Insomnia Series: The Science Behind What You Should Eat for a Good Night’s Sleep

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By Sophie Medlin

Recently, researchers have been learning more about how poor sleep influences our dietary choices, as well as how diet influences sleep quality. Not sleeping for long enough or poor quality sleep are associated with increased food intake, a less healthy diet, and weight gainLack of sleep also leads to increased snacking and overeating. And it causes us to want to eat foods high in fat and carbohydrates — with increased chemical rewards to the brain when we do eat these foods.

Essentially, poor sleep drives your body to find high energy foods to keep you awake which makes fighting the cravings for unhealthy foods very difficult to resist. But, on the other hand, when we have slept well our appetite hormones are at a normal level. We don’t crave unhealthy food so much — and we can make better choices about what to eat.

See also: Learning Language in Deep Sleep Isn’t Just Science Fiction Anymore

The Science of Sleep

All cultures around the world have traditions about which foods promote sleep. Foods such as milk, chamomile, kiwi fruit, and tart cherries, have all been said to work wonders for a good night’s sleep. Given how much the food we eat affects us on a day-to-day basis, it is not surprising that our diet plays such a big role in our quality of sleep. What we eat also has a big impact on our organ function, immune system, hormone production, and brain function.

A really important hormone that controls our sleep patterns is melatonin. Melatonin is produced in the brain and the amount of melatonin you produce, and how efficiently our brain uses it is affected by our diet. One of the biggest influence on our melatonin levels appears to be our intake of a type of proteincalled tryptophan. Tryptophan is an essential amino acid — the building blocks of proteins. Essential amino acids are a group which our bodies cannot make; it can only be sourced through diet.

sleeping cat
Eating and drinking for better sleep is about more than just avoiding caffeine.

Other nutrients that appear to be helpful for sleep include B vitamins and magnesium. This is because they help tryptophan to be more available in the body. If your diet is lacking tryptophan, B vitamins, or magnesium, it is very likely that your melatonin production and secretion will be affected and your sleep quality will be poorer.

Eat to Sleep

It stands to reason then that following overly restrictive diets or diets that put you at risk of nutrient deficiencies can really affect your sleep. But by increasing your intakes of foods rich in specific nutrients, it may well help to promote better sleep quality and duration.

Dairy foods, for example, can be great at helping you sleep. Not only is dairy an excellent source of tryptophan, but it also contains magnesium and B vitamins which help to promote the activity and availability of tryptophan. Nuts, like dairy, also contain all the nutrients known to promote increased melatonin production and support its release.

salmon

Fish is a great source of tryptophan and B vitamins. Fish with bones, such as sardines, will also provide magnesium. Including fish in your diet regularly may help to promote healthy melatonin production when you need it. Pulses, beans, and lentils also contain high amounts of tryptophan and B vitamins. Adding some tofu or paneer to a vegetable stew or curry can also help to increase your likelihood of having a great night’s sleep. You could also add in some soya — which is another good source of tryptophan — to optimize your sleep potential.

See also: Doctors Identified Risk Factors for a Potentially Violent Sleep Disorder

And if you’re still struggling to sleep, it might be that you’d benefit from some meat. Meat of all kinds contains all the essential ingredients for a good night’s sleep. So if you can’t nod off at night, maybe think about adding some lean meat to your diet.

If you find yourself hungry before bed, for the ideal bed time snack, try a glass of semi-skimmed or skimmed milk, a small banana or a few nuts — all of which can really help to improve your sleep and your willpower the next day. It’s also worth pointing out that it takes around an hour for the tryptophan in foods to reach the brain, so don’t wait until just before bedtime to have your snack. And it’s also advisable to have a balanced diet that includes plenty of foods that are high in tryptophan throughout the day to optimize your chances of a good night’s sleep.

Here’s How Relationships Can Affect Your Sleep In The Long-Term, According To Experts

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By Julia Guerra

Not to freak you out or anything, but the choices you make today really do have an impact on your future, even in ways you wouldn’t expect. Life is funny that way; sometimes two completely different aspects of life can collide like colors in a messy drawing, and you’re stuck trying to figure out the bigger picture. Take your love life, for example. Did you know your romantic relationships can affect your sleep? I’m not necessarily referring to that can’t-eat, can’t-sleep phase where everything’s coming up roses and you and your partner can’t get enough of each other, either. According to new research, negative relationship experiences in early adulthood might have some unexpected effects on your sleep quality well into your 30s.

According to the American Sleep Apnea Association, 50 million Americans suffer from chronic sleep disorders, while an additional 20 to 30 million report the occasional night of tossing and turning. If you’re among that 20 to 30 million, but haven’t been able to identify the issue just yet, the results of a new study, published in Personal Relationships, a journal of the International Association For Relationship Research, suggest that negative romantic relationship experiences can impact your sleep quality over the long-term. I know, like the negative relationship itself wasn’t bad enough, right?

Giphy

The study documented the possible correlation between participants’ romantic relationships, stress, and how both of these elements affect sleep quality over the course of adulthood. Researchers recruited 112 participants from the Minnesota Longitudinal Study of Risk and Adaptation and studied them from the age of 23 years old to 32 years old. In the end, per a ScienceDaily press release, the researchers found that people who reported having positive relationship experiences in their early 20s were less stressed and enjoying quality sleep in their early 30s. “Although a large body of evidence shows that relationships are important for health, we are just beginning to understand how the characteristics of people’s close relationships affect health behaviors, such as sleep,” Chloe Huelsnitz, a PhD candidate at the University of Minnesota and lead author of the study, said in a statement, per the ScienceDaily press release.

Generally speaking, says Dr. Tammy Nelson, a sex and relationship expert and licensed psychotherapist, one of the most common emotions that can affect your sleep patterns is anxiety, and as I’m sure you know from experience, no matter how good or bad your relationship is, it can sometimes give you a little bit of stress.

