how to start an essay about sleep deprivation

89 Sleep Deprivation Essay Topic Ideas & Examples

🏆 best sleep deprivation topic ideas & essay examples, 📌 simple & easy sleep deprivation essay titles, 👍 good essay topics on sleep deprivation, ❓ sleep deprivation research questions.

• Problem of Sleep Deprivation This is due to disruption of the sleep cycle. Based on the negative effects of sleep deprivation, there is need to manage this disorder among Americans.
• How Sleep Deprivation Affects College Students’ Academic Performance The study seeks to confirm the position of the hypothesis that sleep deprivation leads to poor academic performance in college students. We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
• Effects of Sleep Deprivation While scientists are at a loss explaining the varying sleeping habits of different animals, they do concede that sleep is crucial and a sleeping disorder may be detrimental to the health and productivity of a […]
• The Issue of Chronic Sleep Deprivation The quality of sleep significantly impacts the health and performance of the human body. These findings point to significant promise for the use of exercise in the treatment of sleep disorders, but a broader body […]
• The Influence of Sleep Deprivation on Human Body It contradicts living in harmony with God, as when the person is irritated and moody, it is more difficult to be virtuous and to be a source of joy for others.
• Sleep Deprivation and Insomnia: Study Sources The topic of this audio record is a variety of problems with sleep and their impact on an organism. They proved the aforementioned conclusion and also paid attention to the impact of sleep deprivation on […]
• Neurocognitive Consequences of Sleep Deprivation The CNS consists of the brain and the spinal cord while the PNS consists of all the endings of the nerve extensions in all organs forming the web that extends throughout the entire organ.
• “Childbirth Fear and Sleep Deprivation in Pregnant Women” by Hall To further show that the information used is current, the authors have used the APA style of referencing which demand the naming of the author as well as the year of publication of the article/book […]
• Sleep Deprivation and Learning at University It is a widely known fact that numerous people face the problem of lack of sleep. Second, sleeping is essential for increasing the productivity of students in the context of learning.
• Sleep Deprivation: Biopsychology and Health Psychology Another theory that has been proposed in relation to sleep is the Circadian theory which suggests that sleep evolved as a mechanism to fit organisms into the light dark cycle of the world.
• Sleep Disorders: Sleep Deprivation of the Public Safety Officers The effects of sleep disorders and fatigue on public safety officers is a social issue that needs to be addressed with more vigor and urgency so that the key issues and factors that are salient […]
• Sleep Deprivation: Personal Experiment As I had been perplexed, I did not take a step of reporting the matter to the police neither did I inform my neighbors.
• Sleep Deprivation: Research Methods The purpose of the research will be to determine sleep deprivation, what causes it, the effect, and why sleep is important.
• Sleep Deprivation and Specific Emotions The purpose of this study is to develop an understanding of the relationship between sleep deprivation and emotional behaviors. The study looks to create a link between the findings of past researches on the emotional […]
• Sleep Deprivation Impacts on College Students Additional research in this field should involve the use of diverse categories of students to determine the effects that sleep deprivation would have on them.
• What Are The Effects Of Sleep Deprivation For Paramedics
• The Innate Immune System During Sleep Deprivation
• Sleep Deprivation Negatively Influences Driving Performance
• What Effect Does Sleep Deprivation Have on Physiological and Cognition
• Sleep Deprivation And Its Effects On The Lives And Culture Of Different
• The Correlation Between Sleep Deprivation And Academic Performance
• The Importance of Sleep and the Health Impact of Sleep Deprivation in Humans
• Effects of Sleep Deprivation on the Academic Performance of DLSL Account
• The Effects Of Sleep Deprivation Among College Students
• The Dangers and Effects of Sleep Deprivation Among Nurses and the Ways to Prevent the Sleep-Related Problem
• Sleep Deprivation and its Affects on Daily Performances
• The Body Of Knowledge Regarding Adolescent Sleep Deprivation
• Poor Performance in School/Work as a Consequence of Sleep Deprivation
• The Fascinating World of Sleep and the Effects of Sleep Deprivation
• Symptoms And Treatment Of Sleep Deprivation
• Sleep Deprivation And Aggression Among College Students
• The Effects Of Sleep Deprivation On Academic Performance
• Sleep Deprivation On Eating And Activity Behaviors
• Sleep Deprivation: What Causes The Sleeplessness And How Long It Lasts
• The Relationship Between Sleep Deprivation And The Human Body
• Students And Chronic Sleep Deprivation: How School Start Times Can Impact This
• What is Sleep and the Effects of Sleep Deprivation
• Several Health and Behavioral Symptoms of Sleep Deprivation
• Sleep Deprivation, Nightmares, And Sleepwalking
• The Factors That Contribute to Sleep Deprivation and Its Effects on the Sleep Cycle
• The Dangers Of Teen Sleep Deprivation: Benefits Of Adopting Later Start Times For High Schools
• The Issue of Sleep Deprivation, Its Results and Associated Risks
• The Negative Effects of Sleep Deprivation in Human Beings
• The Stages of Sleep and the Effects of Sleep Deprivation
• The Negative Effects of Sleep Deprivation to Mental and Physical Health
• Effects Of Sleep Deprivation On One’s Performance And Function
• How Sleep Deprivation Can Effect Weightlifting Performance
• The Causes of Sleep Deprivation in America: a Nation of Walking Zombies
• The Sleep Deprivation Epidemic Is Affecting Teenagers
• Sleep Matters: The Human Condition in the Midst of Sleep Deprivation
• Sleep Deprivation : The Brain Function And Physical Body
• Sleep Deprivation And Reduction, Sleep Disorders, And The Drugs Used To Treat Them
• The Effects of Total Sleep Deprivation on Bayesian Updating
• The Negative Effects of Sleep Deprivation Among Teens and the Solutions to the Problem
• Light Pollution, Sleep Deprivation, and Infant Health at Birth
• The Effects Of Food And Sleep Deprivation During Civilian
• The Study of Rechtschaffen (1983) on Sleep Deprivation
• How Sleep Deprivation Affects Psychological Variables Related to College Students Cognitive Performance
• Sleep Deprivation : Sleep And The Adverse Effects Of Sleep Disorders
• How Does Sleep Deprivation Affect Psychological Health?
• What Effect Does Sleep Deprivation Have on Physiology and Cognition?
• How Does Lack of Sleep Affect Physical Health?
• Does Sleep Deprivation Significantly Interfere With Driving?
• How Does Sleep Deprivation Affect Psychological Variables Related to College Students’ Cognitive Performance?
• Are the Brains’ Motor Function Affected by Sleep Deprivation?
• How Does Sleep Deprivation Affect Work Performance?
• Does Sleep Deprivation Effect College Students’ Academic Performance?
• How Does Sleep Deprivation Affect Cognitive Functions?
• Does Too Much Homework Cause Sleep Deprivation?
• How Can Sleep Deprivation Effect Weightlifting Performance?
• What Are the Effects of Sleep Deprivation for Paramedics?
• How Does Sleep Deprivation Lead to Cardiovascular Disease?
• What Are the Symptoms of Sleep Deprivation?
• How Does Sleep Deprivation Affect Health?
• Can Sleep Problems in Patients With Parkinson’s Disease Be About Serotonin?
• How Common Are Sleep Problems in Teenagers?
• What Are the Criteria to Classify Mild, Moderate, and Severe Sleep Deprivation in Humans?
• How to Measure Sleep and Insomnia in Adult Video Gamers?
• What Are the Physiological and Psychological Effects on Sleep of Electronics in the Bedroom?
• Is Bipolar Disease a Sleep Regulation Disorder?
• What Is the Scale on Sleep Deprivation?
• How Does Lack Sleep Affect Physical Health?
• Does Sleep Deprivation Induce by Reward Rather Than Punishment Result in Different Effects?
• How Does Lack of Sleep Affect the Ability to Concentrate, Think and Learn?
• What Are the Main Types of Sleep Disorders?
• Can a Person either Become Sick or Die After Complete Sleep Deprivation?
• What Are Problems Can Sleep Deprivation Lead To?
• Does Sleep Deprivation Cause Permanent Brain Damage?
• How Long Does It Take to Reverse Sleep Deprivation?
• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2024, February 29). 89 Sleep Deprivation Essay Topic Ideas & Examples. https://ivypanda.com/essays/topic/sleep-deprivation-essay-topics/

"89 Sleep Deprivation Essay Topic Ideas & Examples." IvyPanda , 29 Feb. 2024, ivypanda.com/essays/topic/sleep-deprivation-essay-topics/.

IvyPanda . (2024) '89 Sleep Deprivation Essay Topic Ideas & Examples'. 29 February.

IvyPanda . 2024. "89 Sleep Deprivation Essay Topic Ideas & Examples." February 29, 2024. https://ivypanda.com/essays/topic/sleep-deprivation-essay-topics/.

1. IvyPanda . "89 Sleep Deprivation Essay Topic Ideas & Examples." February 29, 2024. https://ivypanda.com/essays/topic/sleep-deprivation-essay-topics/.

Bibliography

IvyPanda . "89 Sleep Deprivation Essay Topic Ideas & Examples." February 29, 2024. https://ivypanda.com/essays/topic/sleep-deprivation-essay-topics/.

• Sleep Research Topics
• Insomnia Questions
• Dreaming Essay Titles
• Sleep Disorders Research Topics
• Postpartum Depression Paper Topics
• Caffeine Paper Topics
• Mental Disorder Essay Topics
• Disability Essay Topics
• Bipolar Disorder Research Ideas
• Disease Questions
• Disorders Ideas
• Biomedicine Essay Topics
• Chronic Pain Research Ideas
• Hyperactivity Disorder Research Ideas
• Dementia Research Ideas

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Heart-Healthy Living
• High Blood Pressure
• Sickle Cell Disease
• Sleep Apnea
• Information & Resources on COVID-19
• The Heart Truth®
• Learn More Breathe Better®
• Blood Diseases and Disorders Education Program
• Publications and Resources
• Blood Disorders and Blood Safety
• Sleep Science and Sleep Disorders
• Lung Diseases
• Health Disparities and Inequities
• Heart and Vascular Diseases
• Precision Medicine Activities
• Obesity, Nutrition, and Physical Activity
• Population and Epidemiology Studies
• Women’s Health
• Research Topics
• Clinical Trials
• All Science A-Z
• Grants and Training Home
• Policies and Guidelines
• Funding Opportunities and Contacts
• Training and Career Development
• Email Alerts
• NHLBI in the Press
• Research Features
• Past Events
• Upcoming Events
• Mission and Strategic Vision
• Divisions, Offices and Centers
• Advisory Committees
• Budget and Legislative Information
• Jobs and Working at the NHLBI
• Contact and FAQs
• NIH Sleep Research Plan
• < Back To Sleep Deprivation and Deficiency
• How Sleep Affects Your Health
• What Are Sleep Deprivation and Deficiency?
• What Makes You Sleep?
• How Much Sleep Is Enough
• Healthy Sleep Habits

MORE INFORMATION

Sleep Deprivation and Deficiency How Sleep Affects Your Health

Language switcher.

Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.

How do I know if I’m not getting enough sleep?

Sleep deficiency can cause you to feel very tired during the day. You may not feel refreshed and alert when you wake up. Sleep deficiency also can interfere with work, school, driving, and social functioning.

How sleepy you feel during the day can help you figure out whether you're having symptoms of problem sleepiness.

You might be sleep deficient if you often feel like you could doze off while:

• Sitting and reading or watching TV
• Sitting still in a public place, such as a movie theater, meeting, or classroom
• Riding in a car for an hour without stopping
• Sitting and talking to someone
• Sitting quietly after lunch
• Sitting in traffic for a few minutes

Sleep deficiency can cause problems with learning, focusing, and reacting. You may have trouble making decisions, solving problems, remembering things, managing your emotions and behavior, and coping with change. You may take longer to finish tasks, have a slower reaction time, and make more mistakes.

Symptoms in children

The symptoms of sleep deficiency may differ between children and adults. Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave, and their school performance can suffer.

Sleep-deficient children may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation.

Sleep and your health

The way you feel while you're awake depends in part on what happens while you're sleeping. During sleep, your body is working to support healthy brain function and support your physical health. In children and teens, sleep also helps support growth and development.

The damage from sleep deficiency can happen in an instant (such as a car crash), or it can harm you over time. For example, ongoing sleep deficiency can raise your risk of some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others.

Mental health benefits

Sleep helps your brain work properly. While you're sleeping, your brain is getting ready for the next day. It's forming new pathways to help you learn and remember information.

Studies show that a good night's sleep improves learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative.

Studies also show that sleep deficiency changes activity in some parts of the brain. If you're sleep deficient, you may have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change. Sleep deficiency has also been linked to depression, suicide, and risk-taking behavior.

Children and teens who are sleep deficient may have problems getting along with others. They may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation. They also may have problems paying attention, and they may get lower grades and feel stressed.

Physical health benefits

Sleep plays an important role in your physical health.

