Insufficient Sleep

Sleep deprivation is when you aren’t sleeping enough, or you aren’t getting good, quality sleep. When it’s severe or happens over an extended period, it can cause very disruptive symptoms that interfere with even the most routine activities. Long-term sleep deprivation can worsen many major health conditions. This condition is usually treatable.

What is sleep deprivation?

Sleep deprivation is when a person doesn’t get enough sleep. This can be a short-term issue, affecting one or a few nights, or it can be a chronic concern that lasts weeks or even months. Sleep deprivation can happen for countless reasons, many of them harmless, but it’s also a key symptom of certain health conditions.

Sleep is something that everyone needs, and most people need a similar amount, depending on their age. That amount also changes with age. However, some people need more sleep to feel well-rested, while others need less, but these exceptions aren’t common. A change in your sleep patterns, gradual or sudden, is a reason to talk to a healthcare provider.

The average daily amount of sleep needed, by age, is:

Newborns (up to 3 months old): 14 to 17 hours.
Infants (4 to 12 months old): 12 to 16 hours, including naptime.
Young children (1 to 5 years old): 10 to 14 hours, including naptime.
School-aged children (6 to 12 years old): 9 to 12 hours.
Teenagers (13 to 18 years old): 8 to 10 hours.
Adults (18 years and up): 7 to 9 hours.

Sleep deprivation can also take different forms. For some people, sleep deprivation happens because they stay awake instead of sleeping. For others, they’re still sleeping, but they aren’t getting quality sleep, so they still wake up feeling tired.

Sleep deprivation usually isn’t a major problem in limited, isolated amounts. However, research shows that chronic sleep deprivation can cause or contribute to a variety of health issues.

What is the difference between sleep deprivation and insomnia?

Insomnia and sleep deprivation are closely related but aren’t the same thing. Insomnia is when you’re unable to sleep when you try. Sleep deprivation is what happens when you don’t give yourself enough time to sleep don’t get enough sleep or both.

Who does it affect?

Sleep deprivation can happen to everyone at any point in their life.

How common is this condition?

Sleep deprivation is very common. Experts estimate between 50 million to 70 million adults in the U.S. meet the medical criteria for sleep deprivation at any point in time. Virtually every human being experiences sleep deprivation at some point in their life. For some people, it’s simply a greater or longer-lasting issue, or it happens for a more serious reason.

How does this condition affect my body?

Your body needs sleep to regenerate certain systems and carry out certain processes. To understand more about that, it helps to know a little more about the human sleep cycle. That cycle involves different stages of sleep. Those are:

Stage 1: Light sleep. This is a short stage, usually no more than 5% of your total sleep, which begins right after you fall asleep.
Stage 2: Deeper sleep. This stage is deeper and makes up about 45% of all the time you spend sleeping (this number goes up as you get older). Research indicates this stage is key in memory storage and learning.
Stage 3: Deepest sleep. This stage makes up about 25% of the time you spend sleeping (this number goes down with age). There’s evidence that this stage is the most important to how your body recovers and maintains itself because the brain prioritizes this stage in people with sleep deprivation. It’s very hard to wake someone up from this stage, and they’ll usually feel foggy or confused for up to 30 minutes after waking up.
REM sleep: REM stands for “rapid eye movement.” This stage is when you dream. When a person is in REM sleep, you can see their eyes moving beneath their eyelids.

When you fall asleep, you typically enter stage 1 and then move in and out of stages 2 and 3. After that, you go into REM sleep and start dreaming. After the first REM cycle, you start a new sleep cycle and go back into stage 1 or 2. One cycle normally takes about 90 to 120 minutes before another begins. Most people go through four or five cycles per night (assuming they get a full eight hours).

Systems affected

Sleep deprivation has negative effects in multiple ways throughout your body. Those can affect the following body systems, organs and processes:

Heart and circulatory systems: Sleep deprivation has long-term damaging effects on your heart and circulatory health. People with chronic sleep deprivation are more likely to develop high blood pressure (hypertension) and high cholesterol (hyperlipidemia).
Metabolic systems: People with chronic sleep deprivation are at a much higher risk of developing Type 2 diabetes.
Immune system: Your body’s natural defenses against infections can’t work properly if you aren’t getting enough sleep.
Nervous system: It’s common for people who aren’t sleeping enough to have higher pain sensitivity, which means they feel pain more easily, the pain is more intense or both.
Brain: Sleep deprivation has very negative effects on how your brain works. While experts don’t fully understand sleep’s role in brain function, they do know it’s a key part of how people learn and remember. There’s also some evidence that sleep deprivation could play a role in the development of Alzheimer’s disease.
Mental health: Sleep deprivation also negatively affects your mental health, making it harder for you to manage and process your emotions. People with sleep deprivation are more likely to feel symptoms of depression and anxiety.

