Exhaustion Kills: Why We Need a Federal Sleep Protection Agency

We need more than nap rooms and Ambien. If we mean to reduce healthcare costs, increase healthy longevity, lower stress and improve our relationships, we have to make wholesale changes in how we plan our days.
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Tired businessman working late at laptop
Tired businessman working late at laptop

When we think of the essentials for human life, we think of food, water, air - but often forget something equally necessary: sleep. Just as we cannot thrive on inadequate nutrition, sleeplessness causes both immediate discomfort and long-term harm. Prolonged sleep deprivation is as deadly as dehydration or starvation. But school, business and social schedules cater to the needs of corporations and bureaucracies, not human bodies. Consequently, millions upon millions of Americans -- including the majority our children and teens - don't get enough sleep.

The problem of chronic sleep loss is treated as a personal one, hashed out between patients and doctors, most often with sleeping pills, which themselves prevent normal sleep, and which have not been approved for long-term use. But we can't fix this problem without addressing its systemic causes. Organizations like the CDC are beginning to recognize sleeplessness as a public health issue, but little action has yet been taken to address it.

Because food is essential, it's regulated and tested for safety, and we have a Supplemental Nutrition Assistance Program for low-income community members. Because water is essential, we provide clean running water to our cities, often moving it hundreds of miles in aqueducts. Because air is essential, we regulate emissions from cars and industry.

But there is no government entity or set of regulations to make sure that Americans are able to get enough sleep, and we all suffer the consequences to our quality of life, to our productivity, and to our health and longevity.

As Johns Hopkins Sleep Disorders Center Director Dr. Charlene Gamaldo noted at the April American Academy of Neurology (AAN) Annual Meeting, sleep is so vital that it trumps every other drive, including hunger, thirst, sex, and fear for our lives. But why?

It's common knowledge that the circadian rhythm -- or the body's internal clock -- has a lot to do with when we get sleepy and when we wake up, though we mainly only worry about it when we're suffering from jet lag or insomnia. But the circadian rhythm governs proteins that regulate gene functions within every single cell in our bodies. These rhythms need to be synchronized with the homeostatic system that regulates the working of our organs, as well as our heart rate, blood pressure, breathing and circulation. All of those things -- from the internal workings of our cells to whole-body systems -- suffer when we're sleep deprived, or our sleep schedule isn't properly aligned with the day/night cycle.

When we're over-tired, we can feel ourselves becoming more irritable, forgetful and impulsive, and less able to focus or have good judgement. These are merely the most noticeable symptoms of damage being done to our entire bodies. Normal brain development in children and abnormal, disease-causing processes in adults are determined at least in part by the amount and consistency of sleep cycles, according to research presented at the AAN.

This is in addition to the fatal accidents - both on the road and on the job - caused by exhaustion.

More than a third of American adults are not getting enough sleep hours, and two thirds of high school students get less than eight hours' sleep on school nights. Although there are things individuals can and should do to sleep better, that alone won't solve this epidemic. Right now, the unchecked demands of the workplace are taking precedence over our health and well-being. Although we have regulations to ensure our safety at work, they fall far short in the area of protecting our right to a healthy amount of sleep.

We can, as a society, choose to live differently. Our bodies were designed by millions of years of evolution to function well under particular circumstances. When we flout the needs and rhythms of our bodies and instead follow the rhythms of the factory floor, we are setting ourselves up for failure, for struggling against our schedules rather than flourishing within them.

Addressing this one family or office at a time won't work. We need more than nap rooms and Ambien. If we mean to reduce healthcare costs, increase healthy longevity, lower stress and improve our relationships, we have to make wholesale changes in how we plan our days.

This would mean changing work and school hours to permit us to remain in rhythm with the sun, shifting several times over the year as daylight hours change. This would mean stabilizing and rationalizing the hours (worked and on-call) of service industry employees, reducing shiftwork where possible and providing consistency where it is required. It would mean not checking work email at midnight. It would mean developing and installing lighting for homes and workplaces that better matched the cycle of daylight. It would mean a commitment to making sure that everyone has a safe, guaranteed place to sleep at night.

Better rested people are better workers and students, parents and friends. They are also healthier and happier. In the wealthiest nation in the world, we should all be able to afford a good night's sleep.


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