Smartphones hurting our ability to sleep and work

An article from the Wall Street Journal discusses how smartphones make us tired which can both hurt our ability to sleep at night and to be productive during the day.

For a productive day at work tomorrow, give the smartphone a rest tonight.

Reading and sending work email on a smartphone late into the evening doesn’t just make it harder to get a decent night’s sleep. New research findings show it also exhausts workers by morning and leaves them disengaged by the next afternoon.

That means the way most knowledge workers do their jobs—monitoring their iPhones for notes from the boss long after the office day is done and responding to colleagues at all hours—ultimately makes them less effective, posit researchers from University of Florida, Michigan State University and University of Washington.

The scholars conducted two studies of workers’ nighttime technology habits, sleep duration and quality, energy and workplace engagement. In the first study, 82 mid- to high-level managers were asked every morning how many minutes they used their smartphone after 9:00 pm the night before and how many hours they slept. Then, they were asked to rate their agreement with statements like “I feel drained” and “Right now, it would take a lot of effort for me to concentrate on something.”

In the afternoon, they had to assess statements about work engagement, such as “Today while working, I forgot everything else around me.”

Prior studies have shown that staying focused and resisting distractions takes a lot of effort, so when smartphone use interferes with sleep, it takes a toll the next day.

“The benefit of smartphone use may…be offset by the inability of employees to fully recover from work activities while away from the office,” the researchers write.

After accounting for sleep quality, the researchers found that work-related smartphone use in the evening was associated with fewer hours of sleep. The subjects who recorded shorter nights also reported depleted reserves of self-control, and those who felt morning exhaustion also indicated they were less engaged during the day, a domino effect that shows how an unending workday ultimately leads to poorer work.

The second study, which involved 161 workers, measured how late-night tech use—on smartphones, laptops, tablets and TV—can disrupt sleep and next-day work engagement.

In her book, “Sleeping With Your Smartphone,” Harvard Business School professor Leslie Perlow studied executives at Boston Consulting Group who were given a chance to disconnect on a regular basis. The executives became more excited about their work, felt more satisfied about their professional and personal lives and even became more collaborative and efficient.

Using any kind of electronic device affects sleep quantity and focus the following day, but smartphones are especially draining. That’s partly because the always-on, always-handy phone the first device we turn to, says Christopher M. Barnes, an assistant professor of management at University of Washington’s Michael G. Foster School of Business and a co-author of the paper. Having a screen so close to our faces probably doesn’t help us prepare for sleep, he adds.

The researchers don’t yet know if there’s a particular threshold at which smartphone use begins to affect sleep habits, but even 30 minutes before bedtime can take a toll, Barnes says.

The fix, researchers say, is to put down the phone and enjoy the evening. But that’s easier said than done, so long as managers send emails at 10:30 p.m. and expect responses by 10:31 pm. Barnes says real change will have to come from the top, with managers setting an example by not sending those messages in the first place, or at least toning down expectations on response time.

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Autism symptoms in adults eased by challenges at work

Challenges in the workplace can ease autism symptoms in adults.

For adults with autism, having the chance to work somewhat independently may lead to a reduction in symptoms of the disorder, a new study suggests.

The research puts new emphasis on the potential for adults with autism to develop and improve over their lifetimes, said study author Julie Lounds Taylor, an assistant professor of pediatrics at Vanderbilt University, in Nashville.

"We have assumed it's really hard to budge autism symptoms in adulthood. Drugs are targeted to problems like acting out, for example," she said. "But this study suggests that these adults need a place where they're intellectually stimulated, and then we'll see a reduction in symptoms."

The challenge is to find the right fit between a person's abilities and interests and a specific job, she explained.

"How independent can they be and what are the risks of failure? We have to be careful. You're talking about a huge range of people with autism," Taylor said. "I've seen people who can manage pretty high-level jobs, like computer programming or being in the military, while others have more [mental] challenges, but can still work a job in the community with support."

