Link between insomnia and depression

This article discusses the link that exists between insomnia and depression.

We all have times when we feel blue. And there are nights when we just can’t sleep. But it seems that depression and insomnia are closely intertwined, exacerbating each other’s symptoms and complicating treatment.

Insomnia has long been viewed as a symptom of depression. At least 80 percent of depressed patients have trouble falling or staying asleep. An additional 15 percent report they sleep too much. Doctors believed that treating the depression would alleviate sleep problems at the same time.

New research indicates that curing insomnia may make depression treatments more effective. A study conducted by Colleen Carney at Ryerson University in Toronto found that 87 percent of subjects who resolved sleep issues using biweekly talk therapy also saw their depression improve after eight weeks of treatment. That’s twice the success rate of the subjects who didn’t better their sleep.

In 2008, Rachel Manber of Stanford found that 60 percent of patients receiving seven sessions of talk therapy plus an antidepressant fully recovered from their depression, compared to 33 percent who received the same medication and sleep hygiene counseling alone.

The kind of therapy used in these experiments is called cognitive behavioral therapy for insomnia, or CBT-I. The therapist instructs clients to establish and adhere to a regular sleep schedule, to get out of bed during periods of wakefulness, to avoid eating or use of electronics in bed and to eliminate daytime napping.

Insomnia may even predict the onset of depression. Sleep researcher Michael Perlis, Ph.D., has shown that sleep disturbances precede episodes of depression by about five weeks. And sleep disorders intensify over the course of a new depressive episode or relapse.

According to Perlis, associate professor of psychiatry and neuroscience at the University of Rochester, disordered sleep sets off a chain of disruptive symptoms that leads to fatigue, irritability, confusion and loss of memory, disinterest in social activities and lack of pleasure.

The subsequent sleep loss makes people more susceptible to depression and increases the likelihood of further episodes.

The good news is that both disorders are treatable regardless of which causes the other. The first step is to get a proper diagnosis in order to embark on the appropriate path.

ELIMINATING INSOMNIA

The National Sleep Foundation offers the following suggestions for overcoming insomnia:

• Keep a sleep diary. Include all pertinent data, such as the time you go to bed, number of times you wake up during the night, medications taken, amount of caffeine consumed during the day, number of naps and time spent exercising. You’ll quickly notice which actions support good sleep behavior and which ones cause disruptions.
• Eat light meals early in the evening. Heavy meals can cause discomfort. Spicy food may lead to heartburn.
• Steer clear of alcohol. Although alcohol is a sedative and may initially help you fall asleep, it disrupts sleep later in the night.
• Learn to relax. One simple technique is to lie quietly on your bed and systematically tense and relax various muscle groups in your body. You may also practice deep breathing, guided imagery or meditation.
• Evaluate your room. Make sure you have a clean, comfortable, quiet and dark sleep space. Use a sound machine or fan to block unwanted noise. Install blinds to close out streetlights and morning light.
• Wind down. Your body needs time to shift into sleep mode. Devote the hour before bedtime to calming activities, such as reading or taking a warm bath. You’ll be mentally and physically calmer. Your actions will signal your brain that it’s time to go to bed.
  
  Read more here
• 
  Read more here: http://www.sanluisobispo.com/2014/06/17/3114766/insomnia-can-predict-the-blues.html?sp=/99/151//#storylink=cpywd

The danger of overlooking insomnia

The article details how important it is to get insomnia symptoms checked by a doctor, and discusses what health outcomes could occur from not doing so.

With our busy lives, it can be tempting to shrug off—or ignore altogether—difficulties with sleep. Trouble falling asleep, difficulty staying asleep throughout the night, waking feeling tired and unrefreshed: these are commonly experienced disruptions to sleep for millions of adults. Too often, these sleep problems aren’t taken seriously, or are considered the less-than-ideal price to pay for living full and sometimes hectic lives.

Difficulty falling asleep, waking during the night, waking very early in the morning, and experiencing un-restorative sleep are all symptoms of insomnia, a serious sleep disorder. People may experience these symptoms all at once, or some of them and not others. They may experience them chronically or every so often. They are signs of disrupted, poor quality sleep and they should never be ignored.

