CHAPTER ONE

Power Sleep

The Revolutionary Program that Prepares Your Mind for Peak Performance



By DR. JAMES B. MAAS WITH MEGAN L. WHERRY, DAVID J. AXELROD, BARBARA R. HOGAN, and JENNIFER A. BLUMIN



Villard

LEARNING ABOUT THE

POWER OF SLEEP

HOW MUCH SLEEP DO YOU GET?

Ask this question and you'll hear some interesting answers. The prolific inventor Thomas Edison slept three or four hours at night, regarding sleep as a waste of time, "a heritage from our cave days." President Clinton grabs five to six hours. The performer Janis Joplin never wanted to sleep for fear she might miss a good party. Martha Stewart, an expert on planning good parties, only sleeps four to five hours each night. The comedian Jay Leno manages five hours and the millions of Americans who stay up to watch his late-night TV show won't get much more.

Then there are those at the other end of the sleep-length spectrum. Albert Einstein claimed he needed ten hours of sleep to function well. President Calvin Coolidge demanded eleven. Nighttime sleep wasn't adequate for Presidents Lyndon Johnson and Ronald Reagan and Prime Minister Winston Churchill. They took naps (and, incidentally, so did Edison). As Reagan half jokingly remarked to members of the press, "No matter what time it is, wake me up, even if it's in the middle of a cabinet meeting."

Ask Grandma her "expert" opinion and you'll get an earful of advice on sleep needs and strategies:

Everybody needs a good eight hours of sleep.

A heavy meal makes you sleepy.

Snacks before bedtime aren't good for you.

Sleep before midnight is best.

Early to bed, early to rise, makes a man healthy, wealthy, and wise.

Older people need less sleep.

Just a friendly warning: Grandmother psychology is sometimes on target, but not always.

Since everybody on earth sleeps at least once every twenty-four hours, we should all be experts. Knowledge about sleep, just like knowledge about nutrition and exercise, is essential to your life, for happiness, productivity, and general health. Everyone should know exactly how much sleep he or she requires to feel wide awake, dynamic, and energetic all day long. Everyone should know the strategies and techniques for getting quality nocturnal sleep for maximum daytime performance. And everyone should know how to cope with sleep deprivation when it does occur. But, alas, we are grossly ignorant when it comes to our own need for sleep.

In today's frenetic society people who sleep six hours or less are regarded as being tough, competitive, and ambitious. If you say you need lots of sleep you run the risk of being perceived as one who lacks what it takes to be successful. Maybe you'll even be regarded as lazy. Can people function well on six or seven hours of sleep? Or does everyone actually need eight or more hours to ensure good health and optimal daytime performance? Do men need more sleep than women? Do you need less sleep as you get older? When is the best time to exercise if you want a good night's sleep? Does a glass of wine before bedtime help you sleep better? Can you accurately assess how well you slept last night? What's the ideal bedroom temperature? Are naps good for you? Strangely enough, few of us can accurately answer even the most basic questions regarding sleep. We'll test your "sleep IQ" and your "sleep strategies" in the next chapter. Expect to fail, but that's okay. Otherwise, this book would not be necessary.

ARE YOU GETTING ENOUGH SLEEP?

Ask yourself:

How much sleep do I get each night during the week?

Does it differ on the weekends?

Do I fall asleep the minute my head hits the pillow?

Do I need an alarm dock to wake me up?

If you're getting less than eight hours of sleep each night, including weekends, or if you fall asleep instantly, or need an alarm clock to wake up, consider yourself one of millions of chronically sleep-deprived people--perhaps blissfully ignorant of how sleepy and ineffective you are, or how dynamic you could be with adequate sleep. We'll test your "sleep deprivation" in the next chapter. Again, expect to fail; you'll be joined by the majority of our teenage and adult population.

According to sleep experts, if you want to be fully alert, in a good mood, mentally sharp, creative, and energetic all day long, you might need to spend at least one third of your life sleeping. Over an average lifetime that's a commitment of nearly twenty-four years in bed!

Who can afford so much time asleep? Motivational speakers make big money encouraging us to spend less time sleeping and more time working. They'll try to convince you that you can condition yourself to sleep just four hours a night. Yes, you can condition yourself to wake up after four hours. But I've got news for you. There's a definite downside that you're not being told.... Reading this book will provide some illuminating facts that might save your career, your health, and even your life.

