Insufficient Sleep Syndrome

Insufficient sleep syndrome

Insufficient sleep syndrome

In recent years, although the importance of sleep for a good quality of life has been highlighted, there is a decrease in the hours designated for this activity, this can be related to many people choose to remain awake because their daytime activitiesThey have not been completed and subtract hours from rest to achieve it.

There is a consensus on the sleep hours required to function properly and was established by the American Academy of Sleep Medicine in conjunction with the National Sleep Foundation, it suggests that school -age children should sleep up to 10 hours per night, while theadults should sleep from 7 to 8 hours a day.1, 2, 3 However, the reality is very different, the amount of hours dedicated to rest has been declining, in many cases it is associated with the hours dedicated to work activity, since many people finish work shifts up to highnight hours and should start their activity very early, which does not allow them to sleep enough.4

There are other factors that can subtract time from rest such as academic, social activities or the use of electronic devices, this occurs mainly among adolescents5 who give priority to their social life and the use of tablets, computers or video games with whichThey subject sleep restriction and suffer from diurnal effects such as drowsiness mainly.

Other effects that sleep restriction have are observed at the cognitive level such as the difficulty in concentrating, memory problems, increased reaction time;At the physiological level, the response of the immune system tends to decrease with what is most prone to suffering from a disease. It is also possible that sleeping a few hours affects mood.6

If this lack of sleep persists as a lifestyle, it is likely that people end up developing what is known as insufficient sleep syndrome, it is also known as insufficient sleep syndrome behaviorally, insufficient night dream, chronic sleep deprivationor sleep restriction and was first recognized as a clinical syndrome in the diagnostic classification of sleep disorders and activation of the association of sleep disorders. 7

According to the third international classification of sleep disorders, insufficient sleep syndrome is a disorder that is located within central hypersomnias, it is a different entity and has its own diagnostic criteria which are 8:

A. The patient presents daily an irrepressible need to sleep or falls asleep during the day or, in the case of prepuberes, there is an abnormal conduct complaint that is attributed to drowsiness.

B. The patient’s sleep time according to his personal background is shorter than expected for his age.

C. Sleep restriction is present most of the week for at least three months.

D. The patient shortens his sleeping hours with an alarm clock or if someone else wakes him up and generally his dream is longer on weekends or on vacation where he does not use these methods.

AND. Increase the total sleep time solves the symptoms of drowsiness.

F. Symptoms are not better explained by another sleep disorder, the effects of medicines or drugs, some medical, neurological condition or mental disorder.

This syndrome occurs when persistently a person fails to obtain the amount of sleep required to maintain adequate levels of vigil and alert, this happens due to a decrease in bed time which generates a chronic sleep restriction. The ability to start or maintain sleep is intact, there is no psychopathology or medical cause that can be associated with daytime sleepiness. A review of your sleep patterns history reveals that there is a disparity between the necessary sleep hours and what really falls asleep. Symptoms such as sleep paralysis and hypnagogical hallucinations may appear.8

Lack of sleep can cause serious health ravages, the following table summarizes the main effects.

Table 1. Summary of the main consequences of insufficient sleep 9

Complications

Effects

Diurnal sleepiness

-Fall asleep during sedentary activities, such as meetings, reading, watching television or movies, or while driving increasing the risk of car accidents

Emotional alteration

-Most negative mood, optimism and sociability are reduced. Complaints increase pain or discomfort.

-In healthy adolescents, irritable mood is observed.

Effects on brain functions

-Cognitive deterioration, prefrontal cortex dysfunction, novelty detection, which is a mechanism that involves the frontal lobes, is diminished.

-Memory disorders

Effects on brain structure

-Decrease in the cells of the dentated circumvolution of the hippocampus

-Structural changes in cortical neurons

-Neuronal Degeneration of Locus Ceruleus

Effects on the body

-Increase in weight during the insufficient sleep period that is reversed when normal dream resumes.

-Decreases the leptin hormone that suppresses appetite and increases the greline levels that informs the body that should feed.

Glucose metabolism

-The glucose tolerance test shows a pre-diabetic state in normal people.

-Changes in insulin sensitivity and body weight.

-Increase insulin resistance in diabetes.

Cardiovascular system

-Hypertension, arrhythmia, oxidative stress, endothelial dysfunction, inflammation and metabolic disorder in patients with coronary heart disease

– Coronary heart disease

Reproductive system

-Sperm deterioration.

Genes linked to immunological and inflammatory processes

– Fraternal twins have shown that resistance and vulnerability to sleep loss are highly inheritable.

– Variant in the ABCC9 gene that explains approximately 5% of the variation in sleep duration.

– Genetic polymorphisms related to orexin signaling are important to predict a vulnerable individual to eat in excess and gain weight when it is deprived of sleep

Circadian rhythm

– Reduction of Circardian transcripts in blood

Immune system, inflammation and infection

– Decreased antibody production after influenza vaccination.

– Moverning the normal function and regulation of circadian T cells

– Associated with a relative risk of 1.39 to develop pneumonia

– Alterations in Interleucin 6 and the tumor necrosis factor Alfa

– It leads to cardiovascular diseases, insulin resistance and osteoporosis.

