Sleep and Mental Health
The Connection Between Sleep And Mental Health
Many people experience problems sleeping including not getting enough sleep, not feeling rested and not sleeping well. This problem can lead to difficulties functioning during the daytime and have unpleasant effects on your work, social and family life. Problems sleeping can be secondary to a medical illness such as sleep apnea, or a mental health condition like depression. Sleep issues can be a sign of an impending condition such as bipolar disorder. In addition to affecting sleep itself, many medical and mental health conditions can be worsened by sleep-related problems.
Insomnia
One of the major sleep disorders that people face is insomnia. Insomnia is an inability to get the amount of sleep needed to function efficiently during the daytime. Over one-third of Americans report difficulty sleeping. Insomnia is caused by difficulty falling asleep, difficulty staying asleep or waking up too early in the morning.
Insomnia is rarely an isolated medical or mental illness but rather a symptom of another illness to be investigated by a person and their medical doctors. In other people, insomnia can be a result of a person’s lifestyle or work schedule.
Sometimes insomnia or other sleep problems can be caused by sleep apnea, which is a separate medical condition that affects a person’s ability to breathe while sleeping. A doctor or sleep specialist can diagnose sleep apnea and provide treatment to improve sleep.
Short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks and should be investigated by a physician with a potential referral to a sleep disorder specialist, which includes psychiatrists, neurologists and pulmonologists who have expertise in sleep disorders.
Cause And Effect
More than one-half of insomnia cases are related to depression, anxiety or psychological stress. Often the qualities of a person’s insomnia and their other symptoms can be helpful in determining the role of mental illness in a person’s inability to sleep. Early morning wakefulness can be a sign of depression, along with low energy, inability to concentrate, sadness and a change in appetite or weight. On the other hand, a sudden dramatic decrease in sleep which is accompanied by increase in energy, or the lack of need for sleep may be a sign of mania.
Many anxiety disorders are associated with difficulties sleeping. Obsessive-compulsive disorder (OCD) is frequently associated with poor sleep. Panic attacks during sleep may suggest a panic disorder. Poor sleep resulting from nightmares may be associated with posttraumatic stress disorder (PTSD).
Substance abuse can also cause problems with sleep. While alcohol is sedating in limited quantities, intoxication with alcohol can make you wake up numerous times in the night and disturbs your sleep patterns. Hallucinogenic drugs, such as LSD, ecstasy and Molly, and are also associated with interruptions in sleep. Some sedative medications may cause sleepiness during intoxication but can disturb sleep and cause serious problems sleeping in people who are addicted to or withdrawing from these medications.
Poor sleep has been shown to significantly worsen the symptoms of many mental health issues. Severe sleep problems can decrease the effectiveness of certain treatments. Treatment of sleep disorders has also been studied in relationship to schizophrenia, ADHD and other mental illnesses. All of the scientific data shows the connection between medical and mental illnesses: good sleep is necessary for recovery—or prevention—in both types of conditions.
Treatment
The first-line treatment for insomnia is good sleeping habits and taking care of any underlying conditions that may be causing the problems with sleeping. But when these are not enough, other treatment options can be considered.
Many people experience problems sleeping including not getting enough sleep, not feeling rested and not sleeping well. This problem can lead to difficulties functioning during the daytime and have unpleasant effects on your work, social and family life. Problems sleeping can be secondary to a medical illness such as sleep apnea, or a mental health condition like depression. Sleep issues can be a sign of an impending condition such as bipolar disorder. In addition to affecting sleep itself, many medical and mental health conditions can be worsened by sleep-related problems.
Insomnia
One of the major sleep disorders that people face is insomnia. Insomnia is an inability to get the amount of sleep needed to function efficiently during the daytime. Over one-third of Americans report difficulty sleeping. Insomnia is caused by difficulty falling asleep, difficulty staying asleep or waking up too early in the morning.
Insomnia is rarely an isolated medical or mental illness but rather a symptom of another illness to be investigated by a person and their medical doctors. In other people, insomnia can be a result of a person’s lifestyle or work schedule.
Sometimes insomnia or other sleep problems can be caused by sleep apnea, which is a separate medical condition that affects a person’s ability to breathe while sleeping. A doctor or sleep specialist can diagnose sleep apnea and provide treatment to improve sleep.
Short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks and should be investigated by a physician with a potential referral to a sleep disorder specialist, which includes psychiatrists, neurologists and pulmonologists who have expertise in sleep disorders.
