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  1. 1. SLEEP DEPRIVATION Amanda L. Conrad ENC 1101 Dr. Ellingham November 28, 2006
  2. 2. Sleep Deprivation Research Paper Thesis: In order to understand how serious sleep deprivation can be, one needs to know what it actually is, what causes it, what the effects are, and why sleep is so important to begin with. I. Sleep A. Sleep Cycles 1. Stage one 2. Stage two 3. Stage three 4. Stage four 5. Stage five (REM) II. Causes of Sleep Deprivation A. Lifestyle 1. Shift Work 2. Caffeine 3. Alcohol 4. Nicotine B. Health Complications 1. Posttraumatic Stress Disorder (PTSD) 2. Attention Deficit Hyperactive Disorder (ADHD) C. Sleep Disorders 1. Sleep Apnea 2. Restless Legs Syndrome (RLS) 3. Periodic Limb Movement Disorder (PLMD) III. Effects of Sleep Deprivation A. Physical 1. Immune System 2. Weight B. Psychological 1. Emotions 2. Speech 3. Memory C. Social 1. Relationships 2. Community Activities Conclusion: Although sleep deprivation is a serious problem, with proper diagnosis and treatment, this condition can be cured.
  3. 3. There is no substitution for sleep. It is a necessary process we must carry out to sustain life. Sleep is the physical and mental resting state in which a person becomes moderately inactive and unaware of the environment. Although our bodies may be the picture of tranquility while we’re sleeping, there are numerous biochemical, physiological, and psychological events constantly taking place. There is an alarming lack of awareness about sleep in the medical community and the general public. To understand how serious sleep deprivation can be, one needs to know what it actually is, what causes it, what the effects are, and why sleep is so important to begin with. During sleep, our body becomes relatively still and inactive; however, our brain begins to orchestrate a wide range of activities. Sleep is divided into five distinct stages. The brain will cycle through these stages about five to six times each night. Different stages serve different purposes; therefore, it is important to cycle through them all. Stage one is the transition between alertness and drowsiness. This is when the brain and body become more relaxed. Our body temperature drops and our breathing becomes more regular. Stage one is a very light sleep in which the sleeper may be awakened quite easily. This stage usually lasts for five to ten minutes (Help the Aged 1 ; Sleep Channel 2). During stage two, the heartbeat and respiration become regular. This is when you lose consciousness. Senses such as hearing are reserved. Sleepers can still be aroused but not as easily as during the first stage of sleep. These first two stages account for about fifty percent of all sleep time. The person sleeping will spend about thirty minutes in stages one and two before passing into stage three (Help the Aged 1 ; Sleep Channel 2). Stages three and four are both phases of deep sleep. However, stage four is the deepest sleep of all. This stage lasts for about two to three hours. During deep sleep, a person becomes very difficult to awaken. If the sleeper is aroused, they may still feel groggy and react slow to physical and verbal stimuli. This period of sleep is the most restorative. The body is given the opportunity to cleanse, repair and rejuvenate itself (Help the Aged 1 ; Sleep Channel 2). Our dream sleep occurs during stage five. This stage illustrates rapid eye 1
  4. 4. movement which is identified as REM sleep. During this final phase of sleep one becomes temporarily paralyzed with the exception of the eyes. It is known that the eyes move rapidly back and forth under closed eyelids during this period. The sleeper’s brain activity, blood pressure, and heartbeat all speed up. REM sleep is also fundamental to our welfare. Our mind is able to clean out and categorize our thoughts collected during the day. This process prepares us with a fresh mental state for the following morning (Help the Aged 1 ; Sleep Channel 2). The normal sleep cycle sequence will not be followed if our REM sleep is interrupted. This will cause a break in the chain, even if it only happens one night. The next time you fall asleep you will start in REM sleep until your body, yet again, reaches the point it was previously in (Getting the Sleep You Need 2). If a people get less sleep than their brain requires, they are, by definition, sleep deprived. “Sleep deprivation is a common condition that afflicts 47 million American adults, or almost a quarter of the population” (Sleep Deprivation 1). Some of the symptoms that are primarily noticed by lack