Duration, timing and quality of sleep are each vital for health, performance and safety

Published:January 13, 2015DOI:https://doi.org/10.1016/j.sleh.2014.12.008
      More than 30 years ago, Rechtschaffen et al
      • Rechtschaffen A.
      • Gilliland M.A.
      • Bergmann B.M.
      • Winter J.B.
      Physiological correlates of prolonged sleep deprivation in rats.
      demonstrated that sleep is just as necessary as food for bodily survival. Yet, as recently as 2005, Hobson
      • Hobson J.A.
      Sleep is of the brain, by the brain and for the brain.
      has argued that “sleep is of the brain, by the brain, and for the brain.” In 2007, systems biologist Van Savage and theoretical physicist Geoffrey West concluded that the reason why small mammals with a high metabolic rate like the mouse sleep so much longer, approximately 14 hours per day, than large mammals with a low metabolic rate like the elephant, which sleeps only 3.5 hours per day, is that the core function of sleep is to repair, reorganize, and maintain the brain's neurons, which burn more energy per unit mass than any other tissue.
      • Savage V.M.
      • West G.B.
      A quantitative, theoretical framework for understanding mammalian sleep.
      The landmark discovery that sleep facilitates the clearance of toxic metabolic debris, including amyloid β, that is generated by neural activity and accumulates during wakefulness, supports and extends that theory.
      • Nedergaard M.
      Neuroscience. Garbage truck of the brain.
      • Xie L.
      • Kang H.
      • Xu Q.
      • Chen M.J.
      • Liao Y.
      • Thiyagarajan M.
      • et al.
      Sleep drives metabolite clearance from the adult brain.
      Evidence of the crucial role that sleep plays in brain development, synaptic pruning, plasticity, rehearsal, memory consolidation, learning, and insight further supports the conclusion that sleep is critical for brain functioning,
      • Roffwarg H.P.
      • Muzio J.N.
      • Dement W.C.
      Ontogenetic development of the human sleep-dream cycle.
      • Stickgold R.
      • Walker M.P.
      Sleep-dependent memory triage: evolving generalization through selective processing.
      • Frank M.G.
      Sleep and developmental plasticity not just for kids.
      • Tononi G.
      • Cirelli C.
      Sleep and the price of plasticity: from synaptic and cellular homeostasis to memory consolidation and integration.
      • Bendor D.
      • Wilson M.A.
      Biasing the content of hippocampal replay during sleep.
      • Vorster A.P.
      • Born J.
      Sleep and memory in mammals, birds and invertebrates.
      rather than simply serving to keep us out of trouble at night.
      • Siegel J.M.
      Sleep viewed as a state of adaptive inactivity.
      Moreover, in the 15 years since Eve Van Cauter and her colleagues at the University of Chicago discovered that sleep deficiency adversely impacts metabolic and endocrine functions,
      • Spiegel K.
      • Leproult R.
      • Van Cauter E.
      Impact of sleep debt on metabolic and endocrine function.
      it has been demonstrated unequivocally that the duration, timing, and quality of sleep also critically affect physical health, mental health, performance, and safety.
      Committee on Sleep Medicine Research Board on Health Sciences Policy.
      Thus, it is clear that sleep is critical not just for optimal brain functioning but also for optimal functioning of the body as well.
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      References

        • Rechtschaffen A.
        • Gilliland M.A.
        • Bergmann B.M.
        • Winter J.B.
        Physiological correlates of prolonged sleep deprivation in rats.
        Science. 1983; 221: 182-184
        • Hobson J.A.
        Sleep is of the brain, by the brain and for the brain.
        Nature. 2005; 437: 1254-1256
        • Savage V.M.
        • West G.B.
        A quantitative, theoretical framework for understanding mammalian sleep.
        Proc Natl Acad Sci U S A. 2007; 104: 1051-1056
        • Nedergaard M.
