Dying for Sleep

A while back a colleague told me about an interesting entitled book “Lights Out”1, a used copy of which I promptly procured online for a few dollars. It arrived last Thursday about noon — and a few hours later the largest blackout in the history of North America enveloped much of the Northeast. Now, I’m not a superstitious type. Nor am I egotistical, or crazy, enough to consider the possibility that the arrival of that book had anything to do with the blackout. But it certainly did give me pause to reconsider that whole phenomena of cause and effect. They say - whoever “they” are - that there is no such things as a coincidence. So, just in case, if it in fact was anything more than pure coincidence, I hereby publicly and contritely offer my most humble apologies...

Black out or not, the book actually is quite fascinating and its basic thesis is well worth considering. Simply put, the authors maintain that the advent of nearly universal access to electric lighting - at least in the developed world - has had unintended and dire consequence on our health. Freed of a dependence on the sun’s light to be active physically and mentally, we have also become independent of the natural rhythms of day and night.

Instead of being active during daylight and sleeping when it is dark, we have created our own sleep patterns which as a rule are long on being active and short on sleep. The claim is that not only do we just not sleep as much as we used to but that we don’t sleep as much as we need. The author’s research shows that physiologically, our bodies need about 9 hours of sleep and anything less is a deprivation that we ignore at our own peril.

The premise certainly is easy to grasp, but that doesn’t make the implications any less profound. It makes me recall the oldest known Chinese medical classics written five or so thousand years ago - but which were the accumulated wisdom of many more thousands of years before that.

What surprised me when I started to read them was the fact that they begin with the statement that the most fundamental principle for maintaining good health is the need to get up with the sun and go to sleep when it is dark. And that means sleeping more in the winter and less in the summer. (Obviously written in a temperate location like ours, we’ll put aside the needs of Inuits and Scandinavians.)

There it is, as clear and obvious as, well, day and night. So, many millennium later we have a contemporary pronouncement on our need for adequate amounts for sleep and a scientific explanation of the effects of sleep irregularities, which includes deprivation (less than the prescribed 9 hours a day), as well as not sleeping when we're supposed to (ie. when the sun goes down until it comes back up again).

The backgrounds of the authors, T. S. Wiley and Bent Formby, lend to the credibility of their claims as do the 97 pages of endnotes and scientific references. They are researchers at the Sansum Medical Research Institute, a 60 year old organization dedicated to research and education in medicine, and one of the leading diabetes research institutions in the United States. (The founder of the Institute, Dr. William D. Sansum, was introduced the use of insulin to treat diabetes in the United States.) One has doctorates in biochemistry, biophysics and molecular biology. The other is an anthropologist and medical theorist.

Wiley and Formby write that the advent of our electrical era, which is less than a century old, ranks up there with the discovery of fire and the emergence of agriculture as a “point of no return in human history”. They have poured over more than a thousand scientific documents and a decade of research at the National Institutes of Health to reach their conclusions: the major degenerative diseases of our era like heart disease, cancer, diabetes and obesity as well as premature aging and many mood disorders (think SADs, for one) are “caused by short nights, by working ridiculously long hours, by, literally, burning the candle at both ends, and by the electricity that gives us the ability to do it.”2

Their research showed that a century ago adults were sleeping on the average 9 to 10 hours every night. Today, we hold to 8 hours as an ideal, but most of us are getting 7 or less hours of sleep. Our leisure time has also diminished in quantity and quality. Just in the last 3 decades, this has gone from 27 to 15 hours a week in the United States. And we have switched from soothing activities like gardening and woodworking to more frenetic and over-stimulating ones like aerobics, TV and eBay. So, what is the mechanism by which these changes affect our health? To paraphrase the research, when our sleep is insufficient and out of sync with the natural daily light cycle, our evolutionary physiology is thrown out of balance. Biological rhythms control our hormones and neurotransmitters, which in turn control appetite, fertility, and mental and physical health. Extending our day until 11 PM, midnight, and beyond, the body is fooled into “living in a perpetual state of summer.” Like squirrels gathering nuts, we are biologically programmed to anticipate a scarce food supply and forced inactivity over the winter, so our bodies begin to store fat and the metabolism slows down to carry us through the winter and the “months of hibernation and hunger that never arrive.”

This leads to a most interesting conclusion: that the artificially extended day leads to a craving for sugar, especially concentrated, refined carbohydrates. Moreover, a lack of sleep inhibits the production of the hormones prolactin and melatonin--deranging our immune systems and causing depression, diabetes, heart disease, and cancer. (By the way, the authors are not big fans of hormone supplants like melatonin because they feel it further depresses the capacity of the body to produce them.)

Also of interest is the revelation that government sponsored research has long been available to prove the consequences of inadequate and unnatural sleep, but that is has been almost totally ignored by the medical establishment. The implication, of course is that it remains one of the best-kept secrets of our day because there is little profit motive in having people sleep longer during the night.

Although the writing of Wiley and Formby often strikes a tone that is a little over the top (as one reviewer put it, “strident and all-knowing), that should not diminish from the validity of their conclusions. Evidently, their harsh style reflects a frustration that something so well researched and obvious has been dismissed and overlooked for so long.

But, the best attribute of this book is the simple prescription by which the situation can be remedied: sleep at least nine and a half hours in the dark during the dark half of the year, lay off the carbohydrates (where have you heard that before?), eat more protein, vegetables and good quality fats. Good luck.

1. Wiley, T.S. and Formby, Bent, Ph.D. “Lights Out: Sleep, Sugar and Survival”, Pocket Books; New York, NY. 2000

2. Ibid. pg. 3