an essay about sleep deprivation

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How Lack of Sleep Impacts Cognitive Performance and Focus

Staff Writer

Eric Suni has over a decade of experience as a science writer and was previously an information specialist for the National Cancer Institute.

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Dr. Nilong Vyas

Pediatrician

Dr. Vyas is a pediatrician and founder of Sleepless in NOLA. She specializes in helping parents establish healthy sleep habits for children.

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Table of Contents

How Poor Sleep Affects the Brain

How does poor sleep affect creativity and other cognitive processes, are the cognitive impacts of poor sleep the same for everyone, can sleep disorders affect cognition, does too much sleep affect cognition, will improving sleep quality benefit cognition.

Getting enough hours of high-quality sleep fosters attention and concentration, which are prerequisites for most learning. Sleep also supports numerous other aspects of cognition, including memory, problem-solving, creativity, emotional processing, and judgment. Levels of brain activity fluctuate during each stage of sleep — including both rapid eye movement (REM) and non-REM (NREM) sleep — and evidence increasingly suggests that sleep enhances most types of cognitive function.

For people with sleep deprivation, insomnia, sleep apnea, or other conditions that prevent them from getting adequate rest, short-term daytime cognitive impairment is common. Improving sleep quality can boost cognitive performance, promote sharper thinking, and may reduce the likelihood of age-related cognitive decline.

Is Your Troubled Sleep a Health Risk?

A variety of issues can cause problems sleeping. Answer three questions to understand if it’s a concern you should worry about.

During a typical night of sleep, an individual cycles through the three stages of NREM sleep, followed by a period of REM sleep every 90 to 120 minutes, several times per night. Both the brain and body experience distinct changes during these cycles that correspond to individual stages of sleep . During each part of this process, different chemicals in the brain become activated or deactivated to coordinate rest and recovery.

Poor sleep can take many forms, including short sleep duration or fragmented sleep. Without adequate sleep, the brain struggles to function properly. Because they do not have time to recuperate, neurons in the brain become overworked and less capable of optimal performance in various types of thinking.

The short-term detriments of poor sleep on the brain and cognition can be the result of pulling an occasional all-nighter, while those with chronic sleep problems may see a continuous negative effect on day-to-day tasks. Over the long-term, poor sleep may put someone at a higher risk of cognitive decline and dementia.

What Are the Short-Term Cognitive Impacts of Poor Sleep?

Poor sleep can harm intellectual performance, academic achievement, creative pursuits, and productivity at work. The cognitive impacts of poor sleep can also create safety risks, including drowsy driving . Motor skills, keeping rhythm, and even some types of speech can decline without proper sleep. The potential short-term impacts of poor sleep are wide-ranging:

• Excessive Sleepiness: Drowsiness and fatigue are common daytime effects of a night of poor sleep. In response to excessive fatigue, a person may inadvertently nod off for a few seconds, which is known as a microsleep .
• Poor Attention Span: Poor sleep reduces a person’s attention, as well as their learning and processing. A lack of sleep has also been found to induce effects that are similar to being drunk Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , which slows down thinking and reaction time . Poor sleep also diminishes placekeeping Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , which includes the ability to carry out instructions.
• Reduced Adaptability: Some studies have found lack of sleep to hinder cognitive flexibility, reducing the ability to adapt and thrive in uncertain or changing circumstances. A major reason this occurs is rigid thinking and “feedback blunting” Trusted Source Oxford Academic Journals (OUP) OUP publishes the highest quality journals and delivers this research to the widest possible audience. View Source , in which the capacity to learn and improve on-the-fly is diminished.
• Reduced Emotional Capacity: Poor sleep can also alter how emotional information is understood Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . When learning something new, analyzing a problem, or making a decision, recognizing the emotional context is often important. However, insufficient sleep impedes the ability to properly process the emotional component of information.
• Impaired Judgment: In some cases, this dysregulated emotional response impairs judgment. People who do not get sufficient sleep are more likely to make risky choices Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source and may focus on a potential reward rather than downsides. It can be difficult to learn from these mistakes, since the normal method of processing and consolidating emotional memory is compromised due to lack of sleep.

What Are the Long-Term Cognitive Impacts of Poor Sleep?

Insufficient sleep and sleep fragmentation are frequently associated with cognitive decline and dementia. Furthermore, in people already diagnosed with dementia, poor sleep has been linked to a worse disease prognosis. Some cognitive effects of poor sleep can be felt immediately, but mounting evidence shows that sleep influences your long-term risk of cognition issues:

• Impaired Memory: Both NREM and REM sleep appear to be important for broader memory consolidation Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , which helps reinforce information in the brain so that it can be recalled when needed. NREM sleep has been linked with declarative memory, which includes things like basic facts or statistics, and REM sleep is believed to boost procedural memory such as remembering a sequence of steps. Poor sleep impairs memory consolidation by disrupting the normal process that draws on both NREM and REM sleep for building and retaining memories. Studies have even found that people who are sleep deprived are at risk of forming false memories Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .
• Alzheimer’s Disease: Research shows that sleep helps the brain conduct important housekeeping, such as clearing out potentially dangerous beta amyloid proteins. In Alzheimer’s disease, beta amyloid forms in clusters, called plaques, that worsen cognitive function. Studies have found that even one night of sleep deprivation can increase the amount of beta amyloid in the brain Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . One analysis found a considerably higher risk of Alzheimer’s disease Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source in people with sleep problems, estimating as many as 15% of cases of Alzheimer’s disease were attributable to poor sleep.

Creativity is another aspect of cognition that is hindered by sleeping problems. Connecting loosely associated ideas is a hallmark of creativity, and this ability is strengthened by good sleep. NREM sleep provides an opportunity for information to be restructured and reorganized Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source in the brain, while new ideas and links between thoughts often emerge during REM sleep. These processes enable insight, a core element of innovation and creative problem-solving.

Limited or restless sleep can also indirectly affect cognition. For example, migraine sufferers are more likely to have morning headache attacks Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source when they do not get enough sleep, and lack of sleep can increase the risk of infections Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source like the common cold. Sleep deprivation may worsen symptoms of mental health conditions like anxiety and depression. These and numerous other physical and mental health issues are shaped by sleep quality, and may affect a person’s attention and concentration.

Not everyone is affected by poor sleep in the same way. Studies have found that some individuals may be more susceptible to cognitive impairment from sleep deprivation, and this may be influenced by genetics.

Research has discovered that adults are better at overcoming the effects of sleep deprivation than younger people. Teens are considered to be at a heightened risk for detrimental effects of poor sleep on thinking, decision-making, and academic performance because of the ongoing brain development that occurs during teen years .

Some studies have also found that women are more adept at coping with the effects of sleep deprivation than men, although it is not yet clear if this is related to biological factors, social and cultural influences, or a combination of both.

Sleep disorders, like insomnia, frequently involve insufficient or fragmented sleep, so it comes as little surprise that they can be linked to cognitive impairment.

Obstructive sleep apnea (OSA) is among the most common sleep disorders. It occurs when the airway gets blocked, which then leads to lapses in breathing during sleep and reduced oxygen in the blood. OSA has been associated with daytime sleepiness as well as notable cognitive problems related to attention, thinking, memory, and communication. Studies have also found that people with sleep apnea have a higher risk of developing dementia .

Many studies examining the effects of sleep on thinking have found that an excess of sleep can also be problematic for brain health. In many cases, research has discovered that both too little and too much sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source are associated with cognitive decline.

The explanation for this association remains unclear. It is not known if excess sleep is caused by a coexisting health condition that may also predispose someone to cognitive problems. Overall, these research findings are an important reminder to get the right amount of sleep each night.

For people with sleeping problems, improving sleep quality offers a practical way to enhance cognitive performance. Getting the recommended amount of uninterrupted sleep can help the brain recuperate and avoid many of the negative consequences of poor sleep on diverse aspects of thinking.

Researchers and public health experts increasingly view good sleep as a potential form of prevention against dementia and Alzheimer’s disease Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Although more studies are needed to conclusively determine sleep’s role in preventing cognitive decline, early research suggests that taking steps to improve sleep may reduce the longer-term likelihood of developing Alzheimer’s disease.

Tips To Improve Sleep and Cognitive Performance

Anyone who feels that they are experiencing cognitive impairment or excessive daytime sleepiness should first speak with their doctor. A physician can help identify or rule out any other conditions, including sleep disorders, that may be causing these symptoms. They can also discuss strategies to get better sleep.

Many approaches to improving sleep start with healthy sleep hygiene . By optimizing your bedroom environment and everyday habits and routines, you can eliminate many common barriers to sleep. Setting a regular bedtime and sleep schedule, avoiding alcohol and caffeine in the evening, and minimizing electronics in the bedroom are a few examples of sleep hygiene tips that can make it easier to rest well each night.

About Our Editorial Team

Eric Suni, Staff Writer

Medically Reviewed by

Dr. Nilong Vyas, Pediatrician MD

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Whitney, P., Hinson, J. M., Jackson, M. L., & Van Dongen, H. P. (2015). Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback. Sleep, 38(5), 745–754.

Killgore, W. D. (2010). Effects of sleep deprivation on cognition. Progress in Brain Research, 185, 105–129.

Van Someren, E. J., Cirelli, C., Dijk, D. J., Van Cauter, E., Schwartz, S., & Chee, M. W. (2015). Disrupted sleep: From molecules to cognition. The Journal of Neuroscience, 35(41), 13889–13895.

Maquet P. (2000). Sleep on it!. Nature neuroscience, 3(12), 1235–1236.

Lo, J. C., Chong, P. L., Ganesan, S., Leong, R. L., & Chee, M. W. (2016). Sleep deprivation increases formation of false memory. Journal of sleep research, 25(6), 673–682.

Shokri-Kojori, E., Wang, G. J., Wiers, C. E., Demiral, S. B., Guo, M., Kim, S. W., Lindgren, E., Ramirez, V., Zehra, A., Freeman, C., Miller, G., Manza, P., Srivastava, T., De Santi, S., Tomasi, D., Benveniste, H., & Volkow, N. D. (2018). β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proceedings of the National Academy of Sciences of the United States of America, 115(17), 4483–4488.

Bubu, O. M., Brannick, M., Mortimer, J., Umasabor-Bubu, O., Sebastião, Y. V., Wen, Y., Schwartz, S., Borenstein, A. R., Wu, Y., Morgan, D., & Anderson, W. M. (2017). Sleep, Cognitive impairment, and Alzheimer’s disease: A Systematic Review and Meta-Analysis. Sleep, 40(1), 10.1093/sleep/zsw032.

Yordanova, J., Kolev, V., Wagner, U., & Verleger, R. (2010). Differential associations of early- and late-night sleep with functional brain states promoting insight to abstract task regularity. PloS one, 5(2), e9442.

Lin, Y. K., Lin, G. Y., Lee, J. T., Lee, M. S., Tsai, C. K., Hsu, Y. W., Lin, Y. Z., Tsai, Y. C., & Yang, F. C. (2016). Associations Between Sleep Quality and Migraine Frequency: A Cross-Sectional Case-Control Study. Medicine, 95(17), e3554.

Prather, A. A., Janicki-Deverts, D., Hall, M. H., & Cohen, S. (2015). Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep, 38(9), 1353–1359.

Ma, Y., Liang, L., Zheng, F., Shi, L., Zhong, B., & Xie, W. (2020). Association Between Sleep Duration and Cognitive Decline. JAMA network open, 3(9), e2013573.

Spira, A. P., Chen-Edinboro, L. P., Wu, M. N., & Yaffe, K. (2014). Impact of sleep on the risk of cognitive decline and dementia. Current Opinion in Psychiatry, 27(6):478-83.

Learn More About Sleep Deprivation

Can a Lack of Sleep Cause Headaches?

How Sleep Deprivation Affects Your Heart

Interrupted Sleep: Causes & Helpful Tips

Sleep Deprivation: Symptoms, Treatment, & Effects

Lack of Sleep May Increase Calorie Consumption

Sleepless Nights: How to Function on No Sleep

What All-Nighters Do To Your Cognition

Sleep Deprivation and Reaction Time

Understanding Sleep Deprivation and New Parenthood

Effects of Sleep Deprivation

Other articles of interest, sleep solutions, sleep hygiene, sleep apnea.

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Health Infographic

The Effects of Sleep Deprivation

Sleep deprivation effects.

Not getting enough sleep can affect your health in far-reaching and surprising ways.

Increased Risk for Colorectal Cancer

36% increased in risk for colorectal cancer

Impacted Immunity

Less active immunity protectors called natural killer cells

Increased Risk for Type 2 Diabetes

Nearly 3X increased risk for developing type 2 diabetes

48% increased risk of developing heart disease

Higher Blood Pressure

Increased risk of high blood pressure

3X more likely to catch a cold

Increased Cravings

Increased cravings for sweet, salty and savory food

Feeling Hungrier

Higher levels of the hunger hormone ghrelin

Higher Risk for Obesity

50% higher risk for obesity if you get less than 5 hours of sleep nightly

Less Appetite Control

Lower levels of the appetite-control hormone leptin

Brain Effects

Brain Effects Sleep Deprivation Leads to Greater Risk For:

• Irritability
• Forgetfulness
• Fuzzy Thinking

4 Signs You Might Have Sleep Apnea

Do You Need Sleep Help?

Lack of Sleep and Cancer: Is There a Connection?

Related Topics

• Health Risks of Poor Sleep
• Sleep Conditions

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Among teens, sleep deprivation an epidemic

Sleep deprivation increases the likelihood teens will suffer myriad negative consequences, including an inability to concentrate, poor grades, drowsy-driving incidents, anxiety, depression, thoughts of suicide and even suicide attempts.

October 8, 2015 - By Ruthann Richter

The most recent national poll shows that more than 87 percent of U.S. high school students get far less than the recommended eight to 10 hours of sleep each night. Christopher Silas Neal

Carolyn Walworth, 17, often reaches a breaking point around 11 p.m., when she collapses in tears. For 10 minutes or so, she just sits at her desk and cries, overwhelmed by unrelenting school demands. She is desperately tired and longs for sleep. But she knows she must move through it, because more assignments in physics, calculus or French await her. She finally crawls into bed around midnight or 12:30 a.m.

The next morning, she fights to stay awake in her first-period U.S. history class, which begins at 8:15. She is unable to focus on what’s being taught, and her mind drifts. “You feel tired and exhausted, but you think you just need to get through the day so you can go home and sleep,” said the Palo Alto, California, teen. But that night, she will have to try to catch up on what she missed in class. And the cycle begins again.

“It’s an insane system. … The whole essence of learning is lost,” she said.

Walworth is among a generation of teens growing up chronically sleep-deprived. According to a 2006 National Sleep Foundation poll, the organization’s most recent survey of teen sleep, more than 87 percent of high school students in the United States get far less than the recommended eight to 10 hours, and the amount of time they sleep is decreasing — a serious threat to their health, safety and academic success. Sleep deprivation increases the likelihood teens will suffer myriad negative consequences, including an inability to concentrate, poor grades, drowsy-driving incidents, anxiety, depression, thoughts of suicide and even suicide attempts. It’s a problem that knows no economic boundaries.

