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Sleep Debt
I know that we here about sleep debt in many of the post. Do we actually inderstand this debt? I ask because before I started my sleep job I had no idea what it was. To be perfectly honest it was not something I truly understood for quite some time. I believed that sleep was directly related to the amount of phyisical effort I had put out in that particular day. Boy was I wrong. Physical effort does play a roll in the way we sleep. A small one. The amount of effort you put out in a day might affect the way you sleep. It does not however have any effect on your sleep debt.
What is sleep debt? To understand this phenom we must first look at sleep deprivation. For a normal person sleep deprivation is what happens any time you stay up longer than 16 hours in any day. If you are up for 24+ sleep deprivation will have the same effect on you that a BAC of .06 does. Loss of coordination, inhibition, and cognitive thought. What causes this you might ask? Dement and his collegues talk a great deal about this in many of their studies. Dement explains the sleep to wake ratio as such 1-2. This means that for every 2 hours that you are awake you need 1 hour of sleep in a normal day( or 8 hours in a day). This makes it pretty easy to see why in a 24 hour day sleep deprivaton begins at 16 hours of being awake.
This is when it gets a little complicated. Sleep debt is the amount of sleep not paid back to that ratio of 1-2. Let us say that a person is up for 20 hours due to family and work obligations. Regardless of when they go to bed they have to get up at the same time. They get 4 hours of sleep. Using the above ratio they needed at least 8-10 to make up for the amount of time they were awake. This person now has a sleep debt of 4-6 hours. sleep debt has to be paid back by the hour not the normal 1-2 ratio. Consider it a vig for you poker players. The next night this person would have to sleep 12 -14 hours to make up fro the lost sleep. This for most people is impossible. Most would make up for this with an hour here or an hour there. Regardless of when or how it is made up the body demands it. If a person does not take the steps to pay off this debt the body will eventually collect on it. Drowsiness means red alert! Your body does not care what you are doing if it needs sleep as soon as you relax enough it will take it. Beware!
Apneac pts carry a huge sleep debt. The reason fro this is that apneans do not get real sleep. they at least do not get deep sleep, because this is when we have the most apneac events. When your o2 goes down or you stop breathing you body begins the process of doing whatever it takes to improve that situation. This usually means bringing you to a lighter stage of sleep. If you continuously have events in stage 3 and REM then you will continuously be knocked out of those stages. No stage 3 + no REM= no sleep. This is why people that get 7-10 hours of sleep do not feel rested. Night after night of going through this not only affects your health, but your sleep debt as well. It has a stacking effect on your mind and body. There are no studies to show how much sleep debt your body will hang on to. Only theories. If you continuously lose 2 hours of sleep for a year due to apnea, then in theory you could have to pay back all of that sleep before you begin to feel rested once you begin PAP therapy. if you don't you will continue to carry all that debt around with you in the form of fatigue.
I hope this helps.
What is sleep debt? To understand this phenom we must first look at sleep deprivation. For a normal person sleep deprivation is what happens any time you stay up longer than 16 hours in any day. If you are up for 24+ sleep deprivation will have the same effect on you that a BAC of .06 does. Loss of coordination, inhibition, and cognitive thought. What causes this you might ask? Dement and his collegues talk a great deal about this in many of their studies. Dement explains the sleep to wake ratio as such 1-2. This means that for every 2 hours that you are awake you need 1 hour of sleep in a normal day( or 8 hours in a day). This makes it pretty easy to see why in a 24 hour day sleep deprivaton begins at 16 hours of being awake.
This is when it gets a little complicated. Sleep debt is the amount of sleep not paid back to that ratio of 1-2. Let us say that a person is up for 20 hours due to family and work obligations. Regardless of when they go to bed they have to get up at the same time. They get 4 hours of sleep. Using the above ratio they needed at least 8-10 to make up for the amount of time they were awake. This person now has a sleep debt of 4-6 hours. sleep debt has to be paid back by the hour not the normal 1-2 ratio. Consider it a vig for you poker players. The next night this person would have to sleep 12 -14 hours to make up fro the lost sleep. This for most people is impossible. Most would make up for this with an hour here or an hour there. Regardless of when or how it is made up the body demands it. If a person does not take the steps to pay off this debt the body will eventually collect on it. Drowsiness means red alert! Your body does not care what you are doing if it needs sleep as soon as you relax enough it will take it. Beware!
Apneac pts carry a huge sleep debt. The reason fro this is that apneans do not get real sleep. they at least do not get deep sleep, because this is when we have the most apneac events. When your o2 goes down or you stop breathing you body begins the process of doing whatever it takes to improve that situation. This usually means bringing you to a lighter stage of sleep. If you continuously have events in stage 3 and REM then you will continuously be knocked out of those stages. No stage 3 + no REM= no sleep. This is why people that get 7-10 hours of sleep do not feel rested. Night after night of going through this not only affects your health, but your sleep debt as well. It has a stacking effect on your mind and body. There are no studies to show how much sleep debt your body will hang on to. Only theories. If you continuously lose 2 hours of sleep for a year due to apnea, then in theory you could have to pay back all of that sleep before you begin to feel rested once you begin PAP therapy. if you don't you will continue to carry all that debt around with you in the form of fatigue.
