How Does Mental Health Affect Your Sleep?
Contributed By: Rose MacDowell, Sleepopolis
Expert Verified By: Dr. Nicole Moshfegh, Psy.D.
The term mental health describes emotional, cognitive, and social well-being. Mental health is important at every stage of life, from childhood and adolescence through adulthood. Mental health affects not just how we feel, but how we think and behave. Our psychological condition determines how we handle stress, relate to others, and make choices.
There are more than 200 types of mental illness, which is defined by the American Psychiatric Association as “a health condition involving changes in emotion, thinking, and behavior.” Mental illness is based in the brain and can have a significant impact on relationships and quality of life.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
Mental Illness: Causes and Symptoms
Mental health problems can affect self-esteem, happiness, and basic functions, such as eating and sleeping. (1) Social and financial success is strongly influenced by psychological wellness, including self-awareness and our ability to exercise self-control.
Many factors contribute to mental health issues, including:
Genes and brain chemistry
Family history of mental health problems
Life experiences, such as trauma or abuse
Mental health issues run the gamut from minor difficulty with daily living to full-blown psychosis. Treatment can have a significant impact on the course and outlook of psychological issues, making early detection crucial.
Mental illness can appear in early childhood or not until adulthood. (2) Some psychological issues may not emerge until later in life and can be influenced by certain drugs and medical conditions. There are numerous warning signs of mental health issues. These vary depending on the nature of the condition, and may include:
Eating or sleeping too much or too little
Withdrawing from relationships and usual activities
Having low or no energy
Feeling numb
Experiencing unexplained aches and pains
Feeling helpless or hopeless
FAQ
Q: What is the most common mental illness?A: Depression, a mood disorder that affects 300 million people worldwide, is the single most common mental illness. Anxiety disorders are more prevalent overall.
Psychological difficulties increase the risk of troubled relationships with family and friends. (3) Interpersonal conflict can be caused by irritability and mood swings, or feelings such as fear and anger. Other cognitive signs associated with mental health issues include worry, confusion, memory loss, and intrusive thoughts.
More serious mental disorders may cause hallucinations, including hearing voices or believing things that are not true. Suicidal behavior or thoughts of harming another person are also common signs of psychological issues. A person suffering from mental illness may experience paranoia, imagined physical ailments, or the need to abuse drugs or alcohol.
Types of Mental Health Disorders
Each type of mood disorder is characterized by unique signs and symptoms and may co-occur with other disorders. For example, anxiety might occur along with substance abuse, physical complaints, or a sleep disorder like insomnia.
The following are some of the most common mental health disorders:
Anxiety Disorders. People with anxiety disorders respond to certain objects or situations with fear and dread. Anxiety disorders can include panic disorders, generalized anxiety disorder, and phobias. (4) Symptoms of anxiety include:
Fatigue
Feelings of restlessness or irritability
Difficulty focusing or learning new concepts
Chronic pain or muscle tension
Trouble controlling feelings of worry
Problems sleeping, including the inability to sleep, unsatisfying sleep, or excessive sleeping
Psychiatric Disorders in Children. Common psychiatric disorders in children include attention deficit hyperactivity disorder (ADHD) a neurodevelopmental disorder that usually persists into adulthood. Symptoms include impulsiveness, trouble focusing on tasks or conversations, restlessness, and feeling easily frustrated. Oppositional defiant disorder is part of a spectrum known as disruptive, impulse-control, and conduct disorders. Symptoms of oppositional defiant disorder include hostility toward and lack of cooperation with teachers, parents, and other authority figures. (5)
Eating Disorders. Eating disorders involve extreme emotions, attitudes, and behaviors related to weight and food. Common eating disorders include anorexia, bulimia, and binge eating.
Substance Use Disorders. Mental health problems and substance abuse disorders often occur together. (6) Substance abuse can be a cause or a result of psychiatric issues, and may be an attempt by some patients to self-medicate or reduce symptoms.
Mood Disorders. Almost one in ten people aged eighteen or older have a mood disorder. Mood disorders involve persistent feelings of sadness, or feelings that fluctuate between extreme happiness and extreme sadness. Mood disorders include:
Depression. Approximately 17.3 million people in the US — 7.1% of adults — suffered from one or more major depressive episodes in the last year. Depression is characterized by sadness and lack of usual enjoyment that continue for two weeks or longer. Grief and sadness related to a change in life circumstances are different from depression, which doesn’t improve in response to external events
Bipolar disorder. Bipolar disorder affects approximately six million adults in the US, and impacts men and women equally. The disorder is characterized by severe fluctuations in mood, behavior, and thought patterns. Fluctuations can last from a few hours to several months, and may be affected seasonal and light changes
Personality Disorders. People with personality disorders have inflexible personality traits that are distressing to the sufferer and may cause problems in work, school, or social relationships. (7) These disorders are highly resistant to treatment, and include the following:
Antisocial personality disorder, or APD. People with antisocial personality disorder exploit, manipulate, and disregard the feelings of others. APD describes the behavior of sociopaths and psychopaths. Psychopaths do not have a conscience, whereas sociopaths have a conscience that is severely disordered
Narcissistic personality disorder, or NPD. Approximately 1% of people are afflicted with NPD. The disorder is associated with lack of empathy, feelings of superiority, and a need for admiration. Narcissists tend to be easily hurt and are unable to tolerate criticism. Treatment is generally ineffective because people with NPD don’t believe they have a mental health issue
Borderline personality disorder, or BPD. People with borderline personality disorder have trouble regulating their emotions. They tend to act impulsively, resulting in career and relationship difficulties. Of the 1.4% of the population with BPD, 75% are women, though this number may represent misdiagnosis in many men with the disorder
Psychotic Disorders. Psychotic disorders are characterized by abnormal perceptions such as hallucinations and delusions. Hallucinations are false perceptions that involve hearing or seeing things that don’t exist. Delusions are false beliefs, such as being pursued by authorities or people wishing to do the sufferer harm. The most common psychotic disorder is schizophrenia, which typically appears in the mid to late twenties. Possible causes of schizophrenia include genetic and environmental factors, disordered brain circuitry, trauma, and drug abuse.
