By Dr. Brian Goldman
Statistics Canada says nearly a third of Canadians are sleep deprived. The health effects include obesity, heart disease and premature death. Today, a group of American doctors published new guidelines on how to combat a growing health menace.
A policy statement by the American Thoracic Society says good sleep is critical for good health and quality of life. The amount of sleep needed by an individual varies significantly with age across the lifespan. However, the average adult needs 7 to 9 hours of sleep per night to maintain good health. Call it the Goldilocks approach. For most Canadians, getting 6 hours of sleep per night or less is associated with negative effects on your health and can even lead to premature death. At the same time, too much of a good thing is also bad for your health. Researchers have recently found that for most people, getting more than 9 or 10 hours of sleep a night can also be hazardous to your health.
A report by the Institute of Medicine in the U.S. called sleep deprivation a massive public health problem. It’s not hard to see why. Obesity is a major consequence. One study found that people in their twenties who get fewer than 6 hours of sleep a night are nearly 8 times more likely to become obese even if they exercise. Chronic sleep deprivation lowers blood levels of leptin, a hormone that controls appetite. It also leads to higher levels of ghrelin, which makes you overeat because you’re hungry. Middle-aged adults who get 6 hours of sleep each night are nearly 2 times more likely to get diabetes. Insomnia increases the risk of heart attack by up to 45 percent, and triples the risk of heart failure.
We’re hearing more about it these days in part because people are working harder. Longer hours on the job are associated with sleeping less. Interestingly, so are higher levels of income. A study by Statistics Canada found that making over $60,000 per year is associated with sleeping 40 minutes less than people who made less than $20,000. Rising house prices are also a big trend. The search for cheaper homes outside of town leads to longer commute times. For workers, commutes over 60 minutes mean an average loss of 22 minutes of sleep per night. Smart phones, tablets and notebook computers increase your stress level at night, and increase sleep deprivation.
The U.S. guidelines point out that children are not merely smaller adults with regard to sleep. They differ from adults in the amount of sleep they require. The amount varies as kids mature. According to the National Sleep Foundation, teenagers need 8 to 10 hours of sleep per night. Eighty-five per cent of teens get less than that. We know from many studies that sleep deprivation that leads to falling asleep behind the wheel is an important cause of motor vehicle crashes. It turns out that adolescents may be particularly susceptible to drowsy driving.
We’re just kind of getting out of the dark ages. The authors of the new guidelines say health care providers receive very little formal education on the importance of sleep to health or on the evaluation and management of common sleep disorders. They guidelines call for more education. Without that, it’s hard for MDs to play a major role. For children, we’re even more in the dark. The guidelines call on experts to develop recommendations for kids of all ages. For adolescents, the American Thoracic Society suggests that school start times be delayed so that teens can get more sleep. The problem may be urgent, but we’ve got a long way to go before we turn things around.