        Neuroscience. Garbage truck of the brain.
        Science. 2013; 340: 1529-1530
        • Xie L.
        • Kang H.
        • Xu Q.
        • Chen M.J.
        • Liao Y.
        • Thiyagarajan M.
        • et al.
        Sleep drives metabolite clearance from the adult brain.
        Science. 2013; 342: 373-377
        • Roffwarg H.P.
        • Muzio J.N.
        • Dement W.C.
        Ontogenetic development of the human sleep-dream cycle.
        Science. 1966; 152: 604-619
        • Stickgold R.
        • Walker M.P.
        Sleep-dependent memory triage: evolving generalization through selective processing.
        Nat Neurosci. 2013; 16: 139-145
        • Frank M.G.
        Sleep and developmental plasticity not just for kids.
        Prog Brain Res. 2011; 193: 221-232
        • Tononi G.
        • Cirelli C.
        Sleep and the price of plasticity: from synaptic and cellular homeostasis to memory consolidation and integration.
        Neuron. 2014; 81: 12-34
        • Bendor D.
        • Wilson M.A.
        Biasing the content of hippocampal replay during sleep.
        Nat Neurosci. 2012; 15: 1439-1444
        • Vorster A.P.
        • Born J.
        Sleep and memory in mammals, birds and invertebrates.
        Neurosci Biobehav Rev. 2014; ([Epub ahead of print])https://doi.org/10.1016/j.neubiorev.2014.09.020
        • Siegel J.M.
        Sleep viewed as a state of adaptive inactivity.
        Nat Rev Neurosci. 2009; 10: 747-753
        • Spiegel K.
        • Leproult R.
        • Van Cauter E.
        Impact of sleep debt on metabolic and endocrine function.
        Lancet. 1999; 354: 1435-1439
      1. Committee on Sleep Medicine Research Board on Health Sciences Policy.
        in: Sleep disorders and sleep deprivation. An Unmet Public Health Problem. Institute of Medicine of the National Academies; The National Academies Press, Washington, D.C.2006
        • Centers for Disease Control and Prevention
        Perceived insufficient rest or sleep among adults—United States, 2008.
        MMWR. 2009; 58: 1175-1179
        • Centers for Disease Control and Prevention
        Short sleep duration among workers—United States, 2010.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 281-285
        • Czeisler C.A.
        Perspective: casting light on sleep deficiency.
        Nature. 2013; 497: S13
        • Spiegel K.
        • Leproult R.
        • Tasali E.
        • Penev P.
        • Van Cauter E.
        Brief Communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels and increased hunger and appetite.
        Ann Int Med. 2004; 141: 846-850
        • Markwald R.R.
        • Melanson E.L.
        • Smith M.R.
        • Higgins J.
        • Perreault L.
        • Eckel R.H.
        • et al.
        Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain.
        Proc Natl Acad Sci U S A. 2013; 10: 5695-5700
        • Van Cauter E.
        • Holmback U.
        • Knutson K.
        • Leproult R.
        • Miller A.
        • Nedeltcheva A.
        • et al.
        Impact of sleep and sleep loss on neuroendocrine and metabolic function.
        Horm Res. 2007; 67: 2-9
        • Broussard J.L.
        • Ehrmann D.A.
        • Van Cauter E.
        • Tasali E.
        • Brady M.J.
        Impaired insulin signaling in human adipocytes after experimental sleep restriction: a randomized crossover study.
        Ann Intern Med. 2012; 157: 549-557
        • Spiegel K.
        • Sheridan J.F.
        • Van Cauter E.
        Effect of sleep deprivation on response to immunization.
        J Am Med Assoc. 2002; 288: 1471-1472
        • Cohen S.
        • Doyle W.J.
        • Alper C.M.
        • Janicki-Deverts D.
        • Turner R.B.
        Sleep habits and susceptibility to the common cold.
        Arch Intern Med. 2009; 169: 62-67
        • Dinges D.F.
