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The Toll of Sleep Loss in America

Sleep loss is taking a toll on our physical and emotional health, and on our nation's highways.

The Science of Sleep continued...

Hypersomnia: This is sleep deprivation, or excessive daytime sleepiness without an obvious cause. This pattern "should be taken very seriously," Mahowald writes. The result is sleepiness, which results in impaired sustained attention, with adverse, occasionally disastrous consequences in the classroom, workplace, or the highways. It is likely that more than 100,000 crashes occur annually in the U.S. due to driving while drowsy, he adds.

The most common cause of hypersomnia is voluntary sleep deprivation done for social or economic reasons - like work or surfing the Internet, he notes. "We get 20% less sleep than previous generations, yet there is no evidence that earlier generations required more sleep - or that ours needs less," he writes.

Insomnia: This is the most common sleep complaint, says Mahowald. It is not defined by total sleep time but by trouble falling or staying asleep. It is the inability to obtain sleep that is sufficiently long or "good enough" to result in feeling rested or restored the following day. Depression has been linked as a cause of insomnia; however, for many people, untreated insomnia may be a risk factor for depression, he tells WebMD.

Many insomniacs may have a condition called hyperarousal - essentially, they're always on alert, which means they rarely can sleep, Mahowald explains. "There is overwhelming evidence that many who have insomnia have a constitutional predisposition to be hyperaroused 24 hours a day. They have trouble sleeping, then feel miserable during the day, fatigued, washed out, have trouble concentrating. But they are not sleepy. They never take naps, because the same thing happens - they can't sleep during the day."

Neurological scans show differences between the brains of insomniacs and non-insomniacs. There seems to be a genetic component to both hyperarousal and insomnia, Mahowald tells WebMD.

"They typically have a family history of insomnia. Many people have had it as long as they can remember, since childhood. It takes very little for them to get insomnia - a test the next day, an upcoming trip. They can get insomnia for what seems like very trivial reasons, but it's probably constitutional. They are very fragile sleepers because they are predisposed to developing insomnia."

The Effects of Lost Sleep

An NIH State-of-the-Science Conference focused on the public health issues of chronic insomnia - including the larger impact that is not often noticed. When children and the elderly (particularly nursing home residents) suffer from insomnia, parents and caregivers also suffer. Employers suffer when an insomniac's work performance is affected.

Most people need between seven and eight hours of sleep each night to feel refreshed and function optimally, says Hunt. "Obviously there's some variation, some people intrinsically need more sleep than others. A few people skip by successfully long-term getting less sleep - but that's a very small number."

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