Autism spectrum disorders are a class of neurodevelopmental disorders defined by difficulties with social functioning and communication, according to the researchers. Symptoms include restricted interests, repetitive behaviors and difficulty with social interactions.

The study findings were reported online recently in the Journal of Autism and Developmental Disorders.

Increasing the level of independence in adults with autism isn't necessarily difficult to do, Taylor said. "We found behavior changes any time you could bump [them] up to doing something a little more independent," she said. "As they get more independent, you see more benefit."

Yet understanding what makes a good fit is a huge challenge, she said. "Insight is one of the characteristics people with autism typically may not have, so we will probably need the person's perspective and then gather information from families, looking at what's available, and incorporating all of that together," Taylor explained.

About 50 percent of adults with autism spend their time in sheltered settings, and a minority work in the community, according to Taylor. Most have trouble holding steady jobs, she added.

For the study, the researchers tracked the behavioral development and activities of 153 people with autism spectrum disorder over a five-year period. Their average age was about 30.

The data came from a larger study conducted at the University of Wisconsin-Madison, which followed 400 families with adolescents with autism over 10 years. Data were collected at two different points in time almost six years apart. Data came from the primary caregiver -- 150 were mothers and three were fathers.

The researchers found that having greater vocational independence and engagement was related to reduction in autism symptoms and maladaptive behaviors. It was also associated with improvements in daily life activities.

An expert in autism spectrum disorders who was not involved in the study said the results were not surprising.

"This study suggests that, as with nondisabled individuals, a more positive work experience can have many important associated benefits downstream," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven & Alexandra Cohen Children's Medical Center of New York, in New Hyde Park.

If the research can be replicated, Adesman said it suggests greater emphasis needs to be given to helping adults with autism spectrum disorder find as independent and engaging a work environment as possible.

Taylor said the key point for parents of adults with autism spectrum disorder is to understand the value of getting the best possible vocational placement for their son or daughter and advocating for it.

"If it's a terrible fit, in ability or in what interests them, it won't work out," she said. "But a job can have lasting behavioral impact across the lifespan."

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Daylight increases sleep quality

Exposure to daylight in the workplace leads to increased sleep quality and duration.

Think of your ideal workspace. Do you prefer fluorescent lights flickering overhead, or daylight streaming in through wide windows?

If you need help deciding, consider new findings that suggest a strong link between windows in the workplace and workers' sleep, vitality, and quality of life.

In preliminary research presented this week at the SLEEP 2013 conference in Baltimore, a team led by doctoral candidate Ivy Cheung of Northwestern University found that those who had windows in the workplace slept an average of 47 more minutes per night compared to workers in offices without daylight exposure.

They also had 173 percent more white light exposure during the workday, were more physically active, and reported better sleep quality and efficiency.

"The extent to which daylight exposure impacts office workers is remarkable," said Cheung.

Cheung's study included 49 day-shift office workers, 27 of whom worked in a windowless workplace and 22 of whom worked with windows.

The participants answered the Short-Form Health Survey (SF-36) and the Pittsburgh Sleep Quality Index (PSQI), self-report questionnaires that assess their general quality of life and sleep quality, respectively.

In a subset of 21 participants, including 10 windowless workers and 11 workers with windows, researchers measured light exposure, activity, and sleep-wake patterns with actigraphy, a monitoring technique in which wrist monitors record motor activity and other sleep-related factors like light and temperature.

The workers without windows in the workplace had worse quality of life measures related to vitality and physical problems, and poorer scores on measures of overall sleep quality, sleep efficiency, sleep disturbances, and daytime dysfunction on the PSQI. No significant actigraphy results were reported.

The researchers suggest that architects and employers should take natural daylight exposure and light levels into account when considering the structural forces that motivate office workers and encourage overall health.

"Enhanced indoor lighting for those with insufficient daylight in current offices as well as increased emphasis on sufficient daylight exposure in the architectural design of future office environments may improve office workers' physical and mental well-being," they conclude.

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Physical jobs lead to sleep duration extremes

A new study shows that jobs that are high-activity and physically demanding lead to either short sleep duration or long sleep duration.

