We may have greatly underestimated the dangers of sleep deprivation

Getting a solid shut eye is not something you can just abandon — not if you want to stay in good health.

Image credits: Henning Roettger.

Sleep deprivation research isn’t new. Previous research has shown that sleep deprivation can cause a number of health problems, ranging from aching muscles and headaches to depression, memory loss, decreased immunity, and even depression.

But we may still be underestimating the damage that sleep deprivation can cause. An often-overlooked effect of lack of sleep is the propensity for errors. Simply put, the more tired you are, the more likely you are to make mistakes.

“If you look at mistakes and accidents in surgery, public transportation and even operating nuclear power plants, lack of sleep is one of the primary reasons for human error,” said Kimberly Fenn, associate professor of psychology and director of the MSU Sleep and Learning Lab. Sometimes, this lack of sleep reaches alarming levels. “There are many people in critical professions who are sleep-deprived. Research has found that nearly one-quarter of the people with procedure-heavy jobs have fallen asleep on the job.”

Of course, some errors are basic and make no significant difference in the grand scheme of things. You may forget where you left your cup or make a typo in an email — that kind of thing doesn’t really matter. But for millions of people, the daily routine also involves driving, and sleep deprivation is a prime cause for traffic accidents. For people operating complex machinery or doing complex procedures, that risk is even higher.

If you look at road accidents or major catastrophes such as Chernobyl or the Exxon Valdez oil spill, they often involve human error — and human errors are exacerbated by sleep deprivation.

So there is a great deal of evidence suggesting that lack of sleep can cause disasters. Quantifying that, however, has remained challenging. This latest study analyzed the effect lack of sleep has on a person’s ability to follow a procedure and maintain attention. In particular, Fenn’s team looked at how sleep-deprived people perform tasks when they are interrupted. Spoiler alert — it’s not good.

“Every day, approximately 11 sponges are left inside of patients who have undergone surgery. That’s 4,000 potentially dire missteps each year and an example of a procedural task gone terribly wrong that can result from sleep deprivation,” Fenn said. “Our research suggests that sleep-deprived people shouldn’t perform tasks in which they are interrupted — or, only perform them for short periods.”

In the experiments, researchers brought 234 people into the sleep lab at 10 PM. They had participants work on a sequence-based procedure that involved doing a series of activities in order. They were periodically interrupted and had to remember what they were doing in the procedure. At midnight, half of the participants went home to sleep and completed the procedure in the morning, and the other half stayed awake all night to pull through.

There was a stark jump in errors for the group that worked through the night — sleep deprivation was taking its toll.

“All participants met performance criteria in the evening, but roughly 15 percent of participants in the sleep-deprived group failed in the morning, compared to 1 percent of those who slept,” Fenn said. “Furthermore, sleep-deprived participants not only showed more errors than those who slept but also showed a progressive increase in errors associated with memory as they performed the task — an effect not observed in those who slept. This shows that the sleep-deprived group experienced a great deal of difficulty remembering where they were in the sequence during interruptions.”

The culprit for this is memory maintenance. When we don’t get enough sleep, our memory is hindered and we struggle to pick up tasks where we left off. Considering that we face a number of distractions every day, sleep deprivation can really ramp up our errors, even if we might not realize it.

“Our research showed that sleep deprivation doubles the odds of making placekeeping errors and triples the number of lapses in attention, which is startling,” said Kimberly Fenn, professor of psychology and director of the Sleep and Learning Lab. “Sleep-deprived individuals need to exercise caution in absolutely everything that they do, and simply can’t trust that they won’t make costly errors. Oftentimes – like when behind the wheel of a car – these errors can have tragic consequences.”

This is consistent with previous research and should be considered in real life situations, particularly in medicine and driving, researchers conclude.

“Our findings debunk a common theory that suggests that attention is the only cognitive function affected by sleep deprivation,” said co-author Michelle Stepan. “Some sleep-deprived people might be able to hold it together under routine tasks, like a doctor taking a patient’s vitals. But our results suggest that completing an activity that requires following multiple steps, such as a doctor completing a medical procedure, is much riskier under conditions of sleep deprivation.”

Journal Reference: Michelle E. Stepan, Kimberly M. Fenn, Erik M. Altmann. Effects of sleep deprivation on procedural errors. Journal of Experimental Psychology: General, 2018; DOI: 10.1037/xge0000495

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