The Walking Dead – The New Yorker

Credit Illustration by Min Heo

This is the third piece in a three-part series on sleep. Read part one, on falling asleep, and part two, on sleeping and dreaming.

Did you get enough sleep last night? Are you feeling fully awake, like your brightest, smartest, and most capable self? This, unfortunately, is a pipe dream for the majority of Americans. Most of us are operating at suboptimal levels basically always, the Harvard neurologist and sleep medicine physician Josna Adusumilli told me. Fifty to seventy million Americans, Adusumilli says, have chronic sleep disorders.

In a series of conversations with sleep scientists this May, facilitated by a Harvard Medical School Media Fellowship, I learned that the consequences of lack of sleep are severe. While we all suffer from sleep inertia (a general grogginess and lack of mental clarity), the stickiness of that inertia depends largely on the quantity and quality of the sleep that precedes it. If youre fully rested, sleep inertia dissipates relatively quickly. But, when youre not, it can last far into the day, with unpleasant and even risky results.

Many of us have been experiencing the repercussions of inadequate sleep since childhood. Judith Owens, the director of the Center for Pediatric Sleep Disorders at Boston Childrens Hospital, has been studying the effects of school start times on the well-being of school-age kidsand her conclusions are not encouraging. Most adults are fine with about eight hours of sleep, but toddlers need around thirteen hours, including a daytime nap. Teens need around nine and a half hours; whats more, they tend to be night owls, whose ideal circadian rhythm has them going to bed and waking up late. As schools have pushed their start times earlier and earliera trend that first started in the sixties, Owens saysthe health effects on students have been severe. Its not just sleep loss. Its circadian disruption, Owens says. They have to wake up when their brain tells them to be deeply asleep. Waking a teen at six in the morning is like waking an adult at three at night.

The result is a kind of constant jet lagand one that is exacerbated by sleeping in on the weekends. Executive function and emotional responses get worse, hurting everything from judgment to emotional reactivity. The ability to make good decisions can suffer, and kids can become more prone to act out and get depressed. In fact, the rise in A.D.H.D. diagnoses may, in part, be the result of inadequate sleep: in children, symptoms of sleep deprivation include hyperactivity and impaired interpretation of social cues. Owens has seen many such misdiagnoses in her clinical practice. The effects are physical, as well. Children who undersleep are more likely to gain weight and become obese. Even for infants as young as six months, amounts of sleep can predict weight gain three years later.

Schools with healthier start times, on the other hand, see an increase in attendance, test scores, G.P.A.s, and health. In one study in which an intervention pushed start times later, it wasnt just academic outcomes that improved; car crashes went down by as much as seventy per cent, and self-reported depression rates fell. Even a delay of as little as half an hour, Owens has found, improves outcomes. It should be about the health and well-being of the students, she told me, and not the convenience of adults.

As we age, unfortunately, our quality of sleep only gets worse. If you sleep six hours a night for twelve days, Adusumilli saysand thats about how much many Americans sleep all year roundyour cognitive and physical performance becomes virtually indistinguishable from that of someone who has been awake for twenty-four hours straight. (The same effect is produced by six days of four-hour nights.) And the performance of someone who has been awake for twenty-four hours straight is similar to that of someone with a blood alcohol level of 0.1 per cent. In other words, normal amounts of sleep deprivation have us acting like were drunk. (Charles Czeisler recalls presenting these facts to a Times journalist; when the journalist handed in the story, the editor said it couldnt possibly be true. Most people in the newsroom were sleep-deprived, and they still managed to produce the Times every day. Surely an intoxicated newsroom would be incapable of such a feat.)

In the short term, these types of deficits have a significant effect on our performance across the board. Perception deteriorates, along with motor skills: in one study of college basketball players, well-rested players performed better than those who followed their usual schedules. Emotional control suffersthe connection between the prefrontal cortex (where we make executive decisions) and the amygdala (which is associated with fear and other emotions) degradesand we become more impulsive and prone to depression. And our ability to think and to make sound decisions plummets. We become worse at learning, memory, and simple tasks of arithmetic and analytic reasoning. The rate of accidents and errors rises. In one study, which compared first-year interns at Brigham and Womens Hospital who worked on a regular schedule to those working on shorter, sixteen-hour shifts that included a nap, the sleep-deprived residents made more than double the number of attentional errors at nighta result that has been replicated multiple times.

Equally troubling are the health impacts in the long term. We become more prone to metabolic and endocrine problems, including weight gain, with a resulting increased risk of diabetes and cardiovascular disease. We decrease our immune function and could increase the risk of multiple types of cancer. We speed up our cognitive decline and increase the risk of dementia.

Originally posted here:
The Walking Dead - The New Yorker

Reviewed and Recommended by Erik Baquero