Epidemiology

Lack of sleep is an increasingly common problem in todayMaintain two work shifts, which represents a very significant change in sleep culture worldwide. The marked tendency to be more productive at the expense of rest has had important consequences for public health both in adults and children.9

It has been reported that due to the pressures of contemporary life, a loss of more than 90 minutes has been reached in the total duration of sleep10, even in children it has been reported that they sleep 37 minutes less than advised for a good quality oflife.11 This phenomenon is increasing in various parts of the world.

The National Sleep Foundation in 2013, conducted a survey on the sleep habits of a representative sample of residents of five high -income organizations for the Organization for Economic Cooperation and Development (OECD) (Canada, Germany, Japan, the United Kingdomand the United States), found that lack of sleep was a commonly reported problem, confirming that it is present in these countries with high income.3

Table 2. Proportion of the population that sleeps less than 7 hours 3

USES

United Kingdom

Germany

Japan

Canada

Less than 6 hours

18%

16%

9%

16%

6%

6 to 7 hours

27%

19%

twenty-one%

40%

twenty%

Insufficient dream is a global problem that is not limited to a particular group of people, a nation, a gender or a specific age group9. Among adolescents for example, their social life can extend until late at night, this tends to press them to sleep less than necessary8.

In a study carried out in Tokyo, at the sleep clinic of the Urayasu Medical Center, of the 2,157 patients who visited it from August 2012 to March 2017, 181 were 20 years old or less, in them the most frequent diagnosis was the most frequent diagnosis was theInsufficient sleep syndrome (n = 56) which is equivalent to a little more than 30%, followed by the circadian rhythm disorder of sleep-vigilia (n = 28), insomnia (n = 28) and movement disorder related to movement related toThe dream (n = 15).12

Among the different factors that are associated with a short -term dream are:

Table 3. Factors associated with a short -lived dream 13

Lifestyle and health

Body mass index

People with an BMI considered overweight or obesity sleep on average between approximately 2.5 minutes 7 minutes less than those with a normal BMI.

Smoke

Current smokers sleep on average 5 minutes less per day than non -smokers.

Sugary drinks

People who consume more than two sugary drinks per day sleep on average 3.4 minutes less than those that consume less sugary drinks.

Physical activity

People who perform less than 120 minutes of physical activity per week sleep approximately 2.6 minutes less per day than those who report more than the recommended 150 minutes of physical activity per week.

Mental health

People with medium to high risk of mental health problems sleep on average 17.2 minutes less than those with low risk of mental health problems.

Personal and sociodemographic factors

Financial concerns

People with financial concerns sleep on average about 10 minutes less per day than those without concerns

Take care of others without payment

People who provide unpaid attention to relatives, close relatives or friends sleep on average approximately 5 minutes less than those who do not provide unpaid attention.

Kids

People with dependent children under 18 who live in the same home sleep on average approximately 4.2 minutes less than those without dependent children under 18 years.

Gender

Men sleep on average about 9 minutes less per day than women.

Marital status

People who report being separated from their partner sleep on average 6.5 minutes less per day than those who report being married. In the same way, the people who reported that they never married sleep on average 4.8 minutes less than those who married.

Psychosocial and labor factors of the workplace

Low opportunity of choice

People who report a lack of choice in their daily work routine sleep on average 2.3 minutes less per day than those that report more options at work.

Unrealistic time pressures

People who report unrealistic time and stress pressures in the workplace sleep on average 8 minutes less than those who inform low levels of time pressure.

Irregular schedule

People who work in irregular hours (for example, work in turn) sleep on average 2.7 minutes less than those who work in regular hours.

Displacements

People who travel between 30 and 60 minutes to work sleep an average of 9.2 minutes less per day compared to those with a daily displacement from zero to 15 minutes. Travelers who travel more than 60 minutes to work sleep on average 16.5 minutes less than those with short trips

It may seem that the lost minutes in sleep are insignificant, but if one or two factors are added together, the lost time of sleep is significant, for example if an employee who works irregular hours, invests from 30 to 60 minutes of time to transportTo his work and is exposed to pressures, he will sleep on average 28.5 minutes per day less than an employee who has a regular work schedule, invests 15 minutes on the way to work and is not exposed to psychosocial risk factors, in the long term, equivalent to more than 173 hours of sleep lost per year. 13

The chronicle loss of sleep affects not only the individual as already mentioned, but also affects their social and labor environment. The lack of sleep with car accidents, work errors and even catastrophes such as Chernobyl nuclear explosion, Three nuclear incident of Three Mile Island, the spill of Exxon Valdez and the tragedy of the challenger spacecraft.9

It also insides on the economic aspect, since a person who sleeps less than required will be unproductive and will be more prone to work errors, since one of the main consequences of the lack of hours of sleep is daytime drowsiness, whatthat makes people slower in their response before stimuli.

