Sleep Deprivation

Sleep Deprivation: What it is and What it Means to You

Sleep deprivation, insufficient nocturnal sleep, sleep reduction, and inadequate sleep – all names for the same syndrome – and all equally disruptive if you suffer from the problem! Regardless of what you call it, sleep deprivation can occur at any time to anyone – and the difference between the need for sleep and the amount of sleep you get may be enormous.

Alarm Clock

A normal, healthy person who gets enough sleep does not need an alarm clock to wake up in the morning yet over half of all Americans report that they need an alarm clock to wake up. Because alarm clocks interrupt the normal sleep cycle, if you need an alarm clock to get up in the morning, you may find yourself suffering from sleep deprivation – and with the resulting lack of energy.

What is Sleep Deprivation?

The International Classification of Sleep Disorders (ICSD) calls sleep deprivation “insufficient sleep syndrome” and defines the syndrome as “a disorder that occurs in an individual who persistently fails to obtain sufficient nocturnal sleep required to support normally alert wakefulness”. In the ICSD, sleep deprivation is categorized as a dyssomnia that originates from causes outside of the body. A dyssomnia is a sleep disorder that produces difficulty going to sleep or staying asleep resulting in excessive sleepiness. Stedman’s Medical Dictionary defines sleep deprivation more simply as “a lack of sufficient sleep over a period of time that causes physical or psychiatric symptoms and affects routine performance of tasks”.

Sleep deprivation is different from insomnia. If you have insomnia, you have problems going to sleep or staying asleep. Insomnia may lead to sleep deprivation which simply means you are not getting enough quality sleep. As a matter of fact, many of the recognized sleep disorders may lead to sleep deprivation.

Statistics

Sleep Deprivation Prevalence and Statistics

Sleep problems in general are estimated to be among the most common health problems in America with estimates of 50 to 70 million Americans suffering from some sort of sleep disorder. About 2 percent of patients who are seen in sleep centers are also diagnosed with sleep deprivation.

Men are slightly more likely to be affected than women. Typically, this syndrome begins in the mid to late 30’s; however, the syndrome may affect children or may not be diagnosed until you are over 40 years old.

In one study, over 40 percent of those interviewed reported that daytime sleepiness resulting from sleep deprivation interfered with their daytime activities. In one well-documented study, it was found that as many as 40 percent of semi-truck accidents are due to fatigue caused by sleep deprivation.

Children, especially adolescents, are not immune to the disorder. In a sleep study done with adolescents, it was found that children with sleep deprivation are two times more likely to abuse drugs and alcohol than their well-rested peers. And some surveys report that 60 percent of students show some signs of sleep deprivation.

Signs/Symptoms

What are the Signs and Symptoms of Sleep Deprivation?

Main health effects of sleep deprivation

How do you know if you are sleep deprived?

You may find yourself sleeping much longer on the weekends in an attempt to “make up” for lost sleep during the week – this symptom by itself may suggest that you are sleep deprived. Signs and symptoms of sleep deprivation will depend on the amount of “sleep debt” – that is, how much sleep you have lost in a given period of time.

Obviously, the more sleep you lose, the more pronounced the symptoms will be. Initially, when you are sleep deprived, you may be restless or irritable. You might also have severe fatigue, memory loss and lack of energy. As these symptoms increase, you (and your boss!) may begin to notice that your performance on everyday tasks will begin to deteriorate

With extreme sleep deprivation, you may experience disorientation, paranoia, and hallucinations. Some research suggests that just 24 hours of sleep deprivation may be equivalent to being legally drunk!

In addition to the behaviors associated with sleep deprivation, you may experience some physical symptoms including body aches, headaches, dizziness, yawning, and blurred vision. Particularly with children and adolescents, you may notice that school performance and appetite both tend to decrease as the sleep debt increases.

Eventually, your body will make you go to sleep and you will very likely NOT experience REM sleep until you have had two or three nights of deep non-REM sleep.

Chronic Sleep Deprivation

Occasional sleep deprivation is certainly annoying but is usually not a problem. When you have short periods of sleep deprivation, you may have low energy and difficulty concentrating. However, chronic sleep deprivation CAN become a problem.

Chronic sleep deprivation is a risk factor for other very serious health problems including diabetes, obesity, heart disease and atherosclerosis. In addition, insufficient sleep may cause depression and other psychological problems.

Diagnosis

How is Sleep Deprivation Diagnosed?

The diagnosis of sleep deprivation is relatively easy. If you are losing sleep for any reason and have the signs and symptoms of sleep deprivation, you are probably sleep deprive.

Your doctor will ask you about your sleep habits and may ask you to keep a sleep journal. The Epworth Sleepiness Scale (ESS) is a test that you might take. The ESS measures how sleepy you are during the day when you should be wide awake. This questionnaire asks you how likely you are to fall asleep during common daytime activities like sitting in a movie, talking on the phone, sitting quietyly by yourself, driving your car, and while lying down.

