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SUMMARY AND BACKGROUND
"A good night of sleep is as important as eating a healthy diet and regular exercise." 3
- Frank Hu
"We don't think of [reducing sleep] as increasing our risk of cardiovascular, accidents and motor vehicle crashes, and potentially increasing the risk of metabolic disorders that lead to diabetes. But that is how sensitive the biology of our system is to this." 4
- Charles Czeisler
"If you really thought about the health, the wellbeing of your child, you would think, as a society, we could push to a [later] physiologic start time [to school days] so our children get that opportunity to sleep at night." 6
- Susan Redline
"[OSHA] can cite healthcare organizations if there is evidence that patients are being hurt [due to sleep-deprived healthcare workers]. And, if there were some high visibility citations and hospitals were put on the front page of the paper for that, I think it would have an effect." 8
- Lucian Leape
Coming in Sept. — HSPH Continuing Professional Education: Sleep and Shift Work: Optimizing Productivity and Health Management in the 24/7 Global Economy
American society conspires against the need for sleep. Children set off for school before many workdays begin. Tough financial times push cash-strapped workers into seeking multiple jobs. Shift work conflicts with the body's natural clock. Hard-charging executives push themselves to work long hours. The cost is more than fatigue. Sleep deprivation has been associated with a myriad of health problems, including increased risk of obesity, diabetes, high blood pressure, heart attack, stroke and depression. Cognitive abilities decline as people tire. Risky behavior, such as driving while deeply fatigued, can put others in harm's way. This Forum event — held just days before the country will lose an hour of sleep due to daylight saving time — explored what we mean by "sleep deprivation," what happens in tired brains and bodies, what are the longterm health risks for children and adults, and what kinds of policies should be considered for schools and businesses to protect health. And a good night's sleep.
Background
- SLEEP DISORDERS AND SLEEP DEPRIVATION: AN UNMET PUBLIC HEALTH PROBLEM
- IOM Report
- ROTATING NIGHT SHIFT WORK LINKED TO INCREASED RISK OF TYPE 2 DIABETES IN WOMEN
- HSPH Press Release
- RELATED PAPER: PLOS MEDICINE
- DIVISION OF SLEEP MEDICINE, HARVARD MEDICAL SCHOOL
- DIVISION OF SLEEP MEDICINE, BRIGHAM AND WOMEN'S HOSPITAL
- FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION
- U.S. Department of Transportation
- SLEEP DEFICIT: THE PERFORMANCE KILLER
- Harvard Business Review
- STUDY LINKS 'BODY CLOCK' TO SUDDEN CARDIAC DEATH
- HealthDay
Photo © iStockphoto.com/weareadventurers
Thank you for this very useful conference.
I have just to remark that the discussants and the audience did not mention epilepsy as one of the most sensitive conditions that are negatively influenced by sleep deprivation.
Can you comment on this?
Best regards.
Giovanni Invernizzi
MD
with my personal experience and other readings, there is a clear link between obesity and sleep deprivation. according to http://www.hsph.harvard.edu/nutritionsource/healthy-weight/sleep/index.html, "In general, children and adults who get too little sleep tend to weigh more than those who get enough sleep.
As a current and long time sufferer of Myotonic Dystrophy I, with Chronic Congestive Heart Disease and Sleep Apnea, the concept of Sleep dysfunction is a very personal one. Essentially, because of the underlying condition, my "sleep deficit" continues to mount. Drugs appear to be out of the question. As Physicians have most likely been correct in their assessments, my pain is long-term, chronic and escalating with the passing years. They refuse to start me on ANYTHING, therefore, as it would, indeed, become a dependency. Beyond the inevitable "Dirt Nap", is there any useful research into MD1 that might yield relief?
I will be looking forward to the discussion with the experts. Here in Honduras we are facing a lot of variables in regard to the amount of hours of sleep necessary to be productive. Violence, delinquency, robbery, lack of a good infrastructure in transportation, unemployment, and the like. Mothers and fathers barely can eat. They require to work for 10 or 12 hours daily. What can we expect from this type of "society". We just don't have time to plan our life and less to think about productivity,
I will be very close and listen carefully to what the panelists might say.
I have a sleep issue. Have been taking Lunesta for quite awhile and am tapering off on the dosage. Only take it when I have a hard time falling asleep or when I wake up within a few hours after I've fallen asleep on my own. I do not nap during the day. I may sleep 5 hours a night, sometimes 6. Sleeping 7 is very rare. Would love to sleep 7 hours at a stretch.