THE POWER OF SLEEP

Given that you might need to spend at least a third of your life sleeping, you should know what's going on. As I mentioned in my introduction, sleep is not a vast wasteland of inactivity. The sleeping brain is highly active at various times during the night, performing numerous physiological, neurological, and biochemical housekeeping tasks. These are essential for everything from maintaining life itself to reorganizing and enhancing thinking and memory. This enables us to remember the past, organize the present, and anticipate the future.

The process of sleep, if given adequate time and the proper environment, provides tremendous power. It restores, rejuvenates, and energizes the body and brain. The third of your life that you should spend sleeping has profound effects on the other two thirds of your life, in terms of alertness, energy, mood, body weight, perception, memory, thinking, reaction time, productivity, performance, communication skills, creativity, safety, and good health.

If our sleep is limited, our health and daytime potential is significantly reduced, if not destroyed. With adequate sleep and its concomitant brain activity, the world is our oyster ... a pretty good deal for something that is enjoyable to do and doesn't take much, if any, effort!

ASLEEP IN THE FAST LANE

Before Thomas Edison's invention of the electric light in 1879, most people slept ten hours each night, a duration we've just recently discovered is ideal for optimal performance. When activity no longer was limited by the day's natural light, sleep habits changed. Over the next century we gradually reduced our total nightly sleep time by 20 percent, to eight hours per night. But that's not nearly the end of the story. Recent studies indicate that Americans now average seven hours per night, approximately two and a half hours less than ideal. Amazingly, and foolishly, one third of our population is sleeping less than six hours each night. Are we losing our minds?

In just the last twenty years we have added 158 hours to our annual working and commuting time--the equivalent of a full month of working hours. According to Dr. William Dement, professor of medicine at Stanford University, working mothers with young children have added 241 hours to their work and commuting schedules since 1969. Those who also provide care for aging parents who may have age-related sleep problems might be doubly vulnerable to loss of sleep.

We now live in a twenty-four-hour society, a "rat race" where sleep is not valued. With heavy demands of work, household chores, parenting and family responsibilities, and a desire for social life, exercise, and recreation, four out of every ten of us are cutting back on sleep to gain time for what seems more important or interesting. This can be an extremely costly and dangerous mistake. Stop sleeping altogether and you will die. Large periods of sleep deprivation, as often occur in brainwashing of war captives or cult members, "can cause even heroically patriotic citizens to denounce their own nations and ideals, to sign patently false declarations, and to join political movements that have been lifelong anathemas to them," notes J. Allan Hobson, professor of psychiatry at Harvard Medical School. People who by choice or because of work, illness, or force of circumstance go without sleep for five to ten days become irrational, paranoid, confused, and even hallucinatory.

Few of us are subjected to such extreme sleep loss. But most of us, consciously or unconsciously, occasionally if not chronically, deprive ourselves or others of adequate sleep. Can we adapt to minimal sleep without feeling drowsy and experiencing a decline in mood and performance?

On a day the White House planned to bask in good economic news, President Clinton instead exploded in anger at reporters' questions.... Within an hour of his comments, Clinton summoned the reporter ... Bill Plante of CBS News, to apologize for losing his temper. Clinton said he hadn't been sleeping much since the July 17 crash of TWA Flight 800.

Let's look at some statistics:

