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Rachel Brownrigg

May 27th, 2016


Block 4

The Health Effects and Treatment of Sleep


Deprivation

Introduction
Sleep is a natural state with an altered consciousness and inhibited
sensory activity including that of nearly all voluntary muscles. It is
considered to be important to body restitution and essential for cognitive
performance, especially memory consolidation. Our bodies all require long
periods of sleep in order to restore and rejuvenate, to grow muscle, repair
tissue and synthesize hormones. If sleep is cut short the body doesnt have
time to complete all the phases that is needed for muscle repair, memory
consolidation and the release of hormones that regulate growth and
appetite. When that happens the body experiences sleep deprivation
(Nordqvist, 2015).
This paper will examine several inquiry questions related to sleep
deprivation. Firstly, the physiological effects of sleep deprivation and the
affect it has on memory retention and behaviour. Secondly, how
pharmaceuticals can play a role in treating sleep deprivation. Lastly, how the
change in behaviour caused by sleep deprivation affects social interactions.

Analysis
The Five Stages of Sleep
The sleep cycle follows a pattern of alternating REM (Rapid Eye
Movement) and NREM (Non- Rapid Eye Movement) sleep that repeats
roughly every 90 minutes. As the body begins to fall asleep, it enters NREM
sleep which is composed of 3 stages. Stage 1 is a light sleep between being
awake and falling asleep. In Stage 2, breathing and heart rate become
irregular, body temperature drops and individuals become disengaged from
surroundings. Stage 3 is the deepest and most restorative sleep besides REM
sleep. Blood pressure drops, breathing slows and muscles are relaxed.
Energy is restored and tissue and growth repair occurs when the blood
supply to muscles increases (National Sleep Foundation, 2014).
After Stage 3 of NREM sleep the body enters REM, which is characterized
by quick, random movements of the eyes and paralysis of the muscles.
People usually experience REM sleep 4 or 5 times a night. The duration spent

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in REM sleep varies significantly with age. For adults it represents


approximately 20-25% of the total time spent asleep, whereas in infants its
about 90-120 minutes. REM sleep first occurs around 90 minutes after falling
asleep and only lasts for a short time and recurs every 90 minutes; with each
following cycle lasting longer than the previous. This stage provides energy
to the brain and body and is where dreams occur and our brain is active.
Most of the muscles become paralyzed and the activity of the brains
neurons becomes intense almost to the degree of wakefulness. This muscle
inactivity can affect the breathing muscles, which is a cause of snoring as
well as other breathing problems during sleep. REM sleep is reached faster
by those who get inadequate sleep than those who get adequate sleep
(Priest et al., 2001).
After a night without sleep the mesolimbic system, which is the pathway
between the primitive brain and advanced brain, becomes stimulated. A
compound called dopamine, which is the precursor of epinephrine, is
released sending us into autopilot. Dopamine is a neurotransmitter and when
released triggers extra energy, motivation and positivity which leads to
impulsive behavior and tricks the body into wakefulness. However, once
exhaustion sets in reaction time, perception and cognitive function is
reduced. After a day or two without sleep the body loses its ability to
metabolize glucose properly. The immune system stops working as well and
in some cases up to 3 days without sleep has led to hallucinations. When
individuals go excessive amounts of time with no sleep it can lead to an
incredibly rare disease called Fatal Familial Insomnia. The disease kills within
18 months as those suffering slowly lose all ability to sleep and their organs
start to shut down (Polo-Kantola et al., 2007).

