Why can’t I sleep?

I really personally believe that many psychological disturbances are due to inadequate sleep.

It’s a 24-hour culture, whether it’s work or play.I did something stupid a couple weeks ago. I was pulling out of the Starbucks parking lot on a Saturday morning, and somehow my foot was on the gas instead of the brake as I put the car in reverse. It lurched backward about eight feet before I processed what was happening and hit the brake.

I’ve been driving for two decades. My record is spotless. I’d never slipped up navigating the simple spatial relationship between foot and pedals like that before. It took several minutes to even believe it happened, then a few more minutes to realize how lucky I was that nobody had been standing behind my car in the small, busy lot.

My almost-2-year-old had been sick for a few days right before that. He’d been particularly restless at night. I’d figured that as a busy mom, I was more or less accustomed to inconsistent sleep. But sitting there halfway out of the parking space, heart rate spiking from near-shock, picturing the potential disaster that had just occurred, there was no denying that waking up six or seven times a night for three nights in a row had taken a pretty serious toll, and a “grande drip with room” wasn’t going to fix anything.

I was more sleep-deprived than usual that day, but even when my son sleeps through the night, there’s usually a list of things on my list to accomplish during the late hours that are more urgent than sleep. And I’m apparently in the majority on this one. It seems like no one sleeps that well anymore. It seems like we’re not even supposed to sleep well, like a lot of us are burning the midnight oil, whether by necessity or habit—or just because “it’s the right thing to do.”

I started wondering what’s so great about aiming for less sleep. And whether we’re doomed to resign ourselves to being a society of insomniacs.

I checked in with two neurologists from local sleep disorder centers and asked them what’s keeping everybody awake. It turns out that our need for Zs is competing against some deeply entrenched societal expectations.

Demand vs. supply
Dr. Aditya Bhargava is director of the SpectREM Sleep Medicine Center, affiliated with the University of Nevada School of Medicine.

“Sleep is a state that we acquire during the night, where we lose perception of our surroundings, and our body and our mind are supposed to relax and rest and rejuvenate for the next day,” he says, sorting through words to boil down a series of physical and neurological processes into a layperson-friendly definition.

“Ordinarily, when we sleep at night, we go through what I like to think of as one-and-a-half-hour chunks of sleep,” says Dr. Bill Torch, neurologist and medical director of the Washoe Sleep Disorders Center.

Each 90-minute chunk involves a cycle of five stages, culminating in REM (rapid eye movement) sleep.

“That’s the stage where we see real creativity, some solution of problems. Emotional issues are worked out in the dream state. A lot of invention occurs during that state of sleep,” Torch says. Ideally, he continues, we need six of those 90-minute cycles to function optimally. That would be nine hours of sleep.

The average American adult sleeps more like seven.

What’s keeping you awake?
The American Academy of Sleep Medicine lists 84 kinds of sleep problems and disorders. Some are associated with medical, neurological or psychological problems, but the doctors I spoke with stressed that a lot of problems are environmental and lifestyle-based, too.

One oft-cited reason we stay awake is because we can. During the 19th century, when the world was lit and entertained without electricity, people spent the dark hours between sunset and sunrise sleeping. The average nighttime slumber back then lasted nine hours.

“That’s the way sleep occurred for the last hundred-thousand years,” Torch points out. “We changed all the rules.”

The change happened pretty suddenly, after 1913, when the electric light bulb, under development for about a century by then, became efficient enough to mass-market. That made it possible for factories and households to run as late as they found useful.

Thomas Edison, one of a long line of inventors who improved on the light bulb, but who’s often singled out for full credit, asserted that a few hours of sleep was all a person needed. He claimed to thrive on four or five hours a night.

“Edison … profoundly changed the psychology of the modern world. It was his desire to be known as the man who finally eradicated the waste of human potential represented by all those hours spent in ‘unproductive sleep,'” writes author Stanley Coren in his 1996 book, The Sleep Thieves.

He suggests that Edison would be pleased to know his enthusiasm for productivity caught on. Based on Coren’s estimation that the average American sleeps seven-and-a-half hours a night, as opposed to the pre-incandescent-era nine hours, each of us now has 500 extra hours a year to devote to getting things accomplished. (Seven and a half is a liberal figure; far more studies conclude it’s seven hours.)

Or at least 500 extra hours to devote to something. Torch and Bhargava each sound a little frustrated when they point out, during separate interviews, that a lot of people habitually stay awake after they’re tired to watch television, use computers and play video games.

“It’s a 24-hour culture, whether it’s work or play,” says Bhargava. He refers to a study conducted in the Midwest, where people on a camping trip were monitored for sleeping activity. Without electronic distractions, they slept an hour more than they tended to sleep at home.

But most people aren’t usually out camping. We’re in the middle of busy lives, with jobs and school and kids and social obligations. Plus, we have that deeply ingrained Protestant work ethic to maintain.

“This is why I believe we have a very addictive society,” Torch says. “It has to do with the work ethic, the social pressures that people feel in this society.” He attributes the success of the aforementioned gourmet coffee chain and caffeinated sodas and energy drinks to the need to keep working and playing when we should be resting.

"[Caffeine] has become a required vitamin to function in this very dysfunctional society that we live in,” he laments. He adds that other chemical stimulants occupy a similar role in a frenzied culture.

“I’ve seen quite a number of meth addicts who chose methamphetamine as their drug of choice because they would otherwise fall asleep; they’re very tired.” He says a lot of blue-collar workers rely on meth to stay awake, and he adds, “I have a feeling it’s unspoken among other groups.”

Even some legal—and reputedly relaxing—substances, nicotine and alcohol, aren’t sleep-friendly, says Torch.

