Men and Sleep; Yes – Men have Challenges Too
Going for 22 hours without sleep is equivalent to having a blood alcohol level of 0.05. One is perfectly legal, but the other could cause you to be arrested for being behind the wheel and kicked out of work. Shift workers, especially night shift workers, might see nothing out of the ordinary in going 22 hours without sleep, but they pay for it with their health, and sometimes even with their lives. Exhaustion decreases alertness, attention and the ability to process new information, creating danger on the job. When working with machinery, as many shift workers do, or in health care of emergency services, one slip of attention can cause accidents, injury, and death. Bad sleep habits also set off a whole variety of health problems, including weight gain leading to obesity. Many existing issues, such as depression, asthma, and addiction to drugs or smoking can make sleep habits worse, and then continue to worsen themselves because of the troubled sleep. Sleeping pill prescriptions reached 56 million in 2008, showing the extent to which sleep problems haunt Americans. But this is a problem that can be conquered.
This white paper will address the following points:
· Men who report symptoms of exhaustion have twice as many heart attacks.
· Regularly sleeping only 5 hours during a 24 hour period significantly increases the risk of developing high blood pressure, possibly resulting in more heart attacks.
Background on Sleep
When we sleep we drift through repeated REM cycles of 90-120 minutes; each cycle ends in REM sleep.
We pass through five phases of sleep:
Stage 1 – Non-REM Sleep – During light sleep we drift in and out of sleep and can be awakened easily
Stage 2 – Non-REM Sleep – Accounts for 50% of the sleep cycle; breathing and heart rates slow and body temperature drops
Stage 3 – Non-REM Sleep – Deep sleep; when awakened one cannot adjust quickly and feel disoriented
Stage 4 – Non-REM Sleep – Also deep sleep; no eye movement or muscle activity
Stage 5 – REM Sleep (rapid eye movement) – Accounts for 20% of the sleep cycle; when we experience dreams
The first REM cycle occurs about 90 minutes after we first fall asleep. During an 8 hour sleep period the average person has 4-6 REM stages each night. During short sleep periods, important phases of non-REM and REM sleep periods are missed. When REM sleep is disrupted, the next time we doze off we slip directly into REM sleep to make up for the lost REM time. In this case we miss the non-RME periods.
A study by Dr. Jan Born, at the University of Lubeck, in Germany, has suggested that creativity and solving problems may happen during the portion of non-REM sleep known as slow-wave sleep — the deepest type of sleep, usually occurring during Stage 3 and 4 of the sleep cycle. During this period, our sleeping brains appear to continue to focus on problems that baffle us when we are awake. In addition, besides being well rested when learning new information, it may also be important to have a good night’s sleep afterward, to successfully move that information into long-term memory.
Starting at about age 40, slow wave sleep starts to disappear, diminishing from about 20 percent of the night to near zero. And since slow-wave sleep helps us to consolidate certain types of memories, this might explain a substantial component of our memory decline with age.
Exhaustion, Lack of Sleep and Risk of Heart Attack
Problems with going to sleep and staying asleep have long been implicated as possible risk factors for coronary artery disease. The Rotterdam Civil Servant Study evaluated 3,877 middle aged men. The subjects were screened for cardiovascular risk factors at the beginning of the study. They were also evaluated for signs of exhaustion such as excess fatigue, loss of energy, increased irritability and low selfesteem. Over the 4 year follow up period from the study, the exhausted subjects had significantly elevated risks of myocardial infarction (heart attack); 2.28 times the normal risk.
Another study investigated sleep complaints in exhausted subjects even more closely. This study indicated that there was a high prevalence of chronic sleep complaints about going to sleep and staying asleep in exhausted subjects. 1 Exhausted subjects reported more sleep complaints than non-exhausted subjects. More than 55% of the exhausted subjects reported being awake for at least 20 minutes before falling back asleep and reported that they napped at least once a week. The study evaluated the sleep habits of the subjects from the past three months and over a 21 day self-monitored period. The exhausted subjects reported both their past sleep and sleep during the 21 day period as more disturbed than the studies control group. Both groups reported the same estimates of lying awake. Because various studies have provided evidence that a deficiency in slow wave sleep may result in exhaustion, the study was expanded to evaluate nine exhausted and eight non-exhausted subjects for four nights.
The study found that sleep complaints were reported exclusively by exhausted subjects. While habitual sleep durations were not found to be different between the two groups, the sleep quality score of exhausted subjects was significantly higher indicating that their habitual sleep quality was poor. The exhausted subjects had problems initiating sleep, maintaining sleep, difficulty waking up, tiredness upon waking and experienced daytime sleepiness. The study found that the sleep of the exhausted subjects was characterized by a relative absence of slow wave sleep. Reduced slow wave sleep is usually associated with a depressive disorder or a medical illness. But, none of the exhausted subjects was diagnosed by a consulting psychiatrist as having a major or minor depression. Subjects suffering from medical illnesses were excluded from the study.
So, this study’s major finding was that there was a relative absence of slow wave sleep reported in subjects suffering from feelings associated with heart attacks, including feeling fatigued, experiencing a loss of energy, being irritable and having low self-esteem.
In another study, researchers looked at information on sleep and high blood pressure reported over an eight to 10 year period by 4,810 people who took part in the study. 2 People were asked how long they slept each night, about the diseases they had, their physical activity levels, alcohol and salt consumption, depression, daytime sleepiness and other factors. They were also asked about their blood pressure during follow-up surveys. They were deemed to have high blood pressure when they said their doctors had told them they had it. The study found that the risk of high blood pressure was nearly double for people between the ages of 32 and 59 who slept five hours or less each night. The increased risk was not found in older people in the study. And when factors such as daytime sleepiness, depression, physical activity, alcohol and salt consumption, smoking, pulse rate and gender were taken into account, the risk remained the same.
1 Psychosomatic Medicine 56:28-35 (1994); Rob Van Diest PhD and W.P.M. Appels, PhD
2 Hypertension. 2006;47:1-7
Impact for Male Shift Workers
According to the Bureau of Labor Statistics, men are more likely than women to work an alternative shift (16.7% vs. 12.4 %). So while some of the following statistics are about shift workers overall, the issues
impact more men than women overall:
· Shift workers sleep an average 6.5 hours on workdays—nightshift-only workers sleep even less
· 41% of shift workers report having nodded off while driving to or from work. 24.3% report this happening several times per month
· 60% of shift workers report feeling drowsy at work several times per month—11.6% report feeling this way several times per shift
· 26.5% of shift workers report making mistakes of inattention several times per month
· Nearly 12% of shift workers have obstructive sleep apnea, compared to 2%-4% of the regular population
· Risk factors for obstructive sleep apnea include being male, having a 17” neck, smoking, excessive drinking, being overweight
· Shift workers have up to a 50% increase of cardiovascular disease3
Options to Improve Sleep:
To reduce the risks of cardiovascular disease male shift workers need to:
· Try to go to bed at the same time and get up at the same time every 24 hour period and when shifts rotate build in some transition rest time
· Stay away from stimulants, like caffeine, and avoid alcohol
· Avoid exercising near bedtime (no exercise at least 3 hours before bed) but get exercise during other waking hours
· Don’t go to bed hungry; have a light snack before bed
· Create bedtime routines
· If you have difficulty sleeping see a physician to rule out or diagnose and treat sleep disorders
©2008workingnights
This material is provided for personal, non-commercial, educational and informational purposes only and does not constitute a recommendation or endorsement
Tags: biological clock, circadian rhythms, heart disease, sleep
