Wake-up callPage 2 of 2 -- "Sleep has been something of a rogue field," said Dr. David P. White, who will occupy another of the newly endowed chairs at Harvard. "But now it's at a really interesting time, at the same time that the science is getting really interesting."
White, who specializes in the breathing aspects of sleep, described the research on circadian rhythms -- the body clock that influences sleep and waking -- as "on fire." Work on apnea and other breathing conditions is also forging ahead, he said, and great strides have been made in understanding and treating narcolepsy, a disease that causes frequent, overwhelming sleepiness. Only insomnia, he said, remains something of a scientific "wasteland" -- which is troubling because an estimated 10 percent of the population suffers from long nights of staring at the ceiling. "We don't know beans about it," White said.
That lack of basic understanding did not stop the Marlborough-based
Another anti-insomnia drug that is nearly ready for market, Indiplon, is actually two pills -- a short-acting capsule to bring on sleep, and a sustained release tablet to help prolong it. The companies making it, New York-based Both drugmakers are expected to advertise aggressively, White said, to "go on the air and tell people it's perfectly OK to take a pill forever."
Harvard's three new professorships -- one remains to be filled -- are financed by a different corner of the burgeoning sleep industry. Their sponsors are Although such corporate involvement suggests that the profit motive is over-medicalizing sleep, Carl Hunt, director of the federal government's National Center on Sleep Disorders Research, said the opposite problem is still true: "The issue is not over-diagnosing. The issue at this point in time is still under-diagnosing." An estimated 50 percent to 70 percent of apnea patients who need treatment are not diagnosed, he said. And a study this month in the journal, Sleep, estimated that if sleep apnea were properly diagnosed and treated, 980 lives lost in auto accidents each year could be saved, along with $11.1 billion in damage. Researchers also still need to resolve exactly what they mean by dangerous undersleeping, which is still a matter of debate. Some studies have examined people who stay up all night; others those who routinely sleep just four to six hours a night. Helen and Uwe Koehn of Storrs, Conn., try to sleep a full night, but the quality of their sleep often leaves them tired. Like an estimated 1 million Americans, both sleep with an anti-apnea breathing machine, called a Continuous Positive Airway Pressure, or CPAP. But Helen is still having some trouble sleeping, and Uwe still feels "not quite slept through." Both believe in correcting medical problems -- and are aware of the new data on the potential health consequences of a bad sleep life. "Seventy percent of people who have untreated sleep apnea die prematurely -- I was shocked by that, that it's such a serious health problem," Helen said. White, who saw them last month at a Newton clinic, suggested an array of next steps for the couple, including possible medications, adjustments to their CPAP machines, and, for Helen, whose apnea is mild, switching from the machine to a dental appliance. He scheduled Uwe for a nighttime observation to see what was going wrong. Helen said she knows that sleep medicine is becoming "a big moneymaker" for doctors. But it is also "all very necessary." As for the new sleeping pills soon to come available: "Oh, I can't wait!' she said longingly. "Oh, sleep . . ."
Carey Goldberg can be reached at goldberg@globe.com. © Copyright 2004 Globe Newspaper Company.
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