Good-quality sleep:

• Heals and repairs your heart and blood vessels.
• Helps support a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin): When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you're well-rested.
• Affects how your body reacts to insulin: Insulin is the hormone that controls your blood glucose (sugar) level. Sleep deficiency results in a higher-than-normal blood sugar level, which may raise your risk of diabetes.
• Supports healthy growth and development: Deep sleep triggers the body to release the hormone that promotes normal growth in children and teens. This hormone also boosts muscle mass and helps repair cells and tissues in children, teens, and adults. Sleep also plays a role in puberty and fertility.
• Affects your body’s ability to fight germs and sickness: Ongoing sleep deficiency can change the way your body’s natural defense against germs and sickness responds. For example, if you're sleep deficient, you may have trouble fighting common infections.
• Decreases   your risk of health problems, including heart disease, high blood pressure, obesity, and stroke.

Research for Your Health

NHLBI-funded research found that adults who regularly get 7-8 hours of sleep a night have a lower risk of obesity and high blood pressure. Other NHLBI-funded research found that untreated sleep disorders rase the risk for heart problems and problems during pregnancy, including high blood pressure and diabetes.

Daytime performance and safety

Getting enough quality sleep at the right times helps you function well throughout the day. People who are sleep deficient are less productive at work and school. They take longer to finish tasks, have a slower reaction time, and make more mistakes.

After several nights of losing sleep — even a loss of just 1 to 2 hours per night — your ability to function suffers as if you haven't slept at all for a day or two.

Lack of sleep also may lead to microsleep. Microsleep refers to brief moments of sleep that happen when you're normally awake.

You can't control microsleep, and you might not be aware of it. For example, have you ever driven somewhere and then not remembered part of the trip? If so, you may have experienced microsleep.

Even if you're not driving, microsleep can affect how you function. If you're listening to a lecture, for example, you might miss some of the information or feel like you don't understand the point. You may have slept through part of the lecture and not realized it.

Some people aren't aware of the risks of sleep deficiency. In fact, they may not even realize that they're sleep deficient. Even with limited or poor-quality sleep, they may still think they can function well.

For example, sleepy drivers may feel able to drive. Yet studies show that sleep deficiency harms your driving ability as much or more than being drunk. It's estimated that driver sleepiness is a factor in about 100,000 car accidents each year, resulting in about 1,500 deaths.

Drivers aren't the only ones affected by sleep deficiency. It can affect people in all lines of work, including healthcare workers, pilots, students, lawyers, mechanics, and assembly line workers.

Lung Health Basics: Sleep

People with lung disease often have  trouble sleeping. Sleep is critical to overall health, so take the first step to sleeping better: learn these sleep terms, and find out about treatments that can help with sleep apnea.

• See All Locations
• Primary Care
• Urgent Care Facilities
• Emergency Rooms
• Surgery Centers
• Medical Offices
• Imaging Facilities
• Browse All Specialties
• Diabetes & Endocrinology
• Digestive & Liver Diseases
• Ear, Nose & Throat
• General Surgery
• Neurology & Neurosurgery
• Obstetrics & Gynecology
• Orthopaedics
• Pain Medicine
• Pediatrics at Guerin Children’s
• Urgent Care
• Medical Records Request
• Insurance & Billing
• Pay Your Bill
• Advanced Healthcare Directive
• Initiate a Request
• Help Paying Your Bill

Sleep Deprivation

What is sleep deprivation.

Sleep deprivation means you’re not getting enough sleep. For most adults, the amount of sleep needed for best health is 7 to 8 hours each night.

When you get less sleep than that, as many people do, it can eventually lead to many health problems. These can include forgetfulness, being less able to fight off infections, and even mood swings and depression.

What causes sleep deprivation?

Sleep deprivation is not a specific disease. It's usually the result of other illnesses or from life circumstances.

Sleep deprivation is becoming more common. Many people try to adjust their schedule to get as much done as possible, and sleep is sacrificed.

Sleep deprivation also becomes a greater problem as people grow older. Older adults probably need as much sleep as younger adults, but they typically sleep more lightly. They also sleep for shorter time spans than younger people. Half of all people older than 65 have frequent sleeping problems.

Sleep deprivation can occur for a number of reasons:

• Sleep disorder. These include insomnia, sleep apnea, narcolepsy, and restless legs syndrome.
• Aging. People older than 65 have trouble sleeping because of aging, medicine they’re taking, or health problems they’re having.
• Illness. Sleep deprivation is common with depression, schizophrenia, chronic pain syndrome, cancer, stroke, and Alzheimer disease.
• Other factors. Many people have occasional sleep deprivation for other reasons. These include stress, a change in schedule, or a new baby disrupting their sleep schedule.

What are the symptoms of sleep deprivation?

At first, sleep deprivation may cause minor symptoms. But over time, these symptoms can become more serious.

Early sleep deprivation symptoms may include:

• Inability to concentrate
• Memory problems
• Less physical strength
• Less ability to fight off infections

Sleep deprivation problems over time may include:

• Increased risk for depression and mental illness
• Increased risk for stroke and asthma attack
• Increased risk for potentially life-threatening problems. These include car accidents, and untreated sleep disorders such as insomnia, sleep apnea, and narcolepsy.
• Hallucinations
• Severe mood swings

How is sleep deprivation diagnosed?

Sleep specialists say that one of the telltale signs of sleep deprivation is feeling drowsy during the day. In fact, even if a task is boring, you should be able to stay alert during it if you are not sleep-deprived. If you often fall asleep within 5 minutes of lying down, then you likely have severe sleep deprivation. People with sleep deprivation also have “microsleeps.” These are brief periods of sleep during waking time. In many cases, sleep-deprived people may not even be aware that they are having these microsleeps.

If you have any of these warning signs listed above, see your doctor or ask for a referral to a sleep specialist. Your doctor will ask you detailed questions to get a better sense of the nature of your sleeping problems.

In some cases, if your doctor thinks you have a more serious and possibly life-threatening sleep disorder such sleep apnea, then the sleep specialist may do a test called a sleep study (polysomnography). This test actually monitors your breathing, heart rate, and other vital signs during an entire night of sleep. It gives the sleep specialist useful information to help diagnose and treat your underlying disorder.

How is sleep deprivation treated?

Treatments for sleep deprivation vary based on how severe it is. In some cases, your doctor may want you to try self-care methods before turning to medicine. Your doctor may prescribe sleeping pills. But keep in mind that they tend to work less well after a few weeks. They can actually disrupt your sleep. Sometime insomnia is caused by an adjustment in your body clock. This is called a circadian rhythm disorder. For this, your doctor may have you try light therapy. It can help your body’s internal clock readjust and allow you to sleep more restfully.

If you are diagnosed with sleep apnea, your doctor may prescribe a special breathing machine to use while you sleep. It's called CPAP (continuous positive airway pressure). This machine gives you a continuous flow of air through a mask. This help keep your airway open.

Can sleep deprivation be prevented?

If your sleep deprivation is mild, these simple strategies may help you to get a better night’s sleep:

• Exercise at least 20 to 30 minutes each day, at least 5 to 6 hours before going to bed. This will make you more likely to fall asleep later in the day.
• Don't use substances that contain caffeine, nicotine, or alcohol. Any of these can disrupt your regular sleep patterns. Quitting smoking is always a good idea.

How to manage sleep deprivation

Creating a relaxing bedtime routine often helps conquer sleep deprivation and give you a good night’s sleep. This can include taking a warm bath, reading, or meditating. Let your mind drift peacefully to sleep. But don't eat a large meal just before bed. It can make it hard to sleep.

Another step that may help you to get a good night’s sleep is sticking to a consistent schedule. This, means that you go to bed and wake up at the same time every day. If possible, waking up with the sun is a good way to reset your body’s clock more naturally.

Also keep your bedroom at a reasonable temperature. A bedroom that is too hot or too cold can disrupt sleep.

If you’re having trouble sleeping, try doing something else like reading a book for a few minutes. The anxiety of not being able to fall asleep can actually make sleep deprivation worse for some people.

Finally, see a doctor if your problems with sleep deprivation continue. Don’t let sleep problems linger.

Key points about sleep deprivation

• Sleep deprivation is not a specific disease. It's usually the result of other illnesses or life circumstances.
• Sleep deprivation can become a greater problem as people grow older.
• One of the telltale signs of sleep deprivation is feeling drowsy during the day.
• Treatments for sleep deprivation vary based on how severe it is.
• Creating a relaxing bedtime routine often helps to conquer sleep deprivation and get a good night’s sleep.
• The anxiety of not being able to fall asleep can actually make sleep deprivation worse for some people.

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Choose a doctor and schedule an appointment.

Get the care you need from world-class medical providers working with advanced technology.

Cedars-Sinai has a range of comprehensive treatment options.

(1-800-233-2771)

Available 7 days a week, 6 am - 9 pm PT

Expert Care for Life™ Starts Here

Looking for a physician.

How Sleep Deprivation Decays the Mind and Body

Getting too little sleep can have serious health consequences, including depression, weight gain, and heart disease. It is torture. I know.

I awoke in a bed for the first time in days.  My joints ached and my eyelids, which had been open for so long, now lay heavy as old hinges above my cheekbones. I wore two pieces of clothing: an assless gown and a plastic bracelet.

I remembered the hallway I had been wheeled down, and the doctor’s office where I told the psychiatrist he was the devil, but not this room. I forced myself up and stumbled, grabbing the chair and the bathroom doorknob for balance. I made it to the toilet, then threw water on my face at the sink, staring into the mirror in the little lavatory. My tousled hair shot out around my puffy face; my head throbbed. I looked hungover.

In those first moments, I remembered the basics about what had landed me in the hospital: Some pseudo-philosophical ranting and flailing brought on by a poorly executed experiment to see how long I could last without sleep.

I was 18, in Italy, on a school-sponsored trip with that pompously misnamed group for American teens who earn As and Bs, the National Honor Society.  I stayed up writing all night, and the next morning, on little more than impulse, I decided to go for it.

Why? There are a few layers of “why,” and I will mine them later.

To this day, I am not sure how many consecutive nights I spent awake, but it was at least four. Espresso helped me keep going. So did furiously paced, illogical scribbling in a fat blue pocket notebook. As the sleepless days passed, I experienced the increasingly severe psychological effects common with extended sleep deprivation: I hallucinated, rambled, and lost focus. Toward the end of the ordeal, in New York’s John F. Kennedy Airport, my body was giving out, too. While imposing a monologue on my biology teacher—who, I later learned, thought I was tripping on LSD—I blacked out and slumped mid-sentence. This happened more than once on my final day awake. Sleep specialists call these involuntary collapses “microsleeps.” It’s not hard to see why anybody—a high school chaperone, a parent, a doctor—might view a twitching, crumpling, babbling kid like me as some sort of nutcase. But what happened to me could happen to anyone who stays awake that long, voluntarily or otherwise.

Unlike other basic bodily functions, such as eating and breathing, we still do not fully understand why people need to sleep. There are theories—some think sleep may be the process by which the brain shuts down so it can store the day’s memories . Others, like Dr. Joyce Walseben, a psychiatrist and the former director of Bellevue Hospital’s Sleep Disorders Center , point to sleep’s importance in regulating the body’s hormones. But these theories are not complete.

“It may be the biggest open question in biology,'' Dr. Allan Rechtschaffen, a sleep expert and a professor emeritus at the University of Chicago, told the New York Times in 2003. “While we sleep, we do not procreate, protect or nurture the young, gather food, earn money, write papers, etc.,'' he wrote .

Dr. Steven Feinsilver is a pulmonologist and sleep specialist who said that humans need, on average, seven and one quarter hours of sleep to stay healthy. “Now clearly like all biological things there are probably people who feel great on five hours, and they’re really lucky, and some people who need nine hours, and they’re not so lucky,” Feinsilver said. “Whether you can train that to change, I don’t know.”

Sleep deprivation is nearly as misunderstood as sleep itself, but it can physically and mentally harm people in myriad ways. Losing sleep can cause hallucinations, psychosis , and long-term memory impairment. Some studies have linked sleep deprivation to chronic conditions like hypertension , diabetes , and bipolar disorder. In 2003, neurologists at the University of Pennsylvania found that sleep deprivation over three consecutive nights (in the study , staying awake for 88 hours) as well as chronic sleep loss (in the study, four to six hours of sleep each night for 14 nights) seriously impaired cognitive functions in healthy adults. Also in 2003, Japanese researchers found that total sleep deprivation can cause high blood pressure and has “profound” effects on the immune system.

Recommended Reading

The Care and Keeping of Raccoon Dogs

Companies Want Remote Workers in All States but 1

Spiders Can Fly Hundreds of Miles Using Electricity

In 1989, at the University of Chicago, researchers observed rats which died after being kept awake non-stop for several weeks. (According to a 2009 Slate article , specialists who have looked at the 1989 study dispute which effects of sleep deprivation ultimately killed the rats. It could have been hypothermia brought on by decreased body temperatures, illnesses that arose from damaged immune systems, or severe brain damage.) In July 2012, Chinese soccer fan Jiang Xiaoshan died after staying awake for 11 days to watch all of the European Football Championship. In August, a Bank of America intern died after three days of sleep deprivation.

Feinsilver directs the Center for Sleep Medicine at Mt. Sinai School of Medicine in New York City. He speaks precisely and often adds cheerful “maybes” and “I wonders” into his sentences, taking care to not overstate anything. More than 30 years ago, Feinsilver learned first-hand the toll that sleep deprivation can take. One autumn, when he was an intern in an intensive-care unit, he had to work through every other night for six straight weeks.