“Being anxious can keep us up at night, prevent sleep, and wake us up once we are asleep,” because it raises blood pressure, increases heart rate, quickens your pulse, and tenses up your muscles, Nelson tells Elite Daily over email. “These are all reactions that are in direct opposition to the relaxation that needs to happen when we are asleep.”

But even after you and a partner eventually decide to part ways, if you’re still dealing with pent-up feelings of stress from the relationship, Natalie Dautovich, an environmental scholar for the National Sleep Foundation, says you can still be affected. “We are physically most vulnerable when we are sleeping, so sleep is most possible when we feel safe and secure,” Dautovich tells Elite Daily.

Giphy

If you’re reading all of this and thinking “well, that’s pretty unfair,” you aren’t wrong. But the thing is, you still have control over your sleep health, and there are ways to ensure that, no matter what happens in terms of your love life, you’re still doing everything you can to get your rest.

Of course, if you are currently in a relationship, that doesn’t just automatically mean your sleep health, in the short- or long-term, is doomed. In fact, a physical connection with a loved one, such as a hug, kiss, or even sex, can calm your nervous system, therefore decreasing stress and anxiety, making it easier to fall and stay asleep, Nelson explains. However, at the same time, it’s important to remember that having your own bedtime routine of some kind, made up of rituals (taking a warm bath, meditating, journaling, diffusing essential oils, etc.) that soothe you without the help of a partner, she adds, is just as key.

Having an SO around can also benefit your sleep health in some slightly more unexpected ways. For instance, they can be there to help hold you accountable when you’re trying to cut back on using your phone in bed, or stick to an earlier bedtime. “A benefit of having a sleeping partner is that they often are the first to notice sleep difficulties (e.g., snoring related to sleep apnea),” Dautovich says, so the two of you can both provide support and promote healthy sleep behaviors for one another. It’s certainly worth the try, right? Clearly the sleep of your future self depends on it.

Cognitive Behavioral Therapy for Insomnia | Patient Advice | US News

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By Michael O. Schroeder

Many, many people have difficulty falling asleep or staying asleep. Research generally suggests that around a third of Americans have insomnia at any given time, and about 1 in 10 have chronic insomnia, lasting three months or longer.

Not getting adequate rest can affect mood (while depression can also contribute to insomnia), undermine motivation, increase irritability and make it difficult to just get through the day. “For those who take care of small children or have a lot of family and work responsibilities to balance,” the National Sleep Foundation notes, “insomnia can make these tasks feel even more overwhelming when you are tired.”

Often people try over-the-counter sleep aids or nothing at all – just thinking they have to live with it – rather than seeking help from a professional.

It’s common for patients who see Dr. Rafael Pelayo to have been struggling with insomnia for years. It’s “not unusual for me to see someone with decades of poor sleep,” says the sleep specialist and clinical professor of psychiatry and behavioral sciences at the Stanford Center for Sleep Sciences and Medicine. But even those who’ve had chronic insomnia for years can still get better when the insomnia is addressed correctly, he says.

And although the treatment isn’t new, there’s growing recognition of a tailored therapeutic approach used to change a person’s thinking and behavior that has lasting benefits for the majority who undergo it: cognitive behavioral therapy for insomnia. Most who undergo four to eight sessions of CBT-I experience a significant reduction in their symptoms – namely the time required to fall asleep, the amount of time spent awake or both – notes Michael Perlis, director of the behavioral sleep medicine program in the department of psychiatry at the University of Pennsylvania.

While experts note that sleep medication, prescribed in combination with CBT-I or alone, is another option, CBT-I’s “durable results” – generally continuing after a person stops the therapy – make it an optimal approach. “It is recommended as the first line treatment,” Perlis says.

It’s not just mental health professionals advocating for the treatment either, but the medical establishment. The American College of Physicians led the way in guidelines published in 2016ACP recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder,” the medical society asserted.

Perlis explains that CBT-I has four components: sleep restriction, stimulus control, sleep hygiene and cognitive therapy. Often it’s counterintuitive, too, like with sleep restriction. One might think that if you can’t sleep you should stay in bed for longer. But actually experts say it’s important to match your sleep opportunity, or how long you’re in bed, with how long you’re able to sleep, and then gradually work on increasing sleep time. “It doesn’t aim to restrict actual sleep time but rather to initially restrict the time spent in bed,” Stanford Health Care’s website explains, regarding the sleep restriction component of CBT-I. “Subsequent steps consist of gradually increasing the time spent in bed.”

While some people may feel they’re familiar with certain concepts and components of CBT-I, like sleep hygiene (being mindful of how factors like substance use, such as caffeine and alcohol consumption, can affect sleep), implementing it correctly tends to be more complex and involved. Experts say that’s why it’s key to see a professional experienced in CBT-I for effective treatment. “Those that try to do CBT-I to themselves are likely to not be successful,” Perlis says. “But worse is that they will believe that they’ve been there, done that, and so the likelihood of seeking out professionally administered CBT-I goes way down.”

One significant limitation with CBT-I, however, is access. “Finding a therapist is not easy,” Perlis says. “CBT-I is not yet available in every state or every city.” However, there are some directories – he recommends a couple through Perelman School of Medicine at Pennsylvania University and the Society of Behavioral Sleep Medicine, respectively – that can be used to find therapists who do CBT-I.

Pelayo points out that for those who aren’t able to see a professional who does CBT-I in their area, there are online CBT-I programs that allow a person to engage in the therapy from home virtually. “I’m OK with somebody doing it online if they want to – if they live far away,” Pelayo says. “And if they got better, I’m happy for them, of course. But if they don’t get better, if they’ve done the online thing, then we actually want them to have a face-to-face.”

He says patients typically pay cash for online CBT-I.

Insurance coverage of in-person cognitive behavioral therapy for insomnia varies. So it’s important to check in advance to determine that. As the therapy is more widely used, and given the support for its effectiveness, clinicians are hopeful insurance coverage of CBT-I will improve, but it’s not universal today.

