Sleep, The Bedrock Of Public Health, Is Eroding. This Is How Experts Say We Can Fix It

After giving birth to my daughter over a year ago, my brain is still foggy and my memory often slips. I have trouble remembering some important details of my life. I was too embarrassed to admit that the name of a distant relative was on the tip of my tongue.

Then it was time for my in-laws to turn on my kitchen light (to turn off the dining light in front of me). But after a few weeks I told my husband. We broke a lot of light bulbs. Some might say it's a case of "mom brain," the forgetfulness and memory loss that comes with motherhood. While it's true that motherhood affects women's brains (not in a sexist way), what I was suffering from was severe sleep deprivation.

For over a year, my little guy has woken up at least once in the middle of the night for about 90 percent of his life, saving me from the reality that four to five hours of solid stretching should be fine. Despite the fact that sleep deprivation is not new to many parents of young children, it's not just parents of young children who suffer from insomnia. The CDC estimates that one in three Americans don't get enough sleep. A 2019 analysis in the Journal of Community Health found that sleep deprivation is on the rise among working adults . About 58% of middle school students and 73% of high school students also do not get enough sleep.

There is no clear definition of what constitutes a public health crisis or emergency. According to the researchers , it is often determined by "causal and predisposing factors, as well as health effects." A situation can be considered an emergency when its health impacts "exceed the daily coping capacity of the community". Aren't we in America affected by insomnia?

Neurologist, sleep medicine specialist and Sleep Reimagined. Author of Fast Track to a Revitalized Life. "The CDC has actually called sleep deprivation a public health epidemic, and it's probably gotten worse since then," Pedram Nawab told me over the phone. In fact, in 2014, the CDC described sleep deprivation as a “public health epidemic” linked to a number of medical problems, including obesity, diabetes, cardiovascular disease, and mental health disorders.

Almost ten years later, the sleep problems persist. Every fifth American uses sleeping pills. Now, "sleep tourism," where people vacation just to get a good night's sleep, is another trend. Is it time for more action by public health officials?

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Vice-Chairman of the American Academy of Sleep Medicine Public Safety Committee and neuroscientist Dr. Jocelyn Cheng told me that while there is no official definition of a public health crisis, she describes America's lack of sleep as a "good problem." That its implications are not adequately recognized by most people.

"I think we all know that we're sleep deprived to some degree, and at a fundamental level it can have a detrimental effect on us," says Cheng. "But I don't think people realize what a serious health impact it has."

There is much public debate about how the country is dealing with a variety of public health issues, from the overdose crisis to climate change. Treating insomnia can be a first step as part of a solution to other epidemics, such as obesity, diabetes and mental health disorders, sleep experts say.

For example, Nawab says that when people sleep well, they produce a hormone called leptin, which tells you if you're full after eating. When people don't sleep well, it's harder or almost impossible for the body to transmit these signals. "So we tend to overeat, and because of that we can get fat, we can get diabetes and high blood pressure," he said. It all depends on these hormones. He also adds that lack of sleep can activate inflammation, which can predispose a person to various health conditions.

By the end of 2022, the CDC has warned that diabetes in people under 20 will increase rapidly over the next few decades. Specifically, this number could increase by nearly 700 percent by 2060, according to modeling studies. Nawab said that while being physically active is often encouraged as a way to protect against or manage type 2 diabetes, getting good sleep is just as important.

"Doctors who treat these problems don't know much about sleep, so the easiest thing for them to do to treat diabetes and hypertension is to prescribe a proper diet and exercise," Nawab said. “But sleep has to be part of the conversation. I think that's as important as anything else."

As I've reported before, sleep trends in America have changed dramatically over the past century. Before the current, people usually sleep about two hours after sunset, and then sleep in two stages, known as "biphasic sleep". During the first stage of sleep, which lasts four to six hours, people wake up for an hour or two and then go back to sleep until dawn. Nowadays, people rarely sleep together. In the 1940s, US adults slept an average of 7.9 hours. Now down to 6.8. Nawab said adults need at least seven hours of good sleep, while teenagers need eight to 10 hours. Asked what was behind the difficulty of getting enough sleep, Nawab said long working hours, high expectations from employers and screen use certainly didn't help.

One of the problems with treating sleep deprivation in America is that it's difficult for doctors to change their lifestyle, Cheng said. Education is something that can be done, but ideally, health care providers have time to talk to their patients and see if they're getting healthy sleep, he said. "Sometimes it's not just about your lifestyle," says Cheng. "Sometimes there is an underlying medical cause, such as obstructive sleep apnea, which is quite common in the population."

From a public policy perspective, he wants to see later school start times. "If we can, for example, change the time that school starts, getting enough sleep for these children and teenagers will help them learn more, learn better and be good for their health. Because,” he says. Of course, this requires an employer and start-up time. Nawab adds that he hopes a cultural shift and more free time will help alleviate America's sleep deprivation.

"We need to make sure people are getting enough sleep and have the opportunity to sleep," he said. "Most people don't spend enough time in bed sleeping."

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