Introduction

Sleep deprivation is a condition whereby one does not get sufficient sleep at night. It is common in modern society due to the increased workload and night activity. Sleep is vital because it helps the body restore itself, heal, and remove some metabolic wastes. It is an important indicator of overall health and well-being and is used in the diagnosis of many health conditions. An adult requires about seven to eight hours of sleep at night to feel refreshed and well-rested. Getting insufficient sleep repeatedly can lead to complications, such as daytime sleepiness, hypersomnia, an impaired immune system, difficulty concentrating, lack of energy, and poor memory. Sleep deprivation is mainly caused by sleep disturbances that reduce the amount of sleep time that a person gets. These disturbances can be caused by underlying health conditions, including stress, depression, and anxiety. Poor sleep hygiene, such as taking stimulants before bed and sleeping in a noisy environment can also lead to insufficient sleep. The condition is treated using medication, supplements, over the counter products and other natural means.

Symptoms

Sleep deprivation is commonly characterized by sleepiness, irritability, anxiety, and depression. The major symptoms of the condition are:

1. Impaired cognitive performance

Sleep deprivation is commonly associated with decreased alertness, vigilance, and response speed. It leads to impaired cognitive performance due to the destabilization of neurobehavioral functions in wakefulness. The cognitive functions that are mainly affected by sleep deprivation include:

  • Working memory
  • Psychomotor speed
  • Attention
  • Concentration

Prolonged sleep deprivation leads to persistent cognitive deficits leading to changes in different parts of the brain, including:

  • The frontal control region
  • Parietal control region
  • Secondary sensory processing areas
  • Thalamic region

The individual with the condition is not usually aware of the accumulating cognitive deficits. However, with time, the changes become severe and noticeable by affecting one’s performance in routine tasks.

2. Daytime sleepiness

Daytime sleepiness is the most commonly used symptom in the diagnosis of sleep deprivation. Insufficient sleep causes a person to feel drowsy during the day. Adults require about eight hours of uninterrupted sleep at night for the body to be refreshed and alert throughout the day. A prolonged lack of sufficient sleep leads to excessive sleepiness and general lack of alertness during the day. Daytime sleepiness increases the risk of hurting oneself or others when one falls asleep during activities such as driving and operating heavy machinery. An individual with daytime sleepiness can fall asleep abruptly and cause serious accidents, with the most common reported cases being sleep-related car crashes.

3. Obesity

Sleep deprivation can increase the risk of obesity. Studies have shown that sleep deprivation is associated with weight gain because it alters the metabolism of glucose, increases one’s appetite, and reduces the use of energy. The person with the condition is, therefore, likely to gain a lot of weight leading to obesity.

Causes of sleep deprivation

Sleep deprivation is caused by a lack of sufficient sleep, which causes the person to feel unrefreshed. Some complications that affect one’s sleep, which can lead to the condition, include:

1. Depression

Depression affects a person’s sleep by causing difficulty in falling asleep and maintaining uninterrupted sleep throughout the night. It increases the time taken to fall asleep (prolonged sleep latency), which reduces the amount of time that a person stays asleep. Depression also causes frequent awakening during the night and early awakening in the morning. Hence, one’s sleep quality is significantly reduced and they do not feel refreshed in the morning. A consistent lack of sufficient sleep becomes sleep deprivation.

2. Alterations in the circadian rhythm

The body’s sleep and wake times are controlled by a biological clock in the hypothalamus region of the brain. The internal clock regulates the time that a person falls asleep and wakes up. This regulation creates a rhythm known as the circadian rhythm. When this rhythm is altered, the person has difficulty falling asleep and wakes up during abnormal times. These alterations can be caused by poor sleep hygiene, irregular sleep schedules, and the use of medications that affect sleep. Frequent changes in a person’s sleep patterns cause significant alterations to the circadian rhythm that lead to sleep deprivation.