Psychosis
Psychosis describes mental conditions that involve loss of contact with reality.
Mental Health and Sleep
One common sign of mental health difficulty is trouble sleeping. (8) The sleep disorder most closely associated with psychiatric disturbances is chronic insomnia. Some common mental illnesses and their effect on sleep include the following:
Depression. Clinical depression often presents with persistent insomnia, or the inability to sleep. (9) Hypersomnia, or excessive drowsiness, can be a sign of depression, as well. Sleep disorders are associated so strongly with depression that some medical practitioners advise caution in diagnosing depression in patients without symptoms of a sleep disorder. Up to 75% of people diagnosed with depression also suffer from insomnia.
Bipolar Disorder. Bipolar disorder is strongly associated with the inability to fall asleep, stay asleep, fall back to sleep, or all three. People in the manic phase of bipolar disorder often have difficulty sleeping, whereas those in the depressive phase may sleep much more than usual. Studies show that sleep deprivation can aggravate the struggles with emotional regulation that are common in people who are bipolar. (10) For many sufferers, trouble sleeping can be an indication of an approaching manic phase.
Anxiety Disorder. Anxiety is a principal cause of chronic insomnia. Even common anxiety related to work and life circumstances may trigger insomnia. A primary cause of chronic insomnia is conditioned anxiety related to sleep and the bedtime routine. Anxiety’s impact on the body includes hyperactivity of the central nervous system and excessive release of stress hormones, such as adrenaline and cortisol. Studies show a strong association between a history of insomnia and anxiety disorder, panic disorder, and social anxiety disorder. (11)
Borderline Personality Disorder. BPD sufferers with insomnia typically experience the daytime consequences of sleep loss, including sleepiness, difficulty concentrating, and irritability. Symptoms of BPD can be worsened by insomnia, leading to a vicious cycle of sleeplessness and behavioral issues.
Personality Disorders. Some personality disorders may be associated with disturbed sleep patterns. (12) One study revealed that people with circadian rhythm disorder are more likely to have a personality disorder than people with normal sleep and wake cycles.
Psychotic Disorders. Psychotic disorders such as schizophrenia can have a profound impact on sleep. Sleep disturbances are often an early sign of schizophrenia and can precede psychiatric symptoms by months or years. Schizophrenia patients are more likely to suffer from other sleep disorders, as well, including:
Obstructive sleep apnea
Restless legs syndrome
Periodic limb movement disorder
Circadian rhythm dysfunction
FAQ
Q: What is circadian rhythm dysfunction?A: Circadian rhythm dysfunction is caused by a loss of synchronization between sleep-wake cycles and natural light and darkness signals. Symptoms include the inability to fall or stay asleep, cognitive dysfunction, and trouble maintaining a traditional sleep schedule.
Does Depression Cause Insomnia, or Vice Versa?
It was once thought that insomnia symptoms resulted from psychiatric disorders and depression, not the other way around. Now the evidence isn’t so clear. Sleep problems may not just be the result of emotional disturbances, they may increase the likelihood of suffering from them, as well.
Medications to treat psychiatric disturbances may also cause insomnia. Psychotropic medications can have stimulating effects that contribute to interrupted sleep. Restless leg syndrome and periodic limb movements may be triggered or exacerbated by antidepressants and other drugs used to treat mood disorders.
An analysis of major studies revealed that volunteers who suffered from insomnia symptoms were twice as likely to be diagnosed with depression as those without sleep difficulties. Why? Though the connection between mood disorders and insomnia isn’t entirely understood, it is well-known that hormones and neurotransmitters are affected by poor sleep. Sleep is a restorative activity that reduces stress in the body and areas of the brain, especially the axis between the hypothalamus and adrenal and pituitary glands. Excess secretion of cortisol — also known as “the stress hormone” — may play a role, as well.
Lack of sleep and the resulting physiological stress may predispose insomnia sufferers to major mood disturbances, making early treatment of sleep disorders essential, especially in people with a family history of mental health issues. (13)
Depression and Other Sleep Disorders
Insomnia is not the only sleep disorder associated with depression and anxiety. (14) Sleep apnea is a common cause of depression, as is hypersomnia. Sleep apnea is characterized by blockage of the airway and repeated awakenings during the night. Chronic sleep apnea can result in weight gain, increased risk of heart attack and stroke, and memory problems.
Hypersomnia is associated with excessive time spent sleeping and daytime sleepiness. The disorder can be caused by medical conditions, certain drugs, and immune system dysfunction. Though most people need between seven and nine hours of sleep each night, the need for significantly more can indicate a mood disorder. Like sleep apnea, hypersomnia is related to a greater likelihood of heart attack and stroke.
Hypersomnia
A sleep disorder associated with excessive sleeping. Hypersomnia includes narcolepsy, an autoimmune disease that can cause extreme sleepiness and muscle weakness.
