Sleep Deprivation: Causes, Treatment, and Prevention

Expert Insights from Dr. Luis Javier Peña-Hernández, MD, FCCP, a lung health specialist at PCSI, the largest integrated pulmonary and chest specialty group in Palm Beach County.

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According to the Center for Disease Control, nearly one in three people are not getting enough hours of sleep each night. That equates to more than 40 million people whose sleep quality is severely suffering.

You may not believe that a loss of sleep can be severe, but if an individual is chronically sleep-deprived they can be at risk for serious health complications in the short- and long-term.

What is Sleep Deprivation?

Sleep deprivation is a condition that occurs when a person isn’t getting his/her required amount of sleep each night in order to feel rested and functional throughout the day. The amount of sleep each person requires in order to function varies from one person to the next, but when a person isn’t getting their desired amount each night a sleep debt begins to accumulate.

The amount of sleep debt a person experiences before becoming vulnerable to the effects of sleep deprivation also varies from one person to the next. Typically, older adults are less prone to sleep deprivation while children and young adults are more susceptible to it.

The effects of severe sleep loss can decrease a person’s overall quality of life and cause difficulties in a person’s ability to function every day.

How Common Is Sleep Deprivation Around the World?

Short sleep duration is becoming more common, particularly because people are getting busier. With access to technology, it’s harder to “shut off” in the evening, which can lead to major sleep problems. The company Phillips surveyed 12 countries to gauge sleep deprivation around the world.

Sixty-two percent of those surveyed said they did not get enough sleep. That’s over half of the world’s population!

How Many People are Sleep Deprived in America?

The statistics give us a pretty good picture of just how tired we are as a nation. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 3 three adults don’t get the minimum recommended 7 hours of sleep, essentially one third of our country.

In addition, there are now 80 different sleep disorders being treated regularly at sleep clinics all over the United States. A 2013 National Gallup Poll found people were sleeping on average about 6.8 hours a night and an estimated 70 million adults have some form of sleep disorder.These numbers may not mean much until you understand that sleep deprivation has serious consequences. Sleep deprivation:

• Is responsible for about 20 percent of all motor vehicle crashes.
• Is across the board lowering job performance and academic performance from preschool through graduate school.
• Affects physical health and adds to the rising cost of healthcare.
• Has a profound effect on mental health increasing your chances of depression and anxiety and further adding to the nationwide mental health crisis.

Sleep is so vital to good functioning that to say 30 percent of the population isn’t getting enough sleep is like saying 1 out of every 3 people you pass on the street is struggling to function. Not an optimal way to be living.

We are also spending like crazy trying to solve the problem. Estimates are in the neighborhood of 52 billion dollars, that will be spent on sleep products in 2020. These include sleep apps, sleep sensors, better mattresses, white noise machines, aromatherapy diffusers, sleep medications, books on sleep, and sleep aids like pillows, eye covers, room darkening curtains and more. Sleep remedies have become a big business in the United States in response to the growing epidemic of sleep deprived individuals.

Sleep Deprivation: The Statistics

By Sleep Disorder

The Phillips company study asked people across 12 countries if they experience a sleep disorder. Many said they did, and we break down the numbers below.

• Insomnia: 37% of those surveyed struggle to fall asleep and stay asleep.
• Obstructive Sleep Apnea: 10% reported irregular breathing and 29% reported snoring that interfered with their sleep.
• Restless Legs Syndrome (RLT): 7-10% of Americans suffer from RLT, according to the National Institutes of Health (NIH).
• Narcolepsy: The NIH estimates 135,000 to 200,000 Americans experience chronic daytime drowsiness and irresistible sleep.

By Age Group

Sleep habits change as we age. Children tend to sleep the most, while the elderly get less sleep. Still, people of all ages experience sleep deprivation. The CDC reports the following percentages for short sleep duration by age.

• 18–24 years old: 32.2%
• 25–34 years old: 37.9%
• 35–44 years old: 38.3%
• 45–54 years old: 39.0%
• 55–64 years old: 35.6%
• ≥65 years old: 26.3%

Reports of sleep deprivation may differ from the reality. For example, the CDC cites 26.3% of those over 65 years old experiencing short sleep duration, but Columbia University estimates that the number could be as high as 50%.

