Frequency and Correlates of Sleep Debt in St. Petersburg

Abstract

Purpose

During weekdays, many of us fail meeting their physiologic sleep need. During weekends, however, when given additional sleep opportunity, homeostatic sleep pressure will typically lead to longer bedtimes, manifesting the cumulative sleep debt. This study aims at examining the prevalence and determinants of sleep debt, as indicated by the presence of ≥ 2 h weekend bedtime prolongation, in a general population.

Methods

We studied 257 healthy subjects living in St. Petersburg, Russia. All participants indicated their habitual bedtimes during weekdays and weekends, and completed the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale, Fatigue Impact Scale, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale.

Results

One-hundred-three participants (40%) exhibited a relevant sleep debt (≥ 2 h weekend–weekday difference in habitual bedtime). Compared to participants without sleep debt, the frequency of excessive daytime sleepiness (ESS score ≥ 11)—but not of fatigue, impaired sleep quality and mood disturbances—was higher in participants with sleep debt (21% vs. 10%, p = 0.01). Multiple regression analysis revealed younger age, higher ESS and lower body mass index as independent associates of sleep debt.

Conclusions

Sleep debt appeared to be very common among healthy subjects, and independently associated with younger age, higher ESS scores and lower BMI. However, the presence of sleep debt did not have an impact on fatigue or mood, as measured by validated questionnaires.

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Abbreviations

BMI:

Body mass index

ESS:

Epworth Sleepiness Scale

FIS:

Fatigue Impact Scale

FSS:

Fatigue Severity Scale

HADS:

Hospital Anxiety and Depression Scale

HBD:

Habitual bedtime duration

OSAS:

Obstructive sleep apnea syndrome

PLMS:

Periodic limb movements during sleep

PSQI:

Pittsburgh Sleep Quality Index

UTC:

Coordinated universal time

References

  1. 1.

    Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354(9188):1435–9.

    CAS  PubMed  Google Scholar 

  2. 2.

    Cappuccio FP, Cooper D, D'Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.

    PubMed  Google Scholar 

  3. 3.

    Goel N, Basner M, Rao H, Dinges DF. Circadian rhythms, sleep deprivation, and human performance. Prog Mol Biol Transl Sci. 2013;119:155–90.

    PubMed  PubMed Central  Google Scholar 

  4. 4.

    Gottlieb DJ, Ellenbogen JM, Bianchi MT, Czeisler CA. Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study. BMC Med. 2018;16(1):44.

    PubMed  PubMed Central  Google Scholar 

  5. 5.

    Hafner M, Stepanek M, Taylor J, Troxel WM, van Stolk C. Why sleep matters-the economic costs of insufficient sleep: a cross-country comparative analysis. Rand Health Q. 2017;6(4):11.

    PubMed  PubMed Central  Google Scholar 

  6. 6.

    Luyster FS, Strollo P, Zee PC, Walsh JK. Sleep: a health imperative. Sleep. 2012;35(6):727–34.

    PubMed  PubMed Central  Google Scholar 

  7. 7.

    Basner M, Rao H, Goel N, Dinges DF. Sleep deprivation and neurobehavioral dynamics. Curr Opin Neurobiol. 2013;23(5):854–63.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Belenky G, Wesensten NJ, Thorne DR, 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):1–12.

    PubMed  Google Scholar 

  9. 9.

    Van Dongen HP, Maislin G, Mullington JM, Dinges DF. 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(2):117–26.

    PubMed  Google Scholar 

  10. 10.

    Richardson GS, Drake CL, Roehrs TA, Roth T. Habitual sleep time predicts accuracy of self-reported alertness. Sleep. 2002;25:A145.

    Google Scholar 

  11. 11.

    Klerman EB, Dijk DJ. Interindividual variation in sleep duration and its association with sleep debt in young adults. Sleep. 2005;28(10):1253–9.

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation's updated sleep duration recommendations: final report. Sleep Health. 2015;1(4):233–43.

    PubMed  Google Scholar 

  13. 13.

    Hublin C, Kaprio J, Partinen M, Koskenvuo M. Insufficient sleep—a population-based study in adults. Sleep. 2001;24(4):392–400.

    CAS  PubMed  Google Scholar 

  14. 14.

    Hysing M, Pallesen S, Stormark KM, Lundervold AJ, Sivertsen B. Sleep patterns and insomnia among adolescents: a population-based study. J Sleep Res. 2013;22(5):549–56.

    PubMed  Google Scholar 

  15. 15.

    Fox EC, Wang K, Aquino M, et al. Sleep debt at the community level: impact of age, sex, race/ethnicity and health. Sleep Health. 2018;4(4):317–24.

    PubMed  PubMed Central  Google Scholar 

  16. 16.

    Kim SJ, Lee YJ, Cho SJ, Cho IH, Lim W, Lim W. Relationship between weekend catch-up sleep and poor performance on attention tasks in Korean adolescents. Arch Pediatr Adolesc Med. 2011;165(9):806–12.

    PubMed  Google Scholar 

  17. 17.

    Kim CW, Choi MK, Im HJ, et al. Weekend catch-up sleep is associated with decreased risk of being overweight among fifth-grade students with short sleep duration. J Sleep Res. 2012;21(5):546–51.

    PubMed  Google Scholar 

  18. 18.

    Lee YJ, Park J, Kim S, Cho SJ, Kim SJ. Academic performance among adolescents with behaviorally induced insufficient sleep syndrome. J Clin Sleep Med. 2015;11(1):61–8.

    PubMed  PubMed Central  Google Scholar 

  19. 19.

