27 horrible things that happen if you don't get enough sleep
Many people might think they can get by with a short amount of sleep during the week - maybe making up for it on the weekend - but those people might be surprised by just how serious a problem sleep loss really is.
Even though the NIH recommends that adults get seven to nine hours of shuteye a night, many of us get far less. Teens and younger kids need even more sleep.
Up to 70 million Americans have a sleep disorder, according to officials at the CDC, who suggest that the current status of how much we sleep is bad enough be a public health problem.
Here are 27 unfortunate risks of partial and total sleep deprivation, some more common than others.
1. Short term memory and learning problems
Sleepiness has long been a problem for students. One study of middle school kids found that "delaying school start times by one hour, from roughly 7:30 to 8:30, increases standardized test scores by at least 2 percentile points in math and 1 percentile point in reading." Sleep researchers say that teens, who naturally tend to become night owls, suffer even more from early start times.
But it's not just kids. Sleep deprivation also wrecks adults' short-term memory, according to one study that found cutting sleep short significantly impaired the ability of adult volunteers to remember words they'd been shown the day before. In another study, researchers found that while people tend to improve on a task when they do it more than once, this isn't true if they are kept awake after they try it the first time - even if they sleep again before doing it again.
Source: Nature, 1999; Nature Neuroscience, 2000; Education Next, 2012
2. Irritability
"Complaints of irritability and [emotional] volatility following sleepless nights" are common, a team of Israeli researchers observed. They put those complaints to the test by following a group of sleep-deprived medical residents. The study found that the negative emotional effects of disruptive events - things like being interrupted while in the middle of doing something - were amplified by sleep loss.
Source: Sleep, 2005
3. Skin aging
Poor sleep quality is strongly correlated to chronic skin problems, according to some research out of the University of Wisconsin. Other research has shown that people who don't sleep well or sleep five hours a night or less have a harder time recovering from skin damage caused by ultraviolet light exposure and by having tape taken off of their skin. When researchers compared those participants to people who slept well, they found more signs of skin aging in poor sleepers.
Source: Clinical and Experimental Dermatology, 2015; Cutis, 2008
4. Weight gain and impulse control problems
People who don't get enough sleep have a harder time resisting high-calorie foods, more cravings for unhealthy meals, and a hard time controlling their impulses. Researchers think going without sleep causes hormonal imbalances that are responsible for this, imbalances they link to a high body mass index and obesity.
Source: Journal of Clinical Endocrinology & Metabolism, 2012; PLOS Medicine, 2004; Nature Communications, 2013; PNAS, 2013
5. Alzheimer's-linked toxin build-up in the brain
One 2015 study found that sleep helps cleanse the brain of the beta-amyloid protein that can build up while you are awake. That protein is strongly associated with Alzheimer's disease, and researchers say that this process can lead to a vicious cycle, since the more beta-amyloid there is in the brain, the harder it is to get to a cleansing deep sleep state.
Source: Nature Neuroscience, 2015
6. Vision problems
Sleep deprivation is associated with tunnel vision, double vision, and dimness. The longer you are awake, the more visual errors you'll encounter, and the more likely you are to experience outright hallucinations.
Source: International Journal of Occupational Medicine and Environmental Health, 2010
7. Heart disease risk
When researchers kept people awake for 88 hours, their blood pressure went up - no big surprise there. But even subjects who were allowed to sleep for 4 hours a night had an elevated heart rate when compared to those getting 8 hours. Concentrations of C-reactive protein, a marker of heart disease risk, increased in those fully and partially deprived of sleep.
Source: Journal of the American College of Cardiology, 2004; PLOS ONE, 2009; Sleep Medicine Reviews, 2012
8. Slowed reactions
Your reaction time is severely impeded when you don't get enough sleep. When researchers gave West Point cadets two tests that require quick decision-making, some were allowed to sleep between the tests, while others were not. Those who had slept did better the second time - those who had not did worse, and their reactions slowed down. A study in college athletes found similar results.
Source: Sleep, 2009; Asian Journal of Sports Medicine, 2012
9. Immune system issues
You know that great thing your immune system does, where when you get an open wound of some kind it doesn't always get infected immediately? Prolonged sleep deprivation and even one night of sleeplessness can impede your body's natural defenses against infection.
In another small study that showed sleep deprivation can make vaccines less effective, 19 people were vaccinated against Hepatitis A. Ten of them got 8 hours of sleep the following night, while the rest pulled an all-nighter. Four weeks later, those who had slept normally had levels of Hepatitis A antibodies almost twice as high as those who'd been kept awake.
