NEAL CONAN, host:
This is TALK OF THE NATION. I'm Neal Conan in Washington.
A good night's sleep - eight solid hours. When's the last time you had one? Some of us suffer from sleep disorders. Others can't sleep due to other medical problems. But for most of us there's no excuse, which doesn't stop us from inventing one.
New polling numbers show that sleep time in the U.S. continues to decline. Experts say we're in denial, that we lie to ourselves that we really only need four to five hours a night, or a hundred other rationalizations. So what is your excuse? Our number is 800-989-8255. That's 800-989-TALK. Email firstname.lastname@example.org. And you can also excuse yourself on our blog. That's at npr.org/blogofthenation. Joining us now is Dr. William Dement. He's the chief of the Stanford University Division of Sleep, and he's been studying sleep medicine for over 55 years. He joins us today from the studios at Stanford University in California. And Dr. Dement, it's nice to talk to you again.
Dr. WILLIAM DEMENT (Psychiatry and Behavioral Sciences, Stanford University): Well, it's nice to talk to you.
CONAN: We last spoke on this program 10 years ago. Do we get…
Dr. DEMENT: Oh, it's that long.
CONAN: That long.
Dr. DEMENT: Whoa.
CONAN: Do we get less sleep now than we did a decade ago?
Dr. DEMENT: Probably. I think that it's slowly going down. It's often - you know, to really, really know what everybody is doing is a little difficult, but polls definitely show that.
CONAN: Mm-hmm. And these are not necessarily scientific surveys, but polls show a trend that is shorter and shorter amounts of sleep.
Dr. DEMENT: That's correct. And that means there's a higher and higher risk for, you know, negative consequences - falling asleep at the wheel, that sort of thing.
CONAN: And safety - falling asleep at the wheel, that sort of thing, as you say - these are real issues. This is not a joke.
Dr. DEMENT: No, not at all. It's a devastating negative consequence. You know, and when someone falls - like truck driver falls asleep at the wheel, he may - there is a figure, there are - I think eight innocent victims are killed in a fatal to the driver truck accident. And mistakes, and you can - there was someone - I remember someone forgetting to converting inches to centimeters in the $6 billion mistake in the Mars mission.
CONAN: A lack of sleep, you suspect.
Dr. DEMENT: I suspect. I always suspect that.
(Soundbite of laughter)
CONAN: Well, it's your…
Dr. DEMENT: That's my business.
CONAN: That's your job.
(Soundbite of laughter)
CONAN: Now this ability of the human mind, though, to tell itself reasons why it doesn't get enough sleep and to rationalize them, this is powerful, isn't it?
Dr. DEMENT: Very powerful. And mainly it's ignorance. And we're ignorant about sleep disorders. We have - right now, we're carrying out the largest clinical trial on the treatment of obstructive sleep apnea. But it's amazing, people don't know they have this illness, and yet there's a very, very affective treatment. And by the way, we could use a few more subjects. We're winding up this study, and…
CONAN: And do you have to be in California to be subject of this study?
Dr. DEMENT: No, it's actually in five cities: Boston, Tucson, Walla Walla, Washington, Stanford and St. Louis. The number to call - I'll just say it - email@example.com.
CONAN: That's the - we'll get somebody, one our nimble-fingered production assistants to scribble that down and we'll put it on our Web site for those of you who didn't get it down quickly enough. So we'll have that at npr.org/talk.
Dr. Dement, as we listen to people's excuses - here, Tim in Pinedale, New York. I am constantly sleep deprived due to "World of Warcraft," as I'm sure many of the other eight million players are as well. Playing regularly keeps me up until 2:00 or 3:00 AM. At work, I make up for it with at least eight shots of espresso a day. So it's not a problem yet, he adds.
Dr. DEMENT: Well, I think what most people don't realize it is a problem. And we've actually been studying this very closely in recent years, that if you take any individual and have them get extra sleep, their performance improves. And, you know, it's always like here's my personal best. You know, I'm at my personal - well, it gets better. And that's a big surprise.
