If you wonder what lack of sleep looks like, look no further than Elon Musk’s erratic behavior over the past few months. From believing that he alone had the time and unique resources to save the Thai boys trapped in a cave to prematurely tweeting that he had “funding secured” (when he didn’t) for a private buyout of Tesla, his embattled electric car company, Musk has shown a troubling pattern of ignoring his own self-care.
So what does lack of sleep look like, and why is it so bad? Let’s take a look.
Sleep is vital to our body’s functioning, our mental and cognitive abilities, and our overall health. Research has shown that a person who constantly and consistently deprives themselves of a good night’s sleep can also have a shorter life expectancy. Lack of sleep can literally kill you sooner.
Most people put off these concerns with, “Well, I’ll sleep more when X is done,” or, “I’ll catch up with sleep on the weekend.” Not only do these things never happen, they can actually hurt. For instance, one study found that skimping on sleep and then trying to catch up on it later hurts both attention and creativity. But problems with lack of sleep don’t end there. Lack of sleep leads to increased anxiety — hardly something you want to be cultivating in your life.
Elon Musk’s Workaholism
Lack of sleep can be tied to workaholism, and an overarching belief that a person needs to continue working because only he or she can get the work needed done, done right, and done in a timely manner. In an interview with the New York Times published in mid-August, Elon Musk detailed the “excruciating” year he’s had as the chairman and chief executive of Tesla, the electric car maker.
He said he had been working up to 120 hours a week recently — echoing the reason he cited in a recent public apology to an analyst whom he had berated. In the interview, Mr. Musk said he had not taken more than a week off since 2001, when he was bedridden with malaria.
“There were times when I didn’t leave the factory for three or four days — days when I didn’t go outside,” he said. “This has really come at the expense of seeing my kids. And seeing friends.”
This is concerning behavior for anyone. If a loved one started acting this way in our lives, I think we’d all be concerned and reach out to him or her to express our desire to help this person slow down a bit.
Most companies — even startups — don’t require or need their chief executive to work 120 hours a week. That’s not normal behavior for a chief executive. If he or she is working that much, that indicates a serious leadership and organizational problem within the company.
More concerning is that if Musk really is working 120 hours a week, that means he’s working an average 17 hours per day. That leaves only 7 hours a day for things like commuting, eating, and sleeping — not to mention his constant tweeting and conversations with others on social media. It’s no wonder a person in Musk’s position might feel overwhelmed, because that’s not enough time to actually engage — for most people anyway — the most meaningful part of our lives: friends and family.
Social connections define most people’s lives, they aren’t just an afterthought or something you have to schedule around your work. It would be concerning to me if a loved one was acting in this way, putting such an unnatural emphasis solely on work. Nobody is at their best when they engage 17 hours straight, 7 days a week, in activities requiring consistent and reliable cognition, attention, and focus.
Good Sleep via Ambien
Although Ambien (zolpidem) increases sleep quality and quantity in most people who take it (Huang et al., 2012), using it regularly to get a good night’s sleep is not usually recommended. Joshua Lio, MD, a physician at Brigham and Women’s Hospital in Boston and a clinical fellow at Harvard Medical School wrote a few years ago about the downsides of Ambien:
On one hand, sleep medications like Ambien can work, and work well. Insomnia can be debilitating. Many have used them safely and effectively, and some people swear by them. On the other hand, they can lead to dependence and worsen the mental clouding that many insomniacs already experience.
More importantly, by limiting discussions to specific medications and their doses, we miss a fundamental issue in treating insomnia: sleep hygiene. By focusing on “hygienic” habits around sleep (avoiding napping, not eating or drinking caffeine or alcohol right before bed, establishing regular bedtime routines, exercising, using beds only for sleep, etc.) many people can achieve better sleep. Adopting those habits can often mean that medications can be used more sparingly, and at lower doses, if at all.
Some research has shown that certain kinds of use of Ambien (zolpidem) can result in memory issues (Hall-Porter et al., 2014; Pompeia et al., 2004; Wesensten et al., 1995). A meta-analysis and review of the research of Ambien’s cognitive effects (Stranks & Crowe, 2014) found:
[T]he effect sizes calculated for each domain of cognitive functioning based on data of participants who ingested zolpidem prior to bedtime revealed that performance on attention, performance on verbal memory, and performance on psychomotor speed were each impaired as compared to that of controls, with attention and verbal memory both found to be moderately impaired.
Overall, this pattern of results indicates that the use of zopiclone has fewer deleterious effects on cognition in healthy adults than does zolpidem, which has additional specific adverse effects on attention and processing speed.