Young adults—those between ages 10 and 24—who experience sleep disturbances are more likely to struggle with sleep as adults, according to the NIH. 68.8% of high school students report high levels of sleep deprivation, which can seriously affect academic performance and contribute to health problems later in life.

By Country

The popular Sleep Cycle app collects data on sleep habits all over the world. They note that there doesn’t seem to be a sleep advantage for higher-income countries. Here is how a few countries fare when it comes to average total hours of sleep per night:

• 7.5 hours: New Zealand, Netherlands, Finland, Britain, Australia
• 7.25 hours: Ireland, France, Canada, Germany, United States, South Africa
• 7 hours: China, Costa Rica, Russia, Spain, Italy
• 6.75 hours: Thailand, Mexico, Chile, Israel, Hong Kong, India
• 6.25 hours: Japan, South Korea, Saudi Arabia

By Occupation

According to sleep research, some occupations put people at higher risk for sleep deprivation. A National Health Interview Survey by the CDC says the occupations with highest risk are:

• Protective services and military: 50%
• Healthcare workers: 45%
• Transport and material movers: 41%
• Production workers: 41%

Unfortunately, many of the occupations that cause poor sleep also require the most sleep. Take healthcare workers, for example. Emergency room doctors, nurses, and surgeons need to be alert and clear-minded while treating patients; however, hospital workers typically work in 12-hour shifts, often at night.

Every year, millions of dollars are lost because of problems resulting from poor sleep. The Rand Corporation estimates that the U.S. tops the list of losses by country at $411 billion per year, or over 2% of its GDP.

Short-Term Effects of Sleep Deprivation

The impact of poor sleep patterns paired with less sleep time each night presents the body with a variety of symptoms and long-term effects. The most prevalent symptom of sleep deprivation is excessive daytime sleepiness. In addition to this, the symptoms of sleep deprivation include:

• Anxiety and depression
• Irritability and moodiness
• Clumsiness and a higher risk for serious accidents
• A slower reaction time
• Learning and memory impairments
• Lack of concentration
• Increased appetite with carbohydrate cravings
• Reduced sex drive

It is very common for those who are sleep-deprived to be involved in work-related accidents, as well as car accidents caused by falling asleep behind the wheel. This is because sleep deprivation makes it difficult for a person to stay awake consistently during the day.

As little as one night of sleep deprivation can cause a person to experience “microsleeps,” a phenomenon that causes a person’s brain to fall asleep for short periods of time that last up to 30 seconds in length. This can be incredibly dangerous for those who are operating heavy equipment, including driving your vehicle.

Long-Term Effects of Sleep Deprivation

“While the short-term effects of sleep deprivation may seem harmless, long-term sleep deprivation can be dangerous and harmful to your health,” says Dr. Peña-Hernández. “The long-term effects of sleep deprivation can include weight gain, obesity, diabetes, cardiovascular disease, hormonal imbalances, and even effects on the brain.”

On a long-term basis, sleep-deprived people oftentimes experience health risks that can escalate to issues as serious as an increased risk of early death. This is due to the primary long-term effects of sleep deprivation which include a weakened immune system, risk of diabetes and cardiovascular disease, and certain cancers.

Immune System Upset

An inability to get a good night’s rest consistently prevents the body from boosting its immune system and producing the cytokines needed to fight infections. This may cause a person to experience longer recovery time when they become sick, as well as cause a greater risk for chronic illnesses.

Weight Gain, Obesity, and Diabetes

Sleep deprivation can impact body weight on a grand scale. The two hormones that control hunger and feeling full—leptin and ghrelin—are impacted by sleep. Without proper sleep time, these hormones become irregulated, leading to weight gain. Sleep deprivation also causes insulin to be released in the body which is responsible for an increase in fat storage. This can lead to type 2 diabetes.

Cardiovascular Disease

When we sleep, the heart vessels rebuild, heal, and maintain blood pressure, sugar levels, and control for inflammation. When we don’t get enough sleep this upsets the balance in the heart and puts us at a 48% increased risk for cardiovascular disease.

Hormonal Imbalances

Hormones are also produced while we sleep, so when we aren’t getting enough of it our hormonal levels can become imbalanced. This includes an increase in stress hormones and impacts on the production of growth hormones and testosterone in men.

Effects on the Brain

Sleep deprivation can also age the brain an average of 3-5 years. Some of the more severe effects of a lack of sleep on the brain include hallucinations and false memories. One study showed that laboratory animals who were forced into sleep deprivation experienced fatal results. This is difficult for humans, however, as we will typically fall asleep before facing fatal consequences that aren’t related to accidents.