While studies show that both adults and teens in industrialized nations are becoming more sleep deprived, the problem is most acute among teens, said Nanci Yuan , MD, director of the Stanford Children’s Health Sleep Center . In a detailed 2014 report, the American Academy of Pediatrics called the problem of tired teens a public health epidemic.

“I think high school is the real danger spot in terms of sleep deprivation,” said William Dement , MD, PhD, founder of the Stanford Sleep Disorders Clinic , the first of its kind in the world. “It’s a huge problem. What it means is that nobody performs at the level they could perform,” whether it’s in school, on the roadways, on the sports field or in terms of physical and emotional health.

Social and cultural factors, as well as the advent of technology, all have collided with the biology of the adolescent to prevent teens from getting enough rest. Since the early 1990s, it’s been established that teens have a biologic tendency to go to sleep later — as much as two hours later — than their younger counterparts.

Yet when they enter their high school years, they find themselves at schools that typically start the day at a relatively early hour. So their time for sleep is compressed, and many are jolted out of bed before they are physically or mentally ready. In the process, they not only lose precious hours of rest, but their natural rhythm is disrupted, as they are being robbed of the dream-rich, rapid-eye-movement stage of sleep, some of the deepest, most productive sleep time, said pediatric sleep specialist Rafael Pelayo , MD, with the Stanford Sleep Disorders Clinic.

“When teens wake up earlier, it cuts off their dreams,” said Pelayo, a clinical professor of psychiatry and behavioral sciences. “We’re not giving them a chance to dream.”

Teens have a biologic tendency to go to sleep later, yet many high schools start the day at a relatively early hour, disrupting their natural rhythym. Monkey Business/Fotolia

Understanding teen sleep

On a sunny June afternoon, Dement maneuvered his golf cart, nicknamed the Sleep and Dreams Shuttle, through the Stanford University campus to Jerry House, a sprawling, Mediterranean-style dormitory where he and his colleagues conducted some of the early, seminal work on sleep, including teen sleep.

Beginning in 1975, the researchers recruited a few dozen local youngsters between the ages of 10 and 12 who were willing to participate in a unique sleep camp. During the day, the young volunteers would play volleyball in the backyard, which faces a now-barren Lake Lagunita, all the while sporting a nest of electrodes on their heads.

At night, they dozed in a dorm while researchers in a nearby room monitored their brain waves on 6-foot electroencephalogram machines, old-fashioned polygraphs that spit out wave patterns of their sleep.

One of Dement’s colleagues at the time was Mary Carskadon, PhD, then a graduate student at Stanford. They studied the youngsters over the course of several summers, observing their sleep habits as they entered puberty and beyond.

Dement and Carskadon had expected to find that as the participants grew older, they would need less sleep. But to their surprise, their sleep needs remained the same — roughly nine hours a night — through their teen years. “We thought, ‘Oh, wow, this is interesting,’” said Carskadon, now a professor of psychiatry and human behavior at Brown University and a nationally recognized expert on teen sleep.

Moreover, the researchers made a number of other key observations that would plant the seed for what is now accepted dogma in the sleep field. For one, they noticed that when older adolescents were restricted to just five hours of sleep a night, they would become progressively sleepier during the course of the week. The loss was cumulative, accounting for what is now commonly known as sleep debt.

“The concept of sleep debt had yet to be developed,” said Dement, the Lowell W. and Josephine Q. Berry Professor in the Department of Psychiatry and Behavioral Sciences. It’s since become the basis for his ongoing campaign against drowsy driving among adults and teens. “That’s why you have these terrible accidents on the road,” he said. “People carry a large sleep debt, which they don’t understand and cannot evaluate.”

The researchers also noticed that as the kids got older, they were naturally inclined to go to bed later. By the early 1990s, Carskadon established what has become a widely recognized phenomenon — that teens experience a so-called sleep-phase delay. Their circadian rhythm — their internal biological clock — shifts to a later time, making it more difficult for them to fall asleep before 11 p.m.

Teens are also biologically disposed to a later sleep time because of a shift in the system that governs the natural sleep-wake cycle. Among older teens, the push to fall asleep builds more slowly during the day, signaling them to be more alert in the evening.

“It’s as if the brain is giving them permission, or making it easier, to stay awake longer,” Carskadon said. “So you add that to the phase delay, and it’s hard to fight against it.”

Pressures not to sleep

After an evening with four or five hours of homework, Walworth turns to her cellphone for relief. She texts or talks to friends and surfs the Web. “It’s nice to stay up and talk to your friends or watch a funny YouTube video,” she said. “There are plenty of online distractions.”

While teens are biologically programmed to stay up late, many social and cultural forces further limit their time for sleep. For one, the pressure on teens to succeed is intense, and they must compete with a growing number of peers for college slots that have largely remained constant. In high-achieving communities like Palo Alto, that translates into students who are overwhelmed by additional homework for Advanced Placement classes, outside activities such as sports or social service projects, and in some cases, part-time jobs, as well as peer, parental and community pressures to excel.

William Dement

At the same time, today’s teens are maturing in an era of ubiquitous electronic media, and they are fervent participants. Some 92 percent of U.S. teens have smartphones, and 24 percent report being online “constantly,” according to a 2015 report by the Pew Research Center. Teens have access to multiple electronic devices they use simultaneously, often at night. Some 72 percent bring cellphones into their bedrooms and use them when they are trying to go to sleep, and 28 percent leave their phones on while sleeping, only to be awakened at night by texts, calls or emails, according to a 2011 National Sleep Foundation poll on electronic use. In addition, some 64 percent use electronic music devices, 60 percent use laptops and 23 percent play video games in the hour before they went to sleep, the poll found. More than half reported texting in the hour before they went to sleep, and these media fans were less likely to report getting a good night’s sleep and feeling refreshed in the morning. They were also more likely to drive when drowsy, the poll found.

The problem of sleep-phase delay is exacerbated when teens are exposed late at night to lit screens, which send a message via the retina to the portion of the brain that controls the body’s circadian clock. The message: It’s not nighttime yet.

Yuan, a clinical associate professor of pediatrics, said she routinely sees young patients in her clinic who fall asleep at night with cellphones in hand.

“With academic demands and extracurricular activities, the kids are going nonstop until they fall asleep exhausted at night. There is not an emphasis on the importance of sleep, as there is with nutrition and exercise,” she said. “They say they are tired, but they don’t realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity.”

The role of parents

Adolescents are also entering a period in which they are striving for autonomy and want to make their own decisions, including when to go to sleep. But studies suggest adolescents do better in terms of mood and fatigue levels if parents set the bedtime — and choose a time that is realistic for the child’s needs. According to a 2010 study published in the journal Sleep , children are more likely to be depressed and to entertain thoughts of suicide if a parent sets a late bedtime of midnight or beyond.

In families where parents set the time for sleep, the teens’ happier, better-rested state “may be a sign of an organized family life, not simply a matter of bedtime,” Carskadon said. “On the other hand, the growing child and growing teens still benefit from someone who will help set the structure for their lives. And they aren’t good at making good decisions.”

They say they are tired, but they don’t realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity.

According to the 2011 sleep poll, by the time U.S. students reach their senior year in high school, they are sleeping an average of 6.9 hours a night, down from an average of 8.4 hours in the sixth grade. The poll included teens from across the country from diverse ethnic backgrounds.

American teens aren’t the worst off when it comes to sleep, however; South Korean adolescents have that distinction, sleeping on average 4.9 hours a night, according to a 2012 study in Sleep by South Korean researchers. These Asian teens routinely begin school between 7 and 8:30 a.m., and most sign up for additional evening classes that may keep them up as late as midnight. South Korean adolescents also have relatively high suicide rates (10.7 per 100,000 a year), and the researchers speculate that chronic sleep deprivation is a contributor to this disturbing phenomenon.

By contrast, Australian teens are among those who do particularly well when it comes to sleep time, averaging about nine hours a night, possibly because schools there usually start later.

Regardless of where they live, most teens follow a pattern of sleeping less during the week and sleeping in on the weekends to compensate. But many accumulate such a backlog of sleep debt that they don’t sufficiently recover on the weekend and still wake up fatigued when Monday comes around.

Moreover, the shifting sleep patterns on the weekend — late nights with friends, followed by late mornings in bed — are out of sync with their weekday rhythm. Carskadon refers to this as “social jet lag.”

“Every day we teach our internal circadian timing system what time it is — is it day or night? — and if that message is substantially different every day, then the clock isn’t able to set things appropriately in motion,” she said. “In the last few years, we have learned there is a master clock in the brain, but there are other clocks in other organs, like liver or kidneys or lungs, so the master clock is the coxswain, trying to get everybody to work together to improve efficiency and health. So if the coxswain is changing the pace, all the crew become disorganized and don’t function well.”

This disrupted rhythm, as well as the shortage of sleep, can have far-reaching effects on adolescent health and well-being, she said.

“It certainly plays into learning and memory. It plays into appetite and metabolism and weight gain. It plays into mood and emotion, which are already heightened at that age. It also plays into risk behaviors — taking risks while driving, taking risks with substances, taking risks maybe with sexual activity. So the more we look outside, the more we’re learning about the core role that sleep plays,” Carskadon said.

Many studies show students who sleep less suffer academically, as chronic sleep loss impairs the ability to remember, concentrate, think abstractly and solve problems. In one of many studies on sleep and academic performance, Carskadon and her colleagues surveyed 3,000 high school students and found that those with higher grades reported sleeping more, going to bed earlier on school nights and sleeping in less on weekends than students who had lower grades.

Sleep is believed to reinforce learning and memory, with studies showing that people perform better on mental tasks when they are well-rested. “We hypothesize that when teens sleep, the brain is going through processes of consolidation — learning of experiences or making memories,” Yuan said. “It’s like your brain is filtering itself — consolidating the important things and filtering out those unimportant things.” When the brain is deprived of that opportunity, cognitive function suffers, along with the capacity to learn.

“It impacts academic performance. It’s harder to take tests and answer questions if you are sleep-deprived,” she said.

That’s why cramming, at the expense of sleep, is counter­productive, said Pelayo, who advises students: Don’t lose sleep to study, or you’ll lose out in the end.

The panic attack

Chloe Mauvais, 16, hit her breaking point at the end of a very challenging sophomore year when she reached “the depths of frustration and anxiety.” After months of late nights spent studying to keep up with academic demands, she suffered a panic attack one evening at home.

“I sat in the living room in our house on the ground, crying and having horrible breathing problems,” said the senior at Menlo-Atherton High School. “It was so scary. I think it was from the accumulated stress, the fear over my grades, the lack of sleep and the crushing sense of responsibility. High school is a very hard place to be.”

We hypothesize that when teens sleep, the brain is going through processes of consolidation — learning of experiences or making memories. It’s like your brain is filtering itself.

Where she once had good sleep habits, she had drifted into an unhealthy pattern of staying up late, sometimes until 3 a.m., researching and writing papers for her AP European history class and prepping for tests.

“I have difficulty remembering events of that year, and I think it’s because I didn’t get enough sleep,” she said. “The lack of sleep rendered me emotionally useless. I couldn’t address the stress because I had no coherent thoughts. I couldn’t step back and have perspective. … You could probably talk to any teen and find they reach their breaking point. You’ve pushed yourself so much and not slept enough and you just lose it.”

The experience was a kind of wake-up call, as she recognized the need to return to a more balanced life and a better sleep pattern, she said. But for some teens, this toxic mix of sleep deprivation, stress and anxiety, together with other external pressures, can tip their thinking toward dire solutions.

Research has shown that sleep problems among adolescents are a major risk factor for suicidal thoughts and death by suicide, which ranks as the third-leading cause of fatalities among 15- to 24-year-olds. And this link between sleep and suicidal thoughts remains strong, independent of whether the teen is depressed or has drug and alcohol issues, according to some studies.

“Sleep, especially deep sleep, is like a balm for the brain,” said Shashank Joshi, MD, associate professor of psychiatry and behavioral sciences at Stanford. “The better your sleep, the more clearly you can think while awake, and it may enable you to seek help when a problem arises. You have your faculties with you. You may think, ‘I have 16 things to do, but I know where to start.’ Sleep deprivation can make it hard to remember what you need to do for your busy teen life. It takes away the support, the infrastructure.”

Sleep is believed to help regulate emotions, and its deprivation is an underlying component of many mood disorders, such as anxiety, depression and bipolar disorder. For students who are prone to these disorders, better sleep can help serve as a buffer and help prevent a downhill slide, Joshi said.

Rebecca Bernert, PhD, who directs the Suicide Prevention Research Lab at Stanford, said sleep may affect the way in which teens process emotions. Her work with civilians and military veterans indicates that lack of sleep can make people more receptive to negative emotional information, which they might shrug off if they were fully rested, she said.

“Based on prior research, we have theorized that sleep disturbances may result in difficulty regulating emotional information, and this may lower the threshold for suicidal behaviors among at-risk individuals,” said Bernert, an instructor of psychiatry and behavioral sciences. Now she’s studying whether a brief nondrug treatment for insomnia reduces depression and risk for suicide.

Sleep deprivation also has been shown to lower inhibitions among both adults and teens. In the teen brain, the frontal lobe, which helps restrain impulsivity, isn’t fully developed, so teens are naturally prone to impulsive behavior. “When you throw into the mix sleep deprivation, which can also be disinhibiting, mood problems and the normal impulsivity of adolescence, then you have a potentially dangerous situation,” Joshi said.

Some schools shift

Given the health risks associated with sleep problems, school districts around the country have been looking at one issue over which they have some control: when school starts in the morning. The trend was set by the town of Edina, Minnesota, a well-to-do suburb of Minneapolis, which conducted a landmark experiment in student sleep in the late 1990s. It shifted the high school’s start time from 7:20 a.m. to 8:30 a.m. and then asked University of Minnesota researchers to look at the impact of the change. The researchers found some surprising results: Students reported feeling less depressed and less sleepy during the day and more empowered to succeed. There was no comparable improvement in student well-being in surrounding school districts where start times remained the same.

With these findings in hand, the entire Minneapolis Public School District shifted start times for 57,000 students at all of its schools in 1997 and found similarly positive results. Attendance rates rose, and students reported getting an hour’s more sleep each school night — or a total of five more hours of sleep a week — countering skeptics who argued that the students would respond by just going to bed later.

For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth.

Other studies have reinforced the link between later start times and positive health benefits. One 2010 study at an independent high school in Rhode Island found that after delaying the start time by just 30 minutes, students slept more and showed significant improvements in alertness and mood. And a 2014 study in two counties in Virginia found that teens were much less likely to be involved in car crashes in a county where start times were later, compared with a county with an earlier start time.

