Sleep deprivation

Short description: Condition of not having enough sleep

"Sleep Deprivation" redirects here. For the song by Simian Mobile Disco, see Attack Decay Sustain Release.

Not to be confused with Insomnia.

Sleep deprivation

Other names| Sleeplessness, sleep insufficiency
Specialty| Sleep medicine
Symptoms| Fatigue, eye bags, poor memory, irritable mood, weight gain
Complications| Car and work accidents, weight gain, cardiovascular disease
Causes| Insomnia, sleep apnea, stimulants (caffeine, amphetamine), voluntary imposition (school, work), mood disorders
Treatment| Cognitive behavioral therapy, caffeine (to induce alertness), hypnotics
The Centers for Disease Control and Prevention's (CDC) recommendations for the amount of sleep needed decrease with age.[1]

Sleep deprivation, also known as sleep insufficiency[2] or sleeplessness, is the condition of not having adequate duration or quality of sleep to support decent alertness, performance, and health. It can be either chronic or acute and may vary widely in severity. This means it can happen over both short and long periods of time. Sleep is important because adequate sleep, or restful sleep, is essential for maintaining overall health, brain performance, emotional regulation, and metabolic balance. Persistent sleep insufficiency can contribute to cognitive decline, emotional instability, and biological wear that has effects similar to accelerated aging. Scientific research demonstrates overwhelming evidence that inadequate sleep produces chronic consequences for overall health, ranging from attentional lapses to long-term neurodegenerative changes.[3]

The human body and most living organisms depend on sleep for neural recovery. All known animals sleep or exhibit some form of sleep behavior, and the importance of sleep is self-evident for humans, as nearly a third of a person's life is spent sleeping.[2] Sleep deprivation is common as it affects about one-third of the population.[4]

The US National Sleep Foundation recommends that adults aim for 7 hours of sleep per night. Children and teenagers require even more sleep, ranging from 8–16 hours per night.[5] For healthy young individuals with normal sleep, the appropriate sleep duration for school-aged children is between 9 and 11 hours.[6][7] Acute sleep deprivation occurs when a person sleeps less than usual or does not sleep at all for a short period, typically lasting one to two days. However, if the sleepless pattern persists without external factors, it may lead to chronic sleep issues. Chronic sleep deprivation occurs when a person routinely sleeps less than the amount required for proper functioning. The amount of sleep needed can depend on sleep quality, age, pregnancy, and level of sleep deprivation. Sleep deprivation is linked to various adverse health outcomes, including cognitive impairments, mood disturbances, and increased risk for chronic conditions. A meta-analysis published in Sleep Medicine Reviews indicates that individuals who experience chronic sleep deprivation are at a higher risk for developing conditions such as obesity, diabetes, and cardiovascular diseases.[8]

Insufficient sleep has been linked to weight gain, high blood pressure, diabetes, depression, heart disease, and strokes.[9] Sleep deprivation can also lead to high anxiety, irritability, erratic behavior, poor cognitive functioning and performance, and psychotic episodes.[10] A chronic sleep-restricted state adversely affects the brain and cognitive function.[11] However, in a subset of cases, sleep deprivation can paradoxically lead to increased energy and alertness; although its long-term consequences have never been evaluated, sleep deprivation has even been used as a treatment for depression.[12][13]

To date, most sleep deprivation studies have focused on acute sleep deprivation, suggesting that acute sleep deprivation can cause significant damage to cognitive, emotional, and physical functions and brain mechanisms.[14] Few studies have compared the effects of acute total sleep deprivation and chronic partial sleep restriction.[11] A complete absence of sleep over a long period is not frequent in humans (unless they have fatal insomnia or specific issues caused by surgery); it appears that brief microsleeps cannot be avoided.[15] Long-term total sleep deprivation has caused death in lab animals.[16]

## Contents

* 1 Terminology
* 1.1 Sleep deprivation vs sleep restriction
* 1.2 Sleep debt
* 1.3 Insomnia
* 2 Health effects of sleep deprivation
* 2.1 Cognitive and neurobehavioral effects
* 2.1.1 Attention
* 2.1.2 Experimental based evidence
* 2.2 Effects on the body
* 2.2.1 Driving ability
* 2.2.2 Impacts on reasoning and decision-making
* 2.2.3 Working memory
* 2.2.4 Mood and behavior
* 2.2.5 Subjective age
* 2.2.6 Fatigue
* 2.2.6.1 Propensity
* 2.2.6.2 Impact on the sleep-wake cycle
* 2.3 Genetic and circadian effects
* 2.3.1 Microsleep
* 2.3.2 Cardiovascular morbidity
* 2.3.3 Immunosuppression
* 2.3.4 Weight gain
* 2.3.5 Type 2 diabetes
* 2.3.6 Other effects
* 2.4 Positive effects
* 2.4.1 Increased energy and alertness in some cases
* 3 Causes
* 3.1 Environmental factors
* 3.2 Insomnia
* 3.3 Sleep apnea
* 3.4 Self-imposed
* 3.4.1 Caffeine
* 3.4.2 Studying
* 3.5 Mental illness
* 3.6 Hospital stay
* 3.7 Time online
* 3.8 Shift work
* 4 Treatments and prevention
* 4.1 Sleep hygiene
* 4.2 CBT
* 4.3 Assessments
* 4.4 Sleep diaries
* 4.5 Sleep questionnaires
* 4.6 Measures to increase alertness
* 4.7 Actigraphy
* 4.8 Wearable devices
* 5 Uses
* 5.1 Treating depression
* 5.2 Treating insomnia
* 6 Additional information
* 6.1 Military use and training
* 6.1.1 To facilitate abusive control
* 6.1.2 Interrogation
* 7 Changes in American sleep habits
* 8 Longest periods without sleep
* 9 See also
* 10 References

## Terminology

### Sleep deprivation vs sleep restriction

Reviews differentiate between having no sleep over a short-term period, such as one night ('sleep deprivation'), and having less than required sleep over a longer period ('sleep restriction'). Sleep deprivation was seen as more impactful in the short term, but sleep restriction had similar effects over a longer period.[17][18][19][20][21] A 2022 study found that in most cases the changes induced by chronic or acute sleep loss waxed or waned across the waking day.[22]

### Sleep debt

Sleep debt refers to a build up of lost optimum sleep. Sleep deprivation is known to be cumulative.[23] This means that the fatigue and sleep one lost as a result of, for example, staying awake all night, would be carried over to the following day.[24][25][26] Not getting enough sleep for a couple of days cumulatively builds up a deficiency and causes symptoms of sleep deprivation to appear. A well-rested and healthy individual will generally spend less time in the REM stage of sleep. Studies have shown an inverse relationship between time spent in the REM stage of sleep and subsequent wakefulness during waking hours.[27] Short-term insomnia can be induced by stress or when the body experiences changes in environment and regimen.[28]

### Insomnia

Insomnia is a sleep disorder where people have difficulty falling asleep, or staying asleep for as long as desired.[29][30][31][32] Insomnia may be a factor in causing sleep deprivation. There are three different types of insomnia:

* Transient insomnia - short-term sleep problems that last less than three weeks;
* Acute insomnia - sleep problems which last 1‍– 3 weeks;
* Chronic insomnia - sleep problems which last for at least 3 months and which happen at least 3 nights per week.

Insomnia can be caused by stress, anxiety, depression, medications, poor sleeping habits, and genetics. It can be treated with cognitive behavioral therapy or with lifestyle changes such as establishing a regular sleep schedule or changing one's bedtime routine, with or without the assistance of medications such as sedatives and antidepressants.[33]

## Health effects of sleep deprivation

Main health effects of sleep deprivation

### Cognitive and neurobehavioral effects

Cognitive function depends heavily on adequate sleep, particularly in the prefrontal cortex, which controls executive functions like reasoning, decision-making, and attention.[34] In a study conducted in 2010, researchers were able to identify the declines in complex cognitive processes after just a single night of sleep deprivation. Participants displayed slower reaction times, impaired logical reasoning, and reduced cognitive flexibility. All of these dysfunctions can be attributed to diminished prefrontal activation. Neuroimaging studies also confirmed similar patterns: sleep-deprived brains show reduced glucose metabolism (the body's process for creating glucose energy in the blood) in regions critical for alertness and attentional control.

One study suggested, based on neuroimaging, that 35 hours of total sleep deprivation in healthy controls negatively affected the brain's ability to put an emotional event into the proper perspective and make a controlled, suitable response to the event.[35]

According to the latest research, lack of sleep may cause more harm than previously thought and may lead to the permanent loss of brain cells.[36] The negative effects of sleep deprivation on alertness and cognitive performance suggest decreases in brain activity and function. These changes primarily occur in two regions: the thalamus, a structure involved in alertness and attention, and the prefrontal cortex, a region subserving alertness, attention, and higher-order cognitive processes.[37] Interestingly, the effects of sleep deprivation appear to be constant across "night owls" and "early birds", or different sleep chronotypes, as revealed by fMRI and graph theory.[38]

A 2009 review found that sleep loss had a wide range of cognitive and neurobehavioral effects including unstable attention, slowing of response times, decline of memory performance, reduced learning of cognitive tasks, deterioration of performance in tasks requiring divergent thinking, perseveration with ineffective solutions, performance deterioration as task duration increases; and growing neglect of activities judged to be nonessential.[39]

#### Attention

The affects of inadequate sleep extend to learning, memory, and attention. Deficits in attention and working memory are one of the most important; such lapses in mundane routines can lead to unfortunate results, from forgetting ingredients while cooking to missing a sentence while taking notes. Performing tasks that require attention appears to be correlated with the number of hours of sleep received each night, declining as a function of hours of sleep deprivation. Working memory is tested by methods such as choice-reaction time tasks.

A 2009 review found that sleep loss had a wide range of cognitive and neurobehavioral effects including unstable attention, slowing of response times, decline of memory performance, reduced learning of cognitive tasks, deterioration of performance in tasks requiring divergent thinking, perseveration with ineffective solutions, performance deterioration as task duration increases; and growing neglect of activities judged to be nonessential. A study in 2025 found that just after 24 hours of sleep deprivation in healthy participants caused significant decreases in attentional processing, increased reaction times, and reduced focus.{{citation needed|date=October 2025} o exhibited difficulty switching between tasks, or disrupted cognitive flexibility, an important skill for problem-solving.

Attentional lapses also extend into more critical domains in which the consequences can be life or death; car crashes and industrial disasters can result from inattentiveness attributable to sleep deprivation. To empirically measure the magnitude of attention deficits, researchers typically employ the psychomotor vigilance task (PVT), which requires the subject to press a button in response to a light at random intervals. Failure to press the button in response to the stimulus (light) is recorded as an error, attributable to the microsleeps that occur as a product of sleep deprivation.[40]

Crucially, individuals' subjective evaluations of their fatigue often do not predict actual performance on the PVT. While totally sleep-deprived individuals are usually aware of the degree of their impairment, lapses from chronic (lesser) sleep deprivation can build up over time so that they are equal in number and severity to the lapses occurring from total (acute) sleep deprivation. Chronically sleep-deprived people, however, continue to rate themselves considerably less impaired than totally sleep-deprived participants.[41] Since people usually evaluate their capability on tasks like driving subjectively, their evaluations may lead them to the false conclusion that they can perform tasks that require constant attention when their abilities are in fact impaired.