of sleep are overtiredness, low energy, and weakness. Sleep deprivation can be divided into three broad areas including, lifestyle, health complications, and sleep disorders. In this day and age sleep, has become an inconvenience for some people. With all the work and play to carry out, sleep is sometimes neglected. Shift work is a way of life that consumes nearly twenty percent of employees with jobs in America. This causes an extreme change in sleep habits. By nature, humans are active during the day and restful at night. Shift work reverses this natural order and our bodies may never completely adapt to the change. Circadian rhythms run on a twenty four hour succession. If people have a non-fluctuating, shift, work schedule, their bodies may adapt to it. This schedule is when the workers stay with the same timetable every day, even though it is during untraditional work hours. If a people fluctuate between the three different shifts, which are usually 7a.m. to 3 p.m., 3 p.m. to 11 p.m., & 11 p.m. to 7 a.m., they are at higher risk of sleep deprivation. The body will not be able to unwind and restore itself with these constant disruptions to the circadian rhythms (Shift Work - Sleep Channel 1& 2). 2
  5. 5. Caffeine, alcohol, and nicotine are substances used that may cause lack of sleep. Caffeine is a stimulant that will help a person stay wakeful. Consuming anything with caffeine in it should be avoided before going to bed. Caffeine, if taken in excessive amounts, can cause an unkind cycle. This substance may become a necessity to stay awake; however, when it is time to sleep it will prevent you from resting properly. When alcohol is initially ingested, it causes a stimulating effect, but after awhile it begins to have a sedative result. A person may sleep soundly for the first few hours. Ultimately, the remainder of one’s sleep will become fragmented, with frequent awakenings (Alcohol and Sleep 1). As a result, one will wake up feeling worn out. It requires about one and one-half hours to metabolize one ounce of alcohol: the mild withdrawal effects last for another two to four hours. This means that a glass of wine with dinner will probably not affect sleep. However, one ounce of alcohol within two hours of bedtime or more than one ounce after dinner probably will disrupt sleep. (Jacobs 1) Nicotine and caffeine have similar effects. They both speed up brain waves and increase heart rate and blood pressure. The effects of smoking a cigarette continue for quite a few hours afterward. This makes it harder for a person to fall asleep and to maintain sleeping. Refraining from smoking at least a few hours before bedtime will decrease the stimulating and withdrawal effects of nicotine. This will improve a person’s sleep cycle dramatically ( Jacobs 1). Underlying health complications are an additional cause of sleep deprivation. Both physical and mental conditions can affect a person’s ability to sleep properly. Two medical conditions that may be overlooked as an origin of sleep deprivation include posttraumatic stress disorder and attention deficit hyperactive disorder. Posttraumatic stress disorder, also known as PTSD, causes numerous amounts of people to struggle with sufficient sleep. Some individuals that have been exposed to traumatic physical or psychological events, such as, rape, military combat, violence, or natural disasters, may develop this disorder. People who suffer from this condition may have trouble falling asleep or sustaining an undisturbed sleep. Biological changes 3
  6. 6. may happen as a product of trauma. People may feel that they have to stay alert in order to protect themselves from harm. PTSD may also cause medical problems such as chronic pain which, in turn, leads to discomfort and restless sleep. A person with PTSD may have trouble staying asleep because of nightmares, anxiety attacks, and light sleep. Nightmares may be a way for the person suffering from this disorder to express prevailing emotions of the traumatic event. These feelings are usually panic and terror. This could cause anxiety attacks that would interrupt sleep. People may wake up repeatedly during the night to check on their surroundings. These measures are taken to ensure danger is absent (Swales 1 & 2). Another medical condition that may lead to sleep deprivation is attention deficit hyperactive disorder, also identified as ADHD. Some experts say that as many as 70%-80% of all patients with ADHD have difficulty sleeping. By far, the most common complaint is not being able to fall asleep. One study showed that patients with ADHD vary nightly