Bolstered by the evidence, the American Academy of Pediatrics in 2014 issued a strong policy statement encouraging middle and high school districts across the country to start school no earlier than 8:30 a.m. to help preserve the health of the nation’s youth. Some districts have heeded the call, though the decisions have been hugely contentious, as many consider school schedules sacrosanct and cite practical issues, such as bus schedules, as obstacles.

In Fairfax County, Virginia, it took a decade of debate before the school board voted in 2014 to push back the opening school bell for its 57,000 students. And in Palo Alto, where a recent cluster of suicides has caused much communitywide soul-searching, the district superintendent issued a decision in the spring, over the strenuous objections of some teachers, students and administrators, to eliminate “zero period” for academic classes — an optional period that begins at 7:20 a.m. and is generally offered for advanced studies.

Certainly, changing school start times is only part of the solution, experts say. More widespread education about sleep and more resources for students are needed. Parents and teachers need to trim back their expectations and minimize pressures that interfere with teen sleep. And there needs to be a cultural shift, including a move to discourage late-night use of electronic devices, to help youngsters gain much-needed rest.

“At some point, we are going to have to confront this as a society,” Carskadon said. “For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth.”

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

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89 Sleep Deprivation Essay Topic Ideas & Examples

🏆 best sleep deprivation topic ideas & essay examples, 📌 simple & easy sleep deprivation essay titles, 👍 good essay topics on sleep deprivation, ❓ sleep deprivation research questions.

• Problem of Sleep Deprivation This is due to disruption of the sleep cycle. Based on the negative effects of sleep deprivation, there is need to manage this disorder among Americans.
• The Influence of Sleep Deprivation on Human Body It contradicts living in harmony with God, as when the person is irritated and moody, it is more difficult to be virtuous and to be a source of joy for others.
• Sleep Deprivation and Insomnia: Study Sources The topic of this audio record is a variety of problems with sleep and their impact on an organism. They proved the aforementioned conclusion and also paid attention to the impact of sleep deprivation on […]
• Neurocognitive Consequences of Sleep Deprivation The CNS consists of the brain and the spinal cord while the PNS consists of all the endings of the nerve extensions in all organs forming the web that extends throughout the entire organ.
• “Childbirth Fear and Sleep Deprivation in Pregnant Women” by Hall To further show that the information used is current, the authors have used the APA style of referencing which demand the naming of the author as well as the year of publication of the article/book […]
• Sleep Deprivation and Learning at University It is a widely known fact that numerous people face the problem of lack of sleep. Second, sleeping is essential for increasing the productivity of students in the context of learning.
• Sleep Deprivation: Biopsychology and Health Psychology Another theory that has been proposed in relation to sleep is the Circadian theory which suggests that sleep evolved as a mechanism to fit organisms into the light dark cycle of the world.
• Sleep Disorders: Sleep Deprivation of the Public Safety Officers The effects of sleep disorders and fatigue on public safety officers is a social issue that needs to be addressed with more vigor and urgency so that the key issues and factors that are salient […]
• Sleep Deprivation: Personal Experiment As I had been perplexed, I did not take a step of reporting the matter to the police neither did I inform my neighbors.
• Sleep Deprivation and Specific Emotions The purpose of this study is to develop an understanding of the relationship between sleep deprivation and emotional behaviors. The study looks to create a link between the findings of past researches on the emotional […]
• Sleep Deprivation Impacts on College Students Additional research in this field should involve the use of diverse categories of students to determine the effects that sleep deprivation would have on them.
• How Sleep Deprivation Affects College Students’ Academic Performance The study seeks to confirm the position of the hypothesis that sleep deprivation leads to poor academic performance in college students.
• Effects of Sleep Deprivation While scientists are at a loss explaining the varying sleeping habits of different animals, they do concede that sleep is crucial and a sleeping disorder may be detrimental to the health and productivity of a […]
• What Are The Effects Of Sleep Deprivation For Paramedics
• The Innate Immune System During Sleep Deprivation
• Sleep Deprivation Negatively Influences Driving Performance
• What Effect Does Sleep Deprivation Have on Physiological and Cognition
• Sleep Deprivation And Its Effects On The Lives And Culture Of Different
• The Correlation Between Sleep Deprivation And Academic Performance
• The Importance of Sleep and the Health Impact of Sleep Deprivation in Humans
• Effects of Sleep Deprivation on the Academic Performance of DLSL Account
• The Effects Of Sleep Deprivation Among College Students
• The Dangers and Effects of Sleep Deprivation Among Nurses and the Ways to Prevent the Sleep-Related Problem
• Sleep Deprivation and its Affects on Daily Performances
• The Body Of Knowledge Regarding Adolescent Sleep Deprivation
• Poor Performance in School/Work as a Consequence of Sleep Deprivation
• The Fascinating World of Sleep and the Effects of Sleep Deprivation
• Symptoms And Treatment Of Sleep Deprivation
• Sleep Deprivation And Aggression Among College Students
• The Effects Of Sleep Deprivation On Academic Performance
• Sleep Deprivation On Eating And Activity Behaviors
• Sleep Deprivation: What Causes The Sleeplessness And How Long It Lasts
• The Relationship Between Sleep Deprivation And The Human Body
• Students And Chronic Sleep Deprivation: How School Start Times Can Impact This
• What is Sleep and the Effects of Sleep Deprivation
• Several Health and Behavioral Symptoms of Sleep Deprivation
• Sleep Deprivation, Nightmares, And Sleepwalking
• The Factors That Contribute to Sleep Deprivation and Its Effects on the Sleep Cycle
• The Dangers Of Teen Sleep Deprivation: Benefits Of Adopting Later Start Times For High Schools
• The Issue of Sleep Deprivation, Its Results and Associated Risks
• The Negative Effects of Sleep Deprivation in Human Beings
• The Stages of Sleep and the Effects of Sleep Deprivation
• The Negative Effects of Sleep Deprivation to Mental and Physical Health
• Effects Of Sleep Deprivation On One’s Performance And Function
• How Sleep Deprivation Can Effect Weightlifting Performance
• The Causes of Sleep Deprivation in America: a Nation of Walking Zombies
• The Sleep Deprivation Epidemic Is Affecting Teenagers
• Sleep Matters: The Human Condition in the Midst of Sleep Deprivation
• Sleep Deprivation : The Brain Function And Physical Body
• Sleep Deprivation And Reduction, Sleep Disorders, And The Drugs Used To Treat Them
• The Effects of Total Sleep Deprivation on Bayesian Updating
• The Negative Effects of Sleep Deprivation Among Teens and the Solutions to the Problem
• Light Pollution, Sleep Deprivation, and Infant Health at Birth
• The Effects Of Food And Sleep Deprivation During Civilian
• The Study of Rechtschaffen (1983) on Sleep Deprivation
• How Sleep Deprivation Affects Psychological Variables Related to College Students Cognitive Performance
• Sleep Deprivation : Sleep And The Adverse Effects Of Sleep Disorders
• How Does Sleep Deprivation Affect Psychological Health?
• What Effect Does Sleep Deprivation Have on Physiology and Cognition?
• How Does Lack of Sleep Affect Physical Health?
• Does Sleep Deprivation Significantly Interfere With Driving?
• How Does Sleep Deprivation Affect Psychological Variables Related to College Students’ Cognitive Performance?
• Are the Brains’ Motor Function Affected by Sleep Deprivation?
• How Does Sleep Deprivation Affect Work Performance?
• Does Sleep Deprivation Effect College Students’ Academic Performance?
• How Does Sleep Deprivation Affect Cognitive Functions?
• Does Too Much Homework Cause Sleep Deprivation?
• How Can Sleep Deprivation Effect Weightlifting Performance?
• What Are the Effects of Sleep Deprivation for Paramedics?
• How Does Sleep Deprivation Lead to Cardiovascular Disease?
• What Are the Symptoms of Sleep Deprivation?
• How Does Sleep Deprivation Affect Health?
• Can Sleep Problems in Patients With Parkinson’s Disease Be About Serotonin?
• How Common Are Sleep Problems in Teenagers?
• What Are the Criteria to Classify Mild, Moderate, and Severe Sleep Deprivation in Humans?
• How to Measure Sleep and Insomnia in Adult Video Gamers?
• What Are the Physiological and Psychological Effects on Sleep of Electronics in the Bedroom?
• Is Bipolar Disease a Sleep Regulation Disorder?
• What Is the Scale on Sleep Deprivation?
• How Does Lack Sleep Affect Physical Health?
• Does Sleep Deprivation Induce by Reward Rather Than Punishment Result in Different Effects?
• How Does Lack of Sleep Affect the Ability to Concentrate, Think and Learn?
• What Are the Main Types of Sleep Disorders?
• Can a Person either Become Sick or Die After Complete Sleep Deprivation?
• What Are Problems Can Sleep Deprivation Lead To?
• Does Sleep Deprivation Cause Permanent Brain Damage?
• How Long Does It Take to Reverse Sleep Deprivation?
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Why sleep is important

Sleep is essential for a person’s health and wellbeing, according to the National Sleep Foundation (NSF). Yet millions of people do not get enough sleep and many suffer from lack of sleep. For example, surveys conducted by the NSF (1999-2004) reveal that at least 40 million Americans suffer from over 70 different sleep disorders and 60 percent of adults report having sleep problems a few nights a week or more. Most of those with these problems go undiagnosed and untreated. In addition, more than 40 percent of adults experience daytime sleepiness severe enough to interfere with their daily activities at least a few days each month — with 20 percent reporting problem sleepiness a few days a week or more. Furthermore, 69 percent of children experience one or more sleep problems a few nights or more during a week.

According to psychologist and sleep expert David F. Dinges, Ph.D., of the Division of Sleep and Chronobiology and Department of Psychiatry at the University of Pennsylvania School of Medicine, irritability, moodiness and disinhibition are some of the first signs a person experiences from lack of sleep . If a sleep-deprived person doesn’t sleep after the initial signs, said Dinges, the person may then start to experience apathy, slowed speech and flattened emotional responses, impaired memory and an inability to be novel or multitask. As a person gets to the point of falling asleep, he or she will fall into micro sleeps (5-10 seconds) that cause lapses in attention, nod off while doing an activity like driving or reading and then finally experience hypnagogic hallucinations, the beginning of REM sleep. (Dinges, Sleep, Sleepiness and Performance , 1991)

Everyone’s individual sleep needs vary. In general, most healthy adults are built for 16 hours of wakefulness and need an average of eight hours of sleep a night. However, some individuals are able to function without sleepiness or drowsiness after as little as six hours of sleep. Others can't perform at their peak unless they've slept ten hours. And, contrary to common myth, the need for sleep doesn't decline with age but the ability to sleep for six to eight hours at one time may be reduced. (Van Dongen & Dinges, Principles & Practice of Sleep Medicine , 2000)

Psychologists and other scientists who study the causes of sleep disorders have shown that such problems can directly or indirectly be tied to abnormalities in the following systems:

Physiological systems

Brain and nervous system

Cardiovascular system

Metabolic functions

Immune system

Furthermore, unhealthy conditions, disorders and diseases can also cause sleep problems, including:

Pathological sleepiness, insomnia and accidents

Hypertension and elevated cardiovascular risks (MI, stroke)

Emotional disorders (depression, bipolar disorder)

Obesity; metabolic syndrome and diabetes

Alcohol and drug abuse (Dinges, 2004)

Groups that are at particular risk for sleep deprivation include night shift workers, physicians (average sleep = 6.5 hours a day; residents = 5 hours a day), truck drivers, parents and teenagers. (American Academy of Sleep Medicine and National Heart, Lung, and Blood Institute Working Group on Problem Sleepiness. 1997).

Stress is the number one cause of short-term sleeping difficulties , according to sleep experts. Common triggers include school- or job-related pressures, a family or marriage problem and a serious illness or death in the family. Usually the sleep problem disappears when the stressful situation passes. However, if short-term sleep problems such as insomnia aren't managed properly from the beginning, they can persist long after the original stress has passed.

Drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and working or doing other mentally intense activities right before or after getting into bed can disrupt sleep.

If you are among the 20 percent of employees in the United States who are shift workers, sleep may be particularly elusive. Shift work forces you to try to sleep when activities around you — and your own "biological rhythms" — signal you to be awake. One study shows that shift workers are two to five times more likely than employees with regular, daytime hours to fall asleep on the job.

Traveling also disrupts sleep, especially jet lag and traveling across several time zones. This can upset your biological or “circadian” rhythms.

Environmental factors such as a room that's too hot or cold, too noisy or too brightly lit can be a barrier to sound sleep. And interruptions from children or other family members can also disrupt sleep. Other influences to pay attention to are the comfort and size of your bed and the habits of your sleep partner. If you have to lie beside someone who has different sleep preferences, snores, can't fall or stay asleep, or has other sleep difficulties, it often becomes your problem too!

Having a 24/7 lifestyle can also interrupt regular sleep patterns: the global economy that includes round the clock industries working to beat the competition; widespread use of nonstop automated systems to communicate and an increase in shift work makes for sleeping at regular times difficult.

A number of physical problems can interfere with your ability to fall or stay asleep. For example, arthritis and other conditions that cause pain, backache, or discomfort can make it difficult to sleep well.

Epidemiological studies suggest self-reported sleep complaints are associated with an increased relative risk of cardiovascular morbidity and mortality. For women, pregnancy and hormonal shifts including those that cause premenstrual syndrome (PMS) or menopause and its accompanying hot flashes can also intrude on sleep.

Finally, certain medications such as decongestants, steroids and some medicines for high blood pressure, asthma, or depression can cause sleeping difficulties as a side effect.

It is a good idea to talk to a physician or mental health provider about any sleeping problem that recurs or persists for longer than a few weeks.

According to the DSM, some psychiatric disorders have fatigue as a major symptom. Included are: major depressive disorder (includes postpartum blues), minor depression , dysthymia, mixed anxiety-depression, seasonal affective disorder and bipolar disorder .

According to a long-term study published in the 2004 April issue of Alcoholism: Clinical and Experimental Research , young teenagers whose preschool sleep habits were poor were more than twice as likely to use drugs, tobacco or alcohol. This finding was made by the University of Michigan Health System as part of a family health study that followed 257 boys and their parents for 10 years. The study found a significant connection between sleep problems in children and later drug use, even when other issues such as depression, aggression, attention problems and parental alcoholism were taken into account. Long-term data on girls isn't available yet. The researchers suggest that early sleep problems may be a "marker" for predicting later risk of early adolescent substance abuse — and that there may be a common biological factor underlying both traits. Although the relationship between sleep problems and the abuse of alcohol in adults is well known, this is the first study to look at the issue in children.

Nightmares are dreams with vivid and disturbing content. They are common in children during REM sleep. They usually involve an immediate awakening and good recall of the dream content.

