What Is Chronic Sleep Deprivation?

In the simplest terms, chronic sleep deprivation refers to the case of getting insufficient sleep or experiencing sleeplessness over an extended period of time. Chronic sleep deprivation can vary in its severity.

Chronic sleep deprivation may be primary or secondary, meaning that it could be a problem in and of itself (e.g., caused by insomnia or anxiety) or caused by some other unrelated issue (e.g., a medical condition).

Accumulated sleep debt can lead to impairments in all areas of your life, and fixing the problem can be difficult depending on the cause. That being said, there are steps you can take to cope with sleep deprivation and ensure it does not lead to more serious issues.

Sleep Deprivation Symptoms

If you live with insomnia or work shifts, you may be painfully aware that you're not getting enough sleep. Some people living with undiagnosed sleep disorders, however, may not understand right away that sleep debt is the cause of what they are feeling.

Below are some signs that you may be experiencing chronic sleep deprivation:

• Dark under-eye circles
• Drifting out of your lane while driving
• Head nodding
• Inability to keep your eyes open
• Irritability
• Lacking energy for daily tasks
• Rolling down your window or turning up your radio while driving your vehicle to try and stay awake
• Sleepiness during daytime hours
• Trouble concentrating
• Waking up not feeling refreshed
• Yawning

Effects

Many of the effects of chronic sleep deprivation can have adverse secondary effects on your life, such as interfering with your relationships and jobs, impacting your judgment, and reducing your overall quality of life.

Physical Effects

The physical effects of sleep deprivation can range from decreased daily functioning to more long-term health issues. Below are several such effects:

• Accidents in the workplace
• Headaches
• Heart failure
• High blood pressure
• Increased appetite and related weight gain (due to hormone fluctuations)
• Increased risk of fibromyalgia
• Increased risk of heart attack and stroke
• Increased risk of mortality
• Increased risk of seizures
• Increased risk of type 2 diabetes
• Lowered fertility
• Lowered libido
• Muscle soreness and aching
• Overall fatigue
• Tremors in the hands

Mental Effects

Some of the most significant negative effects of sleep debt may not be obvious to an outside observer but can cause severe impairment on a daily basis, including:

• False memories
• Failure to stay alert
• Hallucinations
• Increased levels of stress hormones
• Memory impairments
• Problems processing information
• Problems with the ability to think clearly
• Symptoms of psychosis
• Symptoms similar to those of attention-deficit/hyperactivity disorder (ADHD)
• Triggering of mania
• Trouble sustaining attention

Causes

There are various potential causes of chronic sleep deprivation. While not everyone who experiences it will have the same underlying factors, there are some common causes:

• Life stress (e.g., marital, financial)
• Working conditions (e.g., overwork, work stress, shift work)
• Medical conditions (e.g., chronic pain, pregnancy, gastrointestinal issues, upper respiratory infection)
• Sleep disorders (e.g., sleep apnea, insomnia)
• Mental health conditions (e.g., bipolar disorder, depression, anxiety, attention-deficit/hyperactivity disorder, restless legs syndrome, post-traumatic stress disorder)
• Fatal familial insomnia (a neurodegenerative disease that results in eventual death due to the inability to experience sleep beyond stage 1 of NREM; this condition leads to panic, paranoia, phobias, hallucinations, dementia, weight loss, and death within three years)
• School schedules (e.g., teenagers need to sleep later and stay up later according to their physiology, but school schedules often conflict with this)
• Using too much caffeine close to bedtime
• Screen use too close to bedtime
• Frustration or worry about being unable to fall asleep due to insomnia

Diagnosis

If you think you are suffering from chronic sleep deprivation, it's a good idea to get professional help. Your doctor can identify some effects of sleep deprivation based on a physical examination and diagnostic testing. You may also need to attend a sleep study to evaluate whether you have a sleep disorder or medical condition that could be affecting your sleep.

