One of the most common and easily treatable health problems is sleep loss and sleep disruption. Ever tried being productive after tossing and turning an entire night? Sleep thus plays a critical role in ensuring our smooth and productive functioning on a daily basis but is often neglected. For instance, recently Rudresh Patil* a long-haul truck driver had to be rescued on a national highway, after his vehicle turned turtle. The reason for the accident? Lack of sleep as the trucker had tried to push himself with inadequate sleep to meet a delivery deadline, thus leading to an error in judgement. Luckily no one was seriously injured in the accident, but that always is not the case.

There are obviously both shortand long-term consequences – if sleep disruption is not treated – both for the individual and the society at large. The unfortunate bit is that, even a significant section of medical professionals still does not diagnose sleep disruption early enough, though that is fortunately changing fast. A number of scientific studies over the recent past have unearthed a series of medical problems which can be directly attributed to sleep disruption.

Amongst others, the National Centre for Biotechnology Information (NCBI) a prestigious scientific body in numerous research papers published on its website, points out, some of the most common medical conditions, which can be attributed to inadequate or disturbed sleep. These include memory issues, depression and anxiety, hypertension (blood pressure), weakened immunity, inability to think and concentrate (impairment of cognitive functions), Diabetes, Obesity, decreased fertility (low sex drive), heart attack and stroke, poor balance and coordination apart from other psychiatric disorders. Let us look at each of these challenges a little bit more in detail.

Weakened Immunity

When 39-year-old Sriranga Iyengar an start-up entrepreneur quit his cushy job to launch his own company, his family had a mix of trepidation as well as joy. They were worried about the loss of a regular high income which he used to get by working with a leading multinational but at the same happy that he could finally chase his dream of building a small accounting SaaS (Software As a Service) company. What they did not expect though was that within nine months of starting his own company, that Sriranga would repeatedly fall ill and would complain of abdominal pain, bloating and occasionally diarrhea.

After numerous tests failed to diagonise what was the cause for what he was undergoing, finally a family friend advised him to take it easy. In order to build and market the seven-member start-up the entrepreneur was taking on so much stress and anxiety that Sriranga most days could hardly sleep a few hours. The friend also advised him to consult a sleep therapist. The Doctor found that the symptoms Sriranga was experiencing were due to weakened immunity caused by inadequate sleep.

Sriranga’s health took a turn for the better ever since he got on board a cofounder who took on some of the tasks he was doing earlier, as well as infusing funds, which meant that he could now get a good night’s rest. This he says has improved his condition remarkably. “Cannot stress enough, how important 7-8 hours of proper sleep is for the body to recharge,” he now avers.

Risk factors for sleep disruption are vast and involve a combination of biological, psychological, genetic, and social factors

Depression and Anxiety

It has now been scientifically established that Melatonin often dubbed as the sleep hormone plays a vital role in maintaining the body’s sleep-wake cycle. 43-year-old Kalavathi who ran a saree retailing store in Chennai had never heard of Melatonin until recently. The single mother of two school aged children, went into a depression after she could not open her shop due to the Covid-19 pandemic related restrictions. After exhausting her meagre savings, Kalavathi became anxious on how she would support herself and her children.

Due to this she was hardly able to sleep. “If I am not able to sell sarees which I source from the weavers, I don’t make money and I have rent, food, online school fee, water, power and numerous other bills to pay. Anxious and depressed, I had become irritable and would often snap or beat my children for small reasons. Later on I would regret it and have a panic attack. While I would lay on my bed for hours, I could hardly catch a wink. I would get up feeling lethargic.”

After a physician examined her and prescribed a dietary supplement which had melatonin, Kalavathi says she is now able to function better as she now gets relatively sound sleep. Also now she has started a website as well as a telegram group through which she has been able to generate some sales. ‘It is early days yet and mentally I am in a better place than before. But I never realised that lack of sleep could create so many problems.

Hypertension and Diabetes

India is considered the diabetes capital of the world with a third of the global population suffering from this disease resident here. Both hypertension and diabetes come under the category of life style disease. A number of scientific studies have shown how the quantum of insulin produced in the body as well as processing of glucose is directly related to the number of hours that person sleeps. This is specially true in the case of Type 2 diabetes which is widely prevalent and can be addressed with changes in lifestyle including getting enough number of hours of shut-eye.