Sleep terrors are often described as extreme nightmares. Like nightmares, they most often occur during childhood, however they typically take place during non-REM (NREM) sleep. Characteristics of a sleep terror include arousal, agitation, large pupils, sweating, and increased blood pressure. The child appears terrified, screams and is usually inconsolable for several minutes, after which he or she relaxes and returns to sleep. Sleep terrors usually take place early in the night and may be combined with sleepwalking. The child typically does not remember or has only a vague memory of the terrifying events.

In the August 2004 issue of the journal Sleep , Dr. Timothy Roehrs, the Director of research at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit published one of the first studies to measure the effect of sleepiness on decision making and risk taking. He found that sleepiness does take a toll on effective decision making.

Cited in the October 12, New York Times Science section, Dr. Roehrs and his colleagues paid sleepy and fully alert subjects to complete a series of computer tasks. At random times, they were given a choice to take their money and stop. Or they could forge ahead with the potential of either earning more money or losing it all if their work was not completed within an unknown remainder of time.

Dr. Roehrs found that the alert people were very sensitive to the amount of work they needed to do to finish the tasks and understood the risk of losing their money if they didn't. But the sleepy subjects chose to quit the tasks prematurely or they risked losing everything by trying to finish the task for more money even when it was 100 percent likely that they would be unable to finish, said Dr. Roehrs.

According to the National Commission on Sleep Disorders Research (1998) and reports from the National Highway Safety Administration (NHSA)(2002), high-profile accidents can partly be attributed to people suffering from a severe lack of sleep.

Each year the cost of sleep disorders, sleep deprivation and sleepiness, according to the NCSDR, is estimated to be $15.9 million in direct costs and $50 to $100 billion a year in indirect and related costs. And according to the NHSA, falling asleep while driving is responsible for at least 100,000 crashes, 71,000 injuries and 1,550 deaths each year in the United States. Young people in their teens and twenties, who are particularly susceptible to the effects of chronic sleep loss, are involved in more than half of the fall-asleep crashes on the nation's highways each year. Sleep loss also interferes with the learning of young people in our nation's schools, with 60 percent of grade school and high school children reporting that they are tired during the daytime and 15 percent of them admitting to falling asleep in class.

According to the Department of Transportation (DOT), one to four percent of all highway crashes are due to sleepiness, especially in rural areas and four percent of these crashes are fatal.

Risk factors for drowsy driving crashes:

Late night/early morning driving

Patients with untreated excessive sleepiness

People who obtain six or fewer hours of sleep per day

Young adult males

Commercial truck drivers

Night shift workers

Medical residents after their shift

According to sleep researchers, a night's sleep is divided into five continually shifting stages, defined by types of brain waves that reflect either lighter or deeper sleep. Toward morning, there is an increase in rapid eye movement, or REM sleep, when the muscles are relaxed and dreaming occurs, and recent memories may be consolidated in the brain. The experts say that hitting a snooze alarm over and over again to wake up is not the best way to feel rested. “The restorative value of rest is diminished, especially when the increments are short,” said psychologist Edward Stepanski, PhD who has studied sleep fragmentation at the Rush University Medical Center in Chicago. This on and off again effect of dozing and waking causes shifts in the brain-wave patterns. Sleep-deprived snooze-button addicts are likely to shorten their quota of REM sleep, impairing their mental functioning during the day. ( New York Times , October 12, 2004)

Certain therapies, like cognitive behavioral therapy teach people how to recognize and change patterns of thought and behavior to solve their problems. Recently this type of therapy has been shown to be very effective in getting people to fall asleep and conquer insomnia.

According to a study published in the October 2004 issue of The Archives of Internal Medicine , cognitive behavior therapy is more effective and lasts longer than a widely used sleeping pill, Ambien, in reducing insomnia. The study involved 63 healthy people with insomnia who were randomly assigned to receive Ambien, the cognitive behavior therapy, both or a placebo. The patients in the therapy group received five 30-minute sessions over six weeks. They were given daily exercises to “recognize, challenge and change stress-inducing” thoughts and were taught techniques, like delaying bedtime or getting up to read if they were unable to fall asleep after 20 minutes. The patients taking Ambien were on a full dose for a month and then were weaned off the drug. At three weeks, 44 percent of the patients receiving the therapy and those receiving the combination therapy and pills fell asleep faster compared to 29 percent of the patients taking only the sleeping pills. Two weeks after all the treatment was over, the patients receiving the therapy fell asleep in half the time it took before the study and only 17 percent of the patients taking the sleeping pills fell asleep in half the time. (New York Times, October 5, 2004)

According to leading sleep researchers, there are techniques to combat common sleep problems:

Keep a regular sleep/wake schedule

Don’t drink or eat caffeine four to six hours before bed and minimize daytime use

Don’t smoke, especially near bedtime or if you awake in the night

Avoid alcohol and heavy meals before sleep

Get regular exercise

Minimize noise, light and excessive hot and cold temperatures where you sleep

Develop a regular bed time and go to bed at the same time each night

Try and wake up without an alarm clock

Attempt to go to bed earlier every night for certain period; this will ensure that you’re getting enough sleep

In clinical settings, cognitive-behavior therapy (CBT) has a 70-80 percent success rate for helping those who suffer from chronic insomnia. Almost one third of people with insomnia achieve normal sleep and most reduce their symptoms by 50 percent and sleep an extra 45-60 minutes a night. When insomnia exists along with other psychological disorders like depression, say the experts, the initial treatment should address the underlying condition.

But sometimes even after resolving the underlying condition, the insomnia still exists, says psychologist Jack Edinger, PhD, of the VA Medical Center in Durham, North Carolina and Professor of Psychiatry and Behavioral Sciences at Duke University and cautions that treating the depression usually doesn’t resolve the sleep difficulties. From his clinical experience, he has found that most patients with insomnia should be examined for specific behaviors and thoughts that may perpetuate the sleep problems. When people develop insomnia, they try to compensate by engaging in activities to help them get more sleep. They sleep later in the mornings or spend excessive times in bed. These efforts usually backfire, said Edinger.

From his clinical work and research on sleep, psychologist Charles M. Morin, PhD, a Professor in the Psychology Department and Director of the Sleep Disorders Center at University Laval in Quebec, Canada says that ten percent of adults suffer from chronic insomnia. In a study released in the recent issue of Sleep Medicine Alert published by the NSF, Morin outlines how CBT helps people overcome insomnia. Clinicians use sleep diaries to get an accurate picture of someone’s sleep patterns. Bedtime, waking time, time to fall asleep, number and durations of awakening, actual sleep time and quality of sleep are documented by the person suffering from insomnia.

A person can develop poor sleep habits (i.e. watching TV in bed or eating too much before bedtime), irregular sleep patterns (sleeping too late, taking long naps during the day) to compensate for lost sleep at night. Some patients also develop a fear of not sleeping and a pattern of worrying about the consequences of not sleeping, said Morin. “Treatments that address the poor sleep habits and the faulty beliefs and attitudes about sleep work but sometimes,” said Morin, “medication may play a role in breaking the cycle of insomnia. But behavioral therapies are essential for patients to alter the conditions that perpetuate it.”

CBT attempts to change a patient’s dysfunctional beliefs and attitudes about sleep. “It restructure thoughts — like, ‘I’ve got to sleep eight hours tonight’ or ‘I’ve got to take medication to sleep’ or ‘I just can’t function or I’ll get sick if I don’t sleep.’ These thoughts focus too much on sleep, which can become something like performance anxiety — sleep will come around to you when you’re not chasing it,” said Edinger.

What works in many cases, said Morin and Edinger, is to standardize or restrict a person’s sleep to give a person more control over his or her sleep. A person can keep a sleep diary for a couple of weeks and a clinician can monitor the amount of time spent in bed to the actual amount of time sleeping. Then the clinician can instruct the patient to either go to bed later and get up earlier or visa versa. This procedure improves the length of sleeping time by imposing a mild sleep deprivation situation, which has the result of reducing the anxiety surrounding sleep. To keep from falling asleep during the day, patients are told not to restrict sleep to less than five hours.

Standardizing sleep actually helps a person adjust his or her homeostatic mechanism that balances sleep, said Edinger. “Therefore, if you lose sleep, your homeostatic mechanism will kick in and will work to increase the likelihood of sleeping longer and deeper to promote sleep recovery. This helps a person come back to their baseline and works for the majority.”

A person can also establish more stimulus control over his or her bedroom environment, said Morin. This could include: going to bed only when sleepy, getting out of bed when unable to sleep, prohibiting non-sleep activities in the bedroom, getting up at the same time every morning (including weekends) and avoiding daytime naps.

Finally, a person can incorporate relaxation techniques as part of his or her treatment. For example, a person can give herself or himself an extra hour before bed to relax and unwind and time to write down worries and plans for the following day.

In CBT, said Morin, breaking the thought process and anxiety over sleep is the goal. “After identifying the dysfunctional thought patterns, a clinician can offer alternative interpretations of what is getting the person anxious so a person can think about his or her insomnia in a different way.” Morin offers some techniques to restructure a person’s cognitions. “Keep realistic expectations, don’t blame insomnia for all daytime impairments, do not feel that losing a night’s sleep will bring horrible consequences, do not give too much importance to sleep and finally develop some tolerance to the effects of lost sleep.

According to Edinger, aging weakens a person’s homeostatic sleep drive after age 50. Interestingly, the length of the circadian cycle stays roughly the same over the lifespan but the amplitude of the circadian rhythm may decline somewhat with aging.

National Sleep Foundation http://www.thensf.org

American Academy of Sleep Medicine http://www.aasmnet.org/

American Insomnia Association http://www.americaninsomniaassociation.org/

Sleep Research Society http://www.sleepresearchsociety.org/

NIH National Center for Sleep Disorders Research http://www.nhlbi.nih.gov/sleep

The MayoClinic.com Sleep Center

(Blake, et al, Psychological Reports, 1998; National Heart, Lung and Blood Institute Working Group on Insomnia, 1998)

David F. Dinges, PhD , Professor of Psychology in Psychiatry, Chief, Division of Sleep and Chronobiology, University of Pennsylvania School of Medicine

Jack Edinger, PhD , of the VA Medical Center in Durham, North Carolina and Professor of Psychiatry and Behavioral Sciences at Duke University

Charles M. Morin, PhD , a Professor in the Psychology Department and Director of the Sleep Disorders Center at University Laval in Quebec, Canada

Timothy Roehrs, PhD , the Director of Research, Sleep Disorders and Research Center at Henry Ford Hospital

Edward Stepanski, PhD , who has studied sleep fragmentation at the Rush University Medical Center in Chicago

Related Reading

• Getting a good night’s sleep: How psychologists help with insomnia
• What to Do When You Dread Your Bed

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Sleep Deprivation and Deficiency What Are Sleep Deprivation and Deficiency?

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• You don't get enough sleep (sleep deprivation)
• You sleep at the wrong time of day
• You don't sleep well or get all the different types of sleep your body needs
• You have a sleep disorder that prevents you from getting enough sleep or causes poor-quality sleep

This topic focuses on sleep deficiency.

Sleeping is a basic human need, like eating, drinking, and breathing. Like these other needs, sleeping is vital for good health and well-being throughout your lifetime.

According to the Centers for Disease Control and Prevention, about 1 in 3 adults in the United States reported not getting enough rest or sleep every day.

Nearly 40% of adults report falling asleep during the day without meaning to at least once a month. Also, an estimated 50 to 70 million Americans have chronic, or ongoing, sleep disorders.

Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater likelihood of death. To understand sleep deficiency, it helps to understand what makes you sleep and how it affects your health .

Learn the science behind how sleep works .

Sleep deficiency can interfere with work, school, driving, and social functioning. You might have trouble learning, focusing, and reacting. Also, you might find it hard to judge other people's emotions and reactions. Sleep deficiency also can make you feel frustrated, cranky, or worried in social situations.

The symptoms of sleep deficiency may differ between children and adults. Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave, and their school performance can suffer.

Sleep deficiency is linked to many chronic health problems, including heart disease , kidney disease, high blood pressure , diabetes, stroke , obesity , and depression.

Sleep deficiency is also linked to a higher chance of injury in adults, teens, and children. For example, sleepiness while driving (not related to alcohol) is responsible for serious car crash injuries and death. In older adults, sleep deficiency may be linked to a higher chance of falls and broken bones.

Sleep deficiency has also played a role in human mistakes linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and plane crashes.

A common myth is that people can learn to get by on little sleep with no negative effects. However, research shows that getting enough quality sleep at the right times is vital for mental health, physical health, quality of life, and safety.

Home — Essay Samples — Nursing & Health — Neurology & Nervous System Diseases — Sleep Deprivation

Sleep Deprivation Essay Examples

What makes a good sleep deprivation essay topics.

When it comes to writing an essay on sleep deprivation, choosing the right topic is crucial. A good essay topic should be thought-provoking, engaging, and relevant to the subject matter. In order to come up with a strong essay topic on sleep deprivation, it is important to consider various factors such as the target audience, the scope of the topic, and the availability of research material. Here are some recommendations on how to brainstorm and choose an essay topic on sleep deprivation.

First, start by brainstorming ideas related to sleep deprivation. Consider the various aspects of sleep deprivation that are of interest to you and that you think would be relevant to your audience. This could include topics such as the impact of sleep deprivation on cognitive function, the relationship between sleep deprivation and mental health, or the effects of sleep deprivation on physical health.

Next, consider What Makes a Good essay topic. A good essay topic should be specific, focused, and relevant to the subject matter. It should also be unique and thought-provoking, allowing for a deep exploration of the topic. When choosing an essay topic on sleep deprivation, consider the availability of research material and the potential for new insights and perspectives.

Finally, consider the target audience for your essay. What are the interests and concerns of your readers? What topics are likely to engage and captivate them? By considering the needs and interests of your audience, you can choose a topic that will resonate with them and provide valuable insights into the subject of sleep deprivation.

In , a good essay topic on sleep deprivation should be specific, focused, and relevant to the subject matter. It should also be thought-provoking, engaging, and relevant to the target audience. By considering these factors, you can brainstorm and choose an essay topic that will captivate your readers and provide valuable insights into the topic of sleep deprivation.