        • Pack F.
        • Williams K.
        • Gillen K.A.
        • Powell J.W.
        • Ott G.E.
        • et al.
        Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night.
        Sleep. 1997; 20: 267-277
        • Van Dongen H.P.A.
        • Maislin G.
        • Mullington J.M.
        • Dinges D.F.
        The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation.
        Sleep. 2003; 26: 117-126
        • Belenky G.
        • Wesensten N.J.
        • Thorne D.R.
        • Thomas M.L.
        • Sing H.C.
        • Redmond D.P.
        • et al.
        Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: a sleep dose-response study.
        J Sleep Res. 2003; 12: 1-12
        • Buxton O.M.
        • Cain S.W.
        • O'Connor S.P.
        • Porter J.H.
        • Duffy J.F.
        • Wang W.
        • et al.
        Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption.
        Sci Transl Med. 2012; 4: 129ra143
        • Cappuccio F.P.
        • Taggart F.M.
        • Kandala N.B.
        • Currie A.
        • Peile E.
        • Stranges S.
        • et al.
        Meta-analysis of short sleep duration and obesity in children and adults.
        Sleep. 2008; 31: 619-626
        • Taveras E.M.
        • Rifas-Shiman S.L.
        • Oken E.
        • Gunderson E.P.
        • Gillman M.W.
        Short sleep duration in infancy and risk of childhood overweight.
        Arch Pediatr Adolesc Med. 2008; 162: 305-311
        • Carter P.J.
        • Taylor B.J.
        • Williams S.M.
        • Taylor R.W.
        Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study.
        BMJ. 2011; 342: d2712
        • Landhuis C.E.
        • Poulton R.
        • Welch D.
        • Hancox R.J.
        Childhood sleep time and long-term risk for obesity: a 32-year prospective birth cohort study.
        Pediatrics. 2008; 122: 955-960
        • King C.R.
        • Knutson K.L.
        • Rathouz P.J.
        • Sidney S.
        • Liu K.
        • Lauderdale D.S.
        Short sleep duration and incident coronary artery calcification.
        J Am Med Assoc. 2008; 300: 2859-2866
        • Cappuccio F.P.
        • Cooper D.
        • D'Elia L.
        • Strazzullo P.
        • Miller M.A.
        Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.
        Eur Heart J. 2011; 32: 1484-1492
        • Yaggi H.K.
        • Araujo A.B.
        • McKinlay J.B.
        Sleep duration as a risk factor for the development of type 2 diabetes.
        Diabetes Care. 2006; 29: 657-661
        • Jackson C.L.
        • Redline S.
        • Kawachi I.
        • Hu F.B.
        Association between sleep duration and diabetes in black and white adults.
        Diabetes Care. 2013; 36: 3557-3565
        • Cappuccio F.P.
        • D'Elia L.
        • Strazzullo P.
        • Miller M.A.
        Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis.
        Diabetes Care. 2010; 33: 414-420
        • Holliday E.G.
        • Magee C.A.
        • Kritharides L.
        • Banks E.
        • Attia J.
        Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis.
        PLoS One. 2013; 8: e82305
        • Grandner M.A.
        • Hale L.
        • Moore M.
        • Patel N.P.
        Mortality associated with short sleep duration: the evidence, the possible mechanisms, and the future.
        Sleep Med Rev. 2010; 14: 191-203
        • Cappuccio F.P.
        • D'Elia L.
        • Strazzullo P.
        • Miller M.A.
        Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies.
        Sleep. 2010; 33: 585-592
        • Hansen J.
        • Lassen C.F.
        Nested case-control study of night shift work and breast cancer risk among women in the Danish military.
        Occup Environ Med. 2012; 69: 551-556
        • He C.
        • Anand S.T.
        • Ebell M.H.
        • Vena J.E.
        • Robb S.W.
        Circadian disrupting exposures and breast cancer risk: a meta-analysis.
