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Tips For Sleep Deprived America; Philadelphia Strives To Get Fit

Aired March 25, 2006 - 08:30   ET


DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning. And welcome to HOUSE CALL. I'm Dr. Sanjay Gupta.
So here's the question. How did you sleep last night? Well if you're like the majority of Americans, probably not very well. And probably not long enough either.

You know what? It's costing us, from health-related problems like diabetes and heart disease to loss of productivity and auto accidents.


GUPTA (voice-over): We live in a world where day and night no longer matter. You can work, play, eat, pretty much do anything we want around the clock. What we don't do enough of is sleep.

UNIDENTIFIED MALE: I would say that I average about six hours of sleep.

UNIDENTIFIED MALE: About four to six hours maybe.

UNIDENTIFIED MALE: Probably get four or five hours.

UNIDENTIFIED MALE: Four or five hours.

UNIDENTIFIED MALE: I'm tired every day. Every night I'm tired.

GUPTA: As a society, we are chronically sleep-deprived, researchers say. Most of us need seven and a half to eight hours of sleep, but we're only getting an average of about six and a half during the week, a little more on weekends. This shortfall doesn't go away. In fact, it builds. Researchers call this our sleep debt.

DAVID DINGES, UNIVERSITY OF PENNSYLVANIA: Day after day, living on reduced amounts of sleep, you become more and more impaired, more dependent on caffeine, have more difficulty concentrating, at greater risk for falling asleep, more difficulty remembering, but you think you're doing fine.

The facility is set up to control those factors that typically influence sleep/wake behavior.

GUPTA: David Dinges runs the sleep and chronobiology lab at the University of Pennsylvania. His lab deprives healthy people of sleep to see how they do. UNIDENTIFIED FEMALE: The baby cried and upset her...


UNIDENTIFIED FEMALE: George could not believe his son stole a...


UNIDENTIFIED MALE: Blue, red, green.

GUPTA: Stay up for 24 hours, like this test subject, and you're likely to perform as well as someone who's had a couple of drinks.

Here's something else. Experiments show for the vast majority of people, sleeping six hours a night for a week will result in mental lapses and sleepiness, as severe as if you'd stayed up all night long. Long-term, lack of sleep can have serious consequences on our health.

DINGES: The less you sleep, the more likely you are to die of all causes, or to have a heart attack or a stroke or to have diabetes or to have weight gain.

GUPTA: Eye-opening problems that should make us all want to get a good night's sleep.


GUPTA: All right, so as you can see, not getting enough sleep can be serious.

So the question is, are you getting enough? Well, take this quiz with us. If you use weekends to catch up on sleep and fight to stay away during long meetings, you probably need more sleep. Check.

Also if it takes 30 minutes to either fall asleep and you wake up groggy you might actually be sleep deprived, as well, and possibly might want to see your doctor.

Or you can listen to our guest, Mark Rosekind. He's a sleep specialist. He's a former NASA scientist, and he's president of Alertness Solutions, which sounds like a very interesting place to work.

Thanks for joining us.


GUPTA: Doctor, why is sleep so important? Some people -- you know, my father always used to tell me that you can sleep when you're dead. A lot of people think of it as a waste of time. What do you think?

ROSEKIND: You know, sleep is so basic for us as humans. It is as a basic need as food, water, air. We just need it for our survival. And the other part is if you lose sleep you pay for it. And that means you're going to pay with impaired performance, safety, health, mood, the quality of your life. So it is a basic need for us, and if you don't get what you need, you will pay.

GUPTA: You know, it's interesting and we're going to talk a lot about why we actually sleep during the show. But we are figuring out what happens if we don't sleep, and we received a lot of e-mails on this particular topic.

Let's start from Don in Oregon, who writes this: "Does sleep deprivation over an extended period of time contribute to high blood pressure or diabetes and if so, why?"

And Dr. Rosekind, we've heard a bit about this in the piece, obviously. But why does it actually cause long-term health problems?