#### Experimental based evidence

REM sleep deprivation causes swollen mitochondria in neurons (caused by cytochrome c); noradrenaline receptor blockers keep their inner cristae intact.

Studies on rodents show that the response to neuronal injury due to acute sleep deprivation is adaptative before three hours of sleep loss per night and becomes maladaptative, and apoptosis occurs after.[42] Studies in mice show neuronal death (in the hippocampus, locus coeruleus, and medial PFC) occurs after two days of REM sleep deprivation. However, mice do not model the effects in humans well since they sleep a third of the duration of REM sleep of humans and caspase-3, the main effector of apoptosis, kills three times the number of cells in humans than in mice.[43] Also not accounted for in nearly all of the studies is that acute REM sleep deprivation induces lasting (> 20 days) neuronal apoptosis in mice, and the apoptosis rate increases on the day following its end, so the amount of apoptosis is often undercounted in mice because experiments nearly always measure it the day the sleep deprivation ends.[44] For these reasons, both the time before cells degenerate and the extent of degeneration could be greatly under evaluated in humans.

Such histological studies cannot be performed on humans for ethical reasons, but long-term studies show that sleep quality is more associated with gray matter volume reduction[45] than age,[46] occurring in areas like the precuneus.[47]

The researchers aimed to investigate whether sleep deprivation would enhance impulsive behavior and hinder inhibitory control. The procedure involved having participants undergo three nights of partial sleep deprivation, followed by participation in a simulated shooting task categorized into threat and no-threat conditions. The authors employed a variety of statistical techniques, including confidence intervals, regression/mixed models, and SSRTs. A total of 52 participants were involved, with 28 in the partial sleep deprivation group and 24 in the control group. The sample size is sufficient as this number is typical for mixed model studies focused on cognitive functions.[11] Key findings included confirming that threats elevate impulsive responses and impair inhibition, as well as finding that sleep deprivation lowers accuracy, effectively answering the research question. Additionally, they discovered that partial sleep deprivation (5 hours versus 8 hours over 3 nights) significantly decreased overall response accuracy. Limitations of the study included a lack of alternative tasks for participants to demonstrate inhibitory control, insufficient evidence for the interaction between sleep and threat, and the absence of participants from high-stakes job roles, which could have provided a more realistic context for the experiment.

### Effects on the body

Molecular pathway of REM sleep deprivation-induced apoptosis in neurons

Sleep is necessary to repair cellular damage caused by reactive oxygen species and DNA damage. During long-term sleep deprivation, cellular damage aggregates up to a tipping point that triggers cellular degeneration and apoptosis. REM sleep deprivation causes an increase in noradrenaline (which incidentally causes the person sleep deprived to be stressed) due to the neurons in the locus coeruleus producing it not ceasing to do so, which causes an increase in the activity of the Na⁺/K⁺-ATPase pump, which itself activates the intrinsic pathway of apoptosis[48] and prevents autophagy, which also induces the mitochondrial pathway of apoptosis.

Sleep outside of the REM phase may allow enzymes to repair brain cell damage caused by free radicals. High metabolic activity while awake damages the enzymes themselves, preventing efficient repair. This study observed the first evidence of brain damage in rats as a direct result of sleep deprivation.[49]

#### Driving ability

According to a 2000 study, sleep deprivation can have some of the same hazardous effects as being drunk.[50] People who drove after being awake for 17–19 hours performed worse than those with a blood alcohol level of 0.05 percent, which is the legal limit for drunk driving in most western European countries and Australia. Another study suggested that performance begins to degrade after 16 hours awake, and 21 hours awake was equivalent to a blood alcohol content of 0.08 percent, which is the blood alcohol limit for drunk driving in Canada, the U.S., and the U.K.[51]

The fatigue of drivers of goods trucks and passenger vehicles has come to the attention of authorities in many countries, where specific laws have been introduced with the aim of reducing the risk of traffic accidents due to driver fatigue. The right amount of sleep prepares the brain to encode added information the following day, and sleep plays a vital role in consolidating motor tasks compared to declarative memory. Rules concerning minimum break lengths, maximum shift lengths, and minimum time between shifts are common in the driving regulations used in different countries and regions, such as the drivers' working hours regulations in the European Union and hours of service regulations in the United States. The American Academy of Sleep Medicine (AASM) reports that one in every five serious motor vehicle injuries are related to driver fatigue. The National Sleep Foundation identifies several warning signs that a driver is dangerously fatigued. These include rolling down the window, turning up the radio, having trouble keeping eyes open, head-nodding, drifting out of their lane, and daydreaming. At particular risk are lone drivers between midnight and 6:00 a.m.[52]

Sleep deprivation can negatively impact overall performance and has led to major fatal accidents. Due largely to the February 2009 crash of Colgan Air Flight 3407, which killed 50 people and was partially attributed to pilot fatigue, the FAA reviewed its procedures to ensure that pilots are sufficiently rested. Air traffic controllers were under scrutiny when, in 2010, there were 10 incidents of controllers falling asleep while on shift. The common practice of turn-around shifts caused sleep deprivation and was a contributing factor to all air traffic control incidents. The FAA reviewed its practices for shift changes, and the findings showed that controllers were not well rested.[53] A 2004 study also found medical residents with less than four hours of sleep a night made more than twice as many errors as the 11% of surveyed residents who slept for more than seven hours a night.[54]

#### Impacts on reasoning and decision-making

Twenty-four hours of continuous sleep deprivation results in the choice of less difficult math tasks without a decrease in subjective reports of effort applied to the task.[55] Naturally occurring sleep loss affects the choice of everyday tasks, such that low-effort tasks are mostly commonly selected.[56] Adolescents who experience less sleep show a decreased willingness to engage in sports activities that require effort through fine motor coordination and attention to detail.[57][58]

Astronauts have reported performance errors and decreased cognitive ability during periods of extended working hours and wakefulness, as well as sleep loss caused by circadian rhythm disruption and environmental factors.[59]

One study showed that individuals who were sleep deprived could make normal everyday decisions but found it difficult when evaluating long term consequences.[60]

Recent reviews indicate that sleep loss impairs decision-making by altering underlying cognitive processes rather than simply degrading overt task performance. Computational modeling studies show that sleep deprivation reduces sensitivity to reward and punishment values while increasing decision noise, leading to more variable and less consistent choices. These cognitive changes can occur even when overall task accuracy appears preserved, suggesting that traditional behavioral measures may underestimate the impact of sleep loss on reasoning. Such findings imply that sleep deprivation disrupts the mechanisms required to evaluate options reliably, particularly in decisions involving risk, effort, and long-term consequences.[61]

#### Working memory

Deficits in attention and working memory are one of the most important;[11] such lapses in mundane routines can lead to unfortunate results, from forgetting ingredients while cooking to missing a sentence while taking notes. Performing tasks that require attention appears to be correlated with the number of hours of sleep received each night, declining as a function of hours of sleep deprivation.[62] Working memory is tested by methods such as choice-reaction time tasks.[11] Short-term patterns of chronic restricted sleep, even in short intervals (5-6 hrs a night), have been shown to result in a performance decline equivalent to two full nights of total sleep deprivation.[63] This same study found that sleep deprivation interferes with memory formation in hippocampal long-term potentiation and thereby disrupts the acquisition of new information. This results in fragmented memory encoding and increased memory retrieval errors. This can be directly applied to school and occupational environments where pressure can causes individuals to prioritize work over sleep, compromising performance.[64]

#### Mood and behavior

Sleep deprivation can have a negative impact on mood.[65] Staying up all night or taking an unexpected night shift can make one feel irritable. Once one catches up on sleep, one's mood will often return to baseline or normal. Even partial sleep deprivation can have a significant impact on mood. In one study, subjects reported increased sleepiness, fatigue, confusion, tension, and total mood disturbance, which all recovered to their baseline after one to two full nights of sleep.[66][67] Research has found that lack of sleep disrupts prefrontal inhibition of hippocampal activity, which causes memory intrusions and increased susceptibility to emotional disruptions. When applied to human behavior, we would see this in an adult or child experiencing sleep-deprivation, unable to think clearly, difficulty controlling intrusive and stress-related thoughts. Additionally, sleep deprivation also promotes impulsivity.[68]

A scatter plot illustrating the prevalence of adults reporting ≥7 hours of sleep versus the prevalence of adults reporting depression, by U.S. state in 2020. The data suggests a lack of correlation between these two variables across states.

Depression and sleep are in a bidirectional relationship. Poor sleep can lead to the development of depression, and depression can cause insomnia, hypersomnia, or obstructive sleep apnea.[69][70] About 75% of adult patients with depression can present with insomnia.[71] Sleep deprivation, whether total or not, can induce significant anxiety, and longer sleep deprivations tend to result in an increased level of anxiety.[72] Depression can also affect children in similar ways, it can lead to persistent sadness, constant irritability, and has a negative effect in the way that children perform at school. Depression can also make it hard for children to remember things.[73]

Sleep deprivation has also shown some positive effects on mood and can be used to treat depression.[13] Chronotype can affect how sleep deprivation influences mood. Those with morningness (advanced sleep period or "lark") preference become more depressed after sleep deprivation, while those with eveningness (delayed sleep period or "owl") preference show an improvement in mood.[74]

Mood and mental states can affect sleep as well. Increased agitation and arousal from anxiety or stress can keep one more aroused, awake, and alert.[66]

#### Subjective age

One study found that sleepiness increases the subjective sense one is old, with extreme sleepiness leading people to feel 10 years older.[75] Other studies have also shown a correlation between relatively old subjective age and poor sleep quality.[76][77]

Some animal research found that prolonged sleep deprivation can be tied to lower testosterone and reduced sperm count in males.[78]

#### Fatigue

Sleep deprivation and disruption is associated with subsequent fatigue.[79][80] Fatigue has different effects and characteristics from sleep deprivation.

Pain and recovery

Research shows that chronic sleep deprivation can lead to greater pain sensitivity when injuries occur as well as slow recovery.[81] A study published in Sleep and Oxidative Stress: Current Perspectives [82] on the Role of NRF2 showed that the factor responsible for antioxidant regulation, NRF2, is inhibited after prolonged wakefulness. An important part of the study was that oxidative damage accumulates systemically, which can have serious effects on inflammation and circadian homeostasis. Persistent exposure to oxidative stress has been associated with chronic pain disorders. The study reported that sleep deprivation amplifies the production of inflammatory cytokines, chemical messengers that help your body resist and fight germs and infections. The heightened inflammatory response driven by elevated cytokines during sleep loss is linked to systemic inflammation and increased risk of chronic illness. This is all evidence of how poor sleep contributes to somatic hypersensitivity. It also suggests that sleep is an active, restorative process rather than a passive one, during which biochemical systems engage to recalibrate redox, detoxify the natural environment, and maintain immune resistance.

