In our roles as preparedness experts for disasters and epidemics, we’re often asked to come on various media outlets to give our opinion, mostly on medical issues. Sometimes it’s about current events relating to our podcast American Survival Radio. Rarer is the interview request that seems to be a medical topic but has obvious political overtones. Just yesterday, I received one of these when a radio station asked me to comment, as a doctor, on whether Donald Trump’s 4-Hour a night sleep habit “impacts his ability to make rational & sound decisions”.

You might not have realized that this is Donald’s sleep pattern, but a lot of 3 am tweets suggest that it is. In an interview a year ago, he said: “You know, I’m not a big sleeper, I like three hours, four hours, I toss, I turn….I want to find out what’s going on.”

So right from the horse’s mouth: 70-year old Donald Trump says he only gets 4 hours of sleep a night. Many in the media believe that makes him dangerous, and some have written articles that try to “explain” him as a severely incapacitated victim of sleep deprivation. You might be surprised to know, however, that he’s actually in pretty good company with regards to sleep habits.

Five hours was reported as a good night’s sleep for Bill Clinton while president. Winston Churchill liked naps but slept little at night. Martha Stewart is just one of many business leaders that get less than the recommended 7-8 hours per night. There are, in fact, quite a few highly successful folks who seem to do just fine with little shut-eye. What’s with that?

Some people believe that you need less sleep when you’re older. Not true.  Sleep Deprivation, at any age, can significantly impair your brain’s function. The parts of the brain involved in alertness and attention, (the thalamus) and the area that controls many higher-level thought processes (the prefrontal cortex) are especially vulnerable.  If the brain doesn’t get enough rest, you may become incapable of putting events into the proper perspective and taking appropriate action, a pretty big issue whether you’re president of the United States or the survivor of a major disaster.

Scientific studies bear this out. Indeed, The British Medical Journal equates the effects of 17-21 hours without sleep as the equivalent, in terms of affecting behavior, of having a blood alcohol level close to the legal limit of intoxication. In a 2004 study that evaluated the performance of medical residents, those getting less than 4 hours of sleep made twice the number of medical errors that residents who slept 7-8 hours a night.

But don’t older people naturally sleep less hours and less deeply? Studies show that that the elderly do get less sleep, but it’s not necessarily because they need less. Sleep could be affected for all sorts of reasons: sleep apnea, arthritis pain, heart issues, etc. Those in their later years also might develop something called “advanced sleep-phase syndrome”. These folks’ bodies want to go to sleep earlier and wake up earlier but their minds (and HBO, I expect) keep them from getting to sleep at a reasonable hour. Result: Sleep Deprivation.

In addition to what’s happening in your brain, the failure to get 7-8 hours of sleep every night causes a whole set of symptoms, none of which are particularly good for either a chief executive or a survivalist:

  • Irritability
  • Depression
  • Tremors
  • Bloodshot, puffy eyes
  • Headaches
  • Confusion
  • Memory loss
  • Muscle aches
  • Hallucinations and other psychotic symptoms
  • Ill effects on control of diabetes and high blood pressure
  • Blackouts (also called “microsleeps”)

Most of the above doesn’t seem to apply to Donald Trump, but some does (how about those puffy eyes?); the rest is either up to his doctor to determine or for TV pundits to speculate about.

As you get older, any existing sleep disorders worsen, especially in men. Insomnia, sleep apnea, and other problems often become more pronounced in men as times goes on. Outside of pregnancy, women are better off until they hit menopause.

Before you start worrying, or, for the Democrats in the audience, worry more about the guy who’s going to get the nuclear codes, you should know that there are a number of people that seem to function just fine with less than the average number of sleep hours. No one is quite sure why this is so, but it appears to involve about 5% of the population and may be related to genetics. For the rest, it rapidly becomes clear that they need more sleep. I would think that signs of sleep deprivation would have become obvious years ago with Donald Trump.

There are things that Donald Trump or even you, dear readers out there, can do to get a few more hours of shut-eye each night. The best start is to consider a concept we’ll call “sleep hygiene”.  Sleep hygiene involves adjusting your behavior to maximize the amount of restful sleep you get.  Consider:

  • Sticking to a standard bedtime and wakeup time
  • Making your nighttime environment as comfortable as possible
  • Avoiding Nicotine, Caffeine, and Alcohol before going to bed.
  • Staying awake from heavy foods for at least 2 hours before going to sleep
  • Exercising regularly, but not right before going to bed
  • Eliminating as much light as possible in the room at bedtime
  • And the biggest obstacle I see for President-Elect Trump: Keeping your mind clear of stressful issues at bedtime

Critics aside, Donald Trump seems to have the ability to deal with less sleep than the average person. But staying healthy in normal times or in the aftermath of disaster involves, not only maintaining good physical hygiene, but maintaining good sleep hygiene as well.

Joe Alton, MD

American Survival Radio

Joe and Amy Alton