Thursday, June 15, 2006


I have a long-standing interest in sleep and have posted on it before. I was pleased recently to find the website of the Australian Sleep Association. The ASA is a group of medical practitioners and researchers concerned with sleep problems. As an economist I am interested in the 2004 study by Access Economics, ‘Wake Up Australia, The Value of Healthy Sleep’ which is posted here. I was also interested in the Fatigue and Transportation report there. Fatigue is an occupational health and safety issue, a major cause of traffic accidents and fatalities and a major health problem.

The Australian provided a good overview of the issues and provided some summary statistics on the cost of sleep disorders to the Australian economy from the Access Economics report:

  • Sleep disorders cost the Australian economy $10.3 billion.
  • 1.2 million Australians suffer from sleep disorders.
  • 10% of work accidents are attributable to sleep disorders.
  • 7.6% of non-work vehicle work accidents are attributable to sleep disorders.
  • Cost of treating sleep disorders is $2.7 billion.
  • Cost of treating sleep-related depression $100 million.
  • Cost of lost production from sleep-related absenteeism and low productivity $79 million.
  • Lost earnings from job losses due to sleep disorders $1.57 billion.
  • Annual cost of sleep disorders per capita $310.
  • Annual cost of sleep disorders a sufferer, $5175.

We are also acting as if we are a nation of tired people with rapidly growing sales of caffeine and guarana-enriched soft drinks as well as use of more harmful stimulant drugs such as ice.

What is interesting are the connections between untreated sleep apnoea, obesity, high blood pressure and heart disease. For example, there is clear evidence that among young people sleep deprivation increases insulin resistance, the condition that leads to Type 2 diabetes. Among infants there are developmental problems associated with poor sleep. The major risk factor for apnoea is definitely obesity. About 2 out of 3 people with diabetes die from heart disease or stroke. And about 2 out of 3 people with diabetes have high blood pressure.

Diabetes has reached pandemic proportions in Australia as have obesity and sleep problems. They combine to be potent killers through their effects in driving heart disease and stroke. The message seems to be try not to be obese by watching your energy intake and doing sufficient exercise. And try to get a good night’s sleep. If you don’t sleep well visit your doctor and find out what is happening.


-A. said...

A little off-topic, I agree, but I'd be interested in any sociological theories on why late nights are percieved as devious and earlier mornings are virtuous. It seems to be utterly irrational, but as a night owl (it's just ticked over 4am as I write) it's a prejudice I frequently come up against.

hc said...

-a, I assume the conventional work ethic. I am a night owl-insomniac too - mornings? Abolish them.

civitas said...

Count me in the night owl insomniac club too. Ie lived on ambien for years and now live on Lunesta, which works well but leaves a God-awful after-taste the entire next day.

I have one child who was born a night-owl insomniac and two that could sleep standing up at any hour of the day or night. My mother always says they have clean consciences, which leaves me I guess with a suspect conscience. I used to sleep so well but as I got older I've slept much less well, I can stay up for 3-4 days straight without batting an eyelid and would, if it weren't for Lunesta. Is Lunesta available in Australia? I know some people don't believe in better living through chemistry but if you have to sleep, you have to sleep.

There's a huge proliferation of sleep clinics over the last couple of years in the US. They give you all the standard answers, cool the room, no TV in the bedroom, don't exercise late in the day, and then they hand you the drugs. Also, many, many people in the US, because they are so grossly overweight have horrible sleep apnea, life threatening sleep apnea and use one of those C-paps (sp?). Terrible to look at but they say they've had the first good night's sleep in years after trying it.

FXH said...

ari - the vast majority are early-ish birds - I think only about 20% of the popn. are true night owls. So the majority rules and we have the situation where getting in to work at 7:30am is seen as virtuous and getting in at 10:00am seen as lazy.

