Syed K.Haque, M.D.
Sleep is defined as ” a readily reversible suspension of sensorimotor interaction with the environment, usually associated with recumbency and immobility.” Most people love sleep. This is evident from the fact that one of the top popular facebookfan pages is “I love Sleep“. Yet, there are many among us who deprive ourselves of sleep for a variety of reasons. Many of the ailments that we complain of may actually be the result of lack of sleep.
Effect of sleep on memory consolidation is a subject of extensive research. The fact that sleep affects memory is pretty well established. Recent researches show that Non-REM sleep plays a mazor role in memory. REM sleep is “a stage of sleep characterized by rapid movements of the eye and low voltage fast pattern EEG. It is usually associated with dreaming”. While researches on the role of sleep on memory is ongoing, evidence has accumulated showing that all stages of sleep play some kind of role in memory. Medications or conditions affecting any of the stages of sleep could affect memory(1).
All prescriptions need to be oversee professionally, please keep in mind drug rehab facilities are always available for help and advice.
An interesting case related to sleep deprivation is Libby Zion Law in New York state in 1989. It stated that residents could not work more than 80 hours a week or more than 24 consecutive hours. Zion died from complications of serotonin syndrome which was caused by a combination of meperidine and phenelzine. At that time she was just 18 years old. The error apparently happened when two residents prescribed the drug meperidine for her symptoms(2). The sleep deprived and overworked residents allegedly made an error in evaluation. At that time “the residents were exonerated of all charges by a review panel with lay and physician representation after testimony of expert witnesses. Although the Commissioner of Health concurred with this verdict, residents were charged with gross negligence by the Board of Regents, a lay panel(2).”
Recent studies have shown reduced working memory capacity among internal medicine residents who were sleep deprived during a month of call rotations(3). So would’t it have been right to charge the people responsible for sleep deprivation among residents ? But in the not-so-ideal world that we live in, this is how things work. In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) common duty hour standards put a cap of 80 hours per week in resident training and a 24 hour limit on continuous duty time with an additional 6 hours to maintain continuity of care and education(4).
Sleep Deprivation on Pregnancy
Sleep deprivation during pregnancy could have negative effect onthe offspring. In a controlled experiment, conducted on pregnant Wistar rats to examine the effect of sleep deprivation onthe offspringof pregnant rats, it was found thatthe offspringfrom sleep deprived mothers had higher blood pressure and reduced renal development(5).Other studies have found higher risk of miscarriage among sleep deprived pregnant women(6).
Sleep Deprivation increases risk of Obesity and Diabetes
Experiments have shown that sleep deprivation impairs glucose tolerance by decreasing insulin sensitivity in healthy people. In a recent study, diabetic patients were tested once after a full night sleep ,and then next after a night of just 4 hours of sleep. Sleep deprived with just 4 hours of sleep, they showed increased insulin resistance the following day(7). This suggests that people with diabetes should be encouraged to get complete sleep as part of lifestyle changes to help maintain proper glucose control.
Studies have found that obese people report less sleep than those with normal body mass index.Though, this has not been true for the extremely obese ones with BMI > 40(8). These studies suggest investigating if lack of sleep could be one of the causes of obesity.
A Therapeutic Use of Sleep Deprivation
Sleep deprivation has proved to be a very powerful antidepressant showing antidepressant effect within hours in 40-60% of depressed patients.But in more than 80% of such patients, depression strikes again after the recovery night (9).
1. Rauchs G, Desgranges B, Foret J et al.The relationships between memory systems and sleep stages.J Sleep Res. 2005 Jun;14(2):123-40.
2. Spritz N.Oversight of physicians’ conduct by state licensing agencies. Lessons from New York’s Libby Zion case.Ann Intern Med. 1991 Aug 1;115(3):219-22.
3.Gohar A, Adams A, Gertner E et al.Working memory capacity is decreased in sleep-deprived internal medicine residents.J Clin Sleep Med. 2009 Jun 15;5(3):191-7.
4.ACGME Duty Hours Standards Fact Sheet.http://www.acgme.org/acWebsite/newsRoom/newsRm_dutyHours.asp Updated: No Update. Accessed Jan 31, 2011.
5.Thomal JT, Palma BD, Ponzio BF et al. Sleep restriction during pregnancy: hypertension and renal abnormalities in young offspring rats.Sleep. 2010 Oct 1;33(10):1357-62.
6. Samaraweera Y, Abeysena C.Maternal sleep deprivation, sedentary lifestyle and cooking smoke: Risk factors for miscarriage: A case control study.Aust N Z J Obstet Gynaecol. 2010 Aug;50(4):352-7.
7.Donga E, van Dijk M, van Dijk JG et al.Partial sleep restriction decreases insulin sensitivity in type 1 diabetes.Diabetes Care. 2010 Jul;33(7):1573-7.
8.Vorona RD, Winn MP, Babineau TW, Eng BP, Feldman HR, Ware JC.Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index.Arch Intern Med. 2005 Jan 10;165(1):25-30.
9.Hemmeter UM, Hemmeter-Spernal J, Krieg JC.Sleep deprivation in depression.Expert Rev Neurother. 2010 Jul;10(7):1101-15.
Last updated: Feb 2, 2011
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