When It Comes to Sleep, Perception Is Everything

Psychiatric TimesPsychiatric Times Vol 36, Issue 2
Volume 36
Issue 2

It turns out that sleep deprivation has an effect not only on the traditional concept of “beauty,” but also on whether a person is perceived as being socially desirable.

Beauty sleep is an old concept, and there is evidence that getting adequate sleep can have an impact on a person’s appearance. It turns out that sleep deprivation has an effect not only on the traditional concept of beauty, but also on whether a person is perceived as being socially desirable.

Sleep and attractiveness

A study by Axelsson and colleagues1 in Sweden asked observers to rate the heath, attractiveness, and fatigue of a group of participants based on photos of their faces. The study participants, who were equally divided among men and women, were photographed after a normal night of sleep and after a night of deliberate sleep deprivation. The subjects were instructed not to wear makeup for any of the photos and to maintain the same facial grooming standards and hairstyles for their sleep-deprived photos as they did for their well-rested photos.

The 65 observers who rated the photos were blinded to the purpose of the study. The observers perceived that each individual had a 6% decrease in health, a 4% decrease in attractiveness, and a 19% increase in tiredness in the sleep deprived condition when compared with their well-rested condition.

Given that a person generally looks about the same from one day to the next, this degree of decline in health and attractiveness rating can have a major impact on how a person is perceived by others. While physical attractiveness may be considered as a feature that primarily influences romantic appeal, the change in a person’s appearance that results from sleep deprivation can affect other interpersonal issues as well.

Sleep affects social appeal and trust

In another study, volunteers were asked to rate photographs of participants, but this time on several additional characteristics.2 The participants were photographed after a night of adequate sleep and after two nights of sleep deprivation. Those who rated the photographs were asked how much they would like to socialize with the people in the photos, as well as to rate them on perceived health, attractiveness, sleepiness, and trustworthiness.

The 122 volunteers who rated the photos perceived the participants as less healthy, less attractive, and sleepier when looking at sleep-deprived photos. This is similar to the results of the previous study. But this group of observers also said that they would be less likely to want to socialize with the sleep-deprived people in the photographs, despite the fact that they rated them as equally trustworthy regardless of their amount of sleep. This is a surprising result, given that trust- worthiness has long been considered one of the important qualities that people consider when deciding who they want to socialize with.

Are there benefits of excess sleep?

A population-based study that included 24,671 people between the ages of 15 and 85 used sleep logs to assess sleep duration.3 Prolonged sleep was defined as an average of longer than 10 hours per night. The long sleepers did not have any advantages when compared with the short sleepers (who slept less than 5 hours per night) or to those who slept between 5 to 10 hours per night. In fact, the long sleepers were more likely than the other two groups to be obese and/or to have psychiatric disorders.

A few nights of normal restorative sleep can reverse the superficial effects of brief periods of sleep deprivation, but excess sleep has not been shown to alleviate the effects. Prolonged sleep is most likely a consequence of health problems, and there has not been any evidence that people can force themselves to gain additional restorative sleep once the required daily amount is achieved.


This article was originally published on 12/6/18 and has since been updated.


Dr Moawad is a neurologist and teaches medical students and undergraduate students at Case Western Reserve University and John Carroll University in Cleveland, Ohio. She teaches physiology courses as well as writing courses. Dr Moawad is also a medical writer and medical content editor and has been writing about medical issues and health care careers for over ten years. She is the author of Careers Beyond Clinical Medicine.


1. Axelsson J, Sundelin T, Ingre M, et al. Beauty sleep: experimental study on the perceived health and attractiveness of sleep deprived people. BMJ. 2010;341:c6614.

2. Sundelin T, Lekander M, Sorjonen K, Axelsson J. Negative effects of restricted sleep on facial appearance and social appeal. R Soc Open Sci. 2017;4:160918.

3. Léger D, Beck F, Richard JB, et al. The risks of sleeping "too much". Survey of a National Representative Sample of 24671 adults (INPES health barometer). PLoS One. 2014;9:e106950.


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