ROSEKIND: Yes, we're still figuring that one out. It is clear that when you lose sleep it can reduce your immune function. So you know when our parents were telling you if you don't sleep you're going to get sick, that seems to be true.

What we're now understanding is it can also disrupt all other aspects of what's going on in our body, like metabolism. So you know, even a little bit of sleep loss can affect your metabolism, make you look like you have diabetes, for example.

So we're just learning what the effects are. We don't really fully understand what the mechanisms are yet.

GUPTA: It's really amazing. One of the things we talk a lot about in the piece, is someone who doesn't sleep enough could actually put on weight, which people find fascinating.

Someone else battling the elusiveness of sleep is Chris in Maryland. He writes this: "I keep waking up in the middle of the night and cannot get back to sleep. I've tried various sleep medications and nothing works. How can I enjoy at least six hours of sleep without waking up?"

And Dr. Rosekind, and this sounds like a classic case of insomnia, the most common sleeping disorder. A lot of people complain about this. He's tried the pills already. He's tried good sleep hygiene. What advice do you have for him?

ROSEKIND: You know, one thing is you can actually train yourself to wake up in the middle of the night. We do this to ourselves. We do it to our babies and things like that.

So for example a couple of very specific things. Don't become a clock watcher. One of the problems is people wake up in the middle of the night and, because of digital clocks you're over there watching the minutes go by.

A second thing is give yourself something to do. Pick a relaxation skill or some technique where you're tensing and relaxing muscles, using positive imagery, deep breathing. Don't just lay there worrying about the fact you can't get back to sleep.

And the third thing is, we have something we call the 30-minute toss and turn rule. If you can't fall asleep in 30 minutes, you might as well get out of bed rather than just staying in bed and struggling through it.

The other thing is I would just suggest that different sleep medications help you in different ways. So even though Chris has tried some stuff it might be interesting to talk to his doctor, because there may be one that could help him with maintaining sleep, and he might have been trying ones that were just more helpful, say, in trying to get to sleep.

GUPTA: The whole idea of actually getting out of bed when you can't sleep is a really good one. I do that myself sometimes, and all of a sudden I feel a lot sleepier. It works out pretty well for me.

We are talking to Dr. Mark Rosekind. More of your questions answered, coming up on HOUSE CALL. Stay with us.


KYRA PHILLIPS, CNN ANCHOR (voice-over): Drowsy driving. We've all done it, but at what cost?

TOM CALLAGHY, GOT IN ACCIDENT FROM DRIVING TIRED: My kids had a mother one day and not the next.

PHILLIPS: The devastating effects of sleeplessness just ahead.

Plus we head to the city of brotherly love, where some residents are swapping their cheesesteaks for working out.

First, take today's quiz. Before the light bulb was invented, how many hours did people sleep? That answer coming up.




PHILLIPS: Before the break we asked before the light bulb was invented, how many hours did people sleep? The answer, 10 hours. Compare that to the current average of just seven hours per night.


GUPTA: And most experts will tell you seven to nine hours is what most people need to feel rested.

And helping to get those Z's is our guest today, Dr. Mark Rosekind. He's a sleep specialist who recently designed bedrooms for U.S. Olympians, as well. Really interesting. Helping them sleep better. And we also talked with American speed skating gold medallist Apolo Ohno. He aims for nine hours of sleep per night. He says without it he's not in top form. That's something to think about for all of us.

So let's jump right back into our inbox, take an e-mail from Tom in Florida, who's trying to play catch up. "My normal pattern," he says, "is to get five hours of sleep during the weekdays. But by Friday I'm beat, and I try to catch up somewhat on weekends with eight to 10 hours of sleep. Is this harmful?"

Dr. Rosekind, I've got to tell you, just about everybody I know, including myself, probably yourself as well, has done this at some point. Is it harmful?

ROSEKIND: This is the American way, it seems. Tom really represents all of us. I wouldn't say it's so much harmful, but what you've got there is that basically it's not just the sleep you had last night, but when you've lost sleep it builds into what we call a sleep debt.

You should think about that just like your bank account. Basically, for every hour of lost sleep you're going deeper and deeper into the red. For most of us we're probably bankrupt, frankly.

