Everyone knows that getting a good night鈥檚 sleep is essential if we want to be our best, with a sharp mind, reliable memory, good motor control, a responsive immune system, a positive attitude, and even a fit body. So why don鈥檛 we do it?
The short answer is that it鈥檚 not entirely our fault. For most of human existence, things were pretty simple. We woke up with the sunrise and got sleepy when it fell, a very predictable rhythm around the day, or circa diem. That鈥檚 the Latin phrase from which we get the term circadian rhythm 鈥� natural timetables that seem to govern everything alive.
Bruce Jarrell and Emerson Wickwire on Face to Face
Human progress began eroding that regular pattern of sleep a long time ago with the invention of everything from the light bulb, which allowed us to work during odd hours of the night, to the computer, whose blue screens suppress our production of melatonin, the chemical that makes us sleepy after the sun goes down.
Along the way, alcohol, cigarettes, pharmaceuticals, poor diets, diminishing exercise, lights everywhere, and simmering undercurrent of stress have combined to rob millions of the sleep they need. Add to that the anxiety and uncertainty brought on by COVID-19, and the problem is that much worse.
We haven鈥檛 had time to measure the full effects of the pandemic yet, but in 2014 the Centers for Disease Control and Prevention compiled data for , showing about 35 percent weren鈥榯 getting enough sleep. In Baltimore, that number was 42 percent.
The same study showed short-sleepers were much more likely to suffer from 11 chronic conditions 鈥� heart attack, coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer, arthritis, depression, chronic kidney disease, and diabetes.
What鈥檚 more, a study in the journal found drivers who slept fewer than seven of the previous 24 hours were much more likely to be responsible for vehicular accidents. The says in 2017 more than 91,000 crashes and nearly 800 deaths involved drowsy driving.
It鈥檚 the same in the workplace. A estimated that insomnia accounted for more than a quarter-million workplace accidents and errors, and more than $30 billion in losses each year. The total cost to the U.S. economy, factoring in lost productivity, is close to $400 billion, according to a recent .
A great deal of money also is spent trying to compensate for poor sleep. The global sleeping aids market 鈥� everything from supplements and CPAPs (continuous positive airway pressure machines) to Sleep Number beds 鈥� totaled nearly $80 billion in 2019 and is projected to more than double by 2030.
To help explain our sleep problems and how to overcome them, 91大神, Baltimore (UMB) President Bruce E. Jarrell, MD, FACS, invited sleep expert and 91大神 School of Medicine professor Emerson Wickwire, MD, to join him on the March 25, 2021 edition of Virtual Face to Face with President Bruce Jarrell.
鈥淭o a certain extent, obviously, we鈥檙e in a much better position as a society than we were six or eight or 10 or 12 months ago. But even so, we鈥檙e not out of the woods yet. So, there鈥檚 a pervasive sense of uncertainty,鈥� Wickwire explained to the audience.
For many, the pandemic has imposed significant changes in routine 鈥� another sleep impediment. 鈥淔or many professionals, productivity has gone way up. But one of the reasons is that the number of working hours has also gone way up. So we鈥檝e lost the hop in the car and commute to work or walk to work and then commute home at the end of the day, those boundaries are gone,鈥� Wickwire offered.
鈥淚t鈥檚 been discussed that there are secrets to getting a good sleep,鈥� Jarrell probed. 鈥淗ow do you prepare what your bedroom should be like, and all of those kinds of things? Could you give us your wisdom on what works, what we should be thinking?鈥�
鈥淭he first piece is to create a sacred bedroom environment for sleep. That environment should be cool, quiet, dark, uncluttered. This should be a calm, soothing space, to the extent possible devoid of stimuli,鈥� Wickwire responded. 鈥淭he reason is that we want to create a cave where as we enter that space, through repetition, we train our body and brain that this is a space for sleep. ... It鈥檚 one reason why we so strongly encourage patients when they're having trouble sleeping, not to stay in bed. Otherwise, you鈥檙e actually practicing, of course, having insomnia through repetition training yourself, that the bed is a place to be awake, which is the opposite of what we want to do.鈥�
The virtual audience was quick to pepper Wickwire with practical questions, from how to handle sleepless kids, to which mechanical and surgical cures for snoring might he recommend, and how long before bedtime should we quit starting at computer and cellphone screens?
鈥淎t minimum, 60 to 90 minutes, if you鈥檙e a good sleeper and being mindful of your sleep health, 60 to 90 minutes if you are a Type A or if you are a hard driver, if you have a lot of pressures from your daytime work or your family, you may well need more time than that,鈥� Wickwire said.
One audience member asked about trouble getting to sleep. 鈥淚f your mind doesn鈥檛 want to shut down, what can you do when your mind races up with the day鈥檚 events? Or perhaps the next day鈥檚 events? What can you do to get to sleep?鈥�
鈥淲ell, if you waited until you can鈥檛 sleep, you've probably waited too long,鈥� Wickwire answered. 鈥淎nd what I mean by that is that it鈥檚 not that your brain is overactive only at midnight, it鈥檚 probably overactive at noon as well. And so, what we need to do is begin to create some of that rhythm, some of which has become very difficult during COVID for reasons we discussed earlier, so that I can increase my engagement during the working day and then maximize my disengagement during the sleep period.鈥�
鈥淚s it OK to hit the snooze button on the alarm clock?鈥� asked another.
鈥淚f you鈥檙e needing to snooze, by definition what you're saying is, I am sleep-deprived, and it's a sign that you're not getting enough sleep. And there's only way you can get more sleep, you can go to bed earlier, you can sleep in later, or you can nap. And for most folks going to bed earlier or sleeping in later is a more reliable strategy than napping because most of us have jobs during the day,鈥� Wickwire said. 鈥淪o, if you're fighting to wake up in the morning, it either means that you鈥檙e not getting enough sleep or not enough quality sleep, which of course could be due to an undiagnosed sleep disorder.鈥�
Watch the entire discussion, including questions from the live audience, by accessing the link at the top of the page.