A study from the Perelman School of Medicine at the University of Pennsylvania has found that people who work in jobs that are more physically demanding tend to be either shorter sleepers (fewer than 6 hours a night) or longer sleepers (longer than 9 hours).

Since previous research has shown that people who report short or long sleep are more likely to have worse health over time, such as weight gain, heart disease and diabetes, the new study suggests that people's jobs may predispose them to unhealthy sleep patterns that could detrimentally affect their health. The findings go against the concept that physical activity in general seems to be healthy, and physical activity tends to be good for sleep.

Penn researchers examined sleep patterns and job classifications of over 17,000 study participants. Job activity was classified as low (mostly sitting or standing), moderate (mostly walking), or high (mostly manual labor). Compared to those in low activity jobs, those working moderate activity jobs, such as postal service employees, were more likely to be short sleepers and long sleepers, and those working high-activity jobs, such as construction workers, were more likely to be short sleepers.

According to the research team, possible explanations for the findings include:

1) the higher demands of the job require longer hours, not allowing for a full night of sleep;

2) job-related stress is keeping people up at night; and

3) the physical demands of the job are causing persons to stay awake.

The research team includes Holly E. Barilla, Charles Corbitt, Subhajit Chakravorty, Michael Perlis, PhD, and Michael Grandner, PhD.

The study is scheduled to be presented June 3 at SLEEP 2013, the annual meeting of the Associated Professional Sleep Societies in Baltimore.

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Police need sleep for health and adequate performance

One study looks into reasons why police specifically need enough sleep.

Forget bad guys and gunfire: Being a police officer can be hazardous to your health in other ways.

Researchers at the University of Iowa have found that police officers who sleep fewer than six hours per night are more susceptible to chronic fatigue and health problems, such as being overweight or obese, and contracting diabetes or heart disease. The study found that officers working the evening or night shifts were 14 times more likely to get less restful sleep than day-shift officers, and also were subjected to more back-to-back shifts, exacerbating their sleep deficit.

The study is the first peer-reviewed look at differences in duration and quality of sleep in the context of shift work and health risks in the police force, the authors noted.

"This study further confirmed the impact of shift work on law enforcement officers and the importance of sleep as a modifiable risk factor for police," wrote Sandra Ramey, assistant professor in the College of Nursing at the UI and the lead author on the paper published inWorkplace Health & Safety. "The good news is this is correctable. There are approaches we can take to break the cascade of poor sleep for police officers."

The research is important because getting fewer than six hours of sleep could affect officers' ability to do their jobs, which could affect public safety. It also boosts the risk for health problems, which could affect staffing and could lead to higher health costs borne by taxpayers.

The researchers recommend putting practices in place to ensure officers get proper sleep. For example, 83 percent of police on the evening or night shift reported having to report to duty early the next morning at least occasionally. One idea from the UI team is to change the morning time that evening or night-shift officers may need to appear in court, to ensure that they get full rest. They also recommend that law enforcement and nurses partner more closely, to encourage officers to get 7-8 hours of sleep per night.

The researchers surveyed 85 male police officers ranging in age from 22 to 63 years old from three police departments in eastern Iowa. The respondents were equally divided between those who worked the day shift and those who worked the evening or night shifts. The officers, who worked on average 46 hours per week, were queried on their levels of stress and fatigue, while their height, weight, and C-reactive protein levels (marks inflammation levels in the blood) were measured.

While officers working the evening or night shifts were more likely to get fewer than six hours of sleep, the researchers also found that police who slept fewer than six hours were twice as likely to sleep poorly. That finding is important, because poor sleep can lead to "vital exhaustion," or chronic fatigue, the authors noted, which can trigger additional health problems.

The UI study builds on other studies that show a possible link between sleep deprivation and ill health and chronic fatigue in police officers. "This finding is supported by other studies that suggested poor sleep and short sleep (with resultant fatigue) may be related to psychological stress," they wrote.

Somewhat surprisingly, the researchers did not find a strong tie between lack of sleep and the onset of health complications, although they said a larger statistical sample may be needed to more fully understand the relationship.