And what you see as the classic pattern is, you know, go into debt during the week and then on the weekends you're trying to recover. And then hopefully, you know, during the week you're OK again and that's so you can recover the next weekend.

GUPTA: Is it like the national debt, Mark, or is this something you can pay off pretty quickly?

ROSEKIND: And you know what's interesting: some people think that our national sleep debt probably far exceeds our national economic debt if you add all the hours up together. But how do you pay it back is a great question.

It ends up you pay it back sleeping deeper, not a lot longer. So the good news is you probably don't have to pay it back hour for hour. But there's bad news, and that is you can't put credit in the bank either. So you've got a bad week coming up? I'll just sleep all weekend and then take it out when I need it? Unfortunately, you can't do that.

GUPTA: Well, Tom, good luck with getting some of that sleep back.

The most dangerous side effect of not getting enough sleep is accidents. A recent poll showed 60 percent of adult drivers said they have driven drowsy. According to government figures, his leads to about 100,000 reported auto accidents every year, some of them with very deadly endings.

(BEGIN VIDEOTAPE) GUPTA (voice-over): Most of us have felt this way, at some time in our lives, fighting to stay awake behind the wheel. This man is part of a first of its kind study: 100 cars wired for a year to see how people really drive.

Experts say too many of us are like this, dangerously tired behind the wheel.

DR. CHARLES CZEISLER, BRIGHAM AND WOMEN'S HOSPITAL: Every second in this country somebody is nodding off or falling asleep at the wheel, and every two minutes -- that's 30 times an hour -- there is a fall-asleep crash on our nation's highways associated with people who haven't gotten enough sleep at night.

GUPTA: According to federal estimates, drowsy driving crashes cause 1,500 deaths and 71,000 injuries in the United States every year.

(on camera): If you're one of the people who turns up the radio or cracks the window when you start nodding off behind the wheel, stop. Experts agree that nothing works well to keep YOU awake for more than just a few minutes. The only real solution is to get off the road.

(voice-over): Tom Callaghy was driving home from Virginia to Pennsylvania with his wife, when he started getting drowsy.

CALLAGHY: Actually I left in the middle of Sunday afternoon, and it was a gray, sort of overcast day. It had been drizzling, and I was getting sleepy. I turned on the radio, opened the window a little bit. I moved around. And I actually had my hand partway across the seat to wake her up, and the next thing I knew, I'd gone off the road and into the trees.

GUPTA: Tom Callaghy's wife, Janie, died in that crash. Callaghy talks about the accident to warn others about the dangers of drowsy driving.

CALLAGHY: My kids had a mother one day, and not the next. I mean, Kathleen said, my daughter, said that mom went away for the weekend and just never came home.


GUPTA: And the impact drowsiness has on your reflexes and your reaction time is amazing. I actually went without sleep for over 30 hours while shooting my sleep special, and you'll see what happens to me when you tune in Sunday night. Really remarkable.

And Doctor, if you're not getting enough sleep at night, really quickly, would a nap help?

ROSEKIND: Naps are probably the most powerful strategy that you can use. While I was at NASA we did a study giving pilots naps in the cockpit. And what we found is that even a 26-minute nap was able to improve performance by 34 percent and their alertness by 54 percent. GUPTA: All right.

ROSEKIND: It's an extremely powerful, effective strategy.

GUPTA: Even less than a half hour. That's good news for a lot of people out there.

We're looking at ways for all of us to get more shuteye. That's coming up on HOUSE CALL.


PHILLIPS: From pills to clips and strips, what is the best way to help you get those Z's? Find out after the break.

And later, why experts say your workout could be cutting down on your shuteye.

First, this week's medical headlines in "The Pulse."

JUDY FORTIN, CNN CORRESPONDENT: Weight loss may not be the only long-lasting benefit of gastric bypass surgery. It may also ease hypertension.

A new study published in the "Journal of the American Medical Association" says patients saw a significant drop in their blood pressure after surgery. Patients taking hypertension medicine prior to the operation were also able to stop taking the drugs.