Cause And Effect
More than one-half of insomnia cases are related to depression, anxiety or psychological stress. Often the qualities of a person’s insomnia and their other symptoms can be helpful in determining the role of mental illness in a person’s inability to sleep. Early morning wakefulness can be a sign of depression, along with low energy, inability to concentrate, sadness and a change in appetite or weight. On the other hand, a sudden dramatic decrease in sleep which is accompanied by increase in energy, or the lack of need for sleep may be a sign of mania.
Many anxiety disorders are associated with difficulties sleeping. Obsessive-compulsive disorder (OCD) is frequently associated with poor sleep. Panic attacks during sleep may suggest a panic disorder. Poor sleep resulting from nightmares may be associated with posttraumatic stress disorder (PTSD).
Substance abuse can also cause problems with sleep. While alcohol is sedating in limited quantities, intoxication with alcohol can make you wake up numerous times in the night and disturbs your sleep patterns. Hallucinogenic drugs, such as LSD, ecstasy and Molly, and are also associated with interruptions in sleep. Some sedative medications may cause sleepiness during intoxication but can disturb sleep and cause serious problems sleeping in people who are addicted to or withdrawing from these medications.
Poor sleep has been shown to significantly worsen the symptoms of many mental health issues. Severe sleep problems can decrease the effectiveness of certain treatments. Treatment of sleep disorders has also been studied in relationship to schizophrenia, ADHD and other mental illnesses. All of the scientific data shows the connection between medical and mental illnesses: good sleep is necessary for recovery—or prevention—in both types of conditions.
Treatment
The first-line treatment for insomnia is good sleeping habits and taking care of any underlying conditions that may be causing the problems with sleeping. But when these are not enough, other treatment options can be considered.
- Good sleeping habits. A first-line treatment for treatment of insomnia, these can include maintaining a regular sleep schedule, avoiding stimulating activities like exercise before bed, and having a comfortable sleep environment.
- Relaxation techniques. Deep breathing, progressive muscle relaxation and mindfulness can help people become aware of their body and decrease anxiety about going to sleep.
- Medication. Many psychiatric drugs are used to promote sleep in people with insomnia. One should be careful regarding the risk of becoming “over-sedated” by using other drugs and alcohol when taking some of these medications. Doctors don't generally recommend staying on medication for more than a few weeks but there are a few medications that have been approved for long term use.
- Herbal remedies. Melatonin and valerian root are two herbal remedies that are available at many pharmacies and other locations. The effectiveness of these treatments has not been proven for most people, and neither treatment has been approved by the FDA.
- Sleep restriction. This is a form of therapy that increases “sleep efficiency” by decreasing the amount of time that a person spends in bed awake. This involves very strict rules regarding the amount of time that a person can lay in bed for at night which gradually increases over time.
- Cognitive behavioral therapy. This therapy can help you control or eliminate negative thoughts and worries that keep you awake.
- Light therapy. Also known as phototherapy, this can be specifically helpful in people with a condition called “delayed sleep phase syndrome.”
- Exercise is associated with improved sleep quality. Talk with your health care provider about the kind of exercise that will work for you.
Sleep Issues with Mental Illnesses
From https://www.onlinemattressreview.com/sleep-mental-health/
Maintaining good mental health is simply impossible in the long run without the proper amount of sleep. Sleep is both productive and restorative, meaning it actively produces important hormones and also repairs any damage the day may have done. Not getting enough sleep has been associated with all manner of emotional disturbance, so its importance cannot be overstated. While it’s not always clear where the line is between causation and correlation, study upon study shows people are simply more likely to be mentally healthy if they are sleeping enough at night.
Attention Deficit Hyperactivity Disorder (ADHD)
While it is not uncommon for people to have trouble sleeping, people with ADHD suffer at a far greater rate than the general population. The problem is, those of us with ADHD suffer from a lack of sleep, which often makes the symptoms of ADHD worse, which can further decrease the person’s lack of sleep, and so on. It’s a bit of a self-fulfilling prophecy, and these people suffer all the more for it.
When talking about ADHD, we’d be remiss if we didn’t focus on children. Kids with ADHD are two to three times more likely to suffer from a lack of sleep than children without the disorder, but what can be done to ensure children with ADHD get all the sleep they can? The tips are similar to what you’d tell someone even without ADHD, though children with ADHD should hold more strictly to these guidelines. First, put the phone away. In fact, put all screens away. This will help stop the distractions these cause. Second, stick to a schedule. While binge-watching that show might seem like a good idea now, children’s’ minds will thank them in the morning when they can think clearly and avoid an exaggerated presentation of ADHD symptoms. Finally, eat and drink with sleep in mind. Children (or, more likely, the people feeding them) should remember that their bodies will spend the night digesting what they ingest, so be careful with what you ask them to do.
