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Research Christmas 2010: Research

Beauty sleep: experimental study on the perceived health and attractiveness of sleep deprived people

BMJ 2010; 341 doi: (Published 15 December 2010) Cite this as: BMJ 2010;341:c6614
  1. John Axelsson, researcher12,
  2. Tina Sundelin, research assistant and MSc student2,
  3. Michael Ingre, statistician and PhD student3,
  4. Eus J W Van Someren, researcher4,
  5. Andreas Olsson, researcher2,
  6. Mats Lekander, researcher13
  1. 1Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
  2. 2Division for Psychology, Department of Clinical Neuroscience, Karolinska Institutet
  3. 3Stress Research Institute, Stockholm University, Stockholm
  4. 4Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, and VU Medical Center, Amsterdam, Netherlands
  1. Correspondence to: J Axelsson john.axelsson{at}
  • Accepted 22 October 2010


Objective To investigate whether sleep deprived people are perceived as less healthy, less attractive, and more tired than after a normal night’s sleep.

Design Experimental study.

Setting Sleep laboratory in Stockholm, Sweden.

Participants 23 healthy, sleep deprived adults (age 18-31) who were photographed and 65 untrained observers (age 18-61) who rated the photographs.

Intervention Participants were photographed after a normal night’s sleep (eight hours) and after sleep deprivation (31 hours of wakefulness after a night of reduced sleep). The photographs were presented in a randomised order and rated by untrained observers.

Main outcome measure Difference in observer ratings of perceived health, attractiveness, and tiredness between sleep deprived and well rested participants using a visual analogue scale (100 mm).

Results Sleep deprived people were rated as less healthy (visual analogue scale scores, mean 63 (SE 2) v 68 (SE 2), P<0.001), more tired (53 (SE 3) v 44 (SE 3), P<0.001), and less attractive (38 (SE 2) v 40 (SE 2), P<0.001) than after a normal night’s sleep. The decrease in rated health was associated with ratings of increased tiredness and decreased attractiveness.

Conclusion Our findings show that sleep deprived people appear less healthy, less attractive, and more tired compared with when they are well rested. This suggests that humans are sensitive to sleep related facial cues, with potential implications for social and clinical judgments and behaviour. Studies are warranted for understanding how these effects may affect clinical decision making and can add knowledge with direct implications in a medical context.


  • We thank B Karshikoff for support with data acquisition and M Ingvar for comments on an earlier draft of the manuscript, both without compensation and working at the Department for Clinical Neuroscience, Karolinska Institutet, Sweden.

  • Contributors: JA designed the data collection, supervised and monitored data collection, wrote the statistical analysis plan, carried out the statistical analyses, obtained funding, drafted and revised the manuscript, and is guarantor. TS designed and carried out the data collection, cleaned the data, drafted, revised the manuscript, and had final approval of the manuscript. JA and TS contributed equally to the work. MI wrote the statistical analysis plan, carried out the statistical analyses, drafted the manuscript, and critically revised the manuscript. EJWVS provided statistical advice, advised on data handling, and critically revised the manuscript. AO provided advice on the methods and critically revised the manuscript. ML provided administrative support, drafted the manuscript, and critically revised the manuscript. All authors approved the final version of the manuscript.

  • Funding: This study was funded by the Swedish Society for Medical Research, Rut and Arvid Wolff’s Memory Fund, and the Osher Center for Integrative Medicine.

  • Competing interests: All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare: no support from any company for the submitted work; no financial relationships with any companies that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: This study was approved by the Karolinska Institutet’s ethical committee. Participants were compensated for their participation.

  • Participant consent: Participant’s consent obtained.

  • Data sharing: Statistical code and dataset of ratings are available from the corresponding author at john.axelsson{at}

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