The term ‘sleep debt’ is widely used to describe the effects of sleep loss. The construct of sleep debt, however, is poorly defined in the scientific literature. Cumulative build-up of sleep pressure appears to be a key feature of sleep debt. The concepts of ‘core sleep’ and ‘basal sleep need’ have been proposed to provide a theoretical framework, albeit without strong empirical basis. It has been hypothesized that adaptation to sleep debt may be possible over time, but experimental evidence for this hypothesis is ambiguous. Recent experiments using chronic sleep restriction have revealed significant effects of sleep debt on daytime sleep latency and behavioral alertness. In a series of strictly controlled laboratory studies, we found that sleep debt can lead to fundamentally different daytime responses, depending on whether homeostatic sleep pressure (as measured in the waking electroencephalogram (EEG)) or behavioral alertness (as measured with psychomotor vigilance lapses) is considered. This suggests the existence of an as yet unidentified regulatory mechanism of waking neurobehavioral function. To study the nature of this regulatory process under chronic sleep restriction, advantage can be taken of the natural variability in sleep need frequently cited in the literature. We also obtained evidence for interindividual differences in vulnerability to sleep loss regardless of sleep need. Statistical modeling of the effects of chronic sleep restriction on behavioral alertness, taking into account these interindividual differences, provided a reference for defining sleep debt. The results suggested that sleep debt may be defined as the cumulative hours of sleep loss with respect to a subject-specific daily need for sleep.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Kleitman N. Sleep and Wakefulness, 2nd edn. Chicago: University of Chicago Press, 1963.
Dement WC, Vaughan C. The Promise of Sleep. New York: Dell Publishing, 1999.
Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine, 3rd edn. Philadelphia: Saunders, 2000.
Carskadon MA. Encyclopedia of Sleep and Dreaming. New York: Macmillan Publishers, 1993.
Carskadon MA, Dement WC. Cumulative effects of sleep restriction on daytime sleepiness. Psychophysiology 1981; 18: 107–13.
Carskadon MA, Roth T. Sleep restriction. In: Monk TH, ed. Sleep, Sleepiness and Performance. Chichester: John Wiley & Sons, 1991; 155–67.
Dinges DF, Pack F, Williams K et al. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4–5 hours per night. Sleep 1997; 20: 267–77.
Webb WB, Agnew HW Jr. The effects of a chronic limitation of sleep length. Psychophysiology 1974; 11: 265–74.
Friedmann J, Globus G, Huntley A, Mullaney D, Naitoh P, Johnson L. Performance and mood during and after gradual sleep reduction. Psychophysiology 1977; 14: 245–50.
Horne JA, Wilkinson S. Chronic sleep reduction: Daytime vigilance performance and FFG measures of sleepiness, with particular reference to ‘practice’ effects. Psychophysiology 1985; 22: 69–78.
Blagrove M, Alexander C, Horne JA. The effects of chronic sleep reduction on the performance of cognitive tasks sensitive to sleep deprivation. Appl. Cogn. Psychology 1995; 9: 21–40.
Pilcher JJ, Huffcutt AI. Fffects of sleep deprivation on performance: a meta-analysis. Sleep 1996; 19: 318–26.
Spiegel K, Leproult R, Van Cauter F. Impact of sleep debt on metabolic and endocrine function. Lancet 1999; 354: 1435–9.
Rogers NL, Szuba MP, Staab JP, Fvans DL, Dinges DF. Neuroimmunologic aspects of sleep and sleep loss. Semin. Clin. Neuropsychiatry 2001; 6: 295–307.
Horne JA. Sleep function, with particular reference to sleep deprivation. Ann. Clin. Res. 1985; 17: 199–208.
Horne JA. Why We Sleep. Oxford: Oxford University Press, 1988.
Borbély AA. A two-process model of sleep regulation. Hum. Neurobiol. 1982; 1: 195–204.
Drake CL, Roehrs TA, Burduvali F, Bonahoom A, Rosekind M, Roth T. Effects of rapid versus slow accumulation of eight hours of sleep loss. Psychophysiology 2001; 38: 979–87.
