Sleep deprivation may exacerbate these serious health conditions

By Naveed Saleh, MD, MS, for MDLinx
Published February 1, 2019

Key Takeaways

Different individuals require different amounts of sleep to remain healthy, with no set time applying to every adult. For instance, some people—including President Trump—claim to need only 3 to 4 hours of sleep each night, while others—such as former president Barack Obama, Elon Musk, and Richard Branson—require about 6 hours per night to feel rested. On the other end of the spectrum, there are those who feel that no amount of sleep is sufficient, and aim to get as much shut-eye as possible.

According to the American Academy of Sleep Medicine (AASM), sleep deprivation “occurs when an individual fails to get enough sleep. The amount of sleep that a person needs varies from one person to another, but on average most adults need about seven to eight hours of sleep each night to feel alert and well rested.”

Sleep deprivation has been linked to high blood pressure, heart attack, diabetes, obesity, and even increased risk of age-specific mortality. Researchers still don’t know exactly why inadequate sleep is linked to these conditions, but they do know that a lack of sleep disrupts underlying health conditions and biological processes such as glucose metabolism, blood pressure, and inflammation. (Excess sleep may cause many of the same effects.)

Besides these complications, insufficient sleep can have other negative effects on one’s health.

Effects of sleep deprivation

Researchers have shown that sleep-deprived animals will die within a few weeks, despite being well fed, watered, and housed. In humans, however, it’s unclear whether sleep deprivation for prolonged periods results in death. Nevertheless, people who are deprived of sleep do experience unpleasant symptoms distinct from insomnia.

The primary symptom of sleep deprivation is excessive daytime sleepiness. People who are sleep-deprived often fall asleep while at work or driving, which can result in accident and injury. Other effects of sleep deprivation include:

  • Irritability
  • Attention deficit
  • Decreased vigilance
  • Deterioration of skilled motor activities
  • Prolonged reaction times
  • Distractibility
  • Lack of energy
  • Lack of concentration
  • Lack of motivation
  • Neglected self-care
  • Lapses in judgment

If a person is deprived of enough sleep, their perception of inner experiences and of the outside world can become compromised, and visual and tactile hallucinations may occur. In people with bipolar disorder, sleep deprivation can induce mania. Moreover, experts have shown that prolonged sleep deprivation can result in psychosis (albeit rarely). In one study of sleep deprivation (up to 112 hours), 2% of 350 study participants experienced temporary symptoms resembling acute paranoid schizophrenia.

Neurological signs of sleep deprivation

Sleep deprivation can manifest as neurological signs including mild nystagmus, impairment of saccadic eye movements, loss of accommodation, exophoria (ie, deviation of the eyes outward), hand tremor, ptosis of the eyelids, expressionless face, thickened speech, mispronunciations, and incorrect choice of words.

In sleep-deprived individuals, electroencephalogram (EEG) readings often display a decrease in alpha waves, with eye closure no longer generating alpha activity. Furthermore, seizure threshold may be decreased, and seizure foci on EEG may be triggered.

Causes of sleep deprivation

About one of five adults are sleep-deprived, according to AASM. Causes of sleep deprivation include work obligations, personal obligations, and medical problems. Moreover, some people voluntarily or forcibly restrict their sleep time. This newly defined type of hypersomnia is known as behaviorally induced insufficient sleep syndrome (BIISS) and is a prevalent cause of excessive daytime sleepiness and daytime fatigue. People who work long hours or night shifts may be more susceptible to BIISS.

Sleep restoration

Unfortunately, no amount of “make-up” rest will compensate for total sleep lost due to deprivation.

Of note, non-REM, or normal sleep, is divided into three stages according to increased deepness of sleep: N1, N2, and N3. On the first night of recovery after a long period of sleep deprivation, a person rapidly enters deep non-REM sleep (stage N3) for several hours at the expense of REM and N2 sleep. On the second recovery night, REM rebounds and exceeds the usual REM length of the predeprivation period. Overall, N3 sleep is the most important in healing from prolonged sleep deprivation.

Keep in mind that if you’re sleep deprived, the only panacea is to increase your nightly sleep time to a level that you need. Nevertheless, certain coping mechanisms that may help, including caffeine use, power naps that last 30 or fewer minutes, and prophylactic napping (napping in anticipation of expected periods of sleep deprivation).

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