Lack of Sleep

We are getting new insights into the importance of sleep and its relation with overall health. A lack of sleep can have severe repercussions and even contribute to psychiatric disorders and vice versa. Between 50% to 80% of psychiatric patients suffer from chronic sleep problems in the U.S. compared to 10% to 18% of all American adults. Patients suffering from anxiety, bipolar disorders and attention deficit hyperactivity disorder (ADHD) are particularly prone to sleeping disorders. Between 25 – 50% of children who suffer from ADHD do not sleep enough and often have symptoms like twitching limbs, also known as restless legs syndrome.

Other problems stemming from insufficient sleep include an inability to concentrate, emotional instability, declining work performance, anger and depression, and strained relationships.

The earlier approach to psychiatric patients with sleeping disorders was to treat the latter as a symptom of the psychosis. Recent studies in adults and children suggest however that sleeping problems may exacerbate existing psychoses as well as lead to the development of new ones. Treating sleeping disorders may have a beneficial effect on people who concurrently have mental health issues.

It is not yet known whether there is a correlation between sleep and brain health.  Neuroimaging and neurochemistry studies suggest that proper sleep helps with mental and emotional resilience while sleep deprivation can lead to negative and impaired thinking, mental illness, and emotional vulnerability.

There are more than 70 known sleeping disorders with insomnia, obstructive sleep apnea (disordered breathing leading to waking up frequently), movement syndromes (leading to fidgeting at night) and narcolepsy (severe sleepiness or falling asleep suddenly during the day) being the most common. The overlap between sleep disorders and psychiatric problems is so pronounced that researchers suspect that both conditions have common biological roots.

One psychiatric disorder linked with sleep deprivation is depression. It has been estimated that between 65% – 90% of adult patients with major depression and about 90% of depressed children have a sleeping problem, mostly insomnia but also obstructive sleep apnea in about 20% of all cases. The reverse also applies with people being at risk of developing depression if they have sleep disorders.  Insomnia precedes and has a stronger connection with major depression more than any other psychiatric disorder.

Bipolar disorders also impact on sleep patterns. Between 69% to 99% of bipolar patients suffer from insomnia and between 23% to 78% sleep excessively (hypersomnia).

Other psychiatric disorders which have a correlation with sleep include anxiety disorders. Anxiety disorders are common in people suffering from post-traumatic stress disorder (PTSD) and may result in panic, obsessive-compulsive patterns, and phobias.  These are also common in children and adolescents.

There are several remedial measures for sleep disorders. Perhaps the most fundamentally important one would be a change of lifestyle and doing away with or minimizing the intake of caffeine, alcohol, and nicotine. Physical exercise also assists in falling asleep faster and having deeper uninterrupted sleep. Having a dark bedroom also contributes to a restful atmosphere. Meditation exercises help in quietening the mind thereby making it easier to sleep.

Medication is also an option though perhaps it should be considered as a last resort. Prozac can help improve both mood and sleep. Ambien is another drug which helps with better sleep and daytime functioning.  Xanax and Restoril help to treat both insomnia and anxiety disorders.

Getting enough sleep is vitally important. It allows the body to repair and restore itself physically and improves learning, memory and insight. Between seven to eight hours a night is the recommended norm. Less than six hours a night for a week leads to the loss of a full night’s sleep and this will take its toll, both physically and mentally. Sleep time should be valued and taken seriously by everybody as otherwise there is a heavy price to pay.