        Int Arch Occup Environ Health. 2014; ([Epub ahead of print])
        • Viswanathan A.N.
        • Hankinson S.E.
        • Schernhammer E.S.
        Night shift work and the risk of endometrial cancer.
        Cancer Res. 2007; 67: 10618-10622
        • Schernhammer E.S.
        • Laden F.
        • Speizer F.E.
        • Willett W.C.
        • Hunter D.J.
        • Kawachi I.
        • et al.
        Night-shift work and risk of colorectal cancer in the nurses' health study.
        J Natl Cancer Inst. 2003; 95: 825-828
        • Papantoniou K.
        • Kogevinas M.
        • Martin Sanchez V.
        • Moreno V.
        • Pollan M.
        • Moleón J.J.
        • et al.
        0058 Colorectal cancer risk and shift work in a population-based case-control study in Spain (MCC-Spain).
        Occup Environ Med. 2014; 71: A5-A6https://doi.org/10.1136/oemed-2014-102362.16
        • Kubo T.
        • Ozasa K.
        • Mikami K.
        • Wakai K.
        • Fujino Y.
        • Watanabe Y.
        • et al.
        Prospective cohort study of the risk of prostate cancer among rotating-shift workers: findings from the Japan collaborative cohort study.
        Am J Epidemiol. 2006; 164: 549-555
        • Sigurdardottir L.G.
        • Valdimarsdottir U.A.
        • Fall K.
        • Rider J.R.
        • Lockley S.W.
        • Schernhammer E.
        • et al.
        Circadian disruption, sleep loss, and prostate cancer risk: a systematic review of epidemiologic studies.
        Cancer Epidemiol Biomarkers Prev. 2012; 21: 1002-1011
        • Papantoniou K.
        • Castaño-Vinyals G.
        • Espinosa A.
        • Aragonés N.
        • Pérez-Gómez B.
        • Burgos J.
        • et al.
        Night shift work, chronotype and prostate cancer risk in the MCC-Spain case-control study.
        Int J Cancer. 2014; ([Epub ahead of print])
        • World Health Organization International Agency for Research on Cancer
        Painting, firefighting and shiftwork.
        in: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. vol. 98. World Health Organization, Geneva, Switzerland2010
        • Gordon J.A.
        • Alexander E.K.
        • Lockley S.W.
        • Evans E.E.
        • Venkatan S.K.
        • Landrigan C.P.
        • et al.
        Does simulator-based clinical performance correlate with actual hospital behavior? The effect of extended work hours on patient care provided by medical interns.
        Acad Med. 2010; 85: 1583-1588
        • Philibert I.
        Sleep loss and performance in residents and nonphysicians: a meta-analytic examination.
        Sleep. 2005; 28: 1392-1402
        • Czeisler C.A.
        The Gordon Wilson Lecture: work hours, sleep and patient safety in residency training.
        Trans Am Clin Climatol Assoc. 2006; 117: 159-189
        • Rogers A.E.
        The effects of fatigue and sleepiness on nurse performance and patient safety.
        in: Hughes R.G. Patient safety and quality: an evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US, Rockville (MD)2008 ([Chapter 40])
        • Dembe A.E.
        • Erickson J.B.
        • Delbos R.G.
        • Banks S.M.
        The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States.
        Occup Environ Med. 2005; 62: 588-597
        • McHill A.W.
        • Melanson E.L.
        • Higgins J.
        • Connick E.
        • Moehlman T.M.
        • Stothard E.R.
        • et al.
        Impact of circadian misalignment on energy metabolism during simulated nightshift work.
        Proc Natl Acad Sci U S A. 2014; 111: 17302-17307
        • Scheer F.A.
        • Hilton M.F.
        • Mantzoros C.S.
        • Shea S.A.
        Adverse metabolic and cardiovascular consequences of circadian misalignment.