* High school and college students are among the most sleep-deprived people in our population. Thirty percent fall asleep in class at least once a week. On November 25, 1991, when President George Bush spoke at an Ohio high school, "At least a third of the high school students were clearly asleep in the overheated auditorium. . . ." If these students can't stay awake for the President, it's no wonder teachers can't keep them awake. * Thirty-one percent of all drivers have fallen asleep at the wheel at least once in their lifetime. The National Sleep Foundation reports that each year on our highways at least 100,000 accidents and 1,500 fatalities (the equivalent of four fully loaded Boeing 747 airplanes) are due to failing asleep at the wheel. This is a very conservative estimate, as most states do not keep adequate statistics. The actual annual figures might be as high as 200,000 accidents and 5,000 fatalities (the equivalent of twelve fully loaded 747s). In addition to the tragic loss of lives, these accidents cost American society more than $30 billion annually. In 1990 a high school student in New Hampshire who had been named America's Safest Teen Driver fell asleep at the wheel around 5 p.m., drifting over the yellow line into oncoming traffic. He killed himself and the nineteen-year-old female driver of another car. According to his father, "Safe driving was an obsession with him. The question of why he didn't recognize the fatigue and respond to it is something we will never know." * The transportation industry is being hit hard by the ravages of sleep deprivation on the highways, the rails, at sea, and in the air. According to the National Transportation Safety Board, "Fatigue is the No. 1 factor that detrimentally impacts the ability of pilots." In the PBS television documentary "Sleep Alert," a Boeing 747 captain noted: "It is not unusual for me to fall asleep in the cockpit, wake up twenty minutes later and find the other two crew members totally asleep." In another report, "A Boeing 757 captain told how his forehead hit the control column on his approach to New York's Kennedy airport as the need for sleep became overwhelming." * Even airline passengers are not exempt from the effects of sleep deprivation. Job demands are forcing business executives and government officials to operate well beyond the design specifications of the human brain and body. They undertake exhausting schedules, whisk across multiple time zones, and work long days. Often suffering from the debilitating effects of jet lag, these people's health and performance are put in jeopardy. Dr. Martin Moore-Ede, a professor of physiology at Harvard Medical School and an expert on circadian rhythms and sleep, described President Bush's grueling schedule of sixteen-hour days on the back side of the clock during a ten-day visit to Japan: It is 5:30 A.M. in Washington, D.C., but [Bush] has already put in a long day in Tokyo. Suddenly, under the unforgiving eye of the TV cameras, he vomits, collapses, and slides under the table at a banquet with the Japanese Prime Minister, Kiichi Miyazawa, where Bush is the guest of honor.... His biological clock was still set somewhere in mid-Pacific and had not yet joined him in Japan. He became just one more victim of the human drive to reach beyond our physiological capacities. * Twenty percent of all employees work at night, and suffer disproportionately from drowsiness, gastrointestinal and cardiovascular problems, infertility, depression, and accidents. Fifty-six percent of shift workers fall asleep on the job at least once a week. The Wall Street Journal reported that $70 billion is lost per year in productivity, accidents, and health costs as a result of workers' inability to adjust to late-night work schedules. For example, the near cataclysmic nuclear accidents at Chernobyl and Three Mile Island all occurred in the early-morning hours, during one of two periods in the twenty-four-hour day when we are most fatigued. The disasters all started because "nightshift workers missed or were confused by warning signals on their control panels." * Medical residents and interns are among the most severely sleep-deprived individuals. Many work more than 130 hours per week in shifts of twelve to sixty hours' duration, and every other night they are on call. They may be responsible for the care of forty to sixty patients. Sometimes mistakes are made. Fatal mistakes. An eighteen-year-old woman died "after a night of inattentive care by fatigued and inexperienced residents in one of New York's major teaching hospitals.... A Manhattan grand jury concluded that the patient had received `woefully inadequate' care and had suffered repeated mistakes by first-year interns and second-year residents who had had little sleep."

We are biologically ill-prepared to function on minimal sleep. Our prehistoric genetic blueprint for sleep has not evolved quickly enough to keep up with the pace of our frenetic society that runs twenty-four hours a day. As Dr. Moore-Ede asserts, "If we operated machinery the way we are now operating the human body, we would be accused of reckless endangerment." According to recent Gallup surveys, 56 percent of the adult population now reports daytime drowsiness as a problem. The cost of sleep deprivation is nothing short of devastating in terms of wasted education and training, impaired performance, diminished productivity, loss of income, accidents, illness, the quality of life, and the loss of life. Are you victimizing yourself and endangering the welfare of your family and your career by not getting adequate sleep?

SLEEP DISORDERS

Even when we're exhausted and give in to our body's demands for rest, sleep can be elusive. Being stressed, harried, and hurried can make it difficult for us to fall asleep or stay asleep. Or we may be struggling with one of more than eighty disorders of the sleeping/waking state that have been identified by sleep researchers.

Insomnia

In 1995 a Gallup poll found that 49 percent of American adults were suffering from insomnia and other sleep-related disorders, a 15 percent increase since 1991. According to many medical specialists, sleep disorders collectively constitute the number one health problem in America. The National Sleep Foundation attributes this to the increasingly frantic pace of life, work pressures, and an aging population.

