© Min Heo
Did you get enough sleep last night? Are you feeling fully awake, like your brightest, smartest, and most capable self? This, unfortunately, is a pipe dream for the majority of Americans. "Most of us are operating at suboptimal levels basically always," the Harvard neurologist and sleep medicine physician Josna Adusumilli told me. Fifty to seventy million Americans, Adusumilli says, have chronic sleep disorders.
In a series of conversations with sleep scientists this May, facilitated by a Harvard Medical School Media Fellowship, I learned that the consequences of lack of sleep are severe. While we all suffer from
sleep inertia (a general grogginess and lack of mental clarity), the stickiness of that inertia
depends largely on the quantity and quality of the sleep that precedes it. If you're fully rested, sleep inertia dissipates relatively quickly. But, when you're not, it can last far into the day, with unpleasant and even risky results.
Many of us have been experiencing the repercussions of inadequate sleep since childhood.
Judith Owens, the director of the Center for Pediatric Sleep Disorders at Boston Children's Hospital, has been studying the effects of school start times on the well-being of school-age kids—and her conclusions are not encouraging. Most adults are fine with about eight hours of sleep, but toddlers need around thirteen hours, including a daytime nap. Teens need around nine and a half hours; what's more, they tend to be night owls, whose ideal circadian rhythm has them going to bed and waking up late. As schools have pushed their start times earlier and earlier—a trend that first started in the sixties, Owens says—the health effects on students have been severe. "It's not just sleep loss. It's circadian disruption," Owens says. "They have to wake up when their brain tells them to be deeply asleep. Waking a teen at six in the morning is like waking an adult at three at night."The
result is a kind of constant jet lag—and one that is exacerbated by sleeping in on the weekends. Executive function and emotional responses get worse, hurting everything from judgment to emotional reactivity. The ability to make good decisions can suffer, and kids can become more prone to act out and get depressed.
In fact, the rise in A.D.H.D. diagnoses may, in part, be the result of inadequate sleep: in children, symptoms of sleep deprivation include hyperactivity and impaired interpretation of social cues. Owens has seen many such misdiagnoses in her clinical practice. The effects are physical, as well. Children who undersleep are more likely to gain weight and become obese. Even for infants as young as six months, amounts of sleep can predict weight gain three years later.
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