Q&A: Consecutive sleep loss negatively impacts physical symptoms, emotional well-being

Consecutive sleep loss predicted poorer daily affective and physical well-being among a large sample of U.S. adults, with well-being declining after one night of sleep loss, according to findings published in Annals of Behavioral Medicine.

“Habitual sleep loss, defined as having less than the recommended minimum of 6 [hours] of sleep per night, is negatively associated with psychological well-being, cognitive plasticity, and mental and physical health. However, sleep loss is common among U.S. adults, with approximately one-third reporting sleeping less than 6 [hours] per night,” Soomi Lee, PhD, assistant professor in the School of Aging Studies, College of Behavioral and Community Sciences, at the University of South Florida, wrote. “Experimental studies show the causal effect of total sleep deprivation (eg, no sleep for 1 night) on next-day performance.”

Lee aimed to examine the impact of naturally occurring consecutive sleep loss on day-to-day trajectories of affective and physical well-being in a cohort of 1,958 adults from the Midlife in the United States Study who provided daily diary data for 8 consecutive days, with consecutive sleep loss operationalized as the within-person number of consecutive nights with less than 6 hours of sleep.

Healio Neurology spoke with Lee to learn more about the study results and the clinical impact of the findings.

Healio Neurology: What prompted this research?

Lee: The negative effects of sleep loss on memory and performance have been reported, but most of the studies used an experimental design and focused on examining short-term influences of sleep loss. For example, they examined degraded performance on cognitive tests after one night of an extremely short sleep duration in a lab setting. I wanted to examine whether there are cumulative effects of repeated sleep loss on daily well-being, by observing naturally occurring sleep loss.

Healio Neurology: What is currently know about the detrimental impact of lost sleep?

Lee: Chronic sleep loss is associated with adverse consequences on daily psychological and physical well-being. Further, these effects are present regardless of one’s demographic or socioeconomic status, suggesting that sleep loss is harmful to anyone.

More specifically, my previous research has found that losing sleep is associated with perceiving more stress, having more ruminative thoughts and lower mindful attention. Thus, insufficient or poor sleep impact us in our everyday lives.

Healio Neurology: Why is it important to understand the consequences of consecutive sleep loss?

Lee: Sleep loss is common among U.S. adults. Approximately one-third reporting sleeping less than 6 hours per night. Many of us experience sleep issues and this has become more common during the COVID-19 pandemic.

Recent research shows that sleep in adults and families across the world has been degraded since the COVID-19 pandemic. Stress and less structured schedules might have contributed to this. Adults’ sleep routines also influence their children’s sleep routines. Thus, highlighting the importance of adults’ optimal sleep is important for general population health and well-being. Sleep health is perhaps one of the most under-valued aspects of general health in our society.

Healio Neurology: Can you provide a brief overview of your results?

Lee: This study examined how consecutive sleep loss affects daily well-being in a sample of U.S. adults. Sleep loss was defined as less than 6 hours of sleep a night. While there may be individual differences in the amount of needed sleep, this study used the criterion of a minimum sleep duration suggested as appropriate for most adults by several sleep expert panels.

Consecutive sleep loss was associated with decreases in positive emotions, increases in negative emotions and greater frequency and severity of physical symptoms. The associations were not linear and the rate of change in daily well-being differed by the number of consecutive nights of sleep loss. After just one night of sleep loss, daily well-being significantly worsened. Daily well-being steadily got worse, peaking on day 3, which is after 3 consecutive nights of sleep loss. The rate of change decelerated as the number of nights of consecutive sleep loss increased. However, that all changed on day 6, when participants reported that the severity of physical symptoms were at their worst.

Healio Neurology: Did you observe anything surprising or unexpected?

Lee: Most of the findings were expected, but there was a surprising finding as well. I expected that our bodies may get used to sleep loss if it is repeated. However, the levels of daily well-being were significantly lower than baseline when sleep loss did not occur. This means that just one night of sleep loss can be harmful.

When sleep loss is repeated, over 4 to 5 days, our minds and bodies seem relatively used to the repeated sleep loss, but when sleep loss occurs almost every day, when sleep loss is chronic, that is when our minds and bodies cannot tolerate it any longer.

The results showed that consecutive sleep loss resulted in incomplete recovery and stress pileup and thus degraded daily well-being.

Healio Neurology: How might the results from this study be used in clinical practice?

Lee: Sleep is modifiable. Sleep can be improved by individual efforts and interventions. In clinical settings, it may be important to ask about patients’ sleep patterns and provide simple sleep hygiene tips they can practice. Sleep problems coexist with many mental health disorders, such as depression and anxiety. Perhaps asking about sleep can help identify those with early symptoms of these mental health disorders. Individuals may also be more willing to seek help for their sleep issues rather than other mental health issues.

Healio Neurology: What are the next steps for this research?

Lee: Next is replicating findings from this study among diverse samples of workers, including groups more vulnerable to sleep issues, such as shift workers and family caregivers.

I am also interested in examining diverse factors that are affected by sleep and may also affect sleep. Stress, physical activity and diet are among those factors and there may be other novel factors we have not discovered yet.

Lastly, my long-term plan is to develop a sleep promotion/intervention program that is easy to participate and practice in daily life.

References:

Lee S. Ann Behav Med. 2021;doi:10.1093/abm/kaab055.

Lee S, et al. J Sleep Res. 2016;doi:10.1111/jsr.12488.

Lee S, et al. Sleep Health. 2021;doi:10.1016/j.sleh.2020.07.005.

Lee S, et al. Sleep Health. 2019;doi:10.1016/j.sleh.2019.01.007.