The study, titled "The effect of work shift and sleep duration on various aspects of police officers' health," was published in the May edition of the journal. M. Kathleen Clark, Yelena Perhounkova, and Hui-Chen Tseng from the UI College of Nursing are co-authors on the study. Laura Budde, from Mercy Hospital in Iowa City, and Mikyung Moon, from Keimyung University in South Korea, are contributing authors on the paper.

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Sleep Deprivation was the cause of a Pilot's Meltdown

The JetBlue airline pilot who went on a frightening in-flight tirade in March, forcing the flight to be diverted, was having a "brief psychotic disorder" because of sleep deprivation, a psychologist testified at a hearing. The psychologist's testimony, given last week, was revealed in court documents released today.

According to witnesses, Clayton Osbon, 49, was flying a New York-to-Las Vegas jetliner March 27 when he went on a rampage in the cabin, ranting about Sept. 11, 2001, making allusions to terrorists and yelling, "Guys, push it to full throttle."

"Osbon also yelled jumbled comments about Jesus, September 11, Iraq, Iran, and terrorists," according to a criminal complaint. The plane was carrying 131 passengers and six crew members.

"The captain of the plane just went berserk," passenger Wayne Holmes told ABC News. "He came out of the other end of the plane -- came running back to the cockpit and he was shouting out these numbers -- 500 something. He started banging on the cockpit door."

A passenger subdued Osbon, a veteran captain, and the flight was diverted safely to Amarillo, Texas. Osbon was later suspended from his duties and charged with interfering with flight crew instructions

The U.S. Attorney's Office did not dispute the psychologist's testimony on July 3 and a federal judge in Texas found Osbon not guilty by reason of insanity.

"The defendant appeared to suffer from a severe mental disease or defect that impaired his ability to appreciate the nature, quality or wrongfulness of his behavior," U.S. District Judge Mary Lous Robinson said last week.

Osbon was sent to a mental health facility in Fort Worth for additional treatment.

Despite denials from the airline industry, ABC News has found that large numbers of pilots have reported for duty every day after getting only a few hours of what fatigue experts call "destructive sleep" in crowded crew lounges and so-called "crash pads."

Critics say that widespread pilot fatigue is putting airline passengers at risk, and may already have cost lives.

JetBlue told ABC News today, however, that Osbon had the weekend off before that Tuesday flight and that Monday he'd only flown two trips before having an additional 17 hours off.

The airline said that it continued to comply with new rules instituted by the Federal Aviation Administration in December that require a 10-hour rest period for pilots between flights and 30 consecutive hours off during the week.

Ten passengers from the flight filed the first of what is expected to be many lawsuits demanding unspecified damages from Osbon and JetBlue.

Alison Croyle, an airline spokeswoman, told The Associated Press today that Osbon was still employed by JetBlue and on "inactive status."

Osbon could be released as early as August, when he is expected to have another hearing. A judge may determine whether he can be permanently released or committed to a facility.

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Young adults with autism lag in school and work

Young adults withautism are less likely to go to college or hold down a job than their peers with other types of disabilities, a new U.S. study finds.

Researchers found that more than one-third of young adults with an autism spectrum disorder had not gotten a job or gone into higher education since high school. And that number was much higher compared with young adults with learning disabilities or other impairments.

It's estimated that about one in 88 U.S. children has an autism spectrum disorder, or ASD.

That's up 78 percent from a decade ago — which health officials attribute to better diagnosis, as well as broader definitions of what constitutes an ASD.

ASDs are a group of developmental brain disorders that hinder a person's ability to communicate and interact socially — ranging from the severe cases of "classic" autism to the relatively mild form calledAsperger's syndrome.

But while rates of ASD diagnoses are shooting up, researchers have not known all that much about how kids with the disorders fare after high school.

So for the new study, researchers collected data on 680 young U.S. adults with an ASD, along with nearly 1,400 young people with learning disabilities, speech or language impairments or intellectual impairment.