New research indicates how high a price we may pay for overlooking signs of insomnia. Scientists at Massachusetts’ Brigham & Women’s Hospital have identified a link between insomnia symptoms and elevated risk of death. Their study, which included more than 23,000 men, found certain symptoms of insomnia associated with higher mortality risk from cardiovascular disease. The men were all participants in the Health Professionals’ Follow-Up Study, a long-term, ongoing research endeavor that investigates issues related to men’s health. In 2004, 23,447 men reported to researchers about their sleep and any insomnia symptoms. Researchers followed up with the men over a period of 6 years, during which time 2,025 of the men died. After adjusting for other mortality-influencing factors including age, lifestyle habits, and other health problems, researchers analyzed data on men’s mortality as related to the presence of the following insomnia symptoms:

• Trouble falling asleep
• Difficulty maintaining sleep
• Waking in the early morning
• Experiencing non-restorative sleep

They found that several symptoms of insomnia were associated with higher rates of cardiovascular death among the men. In particular:

• Men who reported having difficulty falling asleep had a 55% increased risk of death from cardiovascular disease as compared to those men who did not experience this sleep difficulty.
• Men who reported experiencing un-refreshing sleep most of the time were at 32% higher risk for cardiovascular death than men who did not report this symptom.

Poor sleep is well understood to have a serious, negative impact on heart health. Not sleeping well, or enough, raises the risks for a number of cardiovascular problems, including high blood pressure, heart attack, heart failure, and stroke. Protecting the quality of sleep as we age is a critical component of protecting long-term cardiovascular health.

This isn’t the first scientific evidence of a link between poor sleep and increased mortality risk. But the news is particularly worrisome because these symptoms are quite common, particularly as we age. Estimates suggest that 30% or more of American adults experience some insomnia symptoms at least periodically, and for 10-15%, insomnia is chronic. Insomnia grows increasingly common with age: more than half of adults over the age of 65 experience symptoms of insomnia. Women are at higher risk than men for insomnia, due in part to hormonal cycles during childbearing years and to the hormonal changes associated with menopause. This current study included only men, but other research has shown higher risks of mortality associated with poor sleep in both men and women:

• In a number of studies that included both men and women, sleeping fewer than 6 hours and more than 8 hours per night has been associated with increased mortality risk.

• Obstructive sleep apnea in men and in women is linked to significantly highercardiovascular and overall mortality risks. Studies have shown that mortality risks from cardiovascular problems are 2 or more times greater for adults with obstructive sleep apnea. The more severe the obstructive sleep apnea, the greater the mortality risks.

• Research has also linked use of sleeping pills to increased mortality risk. The link between higher rates of mortality and sleeping pill use exists even after factoring out other possible contributors to death risk, including health problems, age, and gender.

Ready for some good news? While sleep problems left untreated may shorten longevity, improving sleep can have powerful positive health benefits. A study conducted recently in the Netherlands found that a regular routine of 7-8 hours of sleep may have as significant an impact on risk for cardiovascular death as not smoking.Regular, sufficient amounts of high-quality sleep have also been linked to reduced riskfor type 2 diabetes, largely because of the positive effect that sleep can have on improving insulin sensitivity.

If you have symptoms of insomnia, don’t ignore them. Share them with your doctor. Make an honest assessment of your sleep habits and make a commitment to taking simple steps to improve your sleep routine and your overall sleep hygiene. Taking steps to improve the quality and quantity of your sleep is one important way to protect your cardiovascular and overall health for the duration of your life. And sleeping well may actually help you extend that duration.

Read more here

Insomnia symptoms can raise risk of death

Both insomnia, and the symptoms of insomnia such as issues falling asleep or staying asleep, have been shown to risk a person's risk of death.

With our busy lives, it can be tempting to shrug off -- or ignore altogether -- difficulties with sleep. Trouble falling asleep, difficulty staying asleep throughout the night, waking feeling tired and unrefreshed: These are commonly experienced disruptions to sleep for millions of adults. Too often, these sleep problems aren't taken seriously, or are considered the less-than-ideal price to pay for living full and sometimes hectic lives.