ADHD and Sleep Disorder
National Sleep Foundation: ADHD
ADHD and Sleep Disorders: Are Kids Getting Misdiagnosed?
How ADHD Affects Kids’ Sleep and What You Can Do
ADHD and Sleep in Children
Sleep Tips When You Have ADHD
Anxiety
Over 40 million Americans suffer some type of sleep disorder, and studies have shown anxiety disorder can make things worse. Unfortunately, anxiety disorder and sleep disorders such as insomnia go hand in hand, so it’s important that anyone with anxiety arms themselves with knowledge as much as possible.
Much like ADHD and sleep disorders, it can be difficult to determine which comes first, but the fact of the matter is, when it comes to addressing a lack of sleep, it doesn’t matter. For the most part, treatment doesn’t change with causation. Treatments can vary between the clinical and the behavioral, but in general, the most common treatments you’ll see for sleep disorders in conjunction with anxiety are sleep medicine and therapy, especially cognitive-behavior therapy. Cognitive-behavior therapy teaches how to modify the types of behaviors that can negatively impact sleep.
How to Overcome Sleep Anxiety
Sleep Anxiety in Children
Chronic Anxiety and Sleep Problems
Trouble Sleeping at Night Due to Anxiety
Sleep You Anxiety Away
A Vicious Cycle: Insomnia, Anxiety, and Depression
Sleep Guide for Anxiety
Bipolar Disorder
As with many mental disorders, bipolar disorder can affect sleep in a multitude of ways. The anxiety produced by bipolar disorder can lead to severe and debilitating insomnia. On the other hand, the depression brought on by bipolar disorder can lead to hypersomnia, or over-sleeping. Neither is good for your mental or physical health and need to be addressed if the disorder affects you in this way.
Further, these sleep issues, which are in many cases caused by bipolar disorder, can co-occur with other common issues, such as sleep apnea. Sleep apnea, or stopping breathing when sleeping, can cause excessive tiredness the next day and exacerbate the symptoms of both the bipolar disorder and the sleep issues they cause.
The Connection Between Sleep and Mental Health
Sleep Loss as a Trigger of Mood Episodes in Bipolar Disorder
Bipolar Disorder and Dreaming
Sleep Disturbance in Bipolar Disorder
Consistent Routines May Ease Bipolar Disorder
Insomnia and Psychiatric Disorders
Sleep Disorders and Mental Illness Go Hand In Hand
Depression
While we all know what it is to be sad, even for days on end, depression can take emotions like sadness, hopelessness, and anxiety, to the next level. When you become consumed with these emotions, you may be diagnosed with depression, and this depression can have an adverse relationship with any healthy sleep habits you may have. Depression affects people in a wide variety of ways. It can affect the way someone behaves, eats, and sleeps.
Insomnia is likely to either co-occur with depression or be caused by it. This lack of sleep, like every other disorder mentioned in this article, can exacerbate the effect depression has on all aspects of life. Like with bipolar disorder, sleep apnea also tends to be an issue for people with depression.
Depression Toolkit: Sleeping Better with Depression
How to Get a Better Night’s Sleep with Depression
Lack of Sleep and Depression: Causes and Treatment Options
Depression and Sleep Disorders
Depression and Sleep: Pathophysiology and Treatment
Social Media Use Tied to Sleep Problems and Depression
From https://www.onlinemattressreview.com/sleep-mental-health/
Maintaining good mental health is simply impossible in the long run without the proper amount of sleep. Sleep is both productive and restorative, meaning it actively produces important hormones and also repairs any damage the day may have done. Not getting enough sleep has been associated with all manner of emotional disturbance, so its importance cannot be overstated. While it’s not always clear where the line is between causation and correlation, study upon study shows people are simply more likely to be mentally healthy if they are sleeping enough at night.
Attention Deficit Hyperactivity Disorder (ADHD)
While it is not uncommon for people to have trouble sleeping, people with ADHD suffer at a far greater rate than the general population. The problem is, those of us with ADHD suffer from a lack of sleep, which often makes the symptoms of ADHD worse, which can further decrease the person’s lack of sleep, and so on. It’s a bit of a self-fulfilling prophecy, and these people suffer all the more for it.
