It is 11.30pm on a Sunday night and a 26-year-old worker has checked into the London Clinic on Harley Street. His private room is plush and spacious but he is not comfortable.

Several dozen electrodes are glued to his head, chest and limbs; elasticated belts circle his torso; and a blood oxygen monitor is clipped to his right index finger.

Alex Webb (not his real name) is here because, according to his girlfriend, he has been behaving oddly in his sleep. He thrashes around as if fighting the bedclothes. He punches the wall or knocks things off the bedside table. Sometimes he'll speak to her angrily before drifting off again. He wakes up with no recollection of these things, exhausted.

“It's bad enough that my id is having conversations with my girlfriend without my knowledge,” he says. “But what concerns me most is that I might harm her.”

Hence the test, a polysomnogram or “sleep study”. It was arranged by Gaby Badre, a consultant at the London Clinic and professor at Gothenburg University, Sweden. He has a hypothesis about Mr Webb's condition, but he needs to prove it. He wants to record the patient's brain activity and analyse the way he dreams. 

Polysomnograms have become more widely used in recent years. The number of sleep complaints in western countries is rising sharply, says Dr Louise Reyner, senior lecturer at Loughborough University's sleep research centre, though it is unclear how much of this is down to greater awareness and better diagnostics.

“There's not a lot of evidence to show that sleep quality and quantity is declining,” she says. “What we are finding is that people are doing more complex tasks than they used to, and that sleepiness is affecting their lives adversely to a greater extent.”

Prof Badre believes modern working habits are pushing human physiology to its limits. “For 1,000 years we had a biphasic existence: working in the day, sleeping at night,” he says. “Now we're in a 24/7 culture in which we feel we have to be ‘connected' – to the office, to our family and to our friends – at all times.”

He has treated numerous City workers who are “completely burned out” because they have chosen to sleep less in order to fit other things into their lives, and so have accumulated a massive “sleep debt”.

“We see more young people with chronic sleep debt developing problems such as hormonal defects, decreased immunological function, high blood pressure and cardiovascular problems, increased weight and type-II diabetes,” he says.

Many of these symptoms are linked to a disorder called obstructive sleep apnoea. OSA causes severe breathing difficulties during the night and sleepiness during the day. The higher your bodyweight, the more likely you are to have OSA, which typically causes loud snoring and choking during sleep.

Marianne Davey, a co-founder of the British Snoring and Sleep Apnoea Association, says levels of OSA in the west have risen in line with increased obesity, as well as improved awareness and diagnosis. In the UK an estimated four in 1,000 people now suffer from OSA in comparison with one in 1,000 in 1991, although some surveys suggest the incidence is much higher.

“Being overweight, smoking and drinking are the three main reasons why people snore, so lifestyle is the biggest contributing factor,” she says.

Yet the worst lifestyle choice is to lose sleep deliberately, Prof Badre says. He has seen a small but growing number of clients who abuse drugs in order to stay awake and alert for unhealthy periods of time.

He recently treated a young investment banker who could apparently work for three to five days to complete a deal, before taking a long weekend to recover. He kept himself awake with a drug called modafinil and then put himself to sleep with a hypnotic agent called zopiclone. Both are available only by prescription, but he had ordered them on the internet.

City high-flyers are being lulled into a false sense of security, Prof Badre says. If you keep yourself awake all night, by any method, and work the following day, you will suffer at least from some cognitive dysfunction.

“This could lead to a small injury. Or it could lead you to miss a traffic light. Or it could lead you to make an error in a million-dollar contract,” he says.

Three days after his sleep test, Mr Webb meets Prof Badre for the results. As suspected, the smoking gun is in his brain activity. A healthy sleeper will experience four or five “sleep cycles” a night, between the troughs of deep sleep, when tissue repair takes place, and the peaks of rapid eye movement, when dreaming takes place.

Mr Webb is in REM more than half the night, having feature-length dreams. What is more, he acts out those dreams because, unlike a normal sleeper, his brain is failing to paralyse his body.

The diagnosis is REM behaviour disorder, a condition that can lead sleepers to injure themselves and partners. It is a neurological problem, so his lifestyle is not to blame, but stress can trigger its worst effects.

He is prescribed a mild dose of a sedative called clonazepam to relax his muscles at night so his body can “unlearn” its misbehaviour. He is also taught to restore his “Circadian rhythms”, the daily physiological cyclesthat regulate our sleep patterns. In weeks he is sleeping like a baby.

Mr Webb was lucky. His health insurance covered him for the sleep test – many UK policies do not. He also responded well to treatment. Most importantly, he was alerted to the problem and acted. According to specialists, many of the sleepless are either too embarrassed or unaware to take even these simple steps. 

某個周日的夜間11點30分，26歲的工人亞歷克斯•韋布(Alex Webb，非真名)走進了位于哈利街(Harley Street)的倫敦診所(London Clinic)。他的專用房間豪華寬敞，但他卻感到不舒服。

幾十個電極安置在他的頭部、胸部和四肢；幾條松緊帶環(huán)繞在他的軀干部位；血氧監(jiān)測儀探頭夾在他的右手食指上。

韋布的女友表示，他之所以來看醫(yī)生，是因為他睡覺時行為怪異。他會在床上亂動，好像在與床單搏斗；他會擊打墻壁，或打翻床頭柜上的東西。有時，他會與女友生氣地講話，然后再次入睡。但在他疲憊不堪地醒來后，卻一點都不記得這些事。

“真是糟糕透了，另一個‘我’竟在我不知情的情況下與我的女友說話，”他表示，“但我最擔心的是，我可能會傷害到她。”

