Skipping Sleep: Every Other Day, Possible Or Perilous?

Is it possible to sleep every other day? While there is limited research on the topic, some people claim to follow a sleep pattern known as segmented sleep or polyphasic sleep, where they sleep every other day or break their sleep into two or more shifts. However, sleep is crucial for our physical, cognitive, and mental well-being, and sleep deprivation can have negative consequences on our health.

Segmented sleep: sleeping in two shifts

Segmented sleep, also known as biphasic or polyphasic sleep, is when you break up your sleep into two or more shifts with periods of being awake in between. This might look like sleeping for four or five hours at night before getting up early for work, and then taking a two or three-hour nap during the day.

Segmented sleep has its roots in ancient civilisations and was common through to the early 19th century. People would sleep just after dusk, wake up a few hours later, and then head back to bed for a second sleep that lasted until morning. In pre-industrial times, it was also normal to get up for a couple of hours in the middle of the night, spending this time praying, smoking, having sex, or visiting neighbours.

Some people still adopt this sleep pattern in contemporary settings to reduce the effects of lost sleep and maintain productivity. In some cultures, segmented sleep still exists in some form, such as siesta time in Spain and Italy.

There are mixed views on whether segmented sleep is safe. There hasn't been much research on the health effects of sleeping in shifts, so it's best to avoid it unless there's a reason you need to sleep that way. However, one sleep researcher says she doesn't know of evidence that sleeping in two rounds at night causes health problems, so it's okay if you naturally sleep that way.

If you try segmented sleep, there are a few things to keep in mind. First, aim for eight hours of rest in as lengthy blocks as possible. Second, try to get nighttime sleep, or at least mimic it with blackout curtains and earplugs. Third, don't nap too close to bedtime—the "Forbidden Zone" is after 7 pm, which would wipe out the sleep drive you've built up during the day.

Non-24-hour sleep-wake disorder

The disorder is characterised by a "chronic steady pattern" of daily delays in sleep onset and wake times. The non-entrained (free-running) endogenous circadian rhythm drifts out of alignment with the light-dark cycle in nature. This results in symptoms such as inappropriate fluctuations in appetite, mood, and alertness. During periods when their body clock is heavily desynchronized, they show a natural preference for sleeping in the middle of the day and difficulty sleeping at night.

The disorder can also occur in sighted people, although the cause is not well understood. It may be linked to a traumatic brain injury or a prior diagnosis of a mental health disorder. The largest study of sighted people with N24SWD found that the majority were male, with symptoms starting in their teens or twenties.

Although non-24-hour sleep-wake disorder is assumed to be a lifelong condition, certain treatments can help restore a 24-hour rhythm. These include melatonin supplements or the FDA-approved melatonin receptor agonist, tasimelteon. Bright light therapy in the morning may also be an option for N24SWD in sighted people.

Sleep deprivation

While it may be possible to sleep every other day, this would likely result in sleep deprivation, which can have serious consequences for your health, productivity, and safety. Sleep deprivation is a condition that occurs when you don't get enough sleep, or when the sleep you get is not good quality.

The amount of sleep a person needs varies depending on their age. Newborns, for example, require 14 to 17 hours of sleep per day, while adults generally need 7 to 9 hours. Sleep deprivation can happen for a variety of reasons, from shift work and alcohol use to sleep disorders such as sleep apnea or insomnia.

The effects of sleep deprivation can be far-reaching and include trouble thinking, focusing, and remembering, as well as slowed reaction times. If sleep deprivation continues, more severe symptoms can occur, such as hallucinations, trouble speaking clearly, and impulsive behaviour. Sleep deprivation can also negatively impact your mental health, making it harder to manage and process emotions, and increasing the likelihood of experiencing symptoms of depression and anxiety.

In addition to the cognitive and mental health effects, sleep deprivation can also have physical consequences. It can disrupt your body's metabolism, increasing the risk of weight gain and the development of Type 2 diabetes. It can also weaken your immune system, making it harder for your body to fight off infections.

Furthermore, sleep deprivation can have a significant impact on your daily life and social functioning. It can interfere with work, school, driving, and social interactions. It can make it difficult to learn new things, focus, and react to your surroundings. It may also affect your ability to judge other people's emotions and reactions, and can lead to feelings of frustration, crankiness, or worry in social situations.

Overall, sleep deprivation is a serious condition that can have wide-ranging effects on your health, well-being, and daily functioning. It is important to prioritize getting sufficient, quality sleep to maintain optimal physical and mental health.

Sleep patterns and insomnia

Sleep is an essential part of our health. While it may be tempting to try and cut down on sleep to gain more waking hours, it is not a good idea. Most adults need around seven to nine hours of sleep per night. Sleep deprivation can cause a host of issues, including:

• Changes in metabolism
• Increased risk of weight gain
• Impaired learning and memory
• Increased risk of accidents

Some people naturally need less sleep than others, and this may even be due to genetic factors. However, for those who consistently get less than seven hours of sleep per night, there can be serious consequences.