##### Propensity

Sleep propensity can be defined as the readiness to transition from wakefulness to sleep or the ability to stay asleep if already sleeping.[83] Sleep deprivation increases this propensity, which can be measured by polysomnography (PSG) as a reduction in sleep latency (the time needed to fall asleep).[84] An indicator of sleep propensity can also be seen in the shortening of the transition from light stages of non-REM sleep to deeper slow-wave oscillations.[84]

On average, the latency in healthy adults decreases by a few minutes after a night without sleep, and the latency from sleep onset to slow-wave sleep is halved.[84] Sleep latency is generally measured with the multiple sleep latency test (MSLT). In contrast, the maintenance of wakefulness test (MWT) also uses sleep latency, but this time as a measure of the capacity of the participants to stay awake (when asked to) instead of falling asleep.[84]

##### Impact on the sleep-wake cycle

Some research shows that sleep deprivation dysregulates the sleep-wake cycle.[84] Multiple studies that identified the role of the hypothalamus and multiple neural systems controlling circadian rhythms and homeostasis have been helpful in understanding sleep deprivation better.[84][85]

Some recent studies also show that sleep deprivation alters the expression of genes. These genes are responsible for reguating circadian rhythms as well as metabolism and immune function.[86]

To describe the temporal course of the sleep-wake cycle, a two-process model of sleep regulation can be mentioned.[84] This model proposes a homeostatic process (Process S) and a circadian process (Process C) that interact to define the time and intensity of sleep.[87] Process S represents the drive for sleep, increasing during wakefulness and decreasing during sleep until a defined threshold level, while Process C is the oscillator responsible for these levels. When being sleep deprived, homeostatic pressure accumulates to the point that waking functions will be degraded even at the highest circadian drive for wakefulness.[84][87]

### Genetic and circadian effects

#### Microsleep

Microsleeps are periods of brief sleep that most frequently occur when a person has a significant level of sleep deprivation.[88] Microsleeps usually last for a few seconds, usually no longer than 15 seconds,[89] and happen most frequently when a person is trying to stay awake when they are feeling sleepy.[90] The person usually falls into microsleep while doing a monotonous task like driving, reading a book, or staring at a computer.[91] Microsleeps are similar to blackouts, and a person experiencing them is not consciously aware that they are occurring.

An even lighter type of sleep has been seen in rats that have been kept awake for long periods of time. In a process known as local sleep, specific localized brain regions went into periods of short (~80 ms) but frequent (~40/min) NREM-like states. Despite the on-and-off periods where neurons shut off, the rats appeared to be awake, although they performed poorly at tests.[92]

#### Cardiovascular morbidity

Decreased sleep duration is associated with many adverse cardiovascular consequences.[93][94][95][96] The American Heart Association has stated that sleep restriction is a risk factor for adverse cardiometabolic profiles and outcomes. The organization recommends healthy sleep habits for ideal cardiac health, along with other well-known factors like blood pressure, cholesterol, diet, glucose, weight, smoking, and physical activity.[97] The Centers for Disease Control and Prevention has noted that adults who sleep less than seven hours per day are more likely to have chronic health conditions, including heart attack, coronary heart disease, and stroke, compared to those with an adequate amount of sleep.[98]

In a study that followed over 160,000 healthy, non-obese adults, the subjects who self-reported sleep duration less than six hours a day were at increased risk for developing multiple cardiometabolic risk factors. They presented with increased central obesity, elevated fasting glucose, hypertension, low high-density lipoprotein, hypertriglyceridemia, and metabolic syndrome. The presence or lack of insomnia symptoms did not modify the effects of sleep duration in this study.[99]

The United Kingdom Biobank studied nearly 500,000 adults who had no cardiovascular disease, and the subjects who slept less than six hours a day were associated with a 20 percent increase in the risk of developing myocardial infarction (MI) over a seven-year follow-up period. Interestingly, a long sleep duration of more than nine hours a night was also a risk factor.[100]

#### Immunosuppression

Among the myriad of health consequences that sleep deprivation can cause, disruption of the immune system is one of them. While it is not clearly understood, researchers believe that sleep is essential to providing sufficient energy for the immune system to work and allowing inflammation to take place during sleep. Also, just as sleep can reinforce memory in a person's brain, it can help consolidate the memory of the immune system, or adaptive immunity.[101][102]

Sleep quality is directly related to immunity levels. The team, led by Professor Cohen of Carnegie Mellon University in the United States, found that even a slight disturbance of sleep may affect the body's response to the cold virus. Those with better sleep quality had significantly higher blood T and B lymphocytes than those with poor sleep quality. These two lymphocytes are the main body of immune function in the human body.[103]

Research by Prather and colleagues at the University of California examined sleep habits and their influence on the body's response to the flu vaccine. After taking the vaccination, the study showed that those who experienced poorer sleep quality produced significantly less antibodies. In order for the immune system to fight off infection, good sleep quality is needed in order for these antibodies to work at their fullest capacity. This notion supports the claim that sleep is essential for healthy immunity levels.[104]

An adequate amount of sleep improves the effects of vaccines that utilize adaptive immunity. When vaccines expose the body to a weakened or deactivated antigen, the body initiates an immune response. The immune system learns to recognize that antigen and attacks it when exposed again in the future. Studies have found that people who don't sleep the night after getting a vaccine are less likely to develop a proper immune response to the vaccine and sometimes even require a second dose. People who are sleep deprived in general also do not provide their bodies with sufficient time for an adequate immunological memory to form and, thus, can fail to benefit from vaccination.[101]

People who sleep less than six hours a night are more susceptible to infection and are more likely to catch a cold or flu. A lack of sleep can also prolong the recovery time of patients in the intensive care unit (ICU).[101][105][106]

#### Weight gain

Main article: Biology:Sleep and weight

A lack of sleep can cause an imbalance in several hormones that are critical for weight gain. Sleep deprivation increases the level of ghrelin (hunger hormone) and decreases the level of leptin (fullness hormone), resulting in an increased feeling of hunger and a desire for high-calorie foods.[107][108] Sleep loss is also associated with decreased growth hormone and elevated cortisol levels, which are connected to obesity. People who do not get sufficient sleep can also feel sleepy and fatigued during the day and get less exercise. Obesity can cause poor sleep quality as well. Individuals who are overweight or obese can experience obstructive sleep apnea, gastroesophageal reflux disease (GERD), depression, asthma, and osteoarthritis, all of which can disrupt a good night's sleep.[109]

In rats, prolonged, complete sleep deprivation increased both food intake and energy expenditure, with a net effect of weight loss and ultimately death.[110] This study hypothesizes that the moderate chronic sleep debt associated with habitual short sleep is associated with increased appetite and energy expenditure, with the equation tipped towards food intake rather than expenditure in societies where high-calorie food is freely available.[108]

#### Type 2 diabetes

It has been suggested that people experiencing short-term sleep restrictions process glucose more slowly than individuals receiving a full 8 hours of sleep, increasing the likelihood of developing type 2 diabetes.[111] Poor sleep quality is linked to high blood sugar levels in diabetic and prediabetic patients, but the causal relationship is not clearly understood. Researchers suspect that sleep deprivation affects insulin, cortisol, and oxidative stress, which subsequently influence blood sugar levels. Sleep deprivation can increase the level of ghrelin and decrease the level of leptin. People who get insufficient amounts of sleep are more likely to crave food in order to compensate for the lack of energy. This habit can raise blood sugar and put them at risk of obesity and diabetes.[112]

In 2005, a study of over 1400 participants showed that participants who habitually slept fewer hours were more likely to have associations with type 2 diabetes.[113] However, because this study was merely correlational, the direction of cause and effect between little sleep and diabetes is uncertain. The authors point to an earlier study that showed that experimental rather than habitual restriction of sleep resulted in impaired glucose tolerance (IGT).[114]

#### Other effects

Sleep deprivation may facilitate or intensify:[115]

* aching muscles[116]
* confusion, memory lapses or loss[117]
* depression[117]
* development of false memory
* hypnagogic and hypnopompic hallucinations during falling asleep and waking, which are entirely normal[118]
* hand tremor[119]
* headaches
* malaise
* stye
* periorbital puffiness, commonly known as "bags under eyes" or eye bags
* increased blood pressure[120]
* increased stress hormone levels[120]
* increased risk of type 2 diabetes[120]
* lowering of immunity, increased susceptibility to illness[121]
* increased risk of fibromyalgia[122]
* irritability[115]
* nystagmus (rapid involuntary rhythmic eye movement)[123]
* obesity[120]
* seizures[124]
* mania[125]
* Sleep inertia[126]
* tachycardia risk. One study found that a single night of sleep deprivation may cause tachycardia, a condition in which the heart rate exceeds 100 beats per minute (in the following day).[127][128]
* temper tantrums in children[115]
* violent behavior[129]
* yawning[115]

Sleep deprivation may cause symptoms similar to:

* attention-deficit hyperactivity disorder (ADHD)[115]
* psychosis[118][130][131][132]

### Positive effects

#### Increased energy and alertness in some cases

In a subset of cases, sleep deprivation can paradoxically lead to increased energy and alertness.[12][13]

## Causes

Modern society has redefined sleep as expendable. Population data indicate that sleep deprivation is widespread, affecting significant proportions of students, workers, and the elderly worldwide. Studies among students and healthcare workers document chronic patterns of sleep deprivation connected to academic pressure and shift-based labor demands. A 2025 study conducted by the University of South Florida reported that college students average 5.8 hours of sleep per night, leading to measurable and significant decreases in memory recall, focus, and emotional resilience. This "sleep culture" overlooks the brain and body's critical restorative needs. Societal expectations combined with environmental disruptions foster a chronic misalignment between biological clocks and social schedules, further intensifying the detrimental effects of sleep loss.

People aged 18 to 64 need seven to nine hours of sleep per night.[133] Sleep deprivation occurs when this is not achieved. Causes of this can be as follows:

### Environmental factors

Environmental factors significantly influence sleep quality and can contribute to sleep deprivation in various ways. Noise pollution from traffic, construction, and loud neighbors can disrupt sleep by causing awakenings and preventing deeper sleep stages.[134] Similarly, light exposure, particularly from artificial sources like screens, interferes with the body's natural circadian rhythms by suppressing melatonin production, making it challenging to fall asleep.[135] Air quality, odours and temperatures can all affect sleep quality and duration as well.[136]

To mitigate the effects of these environmental influences, individuals can consider strategies, such as using soundproofing measures, installing blackout curtains, adjusting room temperatures,[137] investing in comfortable bedding, and improving air quality with purifiers. By addressing these environmental factors, individuals can enhance their sleep hygiene and overall health.