“The reason I know it was October was there was a pumpkin at the nursing station, and I hallucinated vividly the pumpkin was talking to me,” he said. “It’s the only time I’ve ever hallucinated in my life.” Ah, he thought for the first time, sleep deprivation resembles psychosis.

According to Walseban, sleep loss can cause psychological damage because sleep regulates the brain’s flow of epinephrine, dopamine, and serotonin, chemicals closely associated with mood and behavior.

“Mood and sleep use the same neurotransmitters,” she said. “It’s very hard to tell if someone has sleep loss or depression.” Walseban added that when these neurotransmitters are disrupted by sleep loss, the chemical changes in the brain can also result in manic feelings and behavior similar to bi-polar disorder: high highs of ecstasy and low lows of depression and anger.

This aligns with my experience; while sleep deprived, I swung from profound bliss and satisfaction, laughing at Renaissance frescos, to deep sadness and rage, grunting like a gorilla one night in a Lucerne hotel room where I chucked empty glass soda bottles at my best friend’s head.

When I tried to stay awake for as long as I could, I was an aggrieved, angst-filled teenager. I did it to show that I could, to prove something about myself, and to conquer some adolescent frustrations. I felt that I did not have much time on Earth, and death scared me. I did not really believe in an afterlife, and my fears made me wish I had more hours and years to live. Needing to sleep a third of each day bothered me, and I started staying up late to watch television, read, and write. Eventually I was only sleeping four or five hours each night. One day, I told myself, I would prove how much time sleep stole from us by staying awake for as long as I could and documenting everything I did and accomplished. I imagined that when I could not take it anymore, I would pass out, then sleep long and deep to make up for the extra time awake, and that would be the end of it.

Feinsilver said the notion that a person can “catch up” on lost sleep is misconstrued. “If you’re getting five hours of sleep Monday through Friday, by Friday, you owe yourself like, 10 or 12 hours of sleep,” he said. “It’s not quite that simple. What that means is that, in order for you to catch up on weekends, you’d have to sleep ridiculous hours. And nobody does. You’d have to sleep the seven, plus an extra 12.”

A sleep-deprived person recovers from sleep loss similar to a traveller recovering from a flight; she spends a certain amount of time tiring out her body and can rehabilitate with an equivalent or duplicative amount of recovery time. For each hour spent in a plane, a person needs approximately the same number of days to fully recover from jetlag. In a widely cited paper from 2006, European researchers compared this process to the body’s method of loss and recovery when it chronically loses sleep. The problem, the researchers write, is that many people who chronically lose sleep live in societies where their work and school schedules are not aligned with the body’s circadian rhythms.  So they never make up for lost sleep from the nights before, and build up a “sleep debt” that is never repaid. The consequence of chronic sleep debt, they say, is “social jetlag”—a chronic slowing of concentration and hampering of bodily systems. Researchers like Feinsilver and Walseban fear that this affect has been widespread. “We’re a sleep deprived society,” Feinsilver said.

Feinsilver’s memory of the talking pumpkin stayed with him, but he did not decide to pursue sleep research until he won a fellowship to study the ventilatory drive, the mechanism by which the brain sends signals to the lungs and makes a person breathe. At the time, he said, people erroneously thought that sleep apnea was caused by problems with those signals. The research gripped him enough that that he decided to open his own sleep lab. Today, although his focus remains on sleep problems associated with breathing and the lungs, he continues to investigate the other negative effects that sleep deprivation has on the mind and body.

“Definitely, we know that sleep deprivation leads to depression, high blood pressure, weight gain, heart disease, and probably mortality,” he said. People that regularly sleep those seven and a quarter hours have been shown to live longer than those who routinely sleep less or more. He added that lack of sleep disrupts other systems in the body.

“For instance, if you stay up until 3 a.m., you might get very cold,” he said, clarifying that sleep helps to regulate your body temperature. “Your G.I. tract can get messed up. You’re not supposed to eat at three in the morning. It’s a fairly miserable experience.”

Both Feinsilver and Walseben, whose background is in biopsychology, said that these interruptions, as well as the aforementioned neurotransmitter disturbances, can disrupt reaction times and concentration. Walseben noted that certain famous historical accidents—such as the the spill of the Exxon Valdez oil tanker —were caused by sleep deprived workers. More recently, a Metro North train in New York may have derailed when a sleep-deprived engineer nodded off at the helm. Feinsilver said that lack of sleep is also a leading cause of automobile accidents, mainly because when the brain is deprived of sleep, it becomes particularly difficult to perform prolonged, repetitive tasks like driving.

While a person sleeps, her cells undergo a cycle of repair that provides both oxygen and glucose. When a person stays up all night, the brain’s cells are denied the products of this cycle, severely hampering the organs’ reactions to stimuli and instructions. “Every cell in our body needs food and it produces waste, so all those things occur in a regular, regimented way when we’ve slept well. And when we interfere with that, systems go out of sync,” Walseben said.

Feinsilver said that while we sleep, the blood stream is cleared of a substance that researchers call “substance S.” Many believe substance S is adenosine, a byproduct of energy production that cells release into the blood throughout waking hours. He said that without sleep, the blood gets clogged with substance S, slowing a person down from head to toe.

“It looks like there’s a toxic substance building up in you, where the more you’re awake, the more you see this stuff floating around the bloodstream, and the only way to get rid of it is to sleep,” he said.

While I was awake in Europe, my reaction time was horribly off and my ability to concentrate fell apart, and I became increasingly clumsy and weak. Today, I still feel like I have more difficulty concentrating than I did beforehand. It might just be my imagination. I will probably never be sure.

Many sleep researchers study people who have partial sleep deprivation. These subjects have social jetlag; in a typical sleep lab, they might sleep four hours or so every night for one week. But the experts I interviewed said that less is known about total sleep deprivation and its lasting impacts because researchers have moral concerns about forcing people to stay awake.

“Once you are up all night, by mid-afternoon, it becomes unbearable,” Feinsilver said. “You can do it, but it’s really torture.”

“You know what people might be doing that?” he added. “The army.”

A 2007 report on American torture tactics—written by non-governmental organizations Physicians for Human Rights and Human Rights First —has a section on sleep deprivation that begins with descriptions of a Soviet gulag. In The Gulag Archipelago , Alexandr Solzhenitsyn lists sleeplessness as one of 31 methods that his captors used to break a prisoner’s will. “Sleeplessness befogs the reason, undermines the will, and the human being ceases to be himself, to be his own ‘I,’” Solzhenitsyn writes. He says that guards in the gulag kept prisoners awake for up to five days by perpetually standing them up or by kicking them when their eyes drooped. The author quotes an inmate who endured this, listing his many symptoms, including chills, eyes “dried out as if someone were holding a red-hot iron in front of them,” a swollen and prickling tongue and a throat racked with spasms. “Sleeplessness was a great form of torture: it left no visible marks and could not provide grounds for complaint even if an inspection—something unheard of anyway—were to strike on the morrow,” Solzhenitsyn writes.

Because sleep deprivation “leaves no marks” and is believed to break a detainee’s will, across the world, the tactic has been adopted by government and security forces, notably by Chilean dictator Augusto Pinochet in the 1970s. Most notoriously, sleep deprivation has been used on several prisoners at the United States’ Guantánamo Bay prison camp in Cuba.

In the middle of the night, on May 7, 2004 , American officers unshackled Afghan Guantánamo detainee Mohammed Jawad; they moved him to another cell, and re-shackled him. Three hours later, Jawad was unshackled, moved, and re-shackled again. Over 14 days, Jawad was moved from cell to cell 112 times . In response to motions filed by Jawad and the ACLU, the military claimed in court that, as a result of the tactic, Jawad had not suffered permanent physical harm, and that the long-term psychological damage to Jawad had been “unclear.” But some specific effects that this program had on Jawad are known. According to reports by the Associated Press and Jawad’s lawyers , he lost 10 percent of his body weight while sleep deprived.  In a legal claim against the government arguing that Jawad’s imprisonment was illegal under habeus corpus, ACLU lawyers also wrote that while kept awake, Jawad had blood in his urine. “The torture, cruelty, and harsh treatment to which Mohammed has been subjected throughout his six years in U.S. custody have resulted in severe and ongoing psychological harm,” they concluded.

Rather than kicking prisoners, as the Soviets did, Guantánamo guards kept prisoners awake by chaining their feet and wrists to the floor of their cell , so they could not fall over without being caught by the chains, and moving prisoners between cells every two or three hours. This sleep deprivation program was referred to as the “frequent-flyer” program , or “ Operation Sandman ,” and was used against at least 17 GITMO detainees, according to the military’s own logs kept at the prison in 2003 and 2004. In memos authorizing the program that were de-classified in 2009, Justice Department lawyers asserted that sleep deprivation works well as an interrogation technique, because it breaks down detainees’ ability to resist coercion, and because it decreases prisoners’ tolerance for physical pain. In 2012, a letter from British detainee Shaker Aamer asserted that despite being formally banned in 2009 , the frequent flyer program was still in use at the prison.

As for Jawad, he was originally taken to Guantánamo for allegedly throwing a grenade into a jeep in Kabul, in December 2002, severely wounding two American Special Forces soldiers and their translator. On Christmas Day that year, he tried to commit suicide by repeatedly banging his head against one of his cell walls. His sleep deprivation program began four and a half months later.

In hindsight, I conducted my experiment inelegantly, under terrible conditions. In the first days of the trip, I was already only sleeping about four or five hours each night, so I began prematurely fatigued. A better scientist might have begun on full rest.

By the third day, I had two theories about the origin of the universe that I was certain were true and would change the world. The days all blend together now, but at some point I tried to speak exclusively in rhyme. On another day, I renounced speech altogether. I remember telling people that circles were divine and instituting a policy of smacking my head when I made mistakes, finally breaking my own glasses with one blow. At a stop in Austria, I stole a kaleidoscope from a mountainside gift shop, and at a cultural night in Switzerland, I volunteered to yodel for the crowd, all too confidently. I bought and wore a headband I refused to remove.

I remember realizing the obvious while waiting for our flight home: that this whole not-sleeping thing was actually inefficient, because I could accomplish more in fewer hours on full rest. I resolved to sleep on the plane home, but when I closed my eyes, my head spun, and I heard a woman’s soothing baritone voice. On the bus ride home from JFK airport, I thought that if I concentrated hard enough, I could jump out of our bus onto the highway, land at a run, and sprint on—to where? I have no idea. Luckily for me, our driver refused to open the bus’s door. I remember thinking I was dead, and that I had landed in a very Earthlike eternity.

We arrived at the high school, and my chaperones had me stay on the bus. They went outside and spoke to my parents. When I sat in the car, my mother asked me through tears about my trip while my father drove in silence. Within minutes we were at the hospital, where I was placed in a wheelchair, asked if I had smoked crack or taken LSD, and peed in a cup. I demanded that my brother drive to the hospital from his home, three hours away in Philadelphia, so I could ask him about astrophysics. He came. I bestowed the headband I had been wearing on my father. He put it on. Eventually I agreed to take the medication they handed me. I do not remember what happened next.

Later that first morning in the hospital, I sat at a table with a nurse in a bright, fluorescent room—all yellow light and white Formica—where several other pairs of people conversed. My legs and elbows shook. A nurse told me that I had been asleep for two days. She asked me if I remembered what had happened. When I answered, stringing the events together became more troublesome than I anticipated. I felt myself sway and I heard my words jumble. It was frustrating. I chuckled between sentences and glanced around the room.

There were holes in my memory and in my logic. It all had something to do with existence, productivity, efficiency. My grand theories had made sense in my head while sleep deprived, but now, for some reason they no longer did. The nurses and doctors responded by prescribing me anti-psychotic medication. This was 2004, and I was 18. It was a common age to be diagnosed with a mental disorder.

Throughout the next week in the hospital, I spoke every day with the first nurse and the head psychiatrist. My main goal was to convince them I was fine, so I could get the hell out of there. I was assigned to art therapy, where I tried to draw images that evoked solemnity and composure—it was all about showing I was fine, not feeling fine—including the most maudlin and transparent of these, a blue and green earth with stars and the word “Peace” floating above it. This had all been a misunderstanding.

When I finally went home, a week after entering the hospital, I had prescriptions and appointments with a psychologist and a psychiatrist. The psychologist believed I was not crazy. She and my parents argued with the psychiatrist about the medication, who eventually agreed to first wean me off an anti-psychotic by transitioning me to an anti-depressant, and then to wean me off of the anti-depressant entirely. This process lasted four months. Before the sleepless nights, I had been a strong test taker, and I never felt nervous while writing. On the contrary, writing had been one of the few tasks that gave me confidence, even calm. But in the middle of a standardized test in May, I shook with anxiety and asked to leave the room. (I later finished the test by myself under the supervision of a guidance counselor.) In June, night after night, I sat down a write a research paper, and my head pounded and swirled.

No doctors or psychiatrists suggested that this had all happened because of sleep deprivation. They were sure it was something endemic that had caused the hallucinations and the existential rambling. I spent much of that summer alone, learning to trust my mind again by reading and writing and speaking with my family. I left for college in the fall, off medication, unsure of how my foray into sleep deprivation and its ensuing madness would affect me, and I worried it would creep up on me again. In the nine years since then it has not. I feel like I might have more trouble concentrating, but it’s unclear whether this trouble stems from sleep deprivation, or from that vortex of distraction, the Internet.