The physiological effects of sleep deprivation and the affect it


has on memory retention and behaviour.
There are two types of sleep deprivation (SD); Total SD and Partial SD.
Total SD is when individuals are deprived of all stages of sleep, including
REM. This type impairs attention and working memory and affects other
functions such as long term memory and decision making. Partial SD is when
individuals are only deprived on one stage - usually REM sleep. This type of
deprivation influences attention span (Nordqvist, 2015).
In addition to sleep deprivation, there are multiple sleep disorders;
one of the most common is insomnia. Insomnia is the inability to get the
amount of sleep needed to wake up feeling rested and refreshed. Because

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different people need different amounts of sleep, insomnia is defined by the


quality of sleepnot the number of hours slept or how quickly sleep was
reached (Robinson et al., 2016).
When individuals are deprived of sleep or experiencing insomnia,
which results in sleep deprivation, the brain doesnt have time to regenerate.
The hormones that are released during sleep to promote growth and repair
cells and tissues are repressed in children and adolescents. Therefore sleep
is vital to development during puberty. Lack of sleep affects cognitive
abilities and emotional state and if the deprivation continues long enough it
can lower the bodys defences, putting one at risk of developing chronic
illness. The obvious signs of insomnia are excessive sleepiness, yawning and
irritability. In addition, sleep is also necessary to maintain proper function
over the central nervous system and a lack of sleep can negatively impact
both short-term and long-term memory. Emotions also become affected,
resulting in a short temper and mood swings (Baddeley, 2010).
During sleep, the immune system produces protective cytokines which
are cell signalling molecules that aid cell to cell communication in immune
responses and stimulate the movement of cells towards sites of
inflammation, infection and trauma (Conklin et al., 2013). These cytokines
give the immune system more energy to defend against illness during sleep.
However, adequate sleep is required to give the immune system a chance to
build up its forces. If a healthy amount of sleep is not reached, it will be
harder for the body to be able to fend off invaders and it may take longer to
recover from illness. Long-term sleep deprivation raises the risk of
developing chronic illnesses like diabetes and cardiovascular diseases. Since
sleep deprivation can weaken the immune system, the body becomes more
vulnerable to respiratory problems. According to Medical News Daily, there is
also a clear link between lack of sleep and weight gain. Lack of sleep lowers
the levels of a hormone called leptin in the body, which tells the brain that
youve had enough to eat. It also raises the levels of a biochemical called
ghrelin; an appetite stimulant (Lentino, 2000).
In addition, sleep deprivation prompts the body to release higher levels
of insulin after eating which promotes fat storage, increasing the risk of
developing type II diabetes.
Since lack of sleep is linked to weight gain, it also increases the risk of
cardiovascular problems. Sleep plays an important role in the bodys ability
to repair blood vessels and the heart, resulting in a higher risk of chronic
health problems, high blood pressure, heart disease and stroke (Kim et al.,
2001).

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The role that pharmaceuticals can play in treating sleep


deprivation
Sleep deprivation is often caused by an underlying factor such as
stress, anxiety or depression. In those cases anti-depressants such as
Trazadone (C19H23Cl2N5O) are often prescribed. Trazadone is an
antidepressant medicine that affects chemicals in the brain that may be
unbalanced in people with depression. Trazadone helps restore the balance
of a certain natural chemical called serotonin (C10H12N2O), which helps
regulate mood and is converted into melatonin (C13H16N2O2) in the absence of
UV light through the pineal gland. Melatonin then helps induce rest and sleep
during darkness. This antidepressant is known for improving mood, appetite
and energy level as well as decreasing anxiety and insomnia. The serious
side effects associated with Trazadone include blurred vision, eye pain, stiff
and rigid muscles, tunnel vision, and tremors. The more common side effects
are vision changes, altered sense of taste and drowsiness (eMedicineHealth,
2015).
In addition to antidepressants which help treat one of the more
common underlying causes of insomnia, there are several pharmaceuticals
that can be used to treat insomnia as well. Zolpidem (C23H27N3O7) is a
sedative; a nonbenzodiazepine compound that increases the effect of
Gamma-Amino Butyric acid (C4H9NO2) also known as GABA. GABA is an
amino acid that acts as a neurotransmitter in the central nervous system. It
inhibits nerve transmission in the brain, calming nervous activity and affects
the chemicals in the brain that may be unbalanced in people with sleep
problems such as insomnia and slows down brain activity to allow sleep. It
works quickly, usually within 15 minutes, and has a short half-life of two to
three hours. The side effects include drowsiness, tiredness, dizziness,
changes in appetite and uncontrollable shaking of the body. The serious side
effects are swelling of the eyes, face, tongue or throat, difficulty breathing or
swallowing and blurred vision (US National Library of Medicine, 2015).
Furthermore, another effective pharmaceutical used for treating
insomnia is Rozerem (C16H21NO2). This is a sleep medication that works
differently than the others. Instead of depressing the central nervous system
this drug works by targeting melatonin receptors which are responsible for
the brains sleep-wake cycle. Rozerem is prescribed for people who had
difficulty falling asleep and its side effects include drowsiness, dizziness and
nausea. Serious side effects associated with Rozerem include unusual