Psychiatric Medications and Sleep
Medications to treat psychological disturbances can have a positive or negative impact on sleep. (15) Most antidepressant medications influence the neurotransmitters dopamine, serotonin, and norepinephrine, all of which help to regulate sleep and wake cycles. Some can have stimulating effects that contribute to insomnia.
Restless legs syndrome and periodic limb movements can be triggered or exacerbated by antidepressants and other drugs used to treat mood disorders. (16) These medications can be helpful in patients without movement-related sleep disorders who suffer from hypersomnia.
Other medications such as older tricyclic drugs can help establish healthy sleep patterns in depressed patients with insomnia. Once a depressed patient starts taking medication, insomnia may be the last symptom to improve. Newer antidepressants such as selective serotonin reuptake inhibitors can suppress the REM stage of sleep, as well as the vivid dreaming that occurs during REM sleep.
Antipsychotic medications can help with insomnia, a common issue for schizophrenia sufferers. Some of these drugs can also cause daytime sleepiness, which may be preferable to insomnia. (17) Hypnotic medications are often prescribed along with antipsychotics, and may initially help with insomnia due to their sedative effects. However, many patients become tolerant of hypnotics or develop a rebound response, which can limit their usefulness for insomnia over the long-term.
Suicidal Behavior and Sleep
Suicidal behavior is a common feature of certain psychiatric conditions, including bipolar disorder and depression. Suicidal thoughts and actions can also occur in the absence of a psychiatric condition. Suicide is the second leading cause of death in people between 15 and 24. Suicide is more likely to be completed by people with access to guns.
Signs of suicidal thoughts and behavior may include the following:
Speaking about suicide or the desire to die
Feeling or talking about feeling hopeless
Researching ways to commit suicide
Appearing anxious or depressed
Excessive use of alcohol, or use of drugs
Exhibiting unusual behavior, such as rage, mood swings, or agitation
Suicidal behavior is often caused by psychiatric conditions, but may also be triggered by difficult life events, stress, loss of a loved one, or past trauma such as emotional, physical, or sexual abuse. Suicidal behavior is also more common in people suffering from post-traumatic stress disorder or chronic pain.
Recent research reveals that suicidal behavior and lack of sufficient sleep are related in adolescents and adults. (18) People who completed their suicidal actions were more likely to have suffered from insomnia, hypersomnia, or another sleep disturbance. Though further research is needed to better understand this link, existing studies reveal a strong association between mental health and sleep.
FAQ
Q: What is suicidal ideation?A: Suicidal ideation involves thinking about, planning, or considering suicide.
Last Word From Sleepopolis
Mental health is critically important to happiness and well-being. Research reveals a connection between mental illness and disturbed sleep, an association that may exist months or years before psychiatric symptoms appear.
Medications and other mental health treatments can help regulate sleep patterns, but may also cause or worsen insomnia, hypersomnia, and other sleep difficulties. Adjustment of medications or separate treatment of sleep issues can help establish healthy sleep patterns and improve quality of life for people suffering from mental health disorders.
References
Amy C. Watson, Self-Stigma in People With Mental Illness, Schizophrenia Bulletin, January 25, 2007
William Copeland Ph.D., Cumulative Prevalence of Psychiatric Disorders by Young Adulthood: A Prospective Cohort Analysis From the Great Smoky Mountains Study, Journal of the American Academy of Child & Adolescent Psychiatry, March 2011
Alan R. Teo, Social Relationships and Depression: Ten-Year Follow-Up from a Nationally Representative Study, Plos One, April 30, 2013
Peter J. Norton, Transdiagnostic models of anxiety disorder: Theoretical and empirical underpinnings, Clinical Psychology Review, August 2017
Martin B. Keller, MD, The Disruptive Behavioral Disorder in Children and Adolescents: Comorbidity and Clinical Course, Journal of the American Academy of Child & Adolescent Psychiatry, March 1992
Robert E Drake, et al. A systematic review of psychosocial research on psychosocial interventions for people with co-occurring severe mental and substance use disorders, Journal of Substance Abuse Treatment, January 2008
Tyrer P, Mulder R, Crawford M, Newton-Howes G, Simonsen E, Ndetei D, Koldobsky N, Fossati A, Mbatia J, Barrett B., Personality disorder: a new global perspective, World Psychiatry, February 2010
Krahn LE., Psychiatric disorders associated with disturbed sleep, Seminars in Neurology, March 25, 2005
Chiara Baglioni et al., Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies, Journal of Affective Disorders, December 2011
Harvey AG, Talbot LS, Gershon A, Sleep Disturbance in Bipolar Disorder Across the Lifespan, Clinical Psychology, New York State Psychiatric Institute, April 8, 2012
Heidemarie Blumenthal, et al., The Links Between Social Anxiety Disorder, Insomnia Symptoms, and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States, Behavior Therapy, January 2019
Yaron Dagan, High prevalence of personality disorders among Circadian Rhythm Sleep Disorders (CRSD) patients, Journal of Psychosomatic Research, October 1996
Liu X, Buysse DJ, Gentzler AL, Kiss E, Mayer L, Kapornai K, Vetró A, Kovacs M., Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression, Sleep, January 30, 2007
Nutt D, Wilson S, Paterson L., Sleep disorders as core symptoms of depression, Dialogues in Clinical Neuroscience, September 2008
DeMartinis NA, Winokur A., Effects of psychiatric medications on sleep and sleep disorders, CNS and Neurological Disorders Drug Targets, February 6, 2007
Staner L., Sleep disturbances, psychiatric disorders, and psychotropic drugs, Dialogues in Clincal Neuroscience, December 7, 2005
Waite F, Myers E, Harvey AG, Espie CA, Startup H, Sheaves B, Freeman D., Treating Sleep Problems in Patients with Schizophrenia, Behavioural and Cognitive Psychotherapy, May 2016
Goldstein TR, Bridge JA, Brent DA., Sleep Disturbance Preceding Completed Suicide in Adolescents, Journal of Consulting and Clinical Psychology, February 17, 2010
Original article: https://sleepopolis.com/education/how-does-mental-health-affect-your-sleep/
Rose MacDowell
Rose is the Chief Research Officer at Sleepopolis, which allows her to indulge her twin passions for dense scientific studies and writing about health and wellness. An incurable night owl, she loves discovering the latest information about sleep and how to get (lots) more of it. She is a published novelist who has written everything from an article about cheese factories to clock-in instructions for assembly line workers in Belgium. One of her favorite parts of her job is connecting with the best sleep experts in the industry and utilizing their wealth of knowledge in the pieces she writes. She enjoys creating engaging articles that make a difference in people’s lives. Her writing has been reviewed by The Boston Globe, Cosmopolitan, and the Associated Press, and received a starred review in Publishers Weekly. When she isn’t musing about sleep, she’s usually at the gym, eating extremely spicy food, or wishing she were snowboarding in her native Colorado. Active though she is, she considers staying in bed until noon on Sundays to be important research.