Best Sleep Deprivation Essay Topics

• The impact of sleep deprivation on academic performance
• Sleep deprivation and its effects on mental health
• The relationship between sleep deprivation and physical health
• The role of technology in contributing to sleep deprivation
• Sleep deprivation and its impact on workplace productivity
• The effects of sleep deprivation on memory and cognitive function
• Sleep deprivation and its impact on decision-making
• The relationship between sleep deprivation and mood disorders
• The impact of sleep deprivation on athletic performance
• Sleep deprivation and its effects on aging
• The role of genetics in sleep deprivation
• Sleep deprivation and its impact on obesity
• The effects of sleep deprivation on immune function
• Sleep deprivation and its impact on driving safety
• The relationship between sleep deprivation and chronic pain
• Sleep deprivation and its impact on creativity and innovation
• The effects of sleep deprivation on social interactions
• Sleep deprivation and its impact on learning and memory
• The relationship between sleep deprivation and substance abuse
• Sleep deprivation and its impact on overall well-being

Sleep Deprivation essay topics Prompts

• Imagine a world where sleep deprivation is non-existent. How would this impact society and individuals?
• Write a fictional story about a character who suffers from chronic sleep deprivation and the impact it has on their life.
• Research and analyze the impact of sleep deprivation on a specific demographic, such as teenagers or shift workers.
• Explore the connection between sleep deprivation and societal issues such as poverty or inequality.
• Write a persuasive essay advocating for better awareness and support for individuals suffering from sleep deprivation.

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Major Health Risks of Sleep Deprivation

Sleep & problems connected with it, impact of sleeping habits on our life, effects of poor sleep hygiene, analysis of the different ways in which sleep affects memory, sleep deprivation and disorders effects on health, why sleep is vital: the importance of a good sleep, zolpidem: the effect on sleep, call center agents and health status with sleep deprivation, miracle pill from sleep deprivation, nurses on night shifts: their lived experiences, sleep deprivation: a headache for people in the 21 century, what happens to the body when you don’t get enough sleep, sleep deprivation and its relation to metabolic syndrome, the matter of sleep deprivation in clinical settings, the effects of sleep deprivation, sleep deprivation: causes, effects, and solutions, relevant topics.

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This sleep routine can cut your heart disease risk by 20%: new study.

Now you have a new excuse to hit the snooze button on weekends .

New research finds that people who catch up on z’s on their days off can cut their risk of heart disease by up to 20%.

“Sufficient compensatory sleep is linked to a lower risk of heart disease,” said study co-author Yanjun Song, a researcher with Fuwai Hospital in Beijing. “The association becomes even more pronounced among individuals who regularly experience inadequate sleep on weekdays.”

Song’s team analyzed sleep data from 90,900 UK residents. Nearly 22% — about 19,800 participants — were categorized as sleep-deprived because they slumbered less than seven hours a night on average.

Researchers followed the participants for nearly 14 years, monitoring hospital and death records for cardiac diseases including heart failure, atrial fibrillation and stroke . 

Participants who logged the most compensatory sleep were 19% less likely to develop heart disease.

Among the sleep-deprived participants, the highest amounts of compensatory sleep meant a 20% lower risk of heart disease.

The data did not reveal differences between men and women.

Dr. Nisha Parikh , director of the Women’s Heart Program for Northwell Health’s Cardiovascular Institute and the Katz Institute for Women’s Health, called the study a “well-conducted analysis.”

“Sleep disorders including sleep deprivation have been linked to cardiometabolic diseases, including hypertension, diabetes , obesity and cardiovascular diseases,” Parikh told The Post. “It is reassuring that weekend catch-up sleep can at least partially mitigate the effects of weekday sleep deprivation.”

The research was presented Thursday at the annual European Society of Cardiology conference.

“Our results show that for the significant proportion of the population in modern society that suffers from sleep deprivation, those who have the most ‘catch-up’ sleep at weekends have significantly lower rates of heart disease than those with the least,” study co-author Zechen Liu said.

Still, experts recommend adults consistently get seven to nine hours of sleep every night so they don’t find themselves in sleep debt.

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Also Thursday at the ESC Congress, researchers from Denmark presented their work that found that women with endometriosis face a 20% greater risk of heart attack and stroke compared with women without endometriosis.

The painful condition, which affects more than 6.5 million American women , occurs when endometrial-like tissue grows outside the uterus.

Meanwhile, it was revealed in another presentation that men with coronary artery disease — the most common type of  heart disease in the US — can cut their risk of a major heart incident by nearly half by quitting smoking for good.

Simply cutting back on cigarettes isn’t enough to move the needle, the study authors from Paris told the ESC Congress.

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Catching up on sleep on weekend could lower heart disease risk

While there’s no replacement for missed sleep, a new study says sleeping in could prolong your life.

By Lois M. Collins

We’ve all been told that the best sleeping habit is getting up at the same time every day. But a new study suggests that people who “catch up” on sleep by sleeping in on weekends may lower their risk of heart disease by 20%.

People are swamped and work and school demands often interfere with getting adequate sleep.

“Sufficient compensatory sleep is linked to a lower risk of heart disease,” said study co-author Yanjun Song of the State Key Laboratory of Infectious Disease, Fuwai Hospital, National Centre for Cardiovascular Disease, in Beijing. “The association becomes even more pronounced among individuals who regularly experience inadequate sleep on weekdays.”

The findings were presented at the European Society of Cardiology Congress 2024.

People who are tired during the week often sleep in on weekends, but little research has been done on whether so-called compensatory sleep helps heart health, the researchers said in a news release. This study suggests that it does.

James Leiper, an associate medical director at the British Heart Foundation, who was not part of the study, told The Guardian : “Lots of us don’t get enough sleep due to work or family commitments and while a weekend lie-in is no replacement for a regular good night’s sleep, this large study suggests that it might help reduce risk of heart disease.”

Not a long-term fix?

Another expert, Christopher Depner, a professor in the Department of Health and Kinesiology at the University of Utah, expressed skepticism, telling The Guardian that the study has not been peer reviewed.

Melanie Murphy Richter, a registered dietitian nutritionist and spokesperson for the nutrition company Prolon, also not involved in the study, told Medical News Today that sleeping in to catch up on sleep is a short-term solution, but not the solution over time for people who want to be healthy physically and mentally.

“Consistent lack of sleep can lead to a buildup of stress hormones, imbalances to your metabolism, and increases inflammation — things that a few extra hours of sleep won’t easily fix. Over time, this can contribute to serious health issues like obesity, diabetes and heart disease, as this study also suggests,” she said.

She added, “From a functional health perspective, it’s crucial to maintain a regular sleep schedule and prioritize sleep quality just as much as quantity, rather than ‘banking’ on being able to make up for it through naps or longer sleep on the weekends. Think of sleep as the foundation that supports everything else you do for your health — whether it’s nutrition, exercise or stress management. While you can recover a bit after a rough week, the best strategy is to avoid sleep debt in the first place by making consistent, quality sleep a non-negotiable part of your routine.”

Napping — in moderation — is another tool to counter feeling draggy, especially for those who have a mid-afternoon slump, as Deseret News earlier reported . Sleep experts say it can boost help with memory and cognition, but naps should be short. Twenty minutes is pretty ideal.

About the study

The study included data from 90,903 people who were part of the UK Biobank project. To see if there was a relationship between weekend extra sleep and heart disease, sleep data was recorded using accelerometers. Then findings were stratified into four groups, from the least amount of compensatory sleep to most.

Those who self-reported less than seven hours of sleep a night were considered sleep-deprived. A total of 19,816 people in the study (21.8%) fit that category. The rest were sometimes short on sleep, but weren’t actually sleep-deprived, which the researchers considered a limitation to their data.

They used hospital records and cause of death registry information to diagnose heart disease, including ischemic heart disease where less blood flows to the body, heart failure, atrial fibrillation and stroke. The average follow up was close to 14 years and those in the group who slept in on weekends the most were 19% less apt to develop heart disease than those in the category that slept in the least.

They found no difference between men and women.

“Our results show that for the significant proportion of the population in modern society that suffers from sleep deprivation, those who have the most ‘catch-up’ sleep at weekends have significantly lower rates of heart disease than those with the least,” said Song’s co-author and colleague, Zechen Liu.

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• v.3(5); 2007 Oct

Sleep deprivation: Impact on cognitive performance

Paula alhola.

1 Department of Psychology

Päivi Polo-Kantola

2 Sleep Research Unit (Department of Physiology), University of Turku, Turku, Finland

Today, prolonged wakefulness is a widespread phenomenon. Nevertheless, in the field of sleep and wakefulness, several unanswered questions remain. Prolonged wakefulness can be due to acute total sleep deprivation (SD) or to chronic partial sleep restriction. Although the latter is more common in everyday life, the effects of total SD have been examined more thoroughly. Both total and partial SD induce adverse changes in cognitive performance. First and foremost, total SD impairs attention and working memory, but it also affects other functions, such as long-term memory and decision-making. Partial SD is found to influence attention, especially vigilance. Studies on its effects on more demanding cognitive functions are lacking. Coping with SD depends on several factors, especially aging and gender. Also interindividual differences in responses are substantial. In addition to coping with SD, recovering from it also deserves attention. Cognitive recovery processes, although insufficiently studied, seem to be more demanding in partial sleep restriction than in total SD.

Introduction

A person’s quality of life can be disrupted due to many different reasons. One important yet underestimated cause for that is sleep loss ( National Sleep Foundation 2007 ). Working hours are constantly increasing along with an emphasis on active leisure. In certain jobs, people face sleep restriction. Some professions such as health care, security and transportation require working at night. In such fields, the effect of acute total sleep deprivation (SD) on performance is crucial. Furthermore, people tend to stretch their capacity and compromise their nightly sleep, thus becoming chronically sleep deprived.

When considering the effects of sleep loss, the distinction between total and partial SD is important. Although both conditions induce several negative effects including impairments in cognitive performance, the underlying mechanisms seem to be somewhat different. Particularly, results on the recovery from SD have suggested different physiological processes. In this review, we separately consider the effects of acute total and chronic partial SD and describe the effects on cognitive performance. The emphasis on acute total SD reflects the quantity of studies carried out compared with partial SD. The effects of aging and gender, as well as interindividual differences are discussed. We concentrate on the studies that have been published since 1990.

Sleep and sleep loss

The need for sleep varies considerably between individuals ( Shneerson 2000 ). The average sleep length is between 7 and 8.5 h per day ( Kripke et al 2002 ; Carskadon and Dement 2005 ; Kronholm et al 2006 ). Sleep is regulated by two processes: a homeostatic process S and circadian process C (eg, Achermann 2004 ). The homeostatic process S depends on sleep and wakefulness; the need for sleep increases as wakefulness continues. The theory for circadian process C suggests a control of an endogenous circadian pacemaker, which affects thresholds for the onset and offset of a sleep episode. The interaction of these two processes determines the sleep/wake cycle and can be used to describe fluctuations in alertness and vigilance. Although revised “three-process models” (eg, Akerstedt and Folkard 1995 ; Van Dongen et al 2003b ; Achermann 2004 ) have been suggested, this classical model is the principal one used for study designs in SD research.

There are many unanswered questions regarding both the functions of sleep and the effects of sleep loss. Sleep is considered to be important to body restitution, like energy conservation, thermoregulation, and tissue recovery ( Maquet 2001 ). In addition, sleep is essential for cognitive performance, especially memory consolidation ( Maquet 2001 ; Stickgold 2005 ). Sleep loss, instead, seems to activate the sympathetic nervous system, which can lead to a rise of blood pressure ( Ogawa et al 2003 ) and an increase in cortisol secretion ( Spiegel et al 1999 ; Lac and Chamoux 2003 ). Immune response may be impaired and metabolic changes such as insulin resistance may occur (for review, see Spiegel et al 2005 ). People who are exposed to sleep loss usually experience a decline in cognitive performance and changes in mood (for meta-analyses, see Pilcher and Huffcutt 1996 ; Philibert 2005 ).

Sleep deprivation is a study design to assess the effects of sleep loss. In acute total SD protocols, the subjects are kept awake continuously, generally for 24–72 hours. In chronic partial SD, subjects are allowed restricted sleep time during several consecutive nights. Although chronic sleep restriction is more common in the normal population and thus offers a more accurate depiction of real life conditions, total SD has been more thoroughly explored.

Cognitive performances measured in SD studies have included several domains. The most thoroughly evaluated performances include different attentional functions, working memory, and long-term memory. Visuomotor and verbal functions as well as decision-making have also been assessed. Sleep deprivation effects on cognitive performance depend on the type of task or the modality it occupies (eg, verbal, visual, or auditory). In addition, task demands and time on task may play a role. The task characteristics are discussed in more detail in following sections where the existing literature on the cognitive effects of SD is reviewed.

Mechanisms behind sleep loss effects

Some hypotheses are proposed to explain why cognitive performance is vulnerable to prolonged wakefulness. The theories can be divided roughly in two main approaches, in which SD is assumed to have (1) general effects on alertness and attention, or (2) selective effects on certain brain structures and functions. In addition, individual differences in the effects have been reported.

The general explanation relies on the two-process model of sleep regulation. Cognitive impairments would be mediated through decreased alertness and attention through lapses, slowed responses, and wake-state instability. Attentional lapses, brief moments of inattentiveness, have been considered the main reason for the decrease in cognitive performance during sleep deprivation (on lapse hypothesis, eg, Williams et al 1959, see Dorrian et al 2005 ; Kjellberg 1977 ). The lapses are caused by microsleeps characterized by very short periods of sleep-like electro-encephalography (EEG) activity ( Priest et al 2001 ). Originally, it was thought that in between the lapses, cognitive performance almost remained intact, but the slowing of cognitive processing has also been observed independent of lapsing ( Kjellberg 1977 ; Dorrian et al 2005 ). According to these hypotheses, performance during SD would most likely deteriorate in long, simple, and monotonous tasks requiring reaction speed or vigilance. In addition to the lapses and response slowing, considerable fluctuations in alertness and effort have been observed during SD. According to the wake-state instability hypothesis, those fluctuations lead to variation in performance ( Doran et al 2001 ).

According to explanations on selective impact, SD interferes with the functioning of certain brain areas and thus impairs cognitive performance. This approach is also referred to as the ‘sleep-based neuropsychological perspective’ ( Babkoff et al 2005 ). Perhaps the most famous theory in this category is the prefrontal vulnerability hypothesis, first proposed by Horne (1993) . It suggests that SD especially impairs cognitive performances that depend on the prefrontal cortex. These include higher functions, such as language, executive functions, divergent thinking, and creativity. In order to show the SD effect, the tests should be complex, new, and interesting. A good performance would require cognitive flexibility and spontaneity. This theory also assumes that the deterioration of subjects’ performance in simple and long tasks is merely due to boredom ( Harrison and Horne 1998 ; Harrison and Horne 1999 ; Harrison and Horne 2000 ). The specific brain areas that are vulnerable to sleep loss have been explored using functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Those studies, however, have mainly measured working memory or other attentional functions with the type of tasks that are not traditionally emphasized in the prefrontal vulnerability hypothesis (for summary, see Chee et al 2006 ).

Individuals differ in terms of the length, timing, and structure of sleep. Therefore, it is logical to hypothesize that interindividual differences are also important in reaction to SD. Studies have consistently found that some people are more vulnerable to sleep loss than others (for review, see Van Dongen et al 2005 ). In reference to trait differential vulnerability to SD, Van Dongen et al (2005) have proposed the concept of the “trototype”, as compared to the terms “chronotype” and “somnotype”, which define interindividual differences in the timing of circadian rhythmicity and sleep duration. Since a comprehensive review of the interindividual differences in sleep and performance has been published recently ( Van Dongen et al 2005 ), we will focus here on the studies with group comparisons and just briefly address the trait-like vulnerability.

