The pharmaceutical industry prefers researchers not to look in detail at the postmarketing situation. Once a drug is on the market, we are all supposed to be interested in something else. We should just assume the drug has solved whatever the problem was. There’s no need to follow up by measuring how well the drug is actually performing. Except that’s the kind of thinking that delayed the recall of the Cox-2 Inhibitors when there should have been better safety monitoring to show this class of drugs caused heart problems. Worse, this type of resistance to research runs through most different industries as the delayed recall of Toyotas aptly demonstrates. Which brings us to 2010 Sleep in America, a poll conducted by the National Sleep Foundation. This is a regular snapshot of sleeping habits across America. It’s good this research is done, but it’s on the margin with only a thousand or so participants. There should be significantly more participants if the scaling up of the numbers across the general population is to be reliable. As it is, we should not generalize too much from the results.

The first finding is that, on average, we seem to be sleeping about two hours less than we did forty years ago. For some reason not properly explained, the study assumes we should all aim for about eight-and-a-half hours of sleep every night. The current crop of respondents reports sleeping between six and seven hours a night. To keep the accuracy of this report in perspective, there’s good medical evidence that lack of sleep undermines the body’s immune system making us more prone to illness, encourages obesity, increases blood pressure, and raises the risk of heart disease. What is less clear is the point at which these adverse health consequences kick in. It could be between six and seven hours a night, but there is no evidence to support this proposition. About a quarter of the respondents admit to missing work or appointments because they felt too tired. The same percentage admitted they were too tired to have regular sex.

When asked to explain why sleep was more difficult, many referred to increased financial worries during the recession. Personal stress levels were higher with relationship problems. There were also lifestyle choices like watching TV in bed which delayed or disturbed sleep. In racial terms, Asians have the longest sleep patterns and blacks sleep less than whites and Hispanics. Overall, the report makes interesting reading but, until more people are included in the poll, it is difficult to generalize to the population at large. That said, some of the conclusions are intuitively correct. If about 25% of people are finding their lives adversely affected by insomnia, it helps explain why ambien is such a popular drug. As the sleeping pill with the best reputation for safety and effectiveness, it seems to be the drug of choice to get enough sleep. But it does remain something of a mystery why people make it difficult for themselves. About three-quarters of the respondents watched TV immediately before attempting sleep and then expressed surprise they did not immediately fall asleep. The reality is that, unless you resort to ambien, it’s better to relax the mind, say, by listening to gentle music. Moving the TV out of the bedroom and avoiding exciting late-night programs is basic common sense. Going to sleep at the same time every night is a good habit. Living your life around the TV schedule is a bad habit.