Photo by Kinga Cichewicz
What is Sleep Debt?
Sleep debt is a sleep deficit that accumulates over a period of time, caused by insufficiencies either in the amount of sleep or the quality of sleep a person experiences from one day to the next. Over the past two decades there has been a rising trend in self-reported sleep debts, leading some researchers to call it an “epidemic” with great costs to our health, our economies, and our well being as a nation.
Medical recommendations suggest that the average adult requires seven to nine hours of sleep daily for optimal health and functioning. Compare this to numbers of sleep hours people are reporting and you see a pattern of widespread sleep debt with consequences ranging from short-term fatigue to long-term debilitating diseases.
According to the Centers for Disease Control and Prevention (CDC), a third of U.S. adults now report less than the medically recommended amount of sleep on average nights. In addition, an estimated 50 to 70 million Americans have chronic sleep disorders such as insomnia, daytime fatigue, and sleep apnea.
For the most part, this problem remains unrecognized and unacknowledged as people tend to shrug off lost sleep hours and treat the issue as a modern inconvenience. But the effects are more serious than most people realize.
Just How Important is a Good Night’s Sleep?
The short answer: Your life depends on it. Drowsy driving alone causes an average of a million accidents, 500,000 injuries, and 8,000 deaths annually in the U.S. According to Harvard.edu, a single night of limited sleep can potentially impair one’s performance as much as a blood-alcohol level of .10 percent, an amount above the legal limit to drive in every state. And accidents are only part of the story. Inadequate sleep affects brain and body physiology in ways that can inhibit a number of vital functions for physical and mental health, leading doctors and sleep scientists to believe that quality sleep habits are as important to human well-being as proper nutrition and exercise.
What the Science Tells Us
The consensus among sleep scientists and researchers is that it doesn’t take long for the negative consequences of sleep debt to develop. A landmark study at the University of Chicago monitored a group of volunteers who slept four hours nightly for only a single week, and by the sixth day they consistently developed higher blood pressure, higher levels of the stress hormone cortisol, and even showed signs of insulin resistance — a precursor to type 2 diabetes. Even more surprising was the rate of reversal when the volunteers returned to normal sleep hours.
Studies like this show time and again how important sleep is to our lives. Even brief reductions in nightly sleep can lead very rapidly to higher stress levels, anxiety and irritability, daytime fatigue, slowed reaction time, increased distractibility, and impaired memory. What this adds up to is a lower quality of life, a number of additional stressors on both self and others, and decreased performance on the job.
Had these periods of reduced sleep continued, these volunteers would develop health problems ranging from hypertension, obesity, and immunity impairment to fully developed diabetes, heart disease, stroke, cardiovascular disease, kidney disease, and liver disease. Mood disorders and psychiatric problems can develop as well, and more prolonged sleep deprivation is linked to higher risks of cancer and shortened life spans. For those suffering from chronic insomnia, the treatment will depend on their specific condition and the recommendations of a physician. But for many, these consequences are easily avoided with a change in sleep habits.
Top Diagnoses: Sleep Apnea and Insomnia
Sleep disorders are on the rise, and the leading cause is not just unhealthy lifestyle choices, but rising levels of undiagnosed and untreated illnesses. And aside from insomnia, the most prevalent sleep disorder in America is obstructive sleep apnea (OSA), a disorder so common that groups like Sleep Apnea Treatment Centers of America call it “the fastest growing health epidemic in the United States.”
Sleep apnea, a disorder causing shallow or halted breathing during sleep, currently affects over 25 million Americans. And though efforts to diagnose and treat the disorder have been improved by recent increases in public awareness, it is estimated that roughly 80% of sleep apnea sufferers remain undiagnosed, and at least 50% are non-compliant with treatment. One reason for this discrepancy is the treatment itself, a combination of lifestyle changes and Continued Positive Airway Pressure (CPAP) therapy, which some patients stop using due to the inconvenience of wearing a mask at night. What some of these patients may not realize is the extent of the physical and psychological benefits one can gain from this comparatively minor inconvenience.
The Body’s Reboot System
A recent study published in the journal Nature has further elaborated on the science of sleep and how our brains need it to function. A number of special proteins called “sleep need index phosphoproteins” (SNIPPs) accumulate between brain cells during waking hours to facilitate our memory synapses. As we sleep at night these proteins are removed in a kind of rebooting process that clears our minds of excessive and unnecessary activity. A breakthrough discovery on its own, this study is also part of a new and comprehensive understanding of the functions of sleep.
