DESPITE GREAT strides in our understanding of sleep and its disorders, we do not have answers to the most fundamental questions: Why do we sleep? How much sleep do we need? Prolonged sleep deprivation in rats ultimately leads to irreversible metabolic and immunologic effects, then death.1 While similar experiments cannot be conducted in humans, self-reports may provide clues to the effects of sleep. In this issue of the ARCHIVES, Kripke and colleagues2 report analyses from a large epidemiological study that assessed, among other things, self-reported sleep duration and insomnia. Using 6-year follow-up data, the authors analyzed associations between sleep duration and insomnia, and mortality. Both short and long sleep durations were associated with increased mortality, and insomnia with reduced mortality. These findings raise provocative questions: Can sleep be bad for your health? Can insomnia be good?
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