All were between the ages of 19 and 23, and had been in special education programs when they were in school.

Overall, the study found, 35 percent of young adults with ASDs had not gone to school or held a job since high school.

That compared with only 7 percent of young adults with speech or language impairments, and 3 percent of those with learning disabilities. Even young people with intellectual impairments were faring better than the ASD group: one-quarter had not gone on to higher education or the workplace after high school.

The findings appear in the journal Pediatrics.

GAP STRIKING

It's not surprising that many young adults with ASDs would struggle, according to Paul T. Shattuck, the lead researcher on the study.

"But I wasn't prepared for the magnitude of the effect," said Shattuck, an assistant professor at Washington University in St. Louis. "The gap between them and young people with other disabilities was striking."

Another important finding, Shattuck said, was that low-income adults with ASDs were at substantial risk.

Among young adults from families making under $25,000 a year, 55 percent had not worked or started higher education since high school.

That compared with 18 percent of those from families who made more than $75,000 a year.

"That's a huge difference," Shattuck said. The reasons for the gap are not clear from the study, he noted — but it likely has something to do with access to services for people with ASDs.

Another reason, according to Shattuck, may be that higher-income families have more social connections, including people who could help their child find work or get into school.

The researchers estimate that in 2009, about 163,000 U.S. children with an ASD were living below the poverty line.

DOESN'T MAGICALLY DISAPPEAR

There are some services available to help families and kids with ASDs prepare for life as an adult. Shattuck said that special ed programs should include, "as part of the package," some type of transitioning plan for the post-high school years.

"That's the goal anyway," he said. "The reality is, not every kids gets that, and the quality of (the service) will vary from place to place."

There is definitely a need for more research into services for young adults with ASDs, according to Shattuck's team — particularly programs to help kids from low-income families.

The "popular image" associated with autism is the affected child, Shattuck noted.

"But autism doesn't magically disappear in adolescence," he said. "These kids grow up, and that's the age group we know the least about."

CDC claims 41 million American workers don't get enough sleep

If you happen to be at work right now and you're feeling tired, you've got a lot of company. A new CDC study finds more than 40 million workers get fewer than six hours of sleep per night - that's about 30 percent of the country's civilian workforce.

And by not getting the National Sleep Foundation's recommended seven to nine hours of shut-eye per night, the CDC says these workers pose a serious and potentially fatal risk to themselves and coworkers. The CDC's study is published in the April 26 issue of its journal Morbidity and Mortality Weekly Report.

Some workers were hit harder in their slumber time, the survey of more than 15,000 workers found. Forty-four percent of night-shift workers reported not getting enough sleep with rates highest among workers in the transportation or warehouse industries, followed by health care and social assistance workers.

"There about 41 million workers who aren't getting the recommended amount of sleep," study author Dr. Sara Luckhaupt, a medical officer in the division of surveillance, hazard evaluations, and field studies at the CDC's National Institute for Occupational Safety and Health in Washington, D.C, told HealthDay. "Not surprisingly, workers who work the night shift are more likely to not get enough sleep," she said, adding people who work more than one job or more than 40 hours a week are also likely to get too little sleep.

The finding that shift-workers in the transportation industry don't get enough sleep echoes a March National Sleep Foundation poll. That poll found 50 percent of pilots, 44 percent of truck drivers, and 29 percent of bus, taxi and limousine drivers said they rarely got a good night's sleep on workdays, HealthPop reported.

According to the CDC an estimated 20 percent of vehicle crashes are linked to drowsy driving. In 2010, a total of 4,547 workers died from occupational injuries, and approximately 49,000 died from work-related illnesses.

Among all workers surveyed for the new study, those in middle age groups of 30 to 44 years (31.6 percent) and 45 to 64 years (31.8 percent) were significantly more likely than workers aged 18 to 29 years (26.5 percent) or older than 65 years (21.7 percent) to report a short night's sleep.

