Working Sleepless: Surviving A 48-Hour Grind

Sleep deprivation can have serious consequences on your health and ability to function. After just 24 hours without sleep, you can expect to feel tired and off, with increased risk of errors and accidents in everyday tasks. As the time spent awake increases, the symptoms of sleep deprivation become more severe and less tolerable. After 48 hours without sleep, you are likely to experience microsleeps, perceptual distortions, increased irritability, and temporal disorientation.

If you have to work after two days with no sleep, there are some strategies you can use to increase your alertness, such as drinking water, getting sunlight, napping, and consuming caffeine. However, it is important to note that these strategies are only useful in the short term and are not a substitute for adequate sleep.

The dangers of sleep deprivation

Sleep deprivation can have serious negative effects on the body and mind, even after just one night of missed sleep. After 24 hours without sleep, you can expect to feel tired and exhausted, and your risk of errors and accidents in everyday tasks increases. Studies have compared this level of sleep deprivation to having a blood alcohol concentration of 0.10%, which is above the legal limit for driving in most states. You may experience impaired decision-making, vision and hearing impairments, decreased hand-eye coordination, and increased muscle tension.

As the time spent awake extends beyond 24 hours, the symptoms of sleep deprivation become more severe and less tolerable. After 36 hours without sleep, you will have an overwhelming urge to sleep, increased appetite, and extreme fatigue. You may also start to experience microsleeps, which are brief periods of sleep that last up to 30 seconds, and hallucinations.

After 48 hours, it becomes even harder to stay awake, and you are more likely to experience microsleeps. You may also feel increased irritability and temporal disorientation. At this point, sleep deprivation also starts to impact the immune system, with inflammatory markers circulating at increased levels, and a decrease in natural killer (NK) cell activity, which respond to immediate health threats like viruses or bacteria.

After 72 hours without sleep, the urge to sleep becomes even stronger and may feel uncontrollable. Sleep deprivation significantly impairs perception, with hallucinations becoming more complex. Emotional and cognitive functions are also impacted, with people experiencing irritability, a depressed mood, anxiety, paranoia, and difficulty processing others' emotions.

Chronic sleep deprivation, or not getting enough sleep over a longer period, can lead to short-term health risks such as difficulty concentrating, staying alert, cognitive impairments, decreased performance, and increased risk of illness or injury. In the long term, it can reduce immune functioning and increase the risk of certain health conditions.

While it may not always be possible to get a full night's sleep, it is important to prioritize sleep as much as possible to avoid the dangerous physical and mental health consequences of sleep deprivation.

Strategies to stay alert

• Get some sunlight or bright light: Exposure to bright light, especially natural light, will help you feel more alert. Sunlight helps keep the body's internal clock on track, which can keep you feeling awake during the day. If you don't have access to natural light, use a light therapy box or visor to help you feel less sleepy.
• Exercise: A quick break for some physical activity can help you feel more alert. Exercise releases endorphins in the brain that can raise your energy levels, improve your mood, and lessen pain. Taking a short walk is linked to higher energy levels that may last for two hours or more after exercising.
• Eat a healthy breakfast: Eating within an hour of waking up will boost your mood and cognitive performance for the early part of your day. Stick to whole grains, protein, and maybe a little fruit. Avoid simple carbs and sugar as they will make you more sleepy later.
• Drink water: Dehydration can make you feel more tired.
• Caffeine: Caffeine can provide an energy boost and improve physical performance and cognitive ability. However, be careful not to have too much, and avoid caffeine within eight hours before bedtime.
• Power nap: If possible, a quick nap during the day can help you feel more alert. A 5-minute nap is too short to be beneficial, while a 30-minute nap may be too long and leave you feeling groggy. Aim for a 10-20 minute power nap to boost your alertness.

The impact on your body

Sleep is essential for your body to function properly. Even one night of sleep deprivation can have a significant impact on your body and overall health. After two days (48 hours) of no sleep, you can expect your body to react in the following ways:

Extreme sleep deprivation

After 48 hours of sleep deprivation, your body will enter a state of extreme sleep deprivation. It will become increasingly difficult to stay awake, and you will likely experience microsleeps—short periods of light sleep that can last up to 30 seconds. During microsleeps, your brain enters a sleep-like state, and you may feel confused or disoriented when you come out of it. Your immune system will also be affected, with inflammatory markers circulating at increased levels, impairing your body's ability to prevent and target illnesses.

Cognitive impairments

Two days without sleep will also lead to cognitive impairments. Your decision-making abilities will be impaired, and you will have trouble with hand-eye coordination. Your risk of accidents or near misses will increase, and you may experience speech impairments, such as poor word choice and intonation.