Sleep Apnea

Thirty million Americans suffer from sleep apnea, or temporary cessation of breathing, a potentially life-threatening disorder. If you have a serious case of sleep apnea and take a sleeping pill or drink too much alcohol on a given night, you might well induce the longest rest of all--you could die in your sleep. Astonishingly, 95 percent of people with sleep disorders are undiagnosed and untreated, and must struggle through the day feeling unmotivated and exhausted.

For example, a businessman, asked to testify in a public hearing held by the National Commission on Sleep Disorders Research, described his intolerable life before finally being diagnosed and treated for sleep apnea: "I was experiencing constant daytime drowsiness. I would fall into a deep sleep for short periods during meetings, conversations, and public functions. At times, I could awaken and make a very inappropriate comment only to realize that I was commenting on a dream I had just experienced. My associates began to question my mental stability.... It was my practice in those days to carry a large pin or penknife with which I would stab myself in the leg, arm, or hand just to stay awake in meetings and while driving. I was removed from three successive jobs within a year and a half. My income was reduced by 85 percent and my savings were all used up."

Costs of Sleep Disorders

The direct costs of sleep disorders and sleep deprivation for 1990 alone were estimated at $15.9 billion. Indirect costs, in terms of productivity and accidents, were said to be $150 billion. Neither of these figures takes into account the incalculable costs of suffering, family dysfunction, and the loss of human life.

A young mother whose daughter died from sudden infant death syndrome, which is linked inextricably to sleep, stated: "The day after Christmas I found [her] dead in her bassinet. No words can adequately describe the shock, horror, and pain of a parent at such a moment. To hold the cold stiff body of your infant offspring is to receive one unexpected blow, your own future deleted.... To think that this repeats itself seven thousand times per year, one baby every hour ..."

Even though half of American adults have trouble sleeping, physicians rarely ask their patients how they sleep. Less than 1 percent of case histories taken by doctors during routine physical examinations even include a mention of sleep. This is alarming because so many people are suffering needlessly. Do you ever have difficulty sleeping? Might you have a sleep disorder?

SHOULD WE PLACE MORE VALUE ON SLEEP?

As a result of changing lifestyles, increased work, family, and financial pressures, and a stressed-out or aging population with a correspondingly higher incidence of sleep disorders, more than 100 million Americans are, by definition, chronically sleep-deprived. The number of Americans who report trouble sleeping has risen 33 percent in just the last five years. Half of our adult population is studying, working, parenting, and playing while exhausted. We make costly mental errors. We are accident-prone. We get sick too often. We have become a nation at risk. What's more, all technologically advanced societies are experiencing the same disastrous phenomenon, and the problem, if untreated, will grow.

We do not understand the need for sleep and the consequences of sleep deprivation. We must learn to value sleep as much as we value the importance of proper nutrition and exercise. To become peak performers we must change our habits so we can emerge from the fog of sleepiness to which we have become habituated. We must learn to "Power Sleep."

LEARNING ABOUT SLEEP

Why has there been so much ignorance about sleep? The topic is rarely taught in educational settings and until recently has not been part of the medical school curriculum. Not until 1996 did the American Medical Association recognize sleep medicine as a specialty. It is no small wonder that most of us know little about the importance of sleep, the incredibly varied activity that occurs during the course of each night, sleep disorders, and the role of sleep in determining subsequent alertness. Even sleep researchers are just beginning to fully comprehend the mysteries of sleep and its powerful consequences for the quality of life.

In Power Sleep I share important discoveries from sleep laboratories throughout the world, to increase your awareness of the importance of sleep; help you determine your individual sleep requirement; show you how to establish good sleep habits; improve your alertness, mood, productivity, quality of life; and possibly increase your life span.

Don't get too uptight about a little sleep loss from time to time. But if you're often sleep-deprived, feel sluggish and drowsy during the day, and are not performing at a level close to your potential, I'll try to help. By following the advice in this book you will be able to use the power of sleep to prepare your mind for peak performance. You will become a different person--the person you, your parents, your spouse, your children, and your boss always wanted you to be. You should find the material in this book interesting and full of invaluable suggestions. If not, it will put you to sleep--which is perhaps even more helpful!