Acute total sleep deprivation

Attention and working memory.

The two most widely studied cognitive domains in SD research are attention and working memory, which in fact are interrelated. Working memory can be divided into four subsystems: phonological loop, visuospatial sketchpad, episodic buffer and central executive ( Baddeley and Hitch 1974 ; Baddeley 2000 ). The phonological loop is assumed to temporarily store verbal and acoustic information (echo memory); the sketchpad, to hold visuospatial information (iconic memory), and the episodic buffer to integrate information from several different sources. The central executive controls them all. Executive processes of working memory play a role in certain attentional functions, such as sustained attention ( Baddeley et al 1999 ), which is referred to here as vigilance. Both attention and working memory are linked to the functioning of frontal lobes (for a review, see Naghavi and Nyberg 2005 ). Since the frontal brain areas are vulnerable to SD ( Harrison et al 2000 ; Thomas et al 2000 ), it can be hypothesized that both attention and working memory are impaired during prolonged wakefulness.

The decrease in attention and working memory due to SD is well established. Vigilance is especially impaired, but a decline is also observed in several other attentional tasks ( Table 1 ). These include measures of auditory and visuo-spatial attention, serial addition and subtraction tasks, and different reaction time tasks ( Table 1 ). The most frequently used task is the psychomotor vigilance test (PVT, lasts usually 10 min) ( Dinges and Powell 1985 ), which is sensitive to sleep loss effects and provides information about both reaction speed and lapses. In working memory, the tests have varied from n-back style tasks with different demand levels to choice-reaction time tasks with a working memory component ( Table 1 ). However, some studies have also failed to find any effect. After one night of SD, no difference was observed between deprived and non-deprived subjects in simple reaction time, vigilance, or selective attention tasks in one study ( Forest and Godbout 2000 ). Performance on the Wisconsin Card Sorting Test, a measure of frontal lobe function, also remained even ( Binks et al 1999 ; Forest and Godbout 2000 ). These results may be partly biased because of small sample sizes, inadequate control of the subjects’ sleep history or the use of stimulants before the study.

Cognitive tests in which deterioration of performance has been reported during acute total sleep deprivation

Abbreviations: SD, sleep deprivation; WAIS, Wechsler Adult Intelligence Scale; WAIS-R, Wechsler Adult Intelligence Scale-Revised.

Outcomes are inconsistent in various dual tasks used for measuring divided attention. Sleep deprivation of 24 h impaired performance in one study ( Wright and Badia 1999 ), whereas in two others, performance was maintained after 25–35 h of SD ( Drummond et al 2001 ; Alhola et al 2005 ). The divergent findings in these studies may be explained by the uneven loads between different subtests as well as by uncontrolled practice effect. Although dividing attention between different tasks puts high demands on cognitive capacity, subjects often attempt to reduce the load by automating some easier procedures of a dual or multitask. In the study by Wright and Badia (1999) , the test was not described; in the study by Alhola et al (2005) , subjects had to count backwards and carry out a visual search task simultaneously, and in the study by Drummond et al (2001) subjects had to memorize words and complete a serial subtraction task sequentially. In addition, differences in essential study elements, like the age and gender of participants, as well as the duration of SD, further complicate comparison of the results.

In the tasks measuring attention or working memory, two aspects of performance are important: speed and accuracy. In practice, people can switch their emphasis between the two with attentional focusing ( Rinkenauer et al 2004 ). Oftentimes, concentrating on improving one aspect leads to the deterioration of the other. This is called the speed/accuracy trade-off phenomenon. Some SD studies have found impairment only in performance speed, whereas accuracy has remained intact ( De Gennaro et al 2001 ; Chee and Choo 2004 ). In others, the results are the opposite ( Kim et al 2001 ; Gosselin et al 2005 ). De Gennaro et al (2001) proposed that in self-paced tasks, there is likely to be a stronger negative impact on speed, while accuracy remains intact. In experimenter-paced tasks, the effect would be the opposite. However, many studies show detrimental effect on both speed and accuracy (eg, Smith et al 2002 ; Jennings et al 2003 ; Chee and Choo 2004 ; Habeck et al 2004 ; Choo et al 2005 ). The speed/accuracy trade-off phenomenon is moderately affected by gender, age, and individual differences in response style ( Blatter et al 2006 ; Karakorpi et al 2006 ), which could be a reason for inconsistencies in the SD results. It has been argued that low signal rates increase fatigue during performance in SD studies and that subjects may even fall asleep during the test ( Dorrian et al 2005 ). Therefore, tasks with different signal loads may produce different results in terms of performance speed and accuracy.

Long-term memory

Long-term memory can be divided between declarative and non-declarative (procedural) memory. Declarative memory is explicit and limited, whereas non-declarative memory is implicit and has a practically unlimited capacity. Declarative memory includes semantic memory, which consists of knowledge about the world, and episodic memory, which holds autobiographical information. The contents of declarative memory can be stored in visual or verbal forms and they can be voluntarily recalled. Non-declarative or procedural memory includes the information needed in everyday functioning and behavior, eg, motor and perceptual skills, conditioned functions and priming. In previous studies, long-term memory has been measured with a variety of tasks, and the results are somewhat inconsistent.

In verbal episodic memory, SD of 35 h impaired free recall, but not recognition ( Drummond et al 2000 ). The opposite results were obtained with one night of SD ( Forest and Godbout 2000 ). The groups in both studies were quite small (in Drummond’s study, N = 13; in Forest and Godbout’s study, experimental group = 9, control group = 9), which offers a possible explanation for the variation in results. In addition, Drummond et al (2000) used a within-subject design, whereas Forest and Godbout (2000) had a between-subject design. In visual memory, recognition was similar in the experimental and control groups when the measurement was taken once after 36 h SD ( Harrison and Horne 2000 ), whereas the practice effect in visual recall was postponed by SD in a study with three measurements (baseline, 25 h SD, recovery; Alhola et al 2005 ). Performance was impaired in probed forced memory recall ( Wright and Badia 1999 ), and memory search ( McCarthy and Waters 1997 ), but no effect was found in episodic memory ( Nilsson et al 2005 ), implicit memory, prose recall, crystallized semantic memory, procedural memory, or face memory ( Quigley et al 2000 ). In the studies failing to find an effect, however, the subjects spent only the SD night under controlled conditions ( Quigley et al 2000 ; Nilsson et al 2005 ).

Free recall and recognition are both episodic memory functions which seem to be affected differently by SD. Temporal memory for faces (recall) deteriorated during 36 h of SD, although in the same study, face recognition remained intact ( Harrison and Horne 2000 ). In verbal memory, the same pattern was observed ( Drummond et al 2000 ). One explanation may be different neural bases, which supports the prefrontal vulnerability hypothesis. Episodic memory is strongly associated with the functioning of the medial temporal lobes ( Scoville and Milner 2000 ), but during free recall in a rested state, even stronger brain activation is found in the prefrontal cortex ( Hwang and Golby 2006 ). It is unclear whether this prefrontal activation reflects episodic memory function, the organization of information in working memory, or the executive control of attention and memory. Recognition, instead, presumably relies on the thalamus in addition to medial temporal lobes ( Hwang and Golby 2006 ). Since SD especially disturbs the functioning of frontal brain areas ( Drummond et al 1999 ; Thomas et al 2000 ), it is not surprising that free recall is more affected than recognition.

Although the prefrontal cortex vulnerability hypothesis has received wide support in the field of SD research, other brain areas are also involved. For instance, the exact role of the thalamus remains unknown. Some studies measuring attention or working memory have noted an increase in thalamic activation during SD (eg, Portas et al 1998 ; Chee and Choo 2004 ; Habeck et al 2004 ; Choo et al 2005 ). This may reflect an increase in phasic arousal or an attempt to compensate attentional performance during a demanding condition of low arousal caused by SD ( Coull et al 2004 ). In other cognitive tasks such as verbal memory ( Drummond and Brown 2001 ) or logical reasoning ( Drummond et al 2004 ), no increase in thalamic activation was found despite the fact that behavioral deterioration occurred. This implies that thalamic activation during SD is mainly related to some attentional function or compensation, providing further support for the hypothesis that “prefrontal dependent” recall is more affected by SD than “thalamus dependent” recognition. However, it is possible that the brain activation patterns during SD reflect something more than merely different cognitive domains. Harrison and Horne (2000) stated that their results may also reflect the difficulty of the task assigned to subjects.

Other cognitive functions

Sleep deprivation impairs visuomotor performance, which is measured with tasks of digit symbol substitution, letter cancellation, trail-making or maze tracing ( Table 1 ). It is believed that visual tasks would be especially vulnerable to sleep loss because iconic memory has short duration and limited capacity ( Raidy and Scharff 2005 ). Another suggestion is that SD impedes engagement of spatial attention, which can be observed as impairments in saccadic eye movements ( Bocca and Denise 2006 ). Decreased oculomotor functioning is associated with impaired visual performance ( De Gennaro et al 2001 ) and sleepiness (eg, De Gennaro et al 2001 ; Zils et al 2005 ). However, further research is needed to confirm this explanation, since not all studies have found oculomotor impairment with cognitive performance decrements ( Quigley et al 2000 ).

Reasoning ability during SD has for the most part been measured with Baddeley’s logical reasoning task or its modified versions. Again the results are inconsistent (deteriorated performance was reported by Blagrove et al 1995 ; McCarthy and Waters 1997 ; Monk and Carrier 1997 , and Harrison and Horne 1999 ; no effects were noted by Linde and Bergstrom 1992 ; Quigley et al 2000 , or Drummond et al 2004 ). The studies reporting no effect have mainly used SD of ca. 24 h ( Linde and Bergström 1992 ; Quigley et al 2000 ), whereas in the studies showing an adverse effect, the SD period has been longer (36 h). Thus reasoning ability seems to be maintained during short-term SD. However, choosing divergent study designs may result in different outcomes. Monk and Carrier (1997) repeated the cognitive test every 2 h and found deterioration after as little as 16 h of SD. In the studies with zero-results, cognitive tests were carried out in the morning ( Linde and Bergström 1992 ; Quigley et al 2000 ) or the practice effect was not adequately controlled ( Drummond et al 2004 ). In the studies with longer SD, the tests have been conducted either in the late afternoon ( McCarthy and Waters 1997 ; Harrison and Horne 1999 ) or have been repeated several times ( Blagrove et al 1995 ; Monk and Carrier 1997 ). Therefore, the different results may reflect the effect of circadian rhythm on alertness and cognitive performance. In the morning or before noon, the circadian process reaches its peak, inducing greater alertness, whereas the timing of the circadian nadir coincides with the late afternoon testing (see Achermann 2004 ).

In addition to the cognitive domains already introduced, total SD affects several other cognitive processes as well. It increases rigid thinking, perseveration errors, and difficulties in utilizing new information in complex tasks requiring innovative decision-making ( Harrison and Horne 1999 ). Deterioration in decision-making also appears as more variable performance and applied strategies ( Linde et al 1999 ), as well as more risky behavior ( Killgore et al 2006 ). Several other tasks have been used in the sleep deprivation studies ( Table 1 ). For example, motor function, rhythm, receptive and expressive speech, and memory measured with the Luria-Nebraska Neuropsychological Battery deteriorated after one night of SD, whereas tactile function, reading, writing, arithmetic and intellectual processes remain intact ( Kim et al 2001 ).

The adverse effects of total SD shown in experimental designs have also been confirmed in real-life settings, mainly among health care workers, professional drivers and military personnel ( Samkoff and Jacques 1991 ; Otmani et al 2005 ; Philibert 2005 ; Russo et al 2005 ). Performance of residents in routine practice and repetitive tasks requiring vigilance becomes more error-prone when wakefulness is prolonged (for a review, see Samkoff and Jacques 1991 ). However, in new situations or emergencies, the residents seem to be able to mobilize additional energy sources to compensate for the effects of tiredness. More recent meta-analysis shows that SD of less than 30 h causes a significant decrease in both the clinical and overall performance of both residents and non-physicians ( Philibert 2005 ).

What role does motivation play in cognitive performance? Can high motivation reverse the adverse effect of SD? Does poor motivation further deteriorate performance? According to a commonly held opinion, high motivation compensates for a decrease in performance, but only a few attempts have been made to confirm this theory. Estimating the compensatory effect of motivation in performance during SD is generally difficult, because persons participating in research protocols, especially in SD studies, usually have high initial motivation. The concept of motivation is closely linked to the “attentional effort” that is considered a cognitive incentive (for a review, see Sarter et al 2006 ). According to Sarter et al (2006) , “increases in attentional effort do not represent primarily a function of task demands but of subjects’ motivation to perform.” Furthermore, attentional effort is a function of explicit and implicit motivational forces and may be increased especially when the subjects are motivated or when they detect signals of performance decrements ( Sarter et al 2006 ).

Harrison and Horne (1998 , 1999) suggest that the deterioration of cognitive performance during SD could be due to boredom and lack of motivation caused by repeated tasks, especially if the tests are simple and monotonous. They used short, novel, and interesting tasks to abolish this motivational gap, yet still noted that SD impaired performance. In contrast, other researchers suggest that sleep-deprived subjects could maintain performance in short tasks by being able to temporarily increase their attentional effort. When a task is longer, performance deteriorates as a function of time. A meta-analysis by Pilcher and Huffcutt (1996) provides support for that: total SD of less than 45 h deteriorated performance more severely in complex tasks with a long duration than in simple and short tasks. Based on this, it is probably necessary to make a distinction between mere attentional effort and more general motivation. Although attentional effort reflects motivational aspects in performance, motivation in a broader sense can be considered a long-term process such as achieving a previously set goal, eg, completing a study protocol. If one has already invested a great deal of time and effort in the participation, motivation to follow through may be increased.

Different aspects of motivation were investigated in a study with 72 h SD, where the subjects evaluated both motivation to perform the tasks and motivation to carry out leisure activities ( Mikulincer et al 1989 ). Cognitive tasks were repeated every two hours. Performance motivation decreased only during the second night of SD, whereas leisure motivation decreased from the second day until the end of the study on the third day. The authors concluded that the subjects were more motivated to complete experimental testing than to enjoy leisure activities because by performing the tasks, they could advance the completion of the study. The researchers suggested that the increased motivation towards the tasks on the third day reflected the “end spurt effect” caused by the anticipation of sleep.