Difficulty falling asleep, waking during the night, waking very early in the morning, and experiencing un-restorative sleep are all symptoms of insomnia, a serious sleep disorder. People may experience these symptoms all at once, or some of them and not others. They may experience them chronically or every so often. They are signs of disrupted, poor quality sleep and they should never be ignored.

New research indicates how high a price we may pay for overlooking signs of insomnia. Scientists at Massachusetts' Brigham & Women's Hospital have identified a link between insomnia symptoms and elevated risk of death. Their study, which included more than 23,000 men, found certain symptoms of insomnia associated with higher mortality risk from cardiovascular disease. The men were all participants in the Health Professionals' Follow-Up Study, a long-term, ongoing research endeavor that investigates issues related to men's health. In 2004, 23,447 men reported to researchers about their sleep and any insomnia symptoms. Researchers followed up with the men over a period of six years, during which time 2,025 of the men died. After adjusting for other mortality-influencing factors including age, lifestyle habits, and other health problems, researchers analyzed data on men's mortality as related to the presence of the following insomnia symptoms:

• Trouble falling asleep
• Difficulty maintaining sleep
• Waking in the early morning
• Experiencing non-restorative sleep

They found that several symptoms of insomnia were associated with higher rates of cardiovascular death among the men. In particular:

• Men who reported having difficulty falling asleep had a 55 percent increased risk of death from cardiovascular disease as compared to those men who did not experience this sleep difficulty.
• Men who reported experiencing un-refreshing sleep most of the time were at 32 percent higher risk for cardiovascular death than men who did not report this symptom.

Poor sleep is well understood to have a serious, negative impact on heart health. Not sleeping well, or enough, raises the risks for a number of cardiovascular problems, includinghigh blood pressure, heart attack, heart failure, and stroke. Protecting the quality of sleep as we age is a critical component of protecting long-term cardiovascular health.

This isn't the first scientific evidence of a link between poor sleep and increased mortality risk. But the news is particularly worrisome because these symptoms are quite common, particularly as we age. Estimates suggest that 30 percent or more of American adults experience some insomnia symptoms at least periodically, and for 10-15 percent, insomnia is chronic. Insomnia grows increasingly common with age: More than half of adults over the age of 65 experience symptoms of insomnia. Women are at higher risk than men for insomnia, due in part to hormonal cycles during childbearing years and to the hormonal changes associated with menopause. This current study included only men, but other research has shown higher risks of mortality associated with poor sleep in both men and women:

• In a number of studies that included both men and women, sleeping fewer than six hours and more than eight hours per night has been associated with increased mortality risk.
• Obstructive sleep apnea in men and in women is linked to significantly highercardiovascular and overall mortality risks. Studies have shown that mortality risksfrom cardiovascular problems are two or more times greater for adults with obstructive sleep apnea. The more severe the obstructive sleep apnea, the greater the mortality risks.
• Research has also linked use of sleeping pills to increased mortality risk. The link between higher rates of mortality and sleeping pill use exists even after factoring out other possible contributors to death risk, including health problems, age, and gender.

Ready for some good news? While sleep problems left untreated may shorten longevity, improving sleep can have powerful positive health benefits. A study conducted recently in the Netherlands found that a regular routine of 7-8 hours of sleep may have as significant an impact on risk for cardiovascular death as not smoking.Regular, sufficient amounts of high-quality sleep have also been linked to reduced risk for Type 2 diabetes, largely because of the positive effect that sleep can have on improving insulin sensitivity.

If you have symptoms of insomnia, don't ignore them. Share them with your doctor. Make an honest assessment of your sleep habits and make a commitment to taking simple steps to improve your sleep routine and your overall sleep hygiene. Taking steps to improve the quality and quantity of your sleep is one important way to protect your cardiovascular and overall health for the duration of your life. And sleeping well may actually help you extend that duration.

Read more here

Causes and Cures for Insomnia

This article discusses symptoms of insomnia as well as what could be causing it, and how to cure it.

We have all had nights when sleep will not come, but for some people not being able to sleep is a chronic condition — they suffer from insomnia.