### Insomnia

Main article: Medicine:Insomnia

Insomnia, one of the six types of dyssomnia, affects 21–37% of the adult population.[138][139][140] Many of its symptoms are easily recognizable, including excessive daytime sleepiness; frustration or worry about sleep; problems with attention, concentration, or memory; extreme mood changes or irritability; lack of energy or motivation; poor performance at school or work; and tension headaches or stomach aches.

Insomnia can be grouped into primary and secondary, or comorbid, insomnia.[141][142][143]

Primary insomnia is a sleep disorder not attributable to a medical, psychiatric, or environmental cause.[144] There are three main types of primary insomnia. These include psychophysiological, idiopathic insomnia, and sleep state misperception (paradoxical insomnia).[141] Psychophysiological insomnia is anxiety-induced. Idiopathic insomnia generally begins in childhood and lasts for the rest of a person's life. It's suggested that idiopathic insomnia is a neurochemical problem in a part of the brain that controls the sleep-wake cycle, resulting in either under-active sleep signals or over-active wake signals. Sleep state misperception is diagnosed when people get enough sleep but inaccurately perceive that their sleep is insufficient.[145]

Secondary insomnia, or comorbid insomnia, occurs concurrently with other medical, neurological, psychological, and psychiatric conditions. Causation is not necessarily implied.[146] Causes can be from depression, anxiety, and personality disorders.[147]

### Sleep apnea

Main article: Medicine:Sleep apnea

Sleep apnea is a serious disorder that has symptoms of both insomnia and sleep deprivation, among other symptoms like excessive daytime sleepiness, abrupt awakenings, and difficulty concentrating.[148] It is a sleep related breathing disorder that can cause partial or complete obstruction of the upper airways during sleep.[149] One billion people worldwide are affected by obstructive sleep apnea.[149] Those with sleep apnea may experience symptoms such as awakening gasping or choking, restless sleep, morning headaches, morning confusion or irritability, and restlessness. This disorder affects 1 to 10 percent of Americans.[150] It has many serious health outcomes if left untreated. Positive airway pressure therapy using CPAP (continuous positive airway pressure), APAP, or BPAP devices is considered the first-line treatment option for sleep apnea.[151]

Central sleep apnea is caused by a failure of the central nervous system to signal the body to breathe during sleep. Treatments similar to obstructive sleep apnea may be used, as well as other treatments such as adaptive servo ventilation and certain medications. Some medications, such as opioids, may contribute to or cause central sleep apnea.[152]

### Self-imposed

Sleep deprivation can sometimes be self-imposed due to a lack of desire to sleep or the habitual use of stimulant drugs. Bedtime procrastination is a need to stay up late after a busy day to feel like the day is longer, leading to sleep deprivation from staying up and wanting to make the day "seem/feel" longer.[153]

#### Caffeine

This diagram shows how caffeine affects the different areas of the body, both positively and negatively.

Consumption of caffeine in large quantities can have negative effects on one's sleep cycle.

Caffeine consumption, usually in the form of coffee, is one of the most widely used stimulants in the world.[154] While there are short-term performance benefits to caffeine consumption, overuse can lead to insomnia symptoms or worsen pre-existing insomnia.[155] Consuming caffeine to stay awake at night may lead to sleeplessness, anxiety, frequent nighttime awakenings, and overall poorer sleep quality.[156] The main metabolite of melatonin (6-sulfatoxymelatonin) gets reduced with consumption of caffeine in the day, which is one of the mechanisms by which sleep is interrupted.[154]

A study conducted in 2025 used fruit flies as a model to evaluate how caffeine interacts with sleep deprivation and found that although caffeine increased arousal and stimulation responses, it also reduced lifespan after 20-24 hrs of sleeplessness.[157]

In human studies, caffeine temporarily restores alertness by activating adenosine receptors that would have typically decreased after initial stages of sleep deprivation, contracting the brain's "sleep pressure." This interference disrupts sleep structure once caffeine is metabolized in the body. A study showed that caffeine use after sleep deprivation reduces REM deep sleep by 20-40%. This damage impairs the restorative processes necessary for memory and metabolic repair.[158] Similarly, another study found when caffeine is consumed up to 6 hours before bedtime, total sleep is reduced by one hour and efficiency by 10% [159]

#### Studying

The U.S. National Sleep Foundation cites a 1996 paper showing that college/university-aged students get an average of less than 6 hours of sleep each night.[160] A 2018 study highlights the need for a good night's sleep for students, finding that college students who averaged eight hours of sleep for the five nights of finals week scored higher on their final exams than those who did not.[161]

In the study, 70.6% of students reported obtaining less than 8 hours of sleep, and up to 27% of students may be at risk for at least one sleep disorder.[162] Sleep deprivation is common in first-year college students as they adjust to the stress and social activities of college life.

Estevan et al. studied the relationships between sleep and test performance. They found that students tend to sleep less than usual the night before an exam and that exam performance was positively correlated with sleep duration.[163]

A study performed by the Department of Psychology at the National Chung Cheng University in Taiwan concluded that freshmen received the least amount of sleep during the week.[164]

Studies of later start times in schools have consistently reported benefits to adolescent sleep, health, and learning using a wide variety of methodological approaches. In contrast, there are no studies showing that early start times have any positive impact on sleep, health, or learning.[165] Data from international studies demonstrate that "synchronized" start times for adolescents are far later than the start times in the overwhelming majority of educational institutions.[165] In 1997, University of Minnesota researchers compared students who started school at 7:15 a.m. with those who started at 8:40 a.m. They found that students who started at 8:40 got higher grades and more sleep on weekday nights than those who started earlier.[166] One in four U.S. high school students admits to falling asleep in class at least once a week.[167]

It is known that during human adolescence, circadian rhythms and, therefore, sleep patterns typically undergo marked changes. Electroencephalogram (EEG) studies indicate a 50% reduction in deep (stage 4) sleep and a 75% reduction in the peak amplitude of delta waves during NREM sleep in adolescence. School schedules are often incompatible with a corresponding delay in sleep offset, leading to a less than optimal amount of sleep for the majority of adolescents.[168]

### Mental illness

Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).[148]

The specific causal relationships between sleep loss and effects on psychiatric disorders have been most extensively studied in patients with mood disorders.[169] Shifts into mania in bipolar patients are often preceded by periods of insomnia,[170] and sleep deprivation has been shown to induce a manic state in about 30% of patients.[171] Sleep deprivation may represent a final common pathway in the genesis of mania,[172] and manic patients usually have a continuous reduced need for sleep.[173]

The symptoms of sleep deprivation and those of schizophrenia are parallel, including those of positive and cognitive symptoms.[174]

### Hospital stay

A study performed nationwide in the Netherlands found that general ward patients staying at the hospital experienced shorter total sleep (83 min. less), more night-time awakenings, and earlier awakenings compared to sleeping at home. Over 70% experienced being woken up by external causes, such as hospital staff (35.8%). Sleep-disturbing factors included the noise of other patients, medical devices, pain, and toilet visits.[175] Sleep deprivation is even more severe in ICU patients, where the naturally occurring nocturnal peak of melatonin secretion was found to be absent, possibly causing the disruption in the normal sleep-wake cycle.[176] However, as the personal characteristics and the clinical picture of hospital patients are so diverse, the possible solutions to improve sleep and circadian rhythmicity should be tailored to the individual and within the possibilities of the hospital ward. Multiple interventions could be considered to aid patient characteristics, improve hospital routines, or improve the hospital environment.[177]

### Time online

Modern technological factors exacerbate global sleep deficits. Exposure to artificial blue light from screens suppresses melatonin production, disrupts circadian rhythms, and delays sleep onset. The increased use of social media and mobile devices often extends wakefulness beyond biological needs, most prevalent among adolescents and young adults. A 2018 study published in the Journal of Economic Behavior and Organization found that broadband internet connection was associated with sleep deprivation. The study concluded that people with a broadband connection tend to sleep 25 minutes less than those without a broadband connection; hence, they are less likely to get the scientifically recommended 7–9 hours of sleep.[178] Another study conducted on 435 non-medical staff at King Saud University Medical City reported that 9 out of 10 of the respondents used their smartphones at bedtime, with social media being the most used service (80.5%). The study found participants who spent more than 60 minutes using their smartphones at bedtime were 7.4 times more likely to have poor sleep quality than participants who spent less than 15 minutes.[179] Overall, internet usage an hour before bedtime has been found to disrupt sleeping patterns. Social media engagement also contributes to sleep loss because it increases cognitive and emotional arousal, keeping the brain mentally alert instead of winding down before bed.[180] Along with the mental alertness screentime usage at night also caused less rest time, reduced sleep quality, and an increase in daytime fatigue. This effect is shown across multiple age groups, which leads to a big factor in modern sleep deprivation.

### Shift work

Many businesses are operational 24/7, such as airlines, hospitals, etc., where workers perform their duties in different shifts. Shift work patterns cause sleep deprivation and lead to poor concentration, detrimental health effects, and fatigue. Shift work can disrupt the normal circadian rhythms of biologic functions, which is associated with the sleep/wake cycle. Both the sleep length and quality can be affected. A "shift-work sleep disorder" has been diagnosed in approximately 10% of shift workers aged between 18–65 years old according to the International Classification of Sleep Disorders, version 2 (ICSD-2).[181] Shift work remains an unspoken challenge within industries, often disregarded by both employers and employees alike, leading to an increase in occupational injuries. A worker experiencing fatigue poses a potential danger, not only to themselves, but also to others around them. Both employers and employees must acknowledge the risks associated with sleep deprivation and on-the-job fatigue to effectively mitigate the chances of occupational injuries.[182]

## Treatments and prevention

Although there are numerous causes of sleep deprivation, there are some fundamental measures that promote quality sleep, as suggested by organizations such as the Centers for Disease Control and Prevention, the National Institute of Health, the National Institute of Aging, and the American Academy of Family Physicians.

### Sleep hygiene

Historically, sleep hygiene, as first medically defined by Hauri in 1977,[183] was the standard for promoting healthy sleep habits, but evidence that has emerged since the 2010s suggests they are ineffective, both for people with insomnia[184] and for people without.[183] The key is to implement healthier sleep habits, also known as sleep hygiene.[185]

Sleep hygiene recommendations include

* setting a fixed sleep schedule
* taking naps with caution
* maintaining a sleep environment that promotes sleep (cool temperature, limited exposure to light and noise)
* comfortable mattresses and pillows
* exercising daily
* avoiding alcohol, cigarettes and caffeine
* avoiding heavy meals in the evening
* winding down and avoiding electronic use or physical activities close to bedtime
* getting out of bed if unable to fall asleep.[186]

### CBT

For long-term involuntary sleep deprivation, cognitive behavioral therapy for insomnia (CBT-i) is recommended as a first-line treatment after the exclusion of a physical diagnosis (e.g., sleep apnea).[184]

CBT-i contains five different components:

* cognitive therapy
* stimulus control
* sleep restriction
* sleep hygiene
* relaxation.

