On the list of essential habits to practice self-care, cultivate well-being and sustain peak performance, good sleep is at the top. But sleep deprivation is common among lawyers facing heavy caseloads, long work hours, pressing deadlines, and high rates of alcohol use, drug addiction and mental disorders. Lack of sleep impairs your focus, memory, decision-making, and judgment, which are necessary to practice law effectively and ethically.
While there are many factors contributing to lawyer misconduct, there is no doubt that sleep debt makes you tired and less capable of meeting the demands of the profession. When you are sleep deprived, it is much harder to think creatively, solve problems, make steady progress on client matters, and communicate effectively as the rules of professional responsibility require.
What is Good Sleep?
In a 2017 study titled Short- and long-term health consequences of sleep disruption and published in the Nature and Science of Sleep journal, sleep is defined as a biologic process necessary for brain health and the functioning of immune, hormonal and cardiovascular systems in the body.
The American Academy of Sleep Medicine and Sleep Research Society jointly recommend at least 7 hours of sleep per night for adults. Besides adequate duration, sleep also has to be of good quality. This means you sleep for most of the time while in bed (at least 85% of the total time), fall asleep in 30 minutes or less, wake up no more than once per night, and drift back to sleep within 20 minutes if you do wake up, according to a report in Sleep Health.
What is Sleep Debt?
The American Sleep Association defines sleep debt as the cumulative effect of a person not having sufficient sleep, either through total sleep deprivation (when you are kept awake for a minimum of 24 hours) or partial sleep deprivation (when you have limited sleep for several days or weeks).
Long-term sleep debt is difficult to repay and the negative effects are persistent. One 2013 study in the American Journal of Physiology found that extended recovery sleep over the weekend reverses the impact of one work week of mild sleep restriction on daytime sleepiness and fatigue, but does not correct performance deficits.
What Creates Sleep Debt?
Sleep deprivation and disturbances stem from multiple factors, including:
Lifestyle, e.g. consuming too much caffeine, alcohol use, drug abuse, jet lag
Environmental, e.g. excessive noise, excessive light
Psychosocial, e.g. anxiety, worry and rumination; parents of young children; caregivers to a family member with a serious illness
Sleep disorder, e.g. insomnia (difficulty falling or staying asleep), obstructive sleep apnea (disordered breathing that causes multiple awakenings), restless legs syndrome and other movement syndromes (unpleasant sensations that prompt night fidgeting), narcolepsy (extreme sleepiness or falling asleep suddenly during the day)
Medical conditions, e.g. pain, kidney disease, diabetes, neurodegenerative diseases, psychiatric disorders, use of certain medications
There is also a widespread fallacy that lawyers must work long hours for greater achievement, better results, and higher productivity. Getting good sleep is viewed as a luxury, instead of a necessity.
What are the Effects of Sleep Debt?
A 2016 study titled The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys and published in the Journal of Addiction Medicine, reported that among the 12,825 lawyers surveyed, 28%, 19%, and 23% experienced symptoms of depression, anxiety, and stress, respectively.
Sleep Debt Affects Your Well-Being
Funded by the American Bar Association Commission on Lawyer Assistance Programs and Hazelden Betty Ford Foundation, the study helped to trigger a Call to Action for Lawyer Well-Being from the Minnesota Supreme Court and create a National Task Force on Lawyer Well-Being comprised of a consortium of organizations such as the American Bar Association (ABA).
Sleep deprivation is cited as one of the major problems lawyers face. Lack of sleep reduces your overall health and wellness, lowers your energy level, and interferes with coordination, agility, and endurance. As Robin M. Wolpert, Chair of the Lawyers Professional Responsibility Board, notes in her March 2019 Minnesota Lawyer article, “The National Task Force Report’s recommendations could be strengthened by prescribing sleep.”
Sleep Debt Affects Your Cognitive Abilities
The normal sleep cycle is comprised of four different stages: 1, 2, 3 of Non-REM (non-rapid-eye-movement) sleep, followed by REM (rapid-eye-movement) sleep. A complete cycle takes about 90 to 120 minutes. Non-REM sleep (which includes deep sleep) is critical for memory formation, and REM sleep (dream state) boosts creativity and problem solving skills.