When talking about ADHD, we’d be remiss if we didn’t focus on children. Kids with ADHD are two to three times more likely to suffer from a lack of sleep than children without the disorder, but what can be done to ensure children with ADHD get all the sleep they can? The tips are similar to what you’d tell someone even without ADHD, though children with ADHD should hold more strictly to these guidelines. First, put the phone away. In fact, put all screens away. This will help stop the distractions these cause. Second, stick to a schedule. While binge-watching that show might seem like a good idea now, children’s’ minds will thank them in the morning when they can think clearly and avoid an exaggerated presentation of ADHD symptoms. Finally, eat and drink with sleep in mind. Children (or, more likely, the people feeding them) should remember that their bodies will spend the night digesting what they ingest, so be careful with what you ask them to do.
ADHD and Sleep Disorder
National Sleep Foundation: ADHD
ADHD and Sleep Disorders: Are Kids Getting Misdiagnosed?
How ADHD Affects Kids’ Sleep and What You Can Do
ADHD and Sleep in Children
Sleep Tips When You Have ADHD
Anxiety
Over 40 million Americans suffer some type of sleep disorder, and studies have shown anxiety disorder can make things worse. Unfortunately, anxiety disorder and sleep disorders such as insomnia go hand in hand, so it’s important that anyone with anxiety arms themselves with knowledge as much as possible.
Much like ADHD and sleep disorders, it can be difficult to determine which comes first, but the fact of the matter is, when it comes to addressing a lack of sleep, it doesn’t matter. For the most part, treatment doesn’t change with causation. Treatments can vary between the clinical and the behavioral, but in general, the most common treatments you’ll see for sleep disorders in conjunction with anxiety are sleep medicine and therapy, especially cognitive-behavior therapy. Cognitive-behavior therapy teaches how to modify the types of behaviors that can negatively impact sleep.
How to Overcome Sleep Anxiety
Sleep Anxiety in Children
Chronic Anxiety and Sleep Problems
Trouble Sleeping at Night Due to Anxiety
Sleep You Anxiety Away
A Vicious Cycle: Insomnia, Anxiety, and Depression
Sleep Guide for Anxiety
Bipolar Disorder
As with many mental disorders, bipolar disorder can affect sleep in a multitude of ways. The anxiety produced by bipolar disorder can lead to severe and debilitating insomnia. On the other hand, the depression brought on by bipolar disorder can lead to hypersomnia, or over-sleeping. Neither is good for your mental or physical health and need to be addressed if the disorder affects you in this way.
Further, these sleep issues, which are in many cases caused by bipolar disorder, can co-occur with other common issues, such as sleep apnea. Sleep apnea, or stopping breathing when sleeping, can cause excessive tiredness the next day and exacerbate the symptoms of both the bipolar disorder and the sleep issues they cause.
The Connection Between Sleep and Mental Health
Sleep Loss as a Trigger of Mood Episodes in Bipolar Disorder
Bipolar Disorder and Dreaming
Sleep Disturbance in Bipolar Disorder
Consistent Routines May Ease Bipolar Disorder
Insomnia and Psychiatric Disorders
Sleep Disorders and Mental Illness Go Hand In Hand
Depression
While we all know what it is to be sad, even for days on end, depression can take emotions like sadness, hopelessness, and anxiety, to the next level. When you become consumed with these emotions, you may be diagnosed with depression, and this depression can have an adverse relationship with any healthy sleep habits you may have. Depression affects people in a wide variety of ways. It can affect the way someone behaves, eats, and sleeps.
Insomnia is likely to either co-occur with depression or be caused by it. This lack of sleep, like every other disorder mentioned in this article, can exacerbate the effect depression has on all aspects of life. Like with bipolar disorder, sleep apnea also tends to be an issue for people with depression.
Depression Toolkit: Sleeping Better with Depression
How to Get a Better Night’s Sleep with Depression
Lack of Sleep and Depression: Causes and Treatment Options
Depression and Sleep Disorders
Depression and Sleep: Pathophysiology and Treatment
Social Media Use Tied to Sleep Problems and Depression
What’s That Antidepressant Doing to Your Sleep?
Most—but not all—antidepressants tend to suppress and/or delay REM sleep (the stage associated with dreaming). This can be helpful for people with depression.
It’s not necessarily helpful for people with insomnia. In fact, REM sleep irregularities may be a causal factor in insomnia. So it pays to know a bit more about antidepressants if you’re taking them now or before you head down that path.
By Lois Maharg, The Savvy Insomniac on August 31, 2016
thesavvyinsomniac.com/2016/08/31/whats-that-antidepressant-doing-to-your-sleep/
Most antidepressants suppress and delay REM sleepAntidepressants are the third most commonly taken medication in the United States today, prescribed for depression and health problems such as insomnia, pain, anxiety, headaches, and digestive disorders. Most—but not all—antidepressants tend to suppress and/or delay REM sleep (the stage associated with dreaming). This can help people with depression.