Heart Health

Sleep deprivation had been shown to affect the heart both directly and indirectly.

Direct Impacts of Sleep Deprivation

Chronic lack of sleep is strongly linked to certain disorders of the heart like hypertension (HT), coronary heart disease (CHD), and heart failure (HF) from diabetes mellitus. Directly, a lack of sleep results in high blood pressure, which will manifest the next day and is usually accompanied by elevated nervous system activity as well.

Blood pressure naturally falls at night as part of healthy heart regulation. With shortened or interrupted sleep, the heart may not have enough time at the lowered level it needs to ensure proper functioning. In simple terms, the heart rests while you sleep, and it needs enough rest in order to be healthy.

Indirect Impacts of Sleep Deprivation

There are other ways that sleep deprivation can indirectly affect heart health. It is a contributing factor in obesity and type II diabetes, which can both promote heart disease. Lack of sleep alters hormones which can influence both cortisol levels and the part of the brain that controls hunger. These changes in hormone level may result in insulin resistance which can develop into type II diabetes or contribute directly to weight gain.

Further, lowered sleep amounts can result in larger amounts of plaque in the arteries. Both too much sleep and too little sleep can cause higher levels of calcium, one of the primary ingredients, along with fat and cholesterol, that deposit themselves in the blood vessels making plaque. This plaque can lead to cardiovascular disease through the narrowing or blockage of blood vessels.

Causes of Sleep Deprivation

Sleep deprivation has a variety of causes—some are within a person’s control, and others are not.

When a person voluntarily deprives oneself of sleep on a regular basis this is known as behaviorally induced insufficient sleep syndrome, which is a form of hypersomnia. It must happen on an almost daily basis for three months or longer at a time. A person may also become sleep-deprived due to an involuntary sleep disorder or medical problem that is either physical or mental.

Alternative sleeping schedules can also lead to sleep deprivation. Because of this, shift workers are highly susceptible to experiencing sleep deprivation and sleep disorders associated with it. Even non-shift workers can experience these issues.

Consistently being woken up in the middle of the night for any reason could contribute to the issue. There may also be personal obligations that restrict the amount of time a person is able to sleep, such as taking care of family members or providing home care for someone who is sick.

Those who are at the highest risk for sleep deprivation include teenagers, caregivers, military personnel, shift workers, those who suffer from sleep disorders, and those with various medical conditions such as Parkinson’s disease that cause sleep difficulties.

How Long Can You Go Without Sleep?

For most people, even 24 hours without sleep can result in minor impairments including uncomfortable drowsiness and irritability, tremors, and muscle tension that makes precise movements difficult.

Other effects of just one night without sleep include:

• Impaired judgment
• Altered perception
• Memory deficits
• Vision and hearing impairments
• Decreased hand-eye coordination

Overall, there are no long-term effects of pulling an occasional all-nighter and these short-term impairments resolve once you catch up on your sleep. However, from there, things go from bad to worse.

48 Hours Without Sleep

You will feel a stronger and more persistent urge to sleep especially between 3:00 and 5:00 am. You might experience periods of light sleep, aptly called microsleep, that are involuntary and can last up to 30 seconds – plenty of time to cause a deadly auto accident, lose track of a toddler, or cut off a limb with heavy machinery. After two nights without sleep, your immune system begins to suffer, leaving you more vulnerable to illness from viruses and bacteria.

72 Hours Without Sleep

You will have a difficult time concentrating, remembering details, and paying attention. Three night without sleep take a toll on your emotions and mental health as well as your cognitive abilities. You may feel irritable, anxious, depressed, or even paranoid. The effects of several days sleep deprivation may cause significantly altered perception, even to the point of hallucinations. During the early morning hours, you may be unable to stay awake without some outside assistance.

Fatal Sleep Deprivation

Beyond 266 consecutive hours without sleep, it is not clear how long you could survive without sleeping. As you might expect, there aren’t a lot of volunteers for such a study. But there are some cases in which sleep deprivation can be fatal.

Fatal familial insomnia (FFI) is an extremely rare inherited sleep disorder that can result in death. FFI is a type of prion disease that results in damage to the brain. This brain damage can cause:

• Insomnia
• Lack of appetite and weight loss
• Fever and variations in body temperature
• Rapid heart rate
• High blood pressure
• Increased sweating
• Increased tear production
• Anxiety and depression
• Rapidly progressing dementia

Symptoms may be mild at first but quickly worsen. The condition ultimately leads to coma and death.