CONAN: Yet people say there's so many demands on my time. I've got work. I've got kids. I've got - I'm supposed to be - my doctor tells me I'm supposed to be getting exercise every day as well. You've got to burn the candle on at least one end.
Dr. DEMENT: Well, that's - I think what I would say is that, you know, we have all these demands, all these reasons, all these things we must do, and we don't have a good, solid knowledge about sleep to sort of, you know, oppose all that and say, okay, I know that I've got to sleep or I'll - this will happen to me, or my ability to do something will decrease. But people don't honestly know that.
We were studying basketball players recently, and, you know, they have a personal best. I can shoot seven out of 10 foul shots, and that's my absolute best. They get extra sleep, it becomes eight of 10. And it's, you know, that's - people need to know that.
CONAN: Let's get a caller on the line. If you'd like to join us, by the way, it's 800-989-8255. Email is firstname.lastname@example.org. Lisa's with us - Lisa calling from North Carolina.
LISA (Caller): Good afternoon.
LISA: I was wondering what we would do about a husband who you love very dearly and you want to sleep in the same room and be next to him at night, but snores like…
Dr. DEMENT: Yeah.
LISA: …like a bear. It's an awful, awful problem in trying to get rest.
Dr. DEMENT: No, this is a very serious problem. It's, you know, due to a small airway, having tonsils and adenoids, big tongue. Probably, the only effective way to deal with this is surgical. But it's much more important than people realize, because recent studies are showing that if you sleep with someone who snores loudly all night long, you are paying a price. You know, your waking performance is impaired. You…
Dr. DEMENT: …aren't doing things as well as you could. Now whether you can actually get this done or not, I'm not sure, because it's not something that is - has really in the mainstream health care system - you know, treating snoring. But it's certainly a problem at a university, where, you know, you have a snoring roommate, for example. Then you are sleepy all day long. You don't do as well in class.
CONAN: Roommates are easier to change than spouses.
(Soundbite of laughter)
Dr. DEMENT: That's true. That's very wise.
LISA: …these apnea machines. How effective are those? My in-laws, both of them have one of those, and they take them on trip so that they can sleep on the same hotel bed.
Dr. DEMENT: Yeah. They're very effective. Now here's the - if they're snoring and then a pause, then it - that must be treated with a continuous positive airway pressure machine. And you can use it for just - you know, people say benign snoring. I don't think there is any such thing, because it means that airflow is impaired if you snore. So snoring…
CONAN: Now these devices, though, they do look like they come - they're manufactured by Torcamada(ph) Enterprises.
(Soundbite of laughter)
Dr. DEMENT: Well, people swear by them, and I guess maybe a certain percentage find it intolerable. And at that point, you know, you have to do something else. So the dental splints, and, I think, the surgical approach. The beauty of the surgical approach - if insurance covers it - is that it's, you know, forever. It's the lifetime. You don't have to worry about it again.
CONAN: Hmm. All right.
Dr. DEMENT: Whereas wearing the mask, you know, is for the rest of your life.
LISA: Thank you for your help.
CONAN: And good luck, Lisa.
CONAN: Bye-bye. Let's see if we can get - this is Bob. Bob's on the air from Wisconsin.
BOB (Caller): Yes, from Darlington, Wisconsin.
CONAN: Go ahead, please.
BOB: And I've been retired for a number of years down the - I've had the opportunity to turn on my radio at night between 8:30 and 9:00 and listen to NPR.
(Soundbite of laughter)
BOB: They have wonderful programs, and I listen maybe till 11:00, and then I'm kind of tired and then I turn off the radio and fall asleep quite nicely, and I've - get my seven, eight-hours sleep.
CONAN: There are times like a fine formula, as long as you don't adapt it to the middle of the day.
BOB: That's right.
Dr. DEMENT: I get - all I can say is congratulations.