It’s not necessarily helpful for people with insomnia—or for people who might be inclined to sleep problems if pushed in the wrong direction. There’s mounting evidence that REM sleep irregularities may actually be a causal factor in insomnia. So it’s worthwhile knowing about the REM and other sleep effects of antidepressants if you’re taking them now or before you head down that path.
Importance of REM Sleep
Intact, sufficient REM sleep has many benefits. They include the enhancement and consolidation of learned tasks and skills in long-term memory and the regulation of emotion.
Fragmented REM sleep, in contrast, may lead to the inadequate processing of emotion and then to hyperarousal, in turn giving rise to insomnia. Loss of the final REM period, a phenomenon identified in some “short sleepers” (often defined as those who sleep less than 5 hours a night), may increase your appetite and make you more vulnerable to weight gain and obesity.In short, reduced or compromised REM sleep is not something you generally want.
Selective Serotonin Reuptake Inhibitors (and Relatives)
SSRIs are widely prescribed because they’re effective for depression and have relatively few major side effects. But as a class, they tend to suppress REM sleep. (They may also bring about changes in the frequency, intensity, and content of your dreams.) They also tend to delay the onset of sleep and increase awakenings and arousals at night, reducing sleep efficiency. If you have both depression and insomnia, it’s probably best to steer clear of SSRIs. But here’s a caveat. SSRIs and other drugs that act on the serotonin system (which is very complex) are known to have different sleep–wake effects on different people. Trying out a drug like fluoxetine (Prozac) may be the only way to ascertain for sure how it will affect your sleep.
The story is basically the same for serotonin and norepinephrine reuptake inhibitors (SNRIs). Drugs such as duloxetine (Cymbalta) and venlafaxine (Effexor XR) markedly suppress REM sleep and tend to disrupt sleep continuity.
Tricyclic Antidepressants
TCAs aren’t prescribed as often as SSRIs because they tend to cause more side effects. However, like SSRIs, most TCAs (except trimipramine) markedly suppress REM sleep. Also, TCAs like desipramine and protriptyline give rise to increased norepinephrine, which tends to promote wakefulness rather than sleep. In studies of desipramine, the drug degraded the sleep of people with depression by extending sleep onset latency, decreasing sleep efficiency, and increasing their number of awakenings at night.
Most TCAs are not sleep friendly. However, low-dose amitriptyline is known to have sedative effects and is sometimes prescribed for people with depression and insomnia.
Low-dose doxepin has been shown to have sedative effects as well, blocking secretion of histamine, a neurotransmitter associated with wakefulness. Sold today as Silenor, it’s the only antidepressant approved by the FDA for the treatment of insomnia. Clinical trials suggest that Silenor is effective in treating sleep maintenance insomnia but not insomnia that occurs at the beginning of the night.
Atypical Antidepressants
Some antidepressants are atypical in that they don’t fit neatly into any category. Although not approved for the treatment of insomnia (the requisite trials were never conducted), low-dose trazodone (Desyrel) and mirtazapine (Remeron) are often prescribed for people with insomnia because of their sedative effects. Unlike most antidepressants, these drugs have not been found to markedly suppress REM sleep. And the results of a very few studies suggest that they may help people fall asleep more quickly and sleep more deeply.
If you’re taking an antidepressant now (for whatever reason) and you think it may be interfering with your sleep, talk about it with your doctor. And if you’re having sleep problems and considering an antidepressant, be selective about the one you use.
Most—but not all—antidepressants tend to suppress and/or delay REM sleep (the stage associated with dreaming). This can be helpful for people with depression.
It’s not necessarily helpful for people with insomnia. In fact, REM sleep irregularities may be a causal factor in insomnia. So it pays to know a bit more about antidepressants if you’re taking them now or before you head down that path.
By Lois Maharg, The Savvy Insomniac on August 31, 2016
thesavvyinsomniac.com/2016/08/31/whats-that-antidepressant-doing-to-your-sleep/
Most antidepressants suppress and delay REM sleepAntidepressants are the third most commonly taken medication in the United States today, prescribed for depression and health problems such as insomnia, pain, anxiety, headaches, and digestive disorders. Most—but not all—antidepressants tend to suppress and/or delay REM sleep (the stage associated with dreaming). This can help people with depression.
It’s not necessarily helpful for people with insomnia—or for people who might be inclined to sleep problems if pushed in the wrong direction. There’s mounting evidence that REM sleep irregularities may actually be a causal factor in insomnia. So it’s worthwhile knowing about the REM and other sleep effects of antidepressants if you’re taking them now or before you head down that path.