Source: American Journal of Physiology, 1993; The FASEB Journal, 1996; Journal of Immunology, 2011
10. Bad decision-making in ways that put lives and finances in danger
Planning to make some changes to your portfolio? You might want to make sure you're well-rested. "A single night of sleep deprivation evoked a strategy shift during risky decision making such that healthy human volunteers moved from defending against losses to seeking increased gains," researchers concluded.
Other researchers have found that severe sleep deprivation impairs people's ability to follow pre-established procedures for making a "go" or "no-go" decision, something that researchers say contributed to the space shuttle Challenger explosion, the Chernobyl meltdown, and the Exxon Valdez disaster.
Source: The Journal of Neuroscience, 2011; Sleep, 2015
11. Overproduction of urine
When people sleep, the body slows down its normal urine production. This is why most people don't have to pee in the night as much as they do during the day. But when someone is sleep deprived, this normal slowdown doesn't happen, leading to what researchers call "excess nocturnal urine production." This condition may be linked to bed wetting in children and, in adults, it's tied to what's called nocturia - the need to use the bathroom many times during the night.
Source: American Journal of Physiology, 2010; American Journal of Physiology, 2012
12. Distractedness
Having trouble paying attention to what you're reading or listening to? Struggling with anything that requires you to truly focus? "Attention tasks appear to be particularly sensitive to sleep loss," researchers have noted. If you want to stay alert and attentive, sleep is a requirement. Otherwise, you enter "an unstable state that fluctuates within seconds and that cannot be characterized as either fully awake or asleep," and your ability to pay attention is variable at best.
Source: Archives of Italian Biology, 2001; Seminars in Neurology, 2009
13. Trouble speaking normally
Severe sleep deprivation seems to affect your ability to carry on a conversation - much like having way too much to drink. "Volunteers kept awake for 36 hours showed a tendency to use word repetitions and clichés; they spoke monotonously, slowly, [and] indistinctly," one study noted. "They were not able to properly express and verbalize their thoughts."
Source: Sleep, 1997; International Journal of Occupational Medicine and Environmental Health, 2010
14. Colds
If you're wondering why you're sick all the time and seem to pick up every bug that travels around the office, it's probably because you're not getting enough sleep. When a group of 153 people were exposed to a common cold, those who had gotten less than 7 hours of sleep in the two weeks prior were almost 3 times more likely to get sick than those who'd had 8 or more hours of sleep. How well you sleep is also a factor - those who had spent 92% of their time in bed actually asleep were 5.5 times more likely to catch a cold than those who had been peacefully slumbering 98-100% of the time they were in bed.
Source: Archives of Internal Medicine, 2009
15. Muscle atrophy
Lack of sleep causes hormonal changes that make it harder for your body to build muscle and heal. This makes it harder to recover from the muscle damage caused by exercise and worsens conditions related to muscle atrophy. Other research has also shown the reverse - your body releases growth hormone and heals damage during sleep, which is why fitness advocates will always point out that sleep is an essential for getting into shape.
Source: Medical Hypotheses, 2011; International Journal of Endocrinology, 2010
16. Car accidents
Drowsy driving is often compared to drunk driving: You really shouldn't do either. "Motor vehicle accidents related to fatigue, drowsy driving, and falling asleep at the wheel are particularly common, but often underestimated," one review concluded. Pilots, truck drivers, medical residents, and others required to stay awake for long periods of time "show an increased risk of crashes or near misses due to sleep deprivation."
Source: Seminars in Neurology, 2009
17. Depleted sex drive and function
Testosterone is an important component of sexual drive and desire in both women and men. Sleeping increases testosterone levels, while being awake decreases them. Sleep deprivation and disturbed sleep, consequently, are associated with reduced libido and sexual dysfunction, and people suffering from sleep apnea are at particular risk.
Source: American Journal of Obstetrics and Gynecology, 2007; Behavioral Brain Research, 2009; Journal of Sexual Medicine, 2009; Sleep Medicine, 2010; Brain Research, 2011
18. Pain
People in pain - especially those suffering from chronic pain - tend not to get enough sleep. This makes sense: Pain can wake you up in the night and make it hard to fall asleep in the first place. But recently, researchers have begun to suspect that sleep deprivation may actually cause pain or at least increase people's sensitivity to pain. One study found that after research subjects were kept awake all night, their pain threshold - the amount of painful stimulus they were able to endure - was lower.
