The lack of sleep is a common problem in modern society which affects many people at some point in their lives.
Sleep deprivation happens if an individual sleeps less than they need to feel awake and alert. People vary in the amount of sleep it requires to be considered sleep-deprived. Some people, such as older adults, tend to be more resistant to the effects of sleep deprivation while others are more vulnerable, especially children and young adults.
Although occasional interruptions of sleep are typically nothing more than a inconvenience, chronic lack of sleep can lead to excessive daytime sleepiness, emotional problems, poor job performance, obesity and a lower perception of quality of life.
The value of restorative sleep is not questioned, and a certain amount of care is required both to handle and to prevent sleep deprivation.
This report from the Nccmed Information Center discusses the effects of sleep deprivation, as well as what can be done to treat and avoid it.
Fast facts on sleep deprivation
- Sleep loss alters normal functioning of attention and disrupts the ability to focus on environmental sensory input
- Lack of sleep has been implicated as playing a significant role in tragic accidents involving airplanes, ships, trains, automobiles and nuclear power plants
- Children and young adults are most vulnerable to the negative effects of sleep deprivation
- Sleep deprivation can be a symptom of an undiagnosed sleep disorder or other medical problem
- When you fail to get your required amount of sufficient sleep, you start to accumulate a sleep debt.
Symptoms
Excessive daytime sleepiness is the major key symptom of ongoing sleep loss but other symptoms include:
- yawning
- moodiness
- Fatigue
- irritability
- depressed mood
- difficulty learning new concepts
- forgetfulness
- inability to concentrate or a “fuzzy” head
- lack of motivation
- clumsiness
- increased appetite and carbohydrate cravings
- reduced sex drive
Effects
Sleep deprivation can negatively affect a range of systems in the body.
It can have the following impact:
- Not getting enough sleep prevents the body from strengthening the immune system and producing more cytokines to fight infection. This can mean a person can take longer to recover from illness as well as having an increased risk of chronic illness.
- Sleep deprivation can also result in an increased risk of new and advanced respiratory diseases.
- A lack of sleep can affect body weight. Two hormones in the body, leptin and ghrelin, control feelings of hunger and satiety, or fullness. The levels of these hormones are affected by sleep. Sleep deprivation also causes the release of insulin, which leads to increased fat storage and a higher risk of type 2 diabetes.
- Sleep helps the heart vessels to heal and rebuild as well as affecting processes that maintain blood pressure and sugar levels as well as inflammation control. Not sleeping enough increases the risk of cardiovascular disease.
- Insufficient sleep can affect hormone production, including growth hormones and testosterone in men.
Causes
Deprivation of sleep occurs when one does not get a healthy amount of sleep.
The official guidelines of the National Sleep Foundation (NSF) 2015 for appropriate sleeping times for different age groups are:
- Newborns (0 to 3 months): 14 to 17 hours each day
- Infants (4 to 11 months): 12 to 15 hours
- Toddlers (1 to 2 years): 11 to 14 hours
- Preschoolers (3 to 5 years): 10 to 13 hours
- School-age children (6 to 13 years): 9 to 11 hours
- Teenagers (14 to 17 years): 8 to 10 hours
- Adults (18 to 64 years): 7 to 9 hours
- Older adults (over 65 years): 7 to 8 hours
Some groups of people may consider sleep as a waste of time and purposefully deprive themselves of sleep to pursue other things like entertainment, educational goals, or pursuits to make money.
This intentional deprivation of sleep is more likely to be seen in adolescents and young adults.
Unintentionally, other people can not get enough sleep due to shift work , family responsibilities or stressful jobs.
Consistent sleep-wake habits of going to bed late, repeated nighttime excitements, or early waking up can lead to sleep deprivation and sleep debt accumulation.
Many causes of sleep deprivation include medical problems including depression, obstructive sleep apnea, hormone imbalances and other chronic illnesses.
Treatment
Treatment is only necessary if, due to physical or psychological difficulties, a person can not get to sleep.
A psychiatrist or sleep specialist should be able to offer support and coping strategies to achieve a restful and sleeping state.
There are two key methods for sleep deprivation treatment: behavioral and cognitive interventions, and medications.
Behavioral and cognitive treatments
There are a number of successful sleep enhancement methods which do not require medication, including:
- Relaxation techniques: Progressive muscle relaxation involving tensing and untensing different muscles in the body to help calm the body. Meditation techniques, mindfulness training, breathing exercises, and guided imagery can also help in this area. Audio recordings are available that can help a person fall asleep at night.
- Stimulation control: This involves controlling pre-bedtime activities and surroundings to moderate the sleeping pattern. For example, a person controlling their stimulus would spend time in bed only when they feel sleepy, which controls the association between being in bed and feeling ready to sleep.
- Cognitive behavioral therapy (CBT): This is a type of therapy designed to help people understand and change the thought patterns behind certain behaviors. It can challenge beliefs that may not be healthy and promote rational, positive thought. CBT can help a person to develop a healthier sleeping pattern.
Medications
When non-medicinal treatment is ineffective, there are drugs available which can help induce sleep. Some are over-the-counter ( OTC) available, and some are only available with a valid prescription.
There are a wide range of options available, including benzodiazepines, non-benzodiazepine hypnotics, and antagonists to the melatonin receptor.
Some people, however, develop a reliance on sleeping medicines. Limiting dosage is essential, and attempting to use non-medicinal measures where possible.