One in four Americans develop insomnia each year: 75 percent of those with insomnia recover
June 5, 2018
Science Daily/University of Pennsylvania School of Medicine
About 25 percent of Americans experience acute insomnia each year, but about 75 percent of these individuals recover without developing persistent poor sleep or chronic insomnia, according to a new study.
The new study offers the latest data on the prevalence of acute insomnia, which is characterized by difficulty falling asleep or staying asleep for as little as three nights per week for at least two consecutive weeks up to three months. Insomnia becomes chronic when it occurs at least three nights a week for more than three months.
"Whether caused by stress, illness, medications, or other factors, poor sleep is very common," said senior author Michael Perlis, PhD, an associate professor of Psychiatry and director of the Behavioral Sleep Medicine program. "These findings reveal new insights about the paths that acute insomnia takes and can inform interventions that target poor sleep and help people recover sustained sufficient sleep."
The findings, (#0359) will be presented at SLEEP 2018, the 32nd Annual Meeting of the Associated Professional Sleep Societies LLC (APSS) in Baltimore.
Although some studies have offered the prevalence of insomnia symptoms in large populations, to date this is the first study to offer data on transitions of good sleepers (GS) -- defined as those needing fewer than 15 minutes to fall asleep and/or who spend fewer than 15 minutes awake during the night on five or more nights per week. The study specifically determines how GS transition to acute insomnia (AI), to persistent poor sleep (PPS) -- i.e., recurring bouts of AI without sustained recovery or turning to chronic insomnia (CI), to chronic insomnia, and how many of those affected by AI recover.
A total of 1,435 adults were recruited nationwide and tracked for one year during 2015-2017. They were verified as good sleepers over the first three months of the study and assessed on a daily, weekly and monthly basis for one full year. The subjects kept a daily sleep diary for the duration of the study, allowing for a uniquely detailed level of insight into how sleep varies from day to day. Also, regular assessments were made regarding participants' daytime function, stress and life events, and medical and mental health.
Among the 25 percent experiencing acute insomnia, about 75 percent of subjects recovered good sleep within 12 months, while 21 percent remained poor sleepers with recurring bouts of AI, and about 6 percent developed chronic insomnia. No significant differences were observed along racial, ethnic, or gender lines, or among people of varying incomes or BMI.
The new data provides researchers with how many people experience AI each year, as well as how those cases progress, laying the groundwork for additional research now underway to assess what factors predict recovery (resilience) and non-recovery (persistent poor sleep or the new onset of chronic insomnia).
The findings will be presented during the poster session on Tuesday, June 5, from 3:15-3:30 pm in room 337 at the Baltimore Convention Center.
Previous research from the Perlis team has shown that suicides are more likely to occur after midnight than during the daytime or evening and another study showing that more sleep reduces suicide risk in those with insomnia.
https://www.sciencedaily.com/releases/2018/06/180605154114.htm
Inadequate sleep could cost countries billions
June 4, 2018
Science Daily/Oxford University Press USA
Inadequate sleep is a public health problem affecting more than one in three adults worldwide. A new study suggests that insufficient sleep could also have grave economic consequences.
Community sleep surveys suggest that inadequate sleep is substantial and increasing. Surveys performed several years ago demonstrated that complaints of inadequate sleep were common, with between 20 and 30 percent of respondents complaining of inadequate sleep on a regular basis across several Western nations. Recent surveys suggest this proportion is increasing; between 33 and 45 percent of Australian adults now have this complaint.
The growth of the problem over time is shared by other nations with similar demographics. Some 35 percent of U.S. adults are not getting the recommended 7 hours of sleep each night. About 30 percent of Canadians don't feel they're getting enough sleep. Some 37 percent of those in the UK, 28 percent of people in Singapore, and 26 percent of French people also report insufficient sleep.
Insufficient sleep is associated with lapses in attention and the inability to stay focused; reduced motivation; compromised problem solving; confusion, irritability and memory lapses; impaired communication; slowed or faulty information processing and judgment; diminished reaction times; and indifference and loss of empathy. Furthermore, short sleep increases the risk of heart attacks, stroke, hypertension, obesity, diabetes, and depression.
