Category Archives: Sleep Deprivation

I can’t sleep — How can I get more sleep?

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Melissa Killeen

Sleep has a potent effect on the addicted brain

There are many tools available to a recovery coach. Information on the importance of sleep is one of them. Sleep is a necessity for everyone, including those in recovery from addiction. In fact, successful recovery and practicing healthy sleep habits are inseparable. Sleep has a potent effect on the addicted brain, proving to be one of the most influential factors in successful recovery.

Dr Ralph Carson, author of The Brain Fix, describes why proper sleep is crucial while recovering from addiction. He explains that for addicts in an inpatient treatment program, it’s paramount that individuals be prepared to accept new concepts, embrace a different lifestyle, and apply their creativity to this recovery challenge. The effectiveness of treatment is compromised if people aren’t getting quality sleep and thus don’t wake up feeling refreshed, responsive, positive, and committed to the hard work of recovery.

Of special interest to those in recovery, sleep impacts the pre-frontal cortex of the brain. Sleep removes neural toxins from the brain, which provides the brain the opportunity to re-organize the information that it has learned. Addiction negatively affects the pre-frontal cortex of the brain, leading to many problems, including compulsivity, impulsivity and most of all, impaired judgment. Strengthening this part of the brain is an essential part of the recovery process and strengthening the pre-frontal cortex involves getting enough sleep to clear out the neural toxins accumulated during the day.

Psychologist Jack Edinger, Ph.D., of the VA Medical Center in Durham, North Carolina, and Professor of Psychiatry and Behavioral Sciences at Duke University, cautions that treating depression usually doesn’t resolve sleep difficulties. From his clinical experience, he has found that most patients with depression should be checked for insomnia and should be examined for specific behaviors and thoughts that may perpetuate the sleep problems. When people develop insomnia, they try to self-regulate or compensate by engaging in activities to help them get more sleep. Maybe they sleep later in the mornings or spend excessive times in bed or nap. These efforts usually appear as depression and are not helpful in resolving insomnia.

According to sleep researchers, a night’s sleep is divided into five continually shifting stages, defined by the types of brain waves that reflect either lighter or deeper sleep. Toward morning, there is an increase in rapid eye movement, or REM sleep, when the muscles are relaxed and dreaming occurs, and recent memories may be consolidated in the brain. Experts say that hitting a snooze alarm over and over again to wake up is not the best way to feel rested. “The restorative value of rest is diminished, especially when the increments are short,” says psychologist Edward Stepanski, Ph.D. who has studied sleep fragmentation at the Rush University Medical Center in Chicago. This on-and-off-again effect of dozing and waking causes shifts in the brain-wave patterns. Sleep-deprived snooze-button addicts are likely to shorten their quota of REM sleep, impairing their mental functioning during the day.

Cognitive behavioral therapy and sleeping

From his clinical Cognitive Behavioral Therapy (CBT) work and research on sleep, psychologist Charles M. Morin, Ph.D., a Professor in the Psychology Department and Director of the Sleep Disorders Center at University Laval in Quebec, Canada, says that ten percent of adults suffer from chronic insomnia. In a National Sleep Foundation study released in the recent issue of the Sleep Medicine Alert, Morin outlines how CBT helps people overcome insomnia. Clinicians use sleep diaries to get an accurate picture of someone’s sleep patterns. Bedtime, waking time, time to fall asleep, number and durations of awakening, actual sleep time and quality of sleep are documented by the person suffering from insomnia.

A person can develop poor sleep habits like using their smart phone, tablet or laptop in bed, watching Jimmy Fallon in order to go to sleep or eating too much before bedtime. Many times they may compensate by sleeping late the day after a bout of insomnia, or taking a long nap during the day to compensate for the lost sleep. Some develop a fear of not sleeping and a pattern of worrying about the consequences of not sleeping, which perpetuates the insomnia and can result in a dependence on sleep aids. Cognitive behavioral therapies are essential for patients attempting to alter the conditions that perpetuate insomnia.

CBT attempts to change a person’s dysfunctional beliefs and attitudes about sleep such as letting go of thoughts like, “I’ve got to sleep eight hours tonight” or “I’ve got to take medication to sleep” or “I just can’t function if I don’t sleep.” These thoughts focus too much on sleep, which can be similar to performance anxiety. Sleep has a way of creeping up on you when you are not actively seeking it. Banishing negative thoughts will allow sleep to arrive at your bedroom door.