Some tests commonly used to diagnose a chronic sleep disorder, include:

• Overnight oximetry, which involves wearing a probe (similar to a clothespin) on your finger or earlobe to continuously measure oxygen levels and heart rate during sleep
• Polysomnography (PSG), which is the gold standard for diagnosing sleep disorders, involves an overnight stay at a sleep center monitored by a trained technician
• Titration with Continuous Positive Airway Pressure (CPAP), often done during the same night of PSG, involves a technician that gradually increases CPAP pressure (pressurized room air not oxygen) delivered through a soft mask. Some titration studies can be conducted at home.
• Multiple Sleep Latency Testing (MSLT), often called a nap study, is similar to the PSG and involves monitoring you for the onset of sleep and, in particular, REM sleep.
• Actigraphy, which involves wearing a small, wristwatch-sized device for weeks or even months to assess sleep-wake cycles or circadian rhythms over an extended period of time.
• Sleep diary, or sleep log, in which you write down the time that you fall asleep and wake up each day. This will help your doctor to understand your sleep patterns and assess circadian rhythm disorders or insomnia.

Treatment

Usually, treating chronic sleep deprivation will involve treating the underlying cause or causes. For example, in the case of insomnia, treatment might include talk therapy such as cognitive behavioral therapy (CBT) to deal with the worry or anxiety related to being unable to fall asleep.

A therapist can help give you strategies on how to calm your anxious mind to make it easier to fall asleep, including:

• Using relaxation techniques designed to help you calm down, including guided meditation, guided imagery, deep breathing, or progressive muscle relaxation.
• Setting aside a "worry time" so that you don't have to go over your problems at night and instead deal with them at a set time each day.
• Keeping a notebook beside your bed to write down problems and issues as you think of them so that your mind does not keep churning through them as you try to get to sleep.

Other types of treatment used for chronic sleep deprivation might include:

• Prescription medication, such as Ambien (zolpidem), Belsomra (suvorexant), Estazolam (ProSom), Intermezzo (zolpidem), Lunesta (eszopiclone), Restoril (temazepam), Rozerem (ramelteon), Silenor (doxepin), Sonata (zaleplon)
• Relaxation and biofeedback therapy, which uses sensors placed on your skin to track muscle tension or brain rhythms
• Stimulus control therapy, which strengthens the connection between the bed and bedroom with sleep
• Sleep restriction, which limits the amount of time you allow yourself to sleep in the bed
• Aromatherapy, which involves inhaling essential oil molecules (or absorbing essential oils through the skin) to activate brain chemicals involved in controlling sleep

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Coping

If you are living with chronic sleep deprivation, you know that it can disrupt all areas of your life. But that does not mean that you have to live with this condition without relief. If you have not already, visit your doctor to talk about the symptoms that you are experiencing. It's important that medical causes be ruled out before other options are explored.

In the meantime, here are some tips to help increase the odds that you will get to sleep, get better sleep, and feel more rested:

• Establish a regular sleep schedule. Go to bed and wake up each time at the same time, even on weekends.
• Avoid caffeine, alcohol, and nicotine, particularly in the hours close to bedtime.
• Get regular exercise but don't do vigorous exercise close to bedtime.
• Create a healthy sleep environment, including only using the bedroom for sleeping and sex (i.e., no computers, television, or other activities) and keeping it dark and cool enough to be comfortable.
• Spend time outdoors whenever possible during the day to make it easier to sleep at night.
• Take a relaxing hot bath before bedtime, or find a relaxing ritual to wind down at the end of the day.
• Restrict naps to 20 minutes or less, so that they don't interfere with your regular sleeping patterns.

Finally, know that you are not alone living with chronic sleep deprivation. As our world has changed and people are working various schedules, glued to technology, and finding it harder and harder not to worry themselves to sleep at night—you're not the only one.

Summary

Making a plan to deal with your chronic sleep deprivation is the best way to make sure that you are actually taking action and not just gathering information. At some point, it's important to sit down alone or with your doctor to make an action plan with concrete steps that will help you to get your sleep deprivation under control.

What's more, you could find that once you start sleeping better, you have more energy and feel better able to deal with daily issues. It could be that you are more sleep-deprived than you realize and that it will be only through changes to improve your sleep that you'll finally notice a change during your daily waking hours.

What's your plan? Be sure to write one down now while you still have all this information fresh in your mind. And, if you're hoping to help a friend or family member, be sure to jot down notes on what might help that person so that you don't forget the next time you see them.