The Reality of Sleep Debt Repayment

How many times have you said you were going to “catch up on sleep” over the weekend? You push through the week and go to bed later and later, planning to spend some extra time with your millet hulls pillow Sunday morning.


Sleep debt repayment is the idea that you can make up for lost sleep by sleeping more later. This was one of the main pieces of advice my grandmother used to give me as a child, and for years, I dismissed it as being an “old wives tale.” But the reality is – there’s a small bit of truth behind it. Sleep debt repayment is a real thing, although not as simple as my grandmother made it seem.


As many already know (and as we discussed in detail on our blog here), you need about 8 hours of sleep a night. That’s often easier said than done. With busy schedules and so many people having difficulties falling asleep at night, it can be hard to catch a solid 8 hours every single night. In the US, one-third of us get less than 6 hours of sleep a night. This means from Monday to Friday, we’ve accumulated a sleep debt of 10 hours, gaining 2 hours of sleep debt each night.


Determining your sleep debt is quite simple; subtract the amount of sleep you are actually getting from the amount of sleep you need. Research has looked at whether you can repay this debt by napping or sleeping more on the weekends. Simply put, if you have a small amount of sleep debt (e.g., one bad night), you can repay it, but if you are acquiring sleep debt every night, you won’t be able to make up for it over the weekend or with one 20-minute nap curled up on your shredded latex pillow.


The Science of Sleep Debt


A 2016 study found that sleep debt acquires interest. It’s not as simple as getting one extra hour to replace one hour of sleep lost (debt). This study found that for every 1 hour of sleep debt, it takes 4 days to recover to optimal levels. If we apply this to the example of 10 hours sleep debt above, it will take a lot longer than a weekend to “catch up.” Chronic sleep debt is called a sleep deficit and is much harder to get out of.


Let’s use the analogy of a bank account. When you don’t get your 8 hours a night, you are in the red. You’ve overdrawn your account and need to pay back the hours you didn’t get. If this happens night after night, you become so deep in debt you can’t catch up. When you take sleep medications on the weekend and try to force your body to sleep more, it can make it more difficult for you to fall asleep Sunday night, and the cycle repeats itself. It’s like going to get a cash advance with high interest. Although it will help in the interim, it may make it harder to get out of debt in the long run. This is a common issue for shift workers like nurses, flight attendants, first responders and those who work in warehouses.


A paper published in Current Biology stated that individuals who acquired 5 hours of sleep debt during the week but slept an extra 5 hours over the weekend were still affected by the negative consequences of not getting enough sleep. When researchers compared those who “caught up on sleep over the weekend” to those who did not, there was very little difference.


Don’t worry – it doesn’t mean you can never get out of sleep debt. It just means that it will take a lot more time and effort than sleeping in on the weekend. According to Lawrence Epstein, the medical director of Sleep Health Centers, it will take a few months to get back to a regular sleep pattern for those who are chronically sleep-deprived. Adding one extra hour every night is the most effective way to repay the debt. Unfortunately, this is challenging to do in certain professions.


Certain Professions are More at Risk For Sleep Debt


Certain professions are more prone to sleep debt. In fact, many training programs teach these individuals about sleep debt, hygiene, and repayment because the consequences of chronic sleep deficit are so dire.


Plenty of research has looked at the sleep debt nurses acquire. With long, stressful shifts that can change weekly, many nurses find it difficult to sleep on demand when they have time off. Even when working 12-hour shifts, most nurses get less than 8 hours of sleep before going in to work.


A 2019 survey found that based on their fluctuating schedules, house and family responsibilities, and daily tasks, nurses were unable to repay their sleep debt and catch up on days off. One of the researchers stated that multiple days of recovery sleep (10+ hours in bed) would be needed; however, with 12-hour shifts and only a few days in between, catching up isn’t likely.


Firefighters, paramedics, and police officers face similar challenges. Due to an inconsistent sleeping environment and sub-par sleeping conditions, firefighters are the most prone to chronic sleep deficits. Few fire halls are fortunate enough to be equipped with a sobakawa pillow or millet hull pillow, and sleep is unpredictable as they could be called for an emergency at a moment’s notice. This makes it difficult for most firefighters to sleep soundly. Like nurses, the shifts and schedule also makes it difficult for them to repay their sleep debt on days off.


The aviation industry is another one that’s prone to sleep debt. Depending on the airline, route, and country, many flight attendants can legally work up to 17 hours. This, combined with jet lag and time differences, make it very difficult for flight attendants to sleep when needed. In some cases, flight attendants will only have 12 hours between shifts. Add in commute time, meals and showering, and that gives them very little time to sleep. Even with the most comfortable bedding and a shredded latex pillow, it is difficult to fall asleep on demand and get the 8 hours they need. According to data from Aer Lingus, an Irish carrier, up to one-third of their flight crew rely on sleep medication at least once a week. This isn’t exactly surprising seeing as over 90% of their flight attendants reported trouble sleeping at least once a week.


Sleep debt and deficits are sadly more common than they should be. As we’ve previously discussed, sleep deprivation can result in mistakes, cognitive decline, and adverse mental and physical side effects. It’s so prominent in shift workers that there is an official name for it – shift work disorder.


Shift work disorder occurs when a person’s sleep schedule conflicts with their work schedule, resulting in excessive sleep debt and sleep disorders. As a result, some industry associations are pushing for an increased amount of time off to provide more opportunity to catch up on sleep. Unfortunately, many still fall short and don’t provide employees with enough time to repay their sleep debt, as science has revealed. The good news is, there are still ways shift workers and those with a hectic schedule can get out of sleep debt.


How to Repay Your Sleep Debt


Sleep debt repayment includes both the hours of sleep and the quality of sleep. Deep, restful sleep is very important for repaying sleep debt. So although naps are great and can help you feel more rested, they won’t repair a severe sleep deficit. The best bet for those experiencing sleep debt is to first focus on the quality of sleep they are getting. Even for those who work shifts, a relaxing and comfortable bedroom can help you fall asleep faster and enjoy a deeper sleep. Getting a comfortable pillow-like a sobakawa pillow, millet hulls pillow, or a shredded latex pillow can help you fall into a deeper sleep.


Some research suggests that biphasic sleep may allow shift workers to get more quality sleep hours and be more effective in repaying their sleep debt. Biphasic sleep, also known as split napping, segmented or divided sleep, is when a person divides their sleep time into two periods.


A shift worker, for example, may come home from work and sleep for three hours and then wake up and sleep again later for a more extended period, waking up shortly before going back to work. An article in 2016 stated that in modern, industrial societies, segmented sleep patterns are preferable. Many anecdotal reports also say this allows them to be more productive during their waking hours and fall into a deeper sleep. This may not work for everyone, but those who can’t consistently stick to a monophasic sleep schedule may find this works better.


According to William C. Dement, the founder of Stanford University Sleep Clinic, “When you put away sleep debt, you become superhuman.” So schedule in some quality time with your sobakawa pillow, and start repaying your sleep debt!

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