Importance of REM Sleep
Intact, sufficient REM sleep has many benefits. They include the enhancement and consolidation of learned tasks and skills in long-term memory and the regulation of emotion.
Fragmented REM sleep, in contrast, may lead to the inadequate processing of emotion and then to hyperarousal, in turn giving rise to insomnia. Loss of the final REM period, a phenomenon identified in some “short sleepers” (often defined as those who sleep less than 5 hours a night), may increase your appetite and make you more vulnerable to weight gain and obesity.In short, reduced or compromised REM sleep is not something you generally want.
Selective Serotonin Reuptake Inhibitors (and Relatives)
SSRIs are widely prescribed because they’re effective for depression and have relatively few major side effects. But as a class, they tend to suppress REM sleep. (They may also bring about changes in the frequency, intensity, and content of your dreams.) They also tend to delay the onset of sleep and increase awakenings and arousals at night, reducing sleep efficiency. If you have both depression and insomnia, it’s probably best to steer clear of SSRIs. But here’s a caveat. SSRIs and other drugs that act on the serotonin system (which is very complex) are known to have different sleep–wake effects on different people. Trying out a drug like fluoxetine (Prozac) may be the only way to ascertain for sure how it will affect your sleep.
The story is basically the same for serotonin and norepinephrine reuptake inhibitors (SNRIs). Drugs such as duloxetine (Cymbalta) and venlafaxine (Effexor XR) markedly suppress REM sleep and tend to disrupt sleep continuity.
Tricyclic Antidepressants
TCAs aren’t prescribed as often as SSRIs because they tend to cause more side effects. However, like SSRIs, most TCAs (except trimipramine) markedly suppress REM sleep. Also, TCAs like desipramine and protriptyline give rise to increased norepinephrine, which tends to promote wakefulness rather than sleep. In studies of desipramine, the drug degraded the sleep of people with depression by extending sleep onset latency, decreasing sleep efficiency, and increasing their number of awakenings at night.
Most TCAs are not sleep friendly. However, low-dose amitriptyline is known to have sedative effects and is sometimes prescribed for people with depression and insomnia.
Low-dose doxepin has been shown to have sedative effects as well, blocking secretion of histamine, a neurotransmitter associated with wakefulness. Sold today as Silenor, it’s the only antidepressant approved by the FDA for the treatment of insomnia. Clinical trials suggest that Silenor is effective in treating sleep maintenance insomnia but not insomnia that occurs at the beginning of the night.
Atypical Antidepressants
Some antidepressants are atypical in that they don’t fit neatly into any category. Although not approved for the treatment of insomnia (the requisite trials were never conducted), low-dose trazodone (Desyrel) and mirtazapine (Remeron) are often prescribed for people with insomnia because of their sedative effects. Unlike most antidepressants, these drugs have not been found to markedly suppress REM sleep. And the results of a very few studies suggest that they may help people fall asleep more quickly and sleep more deeply.
If you’re taking an antidepressant now (for whatever reason) and you think it may be interfering with your sleep, talk about it with your doctor. And if you’re having sleep problems and considering an antidepressant, be selective about the one you use.
The Role of Prescription Drugs in REM Sleep (P1.109)
Journal of Neurology
April 10, 2018; 90 (15 Supplement) April 22, 2018
Elahhe Afkhamnejad, Sandhya Kumar
Abstract
Objective: To evaluate the effect of antidepressant and antipsychotic drugs on sleep, we hypothesized that patients taking these medications alone or in combination would achieve significantly less REM stage sleep.
Background: Previous research has determined that humans spend 20% of their time sleeping in the rapid-eye movement (REM) stage. Antidepressant medications have been shown to decrease time spent in REM sleep while the effects of antipsychotics have not been fully evaluated.
Design/Methods: We conducted a retrospective chart review of 258 polysomnograms from patients of the Wake Forest Department of Sleep Medicine from September 2012 to July 2017. Participants were included if they were over the age of 18 and had undergone a full night polysomnogram while on an antidepressant and/or an antipsychotic. Participants diagnosed with sleep apnea were excluded. Antidepressants included citalopram, escitalopram, fluoxetine, paroxetine, duloxetine, venlafaxine, bupropion, mirtazapine, and trazadone. Antipsychotics included haloperidol, aripiprazole, lurasidone, olanzapine, risperidone, quetiapine, and ziprasidone.
