Health: Drowsy America

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The most common sleep complaint is insomnia. About a third of Americans have trouble falling asleep or staying asleep, problems that result in listlessness and loss of alertness during the day. Most of the time the distress is temporary, brought on by anxiety about a problem at work or a sudden family crisis. But sometimes sleep difficulties extend for months and years. Faced with a chronic situation, insomniacs frequently medicate themselves with alcohol or drugs. Doctors warn that in most cases sleeping pills should not be taken for longer than two or three weeks. Such drugs can lose their effectiveness with time, and it takes higher and higher dosages to achieve a result. People run the risk of becoming dependent on the pills.

Because so few studies have been done, scientists cannot make definitive comparisons between American sleep patterns and those of other countries. But many researchers believe that all industrialized nations are experiencing sleep-deprivation problems, though usually not as serious as those in the U.S. "The Europeans don't have 24-hour societies like we do," says Henry Ford Hospital's Roth. "If you're in Paris and you're looking for a restaurant at 2 in the morning, you're not going to find one so easily." In Germany most stores close by 6:30 p.m., TV networks usually sign off by 1 a.m., and Sunday remains largely a day of rest.

If any nation can be said to be suffering greater sleep loss than the U.S., it may be Japan. Officeworkers in Tokyo often commute for an hour or more, arriving at their desks at 9 a.m. and staying until 8 p.m. or later. Then they go out to eat and drink with colleagues, an essential part of the job, and catch the last train home at midnight. Workers get only 113 days off a year, compared with Americans' 134 and Germans' 145. Exhausted Japanese can be seen sleeping everywhere: on subways and trains, in elevators, at concerts and baseball games, and during business meetings. The usual apology: "Well, it's not exactly polite, but it can't be helped."

Many Americans concede nothing to the Japanese in the tirelessness department. "People love to boast about how little sleep they've had," says Dr. Neil Kavey, director of Columbia University's sleep center in New York City. "It's macho and dynamic." Those who run themselves ragged are often hailed as ambitious comers, while those who insist on getting their rest are dismissed as lazy plodders.

As long as that attitude persists, the national sleep deficit will not be easy to close. Government and businesses can help by formulating more enlightened work rules and schedules. What is needed most of all, though, is a fundamental change in Americans' thinking about the necessity of sleep. A difficult task, yes. But not impossible. Millions of citizens have already shown themselves capable of making far harder decisions once they realize that theirhealth is at stake. Americans have stubbed out cigarettes, laced up exercise shoes and pushed away plates laden with high-cholesterol, high-fat foods. By comparison, choosing to spend some more time abed in blissful oblivion should be attractive. It is a message that is becoming unmistakable: Wake up, America -- by getting more sleep.