General HealthMental Health

Sleep Deprivation: How Important is Sleep?

Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate duration and/or quality of sleep to support decent alertness, performance, and health. It can be either chronic or acute and may vary widely in severity. According to Johns Hopkins sleep researcher Patrick Finan, Ph.D, not getting enough sleep can affect your mood, memory and health in far-reaching and surprising ways.

The average adult needs seven or more hours of sleep per night to maintain health. The right amount of sleep can vary from person to person, but the Centers for Disease Control and Prevention (CDC) recommend that adults should get at least 7 hours of sleep each night. They also estimate that 1 in 3 adults do not get enough sleep.

The amount of sleep needed can depend on sleep quality, age, pregnancy, and level of sleep deprivation. Insufficient sleep has been linked to weight gain, high blood pressure, diabetes, depression, heart disease, and strokes. Sleep deprivation can also lead to high anxiety, irritability, erratic behavior, poor cognitive functioning and performance, and psychotic episodes.

How much sleep do you need?

The report by National Sleep Foundation has broken it down into nine age-specific categories, with a slight range that allows for individual preferences:

  • Adults, 65+ years: 7 to 8 hours.
  • Adults, 26 to 64 years: 7 to 9 hours.
  • Young adults, 18 to 25 years: 7 to 9 hours.
  • Teenagers, 14 to 17 years: 8 to 10 hours.
  • School-age children, 6 to 13 years: 9 to 11 hours.
  • Preschool children, 3 to 5 years: 10 to 13 hours.
  • Toddlers, 1 to 2 years: 11 to 14 hours.
  • Infants, 4 to 11 months: 12 to 15 hours.
  • Newborns, 0 to 3 months: 14 to 17 hours

What are the types of sleep deprivation?

  1. Acute sleep deprivation is when an individual sleeps less than usual or does not sleep at all for a short period of time – usually lasting one to two days.
  2. Chronic sleep deprivation means when an individual routinely sleeps less than an optimal amount for ideal functioning. Chronic sleep deficiency is often confused with the term insomnia. Although both chronic sleep deficiency and insomnia share decreased quantity and/or quality of sleep as well as impaired function, their difference lies on the ability to fall asleep.

Etiology and Risk Factors

The causes of sleep loss are multifactoral. They fall under two major, somewhat overlapping categories:

  1. Lifestyle/occupational (e.g., shift work,1 prolonged working hours, jet lag, irregular sleep schedules)
  2. Sleep disorders (e.g., insomnia, sleep-disordered breathing, Restless legs syndrome, narcolepsy and circadian rhythm disorders).
  3. Medications – some drugs used to treat disorders such as epilepsy or attention deficit hyperactivity disorder (ADHD) can cause insomnia.
  4. Illness – illnesses such as colds and tonsillitis can cause snoring, gagging and frequent waking, and have a direct effect on sleep by fragmenting it.

What happens when you don’t get enough sleep?

Short-term problems can include:

  1. Lack of alertness/ Constant yawning: Even missing as little as 1.5 hours can have an impact on how you feel.
  2. Excessive daytime sleepiness: It can make you very sleepy and tired during the day and there can be a tendency to doze off when not active for a while; for example, when watching television.
  3. Impaired memory: Lack of sleep can affect your ability to think, remember and process information.
  4. Relationship stress: It can make you feel moody and you can become more likely to have conflicts with others.
  5. Quality of life: You may become less likely to participate in normal daily activities or to exercise.
  6. Grogginess : When waking in the morning and Sleepy grogginess experienced all day long (sleep inertia)

Greater likelihood for car accidents: Drowsy driving accounts for thousands of crashes, injuries and fatalities each year, according to the National Highway Traffic Safety Administration.

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Effect of Lack of Sleep on Various Parts of the Body

Sleep Loss Affects Health

Sleep loss (less than 7 hours per night) may have wide-ranging effects on the cardiovascular, endocrine, immune, and nervous systems, including the following:

  1. Obesity in adults and children
  2. Diabetes and impaired glucose tolerance
  3. Cardiovascular disease and hypertension
  4. Anxiety symptoms
  5. Depressed mood
  6. Alcohol use

Management and Treatment:

The key is to implement healthier sleep habits, also known as sleep hygiene. Sleep hygiene recommendations include

  • setting a fixed sleep schedule,
  • taking naps with caution,
  • maintaining a sleep environment that promotes sleep (cool temperature, limited exposure to light and noise, comfortable mattress and pillows),
  • exercising daily,
  • avoiding alcohol, cigarettes, caffeine, and heavy meals in the evening,
  • winding down and avoiding electronic use or physical activities close to bedtime, and getting out of bed if unable to fall asleep.

For long term involuntary sleep deprivation, cognitive behavioral therapy for Insomnia (CBT-i) is commonly recommended as a first-line treatment, after exclusion of physical diagnosis (f.e. sleep apnea). CBT- contains five different components: cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation. These components together have shown to be effective in adults, with clinical meaningful effect sizes. As this approach has minimal adverse effects, and long-term benefits, it is often preferred to (chronic) drug therapy.

There are several strategies that help increase alertness and counteract the effects of sleep deprivation. Caffeine is often used over short periods to boost wakefulness when acute sleep deprivation is experienced; however, caffeine is less effective if taken routinely. Other strategies recommended by the American Academy of Sleep Medicine include prophylactic sleep before deprivation, naps, other stimulants, and combinations thereof. However, the only sure and safe way to combat sleep deprivation is to increase nightly sleep time.

References:
  1. https://www.ncbi.nlm.nih.gov/books/NBK19961/
  2. https://health.clevelandclinic.org/happens-body-dont-get-enough-sleep/
  3. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-deprivation

Author:

Dr Shilpa Subramanian

Dr. Shilpa Subramanian is a Periodontist and currently manages Global Pharmacovigilance Operations at Indegene Pvt Ltd. She is passionate about staying ahead of the curve in clinical and non-clinical advances in the field of pharma and healthcare.

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