One more reason women should do a monthly self-breast exam. A British study reveals women with asymmetrical or uneven breasts have a higher risk of developing breast cancer. Researchers found the larger the difference in size, the higher the risk.

Judy Fortin, CNN.



GUPTA: For more on my special, "SLEEP", click on Find out whether you've been paying attention to us this morning by taking the sleep quiz. Also, if you're interested, click on the dream dictionary where you can find out whether your dreams are trying to tell you something that you need to know.

We've been talking about sleep with Mark Rosekind. He's a sleep specialist. He's a former NASA scientist. He's also president of Alertness Solutions.

And since you're the president of Alertness Solutions let's talk about some solutions now. There's certainly a lot of claims out there, I hear. Let's start with medication and a question from Erin in Connecticut who writes about that. "Most nights I fall asleep easily but wake up around 2 or 3 and can't get back to sleep for hours. I've started taking an over-the-counter sleeping pill every night and now I feel great in the morning. Will this medicine hurt me in any way?"

Dr. Rosekind, we hear a lot of stories about not being able to get off these drugs. Are there actually long-term side effects in taking them?

ROSEKIND: Yes, you can pretty much get addicted to almost anything. The caution with the over-the-counters is that they can last for 10 or 12 hours in your system, so you may get your eight hours, but sometimes they can last for a couple hours after you wake up, still making you tired.

GUPTA: So the prescription ones actually come off a little bit quicker, don't they?

ROSEKIND: And that's correct, which is that the prescription medications nowadays can have very short working lives in your system, and they may only last from one to two or two to four hours. That's helpful to get you to sleep, stay asleep and it's out of your system when you wake up in the morning.

GUPTA: All right. Another question now on help on snoring. A lot of questions about this, as well. This one from Walt in Texas: "I've seen the strip across the nose, the nostril clips and throat spray. What works best to help reduce snoring?"

ROSEKIND: I would tell people if snoring is bothering you enough or someone in your household enough for you to seek things out, you have to talk to your doctor. Because snoring can be a sign of sleep apnea, where you can't sleep and breathe at the same time, and that can have very dramatic health effects, as well as put you more at risk for car crashes. So if it's bothering you that much, you've got to see your doctor before you go to any over-the-counter kind of memory.

GUPTA: We're talking with Dr. Mark Rosekind about sleep on HOUSE CALL. More after the break, plus our "Fit Nation" tour rolls on.


PHILLIPS: The home of the cheesesteak takes on fat.

GWEN FOSTER, NUTRITIONIST: This program's worked better than we ever anticipated.

PHILLIPS: Our "Fit Nation" tour stops in Philadelphia and finds out how it went from fattest city to fit city.




GUPTA: Throughout history, it has been colleges. It has been places like the University of Michigan that have been the seeds of change.

UNIDENTIFIED MALE: Nobody is marketing peas and carrots and corn.

UNIDENTIFIED FEMALE: The most important thing, I think, is teaching people how to use what they have.

UNIDENTIFIED MALE: I really think we have found the weapons of mass destruction, and those weapons of mass destruction are too many calories and too little physical activity.


GUPTA: We're in the midst of our "Fit Nation" tour to fight obesity. We're really serious about this. And that was just some of what happened at the University of Michigan.

This week we stopped in Philadelphia, Drexel University, where former president, Bill Clinton, joined us and talked about his goal of creating a fitter nation.


BILL CLINTON, FORMER PRESIDENT OF THE UNITED STATES: I personally am optimistic, but I don't think we can get there unless we remove the barriers to access to a healthy life that exist to so many lower income people, which is why I think what Philadelphia has done is so important, and one I hope that will be modeled elsewhere.


GUPTA: And here now, just a look at what Philadelphia has done.


GUPTA (voice-over): When it comes to food and fitness, Philadelphia is really best known just for its food.

UNIDENTIFIED MALE: Just one of the things; you go to Philadelphia, you have to have a cheese steak.