According to a study published in the October 2004 issue of The Archives of Internal Medicine, cognitive behavior therapy is more effective and lasts longer than the sleeping pill, Ambien. The study involved 63 healthy people with insomnia who were randomly assigned to receive Ambien, cognitive behavior therapy, both or using a placebo. The patients in the therapy group received five 30-minute sessions over six weeks. They were given daily exercises to “recognize, challenge and change stress-inducing thoughts” and were taught techniques like delaying bedtime or getting up to read if they were unable to fall asleep after 20 minutes. The patients taking Ambien were on a full dose for a month and then were weaned off the drug. At three weeks, 44 percent of the patients receiving the therapy and those receiving the combination therapy and pills fell asleep faster compared to 29 percent of the patients taking only the sleeping pills. Two weeks after all the treatment was over, the patients receiving the therapy fell asleep in half the time it took prior to the study, and only 17 percent of the patients taking the sleeping pills fell asleep in half the time.

What works in many cases, is to give a person more control over their sleep. A person can keep a sleep diary for a couple of weeks so a clinician can monitor the amount of time spent in bed to the actual amount of time sleeping. Then the clinician can instruct the patient to either go to bed later or get up earlier or vice versa. A person can also establish more stimulus control over his or her bedroom environment, such as going to bed only when sleepy, getting out of bed when unable to sleep, removal of electronic devices from the bedroom and not smoking or drinking before bedtimes. The same wake-up times every morning (including weekends) and avoiding daytime naps are also good regimes to adopt in thwarting insomnia.

Finally, a person can incorporate relaxation techniques as part of his or her treatment. For example, a person can give herself or himself an extra hour before bed to relax and unwind and time to write down gratitude lists, meditate or use tapping (Emotional Freedom Techniques).

In CBT, said Morin, breaking the thought process and anxiety over sleep is the goal. “After identifying the dysfunctional thought patterns, a clinician can offer alternative interpretations of what is getting the person anxious so a person can think about his or her insomnia in a different way.” Morin offers some techniques to restructure a person’s cognitions. “Keep realistic expectations, don’t blame insomnia for all daytime impairments, do not feel that losing a night’s sleep will bring horrible consequences, do not give too much importance to sleep and finally develop some tolerance to the effects of lost sleep.”

How can I get more sleep?

According to leading sleep researchers, here are some techniques to get more sleep:

• Start a sleep diary to chart your progress
• Keep a regular sleep/wake schedule and develop a regular bedtime (go to bed at the same time on weekends as on weeknights)
• Try and wake up without an alarm clock—get rid of the snooze alarm
• Attempt to go to bed earlier every night for a certain period of time; this will ensure that you’re getting enough sleep
• Give yourself a 60-minute relaxation period before you sleep, meditate, chant, write a gratitude list, complete an eleventh step
• Don’t drink or eat caffeine four to six hours before bed and minimize daytime use
• Don’t smoke, especially near bedtime or if you awake in the night
• Avoid alcohol and heavy meals before sleep, curb night eating
• Get regular exercise
• Minimize noise, light and excessive hot and cold temperatures where you sleep
• Avoid daytime naps, especially after 3pm
• Reading is okay, however make it a non-stimulating choice, romance, murder mysteries and sci-fi thrillers are very stimulating and can inhibit the relaxation portion of your pre-sleep ritual
• Consider taking a hot shower at bedtime, instead of in the morning. Use aromatic soaps that promote sleep such as chamomile and lavender

Dr Ralph Carson writes about the additional impacts of having a pre-frontal cortex that is “shut down” due to poor sleep. He explains: “This can cause you to overreact to negative experiences. Instead of facing your problems like a well-reasoned adult, you’ll be more apt to act moody, inpatient, or irritable.” For those in recovery, these negative mood states can be extremely triggering, increasing the likelihood of relapse.

As previously stated, sleep deprivation inhibits the pre-frontal cortex’s ability to work efficiently, making it more difficult to focus on “what your big goals are.” Addicts who increase the duration of their sleep experience an improved ability to “resist relapse.” Increased sleep makes their brains cleaner and better fueled, helping them remember their goals to remain sober.

If you choose to try a few of these suggestions, please first speak to a medical professional about your lack of sleep or insomnia.