Source: Journal of Sleep Research, 2001; Sleep Medicine Reviews, 2006
19. Type-2 diabetes risk - even for non-overweight people
Being awake when your body wants you to be asleep messes with your metabolism, which in turn increases your risk for insulin resistance (often called "pre-diabetes") and type 2 diabetes. "Interventions to extend sleep duration may reduce diabetes risk," one study in adolescents concluded. And four large studies in adults found a strong association - though not a cause-effect relationship - between regular sleep loss and the risk of developing diabetes, even after controlling for other habits that might be relevant.
Source: Journal of Applied Physiology, 2005; Sleep, 2012; Annals of Internal Medicine, 2012
20. Clumsiness
Most people notice that when they're sleepy, they're not at the top of their game. One study found that one sleepless night contributed to a 20-32% increase in the number of errors made by surgeons. People playing sports that require precision - shooting, sailing, cycling, etc. - also make more mistakes when they've been awake for extended periods of time.
Source: The Lancet, 1998; Physiology & Behavior, 2007
21. Cancer risk
Scientists are just beginning to investigate the relationship between sleep and cancer, and different kinds of cancer behave differently. But since disrupted circadian rhythm and reduced immunity are direct results of sleep deprivation, it's no surprise that preliminary research seems to indicate that people who don't get enough sleep are at increased risk for developing certain kinds of cancer, most notably colon and breast cancers.
Source: Journal of the National Cancer Institute, 2003; Pathologie-biologie, 2003; Cancer, 2011; AAOHN Journal, 2011
22. Memory problems
Sleep disruptions in the elderly can lead to structural changes in the brain that are associated with impaired long-term memory - and sleep-related memory deficits have been observed in the general adult population as well. As early as 1924, researchers noticed that people who slept more forgot less.
Source: Cell Signal, 2012; Nature Neuroscience, 2013; JAMA Neurology, 2013
23. Genetic disruption
A 2013 study shed some light on why sleep is tied to so many different aspects of our health and wellness. Poor sleep actually disrupts normal genetic activity. After one week of sleeping less than 6 hours per night, researchers found that more than 700 genes were not behaving normally, including some that help govern immune and stress responses.
Some genes that typically cycle according to a daily (circadian) pattern stopped doing so, while others that don't normally follow a daily pattern began doing so. What does this mean? Just one week of less-than-ideal sleep is enough to make some of your genetic activity go haywire.
Source: Proceedings of the National Academy of Sciences, 2013
24. Unhappiness and depression
In a classic study led by Nobel Prize-winning psychologist Daniel Kahneman, a group of 909 working women kept detailed logs of their moods and day-to-day activities. While differences in income up to $60,000 had little effect on happiness, a poor night's sleep was one of two factors that could ruin the following day's mood. (The other was tight deadlines at work.)
Another study reported higher marital happiness among women with more peaceful sleep, although it's hard to say whether happy people sleep better, better sleep makes people happier, or - most likely - some combination of the two. Insomniacs are also twice as likely to develop depression, and preliminary research suggests that treating sleep problems may successfully treat depressive symptoms.
Source: Science, 2004; Behavioral Sleep Medicine, 2009; Journal of Affective Disorders, 2011
25. Gastrointestinal Problems
One in 250 Americans suffer from Inflammatory Bowel Disease (IBD), and sleep deficiencies make its symptoms much worse. Regular sleep loss also makes you more likely to develop both IBD and inflammatory bowel syndrome, which affects an estimated 10-15% of people in the U.S. And patients with Crohn's disease were twice as likely to experience a relapse when they weren't getting enough sleep.
Source: World Journal of Gastroenterology, 2013
26. Headaches
Scientists don't yet know exactly why sleep deprivation leads to headaches - but it's a connection doctors have noticed for more than a century. Migraines can be triggered by sleepless nights, and 36 to 58% of people with sleep apnea wake up with "nondescript morning headaches."
Source: Headache, 2003; Headache, 2005
27. Death
Many health problems are associated with sleep deprivation and poor sleep, but here's the big one: People who consistently do not get 7-8 hours of sleep are more likely to die during a given time period. Put more simply: We all die eventually, but sleeping too little - or even too much - is associated with a higher risk of dying sooner than you otherwise might.
Source: Sleep, 2010; Sleep Medicine Reviews, 2010
This is an updated version of a post originally by Lauren Friedman.