And, of course, the effects of sleep deprivation often make sleepy people more prone to accidents, especially while driving or operating heavy machinery. The National Highway Traffic Safety Administration estimates that drowsy driving claimed 795 lives in 2017 alone. According to the National Sleep Foundation, sleep deprived workers are 70% more likely to be involved in work-related accidents than well-rested workers due to lapses in judgment, slower reaction time, and careless errors.

Treatment for Sleep Deprivation

“Sleep deprivation can be treated with a variety of methods including lifestyle modifications and even medications in select cases,” says Dr. Peña-Hernández.

There are a variety of therapeutic interventions that have been found to be viable treatment options for sleep deprivation. These include fixing your sleep hygiene, practicing relaxation techniques, cognitive behavioral therapy (CBT), and stimulation control.

Repairing Your Sleep Hygiene

Practicing better sleep hygiene can be examined from a holistic approach. Start with your lifestyle habits. Healthy lifestyle habits for better sleep at night include avoiding caffeine and other stimulants in the late afternoon and evening, regularly exercising, and reducing stress.

Next, consider your bedtime habits. It’s important that you avoid stimulating blue light technologies and allow yourself to wind down in a dark and quiet space. Optimize your bedroom environment for the final piece of the puzzle by blocking out light and noise with dark curtains and a white noise machine if needed.

Consider your sleeping space as well. Is your mattress suited for your sleeping style? If you experience discomfort in any way, identify the roadblock and find a solution to help set yourself up for a better night’s sleep.

Relaxation Techniques

Mental and physical exercises that promote muscle relaxation are ideal for inducing sleep. These typically involve tensing and relaxing different muscles throughout the body to help it unwind. Other relaxation techniques include meditation, listening to ASMR, mindfulness practices, yoga nidra, deep breathing exercises, guided imagery, and also meditative and hypnotic recordings.

Cognitive Behavioral Therapy (CBT)

CBT can help a person gain control over any pervasive thoughts that may be present during the evening while trying to fall asleep. This therapy helps a person tweak behavioral patterns that may prevent getting adequate sleep as well. It is useful in treating anxiety, addictions, and other psychological issues.

Stimulus Control

Stimulus control involves utilizing many of the sleep hygiene tips mentioned above in order to train the brain to become focused on sleep only when in bed. This method is proven to be one of the most effective techniques for managing insomnia when used consistently.

The therapy is based on the premise that insomnia is a conditioned arousal response to bedtime and certain cue related to the sleeping environment. The purpose of stimulus control is to override the negative associations and recreate the natural connection between the bedroom and sleeping.

Seeking Expert Medical Help for Sleep Deprivation

You may also want to seek the help of a sleep specialist or talk to your doctor about your sleeping habits. When doing so, it will help to have a sleep journal recording your hours of sleep each night over the course of a couple of weeks.

A doctor will be able to diagnose any sleep disorders you may have, and may be able to detect any medical conditions that are responsible for sleep issues. Your doctor may prescribe some sleep medicine designed to help you fall and stay asleep throughout the evening.

There are a variety of over-the-counter and prescription sleep aids that can help a person fall and stay asleep. Some sleep medications are habit-forming, so it’s best to discuss this with a doctor before starting treatment.

How to Prevent Sleep Deprivation

There are a variety of actions a person can take to help prevent sleep deprivation before it begins.

The first step is ensuring that a sleep debt isn’t accumulated. If you do lose sleep for a day or two, it’s important that you pay it off as soon as possible. If you don’t make it up soon, that time is forever lost and can contribute to symptoms of sleep deprivation.

“To prevent sleep deprivation, maintain healthy sleep hygiene habits,” says Dr. Peña-Hernández. “Keep up with a regular sleep schedule being sure to get at least 7-9 hours of sleep each night. Plus, make sure you’re getting regular exercise and maintaining a healthy diet to protect your sleep health.”

Getting regular exercise and eating a healthy diet are important components toward being able to sleep throughout the night on a regular basis. It may also help to invest new sleeping tools (like getting the best mattress, best sheets, and best pillows) that are designed to cater specifically to your unique sleeping position and preferences.