As this approach has minimal adverse effects and long-term benefits, it is often preferred to (chronic) drug therapy.[187]

### Assessments

Patients with sleep deprivation may present with complaints of symptoms and signs of insufficient sleep, such as fatigue, sleepiness, drowsy driving, and cognitive difficulties. Sleep insufficiency can easily go unrecognized and undiagnosed unless patients are specifically asked about it by their clinicians.[188]

Several questions are critical in evaluating sleep duration and quality, as well as the cause of sleep deprivation. Sleep patterns (typical bed time or rise time on weekdays and weekends), shift work, and frequency of naps can reveal the direct cause of poor sleep, and quality of sleep should be discussed to rule out any diseases such as obstructive sleep apnea and restless leg syndrome.[188]

### Sleep diaries

Sleep diaries are useful in providing detailed information about sleep patterns. They are inexpensive, readily available, and easy to use. The diaries can be as simple as a 24-hour log to note the time of being asleep or can be detailed to include other relevant information.[189][190]

### Sleep questionnaires

Sleep questionnaires such as the Sleep Timing Questionnaire (STQ) and Tayside children's sleep questionnaire can be used instead of sleep diaries if there is any concern for patient adherence.[191][192]

Sleep quality can be assessed using the Pittsburgh Sleep Quality Index (PSQI), a self-report questionnaire designed to measure sleep quality and disturbances over a one-month period.[193]

### Measures to increase alertness

There are several strategies that help increase alertness and counteract the effects of sleep deprivation.

* Caffeine is often used over short periods to boost wakefulness when acute sleep deprivation is experienced; however, caffeine is less effective if taken routinely.[194]

Other strategies recommended by the American Academy of Sleep Medicine include

* prophylactic sleep before deprivation
* naps
* other stimulants

The American Academy of Sleep Medicine has said that the only sure and safe way to combat sleep deprivation is to increase nightly sleep time.[195]

### Actigraphy

Actigraphy is a useful, objective wrist-worn tool if the validity of self-reported sleep diaries or questionnaires is questionable. Actigraphy works by recording movements and using computerized algorithms to estimate total sleep time, sleep onset latency, the amount of wake after sleep onset, and sleep efficiency. Some devices have light sensors to detect light exposure.[196][197][198][199]

### Wearable devices

Wearable devices such as Fitbits and Apple Watches monitor various body signals, including heart rate, skin temperature, and movement, to provide information about sleep patterns. They operate continuously, collecting extensive data which can be used to offer insights on sleep improvement. These devices are user-friendly and have increased awareness about the significance of quality sleep for health.[200]

## Uses

### Treating depression

Studies show that sleep restriction has some potential for treating depression.[13] Those with depression tend to have earlier occurrences of REM sleep with an increased number of rapid eye movements; therefore, monitoring patients' EEG and awakening them during occurrences of REM sleep appear to have a therapeutic effect, alleviating depressive symptoms.[201] This kind of treatment is known as wake therapy. Although as many as 60% of patients show an immediate recovery when sleep-deprived, most patients relapse the following night. The effect has been shown to be linked to an increase in brain-derived neurotrophic factor (BDNF).[202]  A comprehensive evaluation of the human metabolome in sleep deprivation in 2014 found that 27 metabolites are increased after 24 waking hours and suggested serotonin, tryptophan, and taurine may contribute to the antidepressant effect.[203]

The incidence of relapse can be decreased by combining sleep deprivation with medication or a combination of light therapy and phase advance (going to bed substantially earlier than one's normal time).[204][205] Many tricyclic antidepressants suppress REM sleep, providing additional evidence for a link between mood and sleep.[206] Similarly, tranylcypromine has been shown to completely suppress REM sleep at adequate doses.

Sleep deprivation has been used as a treatment for depression.[12][13]

### Treating insomnia

Sleep deprivation can be implemented for a short period of time in the treatment of insomnia. Some common sleep disorders have been shown to respond to cognitive behavioral therapy for insomnia. Cognitive behavioral therapy for insomnia is a multicomponent process that is composed of stimulus control therapy, sleep restriction therapy (SRT), and sleep hygiene therapy.[207] One of the components is a controlled regime of "sleep restriction" in order to restore the homeostatic drive to sleep and encourage normal "sleep efficiency".[208] Stimulus control therapy is intended to limit behaviors intended to condition the body to sleep while in bed.[207] The main goal of stimulus control and sleep restriction therapy is to create an association between bed and sleep. Although sleep restriction therapy shows efficacy when applied as an element of cognitive-behavioral therapy, its efficacy is yet to be proven when used alone.[208][187] Sleep hygiene therapy is intended to help patients develop and maintain good sleeping habits. Sleep hygiene therapy is not helpful, however, when used as a mono-therapy without the pairing of stimulus control therapy and sleep restriction therapy.[207][184] Light stimulation affects the supraoptic nucleus of the hypothalamus, controlling circadian rhythm and inhibiting the secretion of melatonin from the pineal gland. Light therapy can improve sleep quality, improve sleep efficiency, and extend sleep duration by helping to establish and consolidate regular sleep-wake cycles. Light therapy is a natural, simple, low-cost treatment that does not lead to residual effects or tolerance. Adverse reactions include headaches, eye fatigue, and even mania.[209]

In addition to the cognitive behavioral treatment of insomnia, there are also generally four approaches to treating insomnia medically. These are through the use of barbiturates, benzodiazepines, and benzodiazepine receptor agonists. Barbiturates are not considered to be a primary source of treatment due to the fact that they have a low therapeutic index, while melatonin agonists are shown to have a higher therapeutic index.[207]

## Additional information

### Military use and training

Sleep deprivation has become hardwired into the military culture. It is prevalent in the entire force and especially severe for service members deployed in high-conflict environments.[210][211]

DARPA initiated sleep research to create a highly resilient soldier capable of sustaining extremely prolonged wakefulness, inspired by the white-crowned sparrow's week-long sleeplessness during migration, at a time when it was not understood that migration birds actually slept with half of their brain. This pursuit aimed both to produce a "super soldier" able "to go for a minimum of seven days without sleep, and in the longer term perhaps at least double that time frame, while preserving high levels of mental and physical performance", and to enhance productivity in sleep-deprived personnel. Military experiments on sleep have been conducted on combatants and prisoners, such as those in Guantánamo, where controlled lighting is combined with torture techniques to manipulate sensory experiences. Crary highlights how constant illumination and the removal of day-night distinctions create what he defines as a "time of indifference," utilizing light management as a form of psychological control.[212][213]

However, studies have since evaluated the impact of the sleep deprivation imprint on the military culture. Personnel surveys reveal common challenges such as inadequate sleep, fatigue, and impaired daytime functioning, impacting operational effectiveness and post-deployment reintegration. These sleep issues elevate the risk of severe mental health disorders, including PTSD and depression. Early intervention is crucial. Though promising, implementing cognitive-behavioral and imagery-rehearsal therapies for insomnia remains a challenge. Several high-profile military accidents caused in part or fully by sleep deprivation of personnel have been documented. The military has prioritized sleep education, with recent Army guidelines equating sleep importance to nutrition and exercise. The Navy, particularly influenced by retired Captain John Cordle, has actively experimented with watch schedules to align shipboard life with sailors' circadian needs, leading to improved sleep patterns, especially in submarines, supported by ongoing research efforts at the Naval Postgraduate School. Watch schedules with longer and more reliable resting intervals are nowadays the norm on U.S. submarines and a recommended option for surface ships.[210][211]

In addition to sleep deprivation, circadian misalignment, as commonly experienced by submarine crews, causes several long-term health issues and a decrease in cognitive performance.[214]

#### To facilitate abusive control

Sleep deprivation can be used to disorient abuse victims to help set them up for abusive control.[215][216]

#### Interrogation

Sleep deprivation can be used as a means of interrogation, which has resulted in court trials over whether or not the technique is a form of torture.[217]

Under one interrogation technique, a subject might be kept awake for several days and, when finally allowed to fall asleep, suddenly awakened and questioned. Menachem Begin, the Prime Minister of Israel from 1977 to 1983, described his experience of sleep deprivation as a prisoner of the NKVD in the Soviet Union as follows:

> In the head of the interrogated prisoner, a haze begins to form. His spirit is wearied to death, his legs are unsteady, and he has one sole desire: to sleep... Anyone who has experienced this desire knows that not even hunger and thirst are comparable with it.[218]

Sleep deprivation was one of the five techniques used by the British government in the 1970s. The European Court of Human Rights ruled in 1978 that the five techniques "did not occasion suffering of the particular intensity and cruelty implied by the word torture ... [but] amounted to a practice of inhuman and degrading treatment", in breach of the European Convention on Human Rights.[219] The United States Justice Department released four memos in August 2002 describing interrogation techniques used by the Central Intelligence Agency. They first described 10 techniques used in the interrogation of Abu Zubaydah, described as a terrorist logistics specialist, including sleep deprivation. Memos signed by Steven G. Bradbury in May 2005 claimed that forced sleep deprivation for up to 180 hours (​7 1⁄2 days)[220][221] by shackling a diapered prisoner to the ceiling did not constitute torture,[222] nor did the combination of multiple interrogation methods (including sleep deprivation) constitute torture under United States law.[223][224] These memoranda were repudiated and withdrawn during the first months of the Obama administration.[220]

The question of the extreme use of sleep deprivation as torture has advocates on both sides of the issue. In 2006, Australian Federal Attorney-General Philip Ruddock argued that sleep deprivation does not constitute torture.[225] Nicole Bieske, a spokeswoman for Amnesty International Australia, has stated the opinion of her organization as follows: "At the very least, sleep deprivation is cruel, inhumane and degrading. If used for prolonged periods of time it is torture."[226]

## Changes in American sleep habits

The examples and perspective in this section may not represent a worldwide view of the subject. You may improve this section, discuss the issue on the talk page, or create a new article, as appropriate. (December 2010) (Learn how and when to remove this template message)

|

National Geographic Magazine has reported that the demands of work, social activities, and the availability of 24-hour home entertainment and Internet access have caused people to sleep less now than in premodern times.[227] USA Today reported in 2007 that most adults in the USA get about an hour less than the average sleep time 40 years ago.[228]

Other researchers have questioned these claims. A 2004 editorial in the journal Sleep stated that, according to the available data, the average number of hours of sleep in a 24-hour period has not changed significantly in recent decades among adults. Furthermore, the editorial suggests that there is a range of normal sleep time required by healthy adults, and many indicators used to suggest chronic sleepiness among the population as a whole do not stand up to scientific scrutiny.[229]

