Insomnia's Grip: Five Sleepless Nights And Counting

Sleep deprivation is a common issue, with nearly 30% of adults in the United States experiencing some form of insomnia. While occasional lack of sleep may not seem concerning, its effects can be intense and lingering. Going without sleep for an extended period, such as five days, can have severe consequences on both physical and mental health, including impaired coordination, memory, and judgment, increased risk of serious medical conditions, and even hallucinations. Understanding the causes and impacts of sleep deprivation is crucial for maintaining overall health and well-being.

Sleep deprivation stages

Sleep deprivation can occur after just 24 hours of no sleep, and the longer you go without sleep, the more severe the symptoms become. Here is a breakdown of the five stages of acute sleep deprivation:

Stage 1: After 24 hours

Missing a night of sleep won't cause major health issues, but you will likely feel tired and exhausted. Your risk of errors and accidents in everyday tasks may increase, and your cognitive function and judgement may be impaired. According to the CDC, being awake for 24 hours is similar to having a blood alcohol concentration of 0.1%, which is over the legal limit for driving.

Stage 2: After 36 hours

After missing 36 hours of sleep, you will have an overwhelming urge to sleep. Along with the effects of the previous stage, you may experience an increased appetite, extreme fatigue, and microsleeps. Microsleeps are brief periods of rest that usually last between 3 and 15 seconds, during which your brain switches off and you may be unaware of your surroundings. Research has also found that you may begin to hallucinate at this stage.

Stage 3: After 48 hours

Missing sleep for two days is considered extreme sleep deprivation, and it will be increasingly difficult to stay awake. You are more likely to experience microsleeps and may also have perceptual distortions, increased irritability, and temporal disorientation.

Stage 4: Awake for 72 hours

After three days of sleep loss, your urge to sleep will be even stronger and possibly uncontrollable. You will likely experience longer and more frequent microsleeps, and your hallucinations may become more complex. Your perception will be significantly impaired, and you may struggle to distinguish between what is real and what isn't.

Stage 5: Awake for 96 hours or more

By this stage, your perception of reality may be severely distorted, resembling acute psychosis. Your urge to sleep will be unbearable. It is important to note that these symptoms will go away once you get sufficient sleep. However, it can take days or even weeks to fully recover from sleep deprivation, and the longer you've been awake, the longer it will take to get back on track.

Health conditions

Sleep is critical for good health. Not getting enough sleep can lead to a range of health issues. Here are some of the health consequences of going five days (120 hours) without sleep:

After 72 Hours

After three days of sleep loss, you will experience more frequent and longer microsleeps, which are brief periods of complete unconsciousness that last for several seconds. Your perception of reality will be severely distorted, resembling acute psychosis. You may also experience complex hallucinations and delusions.

After 96 Hours or More

As you continue to go without sleep, the effects will intensify. Your perception of reality may completely break down, and you may experience symptoms similar to acute psychosis. You will likely feel an unbearable urge to sleep.

Chronic Sleep Deprivation

Chronic sleep deprivation can have long-term health complications. Over time, sleep disruptions can increase your risk of various health conditions, including:

• High blood pressure (hypertension)
• Cardiovascular issues such as stroke and heart disease
• Type 2 diabetes
• Kidney disease
• Obesity
• Certain cancers, such as colorectal cancer

Recovery from Sleep Deprivation

It can take several days or even weeks to fully recover from prolonged sleep deprivation. The longer you have been awake, the more time it will take to get back to a normal sleep schedule. To aid in recovery, aim for at least seven hours of sleep each night and maintain a consistent sleep schedule.

Causes of insomnia

Sleep is an essential pillar of health, alongside diet and exercise. However, about 30% of adults in the United States experience insomnia, a sleep disorder that affects an individual's ability to fall asleep, remain asleep, and achieve a full night's rest.

Stress

The everyday stresses of life, such as work, family, finances, and physical problems like illness or injury, can keep you awake at night. Stress can provoke a profound reaction in the body, contributing to hyperarousal and making it difficult to fall asleep. This inability to sleep may itself become a source of stress, creating a challenging cycle to break.

Irregular Sleep Schedules

An ideal sleep schedule aligns with the body's internal clock, known as the circadian rhythm, which follows the daily pattern of day and night. However, jet lag and shift work can disrupt this rhythm and lead to insomnia. Additionally, napping late in the afternoon, sleeping in to make up for lost sleep, and using your bed for activities other than sleep can also contribute to insomnia.