Sleep deprivation makes you susceptible to lawyer misconduct because it compromises your cognitive skills and disrupts your brain function at a cellular level. In a 2017 study, researchers at the University of California – Los Angeles Health Sciences found that sleep deprivation disrupts brain cells’ ability to communicate with each other, leading to mental lapses that affect memory and visual perception.
A 2007 study, published in the Neuropsychiatric Disease and Treatment journal, states that total sleep deprivation impairs attention and working memory, as well as long-term memory and decision-making. It adds that partial sleep deprivation affects attention, especially vigilance. This makes it more challenging to focus and concentrate on tasks for steady progress and successful completion.
When you lack sleep, your brain does not get to fully remove dead cells, flush out toxins and complete other housekeeping actions through the glymphatic system (functional waste clearance pathway for the vertebrate central nervous system). Sleep enables you to remove waste and make room for new learning, growth and development.
Acquiring and recalling memories take place when you’re awake. But memory consolidation – which allows you to store new memories for future retrieval – occurs when you’re asleep. Memory consolidation frees up space in the brain to acquire new memories and learn new things the next day.
Sleep debt is often associated with dementia, Alzheimer’s disease, and general cognitive decline. It not only makes it harder to acquire and store memories, but also more challenging to recall memories you already made, such as the password for an account.
The prefrontal cortex, which is the cerebral cortex covering the front part of the frontal lobe of the brain, is especially vulnerable to sleep loss. This region of the brain is responsible for executive functions, such as analyzing complex thoughts, processing information, determining right from wrong, making decisions, predicting outcomes, evaluating risks, understanding consequences, prioritizing and sequences actions, exerting control, and moderating social behavior.
In addition, when sleep is disrupted, you miss out on REM sleep, which is important for creative thinking, staying motivated, and generating ideas. During this stage of sleep, your brain makes important neural connections that are needed for mental health and overall well-being.
Sleep Debt Affects Your Mood
Sleep loss is also associated with changes in levels of hormones, such as serotonin, dopamine, and cortisol.
Serotonin is linked with well-being and happiness. It helps regulate the body’s sleep-wake cycles, increases wakefulness in the morning, and keeps moods stable. Low serotonin levels is associated with depression.
Dopamine is also associated with well-being and happiness. But instead of regulating mood, it makes you feel good. Dopamine drives behavior towards things (e.g. drugs) that will activate the pleasure and reward centers of the brain.
Cortisol regulates a wide range of processes in the body, such as blood sugar levels, metabolism and the immune system. It influences memory formation and is critical in helping the body respond to stress. Excessive cortisol levels contribute to mood swings, anxiety and depression.
Sleep Debt Affects Your Mental Health
Sleep, mood and mental states are closely interrelated and often overlap. Anxiety and extreme stress, for example, make it hard to fall asleep or stay asleep. In turn, sleep problems impair your mental health.
A Harvard Health Publishing article, titled Sleep and mental health, notes that studies reveal 65% to 90% of adult patients with major depression experience some kind of sleep problem, such as insomnia and obstructive sleep apnea. It states that sleep problems increase the risk of developing depression and make it less likely to respond to treatment.
Studies further report that 69% to 99% of patients experience insomnia or report less need for sleep during a manic episode of bipolar disorder. Meanwhile, in bipolar depression, 23% to 78% of patients sleep excessively (hypersomnia), while others may experience insomnia or restless sleep. Lack of sleep can trigger mania, destabilize mood and contribute to relapse.
In addition, sleep problems affect more than 50% of adult patients with generalized anxiety disorder, are prevalent in those with post-traumatic stress disorder (PTSD), and may occur in panic disorder, obsessive-compulsive disorder, and phobias. Insomnia can interfere with recovery or exacerbate the symptoms of anxiety disorders.
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For more information on the Role of Sleep Debt in Lawyer Misconduct and Disciplinary Action, read the related article, Sleep Debt: A Cause of (and a Potential Mitigating Factor for) Lawyer Misconduct – Part 2.
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This article provides general information only. Do not consider it as legal advice for any individual case or situation.
The author, Dyan Williams, is admitted to the Minnesota state bar and focuses on the Minnesota Rules of Professional Conduct, which are subject to change. Check your individual state rules of professional conduct, regulations, ethics opinions and case precedents, instead of relying on this article for specific guidance.
Photo by: Free-Photos
