America's Not So Elite Sleepless

Our puritanical culture celebrates surviving on the least sleep, sneers at those who appear to need more and sacrifices sleep -- a fundamental biological need -- in favor of all other activity.
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The Wall Street Journal's recent article on 'The Sleepless Elite' reminds us a little knowledge can be a dangerous thing. "Sleep may be a waste of time," quips the lede. Sadly, the article conveys little more than a myopic message woefully removed from our highly sleep-disordered American reality.

Americans and our American lifestyles are at conflict with healthy sleep. We term this culture Sleep Machismo -- our puritanical culture celebrates surviving on the least sleep, sneers at those who appear to need more and sacrifices sleep -- a fundamental biological need -- in favor of all other activity.

For Americans, sleep is treated as an expendable luxury instead of the vital function required for longevity, health and wellness that science confirms it to be. Without informed sleep specialists directing the unfolding American conversation on sleep, Americans are left to pick their own way beyond the newest and most treacherous frontier in the War on American Sleep: an uninformed media.

Delivering sleep research amputated from reasoned context and legitimized by media leaves Americans less informed than if they hadn't read anything at all. Devoid of accurate and mature perspective, trivia often masquerades as newsworthy reporting, while major concerns pertaining to sleep go overlooked.

The research discussed in this article is firmly in its infancy -- years away, if ever, from guiding clinical practice and human behavior. Today, I believe this so-called "news" is nothing more than health trivia, perhaps appropriate for Jeopardy but little else. As this research continues, we may well find that the "The Sleepless Elite" suffer from more chronic disease and have shorter lifespans and higher risk for sudden death than do the common sleep-requiring folk. But we won't know for a long time to come.

Today, more than 100 million of us are sleep disordered and, at the very least, 45 million or so are chronically sleep deprived. For a third of Americans, sleep is far from a waste of time; instead, for some, it's the best use of their time. The destructive American anthem of "sleep less, do more" is a familiar one. Even a sleep researcher was recently quoted as saying "Everyone can use more waking hours, even if you just watch movies."

Not so. Most of us need more sleeping hours. Ironically, watching movies is singularly destructive to a good night's sleep. Late night light-emitting screen time, whether television movies or streaming video, is a major contributor to social jetlag -- literally resetting our internal sleep clocks backwards, making us fall asleep ever later and adding to our mounting sleep debt.

And sleep debt costs.

Last month alone we have seen a New York City tour bus operator crash at 5:35 am on March 12, killing 14 passengers after several episodes of lane-drifting known to be a harbinger of sleep-related collisions. Less than two weeks later in D.C., two airliners landed at Reagan National without control tower clearance because the air traffic supervisor was asleep. We are now enthralled by a national spectacle as the FAA reveals its struggles with managing shift workers who are buckling under sleep pressure. Instead of recognizing that there is a biological drive to sleepiness, sleep deprived, shift work disordered air traffic controllers are labeled as 'unprofessional.'

The media commentary around this event has been extraordinarily uninformed, with night after night of network coverage repeatedly missing the mark: shift work causes sleep disorders which place our shift workers, their important work and their fellow citizens at risk.

We are far from a nation in search of the mysteries of a Sleepless Elite. Instead, we are a nation blundering around barely awake at precisely those times when we should be soundly, and safely, asleep. Just when America is mired in an obesity pandemic, some of which is tied to undiagnosed sleep disorders, long work hours and overeating driven by severe chronic partial sleep deprivation, such commentary without context is particularly damaging.

These and similar news stories reveal the profound lack of depth, insight and positioning of meaningful information to an exhausted public desperately indeed of good information about sleep. This gaping deficit, papered over by ill-informed journalists and well-meaning but media-naïve specialists conspire to form a miasma of medical media misinformation which facilitates, rather than dispels confusion. Such medical misinformation is

'nothing short of a public health felony'

in the words of Dr. Jim Metropoulos, an Internist and acknowledged messaging expert from the global healthcare communications arena. Dr. Metropoulos explains further...

"I understand the unrelenting need the 24/7/365 media world has for more and more content. In the pursuit of a never ending supply of material to pipe through their mobile, desktop, tabletop and tablet outlets the media grabs onto trivia and repackages it as news and information -- over and over again -- print to video to audio to print. On and on it goes, and, with each iteration, the material is further removed from meaningful context and the experts that could ensure accuracy. The result is a less informed public, in this case, hoping to find the secret password for membership into the "sleepless elite club."

There are many frontiers in the War on American Sleep: shift work, our flailing economy, our highly digitalized and over-stimulated environment, our multiple and competing roles, our intensely oral culture which promotes over-eating, substance use and over-reliance on pharmacological fixes. The media, unfortunately, is just the latest in a series of obstacles to achieving meaningful balanced and sensible information. Specialists and our patients must partner together to overcome this barrier too.

Fortunately, the war against Sleep Machismo starts not on Wall Street, but on Main Street. Americans are great at making their demands known and good sleep information will follow public calls for more critical, meaningful reporting.