Up to one-third of American adults don’t get the recommended seven to nine hours of sleep every night. Another large proportion of Americans only get this amount of sleep about half the time. Insomnia is a chronic sleep deprivation that involves difficulty falling asleep, staying asleep or both. There are also other conditions that negatively impact the quality and quantity of sleep that a person gets, including sleep apnea, anxiety and more.

In addition to medical conditions, medications used to treat health problems may decrease the amount of sleep you get each night. Often times not sleeping well might start with your mattress. People who are not sure what sleeping style is the best for them should consider purchasing a combination sleeper mattress. This could improve your sleep dramatically.

1. Increased Stress and Mental Health Problems

A lack of sleep increases your stress levels. Your body makes more cortisol, which triggers a cascade of stress responses. People with insomnia are 17 times more likely to be diagnosed with anxiety than people with normal sleep duration. People who have insomnia are twice as likely to be diagnosed with depression. The lack of sleep impacts the brain’s ability to regulate emotions. This exacerbates negative thinking patterns. When people who are severely sleep-deprived are exposed to negative images and words, they show more reactions in their amygdala. This is a part of the brain that regulates emotions and anxiety. Both anxiety and depression can cause insomnia, and insomnia can cause anxiety and depression. It’s a vicious positive feedback cycle.

2. Mood Issues

The decreased ability to regulate your mood when you’re chronically sleep-deprived may lead to mood disorders. You may experience more outbursts of anger or have a hair-trigger sense of rage. For example, a spouse who doesn’t load the dishwasher in the way that the sleep-deprived partner thinks they should may experience the wrath of that person’s rage. Others may experience feelings of sadness, loneliness, isolation or worthlessness.

3. Impaired Cognitive Functions and Memory

People who lose five hours of sleep over a 24-hour period tend to have fewer connections in their hippocampus. This is the part of the brain that is associated with memory formation and learning. A small study of college students who were sleep-deprived demonstrated that people have lower accuracy when they don’t get enough sleep. Those who do get enough sleep are more efficient in how they store their memories. Insufficient sleep impairs the brain’s ability to remove toxins, such as beta-amyloid. This protein is linked to Alzheimer’s disease, other types of dementia and memory loss. Altogether, a person who doesn’t get enough sleep will have trouble learning and remembering information.

4. Weight Gain

A lack of sleep triggers an increase in your appetite. It makes you crave satisfying but unhealthy food, such as sweets and fatty foods. When people don’t get enough sleep for several days in a row, they’re more hungry and have more cravings for snacks. A lack of sleep increases the production of ghrelin, which is a hormone that stimulates one’s appetite. It also inhibits the release of leptin, which is the hormone that makes you feel full. When you’re sleep-deprived, you won’t have as much energy, which makes it more difficult to exercise. People who don’t get enough sleep for just two nights in a row show marked decreases in their levels of physical activity.

5. Increased Risk of Cardiovascular Disease

People who get less than seven hours of sleep each night have a higher risk of cardiovascular disease. When researchers controlled for age, weight, smoking and exercise, this risk held true for a lack of sleep. Insufficient sleep is related to high blood pressure and the ability to regulate stress hormones. Chronic stress inflames your smooth muscle and cardiac muscle, which can increase the risk of a heart attack.

6. Decreased Alertness and Slower Reaction Times

When you’re driving on the interstate, one second makes a huge difference in your ability to react to a danger on the road. Driving while drowsy is nearly identical to driving under the influence of drugs or alcohol. Your awareness, attention and reaction times are all negatively affected. Drivers who got fewer than four hours of sleep in a 24-hour period were 15.1 times more likely to be responsible for an auto accident compared to drivers who slept for seven to nine hours. There’s also an increase in workplace accidents in people who have insomnia.

7. Poor Decisions

Sleep-deprived people exhibit worse judgement and make poorer decisions than those who get enough sleep. That’s because sleep deprivation reduces activity in the area of your brain that controls logical thoughts. You may take more risks or have trouble with ethical decision-making tasks.

Lack of sleep impacts your brain function which in turn can negatively affect your physical, mental, and emotional health. The short-term health effects can slowly turn into long-term adverse effects if not dealt with properly. If you are struggling with getting adequate sleep each night, talk with a doctor to see what steps you can take to create good sleeping habits.