    Gavrilov YV, Shkilnyuk GG, Valko PO, et al. Validation of the Russian version of the Fatigue Impact Scale and Fatigue Severity Scale in multiple sclerosis patients. Acta Neurol Scand. 2018;138(5):408–16.

    PubMed  Google Scholar 

  20. 20.

    Alekseeva TM, Gavrilov YV, Kreis OA, et al. Fatigue in patients with myasthenia gravis. J Neurol. 2018;265(10):2312–21.

    CAS  PubMed  Google Scholar 

  21. 21.

    Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(8):1161–83.

    PubMed  PubMed Central  Google Scholar 

  23. 23.

    Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiat Scand. 1983;67(6):361–70.

    CAS  PubMed  Google Scholar 

  24. 24.

    Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–21313.

    CAS  Google Scholar 

  25. 25.

    Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of healthy sleep duration among adults—United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(6):137–41.

    PubMed  Google Scholar 

  26. 26.

    Krueger PM, Friedman EM. Sleep duration in the United States: a cross-sectional population-based study. Am J Epidemiol. 2009;169(9):1052–63.

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Czeisler CA. Perspective: casting light on sleep deficiency. Nature. 2013;497(7450):S13.

    CAS  PubMed  Google Scholar 

  28. 28.

    Breslau N, Roth T, Rosenthal L, Andreski P. Daytime sleepiness: an epidemiological study of young adults. Am J Public Health. 1997;87(10):1649–53.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Klerman EB, Dijk DJ. Age-related reduction in the maximal capacity for sleep—implications for insomnia. Curr Biol. 2008;18(15):1118–23.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Kleitman N. Sleep and wakefulness. 2nd ed. Chicago: University of Chicago Press; 1963.

    Google Scholar 

  31. 31.

    Pejovic S, Basta M, Vgontzas AN, et al. Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance. Am J Physiol Endocrinol Metab. 2013;305(7):E890–896.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Depner CM, Melanson EL, Eckel RH, et al. Ad libitum weekend recovery sleep fails to prevent metabolic dysregulation during a repeating pattern of insufficient sleep and weekend recovery sleep. Curr Biol. 2019;29(6):957–67.

    CAS  PubMed  Google Scholar 

  33. 33.

    Simpson NS, Diolombi M, Scott-Sutherland J, et al. Repeating patterns of sleep restriction and recovery: do we get used to it? Brain Behav Immun. 2016;58:142–51.

    PubMed  PubMed Central  Google Scholar 

  34. 34.

    Lamond N, Jay SM, Dorrian J, Ferguson SA, Jones C, Dawson D. The dynamics of neurobehavioural recovery following sleep loss. J Sleep Res. 2007;16(1):33–41.

    PubMed  Google Scholar 

  35. 35.

    Wing YK, Li SX, Li AM, Zhang J, Kong AP. The effect of weekend and holiday sleep compensation on childhood overweight and obesity. Pediatrics. 2009;124(5):e994–e1000.

    PubMed  Google Scholar 

  36. 36.

    Im HJ, Baek SH, Chu MK, et al. Association between weekend catch-up sleep and lower body mass: population-based study. Sleep. 2017;40:7. https://doi.org/10.1093/sleep/zsx089.

    Article  Google Scholar 

  37. 37.

    Arora T, Chen MZ, Cooper AR, Andrews RC, Taheri S. The impact of sleep debt on excess adiposity and insulin sensitivity in patients with early type 2 diabetes mellitus. J Clin Sleep Med. 2016;12(5):673–80.

    PubMed  PubMed Central  Google Scholar 

  38. 38.

    Hasler G, Buysse DJ, Klaghofer R, et al. The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep. 2004;27(4):661–6.

    PubMed  Google Scholar 

  39. 39.

    Hwangbo Y, Kim WJ, Chu MK, Yun CH, Yang KI. Association between weekend catch-up sleep duration and hypertension in Korean adults. Sleep Med. 2013;14(6):549–54.

    PubMed  Google Scholar 

  40. 40.

    Gupta N, Maranda L, Gupta R. Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension. Clin Hypertens. 2018;24:7.

    PubMed  PubMed Central  Google Scholar 

  41. 41.

    Hagell P, Broman JE. Measurement properties and hierarchical item structure of the Epworth Sleepiness Scale in Parkinson's disease. J Sleep Res. 2007;16(1):102–9.

    PubMed  Google Scholar 

  42. 42.

    Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: a systematic review. Sleep Med Rev. 2014;18(4):321–31.

    PubMed  Google Scholar 

  43. 43.

    Borisenkov MF, Petrova NB, Timonin VD, et al. Sleep characteristics, chronotype and winter depression in 10–20-year-olds in northern European Russia. J Sleep Res. 2015;24(3):288–95.

    PubMed  Google Scholar 

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Affiliations

Authors

Contributions

YVG and POV contributed to the conception and design of the study; YVG and YV contributed to the translation and cultural adaptation of the questionnaires; YVG, GGS, EAK and IRG contributed to the acquisition of data; YVG and POV contributed to the statistical analysis, drafting the text and preparing the figures. All authors critically reviewed the final draft of the manuscript.

Corresponding author

Correspondence to Philipp O. Valko.

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The authors declare that they have no competing interest.

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Gavrilov, Y.V., Shkilnyuk, G.G., Konkina, E.A. et al. Frequency and Correlates of Sleep Debt in St. Petersburg. Sleep Vigilance (2020). https://doi.org/10.1007/s41782-020-00091-8

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Keywords

  • Habitual bedrest duration
  • Daytime sleepiness
  • Chronic sleep restriction
  • Social jetlag
  • Validation