Insufficient sleep syndrome

K K Jain MD (Dr. Jain is a consultant in neurology and has no relevant financial relationships to disclose.)
Originally released July 9, 1993; last updated July 18, 2017; expires July 18, 2017

This article includes discussion of insufficient sleep syndrome, chronic insufficient sleep, sleep deprivation, voluntary sleep curtailment, voluntary sleep reduction, and voluntary sleep restriction. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Sleep deprivation, or insufficient sleep syndrome, is a serious sleep problem of epidemic proportions. Outlined in this article are the causes, consequences, and management of sleep deprivation and ways of recognizing it. In this article, the author elaborates on the clinical manifestations of the condition and the negative consequences of insufficient sleep during pregnancy.

Key points

 

• Insufficient sleep syndrome is the most common cause of daytime sleepiness among the general population.

 

• This condition is due to insufficient duration of sleep nightly, resulting in daytime sleepiness.

 

• Insufficient sleep affects all systems of the body, but cognitive impairment, obesity, and diabetes are the most pronounced.

 

• Consequences of insufficient sleep syndrome are often under-recognized by the patient and include sleepiness, tiredness, fatigue, and irritability.

 

• Chronic sleep deprivation has been linked to increased risk of automobile and industrial accidents, declining job performance, and disrupted sociability.

 

• Treatment consists of extending nocturnal sleep time every day by 1 to several hours nightly.

Historical note and terminology

Insufficient sleep syndrome, also referred to as “chronic insufficient sleep,” “voluntary sleep curtailment,” “sleep reduction,” “sleep restriction,” “inadequate sleep,” or “sleep deprivation” was first recognized as a clinical syndrome in 1979 with its inclusion in the Diagnostic Classification of Sleep and Arousal Disorders (Association of Sleep Disorders Centers 1979). Sleep deprivation experiments were conducted more than a century ago in an attempt to understand the function of sleep. Since then, several studies have shown that neurologic function and cognition deteriorate during sleep loss, with reaction time, mood, and judgment suffering from being awake for too long. However, the first series of patients with insufficient sleep syndrome were reported in 1983. Prior to its identification, patients presenting with excessive daytime sleepiness, but having none of the accessory symptoms and signs of narcolepsy, received diagnoses of idiopathic hypersomnolence, NREM narcolepsy, a mood disorder, or were considered malingerers. In the International Classification of Sleep Disorders (ICSD-3), insufficient sleep syndrome is included in the section “Hypersomnias of central origin” (American Academy of Sleep Medicine 2014). Diagnostic criteria for idiopathic hypersomnia include lack of improvement of sleepiness after an adequate trial of increased nocturnal time in bed.

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