GUPTA: Home of the world renowned Philly cheesesteak, homemade Italian water ice, soft pretzels and Tastykake snacks. Not surprisingly, Philadelphia ranked at the top of "Men's Fitness" magazine's fattest cities list in 2000.

(on camera): Just about the only fit thing that is associated with Philly are when Rocky ran up these steps training for a fight, and the regatta that takes place here on the Schuylkill River.

(voice-over): But in the six years since Philly was dubbed the "City of Blubberly Love," it's managed to slim down to No. 23 on the list.

NEAL BOULTON, EDITOR, "MEN'S FITNESS": Philadelphia is an amazing success story in this country primarily because the mayor, John street, has really gotten involved.

GUPTA: Sixty-two-year-old Mayor Street sprang into action after the city received its terrible ranking.

JOHN STREET, MAYOR OF PHILADELPHIA: We're probably a whole lot fatter than we need to be and a whole lot less fit than we need to be. And so we just sort of took it as a challenge and started instituting this program.

GUPTA: So Street appointed his childhood friend, nutritionist guru Gwen Foster, as the city's first health and fitness czar.

FOSTER: I had to think of something that would be cost effective, having no budget, and that would be effective. Our signature program, of course, is what we call the Health Journey.

GUPTA: The fitness journey lasts 10 weeks. You sign up at a local checkpoint. Once enrolled, you receive a health passport and a pre-health assessment. The passport grants you access to top notch local health clubs and fitness class, cooking classes and even massages for only 25 bucks.

FOSTER: This program worked better than we ever anticipated. A conservative figure is 30,000, that we can account for.

GUPTA: Experts at "Men's Fitness" say its success is partly the result of the mayor himself leading by example.

STREET: I've run five marathons and I have run two marathons since I've topped 50 years old. I decided, oh, I'm 50 now. I'm going to see if I can still run a marathon.

GUPTA: Local doctors are apparently noticing the difference, as well.

FOSTER: We know we have a winner, because physicians cannot believe these patients that they have to take them off of their blood pressure medication.

GUPTA: So what about those award-winning cheesesteaks?

FOSTER: We're losers but we're winners.


GUPTA: Do you like that with the Rocky Balboa thing? Good luck, Philly. Keep up the good work.

More HOUSE CALL coming up after the break.



CAROL COSTELLO, CNN ANCHOR (voice-over): Can working out before bedtime interfere with a good night's sleep? One study published in the "Journal of Physiology and Behavior" studied college students who exercised in the evening and found no significant effect on students falling or staying asleep, but... UNIDENTIFIED MALE: Come on in.

COSTELLO: Dr. Rosenberg says some types of late workouts may lead to sleeping problems.

DR. RUSSELL ROSENBERG, DIRECTOR, NORTHSIDE HOSPITAL SLEEP INSTITUTE: I do have a slight concern of the lifting of weights at nighttime, and whether some of those weight lifting activities might actually cause some slight discomfort at points in the middle of the night that could wake you up.

COSTELLO: Dr. Rosenberg encourages his patients to exercise but to stop intense workouts three hours before bedtime. This allows the body time to cool down.


COSTELLO: A preliminary study by a Harvard researcher found 20 minutes of yoga may help you fall asleep.

SAT BIR KHALSA, HARVARD RESEARCHER: The subjects who have done the yoga practice on a regular basis have actually improved their insomnia.

COSTELLO: Carol Costello, CNN.


GUPTA: Our guest has been Dr. Mark Rosekind.

Unfortunately, we're getting short on time. Do you have a final thought for our viewers?

ROSEKIND: I think you've got it. Diet, exercise, sleep. They are the basics of health, and you've covered it.

GUPTA: We're trying to do that, you know. We're trying to make America healthy. And I want to thank you for being with us and helping us as well, Dr. Mark Rosekind.

Don't forget to watch my sleep special, Dr. Rosekind, everyone at home, as well. This weekend, I'm going to talk with the top experts investigating remedies for sleeplessness, the meaning of dreams and some bizarre sleep disorders that I found, as well. You're not going to want to miss this, Sunday night at 10 Eastern.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.


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