Lifestyle Choices

Certain lifestyle choices can increase the risk of insomnia. These include working late, playing video games, or using electronic devices until late in the evening, stimulating the brain when it should be winding down. Consuming heavy meals, spicy foods, caffeine, nicotine, and alcohol later in the evening can also disrupt the digestive process and contribute to sleeping problems.

Mental Health Disorders

Mental health conditions such as anxiety, depression, bipolar disorder, and post-traumatic stress disorder (PTSD) frequently lead to serious sleeping problems. These conditions can incite pervasive negative thoughts and mental hyperarousal, disturbing sleep. Poor sleep can, in turn, trigger or worsen existing mental health disorders, creating a complex cycle.

Physical Illness and Pain

Any condition that causes pain, such as back problems or arthritis, can disrupt sleep by making it difficult to find a comfortable position in bed. Additionally, dwelling on pain when sleepless can amplify it, increasing stress and exacerbating sleeping problems.

Medications

Sleeping problems and insomnia can be side effects of various medications, including blood pressure drugs, anti-asthma medications, antidepressants, cold medicines, steroids, and non-prescription diet aids. Additionally, withdrawing from certain drugs can also create difficulties for sleep.

Neurological Problems

Neurodegenerative and neurodevelopmental disorders have been associated with an elevated risk of insomnia. Dementia and Alzheimer's dementia, for example, can disrupt the circadian rhythm and perception of daily cues that drive the sleep-wake cycle, leading to insomnia. Attention-deficit/hyperactivity disorder (ADHD) can cause hyperarousal, making it challenging for individuals to get sufficient sleep.

Specific Sleep Disorders

Specific sleep disorders, such as obstructive sleep apnea, restless legs syndrome (RLS), and REM sleep behaviour disorder, can also cause insomnia. Obstructive sleep apnea, which affects up to 20% of people, involves numerous breathing lapses and temporary sleep interruptions, leading to daytime sleepiness and insomnia. RLS creates a powerful urge to move the legs, often during sleep, disrupting sleep.

Treating insomnia

Sleep is an essential pillar of health, alongside diet and exercise. However, about 30% of adults in the United States experience insomnia, a condition that disrupts sleep patterns and causes sleep deprivation. Insomnia can be acute (short-term) or chronic (long-term), with the latter being more severe and persistent. If you are experiencing insomnia, there are several treatment options available to help you get a good night's rest. Here are some detailed instructions to treat insomnia:

Identify the Cause:

First, it is important to identify the underlying cause of your insomnia. Insomnia can be primary, meaning it occurs on its own, or secondary, indicating it is a symptom of another condition. Common causes of insomnia include stress, changes in schedule, medications, mental health disorders, physical health conditions, substance use (such as alcohol, nicotine, or caffeine), and poor sleep habits. Understanding the cause of your insomnia can help you address it more effectively.

Practice Good Sleep Hygiene:

Sleep hygiene refers to habits and practices that promote better sleep. Here are some tips to improve your sleep hygiene:

• Maintain a consistent sleep schedule: Go to bed and wake up at the same time each day, even on weekends.
• Avoid napping during the day, especially in the late afternoon or early evening, as it can disrupt your sleep at night.
• Create a comfortable sleeping environment: Ensure your bedroom is relaxing, quiet, and maintained at a cool temperature.
• Limit electronic device usage before bed: Put down electronic devices at least 30 minutes before bedtime, as the light from these devices can interfere with your sleep hormones.
• Avoid large meals, caffeine, and alcohol before bed: Eating or drinking certain substances close to bedtime can disrupt your sleep. Alcohol may make you fall asleep faster, but it can also cause you to wake up in the middle of the night and make it difficult to fall back asleep.
• Engage in physical activity: Staying active during the day, even through light activities like walking, can improve your sleep quality.

Make Lifestyle Changes:

In addition to sleep hygiene, consider making some lifestyle changes to promote better sleep:

• Manage stress: Practice relaxation techniques such as progressive muscle relaxation or deep breathing exercises to calm your mind and body before bed.
• Create a bedtime routine: Allow yourself time to wind down before bed. Engage in calming activities such as reading, listening to soothing music, or taking a warm bath.
• Maintain a healthy diet: Avoid heavy meals and excessive fluids late in the evening. Consume a balanced diet throughout the day to ensure your body has the nutrients it needs for optimal rest.

