[Paleopsych] NYT: Snooze Alarm Takes Its Toll on a Nation

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Snooze Alarm Takes Its Toll on a Nation
NYT October 12, 2004
By MARTICA HEANER

When his clock-radio goes off at 7 a.m., David Epstein's
latest wake-up strategy roars into high gear: he stumbles
out of bed, walks across the room and pushes the snooze
button. Then he climbs between the sheets.

A few minutes later, his travel clock rings. He presses
snooze and rolls over for more sleep - until the alarm on
his BlackBerry goes off. Sitting up, he punches keys to
reset it for 10 more minutes, then it's back to the pillow.


The pattern repeats amid a cacophony of assorted rings
until his real wake-up time, 8 a.m.

In a nation that clocks around six to seven hours of sleep
a night when an average of eight hours is recommended, it
is a rare person who wakes up without an alarm. And because
it is usually a struggle, pushing snooze to delay the day
has become as much a part of the wake-up ritual as a cup of
coffee.

But is a bumpy arousal for 30, 60 or even 90 minutes a way
to recoup much-needed sleep? Or is it a recipe for
exhaustion?

Although scientists have not specifically tackled the
question, sleep researchers agree that short bouts of sleep
are far from ideal. The restorative value of rest is
diminished, especially when the increments are short, said
Dr. Edward Stepanski, who has studied sleep fragmentation
at the Rush University Medical Center in Chicago. And a
teeter-totter effect of dozing and waking causes shifts in
the brain-wave patterns.

"Even a subtle noise that doesn't actually wake you up is
disruptive enough to affect the sleep quality," Dr.
Stepanski said. "That's why someone who falls asleep with
the TV on may wake up exhausted. So, if a person is rousing
themselves enough to reset a clock, there's likely to be an
even more profound effect."

It is an axiom of sleep research that not all sleep is
equal. A night's sleep is divided into five continually
shifting stages, defined by types of brain waves that
reflect either lighter or deeper sleep. Toward morning,
there is an increase in rapid eye movement, or REM sleep,
when the muscles are relaxed and dreaming occurs, and
recent memories may be consolidated in the brain.
Sleep-deprived snooze-button addicts are likely to cut
short their quota of REM sleep, impairing their mental
functioning during the day.

How tired a person is when the snooze-button frenzy begins
is important, experts say. Someone who got a full eight
hours of sleep may push the snooze button, but won't nod
off again that easily, Dr. Stepanski said. And some people
seem to be more tolerant of short-term sleep loss.

But the person who has been getting too little sleep for
too long may be a wreck, especially by Friday after racking
up a large sleep debt during the week.

To complicate matters, feeling alert is not just a matter
of getting the right dose of different kinds of sleep. The
body has its own alarm clock, a circadian rhythm in which
fluctuations in hormones like cortisol, melatonin, ghrelin
and growth hormone regulate sleepiness and alertness, as
well as other body functions.

And sleep patterns can run on a schedule different from a
person's body clock. Trying to sneak in more sleep when
someone is used to getting up early can cause the body to
switch to an alert mode, making any extra sleep light and
fragmented, said Dr. Timothy Roehrs, the director of
research at the Sleep Disorders and Research Center at
Henry Ford Hospital in Detroit.

On the other hand, if someone's body is on a later cycle
from habitually staying up late, waking up early is that
much harder because the body is not yet pumping out peak
levels of cortisol and other hormones that help wake people
up.

Still, most hard-working people cope, managing to live in
what researchers agree is a perpetual sleep-deprived state.
They mask fatigue by keeping themselves alert with a
variety of stimuli, like caffeine, exercise or simply
keeping busy. Some people with sleep debts do not consider
themselves tired, believing that they are functioning
normally, said Dr. David Dinges, chief of the sleep and
chronobiology division at the University of Pennsylvania
School of Medicine.

But evidence is mounting on the behavioral risks of
long-term partial sleep deprivation. Not getting enough
sleep day after day takes its toll. And it is not only
medical interns and truck drivers doing double shifts who
can suffer from serious mistakes at work because of it.

In the August issue of the journal Sleep, Dr. Roehrs
published one of the first studies to measure the effect of
sleepiness on decision making and risk taking.

Dr. Roehrs and his colleagues paid sleepy and fully alert
subjects to complete a series of computer tasks. At random
times, they were given a choice to take their money and
stop. Or they could forge ahead with the potential of
either earning more money or losing it all if their work
was not completed within an unknown remainder of time.

"The alert people were very sensitive to the amount of work
necessary to finish and the risk of losing their money if
they didn't," Dr. Roehrs said. "The more work they had, the
more apt they were to stop. Without fail, the sleepy people
chose to quit when it was optimal to continue, and they
gambled losing it all by trying to finish the task for more
money even when it was 100 percent likely that they would
be unable to finish."

Numerous studies have documented sleep impairments on
memory, reaction time, comprehension and attention. Even
emotional states can be affected. One of the first signs of
sleep debt is irritability and increased depression, said
Dr. Arthur Spielman, a professor of psychology and sleep
researcher at City College of New York.

"Creativity and a zest for life are also dampened," Dr.
Spielman said. "You just don't feel like doing much."

Moreover, there is a growing realization that chronic sleep
loss affects health, from minor disturbances like a
headache to an increased risk for obesity, diabetes and
cardiovascular disease.

So what is a sleepy person to do? Start paying back sleep
debt, for starters, experts say. Turn off David Letterman
and get to bed half an hour earlier. Night owls who do not
feel sleepy should cut off the stimulation: turn off the
lights and television and lie in bed with closed eyes for
one minute to unmask their sleepiness, Dr. Spielman
recommended.

He added that those who still found it hard to get to sleep
early at night should wake up early and experience morning
light to reset the body clock.

After a couple of weeks, they will feel more tired in the
evening and go to sleep earlier, making it easier to get up
the next day, he added.

And come morning, setting the clock for only 10 minutes
earlier than the optimal wake-up time, allowing for only a
single opportunity to press the snooze button, will provide
the most restorative period of solid sleep.

Of course, waking at the last possible minute requires a
leap of faith.

"I'm not convinced that this would work because I don't
trust myself to get up," Mr. Epstein admitted. "Besides, I
like to ease myself out of bed. When that alarm rings, I
would sell my soul for an extra 15 minutes of sleep.

"So, by setting my clocks an hour earlier, I get to wake up
and know that I can go back to bed. It feels really good."

http://www.nytimes.com/2004/10/12/health/12snoo.html



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