Pelayo says some individuals, like those with profound autism or schizophrenia, aren’t able to participate in CBT-I. Others, he says, either prefer not to undergo therapy, or aren’t able or don’t want to make the time commitment.

Certainly, CBT-I has advantages – notably the lasting benefits, after a person has stopped therapy; that differs from medication that provides benefit while on it. But experts say, first and foremost, it’s key that those with chronic insomnia generally seek help to get a better idea of what’s behind it and explore treatment options.

In some cases, it may be a medical or mental health issue that’s causing sleep problems or making things worse, and cognitive therapy may still be useful (like with depression). But having a fuller picture, is critical. For example, often thyroid disease can contribute to sleep woes and is overlooked, Pelayo says. Or a person may have another disorder like sleep apnea, along with insomnia, that needs to be addressed as well, he says.

None of that will be rectified through an online search in your pajamas (though you might find a sleep specialist that way).

“I tell all my patients that if they don’t wake up feeling refreshed, something is wrong,” Pelayo says. When sleep problems persist, experts say, instead of trying to put them out of your waking mind – seek help to get them addressed.

Why People With A History Of Bad Relationships Don’t Sleep Well

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By Kelly Gonsalvez

Anyone who has ever slept next to a partner knows being part of a unit can affect how well you sleep—from dealing with the other person’s weird tossing and turning all night to battling for your fair share of the blanket to trying to get some shut-eye when you’re still halfway through a fight with the person lying next to you and you can’t stop thinking about it.

Past research has shown your relationship can affect your sleep, but a new study published in the Personal Relationships journal has now found an even deeper connection between your love life and sleep: Apparently having a history of stressful relationships may make you more likely to have poorer sleep quality.

Researchers analyzed existing data that had been collected on over 260 people born in the mid-1970s regularly from the time they were born until mid-adulthood. These participants were asked questions about their lives periodically, including being surveyed and interviewed about their recent romantic relationships, experiences with stress, and sleep quality. Analyzing these people’s responses between ages 23 and 37, the researchers discovered a trend: People who’d had better relationships during their early adult years dealt with fewer and less disruptive stressful life experiences at age 32, and that led to having better sleep quality at age 37. That was true regardless of depression status, gender, ethnicity, income, education, and even how much stress people currently had at age 37.

In other words, having a history of good relationships as a young adult—that is, stable long-term relationships where there’s mutual care, trust, emotional closeness, and sensitivity to each other’s needs and where conflicts are resolved in a healthy and satisfying way—tended to lead to less stressful experiences throughout adulthood, which in turn led to better sleep over time.

It’s understandable why stressful life experiences (like job changes, health issues, legal battles, and interpersonal conflicts) would take their toll on a person’s sleep quality; a lot of past research has shown that having a lot of stress can seriously disrupt your sleep. But why might having a better love life lead to having fewer of these types of seemingly unrelated tough life events, or at least having them be less stressful?

“One explanation is that people who possess the interpersonal competencies necessary to maintain relationships marked by mutual caring, trust, conflict resolution, and other positive characteristics are also more likely to have other traits that may mitigate their exposure to and reduce the severity of those stressors when they occur,” the researchers write in the paper. “For instance, people who score high in romantic relationship effectiveness may be more likely to demonstrate caring and responsiveness in other types of relationships (e.g., with family or co-workers), which might reduce exposure to conflict. Moreover, when stressful events due to uncontrollable sources are encountered (e.g., unemployment, death of a family member), people high in relationship effectiveness may also be more likely to possess intrapersonal and interpersonal resources, allowing them to cope better with the stressful life event and reduce its severity.”

So people who are good at romantic love are probably good at dealing with people in other parts of their life, and those skills and emotional experiences set them up to either avoid stressful occasions or deal with them well when they occur.

“Cues of social belongingness and emotional security can facilitate a sense of protection that down-regulates stress reactivity and promotes better sleep,” the researchers explain. “Given that romantic relationships are an especially potent source of social belongingness and emotional security in adulthood, one’s experiences, tendencies, and engagement in his or her romantic relationships should have a particularly strong impact on sleep patterns.”

This is all pretty hard news to hear for anyone who feels like they’ve had a pretty unlucky love life thus far. But don’t worry: The point here isn’t that if romance isn’t the easiest for you, you’re doomed to a life of stress and bad sleep. Rather, this study simply reinforces one of the most important benefits of being in a relationship: being able to learn about how to communicate better, navigate conflicts, take care of another person, and take care of yourself. Relationships are far less about validating your worth as much as they are about learning how to become a better human being.

The good news? You can totally do that without a partner, too. Romantic relationships happen to be a great place to learn those lessons, but so are so many other parts of our social lives—our family relationships, our friendships, our professional connections, and more.

If your sleep and mental health are important to you, then your social relationships should be too. Interfacing with other people is pivotal not only to learning how to deal with stress and conflict but also to having a support system in place during all those bad times. That stability seems to be the real key to being able to have a secure, peaceful night’s sleep over time.

Insomnia Series: How Did You Sleep? NPR Wants Your Slumber Stories

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Meagan Keane

Getting a good night’s rest is easier said than done. NPR’s Science Desk is reporting on the science of sleep, and we want to hear from you.

Ask us your questions about winding down, dealing with insomnia and attempts to hack sleep. Share your stories and best tips for getting those precious hours of sleep each night.

Please fill out our form or follow this link to respond. Part of this project involves putting voices on air, so we’d love it if you could also send us a voice memo. You can do that in the form, or email a voice memo to talktous@npr.org, with “Sleeping Well” in the subject line.

Your response may be used in an upcoming story, on air or on NPR.org. Thanks!

What Is Chronic Insomnia And How Is It Treated?