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thoughts or behavior, hallucinations and worsening depression. This drug has


shown no evidence of abuse or dependence (Kluwer, 2011).
In addition to those examples referred to above, the pharmaceutical
treatments for sleep deprivation are numerous as are the nonpharmaceutical treatments; the most common of which is a healthy diet and
lifestyle. Emotional issues such as stress, anxiety and depression as listed
above cause about half of all insomnia cases which lead to sleep deprivation.
Daytime habits, sleep routine and physical health also play a major role in
treating insomnia (Robinson et al., 2016).

How the change in behaviour caused by sleep deprivation


affects social interactions
Sleep deprivation affects an individuals performance, safety and quality
of life. Nearly all types of sleep problems are associated with performance
deficits in educational or occupational settings. The performance deficits
include attention, cognitive ability, memory and complex decision making.
Furthermore, lack of sleep and sleep disorders have a significant social and
economic impact. Hundreds of billions of dollars are spent on medical costs
associated with hospital services, prescriptions and doctor visits per year
(Colten et al., 2006).
Sleep deprivation is common in adolescence and is particularly high in
young adults attending post-secondary. Sleep loss is associated with a
decrease in cognitive performance and therefore negatively impacts the
ability to perform mentally demanding skills resulting in a decrease of
academic performance. Moreover, the safety of individuals is also a risk
factor when sleep is being deprived. Tiredness has been proven to be a
significant contributor to serious motor vehicle and work-place accidents.
Lack of concentration; a side effect of sleep deprivation, can result in
careless behavior and an impaired ability to perform complex tasks.
Compared to healthy individuals, individuals suffering from sleep loss are
less productive, have a greater tendency to suffer health related deficits and
have an increased likelihood of accidents (National Sleep Foundation, 2011).
The behavioral effects of sleep deprivation that includes irritability and
psychosis have significant and negative impacts on the individual and the
relationships with others. The effect of such behaviour can impact the family
unit. In extreme cases the impact can be a complete breakdown in the family
including separation, divorce and relationship crisis. The downward spiral of
these events, exacerbate the problem due to stress and anxiety in the

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individual which is a common underlying cause of sleep deprivation (Meltzer


et al., 2007).

Conclusion
This paper presented three inquiry questions that have been analyzed
with the following conclusions. Sleep deprivation causes serious physiological
effects by weakening the bodys immune system. A weakened immune
system can potentially lead to additional health issues, including respiratory
problems and cardiovascular disease (Lentino, 2000). However, there are
pharmaceutical treatments for sleep disorders, such as insomnia, and to
improve ones quality of sleep. Some common drugs include Trazadone,
Zolpidem, and Rozerem. Not only does lack of sleep affect the bodys
immune function but the cognitive abilities and emotional state, which can
negatively impact social interactions.
Areas for future scientific research include study of the chemical
conditions in the healthy and sleep deprived brain. This research, together
with the effects on brain chemistry of pharmaceuticals, will help us
understand the underlying biochemical conditions of sleep deprivation and
its causes. If we understand this better, maybe we will learn as a society,
how to self-manage or intervene early to prevent long term problems.

Bibliography

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Rachel Brownrigg
May 27th, 2016
Block 4