Short sleep, mental health problems predict long-term insomnia

Mental health problems and getting less than six hours of sleep play key roles in the persistence of insomnia. A study in the January edition of SLEEP found these risk factors in people experiencing insomnia for at least 7½ years. Smoking, caffeine and alcohol consumption, and sleep apnea did not predict persistent insomnia.

The study looked at 1,395 random subjects who reported having insomnia 7½ years earlier. Researchers found that 44 percent of them still had insomnia. Nearly a third (30 percent) were sleeping poorly but 26 percent were sleeping normally again. Those who still had insomnia had strong links to mental health problems and short periods of sleep. Depression was the most common mental health problem reported.

Researchers concluded that addressing mental health issues should be a priority in cases of chronic insomnia. They also suggested that people sleeping less than six hours were strong candidates for chronic insomnia. The study was done by Pennsylvania State University, and the universities of Athens and Crete, both in Greece.

Read more about insomnia due to medical condition, alcohol or drugs or mental disorders.

Did Sleep Deprivation Lead to Attack on U.S. Rep. Gabrielle Giffords?

Politicians and pundits continue to argue whether vitriolic partisan politics inspired the shooting of U.S. Rep. Gabrielle Giffords on Saturday. Another factor that may have pushed alleged gunman Jared Lee Loughner to go on a killing spree that left six dead and 14 injured remains left out of the discussion.

Bizarre online ramblings allegedly posted by Loughner reveal he may have had insomnia prior to the Arizona attack. He writes:

“All humans are in need of sleep.
Jared Loughner is a human.
Hence, Jared Loughner is in need of sleep.”

Other passages in the YouTube rant mention sleepwalking and so-called conscious dreaming about the government. It’s unclear whether his message is intended to be literal, symbolic or just the incoherent ramblings of someone with serious mental health problems. Former classmates indicate it may be the latter.

And it all could have started with insomnia. Young adults with long-term sleep deprivation have an increased risk for mental illness, a study published last year in the journal SLEEP reported. A history of depression, anxiety or general emotional distress further raises the risk.

So was the shooting a product of partisan speech with violent undertones? Was it long-term insomnia? Or was the alleged gunman simply seriously disturbed? Chances are we will find out more in the coming months.

Depression, Mental Distress May Start with Short Sleep

A variety of everyday problems can be maddeningly difficult on little sleep. Minor conflicts may cause a sleep-deprived person to feel frustration, anger or even sadness. Slight disruptions become emotional eruptions in the absence of restful sleep.

For teenagers and young adults who already grapple with heightened hormones, a string of sleepless nights can turn them into walking time-bombs. Mental illness is a real risk for many people less than 24 years of age who don’t get enough sleep, according to a new study in the September issue of the journal SLEEP.

The study reports that every hour of sleep loss significantly raises the risk of emotional distress, a combination of high levels of depressive and anxious symptoms. The risk is most relevant for people with pre-existing mental health issues or a history of depression.

Young adults who otherwise have no mental health history can develop mental distress by severely limiting sleep over a long period of time. The study found people with no psychological distress who slept five hours or less are three times more likely to be distressed a year later.

The study design involved 20,000 Australians aged 17 to 24. Each participant completed a sleep diary by listing the amount of hours slept per night over the course of a month. Subjects also answered the Kessler Psychological Distress Scale (K10), a mental assessment that includes questions about feeling tired, nervous, hopeless, restless, depressed, sad and worthless.

A randomly selected group consisting of about 10 percent of the participants completed a follow-up survey about a year later. Approximately 1 in 5 young adults who responded slept fewer than seven hours per night. Less than two percent were extremely short sleepers with less than five hours per night.

Mental health and psychological stress is a serious concern for young adults of any nation. The U.S. government estimates nearly 1 in 5 people between the ages of 18 and 25 years of age experienced serious psychological distress in the past year.

There’s been much discussion this early September about the risks related to insomnia and short sleep duration. A widely-reported study linked long-term insomnia to death for middle age males. Another study published in the same journal focused on teenage sleep patterns and suggested a relationship between sleep length and obesity. It concluded teenagers who sleep less than eight hours a night usually have unhealthier diets, consisting of fatty foods and frequent snacks.

Teenagers and young adults need more sleep than their parents or older siblings yet many in the age group are inclined to stay up late due to natural night-owl tendencies. High levels of stress and numerous distractions such as cell phones and video games also keep young adults from getting to bed at a decent hour.

