Sleep Deprivation: Days Until Psychosis Kicks In

Sleep deprivation can have serious consequences for a person's mental health. After 24 hours without sleep, people may experience impaired decision-making, vision and hearing impairments, decreased hand-eye coordination, increased muscle tension, and increased risk of accidents. After 48 hours, symptoms can include distorted perception, anxiety, irritability, and depersonalisation. After 72 hours, people may experience complex hallucinations and delusions, and their mental state may resemble acute psychosis or toxic delirium.

A 2018 review of 21 articles on the correlation between time spent without sleep and symptoms of psychosis found that the first symptoms typically appear within 24 to 48 hours of not sleeping. These can include distorted perception, anxiety, irritability, and depersonalisation. After 48 hours, symptoms tend to become more complex, with people experiencing disorganised thinking and, after 72 hours, persistent complex hallucinations and delusions.

The treatment for sleep deprivation psychosis is, simply, sleep. The longer a person has gone without sleep, the more time they will need to recover.

Sleep deprivation can cause hallucinations and delusions

It is unclear exactly how long humans can survive without sleep, but the effects of sleep deprivation start to show after just a few days. After three or four nights without sleep, people can start to hallucinate. After 72 hours without sleep, most people experience an overwhelming urge to sleep and many are unable to stay awake on their own.

Symptoms of Sleep Deprivation Psychosis

Symptoms of sleep deprivation psychosis can change with time. More intense symptoms, like hallucinations, develop after the first 24 hours without sleeping. A 2018 research review examined 21 articles on the correlation between time spent without any sleep and symptoms of psychosis. Based on results gathered from 760 participants, the researchers noticed that people typically start experiencing the first symptoms within 24 to 48 hours of not sleeping. These symptoms typically include distorted perception, anxiety and irritability, not feeling like yourself and other signs of depersonalisation and dissociation, and loss of time and your sense of orientation.

The review also suggested that symptoms of psychosis rapidly progress as more sleep loss is experienced. Most participants experienced more complex symptoms after 48 hours without sleep, including disorganised thinking and, after 72 hours of not sleeping, people started experiencing persistent complex hallucinations and elaborated delusions.

Sleep deprivation psychosis refers to experiencing an altered perception of reality caused by a prolonged lack of sleep. Psychosis, in general, refers to an episode in which your brain perceives reality differently from other people in the same situation. Psychosis is a formal diagnosis and can be a result of many factors. In this case, not sleeping for a long time can be the cause.

A 2018 study in the journal Frontiers in Psychiatry identified the following signs and symptoms of sleep deprivation psychosis: anxiety, depression, and other mood changes; perceptual distortions such as blurred vision and increased sensitivity to colours and sounds; temporal distortion (inability to properly track the passage of time); disordered thinking, which can include problems forming logical thought patterns or maintaining a clear train of thought; inability to speak in a manner that is logical and understandable; auditory and visual hallucinations (hearing or seeing things that aren’t there); and delusions (believing things that clearly have no basis in reality).

Treatment for Sleep Deprivation Psychosis

The optimal treatment for sleep deprivation psychosis can depend on a variety of personal factors, including the types of symptoms you’ve been experiencing and the underlying cause of your sleep deprivation. For example, if your sleep deprivation is the result of substance abuse or a mental health condition, you may need medical attention, therapeutic services, or both. The medications that are incorporated into treatment for these concerns may improve your mood, stabilise your emotions, and ease certain other symptoms. If you’ve been struggling with addiction, medication may help you complete the withdrawal process with minimal discomfort.

How to Treat Sleep Deprivation

The ways to treat sleep deprivation will depend on what’s causing the issue and how severe it is. Here are some potential treatment options:

• Lifestyle changes: Keeping a consistent sleep schedule, daytime exercise, avoiding caffeine and alcohol close to bedtime, cutting off electronic devices before bed, and creating a relaxing bedtime routine.
• Sleep disorder treatment: Treatments for sleep disorders may also help mitigate sleep deprivation. However, the treatment will depend on the type of disorder.
• Medications: In more severe cases of insomnia, doctors may prescribe sleeping pills to help a patient catch up on rest. However, these pills are meant to be a temporary solution and are not typically intended for long-term use.
• Catch up on sleep: Taking a nap or sleeping in on the weekends can help you feel more alert, but it’s important to note that this won’t reverse the metabolic dysregulation that can result from sleep loss.

The first signs of sleep deprivation psychosis can appear after 24 hours

Sleep deprivation psychosis refers to experiencing an altered perception of reality caused by a prolonged lack of sleep. The first signs of sleep deprivation psychosis can appear after 24 hours without sleep. However, the symptoms of sleep deprivation psychosis can change with time and become more intense.

