Acute Sleep Deprivation
– Dr Tripat Deep Singh

Acute total sleep deprivation refers to wake periods that last beyond 16-18hrs. We all suffer from acute total sleep deprivation at some point of our lives due to one or the other reason.

It is very important to understand the effects of acute sleep deprivation on our brain function as acute sleep deprivation affects our cognitive functions mainly which can lead to road traffic and occupational accidents.

What happens if adults suffer acute total sleep deprivation?

Sometimes we suffer acute sleep deprivation for 1-2 nights due to social engagements or work-related activities or due to some acute stressor. Acute total sleep deprivation affects neuro-cognitive functions mainly-

· Cognitive processing speed is decreased1

· Constructive thinking is affected: It refers to effects on Intra-personal functioning (reduced self-regard, assertiveness, sense of independence, and self-actualization), Interpersonal functioning (reduced empathy toward others and quality of interpersonal relationships), Stress Management skills (reduced impulse control and difficulty with delay of gratification), and Behavioral Coping (reduced positive thinking and action orientation). Also, Esoteric Thinking (greater reliance on formal superstitions and magical thinking processes) was increased.

· Verbal memory is affected3

· Spatial working memory is afected4

· Form more false memories: Five or fewer hours of sleep the night before the experiment were more likely to report that they had witnessed a news event that they did not actually see, compared with rested participants. There was also a trend for these participants to incorporate more misleading information into their memory for visual materials.

· Reduced threshold for stress and elevated stress reaction6,7

Reasoning and complex cognitive tasks remain unaffected by acute total sleep deprivation.8

· Microsleep leading to accidents: One very worrisome development with acute total sleep deprivation is momentary lapses in attention lasting half a second to 10sec or longer which can lead to errors or accidents. This brief lapse in attention has been referred to as “Microsleep”.9 One is not aware of these microsleep episodes.

Performance during sleep deprivation is increasingly variable due to the influence of sleep initiating mechanisms on the endogenous capacity to maintain attention and alertness, thereby creating an unstable state that fluctuates within seconds and that cannot be characterized as either fully awake or asleep.9

· With daytime waking exceeding 16 hours, impairs driving performance to levels equivalent to blood alcohol levels (BAC) levels between 0.05% and 0.1%.

a. In a study of simulated driving performance, impairments in lane-keeping ability after a night without sleep were equivalent to those observed at a blood alcohol content (BAC) of 0.07%.10

b. Similarly, a study of professional truck drivers found that deficits in performance accuracy and reaction time after 28 hours of sleep deprivation were equivalent to those found after alcohol intoxication (BAC at 0.1%).11

There are interindividual differences in deterioration of cognitive functions associated with acute total sleep deprivation.

How long it takes to recover after acute total sleep deprivation?

Shorter periods of sleep deprivation(<12-14hrs) increase NREM, Longer periods of sleep deprivation (>24hrs) increase REM sleep.

Make sure that recovery sleep opportunity duration is >6hrs after 1 or 2 nights of acute total sleep deprivation to speed up the recovery from sleep deprivation. More severe the sleep loss, longer the recovery sleep opportunity required.

Sleep architecture returns to normal on 3 night of recovery sleep after acute sleep deprivation. Following changes are seen in sleep architecture on first 3 nights on recovery from 1 or 2 nights of acute total sleep deprivation-

First recovery night

• Shorter sleep latency

• Less stage W, N1&N2

• Longer TST

• Higher %age of N3

• Lower %age of R

• REM Latency unchanged

Second recovery night

• Increase Stage R

• TST increased

• Stage N3 normal %age of TST

Third recovery night

• Sleep variables approach normal

My advice to all of you is-

· Do not drive or operate heavy machinery If you have suffered from acute total sleep deprivation. Give yourself 3 nights of recovery sleep before engaging in these activities.

· Do not acutely sleep deprive yourself before the exams. Rather sleep well 1-2 nights before the exam after systematic reading during the daytime. I am sure you will fare much better in the exams when you are well slept.

We are becoming a chronically sleep deprived society with detrimental effects on our health. In my next blog I will discuss about Chronic sleep deprivation and its effects on our health.

Until then, sleep well and sleep on time.

Links to other blogs:

1. Sleep- Foundation of Health https://www.rem42.ai/blog/sleep-is-the-foundation-of-health/

2. How to sleep well at night? https://www.rem42.ai/blog/how-to-sleep-well-at-night/

References:

1. Banks S, Van Dongen HP, Maislin G, Dinges DF. Neurobehavioral dynamics following chronic sleep restriction: dose-response effects of one night for recovery. Sleep. 2010;33(8):1013-1026.

2. Killgore WD, Kahn-Greene ET, Lipizzi EL, Newman RA, Kamimori GH, Balkin TJ. Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills. Sleep Med. 2008;9(5):517-526.

3. Harrison Y, Horne JA. Sleep loss impairs short and novel language tasks having a prefrontal focus. J Sleep Res. 1998;7(2):95-100.

4. Heuer H, Kohlisch O, Klein W. The effects of total sleep deprivation on the generation of random sequences of key-presses, numbers and nouns. Q J Exp Psychol A. 2005;58(2):275-307.

5. Frenda SJ, Patihis L, Loftus EF, Lewis HC, Fenn KM. Sleep deprivation and false memories. Psychol Sci. 2014;25(9):1674-1681.

6. Minkel JD, Banks S, Htaik O, et al. Sleep deprivation and stressors: evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion. 2012;12(5):1015-1020.

7. Minkel J, Htaik O, Banks S, Dinges D. Emotional expressiveness in sleep-deprived healthy adults. Behav Sleep Med. 2011;9(1):5-14.

8. Goel N, Rao H, Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2009;29(4):320-339.

9. Doran SM, Van Dongen HP, Dinges DF. Sustained attention performance during sleep deprivation: evidence of state instability. Arch Ital Biol. 2001;139(3):253-267.

10. Fairclough SH, Graham R. Impairment of driving performance caused by sleep deprivation or alcohol: a comparative study. Hum Factors. 1999;41(1):118-128.

11. Williamson AM, Feyer AM. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med. 2000;57(10):649-655.