Resources using in compiling this blog:

National Sleep Foundation
http://www.sleepfoundation.org/

American Academy of Sleep Medicine
http://www.aasmnet.org/

American Insomnia Association
http://www.americaninsomniaassociation.org/

Sleep Research Society
http://www.sleepresearchsociety.org/

NIH National Center for Sleep Disorders Research
http://www.nhlbi.nih.gov/sleep

The MayoClinic.com Sleep Center
MayoClinic.com

Ralph Carson (2012) The Brain Fix, Health Communications, Deerfield Beach, Florida, p 214
http://ralphcarson.com/

National Institute of Health (2013) How Sleep Clears the Brain,
http://www.nih.gov/researchmatters/october2013/10282013clear.htm

National Institute of Health (2013), New Brain Cleaning System Discovered:
http://www.nih.gov/researchmatters/september2012/09172012brain.htm

Martica Heaner (2004), Snooze Alarm Takes Its Toll on a Nation, Health Section, New York Times.com, http://www.nytimes.com/2004/10/12/health/12snoo.html

American Psychological Association (2014 ) Why Sleep is so important and what happens when you don’t get enough, http://www.apa.org/topics/sleep/why.aspx

John O’Neil (October 5, 2004) Treatment: Think before You Sleep, New York Times.com, Vital Signs Section, http://www.nytimes.com/2004/10/05/health/05trea.html

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I can’t sleep — Why I can’t make a good decision when I am fatigued?

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Melissa Killeen

Lack of sleep takes a toll on the brain

In the August 2004 issue of the journal Sleep, Dr. Timothy Roehrs, the Director of Research at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit, published one of the first studies to measure the effect of sleepiness on decision-making and risk-taking. He found that indeed it does take a toll on effective decision-making.

Cited in the October 12, New York Times Science section, Dr. Roehrs and his colleagues monetarily rewarded sleepy and fully alert subjects who completed a series of decisions and tasks. At random times, the subjects were given a choice to take their money and stop. Or they could forge ahead with the potential of either earning more money or losing it all if their work was not completed within the time remaining. A kind of “Who wants to be a Millionaire” science experiment.

Dr. Roehrs found that the alert people were very sensitive to the amount of work and time they needed to do in order to finish the tasks and understood the risk of losing their money if they didn’t. But the sleepy subjects chose to quit the tasks prematurely or they risked losing everything by trying to finish the task for more money, even though it was likely that they would not be able to finish.

According to the National Commission on Sleep Disorders Research (1998) and reports from the National Highway Safety Administration (NHSA, 2002), a high number of accidents can partly be attributed to people suffering from a severe lack of sleep.

Each year, according to the NCSDR, the cost of sleep disorders, sleep deprivation and sleepiness is estimated to be $15.9 million in direct costs and $50 to $100 billion a year in indirect and related costs. And according to the NHSA, falling asleep while driving is responsible for at least 100,000 crashes, 71,000 injuries and 1,550 deaths each year in the United States. Young people, in their teens and twenties, who are particularly susceptible to the effects of chronic sleep loss, are involved in more than half of the fall-asleep crashes on the nation’s highways each year. Sleep loss also interferes with the learning of young people in our nation’s schools, with 60 percent of grade school and high school children reporting that they are tired during the daytime and 15 percent of them admitting to falling asleep in class.

We’ve always known that sleep is good for your brain, but new research from the University of Rochester provides the first direct evidence for why your brain cells need you to sleep, and sleep the right way. The study found that when you sleep your brain removes toxic proteins from its neurons that are by-products of neural activity when you’re awake. Unfortunately, your brain can remove them only while you’re asleep. So when you don’t get enough sleep, the toxic proteins remain in your brain cells, wreaking havoc by impairing your ability to think — something no amount of caffeine can fix.

Skipping sleep impairs your brain function across the board. It slows your ability to process information and problem-solve, kills your creativity, and raises your stress levels and emotional reactivity. Basically, it affects your decision-making ability.

Decision Fatigue

The mental work of making decisions time after time can wear you down. Decision fatigue is the newest discovery involving a phenomenon called ego depletion, a term coined by the social psychologist Roy F. Baumeister. This sort of fatigue can make quarterbacks prone to dubious choices late in the game, a CEO leans toward disastrous dalliances late in the evening or a recovering addict deciding to use after a long day at work. It routinely warps the judgment of everyone, executive, delivery driver, rich or poor — in fact, it can take a special toll on the poor. Yet few people are even aware of it, and researchers are only beginning to understand why it happens and how to counteract it.

Decision fatigue helps explain why ordinarily sensible people get angry at colleagues, splurge on clothes, pick up candy at the market’s check out lane and can’t resist the dealer’s offer to rustproof their new car. No matter how rational and high-minded you try to be, you can’t make decision after decision without paying a price. It’s different from ordinary physical fatigue — you’re not consciously aware of being tired — but you’re low on mental energy. The more choices you make throughout the day, the harder each one becomes for your brain, and eventually it looks for shortcuts, usually in either of two very different ways.