on how long it takes to fall asleep, by as much as 2-3 hours, while those without ADHA normally fell asleep within 40 minutes. (Bailey 1) Some of the symptoms that are associated with ADHD are the basis for poor sleep. Individuals may not be able to stop fidgeting or squirming enough to relax. It is often hard for one with ADHD to enjoy leisure activities quietly. An individual may possibly fail to stop thinking about plans or assignments that have been left unfinished. They may also be distracted with things such as T.V., computers, or video games. At times, it becomes hard for the individuals with ADHD to stop when the activity is interesting to them. About one-third of children with ADHD also suffer from nocturnal enuresis, or bedwetting. Usually nocturnal enuresis ends by age 10, but some children suffer into their teen years. (Bailey 1) If a child or teenager experiences this situation, it may cause nervousness about going to bed. They may be fearful of this happening to them, so in return, they stay awake. “According to the National Institute of Neurological Disorders and Stroke, chronic, long-term sleep disorders affect at least 40 million Americans each year” (Sleep 4
  7. 7. Disorders and Problem Symptoms 1). A sleep disorder is when a person exhibits any impediment with sleep. There are over 100 types of sleep disorders. Among the most common ones that cause sleep deprivation are sleep apnea, restless legs syndrome (RLS), and periodic limb movement disorder (PLMD). Sleep apnea is a surprisingly common, debilitating, and potentially fatal sleep disorder. People with sleep apnea stop breathing continually throughout the time they are sleeping. Sometimes they may not even be aware of this event taking place. Breathing may stop up to hundreds of times a night and may not start again for a minute or longer (Sleep Apnea Information 1). Individuals with this disorder have continuous sleep and breathing disruptions that deprive them of both sleep and oxygen. This causes not only the effects of sleep deprivation, but leads to other health hazards such as cardiovascular disease, high blood pressure, and weight gain (Sleep Apnea Information 2). Restless leg syndrome (RLS) is a disorder characterized by uncomfortable tingling or crawling sensations in the lower extremities. This causes an irresistible urge to keep them moving. These symptoms can be quite aggravating and even painful at times. One of the attributes of this disorder is that the symptoms are triggered by the person lying down. This will cause a person to have trouble falling asleep or staying asleep once achieved. This is sufficient grounds for leading to sleep deprivation (Restless Legs Syndrome Fact Sheet 1). Another disorder that is similar to RLS is periodic limb movement disorder (PLMD). This condition causes episodes of rhythmic jerking movements during sleep which often reaches the point of disturbing one’s slumber. The movements are involuntary which makes it even harder to stay asleep. These actions happen about every 10 to 60 seconds which can take place the entire night (Restless Legs Syndrome Fact Sheet 1). Individuals with this disorder have steady interruptions with their sleep which impairs their daytime function. Not getting enough sleep can have a poisonous effect on your whole life. It does not matter if sleep is lost because of life style, health complications, or a sleep disorder. Inadequate rest impairs our ability to think, to handle stress, to maintain proper 5
  8. 8. health, to moderate our emotions and, in some cases, may even cause death. If sleep deprivation goes unrecognized or untreated, a person has the foundation for various, physical, psychological, and social problems. The dangers of sleep deprivation may affect a person’s physical well-being in several ways. Some people may not realize that adequate rest and a properly functioning immune system are closely related. The blood levels of specialized immune cells and important proteins called cytokines are altered when the body does not get enough rest ( Hanson ; Kruger 1). This creates a greater than normal chance of infections. A person who is sleep deprived may catch the common cold more frequently than a well-rested person. Sleep deprivation has also been linked to spawning diabetes. A new study presented at the annual meeting of the American Diabetes Society suggests that healthy young people who regularly got less than 6.5 hours of sleep a night had greater insulin resistance than people who got 7.5 to 8.5 hours of rest. Insulin resistance is the condition that often leads to Type 2 