Archived Columns
Sleep Debt
September 25, 2000
One of the most successful symposia at the year 2000 convention of the Associated Professional Sleep Societies (I will describe some of the sleep professional organizations and their missions in a later commentary) was titled "Sleep Debt." The scientific presentations were excellent and their highly visible presence on the APSS program validated the importance of sleep debt and the fundamental principle that all lost sleep accumulates as a debt.
I have stated in many other places that I view sleep debt and its consequences as the number one problem in America. Carrying a large sleep debt has serious negative consequences for an individual and those with whom he or she comes in contact. These consequences are typically negative interpersonal interactions or impaired functioning which creates risk for everyone especially in hazardous situations. Chronic sleep loss and sleep disorders are so pervasive in our society that sleepy behavior is accepted as the norm. Thus, it is considered normal to be drowsy in the early afternoon following the midday meal, to have some difficulty getting up in the morning and to be somewhat sluggish and unmotivated.
This is the first time I have enjoyed the freedom and support to maintain a weekly column or commentary indefinitely. I am therefore absolutely committed to producing a brief commentary for the SleepQuest audience every single week with very occasional exceptions. This also creates the daunting challenge of avoiding repetition, not that repetition should always be avoided. Maintaining brevity is also a challenge, and it should be absolutely clear that a topic as important and complex as "sleep debt" cannot be dealt with in three or four paragraphs. Having designated this topic as our number one issue, it is clear that I will return to it many times. In addition, I hope to be guided as much as possible by our readers and their interests. Therefore, your feedback is essential. I would particularly appreciate knowing when something is not crystal clear. You may email SleepQuest at contact@sleepquest.com.
Introduction To Crucial Definitions, Facts And Principles Of Sleep Debt
The following definitions and concepts are the most important to understand as we begin our discussions of sleep debt, how it affects our lives and what we can do about it.
Sleep Homeostasis
When a process works continually to maintain a constant level or flow of something in our bodies, it is called "homeostatic." An example of such a process is the regulation of one's internal core body temperature. One powerful component of sleep regulation is sleep homeostasis. When our prior nocturnal sleep time has been reduced, our tendency to fall asleep the next day increases, and we tend to sleep more deeply the next night as well. When we obtain substantial "extra" sleep, we are less likely to fall asleep or become drowsy on the next day, and we may not sleep as deeply the next night. The obvious purpose of this homeostatic process is to ensure that each of us will obtain a certain amount of sleep as a daily average.
Sleep Need
Each of us needs a certain amount of sleep which, if obtained on a daily basis, will maintain our homeostatic equilibrium. In other words, if we are fulfilling our daily sleep requirement, the consequences described in the preceding paragraph would not occur. Our tendency to fall asleep in the daytime would neither increase nor decrease. Although there are individual differences, most people's daily sleep requirement is around eight hours.
Sleep Debt
Having defined sleep need and individual daily sleep requirement, sleep debt is therefore the accumulated amount of lost sleep. For example, if the average daily amount of sleep needed by an individual is eight hours, sleeping six hours a night for one week will create a sleep debt of fourteen hours. The larger the sleep debt, the stronger the tendency to fall asleep. The size of the sleep debt is the major determinant of the strength of the tendency to fall asleep at any particular moment while we are awake.
What most people do not know, is that sleep debt does not go away by itself. It must be repaid just like a financial debt. Any sleep debt that we have accumulated will stay with us as far as we now know, forever. A very large sleep debt can be accumulated by losing a small amount of sleep each day. Often, people feel very fatigued and they do not know why. They have forgotten that they didn't get enough sleep on several nights a week ago and haven't made it up. The total amount of sleep you have lost in the last few months is your personal sleep debt. Whatever sleep debt you are carrying, it will not go away. It is no more likely to disappear than your credit card balance.
How Do You Know If You Have A Large Sleep Debt?
It could not be simpler. If you become drowsy at anytime during the day, you have a sizable sleep debt. Large scale surveys have shown that about 90% of all adults experience sleepiness after lunch. In what may be the number one erroneous belief in our society, we assume that eating a big lunch causes us to become sleepy. This is completely wrong! When our sleep debt is low, we do not become sleepy after lunch. When our sleep debt is large, our alertness will diminish in the mid-afternoon whether or not we have had lunch. Other signs that we have a large sleep debt are difficulty waking up in the morning, difficulty concentrating, low motivation, and a tendency to be cranky and irritable.
Sleep Debt "Unmasked"
In addition to a heavy lunch, most people think that a warm room, boredom and monotomy, or an alcoholic beverage are direct causes of sleepiness. None of these things directly cause sleepiness. Rather, they unmask sleepiness. They unmask and reveal your sleep debt. If you do not have a sizable sleep debt, things like lunch, boredom or alcohol will not cause you to become sleepy. Anytime you experience daytime drowsiness, no matter what you are doing, you must conclude you are carrying a sleep debt. Some people who are carrying an unusually large sleep debt think they have "chronic fatigue syndrome."
Sleep Debt Is The Number One Problem; Understanding Sleep Debt Is Our Number One Challenge
I have been selecting, clarifying, organizing and presenting what I strongly believe are the key facts that every person on the planet must learn, thoroughly understand, and apply in their lives without delay. All these key facts are of supreme importance, but as I said at the beginning of this commentary, if I am asked what is number one, it is understanding sleep debt and its consequences. It is fundamentally changing our perspective about the way we feel during the day.
Stay tuned.
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