Can Poor Sleep Quality Affect Longevity?

It is well known that sleep affects general health, and a strong suspicion that it affects longevity too. Several studies have put this to the test. 

The ongoing Australian “Busselton Study” is a long-term and on-going health study of the relationship between sleep and pulmonary disease, diabetes and cancer. The study suggests that optimum sleep reduces both co-morbidity and mortality. 

Another study supporting this association is from the highly publicized Wisconsin Sleep Cohort study in the US. An 18-year follow up showed a significant high mortality risk with untreated Sleep Disordered Breathing (SDB) independent of age, sex, and BMI. It clearly illustrated the need for heightened clinical recognition and treatment of SDB indicated by frequent episodes of apnea and hypopnea, irrespective of symptoms of sleepiness. To date, this appears to be ignored with Canadian estimates of 5.4+ million adults with SDM, yet still less than 8% medically diagnosed! 

A further study in the UK, the “Whitehall Study”, showed that those who had cut their sleeping from 7 hours down to 5 hours or less faced a 1.7 times increased risk in mortality from all causes and twice the increased risk of death from a cardiovascular problem in particular. 

As our society becomes an “open all hours” 24-hour affair, we must be mindful of the need for 7-8 hours quality sleep per night and for most the saying, “early to bed, early to rise – makes a man both wealthy and wise” holds true. 

Warning Signs of Sleep Deprivation 

Guidelines currently suggest healthy adults should aim for 7 to 8 hours of sleep each night. According to healthcare experts, sleep deprivation is defined as a failure to obtain sufficient total sleep and can have serious health consequences. 

Sleep deprivation has a cumulative effect and individuals vary in how little sleep it takes to make them feel sleep deprived. For example, one person may feel sleep-deprived after 6 hours of sleep, and another might only feel sleep-deprived after only 2 or 3 hours of sleep. 

Sleep deprivation is associated with increased risks for obesity, type 2 diabetes, high blood pressure and cardiovascular disease.  

Insufficient sleep weakens the immune system and sleep-deprived patients do not respond as well to vaccines as individuals who have had sufficient sleep. In a viral outbreak, resistance to both the disease and vaccination is important. 

Sleep deprivation is also associated with kidney disease, stroke, and increased signs of skin aging. Patients struggling with sleep issues should seek assistance for both now and future health protection. 

Sleep deprivation may result from a lack of quality sleep as much as quantity. The most frequent cause of decreased sleep quality is Sleep Disordered Breathing (SDB) which includes Obstructive Sleep Apnea (OSA), Snoring and what’s called, “Upper Airway Resistance Syndrome” (UARS). 

In our office, we ask about the patient’s sleep routines and sleeping environment and we might recommend participating in a home sleep study to check for underlying conditions that could be affecting sleep quality and duration. Obstructive Sleep Apnea has been estimated to affect over a quarter of adults. 

Yawning and fatigue 

Yawning and fatigue may both signs of insufficient sleep, and these can occur after even just one night of poor sleep. For example, patients might find themselves yawning on their way to work or even at the office the next day and they may yawn more frequently as the day progresses. 

Fatigue can make patients feel groggy and it is often difficult for patients to stay attentive throughout the working day.  

After a night of poor sleep, it is common for individuals to feel like they need to take a nap during the day, lack energy or have deteriorating memories. 

Both yawning and fatigue increase with each successive night of poor sleep and fatigue is known to impair coordination. This could increase a patient’s risk for motor vehicle accidents, trips, and falls. Even moderate levels of Obstructive Sleep Apnea have been shown to increase motor vehicle accidents by 7-10 times compared to those without OSA. 

Patients who experience fatigue that is not relieved by a few nights of sufficient sleep should seek assistance to check for such underlying health issues.  

Forgetfulness 

Sleep deprivation negatively impacts the brain, and this typically manifests as forgetfulness. Short-term, long-term and working memory are all affected. 

Moodiness 

Those who experience sleep deprivation for a few nights typically display moodiness. They might be irritable, and they could overreact or become quick-tempered. In addition, they could seem more troubled than usual by stressful situations, and they might have a lower threshold for what they define ‘stressful.’ In other words, it becomes more difficult to deal with life in general. The recent COVID outbreak has illustrated this well! 