One shortcut is to become reckless: to act impulsively instead of expending the energy to first think through the consequences. (Sure, tweet that photo! What could go wrong?) The other shortcut is the ultimate energy saver: do nothing. Instead of agonizing over decisions, avoid any choice. Ducking a decision often creates bigger problems in the long run, but for the moment, it eases the mental strain. You start to resist any change, any potentially risky move — like releasing a prisoner who might commit a crime. So a fatigued judge on a parole board takes the easy way out, and the prisoner stays in prison.

These experiments on Decision Fatigue demonstrated that there is a finite store of mental energy for exerting self-control. When people fended off the temptation to scarf down M&Ms or freshly baked chocolate-chip cookies all day at the office, they were then less able to resist other temptations, like stopping for a bottle of brandy on the drive home. When they forced themselves to remain stoic during a tearjerker movie, afterward, they gave up more quickly on tasks requiring self-discipline such as brushing their teeth, taking off their make-up or sleeping with the guy that paid for the movie. Willpower turned out to be more than a folk concept or a metaphor. It really was a form of mental energy that could be exhausted.

In the rest of the animal kingdom, there aren’t a lot of protracted negotiations between predators and prey. A lioness doesn’t arbitrate with an antelope. To compromise is a complex human ability and therefore, it is one of the first abilities to decline when Decision Fatigue sets in. If you’re shopping, you’re liable to look at only one dimension, like price: just give me the cheapest. Or purchase only the products you have coupons for. Or purchase only the items which are covered by food stamps. Or limit yourself to only the $100. you have in your budget for groceries. And now, you have to put away the barrettes you got for your daughter, and the athletic socks for your son. Shopping can be especially tiring for the poor, who have to struggle continually with trade-offs.

Researchers argue that this sort of Decision Fatigue is a major, and a largely ignored factor in trapping people in poverty. Because their financial situation forces them to make so many trade-offs, they have less willpower to devote to school, work and other activities that might move them up into the middle class. It’s hard to know exactly how important this factor is, but there’s no doubt that willpower is a special problem for poor people.

Decision Fatigue is a reason that the liquor, candy and soda is displayed in the front of the store, featured prominently near the cash register, just when shoppers have depleted all their decisions in the aisles. With their willpower reduced, they’re more likely to yield to any kind of temptation, but they’re especially vulnerable to booze, candy and soda. While supermarkets figured this out a long time ago, only recently did researchers discover why.

Despite this series of findings, brain researchers did find that glucose is a vital part of willpower. They helped solve the puzzle of how it increases the brain’s energy. Your brain does not stop working when glucose is low. It stops doing some things and starts doing others. It responds more strongly to immediate rewards and pays less attention to long-term prospects. A perfect environment for alcohol abuse.

The discoveries about glucose help explain why dieting is a uniquely difficult test of self-control and why even those people with phenomenally strong willpower in the rest of their lives can have such a hard time losing weight. They start their day with virtuous intentions, resisting croissants at breakfast and dessert at lunch, but each act of resistance further lowers their willpower. As their willpower weakens late in the day, they need to replenish it. But to resupply that energy, they need to give the body glucose. They’re trapped in a nutritional catch-22:

1. In order not to eat, a dieter needs willpower.
2. In order to have willpower, a dieter needs to eat.

Fatigue at work

At work when we are fatigued, we are pretty good at avoiding the urge to spend money, but not so good at resisting the lure of relaxation, such as scrolling through Facebook, online shopping or viewing pornography on the web.  Today there are so many choices to make. Your body may have dutifully reported to work on time, but your mind can escape at any instant. A typical computer user looks at more than three dozen Web sites a day and gets fatigued by the continual decision-making — whether to keep working on a project, or check out YouTube, or follow a link to another interesting research topic or buy something on Amazon. Ever wonder why Cyber Monday is one of the biggest shopping days of the year?

The cumulative effect of these temptations and decisions isn’t intuitively obvious. Virtually no one has a gut-level sense of just how tiring it is to decide. Big decisions, small decisions, they all add up. Choosing what to have for breakfast, where to go on vacation, what to do next, how much to spend from this paycheck— these all deplete willpower, and there’s no blinking indicator light on your dashboard to warn you that your willpower is low.

