What is Sleep Deprivation?
Lack of sleep is a common issue that often goes unnoticed and untreated by doctors. It is strongly linked to serious health problems like diabetes and insulin resistance, high blood pressure, obesity, sleep apnea, depression, and anxiety. These health issues can increase the risk of heart attacks and strokes. Chronic sleep loss can also lead to other negative outcomes such as higher death and illness rates, accidents and injuries from poor performance during the day, a lower quality of life, decreased family happiness, and less use of health care services.
It’s clear that not getting enough sleep has a significant impact on one’s health and happiness. The amount and quality of sleep can greatly affect one’s mental and physical health, and should be taken into account in any plan to improve a person’s health.
What Causes Sleep Deprivation?
Sleep loss can happen for many reasons and is often due to more than one factor. Some common causes include sleep apnea (a sleep disorder in which breathing repeatedly stops and starts), insomnia (difficulty falling or staying asleep), restless leg syndrome (a condition causing an uncontrollable urge to move your legs), certain sleep disorders causing abnormal behavior during sleep, mood issues, psychiatric or neurological conditions, and other health problems.
When trying to figure out why someone is losing sleep, it’s important to directly address these possible causes. Doctors won’t just treat the symptoms (like feeling sleepy) if they can treat the actual cause. If the doctor can’t find any cause for the sleep loss, they’ll often diagnose it as primary insomnia, which mainly affects older people. As people get older, their sleep patterns change; they spend more time in lighter sleep and less time in deep, restful sleep, leading to more awakenings during the night. As a result, their total sleep time usually decreases.
It’s also important to note that other health conditions can both cause and be caused by losing sleep over a long time. For example, if someone gains a lot of weight and becomes obese, they can develop sleep apnea. Then, the poor-quality sleep caused by sleep apnea can lead to higher levels of a hormone called cortisol in their blood, which can cause more weight gain.
Risk Factors and Frequency for Sleep Deprivation
Lack of sleep is a widespread issue that becomes more common as people get older. As the elderly population grows in the U.S. and across the world, sleep disorders are expected to increase. Other factors contributing to sleep loss, such as obesity leading to obstructive sleep apnea, are also on the rise. It’s estimated that 50 to 70 million Americans struggle with some form of sleep loss.
Several societal changes contribute to the growing prevalence of sleep loss. These include working longer hours, doing shift work, and having increased access to television and the internet. People are choosing to sleep less to accomplish more work or they stay up late watching TV or surfing the web.
- In a recent study, it was found that 20% of people between the ages of 25 and 45 were regularly sleeping 90 minutes less than what is required for good health.
- Due to our 24/7 society with always-available activities and increased nighttime use of electronics like computers and mobile phones, the problem of insufficient sleep is likely to worsen.
- Research has shown that there has been a reduction in sleep duration by up to 18 minutes each night over the past three decades.
It’s important to note that the real scale of the problem might be underreported. This is because many studies depend on individuals reporting their own sleeping patterns, which do not differentiate between time spent sleeping and time simply spent in bed. While polysomnography is an accurate method to gather data on sleep, it’s expensive and time-consuming. Consequently, a new, more affordable method called actigraphy is being used to study sleeping habits.
Signs and Symptoms of Sleep Deprivation
The amount and quality of sleep a person gets can impact their health significantly. Adults generally require seven to eight hours of sleep, while adolescents need about nine hours. Not sleeping enough can lead to many health problems, including obesity, diabetes, cardiovascular disease, anxiety, and even alcohol use. If a person has these health issues, it may be a signal that their sleep quality is poor. The sicker a person is, the less likely they have a good sleep pattern.
To understand a patient’s sleep pattern, various important questions must be asked like:
- Do you have trouble falling asleep or staying asleep?
- Do you feel tired when you wake up?
If the patient answers yes to these questions, the next crucial questions will include:
- Do you have difficulty sleeping even when you have enough time to rest?
- Does your sleep difficulty affect your daytime activities?
- Are you distressed because of your poor sleep quality?
Don’t forget to also ask about the severity and frequency of these symptoms. A person who isn’t getting enough sleep may experience daytime sleepiness, difficulty concentrating, fatigue, mood swings, decreased sex drive, and other related symptoms. It’s important to first improve the patient’s sleep before addressing these symptoms. Remember to treat the cause, not just the symptoms.