I am in good health, walk 4 miles on my treadmill at least 4 times a week, sometimes more. Feel good about that. I am an active 83 years old who takes blood pressure medication, calcium and vitamins. Just wish my sleep were not interrupted. If that occurs, would love to go back to sleep easily. Any suggestions?
Hope your forum goes well.
Could it be true that the excessive demands placed on workers during the Industrial Revolution forced humans into the 8-hour sleep pattern which, today, we accept as normal?
Maybe humans would benefit more if we enjoyed 2 sleeps (maybe a 5-hour sleep and a 3-hour sleep, or something like that).
A couple of hours kip on the couch when I get home from work turns me into a Spring Heeled Jack for a good few hours afterwards. Highly recommended!
FORUM WEB EDITOR
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How can we understand that a person suffers from sleep deficiency and not from sleepiness? In other words, where is the dividing line between sleepiness and sleep deficiency?
In addition, is sleep deficiency more common in professions that require shift work or extended work hours, like police officers or medical interns? In which case, what is the next generation technology for fatigue management in order to reduce adverse health effects and performance degradation?
Dimitrios Sakellariou
FORUM WEB EDITOR
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Given that some studies supported a potential "U" shaped association with sleep duration, would it be possible for the experts to comment on the potential effect of long sleep duration on health conditions, especially on cancer risk?
Xuehong Zhang, MD,ScD, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School
FORUM WEB EDITOR
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Will recommendations be made as to how to improve ones sleep?
Roy Engstrom
FORUM WEB EDITOR
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Read that sleeping medication "shortens people's lives". So many other factors can shorten people's lives. Have no idea what research prompted that conclusion.
June Freeman
I would be interested to hear about how regular exercise can help with sleep quality. And if it does, what is the mechanism and how much exercise would someone need to see an effect?
Just wondering about the link between sleep deprivation and overweight and obesity?
Any advice for shift workers?
Would you please address the impact of a chronic lack of sleep on mental capacity, especially memory, and whether or not that is permanent?
Also, would you please discuss the effectiveness and safety of Rozerem?
FORUM WEB EDITOR
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If research shows the adverse health effects of sleep deprivation, why do work and children's educational schedules go against this and are there any changes being discussed and mandated?
For example, my children used to get up at 6:00am to catch the bus for school (that started at 7:00am). They were let out of school at 2:00pm - I think they would rather have slept until 10:00am - or later.
Medical school training and some other professional educational and work tracts (architecture) require countless sleepless nights.
Elizabeth McCurdy, MPH, Program Coordinator, Harvard Global Studies and Population Health
FORUM WEB EDITOR
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I would like to know what you have to say about women when they reach menopause. Estrogen levels decrease and with that so does good sleep. Even worse, when women get breast cancer they find themselves taking drugs that further decrease estrogen, making sleep very difficult.
Fibromyalgia can be triggered by lack of sleepwhat do you recommend for women in these situations?
Sue Auclair, Boston
FORUM WEB EDITOR
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What do you think of polyphasic SLEEP?
Antonio Giacomo Rizzo, Sicily
Thank you for answering my question on sleep deprivation.
It was very enlightening and I have taken a good few notes
I have suspected for a very long time that lack of sleep was the not-so-sleeping partner behind many disorders which occur throughout our populations.
In New Zealand there is the refrain from Govt that we need to be more productive & to think smarter (however, I sympathise with our Govt on this point. We are a small nation well away from our markets and if we suffer if we are not productive.) But the cost of it all - lack of sleep.
Thank you.
FORUM WEB EDITOR
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What are the best exercises to do and how much time prior going to bed?
Ed Weiss
FORUM WEB EDITOR
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How do you screen for sleep disorders within an employee population?
Lucio Fabris, B.Sc. Phm., CAE, Med-I-Well Services Ltd., Sudbury, ON, Canada
FORUM WEB EDITOR
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What can be done for older people who suffer from interrupted sleep -- waking up after a 2-4 hour period of sleep and having difficulty in going back to sleep?
Issues related to taking sleeping medication. Risks versus benefits.
June Freeman
FORUM WEB EDITOR
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Is broken sleep ie; 4 hours sleep then waking then possible 3-4 mores? How to change to internal clock? Stance on long term prescription sleeping pills?
Sterlena A. Harris
FORUM WEB EDITOR
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I was unable to join the forum and therefore unable to ask this question.
What is the effect of sleep deprivation on children 2-5 years of age who suffer from chronic pain, chronic infection and malnutrition.
The population I refer to are the 1 million children who have untreated dental caries (ECC) .
Thank you,
Dr. Leonard B Smith, DDS,M.Sc.,FRCD( C),FAAPD,FICD, Diplomate of the American Board of Pediatric Dentistry