In an age of superfluous information and increasingly stimulating environments, our sleep hours allow our bodily systems to reset, helping us cope and even thrive despite the challenges. On the other hand, we’re also learning more about the damage we’re doing when we prioritize a few extra waking hours over a full night’s sleep. By looking deeper at what sleep does for us, it is easy to see how inadequate sleep can affect our ability to perform the tasks of our everyday lives.
While the U.S. population ages and obesity remains on the rise, the number of people affected by sleep disorders like OSA is expected to continue its upward trajectory in the coming years, and America is not unique in this respect. The issue of sleep disorders is a global concern affecting a growing sector of the world population in the 21st century. But what should we do about it?
Step One: Whether you’re behind the wheel of a car or walking across a street, exhaustion can sneak up when you’re not expecting it. Therefore, your first concern should be for meeting your basic needs of safety and survival. This requires as much sleep as you can afford to give yourself. Adopting good sleep habits means raising quality sleep standards to the highest priority.
Step Two: Address your sleep problems immediately. Some common symptoms of sleep apnea include sudden awakenings from sleep, snoring, choking or gasping, headaches, and daytime drowsiness. If this sounds familiar, get yourself tested. Even insomnia can be a symptom of apnea events in the night. The sooner you are tested, the sooner you will know. And knowledge is the precursor to positive change.
Step Three: Making new habits work. Getting tested is an important step, but if you’re diagnosed, it is your responsibility to follow through with the treatment. This can include medications, therapies, and even surgery. But for many individuals with sleep problems, a change in nightly routines, schedules, and sometimes bedroom environments, can all play an important role in sleep debt recovery.
Another important change is exercise. It is not just what you do at night that affects sleep, but how you spend your waking hours. If you are not currently getting exercise; do something about it. Even a few minutes of sustained movement can make a big difference and leave you physically tired for the sleep hours later in the night. Also, avoiding stimulants and preparing for relaxation at late hours can get your melatonin going as the time for sleep draws near.
Finally, tracking your sleep experiences with smart technology is a great way to create a detailed log of your efforts. Smartphone apps and other record-keeping software, bedside monitors, and wearable items like smart-bracelets or smart-watches can collect and analyze sleep data with little effort on your part, keeping detailed records for easy transmission to a clinic or family physician. In order to pay off your sleep debt and embrace a healthier lifestyle, you may need to make a compromise with your current routine.
As a nation and as individuals, we need to demand an absolute minimum of sleep hours that we can abide by. Only by embracing sleep as a valuable part of our lives can we begin to turn the sleep recession around in the direction of a surplus. Just as we value work and productivity, we can continue to maintain the same diligent pursuits with our hearts and minds rested from full nights of pleasant sleep, and pleasant dreams.
The National Healthy Sleep Awareness Project is the sleep science division of Healthy People 2020, which focuses on 10-year objectives for improving the health of all Americans. The Healthy Sleep Project’s primary objectives are to increase medical evaluations for Americans with symptoms of obstructive sleep apnea, reduce vehicular and occupational accidents due to drowsiness, and ensure that more Americans get adequate sleep by the 2020 benchmark.
Sleep apnea: Fastest growing health epidemic in the United States – http://curemysleepapnea.com/partners/sleep-apnea-fastest-growing-health-epidemic-in-the-united-states. Sleep Apnea Tx Centers of America
Get sleep – http://healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/health. Harvard.edu
Consequences of sleep disruption – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/. Dove Medical Press
Sleep and sleep disorders – https://www.cdc.gov/sleep/index.html. Centers for Disease Control and Prevention
New discovery reveals how your brain changes when you need sleep – https://www.forbes.com/sites/fionamcmillan/2018/06/19/new-discovery-reveals-how-your-brain-changes-when-you-need-sleep/#41dc88b56dee. Sleep.
Quantitative phosphoproteomic analysis of the molecular substrates of sleep needs – https://www.nature.com/articles/s41586-018-0218-8. Nature
The great American sleep recession – https://www.cnn.com/2015/02/18/health/great-sleep-recession/. CNN.com
Insufficient sleep: definition, epidemiology, and adverse outcomes – https://www.uptodate.com/contents/insufficient-sleep-definition-epidemiology-and-adverse-outcom. UptoDate.com
Sleep research reveals keys to health – https://www.uchicago.edu/features/20120806_sleep/. University of Chicago Magazine
Prevalence of sleep apnea threatens public health – https://aasm.org/rising-prevalence-of-sleep-apnea-in-u-s-threatens-public-health/. American Academy of Sleep Medicine
Lack of sleep increases your risk of some cancers – https://www.sleepfoundation.org/sleep-news/lack-sleep-increases-your-risk-some-cancers. National Sleep Foundation