I roll my eyes when I see articles about how we humans are prone to miscalculating sleep time—in particular, people with insomnia. We tend to underestimate how long we sleep, and the conclusion is often that if we knew how long we were really sleeping, we wouldn’t complain so much.
That’s not the message of the latest of these articles, written by Derek Thompson in The Atlantic. Thompson looks at how the quest to prolong sleep ties in with the use of sleeping pills—but I think his analysis falls short.
Yes, We Are Unreliable
To show how unreliable we are at estimating sleep, Thompson presents data from two surveys. In one, Americans report averaging 6 hours and 45 minutes of shut-eye a night. In the other, Americans report an average of 8 hours and 42 minutes’ sleep—a whopping two-hour difference. He goes on to cite a sleep study in which New Yorker writer Elizabeth Kolbert thought she lay awake for 3 hours before finally drifting off. In reality, according to the study, she fell asleep within 10 minutes of getting in bed.
Not only are we in the dark about how much time we’re sleeping, Thompson says. The number of insomnia diagnoses and sleeping pill prescriptions has more than quintupled since 1990, yet Americans not sleeping any longer today than they were then. He concludes by suggesting that we need more accurate data about how long we’re sleeping and better drugs.
I’m all in favor of calling for better sleeping pills. The ones we’ve got now—like Ambien and Lunesta—have side effects and alter the nature of the sleep we get. But I’d like to steer the conversation away from the unreliability of our sleep estimates and the idea that prolonging sleep should be the main gauge of a drug’s effectiveness.
There are explanations for why humans—especially people with insomnia—tend to miscalculate how long we sleep. It’s easy to perceive Stage 1 sleep, the earliest and lightest stage, as wakefulness. In a retrospective study published in October 2013, Belgian investigators found that as we fall asleep, people with insomnia tend to have more high-frequency activity occurring in our brains than do normal sleepers. This suggests a higher degree of information processing, which may feel like wakefulness rather than sleep. In another recent study, German researchers found more high-frequency activity occurring in the brains of insomniacs during Stage 2 sleep.
No wonder we’re unreliable at estimating sleep time. Some of the sleep we get feels like wakefulness. So the real culprit for some of us may not be sleep length at all. It may be our poor sleep quality—an inability to shut the brain down completely and keep it offline for a sustained period of time.
In Search of Sleep Quality
There’s no definitive way to measure sleep quality today; it can’t be assessed in a sleep lab. But a recent meta-analysis of sleep studies concludes that people with insomnia get less deep sleep—associated with feelings of restoration—and less REM sleep—associated with dreams and emotional processing—than good sleepers. Maybe these are not exactly measures of sleep quality. But I’ve got a hunch they’ve got something to do with it.
What insomniacs need is not just information about how long we’re sleeping, and it may not even be that we need drugs that greatly prolong our sleep. The real problem for many of us is poor sleep quality.
Hey, Big Pharma, give us drugs to improve that.
What are your main sleep complaints? If you’ve tried sleeping pills, have they helped?