The good news is after high-school, many have a more flexible schedule that can suit their sleep needs. This is especially the case for college students, who can avoid early morning classes if they wish. There’s no mental harm in sleeping too much. The study reports participants who reported sleep durations of more than nine hours showed no heightened mental distress.

Image by Andi Jetaime

Sleepless Nights for Army Wives

A new study examined how deployment affects the mental health of the wives of U.S. Army soldiers. The results were published yesterday in the New England Journal of Medicine.

The study involved 250,626 wives of active-duty U.S. Army soldiers. Their electronic medical records from 2003 to 2006 were analyzed.

Results were compared according to the deployment status of their husbands. Length of deployment also was considered. Deployments included both Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan.

Adjusted results show that the wives of deployed soldiers had more sleep problems than the wives of soldiers who were not deployed. They also had more cases of depression and anxiety.

They had 11.6 excess cases of sleep disorders per 1,000 wives when the deployment lasted up to 11 months. This rate increased to 23.5 excess cases when their husband was deployed for more than 11 months.

“This study confirms what many people have long suspected,” lead author Alyssa Mansfield, PhD, said in a news release. “It provides compelling evidence that Army spouses are feeling the impact of recent deployments to Iraq and Afghanistan. The result is more depression, more stress, more sleepless nights.”

The authors noted that current warfare in Iraq and Afghanistan differs greatly from other recent conflicts involving the U.S. Both operations have involved sustained ground combat. They also have been met by strong insurgent attacks.

As a result the wives of deployed soldiers may fear for the safety of their loved ones. At the same time they face the stress of maintaining a household and caring for children alone.

The authors also suggested that the results may underestimate the severity of the problem. In the military seeking care for mental health concerns may involve a stigma. So some spouses may avoid seeking care.

“The majority of active-duty soldiers are married, so we need to pay attention to the needs of their families,” said Mansfield.

Get help for a sleep problem at an AASM-accredited sleep center near you.

Image courtesy of the U.S. Army

Sleep, Traumatic Injuries & Mental Health

A new study evaluated how sleep problems prior to a traumatic injury may affect mental health. The results were published in the Jan. 1 issue of the journal Sleep.

The study was performed in Australia. It involved 1,033 people who had a traumatic injury. They spent an average of 12.5 days in the hospital.

About 65 percent were hurt in a motor-vehicle accident. Fifteen percent were injured in a traumatic fall. Seven percent had an industrial accident. And six percent were victims of assault.

An initial assessment took place during their hospital admission. This included an evaluation of sleep disturbance in the two weeks prior to the injury. They were re-assessed three months later.

Results show that mental health problems were common at the three-month follow-up. Thirty percent of people who had no prior disorder developed a new psychiatric disorder after the injury.

The most common disorders were major depression and agoraphobia. Other common disorders were PTSD and generalized anxiety disorder.

Data analysis found that sleep impairment prior to the injury was a risk factor for the development of a mental health disorder. People with disturbed sleep prior to trauma were two times more likely to develop a psychiatric disorder.

The risk was even greater for people with no history of mental health problems. They were three times more likely to develop a psychiatric disorder if they had sleep problems prior to the trauma.

The authors suggested that sleep problems may limit your ability to manage stress after a traumatic event. Poor sleep may reduce your emotional, mental and physical resources. This may hinder your recovery.

They also noted that sleep problems may have contributed directly to the traumatic injuries. Disturbed sleep can result in fatigue, poor concentration and slow reaction times.

In November the Sleep Education Blog reported that the higher rate of insomnia in women may be linked to mental health problems such as depression. Read more about sleep and depression.

Get help for a sleep problem at an AASM-accredited sleep center near you.

Image by Joe

Insomnia & Depression in Women

A new study examined why insomnia is more common in women than men.

The study analyzed data from the National Health and Nutrition Examination Survey. The survey is unique in that it combines interviews and physical exams.

The sample involved 5,469 young adults; their age ranged from 20 years to 39 years.

Results show that 16.7 percent of women reported insomnia symptoms; 9.2 percent of men had an insomnia complaint.

Why are women more likely than men to have insomnia? The study suggests that mental health is a key factor.

The gender difference in the odds of insomnia was no longer significant after adjusting for history of mental health conditions. The authors concluded that the higher rate of insomnia in women may be linked to mental health problems such as depression.

The NIMH reports that depression is also more common among women than men. This may be explained in part by hormonal factors that are unique to women.

