You might think it’s easy to tell when you’re sleep deprived—for example, you fall asleep as soon as your head hits the pillow, or you doze off during boring meetings or at movies. But the reality is, symptoms of sleep deprivation are often so subtle that they are easily missed, says Christopher Winter, MD, a sleep specialist in Charlottesville, Virginia and author of The Sleep Solution: Why Your Sleep Is Broken and How to Fix It.
Take this quiz (check your score at the end) to find out if your sleep habits are putting you at risk—and what you can do about it.
Are you always hungry?
A: Yes, but I haven’t gained weight
B: Yes, and I’ve put on some extra pounds
C: No, my appetite is under control
Research published in the Annals of Medicine shows that not getting enough shut-eye can alter two hunger hormones in your body. It increases levels of ghrelin, which ramps up your appetite while lowering levels of leptin, a hormone made by fat cells that actually works to suppress your appetite.
“Being hungry and tired is a dangerous combination because your body automatically gravitates toward things that give you more quick energy, such as a bag of chips or an ice cream sandwich,” says Winter. “You’re essentially eating to keep yourself awake.” Packing on weight may be a sign of even more severe sleep deprivation. One study published in the Annals of Internal Medicine found that just four and a half hours of sleep for four days straight reduces your fat cells’ ability to respond to insulin, one of the hormones responsible for fat storage, by 30%.
Your partner leaves dirty underwear on the floor in the bedroom. You:
A: Stomp around the bedroom for five minutes cursing until you feel better
B: Scream at the top of your lungs, “Get in here!” and then when he enters, burst into tears and throw the underwear at him
C: Go downstairs and tell him calmly but firmly that you’re not the maid and you need him to pick up after himself
When you’re not getting enough sleep, you tend to fly off the handle more easily and act without thinking, both of which are often detrimental to your job and relationships, points out Winter. Another red flag: becoming over-reactive to things that normally haven’t fazed you in the past. So if you suddenly find yourself sobbing uncontrollably after a Lifetime movie or feeling exceptionally frazzled over a routine work deadline, the culprit could be lack of sleep.
How often do you forget little things, like the name of the movie you saw a couple weeks ago or where you put your house key?
A: Once or twice a week
B: Once or twice a day
C: Rarely, my memory is sharp as a tack
Before you panic about early Alzheimer’s, consider your forgetfulness a sign that you’re not getting enough sleep. When you’re asleep, your brain is busy strengthening connections between brain cells and transferring information from your hippocampus, which is responsible for short-term memory, to your neocortex, which is responsible for long-term memory, explains Winter.
As a result, it not only prevents memories from fading, but it also makes them easier to access, according to a 2015 University of Exeter study. When the researchers gave participants an unfamiliar made-up word, then asked them to remember it 12 hours later after either a period of sleep or wakefulness, those who had gotten rest were more likely to recall the word. Sleep is also crucial for your brain health long term: A 2013 study published in the medical journal Science found that it allows your brain to flush out harmful toxins that can damage your noggin over time.
Over the last couple of weeks, have you noticed that it takes you longer to do tasks or work at home?
A: Sometimes—mostly when they’re boring
Sleep deprivation slows down your reaction time, so things are harder and take longer to do. That means essential functions, like problem-solving or time management, become even more difficult to carry out. One study published in the medical journal Sleep had both sleep-deprived and well-rested West Point cadets perform a series of tasks that involved quick decision-making twice, separated by a 24-hour period. Sleep-deprived cadets saw accuracy decline by 2.4% while well-rested ones saw an improvement of 4.3%.
How often have you been sick with a virus such as a cold or stomach bug over the last six months?
A: Two or three times
B: Five or six times—about once a month
C: A couple, but I bounced back quickly
When you don’t get enough zzz’s, your immune system suffers, Winter says. One 2017 University of Washington study published in Sleep looked at blood samples of 11 pairs of identical twins with different sleep patterns and discovered that the twins with shorter sleep duration had less robust immune systems than their siblings. Other research has found that folks who clock fewer than seven hours of sleep a night are almost three times as likely to get a cold than those who get at least eight hours.
How does your skin look?
A: A little dull, and I’m starting to see some fine lines
B: Sallow and sagging—my age is catching up with me
C: Fairly smooth and supple, without a lot of wrinkles
It’s called beauty sleep for a reason. “When you sleep, your skin can repair damaged skin cells,” explains Winter. “But when you don’t get enough rest, your body can’t produce enough growth hormone, which helps boost elastin and collagen, two substances you need to plump up skin cells.” We’ve all woken up after too little sleep with bags and dark circles under our eyes, both of which make a person appear older. What’s more, when you’re sleep deprived, your body also churns out stress hormones to compensate, which can further damage skin.
Are you having trouble completing your regular workout?
A: It’s happened before, but usually when I haven’t had enough to eat
B: Yes, and it’s occurring more and more frequently
C: Nope, I’m full of pep
The more sleep you get, the better your reflexes, and the more stamina you’ll bring to your workout, Winter says. If you’re finding that you’re suddenly feeling pooped during your usual exercise class, or you’re tripping or being more of a klutz than you’re used to, it could be that sleep deprivation is to blame.
How did you do?
If you answered mostly A’s…
Your sleep routine isn’t awful, but it could use improvement.
Although you may feel okay, occasional skimping on sleep is probably affecting your day to day functioning, says Winter. Case in point: a study published in Sleep found that people who get by on six hours of sleep performed just as poorly as those forced to stay awake for two days, even though they thought they were doing just fine.
Aim for at least seven hours of shut-eye a night. If you have trouble falling asleep, make sure you’re following some basic sleep-promoting tips such as cutting out caffeine a few hours before bed, exercising every day, and powering down electronics an hour or two before sleepy time. (Or try one of these 10 nighttime activities to help you relax.)
If you answered mostly B’s…
You’re in need of a sleep intervention, pronto.
Research clearly shows that people who skimp on sleep are at higher risk of health conditions such as obesity, heart disease, diabetes, and mood disorders such as depression and anxiety. (Here’s a closer look at what happens to your body when you don’t get enough sleep.) Even more frightening, routinely sleeping less than five hours a night raises your risk of dying from any cause by about 15 percent.
If you are getting enough sleep but still have these symptoms, see your doctor, Winter advises. He or she can refer you to a sleep specialist who can evaluate you for other conditions possibly affecting your ability to get good quality slumber, such as sleep apnea or restless legs syndrome.
If you answered mostly C’s…
Congrats on being well-rested!
Keep up this positive trend by making sure you get at least seven to eight hours of sleep a night. It’s also a good idea to cut out caffeine at least six hours before bedtime and limit your alcohol intake in the evening. Adopt a soothing nighttime routine by reading a good book or doing relaxation exercises in the hour before bed, and try to keep computers, iPads, and other electronics out of your bedroom (screens can emit a blue light that interferes with the body’s production of the sleep hormone melatonin). Continue your good sleep habits, and you’ll be more likely to stay healthy and happy in the long run.