Depressive Symptoms 

Lack of motivation is a frequent symptom of chronic sleep deprivation too; it is difficult to strive when you’ve nothing left to give. Individuals might feel overwhelmed by even the simplest tasks at home or work, and they could feel unable to start a task at all. 

This lack of motivation may progress to chronic procrastination and patients could have poor work or school performance. Patients may not be able to focus on their goals, and it may seem impossible to even define their goals. 

Lack of motivation is often seen in depressed patients, and sleep-deprived individuals who display this symptom or who have depression may also be more likely to engage in risk-taking and dangerous behaviour in the long term. 

They are significantly more likely to experience suicidal thoughts. Individuals who struggle with motivation over a prolonged period may want to keep a journal to document their struggles and it could also help to see a sleep specialist. Motivation may improve with sufficient sleep. If not, assistance should be sought. 

Inability to Concentrate 

Sleep deprivation is strongly linked to an inability to concentrate. The effects of sleep deprivation on an individual’s short-term memory make it hard for them to organize things, plan, or come up with creative solutions to problems. 

Studies show sleep-deprived patients have shorter attention spans than those who are not sleep-deprived. Sleep deprivation causes individuals to be less alert, and patients often develop impairments in judgment and reasoning skills. 

Decision making becomes challenging and patients are easily confused. They are less able to correctly assess the risk associated with certain situations and they might make poor choices as a result. Work evaluations, school grades, relationships and family life could all suffer due to an inability to concentrate. 

There is a known association between quality sleep deprivation and Attention Deficit Hyperactivity Disorder (ADHD). 

Patients who notice this symptom regularly may want to consider having a sleep study. For most individuals, concentration issues caused by a few nights of sleep deprivation will improve once they achieve adequate quality sleep. 

Adults and children respond differently to a lack of sleep. This is true of children and the “Walmart Syndrome” where kids play up - but often due to sleep deprivation, while sleep deprived adults often show fatigue or irritability. Obstructive Sleep Apnea is common in children too. From 3 to 12 % of children snore, while Obstructive Sleep Apnea syndrome affects up to 10% of children.  

Sleep Duration and Mortality: The Future. 

Both short and long duration of sleep are significant predictors of death in prospective population studies, including those already mentioned, yet many questions remain regarding the sleep-mortality relationship. 

A better understanding the physiological/psychosocial connections between amount of sleep and shortened lifespan is critical. Simply documenting this relationship is no longer sufficient – we must explore possible mechanisms and pathways as well as develop targeted interventions that can positively alter this relationship. The management of Obstructive Sleep Apnea using CPAP or Dental Oral Appliance Therapy are examples. 

Research programs should investigate long and short sleep separately as both are associated with increased mortality risk, but the pathways may vary. 

Therefore, increased research needs to phenotype habitual long and short sleepers to better characterize these groups in terms of prospective and/or objective sleep, psychological functioning, performance, and health status which includes obesity, cardiovascular functioning, glucose tolerance, etc. 

Sleep quality should be considered more carefully in addition to simply sleep duration. Sleep duration alone is an insufficient measure for characterizing sleep. For example, short sleep is not the same as sleep insufficiency. Studying sleep disturbance, alone and with sleep duration, will better elucidate the public health implications of sleep. 

It is important to recognize that sleep deprivation is not only the result of not spending enough time in bed asleep, although clearly this is one reason. Remember, anything affecting sleep quality (Obstructive Sleep Apnea and snoring) or Insomnia (physiological or emotional) will also cause the same effects and must therefore be screened for. 

Conclusions – Does Quality Sleep Help you Live Longer? 

Quality sleep requires no interruption. Seep Disordered Breathing interrupts sleep significantly. 

Statistical evidence supports that adequate sleep for that individual, which is 7-8 hours per night; provides the best chance of maximizing your longevity from a sleep standpoint providing the sleep is uninterrupted (Obstructive Sleep Apnea fragments sleep). Poor sleep or periods less than this decreases optimum life expectancy. 

Obstructive Sleep Apnea remains a common cause of sleep disruption - fragmented sleep patterns, leading to in effect, the signs and symptoms of sleep deprivation. If you have any concerns that you may have Obstructive Sleep Apnea - call us so that you can get on with your life, the way it was meant to be!  

For more Blogs - please see - www.abettersleep.net - Stephen Bray (2020)