From winnipegfreepress.com
By: Josi Peters
Let’s talk again about connections between sleep and mental health. Recall that sufficient sleep is essential for general health and wellbeing. But millions of people fail to sleep enough regularly and suffer from that lack. Sadly, most people with sleep problems go undiagnosed and untreated.
Studies focusing on different populations estimate that 65 percent to 90 percent of adults who live with major depression, and about 90 percent of children who have the disorder, also experience sleep problems. Most people with depression have insomnia and approximately one in five experiences obstructive sleep apnoea.
Having sleep problems also increases risks of developing depression. One study of 1,000 young adults aged 21 to 30 found that, compared with normal sleepers, those with a history of insomnia were four times as likely to have developed major depression three years later. And two other studies in young adults found that their sleep problems developed before any major depression began.
Recent research teaches that sleep problems affect outcomes for patients living with depression. Depressed patients whose insomnia continues are less likely to benefit from treatment than patients without sleep problems. And people who improved with antidepressant therapy were more likely to relapse later. Sleep deprived depressed people have more thoughts about suicide and are more likely to die by suicide than depressed people who sleep normally.
Sleep problems also affect over half of adults with generalized anxiety disorder. Sleep disruption is common for those with post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder, and phobias. One sleep study found children and adolescents with anxiety disorders needed longer to fall asleep and slept less deeply, compared to healthy children. Insomnia is a risk factor for developing an anxiety disorder and can worsen anxiety disorder symptoms or delay recovery.
Studies of people with bipolar disorder report that 69 percent to 99 percent experience frequent insomnia or report less need for sleep during manic episodes of their illness. In their depressive phase, 23 percent to 78 percent reported sleeping excessively, while others reported insomnia or restless sleep in this phase also. Longer term research suggests insomnia and other sleep problems get worse before episodes of mania or bipolar depression, and that lack of sleep can trigger the manic phase. Sleep problems also negative effects patient’s moods and contribute to relapse.
People often ask
Q. What is sleep hygiene?
A. Based on recent research, many experts believe that we can learn to sleep better. Good sleep hygiene refers to healthy sleeping habits like maintaining a regular sleep-and-wake schedule, using bedrooms only for sleeping or sex, and keeping bedrooms dark when we should sleep and free of distractions like computers, communication devices, or television.
Achieving good sleep hygiene may involve certain lifestyle changes. For example, most people know caffeine contributes to sleeplessness, but aren’t aware that alcohol and nicotine do also. Alcohol initially depresses the nervous systems, helping some people fall asleep but the effect usually wears off quickly and people wake up. Nicotine is another stimulant, acting to speed heart rates, thereby making us less likely to sleep if we smoke in late afternoon or evening. Giving up these substances entirely is best for sleep health and overall health, but avoiding them before bedtime is a minimal option.
Other lifestyle changes to maximize sleep include physical activity, relaxation techniques, cognitive therapy, or medication. Regular aerobic exercise helps us fall asleep, causes us to spend more time in deep sleep, and prevents us from waking as often overnight. Meditation, deep breathing exercises, and progressive muscle relaxation are helpful to counter anxiety and racing thoughts that prevent us falling asleep.
Because people with insomnia may become anxious about not falling asleep, cognitive behavioural techniques can help change negative expectations and build more confidence that they can sleep well. Most therapists are trained to teach meditation, progressive muscle relaxation, and deep breathing strategies for relaxation. If these are not helpful, we can talk with our physicians about medication. Effective medications are available to treat sleep problems and, in some cases, both the sleep disorder and a psychiatric problem can be relieved with one medication.
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