Dr. Michael J. Breus, a sleep expert and clinical psychologist, told WebMD that if you fall asleep in less than 10 minutes, you're probably sleep deprived. Another sign that may ring familiar to some: "If you hit the snooze button more than twice you are probably sleep-deprived," Breus said.

What should the nation's sleepy workforce do to stop the trends?

Luckhaupt told WebMD that employers should take steps to make sure their workers are getting enough sleep, such as by tweaking night shift schedules or imposing limits on consecutive shifts. Employers should also have wellness initiatives that encourage workers to go to sleep at the same time every night and create a relaxing bedroom environment. That also means avoiding reading or television in bed and turning off that smartphone.

Besides going a long way towards workplace safety, getting the right amount of sleep can boost a person's health. A study earlier this month found people who don't get sufficient sleep significantly raise their risks for diabetes and obesity.

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Pilot Performance, Jet Lag and Sleep Deprivation

Night-time departures, early morning arrivals, and adjusting to several time zones in a matter of days can rattle circadian rhythms, compromise attention and challenge vigilance. And yet, these are the very conditions many pilots face as they contend with a technically challenging job in which potentially hundreds of lives are at stake.

In an article to be published in a forthcoming issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science, John A Caldwell, a psychologist and senior scientist at Fatigue Science, a Honolulu business focusing on fatigue assessment, examines the problem of sleep deprived pilots by teasing out the complex interplay of inadequate sleep and circadian rhythms. He explains how airline industry solutions miss the point and then suggests other options.

Caldwell points out that "fatigue-related performance problems in aviation have been consistently underestimated and underappreciated, despite the fact that decades of research on pilots and other operational personnel has clearly established that fatigue from insufficient sleep significantly degrades basic cognitive performance, psychological mood, and fundamental piloting skills."

Evidence abounds. In 2004, a corporate airlines flight crashed as it approached Kirksville Regional Airport; in 2008, Honolulu based pilots of Go! Airlines overshot their destination by more than thirty miles because they fell asleep during a trip that was only fifty minutes long. A Northwest Airlines Flight overflew its destination by 150 miles because pilots had dozed off at the controls. In 2009, fifty people were killed when a Continental Connection flight en route from Newark to Buffalo crashed into a house. Pilots failed to respond properly to a stall warning and the flight went out of control.

After examining what went wrong, the NTSB concluded that, "the pilots' performance was likely impaired because of fatigue." Since 1990 the US National Transportation Safety Board has placed pilot fatigue on the Most Wanted List of safety related priorities.

Why? Because as fatigue increases, "accuracy and timing degrade, lower standards of performance are accepted, the ability to integrate information from individual flight instruments into a meaningful and overall pattern declines, and attention narrows. "

In one study, F-117 pilots were deprived of one night of sleep and then were tested on precision instruments. Not only did pilot errors on those instruments double after one night of sleep loss, pilots reported feeling depressed and confused.

Clearly fatigue is fundamentally the result of insufficient sleep, but for pilots the important issue is the consequences of that sleep loss when they are sitting at the control panel. The author suggests that "fatigue related risks increase substantially when (a) the waking period is longer than 16 hours, (b) the preduty sleep period is shorter than 6 hours, or (c) the work period occurs during the pilot's usual sleep hours."

"Regulators, and often the pilots themselves, have tried to address the fatigue problem by focusing on duty hours rather than focusing on the physiological factors that are truly responsible," Caldwell says. "The combination of insufficient sleep and circadian factors is at the heart of the fatigue problem in any operational context."

The two most important variables for alertness are recent sleep and the body's natural circadian rhythm, or "body clock." What that means is that when a pilot reports for duty, he or she should have had from seven to nine hours of good sleep within a reasonable period of time before work and that as often as possible, the work schedule is in some harmony with the pilot's natural daily rhythm.

The amount of time that a pilot is actually working is much less important. But that is the area airlines and regulators have focused on to address the problem. "Hours-of- service" regulations have been instituted to mitigate fatigue, but "that seems to be a function of convenience rather than science." Caldwell writes that in traditional regulatory approaches "one hour of daytime flight in one's home time zone after plenty of sleep is considered to generate the same amount of fatigue as an hour of nighttime flight" that was preceded by a transcontinental transition and sleep outside of a normal sleep cycle. Fortunately, new Federal Aviation Administration regulations better account for the true physiological nature of fatigue, but additional fatigue-management strategies are needed.