BOB: Well, I just sort of a fell in to this pattern, and I didn't know how it was going to work out, but it just worked out beautifully, especially on Sunday and Saturday night when Norman Gilliland has the old-time radio program, sort of like "The Lone Ranger".
CONAN: Nothing easier to fall asleep to than Fibber McGee and Molly.
BOB: That's exactly right. So it seems to work beautifully for me. And then at the end of the sleep time, it seems like I've had my, well, at least seven and a half, eight hours sleep, so that's not bad.
CONAN: Not bad at all. Dr. William Dement, is it true that we - it's harder to get eight hours of sleep as we get older?
Dr. DEMENT: Yes, but the actual need for sleep probably decreases somewhat at least by an hour from young adulthood to elderly. And I think that the key is not so much saying I need a certain amount of sleep, but if I feel wide awake, rested and, you know, energetic and wanting to do things throughout the entire day, then you are getting the sleep you need.
BOB: And could I say something?
CONAN: Go ahead, Bob.
BOB: If I sleep, like, seven hours, let's say - I'm 75 years old now - and if I sleep the reasonable seven hours, I feel quite refreshed.
Dr. DEMENT: You know, that sounds about right. And that…
BOB: But if it's much less than that, well, then it's a little more uncomfortable, right?
Dr. DEMENT: Exactly.
CONAN: All right, Bob.
BOB: Thank you very much.
CONAN: And have a good night.
CONAN: All right. Bye-bye. Here's an email from Bill:
I try to get by on five hours per day. There's too much life to live. I'll sleep when I'm dead.
(Soundbite of laughter)
Dr. DEMENT: No, I'd say - would you - the choice is going through life losing an hour of sleep at night, going through life as a zombie, or getting - giving up that one hour of being a zombie for wide awake, alert and at your personal best all day long. And I think the main things people - a lot of people just haven't experienced that since they were kids.
So when we actually do our sleep debt reductions maneuvers, people say, oh my God, I haven't felt this great, you know, for years. I didn't realize - and then they are motivated to maintain it - maintain the schedule.
CONAN: Let's get - this is Wyatt. Wyatt's with us from Minnesota.
WYATT (Caller): Hi. My question was how do you naps relate if you're in need for sleep time? For example, last night, I slept four hours. And I'm at work right now. And when I get home, I'll probably take a three-hour nap. Does that mean that I'm reset?
Dr. DEMENT: Well, it can reset, but most people who nap, they can maintain their schedule. And certainly, if you lose sleep at night, a nap in the daytime is a good idea. I thought you were going to say how do you nap?
(Soundbite of laughter)
Dr. DEMENT: Everybody has their own little style.
CONAN: Mm-hmm. What is a useful nap? Is 10 or 20 minutes useful? Do you need to get 40 minutes or an hour and a half to get a full rhythm in?
Dr. DEMENT: I think that there's kind of a miraculous - and most people will report this - if they feel sleepy, their eyelids want to close and they let it happen and sleep for five minutes to 10 minutes, when they awaken, they're very refreshed, and it's kind of hard to explain. If you really, really want to replace lost sleep, again, it's probably a longer nap.
But I think that a very short nap can - it's like going over some sort of boundary into sleepiness, and you get - a little bit of sleep can get you back across that boundary, so that you can keep your eyes open and, you know, continue to drive or whatever it is you're doing.
CONAN: Wyatt, thanks for the call.
WYATT: Thank you.
CONAN: We're talking with Dr. William Dement, chief of the Stanford University Division of Sleep, and you're listening to TALK OF THE NATION from NPR News.
And an email here from Neil:
I was a soldier in the U.S. Army, stationed in Iraq in 2003. Army doctrine is that soldiers are only required four hours of uninterrupted sleep for a - in a 24-hour period to maintain combat operation functionality. In my experience, he writes, this was not enough by a large margin.
Dr. DEMENT: And he's absolutely right, and I am aware of this erroneous doctrine. It's also at the Great Lakes Naval Training Station, where we've had the same thing we've - I think we've managed to change that because no one -almost no one can get along in four hours of sleep at night. And I think you get errors, friendly fire, all kinds of bad things happening. The Army should be well rested.