Sleep remains mysterious to researchers like Walseben and Feinsilver. Despite the negative effects they have observed and others have researched, the definitive reasons why people need to sleep remain unknown. We only know some of the negative effects that occur over time, and that we require sleep to survive.

“Clearly, even though we cannot tell you why you need to sleep, you must sleep,” Walseben said. “It’s a basic physiological function that none of us have been able to get away without. Even though you may think you can, bad things tend to happen.”

Anyone who has endured one night without sleep knows that functioning through the next day can be uncomfortable and frustrating. It is fair to call a sleepless night a common experience. But I believed that in staying awake for consecutive nights, the effects on my mind and body would differ from the one sleepless night only in degree. Obviously, I was wrong. It seems to me that this common experience and misunderstanding — and the things that researchers still do not understand about sleep — has created a public that all too readily sleep deprives itself and cavalierly imposes sleep deprivation on others. In keeping ourselves and our prisoners awake, we do not really know what we are doing. We are fumbling in the dark.

• See us on facebook
• See us on twitter
• See us on youtube
• See us on linkedin
• See us on instagram

Among teens, sleep deprivation an epidemic

Sleep deprivation increases the likelihood teens will suffer myriad negative consequences, including an inability to concentrate, poor grades, drowsy-driving incidents, anxiety, depression, thoughts of suicide and even suicide attempts.

October 8, 2015 - By Ruthann Richter

The most recent national poll shows that more than 87 percent of U.S. high school students get far less than the recommended eight to 10 hours of sleep each night. Christopher Silas Neal

Carolyn Walworth, 17, often reaches a breaking point around 11 p.m., when she collapses in tears. For 10 minutes or so, she just sits at her desk and cries, overwhelmed by unrelenting school demands. She is desperately tired and longs for sleep. But she knows she must move through it, because more assignments in physics, calculus or French await her. She finally crawls into bed around midnight or 12:30 a.m.

The next morning, she fights to stay awake in her first-period U.S. history class, which begins at 8:15. She is unable to focus on what’s being taught, and her mind drifts. “You feel tired and exhausted, but you think you just need to get through the day so you can go home and sleep,” said the Palo Alto, California, teen. But that night, she will have to try to catch up on what she missed in class. And the cycle begins again.

“It’s an insane system. … The whole essence of learning is lost,” she said.

Walworth is among a generation of teens growing up chronically sleep-deprived. According to a 2006 National Sleep Foundation poll, the organization’s most recent survey of teen sleep, more than 87 percent of high school students in the United States get far less than the recommended eight to 10 hours, and the amount of time they sleep is decreasing — a serious threat to their health, safety and academic success. Sleep deprivation increases the likelihood teens will suffer myriad negative consequences, including an inability to concentrate, poor grades, drowsy-driving incidents, anxiety, depression, thoughts of suicide and even suicide attempts. It’s a problem that knows no economic boundaries.

While studies show that both adults and teens in industrialized nations are becoming more sleep deprived, the problem is most acute among teens, said Nanci Yuan , MD, director of the Stanford Children’s Health Sleep Center . In a detailed 2014 report, the American Academy of Pediatrics called the problem of tired teens a public health epidemic.

“I think high school is the real danger spot in terms of sleep deprivation,” said William Dement , MD, PhD, founder of the Stanford Sleep Disorders Clinic , the first of its kind in the world. “It’s a huge problem. What it means is that nobody performs at the level they could perform,” whether it’s in school, on the roadways, on the sports field or in terms of physical and emotional health.

Social and cultural factors, as well as the advent of technology, all have collided with the biology of the adolescent to prevent teens from getting enough rest. Since the early 1990s, it’s been established that teens have a biologic tendency to go to sleep later — as much as two hours later — than their younger counterparts.

Yet when they enter their high school years, they find themselves at schools that typically start the day at a relatively early hour. So their time for sleep is compressed, and many are jolted out of bed before they are physically or mentally ready. In the process, they not only lose precious hours of rest, but their natural rhythm is disrupted, as they are being robbed of the dream-rich, rapid-eye-movement stage of sleep, some of the deepest, most productive sleep time, said pediatric sleep specialist Rafael Pelayo , MD, with the Stanford Sleep Disorders Clinic.

“When teens wake up earlier, it cuts off their dreams,” said Pelayo, a clinical professor of psychiatry and behavioral sciences. “We’re not giving them a chance to dream.”

Teens have a biologic tendency to go to sleep later, yet many high schools start the day at a relatively early hour, disrupting their natural rhythym. Monkey Business/Fotolia

Understanding teen sleep

On a sunny June afternoon, Dement maneuvered his golf cart, nicknamed the Sleep and Dreams Shuttle, through the Stanford University campus to Jerry House, a sprawling, Mediterranean-style dormitory where he and his colleagues conducted some of the early, seminal work on sleep, including teen sleep.

Beginning in 1975, the researchers recruited a few dozen local youngsters between the ages of 10 and 12 who were willing to participate in a unique sleep camp. During the day, the young volunteers would play volleyball in the backyard, which faces a now-barren Lake Lagunita, all the while sporting a nest of electrodes on their heads.

At night, they dozed in a dorm while researchers in a nearby room monitored their brain waves on 6-foot electroencephalogram machines, old-fashioned polygraphs that spit out wave patterns of their sleep.

One of Dement’s colleagues at the time was Mary Carskadon, PhD, then a graduate student at Stanford. They studied the youngsters over the course of several summers, observing their sleep habits as they entered puberty and beyond.

Dement and Carskadon had expected to find that as the participants grew older, they would need less sleep. But to their surprise, their sleep needs remained the same — roughly nine hours a night — through their teen years. “We thought, ‘Oh, wow, this is interesting,’” said Carskadon, now a professor of psychiatry and human behavior at Brown University and a nationally recognized expert on teen sleep.

Moreover, the researchers made a number of other key observations that would plant the seed for what is now accepted dogma in the sleep field. For one, they noticed that when older adolescents were restricted to just five hours of sleep a night, they would become progressively sleepier during the course of the week. The loss was cumulative, accounting for what is now commonly known as sleep debt.

“The concept of sleep debt had yet to be developed,” said Dement, the Lowell W. and Josephine Q. Berry Professor in the Department of Psychiatry and Behavioral Sciences. It’s since become the basis for his ongoing campaign against drowsy driving among adults and teens. “That’s why you have these terrible accidents on the road,” he said. “People carry a large sleep debt, which they don’t understand and cannot evaluate.”

The researchers also noticed that as the kids got older, they were naturally inclined to go to bed later. By the early 1990s, Carskadon established what has become a widely recognized phenomenon — that teens experience a so-called sleep-phase delay. Their circadian rhythm — their internal biological clock — shifts to a later time, making it more difficult for them to fall asleep before 11 p.m.

Teens are also biologically disposed to a later sleep time because of a shift in the system that governs the natural sleep-wake cycle. Among older teens, the push to fall asleep builds more slowly during the day, signaling them to be more alert in the evening.

“It’s as if the brain is giving them permission, or making it easier, to stay awake longer,” Carskadon said. “So you add that to the phase delay, and it’s hard to fight against it.”

Pressures not to sleep

After an evening with four or five hours of homework, Walworth turns to her cellphone for relief. She texts or talks to friends and surfs the Web. “It’s nice to stay up and talk to your friends or watch a funny YouTube video,” she said. “There are plenty of online distractions.”

While teens are biologically programmed to stay up late, many social and cultural forces further limit their time for sleep. For one, the pressure on teens to succeed is intense, and they must compete with a growing number of peers for college slots that have largely remained constant. In high-achieving communities like Palo Alto, that translates into students who are overwhelmed by additional homework for Advanced Placement classes, outside activities such as sports or social service projects, and in some cases, part-time jobs, as well as peer, parental and community pressures to excel.

William Dement

At the same time, today’s teens are maturing in an era of ubiquitous electronic media, and they are fervent participants. Some 92 percent of U.S. teens have smartphones, and 24 percent report being online “constantly,” according to a 2015 report by the Pew Research Center. Teens have access to multiple electronic devices they use simultaneously, often at night. Some 72 percent bring cellphones into their bedrooms and use them when they are trying to go to sleep, and 28 percent leave their phones on while sleeping, only to be awakened at night by texts, calls or emails, according to a 2011 National Sleep Foundation poll on electronic use. In addition, some 64 percent use electronic music devices, 60 percent use laptops and 23 percent play video games in the hour before they went to sleep, the poll found. More than half reported texting in the hour before they went to sleep, and these media fans were less likely to report getting a good night’s sleep and feeling refreshed in the morning. They were also more likely to drive when drowsy, the poll found.

The problem of sleep-phase delay is exacerbated when teens are exposed late at night to lit screens, which send a message via the retina to the portion of the brain that controls the body’s circadian clock. The message: It’s not nighttime yet.

Yuan, a clinical associate professor of pediatrics, said she routinely sees young patients in her clinic who fall asleep at night with cellphones in hand.

“With academic demands and extracurricular activities, the kids are going nonstop until they fall asleep exhausted at night. There is not an emphasis on the importance of sleep, as there is with nutrition and exercise,” she said. “They say they are tired, but they don’t realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity.”

The role of parents

Adolescents are also entering a period in which they are striving for autonomy and want to make their own decisions, including when to go to sleep. But studies suggest adolescents do better in terms of mood and fatigue levels if parents set the bedtime — and choose a time that is realistic for the child’s needs. According to a 2010 study published in the journal Sleep , children are more likely to be depressed and to entertain thoughts of suicide if a parent sets a late bedtime of midnight or beyond.

In families where parents set the time for sleep, the teens’ happier, better-rested state “may be a sign of an organized family life, not simply a matter of bedtime,” Carskadon said. “On the other hand, the growing child and growing teens still benefit from someone who will help set the structure for their lives. And they aren’t good at making good decisions.”

They say they are tired, but they don’t realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity.

According to the 2011 sleep poll, by the time U.S. students reach their senior year in high school, they are sleeping an average of 6.9 hours a night, down from an average of 8.4 hours in the sixth grade. The poll included teens from across the country from diverse ethnic backgrounds.

American teens aren’t the worst off when it comes to sleep, however; South Korean adolescents have that distinction, sleeping on average 4.9 hours a night, according to a 2012 study in Sleep by South Korean researchers. These Asian teens routinely begin school between 7 and 8:30 a.m., and most sign up for additional evening classes that may keep them up as late as midnight. South Korean adolescents also have relatively high suicide rates (10.7 per 100,000 a year), and the researchers speculate that chronic sleep deprivation is a contributor to this disturbing phenomenon.

By contrast, Australian teens are among those who do particularly well when it comes to sleep time, averaging about nine hours a night, possibly because schools there usually start later.

Regardless of where they live, most teens follow a pattern of sleeping less during the week and sleeping in on the weekends to compensate. But many accumulate such a backlog of sleep debt that they don’t sufficiently recover on the weekend and still wake up fatigued when Monday comes around.

Moreover, the shifting sleep patterns on the weekend — late nights with friends, followed by late mornings in bed — are out of sync with their weekday rhythm. Carskadon refers to this as “social jet lag.”

“Every day we teach our internal circadian timing system what time it is — is it day or night? — and if that message is substantially different every day, then the clock isn’t able to set things appropriately in motion,” she said. “In the last few years, we have learned there is a master clock in the brain, but there are other clocks in other organs, like liver or kidneys or lungs, so the master clock is the coxswain, trying to get everybody to work together to improve efficiency and health. So if the coxswain is changing the pace, all the crew become disorganized and don’t function well.”

This disrupted rhythm, as well as the shortage of sleep, can have far-reaching effects on adolescent health and well-being, she said.

“It certainly plays into learning and memory. It plays into appetite and metabolism and weight gain. It plays into mood and emotion, which are already heightened at that age. It also plays into risk behaviors — taking risks while driving, taking risks with substances, taking risks maybe with sexual activity. So the more we look outside, the more we’re learning about the core role that sleep plays,” Carskadon said.

Many studies show students who sleep less suffer academically, as chronic sleep loss impairs the ability to remember, concentrate, think abstractly and solve problems. In one of many studies on sleep and academic performance, Carskadon and her colleagues surveyed 3,000 high school students and found that those with higher grades reported sleeping more, going to bed earlier on school nights and sleeping in less on weekends than students who had lower grades.

Sleep is believed to reinforce learning and memory, with studies showing that people perform better on mental tasks when they are well-rested. “We hypothesize that when teens sleep, the brain is going through processes of consolidation — learning of experiences or making memories,” Yuan said. “It’s like your brain is filtering itself — consolidating the important things and filtering out those unimportant things.” When the brain is deprived of that opportunity, cognitive function suffers, along with the capacity to learn.

“It impacts academic performance. It’s harder to take tests and answer questions if you are sleep-deprived,” she said.

That’s why cramming, at the expense of sleep, is counter­productive, said Pelayo, who advises students: Don’t lose sleep to study, or you’ll lose out in the end.

The panic attack

Chloe Mauvais, 16, hit her breaking point at the end of a very challenging sophomore year when she reached “the depths of frustration and anxiety.” After months of late nights spent studying to keep up with academic demands, she suffered a panic attack one evening at home.