The effects of sleep deprivation depend on why it happens and how long it lasts. The longer a person has sleep deprivation, the greater — and more severe — the effects.

Conditions that can get worse or happen because of sleep deprivation

Sleep deprivation also increases your risk of developing certain conditions or making them worse if you have them. These conditions include:

Type 2 diabetes.
High blood pressure (hypertension).
Obesity.
Obstructive sleep apnea.
Vascular disease.
Stroke.
Heart attack.
Depression.
Anxiety.
Conditions that involve psychosis.

Sleep deprivation causes many symptoms. Some of the most common symptoms include:

Daytime sleepiness.
Fatigue.
Irritability.
Trouble thinking, focusing and remembering.
Slowed reaction times.
Headaches.

As sleep deprivation goes on for longer, the symptoms become more severe. Many of the more severe symptoms look like the effects of alcohol intoxication. The severe symptoms of sleep deprivation include:

“Microsleeps” (when a person briefly falls asleep for only seconds before waking back up).
Uncontrollable eye movements (nystagmus).
Trouble speaking clearly.
Drooping eyelids (ptosis).
Hand tremors.
Visual and tactile (touch-based) hallucinations.
Impaired judgment.
Impulsive (or even reckless) behavior.

Stages of sleep deprivation

Total sleep deprivation, which is when you aren’t getting any sleep, happens in stages. These stages are:

Stage 1: This is when you go at least 24 hours without sleeping. In this stage, the effects of sleep deprivation are similar to being under the influence of alcohol to the point where it isn’t safe for you to drive.
Stage 2: Common symptoms of sleep deprivation intensify. Most people start to experience microsleeps in this stage and have trouble thinking or focusing.
Stage 3: People in this stage start to show very severe symptoms like hallucinations. They may also struggle to communicate with people around them.
Stage 4: The symptoms of sleep deprivation are at their most extreme. The above symptoms worsen to severe or extreme levels. Hallucinations are common and you struggle to tell what’s real and what isn’t.

Sleep deprivation can happen for numerous reasons. Many of these have to do with the circumstances of your life.

Shift work (especially shifts that happen partly or fully during nighttime hours).
Alcohol use (especially misuse).
Using stimulants like caffeine later in the day.
Bad sleep-related habits (known as sleep hygiene).
High stress levels.
Sleeping in a new or unfamiliar place, such as in a hotel while traveling.

However, sleep deprivation can also happen for medical reasons. Some examples include:

Lack of quality sleep due to sleep apnea.
Degenerative brain disorders such as Alzheimer’s disease or Parkinson’s disease.
Mental health concerns (see below for more about these).
Concussions and traumatic brain injuries.
Pain.
Insomnia.
Restless leg syndrome.
Parasomnias (disruptive sleep disorders) such as night terrors, sleep paralysis, sleepwalking and more.
Medications such as corticosteroids, stimulants and more.
Short-term illnesses and infections, such as the common cold, the flu and more.

Mental health concerns

Your mental health has a major impact on your sleep and vice versa. This can set up a cycle that reinforces itself as it gets worse. An example of this would be depression that makes it harder to sleep, which causes sleep deprivation, which then makes you feel even more depressed.

Mental health issues that can affect sleep include, but aren’t limited to, the following:

Anxiety.
Bipolar disorder.
Depression.
Mania.
Panic disorder.
Post-traumatic stress disorder (PTSD).
Somniphobia (fear of sleep).

Is it contagious?

Sleep deprivation isn’t contagious. You can’t catch it from or spread it to others.

