by Zeenat Farooq

Sleeping

Loss of sleep is a common problem in our modern-day society, affecting many individuals at some point of time in their lives. Although occasional sleep interruptions are generally not much harmful, on-going lack of sleep can lead to severe problems like excessive daytime sleepiness, emotional difficulties, poor job performance, obesity and a lowered perception of the quality of life.

And the saying goes: a person who has gone for even one night without sleep is as impaired as an intoxicated individual.  Hence, there should always be a certain amount of necessary attention to both manage and prevent sleep deprivation.

Sleep Deprivation

Sleep deprivation is a term, which is associated with a person who gets less sleep than needed to feel awake and alert. When an individual does not get enough sleep, he begins to experience symptoms of “sleep deprivation”. People vary in how little sleep is needed to be considered as sleep deprivation.

Old age individuals seem to be more resistant to the effects of sleep deprivation, while children and young adults are more vulnerable.

The National Sleep Foundation (NSF), USA 2015 recommendations for appropriate sleep durations per 24 hours for specific age groups are:

New-borns (0-3 months):                           14-17 hours each day
Infants (4-11 months):                                12-15 hours
Toddlers (1-2 years):                                   11-14 hours
Pre-schoolers (3-5 years):                           10-13 hours
School-age children (6-13 years):             9-11 hours
Teenagers (14-17 years):                           8-10 hours
Adults (18-64 years):                                  7-9 hours
Older adults (65+ years):                           7-8 hours

Micro Sleeps and their Dire Consequences

After around 16 hours of staying awake, the body attempts to balance the need for sleep. If sleep is thwarted, the brain obtains sleep through short sleep attacks (microsleeps). This is an uncontrollable brain response that renders a person unable to process environmental stimulation and sensory information for a brief amount of time.

A person’s eyes often remain open during microsleeps, but he is essentially “zoned out”. As the nature of these attacks is sudden, for a sleep-deprived individual operating heavy machinery or driving, the consequences can be catastrophic to both the individual, as well as innocent bystanders.

Micro-sleeps will continue to occur despite an individual’s forced attempt to stay awake, and because of this inbuilt sleep mechanism; it is extremely difficult for an individual to remain awake for more than 48 hours straight.

Causes of Sleep Deprivation and Sleep Debt

Some groups of people, especially youngsters, may consider sleep as wasted time and purposely deprive themselves of sleep in order to pursue other things such as entertainment, educational goals or other activities. This intentional sleep deprivation, as already mentioned, is most likely to be seen in teenagers and young adults. Others may unintentionally not get enough sleep because of shift work, family obligations or demanding jobs.

Consistent sleep-wake patterns of going to bed late, frequent night-time arousals or waking up early can lead to sleep deprivation and the accumulation of sleep debt.  When a person fails to get your required amount of sufficient sleep, he starts to accumulate a sleep debt. For example, if a person needs 7 hours of sleep nightly to feel awake and alert and only get 5 hours, he has a sleep debt of 2 hours and  If he continues that pattern for five nights, he has an accumulated sleep debt of 10 hours.

The only way to erase a sleep debt is to get more sleep. Depending on how great the sleep debt is, it will take some time to fully recover. But positive effects will be felt rather quickly. To pay back a sleep debt, it is necessary to start getting the sleep one needs, plus an additional hour or so per night until the debt is paid.

Afterwards, the required amount of sleep can be resumed without an additional hour. If the sleep debt is hundreds or even thousands of hours, it still can be successfully reconciled with a conscious effort. Additional causes of sleep deprivation include medical problems such as depression, obstructive sleep apnea, hormone imbalances and other chronic illnesses.

Symptoms of Sleep Deprivation

The main symptom of on-going sleep loss is excessive daytime sleepiness, but other symptoms include:

  • Yawning
  • Moodiness
  • Fatigue
  • Irritability
  • Depressed mood
  • Lack of motivation
  • Clumsiness
  • Inability to concentrate or a “fuzzy” head
  • Difficulty in learning new concepts and forgetfulness due to constant over-activation of a learning centre in the brain which over a long time leads to its exhaustion. Also, prolonged sleep deprivation diminishes the ability of the brain to form new nerve connections. This also increases the likelihood of a person developing neurological problems like Alzheimer’s disease later in his life.
  • Increased appetite and carbohydrate cravings due to the constant secretion of some molecules which stimulates the increased appetite for carbohydrate foods and thus increase the likelihood of obesity and other metabolic disorders.

Complications of Sleep Deprivation

It has been investigated by researchers that a person who is deprived of sleep for a long time is as good as a person who is addicted to the drug “marijuana” as both stimulate the same areas in the cortex of the brain. Sleep deprivation also weakens the ability of the reasoning part of the brain leading to abnormal processing of emotions. When the brain is deprived of sleep, it is difficult to concentrate and form new memories.

When we stay awake all night or significantly cut sleep short, the body does not release the hormones necessary to regulate growth and appetite, and instead an overabundance of stress chemicals such as Norepinephrine and Cortisol forms.

Research suggests that shorter sleep durations may be a predictor of weight gain in adults and children. Each 1-hour reduction of sleep per day is associated with an increase of 0.35 kg in body mass index (BMI). These changes result in an increased risk for hypertension, diabetes, obesity, heart attack and stroke in the sleep-deprived individual.

Sleep loss can have a profound impact on both emotional functioning and normal thinking abilities in healthy individuals resulting in a reduced tendency to think positively, bad moods, a decreased willingness to solve problems, greater tendency towards superstitious and magical thinking, intolerance and less empathy toward others, poor impulse control and inability to delay gratification.

Sleep-deprived people are also more likely to report increased feelings of worthlessness, inadequacy, powerlessness, failure, low self-esteem, poor job performance and an increase in incidents of conflicts with co-workers.

Finally, sleep-deprived individuals are also at an increased risk of clinical outcomes like depression, anxiety, and paranoia.

Treatment and Prevention of Sleep Deprivation

Most of the negative effects of sleep deprivation reverse when sufficient sleep is obtained. The treatment for sleep deprivation is to satisfy the biological sleep need, prevent deprivation and “pay-back” accumulated sleep debt.  Some suggestions for obtaining sufficient sleep through 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 for around 2-3 hours before bedtime
  • If unable to fall asleep after 20 minutes of trying, going to another room and trying to read until feeling sleepy and then returning to bed.
  • Engaging in regular exercise during the day.
  • Keeping the bedroom quiet, dark and at a comfortably cool temperature.
  • Turning off electronic devices when you go to bed.

If sleep deprivation is on-going and negative symptoms persist despite practising good sleep and other health and hygiene measures, consultation with a health care provider is recommended.

(Author is a Research Scholar at Department of Biotechnology, University of Kashmir.)

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