The Economics of Sleep

Allen Blaivas, M.D. Health Pro
  • I'd like to devote some time to a very interesting article from the November 18th New York Times Magazine titled "The Sleep Industrial Complex".


    Firstly, the article notes a recent boom in the "sleep economy". As we have discussed in the past, chronic sleep deprivation can lead to a vast amount of medically related problems including obesity, diabetes, heart disease, weakened immune function, and poor pain tolerance. The NIH estimates that sleeplessness creates $16 billion in yearly health care expenses and $50 billion in lost productivity. This leads to the "sleep economy", estimated to be a burgeoning $20 billion business of all things sleep - from sleep centers, machines and face masks for sleep apnea, to high-tech beds, and, of course, sleeping pills.

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    Most of the article talks about high-end mattresses and their suggested ability to cure our sleep woes. Without spending too much time on the research (or more accurately, the lack thereof) to back those claims, it is safe to say that there are some common misconceptions about mattress buying. A Consumer Reports (June 2005) article outlined some of the typical myths:

    • Firmer is better. In fact, in patients with low back pain, a medium-firm mattress improved the pain more often then a firm mattress.
    • Coil count is critical. Any number above 390 in a queen-size mattress should be plenty.
    • A higher price guarantees a better bed. Anything but the really cheap mattresses can be a fine choice.
    • If you move in your sleep, the bed is to blame. It is perfectly normal to move 40-60 times a night and does not show that your mattress is uncomfortable.

    What I really want to key in on is the author's remarks (near the end of the article) regarding our inability to "force" ourselves to sleep. He describes his conversation with a psychologist who notes the "performance anxiety" that can occur when we feel that we cannot go on without a good night's sleep.


    In the past, we have described this phenomenon as psycho physiological insomnia (see "The Different Types of Insomnia" blog). It means that a person starts having an actual physical response to the psychological pressure of needing sleep; the heart and mind race, the adrenaline starts pumping and cause the body temperature and metabolism to rise- exactly the opposite of what is needed to ensure an easy fall off to sleep.


    The best treatments for this are not the commonly prescribed sleeping pills, but rather a type of psychological therapy called cognitive behavioral therapy (CBT). CBT tries to help people realize that (1) they can function well even on reduced sleep, (2) they sleep more than they realize, (3) they can manage the stresses of the day, and (4) they must become responsible for their thoughts of the day so that their sleep can improve. In essence, what we try to do is "retrain" the insomnia sufferer on how to sleep, by changing beliefs that get in the way of rest.


    I will continue from that thought in my next blog. I will also try to cover a little more about the mattress buying conundrum.


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    In the mean time check out this article, titled

    "$20 billion For a Good Night's Rest", which will fill you in more on "sleeponomics".


Published On: November 29, 2007