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Overview

Insomnia is a common sleep disorder in which you may have trouble falling asleep, staying asleep, or both. A third of Americans report that they don’t get the recommended amount of sleep every night, which is at least seven hours.

Periodically having trouble sleeping, also known as acute insomnia, is common. Acute insomnia lasts for a few days or weeks and often occurs during times of stress or life changes.

Have trouble getting to sleep or staying asleep more than three nights a week for three months or more is considered chronic insomnia. This is also known as chronic insomnia disorder.

Types of chronic insomnia

There are two main types of chronic insomnia: primary and secondary.

Primary insomnia isn’t due to other medical conditions or medications and is poorly understood by scientists. Specialized MRI scans are being used to study this condition. Primary insomnia may be related to changes in levels of certain brain chemicals, but research is ongoing.

Secondary insomnia is caused by other conditions or situations. This means that it’s a symptom that goes along with some medical issues, such as emotional stress, trauma, and ongoing health problems; certain lifestyle patterns; or taking certain drugs and medications.

Symptoms of chronic insomnia

Chronic insomnia can cause symptoms at night as well as during the day and can interfere with your ability to go on with your daily tasks.

Symptoms may include:

  • trouble falling asleep
  • waking up throughout the night
  • trouble staying asleep or trouble returning to sleep
  • waking up too early
  • daytime sleepiness or grogginess
  • not feeling rested after a night’s sleep
  • irritability
  • mood changes, such as feeling depressed
  • difficulty concentrating
  • problems with memory
  • increase in mistakes and accidents
Causes of chronic insomnia

There are many things that can cause chronic insomnia, but it’s often linked to an underlying medical condition. Certain medications and stimulants can cause chronic insomnia, along with lifestyle patterns.

Medical conditions

Chronic insomnia can be caused by a number of long-term medical conditions, including:

Medications and stimulants

For some people, certain medications and stimulants may cause chronic insomnia. These include:

  • alcohol
  • antidepressants
  • beta-blockers
  • caffeine
  • chemotherapy drugs
  • cold and allergy medications containing pseudoephedrine
  • diuretics
  • illicit drugs, such as cocaine and other stimulants
  • nicotine
  • stimulant laxatives

Lifestyle patterns

Certain lifestyle patterns may lead to chronic insomnia. These include:

  • rotating shift work
  • frequent travel across multiple time zones, leading to jet lag
  • physical inactivity
  • frequent daytime napping
  • lack of routine for waking and sleeping
  • poor sleeping environment
Treatment of chronic insomnia

A number of at-home and professional treatment options are available for chronic insomnia. Treatment will depend on the cause of your insomnia and may involve medication or therapy to address an underlying condition.

Along with treating any existing conditions, your doctor may recommend one or a combination of treatment options for chronic insomnia.

Cognitive behavioral therapy (CBT)

Research has shown CBT to be as effective, or more effective, than sleep medications in treating chronic insomnia. It involves educating you on sleep and better sleep habits, while teaching you to change the beliefs and behaviors that interfere with your ability to sleep.

Some of the strategies of CBT that are specifically focused on insomnia, known as CBT-I, include the following:

Cognitive techniques

Using journaling to write down worries or concerns before going to bed may help keep a person from actively attempting to work them out while also trying to sleep.

Stimulus control

This entails altering behaviors that condition your mind to fight sleep. Setting a sleep and wake time routine is part this strategy.

Other examples are using your bed only for sleep and sex, and leaving your bedroom if you’re unable to fall asleep within a set number of minutes.

Sleep restriction

This therapy involves limiting the amount of time you spend in bed, including avoiding naps. The goal is to deprive you of enough sleep so that you’re tired at bedtime. Your time in bed is gradually increased as your sleep improves.

Relaxation techniques

Breathing exercises, yoga, guided meditation, and other techniques are used to reduce muscle tension and control your breathing and heart rate so that you’re able to relax.

Paradoxical intention

This strategy involves focusing on staying awake in bed instead of expecting to fall asleep. It helps reduce worry and anxiety over being able to fall asleep. It’s most effective in treating learned insomnia.

Medications

There are a number of prescription medications and over-the-counter (OTC) sleep aids that may help you get to sleep or remain asleep.

While effective, doctors don’t typically recommend using sleeping pills long term because of the side effects, which can include daytime sleepiness, forgetfulness, sleepwalking, balance problems, and falling. Certain classes of sleeping pills are also habit-forming.

Some of the prescription medications that are approved for treating insomnia include:

  • zolpidem (Ambien)
  • eszopiclone (Lunesta)
  • zaleplon (Sonata)
  • doxepin (Silenor)
  • ramelteon (Rozerem)
  • suvorexant (Belsomra)
  • temazepam (Restoril)

OTC sleep aid options may include:

Always speak to your doctor before taking an OTC sleep aid, including natural remedies, such as melatonin and valerian root. Just like prescription drugs, OTC and natural sleep aids can cause unwanted side effects and interfere with other medications.

Cure for chronic insomnia

If your chronic insomnia is caused by an underlying medical condition, such as acid reflux or pain, treating the condition may cure your insomnia.

Chronic health conditions that cause insomnia can be managed with changes in treatment, in turn managing or preventing insomnia. Talk to your doctor about changing medications or treatment plans if a drug you’re taking is causing insomnia.

Home remedies for chronic insomnia

There are several things that you can do at home to treat or prevent chronic insomnia. One important option for treatment is known as sleep hygiene. This calls for changes in patterns of behavior to help improve your ability to fall asleep and stay asleep.

Try the following tips:

  • Avoid caffeine, especially later in the day.
  • Avoid alcohol use and smoking cigarettes before bed.
  • Engage in regular physical activity.
  • Don’t take naps.
  • Don’t eat large meals in the evening.
  • Go to bed and get up at the same time every day, even on days off.
  • Avoid using computers, smartphones, TV, or other technological devices an hour before bedtime.
  • Keep your bedroom dark or use a sleep mask.
  • Keep your bedroom a comfortable temperature.
  • Make sure your sleep surface is comfortable.
Outlook for chronic insomnia

Chronic insomnia can be effectively treated using a combination of behavioral therapies and by making a few lifestyle changes to help improve your sleep. If you’re having trouble sleeping and it’s interfering with your quality of life, talk to your doctor.