diabetes. (Sleep Deprivation & Diabetes 1) Another effect of sleep loss is the risk of obesity. During sleep, your body releases specific hormones and chemicals that control appetite and manage weight gain (Taheri 1). Researchers found that people who sleep two to four hours a night are 73% more likely to be obese than those who get seven to nine hours. Those who get five or more hours of sleep a night are 50% more likely to be obese than normal sleepers. Those who sleep six hours are 23% more likely to be obese. And, the researchers reported, those who get 10 or more hours are 11% less likely to be obese. (Hellmich 3) If weight gain is not managed properly, it may cause other health problems in the future. Without sufficient rest, our psychological state will begin to deteriorate. People become irritable and short-tempered, both with themselves and others. It is possible to even lose control of emotions which can lead to alarming outbursts and even violence. This can be detrimental to relationships with family, friends, and partners. Stress and 6
  9. 9. anxiety levels both mount as a result of sleepiness. This can eventually lead to full blown anxiety disorders and depression. With continual lack of sufficient sleep, the part of the brain that controls language, memory, planning and sense of time is severely affected, practically shutting down. In fact, 17 hours of sustained wakefulness leads to a decrease in performance equivalent to a blood alcohol level of 0.05% (two glasses of wine). This is the legal drunk driving limit in the U.K. (The science of sleep 1) The brain’s ability to problem solve becomes impaired when a person is sleep deprived. Our normal decision making abilities are compromised, and the brain falls into rigid thought patterns that make it hard for us to produce new problem solving ideas. This is why teachers always tell their students to get plenty of rest on the night before a test is given. Inadequate rest can even cause people to have hallucinations. Sleep deprivation may also intrude on one’s social life. Shift workers face problems trying to maintain family relationships and social and community ties. The shift worker has to balance work, personal time, and sleep. Because night shift workers need to sleep during the day, they often miss out on family activities, entertainment, and other social interaction. Childcare, house work, shopping, and leaving a partner alone at night can lead to marital strain and family dysfunction. If family members do work this schedule, it is important to plan special times to share with their friends and family. Sleep deprivation is a serious matter that can cause a chain of various, negative, effects. Sleep is an essential part of our lives. Without it, we would not be restored each day. Our physical, mental, and social interests rely on it. Even though sleep is not completely understood, we have proven that it is required for survival. Sleep deprivation is a serious problem that should not be ignored. With awareness and knowledge of this condition, those suffering can be treated. This will result in healthier, more restful lives. So, the next time you choose to pull an all nighter, you might want to reconsider. Your mind will be missing out on more than just a dream. 7
  10. 10. Work Cited “Alcohol and Sleep” [online] 11/27/06. Bailey, Eillen. “ADHD and Sleep Disorders” [online] 11/27/06. “Getting the Sleep You Need” 11/03/06 [online] 11/21/06. Hansen & Krueger. “Subdiaphragmic vagotomy does not block sleep deprivation-induced Sleep rats” [online] 11/07/06. Hellmich, Nancy. “Sleep loss may equal weight gain,” USA TODAY, 12/06/04 [online] 11/02/06. “Help The Aged” [online] Sleep/as_sleepadv_240106 11/20/06. Jacobs,Gregg “Lifestyle Practices” [online] drjacobs_lifestyle_practices_part2.htm 11/27/06. “Restless Legs Syndrome Fact Sheet” [online] 11/28/06. “Science & Nature: Human Body & Mind: The science of sleep” [online] 11/02/06. “ShiftWork – Sleep Channel” [online] 11/27/06. 8
  11. 11. “Sleep Apnea Information” [online] 11/28/06. “Sleep Channel” [online] 11/21/06. “Sleep Deprivation”, 11/17/06 [online] 11/21/06. “Sleep Deprivation and Diabetes: Insulin resistance” 06/20/06 [online] 11/02/06. “Sleep Disorders and Problems: Symptoms, Tests, and Treatment” [online] 11/21/06. “Sleep and Posttraumatic Stress Disorder (PTSD) // National Center for Post Traumatic Stress Disorder” [online] 11/27/06. Taheri Shahrad, Lin Ling, Austin Diane, Young Terry, Mignot Emmanual. “Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index,” PLoS Medicine, 12/07/04 [online] pmed.0010062 11/07/06. 9