Disturbed sleep may be cause of depression and mental illness

Written by Matthew Hogg BSc (Hons)

Thursday, 18 June 2009 19:33

New research suggests that as well as being a symptom of mental illnesses such as depression and anxiety, insomnia may also cause them.

Anyone who has gone without sleep adequate sleep for a night, whether as a result of social excesses or factors out of their control such as stress or noisy neighbours, knows that it impacts the way they feel the next day. If we don't get enough sleep we feel tired, irritable, unable to concentrate, and generally not ourselves.

Insomnia is defined by the medical profession as taking longer than 30 minutes to fall asleep on several nights each week which causes problems in daytime functioning. For a clinical diagnosis the problem must have persisted for more at least a month.

Now, research is showing that if sleep problems become chronic the result can be the triggering or exacerbation of serious mental disorders including depression, anxiety, and even paranoid delusions. In children , insomnia can result in behavioural problems that bare the hallmarks of attention deficit hyperactivity disorder (ADHD).

In one recent study conducted at Keele University in the UK involving more than 2,500 people, researchers found that individuals with insomnia were nearly three times more likely to develop depression and twice as likely to suffer from anxiety over proceeding 12 months. These findings are supported by US research suggested that people with breathing-related sleeping disorders such as sleep apnea (common in fibromyalgia and related conditions) are at greater risk of developing depression. Results suggest the more severe the sleep disturbance the more likely it is that depression will ultimately result.

In a study conducted at the Institute of Psychiatry, Kings College London, by clinical psychologist Daniel Freeman and colleagues, the link between insomnia and paranoia was investigated. The team assessed 300 individuals sellected at random from the general population and discovered tha those who suffered from insomnia were five times more likely to experience strong paranoid thoughts than those who generally experienced a good quality of sleep. The researchers conclude that the lack of sleep is leading to changes in the brain that increase the chances of someone experiencing paranoid thoughts; although the exact mechanisms involved have yet to be explained.

With regards to sleep problems in children. Finnish research published earlier this year found that children who slept fewer than 7.7 hours per night were more likely to display hyperactivity, restlessness, impulsiveness and lack of concentration. This study involved 280 children aged seven and eight.

So the overwhelming message it seems is that sleep is not only essential to avoid physical tiredness but is also essential to our emotional well-being and mental performance.

This research is of great significance for those suffering from chronic illnesses such as chronic fatigue syndrome (ME/CFS) and fibromyalgia in which sleep disturbances are very common. Patients with these conditions are severely fatigued and often experience cognitive difficulties including poor concentration and memory, as well as depression and anxiety. Doctors specializing in ME/CFS and fibromyalgia emphasise the importance of getting a good night's sleep through whatever means possible.

Practicing good "sleep hygiene" is often used as a starting point and involves having a regular bed time at a reasonable hour, avoiding stimulants such as tea and coffee, maintaining a comfortable temperature in the bedroom, and avoiding watching tv in bed.

If these tips don't work it may be necessary to give sleep ais a try, either pharmaceutical or nutritional/herbal. Doctors who specialize in ME/CFS and fibromyalgia often trial their patients on low doses of medications such as clonazepam (Klonopin/Rivotril) or amitriptyline. The aim of course being to allow patients to get off to sleep and stay asleep all night, while avoiding side-effects such as morning sedation.

Many patients find nutritional and herbal supplements useful. Some of the most commonly used and with the most scientific support include melatonin (available OTC in the US), 5-HTP, niacinamide, l-ornithine, phosphatidylserine (PS), and valerian.