Providing the subjects with feedback on their performance or rewarding them for effort or good performance is shown to help maintain performance both in normal, non-deprived conditions ( Tomporowski and Tinsley 1996 ) and during SD ( Horne and Pettitt 1985 ; Steyvers 1987 ; Steyvers and Gaillard 1993 ). In a large study with 61 subjects (experimental group = 29), with SD of 34–36 h, and with a comprehensive test battery, the subjects were continuously encouraged and provided with 2–3 minute breaks between the tests ( Binks et al 1999 ). Furthermore, they were told they would receive a monetary award for completing all tests with “honest effort”. As result, no deteriorating effect on cognitive performance was found. Unfortunately, a non-motivated control group was not included and thus the effect of motivation remained uncertain. In general, since this issue has not been addressed sufficiently, it is difficult to specify the role of motivation in performance. It seems that motivation affects performance, but it also appears that SD can lead to a loss of motivation.

Self-evaluation of cognitive performance

It has been suggested that the self-evaluation of cognitive performance is impaired by SD. During 36 h SD, the subjects became more confident that their answers were correct as the wakefulness continued ( Harrison and Horne 2000 ). Confidence was even stronger when the answer was actually wrong. In another study, performance was similar between sleep-deprived and control groups in several attentional assessments, but the deprived subjects evaluated their performance as moderately impaired ( Binks et al 1999 ). The controls considered that their performance was high.

The ability to evaluate one’s own cognitive performance depends on age and on the study design. Young people seem to underestimate the effect of SD, whereas older people seem to overestimate it. In a simple reaction time task, both young (aged 20–25 years) and aging (aged 52–63 years) subjects considered that their performance had deteriorated after 24 h SD, although performance was actually impaired only in young subjects ( Philip et al 2004 ). When it comes to the study design and methodology, the way in which the self-evaluation is done may affect the outcome. The answers possibly reflect presuppositions of the subjects or their desire to please the researcher. The repetition of tasks is also essential. Evaluation ability is poor in studies with one measurement only ( Binks et al 1999 ; Harrison and Horne 2000 ; Philip et al 2004 ), whereas in repeated measures, the subjects are shown to be able to assess their performance quite reliably during 60–64 h SD and recovery ( Baranski et al 1994 ; Baranski and Pigeau 1997 ). Thus, self-evaluation is likely to be more accurate when subjects can compare their performance with baseline.

Chronic partial sleep restriction

Although chronic partial sleep restriction is common in everyday life and even more prevalent than total SD, surprisingly few studies have evaluated its effects on cognitive performance. Even fewer studies have compared the effects of acute total sleep deprivation and chronic partial sleep restriction. Belenky and co-workers (2003) evaluated the effect of partial sleep restriction in a laboratory setting in groups which were allowed to spend 3, 5 or 7 h in bed daily for seven consecutive days. The control group spent 9 h in bed. In the 3 h group, both speed and accuracy in the PVT deteriorated almost linearly as the sleep restriction continued. In this group, performance was clearly the worst. In the 5- and 7 h groups, performance speed deteriorated after the first two restriction nights, but then remained stable (though impaired) during the rest of the sleep restriction from the third night onwards. Impairment was greater in the 5- than 7 h group. Accuracy followed the same pattern in the 7 h group, but further declined in the 5 h group as the study went on. The control group’s performance did not change during the study. Intriguingly, a highly similar pattern was observed in another study with the same task when sleep was restricted by 33% of the subject’s habitual nightly sleep, which resulted in 5 h of sleep per night on average ( Dinges et al 1997 ). Both speed and accuracy were impaired at the beginning of the sleep restriction period followed by a plateau and finally, another drop after the seventh night of deprivation. However, no change was found in probed recall memory or serial addition tests, probably because of the practice effect and short duration of the tests (serial addition test: 1 min).

It is difficult to compare the effects of total and partial SD based on existing literature due to large variation in methodologies, including the length of SD or the type of cognitive measures. The only study that has compared total and partial SD found that after controlling learning effects, cognitive performance declined almost linearly in the course of the study in all four experimental groups ( Van Dongen et al 2003a ): one group was exposed to 3 nights total SD, and in other experimental groups, time in bed was restricted to 4 or 6 h for 14 consecutive days. The control group was allowed 8 h in bed for 14 days. Impairment in psychomotor vigilance test and digit symbol substitution task for the 4 h group after 14 days was equal to that of the total SD group after 2 nights. Deterioration in the serial addition/subtraction task for the 4 h group was similar to that of the total SD group after 1 night. The effect of 6 h restricted sleep corresponded to 1 night of total SD in psychomotor vigilance and digit symbol. Performance remained unaffected in the control group.

According to the well-controlled studies ( Dinges et al 1997 ; Belenky et al 2003 ; Van Dongen et al 2003a ), the less sleep obtained due to sleep restriction, the more cognitive performance is impaired. Otherwise, it is difficult to draw conclusions about the effects of chronic sleep restriction because of methodological problems in the previous studies. Blagrove et al (1995) compared subjects that slept at home either 5 h or 8 h per night for 4 weeks and found no effect in a short task of logical reasoning (duration 5 min). The statistical analyses were compromised by the small sample size (6 subjects in the experimental group and only 4 subjects in the control group). In another protocol, they also carried out auditory vigilance test, two column addition, finding embedded figures, and logical reasoning (10 min) tasks, and again no effect was observed with groups of 6–8 subjects having 4, 5 or 8 h sleep per night for 7, 19 or 40 weeks respectively ( Blagrove et al 1995 ). Casement et al (2006) reported no change in working memory and motor speed in the group whose sleep was restricted to 4 h per night for 9 nights. In the control group, performance improved. The study was carried out in a controlled clinical environment, but only one short test session per day was included, which means that subjects may have been able to temporarily increase their effort and thus maintain their performance. Furthermore, the results were confounded by the practice effect. In other sleep restriction studies, SD cannot be considered chronic, since the length of the restriction has been 1–3 nights ( Stenuit and Kerkhofs 2005 ; Swann et al 2006 ; Versace et al 2006 ).

Since chronic partial SD mimics every day life situations more than acute total SD, additional studies on how it affects cognitive performance are warranted. In addition, the tasks used in previous studies have been quite short and simple, and trials with more demanding cognitive tasks are required. The effects of sleep restriction have also been addressed by drive simulation studies, which are interesting and practical designs. Just one night of restricted sleep (4 h) increased right edge-line crossings in a motorway drive simulation of 90 minutes ( Otmani et al 2005 ). However, neither the drivers’ position in the lane nor the amplitude and frequency of steering wheel movements were affected. One sleep-restricted night did not increase the probability of a crash, but after five nights of partial SD, the quantity of accidents increased ( Thorne et al 1999 ).

Cognitive recovering from sleep deprivation

The recovery processes of cognitive performance after sleep loss are still obscure. In many SD studies, the recovery period has either not been included in the protocol or was not reported. Recovery sleep is distinct from normal sleep. Sleep latency is shorter, sleep efficiency is higher, the amounts of SWS and REM-sleep are increased and percentages of stage 1 sleep and awake are decreased ( Armitage et al 2001 ; Kilduff et al 2005 ). The characteristics of recovery sleep may also depend on circumstances and some differences seem to come with eg, aging ( Kalleinen et al 2006 ). Evidence suggests that one sleep period (at least eight hours) can reverse the adverse effects of total SD on cognition ( Brendel et al 1990 ; Corsi-Cabrera et al 2003 ; Adam et al 2006 ; Drummond et al 2006 ; Kendall et al 2006 ). The tasks have been mainly simple attentional tasks; for example, the PVT used by Adam et al (2006) has been proven to have practically no learning curve and little if any correlation with aptitude ( Durmer and Dinges 2005 ). Thus, it is likely that the improvement was mostly caused by the recovery process and not just the practice effect.

After chronic partial sleep restriction, the recovery process of cognitive functioning seems to take longer than after acute total SD. Performance in the PVT was not restored after one 10 h recovery night, but approached the baseline level after two 10 h nights in a study with seven consecutive sleep restriction nights with 5 h sleep/night ( Dinges et al 1997 ). Using the same test, three 8 h recovery nights were not enough to restore performance after one week of sleep restriction even in the group that spent 7 h time in bed (the study is explained in greater detail in paragraph 1 of “Partial sleep restriction”, Belenky et al 2003 ). The group that spent 3 h in bed showed the greatest decline as well as the greatest recovery, although it did not reach baseline level again. In the 5 h group, a similar deterioration-recovery curve was observed, although it was not as steep. Those authors concluded that during mild and moderate chronic partial SD, the brain adapted to a stressful condition to maintain performance, yet at a reduced level. This adaptation process was obviously so demanding that it postponed the restoration of normal functioning. According to their results, it could be further interpreted that when sleep restriction was severe, no such adaptation occurred, which in turn allowed for greater recovery. However, these results may be biased because of poor statistical sensitivity in multiple comparisons. They have also been criticized by eg, Van Dongen et al (2004) , who pointed out that another confounding factor may have been considerable interindividual differences in recovery rates. Since interindividual differences have been observed in response to SD, it is likely – although not yet adequately verified – that those individual traits also affect the recuperation.

Sleep deprivation in different populations

Sleep structure changes with aging. Slow wave sleep and sleep efficiency decrease, and alterations in the circadian rhythm occur (for reviews, see Dzaja et al 2005 ; Gaudreau et al 2005 ). Sleep complaints also become more frequent ( Leger et al 2000 ). Yet, during prolonged wakefulness, cognitive performance seems to be maintained better in aging people than in younger ones ( Bonnet and Rosa 1987 ; Smulders et al 1997 ; Philip et al 2004 ; Stenuit and Kerkhofs 2005 ). Total SD of 24 h deteriorated vigilance in young subjects (20–25 years), whereas performance in aging subjects (52–63 years) remained unaffected ( Philip et al 2004 ). Similarly, during three consecutive nights of partial SD (4 h in bed) performance in psychomotor vigilance task declined more in young subjects (20–30 years) than in aging ones (55–65 years, Stenuit and Kerkhofs 2005 ). In visual episodic memory, visuomotor performance and divided attention, aging subjects (58–72 years) were able to maintain their performance after 25 h of SD and showed improvement only after a recovery night ( Alhola et al 2005 ). However, no comparison with young subjects was made in that study.

Sleep deprivation deteriorates accuracy of performance, especially in young subjects ( Brendel et al 1990 ; Smulders et al 1997 ; Adam et al 2006 ; Karakorpi et al 2006 ). Regarding performance speed, however, results have been inconsistent and the performance of aging subjects has declined more, less, or equally compared to that of younger people. In simple and two-choice reaction time tasks as well as in a vigilance task, reaction speed was impaired in aging subjects (59–72 years) during 40 h SD, whereas young subjects (20–26 years) kept up their speed ( Karakorpi et al 2006 ). These results followed the speed/accuracy trade-off phenomenon so that aging subjects maintained accuracy at the expense of speed and the younger ones did the opposite. In contrast, two other studies found that young subjects were slower than aging subjects ( Brendel et al 1990 ; Adam et al 2006 ). During 24 h wakefulness, performance speed in a vigilance task was impaired in both 20- and 80-year-olds, but more so in the young subjects ( Brendel et al 1990 ). This was confirmed in another study with 40 h SD ( Adam et al 2006 ). When measuring reaction speed in three different choice-reaction time tasks, performance deteriorated similarly in young (18–24 years) and aging (62–73 years) subjects after 28 h total SD ( Smulders et al 1997 ).

Even though there is some evidence that older subjects tolerate SD better than young subjects, it is difficult to determine the age effect during SD with precision. However, because of age-related changes in many aspects of sleep and wakefulness, it is plausible that aging influences reactions to SD. As suggested previously, the weaker SD effect in aging may be due to attenuation of the circadian amplitude, which is reflected in the performance curve in vigilance tasks ( Blatter et al 2006 ). Also, changes in the homeostatic process may play a role. During wakefulness, the accumulation of sleep pressure seems to be reduced in aging ( Murillo-Rodriguez et al 2004 ), which could leave older subjects more alert. There is also evidence that aging subjects recover faster from SD than young subjects in terms of physiological sleep ( Bonnet and Rosa 1987 ; Brendel et al 1990 ). This faster recovery in sleep state may also mean better restoration of cognitive performance ( Bonnet and Rosa 1987 ; Brendel et al 1990 ). However, more research is necessary to confirm these hypotheses.

The age effect found in previous studies could also be explained by methodological factors, such as inadequate control of the baseline conditions. Younger subjects are usually more chronically sleep deprived ( National Sleep Foundation 2002 ) due to several reasons, such as studying, career building or raising children. Chronic sleep restriction may cause long-term changes in brain functions that are not reversible during short adaptation and baseline periods in sleep laboratory studies. Even though subjects of certain studies were instructed to maintain a regular 8 h sleep schedule for 3–5 days, this may not be enough to erase the previous “sleep debt” ( Brendel et al 1990 ; Philip et al 2004 ; Adam et al 2006 ). Furthermore, in the long run, people tend to get used to experiencing sleepiness ( Van Dongen et al 2003a ) and thus may not even recognize being chronically sleep deprived. Perhaps aging people also have more experience that helps them to cope with the challenges posed by SD. Nevertheless, based on the available studies, it is impossible to distinguish the factors behind the age effect.

There are dissimilarities between genders in sleep structure measured with polysomnography (for a review, see Manber and Armitage 1999 ). Furthermore, women of all ages report more sleeping problems than men ( Leger et al 2000 ). Sex hormones affect sleep through several mechanisms, both genomic and nongenomic, including neurochemical and vascular mechanisms (for a review, see Dzaja et al 2005 ). This ensures instant and short-term effects as well as long-term ones.

It is possible that physiological responses to SD are not equal among men and women. During SD of 38 h, EEG showed more sleep activity in men than in women during waking rest and cognitive performance ( Corsi-Cabrera et al 2003 ). Presumably, therefore, one recovery night of nine hours would be enough to restore waking EEG activity in men, but not in women. Only a few studies have examined gender differences in cognitive performance during SD. In a vigilance task, performance was more impaired in men but returned to the baseline level in both men and women after recovery sleep ( Corsi-Cabrera et al 2003 ). In another study, women performed better than men in verbal and in visuo-constructive tasks during 35 h SD ( Binks et al 1999 ). No gender differences were observed in word fluency, maintenance or suppression of attention, auditory attention or cognitive flexibility. In that study, however, only one point of measurement was included, and so the difference in performance could be caused by SD or initial distinctions between the gender groups.

Few attempts have been made to evaluate the effect of sex hormones on coping with SD. It has been suggested that hormone therapy, which is widely used for women during their menopausal transition to help alleviate climacteric symptoms, attenuates physiological stress response ( Lindheim et al 1992 ). However, after 25 h of total SD, no difference was observed between hormone therapy users and nonusers in visual episodic memory, visuomotor performance, verbal attention and shared attention ( Alhola et al 2005 ). In addition, during 40 h of SD, hormone therapy did not produce any advantage in reaction time or vigilance tasks ( Karakorpi et al 2006 ).