A healthcare provider can usually diagnose sleep deprivation simply by asking you questions about your symptoms, health history and your daily and nightly routines. However, there are a few conditions where further tests are needed to determine if a related condition is contributing to or happening because of sleep deprivation. Some possible tests include:

Sleep apnea testing. This can happen in the form of an overnight sleep lab study called a polysomnogram or with an at-home sleep apnea testing device.
Electroencephalogram (EEG). This test detects and records brain waves. Your healthcare provider, usually a neurologist, can examine your brain activity for signs of unusual brain activity that could contribute to sleep problems or other conditions.
Actigraphy. This test involves wearing a device similar to a watch that tracks sleep patterns to see if you may have a different sleep cycle than is typical. This is key in diagnosing circadian rhythm disorders
Multiple sleep latency test (MSLT). This test examines whether a person is prone to falling asleep during the daytime. It’s often a key part of diagnosing narcolepsy.
Maintenance of wakefulness test (MWT). This test looks for whether or not a person can resist falling asleep in situations where it would be easy to do so. It’s a common part of safety testing for people who drive for a living and may have conditions like sleep apnea.

Other tests are also possible when sleep deprivation is something that your healthcare provider suspects. Your provider is the best person to tell you what tests they recommend and why they believe these tests are necessary.

How is it treated, and is there a cure?

Sleep deprivation can happen for many reasons, which means there’s no one way to cure it. Depending on why it happens, it’s often a treatable condition. However, treatment for sleep deprivation can take many different forms. Some treatment approaches focus on changing how a person sleeps (or prepares for sleep), while others focus on treating whatever disrupts a person’s ability to sleep.

Some of the more common treatments for sleep deprivation and related conditions include:

Behavior changes. Many people can prevent sleep deprivation simply by adjusting their sleep-related behaviors and pre-sleep routine.
Medications. Various medications can help a person fall and stay asleep or change the way they sleep. Some medications can even change the way a person dreams, making it less likely that they’ll have severe nightmares or other sleep disturbances. However, many sleep-inducing medications can be habit-forming, so healthcare providers prescribe these cautiously.
Breathing support methods. Conditions that affect breathing during sleep, such as sleep apnea, are treatable with various methods. These include different types of pillows and supports, mouthpieces that adjust your jaw position, surgery to widen your airway, positive airway pressure machines that keep your airway open while you sleep and more.

Complications/side effects of the treatment

The possible complications and side effects vary depending on the treatment, the underlying cause of the sleep deprivation and other factors. Your healthcare provider is the best person to explain the complications or side effects that are possible or likely in your situation.

How to take care of myself or manage the symptoms?

Sleep deprivation is a common issue, and often a person can manage it on their own. However, if the symptoms continue even with attempts to manage them on your own, you should talk to a healthcare provider. This is especially true if you have symptoms of sleep apnea, which is when you stop breathing in your sleep. That condition can cause severe or even life-threatening problems when it goes untreated.

The best things you can do to help treat and prevent sleep deprivation include:

Have a routine. Being consistent with sleep habits can make a big difference in how much and how well you sleep.
Make the time for sleep. Set a bedtime that allows you to get the recommended amount of sleep for your age.
Limit the time you spend around bright lights or using electronics. Light from these too close to bedtime can disrupt your body’s natural sleep-wake functions.
Avoid drinking alcohol or eating a meal too close to bedtime. A light snack is the best option if you feel hungry before bedtime.
Physical activity can help. Staying active, even just going for a walk, can help with the quality of your sleep.
Don’t rely on sleeping medications. Long-term use of sleeping pills and other medications — even ones that are available over-the-counter — can negatively affect your sleep. The only sleep-related medications you should use regularly are ones your healthcare provider prescribes, and you should only take them as instructed.

How soon after treatment will I feel better?

The time it takes to recover from sleep deprivation depends on several factors, including how severe it is and how long it lasts. Most people can recover from sleep deprivation with only a few — or even just one — nights where they get enough quality sleep. However, some people may need several nights of quality sleep to recover from long-term sleep deprivation.

If you have sleep deprivation, the most likely effect you’ll notice is that you feel tired. As the amount of lost sleep increases, feeling tired becomes more noticeable and more severe symptoms will also appear. Eventually, people with severe sleep deprivation struggle to stay awake during the daytime, even while working.

As long as sleep deprivation continues, people with this issue will experience symptoms that can interfere with everyday routines and activities. There’s evidence that long-term or severe sleep deprivation can cause brain damage. There’s also ongoing research into whether or not a person can truly recover from sleep deprivation or if the effects are permanent. Currently, the available data suggests that it’s reversible with adequate sleep.