A comparison of data collected from the Bureau of Labor Statistics' American Time Use Survey from 1965 to 1985 and 1998–2001 has been used to show that the median amount of sleep, napping, and resting done by the average adult American has changed by less than 0.7%, from a median of 482 minutes per day from 1965 through 1985 to 479 minutes per day from 1998 through 2001.[230][231]

## Longest periods without sleep

Randy Gardner holds the scientifically documented record for the longest period of time a human being has intentionally gone without sleep not using stimulants of any kind. Gardner stayed awake for 264 hours (11 days), breaking the previous record of 260 hours held by Tom Rounds of Honolulu.[232] Lieutenant Commander John J. Ross of the U.S. Navy Medical Neuropsychiatric Research Unit later published an account of this event, which became well known among sleep-deprivation researchers.[232][233][234]

The Guinness World Record stands at 449 hours (18 days, 17 hours), held by Maureen Weston of Peterborough, Cambridgeshire, in April 1977, in a rocking-chair marathon.[233]

Claims of total sleep deprivation lasting years have been made several times,[235][236][237] but none are scientifically verified.[238] Claims of partial sleep deprivation are better documented. For example, Rhett Lamb of St. Petersburg, Florida, was initially reported to not sleep at all but actually had a rare condition permitting him to sleep only one to two hours per day in the first three years of his life. He had a rare abnormality called an Arnold–Chiari malformation, where brain tissue protrudes into the spinal canal and the skull puts pressure on the protruding part of the brain. The boy was operated on at All Children's Hospital in St. Petersburg in May 2008. Two days after surgery, he slept through the night.[239][240]

French sleep expert Michel Jouvet and his team reported the case of a patient who was quasi-sleep-deprived for four months, as confirmed by repeated polygraphic recordings showing less than 30 minutes (of stage-1 sleep) per night, a condition they named "agrypnia". The 27-year-old man had Morvan's fibrillary chorea, a rare disease that leads to involuntary movements, and in this particular case, extreme insomnia. The researchers found that treatment with 5-HTP restored almost normal sleep stages. However, some months after this recovery, the patient died during a relapse that was unresponsive to 5-HTP. The cause of death was pulmonary edema. Despite the extreme insomnia, psychological investigation showed no sign of cognitive deficits, except for some hallucinations.[241]

## See also

* Effects of sleep deprivation on cognitive performance
* Narcolepsy
* Polyphasic sleep
* Sleep medicine
* Sleep onset latency
* Wake therapy
* Tony Wright, who claims to hold the world record for sleep deprivation
* Foreign Correspondent, a 1940 film depicting interrogation by sleep deprivation