Here researchers attempted to measure the economic consequences of limited sleep times -- defined as "difficulties with sleep initiation, maintenance or quality associated with the presence of impaired daytime alertness" at least several days a week -- in Australia. Researchers evaluated financial and non-financial cost data derived from national surveys and databases. Costs considered included: financial costs associated with health care, informal care provided outside the healthcare sector, productivity losses, non-medical work and vehicle accident costs, deadweight loss through inefficiencies relating to lost taxation revenue and welfare payments; and nonfinancial costs of a loss of well-being.
The financial cost component was $17.88 billion, comprised of: direct health costs of $160 million for sleep disorders and $1.08 billion for associated conditions; productivity losses of $12.19 billion ($5.22 billion reduced employment, $0.61 billion premature death, $1.73 billion absenteeism, $4.63 billion lost through workers showing up for work but not actually performing work on the job); non-medical accident costs of $2.48 billion; informal care costs of $0.41 billion; and deadweight loss of $1.56 billion. The non-financial cost of reduced well-being was $27.33 billion. Thus, the estimated overall cost of inadequate sleep in Australia in 2016-17 (population: 24.8 million) was $45.21 billion.
The financial and non-financial costs associated with inadequate sleep are substantial. The estimated total financial cost of $17.88 billion represents 1.55% of Australian gross domestic product. The estimated non-financial cost of $27.33 billion represents 4.6% of the total Australian burden of disease for the year. The researchers argue that these costs warrant substantial investment in preventive health measures to address the issue through education and regulation.
In setting national health priorities, governments have attempted to identify issues that involve high communal illness and injury burden with associated high costs for attention through public education, regulation, and other initiatives to effect improvements in health status. The authors say that governments have been remarkably successful in targeting diabetes, depression, and smoking, for example. These data presented above suggest that sleep health may merit similar attention. The situation is likely to be similar in equivalent economies.
Researcher quote: "We are in the midst of a worldwide epidemic of inadequate sleep, some from clinical sleep disorders, some through pressure from competing work, social and family activities and some from failure to give sleep sufficient priority through choice or ignorance. Apart from its impact on well-being, this problem comes at a huge economic cost through its destructive effects on health, safety and productivity. Addressing the issue by education, regulation and other initiatives is likely to deliver substantial economic as well as health benefits."
https://www.sciencedaily.com/releases/2018/06/180604093111.htm
Can't sleep? Could be down to genetics
Large study confirms that insomnia is hereditary
March 9, 2018
Science Daily/Springer
Researchers have identified specific genes that may trigger the development of sleep problems, and have also demonstrated a genetic link between insomnia and psychiatric disorders such as depression, or physical conditions such as type 2 diabetes.
Up to 20 percent of Americans and up to 50 percent of US military veterans are said to have trouble sleeping. The effects insomnia has on a person's health can be debilitating and place a strain on the healthcare system. Chronic insomnia goes hand in hand with various long-term health issues such as heart disease and type 2 diabetes, as well as mental illness such as post-traumatic stress disorder (PTSD) and suicide.
Twin studies have in the past shown that various sleep-related traits, including insomnia, are heritable. Based on these findings, researchers have started to look into the specific gene variants involved. Stein says such studies are important, given the vast range of reasons why people suffer from insomnia, and the different symptoms and varieties of sleeplessness that can be experienced.
"A better understanding of the molecular bases for insomnia will be critical for the development of new treatments," he adds.
In this study, Stein's research team conducted genome-wide association studies (GWAS). DNA samples obtained from more than 33,000 soldiers participating in the Army Study To Assess Risk and Resilience in Servicemembers (STARRS) were analyzed. Data from soldiers of European, African and Latino descent were grouped separately as part of efforts to identify the influence of specific ancestral lineages. Stein and his colleagues also compared their results with those of two recent studies that used data from the UK Biobank.
Overall, the study confirms that insomnia has a partially heritable basis. The researchers also found a strong genetic link between insomnia and type 2 diabetes. Among participants of European descent, there was additionally a genetic tie between sleeplessness and major depression.
"The genetic correlation between insomnia disorder and other psychiatric disorders, such as major depression, and physical disorders such as type 2 diabetes suggests a shared genetic diathesis for these commonly co-occurring phenotypes," says Stein, who adds that the findings strengthen similar conclusions from prior twin and genome-wide association studies.
Insomnia was linked to the occurrence of specific variants on chromosome 7. In people of European descent, there were also differences on chromosome 9. The variant on chromosome 7, for instance, is close to AUTS2, a gene that has been linked to alcohol consumption, as well as others that relate to brain development and sleep-related electric signaling.
"Several of these variants rest comfortably among locations and pathways already known to be related to sleep and circadian rhythms," Stein elaborates. "Such insomnia associated loci may contribute to the genetic risk underlying a range of health conditions including psychiatric disorders and metabolic disease."
https://www.sciencedaily.com/releases/2018/03/180309095520.htm
Sleepless in Japan: How insomnia kills
February 9, 2018
De Gruyter
Lay people tend to think that insomnia is usually a symptom of something else, like stress, a bad diet or a sedentary lifestyle, but this may not be true at all. It is possible that insomnia itself causes many of the conditions that it is seen as a symptom of. Using previous research that shows that insomnia causes a decrease in blood flow in the front dorsal lobe of the brain, which correlates with depression, the authors seek to establish a link between insomnia and depression.
Depression is a hidden killer. It is a condition that affects people all around the world. Suicide is one of the leading causes of death in Japan. The yearly financial cost to the Japanese economy of depression and suicide is estimated by UPI to be USD 4.1 billion. Middle-aged males, one of the groups that was found to suffer the highest rates of insomnia are also the likeliest to commit suicide.
