Chapter 27 - Sleep and healthy decision making

Abstract

Achieving adequate sleep, having a healthy diet, engaging in physical activity, avoiding excessive alcohol and avoiding smoking are key behaviors needed for maintaining health and reducing risk for chronic illness. In this chapter, we will review how sleep behaviors themselves are an area of health decision making and also can impact other health decisions. In addition to sleep, the chapter focuses on four main areas of health behaviors: diet, physical activity, alcohol and smoking. We will review leading theories about how sleep loss and circadian rhythm disruption are related to health decisions including (a) environmental factors/exposures to unhealthy influences when awake at night, (b) what is known about neurobehavioral effects of sleep loss and circadian disruption and how these alterations may affect health behaviors (e.g., increased impulsivity), (c) how changes to emotions and (d) motivation with sleep loss and circadian disruption can influence health decisions. We present a model of how these factors can promote or interfere with decisions to engage in healthy behaviors. Last, we will discuss studies that examined whether extending or improving sleep has an effect on other health behaviors. We propose that sleep itself is a health behavior with many similarities to other health behaviors and that sleep and circadian rhythms are linked through environmental, social and psychological factors to other health behaviors. Improvements to sleep and circadian alignment may also have downstream effects on other health behaviors as well.