When the brain’s regulatory powers weaken, frustrations seem more irritating than usual. Impulses to eat, drink, spend and say stupid things have no filter and alcohol causes self-control to decline further. The Decision Fatigue effect was even demonstrated with dogs in two studies by Holly Miller and Nathan DeWall at the University of Kentucky. After obeying sit and stay commands for 10 minutes, the dogs performed worse on self-control tests and were also more likely to challenge another dog’s turf. Fatigued humans are also more likely to get into needless fights over turf. In making decisions, they take illogical shortcuts and tend to favor short-term gains (like ending the meeting and going home) and delay reviewing costs (yes even adding numbers up on a calculator is a decision).

“Good decision making is not a trait of the person, in the sense that it’s always there,” Baumeister says. “It’s a state that fluctuates.” His studies show that people with the best self-control are the ones who don’t schedule endless back-to-back meetings, they avoid temptations like all-you-can-eat buffets, and they establish good sleeping habits. Instead of deciding every morning whether or not to exercise, they work out with a friend. Instead of counting on willpower to remain robust all day, they conserve it so that it’s available for important decisions.

“Even the wisest people won’t make good choices when they’re not rested and their glucose is low,” Baumeister points out. That’s why the truly wise choose not to restructure the company at 4 p.m. Board meetings are not held at night. Major commitments are not made over cocktails. And if a decision must be made late in the day, they make sure they have eaten something like an apple or an orange to recharge their glucose levels. “The best decision makers,” Baumeister says, “are the ones who know when not to trust themselves.” 

Next week’s post will feature tips and tools on how to achieve a good night’s sleep.


Resources for this article came from:

Baumeister, R.F., & Heatherton, T.F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7, 1-15.

Kathleen D. Vohs and Roy F. Baumeister, Running Head: Self-Regulation and Choice-Decision Fatigue Exhausts Self-Regulatory Resources-But So Does Accommodating to Unchosen Alternatives http://www.chicagobooth.edu/research/workshops/marketing/archive/ WorkshopPapers/vohs.pdf

Baumeister, R. F.; Sparks, E. A.; Stillman, T. F.; Vohs, K. D. (2008). “Free will in consumer behavior: Self-control, ego depletion, and choice”. Journal of Consumer Psychology 18: 4–13. doi:10.1016/j.jcps.2007.10.002.

Baumeister, R. F.; Vohs, K. D. (2007). “Self-regulation, ego depletion, and motivation”. Social and Personality Psychology Compass 1: 115–128. doi:10.1111/j.1751-9004.2007.00001.x.

Dr. Timothy Roehrs, (August 2004), The Journal Sleep, http://www.journalsleep.org/PDF/AbstractBook2004.pdf

Drowsy Driving and Automobile Crashes, NCSDR/NHTSA expert panel on driver fatigue and sleepiness,
http://www.nhtsa.gov/people/injury/drowsy_driving1/drowsy.html

Dr. Travis Bradberry (December, 2014), Sleep Deprivation Is Killing You and Your Career , Forbes Magazine,
http://www.forbes.com/sites/travisbradberry/2014/12/01/skipping-sleep-is-career-suicide/

John Tierney, (2011) Do you suffer from Decision Fatigue? New York Times Magazine,
http://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html?_r=0&pagewanted=print

Holly Miller (2014) Self-control without a “self?”: common self-control processes in humans and dogs Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA.

Psychological Science (Impact Factor: 4.43). 04/2010; 21(4):534-8. DOI: 10.1177/0956797610364968, Source: PubMed

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I can’t go to sleep!

melissa-new-post

Melissa Killeen

Can I function on less than 8 hours of sleep?

Sleep is essential for a person’s health and well-being, according to the National Sleep Foundation (NSF). A recent poll taken by the NSF found that more people are sleeping less than six hours a night, and 75% of us experience sleep difficulties a few nights per week. Although a short-lived bout of insomnia is generally nothing to worry about, most sleep problems go undiagnosed and untreated. In addition, more than 40% of adults experience daytime tiredness, severe enough to interfere with their daily activities, at least a few days each month. The bigger concern is chronic sleep loss, which can contribute to health problems such as weight gain, high blood pressure, and a decrease in the immune system’s power, reports the Harvard Women’s Health Watch.

Everyone’s individual needs are different. Most healthy adults need an average of eight hours of sleep a night. However, some individuals are able to function with as little as six hours. Others can’t perform at their peak unless they’ve slept ten hours. And, contrary to common myth, the need for healthy slumber doesn’t decline with age but the ability to get eight hours a night does.