        Proc Natl Acad Sci U S A. 2009; 106: 4453-4458
        • Santhi N.
        • Horowitz T.S.
        • Duffy J.F.
        • Czeisler C.A.
        Acute sleep deprivation and circadian misalignment associated with transition onto the first night of work impairs visual selective attention.
        PLoS One. 2007; 2: e1233
        • Boivin D.B.
        • Czeisler C.A.
        • Dijk D.J.
        • Duffy J.F.
        • Folkard S.
        • Minors D.S.
        • et al.
        Complex interaction of the sleep-wake cycle and circadian phase modulates mood in healthy subjects.
        Arch Gen Psychiatry. 1997; 54: 145-152
        • Wright Jr., K.P.
        • Hull J.T.
        • Hughes R.J.
        • Ronda J.M.
        • Czeisler C.A.
        Sleep and wakefulness out of phase with internal biological time impairs learning in humans.
        J Cogn Neurosci. 2006; 18: 508-521
        • Ramin C.
        • Devore E.E.
        • Wang W.
        • Pierre-Paul J.
        • Wegrzyn L.R.
        • Schernhammer E.S.
        Night shift work at specific age ranges and chronic disease risk factors.
        Occup Environ Med. 2015; 72: 100-107
        • Toshihiro M.
        • Saito K.
        • Takikawa S.
        • Takebe N.
        • Onoda T.
        • Satoh J.
        Psychosocial factors are independent risk factors for the development of type 2 diabetes in Japanese workers with impaired fasting glucose and/or impaired glucose tolerance.
        Diabet Med. 2008; 25: 1211-1217
        • Suwazono Y.
        • Dochi M.
        • Sakata K.
        • Okubo Y.
        • Oishi M.
        • Tanaka K.
        • et al.
        Shift work is a risk factor for increased blood pressure in Japanese men: a 14-year historical cohort study.
        Hypertension. 2008; 52: 581-586
        • Sakata K.
        • Suwazono Y.
        • Harada H.
        • Okubo Y.
        • Kobayashi E.
        • Nogawa K.
        The relationship between shift work and the onset of hypertension in male Japanese workers.
        J Occup Environ Med. 2003; 45: 1002-1006
        • Kawachi I.
        • Colditz G.A.
        • Stampfer M.J.
        • Willett W.C.
        • Manson J.E.
        • Speizer F.E.
        • et al.
        Prospective study of shift work and risk of coronary heart disease in women.
        Circulation. 1995; 92: 3178-3182
        • Marquié J.C.
        • Tucker P.
        • Folkard S.
        • Gentil C.
        • Ansiau D.
        Chronic effects of shift work on cognition: findings from the VISAT longitudinal study.
        Occup Environ Med. 2014; ([Epub ahead of print])
        • Cho K.
        Chronic “jet lag” produces temporal lobe atrophy and spatial cognitive deficits.
        Nat Neurosci. 2001; 4: 567-568
        • Depner C.M.
        • Stothard E.R.
        • Wright Jr., K.P.
        Metabolic consequences of sleep and circadian disorders.
        Curr Diab Rep. 2014; 14: 507
        • Neckelmann D.
        • Mykletun A.
        • Dahl A.A.
        Chronic insomnia as a risk factor for developing anxiety and depression.
        Sleep. 2007; 30: 873-880
        • Baglioni C.
        • Spiegelhalder K.
        • Nissen C.
        • Riemann D.
        Clinical implications of the causal relationship between insomnia and depression: how individually tailored treatment of sleeping difficulties could prevent the onset of depression.
        EPMA J. 2011; 2: 287-293
        • Sigurdardottir L.G.
        • Valdimarsdottir U.A.
        • Mucci L.A.
        • Fall K.
        • Rider J.R.
        • Schernhammer E.
        • et al.
        Sleep disruption among older men and risk of prostate cancer.
