Cranky? You're Likely Fighting Fatigue

From the WebMD Archives

April 2, 2002 -- We're barking at each other everywhere -- on the road, at the grocery store, at work, at home. All this negativity is caused by too little sleep, according to a new poll from the National Sleep Foundation.

The poll shows that nearly one-quarter of American adults -- some 47 million people -- aren't getting the minimum amount of sleep they need to be alert the next day, says Mark Mahowald, MD, spokesman for the foundation.

Adults sleep an average of 6.9 hours per night on weeknights and 7.5 hours per night on weekends. Only 30% of adults are getting the requisite 8 hours of sleep each night, compared with 38% a year ago. Nearly 40% said they are so sleepy during the day it interferes with their activities at least a few days a month.

"Things are actually getting worse, not better," says Mahowald, director of the Minnesota Regional Sleep Disorders Center and professor of neurology at the University of Minnesota Medical School.

Too little sleep has always been linked with poor performance on the job. In fact, several major disasters have been linked with too little sleep -- Three Mile Island, Chernobyl, and the Exxon Valdez.

But for the first time, the annual poll made a link between sleep deprivation and all sorts of mood problems -- anger, pessimism, stress.

"It's a little more subtle [than performance], but it has serious ramifications," Mahowald tells WebMD. "There are consequences in the workplace, in family life, behind the wheel."

Daytime Sleepiness Takes a Toll

In the survey, Americans were asked to describe their general moods and attitudes on a typical day. The responses suggest a direct link between more sleep and positive feelings -- a sense of peace, satisfaction with life, and being full of energy. Too-little sleep was linked with daytime sleepiness, negative moods, and fatigue.

Among the findings:

  • Those who got fewer than six hours of sleep on weekdays were more likely to describe themselves as stressed, sad, and angry.
  • People who reported often being sleepy during the day were more likely to describe themselves as dissatisfied with life and angry.
  • Those who reported fewer insomnia symptoms were more likely to describe themselves as "full of energy," "relaxed," and "happy."
  • Those who did not get enough sleep were more likely to get impatient or aggravated with such common annoyances as waiting in line or sitting in traffic. They were also more likely to make mistakes and have difficulty getting along with others.

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"Road rage is very often related to people who are very, very short-fused and irritable because they're sleep deprived," he says. "[The effects are] relatively hard to measure, but the consequences should be taken very seriously. It's relatively subtle, but it exacts a major toll."

Late nights have also been liked with overeating and could be part of the national obesity problem, says Richard Castriotta, MD, sleep disorders expert and associate professor of internal medicine at the University of Texas Medical School at Houston.

"The later you stay up, the more you eat," he tells WebMD. "It's a natural tendency. Instead of eating three meals a day, you're going to get a fourth one in."

Sleep Gets No Respect

In the survey, insomnia caused poor sleep in the majority of cases (74%). However, Castriotta also puts the blame on too much computer use.

"The computer allows people to stay up passively, but interacting so that it's stimulating you to stay awake," he tells WebMD. "People are busy on the computer, suddenly it's 3 a.m. and they're not even feeling tired. All of this has taken a toll."

People view sleepiness as an annoyance and nothing worse, Mahowald says. "Most of us were raised to think that sleep was negotiable. Sleep deprivation was a badge of honor."

Your employer probably considers working round-the-clock to be a positive trait, he tells WebMD. "The less sleep you get, the better worker you're perceived to be, the more committed, the more dedicated."

"We never brag about how much sleep we get; we only brag when we get too little sleep," Mahowald says. "The attitude is that sleep deprivation is more respected. The fact is no degree of commitment or dedication can override the need for sleep."

Beware the Energy Drinks, Caffeine Pills

Whole industries have emerged to help us stay awake during the day. It's no accident that, in virtually every society in the world, coffee is the daytime beverage of choice, says Castriotta.

"People have always taken stimulants to stay awake," he tells WebMD. In fact, people today are downing caffeine pills, herbal caffeine pills, and nutritional supplements like ENADA to fight drowsiness.

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"Under certain circumstances, they may be appropriate," Castriotta says. "If you're flying a B-2 bomber from Missouri to Afghanistan and back, you're allowed to take a drug. But once you get back to base, you don't continue to take those drugs."

The same advice pertains to our everyday lives, he says. Take them in a crisis -- when you need to put in extra hours on a big project -- then quit.

The energy-boosting drinks -- Red Bull, Jolt, Lizard Fuel, Mad River Energy Hammer, Red Devil Energy Drink, Sobe Adrenaline Rush -- are just craziness, says Leslie Bonci, MPHRD, director of sports nutrition at the University of Pittsburgh Medical Center.

"If you drink this stuff and are on the ceiling, don't be surprised," Bonci tells WebMD.

The drinks "have huge loads of caffeine -- much more than a Coke or Pepsi," she says. Trouble is, most people drink more than one. Then, when it's finally time to get some sleep, they're so wired that sleep is impossible. "Your mind is circling the room 25,000 times."

Sensitivity to caffeine in any form -- including pills such as No-Doz -- depends on the person, says Bonci. "Your heart may be racing more than otherwise, you can get an acid stomach. Caffeine can also have a diuretic effect, a fluid-losing effect. Yet you're not giving the body any fuel [any food] whatsoever. So when it wears off, the body is in shock. So you're even more tired."

To really give your body an energy boost, grab a glass of orange juice or a handful of pretzels, she advises. "A lot of times, people are not eating regularly. They grab a Red Bull instead of food. [An energy drink] is not a substitute for real energy food."

In the long term, we simply need sleep, say the experts. Sleep is complex, and despite all the research, no one really understands why we have REM and non-REM sleep cycles. "There's a need, a reason why we have a drive to sleep," says Castriotta. "We suspect that there's a major immune function to sleep and immune impairment from lack of sleep."

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If you need an alarm clock to get you out of bed, you're sleep deprived, says Mahowald. "If you weren't, you would have awakened spontaneously. You wouldn't need the alarm."

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