NOTICE: Posting schedule is irregular. I hope to get back to a regular schedule as the day-job allows.

Wednesday, October 10, 2012

The GUIDE: Sleep and Sleep Deprivation [Full link to blog for email clients.]

Still recovering and still struggling with time, the lone writer sits at his computer... and falls asleep.

Sorry, folks, today we had the major canine and small equine festival - i.e. "Dog and Pony Show" at work. Tomorrow night I leave for our annual scientific meeting.  Needless to say, I'm a slacker, as Tom Kratman takes great pleasure in informing me.

One of my regular correspondents writes:  "Speaker, you did a post on sleep and sleep deprivation effects fairly recently. I would like to look at it again and can't find it. Could you point me to it?"

Sure, Sanford.  I imagine that the post you are thinking of was my "Black Friday" piece from last year:

 An Open Letter to U.S. Retailers -

In it, I equate sleep deprivation with intoxication and point out the issues with sudden changes in work shifts, the effects of extended wakefullness and disruption in sleep. You are welcome to read the original, but I've extracted the highlights, below:

The frank truth is that lack of sleep produces many of the same mental effects as being drunk or high, and Black Friday will be staffed by employees operating on too little sleep.  The busiest retail day of the year is also the day when clerks and shoppers both are at the greatest risk of making serious judgmental errors at potentially high costs.
Critical factors are:
  1. Sudden shift from working during the day to working during normal sleep hours.
  2. Long work hours
  3. Difficulty in sleeping during the day
The effects:
Essentially, people who are sleep deprived show many of the same impairments of a person with a legally impaired blood alcohol level even though they do not show the same physical effects [Citek at al., Journal of Forensic Science, September 2011, volume 56, number 5, pages 1170-1179].  While factories, shops and offices that normally operate evening and night shifts have employees who are accustomed to working in the dark hours of the morning, most retail employees (and shoppers) are not.  Thus, not only are Black Friday employees *working* impaired, the customers are also *shopping* and driving while impaired.  The increase in traffic incidents and police responses on Black Friday is commonly attributed to the size of the crowds, however, the increasing trend of early opening and sleep-deprived public has to be be compounding the problem.  

The causative factors are that individuals who normally go to work at 8 AM, and now go out into public at Midnight will essentially start their work period during the times of the day when they are usually asleep and all bodily functions are at a minimum.  This is the equivalent of suddenly travelling from the U.S. to Europe, with all of the symptoms of jet lag, without the elapsed time.  It's even worse when people attempt to go to sleep in the afternoon or early evening so that they get a decent amount of sleep before getting up and going to out to shop or work.  Normal daily cycles and rhythms involve 6-10 hours of sleep, followed by 16-18 hrs awake.  It is difficult to sleep when a person has been awake for less than 12 hours (provided that the person is not already sleep deprived), so trying to go to sleep at 6 PM means spending a lot of time *trying* to sleep, but not succeeding.  It takes "swing-shift" workers about a week to adjust their sleep schedules from day to night shifts (or vice-versa) [Kolla and Auger, Cleveland Clinic Journal of Medicine, October 2011, volume 78, number 10, pages 675-684].

So what's the problem with being a bit sleepy at work? 
Sleep deprivation slows reaction times, impairs memory and alters judgment.  A study in primates a few years ago demonstrated that following a single night of lost sleep, critical brain areas showed reduced activity, while other brain ares have to work harder to compensate [Porrino et al., Public Library of Science - Biology, September 2005, volume 3, number 9, page e299].  When sleep deprived, it is difficult to form and use short term memory and make critical decisions.
For an employee, it may mean a driving incident or accident with heavy machinery.  For employers, it may mean lapses of judgement ranging from charging an incorrect price to making the *wrong* decision when other people's health and safety are at stake. Yes, many businesses, manufactories and professions work through the night, but those people have adjusted their schedules to that purpose.