3. Low melatonin levels

Melatonin, a hormone synthesized by the pineal gland, plays a significant role in sleep regulation. It is part of the natural sleep-wake cycle that enables a person to fall asleep and wake up at the appropriate times. Melatonin is produced when the retina detects darkness, and in large amounts in absence of light. When there is light, the melatonin production decreases to ensure wakefulness. If the body produces low amounts of melatonin, it becomes difficult for a person to fall asleep or to have uninterrupted night time sleep. Therefore, low melatonin levels are said to cause sleep deprivation.

4. Reduced sleep duration

Sleep deprivation occurs when a person does not get the recommended sleep duration of eight hours in each sleep-wake cycle. Sleep duration is commonly affected by disturbances that occur when one is asleep, which can be caused by health conditions, noise, light, alcohol intoxication, drug abuse, and use of some prescribed medications. Further, irregular sleep schedules significantly affect a person’s sleep time. These irregularities can be caused by factors such as changes in work schedules and traveling across time-zones. When one’s sleep time is not sufficient  enough for each night for a prolonged period, they eventually experience sleep deprivation.

5. Insomnia

Insomnia is a sleep disorder that causes difficulty in falling asleep and maintaining sleep throughout the night. The condition can be short-term or chronic, and it causes one to get nonrestorative sleep. Insomnia is commonly caused by factors including poor sleep hygiene, depression, anxiety, some types of medications, and underlying medical conditions. People with insomnia do not get good quality sleep and end up being sleep deprived.

Diagnosis

In hospitals, sleep deprivation and its possible causes can be identified using different tests, including:

1. Polysomnography

A Polysomnography (PSG) is a sleep study that is used to analyze a person’s brain and body activity when asleep. A sleep deprived person has a high sleep propensity and is likely to fall asleep within a short period during the test. The individual will also fall asleep abruptly, even when carrying out activities that require high levels of alertness. Doctors may review a patient’s lifestyle and sleep habits before carrying out a sleep study to help get the background of one’s sleep deprivation.

2. Epworth Sleepiness Scale (ESS)

An ESS is used to measure and analyze a person’s daytime sleepiness. Individuals who are sleep deprived commonly feel sleepy during the day, and the sleepiness can affect their daily activities. The ESS is used as a screening tool to examine and determine the level of sleepiness. The test involves a questionnaire probing one’s sleep habits in different situations during the day. The patient fills it out by indicating their probability of falling asleep in different situations. The test has a scale of 0 to 24, and a person who scores over 16 requires further assessment. ESS and PSG results are commonly used together in diagnosing sleep deprivation.

3. The Multiple Sleep Latency Test (MSLT)

MSLT is a test used to measure the time that a person takes to fall asleep. A sleep deprived person is likely to fall asleep within a short period. They, therefore, have a short sleep latency and tend to fall asleep within less than two minutes. The results of this test can vary depending on the person’s sleep efficiency, sleep duration, drug use, and physical exercise. As an individual continues to lack sufficient sleep, the sleep latency continues to decrease.

4. The Maintenance of Wakefulness Test (MWT)

MWT is a test quite similar to MSLT because it is also used to measure sleep latency. It, however, requires the person to stay awake and resist falling asleep. A sleep-deprived person shows low sleep latency.  They easily fall asleep and struggle to stay awake.

5.     Cognitive assessments

Cognitive assessments are necessary to assess sleep deprivation and its effects on the brain. The lack of sleep has been found to affect different cognitive functions. It has significant effects on activities that require alertness, vigilance, and attentiveness. The cognitive assessments show valid reflections of the effects of lack of sleep on the activity of the brain during wakefulness. Most cognitive assessments involve studying the dorsolateral prefrontal cortex, which plays a major role in controlling alertness.

Functional neuroimaging is a common technique used in cognitive assessment. It shows the effects that sleep deprivation has on the brain. Functional neuroimaging identifies the changes in the brain that are a result of sleep deprivation. These changes take place in the frontal and parietal control regions, secondary sensory processing regions, and the thalamic areas. Neuroimaging shows the prefrontal cortex as the main region that is affected by sleep deprivation.