“I sat in the living room in our house on the ground, crying and having horrible breathing problems,” said the senior at Menlo-Atherton High School. “It was so scary. I think it was from the accumulated stress, the fear over my grades, the lack of sleep and the crushing sense of responsibility. High school is a very hard place to be.”

We hypothesize that when teens sleep, the brain is going through processes of consolidation — learning of experiences or making memories. It’s like your brain is filtering itself.

Where she once had good sleep habits, she had drifted into an unhealthy pattern of staying up late, sometimes until 3 a.m., researching and writing papers for her AP European history class and prepping for tests.

“I have difficulty remembering events of that year, and I think it’s because I didn’t get enough sleep,” she said. “The lack of sleep rendered me emotionally useless. I couldn’t address the stress because I had no coherent thoughts. I couldn’t step back and have perspective. … You could probably talk to any teen and find they reach their breaking point. You’ve pushed yourself so much and not slept enough and you just lose it.”

The experience was a kind of wake-up call, as she recognized the need to return to a more balanced life and a better sleep pattern, she said. But for some teens, this toxic mix of sleep deprivation, stress and anxiety, together with other external pressures, can tip their thinking toward dire solutions.

Research has shown that sleep problems among adolescents are a major risk factor for suicidal thoughts and death by suicide, which ranks as the third-leading cause of fatalities among 15- to 24-year-olds. And this link between sleep and suicidal thoughts remains strong, independent of whether the teen is depressed or has drug and alcohol issues, according to some studies.

“Sleep, especially deep sleep, is like a balm for the brain,” said Shashank Joshi, MD, associate professor of psychiatry and behavioral sciences at Stanford. “The better your sleep, the more clearly you can think while awake, and it may enable you to seek help when a problem arises. You have your faculties with you. You may think, ‘I have 16 things to do, but I know where to start.’ Sleep deprivation can make it hard to remember what you need to do for your busy teen life. It takes away the support, the infrastructure.”

Sleep is believed to help regulate emotions, and its deprivation is an underlying component of many mood disorders, such as anxiety, depression and bipolar disorder. For students who are prone to these disorders, better sleep can help serve as a buffer and help prevent a downhill slide, Joshi said.

Rebecca Bernert, PhD, who directs the Suicide Prevention Research Lab at Stanford, said sleep may affect the way in which teens process emotions. Her work with civilians and military veterans indicates that lack of sleep can make people more receptive to negative emotional information, which they might shrug off if they were fully rested, she said.

“Based on prior research, we have theorized that sleep disturbances may result in difficulty regulating emotional information, and this may lower the threshold for suicidal behaviors among at-risk individuals,” said Bernert, an instructor of psychiatry and behavioral sciences. Now she’s studying whether a brief nondrug treatment for insomnia reduces depression and risk for suicide.

Sleep deprivation also has been shown to lower inhibitions among both adults and teens. In the teen brain, the frontal lobe, which helps restrain impulsivity, isn’t fully developed, so teens are naturally prone to impulsive behavior. “When you throw into the mix sleep deprivation, which can also be disinhibiting, mood problems and the normal impulsivity of adolescence, then you have a potentially dangerous situation,” Joshi said.

Some schools shift

Given the health risks associated with sleep problems, school districts around the country have been looking at one issue over which they have some control: when school starts in the morning. The trend was set by the town of Edina, Minnesota, a well-to-do suburb of Minneapolis, which conducted a landmark experiment in student sleep in the late 1990s. It shifted the high school’s start time from 7:20 a.m. to 8:30 a.m. and then asked University of Minnesota researchers to look at the impact of the change. The researchers found some surprising results: Students reported feeling less depressed and less sleepy during the day and more empowered to succeed. There was no comparable improvement in student well-being in surrounding school districts where start times remained the same.

With these findings in hand, the entire Minneapolis Public School District shifted start times for 57,000 students at all of its schools in 1997 and found similarly positive results. Attendance rates rose, and students reported getting an hour’s more sleep each school night — or a total of five more hours of sleep a week — countering skeptics who argued that the students would respond by just going to bed later.

For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth.

Other studies have reinforced the link between later start times and positive health benefits. One 2010 study at an independent high school in Rhode Island found that after delaying the start time by just 30 minutes, students slept more and showed significant improvements in alertness and mood. And a 2014 study in two counties in Virginia found that teens were much less likely to be involved in car crashes in a county where start times were later, compared with a county with an earlier start time.

Bolstered by the evidence, the American Academy of Pediatrics in 2014 issued a strong policy statement encouraging middle and high school districts across the country to start school no earlier than 8:30 a.m. to help preserve the health of the nation’s youth. Some districts have heeded the call, though the decisions have been hugely contentious, as many consider school schedules sacrosanct and cite practical issues, such as bus schedules, as obstacles.

In Fairfax County, Virginia, it took a decade of debate before the school board voted in 2014 to push back the opening school bell for its 57,000 students. And in Palo Alto, where a recent cluster of suicides has caused much communitywide soul-searching, the district superintendent issued a decision in the spring, over the strenuous objections of some teachers, students and administrators, to eliminate “zero period” for academic classes — an optional period that begins at 7:20 a.m. and is generally offered for advanced studies.

Certainly, changing school start times is only part of the solution, experts say. More widespread education about sleep and more resources for students are needed. Parents and teachers need to trim back their expectations and minimize pressures that interfere with teen sleep. And there needs to be a cultural shift, including a move to discourage late-night use of electronic devices, to help youngsters gain much-needed rest.

“At some point, we are going to have to confront this as a society,” Carskadon said. “For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth.”

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

Artificial intelligence

Exploring ways AI is applied to health care

• Undergraduate
• High School
• Architecture
• American History
• Asian History
• Antique Literature
• American Literature
• Asian Literature
• Classic English Literature
• World Literature
• Creative Writing
• Linguistics
• Criminal Justice
• Legal Issues
• Anthropology
• Archaeology
• Political Science
• World Affairs
• African-American Studies
• East European Studies
• Latin-American Studies
• Native-American Studies
• West European Studies
• Family and Consumer Science
• Social Issues
• Women and Gender Studies
• Social Work
• Natural Sciences
• Pharmacology
• Earth science
• Agriculture
• Agricultural Studies
• Computer Science
• IT Management
• Mathematics
• Investments
• Engineering and Technology
• Engineering
• Aeronautics
• Medicine and Health
• Alternative Medicine
• Communications and Media
• Advertising
• Communication Strategies
• Public Relations
• Educational Theories
• Teacher's Career
• Chicago/Turabian
• Company Analysis
• Education Theories
• Shakespeare
• Canadian Studies
• Food Safety
• Relation of Global Warming and Extreme Weather Condition
• Movie Review
• Admission Essay
• Annotated Bibliography
• Application Essay
• Article Critique

Article Review

• Article Writing
• Book Review
• Business Plan
• Business Proposal
• Capstone Project
• Cover Letter
• Creative Essay
• Dissertation
• Dissertation - Abstract
• Dissertation - Conclusion
• Dissertation - Discussion
• Dissertation - Hypothesis
• Dissertation - Introduction
• Dissertation - Literature
• Dissertation - Methodology
• Dissertation - Results
• GCSE Coursework
• Grant Proposal
• Marketing Plan
• Multiple Choice Quiz
• Personal Statement
• Power Point Presentation
• Power Point Presentation With Speaker Notes
• Questionnaire
• Reaction Paper

Research Paper

• Research Proposal
• SWOT analysis
• Thesis Paper
• Online Quiz
• Literature Review
• Movie Analysis
• Statistics problem
• Math Problem
• All papers examples
• How It Works
• Money Back Policy
• Terms of Use
• Privacy Policy
• We Are Hiring

Sleep Deprivation, Essay Example

Pages: 2

Words: 652

Hire a Writer for Custom Essay

Use 10% Off Discount: "custom10" in 1 Click 👇

You are free to use it as an inspiration or a source for your own work.

Introduction

In this discussion some important aspects of sleep deprivation will be highlighted. They include explorations into the effects of sleep deprivation; when someone becomes tired what are the consequences, how it will affect one’s sleeping pattern, some causes of sleep disturbances and how to improve the quality of sleep.

Development

Lack of sleep affects the body in many ways yet people allow themselves to be deprived of it. Ten serious consequences of sleep deprivation include the potential of getting into accidents, which could cause loss of life along with those of others.  Studies show where people who work in factories tend to become injured due to sleep loss. With respect to danger on the body lack of sleep first manifests as thinking difficulties, which contribute to accidents. Essentially, people are less alert because energy levels fall. The body needs sleep to build red blood cells. This is responsible for many effects of sleep deprivation on the body. Sleep cycles are important for replenishing mental energy. Besides, concentrating and learning is impaired (Smith, Robinson,  & Segal, 2011).

Among other adverse effects on the body are the risks for heart disease, hypertension, diabetes, irregular heart rhythm along with loss of sexual appetite. Studies show that 90% of persons with sleep deprivation ultimately suffer from insomnia, which leads to depression and an aging skin tone. Later the reaction could lead to either weight loss or excessive weight gain. More importantly, studies reveal that lack of sleep hastens death through cardio vascular disease (Pilcher  & Huffcutt, 2015).

Tiredness severely affects the desire to sleep. Scientists have defined perpetual tiredness as chronic fatigue syndrome. Researchers are aware that fatigue and tiredness do affect sleep desire, but distinct characteristic relating the two variables have not been clearly understood. The body’s sleep mechanism requires some measure of relaxation of body and mind. When someone is tired the body and mind are tense and the mechanism required to activate sleep is inhibited. This is why doctors prescribe tranquilizers to initiate sleep in cases when tiredness overtakes the individual (Pilcher & Huffcutt, 2015).

One cause of sleep deprivation is alcohol consumption. Scientists contend that the glass of wine some people think that they need before going to bed can be very dangerous. The initial effect of alcohol might be the desire to sleep, but after that feeling subsides the sleep difficulty emerges. Scientists contend that the body breaks down alcohol as any substance it receives. As this happens the initial stimulating effect rebounds preventing deeper stages of sleep to occur. Bedtime snack is another reason for preventing sleep. When the stomach is supposed to rest a bed time snack causes it to work producing tiredness and withholding sleep (Pilcher  & Huffcutt, 2015).

The question is now asked what can be done to improve sleep qualities. They range from therapies to medication depending on the underlying cause of sleep loss. Some peope just feel compelled not to sleep thinking that either they are disturbed. Others have trained themselves into a routine of taking less than the required amount needed for their bodies. These persons would require therapeutic interventions (Graci & Hardie, 2007).  Others who are deprived due to pain or depression would need medication in resolving the problem. Besides, it is advised to avoid caffeine, nicotine and alcohol, which inhibit sleep or limit your exposure to toxic chemicals (Ramakrishnan & Scheid, 2007).

Graci, G., & Hardie, J. (2007). Evidenced-Based Hypnotherapy for the Management of Sleep Disorders. International Journal of Clinical and Experimental Hypnosis 55 (3): 288–302

Ramakrishnan, K., & Scheid, D. (2007). Treatment options for insomnia. American family physician 76 (4): 517–526

Smith, M.  Robinson, L., & Segal, R. (2011). Sleep Disorders and Sleeping Problems.  NINDS Narcolepsy .

Pilcher, J., & Huffcutt, A (2015). Effects Of Sleep Deprivation On Performance: A Meta-Analysis. Sleep , 19(4); 12 -22.

Stuck with your Essay?

Get in touch with one of our experts for instant help!

Issues Discussed in Republican Debates, Research Paper Example

Effect of Therapist Colour-Blindness on Empathy, Article Review Example

Time is precious

don’t waste it!

Plagiarism-free guarantee

Privacy guarantee

Secure checkout

Money back guarantee

Related Essay Samples & Examples

Voting as a civic responsibility, essay example.

Pages: 1

Words: 287

Utilitarianism and Its Applications, Essay Example

Words: 356

The Age-Related Changes of the Older Person, Essay Example

Words: 448

The Problems ESOL Teachers Face, Essay Example

Pages: 8

Words: 2293

Should English Be the Primary Language? Essay Example

Pages: 4

Words: 999

The Term “Social Construction of Reality”, Essay Example

Words: 371

We use cookies to enhance our website for you. Proceed if you agree to this policy or learn more about it.