Caldwell acknowledges that the very nature of airline travel predisposes pilots to disrupted sleep schedules, but he points out several approaches that can both predict a truly impaired pilot and mitigate the consequences of a lack of sleep. There are some fatigue prediction models that can help determine the impact of work/rest schedules on aviator performance. Crew members should be educated on sleep hygiene so they can snag some restorative rest before duty or during layovers. Onboard cockpit napping should be authorized so that pilots will be able to compensate for a lack of sleep. And new wearable sleep-tracking technologies should be utilized to actually measure the pre-duty and layover sleep of flight crews so that they can better manage and optimize their own sleep.

"As a society, we must come to grips with the fact that the average adult needs 7-9 hours of sleep every single day," he says. "And there is no amount of willpower, professionalism, training, or money that will prevent the performance losses associated with the failure to routinely acquire sufficient sleep."

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Study: The dangers of not getting enough sleep

More people pull the night shift. Teens text past midnight and stumble to school at sunrise. Travellers pack red-eye flights.

Nodding off behind the wheel isn't the only threat from a lack of shut-eye. There's growing evidence that people who regularly sleep too little and at the wrong time suffer long-lasting consequences that a nap won't cure - an increased risk of diabetes, heart disease and other health problems.

"We have a societal conspiracy for sleep deprivation," says Russell Sanna of Harvard Medical School's sleep medicine division, who attended a TEDMED conference last week where scientists called sleep loss one of healthcare's big challenges.

Studies have long shown that people who sleep fewer than five hours a night have an increased risk of developing Type 2 diabetes, the kind that tends to strike later in life.

Rotating shift work - three or more night shifts a month interspersed with day or evening hours - raises the risk, too, according to a recent report from researchers who analysed years of medical records from the huge Nurses' Health Study.

Diet and physical activity are big factors in Type 2 diabetes. Certainly it's harder to exercise or choose an apple over a doughnut when you're tired, especially at 3am when your body's internal clock knows you should be sleeping.

But a recently published study showed sleep plays a more complex role than that. As sleep drops and normal biological rhythms are disrupted, the body physically changes in ways that can help set the stage for diabetes, reports neuroscientist Orfeu Buxton of Boston's Brigham and Women's Hospital.

Buxton's team had 21 healthy volunteers spend almost six weeks living in a laboratory where their diet, physical activity, sleep and even the light was strictly controlled.

The volunteers started out well rested. But for three of those weeks, they were allowed only about 5 ½ hours of sleep every 24 hours - at varying times of the day or night, to mimic a bad shift rotation or prolonged jet lag. That knocked out of whack the body's "circadian rhythm," a master biological clock that regulates such patterns as when we become sleepy and how body temperature rises and falls.

What happened was startling - blood sugar levels increased after meals, sometimes to pre-diabetic levels, because the pancreas stopped secreting enough insulin, Buxton reported in the journal Science Translational Medicine.

At the same time, the volunteers' metabolic rate slowed by eight per cent. The researchers had them on a diet so they didn't gain weight - but Buxton says typically, a metabolism drop of that size could mean gaining about 5kg pounds over a year.

The results make sense, says Dr Michael Thorpy, sleep centre director at New York's Montefiore Medical Center and a neurology professor at Albert Einstein College of Medicine.

"If we're going to spend a third of our day sleeping, there's got to be a good reason for it," said Dr Thorpy.

Impaired sleep has been linked to high blood pressure, heart disease, obesity, depression, memory impairment and a weakened immune system. Plus, The World Health Organization has classified night shift work as a probable carcinogen, because too much light at night may hamper a hormone involved both with sleep and suppressing tumour cells.