Wehr TA, Moul DF, Barbato G et al. Conservation of photoperiod-responsive mechanisms in humans. Am. J. Physiol. 1993; 265: R846–57.
Breslau N, Roth T, Rosenthal L, Andreski P. Daytime sleepiness: An epidemiological study of young adults. Am. J. Public Health 1997; 87: 1649–53.
Jean-Louis G, Kripke DF, Ancoli-Israel S. Sleep and quality of well-being. Sleep 2000; 23: 1115–21.
Kripke DF, Garfinkel L, Wingard DL, Klauber MR, Marler MR. Mortality associated with sleep duration and insomnia. Arch. Gen. Psychiatry 2002; 59: 131–6.
National Sleep Foundation. 2002 Sleep in America Poll. Washington DC: National Sleep Foundation, 2002.
Borbély AA, Achermann P. Sleep homeostasis and models of sleep regulation. J. Biol. Rhythms 1999; 14: 557–68.
Borbély AA. From slow waves to sleep homeostasis: New perspectives. Arch. Ital. Biol. 2001; 139: 53–61.
Dinges DF, Powell JW. Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations. Behav. Res. Meth. Instr. Comp. 1985; 17: 652–5.
Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Los Angeles: UCLA Brain Information Service, 1968.
Åkerstedt T, Gillberg M. Subjective and objective sleepiness in the active individual. Int. J. Neurosci. 1990; 52: 29–37.
Daan S, Beersma DGM, Borbély AA. Timing of human sleep: Recovery process gated by a circadian pacemaker. Am. J. Physiol. 1984; 246: R161–78.
Folkard S, Åkerstedt T, Macdonald I, Tucker P, Spencer MB. Beyond the three-process model of alertness: Estimating phase, time on shift, and successive night effects. J. Biol. Rhythms 1999; 14: 577–87.
Jewett ME, Kronauer RE. Interactive mathematical models of subjective alertness and cognitive throughput in humans. J. Biol. Rhythms 1999; 14: 588–97.
Brunner DP, Dijk D-J, Borbély AA. Repeated partial sleep deprivation progressively changes the EEG during sleep and wakefulness. Sleep 1993; 16: 100–13.
Finelli LA, Baumann H, Borbély AA, Achermann P. Dual electroencephalogram markers of human sleep homeostasis. Correlation between theta activity in waking and slow-wave activity in sleep. Neuroscience 2000; 101: 523–9.
Aeschbach D, Postolache TT, Sher L, Matthews JR, Jackson MA, Wehr TA. Evidence from the waking electroencephalogram that short sleepers live under higher homeostatic sleep pressure than long sleepers. Neuroscience 2001; 102: 493–502.
Heath AC, Eaves LJ, Kirk KM, Martin NG. Effects of lifestyle, personality, symptoms of anxiety and depression, and genetic predisposition on subjective sleep disturbance and sleep pattern. Twin Res. 1998; 1: 176–88.
Franken P, Chollet D, Tafti M. The homeostatic regulation of sleep need is under genetic control. J. Neurosci. 2001; 21: 2610–21.
Monk TH, Buysse DJ, Welsh DK, Kennedy KS, Rose LR. A sleep diary and questionnaire study of naturally short sleepers. J. Sleep Res. 2001; 10: 173–9.
SAS Institute. SAS/STAT User’s Guide 8, 2nd Volume. Cary: SAS Institute, 1999.
Dinges DF, Achermann P. Future considerations for models of human neurobehavioral function. J. Biol. Rhythms 1999; 14: 598–601.
We dedicate this paper to the memory of Dr Martin P Szuba.
About this article
Cite this article
Van Dongen, H.P.A., Rogers, N.L. & Dinges, D.F. Sleep debt: Theoretical and empirical issues. Sleep Biol. Rhythms 1, 5–13 (2003). https://doi.org/10.1046/j.1446-9235.2003.00006.x
- behavioral alertness
- chronic sleep restriction
- cumulative deficits
- sleep debt
- sleep need