• Essay Database >
• Essay Examples >
• Essays Topics >
• Essay on Health

Sleep Deprivation Essay Samples

Type of paper: Essay

Topic: Health , Medicine , Children , Disorders , Sleep , Habits , Time , Night

Published: 03/05/2020

ORDER PAPER LIKE THIS

A lot of people suffer from sleep deprivation but are unaware of the effects it has on one’s health. Sleep deprivation, according to the American Academy of Sleep Medicine, is when a person gets inadequate amount of sleep. Adults usually need about eight hours of sleep at night, while on the average teens need nine hours and children need more than nine hours, depending on the age. There are several causes of sleep deprivation. One major cause of unintentional and chronic sleep deprivation is the presence of sleep disorders such as insomnia or sleep apnea. For other individuals, the lack of sleep is a result of some medications which they take to treat other disorders like epilepsy and attention deficit hyperactivity disorder (ADHD). Moreover, sleep deprivation may be a consequence of other illnesses which includes colds or tonsillitis. As a consequence of these illnesses, an individual may suffer from snoring, gagging and frequent waking, all of which disrupts sleep. Aside from medical causes, sleep deprivation may also be a consequence of the occupation of a person. Some jobs require a shifting in schedules which may disrupt the sleep and wake cycle of individuals; thus, resulting in erratic sleeping patterns. An example of an individual whose job may cause sleep deprivation is the flight attendant. The changes in the time zones make it difficult for them to adjust their sleeping habits. But more than the changes in time zones, another common cause of sleep deprivation is stress related to work. Problems in the work place often take its toll in the sleeping habits of people. Lastly. poor sleeping habits result in sleep deprivation. Sometimes, it would take a change in the lifestyle of a person to prevent sleep deprivation. A lifestyle characterized by drinking coffee before bedtime, partying all night, watching television or reading a book until the wee hours of the night, are perfect components for sleep deprivation. Many people ignore the problem of sleep deprivation thinking that it is harmless. However, studies have shown that a lack of sleep may result in some very serious health issues. The most obvious and immediate effect of sleep deprivation is excessive daytime sleepiness. This effect is a safety hazard because the end result of this may be drowsy driving and workplace injuries. Furthermore, inadequate sleep has a damaging effect on a person in that it affects his moods and work performance. Children who are sleep-deprived usually perform poorly in school because they have a hard time concentrating. In the long run, some of the possible health conditions that may develop because of sleep deprivation are high blood pressure, heart disease, obesity, diabetes, kidney disease and depression. Sleep deprivation should be viewed as an important health issue. Like food and water, sleep is vital for the human body to function well. Getting adequate quality sleep should not be taken for granted. Some of its causes are very much within the control of an individual. If a person wants to stay healthy, he must make sure that he gets the necessary amount of sleep fit for his age and health status. Adequate sleep is vital for one’s physical, mental and overall well-being.

Works Cited

American Academy of Sleep Medicine. "Sleep deprivation." 2008. aasmnet.org. Web. 23 June 2014 <http://www.aasmnet.org/resources/factsheets/sleepdeprivation.pdf>.

Cite this page

Share with friends using:

Removal Request

Finished papers: 1134

This paper is created by writer with

ID 281533954

If you want your paper to be:

Well-researched, fact-checked, and accurate

Original, fresh, based on current data

Eloquently written and immaculately formatted

275 words = 1 page double-spaced

Get your papers done by pros!

Other Pages

Manifestation literature reviews, finer literature reviews, refuse literature reviews, founding literature reviews, suppression literature reviews, accent literature reviews, glance literature reviews, lightning literature reviews, carriage literature reviews, education thesis statements, free research paper on criminal law case study, zombies essay examples, free research proposal on literary research paper, benefits of learning report examples, environmental factors paper essay example, research paper on treatments for ocd, steganography research paper, social performance business plan, child behaviour research paper, free essay on informational interview, haas and flower rhetorical reading essay examples, example of essay on narrative of frederick douglass, example of essay on public personnel management, quantitative critique chronic obstructive pulmonary disease essay sample, research paper on violent video games can they influence behavior, example of advertising and promotion report, free research paper about does the internet make children more smarter or social, free essay about yeh frozen yogurt, music and movie piracy essay examples, career shadow essay sample, marketing research paper examples, good essay on security, sample essay on sudents name, pediatric teaching case study sample, free essay about study questions, la puente essays, duccio essays, honaker essays, monticello essays, fortescue essays, frank lloyd essays, count dracula essays, joan gamper essays.

Password recovery email has been sent to [email protected]

Use your new password to log in

You are not register!

By clicking Register, you agree to our Terms of Service and that you have read our Privacy Policy .

Now you can download documents directly to your device!

Check your email! An email with your password has already been sent to you! Now you can download documents directly to your device.

or Use the QR code to Save this Paper to Your Phone

The sample is NOT original!

Short on a deadline?

Don't waste time. Get help with 11% off using code - GETWOWED

No, thanks! I'm fine with missing my deadline

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Int J Environ Res Public Health

Sleep Health Promotion Interventions and Their Effectiveness: An Umbrella Review

Uthman albakri.

1 Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands; [email protected] (E.D.); [email protected] (R.M.)

2 Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha 65779, Saudi Arabia

Elizabeth Drotos

Ree meertens, associated data.

All relevant data are within the manuscript.

Sleep is receiving increasing attention in public health. The aim of this umbrella review is to determine what non-pharmacological sleep health interventions have been evaluated among healthy populations, by examining target groups, settings, and effectiveness in improving sleep quality and duration. Comprehensive searches were conducted in five electronic databases (January 1975–February 2019), yielding 6505 records. Thirty-five articles were selected meeting the following eligibility criteria: (1) systematic reviews or meta-analyses of (2) sleep health interventions in (3) primarily healthy populations. Two reviewers independently screened for inclusion, extracted the data, and assessed the review quality. This umbrella review was registered with PROSPERO (CRD42019126291). Eleven intervention types were defined, and their effectiveness discussed. Substantial evidence demonstrated the effectiveness of later school start times, behavior change methods, and mind–body exercise. Other intervention types, including sleep education or relaxation techniques, demonstrated some promising impacts on sleep, but with less consistent evidence. Results were limited by high heterogeneity between studies, mixed results, and variable review quality. Nevertheless, this umbrella review is a first step towards understanding the current state of sleep health promotion and gives an overview of interventions across the lifespan.

1. Introduction

Sleep health has been defined as “a multidimensional pattern of sleep-wakefulness, adapted to individual, social, and environmental demands, promoting physical, and mental well-being” [ 1 ]. Insufficient sleep may contribute to chronic diseases, such as obesity [ 2 ], cardiovascular disease [ 3 ], and diabetes [ 4 ]. Lack of sleep may also lead to depression [ 5 ], other mood disorders [ 6 ], and reductions in cognitive performance, including memory and learning difficulties [ 7 ]. Workplace injuries, accidents, and medical errors can also result from insufficient sleep, as daytime drowsiness and fatigue can diminish alertness and decrease reaction time [ 8 , 9 ].

Poor sleep health is a global issue, and studies show an increasing prevalence of inadequate sleep [ 10 , 11 ]. One study estimated that, by 2030, the total number of older adults with sleep problems in low-income countries will be 260 million, an increase from 150 million in 2010 [ 10 ]. Ohayon (2011) estimated that the prevalence of people with sleep deficits in various countries ranged from 20% to 41.7% [ 12 ]. Worldwide, insufficient sleep affects every age group, although in many countries it remains unidentified and underreported [ 10 , 13 ]. Poor sleep also negatively affects the world economy. A combined estimate for the U.S., Canada, the UK, Germany, and Japan, put the annual economic loss due to sleep problems at USD 680 billion [ 14 ].

Most large-scale public health education programs and campaigns have been created to influence diet and exercise, without considering sleep [ 15 , 16 ]. Likewise, the US health agenda in 2010 included guidelines for physical activity and diet as important health-related behaviors, and sleep was not included [ 17 ]. However, sleep has recently made its way onto the US health agenda [ 18 ], and sleep deprivation reduction is also an emerging public health priority in the UK [ 19 ].

Therefore, the aim of promoting healthy sleep is expected to receive growing attention in the next decades. Sleep health promotion involves improving sleep duration and quality. Such work targets sleep-related health behaviors and knowledge among healthcare professionals, policy makers, and the general population [ 20 , 21 ]. Sleep duration is normally defined as the cumulative amount of sleep during the nightly episode of rest, or over a 24-h period [ 22 ]. Sleep quality is described as “one’s satisfaction with the sleep experience, integrating aspects of sleep initiation, sleep maintenance, sleep quantity, and refreshment upon awakening” [ 23 ]. Measures and tools for measuring sleep duration and quality vary, and can be classified as objective or subjective.

Several systematic reviews and meta-analyses have been conducted on sleep health interventions, examining different intervention types, target groups, and settings. However, an ‘umbrella review’, providing an overview of all systematic reviews published across the wide-ranging field of sleep health promotion, is missing from the literature. The purpose of this umbrella review is to systematically summarize the scope and effectiveness of sleep interventions in primarily healthy populations, i.e., not diagnosed with a sleep disorder or specific disease. More specifically, it aims to determine what kinds of non-pharmacological sleep health interventions have been implemented, in what target groups and settings, and how effective they are in improving sleep quality and duration. This overview of sleep health interventions across the lifespan is also meant to introduce interested researchers to this relatively new field of sleep health.

2. Materials and Methods

2.1. search strategy and selection criteria.

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were adapted for conducting this umbrella review [ 24 ]. A systematic search was implemented using six online bibliographic databases/search engines: PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), the Psychological Information Database (PsycINFO), Excerpta Medica dataBASE (Embase), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library, from 1975 to January 2019. The search terms “health education”, “intervention”, “sleep”, “program evaluation”, and related synonyms, were used in the search strategy, including Medical Subject Headings (MeSH) terms in PubMed and thesaurus terms in PsycINFO. A filter was used to limit the retrieved articles to systematic reviews and meta-analyses. The search syntax is available in Appendix A .

Selection criteria were established using the PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). Articles had to include (1) primarily healthy populations (i.e., systematic review/meta-analysis should not be directed at populations with a specific diagnosed (sleep) disorder); (2) sleep health promotion interventions; (3) any public health intervention settings (i.e., not laboratory settings); (4) the evaluation of sleep duration and/or quality; and (5) a systematic review or meta-analysis study design. Only references published in English were eligible. Reviews involving a majority of research participants diagnosed with sleep disorders or other specific conditions, like cancer, were excluded. Articles were also excluded if they were not published in scientific journals, e.g., theses, book chapters, and conference proceedings. This review was registered a priori with PROSPERO (CRD42019126291).

2.2. Screening and Data Extraction

After removing duplicates, two researchers (U.A. and L.P.) first screened the titles and then the abstracts, using the selection criteria. In cases of disagreement, articles were included in the next step. The researchers then performed full-text screening and any disagreements were resolved through discussion with a third reviewer (R.M.).

Two reviewers (U.A. and E.D.) extracted the data independently and any disagreements were resolved through consultation. The Joanna Briggs Institute form was adapted for data extraction. Designs of included studies were categorized into three types: RCTs, crossover study, and quasi-experimental. The quasi-experimental category comprised controlled non-randomized, pre-/posttest, and time series designs [ 25 ].

While extracting the data, definitions of the intervention types were developed considering the interventions most commonly found in the literature. The studies of each review were categorized as one of the defined intervention types; this allowed grouping of particular sleep promotion methods when examining their prevalence and effectiveness. Individual studies from selected reviews were “excluded” and not considered in the conclusions if they did not aim to measure any relevant sleep-related outcome, were conducted in a laboratory setting, or had unsuitable study designs for interventions. Results based on single studies were not listed in the results table, to avoid giving unjustified weight to individual studies.

2.3. Methodological Quality Assessment

Methodological quality was assessed using the JBI Critical Evaluation Controller for Systematic Reviews, which consists of 10 items, awarded 0 or 1 [ 26 ]. Quality scores of 0–5 were considered weak, scores of 6–8 were moderate, and scores of 9 or 10 were strong. Two reviewers (U.A. and E.D.) performed the assessment independently and disagreements were resolved by discussion with a third reviewer (R.M.).

A common limitation in umbrella reviews is the overlap of primary evidence. This occurs when different reviews reference the same component studies, leading to “double-counting” of results and overstating evidence [ 27 ]. A “corrected covered area” (CCA) measure, developed by Pieper et al. (2014), was calculated to evaluate this degree of overlap in the primary data [ 28 ].

3.1. Description of Reviews

3.1.1. included reviews, studies, and quality assessment.

Thirty-five systematic reviews were included after screening, as depicted in Figure 1 . Seventeen included meta-analyses. The number of studies included in these reviews ranged from 4 [ 29 , 30 ] to 112 [ 31 ]. A total of 552 primary studies were included. After examining the overlap between studies reported in multiple reviews, only 443 unique studies were found. Fifty-six studies were found in two reviews, and 21 other studies were included in three or more reviews. The CCA value was calculated at 0.72, which is interpreted as only a small overlap of the component studies [ 28 ].

PRISMA diagram of the literature search.

The quality assessment ratings are presented in Table S1 : Ratings of the included reviews using the JBI Quality Assessment Criteria for Systematic Reviews. Twenty-one reviews were rated high quality, 11 moderate, and three low. For most reviews, the question, inclusion criteria, search strategy, sources used, and criteria for appraising studies were stated clearly. However, the assessment of potential publication bias was particularly lacking, and was not assessed in 20 reviews.

3.1.2. Intervention Types

Eleven intervention categories were grouped, mainly on the basis of the techniques used in the interventions and not, for example, on the theoretical background ( Table 1 ). The intervention types were sleep education, behavior change methods (BCM), relaxation techniques, physical exercise, mind–body exercise (MBE), aromatherapy and/or massage, psychotherapy, environmental interventions, and later school start times. Some reviews also included multicomponent interventions that incorporated multiple intervention types. There were also some other, less commonly observed interventions, such as hypnosis, biofeedback, and magnet therapy, which were gathered into an “other” category.

Categories of intervention types, definition, and population targeted.