## References

1. ↑ "How Much Sleep Do I Need?". Centers for Disease Control and Prevention (CDC). 14 September 2022. https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html. "Last Reviewed: September 14, 2022. Source: National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health."
2. ↑ 2.0 2.1 "Sleep Insufficiency". StatPearls. Treasure Island (FL): StatPearls Publishing. 2022. https://www.ncbi.nlm.nih.gov/books/NBK585109/. Retrieved 2023-05-18.
3. ↑ Sun, Xuefeng; Qu, Zihan; Zhang, Xiaotu; Zhang, Ye; Zhang, Xinye; Zhao, Haifeng; Zhang, Hongshi (2025-07-22). "The effects of sleep deprivation on cognitive flexibility: a scoping review of outcomes and biological mechanisms" (in English). Frontiers in Neuroscience 19. doi:10.3389/fnins.2025.1626309. ISSN 1662-453X. PMID 40766906.
4. ↑ Grandner, Michael A. (2019). "Epidemiology of insufficient sleep and poor sleep quality". Sleep and Health. pp. 11–20. doi:10.1016/B978-0-12-815373-4.00002-2. ISBN 978-0-12-815373-4.
5. ↑ "How Much Sleep Do Kids Need? Recommended Hours by Age" (in en). https://health.clevelandclinic.org/recommended-amount-of-sleep-for-children.
6. ↑ Hirshkowitz, Max; Whiton, Kaitlyn; Albert, Steven M.; Alessi, Cathy; Bruni, Oliviero; DonCarlos, Lydia; Hazen, Nancy; Herman, John et al. (March 2015). "National Sleep Foundation's sleep time duration recommendations: methodology and results summary". Sleep Health 1 (1): 40–43. doi:10.1016/j.sleh.2014.12.010. PMID 29073412.
7. ↑ "Sleep Deprivation: Understanding the Hidden Consequences". SleepFoundation.org. 25 July 2023. https://www.sleepfoundation.org/sleep-deprivation.
8. ↑ Yang, Chao; Yan, Peijing; Wu, Xueyao; Zhang, Wenqiang; Cui, Huijie; Zhang, Li; Xu, Zhengxing; Peng, Shanshan et al. (2024-10-01). "Associations of sleep with cardiometabolic risk factors and cardiovascular diseases: An umbrella review of observational and mendelian randomization studies". Sleep Medicine Reviews 77. doi:10.1016/j.smrv.2024.101965. ISSN 1087-0792. PMID 39137553. https://www.sciencedirect.com/science/article/pii/S1087079224000698.
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10. ↑ "How poor sleep affects your mental health" (in en). Priory. 3 July 2018. http://www.priorygroup.com/blog/how-poor-sleep-affects-your-mental-health.
11. ↑ 11.0 11.1 11.2 11.3 11.4 "Sleep deprivation: Impact on cognitive performance". Neuropsychiatric Disease and Treatment 3 (5): 553–567. October 2007. PMID 19300585. "Although both conditions [total and partial SD] induce several negative effects including impairments in cognitive performance, the underlying mechanisms seem to be somewhat different.".
12. ↑ 12.0 12.1 12.2 "The effects of REM sleep deprivation on the level of sleepiness/alertness". Sleep 21 (6): 609–614. September 1998. doi:10.1093/sleep/21.6.609. PMID 9779520.
13. ↑ 13.0 13.1 13.2 13.3 13.4 "Sleep and depression--results from psychobiological studies: an overview". Biological Psychology 57 (1–3): 67–103. July–August 2001. doi:10.1016/s0301-0511(01)00090-4. PMID 11454435.
14. ↑ "Research progress on the impact of acute sleep deprivation on cognitive and emotional functions and its neural mechanisms." (in zh). Chinese General Medicine 24 (29): 3653–3659. October 2021. doi:10.12114/j.issn.1007-9572.2021.01.016.
15. ↑ Sleep deprivation. Informa Health Care. 2005. pp. 1–2. ISBN 978-0-8247-5949-0. https://books.google.com/books?id=EaGWMXsR5XYC&pg=PA183.
16. ↑ "Sleep deprivation in the rat by the disk-over-water method". Behavioural Brain Research 69 (1–2): 55–63. 1995. doi:10.1016/0166-4328(95)00020-T. PMID 7546318.
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18. ↑ Paprocki, Jonathan (17 July 2012). "The effects of sleep deprivation vs. sleep restriction". https://sleepeducation.org/the-effects-of-sleep-deprivation-vs-sleep-restriction/.
19. ↑ Total sleep deprivation, chronic sleep restriction and sleep disruption. Progress in Brain Research. 185. 2010. pp. 91–103. doi:10.1016/B978-0-444-53702-7.00006-3. ISBN 978-0-444-53702-7.
20. ↑ Mao, Tianxin; Dinges, David; Deng, Yao; Zhao, Ke; Yang, Zijing; Lei, Hui; Fang, Zhuo; Yang, Fan Nils et al. (16 September 2021). "Impaired Vigilant Attention Partly Accounts for Inhibition Control Deficits After Total Sleep Deprivation and Partial Sleep Restriction". Nature and Science of Sleep 13: 1545–1560. doi:10.2147/NSS.S314769. PMID 34557048.
21. ↑ Banks, Siobhan; Dinges, David F. (15 August 2007). "Behavioral and Physiological Consequences of Sleep Restriction". Journal of Clinical Sleep Medicine 03 (5): 519–528. doi:10.5664/jcsm.26918.
22. ↑ "Contrasting Effects of Sleep Restriction, Total Sleep Deprivation, and Sleep Timing on Positive and Negative Affect - PMC". Frontiers in Behavioral Neuroscience 16. 2022. doi:10.3389/fnbeh.2022.911994. PMID 36062257.
23. ↑ "Sleep Deprivation and Deficiency - How Much Sleep Is Enough". 24 March 2022. https://www.nhlbi.nih.gov/health/sleep-deprivation/how-much-sleep.
24. ↑ "Sleep Debt: Can You Catch up on Sleep?" (in en). 2010-01-20. https://www.sleepfoundation.org/how-sleep-works/sleep-debt-and-catch-up-sleep.
25. ↑ Colten, Harvey R.; Altevogt, Bruce M.; Research, Institute of Medicine (US) Committee on Sleep Medicine and (2006). "Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders". Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK19961/.
26. ↑ "Sleep Debt: The Hidden Cost of Insufficient Rest". 20 January 2010. https://www.sleepfoundation.org/how-sleep-works/sleep-debt-and-catch-up-sleep.
27. ↑ Sleep and learning: the magic that makes us healthy and smart. Lanham: Rowman & Littlefield Education. 2009. ISBN 978-1-60709-091-5. OCLC 310224798.
28. ↑ "Insomnia - What Is Insomnia?". 24 March 2022. https://www.nhlbi.nih.gov/health/insomnia.
29. ↑ "What Is Insomnia?". NHLBI. 24 March 2022. https://www.nhlbi.nih.gov/health/insomnia.
30. ↑ "Insomnia: Causes, symptoms, and treatments" (in en). 2020-07-16. https://www.medicalnewstoday.com/articles/9155.
31. ↑ "Insomnia: definition, prevalence, etiology, and consequences". Journal of Clinical Sleep Medicine 3 (5 Suppl): S7–10. August 2007. doi:10.5664/jcsm.26929. PMID 17824495.
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53. ↑ "Fact Sheet – Pilot Fatigue". Federal Aviation Administration. 10 September 2010. http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=11857.
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149. ↑ 149.0 149.1 Shaik, Likhita; Cheema, Mustafa S.; Subramanian, Shyam; Kashyap, Rahul; Surani, Salim R. (24 November 2022). "Sleep and Safety among Healthcare Workers: The Effect of Obstructive Sleep Apnea and Sleep Deprivation on Safety". Medicina 58 (12): 1723. doi:10.3390/medicina58121723. PMID 36556925.
150. ↑ Good nights: how to stop sleep deprivation, overcome insomnia, and get the sleep you need. Zanca, Jane A.. Kansas City: Andrews and McMeel. 1997. ISBN 0-8362-2188-5. OCLC 35849087. https://archive.org/details/goodnightshowtos00zamm.
151. ↑ "Obstructive sleep apnoea syndrome and its management". Therapeutic Advances in Chronic Disease 6 (5): 273–85. September 2015. doi:10.1177/2040622315590318. PMID 26336596.
152. ↑ "Central sleep apnoea-a clinical review". Journal of Thoracic Disease 7 (5): 930–937. May 2015. doi:10.3978/j.issn.2072-1439.2015.04.45. PMID 26101651.
153. ↑ "Revenge Bedtime Procrastination: Definition & Psychology" (in en-US). 2021-02-23. https://www.sleepfoundation.org/sleep-hygiene/revenge-bedtime-procrastination.
154. ↑ 154.0 154.1 O'Callaghan, Frances; Muurlink, Olav; Reid, Natasha (December 2018). "Effects of caffeine on sleep quality and daytime functioning". Risk Management and Healthcare Policy 11: 263–271. doi:10.2147/rmhp.s156404. PMID 30573997.
155. ↑ "Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample". Nutrition 32 (11–12): 1193–1199. 2016-11-01. doi:10.1016/j.nut.2016.04.005. PMID 27377580.
156. ↑ "Caffeine's Connection to Sleep Problems" (in en). 2009-04-17. https://www.sleepfoundation.org/nutrition/caffeine-and-sleep.
157. ↑ Han, Rui; Zhang, Jun; Huang, Hao; Chen, Yi-Jie; Lu, Yu-Yuan; Wang, Yu-Chen; Lo, Chung-Chuan; Tan, Yi-Heng et al. (2025). "Effects of Coffee on Drosophila melanogaster: Concentration-Dependent Enhancement and Sleep Deprivation Recovery" (in en). Ethology 131 (9): 107–121. doi:10.1111/eth.70002. ISSN 1439-0310. https://onlinelibrary.wiley.com/doi/abs/10.1111/eth.70002.
158. ↑ Pauchon, Benoit; Beauchamps, Vincent; Gomez-Mérino, Danielle; Erblang, Mégane; Drogou, Catherine; Beers, Pascal Van; Guillard, Mathias; Quiquempoix, Michaël et al. (2024-10-11). "Caffeine Intake Alters Recovery Sleep after Sleep Deprivation". Nutrients 16 (20): 3442. doi:10.3390/nu16203442. ISSN 2072-6643. PMID 39458438.
159. ↑ Drake, Christopher; Roehrs, Timothy; Shambroom, John; Roth, Thomas (2013-11-15). "Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed". Journal of Clinical Sleep Medicine 9 (11): 1195–1200. doi:10.5664/jcsm.3170. ISSN 1550-9397. PMID 24235903.
160. ↑ "National Sleep Foundation Key Messages/Talking Points". https://sleepfoundation.org/sites/default/files/Drowsy Driving-Key Messages and Talking Points.pdf.
161. ↑ "Students Who Sleep 8 Hours Score Higher On Final Exams". 7 December 2018. https://www.tun.com/blog/students-who-sleep-8-hours-score-higher-on-final-exams/.
162. ↑ "Causes and consequences of sleepiness among college students". Nature and Science of Sleep 6: 73–84. 23 June 2014. doi:10.2147/NSS.S62907. PMID 25018659.
163. ↑ "Should I study or should I go (to sleep)? The influence of test schedule on the sleep behavior of undergraduates and its association with performance". PLOS ONE 16 (3). March 10, 2021. doi:10.1371/journal.pone.0247104. PMID 33690625. Bibcode: 2021PLoSO..1647104E.
164. ↑ Tsai, Ling-Ling; Li, Sheng-Ping (February 2004). "Sleep patterns in college students". Journal of Psychosomatic Research 56 (2): 231–237. doi:10.1016/S0022-3999(03)00507-5. PMID 15016583.
165. ↑ 165.0 165.1 "Synchronizing education to adolescent biology: 'let teens sleep, start school later'". Learning, Media and Technology 40 (2): 220. 1 August 2014. doi:10.1080/17439884.2014.942666.
166. ↑ "Sleep deprivation may be undermining teen health". Monitor on Psychology 32 (9): 42. 2001. http://www.apa.org/monitor/oct01/sleepteen.html.
167. ↑ "Sleep-deprived teens dozing off at school". ABC News. Associated Press. 28 March 2006. https://abcnews.go.com/US/wireStory?id=1775003.
168. ↑ "Linking adolescent sleep, brain maturation, and behavior". The Journal of Adolescent Health 45 (4): 319–320. October 2009. doi:10.1016/j.jadohealth.2009.07.007. PMID 19766933.
169. ↑ "Sleep in psychiatric disorders". Neurologic Clinics 14 (4): 739–764. November 1996. doi:10.1016/s0733-8619(05)70283-8. PMID 8923493.
170. ↑ "Overlapping prefrontal systems involved in cognitive and emotional processing in euthymic bipolar disorder and following sleep deprivation: a review of functional neuroimaging studies". Clinical Psychology Review 32 (7): 650–663. November 2012. doi:10.1016/j.cpr.2012.07.003. PMID 22926687.
171. ↑ "Investigating the mechanism(s) underlying switching between states in bipolar disorder". European Journal of Pharmacology 759: 151–162. July 2015. doi:10.1016/j.ejphar.2015.03.019. PMID 25814263.
172. ↑ "Sleep reduction as a final common pathway in the genesis of mania". The American Journal of Psychiatry 144 (2): 201–204. February 1987. doi:10.1176/ajp.144.2.201. PMID 3812788.
173. ↑ American Psychiatry Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. pp. 123–154. ISBN 978-0-89042-555-8.
174. ↑ "Basic Neuroscience Illuminates Causal Relationship Between Sleep and Memory: Translating to Schizophrenia". Schizophrenia Bulletin 44 (1): 7–14. January 2018. doi:10.1093/schbul/sbx151. PMID 29136236.
175. ↑ "Quality and Quantity of Sleep and Factors Associated With Sleep Disturbance in Hospitalized Patients". JAMA Internal Medicine 178 (9): 1201–1208. September 2018. doi:10.1001/jamainternmed.2018.2669. PMID 30014139.
176. ↑ "Patients in the intensive care unit suffer from severe lack of sleep associated with loss of normal melatonin secretion pattern". The American Journal of the Medical Sciences 317 (5): 278–281. May 1999. doi:10.1016/s0002-9629(15)40528-2. PMID 10334113.
177. ↑ "A narrative review of interventions for improving sleep and reducing circadian disruption in medical inpatients". Sleep Medicine 59: 42–50. July 2019. doi:10.1016/j.sleep.2018.08.007. PMID 30415906.
178. ↑ "Broadband internet causes sleep deprivation, a new study finds". ScienceDaily (Press release). Bocconi University. 2 August 2018.
179. ↑ "The effect of smartphone usage at bedtime on sleep quality among Saudi non- medical staff at King Saud University Medical City". Journal of Family Medicine and Primary Care 8 (6): 1953–1957. June 2019. doi:10.4103/jfmpc.jfmpc_269_19. PMID 31334161.
180. ↑ Ethan, Kinsella, Joshua; N., Chin, Brian (September 2024). "Mechanisms Linking Social Media Use and Sleep in Emerging Adults in the United States" (in en). Behavioral Sciences 14 (9). doi:10.3390/b. ISSN 2076-328X. https://www.mdpi.com/2076-328X/14/9/794. Retrieved 15 November 2025.
181. ↑ Costa, Giovanni (2015). "Sleep deprivation due to shift work". Occupational Neurology. Handbook of Clinical Neurology. 131. pp. 437–446. doi:10.1016/B978-0-444-62627-1.00023-8. ISBN 978-0-444-62627-1.
182. ↑ "Correlation Between Shiftwork, Sleep & Fatigue and Increased Occupational Injuries in a Manufacturing Plant in Pakistan". 1 May 2020. https://aiha-assets.sfo2.digitaloceanspaces.com/AIHA/aihce/2020/Documents/1740.pdf.
183. ↑ 183.0 183.1 "The role of sleep hygiene in promoting public health: A review of empirical evidence". Sleep Medicine Reviews 22: 23–36. August 2015. doi:10.1016/j.smrv.2014.10.001. PMID 25454674.
184. ↑ 184.0 184.1 184.2 "Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline". Journal of Clinical Sleep Medicine 17 (2): 255–262. February 2021. doi:10.5664/jcsm.8986. PMID 33164742.
185. ↑ "How to Sleep Better" (in en). 17 April 2009. https://www.sleepfoundation.org/sleep-hygiene/healthy-sleep-tips.
186. ↑ "CDC - Sleep Hygiene Tips - Sleep and Sleep Disorders" (in en-us). 13 February 2019. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html.
187. ↑ 187.0 187.1 "Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis". Annals of Internal Medicine 163 (3): 191–204. August 2015. doi:10.7326/M14-2841. PMID 26054060.
188. ↑ 188.0 188.1 "Insufficient sleep: Evaluation and management". UpToDate. 7 September 2023. https://www.uptodate.com/contents/insufficient-sleep-evaluation-and-management.
189. ↑ "The consensus sleep diary: standardizing prospective sleep self-monitoring". Sleep 35 (2): 287–302. February 2012. doi:10.5665/sleep.1642. PMID 22294820.
190. ↑ "Sleep Deprivation: Causes, Symptoms, & Treatment" (in en). 3 November 2020. https://www.sleepfoundation.org/sleep-deprivation.
191. ↑ "Measuring sleep habits without using a diary: the sleep timing questionnaire". Sleep 26 (2): 208–212. March 2003. doi:10.1093/sleep/26.2.208. PMID 12683481.
192. ↑ Rizi, Farid Rajaee; Asgarian, Fatemeh Sadat (January 2023). "Reliability, validity, and psychometric properties of the Persian version of the Tayside children's sleep questionnaire" (in en). Sleep and Biological Rhythms 21 (1): 97–103. doi:10.1007/s41105-022-00420-6. PMID 38468908.
193. ↑ Malik, Abdullah; Ali, Azhar; Akram, Muhammad; Rasheed, Rizwan (2 January 2025). "Assessment of sleep quality, fatigue and its association with occupational injuries among shift workers in an electronic industrial environment". International Journal of Occupational Safety and Ergonomics 31 (1): 69–76. doi:10.1080/10803548.2024.2404326. ISSN 1080-3548. PMID 39399919. https://www.tandfonline.com/doi/full/10.1080/10803548.2024.2404326. Retrieved 31 October 2025.
194. ↑ "Sleep Deprivation". 2008. http://www.aasmnet.org/resources/factsheets/sleepdeprivation.pdf.
195. ↑ "Sleep Deprivation Fact Sheet". American Academy of Sleep Medicine. 2 December 2009. http://www.aasmnet.org/Resources/FactSheets/SleepDeprivation.pdf.
196. ↑ "Actigraphy" (in en). https://stanfordhealthcare.org/medical-tests/s/sleep-disorder-tests/procedures/actigraphy.html.
197. ↑ "Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007". Sleep 30 (4): 519–529. April 2007. doi:10.1093/sleep/30.4.519. PMID 17520797.
198. ↑ "Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Clinical Practice Guideline". Journal of Clinical Sleep Medicine 14 (7): 1231–1237. July 2018. doi:10.5664/jcsm.7230. PMID 29991437.
199. ↑ "Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment". Journal of Clinical Sleep Medicine 14 (7): 1209–1230. July 2018. doi:10.5664/jcsm.7228. PMID 29991438.
200. ↑ Zambotti, Massimiliano; Cellini, Nicola; Goldstone, Aimee; Colrain, Ian M; Baker C (2020). "Wearable Sleep Technology in Clinical and Research Settings". Medicine and Science in Sports and Exercise 51 (7): 1538–1557. doi:10.1249/MSS.0000000000001947. PMID 30789439.
201. ↑ Physiology of Behavior (11th ed.). Boston: Pearson. 2013. pp. 578–579. ISBN 978-0-205-23939-9.
202. ↑ "Rapid antidepressant effects of sleep deprivation therapy correlates with serum BDNF changes in major depression". Brain Research Bulletin 80 (3): 158–162. September 2009. doi:10.1016/j.brainresbull.2009.06.016. PMID 19576267.
203. ↑ "Effect of sleep deprivation on the human metabolome". Proceedings of the National Academy of Sciences of the United States of America 111 (29): 10761–10766. July 2014. doi:10.1073/pnas.1402663111. PMID 25002497. Bibcode: 2014PNAS..11110761D.
204. ↑ "Sleep deprivation in depression: what do we know, where do we go?". Biological Psychiatry 46 (4): 445–453. August 1999. doi:10.1016/S0006-3223(99)00125-0. PMID 10459393.
205. ↑ "Chronotherapeutics (light and wake therapy) in affective disorders". Psychological Medicine 35 (7): 939–944. July 2005. doi:10.1017/S003329170500437X. PMID 16045060.
206. ↑ "Disorders That Disrupt Sleep (Parasomnias)". eMedicineHealth. http://www.emedicinehealth.com/articles/42677-5.asp.
207. ↑ 207.0 207.1 207.2 207.3 Psychophysiological Insomnia, Elsevier, 2013, pp. 203–204, doi:10.1016/b978-0-12-378610-4.00177-7, ISBN 978-0-12-378611-1
208. ↑ 208.0 208.1 "The evidence base of sleep restriction therapy for treating insomnia disorder". Sleep Medicine Reviews 18 (5): 415–424. October 2014. doi:10.1016/j.smrv.2014.01.006. PMID 24629826.
209. ↑ "中国失眠症诊断和治疗指南" (in zh). National Medical Journal of China 97 (24): 1844–1856. 2017-06-27. doi:10.3760/cma.j.issn.0376-2491.2017.24.002.
210. ↑ 210.0 210.1 The Costs of Poor Sleep Are Staggering. 2017-03-01. https://www.rand.org/pubs/articles/2017/the-costs-of-poor-sleep-are-staggering.html.
211. ↑ 211.0 211.1 Improving Sleep Health for U.S. Servicemembers: Policies, Programs, Barriers to Implementation, and Recommendations. 2015. doi:10.7249/rb9824. ISBN 978-0-8330-8851-2.
212. ↑ "The Biopolitics of Melanopic Illuminance". Scapegoat (10). 2017. http://www.scapegoatjournal.org/docs/10/14.pdf.
213. ↑ 24/7: late capitalism and the ends of sleep. London: Verso. 2014. ISBN 978-1-78168-310-1.
214. ↑ "Circadian misalignment on submarines and other non-24-h environments - from research to application". Military Medical Research 7 (1). August 2020. doi:10.1186/s40779-020-00268-2. PMID 32814592.
215. ↑ "Sleep Deprivation Used as Abuse Tactic" (in en-US). https://www.domesticshelters.org/articles/identifying-abuse/sleep-deprivation-as-abuse.
216. ↑ "Family and Domestic Violence - Healthy Work Healthy Living Tip Sheet". https://federation.edu.au/staff/working-at-feduni/feduni-against-violence/family-and-domestic-violence?a=282376.
217. ↑ "Binyam Mohamed torture appeal lost by UK government...". BBC News. 2 October 2009. https://news.bbc.co.uk/1/hi/uk/8507852.stm.
218. ↑ White nights: the story of a prisoner in Russia. San Francisco: Harper & Row. 1979. ISBN 978-0-06-010289-0. https://archive.org/details/whitenightsstory00begi.
219. ↑ "HUDOC - European Court of Human Rights". https://hudoc.echr.coe.int/eng.
220. ↑ 220.0 220.1 "Obama assures intelligence officials they won't be prosecuted over interrogations". Los Angeles Times. 17 April 2009. https://www.latimes.com/archives/la-xpm-2009-apr-17-na-interrogation17-story.html.
221. ↑ "Memorandum for John Rizzo". ACLU. 10 May 2005. p. 14. http://media.luxmedia.com/aclu/olc_05102005_bradbury46pg.pdf.
222. ↑ "Scientists Claim CIA Misused Work on Sleep Deprivation". Time. 21 April 2009. http://content.time.com/time/nation/article/0,8599,1892897,00.html.
223. ↑ "Explaining and Authorizing Specific Interrogation Techniques". The New York Times. 17 April 2009. https://www.nytimes.com/interactive/2009/04/17/us/politics/20090417-interrogation-techniques.html.
224. ↑ Department of Justice Office of Professional Responsibility (29 July 2009). ﻿Investigation into the Office of Legal Counsel's Memoranda Concerning Issues Relating to the Central Intelligence Agency's Use of "Enhanced Interrogation Techniques" on Suspected Terrorists﻿ (Report). United States Department of Justice. pp. 133–138. https://www.aclu.org/files/pdfs/natsec/opr20100219/20090729_OPR_Final_Report_with_20100719_declassifications.pdf. Retrieved 29 May 2017.
225. ↑ "Sleep deprivation remains red-hot question". PM (abc.net.au). 3 October 2006. http://www.abc.net.au/pm/content/2006/s1754821.htm.
226. ↑ "Sleep deprivation is torture: Amnesty". The Sydney Morning Herald. AAP. 3 October 2006. https://www.smh.com.au/news/National/Sleep-deprivation-is-torture-Amnesty/2006/10/03/1159641317450.html.
227. ↑ "National Geographic" (in en). https://www.nationalgeographic.com/.
228. ↑ "Study: Sleep deficit may be impossible to make up". USA Today. 25 November 2007. https://www.usatoday.com/news/health/2007-11-25-sleep-deficit_N.htm.
229. ↑ "Is there a sleep debt?". Sleep 27 (6): 1047–1049. September 2004. PMID 15532195.
230. ↑ "National Time Use Studies (1965–1985)". umd.edu. http://www.popcenter.umd.edu/sdaweb/glaser/Doc/GLAS.htm.
231. ↑ "National Time Use Studies (1998 - 2001)". umd.edu. http://www.popcenter.umd.edu/sdaweb/diary9801/Doc/Diar.htm.
232. ↑ 232.0 232.1 "Sleep Deprivation, Psychosis and Mental Efficiency". Psychiatric Times 15 (3). 1 March 1998. http://www.psychiatrictimes.com/display/article/10168/54471. Retrieved 25 November 2009.
233. ↑ 233.0 233.1 "Eleven days awake". Elephants on Acid: And Other Bizarre Experiments. Harvest Books. 5 November 2007. pp. 90–93. ISBN 978-0-15-603135-6. https://books.google.com/books?id=Wc-UlRRWQ1EC&pg=PA90.
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235. ↑ "Vietnam man handles three decades without sleep". Thanh Nien Daily (Vietnam National Youth Federation). http://www.thanhniennews.com/features/?catid=10&newsid=12673.
236. ↑ "Ukrainian man has been lacking sleep for 20 years". 15 January 2005. http://www.pravdareport.com/news/society/sex/15-01-2005/60995-0/.
237. ↑ "11 Baffling Medical Conditions". ABC News: The Boy Who Couldn't Sleep. 30 March 2009. https://abcnews.go.com/Health/story?id=7191766&page=4.
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240. ↑ "Mystery of Sleepless Boy Solved: Boy Who Couldn't Sleep Undergoes Risky, Life-Changing Operation". ABC News. 23 January 2009. https://abcnews.go.com/GMA/OnCall/story?id=6711810&page=1.
241. ↑ Fischer-Perroudon, C.; Mouret, J.; Jouvet, M. (January 1974). "One case of agrypnia (4 months without sleep) in a morvan disease. Favourable action of 5-hydroxytryptophane". Electroencephalography and Clinical Neurophysiology 36 (1): 1–18. doi:10.1016/0013-4694(74)90132-1. PMID 4128428.