Increased appetite and altered food cravings

Sleep deprivation can alter your appetite and the types of food you crave. You may experience an increased appetite and a desire for foods associated with weight gain. Consuming empty calories can leave you feeling even more tired, so it's important to opt for lean, protein-rich foods like nuts, nut butters, cottage cheese, or tofu.

Emotional and mental health impact

Your emotional and mental health will also be affected by two days of sleep deprivation. You may become more irritable, and your mood may be affected, leading to feelings of depression, anxiety, or paranoia. Research has shown that people who are sleep-deprived have difficulty processing others' emotions and recognising facial expressions.

Hallucinations and illusions

Finally, going without sleep for two days can significantly alter your perception of reality. You may experience hallucinations, which are when you see, hear, or feel things that aren't actually there. Illusions are also common, where you misinterpret something that is real, such as seeing a sign and thinking it's a person.

How to recover

Sleep is essential for your body and its physical and mental functions. Sleep deprivation can have long-term damaging effects on your heart and circulatory health, and can also cause or contribute to a variety of health issues. It can take up to four days to recover from an hour of sleep debt and nine days or more to fully recover from a significant deficit. Here are some tips to help you recover from sleep deprivation:

• Get back to your normal routine as soon as possible. Returning to your typical sleep schedule keeps you from accumulating more sleep debt.
• Use afternoon naps in moderation. A quick 20-minute nap during the day can help you function better until bedtime. However, be careful not to nap too long or too late in the day, as this can disrupt your nighttime sleep.
• Avoid stimulants, especially in the afternoon or evening. A cup of coffee may make you feel more alert, but it can adversely affect your sleep, contributing to your sleep debt.
• Keep a sleep diary. Taking notes can enable you to detect patterns and make changes that will help you get more and better sleep.
• Be patient. Expecting your sleep debt to resolve in a night or two can create stress and frustration when you still feel tired after multiple days. Remember that it will take time for your body and mind to recover.
• Talk with your doctor. If you face significant or continual problems that are creating a sleep debt that's affecting you during the day, your doctor can help. They can determine if you have an undiagnosed sleep problem like insomnia or sleep apnea and prescribe treatment.
• 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 large meal too close to bedtime. A light snack is the best option if you feel hungry before bed.
• Exercise. 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 those available over the counter — can negatively affect your sleep. The only sleep-related medications you should use regularly are those prescribed by your doctor, and only as instructed.

When to seek help

Sleep is essential for our health and well-being, and going without it can have significant negative consequences. While you may occasionally have no choice but to work through the night and the following day, it is important to recognize the risks and know when to seek help. Here are some signs that you need to prioritize sleep and take immediate steps to improve your situation:

• Impaired decision-making and cognitive function: Sleep deprivation can affect your ability to think clearly, make decisions, and perform complex tasks. If you find yourself struggling to concentrate, having trouble with memory or learning new things, or making poor decisions, it's time to prioritize sleep.
• Changes in mood and emotional state: Lack of sleep can make you more irritable, anxious, or depressed. If you find yourself experiencing mood swings, feeling overwhelmed by emotions, or struggling to process and recognize emotions in others, it's time to get some rest.
• Hallucinations and perceptual distortions: After a certain point, sleep deprivation can lead to hallucinations and a distorted perception of reality. If you start seeing, hearing, or feeling things that aren't there, it's a serious sign that you need to seek help and get some sleep.
• Microsleeps: Microsleeps are brief periods of sleep that can last from a few seconds to a few minutes. They often occur involuntarily and can be dangerous if they happen while you're driving or operating heavy machinery. If you find yourself experiencing microsleeps, it's crucial to stop what you're doing and get some rest.
• Physical health risks: Sleep deprivation can weaken your immune system, making you more susceptible to illnesses. It can also lead to increased muscle tension and impaired physical performance. If you're feeling unwell or your body is sending you warning signals, prioritize sleep to give your body a chance to recover.
• Changes in appetite and food cravings: Sleep deprivation can alter your appetite and lead to cravings for unhealthy foods. While it's normal to crave simple carbs and sugar when you're sleep-deprived, giving in to these cravings can make you even more tired. If you find yourself reaching for unhealthy snacks and experiencing energy crashes, it's time to focus on getting a good night's sleep.

Remember, these strategies for coping with sleep deprivation are only meant for occasional use and are not sustainable long-term solutions. Chronic sleep deprivation can have serious health consequences and should not be taken lightly. If you consistently have trouble sleeping, it's important to consult a medical professional for advice and treatment options.

Frequently asked questions