3.1.3. Target Populations

The characteristics of the individual reviews are summarized in Table 2 , by age categories. Five reviews included only infants and young children (0–5 years) [ 29 , 32 , 33 , 34 , 62 ], while ten reviews included school-aged children and/or adolescents (5–17 years) [ 35 , 36 , 37 , 38 , 39 , 40 , 47 , 59 , 60 , 61 ]. More than half of the reviews examined adults (>17 years), and four focused exclusively on elderly populations [ 30 , 31 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 63 ]. Some reviews included only very specific groups, such as college students [ 30 , 44 ], shift workers [ 41 , 49 ], athletes [ 42 ], or pregnant women [ 51 ].

Characteristics of and conclusions on the effectiveness of the intervention types of the included reviews: categorized by age category.

NR = Not Reported; RCTs = Randomized Controlled Trials; CBT = Cognitive Behavior Therapy; SMD = Standardized Mean Difference; CI = Confidence Interval; SD = Sleep Duration; SOL = Sleep Onset Latency; SQ = Sleep Quality; MD = Mean Differences; RCSQ = The Richards Campbell Sleep Questionnaire. a individual studies of reviews were not taken into account in this table (i.e., considered non-eligible) if these studies had no outcomes on sleep quality or sleep duration, or had irrelevant study designs for this umbrella review (e.g., correlational study).

3.1.4. Intervention Settings

Most reviews included studies that were conducted in multiple settings [ 29 , 31 , 32 , 33 , 34 , 35 , 36 , 38 , 41 , 43 , 45 , 46 , 49 , 51 , 52 , 57 , 58 , 62 , 63 ]. In reviews that focused on single intervention settings, these included schools [ 37 , 39 , 59 , 60 , 61 ], universities [ 30 , 44 ], the community [ 54 , 55 ], the workplace [ 49 ], outpatient settings [ 47 ], hospitals [ 48 , 50 ], nursing homes [ 56 ], and gyms [ 53 ]. One review did not clearly report the setting [ 42 ].

3.1.5. Sleep Measures

Sleep duration was usually measured using the total sleep time (TST) in a single night or the average TST across a period of time. Sleep quality was measured through composite scores on questionnaires, like the frequently used Pittsburgh Sleep Quality Index (PSQI). Sleep onset latency (SOL) was also considered a sleep quality measure. In infants and young children, the number of night awakenings and bedtime problems were considered indicators of sleep quality [ 34 , 62 ].

Both objective and subjective tools were used to measure outcomes. Actigraphy and polysomnography were commonly used objective tools. Subjective tools included many sleep indices, such as the PSQI or the Insomnia Severity Index, as well as other self-report tools like parent reports, sleep diaries, interviews, and non-standard questionnaires. Twenty-nine reviews included a combination of subjective and objective measures. Four reviews included studies that only measured sleep outcomes subjectively, while two reviews did not identify the measuring techniques.

3.2. Types of Interventions and Their Effectiveness

Table 2 displays the review characteristics, including types and descriptions of interventions, number of eligible studies, study designs, populations, and the results by review. Below, each intervention type and the evidence of its effectiveness is reviewed systematically.

3.2.1. Sleep Education

Seventeen reviews included sleep education, with wide variations in approaches [ 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. These interventions included information on sleep health, sleep cycles, consequences of insufficient sleep, and/or sleep hygiene tips. However, some reviews provided only vague descriptions of the content included. Many methods were used to deliver sleep education, including seminars, pamphlets, telephone calls, and online information. Targeted populations for sleep education varied, but college students and parents with infants and young children were common.

Ten out of the seventeen reviews showed small positive effects of sleep education on sleep duration and/or quality measures [ 29 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 42 , 43 ], though in three, the effects were not maintained at follow-up [ 35 , 38 , 39 ]. For the remaining reviews, two showed no significant effects on sleep duration [ 44 , 46 ], and one reported insufficient evidence [ 30 ]. Although sleep education interventions were included in the meta-analyses in four other reviews, they were combined with different intervention types, so no conclusions could be drawn [ 36 , 40 , 41 , 45 ]. In two reviews, interventions aimed to increase sleep knowledge in school settings [ 30 , 37 ]. While these reviews showed increases in sleep-related knowledge, this was not accompanied by any change in sleep-related behaviors or sleep quality/duration. While some sleep education interventions demonstrated small positive impacts on sleep duration and/or quality, the results were quite mixed.

3.2.2. Behavior Change Methods (BCM)

Eleven reviews covered BCM using varying techniques for different target populations [ 29 , 32 , 33 , 34 , 38 , 40 , 42 , 45 , 47 , 48 , 49 ]. A common target group for BCM was infants and children, with methods implemented by their parents. Examples of BCM are standardized bedtimes, scheduled awakenings, positive routines, controlled comforting, and gradual extinction (i.e., parents leave children alone for extended periods, ignoring protests and crying) [ 34 , 40 , 47 ]. Prescribed sleep wake schedules were used in infants, athletes, and shift workers [ 42 , 45 , 49 ]. BCM were also often employed in combination with sleep education.

In one review, each for infants, athletes, and shift workers, improvements in sleep duration and/or quality were demonstrated [ 33 , 42 ], while one review did not report sleep duration outcome data [ 49 ]. Three other reviews with infants and children showed improvement in sleep quality [ 34 , 40 , 47 ], and another showed improvement in both sleep duration and quality [ 32 ]. Two reviews demonstrated inconsistent evidence [ 38 , 48 ], and one did not report specifically on the effectiveness of BCM [ 45 ]. Overall, there is substantial evidence that BCM in infants and children (as managed by parents) increases sleep duration and quality [ 29 , 32 , 33 , 34 , 40 , 47 ]. There is also some encouraging (but more limited) evidence for other populations.

3.2.3. Relaxation Techniques

Nine reviews examined relaxation techniques [ 31 , 35 , 41 , 44 , 45 , 48 , 50 , 51 , 52 ]. Participants varied in the reviews (adolescents, shift workers, college students, pregnant women, and hospitalized adults). The diversity of techniques used in this category was notable, ranging from progressive muscle relaxation, to mindfulness, relaxing music, etc.

Improvements in sleep duration and/or quality varied from small to large positive effects. Sleep quality was measured in most reviews, while fewer examined sleep duration. One review showed that varying relaxation techniques improved sleep quality with a medium effect size [ 44 ]. One review demonstrated that relaxation had small to large positive effects on sleep quality [ 50 ], while another review demonstrated mixed results on sleep duration and quality [ 31 ]. In five reviews, relaxation techniques were not separately described in terms of effectiveness [ 35 , 41 , 45 , 48 , 51 ]. The strongest evidence in this category was for listening to relaxing music, supported by a meta-analysis [ 52 ]. Evidence for other relaxation techniques was more mixed.

3.2.4. Physical Exercise Interventions

Seven reviews assessed the effect of physical exercise on sleep outcomes, including aerobic exercise [ 45 , 51 , 53 , 55 ], shadow boxing [ 54 ], Pilates [ 46 ], and low-intensity exercise [ 56 ]. The participant groups varied, but the reviews targeted more women than men, including some specific subgroups: postmenopausal, pregnant, postpartum, and middle-aged women.

The effectiveness of physical exercise in improving sleep also ranged from small to large effects. One review showed small effects on sleep quality [ 55 ], while three reviews showed large effects on sleep quality [ 46 , 51 , 53 ]. Mixed results on sleep duration were reported in one review [ 56 ], while another review showed medium effects on sleep duration [ 54 ]. One meta-analysis combined a physical exercise study with different interventions, not reporting the effectiveness of physical exercise alone [ 45 ]. Physical exercise interventions have shown some promising improvements in sleep duration and quality, but the sample sizes in these reviews were relatively small.

3.2.5. Mind–Body Exercise (MBE)

Mind–body exercise was categorized as a separate intervention type, combining physical activity with meditative components. Six reviews included studies that used MBE [ 31 , 51 , 53 , 54 , 55 , 57 ]. Common forms of MBE were tai chi, yoga, and Qigong, but there were also less-common techniques, such as the Rességuier method, which promotes patient awareness of bodily perceptions and control. Participants varied, but older adults were often targeted.

The effectiveness of MBE to improve sleep was mixed, but quite consistently positive. One review reported that tai chi had medium effects on sleep duration and large effects on sleep quality [ 54 ], while another reported that tai chi had small effects on sleep quality [ 55 ]. Another review assessed different types of MBE, and reported positive effects on sleep duration and quality [ 31 ]. For yoga interventions, one review reported improvement in sleep quality [ 51 ], while another showed no significant effects [ 53 ]. Moreover, a meta-analysis pooled data from 14 MBE interventions, demonstrating medium effects in improving sleep quality in older people with sleep complaints undiagnosed with sleep disorders [ 57 ]. MBE was investigated in many studies, including several RCTs, and consistently showed positive impacts, particularly in older adults.

3.2.6. Aromatherapy and/or Massage Interventions

Many interventions combined both aromatherapy and massage, so these two techniques were placed into one category. Six reviews examined aromatherapy and/or massage [ 46 , 48 , 50 , 51 , 56 , 58 ]. Participants varied, and these interventions were often conducted in healthcare settings, such as hospitals and nursing homes.

Two reviews demonstrated that massage combined with aromatherapy has larger effects on sleep quality than aromatherapy alone [ 46 , 50 ]. In contrast, one meta-analysis demonstrated the opposite; while sleep quality consistently improved, a subgroup analysis demonstrated that inhalation aromatherapy was more effective than a combined approach [ 58 ]. One review reported massage as the most promising approach to improve sleep quality among pregnant women compared to other interventions [ 51 ]. Additional reviews included interventions using both aromatherapy and massage, but the results were inconsistent [ 48 , 56 ]. Overall, there is some evidence of improvement in sleep quality with both massage and aromatherapy.

3.2.7. Environmental Interventions

Five reviews included environmental interventions [ 46 , 48 , 49 , 50 , 56 ]. There was notable variation in the techniques used to modify the environment to promote sleep. For instance, daytime bright-light therapy, through the influence of circadian rhythms, was used to improve sleep duration and quality among shift workers and hospitalized patients [ 48 , 49 ]. Nature sounds, white noise, or noise reduction were different techniques to augment the auditory environment [ 48 , 50 ]. Other interventions included infants staying in their mother’s hospital rooms [ 46 ], adjusting bedroom temperature levels, and reducing sleep interruptions for nighttime nursing [ 56 ]. Environmental interventions were often conducted in monitored facilities, such as hospitals or care facilities.

Evidence of the effectiveness of environmental interventions is mixed. One review reported that bright-light therapy and nature sounds had a large positive effect on sleep quality [ 50 ], and another reported that bright light improved sleep duration and/or quality, but not significantly [ 49 ]. Another review concluded that sleep duration and quality were improved through the use of bright light and white noise [ 48 ]. However, noise reduction and reducing night-time nursing care did not show increases in sleep duration [ 56 ]. One review examined environmental interventions with other interventions, and did not report specific results separately [ 46 ]. High heterogeneity and few studies were found in the literature, providing very limited evidence.

3.2.8. Psychotherapy

Four reviews included psychotherapy, conducted online, in groups, or one-on-one with therapists [ 40 , 41 , 44 , 46 ]. Most studies employed cognitive behavior therapy (CBT), but other psychotherapeutic interventions were also observed, such as implosive therapy and constructive worry. Participants varied, including college students, shift workers, and postpartum women.

The reported effectiveness of CBT differed. One review examined CBT and other psychotherapeutic methods, and it showed that CBT had large positive effects on sleep duration, SOL, and other sleep quality metrics. In the same review, other psychotherapeutic interventions showed medium impacts on sleep duration and some sleep quality measures, but not SOL [ 44 ]. This review provided the most substantial evidence for psychotherapy. The remaining three reviews combined CBT studies with other interventions, making it difficult to determine the effect of psychotherapy [ 40 , 41 , 46 ]. In the present umbrella review, we found limited evidence for the use of psychotherapy to promote sleep health in healthy populations.

3.2.9. Later School Start Interventions

Four reviews examined this intervention type, and participants were adolescents and children in formal school settings. School start times were delayed 20–85 min. Two meta-analyses reported an increase in sleep duration: one with a MD of 18–65 min and the other with a MD of 1.39 h [ 59 , 61 ]. In an additional review, the values of sleep duration increasing ranged from 25 to 77 min across the included studies [ 60 ]. The demonstrated effect substantially increased when start times were delayed more than 60 min in comparison to the controls. Overall, very large sample sizes were included in these interventions. This may suggest strong evidence for later school start times, despite the lower number of reviews.

3.2.10. Multicomponent Interventions

Eighteen reviews included multicomponent interventions, which combined techniques from multiple categories [ 29 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 40 , 41 , 44 , 45 , 48 , 49 , 50 , 51 , 56 , 62 ]. Interventions that combined sleep education and BCM targeting infants and children were common and showed positive effects on sleep duration and/or quality [ 29 , 32 , 33 , 34 , 62 ]. The substantial heterogeneity between the multicomponent interventions across different reviews preclude drawing a firm conclusion on their effectiveness.