In March of 2011, over 7000 hospital staff in ten hospitals in the district of Rosai were given a self-administered anonymous questionnaire. The questions included information about the respondent's gender, age, and medical profession, as well as questions about their sleeping history two weeks prior to responding to the survey, as well as detailing their overtime work, and their history of disease and chronic pain. It also asked them to assess their own feelings of depression and fatigue.
The results were alarming. Thirteen percent of men, and nineteen percent of women suffered from insomnia, and the medical profession with the highest rate of insomnia were nurses at twenty percent. For comparison, about ten percent of Americans suffer from chronic insomnia.
Chronic insomnia can lead to depression, and a better understanding of the link between the two conditions could be used to improve treatment, and prevent the condition from worsening while strengthening the world economy. The hope is a survey will be developed for healthcare professionals (and other high-stress professions) that can identify insomnia before it becomes a problem.
https://www.sciencedaily.com/releases/2018/02/180209114224.htm
Exercise is no quick cure for insomnia
August 15, 2013
Science Daily/Northwestern University
Exercise is a common prescription for insomnia. But spending 45 minutes on the treadmill one day won't translate into better sleep that night, according to new Northwestern Medicine® research.
"If you have insomnia you won't exercise yourself into sleep right away," said lead study author Kelly Glazer Baron, a clinical psychologist and director of the behavioral sleep program at Northwestern University Feinberg School of Medicine. "It's a long-term relationship. You have to keep at it and not get discouraged."
This is the first long-term study to show aerobic exercise during the day does not result in improved sleep that same night when people have existing sleep problems. Most studies on the daily effects of exercise and sleep have been done with healthy sleepers.
The study also showed people exercise less following nights with worse sleep.
"Sleeping poorly doesn't change your aerobic capacity, but it changes people's perception of their exertion," Baron said. "They feel more exhausted."
The study will be published August 15 in the Journal of Clinical Sleep Medicine. Baron conducted the study with coauthor Kathryn Reid, research associate professor of neurology at Feinberg and senior author Phyllis Zee, M.D., the Benjamin and Virginia T. Boshes Professor of Neurology at Feinberg and director of the Sleep Disorders Center at Northwestern Memorial Hospital.
"This new study shows exercise and sleep affect each other in both directions: regular long-term exercise is good for sleep but poor sleep can also lead to less exercise. So in the end, sleep still trumps everything as far as health is concerned," Zee said.
Baron decided to analyze the daily effect of exercise after hearing her patients with insomnia complain the exercise she recommended didn't help them right away.
"They'd say, 'I exercised so hard yesterday and didn't sleep at all,'" Baron said. "The prevailing thought is that exercise improves sleep, but I thought it probably wasn't that simple for people with insomnia."
Why does it take time for exercise to impact sleep?
"Patients with insomnia have a heightened level of brain activity and it takes time to re-establish a more normal level that can facilitate sleep," Zee said. "Rather than medications, which can induce sleep quickly, exercise may be a healthier way to improve sleep because it could address the underlying problem."
The study participants were older women, who have the highest prevalence of insomnia. Exercise is an optimum approach to promote sleep in an older population because drugs can cause memory impairment and falls.
Baron thinks the results also could apply to men because there is no evidence of gender differences in behavioral treatments for insomnia.
For the study, Baron performed an analysis of data from a 2010 clinical trial (by the same group of Northwestern researchers on the current paper) that demonstrated the ability of aerobic exercise to improve sleep, mood and vitality over a 16-week period in middle-age-to-older adults with insomnia. She and colleagues examined the daily sleep data from 11 women ages 57 to 70.
The key message is that people with sleep disturbances have to be persistent with exercise.
"People have to realize that even if they don't want to exercise, that's the time they need to dig in their heels and get themselves out there," Baron said. "Write a note on your mirror that says 'Just Do It!' It will help in the long run."
http://www.sciencedaily.com/releases/2013/08/130815084841.htm
Cannot sleep due to stress? Here is the cure
September 5, 2017
Science Daily/University of Tsukuba
Everyone empirically knows that stressful events certainly affect sound sleep. Scientists have found that the active component rich in sugarcane and other natural products may ameliorate stress and help having sound sleep.
In today's world ever-changing environment, demanding job works and socio-economic factors enforces sleep deprivation in human population. Sleep deprivation induces tremendous amount of stress, and stress itself is one of the major factors responsible for sleep loss or difficulty in falling into sleep. Currently available sleeping pills does not address stress component and often have severe side effects. Sleep loss is also associated with certain other diseases including obesity, cardiovascular diseases, depression, anxiety, mania deficits etc.
The research group led by Mahesh K. Kaushik and Yoshihiro Urade of the International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, found that octacosanol reduces stress and restores stress-affected sleep back to normal.
Octacosanol is abundantly present in various everyday foods such as sugarcane (thin whitish layer on surface), rice bran, wheat germ oil, bee wax etc. The crude extract is policosanol, where octacosanol is the major constituent. Policosanol and octacosanol have already been used in humans for various other medical conditions.