People with insomnia may have a hard time falling asleep even though they are tired, or they may wake up in the middle of the night and then lie awake for hours, unable to return to sleep. Sometimes insomniacs do sleep, but the sleep is unrefreshing and they wake up feeling as drowsy and fatigued as if they had experienced no sleep.

Understanding insomnia

Insomnia is not about failing to get eight hours of sleep at night. Rather, it is the inability to get the amount of sleep you need to feel rested. We all need different amounts of sleep, so insomnia is defined by the quality of your sleep and how you feel after sleeping — not by how many hours of sleep you get, or even by how quickly you fall asleep. If you only sleep five hours but feel great you do not have insomnia.

Insomnia usually is not just a sleep disorder; typically, there are other causes at the root of the problem. Insomnia is often the symptom of other issues that are interfering with your ability to sleep. These issues may range from having too much caffeine during the day to medical conditions to psychological issues.

Symptoms

• Difficulty falling asleep even if you are tired
• Waking up repeatedly during the night
• Difficulty falling back to sleep once you have woken up
• Not feeling rested after sleeping
• Needing to rely on sleeping pills or alcohol to fall asleep
• Waking up too early
• Feeling drowsy, tired and irritable during the day
• Having trouble concentrating during the day

Common causes

Many of us experience temporary insomnia — the kind that lasts just for a few days and then goes away. Usually this type is due to nerves over something at work, a relationship issue that is later resolved, jet lag, or some other brief hiccup in our routine.

But when insomnia continues for weeks and months, then it is time to talk with your doctor.

• Psychological causes: Depression, anxiety, chronic stress, bipolar disorder, post-traumatic stress disorder.
• Medications: Antidepressants, cold and flu medications with alcohol, pain relievers with caffeine, diuretics, corticosteroids, thyroid hormone, high blood pressure medications
• Medical causes: Asthma, allergies, Parkinson's disease, hyperthyroidism, acid reflux, kidney disease, cancer, chronic pain and others.
• Sleep disorders: Sleep apnea, narcolepsy, restless leg syndrome

Cures for simple causes of insomnia

• Look at your behavior — are you consuming too much caffeine (soda, coffee, energy drinks)? Try cutting back.
• If you are using alcohol or sleep aids to fall asleep, cut back. These actually disrupt sleep over the long term. Try warm milk to soothe you.
• Shut off your brain at least an hour before bed — no Internet, no TV, no computer, and no vigorous exercise within two hours of bedtime. Unwind with a relaxing book, meditation, etc.
• Keep your bedroom dark, cool and quiet. Try white noise machines, sleep masks or earplugs if need be.
• Do not smoke, especially at night. Nicotine will keep you awake.
• Keep your bedroom only for sleep and sex — not work or other activities.
• Make sure you get good exposure to natural light during the day, but minimize your exposure to artificial light at night. Maintaining this balance will help your body's natural wake/sleep cycle.

When the cause is psychological

If you answer "yes" to any of these questions, it may be helpful to see a psychiatrist regarding your insomnia issues.

• Am I under a lot of stress?
• Am I depressed? Do I feel devoid of emotion and hopeless?
• Do I have chronic feelings of anxiety or worry?
• Have I experienced panic attacks?
• Have I undergone a traumatic experience?

If the cause is chronic anxiety, depression, chronic stress, post-traumatic stress disorder, and the like, then you should consult a psychiatrist. These conditions can be treated with consultations, medication, or other therapies.

A therapist can also instruct you in relaxation techniques that can help you cope better during the day and unwind at night.

When to get help

If you answered "yes," to the questions listed under "When the cause is psychological," then you should consult with a psychiatrist. Professional insomnia treatment is also advised if you experience the following:

• Your insomnia is causing problems at work, home or school.
• Your insomnia hasn't responded to self-help tips like those listed under "Cures for simple causes of insomnia"
• Your insomnia is getting worse, occurring almost every night

Nature intended our minds and bodies to rest. If you are chronically unable to get restful sleep, get help. A good night's sleep can be an amazing restorative to your mental and physical health.

Read more here