Patients were placed into one of four categories based on their medication: One Antidepressant (125 participants), Multiple Antidepressants (70 participants), Antidepressant and Antipsychotic (45 participants), or Antipsychotic Alone (18 participants). The average percent REM sleep for each category was compared to the 20% control value mentioned in the Background and to each other category using a t-test with unequal variances.
Results: The average percent REM sleep for each category was calculated as follows:
One Antidepressant: 12.4%
Multiple Antidepressants: 12.5%
Antidepressant and Antipsychotic: 8.2%
Antipsychotic Alone: 8.8%
All categories achieved statistically significant lower REM amounts than the control (p-value =.0001). Categories 3 and 4 achieved statistically significant lower REM amounts than categories 1 and 2 (p-value =.0002).
Conclusions: Antidepressants and antipsychotics, alone and in combination, reduce REM sleep in humans with antipsychotics driving REM lower than antidepressants. These drugs may interrupt normal sleep architecture by increasing serotonin levels, which typically plummet during REM.
Study Supported by: Clinical and Translational Science Institute
Journal of Neurology
April 10, 2018; 90 (15 Supplement) April 22, 2018
Elahhe Afkhamnejad, Sandhya Kumar
Abstract
Objective: To evaluate the effect of antidepressant and antipsychotic drugs on sleep, we hypothesized that patients taking these medications alone or in combination would achieve significantly less REM stage sleep.
Background: Previous research has determined that humans spend 20% of their time sleeping in the rapid-eye movement (REM) stage. Antidepressant medications have been shown to decrease time spent in REM sleep while the effects of antipsychotics have not been fully evaluated.
Design/Methods: We conducted a retrospective chart review of 258 polysomnograms from patients of the Wake Forest Department of Sleep Medicine from September 2012 to July 2017. Participants were included if they were over the age of 18 and had undergone a full night polysomnogram while on an antidepressant and/or an antipsychotic. Participants diagnosed with sleep apnea were excluded. Antidepressants included citalopram, escitalopram, fluoxetine, paroxetine, duloxetine, venlafaxine, bupropion, mirtazapine, and trazadone. Antipsychotics included haloperidol, aripiprazole, lurasidone, olanzapine, risperidone, quetiapine, and ziprasidone.
Patients were placed into one of four categories based on their medication: One Antidepressant (125 participants), Multiple Antidepressants (70 participants), Antidepressant and Antipsychotic (45 participants), or Antipsychotic Alone (18 participants). The average percent REM sleep for each category was compared to the 20% control value mentioned in the Background and to each other category using a t-test with unequal variances.
Results: The average percent REM sleep for each category was calculated as follows:
One Antidepressant: 12.4%
Multiple Antidepressants: 12.5%
Antidepressant and Antipsychotic: 8.2%
Antipsychotic Alone: 8.8%
All categories achieved statistically significant lower REM amounts than the control (p-value =.0001). Categories 3 and 4 achieved statistically significant lower REM amounts than categories 1 and 2 (p-value =.0002).
Conclusions: Antidepressants and antipsychotics, alone and in combination, reduce REM sleep in humans with antipsychotics driving REM lower than antidepressants. These drugs may interrupt normal sleep architecture by increasing serotonin levels, which typically plummet during REM.
Study Supported by: Clinical and Translational Science Institute
Additional Links provided by Tuck For Advancing Better Sleep
Tuck is a community devoted to promoting sleep health awareness. While many people are aware of the fact that the amount of rest they get can affect their moods, few realize that PTSD, stress, anxiety, and other mental health issues in the aftermath of a traumatic event can trigger sleep disorders. That’s why we've created these guides:
How does trauma affect sleep?
How grief changes sleep patterns
Sleep disorders in military veteran populations
Tuck is a community devoted to promoting sleep health awareness. While many people are aware of the fact that the amount of rest they get can affect their moods, few realize that PTSD, stress, anxiety, and other mental health issues in the aftermath of a traumatic event can trigger sleep disorders. That’s why we've created these guides:
How does trauma affect sleep?
How grief changes sleep patterns
Sleep disorders in military veteran populations
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Lunar Cycle Causes Mental Health to Fluctuate in Bizarre Case Study
At least one illness may really be tied to the rising moon.
By Sarah Sloat
on September 6, 2018
www.inverse.com/article/48728-bipolar-disorder-lunar-cycle-study
Urban legends posit that the moon and its lunar cycles affect human health, but most of those allegations aren’t up to scientific snuff. A few examples: Menstrual cycles are not correlated with an orbiting moon, full moons don’t drive us crazy, and the appearance of a blood moon doesn’t mean the apocalypse has arrived. But there is at least one aspect of human health that appears to be tied to the lunar cycle, and it’s the focus of a bizarre new study published in Translational Psychiatry.