* v
* t
* e

Psychophysiology: Sleep and sleep disorders (F51 and G47 / 307.4 and 327)

Sleep stages|

* Rapid eye movement (REM)
* Non-rapid eye movement
* Slow-wave

Brain waves|

* Alpha wave
* Beta wave
* Delta wave
* Gamma wave
* K-complex
* Mu rhythm
* Sensorimotor rhythm
* Sleep spindle
* Theta wave

Sleep
disorders|

| Dyssomnia|

* Hypersomnia
* Insomnia
* Kleine–Levin syndrome
* Narcolepsy
* Sleep apnea
* Central hypoventilation syndrome
* Obesity hypoventilation syndrome
* Sleep state misperception

|

Circadian rhythm
disorders

* Advanced sleep phase disorder
* Delayed sleep phase disorder
* Irregular sleep–wake rhythm
* Jet lag
* Non-24-hour sleep–wake disorder
* Shift work sleep disorder

Parasomnia|

* Catathrenia
* Night terror
* Rapid eye movement sleep behavior disorder
* Sleepwalking
* Somniloquy

Other|

* Bruxism
* Cyclic alternating pattern
* Night eating syndrome
* Nocturia
* Periodic breathing
* Nocturnal myoclonus

Benign
phenomena|

* Dream
* Exploding head syndrome
* False awakening
* Hypnagogia / Sleep onset
* Hypnic jerk
* Lucid dream
* Nightmare
* Nocturnal clitoral tumescence
* Nocturnal emission
* Nocturnal penile tumescence
* Sleep paralysis
* Somnolence

Related
topics|

* Bed
* Bunk bed
* Daybed
* Four-poster bed
* Futon
* Hammock
* Mattress
* Sleeping bag
* Bed bug
* Bedding
* Bedroom
* Bedtime
* Bedtime story
* Bedtime toy
* Biphasic and polyphasic sleep
* Chronotype
* Dream journal
* Excessive daytime sleepiness
* Hypnopompic state
* Hypnosis
* Lullaby
* Microsleep
* Nap
* Nightwear
* Power nap
* Second wind
* Siesta
* Sleep and creativity
* Sleep and learning
* Sleep debt
* Sleep deprivation
* Sleep diary
* Sleep hygiene
* Sleep induction
* Sleep inertia
* "Sleeping sickness"1
* Sleeping while on duty
* Sleepover
* Snoring
* Somnology
* Polysomnography
* Sleep medicine

* 1 Not a sleep disorder.

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