Never mind that many of the early starters are reading the paper in peace with a cuppa for the first hour "because work hasn't started"

I have been a night owl and problem sleeper since I was a kid. My natural rythmn is to go to bed at say 2am read until 3 am and then toss and turn and sleep and get up around 9 - 9:30am. Some of those early risers go to bed at 9pm to rise at 6am. If I go to bed early I don't get to sleep.

The advent of the net has been a boon to me and other nightowls as it gives something to do in the late hours. Even if I am tired I often don't sleep, so I find I can do "research" and reading on net even if I'm tired. Writing when tired is a bit harder.

There is also the Protestant idea that a well ordered work life and early to bed early to rise is more favourable to god's eyes. That which occurs at night late is seen as furtive.

I have worked with a couple of colleagues who are early risers (but non censorious). When on dealines they would email work over as they were tiring out at 9 pm - when I was just getting revved up, I would work until 3 or 4 am and email back in time for them to get up at 5am and do stuff while I slept till 11am.

I have read just about everything on sleep research and solutions. Most solutions are for people who only think they have a sleep problem - that is objectively in sleep clinics it is shown that they get a fair amount of sleep. The rest focusses on sleep apnea.

The nonsense about routines and getting up if you aren't asleep is not for hard core night owls.
I don't think I have ever awoke at a "normal" time of 6:30 am to 7:30 am without feeling like I have a real hangover. I've never woken up at "normal "times without an alarm clock. I've never ever bounced out of bed. I've had sleeping tablets and then been able to stay up all night working despite swallowing more than the recomended dose.

I used to have a job where the senior exec met once a week over a 7:30 am breakfast. I mostly used to get rolled and have to spend the next day unduing stuff 'cos they'd take advantage of me. One of the few concessions I won was to get proper good coffee. I never feel hungry at breaklfast. I hold that only savages eat a big breakfast and wake up feeling ok. And I hate people who are chatty at breakfast.

Now days I just accept that I might only get 3 hour uninterupted sleep, but get back to sleep in an hour or so, I am set up with dull reading light and a radio with earplugs which I have in all night, I listen to Radio National, talk radio and BBC. I use weekends to catch up and sleep in until 11am if I need it.

If I have to do something at 6am - 7am I'll often prefer to stay up all night rather than go to sleep and not sleep much and wake up wrung out.

I don't consider my self an insomniac because if I follow my clock I go to sleep at about 3 or 4am and wake up without an alarm feeling ok (not great but ok) at 10 or 11 am.

I have however found STILNOX ok to ensure a fairly uninterupted sleep. It doesn't knock me out but if I do sleep I'm less likely to wake up.

I should say I have often had work where I had to start at 7:00 am.

FXH said...

I forgot to add.

I had some success with the sleep regime whereby you push the going to sleep time forward an hour each day until you reach the desired time. It works to an extent. The idea is that it resets the body clock and lasts about 6 months. I found I needed to use it with some chemical assistance.

Say you normally go to bed at 1 am. the first day you go to bed at 2am, next day 3 am and so on over the 24 hours.It does require having a few weeks when you can go to bed in the day.

Based on the idea you can only push the going to sleep time forward - not pull it back.

I can say its worth a try.

I can't find the references just now but it is written up in the Sleep Journals.

The other option is to get a night job.

Anonymous said...

I have suffered from insomnia most of my life and have used sleeping pills etc. I don't use anything at present and am much better off for that. But if I do suffer badly I use for short-periods.

I have used a CPAP mask but find it uncomfortable and discontinued. I experience mild sleep apnoea.

Alcohol is a bad idea if you have a sleep problem. Sex is good but it raises the issue of whether your partner is happy to be used as asurrogate sleeping pill.

patrick said...

Harry, you're an economist, surely you know than to post those, "problem X costs the economy Y dollars" figures, they're . As if the economy would somehow jump by 15 billion odd dollars if all sleep disorders were treated.

Ps, I just put a post on my blog about Richard Florida and creative industries, I would be most interested to know your opinion of that whole movement.

patrick said...

Oops sorry, screwed up my hyperlink there.

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