Consider Cognitive-Behavioral Therapy for Insomnia (CBT-I):

CBT-I is a specific type of therapy designed to treat insomnia. It can help improve your sleep patterns and address thoughts and behaviors that interfere with good sleep. Working with a therapist can help you identify and change unhelpful sleep habits and develop a sleep schedule that gradually improves your sleep duration and quality.

Explore Medication Options:

In some cases, your doctor may recommend prescription or non-prescription sleep medications to help you fall asleep. These include sedative drugs, hypnotic drugs, antidepressants, melatonin supplements, or antihistamine drugs. However, it is important to use these medications cautiously and only as recommended by your healthcare provider, as they can have side effects and may become less effective over time.

Remember, it is important to consult with a healthcare professional if your insomnia persists or interferes with your daily life. They can help you identify the underlying cause, suggest appropriate treatments, and guide you towards a better night's rest.

Sleep hygiene

Optimise Your Sleep Schedule

• Maintain a fixed wake-up time: Keep the same wake-up time every day, even on weekends, to establish a consistent sleep rhythm.
• Prioritise sleep: Avoid sacrificing sleep for other activities. Calculate your target bedtime based on your wake-up time and stick to it as much as possible.
• Make gradual adjustments: If you need to change your sleep schedule, do so gradually, in small steps of up to an hour or two, to avoid disrupting your body's rhythm.
• Limit naps: Naps can be energising during the day, but they can interfere with nighttime sleep. Keep naps short and in the early afternoon to minimise disruption.

Establish a Nightly Routine

• Keep your routine consistent: Follow the same pre-sleep steps each night, such as putting on pajamas and brushing your teeth, to signal to your mind that it's bedtime.
• Wind down for 30 minutes: Engage in calming activities like soft music, light stretching, reading, or relaxation exercises to prepare your mind and body for sleep.
• Dim the lights: Bright lights hinder melatonin production, a hormone that facilitates sleep. Lower the lighting to encourage melatonin release.
• Unplug from electronics: Set aside 30-60 minutes before bed as a device-free buffer. Screens stimulate your mind and emit blue light, which interferes with melatonin production.
• Practice relaxation techniques: Instead of pressuring yourself to fall asleep, focus on relaxation. Try meditation, mindfulness, paced breathing, or other techniques to calm your mind.
• Avoid tossing and turning: If you can't sleep after 20 minutes, get up and engage in a calming activity in low light before trying again. This reinforces the mental association between bed and sleep.

Cultivate Healthy Daily Habits

• Get daylight exposure: Sunlight is a key driver of circadian rhythms, which promote quality sleep.
• Exercise regularly: Physical activity improves sleep quality and offers other health benefits.
• Avoid smoking: Nicotine stimulates the body in ways that disrupt sleep.
• Reduce alcohol consumption: While alcohol may initially promote sleepiness, it can disrupt sleep later in the night. Moderate your intake and avoid drinking close to bedtime.
• Limit caffeine in the afternoon and evening: Caffeine is a stimulant that can keep you wired when you want to rest. Avoid consuming it later in the day.
• Avoid late dinners: Eating a large, heavy, or spicy meal close to bedtime can interfere with sleep as your body is still digesting. Opt for lighter meals or snacks before bed.
• Restrict in-bed activity: Use your bed primarily for sleep and sex. This helps reinforce the mental association between bed and sleep.

Optimise Your Bedroom Environment

• Comfortable mattress and pillow: Choose a sleeping surface that ensures comfort and supports pain-free sleep.
• High-quality bedding: Select sheets and blankets that match your personal preferences for a pleasant sleeping experience.
• Set a cool temperature: A cooler temperature, around 65 degrees Fahrenheit, is ideal for promoting comfortable sleep.
• Block out light: Use heavy curtains or an eye mask to prevent light from interrupting your sleep.
• Drown out noise: Use earplugs, a white noise machine, or a fan to minimise noise disturbances.
• Try calming scents: Light scents like lavender may induce a calmer state of mind and create a positive sleep space.

Frequently asked questions