participation from many levels of society, said Gary Stockman, former president of the public relations agency Porter Novelli, who is advising the Division of Sleep Medicine’s effort as a member of its executive council.
Many smokers were forced to quit when their employers stopped letting them smoke on the job or on the worksite. That’s why the Harvard campaign will be directed first at businesses, with the message that a sleep-deprived employee is a less effective one.
Research has shown that people who are sleep deprived make mistakes more often, can’t solve problems as well, and aren’t as creative.
“We showed 30 years ago that we could substantially increase productivity by ensuring that employees got the rest they needed,” Czeisler said.
Tired employees are also more likely to participate in “cyberloafing” — watching cute cat videos instead of working, said Christopher M. Barnes, an assistant professor of management at the University of Washington, and a leader in research connecting sleep loss and work performance. Workplace injuries rise more than 5 percent the day after the start of daylight savings time, he found in another study, confirming that even a little change in sleep can have a big impact.
Barnes has also shown that sleep-deprived workers are less ethical. Though he can’t prove that the financial scandals that helped trigger the last recession were tied to lost sleep, the crazy work schedules typical of the financial industry make such nefarious activities more likely, he said.
“We fool ourselves into thinking missing a little bit of sleep here and there is no big deal,” Barnes said. “The data indicate it can be a big deal.”
A few companies have already acknowledged the role that sleep plays in employee productivity and effectiveness. At the Huffington Post, employees can slip away into a nap pod, while drug maker Johnson & Johnson has instituted e-mail-free weekends — at least until Sunday night — to give workers a break.
Czeisler would like to see more companies follow suit. The Division of Sleep Medicine has developed formal sleep policy standards for companies, which include encouraging predictable time off from e-mail; paying attention to employee’s circadian rhythms when scheduling shift work or travel; screening certain employees for sleep disorders that might lead to accidents; promoting sleep education; and establishing procedures for napping during the work day.
Harvard is starting to get the message, though it hasn’t yet adopted the full set of standards.
Nancy Costikyan, director of the Office of Work/Life at Harvard, said her office is running a program called Healthy Harvard to encourage staff members to remember all three pillars of good health, including sufficient sleep.
“If we want to be good performers, we need to take care of ourselves,” she said.
Insurance company Harvard Pilgrim Health Care is piloting a program this spring in which employees will track their personal health habits, including sleep, said Tami Ireland, director of Population Health Improvement for the company.
Ireland admits that she struggles to get more than six hours of sleep. The quiet of late night is the only time she has to herself, she said. Besides, she’s naturally a night owl.
“That temptation to stay up later and get things done can be a really hard thing to overcome,” she said.