Insomnia is a common sleep disorder that affects around 10% of the world's population. It is characterised by disruptions in sleep patterns and can be caused by a variety of factors, including:

• Family history
• Brain activity differences
• Medical conditions
• Mental health conditions
• Stressful life circumstances
• Sleep habits (e.g. taking naps, consuming caffeine)

There are two main types of insomnia: acute (short-term) and chronic (long-term). Chronic insomnia, or insomnia disorder, is defined as insomnia that occurs at least three times per week and lasts for at least three months. It can severely impact a person's life, causing daytime sleepiness, mood disruptions, and difficulty with work, social activities, and hobbies.

If you are experiencing insomnia, it is important to seek help from a healthcare professional. Treatment options include lifestyle changes, medication, and mental health support.

In terms of sleep patterns, some people naturally follow a segmented sleep pattern, where they sleep in two or more shifts. This was common in pre-industrial times, and some believe we are hardwired for this type of sleep. However, it is not easy to maintain this sleep pattern in today's world, especially if you have a family or a regular job.

Overall, it is important to prioritise sleep and seek help if you are experiencing insomnia or other sleep disorders. While it may be tempting to reduce sleep to gain more time, the consequences can be serious, and adequate sleep is crucial for optimal health and functioning.

Sleep and mental health

Brain Activity and Sleep

Brain activity fluctuates during sleep, increasing and decreasing during different sleep stages, which play a role in brain health. Sufficient sleep, especially rapid eye movement (REM) sleep, allows the brain to process emotional information. During sleep, the brain evaluates and remembers thoughts and memories, and a lack of sleep is particularly detrimental to the consolidation of positive emotional content. This can influence mood and emotional reactivity and is linked to mental health disorders and their severity, including the risk of suicidal ideation.

Sleep Deprivation and Mental Health Disorders

Not getting enough sleep or poor-quality sleep can increase the risk of mental health disorders. While insomnia can be a symptom of psychiatric disorders like anxiety and depression, it is now recognized that sleep problems can also contribute to the onset and worsening of different mental health problems, including depression, anxiety, and even suicidal ideation. Sleep deprivation studies show that otherwise healthy people can experience increased anxiety and distress levels following poor sleep.

Sleep and Specific Mental Health Conditions

The link between sleep and mental health becomes more apparent when examining specific mental health conditions:

• Depression: Around 75% of depressed people exhibit insomnia symptoms, and many also suffer from excessive daytime sleepiness and hypersomnia (sleeping too much). While sleeping problems were historically viewed as a consequence of depression, growing evidence suggests that poor sleep may induce or exacerbate depression.
• Seasonal Affective Disorder: This subtype of depression is often linked to disruptions in a person's internal biological clock or circadian rhythm, which controls sleep, among other bodily processes.
• Anxiety Disorders: Worry and fear contribute to hyperarousal, a central contributor to insomnia. Sleep problems may become an additional source of worry, creating anticipatory anxiety that makes it harder to fall asleep. Research has found a strong connection between PTSD and sleep, with individuals frequently replaying negative events in their minds, suffering from nightmares, and experiencing a constant state of alertness, all of which interfere with sleep.
• Bipolar Disorder: Sleep patterns change significantly depending on the emotional state of individuals with bipolar disorder. During manic periods, they usually feel less need to sleep, but during depressed periods, they may sleep excessively. Evidence suggests that sleeping problems induce or worsen manic and depressive periods.
• Schizophrenia: Individuals with schizophrenia are more likely to experience insomnia and circadian rhythm disorders. Poor sleep and schizophrenia symptoms may be mutually reinforcing.
• Attention-Deficit/Hyperactivity Disorder (ADHD): Sleep problems are common in people with ADHD, who may have difficulty falling asleep, experience frequent awakenings, and feel excessive daytime sleepiness. There is evidence of a bidirectional relationship between sleep and ADHD, with sleep problems potentially aggravating symptoms like reduced attention span and behavior problems.
• Autism Spectrum Disorder (ASD): Children and adolescents with ASD have a higher prevalence of sleep problems, including insomnia and sleep-disordered breathing. Addressing these issues is crucial for decreasing excessive daytime sleepiness and improving overall health and behavior.

Improving Sleep and Mental Health

The complex relationship between sleep and mental health means that treatment for both issues can go hand-in-hand. Cognitive Behavioral Therapy (CBT), including CBT for insomnia (CBT-I), has proven effective in reducing sleeping problems and improving emotional well-being. Additionally, improving sleep habits, such as maintaining a steady sleep schedule, avoiding caffeine and alcohol, and getting regular exercise, can positively impact both sleep and mental health.

Frequently asked questions