The previous studies suggest that women cope with continuous wakefulness better than men. According to evolution, the demands of child nurturing and rearing in women would support this hypothesis ( Corsi-Cabrera et al 2003 ), but that certainly does not constitute a comprehensive explanation today. Gender differences during SD could be due to either physiological or social factors. There are differences in the brain structure and functioning of men and women ( Ragland et al 2000 ; Cowell et al 2007 ). These can be seen in cognitive performance in normal, non-deprived conditions: men typically have better spatial abilities and mental rotation, and higher visuo-constructive performance, whereas women perform better in visuomotor speed and some verbal functions, especially verbal fluency (for a review, see Kimura 1996 ). Men and women also exhibit behavioral and lifestyle differences, which are mainly due to socialization and gender roles ( Eagly and Wood 1999 ). Current literature, however, provides only minimal evidence of differential effects during SD, and does not resolve the issue of sexual dimorphism in coping with SD.

Interindividual differences

Several studies provide evidence that during total SD, performance becomes more variable as assessed from the within-subject point of view (eg, Smith et al 2002 ; Habeck et al 2004 ; Choo et al 2005 ). This is considered to reflect the wake-state instability caused by prolonged wakefulness. However, Doran et al (2001) were probably the first to also examine between-subjects variability, which they found to increase in PVT as wakefulness was extended to 88 hours. They suggested that some people are more vulnerable to the effects of sleep loss than others, which could probably explain the lack of significant results in some group comparisons. These differences between subjects could have arguably been caused by differences in sleep history, but the sleep patterns for the preceding week were controlled with sleep diaries, actigraph, and calls to the time-stamped voice recorder.

The interindividual variability has been further examined with a thorough protocol where a three night study (baseline, 36 h SD and recovery) was carried out three times ( Van Dongen et al 2004 ). Sleep history was manipulated by instructing subjects to stay in bed for either 6 or 12 h per night for one week before the study. The 12 h procedure was repeated and the order of the conditions was counterbalanced. The cognitive test selection included serial addition/subtraction task, digit symbol, critical tracking, word detection, repeated acquisition of response sequences, and PVT. The authors concluded that interindividual differences were systematic and independent from sleep history. The trait-like differential vulnerability to sleep loss has received support from an fMRI study attempting to reveal the neural basis for the interindividual differences ( Chuah et al 2006 ). They used a go/no-go task to measure response inhibition after 24 h of sleep deprivation. The results indicated that the subjects less vulnerable to SD had lower prefrontal cortex activation at the rested wakefulness than the more vulnerable subjects. During SD, activation increased temporarily in the prefrontal cortex and in some other areas only in the less vulnerable subjects. Since interindividual differences have also been found in other sleep-related variables, such as duration, timing, and quality of sleep, sleepiness, and circadian phase ( Van Dongen 1998 ; Van Dongen et al 2005 ), it is plausible that the tolerance to SD may also vary. Nevertheless, more studies are needed for further support.

Methodological issues and common biases

Although the adverse effects of SD on cognitive performance are quite well established, some studies have failed to detect any deterioration. Inadequate descriptions of study protocols or subject characteristics in some studies make it difficult to interpret the neutral results. However, it is likely that such results are due to methodological shortcomings, such as insensitive cognitive measures, failure to control the practice effect or other confounding factors, like individual sleep history or napping during the study. Also, if the task is carried out only once during the SD period, the results may be influenced by circadian rhythm.

Sleep deprivation studies are laborious and expensive to carry out, which may lead to compromises in the study design: for example, a small sample size can reduce the statistical power of the study, but a larger population may come at the expense of other methodological issues, such as a reduction in the cognitive test selection or in the number of nights spent in the sleep laboratory. Comparison of the results is also complicated because the length of sleep restriction varies and the studies are designed either within- or between-subjects.

Sleeping in unfamiliar surroundings may impair sleep quality. An adaptation night at the sleep laboratory is used to minimize this first night effect. However, in several studies, this has been neglected and the SD period has been preceded by a “normal” night at home (eg, Harrison and Horne 2000 ; Jennings et al 2003 ; Choo et al 2005 ). Although sleeping at home certainly reflects a subject’s reality more accurately, it does not allow for precise control and information of sleeping conditions. Adding a portable recording, such as an actigraph, provides objective information about eg, bedtime and resting periods. In some studies, the first night in the sleep laboratory has been the baseline (eg, Drummond et al 2000 ; Forest and Godbout 2000 ; De Gennaro et al 2001 ; Drummond et al 2001 ), whereas others have included one adaptation night (eg, Casagrande et al 1997 ; Alhola et al 2005 ). Yet, it may be questionable to use data from the second night as the baseline because sleep quality can be better than normal due to the rebound from the first night. Accordingly, only data from the third night should be accepted, which has been the case in a few studies ( Thomas et al 2000 ; Van Dongen et al 2003a ). This, however, makes the procedure very hard. Furthermore, study protocols can be improved by adding an ambulatory EEG recording to confirm the wakefulness of the subjects during the study.

In sleep studies, a common pitfall is recruitment methods. Enrolment via advertisements or from sleep clinics favors the selection of subjects with sleeping problems or concerns about their cognitive performance. Thus, strict exclusion criteria regarding physical or mental diseases or sleeping problems are essential. Further, sleeping habits should be controlled to make sure that the subjects are not initially sleep deprived. For this, use of a sleep diary for eg, 1–3 weeks before the experiment (eg, De Gennaro et al 2001 ; Habeck et al 2004 ; Alhola et al 2005 ) or an actigraph is applicable ( Harrison and Horne 1999 ; Thomas et al 2000 ).

The use of medication or stimulants, such as caffeine, alcohol or tobacco, is often prohibited before the experiment (eg, Thomas et al 2000 ; Van Dongen et al 2003a ; Habeck et al 2004 ; Alhola et al 2005 ; Choo et al 2005 ). In some studies, the subjects have been required to refrain from these substances only 24 h before the study ( Habeck et al 2004 ; Choo et al 2005 ), which may increase withdrawal symptoms and dropping out of the study. Thus a longer abstinence, eg, 1–2 weeks, is more appropriate ( Van Dongen et al 2003a ; Alhola et al 2005 ).

A variety of cognitive tests, from simple reaction time measures to complex decision-making tasks requiring creativity and reasoning, have been used to evaluate the effect of SD on cognition. The greatest problem in repeated cognitive testing is the practice effect, which easily conceals any adverse effects of SD. Therefore, careful control over learning is essential. Cognitive processes are also intertwined in several ways, which makes it difficult to specify exactly which cognitive functions are utilized in certain performances. Because attention is involved in performing any cognitive task, a decrease in other cognitive domains during SD may be mediated through impaired attention. In complex tasks, however, applying previous knowledge and use of strategies or creativity may be more essential. Some studies have concentrated on neural correlates of cognitive functioning during continuous wakefulness. Both fMRI ( Portas et al 1998 ; Drummond et al 2000 ; Drummond et al 2001 ; Chee and Choo 2004 ; Habeck et al 2004 ; Choo et al 2005 ) and PET have been used ( Thomas et al 2000 ). Although these trials yield interesting information about brain functioning, the use of imaging techniques limits the selection of cognitive tests that could be carried out at the same time.

Dorrian et al (2005) have compiled a list of criteria for neurocognitive tests that would be suitable for investigating sleep deprivation effects. The criteria include psychometric quality, ie, reliability and validity, but the tests should also reflect a fundamental aspect of waking neurocognitive functions and it should be possible to interpret them in a meaningful way. The tasks should be repeatable, independent of aptitude, and they should be short with a high signal load. These criteria are not met in some studies. Dorrian et al (2005) also argued that vigilance is the underlying factor through which the sleep deprivation effects are mediated in all other tasks. However, although attention is needed to perform any task to some extent, the hypothesis that sleep deprivation can have an independent effect on other cognitive functions such as memory cannot be ruled out. Nevertheless, when measuring other cognitive functions, the characteristics of the task should be considered carefully and, eg, for repeated measures of memory, parallel test versions should be used.

The negative effect of both acute total and chronic partial SD on attention and working memory is supported by existing literature. Total SD impairs a range of other cognitive functions as well. In partial SD, a more thorough evaluation of higher cognitive functions is needed. Furthermore, the effects of SD have not been thoroughly compared among some essential subpopulations.

Aging influences a person’s ability to cope with SD. Although in general the cognitive performance of aging people is often poorer than that of younger individuals, during SD performance in older subjects seems to deteriorate less. Based on the scarce evidence, it seems that in terms of cognitive performance, women may endure prolonged wakefulness better than men, whereas physiologically they recover slower. Tolerating SD can also depend on individual traits. However, mechanisms inducing differences between the young and aging and between men and women or different individuals are mostly unclear. Several reasons such as physiological mechanisms as well as social or environmental factors may be involved. In conclusion, there is great variation in SD studies in terms of both subject selections and methods, and this makes it difficult to compare the different studies. In the future, methodological issues should be considered more thoroughly.

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Weekend sleep could lower heart disease risk by 20%

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The demands of the working week, often influenced by school or work schedules, can lead to sleep disruption and deprivation. However, new research presented at ESC Congress 2024 shows that people that 'catch up' on their sleep by sleeping in at weekends may see their risk of heart disease fall by one-fifth. 

Sufficient compensatory sleep is linked to a lower risk of heart disease. The association becomes even more pronounced among individuals who regularly experience inadequate sleep on weekdays."  Mr. Yanjun Song, study co-author,  State Key Laboratory of Infectious Disease, Fuwai Hospital, National Centre for Cardiovascular Disease, Beijing, China

It is well known that people who suffer sleep deprivation 'sleep in' on days off to mitigate the effects of sleep deprivation. However, there is a lack of research on whether this compensatory sleep helps heart health. 

The authors used data from 90,903 subjects involved in the UK Biobank project, and to evaluate the relationship between compensated weekend sleep and heart disease, sleep data was recorded using accelerometers and grouped by quartiles (divided into four approximately equal groups from most compensated sleep to least). Q1 (n = 22,475 was the least compensated, having -16.05 hours to -0.26 hours (ie, having even less sleep); Q2 (n = 22,901) had -0.26 to +0.45 hours; Q3 (n=22,692) had +0.45 to +1.28 hours, and Q4 (n=22,695) had the most compensatory sleep (1.28 to 16.06 hours). 

Sleep deprivation was self-reported, with those self-reporting less than 7 hours sleep per night defined as having sleep deprivation. A total of 19,816 (21.8%) of participants were defined as sleep deprived. The rest of the cohort may have experienced occasional inadequate sleep, but on average, their daily hours of sleep did not meet the criteria for sleep deprivation – the authors recognize this a limitation to their data. 

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Hospitalization records and cause of death registry information were used to diagnose various cardiac diseases including ischemic heart disease (IHD), heart failure (HF), atrial fibrillation (AF), and stroke. 

With a median follow-up of almost 14 years, participants in the group with the most compensatory sleep (quartile 4) were 19% less likely to develop heart disease than those with the least (quartile 1). In the subgroup of patients with daily sleep deprivation those with the most compensatory sleep had a 20% lower risk of developing heart disease than those with the least. The analysis did not show any differences between men and women. 

Co-author Mr Zechen Liu, also of State Key Laboratory of Infectious Disease, Fuwai Hospital, National Centre for Cardiovascular Disease, Beijing, China, added: "Our results show that for the significant proportion of the population in modern society that suffers from sleep deprivation, those who have the most 'catch-up' sleep at weekends have significantly lower rates of heart disease than those with the least." 

European Society of Cardiology

Posted in: Medical Research News | Medical Condition News

Tags: Atrial Fibrillation , Cardiology , Cardiovascular Disease , Healthcare , Heart , Heart Disease , Heart Failure , Hospital , Laboratory , Medicine , Research , Sleep , Stroke , UK Biobank

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Acute sleep deprivation-induced hepatotoxicity and dyslipidemia in middle-aged female rats and its amelioration by butanol extract of Tinospora cordifolia

Affiliations.

• 1 Medical Biotechnology Laboratory, Department of Biotechnology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India.
• 2 Department of Pharmacology, Khalsa College of Pharmacy, Amritsar, 143005, India.
• 3 Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India.
• 4 Medical Biotechnology Laboratory, Department of Biotechnology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India. [email protected].
• PMID: 39164744
• PMCID: PMC11337769
• DOI: 10.1186/s42826-024-00216-4

Background: Sleep deprivation (SD) due to an unhealthy lifestyle poses an oxidative challenge and is closely associated with an increased risk and prevalence of different metabolic disorders. Although the negative consequences of SD are well reported on mental health little is known about its detrimental effects on liver function and lipid metabolism. Tinospora cordifolia is reported for its hepatoprotective activity in different pre-clinical model systems. The current study was designed to elucidate the cumulative effects of aging and acute SD on liver functions, oxidative stress, and lipid metabolism, and their management by butanol extract of T. cordifolia (B-TCE) using middle-aged female acyclic rats as the model system.

Results: Rats were divided into 4 groups: (1) Vehicle-undisturbed (VUD) (2) Vehicle-sleep deprived (VSD) (3) B-TCE pre-treated sleep-deprived (TSD) (4) B-TCE pre-treated undisturbed sleep (TUD). TSD and TUD groups were given 35 mg/kg of B-TCE once daily for 15 days followed by 12 h of sleep deprivation (6 a.m.-6 p.m.) of VSD and TSD group animals using the gentle-handling method while VUD and TUD group animals were left undisturbed. SD of VSD group animals increased oxidative stress, liver function disruption, and dyslipidemia which were ameliorated by B-TCE pre-treatment. Further, B-TCE was observed to target AMPK and its downstream lipid metabolism pathways as well as the p-Akt/cyclinD1/p-bad pathway of cell survival as possible underlying mechanisms of its hepatoprotective activity.

Conclusions: These findings suggest that B-TCE being a multi-component extract may be a potential agent in curtailing sleep-related problems and preventing SD-associated hepatotoxicity and dyslipidemia in postmenopausal women.

Keywords: Tinospora cordifolia; Apoptosis; Dyslipidemia; Hepatoprotection; Oxidative stress; Sleep deprivation.

© 2024. The Author(s).

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

B-TCE Supplementation of B-TCE attenuated…

B-TCE Supplementation of B-TCE attenuated SD induced liver function impairments and oxidative stress.…

B-TCE supplementation-maintained serum lipid profile…

B-TCE supplementation-maintained serum lipid profile and prevented dyslipidemia. a , b , c…

Effect of B-TCE pre-treatment on…

Effect of B-TCE pre-treatment on the expression of proteins involved in lipogenesis (SREBP-1…

Cell growth promotion by B-TCE.…

Cell growth promotion by B-TCE. a , b Representative western blot images (n…

Inhibition of apoptosis and maintenance…

Inhibition of apoptosis and maintenance of endothelial functions by B-TCE. a , b…

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• CSIR (21(1135)/22/EMR-II)/CSIR - Indian Institute of Chemical Biology

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