Insomnia Series: Sleep Deprivation Was More Powerful Than Antidepressants For Me

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By Jesse Noakes

On a Saturday night last year, not long after the death of my grandmother, I went to her house to try a little experiment. I’d been depressed again for more than a week. I felt stodgy and frozen, woozy with lethargy, and at the same time prickling with a static sense of anxiety that became especially charged around other people.

I woke just after 2 am on a sofa bed in her guest room. The house was icy cold and lonely. I switched on the heater in her living room, made myself coffee, and sat down at her heavy dining table with my laptop. Five hours, another coffee, and a couple of thousand words later, the sun was up and I drove to the gym. By the time I met my aunt at a cafe near the beach a couple of hours later, I felt fresh and clear in the sunshine. I could lock eyes and smile with the lovely woman at the table next to us and my conversation with my aunt was fluid and enthusiastic. I was feeling good again.

About a decade ago, I figured out that if I stayed up all or most of the night, I’d usually feel a lot better in the morning. For years, I’d been managing major depressive disorder—I was ill at ease with myself, awkward in conversation, and clumsy and self-conscious in my body. My long-term psychiatrist thought I could be bipolar, and put me on a high dose of the mood stabilizer lithium, to no noticeable effect. I spent the remainder of my early 20s playing the pharmaceutical lottery, to no avail.

It was only recently that I started experimenting with sleep deprivation again, after I learned that others had the same idea. In fact, since the early 1970s, when a young German psychiatrist called Bernhard Pflug noticed that some of his patients felt better after a night without sleep, there has been a tiny but growing school of research studying the potential of sleep deprivation as a fast-acting antidepressant.

In a 2015 study that compared the efficacy of exercise versus sleep deprivation, 75 depressed patients in Copenhagen who were treated with three all-nighters in a week had almost double the remission rate compared to another group who used daily exercise. Seven months after their treatment, 62 percent of the sleep-deprived no longer met the criteria for clinical depression. A 2017 meta-analysis looked at 66 studies of sleep deprivation and its effects on depression published in the past three decades, and found that 50 percent of patients had a clinically significant response to the treatment.

What was remarkable about this research was the speed with which the transformation happened. Where antidepressant meds typically take several weeks to kick in, with these sleep deprivation studies, participants saw an improvement in their mood (at least temporarily) overnight. This represents a significant boon for anyone stuck in the airless swamp of depression, but, according to a small 2014 pilot study in South Carolina, it could be especially potent for those experiencing suicidal thoughts or ideation. That research found that a single night of sleep deprivation led to a 63 percent mean reduction on the Columbia Suicide Severity Rating Scale.

“Even in the ‘70s it was clear—when you’ve seen a severely melancholic patient turn into somebody who can actually talk to you and even smile just by staying awake all night, you think it’s absolutely a miracle,” says Anna Wirz-Justice, professor emeritus at the Centre for Chronobiology in Basel, Switzerland, who first became interested in its therapeutic potential shortly after the first publication of Pflug’s remarkable responses.

It seems almost too good to be true—and in some ways, it is. For the vast majority of patients, as many as 95 percent, the effects wear off as soon as they have a decent sleep. As a psychiatrist once put it to Wirz-Justice, “why offer people paradise just to take it away again?”

Several people with depression I’ve spoken to recently have said that non-clinical, DIY sleep deprivation gives them relief, but with cautious enthusiasm. “It’s notable, but nothing life-changing,” David, a 33-year-old from Quebec, tells me. He usually prefers to “sleep a couple hours and have a decent next day with a slightly less noticeable mood boost,” rather than staying up all night but suffer headaches as a result. “But it doesn’t sustain itself for me.”

The cognitive, behavioral, and physical health deficits of sleep deprivation are well-established, and we all recognize them. But the impairments to motor control, memory, and higher cognitive function that the majority report after little or no sleep are also characteristic of depression. Therefore, for depressives, the short-term antidepressant effects of sleep deprivation counter-balance and may outweigh its negative cognitive effects.


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In recent years, most clinical trials have added adjunctive therapies to build on the immediate antidepressant effect of the sleep deprivation. Light therapy, a long-standing treatment for seasonal affective disorder in which patients sit for half an hour in front of a very bright light box, is often used for several mornings after the initial all-nighter. Another method is sleep phase advance (SPA), which begins with early bedtime the night after sleep deprivation and gradually returns the patient’s sleep pattern to normal within a few nights.

It’s also common for patients to be on a longer course of antidepressants like fluoxetine (Prozac), or a mood stabilizer such as lithium, to cement the improvement after the immediate treatment is completed. The combination of sleep deprivation, light therapy, and either SPA or ongoing medication is referred to as ‘triple chronotherapy,’ Wirz-Justice explains. “The idea is you use everything you’ve got to get out and keep out of depression in four days. Isn’t that something to aim for? Why doesn’t it catch on?”

I can think of several reasons, and the main one is it’s just really hard. When I’m depressed, I sleep a lot. A lot of depressed people do. I spent much of my 20s lying in bed, staring at the wall with the blinds down. Getting up at all is an effort, let alone staying up all night. Recognizing this, some clinicians use a partial sleep deprivation where patients sleep the first part of the night and are woken at 2 am—it’s an easier sell, and works almost as well.

This is the protocol I’ve adopted. Studies have found little difference between a full all-nighter and grabbing a couple of hours’ rest, says Francesco Benedetti, head of the psychiatry and clinical psychobiology unit at San Raffaele Hospital in Milan and one of the leading researchers in the field. “[Partial sleep deprivation late in the night was followed by response rates similar to those obtained after total sleep deprivation…but the issues of efficacy, timing and stress are yet debated,” he says.