Most of the time if you are sleep deprived, you will NOT have difficulty going to sleep; however, you will wake up in the morning feeling extremely tired. In order to make an accurate diagnosis, your healthcare provider will want to rule out any psychological or physical explanations for your sleepiness. You should expect that your doctor will draw lab work, do an EKG, get a chest x-ray, check your vital signs, and perhaps do tests to make sure your respiratory system is not causing the problem. If all of the tests are normal, you may be advised to get a sleep study in a sleep lab.

The ICSD defines the formal criteria for a diagnosis of sleep deprivation as:

  • You complain of excessive sleepiness
  • You sleep for a shorter time than normal
  • You may sleep longer on the weekends or vacation
  • Your sleep pattern lasts for at least 3 months
  • When you sleep longer, the symptoms disappear
  • A sleep study may be negative
  • An MSLT demonstrates excessive sleepiness
  • You don’t have any physical or psychological reasons for the sleepiness
  • You don’t have any of the other sleep disorders that may produce sleepiness

Causes

What are the Causes of Sleep Deprivation?

How likely are you to develop sleep deprivation? That depends. Common risk factors for the disorder include:

  • Having another sleep disorder that causes you to lose sleep
  • Having a mental disorder especially depression or anxiety
  • Working inconsistent shifts or shifts that don’t coincide with your own circadian rhythm

There are many other causes of sleep deprivation. Stress and anxiety may be the leading cause of sleeplessness. If you have poor sleep habits, you may find that you are chronically sleep deprived.

  • Is your bedroom too warm?
  • Is there too much light or too much noise?

If you exercise before bed you may find yourself unable to go to sleep. Try to go to bed and wake up at the same time. Sometimes, just maintaining a regular sleep schedule will help you go to sleep faster… and sleep better through the night.

Certain medications can cause you to be sleep deprived

Many medications can keep you awake. Over the counter allergy medications and decongestants are notorious for causing sleeplessness or restless sleep.

If you are taking prescription medications, check with your healthcare provider to see if any of those medications can cause sleep disruption. If so, you may be able to change the schedule so you are taking the medicine earlier in the day.

Your daily diet will have an effect on sleep deprivation

Watch what you eat and drink before going to bed. If you drink any caffeinated beverage before bed, you may find yourself tossing and turning. Weight loss products and alcohol taken too late in the day may cause you to not sleep or wake up during the night. Eating a large meal may cause gastric reflux when you lay down to go to sleep. In this condition, stomach contents and acid back up into your esophagus causing heartburn — and chronic sleep deprivation.

Women specific causes

Particularly in women, hormonal imbalances are a leading cause of insomnia. In addition to a new baby who won’t sleep through the night, hormonal changes during and after pregnancy can lead to significant sleep deprivation for the woman of child-bearing years.

A peri- and post-menopausal woman will have decreased estrogen. In most women, this will cause hot flashes that will wake the woman up during the night leading to the real possibility of sleep deprivation.

Other sleep disorders could cause sleep deprivation

Any sleep disorder (sleep apnea, night terrors in children, and restless leg syndrome) that causes insomnia may also result in sleep deprivation. Other medical disorders or diseases may also cause sleep deprivation

In the elderly, hypertension, constipation or prostate enlargement may cause sleep deprivation. Deficiencies of magnesium and serotonin are common, and easily treated, causes of sleep disruption.

Voluntary Sleep Deprivation

You can also be “voluntarily” sleep deprived. In this kind of sleep deprivation, you force yourself to stay awake or wake up during the night. Students who pull “all nighters” studying for exams know the effects of prolonged sleep deprivation. Parents with a new baby who wakes up for feeding during the night don’t exactly “volunteer” for the experience, but awaken readily to feed the newborn.

One of the best known experiments in voluntary sleep deprivation occurred in 1959 when a New York disc jockey, Peter Tripp, stayed awake and broadcasted his radio show for over 200 hours! During the last 66 hours, doctors helped him stay awake by administering drugs.

The result of his sleep deprivation: severe hallucinations! Fortunately, these voluntary periods of sleep deprivation are typically time limited and the problems of lack of sleep disappear with a few nights of deep sleep.

Treatment

What is the Treatment and Therapy for Sleep Deprivation?

There is no doubt that the best treatment for sleep deprivation is prevention. In addition, using some simple measures may help to treat sleep deprivation if used early.

How can you prevent or intervene early if you are sleep deprived?

Stay active during the day but minimize exercise in the evening. Go to bed at about the same time every night… and wake up at the same time even if you don’t have to. Sleep deprivation may make you sleepy during the day. As sleepy as you might be during the day, avoid the temptation to take naps.

When you are ready to go to bed, try taking a warm bath. Avoid anything that might make you less sleepy including alcohol, nicotine, large meals, and caffeine. Also, talk to your healthcare provider about your medications to make sure they are not keeping you awake.

If you still find yourself chronically sleep deprived, there are other things you can try. Some of these more formal treatments include relaxation techniques to reduce anxiety at bedtime, acupuncture, prescription or over-the-counter medications, and light therapy.

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