The early signs of sleep deprivation psychosis

After 24 hours without sleep, you may experience:

• Impaired decision-making
• Vision and hearing impairments
• Decreased hand-eye coordination
• Increased muscle tension
• Increased risk of accidents or near misses
• Irritability
• Anxiety
• A sense of being disconnected from your thoughts and feelings

The progression of sleep deprivation psychosis

After 48 hours without sleep, you may experience:

• Distorted perception
• Not feeling like yourself and other signs of depersonalisation and dissociation
• Loss of time and your sense of orientation
• Disorganised thinking
• Complex hallucinations

After 72 hours without sleep, you may experience:

• Elaborated delusions
• An overwhelming urge to sleep
• An inability to stay awake
• Difficulty thinking, especially when it comes to executive functions such as multitasking, remembering details, and paying attention
• A depressed mood, anxiety, or paranoia
• Difficulty processing others' emotions
• A reduced ability to think
• Poor decision-making
• Speech impairment

Treatment for sleep deprivation psychosis

The treatment for sleep deprivation psychosis is sleep. The longer you've gone without sleep, the more time you'll need to recover. For every hour of sleep that you've lost, you could need half an hour of sleep to recuperate.

Sleep deprivation psychosis can be caused by lifestyle choices, health conditions, or external factors

Lifestyle Choices

Lifestyle choices that can cause sleep deprivation include pulling an all-nighter to study for an exam or working through the night to complete a project. Some types of drug abuse, such as the habitual use of methamphetamine or other stimulants, can also keep you awake for several days at a time. Other factors include inconsistent sleep schedules, working multiple jobs or extended hours, and shift work.

Health Conditions

Sleep deprivation can also be caused by various health conditions. Insomnia can be a symptom of several mental health disorders, including depressive disorders, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders. Additionally, people living with chronic pain may find it difficult or impossible to sleep. Other conditions that can cause sleep deprivation include sleep apnea, degenerative brain disorders such as Alzheimer's disease or Parkinson's disease, and mental health concerns such as post-traumatic stress disorder (PTSD) and somniphobia (fear of sleep).

External Factors

External factors that can contribute to sleep deprivation include environmental conditions such as noise, extreme temperatures, or discomfort. Additionally, some individuals may experience sleep deprivation as a form of punishment or interrogation, which is considered a form of torture.

Sleep deprivation can be acute or chronic

Chronic sleep deprivation, on the other hand, is when someone doesn't get enough sleep routinely, usually daily, and for three months or longer. This can be caused by unintentional behavioural decisions, personal commitments, work schedules, and medical problems. The long-term complications of chronic sleep loss include an increased risk of high blood pressure, high cholesterol, type 2 diabetes, a weakened immune system, more sensitivity to pain, Alzheimer's disease, depression, and anxiety.

The symptoms of acute sleep deprivation can become more intense with each passing day. After 24 hours without sleep, a person may experience anxiety, depression, and other mood changes, perceptual distortions such as blurred vision, disorganised thinking, and derealisation (feeling detached from one's surroundings). After 48 hours, complex hallucinations and an inability to think clearly may occur. After 72 hours, delusions, firmly held false beliefs, may arise.

The longer a person goes without sleep, the greater the risk of severe, long-lasting effects of sleep deprivation psychosis. Sleep deprivation psychosis is when a person is so sleep-deprived that they struggle to differentiate between reality and their hallucinations. This state of psychosis usually begins after 2-3 days without sleep.

In most cases, sleep deprivation psychosis isn't permanent and can be resolved by getting more sleep. However, the longer a person has been deprived of sleep, the more time they will need to recover.

Sleep deprivation can be treated with lifestyle changes, sleep disorder treatment, medication, or catching up on sleep

Lifestyle Changes

Making changes to your daily routine and sleeping habits can help improve your sleep. This includes:

• Maintaining a consistent sleep schedule, even on weekends
• Avoiding large meals, caffeine, and alcohol close to bedtime
• Exercising regularly during the day
• Creating a quiet, dark, and cool sleep environment
• Limiting the use of electronic devices before bed and keeping them away from the bed

Sleep Disorder Treatment

If sleep deprivation is caused by an underlying health condition, such as sleep apnea, depression, or chronic pain, treating that condition can help improve your sleep. This may involve counselling, medication, or other therapies.

Medication

In some cases, medication can help induce sleep. Over-the-counter options include diphenhydramine (Benadryl) and doxylamine (Unisom). If these are not effective, a doctor may prescribe medications such as butabarbital (Butisol) or temazepam (Restoril). However, it is important to follow a doctor's instructions and be cautious of potential side effects or habit-forming nature of these medications.

Catching Up On Sleep

While it may not fully reverse the effects of chronic sleep deprivation, catching up on sleep by extending your sleep duration on weekends or days off can help reduce the sleep debt. However, it is important to maintain a consistent sleep schedule as much as possible to avoid creating an "at-home jet lag" effect.

Frequently asked questions