Health: Drowsy America

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It was civilization that created the dilemma of sleep loss. The sun presumably dictated the habits of ancient people: when it was up they were awake, and when it went down they slept. Maybe when the moon was full they stayed up a bit later. The discovery of fire probably allowed the first change in that pattern. As flames lit the dark, surely some adventurous souls delayed bedtime. But sweeping change came only a century ago with the introduction of the light bulb. Thomas Edison's glowing invention permitted cheap, safe and efficient illumination throughout the darkest nights. By the end of World War II, people were sleeping about eight hours.

Today new cultural and economic forces are combining to turn the U.S. into a 24-hour society. Many TV stations, restaurants and supermarkets operate through the day and night. Business is increasingly plugged into international markets that require around-the-clock monitoring and frequent travel across time zones. As CEO of Intellicorp, a software company, Tom Kehler, 43, regularly works 12-hour days in his Mountain View, Calif., office and hopscotches the globe. This fall he spent 13 days in Europe, followed by a few days back in California and 10 days in the Orient. Then he flew home and went directly from plane to office. He subsists on four to five hours of sleep a night and occasional 15-minute catnaps during the day -- and unlike most people, he likes it. "Sleep always felt like an interference with life," he says.

Changing family patterns are adding to the national sleep deficit. Working single mothers and two-career families are hard pressed to find time for the children or the household chores. To fit everything in, parents are extending their waking hours. Financial adviser Ben Sax, 34, commutes to New York City each day from his home in a suburb to the north, where he lives with his wife Holly, a lobbyist, and their two children, ages 4 and 6. The parents get by on four to five hours of sleep. "We're shocked when we call people at 9:30 or 10 at night and they're asleep," says Ben. "Our kids are still up at that time." In fact, many working couples are keeping their youngsters up late simply to see them.

Not all sleeplessness is by choice. Clinical sleep disorders are a major contributor to the national drowsiness. Many Americans suffer from nocturnal myoclonus, a condition in which their legs twitch throughout the night and break up their sleep. About 3 million adults, mostly overweight men, are afflicted with sleep apnea. In this disorder, muscles in the upper airway regularly sag and fail to keep the passage open. The struggle to take in air can result in snoring that rivals a jackhammer, though sufferers are often oblivious. "A person with apnea might not even be aware that he woke up 500 to 1,000 times last night, because the arousals are so brief," says psychologist Thomas Roth, chief of Henry Ford Hospital's sleep-disorder center in Detroit. The consequences can be deadly: people with severe apnea have two ( to five times as many automobile accidents as the general population. An overlooked side effect: people with apnea or leg spasms frequently disrupt the sleep of their bed partner. Both apnea and myoclonus can be treated, once diagnosed.