The AASM reports that insomnia is seen in up to 85 percent of people with a major depressive episode. Frequent awakenings during the night are typical; waking up early in the morning and being unable to go back to sleep also is common.

Often the insomnia complaint is among the earliest symptoms to appear in a person with a mental health disorder. People often attribute their mental symptoms to poor sleep.

Read more about sleep and depression. Learn more about insomnia due to mental disorder on SleepEducation.com.

How Moms Influence Teen Sleep

A new study looked for similarities in the sleep patterns of teens and their parents.

The Swiss study involved 293 teens with an average age of almost 18 years; 73 percent were female.

They completed a seven-day sleep log; they also completed questionnaires about their psychological functioning. The teens rated their parents’ sleep and parenting styles.

Results show a correlation between the sleep patterns of the teens and their parents. The study also found that how mothers sleep may have an indirect effect on the sleep of their teens.

Mothers’ poor sleep had a direct impact on their parenting style. This affected the psychological functioning of teens. Parenting style and teens’ mental functioning combined to influence how teens sleep.

The authors concluded that teen sleep problems may mirror an unfavorable parenting style and sleep complaints among mothers. Understanding this relationship could improve family counseling and treatment of teen sleep complaints.

In August the Sleep Education Blog reported that a teen’s sleep pattern may be a marker of his or her risk for developing depression. Another recent study found that technology use may be taking a toll on the sleep of teens.

Get parent tips for teen bed times on SleepEducation.com.

Image by Michael Porter

Preventing Nightmares and PTSD Flashbacks with Tetris

A new study in the online journal PLoS ONE shows that playing the computer game Tetris can reduce unwanted “flashbacks.”

This is promising for people who suffer from post-traumatic stress disorder (PTSD). Could it also help other people who suffer from nightmares?

The study involved 40 people who watched a traumatic, 12-minute film. It contained scenes of real injury and death.

After a 30-minute break, half of the group played Tetris for 10 minutes. The other half sat quietly.

Flashbacks were monitored for one week using a daily diary. Subjects then returned to the lab for an assessment.

Results show that Tetris players had significantly fewer flashbacks. They also had fewer clinical symptoms of trauma.

At the one-week follow up, both groups scored the same on a recognition memory test for the film. This indicates that voluntary recall was similar between the groups. It was the rate of involuntary memories – flashbacks – that was different.

Tetris requires you to arrange a falling puzzle of colorful block-like shapes. The authors told Reuters that the visual aspect of the game may compete with the traumatic, visual memories. It may interfere with how your mind forms and stores the memories.

One of the study’s authors noted that you have about six hours to affect memories before they are stored in the brain. Any type of intervention needs to be done in this window of time.

The AASM reports that nightmares tend to be the most disturbing aspect of PTSD. Often the dreams involve a flashback to the event that seems shockingly real.

Potential implications of the study also extend beyond PTSD. It suggests that a visual distraction like Tetris could reduce nightmares for anyone after a stressful event.

It could be especially helpful for children who are prone to having nightmares after seeing a scary movie or other distressing images.

No Purple Hearts for PTSD

Does a U.S. soldier who has post-traumatic stress disorder (PTSD) deserve a Purple Heart? The question has sparked a heated debate in the military community.

Stars and Stripes, the American Forces Press Service and the New York Times report that the Defense Department recently rejected the idea.

A Purple Heart is only awarded when a soldier with one of the U.S. Armed Services is wounded or killed by enemy action. Army Regulation 600-8-22 defines a wound as “an injury to any part of the body from an outside force or agent.” The wound “must have required treatment by a medical officer.”

The regulation lists PTSD as an injury that clearly does not meet these requirements. The Purple Heart has never been awarded for mental or psychological problems.

In a May article in Stars and Stripes a military psychologist argued for a change in the policy. He said that PTSD is in part a physical disorder because it damages the brain.

The idea got the attention of U.S. Secretary of Defense Robert Gates. This prompted a review of the policy and stoked the debate.

Common signs of PTSD include feelings of intense fear and horror after a terrifying event. Sometimes this response is delayed. Symptoms may not appear until a few days or even weeks after the event.

Recurring nightmares tend to be most disturbing aspect of PTSD. In these dreams the event may be relived in a way that seems shockingly real.

Most people with PTSD also report having disturbed sleep. It can be very hard to fall asleep or stay asleep. This is known as “adjustment insomnia.”

About half of people with PTSD get better within three months. For others it can be a lifelong problem.

What do you think? Are veterans with PTSD being overlooked?