Don't people adjust to the night shift if they're on it long enough? Buxton said rotating shifts could be the biggest worry.In his study, the volunteers' bodies went back to normal after nine nights of sufficient sleep at the right time. No one knows how long it takes before sleep deprivation and an off-kilter biological clock may cause permanent damage.

Dr Thorpy said natural night owls seem to adapt better to night shifts, but people never fully adapt if they swing back to daytime schedules on their days off. About 30 per cent of regular night workers have trouble sleeping during their off hours or are particularly fatigued, he said, something termed "shift work disorder."

For good health:

* The National Institutes of Health in the US says adults need between seven and nine hours of sleep daily for good health.

* If you work nights, go straight to bed when you get home. Avoid too much light along the way. Dr Thorpy says wearing yellow or orange tinted sunglasses on the drive home can block short-wavelength "blue light" that triggers wakefulness.

* Let natural light help keep your biological sleep clock on schedule, advises Harvard's sleep-education website. For most people, sunlight in the morning is key. For the night shift, more bright light in the evening shifts people's internal clock, Buxton explains.

* A sleep-inducing bedroom is one that's dark, quiet and cool. Avoid caffeine, alcohol and stressful situations near bedtime. Electronics right before bed aren't advised, either. Going to bed and waking up at the same time every day also helps.

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Why Americans Don't Sleep Well

Amen. JR

Why are 70 million Americans having trouble getting a good night’s sleep? Let us count the ways:

We are over-caffeinated (coffee, soft drinks, energy drinks, snacks) and over-medicated (prescription and over-the-counter drugs, including alcohol), wreaking havoc with slumber patterns.

We are over-wired (video games, Web browsing, social media, texting) and overstressed (money, work, relationships, overloaded schedules), making us too restless to doze off when we should.

We are overworked (longer hours, night shifts incompatible with our biological clocks) and overweight (perhaps a chicken-or-egg deal, as different studies have found that one leads to the other).

And then there’s societal pressure, what nationally recognized sleep expert Dr. Mark Mahowald calls “the pervasive, erroneous attitude that sleep is not a biological imperative, that it is negotiable. We have raised sleep deprivation to a badge of honor.”

The effects might outnumber the causes, and are hardly as benign as many of us might think. “Any degree of sleep deprivation will impair performance: behind the wheel, in the classroom or workplace,” Mahowald said.

He added that the Bhopal, Challenger, Exxon Valdez and Three Mile Island disasters “all are officially attributed to problems from sleep deprivation. But the biggest risk of sleep deprivation is car crashes, period.”

No wonder the number of accredited sleep centers has risen nationwide by 630 percent in just 15 years. And while sleep study results have been all over the map and sometimes contradictory, experts such as local doctors Mahowald and Michael Schmitz know a lot more than researchers did even a decade ago.

Effects:

• With sleep deprivation, some glucose metabolism problems might predispose one to diabetes. And if so, a consequence could be heart disease and stroke.

• With insomnia, there is no evidence of long-term physical problems or links to other diseases. But insomnia results in poorer quality of life and work absences and can lead to depression.

• There is some evidence that severe sleep apnea can lead to hypertension, heart problems and a higher risk of strokes.

Solutions:

• Improving sleep hygiene -- avoiding late eating and drinking, keeping the room cool and dark, winding down before bedtime -- can improve or resolve transient or acute insomnia but probably not chronic insomnia.

• For chronic insomnia, cognitive behavioral therapy is equally as or more effective than medications. Medication often is useful for acute insomnia.

• Naps can help -- except when they don’t. “We discourage napping when anyone has problems falling or staying asleep at night, which might be an untreated sleep disorder,” said behavioral sleep specialist Schmitz. “We encourage power naps, 30 minutes or less, when folks can’t stay awake or will have late-night events.”

• See your doctor if: You have had difficulty falling and staying asleep for more than a week. Or if you snore, have frequent awakenings and are reporting sleepiness during the day. Anyone with apnea symptoms should seek treatment.

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Read more here: http://www.macon.com/2012/04/09/1981741/americans-are-too-busy-drink-too.html#storylink=cpy