In the current study, authors made an advancement and investigated the effect of octacosanol on sleep regulation in mildly stressed mice by oral administration. Octacosanol reduced corticosterone level in blood plasma, which is a stress marker. The octacosanol-administered mice also showed normal sleep, which was previously disturbed due to stress. They therefore claim that the octacosanol mitigates stress in mice and restores stress-affected sleep to normal in mice. The sleep induced by octacosanol was similar to natural sleep and physiological in nature. However, authors also claimed that octacosanol does not affect sleep in normal animals. These results clearly demonstrated that octacosanol is an active compound that has potential to reduce stress and to increase sleep, and it could potentially be useful for the therapy of insomnia caused by stress. Octacosanol can be considered safe for human use as a therapy, because it is a food-based compound and believed to show no side effects.
Octacosanol/policosanol supplements are used by humans for functions such as lipid metabolism, cholesterol lowering or to provide strength. However, well-planned clinical studies need to be carried out to confirm its effect on humans for its stress-mitigation and sleep-inducing potentials. "Future studies include the identification of target brain area of octacosanol, its BBB permeability, and the mechanism via which octacosanol lowers stress," Kaushik says.
https://www.sciencedaily.com/releases/2017/09/170905111357.htm
Aerobic Exercise Relieves Insomnia
Sep. 15, 2010 —
Science Daily/Northwestern University
The millions of middle-aged and older adults who suffer from insomnia have a new drug-free prescription for a more restful night's sleep. Regular aerobic exercise improves the quality of sleep, mood and vitality, according to a small but significant new study from Northwestern Medicine.
The study is the first to examine the effect of aerobic exercise on middle-aged and older adults with a diagnosis of insomnia. About 50 percent of people in these age groups complain of chronic insomnia symptoms.
"Insomnia increases with age," Zee said. "Around middle age, sleep begins to change dramatically. It is essential that we identify behavioral ways to improve sleep. Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous."
http://www.sciencedaily.com/releases/2010/09/100915140336.htm
The secret connection between anxiety, sleep
July 1, 2017
Science Daily/University of Tsukuba
You may have experienced sleepless nights when you were anxious, stressed or too excited. Such emotions are well-known to affect wakefulness and can even cause insomnia, though the underlying mechanisms in our brain have still been unclear. Scientists have spotted neurons that play crucial roles in connecting emotions and sleep, shedding light on the future discovery of drug targets for anxiety disorder and/or sleep disorders.
Encountering predators, adapting to a novel environment or expecting a reward ― these stressful or emotionally-salient situations require animals to shift their behavior to a vigilant state, altering their physiological conditions through modulation of autonomic and endocrine functions.
The bed nucleus of the stria terminalis (BNST) is a part of the extended amygdala, which is generally considered as a key player in stress response, fear and anxiety. Through projections to various brain regions including relay nuclei of the autonomic nervous system, hypothalamic regions and the central nucleus of the amygdala, the BNST controls endocrine and autonomic reactions in response to emotionally-salient stimuli, along with behavioral expression of anxiety and fear.
A group of researchers led by Takeshi Sakurai, Vice Director of the International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, found that acute optogenetic excitation of GABAergic neurons in BNST during non-rapid eye movement (NREM) sleep in mice resulted in immediate transition to a wakefulness state without the function of orexins, highly important neuropeptides for maintaining wakefulness. Notably, stimulation of the same neurons during REM sleep did not show any effects on sleep/wakefulness states.
Prolonged excitation of GABAergic neurons in BNST by a chemogenetic method evoked a longer-lasting, sustained wakefulness state, and it was abolished by administering a dual orexin receptor blocker (antagonist) DORA 22 in advance, meaning that orexins are involved in this phenomenon.
"Our study revealed a role of the BNST GABAergic system in sleep/wakefulness control, especially in shifting animals' behavioral states from NREM sleep to wakefulness. It also provides an important insight into the pathophysiology of insomnia and the role of orexin in arousal regulation, which will hopefully lead to the first step to develop remedies for sleep disorders," Sakurai says.
https://www.sciencedaily.com/releases/2017/07/170701081720.htm
Purpose in life by day linked to better sleep at night
Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome
July 10, 2017
Science Daily/Northwestern University
Having a purpose in life means you are more likely to sleep better at night with less sleep apnea and restless leg syndrome, reports a new study. Cultivating a purpose in life could be drug-free strategy to improve sleep, scientists said. The study participants were older adults -- who tend to have more insomnia and sleep disturbances -- but researchers said the findings are likely applicable to the broader public.
Having a good reason to get out of bed in the morning means you are more likely to sleep better at night with less sleep apnea and restless leg syndrome, reports a new Northwestern Medicine and Rush University Medical Center study based on older adults.
This is the first study to show having a purpose in life specifically results in fewer sleep disturbances and improved sleep quality and over a long period of time. Previous research showed having a purpose in life generally improves overall sleep when measured at a single point in time.
Although the participants in the study were older, researchers said the findings are likely applicable to the broader public.
"Helping people cultivate a purpose in life could be an effective drug-free strategy to improve sleep quality, particularly for a population that is facing more insomnia," said senior author Jason Ong, an associate professor of neurology at Northwestern University Feinberg School of Medicine. "Purpose in life is something that can be cultivated and enhanced through mindfulness therapies."
The paper will be published in the journal Sleep Science and Practice.
Individuals have more sleep disturbances and insomnia as they get older. Clinicians prefer to use non-drug interventions to improve patients' sleep, a practice now recommended by the American College of Physicians as a first line treatment for insomnia, Ong said.
The next step in the research should be to study the use of mindfulness-based therapies to target purpose in life and resulting sleep quality, said Arlener Turner, the study's first author and a former postdoctoral fellow in neurology at Feinberg.
The 823 participants -- non-demented individuals 60 to 100 years old with an average age of 79 -- were from two cohorts at Rush University Medical Center. More than half were African American and 77 percent were female.