As for doing it at home, as I’ve done recently? “If you’re knowledgeable about it you can find the information and follow the protocol, but to do it on your own I think is very tough,” says David Veale, consultant psychiatrist at the Priory Hospital in North London, where he is running the UK’s first clinical trial of sleep deprivation for depression. He says it’s more difficult than dangerous.“ Perhaps the only potential risk is for people with bipolar disorder who may become manic during the program—so I wouldn’t recommend it if you’re on your own…though it’s probably no different from other medications. If you’ve ever met somebody having a manic episode, it isn’t difficult to tell,” Veale adds. Mania is typically characterized by grandiosity, racing thoughts, irritability, sleeplessness and heightened impulsivity.

It’s not only personally counterintuitive to stay up all night when you’re depressed, it also goes against every prevailing cultural norm. The premium importance of sleep is reinforced everywhere, and with good reason. “If you don’t have depression and you stay up all night, you feel pretty crap, don’t you?” Veale says. Patients with serious clinical depression may respond differently, though. “Depressed patients will have some tiredness, of course, but if they’re responding then they’re also recovering from their depression.”

Part of the reason for this apparent paradox is the neurotransmitter dopamine. A study in the Journal of Neuroscience suggested that a night of sleep deprivation causes increased dopamine production, which “correlated with increases in fatigue and with deterioration in cognitive performance.” However, dopamine also functions as the brain’s reward mechanism, and its subjective effect is often an increase in mood, short-term energy and feelings of positivity. As Veale explains, patients may be fatigued but they’ll also be feeling better in spite of their tiredness.

Another neurochemical that increases in the sleep-deprived brain, adenosine, has been shown to correlate with resilience to depression and its mind-numbing effects while also mediating the effects of an all-nighter, and it seems to be central to the action of other depression treatments, like ketamine. In fact, according to a paper by Benedetti, sleep deprivation affects “almost all the neurotransmitters targeted by antidepressant drugs.”

However, the precise mechanism of how sleep deprivation works for depressed people remains largely mysterious. Both Benedetti and Wirz-Justice note that similar confusion surrounds our understanding of most antidepressant meds. “Maybe you just have to shake up the neurotransmitters,” Wirz-Justice says an old mentor told her. Especially with something as fundamental to our biological and circadian rhythms as sleep, the idea of resetting the clock, so to speak, is a powerful one.

Yet it’s not something that’s caught the popular, or commercial, imagination, Veale says. The fact you can’t patent “not sleeping” might have something to do with it. “How do you do double-blind placebo-controlled trials for something like staying awake all night?” Wirz-Justice says. “Who pays for it? How do you calculate the costs? It’s so different from a pill.”

If I’d known a decade ago that there was clinical evidence for sleep deprivation, I’d have been less likely to dismiss my own experience as just a curiosity, and kept at it. Instead, for years I largely forgot about it—until my uncle emailed a link about Veale’s study, and I decided there might be something to it after all.

One night last week, around 2am, when my emails finally crossed the incoherency threshold, I flipped my Macbook closed and left the couch for bed. I woke before my 5 am alarm with the birds through the window, to hit the gym and beach as usual. By the time I was happily ensconced in the cafe with free refills of Ethiopian coffee, I felt more alert and in sync than I had all week.

Three days later and I’m still in the clear. I’ve felt consistently lucid, engaged, and energized. Last night, after a long Saturday in the Australian sun, I fell asleep at half past nine still in my tennis clothes. It’s not necessary, or possible, to stay up all night every night. Instead, it can act as a jump-start—after that, it’s over to me to channel and maintain my energy through exercise, people, and things that matter.

Like Veale, Wirz-Justice acknowledges the close link between circadian rhythms and the bipolar. “The switch into mania is nearly always accompanied by a lack of sleep, and with medically prescribed sleep deprivation you can switch someone out of depression. So it’s very deeply rooted with bipolarity.” I explained to her that I experience life itself as a fairly up-and-down affair, to which her response was tart: “Yes, well, I prefer the ups.”

Insomnia Series: 8 Weird Facts About Sleep Science Learned In 2019 Alone

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By JR Thorpe

Maybe it’s because 2018 was a hell of a year and we all want to spend most of 2019 in sweet, sweet slumber, but there was a lot of research published in January this year about sleep. Like, a lot of research. These new findings about sleep covered a lot of ground, from the neural patterns of the sleeping brain to the genetics of early risers and the tie between sleep and health — and it’s changing the way we think about rest. If you’ve always been curious about how sleep shapes our lives, this crop of research shows that it’s hugely influential in unprecedented ways.

Sleep involves many moving parts. There are the hormonal signals issued by your brain that indicate when you should fall asleep or wake up; the circadian rhythms of each cell in your body, which dictate your sleep-wake cycle over a 24-hour period; the four separate stages of sleep, including REM or rapid eye movement sleep, which occur multiple times over the course of a night’s slumber; and other factors, including genetics, stress and environment, that influence how your sleep actually progresses. It’s possible to examine sleep from many different angles — and, as these studies show, science is still learning a lot of mind-blowing things about our bodies and minds when we drop off to sleep every night. Here are eight brand-new facts about sleep.

1There’s A Single Gene Behind Our Need To Sleep When Sick

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Many of us experience an increased need for sleep when we’re sick, which makes sense; avoiding over-exertion while the body fights off infection or illness seems logical. Researchers from the University of Pennsylvania found a single gene behind the urge to sleep while sick in fruit flies. They published their findings in Science, and it’s a big deal; the gene itself, which they called nemuri (the Japanese word for sleep), is one of the most tangible bits of concrete proof that sleep and the immune system are biologically connected.