In other words, according to the research, use of Ambien impacts a person’s next-day cognitive abilities.
Ambien & Odd Behavior
Ambien is a sedative hypnotic that binds selectively at the benzodiazepine site containing GABAA receptors. Because of it where it binds to other neurotransmitters in the brain, it makes a person more susceptible to things like sleepwalking and memory blackouts. It’s no wonder then that Ambien has been linked to some odd behavior in some people who rely on it regularly to get to sleep. John Cline, Ph.D., a sleep psychologist, wrote,
Over the past decade, I have worked with a number of patients who could probably sympathize with [Roseanne] Barr’s situation. I have, not infrequently, encountered people who have engaged in sleepwalking, sleep driving, and even criminal activity while under the influence of Ambien. I’ve heard sometimes amusing but more often frightening stories of people who have done things they don’t remember, such as making a purchase and driving to the store to pick it up.
While Roseanne Barr attributed her recent twitter behavior to Ambien, the most famous example of odd behavior while on Ambien takes us back to 2006. That year, Representative Patrick J. Kennedy of Rhode Island had a motor vehicle accident in Washington, DC, which he later attributed to Ambien use. Such odd behavior has been documented in the research literature as well (for example, Farkas et al., 2013).
From the NYT interview article, Musk also appears to be engaging in some odd behaviors of late, including the recent “funding secured” tweet:
[Musk] wrangled with short-sellers and belittled analysts for asking “boring, bonehead” questions. And after sending a team of engineers from one of his companies to help rescue members of a stranded soccer team [the Thailand cave rescue, which ultimately was done without Musk’s help], he lashed out at a cave diver who was dismissive of the gesture, deriding him on Twitter as a “pedo guy,” or pedophile.
To help sleep when he is not working, Mr. Musk said he sometimes takes Ambien. “It is often a choice of no sleep or Ambien,” he said.
But this has worried some board members, who have noted that sometimes the drug does not put Mr. Musk to sleep but instead contributes to late-night Twitter sessions.
It should worry them, since the effects of Ambien are really unknown in any specific person unless that person undergoes neuropsychological testing or has been to a sleep lab.
The NYT’s article notes that for years, Tesla’s board has been trying to recruit a chief operating officer to help take some of the work off of Musk’s crowded plate. It’s unlikely anybody reasonable would want the job, however, because it would require the tunnel-vision dedication to work (“Willing to work 120 hours/week? Have I got the job for you!”) that most people simply don’t have. Not because they’re not dedicated to the work, but because it’s not healthy or normal to work that many hours at a job. For anything.
What’s normal is celebrating your birthday every year with friends and family. What’s normal is taking a day or two off to celebrate your brother’s wedding. What’s normal is finding a balance in your life between work and home. Musk hasn’t done these things, demonstrating traits that some may find attractive — but that most would find concerning, especially if they appeared in a loved one. We hope Musk finds that balance in his life and takes care not just of his physical health, but his mental health too.
Conflict of interest disclosure: The author has no financial stake and holds no positions or interests in TSLA or any of Elon Musk’s companies.
References
Farkas, Ronald H.; Unger, Ellis F.; Temple, R. (2013). Zolpidem and driving impairment—Identifying persons at risk. The New England Journal of Medicine, 369(8), 689-691.
Hall-Porter JM; Schweitzer PK; Eisenstein RD; Ahmed HAH; Walsh JK. (2014). The effect of two benzodiazepine receptor agonist hypnotics on sleep-dependent memory consolidation. J Clin Sleep Med, 10, 27-34.
Huang, Yuli; Mai, Weiyi; Cai, Xiaoyan; Hu, Yunzhao; Song, Yuanbin; Qiu, Ruofeng; Wu, Yanxian; Kuang, J. (2012). The effect of zolpidem on sleep quality, stress status, and nondipping hypertension. Sleep Medicine, 13, 263-268.
Pompéia, S.; Lucchesi, L. M.; Bueno, O. F. A.; Manzano, G. M.; Tufik, S. (2004). Zolpidem and memory: A study using the process-dissociation procedure. Psychopharmacology, 174, 327-333.
Stranks, Elizabeth K.; Crowe, Simon F. (2014). The acute cognitive effects of zopiclone, zolpidem, zaleplon, and eszopiclone: A systematic review and meta-analysis. Journal of Clinical and Experimental Neuropsychology, 36, 691-700.
Wesensten, N. J., Balkin, T. J., Belenky, G. L. (1995). Effects of daytime administration of zolpidem versus triazolam on memory. European Journal of Clinical Pharmacology, 48, 115-122.
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James Parker 