Sleep is one of the most important things that we do each day. How we sleep impacts our health. If affects our memory, learning ability and mood. Not getting enough sleep can take a negative toll on us that will last throughout.

Sleep is foundational: Some sleep strategies to set the foundation for your day

Use bed for sleep (and sex) only: Televisions , laptops, tablets, and video games are problematic not only because of the light they emit, but because of their content. Such activities keep us aroused; they keep us wide awake just as we’re trying to calm it down.  While falling asleep to soothing music can be very helpful to some, not all music is soothing.

Deal With Worrying During The Day: One reason your mind may keep you awake is because you’ve unfortunately practiced an undesired behaviour. You’ve developed a bedtime routine where upon lying down you actually become more alert. If you spend many a night in tossing and turning, worrying, ruminating or being upset – your bed has become a cue for tossing and turning and being upset. What to do: give yourself time earlier in the day to deal with unfinished business and those your worries of yours will be less likely to follow you to bed.

Consistent Sleep Time / Wake Time: Although this may be common knowledge, it bears repeating. If you can maintain a really good sleeping schedule where you are going to bed at the same time, and getting up at the same you will develop a routine that will help you immensely.

Create a calm, uncluttered, cool, dark space to sleep in: Set up your sleep environment optimally for sleep. For example, too much light, especially in the evening, has a very powerful awakening effect on the brain. You want to minimize that impact on alertness and keep your sleep environment dark.

Noise: There many types of noises that impact us: snoring bed partners, or family members watching TV or a busy neighbourhood. Some of these can be fixed or minimized, while other cannot. Some stratgies to consider: foam earplugs, or a fan or white noise machine to mask the sound.

We published an article in the Fall 2011 issue of Rehab Matters.

We posted it below:

From bipolar disorder to schizophrenia–touching both the young and old, rich and poor, weak and strong—mental illnesses are as serious as they are prevalent. The stats are staggering: In Canada one in four suffer from mental health disorders. Moreover, the World Health Organization has reported that four of the ten leading causes of disability in developed countries are mental disorders.

‘Comorbidity between medical and mental conditions is the rule rather than the exception’ (Colby, 2011). From asthma to substance abuse, more than two-thirds of adults with mental disorders have medical conditions. Similarly, there are numerous mental illnesses that have robust comorbid relationships to sleep disorders. In fact, a significant proportion of mental disorders have sleep disturbance as a diagnostic criteria. The delicate relationship between mental and physical health and sleep has been known for quite some time. Hippocrates stated that sleeplessness is a sign of pain and suffering and may lead to mental illness, while sleeping during the day is an indication of illness.

Historically, it has been assumed that mood disorders cause changes in sleep patterns (Benca, 2005). While history may have shown this to be a truth, clinical experience also demonstrates there is a bidirectional relationship between sleep and mood, and sleep disturbances can indeed cause mood disorders. A popular current theory posits that common neural substrates serve as the foundation to both mental health and sleep; and, when compromised, can lead to a disruption in both mental health and the sleep-wake cycle.

Mental health and sleep disturbance: Are they two sides of the same coin? We would argue yes. How does that help us? When mental health is examined we must also, with equal vehemence, assess sleep, as they are integrally related. Of all the mental health disorders associated with sleep disturbances, depression is the most common. It has been estimated that 90% of patients with depression report issues regarding their sleep. Depression just so happens to also be the most costly to employers. ‘The cost of lost productivity for on the job depressed workers (presenteeism) and lost time for depressed workers that are absent from the job (absenteeism) far exceed the cost of treatment (medical and medication cost)’ (Wilkins, 2011).

What happens to a depressed person’s sleep? People with depression exhibit disturbances in sleep stability such as prolonged sleep latency, increased duration and frequency of wakefulness after sleep onset and early morning awakening. Some 15% of the people with depression sleep excessively. A typical night’s sleep has a distinct architecture, which, for sufferers of depression, is fragmented.

Research conducted by Michael Perlis, Ph.D., indicates that insomnia may be a precursor for the onset of depression. His studies have shown that insomnia invariably precedes episodes of depression. Further, his research has demonstrated that the sleep disorder intensifies during the progression of a relapse or new incidence of depression. Treating the insomnia may prevent or shorten the period of depression. ’Perlis believes that behavioral treatment specifically aimed at curbing the insomnia of depression may rout the entire disorder. ‘

There are a number of therapies, ranging from CBT to exercise to pharmacologic to strategies of rest-relaxation that can be effective in treating sleep disorders. Sleep and depression recruit common brain regions – it follows that some interventions that prevent or treat one may help the other.

Sleep disturbances and the accompanying mental health disorders bring about a multitude of challenges across life’s many domains, including the workplace. Treating sleep disturbances that often precede the mental health disorder can minimize the deleterious effects of both these conditions. Secondary to the one suffering the afflictions of a mental illness and sleep disorder, the often rippling effects into family, the community and workplace can be minimized and possibly prevented.

Sleep is not yet a principal component of vocational assessments and it needs to be. During the rehabilitation process disturbed sleep may hinder full recovery and return to work. Recent research has indicated that poor sleep predicts long-term ill health absence as well as later work disability. As noted, sleep and mental health have a bidirectional relationship and sleep disturbances may provide prog¬nostic indicators prior to the onset of disabling disease. Thus, assessing sleep may minimize and in some cases prevent the onset of mental illness, which in turn can only have a favourable impact on return to work.

Sleep and mental health are inextricably linked. The etiology indicates that each is a risk and contributing factor to the other. From assessment to treatment, from diagnosis to prognosis, sleep and mental health are inseparably intertwined. Sleep and mental health, they are stubborn bedfellows.

Ed Yong just posted a fascinating piece describing the importance of our clocks, better yet, our circadian rhythms. In it he shares some research on transplanting arteries from a mouse with a deficient body clock into a normal animal with astounding results:

When he transplanted the arteries from a mouse with a deficient body clock into a normal animal, they developed arteriosclerosis, a disease where the blood vessels thicken and stiffen. Even though the conductor was giving the right rhythm, the musicians in the arterial section ignored his instructions and did their own thing, with disastrous results.

 

Cheng found that normal arteries show no sign of disease if they’re transplanted into normal mice. The arteries even behaved normally when Cheng put them inside mice with faults in two clock genes – Period and Bmal – which disrupt their circadian rhythms. The arteries might develop signs of disease after a longer time, but within the 4 weeks of the experiment, they seemed perfectly healthy.

Researchers at USC are helping our see how powerful circadian rhythms are the genetic level. Their studies have shown that of “the genes that showed rhythmic expression, between 80 and 90 percent were driven by the circadian cycle”.

For more information about circadian rhythms check out this thorough tutorial on the subject.

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