Testing for Sleep Deprivation
When someone is having issues with poor quality sleep, it’s important to find out why. Usually, there’s more than one reason why someone isn’t sleeping well, so it’s best to address each cause directly. For example, obstructive sleep apnea (OSA), which is a condition where a person’s breathing repeatedly stops and starts while they sleep, might be one of the reasons. If it is, it’s best to address it with treatments like a CPAP machine (a device that helps you breathe whilst sleeping) and/or weight loss. If it’s ignored and a person is just given sleep aids to help them sleep, this could actually make the OSA and quality of sleep worse.
It’s also important to take note of any symptoms the person might be experiencing as a result of their lack of sleep. These symptoms should be monitored over time to see how the treatments are working. The most common symptom of sleep loss is excessive sleepiness during the day. But people can also experience symptoms such as feeling low in mood, being unable to concentrate, and problems with memory. Not getting enough sleep can also make other health problems worse, including OSA, obesity, high blood pressure, depression, anxiety, etc.
Lack of sleep can affect someone’s ability to perform tasks that require decision-making and problem-solving skills. Once all the causes of the poor sleep have been dealt with, it’s important to see the person again to check if they are still experiencing any symptoms. At this point, the focus can shift to providing relief from any remaining symptoms.
Treatment Options for Sleep Deprivation
Even though lack of sleep affects public health significantly, it’s not commonly addressed by doctors. Up to this point, there aren’t any formal treatment guidelines. That being said, there are several effective ways to manage sleep loss.
Generally speaking, sleep loss can be tackled through three main strategies:
- Changing behavior or improving sleep habits
- Addressing underlying medical and mental health conditions
- Using medication
One of the first steps is to go over proper sleep habits with the patient to get rid of behaviors that negatively influence sleep. This is because often many other health issues (either physical or mental) can contribute to sleeping difficulties. The specific treatments for these associated conditions aren’t covered in this context. If changing behavior and treating underlying conditions don’t improve sleep problems, medication might be considered.
However, it’s important to note that using medication as a sleep aid should be done cautiously because they might have unintended side effects. For instance, certain drugs can increase daytime fatigue if the dosage is too high or the drug remains in the body for too long. Sedating sleep aids may actually worsen conditions that cause poor sleep. For example, obstructive sleep apnea, a condition where the muscles in the throat relax too much during sleep causing pauses in breathing, can be further worsened by sleep aids that cause weight gain or relax these muscles even more.
If the lack of sleep is due to an unchangeable lifestyle (like shift work), your healthcare provider can help manage excessive sleepiness during the day by providing specific tips to stay alert. There are medications available to promote wakefulness, such as caffeine and medications like modafinil and methylphenidate. Currently, modafinil is the only medication that is FDA-approved specifically for shift work sleep disorder, but not for general sleep loss.
What else can Sleep Deprivation be?
Lack of sleep is a sign of an underlying problem, and it’s important to identify the exact cause to treat it properly. There are many potential reasons for this, such as:
- Insomnia
- Depression
- Anxiety
- Sleep apnea
- Obesity
- Substance misuse
- Chronic pain
There are also specific conditions that mimic lack of sleep symptoms:
- Chronic fatigue syndrome
- Narcolepsy
- Substance misuse
- Depression
- Anxiety
What to expect with Sleep Deprivation
If a doctor correctly diagnoses a lack of sleep, the treatment can be effective, allowing the patient to return to a healthy way of life.
Possible Complications When Diagnosed with Sleep Deprivation
Not getting enough sleep can lead to a variety of health issues. These problems can ironically make it even harder to get a good night’s sleep. When you don’t sleep enough, your body makes more cortisol; the stress hormone. This can make your blood sugar and blood pressure go up. It can also cause cravings for carbohydrates and sugar, which can lead to weight gain and other medical and mental health issues. Feelings of distress from lack of sleep can add to these complications. Here are some potential issues that can arise from sleep loss:
- Diabetes or insulin resistance – When your body doesn’t use insulin properly
- High blood pressure
- Obesity
- Obstructive sleep apnea – a condition where your breathing repeatedly stops and starts during sleep
- Vascular disease – conditions that affect your circulatory system
- Stroke – a sudden interruption in the blood supply to the brain
- Myocardial infarct (Heart attack)
- Depression
- Anxiety
- Psychosis – a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality
Preventing Sleep Deprivation
The most effective way to prevent health issues related to sleep is through educating the individual on the importance of good sleep and how to achieve it. If an individual understands the value and techniques of healthy sleep, they will probably prioritize sleep more. This education should also cover proper sleep habits and address other factors that could lead to poor sleep quality.
It’s important to take a close look at a person’s current sleep patterns to see what they’re doing correctly and where improvements can be made. People should be encouraged to live a healthier lifestyle in general. This not only benefits their overall well-being, but also reduces the likelihood of them developing health issues that could negatively impact their sleep.