This morning I was feeling low and uncomfortable in my own skin; a few hours of catch-up sleep later I felt splendid again, same person, same life, just rested. When I once went several nights in a row on almost no sleep, it didn't stop at a bad mood: I hallucinated, hurt myself and attacked other people. In cases of total sleep deprivation, this progression is documented with startling precision — a review of 21 studies with 760 participants describes perceptual distortions, irritability and feelings of detachment after 24 to 48 hours without sleep, complex hallucinations and disordered thinking after 48 to 90 hours, and delusions from 72 hours on; beyond that point the picture resembles acute psychosis. Losing my impulse control in the process is not a character flaw: after a single sleepless night, test subjects made measurably more errors in a lab task that required not reacting to negative stimuli, and a meta-analysis of 154 studies spanning five decades found that all three forms of sleep loss it examined went along with fewer positive feelings and more anxiety symptoms. Eleven of the 21 studies followed the recovery, seven of them reported full recovery after enough sleep; in some others, confusion, low mood or delusional beliefs persisted in individual participants for days or weeks, which the authors consider most likely due to pre-existing mental illness — and that is exactly why sleep, for me, is not a question of discipline but of safety.
Sources
- Waters F, Chiu V, Atkinson A, Blom JD: Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward Psychosis With Increasing Time Awake, Frontiers in Psychiatry 9, article 303 (2018)
- Palmer CA et al.: Sleep loss and emotion: A systematic review and meta-analysis of over 50 years of experimental research, Psychological Bulletin 150(4):440–463 (2024)
- Anderson C, Platten CR: Sleep deprivation lowers inhibition and enhances impulsivity to negative stimuli, Behavioural Brain Research 217(2):463–466 (2011)