Home management
The good news is that when adequate sleep is received most of the negative effects of sleep deprivation reverse. Sleep deprivation treatment is intended to meet the need for biological sleep, avoid deprivation and “pay back” accumulated sleep debt.
Some suggestions for good sleep habits include:
- going to bed when tired
- following a routine for bed and wake-up times, keeping it consistent every day of the week
- avoiding eating 2 to 3 hours before bedtime
- if unable to fall asleep after 20 minutes of trying, going to another room and trying to read until feeling sleepy, then returning to bed
- engaging in regular exercise during the day
- keeping the bedroom quiet, dark and a comfortably cool temperature
- turning off electronic devices when you go to bed
Paying off the sleep debt
You start accumulating a sleep debt when you don’t get your needed amount of sleep sufficiently. For instance, if you need 7 hours of nightly sleep to feel awake and alert, and only get 5 hours, you have 2 hours of sleep debt. If you follow that trend for five days, you will have 10 hours of accrued sleep debt.
The only way to pay off a sleep debt is to sleep more. It can take some time to fully recover, depending on the sleep debt scale. The positive effects of paying this debt will be quickly felt however.
To repay a sleep debt, you will start getting the sleep you need, plus an extra hour or two every night before the debt is paid. Afterwards, you can restore the necessary amount of sleep without the extra hour.
However if the sleep debt is hundreds or even thousands of hours, it can still be reconciled effectively with a deliberate attempt to restructure commitments, and give enough time off to heal. You’ll know that when you wake up feeling refreshed, you’ve paid off your sleep debt so you don’t feel too drowsy during the day.
If sleep deprivation is ongoing, and negative symptoms persist despite practicing good sleep hygiene measures, consultation with a healthcare provider is recommended.
Diagnosis
It’s necessary to recognise a continuing period of inadequate sleep when diagnosing sleep deprivation.
The first step to understanding a question of sleep is to maintain a recorded history of sleep in a sleep log. Write down every day how many hours you sleep, how many times you wake up at night, how rested you feel after waking up, and any sensations of sleep that you experience throughout the day.
If you have a friend, it might be worth asking them to mention any snoring, gasping, or limb-jerking, because a doctor might inquire about this as well.
Then, any doctor you visit will be able to present this information in a meaningful way.
Sleep specialists can also use a polysomnogram or sleep analysis to recognize a pattern. This is done in a sleep laboratory.
Electrodes are mounted on the body at different points like the scalp and ears. The person with suspected sleep deprivation will sleep in a sleep clinic overnight and these monitors will track breathing, blood, heart rate and rhythm, muscle function, and brain and eye movements while sleeping.
Diagnosis can be as simple as realizing that you don’t get enough sleep and agreeing to make adjustments, especially in those who wilfully sleep too little.
Complications
Sleep deprivation weakens the brain’s ability to control the emotional part, the amygdala, of the part that handles reasoning, known as the prefrontal cortex. That leads to abnormal emotional processing.
It also seems important to sleep to prepare the brain for the learning. When the brain is deprived of sleep, the attention and the development of new memories is difficult.
If we stay awake all night or cut sleep shortened significantly, the body does not release the hormones needed to regulate growth and appetite, and instead forms an overabundance of stress chemicals such as norepinephrine and cortisol.
Research suggests shorter sleep periods may be a weight gain predictor of adults and children. A rise in body weight by 0.35 kilograms (kg) is associated with each 1 hour reduction in sleep time per day. These changes result in an increased risk in the sleep-deprived person for hypertension, diabetes, obesity, heart attack and stroke.
Loss of sleep can have a significant effect in healthy individuals on both emotional function and normal thinking skills, resulting in:
- reduced tendency to think positively
- bad moods, a decreased willingness to solve problems
- a greater tendency towards superstitious and magical thinking
- intolerance and less empathy toward others
- poor impulse control
- inability to delay gratification
Sleep-deprived people are more likely to experience increased feelings of worthlessness, inadequacy, powerlessness, failure, low self-esteem , poor job performance, conflicts with coworkers, and reduced living standards. Many of these deficits remain, even as stimulants such as caffeine sustain alertness.
Finally, sleep-deprived individuals score higher on clinical scales measuring depression, anxiety, and paranoia.
Increased risk of accidents
The body attempts to balance the need for sleep after some 16 hours of remaining awake. If there is not enough sleep in a human, the brain gets sleep through short sleep attacks called microsleeps.
This is an uncontrollable brain response that makes a person incapable for a short time of processing environmental stimulation and sensory information.
The eyes of a person frequently remain open during microsleep but are effectively “zoned out.” Because the nature of such assaults is unexpected, the effects of a sleep-deprived individual operating heavy machinery or driving may be disastrous for both the individual and innocent bystanders.
Microsleeps can tend to occur given an individual’s forced effort to remain awake, so it’s incredibly difficult for an person to stay awake for more than 48 hours straight because of this built-in sleep mechanism.
Prevention
Sleep deficiency can be associated with serious accidents and poor results at work or in school. This can significantly lower overall quality of life for an person. Lack of sleep disrupts the capacity of the brain to regulate emotions and cognitive skills, decreases the normal defenses of the body and raises the risk of having chronic medical problems.
Although the occasional bad night’s sleep is not a serious problem in itself, persistent deprivation of sleep can be possible.
There is no substitute for restorative sleep. A certain amount of caution should be taken to avoid chronic sleep deprivation in people of all ages.