When the nemuri gene was removed from the fruit flies, they stopped feeling the need to sleep when ill — but when it acted normally, the fruit flies slept, and survived being sick in great numbers. If the same thing applies in humans, nemuri is what makes us sleep when we’re sick — and keeps us alive while our immune system fights off threats.

2If You Have Sleep Apnea, You Struggle To Recall Your Memories

Sleep apnea, the condition where breathing stops temporarily during sleep, is pretty common; the National Sleep Association has estimated that around 18 million American adults experience it. A new study revealed that having sleep apnea has an unexpected affect on the brain: it impacts autobiographical memory. The research, published in the Journal of the International Neuropsychological Society, focused onobstructive sleep apnea (OSA), the most common type of the condition, where breathing stops because airways become too narrow for air to pass through. And researchers found that people with OSA had difficulty recalling personal memories.

The people with OSA over-generalized their childhood memories, and while they remembered incidents and important events, were much less likely than people without OSA to remember details, like names or dates. The worse their memories, the more likely they were to have symptoms of depression. Good autobiographical memory is important for our mental health, and it seems that sleep apnea, and its impact on long-term memories, can seriously compromise mood.

3You *Can* Actually Learn Foreign Vocabulary In Your Sleep

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The idea of learning in your sleep has been around for ages, but new research in January showed that it’s more than a fable. It won’t exactly mean you wake up fluent, though. The study, by scientists at the University of Bern, found that learning new vocab in your sleep can depend on when it’s played to you.

In a deep sleep state, brain cells go through slow waves; they’re active for a brief time, then lull into inactivity. The Bern scientists played pairs of words — one actual German word, one nonsense word — to German-speaking people at various stages of sleep. If the pairs were repeated numerous times during an “up” state, when the brain was active, the people were more likely to match the words into pairs when they were awake. It’s a sign that the brain can sort and try and understand new words even while we’re asleep. Don’t rely on it instead of your Duolingo, though.

4We Still “Hear” During Some Parts Of Our Sleep Cycle

According to research published in Nature in January, sleeping people aren’t always as dead to the world as they appear. It turns out that, when we’re asleep, we still listen to the world around us with a small portion of our brains, keeping track of noises that might be relevant. “Sleepers enter a ‘standby mode’ in which they continue tracking relevant signals, finely balancing the need to stay inward for memory consolidation with the ability to rapidly awake when necessary,” explained the researchers.

They tested this by looking at the electrical brain signals of sleeping people while surrounded by various kinds of noises. When they weren’t in deep sleep, their brains ‘spiked’ whenever they heard noises that carried meaning, like familiar voices, while ignoring other noises. When they entered properly deep, non-dreaming sleep, though, the effects vanished. If you’re just dropping off to sleep or waking up up and think you’re ‘hearing’ what’s happening around you, you’re not wrong; your brain is still listening, to make sure you can wake up and deal with a threat if necessary.

5Losing Sleep Due To Stress Changes The Cells In Your Brain

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REM sleep is the period of sleep where we dream, and a January study in PNASreveals that stress directly impacts how much REM sleep we have. According to the research in mice, mild daily stress increases the mice’s amount of REM sleep before it impacts any other sleep stage. Abnormalities in REM sleep are closely tied to depression and mood disorders, so stress might be affecting mood via our sleep. That wasn’t the end of the story, though.

The researchers also found that when stress impacted REM sleep, the brain also physically changed its structure, particularly in the hippocampus. Various cells died, while others were grown — and that’s important, because the hippocampus is a big part of our response to stress and how we deal with it. It seems that in mice, increased REM sleep in response to stress also makes the brain change its shape, to deal with the stress it might encounter while it’s awake.

6Sleep Deprivation Increases Your Risk Of Alzheimer’s And Heart Issues

New science is constantly appearing about the impacts of sleep deprivation, and two new studies in January added to that picture. One, from the Washington School of Medicine, found that sleep deprivation in both mice and people increases the amount of a particular protein, tau, which is found in clumps in the brain of people with Alzheimer’s. The less sleep you get, the more your brain accumulates this protein that can make it vulnerable to long-term issues like Alzheimer’s.

The other study, from the American College of Cardiology, focussed on another area of human health: the heart. They tracked the sleep of over 3,000 Spanish adults and found that those who slept under six hours a night regularly were up to 27 percent more likely to have plaque build-up inside their arteries than those who got an average of eight or nine hours. Plaque build-up narrows the arteries, and is associated with cardiovascular issues and heart attacks.

7Your Neurons Do Different Things In Different Sleep Stages

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What happens in your brain when you sleep? Quite a lot, as it turns out. A study published in Nature found that when we sleep, our neurons fire in many different ways, differing according to our sleep stage and where in the brain they’re located. During REM sleep, the hippocampus neurons don’t fire very much, while those in the frontal cortex show a lot of activity. In non-REM sleep, meanwhile, neural firing – the amount of electrical activity — evened out in both areas, and the communication between neurons slowed down.

What does this mean? Well, understanding brain activity during sleep is a big deal, because our brains do a lot of work while we snooze. Sleep is crucial for the consolidation of our memories, cleans toxic substances out of our brains, and helps cells refresh themselves for the day ahead. It turns out that the neural cells in our brains are doing more complicated work than we thought — and that could help us understand how mechanisms like memory and learning during sleep actually work.

8There Are 351 Bits Of Genetics Associated With Being A Morning Person

Enjoy waking up at the crack of dawn? You’re an early bird — and research indicates that the tendency to wake and sleep early is largely determined by genetics. Research published in January gave us more evidence for that fact, by expanding the amount of genetic loci, or genes in specific locations on chromosomes, associated with early-bird tendencies. And they expanded it a lot — from 24 genetic loci to a whopping 351.

