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Independent expert answers
on psychiatry and psychology

Sleep deprivation - lack of sleep - insomnia

Abstract: Overview of sleeping problems, its effects, causes and what to do about them.

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Sleep deprivation - lack of sleep - insomnia

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Question(s): 
Written by: Jenny Åberg, pscyhology student, under supervison by Gunborg Palme, certified psychologist, certified psychotherapist and certified teacher of psychotherapy.
First version: 22 Jul 2008.
Latest revision: 15 Oct 2017.

Is getting too little sleep dangerous?

Answer:

Sleep deprivation is getting more and more common in our stressed-out society. Nine out of ten people of the working population would sleep longer in the morning if they had the chance, and almost one third of the population suffer from sleep deprivation. About ten percent of the population are constantly getting too little sleep. Half of these cases are due to problems falling asleep and the other half are due to disturbances by, for example, children or noise. Sleep deprivation is more common with women than men.

Most people need between six and nine hours of sleep per day and on average adults sleep eight and a half hour if they are allowed to sleep as much as their body needs. An adult sleeps on average seven and a half hour per day.

Approximately 40 percent of the population use medicines or herbal medicines at least once a week because of sleeping problems.

What is sleep?

Sleep is a complicated process that is needed in order to give the brain and body rest, time to recover and process impressions. Sleep is important for growth during childhood and adolescence. During the day, but especially when we sleep, the body produces growth hormones that, among other things, strengthen the bones and build muscles.

Sleep is usually divided into five stages. When you have passed through all five stages you start over at stage one. One such sequence is called a sleep cycle. Here follows a short description of the five stages of sleep:

  • Drowsiness (stage 1): Your heart rate slows down, you start to breathe slower and your metabolism slows down. This stage usually lasts five to twenty minutes.
  • Light sleep (stage 2): Brain activity is lower than during stage 1. This type of sleep constitutes about half of the total sleep time.
  • Deep sleep (stages 3 and 4): During these stages the brain activity is at its lowest. The body produces almost no stress hormones but a lot of growth hormones.
  • Dream sleep, REM sleep (stage 5): During this stage the eyes are moving rapidly behind the eyelids, hence the name Rapid Eye Movement (REM). During this stage breathing gets faster, the heart beats faster and the blood pressure rises. The brain now works in a similar way as when we are awake. You can dream during all stages of sleep, but dreams are most common during this stage.

The effects of sleep deprivation

There seems to be a connection between long term sleep problems and cardiovascular diseases and depression. Sleep deprivation also lowers the immune defense and can cause heightened sensitivity to pain, which can worsen the symptoms of pain diseases like fibromyalgia and arthritis. Sleep deprivation can also be a factor behind elevated blood pressure. Sleep in itself has a reducing effect on blood pressure and with too little sleep the body's ability to regulate blood pressure is reduced.

Sleep also helps to regulate our feelings of hunger and satisfaction. According to some studies the body's amount of leptine, a hormone that makes us fell sated, is reduced with less sleep. At the same time the amount of ghrelin, a hormone that makes us feel hungry, increases. So it seems as if there is a connection between sleep deprivation and obesity, and all the diseases that are related to obesity.

Sleep is also important for our body's ability to take care of free radicals. These molecules are a factor in the aging of cells and seem to increase the risk of cancer.

Sleep is very important, for body, mind and our general well-being. Long term sleep problems often contribute to a lowered quality of life.

The effects of sleep deprivation

Short term effects

Long term effects

  • Sleepiness
  • Mood swings
  • Short term memory deterioration
  • Diminished ability to come up with, plan and carry out activities
  • Difficulty concentrating
  • Obesity
  • Early aging
  • Exhaustion
  • Increased risk of infections, diabetes, cardiovascular diseases and gastrointestinal diseases
  • Chronic memory loss
  • Weakened immune system

Insomnia:

Insomnia can be defined as a difficulty falling asleep, frequent awakening during the night or a feeling of not getting enough rest. There is a difference between chronic and acute insomnia. Chronic insomnia means that the problem has lasted more than three weeks and acute means it has lasted less than three weeks. Acute insomnia is often due to external factors, for example a death in the family. The symptoms of insomnia are: Difficulty falling asleep (taking at least 30 minutes), waking up more than three times per night or being awake for more than 45 minutes. Another symptom is waking up to early, which is defined as waking up before you have had six hours of sleep, and not being able to go back to sleep. To get the diagnosis insomnia your everyday life has to be negatively affected due to the lack of sleep, for example difficulty concentrating and mood swings.

Insomnia is often not an illness of its own but rather a symptom of other problems, for example psychological conditions like depression, substance abuse and/or anxiety. Other causes of insomnia can be hormonal changes following pregnancy or menopause, pain or medication. Stress or changed sleeping habits can also cause insomnia.

If you experience difficulty falling asleep, or if you wake up during the night or too early in the morning, and if lack of sleep is lowering your quality of life, it might be a good idea to see a doctor. Insomnia can be treated both with psychotherapy and by medications.

Practical advice against sleeping problems

  • Short naps during the day is an effective cure if you are tired. Fifteen minutes of sleep in the middle of the day is more rejuvenating than the last two or three hours of sleep during the night. The downside is that sleeping during the day might negatively effect the night sleep.
  • Change your evening habits. Demands from friends and family can be just as stressful as a work. Thus you should make sure that you don't have any obligations during the evenings and try to go to sleep earlier.
  • Alcohol consumption and smoking deteriorate the quality of your sleep. Thus it might help to quit smoking and/or cut back on alcohol consumption.
  • Stress increases the metabolism which in turn prevents the sleep from being as deep as it should, and it also makes it easier to wake up. This means that it will take longer for you to fall asleep and you will more often wake up during the night or early in the morning.
  • Create a good sleeping environment. Most people sleep best in a dark, cool (14-18°C/57-64°F) and quiet room with a good bed.
  • Avoid alcohol and stimulating beverages such as coffee, tea, energy drinks and cola for at least six hours before you go to bed.
  • Don't go to bed hungry.
  • Sleep at regular hours.
  • Try to have some physical activity every day.
  • Wind down before you go to bed. This can be done by for example reading, watching TV, playing with children or anything else that makes you feel relaxed without feeling like an obligation.
  • Take a warm bath an hour before going to bed.
  • If you can't sleep it might help to get up again and do something else until you feel sleepy.
  • Learn relaxation techniques that you can use when going to bed.
  • Learn "thought stop" to stop ruminative thoughts.
  • Place your alarm clock so that you can't see what time it is from your bed. It can be stressing to see how long you have been lying awake.
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