“Alcohol is bad because it interferes with your normal sleep patterns,” he says. “It actually disrupts brainwave activities. It acts as an anesthetic, as opposed to a sedative. It’ll put you to sleep, but it’ll also disrupt your brainwave activity and create very poor quality sleep.”

Add all these factors together and, as Torch puts it, “We’ve created a mindset that staying up late is good, and going to bed early is bad. We tend to admire people in this society who stay up late.”

Remember being sent bed early as a punishment when you were a kid?

Edison’s probably dancing in his grave.

What’s the damage?
If we’ve been able to create a culture where sleep isn’t Priority One and maintain it for over a century, we must be able to tolerate it. At least to some extent.

Nancy Meyer has been a casino dealer for 29 years. For the past few years, she’s been working the graveyard shift at Fitzgerald’s, 2-10 a.m. She likes the hours. She likes having her days free, and because the casino has fewer tables open in the morning, Meyer says, customers tend to circulate among them instead of staying put, which is good for tips.

Usually, she sleeps two or three hours right after work, then another two or three right before the next shift.

“As long as I can get two or three hours before I go in, I can get through OK,” she says.

As far as adjusting her circadian rhythm around her job, she says, “I don’t know if you ever get used to it.”

After four days of working, she transitions easily back to sleeping through the night for the rest of the week.

Bryan Dickson, 27, is a parking officer at the University of Nevada, Reno. He goes to bed around midnight and gets up around 6 a.m. In between those hours, he wakes up an average of three times to change his 3-month-old’s diaper—and one or two more times to comfort his 2-year-old.

He gets about four to five non-consecutive hours of sleep a night. He says the schedule hasn’t affected his job performance much, though.

“I’m pretty used to it,” he says. “Before having kids, I never got a lot of sleep. I’m the type of person who thinks sleep is a waste of time.”

Meyer and Dickson are among many people who’ve adjusted their lives around a limited amount of sleep.

“Some people have a lot of energy and initiative, and they can function with four to five hours of sleep,” Torch says.

And there’s good news for those who aren’t sleeping all night, every night.

“As far as [long]-standing health effects of acute sleep deprivation go, there don’t seem to be any,” says Bhargava. That’s acute sleep deprivation, which is temporary, he says, as opposed to chronic sleep deprivation, which lasts for longer periods of time and can have more serious consequences.

He’s quick to point out, however, that doing OK on limited sleep doesn’t keep you at the top of your game.

“It affects things like physical and mental functioning. Acutely sleep-deprived people will be sleepy during the day; they may be more irritable; they may not be able to perform as well as their job,” Bhargava says.

“If you have any mental problem, whether it’s anxiety, depression, bi-polar disturbances, those disorders will be exaggerated even more so. If you have attention deficit disorder, your ADD will be worse,” Torch adds.

“As a matter of fact, I really personally believe that many psychological disturbances are due to inadequate sleep. Or disturbed sleep that has not been diagnosed properly,” he continues.

Both doctors mention the increased likelihood of car accidents among sleep-deprived people. The National Sleep Foundation reports that “drowsy driving” is responsible for 71,000 injuries and 1,550 deaths in the United States each year.

That’s enough of a concern that the Washoe Sleep Disorders Center has recently begun working with the Army (where the incidence of sleep deprivation-related accidents is high) and the U.S. Department of Transportation, using a drive simulator to test the driving habits of sleepy people.

Tune out, turn off, get some sleep
The simple answer to fatigue? Get some sleep.

“We advise people that it’s important to get eight or nine hours of sleep if you’re an adult. And if you’re a child or a teenager, progressively more,” says Torch.

But what if that’s easier said than done? For many people, budgeting nine hours of our precious 24 sounds impossible, or at least impractical. What’s a poor overworked, overstimulated, 21st-century American to do?

When patients who are experiencing stress-related or lifestyle-related sleeplessness approach the SpectREM center, Bhargava tries to look at the whole picture.

“We try to use methods to change people’s perception of how they’re feeling. There’s some psychological retraining in terms of how to sleep better,” he explains. Muscle relaxation techniques and stimulus control, for example, are two frequent recommendations. He prescribes medicines for underlying depression or anxiety, but he considers them a temporary fix to help while patients acquire new habits and techniques.

Torch looks at sleeplessness from a similar angle; he also takes personal habits into consideration.

“You have to decide what’s important in your life,” he says. “Is television important in your life? Should the television be on at night, to watch the late news? Or can you seriously turn off your television at 7:30 or 8 o’clock and stop watching, ad nauseum, [all the] crap on the television?” The conviction in his voice makes it clear that his questions aren’t rhetorical.

Both doctors acknowledge that changing one’s habits takes more than the swoosh of a magic wand.

“You’re burdened with a lot of school work. You’ve got friends, you’ve got cell phones, you’ve got televisions, you’ve got radios, you’ve got computers now, all of the things that keep us ‘busy,'” Bhargava says.

But they agree it’s worth the effort.

“I believe we’d lead healthier lives, and that we’d be more efficient in the waking hours, if we did get more sleep,” says Torch. “[Not getting enough sleep] actually creates more of a hassle, and it creates anxiety and stress that makes you want to stay up late at night to finish the work that you didn’t complete. It’s a vicious cycle, and it has to be broken.”

As for Thomas Edison, who naysayed sleep in the name of productivity, Stanley Coren writes: “[He] probably had such a strong work ethic that he simply underestimated the length of time he spent napping to make up for his shortened nighttime hours of sleep. The auto maker Henry Ford once made an unexpected visit to Edison’s lab. One of the technicians stopped him from entering Edison’s private office, noting that ‘Mr. Edison is taking a nap.’

“Ford thought that was a bit amusing and said, ‘I understood that Mr. Edison didn’t sleep very much.’

"'Oh, that’s true,’ said the technician. ‘He doesn’t sleep very much at all, he just naps a lot.'”