Psychologists and other scientists who study the causes of sleep disorders have shown that these problems can directly or indirectly be tied to abnormalities in the following systems:

  1. Brain functions, learning and memory: Sleep helps the brain commit new information to memory through a process called memory consolidation. In studies, people who’d slept after learning a task did better on tests, later.
  2. Metabolic functions and weight: Chronic sleep deprivation may cause weight gain by affecting the way our bodies process and store carbohydrates, and by altering levels of hormones that affect our appetite, and can lead to diabetes.
  3. Mood: Sleep loss may result in irritability, impatience, inability to concentrate, and moodiness. Too little can also leave you too tired to do the things you like to do.
  4. Cardiovascular health: Serious sleep disorders have been linked to hypertension, increased stress hormone levels, chances of stroke and irregular heartbeat.
  5. Immune system, and disease: Sleep deprivation alters immune function, including the activity of the body’s killer cells. Keeping up with sleep may also help fight cancer.

Furthermore, unhealthy conditions, disorders and diseases can also cause sleep problems. They include:

  1. Pathological drowsiness, insomnia and accidents: Lack of sleep contributes to a tendency to fall asleep during the daytime. These lapses may cause falls and mistakes such as medical errors, air traffic mishaps, and road accidents.
  2. Emotional disorders: Depression, bipolar disorders can be aggravated by insomnia
  3. Alcohol and drug abuse: People often use alcohol or drugs in order to sleep.
  4. Decreased decision-making capacity: More on how sleep is essential to the brain’s decision making capacity in next week’s blog

What disrupts your sleep?

Stress is the number one cause of short-term sleeping difficulties. According to experts, common stress triggers for these difficulties include school or job related pressures, a family or marriage problems and a serious illness or death in the family. Usually the sleep problem disappears when the stressful situation passes. However, if short-term sleep problems such as insomnia aren’t managed properly from the beginning, they can persist long after the original stress has passed.

Drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and working or doing other mentally intense activities right before or after getting into bed can disrupt restful slumber.

If you are a shift worker, as are 20% of employees in the United States, sleep may be particularly elusive. Shift work forces you to try to sleep when activities around you — and your own biological rhythms — signal you to be awake. One study shows that shift workers are two to five times more likely than employees with daytime hours to fall asleep on the job. Traveling is also disruptive, especially jet lag and traveling across several time zones. This can upset your biological or circadian rhythms.

Environmental factors such as when a room is too hot or cold, too noisy or too brightly lit, can be a barrier to sound night’s rest. Parents often complain of sleeping problems as interruptions from children or other family members will disrupt sleep. Other influences requiring attention are the comfort and size of your bed and the habits of your sleep partner. If you have to lie beside someone who has different sleep preferences, snores, tosses and turns, can’t fall or stay asleep, or has other sleep difficulties, it often becomes your problem, too. Pets sleeping in the bed are another factor in sleep disruption.

Having a 24/7 lifestyle or the demands of working in a global marketplace can also interrupt regular sleep patterns; the global economy that includes round-the-clock industries working to beat the competition; widespread use of nonstop automated systems to communicate and an increase in shift work makes for sleeping at regular times difficult.

Groups that are at particular risk for sleep deprivation include night shift workers, physicians whose average is 6.5 hours a day; residents whose average sleep is 5 hours a day, truck drivers, parents, caregivers and teenagers.

Next week’s post will focus on why we can’t make good decisions when we are tired. 


Resources for this article came from:

National Sleep Foundation
http://www.sleepfoundation.org/

American Academy of Sleep Medicine
http://www.aasmnet.org/

American Insomnia Association
http://www.americaninsomniaassociation.org/

Sleep Research Society
http://www.sleepresearchsociety.org/

NIH National Center for Sleep Disorders Research
http://www.nhlbi.nih.gov/sleep

The MayoClinic.com Sleep Center

American Psychological Association
http://www.apa.org/topics/sleep/why.aspx

Blake, et al, Psychological Reports, 1998; National Heart, Lung and Blood Institute Working Group on Insomn

David F. Dinges, PhD, Professor of Psychology in Psychiatry, Chief, Division of Sleep and Chronobiology, University of Pennsylvania School of Medicine

Van Dongen HPA, Dinges DF (2005). Sleep, circadian rhythms, and psychomotor vigilance performance. Clinics in Sports Medicine 24: 237-249.

Van Dongen & Dinges, Principles & Practice of Sleep Medicine, 2000

American Academy of Sleep Medicine and National Heart, Lung, and Blood Institute Working Group on Problem Sleepiness, 1997

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