It’s also common for people with sleep deprivation to underestimate its impacts. Research shows that people with sleep deprivation often don’t realize how much the problem affects their brain, body and abilities.

How long does sleep deprivation last?

Sleep deprivation lasts as long as a person isn’t getting enough sleep. This can be a single night or last for weeks, months or even years. If a person has sleep deprivation, they can recover by getting sufficient quality sleep. However, when sleep deprivation is severe or has lasted a long time, it can take multiple nights — or even up to a week — for a person to recover.

What is the outlook for this condition?

The outlook for sleep deprivation can vary, especially depending on why it’s happening, how severe it is and how long it lasts. It can also depend on your overall health, any other conditions you have and more. While sleep deprivation isn’t usually dangerous directly, it can put you in danger if you are so tired that it interferes with tasks that need your full attention, such as driving.

Fortunately, sleep deprivation is usually a very treatable condition. However, it’s important to discuss it with your healthcare provider if you notice it happening. While it’s easy to dismiss it and think it’s not a major problem, sleep deprivation can be an important clue that helps healthcare providers diagnose and treat an issue. It can also delay recovery from other conditions or make those conditions worse, so it’s important to talk about it with your healthcare provider.

It’s possible to reduce the risk of developing sleep deprivation, but it’s virtually impossible to prevent it entirely. Because it can happen for so many reasons, many of which are normal and expected at some point in your life, everyone has some amount of sleep deprivation at some point.

To reduce the risk of having sleep deprivation, following the above recommendations on sleep hygiene, and ensuring you have enough time for an adequate amount of sleep can make a big difference. However, some causes of sleep deprivation are impossible to prevent or avoid, especially when it happens because of a medical condition.

In those instances, the best thing you can do is see your healthcare provider sooner rather than later. Early diagnosis and treatment, if necessary, can help minimize this issue’s effects and prevent it from causing more serious problems.

How do I take care of myself?

If you have sleep deprivation, it’s important to work on improving your sleep. That includes getting enough sleep time-wise and ensuring that you’re getting quality sleep. The above tips on sleep hygiene can help, and your healthcare provider can also offer support and guidance to assist you.

When should I see my healthcare provider?

You should see your healthcare provider if you have sleep deprivation along with sleep apnea symptoms. You should also see them if you have sleep deprivation that doesn’t get better, even with improvements in your sleep hygiene and habits.

When should I go to ER?

Sleep deprivation isn’t a condition that causes immediate, life-threatening problems, so it doesn’t need emergency treatment. However, it can raise the risk of heart attack and stroke, both of which are emergency conditions that need immediate medical care.

References

American Sleep Association | sleepassociation.org. Sleep deprivation stages & effects (https://www.sleepassociation.org/sleep-resources/sleep-deprivation-stages-effects/). Accessed 8/11/2022.
Centers for Disease Control and Prevention | cdc.gov. How much sleep do I need? (https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html) Accessed 8/11/2022.
Hanson JA, Huecker MR. Sleep Deprivation (https://pubmed.ncbi.nlm.nih.gov/31613456/). 2022 Mar 7. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan-. Accessed 08/11/2022.
Jawabri KH, Raja A. Physiology, Sleep Patterns (https://pubmed.ncbi.nlm.nih.gov/31869144/). 2022 May 8. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan-. Accessed 08/11/2022.
Scammell TE, Saper CB, Czeisler CA. Sleep Disorders. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson J, eds. Harrison’s Principles of Internal Medicine. 21st ed. McGraw Hill; 2022.
Sleep and Its Abnormalities. In: Ropper AH, Samuels MA, Klein JP, Prasad S. eds. Adams and Victor’s Principles of Neurology. 11th ed. McGraw Hill; 2019.
Vital-Lopez FG, Doty TJ, Reifman J. Optimal sleep and work schedules to maximize alertness (https://pubmed.ncbi.nlm.nih.gov/34106271/). Sleep. 2021;44(11):zsab144. Accessed 8/11/2022.
Zamore Z, Veasey SC. Neural consequences of chronic sleep disruption (https://pubmed.ncbi.nlm.nih.gov/35691776/). Trends Neurosci. 2022;S0166-2236(22)00101-1. Accessed 8/11/2022.

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Insufficient Sleep