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Singers and Sleep
Alan S. Gordon
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Voices6/1/2005

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When opera singers learn about sleep, it can be a real awakening. Sleep deprivation among singers jeopardizes their creativity, their productivity, their safety, and their well-being. The importance of restorative sleep to vitality and health and the dangers of even short-term sleep deprivation warrant a central place in the consciousness of every performer, regardless of the current stage of their career.

In today’s health-conscious society it would be unheard of to hear a singer repetitively bragging about gorging on high-fat meals loaded with sugar, yet it remains perfectly acceptable, even admired, to trade stories of performing with little or no sleep. Singers, their teachers, and the physicians who care for them, must assure that sleep curtailment and sleep deprivation are not worn like a badge of courage.

Dale Carnegie was wrong in his famous self-help text when he said: “If you can’t sleep, then get up and do something instead of lying there worrying. It’s the worry that gets you, not the lack of sleep.” In fact, it’s the lack of sleep that will diminish your vocal health. Your voice may crack on only one note out of thousands in a three-hour opera, and millions more over the course of your career, but in the brutal world of opera, that’s all it takes for tongues to wag and knives to come out, and for a singer’s sense of self-worth to crumble when the reviews announce that “A star has fallen from the heavens.”

The pharmaceutical industry anticipates that, by the end of this decade, sales of prescription insomnia medication will top $6 billion a year. Recent studies show that 60 percent of American adults report sleep problems, 70 percent get less than the recommended eight hours of sleep per night, and, in a survey at one major opera house, 96 percent of the singers reported that they frequently had trouble falling asleep and, when they did, they never got enough sleep.

Many singers are already aware of the need to understand the impact of reflux problems and the importance of hydration to vocal function and overall vocal hygiene techniques. Obviously, singers also need to have a basic knowledge of sleep and the consequences of poor sleep.

Long thought of as a psychological problem only, it’s no surprise that sleep disorders haven’t come to the forefront of vocal physical health concerns until recently. It was only in 1995 that the American Medical Association even recognized sleep medicine as a specialty. To a significant extent, the demands of the opera world (auditions, rehearsals, working second and third jobs, frequent travel, maximum pre-sleep vocal exertion, and the inherent stress of performance) are incompatible with relaxing for sleep. The subject of sleep and its importance to singers has not yet been extensively explored, despite preliminary research which indicates that sleep deprivation may alter respiratory function and affect speech patterns, particularly intonation, precision, and rate. The prevalence of these issues among opera singers has broad implications for their well-being, their voice training, and their treatment. Unfortunately, too many sleep deprived vocal performers are regarded as normal when, in fact, it may be that when a singer struggles with voice technique, what they may need instead of practice is a good night’s sleep. Even in the current professional voice literature, references to sleep are limited to admonitions to “get enough sleep” in discussions of general vocal hygiene and warnings about potential sedating side effects of medication.

What is sleep?

The dictionary defines sleep as “the rest afforded by a suspension of voluntary bodily functions and the natural suspension of consciousness.” Once thought of as an unproductive period of inactivity and regarded, even by medical professionals, as a time when mind and body are simply turned off, sleep is now understood to be an essential element of human existence that affects mood, thinking, problem solving, memory, performance, productivity, accident rates, and general health.

While an exact medical definition of sleep is difficult, sleep has five identifying characteristics:
  1. It’s a process that’s generated internally by the body. You can do things to help yourself relax, but you can’t make yourself fall asleep;
  2. It’s a condition where some sensory input (like sounds and smells) is diminished;
  3. It follows certain identifiable rhythms or cycles set by the body’s internal alarm clock. Most interesting to performers may by the fact that these rhythms are significantly altered by exposure to light. Knowing this, it follows that singers who rehearse and perform under bright lights report sleep disturbances, because light diminishes the release of melatonin, a hormone which is produced during the hours of darkness that assists in regulating sleep onset;
  4. It rhythmically oscillates between REM (Rapid Eye Movement) and four stages of progressively deepening non-REM sleep, with each cycle lasting approximately 90 minutes. The sleep cycle is repeated four to six times during a seven-eight hour sleep period. Some studies indicate that it is not the length of sleep that determines its restorative value, but the number of complete sleep cycles that occur each night; and
  5. It’s easily reversible, in that normal wakefulness is rapidly achieved.

How much sleep is necessary?

Sleep needs vary from person to person. Generally, studies describe short sleepers as those who habitually sleep 6.5 hours or less per night, normal sleepers as obtaining 7-8 hours of sleep, and long sleepers as those sleeping 9 hours or more. In the real world, few if any working people get anything like that. There is also a newer theory which proposes that a 4-5 hour period of core sleep is essential, but additional sleep is optional and could be progressively shortened without significant increase in daytime sleepiness or decreases in cognitive function. Supposedly, however, the functions of a number of body systems are optimized with approximately 8.25 hours of sleep. Do any of you know anyone who gets 8 hours of sleep?

Effects of sleep deprivation
Sleep deprivation may occur because of common problems like insomnia or obstructive sleep apnea, or because of an intentional curtailment of sleep duration. Either way, lack of sleep causes a wide range of consequences, including mood shifts, diminished concentration and reaction time, impaired short- and long-term memory, decreased logical reasoning, decreased response time, and impaired ability to understand and to think.

Sleep is also crucial in the regulation of the body’s internal systems, in maintaining glucose tolerance, and in preventing decreases in growth hormone. Sleep researchers speculate that the long-term chemical consequences of sleep deprivation may include depletion of the immune system, accumulation of body fat rather than muscle, acceleration of the aging process, potential memory impairment, and increased risk for depression.

Fatigue has an inescapable biochemical basis, and so a singer cannot simply will themselves out of the next day’s sluggishness or off performance. Insomnia is also a contributing factor in a significant number of traffic accidents. Singers, often finishing rehearsals and performances late in the evening, need to exercise extreme caution in driving. They should also realize that the same amount of alcohol that previously had no discernible effect on judgment and reaction times may be fatally sedating when paired with already existing fatigue and lack of sleep.

Of perhaps the greatest concern for working singers, some recent studies have linked sleep to brain functions associated with learning, and the formation of memory. It seems likely that for optimal
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About the Author: Executive Director, American Guild of Musical Artists, AFL-CIO Marvin Fried, MD; Chairman, Department of Otolaryngology, Montefiore Medical Center Pam Harvey, MA, CCC; Division of Otolaryngology, Brigham & Women’s Hospital
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