CONAN: Anybody with automatic weapons should be well rested. I think we can all agree on that. Here's an email from Perry in Portland, Oregon:
I put off sleep because life is so full of activities I love to do. I love what I do for a living, love exercising, love to eat, love to ride my bike, meditating and writing. Who has time for sleep when life is so full and fulfilling? And it's even more so during daylight savings, when the sun's setting between 8:00 and 9:00 PM and the day is being so beautiful. I want to stay out longer. There's just so much so many of us want to do.
Dr. DEMENT: Well, I think that some people do need less sleep, but I think the things like - when we studied meditation some years ago, and all these meditators - it was would sleep. They would all fall asleep. So, I think - I think that people are not sufficiently aware of how they're functioning and what they're doing. So if they want - if you're doing things that are very, very active, yes, it's easy to stay awake, but not meditation or studying.
CONAN: Let's talk with - who is this - Harvey. Harvey is with us from Coral Gables in Florida.
HARVEY (Caller): Good afternoon. I'd like to ask about any research that's been done relative to like a night pulse, circadian rhythm for human beings. If we didn't know, you know, if it was day or night, what might that cycle tend to look like in hours or days or whatever? Is there been any relevant research on that lately?
CONAN: Yup - this is my excuse, that I'm actually an alien from a 27-hour planet.
Dr. DEMENT: That's possible. There has been enormous amount of research in time-isolation facilities in both Europe and the United States. And there is a natural period for human beings, which is - the average is, believe it or not, 24 hours and 11 minutes. There are some individual differences in that. And then what is the most important thing is, how you - how that cycle relates to time of day, so that the alert phase can be early for some people, or it can be very, very late. It certainly tends to be very, very late in college students who - for example, at Stanford - I think the average bedtime is 2:30 a.m.
Dr. DEMENT: Then they - of course, there's difficulty getting up in the morning.
CONAN: Here's a related email from Suzanne in Philadelphia:
I don't get enough sleep at night because I'm on a non-24-hour sleep cycle. As a blind person with no light perception and no retina, I don't have the same ability to metabolize melatonin in the same way as most people. That may be an oversimplification, but I find the subject fascinating.
Dr. DEMENT: Yes, that's - it's almost certainly true. We've studied several blind individuals, and they could not adjust to a 24-hour day so that we either had to - you know, they'd have to be knowledgeable and just do what they could and time their activities, or we could manipulate their sleep cycle with medication, you know, and then synchronize it.
CONAN: Harvey, thanks for the call. Let's see if we can squeeze one last caller in. And this is David - David with us from Syracuse, New York.
DAVID (Caller): Good afternoon.
DAVID: I wanted to ask about sleep prescriptions. The ones that have been tried for me are chloral hydrate, Benadryl and other things. I have a very light, dreaming sleep, not a restful sleep, and so I wind up more tired than without the prescription. So I was wondering why the sleep prescriptions do that, and just give me a light, dreaming sleep, not a restful sleep?
Dr. DEMENT: Well, the names you mentioned are very, very old, and, in a sense, have long since been discarded by physicians. There are four or five more recently evaluated sleep medications, and they require a doctor's prescription, but they're safe and very effective.
DAVID: Such as?
Dr. DEMENT: Well, there's Ambien, Rozerem - these are trade names - Lunesta and Sonata.
CONAN: Good luck with those, David.
CONAN: I just wanted to end with this quote that you gave at something called the Orlando Conference, that "An individual's sleep is normal and adequate should never be taken for granted by anyone. The more correct assumption would be that, until proven otherwise, their sleep is either inadequate, abnormal or both." Dr. Dement, thanks very much for being with us.
Dr. DEMENT: I stand by that.
CONAN: William Dement, professor of psychiatry and behavioral sciences at Stanford University School of Medicine. I'm Neal Conan. It's TALK OF THE NATION from NPR News.
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