People who felt their lives had meaning were 63 percent less likely to have sleep apnea and 52 percent less likely to have restless leg syndrome. They also had moderately better sleep quality, a global measure of sleep disturbance.
For the study, participants answered a 10-question survey on purpose in life and a 32-question survey on sleep. For the purpose in life survey, they were asked to rate their response to such statements as, "I feel good when I think of what I've done in the past and what I hope to do in the future."
The next step in the research should be to study the use of mindfulness-based therapies to target purpose in life and resulting sleep quality, Turner said.
Poor sleep quality is related to having trouble falling asleep, staying asleep and feeling sleepy during the day. Sleep apnea is a common disorder that increases with age in which a person has shallow breathing or pauses in breathing during sleep several times per hour. This disruption often makes a person feel unrefreshed upon waking up and excessively sleepy during the day.
Restless leg syndrome causes uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms commonly occur in the late afternoon or evening hours and are often most severe at night when a person is resting, such as sitting or lying in bed.
https://www.sciencedaily.com/releases/2017/07/170710091734.htm
Chronic Insomnia Requires Increased Brain Activation to Maintain Daily Function
June 12, 2009
Science Daily/American Academy of Sleep Medicine
Patients suffering from chronic primary insomnia have higher levels of brain activation compared to normal sleepers during a working memory test.
According to a research abstract that will be presented on June 9, at Sleep 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies, patients suffering from chronic primary insomnia (PIs) have higher levels of brain activation compared to normal sleepers during a working memory test.
Results show that PIs use increased brain activation relative to good sleepers during the working memory task, particularly in areas responsible for visual-spatial attention and coordination of cognitive processes. This activation may explain how PIs maintain performance on the task despite their sleep difficulties. PIs also were found to have decreased activation in visual and motor areas, which may suggest that PIs have higher baseline activation in these regions relative to good sleepers.
http://www.sciencedaily.com/releases/2009/06/090609072811.htm
Real-Life Exposure to Violence Disrupts a Child's Sleep Habits
June 13, 2012
Science Daily/American Academy of Sleep Medicine
When violence shatters a child's world, the torment can continue into their sleep, according to researchers in Cleveland. The impact is measurable and affected by the severity of the violence, and the effects can last over time.
The study, being presented June 12 at SLEEP 2012, shows how the severity of a violent event affects a child's quality and quantity of sleep. The more severe the violence, the more sleep is impacted. Trouble with nightmares and insomnia have long been associated with exposure to violence, but the Cleveland study found that characteristics of the violent act touch different aspects of the child's sleep.
http://www.sciencedaily.com/releases/2012/06/120613091043.htm
Active Duty Military Personnel Prone to Sleep Disorders and Short Sleep Duration
Jan. 31, 2013 —
Science Daily/American Academy of Sleep Medicine
A new study found a high prevalence of sleep disorders and a startlingly high rate of short sleep duration among active duty military personnel. The study suggests the need for a cultural change toward appropriate sleep practices throughout the military.
"While sleep deprivation is part of the military culture, the high prevalence of short sleep duration in military personnel with sleep disorders was surprising," said Vincent Mysliwiec, MD, the study's principal investigator, lead author and chief of Pulmonary, Critical Care and Sleep Medicine at Madigan Army Medical Center in Tacoma, Wash. "The potential risk of increased accidents as well as long-term clinical consequences of both short sleep duration and a sleep disorder in our population is unknown."
Results show that the majority of participants (85.1 percent) had a clinically relevant sleep disorder. Obstructive sleep apnea (OSA) was the most frequent diagnosis (51.2 percent), followed by insomnia (24.7 percent). Participants' mean self-reported home sleep duration was only 5.74 hours per night, and 41.8 percent reported sleeping five hours or less per night. According to the AASM, individual sleep needs vary; however, most adults need about seven to eight hours of nightly sleep to feel alert and well-rested during the day.
According to the authors, this is the first study to systemically describe primary sleep disorders and associated comorbidities in accordance with standardized diagnostic criteria in a large cohort of military personnel referred with sleep complaints.
The study, appearing in the February issue of the journal SLEEP, involved a retrospective cross-sectional cohort analysis of 725 diagnostic polysomnograms performed in 2010 at Madigan Army Medical Center. Study subjects were active duty military personnel from the U.S. Army, Air Force and Navy, comprising mostly men (93.2%) and combat veterans (85.2%). Sleep disorder diagnoses were adjudicated by a board certified sleep medicine physician.
Results also show that 58.1 percent of the military personnel had one or more medical comorbidities, determined by medical record review. The most common service-related illnesses were depression (22.6%), anxiety (16.8%), post-traumatic stress disorder (13.2%), and mild traumatic brain injury (12.8%). Nearly 25 percent were taking medications for pain. Participants with PTSD were two times more likely to have insomnia, and those with depression or pain syndrome were about 1.5 times more likely to have insomnia.
"Mysliwiec and colleagues have made a significant contribution to our understanding of the link between sleep disorders and service-related illnesses associated with combat operations," Nita Lewis Shattuck, PhD, and Stephanie A.T. Brown, MS, postgraduate students at the Naval Postgraduate School in Monterey, Calif., wrote in a commentary on the study. "Their findings highlight the need for policy and culture change in our military organizations and continued research to understand and ameliorate the injuries these veterans have sustained. Better appreciation of the causal factors associated with veteran's health will lead to better policies for transition to civilian life and ultimately minimize the cost of veterans' health care to society."
http://www.sciencedaily.com/releases/2013/01/130131154408.htm