^Kdication Nation
International
An at ANDREW
open-eyed
look
sleep McGHIE
average person who reaches the age 0 spent around 20 years of his life sleeping. statement is only a somewhat dramatic way o us that we spend about 8 hours in eve y ~4 in the comfortable state of suspended animati VVe call if we could eliminate the sleep. as
^minding
Indeed, r'eed for sleep, we would all add many years o life. Unfortunately, as any parent wi s,eepless infant will testify, loss of sleep leaves
Active
u
sadly lacking in activity and patience the following day. Sleep loss over long periods may not only lower
our
efficiency, but in
extreme cases, reduce
functioning level of a mentally disturbed psychotic patient. Our dependence on a good night's sleep has made fortunes for the manufacturers of sleepinducing drinks and pills. But what is 'a good night's sleep'? Does everyone need the magical us
to the
eight hours undisturbed slumber that the doctor usually advocates? A short survey of the sleep habits of our friends may quickly suggest that this is not so. Some people seem to need more, while others get by very well on considerably less than eight hours. Psychologists with special interest in sleep have conducted more formal surveys embracing samples of thousands of people representative of the population as a whole. When such a large group of people are asked about the length of their usual night's sleep, their answers may be summarised in the diagrams below.
calculate the percentage of people who complain | of any type of insomnia at each age group, we ob' tain the distribution indicated in the diagram
below.
As our sample of people would be expected to contain both men and women of different ageS' we might also ask if the two sexes differ in an)' way as regards their sleep rhythms. The finding5 of such comparisons in published surveys strong^ suggest that disturbance of the normal sleep pattern is a great deal more common in women that in As sleep difficulty and insomnia increase rapidly with age in women than in men, this difference cannot be explained as simply due t? the young mother's sleep being broken by hef hungry infant. Although sleep disturbance is reported more often by older than by younger mefl' there is an interesting difference in the pattern of sleep variation with age between the two sexeS' This difference is perhaps more easily illustrated in the following diagrams which deal with the reported incidence of sleep disturbance by frequefl1 wakening throughout the night. men.
more
Flyure Fiyure /
Umber of timber
hom slept horn
Figure 3 Under 5 Hours
S-(> Horn
7-8 HOURS
9-/0 HOURS
MAIB MALE
I OVER 10 Hrs. \
It can be seen that the majority of people (62% in this survey) report a nightly sleep of between 7 and 8 hours. However, a substantial minority (23%) sleep considerably less than this, while a fortunate 2% manage to put in over 10 hours sleep per night. Such a large sample of thousands of people would however, be expected to contain people of widely differing ages. To see in what way sleep varies with age, we thus have to divide our sample into different age groups and look at the resulting picture. The pattern which emerges when we do this confirms our own observations that, as people grow older, they sleep less. If, for example, we
AGE /5+
Fkjure-2 figure-2
25+
35+
4-5*
55+
65f
75V
figure ?? FEMALE
Age ^yewsyears-
AGE /5-2+ 25-31
35"H\ 45-5*\
55- bf
(>5-7+
75+
/5+
2ft
3fr
45+
55+
65+
7&
The increase in insomnia with age in men is and insignificant until the age of 65 years, when there is a sudden increase in reported sleep difficulty. In contrast, the reports of women suggest that their sleep difficulties increase more uniformly with age and are well established earlier in middle age. The age of 65 is, of course, the normal retiral age for men and the sudden increase in sleep difficulty at this time may reflect with disturbance of normal daily habits consequent to stop-
getting out of bed together! sleep pattern fluctuates with changes in anxiety level and mood we might expect sleep disturbance to be a common feature of psychiatric disorder. Certainly, psychiatrists have long recognised insomnia to be a frequent accompaniment to many types of psychiatric illness. Such clinical observations are supported by the findings of surveys comparing the reports of the sleeping habits of psychiatric patients and non-patient are
slight
Ping work. Whatever
good
groups.
the reason, it would seem that women Seem to obtain more than their fair share of sleep
Pistr/bittiotf
disorder
relative to men. Perhaps they are more anxious and tense compared with the placid male. My own wife puts forward the alternative theory that the higher incidence of disturbed sleep in Woman as age advances may simply be due to the fact that most husbands put on weight at middle age, occupy more of the bed, and thus cause their Unfortunate wife to suffer a poor night's sleep. It has long been recognised that anxiety and Worry are two of the most common factors which cause insomnia. As anxiety is a state of mind inv?lving a heightened level of arousal in the and nervous system, the person who goes to bed tense and worried will be likely to find himself tossing and turning in a vain attempt to find the serenity of sleep. Unless we lead unusually troublefree lives or are lucky enough to have an extreme y carefree nature, most of us have experienced t e disturbed night which may follow a hard day. We are unfortunate enough to be of a worrying Mature, our chronically tense and anxious attitu e ^ay cause us to join the ranks of the habitual insomniac. The sleeping pills, which come^ as a blessed boon to an increasingly large section o
the
community, usually
anxiety
act
group
\ Patient OF Horn SLEPT
30\ 20\ Jo\ % 5 hours
??dily chemistry
and constitution of the individual. basic personality difference may a prime cause of friction in marriage, n ee , years ago, a lady in the U.S.A obtained a divorce on grounds of 'mental cruelty because:
Perhaps e
or/ett
a
Someone once suggested that the human race could be divided into two types?those who waken UP quickly every morning feeling alert, bright an eager to face a new day, and those for whom the Process of getting up in the morning is often an eXtremely painful business'. Although these are extreme types to which most of us only approxima e, there is some suggestion that such different re actions to sleep or wakening are dependent on e such
a
>e husband
insisted in singing and recounting j in the morning. Perhaps all eng g ^?Uples should be encouraged to sleep *?8e a east once before marriage to establish
^st thing
.
Croup
60\
our
by reducing
1l/ormaf J
m
level which will allow the natura state of sleep to follow. to
at
If the
bor7 hours
7 or 8 hours
9 or/O
Oyer to hours?
hours
As illustrated in Figure 5 above, a significantly greater proportion (42%) of patients reported that they habitually sleep less than 7 to 8 hours a night as
compared
with
non-patients (23%). Indeed,
incidence of every form of insomnia is
so
the much
higher in psychiatric groups that we might be tempted to conclude that our sleep pattern is a fairly sensitive barometer of our mental health. However, this picture is somewhat modified by age. The regular increase of prolonged insomnia in the normal population with increasing age (particularly among women) greatly narrows the gap between the incidence of sleep disturbance in psychiatric and non-psychiatric populations. In other words, sleep disturbance in an older person is less likely to indicate emotional or mental disorder than insomnia occurring at a younger age.