Similar experiments have been carried out on long-term sleep disruption leading to elevated levels of hypertension. Less than five hours of sleep on a daily basis for even a few days has shown results of increased blood pressure as a body coping mechanism. An associated and related risk has been observed that sleep disruption also can lead to greater risk of heart disease as higher levels of chemicals in the body leads to inflammation, which is an accentuating factor.

Decreased fertility and low-sex drive

Just like other facets of life, a healthy sex life is key to good physical and mental health. Dr Angana Chakraborty a sexpert says that it has been repeatedly observed that people who don’t get adequate sleep have a lower libido or sex-drive. Particularly in the case of men this has been linked to lower production and consequent levels of testosterone being present.

Dr Chankraborty says that when couples reach out to her to discuss why they are unable to conceive, in a large number of cases, she diagnoses that at least one of the partners is not getting adequate quantity or quality of sleep. “If you are wondering what has sleep got to do with libido, please remember that the same part of brain that controls our circadian rhythms also controls and regulates the release of reproductive hormones. In men disturbed sleep can lead to lower levels of testosterone and in the case of women the hormones which trigger ovulation might not be doing their job.”

The doctor says that to have a satisfactory sex life, good sleep is thus a very important need.

Short-term consequences of sleep disruption include increased stress responsivity; somatic problems; reduced quality of life (QoL); emotional distress; mood disorders and other mental health problems; cognition, memory, and performance deficits; and behavior problems in otherwise healthy individuals

Reduced cognitive functions

Our motor skills and ability to process information is fully functional only when one has had a good night’s rest. Which is why authorities across the world say that never to drive or take any key decision when one is sleep-deprived. Some of the most serious accidents across the globe happens due to sleep disruption which cause our cognitive functions to take a hit. A senior highway patrol officer says that a large number of accidents happen things like balance and coordination at night times because several of the drivers would not have had adequate sleep.

If there is sleep disruption then our ability to make the right decision gets impaired as we experience fatigue, irritability, a kind of mental fog and inability to focus or concentrate. Even the most basic anatomical things like balance and coordination get reduced when we have had less sleep.

Our response time to events is also larger than usual. Sometimes the body might respond by taking involuntary microsleeps. This might lead to more errors of omission and commission.

Memory issues

Sleep is key for enabling our brains to retain memories. It is during sleep that our brains form connections that helps one to process and remember new information. So any kind of negative impact on sleeping patterns whether in terms of quantity or quality has a immediate bearig both on short and long term memory formation.

Number of controlled experiments have been carried out to scientifically show that there is greater retention of memory immediately after a experimental subject gets adequate sleep. The converse has also been found to be true from similar studies carried out where subjects experienced memory issues if they were deprived of sleep.

Obesity and weight gain

Another cause of concern has been obesity which is linked to numerous diseases. It has been observed that test subjects whose sleep was disrupted gained weight. Scientists have explained that this is due to the fact that when people are sleep deprived the chemicals which signal to the brain that we are full is off-kilter. Those chemicals are produced by the body when we are asleep.

Which in reality means that the brain does not get the message that we have eaten according to our need and thus we over-eat leading to weigh gain. Obesity is an epidemic which is sweeping large parts of the globe points out Dr Chakrobarty specially in the more developed parts of the world as they are the ones also experiencing the most sleep disruption.

Lack of sleep leads to greater production of a stress hormone called Cortisol. “When we are stressed we tend to eat emotionally and this leads to poor nutritional habits. The stomach also produces another horomone called gherlin. When a person is sleep deprived or their sleep is disrupted, excess amount of gherlin is produced which makes them ever more hungrier, leading to a vicious cycle of overeating,” says Dr Chakrobarty. She also says that insomania and obesity are inter-linked and are causative factors which feed into one another.

Even some skin related problems like breaking out in rashes have been attributed to elevated levels of stress brought on by inadequate sleep.

Mood swings and psychiatric disorders

Sleep disruption leads an individual to become moody, irritable, emotional and quick-tempered. There can be violent mood swings if there is sustained periods of sleep disruption.

Some may even suffer from paronia and hallucinations, with some medical professionals saying that long term effect of lack of sleep may lead to even schizophrenia.

While each of us react to sleep deficits in various ways and there is no single answer, it is increasing clear that there is some impact which may include some or all of the above mentioned symptoms being exhibited. Modern medicine has therefore taken a proactive approach in ensuring proper diagnosis of sleep related problems. Several of health related challenges from the relatively minor like a rash on the skin to life threatning ones can be effectively treated by addressing the root cause of the issue.