Miguel de Cervantes once said, "Blessings on him that invented sleep! It covers a man, thoughts and all, like a cloak; it is meat for the hungry, drink for the thirsty, heat for the cold, and cold for the hot. It is the currency with which everything may be purchased, and the balance that sets even king and shepherd, simpleton and sage." But what of those poor wakeful souls, staring at the ceiling night after night, spending their days in dazed semislumber? Well, they are among distinguished company. Throughout history, great minds have lain awake for nights on end. Rudyard Kipling suffered from a sleeping disorder for most of his life, prompting his words "Pity us! Oh pity us! We wakeful!" Studies have shown that as many as 30% of North Americans suffer from sleep-related problems. Medicine has made treatment and allaying of the overwhelming effects of these problems much easier. In spite of this, few people recognize the seriousness of sleeping disorders and undergo treatment for them.

Sleep consists of two phases: rapid eye movement (REM) sleep and slow-wave (non-REM, or NREM) sleep. NREM sleep is further divided into different stages during which the sleeper progresses from drowsiness through deeper and deeper levels of relaxation. Dreaming occurs in REM sleep. Sleep disorders can disrupt sleep at any stage, or can prevent sleep entirely. The causes of sleep disorders are poorly understood, a fact that has led to a general ignorance in society with regard to the possible severity of these phenomena and methods of treatment. Sleep disorders come in a variety of forms. Some, such as narcolepsy, cause irresistible sleepiness. Others, for instance sleep apnea, can affect breathing. Still others, like restless legs syndrome (RLS), induce tingling and occasional jerking motions in the legs. Whatever the nature of the disorder, though, sleep-related problems lead to a decline in productivity, exhaustion, and general distress.

The effects of sleeping disorders are profound and far-reaching. These may include daytime fatigue and drowsiness, irritability, anxiety, lack of concentration, and depression. Especially prone to these effects are people who hold jobs that require long or late hours. In 1983, the Philadelphia police department was working on a four-platoon work schedule involving eight-hour days, with six days on and two days off. Under this schedule, half the officers reported a poor quality of sleep. 80% reported falling asleep at least once a week while on the night shift. 25% of the officers reported being in auto accidents or near-misses during the previous year due to sleepiness. Over 75% said that their families were dissatisfied with their work schedules. After a shift change, 35% percent took either an entire week to adjust to the rotation or never did adjust fully. When the department realized the severity of the problem, it changed the schedule to allow for more sleep. There was a fourfold decrease in the number of complaints about poor sleep, and twice as many officers said that they had no daytime sleepiness. The number of incidents of sleeping on the job dropped and the level of alertness improved on the night shift. There was a decline in the number of on-the-job accidents per mile driven, as well as a reduction in the use of sleeping pills and alcohol. Familles were five times more satisfied with the work schedule.

A second study that has confirmed the grievous effects sleeping disorders can have on sufferers was conducted by a team of researchers, led by Merril M. Mitler, Ph.D., at the Scripps Research Institute in La Jolla, California. During the five-days study, 80 truck drivers on 10- or 13-hour shifts were monitored. Mitler and his colleagues recorded the drivers' brain waves and breathing patterns as they slept. The results of the study were widely read by sleep-impairment researchers, after being published in the New England Journal of Medicine (Sept. 11, 1997, Vol. 337 [11], pp. 755-61). Each driver averaged less than five hours of sleep a day, even though they had the opportunity to sleep for eight hours. More than half of the drivers had at least one episode of drowsy driving, most often in the late night or early morning. This research was the first scientific evidence that sleep deprivation in commercial long-haul truck drivers may impair late-night or early-morning driving. The results of the study have led to comparisons between drunk and drowsy driving are being made (Being awake for 17 hours decreases driving performance about as much as having a blood alcohol level of .5 percent, which is the legal limit in many European countries.). Even though certain steps are now being taken to educate workers and schedulers about the importance of adequate sleep with respect to public safety, trucking companies have not yet imposed rules regulating the length or regularity of shifts.

Sleep-related problems have proven to be disastrous for sufferers; however, there remains a decided lack of attention being paid to these maladies in the scientific community. In spite of the fact that investigators are nowhere near comprehending sleep and all its mysteries, little is being done to find out how sleeping patterns work, why they are sometimes disrupted, and what can be done when they are. What little is known regarding sleeping disorders is chiefly common knowledge. For example, it is generally known that the treatment of mild insomnia may involve simple improvement of sleeping conditions or such traditional remedies as warm baths, milk, or systematic relaxation. These are actually techniques used in sleep clinics all over the world. Many of the commonly held beliefs regarding sleep have yet to be disproved. Most people recognize that sleep is often disturbed by stress, drugs, changes in schedule, and physical discomfort. Unfortunately, this appears to be the extent of the scientifically reliable data in respect to sleeping disorders. Studies have proven again and again that something must be done about sleeping disorders, but it seems that all this has led to is the conclusion that we need more studies.

Sleeping disorders are arduous and widespread hardships that can and do affect anyone. The lack of information surrounding sleep has led to a deficit of knowledge regarding sleeping disorders. Doctors, who don't really have any other options, are likely to prescribe drugs for sufferers. The medicines currently being used for insomniacs are varied, but all of them can have harmful effects. The body tends to build up a tolerance to the drug, necessitating more potent dosage. Habitual use can often lead to an addiction. Longtime victims of sleeping disorder are liable to spend the rest of their days battling chemical dependencies, sleepless nights and daytime fatigue. But in spite of this, little is being done to learn alternative ways to offer relief to these people. More time must be spent on discovering ways to help people with sleeping disorders, and to save them from the torment of being unable to attain "tired Nature's sweet restorer," that "most precious of all commodities," sleep.