The good news for many of the disorders that cause sleep deprivation is that after risk assessment, education, and treatment, memory and cognitive deficits improve and the number of injuries decreases.
In the long term, the clinical consequences of untreated sleep disorders are large indeed. They are associated with numerous, serious medical illnesses, including:
- High blood pressure
- Heart attack
- Heart failure
- Psychiatric problems, including depression and other mood disorders
- Attention Deficit Disorder (ADD)
- Mental impairment
- Fetal and childhood growth retardation
- Injury from accidents
- Disruption of bed partner's sleep quality
- Poor quality of life
Studies show an increased mortality risk for those reporting less than either six or seven hours per night. One study found that reduced sleep time is a greater mortality risk than smoking, high blood pressure, and heart disease. Sleep disturbance is also one of the leading predictors of institutionalization in the elderly, and severe insomnia triples the mortality risk in elderly men.
Remarkably, sleep loss may also be a contributing factor to obesity. John Winkelman, MD, PhD, medical director of the Sleep Health Center at Brigham and Women's Hospital and assistant professor of psychiatry at Harvard Medical School sums up this finding up nicely: "What most people do not realize is that better sleep habits may be instrumental to the success of any weight management plan." And Michael Thorpy, MD, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York adds, "Any American making a resolution to lose weight ... should probably consider a parallel commitment for getting more sleep."
It is also important to realize the huge scope and prevalence of these disorders; more than 85 sleep disorders are recognized by the American Sleep Disorders Association, affecting more than 70 million Americans. Up to one-third of Americans have symptoms of insomnia; however, less than 10% of those are identified by primary-care doctors. Sleep-related breathing disorders represent a spectrum of abnormalities that range from simple snoring to sleep apnea (repeated episodes of cessation of breathing during sleep). As highly prevalent as they are, most cases remain undiagnosed and untreated.
- Chronic snoring, for example, is associated with an increased incidence of heart and brain-related diseases. It is present in about 45% of the U.S. population; up to half of those have sleep apnea.
- The prevalence of sleep apnea is on par with diabetes and asthma. More than 20 million Americans -- 24% of adult men and 9% of adult women -- are estimated to have some degree of obstructive sleep apnea. Only a fraction have been diagnosed and treated.
- Sleep apnea is a primary risk factor for high blood pressure; as many as 40% of those people are undiagnosed and untreated for high blood pressure. Effective treatment of sleep apnea in patients with high blood pressure leads to a substantial reduction in stroke risk.
- Patients with moderate to severe sleep apnea perform as poorly as drunk drivers and have up to a 15-fold increased risk of motor vehicle accidents.
With the wealth of information and treatment options available for sleep deprivation, much of the suffering, illness from the many related diseases, increase in accident rates, and effects on productivity, performance, concentration, and memory can be avoided. Increased awareness is the first step, for us individually and the health care community. Some researchers suggest that sleep deprivation should be recognized with the same seriousness that has been associated with the societal impact of alcohol.