I suspect that the summary above is the article you were thinking of, Sanford.  You may in fact want me to expand on the topic, and I would be happy to do so in a future blog.  

In the meantime, let me close with a few myths and truths about sleep deprivation:

Myth:  You can make up short sleep hours by sleeping in on the weekend.
Truth:  In the short term, you need to "make up" as much sleep as you lose.  If you rn short an hour a night, you'd need to sleep 5 extra hours on Saturday. The that bit about needing to be awake for 12 or more hours before your next sleep cycle kicks in - and you can't get to sleep that night, so you sleep in the next day, and end up losing sleep by Monday morning... In the long run, accumulated sleep debt can only be discharged by a drastic change in schedule & health - a new exercise program, diet, stress relief, seasonal change - all of which can help reset your sleep cycle.

Myth:  You need less sleep as a child or elder adult.
Truth:  Children under age 8-10 seem to need about an hour more sleep a night.  For about 3-4 years, the sleep need *seems* to go down, but by mid teens, kids are back to the same sleep needs - except that teens seem to function better with a later waking time in the morning.  Past age 60, the apparent need for sleep diminishes more due to insomnia than any need for less sleep.  Insomnia is often tied to daytime sleepiness, so there may even be the same number of hours of sleep, just broken up through the day.

Myth:  The best sleep is continuous through the night.  
Truth:  Actually, we seem to sleep in cycles of 1-2.5 hrs.  There will be 4-5 of these a night, and it is not at all unusual or unhealthy in waking all the way up between bouts.  Usually the morning tiredness we feel comes when the alarm awakens us in the middle of a cycle.

Note:  The best way to determine how much sleep you need is to stay awake for about 16 hrs, then go to sleep in a cool, dark, quiet room.  Now, sleep until you awaken naturally in the morning - first waking - don't hit the snooze alarm or pull up the covers and roll over.  If you can get up and feel awake, not fuzzy, you've had a full night's sleep.  Repeat a few times.  Now try to adjust your bedtime so that your average wake time is about 5 minutes before your alarm.  I happen to know that I can awaken normally after about 7.5 hrs of sleep.  The normal range is 7-9 hours.

Myth:  Coffee will get me through.
Truth:  All stimulant drugs - and caffeine is *definitely* a stimulant drug (albeit, quite pleasant in most forms) - extract a price, and that price is a crash due to accumulated sleep debt - and by the way, if you are tired enough, you'll sleep even with the whole pot of coffee.  Stimulants don't always improve mental capacity, either, so it's possible to be "awake" yet not aware or fully cognizant of your environment.


Thanks to all of my readers, I have to report that the carpal tunnel surgery was a success - so much so I can't wait to get the other wrist done (my dominant hand) mostly because it's the one that really hurts, now. 
At three weeks after the surgery, nearly full sensation has returned to the fingers of that hand, and I'm gradually regaining strength and dexterity.

So, keep those cards and letter rolling in, folks, and I'll see you next time!

1 comment:

  1. I appreciate this very much. My mother suffers from a long-term sleep disorder and often can't sleep more than four or five hours a night even though she _needs_ more. (Her natural sleep cycle is somewhat like yours, I believe; it's in the seven and a half hour range.) This is because of physical pain, mostly, and other associated health problems due to aging.

    In a personal note, I'm glad that your carpal tunnel surgery went well. I have CTS also, and with two rounds of occupational therapy plus a few cortisone shots a year-plus ago, I was able to resume playing my musical instruments and my typing speed went back to normal (upwards of 75 wpm). But surgery is an option down the line (right now, a combination of exercise and medication seems to hold the CTS in check; it is no better, certainly, but no worse, either, and so long as I can do what I need to do, I'm willing to put up with the occasional bad attack of numbness); it's good to hear that it worked for you, as I've heard roughly a 50/50 split thus far (those for whom the surgery had no effect or a worsening effect, and those, like you, for where it really did help).

    Much appreciated, as always. (I often read but rarely post.)



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