3.2.11. Other Types of Interventions

Seven reviews included other less commonly observed interventions. These were dietary interventions, hypnosis, biofeedback therapy, magnet therapy, drinking herbal tea, acupuncture, cryostimulation (where the body is exposed temporarily to extremely cold temperatures), and infrared light treatment [ 31 , 42 , 44 , 46 , 50 , 51 , 63 ]. One review examined only dietary interventions, which aim to improve sleep by finely manipulating nutritional intake [ 63 ]. The review demonstrated no effects in natural (non-laboratory) settings. One review showed that infrared light irradiation and cryostimulation improved sleep duration and/or quality in athletes [ 42 ]. Acupuncture was reported in two reviews [ 50 , 51 ], and one demonstrated positive effects on sleep quality [ 51 ]. The effectiveness of other interventions varied, and there were few studies.

4. Discussion

Sleep health promotion is an emerging issue in public health. The aim of this research was to conduct an umbrella review, a review of reviews, of sleep health interventions in the general population. Common types of interventions, target groups, and settings were identified, and conclusions were drawn regarding effects on sleep duration and quality.

The scope of the reviews varied widely. Some were very broad, including all non-pharmacological sleep interventions and addressing multiple target groups. Reviews targeting only specific groups, such as shift workers, often included a wide range of intervention types, providing overviews of all sleep promotion interventions in that group. Other reviews only included one intervention type and addressed only one target group (e.g., later school times for children/adolescents). Furthermore, the methodological quality also varied, though many reviews were rated as high quality. Lower-quality reviews reported insufficient details on interventions, designs, methods, and results of the included studies, and/or failed to provide concrete recommendations. Only 7 of the 35 reviews adopted the PRISMA guidelines for reporting.

The most commonly observed intervention types were sleep education and behavior change methods. Sleep education interventions consist of providing basic education about sleep (e.g., what is sleep and its health benefits), often combined with sleep hygiene tips (e.g., ‘No caffeine in the evenings’). Sleep education is frequently conducted in school-aged populations, such as children or college students. Behavior change methods are interventions based on behavioral theories, i.e., strategies to improve sleep by augmenting certain associations with sleeping. Examples of this include using bedtime routines for children, or not rewarding attention seeking and crying at bedtime. As the examples show, behavior change methods often target infants, although some adult subgroups, such as athletes and shift workers, were targeted as well [ 42 , 49 ].

Another common intervention was relaxation techniques. This could involve using such techniques during the day (such as mindfulness) or specifically around bedtime (e.g., progressive muscle relaxation, and listening to music). In interventions defined as ‘mind–body interventions’, meditative techniques are combined with physical exercise, such as tai chi. In contrast, physical exercise interventions only involved physical activity to improve sleep, without explicit relaxation components (e.g., aerobics). While these three intervention types were observed in various target groups, mind–body and physical exercise were investigated in adults in particular [ 31 , 53 , 54 , 55 , 57 ].

Fewer reviews included aromatherapy and/or massage, which involved the use of fragrant oils that are inhaled or massaged into the skin. Massage is implemented alone or often in combination with aromatherapy, involving manual techniques implemented by a therapist (e.g., back massage and foot reflexology). These interventions are often observed in healthcare facilities, such as nursing homes. Another less commonly observed sleep intervention type is environmental interventions, the modification of sleep environments. Examples include bright light and noise or temperature adjustment, the techniques most often used in healthcare settings. Later school start times were also less commonly observed, which involved changing the time of school starts to correspond with the circadian rhythms of adolescents (teenagers undergo a delay in their sleep–wake rhythm, as a consequence of biological processes during puberty) [ 64 ]. However, this is the most common intervention for adolescents, when considering the number of study participants. School districts may set policies to start school days at 9:00 instead of 8:00, as is recommended by the included reviews [ 59 , 60 , 61 ]. Likewise, the American Academy of Pediatrics recommends that middle and high schools aim to start no earlier than 8:30 [ 65 ].

The most common example among the therapies was cognitive behavioral therapy, which aims to support patients in identifying and changing destructive or disturbing patterns of thoughts that negatively affect behavior and emotions [ 66 ]. It should be noted that cognitive behavioral therapy for insomnia is widely acknowledged as an effective treatment for people diagnosed with insomnia [ 67 ]. However, in the present review, addressing the general public, evidence for its effectiveness was limited. Lastly, multicomponent interventions were commonly observed. In particular, sleep education was often combined with behavior change methods, though physical exercise, mindfulness, and environmental modifications were sometimes combined with sleep education too.

Although the 11 defined intervention types adequately describe the sleep health interventions in the included reviews, the distinctions between the intervention categories were sometimes not as straightforward as might be assumed. For example, giving sleep hygiene tips was considered sleep education, but these tips often suggest bedtime relaxation or creating a dark, quiet sleeping environment. One could then argue that education on sleep hygiene also has relaxation and environmental components. Furthermore, CBT and BCM partly share their theoretical underpinning. Nevertheless, CBT and BCM were considered as separate intervention types, as techniques as well as implementers varied considerably. However, in determining the 11 intervention types, the main focus of an intervention could always be identified.

Three categories showed substantially more evidence for improving sleep duration and/or quality: behavior change methods, mind–body exercise, and later school start times. These categories consistently demonstrated statistically significant improvements with relatively large effect sizes. Many reviews featuring behavior change methods and mind–body exercise included rigorous RCT study designs. This included two meta-analyses primarily analyzing behavior change methods [ 33 , 62 ], and two meta-analyses of exclusively mind–body exercises [ 54 , 57 ]. Later school start times also demonstrated strong effects in two reviews with particularly large participant samples. The eight additional intervention types defined in this review also demonstrated some promising impacts on sleep, but with less research conducted and/or less consistent evidence. Some techniques demonstrated higher effectiveness than others within categories. For example, listening to music seemed to be more effective than other relaxation techniques.

These conclusions should be interpreted with caution. There was heterogeneity in study designs, outcome measures, populations targeted, and specific techniques. Generalization is another concern, as some data is from narrow target groups or settings and results may not be applicable in other contexts. For instance, physical exercise to improve sleep was mostly implemented for women, and environmental interventions were mainly applied in healthcare settings. These interventions may not demonstrate similar effectiveness in other populations or settings. Moreover, there were contradictory findings regarding the relative effectiveness of some specific techniques within categories. For example, one meta-analysis showed aromatherapy to be more effective than massage [ 58 ], while another showed that massage was the more effective technique of the two [ 46 ].

4.1. Strengths and Limitations

This review had some notable limitations. First, overlapping of primary studies between reviews is a common limitation in umbrella reviews. However, only a small amount of overlap was detected with the CCA calculation [ 28 ]. There was a high degree of heterogeneity, which made direct comparisons between reviews impossible. Publication bias may have limited what studies were published and included in reviews, which in turn may be a limitation of this umbrella review. Likewise, the quality of an umbrella review depends on the quality of the included reviews, which in turn depends on the quality of the primary studies. Therefore, there may be some undetected sources of bias. However, it is reassuring that the quality scores of most included reviews were strong.

A strength of this review was the broad variety of electronic databases in its search strategy, allowing a broad overview of all possible types of non-pharmacological interventions used across all age groups and settings. Two reviewers conducted the entire screening, data extraction, and quality assessment independently, increasing the validity of the extracted data and methodological strength of the research.

4.2. Implications for Practice and Future Research

Sleep health promotion has been gaining attention in public health, and effective interventions are being developed that improve sleep duration and quality in the general population. Currently, policies regarding sleep have been implemented within different countries and organizations, including later school start times, regulations for shift worker hours, and public education on sleep health [ 59 , 68 ]. Practitioners and policy makers may profit from the insights of this present review to extend such initiatives.

This review also suggests recommendations for future research. As previously mentioned, some intervention types have only targeted specific groups or have not been investigated thoroughly. For instance, mind–body and physical exercise has had promising results among adults and elderly people, so future research could demonstrate if this approach would be effective in children or adolescents. In this age of smartphone technology, apps may be a new channel for sleep intervention implementation, which could be further explored (e.g., to implement behavior control methods more systematically).

In the included reviews, the lack of behavioral theory in intervention development was surprising. Behavioral theory is used to effectively predict and alter many health behaviors, but its use has been very limited in sleep health [ 69 , 70 ]. In fact, only one included review specifically reported and emphasized the foundations of behavioral theory within its interventions [ 37 ]. While there is a small amount of research regarding the factors influencing sleep health and sleep behaviors [ 71 , 72 ], most interventions were not developed explicitly considering these factors, nor how they apply to specific target groups. More research into sleep-related factors and the application of theoretical frameworks of behavior change are lacking in the literature, requiring further research. To steer the reporting and comparability of reviews, following PRISMA guidelines is also heavily encouraged in future reviews.

5. Conclusions

This umbrella review is the first to provide an overview of strategies used in the rapidly evolving field of sleep health promotion, shedding light on target populations and intervention settings. Later school start times, behavior change methods, and mind–body exercise provided the most evidence of effectively improving sleep. Other interventions, such as sleep education, relaxation techniques, physical exercise, aromatherapy, massage, psychotherapy, and environmental interventions, also showed promising but inconsistent or limited results. Conclusions should be considered with caution, as there was high heterogeneity between studies. Nevertheless, this umbrella review can be seen as a first step towards reaching a greater understanding of sleep health promotion.

Acknowledgments

Special thanks to Louk Peters for helping in the screening process.

Supplementary Materials

The following is available online at https://www.mdpi.com/article/10.3390/ijerph18115533/s1 , Table S1: Ratings of the included reviews using the JBI Quality Assessment Criteria for Systematic Reviews.

PubMed Search Syntax.

((((((((((((((((((((((((((((((((((((((((((((((health education[MeSH Terms]) OR health education[Title/Abstract]) OR health promotion[Title/Abstract]) OR educat*[Title/Abstract]) OR promot*[Title/Abstract]) OR education program*[Title/Abstract]) OR Behavior*[Title/Abstract]) OR Behaviour*[Title/Abstract]) OR advice[Title/Abstract]) OR Sleep intervention*[Title/Abstract]) OR Sleep program*[Title/Abstract]) OR Sleep intervention program*[Title/Abstract]) OR Sleep hygiene intervention[Title/Abstract]) OR Sleep hygiene program*[Title/Abstract]) OR Sleep campaign*[Title/Abstract]) OR Sleep hygiene campaign*[Title/Abstract]) OR Sleep train*[Title/Abstract]) OR Sleep cours*[Title/Abstract]) OR Sleep improvement program*[Title/Abstract]) OR Sleep improvement intervention*[Title/Abstract]) OR Sleep management cours*[Title/Abstract]) OR Sleep management program*[Title/Abstract]) OR Sleep management intervention[Title/Abstract]) OR Sleep management campaign*[Title/Abstract]) OR Sleep module*[Title/Abstract]) OR Sleep hygiene module*[Title/Abstract]) OR Sleep intervention cours*[Title/Abstract]) OR Sleep hygiene cours*[Title/Abstract]) OR Sleep lesson*[Title/Abstract]) OR Sleep hygiene lesson*[Title/Abstract]) OR Sleep component*[Title/Abstract]) OR Sleep hygiene component*[Title/Abstract]) OR Sleep part*[Title/Abstract]) OR Sleep hygiene part*[Title/Abstract]) OR Sleep education program*[Title/Abstract]) OR Sleep education campaign*[Title/Abstract]) OR Sleep education cours*[Title/Abstract]) OR Sleep behavior* program*[Title/Abstract]) OR Sleep behaviour* program*[Title/Abstract]) OR Sleep hygiene education[Title/Abstract]) OR Sleep hygiene education program*[Title/Abstract]) OR Sleep hygiene education relaxation training[Title/Abstract]) OR Sleep hygiene education cognitive therapy[Title/Abstract])) AND ((((((((((intervention[Title/Abstract]) OR program*[Title/Abstract]) OR Impact*[Title/Abstract]) OR Prevent*[Title/Abstract]) OR Experiment*[Title/Abstract]) OR Train*[Title/Abstract]) OR Course[Title/Abstract]) OR Campaign[Title/Abstract]) OR Promot*[Title/Abstract]) OR Educat*[Title/Abstract])) AND (((((((((((sleep*[Title/Abstract]) OR sleep deprivation[MeSH Terms]) OR sleep hygiene[MeSH Terms]) OR sleep latency[MeSH Terms]) OR sleep onset[Title/Abstract]) OR time in bed[Title/Abstract]) OR Night rest[Title/Abstract]) OR Bed time[Title/Abstract]) OR Bedtime[Title/Abstract]) OR Sleep time[Title/Abstract]) OR nap*[Title/Abstract])) AND (((((((((program evaluation[MeSH Terms]) OR evaluat*[Title/Abstract]) OR Assess*[Title/Abstract]) OR Influence*[Title/Abstract]) OR Effect*[Title/Abstract]) OR Test*[Title/Abstract]) OR Improv*[Title/Abstract]) OR Trial[Title/Abstract]) OR control[Title/Abstract]).

Author Contributions

R.M. and U.A. conceived the idea for the study; U.A. and E.D. performed the data extraction, synthesis, and quality assessments, with input of R.M.; U.A. wrote the first draft, and E.D. and R.M. made substantial contributions; and all authors contributed to the interpretation of findings, and critical revision of the manuscript. All authors have read and agreed to the published version of the manuscript.

This study was funded by a scholarship to U.A. from the Saudi Arabia Ministry of Education (Albaha University).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Data availability statement, conflicts of interest.

There has been no conflict of interest declared.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.