There are different methods of Functional neuroimaging that are used in cognitive assessment, including:

  • Positron emission tomography (PET)
  • Functional magnetic resonance imaging (FMRI)

These methods examine brain metabolism and changes in neural activity that are related to sleep deprivation.

6. Assessment of underlying health conditions

Sleep deprivation can be as a result of health conditions, such as depression, anxiety, gastrointestinal disturbances, musculoskeletal pain, and the Restless Leg syndrome. This condition occurs as a symptom of other underlying health conditions in many cases. Doctors usually review the patient’s medical history and test them for potential causal health problems. The medications that a patient takes can also lead to sleep deprivation, including oxycodone, codeine, methylphenidate, and ephedrine. Thus, doctors also review one’s active medication use to determine whether they may be contributing to sleep deprivation.

Treatment

Sleep deprivation is mainly treated by addressing the problem that may be causing it, especially lack of sufficient sleep. The condition can be treated using different medications, supplements and lifestyle changes that improve one’s sleep quality. The following are the common treatment options:

1.  Use of hypnotic medications

Hypnotic medications, commonly known as sleeping pills, are used to induce sleep in people who have trouble falling asleep and maintaining sleep throughout the night. These medications are used to treat insomnia, a sleep disorder that causes sleep deprivation.  The common types of hypnotic medications that can be used to treat sleep deprivation include:

a.  Benzodiazepines

Benzodiazepines are drugs that slow down the activity of the brain and induce sleepiness. The commonly used benzodiazepines are Xanax, Ativan, Librium, Valium, and Halcion

b.  Nonbenzodiazepine receptor agonists

These medications are used to treat insomnia and are effective because they do not have adverse effects on the body. The basic forms of Nonbenzodiazepine receptor agonists include:

  • Zolpidem
  • Zaleplon
  • Eszopiclone

c.   Melatonin receptor agonists

These medications bind to melatonin receptors and activate them, enabling the production of melatonin. The hormone induces sleep and improves sleep quality. The common melatonin receptor agonists are:

  • Ramelteon
  • Agomelatine
  • Tasimelteon

d.  Antidepressants

Antidepressants, when used in low doses, can be used to induce sleep. They have a sedating effect that improves sleep quality. The common antidepressants are:

  • Trazodone
  • Amitriptyline
  • Doxepin

2.  Melatonin supplements

The lack of melatonin is a major cause of sleep deprivation, thus OTC melatonin supplements can help alleviate the condition. The supplements are sold in the form of tablets and liquids. When taken they help a person fall asleep and stay asleep throughout the night. Avoiding stimulants when taking melatonin supplements can increase their effectiveness in improving sleep quality.

3.  Proper sleep hygiene

Different practices can help a person get sufficient night time sleep. They include:

  • Avoiding meals too close before bedtime
  • Avoiding caffeine, nicotine, and alcohol before bedtime
  • Sleeping in a dark and quiet environment
  • Following a regular sleep schedule
  • Avoiding naps during the day
  • Having fixed work schedules

4. Self-care

Sleep deprivation increases the risk of sleep-related accidents. It induces psychomotor impairments, same as alcohol. Car crashes are common among the sleep deprived since they can fall asleep abruptly. The condition, therefore, poses a risk to oneself and public safety. A sleep-deprived person can practice self-care by avoiding sensitive tasks that require high levels of alertness, including driving motor vehicles and operating other machinery.

Conclusion

Sleep deprivation is a major sleep disorder throughout the world that affects people’s normal activity and health. It is caused by a lack of sufficient sleep that can be caused by various factors such as underlying health conditions and  poor sleep hygiene. The condition can lead to harm if left untreated because it can cause one to fall asleep when undertaking tasks that require high levels of alertness and concentration, such as driving. It is treated using medications that help a person get sufficient sleep, known as hypnotic medications, which include benzodiazepines, non-benzodiazepine receptor agonists, melatonin receptor agonists, and antidepressants. Melatonin supplements can also help improve a person’s sleep quality without the nasty side effects prescriptions meds bring. Doctors also recommend having proper sleep hygiene to ensure that one gets uninterrupted sleep to feel refreshed in the morning.

 

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