I hope this helps.
Views: 1017
Replies to This Discussion
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Permalink Reply by BeeAsleep on
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Rock, thanks so much for this post. I was hearing a lot about sleep debt on the forum and didn't understand at all what that meant. It also helps me understand why I don't feel like a super star after having only used CPAP since April 3. I guess I thought that if I slept well ONE night then I automatically should feel 100% better the next day. I didn't understand the cumulative effects of low quality of sleep. MUCH thanks for this very educational post.
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Permalink Reply by amott1973 on
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See Mom! I knew this intuitively as a teenager when I'd sleep late on weekends to catch up on my lost sleep from the week. But my mom always said that you can't catch up on your sleep. I guess she was wrong. Heh!
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Permalink Reply by RockRpsgt on
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Yup amott you were right. It is still better to keep up with your sleep. You should keep your sleep schedule pretty routine no matter what day it is. Remember sleep debt is a measurement of sleep deprivation
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Permalink Reply by Chris on
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So if I had apnea for the last 20 years and just started using pap will I ever catch up on my sleep and feel good????????
So far a month of pap has done nothing.
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Yeah Rock, I wondered the same thing as Chris. It would seem that you wouldn't live long enough to ever repay your sleep debt if it were strictly a 1-2 ratio. Could you explain more?
Chris said:So if I had apnea for the last 20 years and just started using pap will I ever catch up on my sleep and feel good????????
So far a month of pap has done nothing.
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Their are no studies to show how much sleep debt a person can hang onto. The longest study measuring sleep debt was 2 weeks. Dement explained that there had to be a point when your body let it go.
quote from pg 63 "The Promise of Sleep". Chapter 3 sleep debt: natures loan shark.
"People also sometimes ask me if the exact accounting could mean that they are still carrying around sleep debt from all of those all-nighters in college. We don't know what happens to sleep debt in the long term. You may have paid off those sleep depriived periods when you got sick shortly afterword and slept for 18 hours at a stretch. or the brain may lose track of sleep debt accumulated months or years earlier."
"We can never be sure that there are not occasional nights with extra sleep, or unintended naps."
Also the members of this site are proof enough that you can combat sleep debt. It will get better guys.
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the 1-2 ratio is for a normal day. this ratio is assuming that you have no sleep debt. Theorist say that once a debt is owed it has to be paid back hour per hour. Thie ratio says that in a 24 hour day you need around 8 hours a day of sleep. Every hour under 8 that you sleep is added to you accumulitive sleep debt and must be paid back on a per hour basis. keep in mind that the amount of sleep needed varies by age. This ratio is based on the average amount of sleep needed by humans. Dement also says in the same chapter that I found this info in that it is posible to start feeling better when a small % of your sleep debt is paid off.
BeeAsleep said:Yeah Rock, I wondered the same thing as Chris. It would seem that you wouldn't live long enough to ever repay your sleep debt if it were strictly a 1-2 ratio. Could you explain more?
Chris said:So if I had apnea for the last 20 years and just started using pap will I ever catch up on my sleep and feel good????????
So far a month of pap has done nothing.
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later in the same chapter Dement discusses the effect of a long sleep debt. He says that a person will pass out due to exhaustion once a sleep debt of 24-32 hours is achieved. This would mean that the average person could stay up for about 48 hours before succumbing to fatigue. This is just an assumption, but I would be willing to say that the our bodies work to keep our overall sleep debt under 50 hours. This would be done by sleeping a little longer, or by taking naps. We also need to remember that to pay off this debt you must sleep over the amount of time required by your body. So if your body requires 7-8 hours of sleep and you consistantly still only sleep 6-8 you might not be paying off any of the debt. CPAP improves the quality of your sleep. It also helps you achieve SWS and REM rebound which are very much needed for the healing process. You must sill work a little to pay off your sleep debt. An extra 15-30 minutes of sleep over the norm for a week or 2 will go along way to reaching this goal. I would not devote much more than an hour to this process as it might make it more difficult to switch back to your normal pattern at a later date.
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Like I said I believe that it is possible for any one person to carry 35-40+ hours of sleep debt. it is not impossible to work off. You just have to commit to the process.
DDNight said:So if I've been suffering from Sleep Apnea for over 8 years and just began treatment with CPAP in Dec of 08, then I'm pretty much hosed (pardon the pun) for quite a few years since I've accumulated so much debt?
No wonder I haven't felt GREAT after being on CPAP for 6 months. BUT, I am feeling better, which is awesome.
Thanks Rock!!!
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Well, I am certainly not letting my husband see this post..hee, hee. He "works off" his sleep debt quite a bit on the weekends. He has become a permanent feature on the living room couch. Smiles. Thanks for the information, I am leaning so much here.
Rock Hinkle said:Like I said I believe that it is possible for any one person to carry 35-40+ hours of sleep debt. it is not impossible to work off. You just have to commit to the process.
DDNight said:So if I've been suffering from Sleep Apnea for over 8 years and just began treatment with CPAP in Dec of 08, then I'm pretty much hosed (pardon the pun) for quite a few years since I've accumulated so much debt?
No wonder I haven't felt GREAT after being on CPAP for 6 months. BUT, I am feeling better, which is awesome.
Thanks Rock!!!
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