Lack of Sleep

When a lack of sleep is suspected, it may require a determined effort to get more. The effort, however, is worth it since life is more enjoyable when you feel refreshed. If a sleep deficit is chronic, it may take many weeks of adequate sleep to fully recover.

A common measure of sleep deficit uses the Epworth Sleepiness Scale. Score your answers to the eight questions below as follows:

0 = no chance of dozing

1 = slight chance of dozing

2 = moderate chance of dozing

3 = high chance of dozing

  • Sitting and reading
  • Watching TV
  • Sitting inactive in a public place (e.g. a theater or a meeting)
  • As a passenger in a car for an hour without a break
  • Lying down to rest in the afternoon when circumstances permit
  • Sitting and talking to someone
  • Sitting quietly after a lunch without alcohol
  • In a car, while stopped for a few minutes in traffic

…and add the total score.

If your score is 1-6, you are getting enough sleep; 7-8 is common but 9 or more means you should think about seeking the advice of a sleep specialist.


Signs, symptoms & indicators of Lack of Sleep

Symptoms - Head - Eyes/Ocular  

Dark areas under eyes

Fatigue will add to the problem of dark circles under the eyes.


Bags under eyes

Being tired will add to the problem of bags under the eyes.

Symptoms - Mind - General  

Short-term memory failure


A 'foggy' mind


Trouble concentrating


Being indecisive

Symptoms - Sleep  

Difficulty getting out of bed




Unsound sleep


Being a light sleeper


(Often) taking naps

Conditions that suggest Lack of Sleep


Elevated Insulin Levels

A study found that people who do not get enough sleep on a regular basis may become less sensitive to insulin which, over time, can raise the risk of obesity, high blood pressure and diabetes. Chronic sleep deprivation (under 6.5 hours per night) had the same effect on insulin resistance as aging.



Problem Caused By Being Overweight

A good night’s sleep can help beat obesity, scientists have revealed, as research suggests being overtired can make you fat. Lack of sleep has been found to create a hormone imbalance, which increases the appetite and leads to putting on weight, it is claimed.

Even partial sleep deprivation was found to be a factor in body weight regulation, with research suggesting a good night’s sleep could have a significant impact in the fight against obesity. Research found that over a third of Americans were obese and more than a quarter get less than six hours sleep a night.

Insufficient sleep is known to raise the risk of metabolic disturbances, particularly insulin resistance, obesity, and type 2 diabetes.

In another report: Sleep deprivation caused a 30% decline in the insulin sensitivity of fat cells of healthy, lean young adults, according to a study in the Oct. 6, 2012 issue of Annals of Internal Medicine.

Counter Indicators

Risk factors for Lack of Sleep


Caffeine Intoxication

It almost goes without saying that coffee decreases the quality of sleep and is one of the leading causes of sleep disturbance. Coffee drinkers are sleepier and groggier than non-coffee drinkers when they get up in the morning, causing them to depend on coffee to get them going. This grogginess may be the result of their entering caffeine withdrawal during the night, or that drinking coffee kept them from sleeping well in the first place, or both.

Symptoms - Mind - General  

Absence of short-term memory loss

Symptoms - Sleep  

Sleeping less than necessary

Counter Indicators
Symptoms - Sleep  

Sleeping more than necessary

Lack of Sleep suggests the following may be present


Lack of Sleep can lead to


Elevated Insulin Levels

A study found that people who do not get enough sleep on a regular basis may become less sensitive to insulin which, over time, can raise the risk of obesity, high blood pressure and diabetes. Chronic sleep deprivation (under 6.5 hours per night) had the same effect on insulin resistance as aging.


Chronic Inflammation

A lack of sleep increases inflammatory cytokines. This helps explain why pain flare-up occurs in response to sleep deprivation in various disorders. Even modest sleep restriction adversely affects inflammatory cytokine levels. In a carefully controlled study, sleep deprivation caused a 40-60% average increase in the inflammatory marker IL-6 in men and women, while men alone showed a 20-30% increase in TNF-a. Both IL-6 and TNF-a are potent pro-inflammatory cytokines that induce systemic inflammation. [Endocrinol Metab Clin North Am. 2002 Mar;31(1): pp.15-36]



Sleep deprivation symptoms include irritability, fatigue, blurred vision, slurring of speech, memory lapses, and inability to concentrate. In extreme stages bizarre behavior and hallucinations can occur.

Recommendations for Lack of Sleep




Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
Very strongly or absolutely counter-indicative
Highly recommended



Usually Chronic illness: Illness extending over a long period of time.


A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Diabetes Mellitus

A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.


Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.


The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.


Cytokines are chemical messengers that control immune responses. They are secreted by white blood cells, T cells, epithelial cells and some other body cells. There are at least 17 different kinds of interleuken and 3 classes of interferon called alpha, beta and gamma and various subsets. Interleukens and interferons are called “cytokines” and there are two general groupings, Th1 and Th2. Th1 (T-cell Helper type 1) promote cell-mediated immunity (CMI) while Th2 (T-cell Helper type 2) induce humoral immunity (antibodies).


Interleukin-6. IL-6 is a pro-inflammatory and immunosuppressive cytokine. Elevations in serum IL-6 correlate with adverse disease features and shortened survival in chronic lymphocytic leukemia.


A false or distorted perception of objects or events, including sensations of sight, sound, taste, smell or touch, typically accompanied by a powerful belief in their reality.

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