The Value of Sleep

Sleep is big business. People need it. They want it. They’ll spend money to get it. And, according to the bulk of presentations at the 25th annual joint meeting of the American Academy of Sleep Medicine and the Sleep Research Society in Minneapolis (SLEEP 2011) last week, the demand for it continues to far outpace the supply. Given these conditions, it’s not surprising that Americans spend nearly $24 billion on sleep-related goods and services annually, and the market for insomnia drugs is predicted to grow by nearly 80%, to approximately $3.9 billion, in 2012, according to market research conducted by Marketdata Enterprises.

Image via Flickr user deansouglass by Creative Commons License.

Evidence of the anything-but-restful sleep market was plentiful in the SLEEP 2011 exhibit hall, with booth after booth of vendors showcasing everything from pharmaceuticals and nutraceuticals to earplugs, continuous positive airway pressure devices, breathing masks, light therapy boxes, aromatherapy sprays, premium mattresses, and customized pillows. There was also row upon row of posters highlighting the latest research on the multiple and varied sleep-related problems that are keeping the vendors in business.

During a walk through the exhibit hall, however, it didn’t take long for the ironic reality of the sleep conundrum to set in. Americans are spending billions of dollars on sleep-related goods and services and researchers are spending billions of dollars seeking insight into the global sleep deficit that, according to the meeting’s scientific program presentations, is leaving children, adolescents, and adults overtired, anxious, depressed, and suboptimally functional and is putting them at risk for a range of adverse health outcomes, including cardiovascular disease, asthma, diabetes, stroke, and obesity. Yet we, as a society, don’t value sleep.

For example, in March of this year, the Centers for Disease Control and Prevention reported that nearly one third of the country’s adults get less than the minimum recommended 7 hours of sleep per night, and it’s not because they’re not tired: nearly 40% of the survey population reported unintentionally falling asleep during the day and nearly 5% reported nodding off while driving in the preceding 30 days.

Notwithstanding suboptimal sleep quality or quantity resulting from chronic sleep disorders, such as insomnia, obstructive sleep apnea, restless leg syndrome, bruxism, narcolepsy, and sleepwalking, the country’s pervasive sleepiness is often a symptom of what has become a “24-hour society,” in which there’s not enough time in a day to do everything we want to do, according to Dr. Michel Cramer Bornemann, co-director of the Minnesota Regional Sleep Disorders Center at Hennepin County Medical Center in Minneapolis. Not only have we become accustomed to trading sleep for work, he said in a session on sleep forensics, “we wear sleep deprivation as a badge of honor, as if lack of sleep is synonymous with hard work or achievement, when really it can impede both.”

Sleep is a biological imperative, Dr. Bornemann stressed. When it’s not valued as such,  “everybody pays.”

— Diana Mahoney (on Twitter @DMPM1)

Straighten Out Your 3-Iron With CPAP

Courtesy flickr user anthony_goto (CC)

Finally, a way to motive patients to use the CPAP machine you’ve prescribed for them.

According to Dr. Marc L. Benton, golfers with obstructive sleep apnea can expect to knock strokes off their game by adhering to nighttime treatment with continuous positive airway pressure. What’s more, the better the player, the bigger the improvement in golf handicap resulting from sticking with CPAP.

Compliance with CPAP is notoriously poor, notes Dr. Benton, a sleep disorders and pulmonary medicine specialist in Madison, N.J. Many patients, put off by CPAP’s noise, inconvenience, and expense, remain unswayed by their physician’s warnings of the serious medical risks they face in foregoing treatment.

Not avid golfers, however. Dr. Benton has shown in a small prospective study that golfers with OSA are are willing–indeed, eager–to embrace the therapy. He calls the prospect of playing a better game a powerful and previously untapped motivator to seek out and adhere to treatment.

“The adherence in this study was absolutely through the roof,” Dr. Benton observed in presenting his study findings at the annual meeting of the American College of Chest Physicians, held in San Diego.

“More so than almost any other sport, golf has a strong intellectual component, with on-course strategizing, focus, and endurance being integral components to achieving good play,” he noted. “Through treatment with nasal positive airway pressure [NPAP] we can improve many cognitive metrics, including attention span, memory, decision-making abilities, and frustration management, which may in turn positively affect a person’s golf game.”

His study included 12 golfers with moderate-to-severe OSA and 12 controls matched by age and golf handicap. None of the golfers with OSA had previously been interested in treatment, but the glowing vision of a lower handicap lured them into study participation.

After 3-5 months of NPAP their handicap dropped from an average of 12.4 to 11.0. All of them felt better able to perform on the links. The control subjects had no change in handicap.

The outcomes were particularly striking among the 5 golfers with OSA who were already very good at the game as defined by a baseline handicap below 12. Their average handicap dropped from 9.2 to 6.3, and they were ecstatic about it. “Most of these better golfers were in their late 50s and early 60s, a time of life when the handicap index is typically going in the other direction due to issues related to the aging process,” Dr. Benton noted.

He estimated that 1-3 million American golfers have OSA. In most cases the disorder is undiagnosed and/or untreated.

—Bruce Jancin