Sleep Debt is Real, But Can You Make up For It?

Paul L. Underwood
by Paul L. Underwood
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Sleep Debt is Real, But Can You Make up For It?

We’ve all been there. Maybe we’re parents of newborns. Maybe we’re blessed with unusually noisy neighbors (with unusually noisy pets or car alarms). Maybe we’re stressed out about work or money or our health or the latest breaking-news alert. Maybe we’re just not practicing good sleep habits. Whatever your situation, it’s pretty fair to say we all have a rough night’s sleep from time to time.

If we’re lucky, the result is nothing more serious than misspeaking in a meeting or missing a stop on the subway. But according to the Centers for Disease Control, more than 1-in-3 Americans don’t get enough sleep, and that excess exhaustion is (literally) killing us. Per the CDC, not getting enough sleep increases your risk of obesity, diabetes, high blood pressure, heart disease, stroke and frequent mental distress. Not to mention the increased risk of, say, having a car accident when you’re tired and behind the wheel.

Which raises a critical question: Can sleep deficits ever be repaid? We asked Dr. Josna Adusumilli, sleep medicine physician at Massachusetts General Hospital and an instructor at Harvard Medical School, for her guidance. From napping to caffeine to a long night of extra sleep, here’s what she told us about getting sleep.

The best way to make up for lost sleep is by sleeping”

The best way to make up for lost sleep is by sleeping,” she says. Her first recommendation, if you can swing it, is to schedule a nap for some point during the next day. Just be warned: Taking such a nap might leave you in a stupor, even after you’ve made up for the missing rest. “You may have ‘sleep inertia’ or a period of grogginess after a nap that will eventually fade,” she says. “So be careful performing activities during this grogginess period.” In other words, maybe stay off the road (or your bike) even after you catch some zzz’s.

“You can also drink caffeine to help you stay awake during the day,” she adds, providing some relief to those of us who turn to the warm comforts of coffee after a rough night and don’t have the benefit of an in-office nap space. (Or the audacity to attempt a snooze while on the clock.) That said, be wary of leaning too much on your local barista for sleep relief. “Ideally, you should go to bed when you feel drowsy, wake up naturally without an alarm clock and not have to depend on caffeine to help you stay awake during the day,” Dr. Adusumilli says. “If you’re not doing this, then you may have a sleep issue.”


Naturally, you might wonder if it’s better to try for one major long night of sleep or to slowly ramp back up. After all, you want to aim for consistency in your bedtime and wake-up routines, but one bad night can throw off your whole schedule. (And a recent Harvard study found that, the more sleep debt we acquire, the harder it is for us to realize how sleep-deprived we are.)

So is it better to adhere to your schedule and let bygone sleep be bygone or give the routine a rest so your body can get one, too? Per Dr. Adusumilli, there’s no one right answer. “Try to get as much sleep as you can,” she says. “Your body is smart, so it makes up for sleep deprivation by readjusting your stages of sleep. If you are sleep deprived, then the next night, you will have more slow wave sleep to recover for it.” (Slow wave sleep, in case you weren’t aware, is an especially deep form of sleep, defined by a lack of rapid eye movement and a slowing of brain wave activity. Slow wave sleep is crucial for the brain’s rest and recovery.)


Just know it’s not exactly a one-for-one thing, and quality of sleep can matter as much as the quantity. Per the same Harvard study: If you missed 10 hours of sleep over the course of a week, add 3–4 extra sleep hours on the weekend and an extra 1–2 per night the following week until you have repaid the debt fully.” (And as the study notes, you can be grateful that sleep deficits don’t come with interest.) For longer-term sleep deficits, consider planning a vacation that’s light on activity and heavy on opportunities for rest. (Think: Naps at the beach, rather than hitting every historic monument in Rome.)

As for what not to do? “You should not just power through it,” Dr. Adusumilli says. “People often misjudge their sleepiness and think their body adapts to their sleep deprivation when, in fact, it doesn’t.” If you can’t work in a quick nap or get a good night’s sleep the next night, try to stay away from doing anything you wouldn’t do when otherwise incapacitated, like driving a car, until you rest up.

As for avoiding future rough nights, determine whether there’s a clear cause for your bad night’s sleep and then correct for that cause. (Putting your phone away earlier, buying earplugs, investing in soundproof windows — whatever works.) If there isn’t a clear cause, and this becomes a recurring situation, consider seeing a doctor, as this could be something more chronic and serious. As with other kinds of debt, sleep deficits are serious business, and the sooner you can start paying it off, the safer — or at least more alert and healthy — you will be.

About the Author

Paul L. Underwood
Paul L. Underwood

Paul is a writer based in Austin, Texas. He tweets here, he Instagrams there and he posts the occasional deep thought at He’s probably working on a run mix as you read this.


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