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Increased Stress May Be Linked to Sleep Problems

Someone needs a nap.
Someone needs a nap.
© iStockphoto.com/princessdlaf

Many problems and frustrations that have become part of the American way of life, from anger and stress to obesity, may have inadequate sleep and widespread sleep problems as contributing factors, according to a 2002 poll released by the National Sleep Foundation (NSF).

Poll results show that while many Americans enjoy the benefits of sufficient sleep, as many as 47 million adults may be putting themselves at risk for injury, and health and behavior problems because they aren't meeting their minimum sleep need in order to be fully alert the next day. People in this army of the walking tired are more likely to sit and seethe in traffic jams, quarrel with other people, or overeat, according to the findings.

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"The 2002 Sleep in America poll establishes a direct association between how Americans are sleeping and their overall behavior, mood, and performance," said NSF's Executive Director, Richard L. Gelula. "It provides new evidence that the quality and quantity of our sleep plays a significant role in our daily lives. In sum, the poll results paint a new and unique profile of Americans that shows 'you are how you sleep.'" And, based on the findings, Gelula noted, "Some of the problems we face as a society — from road rage to obesity — may be linked to lack of sleep or poor sleep."

The poll compared how respondents described their general moods and attitudes on a typical day with their answers to a number of questions about their sleep. The conclusions suggest a direct correlation between more sleep and heightened daytime alertness with positive feelings that include a sense of peace, satisfaction with life, and being full of energy. Shorter sleep periods and greater indications of daytime sleepiness were related to negative moods such as anger, stress, pessimism, and fatigue.

First Clear Link Between Sleep, Mood

"This is the first time we've actually linked people's mood to their sleep habits in our annual nationwide poll," said NSF President James K. Walsh, Ph.D. "Scientists have documented the link between sleep deprivation, mood and performance in the lab before. But this is the first large-scale view of the extent to which insufficient sleep plays out in the real world each day." Walsh added. Dr. Walsh is executive director and senior scientist at St. Luke's Hospital Sleep Medicine & Research Center in Chesterfield, Mo.

The poll found that nearly one-quarter of American adults, or 47 million people, aren't getting the minimum amount of sleep they said they need to be alert the next day, resulting in what appears to be an epidemic of daytime sleepiness that can impact cognition, performance, and state of mind.

Nearly two in five of those polled (37%) said they are so sleepy during the day it interferes with their activities at least a few days a month, and one in six (16%) said they experience this level of daytime sleepiness at least a few days a week.

Daytime sleepiness is especially acute among younger adults: 44 percent of those aged 18-29 said they experience the problem at least a few days a month compared to 38 percent of 30-64 year olds, and 23 percent of those 65 and over.

 

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The poll results provide a clear and interesting link between the quantity and quality of respondents' sleep and their self-described overall mood. A mood and attitude score was calculated for each respondent and these scores were compared for different types of sleepers. The less respondents said they slept, the more they experienced daytime sleepiness, insomnia and other sleep problems, and, in turn, the lower their positive mood and attitude scores.

  • Those who got fewer than six hours of sleep on weekdays were more likely to say they were tired than those getting more than eight hours of sleep (32% vs. 15%). They were also more likely to describe themselves as stressed (32% vs. 16%), sad (14% vs. 7%) and angry (11% vs. 4%).
  • People who reported often being sleepy during the day were more likely to describe themselves as dissatisfied with life (21% vs. 7%) and angry (12% vs. 4%) compared to those who were rarely or never sleepy during the day.
  • On the other hand, the less people experienced insomnia symptoms, the more likely they were to describe themselves as "full of energy," "relaxed," and "happy."

In addition to one's outlook, the poll examined the impact of insufficient sleep on behavior and ease or difficulty with tasks. Adults said when they did not get enough sleep, they were more likely to get impatient or aggravated with such common annoyances as waiting in line or sitting in traffic (64%). They also reported being more likely to make mistakes (65%) and have difficulty getting along with others (44%). A fourth of adults said they ate more than usual following nights of inadequate sleep.

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More than nine out of 10 respondents agreed that not getting adequate sleep can impair their work performance (93%), put them at an increased risk for injuries (91%), and lead to health problems (90%). More than eight in 10 (85%) agreed that lack of sleep can make it difficult to get along with others, and six in 10 (62%) said it is harder to make decisions and listen carefully enough to remember what is being said.

"The new findings clearly indicate the American public understands the strong connection between their sleep, their behavior, and the quality of their daily life," said NSF's Gelula. "Yet, about one quarter of adults in this country fail to meet their own minimum sleep needs at night to be fully alert the next day."

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Sleep and Service Providers

Besides making the link between inadequate sleep and their own mood, behavior, and ability to perform, the poll shows that Americans are concerned about the impact that sleepiness and fatigue can have on certain professionals whose level of alertness is necessary for public health and safety. For example, 86 percent said they would be anxious about their safety if they learned their surgeon had been on duty 24 consecutive hours.

The poll found widespread public support for limiting work hours for physicians, nurses, airline pilots, truck drivers and the police. Specifically, the poll found that:

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  • 70 percent believe the maximum number of hours worked each day by a doctor should be 10 or less.
  • 86 percent agreed that a pilot should be allowed to take a nap to overcome drowsiness while flying if another qualified pilot can take over, and 63 percent said a pilot's maximum workday should be eight hours or less.
  • Almost 50 percent supported limiting workdays of police officers, truck drivers, and nurses to a maximum of eight hours.

These findings conflict with general workplace regulations that typically allow for much longer hours of work.

Sleep Problems Increasing

A majority of respondents (74%) said they frequently experienced at least one symptom of a sleep problem in the last year, a small but significant increase over the 2001 poll (69%) and those in previous years (62%).

The most prevalent sleep problem is insomnia; 58 percent of Americans said they experienced at least one symptom of insomnia at least a few nights a week, and more than one-third (35%) reported having such a symptom every night or almost every night in the past year. (Insomnia symptoms are: difficulty falling asleep, waking a lot during the night, waking up too early and not being able to get back to sleep, and waking up feeling unrefreshed). Young adults (18-29) were more likely to report a symptom of insomnia occurring a few nights a week than their older counterparts, (69% vs. 44% for age 65+).

More than one-third of those polled (37%) said they snore frequently. About one in 10 respondents reported experiencing pauses in breathing during sleep. Both snoring and pauses in breathing can be symptoms of a serious sleep disorder, sleep apnea, which is associated with daytime sleepiness, hypertension, heart attack, and stroke.

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