Some studies in workers who roll shifts, truck drivers, resident doctors and airline pilots show a greater risk of accidents due to lack of sleep. Another problem associated with lack of sleep is car accidents since they have a mortality rate similar to associates with alcohol intake, because lack of sleep can cause psychomotor deficiencies equivalent to those induced by the consumption of this.14

Treatment

The main strategy to solve the ravages caused by insufficient sleep syndrome will logically increase sleep hours to cover individual real rest needs, however in a society that does not give the right weight to rest, this becomes complicated.

Therefore, the strategy would be to public. This would imply acting not only at the individual level if not collective as part of public health.

Hafner13 and his work team propose the following practices to solve this situation:

Recommendations to improve sleep quality

Aimed at individuals

1. Establish stable schedule to get up

two. Limit the use of electronic devices before going to sleep to avoid melatonin suppression that is crucial for the control of the sleep-vigilia cycle.

3. Limit the consumption of coffee, alcohol and nicotine stimulant substances.

4. Exercising, physical activity has been shown to improve sleep quality.

Aimed at employers

1. Employers must recognize the importance of sleep and adverse results for both people and companies derived from lack of sleep. This may require a cultural change in organizational thinking.

two. Provide facilities and services that help employees carry out sleep hygiene.

3. Discourage the widespread use of electronic devices. Employers may indicate limits in the expected availability of personnel after working hours or by introducing policies that limit communications outside working hours and outside the office.

Aimed at authorities

1. Give more support to specialists focused on work with sleep disorders and constantly train other health professionals so that they are prepared to address this type of problem

two. Promote class start schedules later. Public authorities can help promote more effective schedules by introducing delays in the start of classes.

The above makes it clear that sleep is an important part of having a good quality of life, since the lack of this produces various effects on people’s health such as concentration problems, memory, mood changes, drowsinessdaytime, tiredness, obesity, diabetes among others, the same that impact the execution of their daytime activities, so the person can be more susceptible to making mistakes or absent from work and this would imply raising the economic level, so the medicine of the medicine of thedream should charge more relevance in order to promote the importance of sleeping to put aside the wrong idea that sleep is a waste of time or that is not related to our general health, in addition to having trained personnel to properly solve thesleep disorders.

References

1. Paruthi s, et al. RECOMMENDED AMOUNT OF SLEEP FOR PEDIATRIC POPULATIONS: A CONNENSUS STATEMENT OF THE ANNOUND ACADEMY OF SLEEP MEDICINE. J Clin Sleep Med. 2016; 12 (6): 785-6.

two. Watson NF, et al. RECOMMENDED AMOUND OF SLEEP FOR A A HEALTHY ADULT: A JOINT ACCIVIESUS STATEMENT OF THE ANNOUND ACADEMY OF SLEEP MEDICINE AND SLEEP REESARCH SOCIETY. Sleep. 2015; 38 (6): 843-4.

3. National Sleep Foundation. (2013). International Bedroom Poll. As of 28 November 2016: https: // Sleepfoundation.Org/Sleep-Polls-Data/Otherpolls/2013-International-Bedroom-Poll

4. Basner M, Spaeth Am, Dinges DF. SOCIODEMO-GRAPHIC CHARACTERISTICS AND WAKING ACTIVITIES AND ES ROLE IN THE TIMING AND DURATION OF SLEEP. Sleep 2014; 37 (12): 1889–906.

5. Hedin G, Norell-Clarke A, Hagelll P, Tonnesen H, Westergren A and Garmy P Facilitors and Barriers For A Good Night’s Sleep Among Adolescents. Front. Neurosci. 2020: 14:92.

6. Medic G, Wille M, Hemels M. Short –And Long-Term Health Concequences of Sleep Disruption. Nature and Science of Sleep. 2017: 9 151-161.

7. Diagnostic Classification of Sleep and Arousal Disorders. 1979 First Edition. Association of Sleep Disorders Centers and the Association for The Psychophysiological Study of Sleep. Sleep. 19792 (1): 1-154

8. American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. Darien: American Academy of Sleep Medicine;2014

9. Chattu V, Sakhamuri S, Kumar R et. to the. Insufficient Sleep syndrome is it time to classify it as a major noncommunicable disease?. Sleep Sci. 2018; 11 (2): 56-64

10. Karthikeyan R, Spence D, Pandi-Perumal S. The Contribution of Modern 24-Hour Society to The Development of Type 2 Diabetes Mellitus: The Role of Insosophicient Sleep. Sleep Sci. 2019; 12 (3): 227-231

eleven. MATRICCIANI LA, Olds TS, Blunden S, Rigney G, Williams MT. Never Enough Sleep: Brief History of Sleep Recommendations for Children. Pediatrics. 2012; 129 (3): 548-56.

12. Kohyama J, et. to the. Insufficient Sleep syndrome: an arecognized but clinical entity. Pediatric int. 2018 AP; 60 (4): 372-375.

13. Hafner M, Stepanek M, et al. WHY SLEEP MATTERS -THE ECONOMICS OF INSUFFICIENT SLEEP. Rand Health q. 2017 Jan;6 (4): 11.

14. Dure J, Dinges D. Neurocognitive Concequences of Sleep Deprivation. Seminars in Neurology. 2005;25 (1)