USA: Sleep disorders epidemic, study reports

CHICAGO (The Seattle Times), April 5, 2006: Tens of millions of people are suffering fatigue-filled days and wakeful nights as television, the Internet and other distractions contribute to an escalating epidemic of sleeplessness in America, according to a major new government study. An astonishing 50 million to 70 million Americans experience chronic sleep disorders, while millions more are sleep deprived, according to the report by the Institute of Medicine, an arm of the National Academy of Sciences. Increased sleeplessness is "driven largely by broad societal changes, including greater reliance on longer work hours, shift work and greater access to television and the Internet," but physiological factors such as obesity also play a key part, the institute's report found. The study documents the connection between too little shut-eye and problems ranging from poor school performance to injuries and highway accidents. A growing body of scientific evidence links insufficient sleep — less than seven to eight hours a night — to conditions such as hypertension, diabetes and depression. The direct and indirect costs total an estimated "hundreds of billions of dollars" each year. Yet the medical profession is ill-prepared to diagnose and treat people who don't get enough sleep, and federal health agencies haven't given the issue the attention it deserves, the Institute of Medicine said in the study, released Tuesday. "Unfortunately, sleep disorders and sleep deprivation is under-appreciated by the public, the health professions and medical researchers," said Dr. Harvey Colten, a former senior associate dean for health sciences at Columbia University and chairman of a 14-member expert panel that prepared the report. That may come as a surprise to consumers barraged by a seemingly endless series of ads for sleeping pills on late-night TV. The pharmaceutical industry has targeted sleeplessness as an especially attractive growth market: Four major new drugs are set for release in the next year and a half, and a record 43 million prescriptions for sleeping aids were filled last year. Also suggested by the institute: more training in sleep medicine for medical and nursing students, the creation of regional sleep medicine "centers of excellence," more research on sleep problems and treatments, and better education for existing practitioners. The average medical student gets four hours of instruction in sleep, "not nearly enough, given how much we've learned about sleep in the last 10 years," Wyatt said. Chronic insomnia, the inability to fall or stay asleep, is the most common chronic sleep problem in the country, affecting more than 30 million Americans, according to Tuesday's report. An additional 6 million individuals have moderate to severe sleep apnea, an airway obstruction that causes them to briefly stop breathing multiple times a night. More than 6 million people have restless leg syndrome and periodic limb movement disorder, neurological conditions that jolt them awake repeatedly. Millions more have other, less common problems. While medication may help in the short term, sleeping pills can be addictive and have side effects, such as the compulsive nighttime eating recently reported for some users of Ambien, a popular drug. Several experts said behavioral therapies are more effective over the long haul, especially for people with insomnia. If sleeplessness lasts for a month or more, it's time to think about seeing a specialist, some doctors say. By Judith Graham Chicago Tribune Copyright © 2006 The Seattle Times Company