According to first author and scientist emeritus at the National Institute of Mental Health Dr. Thomas Wehr, bipolar disorder can be triggered by celestial movement.
Wehr makes this argument in a case study about a 51-year-old man diagnosed with a rapid-cycling bipolar disorder. People with disorder go through four or more distinct episodes of depression, mania, or hypomania in a one-year period. In the paper, Wehr writes that this man was just one participant in an 18-patient study on manic-depressive cycles, but what made him stand out was the fact that he had kept careful, multi-year records of his mood and sleep. These records allowed Wehr to examine how the lunar and solar cycles affected the patient’s health.
The episodes of mania and depression that typically accompany bipolar disorder are accompanied by dramatic changes a person’s sleeping habits. When a person is depressed, they sleep a lot, and when they are feeling manic, they hardly sleepat all. Some scientists think this means that sleep disturbances aren’t just a symptom of bipolar disorder; rather, sleep (or lack thereof) could actually be the cause. This, in turn, might have to do with the lunar and solar cycles.
Because sleep is regulated in part by the circadian pacemaker, the small group of cells that control the circadian “internal clock”, Wehr hypothesized that people with bipolar disorder may have irregular circadian rhythms. Usually, the circadian pacemaker keeps time with the 24-hour rhythm of the solar day. But in people with bipolar disorder, Wehr argues, these cells may have “uncoupled” from the solar cycle and become fixed to the 24.8-hour rhythm of the lunar tidal day.
The patient’s sleep and mood records revealed that at each new moon, which happens every 29.5 days, the man experienced one or more nights of total insomnia and shift from feeling depressed to manic. But when he stuck to a rigid schedule of sleep during long periods of darkness every night, writes Wehr, “the lunar signal disappeared and his mood cycling stopped.” These periods of darkness seemed to stabilize his moods and increase the circadian pacemaker’s ability to respond to light, allowing the man’s circadian pacemaker to couple to a more normal day-night schedule.
At least one illness may really be tied to the rising moon.
By Sarah Sloat
on September 6, 2018
www.inverse.com/article/48728-bipolar-disorder-lunar-cycle-study
Urban legends posit that the moon and its lunar cycles affect human health, but most of those allegations aren’t up to scientific snuff. A few examples: Menstrual cycles are not correlated with an orbiting moon, full moons don’t drive us crazy, and the appearance of a blood moon doesn’t mean the apocalypse has arrived. But there is at least one aspect of human health that appears to be tied to the lunar cycle, and it’s the focus of a bizarre new study published in Translational Psychiatry.
According to first author and scientist emeritus at the National Institute of Mental Health Dr. Thomas Wehr, bipolar disorder can be triggered by celestial movement.
Wehr makes this argument in a case study about a 51-year-old man diagnosed with a rapid-cycling bipolar disorder. People with disorder go through four or more distinct episodes of depression, mania, or hypomania in a one-year period. In the paper, Wehr writes that this man was just one participant in an 18-patient study on manic-depressive cycles, but what made him stand out was the fact that he had kept careful, multi-year records of his mood and sleep. These records allowed Wehr to examine how the lunar and solar cycles affected the patient’s health.
The episodes of mania and depression that typically accompany bipolar disorder are accompanied by dramatic changes a person’s sleeping habits. When a person is depressed, they sleep a lot, and when they are feeling manic, they hardly sleepat all. Some scientists think this means that sleep disturbances aren’t just a symptom of bipolar disorder; rather, sleep (or lack thereof) could actually be the cause. This, in turn, might have to do with the lunar and solar cycles.
Because sleep is regulated in part by the circadian pacemaker, the small group of cells that control the circadian “internal clock”, Wehr hypothesized that people with bipolar disorder may have irregular circadian rhythms. Usually, the circadian pacemaker keeps time with the 24-hour rhythm of the solar day. But in people with bipolar disorder, Wehr argues, these cells may have “uncoupled” from the solar cycle and become fixed to the 24.8-hour rhythm of the lunar tidal day.
The patient’s sleep and mood records revealed that at each new moon, which happens every 29.5 days, the man experienced one or more nights of total insomnia and shift from feeling depressed to manic. But when he stuck to a rigid schedule of sleep during long periods of darkness every night, writes Wehr, “the lunar signal disappeared and his mood cycling stopped.” These periods of darkness seemed to stabilize his moods and increase the circadian pacemaker’s ability to respond to light, allowing the man’s circadian pacemaker to couple to a more normal day-night schedule.