        Cancer Epidemiol Biomarkers Prev. 2013; 22: 872-879
        • Sofi F.
        • Cesari F.
        • Casini A.
        • Macchi C.
        • Abbate R.
        • Gensini G.F.
        Insomnia and risk of cardiovascular disease: a meta-analysis.
        Eur J Prev Cardiol. 2014; 21: 57-64https://doi.org/10.1177/2047487312460020
        • Parthasarathy S.
        • Vasquez M.M.
        • Halonen M.
        • Bootzin R.
        • Quan S.F.
        • Martinez F.D.
        • et al.
        Persistent insomnia is associated with mortality risk.
        Am J Med. 2014; ([Epub ahead of print])https://doi.org/10.1016/j.amjmed.2014.10.015
        • Young T.
        • Palta M.
        • Dempsey J.
        • Skatrud J.
        • Weber S.
        • Badr S.
        The occurrence of sleep-disordered breathing among middle-aged adults.
        N Engl J Med. 1993; 328: 1230-1235
        • Peppard P.E.
        • Young T.
        • Barnet J.H.
        • Palta M.
        • Hagen E.W.
        • Hla K.M.
        Increased prevalence of sleep-disordered breathing in adults.
        Am J Epidemiol. 2013; 177: 1006-1014
        • Sedky K.
        • Bennett D.S.
        • Carvalho K.S.
        Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis.
        Sleep Med Rev. 2014; 18: 349-356
        • Sookoian S.
        • Pirola C.J.
        Obstructive sleep apnea is associated with fatty liver and abnormal liver enzymes: a meta-analysis.
        Obes Surg. 2013; 23: 1815-1825
        • Musso G.
        • Cassader M.
        • Olivetti C.
        • Rosina F.
        • Carbone G.
        • Gambino R.
        Association of obstructive sleep apnoeawith the presence and severity of non-alcoholic fatty liver disease. A systematic review and meta-analysis.
        Obes Rev. 2013; 14: 417-431
        • Raghuram A.
        • Clay R.
        • Kumbam A.
        • Tereshchenko L.G.
        • Khan A.
        A systematic review of the association between obstructive sleep apnea and ventricular arrhythmias.
        J Clin Sleep Med. 2014; 10: 1155-1160
        • Dong J.Y.
        • Zhang Y.H.
        • Qin L.Q.
        Obstructive sleep apnea and cardiovascular risk: meta-analysis of prospective cohort studies.
        Atherosclerosis. 2013; 229: 489-495
        • Tregear S.
        • Reston J.
        • Schoelles K.
        • Phillips B.
        Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis.
        J Clin Sleep Med. 2009; 5: 573-581
        • Yaggi H.K.
        • Concato J.
        • Kernan W.N.
        • Lichtman J.H.
        • Brass L.M.
        • Mohsenin V.
        Obstructive sleep apnea as a risk factor for stroke and death.
        N Engl J Med. 2005; 353: 2034-2041
        • Young T.
        • Finn L.
        • Peppard P.E.
        • Szklo-Coxe M.
        • Austin D.
        • Nieto F.J.
        • et al.
        Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort.
        Sleep. 2008; 31: 1071-1078
        • Pan W.
        • Kastin A.J.
        Can sleep apnea cause Alzheimer's disease?.
        Neurosci Biobehav Rev. 2014; 47C: 656-669
        • National Center on Sleep Disorders Research
        National Institutes of Health Sleep Disorders Research Plan.
        in: National Institutes of Health, Bethesda, MD2011
        • Horne J.
        Is there a sleep debt?.
        Sleep. 2004; 27: 1047-1049
        • National Sleep Foundation
        Sleep in America Poll: summary of findings.
        in: 2009 ([Washington, DC])
        • Royal D.
        National survey of distracted and drowsy driving attitudes and behavior: 2002.
        in: vol. DOT HS 809 566. National Highway Traffic Safety Administration, Washington, D.C.2003: 1-61