Sounding Off for Sound Sleep

As a University of Chicago medical student, William C. Dement stumbled into a research career that would eventually make him one of the world's foremost experts on sleep. But at the time -- the mid-1950s -- most scientists had doubts when the young researcher announced that our brains are active through the night.

Over the years, Dr. Dement's persistence and scholarship won over skeptics -- and launched today's science of sleep research.

By tracking brain wave activity and eye movements, he discovered rapid eye movement (REM) and mapped the architecture of sleep, learning that we pass through a consistent set of stages during our night's rest.

In 1963, Dr. Dement became a professor of psychiatry at California's Stanford University. By 1970 he had set up the world's first sleep disorders clinic, where patients stayed overnight while doctors monitored their slumber. The result: groundbreaking insights into disorders such as narcolepsy, insomnia and sleep apnea.

Dr. Dement also has campaigned to increase public awareness of sleep problems. He founded the American Sleep Disorders Association in 1975 and served as its president for 12 years. Until recently, he chaired the National Commission on Sleep Disorders Research, and he remains chairman of the National Program on Insomnia and Sleep Disorders.

Q: How important is sleep to overall health?

Dr. Dement: I like to say there's a triumvirate of health: nutrition, physical fitness and sleep. For the most part, sleep gets ignored.

Q: What percentage of us have sleep problems?

Dr. Dement: At least half the population has a sleep disturbance at any given time. Stress-induced insomnia is probably the most common, though it's not a sleep disorder in the clinical sense -- it's more of a symptom.

Q: What's the most common serious sleep disorder?

Dr. Dement: Obstructive sleep apnea. I believe it progresses to death if it isn't treated. It affects 30 million Americans. I think that makes it the No. 1 serious chronic illness.

Q: How can you tell whether you're getting enough sleep?

Dr. Dement: If you feel good all day long -- wide awake and alert -- you're getting enough sleep. If you're feeling pretty drowsy after lunch and it's pretty hard to get up in the morning and you have a glass of wine and it hits you pretty hard, then you've got a sleep debt -- you're not getting as much sleep as you need.

Q: What are the most vital things you can do to sleep well consistently?

Dr. Dement: The first thing is to really take it seriously. What we find is that in our busy lives, people generally don't even think about "will I be able to get enough sleep?"

Q: What are some other habits that ensure good, consistent sleep?

Dr. Dement: Regularity is good. Allowing time to get the sleep you need, planning so that happens, not allowing yourself to get too sleep deprived, avoiding things that you take into your body that disturb sleep -- caffeine being No. 1, alcohol probably being No. 2 -- and realizing that you don't fall asleep when you're all excited or angry.

Q: The bedroom should be reserved for sleeping?

Dr. Dement: Right. And you should have a ritual that favors sleep. People should know when they're getting sleepy. If you pay attention, you'll notice that you get drowsy at the same time.

Q: Does the amount of sleep needed vary a lot from person to person?

Dr. Dement: There's kind of a bell-shaped curve. Eight hours is pretty much the average. Almost everybody is between six and nine. The problem is, with the longer sleepers, there's so much demand to sleep less.

Q: We seem to admire people who can get by on very little sleep.

Dr. Dement: Absolutely, but almost all of them don't really get by. It can kill people. People who don't get enough sleep are impaired. They can't function as well mentally.

Q: What are some effects of sleep deprivation?

Dr. Dement: Mood is negatively affected. Cognition is negatively affected. Reaction time is increased. Human interactions are impaired. You can start to have micro-sleeps, which can be very dangerous. Motivation is impaired -- you become apathetic. There's inconsistency in performance. You make errors of omission and commission.

Q: When do those impairments kick in?

Dr. Dement: You can start to measure them after just a couple of hours of sleep loss.

Q: Do you follow your own advice on sleep?

Dr. Dement: Pretty much. I try to get at least seven hours. I'm the kind of person who will leave a dinner party, will leave guests. I'll say, "It's my bedtime folks, sorry." If I don't respect sleep, who will?