因此他進行了這次“多導(dǎo)睡眠圖”(PSG)檢查，或稱為“睡眠研究”。倫敦診所咨詢師兼瑞典哥特堡大學(xué)(Gothenburg University)教授加比•巴德雷(Gaby Badre)安排了這項檢查。他對韋布的病情有個假設(shè)，但需要驗證。他希望記錄患者的大腦活動，并分析他的做夢方式。

最近幾年，“多導(dǎo)睡眠圖”得到了較為廣泛的應(yīng)用。拉夫堡大學(xué)(Loughborough University)睡眠研究中心高級講師路易絲•雷納博士(Dr Louise Reyner)表示，西方國家的睡眠病例數(shù)量正大幅增加，不過尚不清楚的是，有多少病例是因為人們更加關(guān)注睡眠和有了更好診斷而出現(xiàn)的。
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“沒有太多證據(jù)顯示人們的睡眠質(zhì)量和數(shù)量都在下降，”她表示，“我們發(fā)現(xiàn)，人們的任務(wù)比以前更為復(fù)雜，‘磕睡’正在更大程度上給他們的生活帶來負面影響。”

巴德雷教授認為，現(xiàn)代工作習慣正將人類的生理機能逼至極限。“1000年來，我們有兩種生活狀態(tài)：白天勞作，夜里睡覺，”他表示，“如今，我們生活在一天24小時、一周7天的全天候文化中，我們感到我們不得不在任何時候都與辦公室、家人和朋友‘連接在一起’。”

他治療過眾多倫敦金融城的員工，這些患者“完全筋疲力盡”，原因在于，為了適應(yīng)生活中的其它事情，他們選擇了減少睡眠，累積了大量的“睡眠債”。

他表示：“我們看到更多睡眠長期欠債的年輕人正出現(xiàn)各種問題，例如，荷爾蒙分泌失調(diào)、免疫力下降、高血壓、心血管問題、體重增加和Ⅱ型糖尿病等。”

其中許多癥狀與“阻塞性睡眠呼吸暫停”(obstructive sleep apnoea，OSA)障礙有關(guān)。這種癥狀會令人在夜間出現(xiàn)嚴重的呼吸困難，在白天又會非常困倦。體重越重，患OSA的幾率就越高，這會造成睡眠期間的大聲打鼾和窒息。

英國打鼾和睡眠呼吸暫停協(xié)會(British Snoring and Sleep Apnoea Association)聯(lián)合創(chuàng)始人瑪麗安•戴維(Marianne Davey)表示，在西方，隨著肥胖人群數(shù)量的增多、相關(guān)意識的增強和治療水平的提高，確認OSA癥狀的人數(shù)也在增多。在英國，現(xiàn)在有4‰的人患有OSA癥，而1991年只有1‰，不過一些調(diào)查顯示，真實比例遠高于這個數(shù)字。

她表示：“超重、吸煙和飲酒是打鼾的三大元兇，因此不良的生活方式是罪魁禍首。”

然而，巴德雷教授表示，最糟的生活方式是故意減少睡眠。他已發(fā)現(xiàn)，有少量(但越來越多的)客戶正借助藥品，以求在對健康不利的時間段內(nèi)保持警醒。

最近，巴德雷治療了一位年輕的投資銀行家。顯然，為了完成一筆交易，他可能會連續(xù)工作3至5天，而后用一個長周末來恢復(fù)。他用一種叫作莫達非尼 (modafinil)的藥物來保持清醒，然后用一種叫作佐匹克隆(zopiclone)的藥物讓自己入睡。這兩種藥都是處方藥，但他能從網(wǎng)上訂購。

巴德雷教授表示，金融城里有抱負的人正產(chǎn)生一種錯誤的安全感。不管用何種方法，如果你整夜不睡，然后第二天接著工作，你至少會遇到某種認知功能障礙。

他表示：“這可能會帶來小的傷害�；蛘呖赡軙�讓你看錯交通燈，或者讓你在一份百萬美元的合同上犯錯。”

在進行睡眠測試3天后，韋布約見了巴德雷教授，詢問檢查結(jié)果。正如猜想的那樣，他的大腦活動中出現(xiàn)了一些確鑿的證據(jù)。健康人每晚會經(jīng)歷4個或5個“睡眠周期”，在組織修復(fù)期間，會經(jīng)歷深睡眠的波谷，做夢時則是快速動眼的波峰期。

韋布夜里大部分時間都在進行快速動眼運動，還會做長時間的夢。另外，他會在夢中做出動作，因為與一般的睡眠者不同，他的大腦沒有讓他的身體休息。

巴德雷教授的診斷是，韋布出現(xiàn)了“快速動眼運動障礙”，這種障礙可能使睡眠者傷害他們自己或伴侶。這屬于神經(jīng)問題，因此不能責怪他的生活方式，但壓力可以引發(fā)最糟糕的癥狀。

醫(yī)生給韋布開了小劑量的鎮(zhèn)靜藥，名為氯硝西泮，用來在夜間放松肌肉，讓他的身體可以“忘卻”他的不當行為。醫(yī)生還指導(dǎo)他恢復(fù)了“生理節(jié)奏”，即控制睡眠模式的日常生理周期。幾周后，他的睡眠質(zhì)量就非常高了。

韋布是幸運的。他的健康保險覆蓋了這次睡眠檢測，但英國的許多醫(yī)療保險并不包括這一內(nèi)容。他也積極配合了治療。最重要的是，他注意到了這個問題并采取行動。專家們表示，許多睡眠不好的人要么由于太難為情，要么由于沒意識到問題的存在，甚至連這些簡單的措施也沒有做。