“Sleep is overrated,” proclaims Stephen Klasko, who takes pride in sleeping only four or five hours a night. He believes it has allowed him to write books, run marathons and achieve his lofty professional goals.

An obstetrician and gynecologist, he’s the president and CEO of Jefferson Health. As a doctor, he is aware that inadequate sleep has been associated with a mounting list of cardiovascular, metabolic, mood, immune system and cognitive problems, or, as one researcher put it, “pretty much anything bad.” He recently turned 65 and knows that his habits might catch up with him. But he thinks he’s passing the most important health test: He feels fine.

“I’m not worried,” he said.

Should he be?

Millions of Americans are in the same boat. They’re considered “short sleepers,” which means they get six hours or less of sleep a night. Experts recommend that adults sleep at least seven hours.

“To me, the only thing more important than sleep is air and water,” said Ying-Hui Fu, a molecular biologist and geneticist who studies sleep at the University of California-San Francisco.  

Fu studies a rare and exceedingly lucky group who seem genetically inclined to get — and probably need — less sleep. Many more people — often energetic, extroverted, high achievers — choose to scrimp on rest and say they feel OK, but probably aren’t. Others push themselves and know they feel bad.

Then there are insomniacs, whose difficulty sleeping often is paired with anxiety and stress. People with sleep apnea, who sometimes sleep plenty of hours, may be in a different category altogether because of poor sleep quality.

The new research trend is raising questions that are harder than they first seem, said Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona School of Medicine. It is possible that the amount of sleep individuals need to prevent fatigue or flightiness is different from the amount needed to forestall overeating, diabetes or depression. “Sleep isn’t one thing,” Grandner said. “It’s a whole set of processes.”  

There are an “amazing amount of gaps” in our scientific knowledge of sleep, said Paula Williams, a clinical health psychologist who studies sleep at the University of Utah.

People are getting the message that sleeping too little is bad. James Findley, a psychologist and clinical director of the behavioral sleep medicine program at Penn Medicine, said short sleepers often seek treatment now because they’re worried about their health.

Insomniacs may already be having trouble relaxing because they are worried that they’ll be a wreck the next day. Studies about the ill effects of sleep deprivation just give them something else to obsess about.  

Several sleep researchers said they’re most worried about really short sleepers, those who get less than four hours. Experts also suspect that feeling tired or fuzzy-headed after sleeping four to six hours is a signal that something is wrong. 

Fu has been studying natural short sleepers for about 10 years. She’s found mutations on five genes that seem to change our need for sleep. When mice were genetically altered to express three of these mutations, they also slept less and didn’t appear to suffer otherwise. The group of about 50 natural short sleepers that Fu has found tends to be energetic, thin and optimistic.

People don’t belong in this group, Fu said, if they drink much coffee or tea to stay awake, or need to catch up on sleep on weekends or vacations. Klasko, who has not participated in her research, fits her profile. So does Rosary Giang, an Erie native and University of Pittsburgh grad who now lives in Houston. Her parents forced her and her siblings to spend seven to eight hours in bed each day. She was thrilled that she could sleep only four to five hours after she left home. “It’s not like a choice I make,” she said. “I just go to bed when I’m tired and I just wake up naturally. … I don’t even need an alarm clock to wake up.”

Fu has not studied whether people with the genes are any more or less likely than others to develop health problems or how their short sleep affects life span. Her altered mice seem healthy, but she hasn’t studied them throughout their life spans, either. Such research is very expensive.

While this group seems most likely to evade problems from sleep deprivation, Williams cautions against assuming that.

“Just because something occurs naturally,” she said, “doesn’t mean it’s good."

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