The research, published in Nature Communications, found that these 351 distinct genetic loci are all associated with circadian rhythms that naturally tend towards early-to-bed-early-to-rise sleeping. It was a very big study, using data from 85,760 people, and found that these genetic signals make a significant difference. The subjects with the most early-rise genetic loci woke up 25 minutes earlier, on average, than the people with the fewest loci. If you want to change your early-bird tendencies, this research shows, it might be harder than you think; it could be encoded in your genes.

Sleep is more complicated than it appears. As 2019 goes on, we’ll probably experience more wild and weird revelations about how it works — and may end the year with our minds totally blown. One thing’s universally true, though: sleep is greatand very useful for our health. Get more if you can.

Insomnia Series: Read This If You Wake Up During The Night And Can’t Fall Back Asleep

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It’s frustrating when you collapse into bed at night, only to conk out for a few hours before suddenly finding yourself wide awake and staring at your ceiling. (Or, even worse, listening to your partner snooze away on the other side of the bed.)

The phenomenon is hardly uncommon. A study published in the Journal of Psychiatric Research found that 35 percent of the general population deals with middle-of-the-night insomnia at least three nights a week, and 23 percent wake up at least once every night.

Curious how to halt the issue and get the zzzs you deserve? Below, sleep experts share why you might be waking up at night and some ways to stop it:

The problem: You bring stress into the sheets.

Even if you don’t actively feel stressed when it’s time to sleep, underlying stress may be the reason you’re waking up unprompted in the middle of the night.

To help with this, work on making your bedroom into a sleep sanctuary, said Rebecca Robbins, a postdoctoral fellow at the NYU School of Medicine and a consultant for mattress maker Beautyrest. This doesn’t mean you have to shell out a ton of cash on pricey décor, but you should make sure your bedroom is a place that promotes quiet, calm and darkness.

This might mean swapping shades for room-darkening blinds, or investing in a weighted blanket if you think it would be helpful to decompress at night (there’s little scientific evidence on the effectiveness of these, but many find them comforting regardless).

One thing to investigate is your mattress. A 2009 study published in the Journal of Chiropractic Medicine found that an old mattress can increase stress levels, as back pain and the poor sleep associated with it is linked to increased levels of cortisol (the hormone responsible for stress) in the body.

The Better Sleep Council, an advertising collaborative of mattress manufacturers, recommends replacing your mattress every seven years. An easy test for your pillow is to fold it in half, says the National Sleep Foundation, a sleep research and education nonprofit partly funded by sleep-industry companies. If it stays that way, it’s time for new ones.

As for a racing mind that’s keeping you awake? If it’s been more than 20 or 30 minutes, get out of bed and go to a different room. Otherwise, your brain will start to associate your mattress with being awake, according to Steve Orma, a clinical psychologist and author of Stop Worrying and Go to Sleep: How to Put Insomnia to Bed for GoodYou can also try writing down what’s worrying you as a way to dump out what’s floating around in your brain.

The problem: There’s too much noise or movement.

The stage of sleep you’re in ― whether it’s the rapid eye movement phase (a deep level of sleep) or one of the non-rapid eye movement periods (which can be a lighter stage of sleep) ― will determine how easily you wake up to sound in your bedroom.

Noises like snoring, a loud radiator, or traffic are all sounds that likely won’t affect you during REM sleep, but they can wake you up as you transition through the lighter NREM sleep stages, said Nate Watson, a scientific advisory board member at SleepScore Labs, which sells an array of sleep-related apps and products. Watson also is a former president of the American Academy of Sleep Medicine, a professional group.

When noise awakens you, there are a few things you can do to get back to sleep. Watson recommended a white noise machine, as consistent ambient noise will prevent spontaneous sounds such as snoring, coughing or old creaky pipes from stirring you awake. (A 2005 study published in Sleep Medicine corroborates this suggestion. It found when patients in an intensive care unit used a white noise machine, sleep disruptions caused by high-peak noises where reduced.)

If you sleep with a partner who tends to toss and turn, Watson said having separate mattresses side-by-side instead of one mattress can help prevent disturbances from too much movement. If you go this route, you can buy a foam mattress connector that will keep the bed together, still looking and essentially functioning as one bed.

The problem: You’re drinking too much before bed.

This includes both alcoholic and non-alcoholic drinks. A study published in Alcoholism: Clinical & Experimental Research found that while drinking booze before bed may cause some to fall asleep easier, it can lead to sleep disruptions later in the night, causing you to wake up and have difficulty getting back to sleep.

If you enjoy a glass of wine before bed, keep it to just that, Robbins said. And keep in mind that a standard serving of wine is four ounces, which may be much less than you typically pour yourself. As for fluids in general, try to cut them off 90 minutes before bed. It’ll help minimize your chances of waking up in the middle of the night to go to the bathroom, Robbins added.

The problem: You may have an underlying health issue.

Generally, it’s OK if you have occasional sleep disruption. “Everybody has a bad night’s sleep every now and then,” Watson said. “This is normal and doesn’t require treatment.”

Watson said over-the-counter remedies are fine for these instances, such as products with the ingredient diphenhydramine HCL, like ZzzQuil, or melatonin. Just make sure to monitor how frequently you’re using these. If you lean on them too often, you might have an underlying issue you need to get checked.

“When use of sleep aids becomes regular, it suggests a sleep disorder is present and you should see a health care provider to get to the root cause of the problem,” Watson said.

Talk to your doctor to rule out a condition like obstructive sleep apnea, restless leg syndrome or even something as simple as nighttime heartburn, Watson said.

 

Insomnia Series: 11 Bedtime Rituals Of The Healthiest People On Earth

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People who reside in longevity hotspots, like Costa Rica, Greece, and Japan, have consistently proven that whatever they’re doing works big-time. And the cultural secrets of those living in these so-called Blue Zones are secrets no more. Staying naturally active, living life with purpose, or simply drinking a glass of red wine every day—what’s not to like? Not all day-to-day activities are created equal, but according to Blue Zoners, an evening routine with healthy sleep habits is high on the list.

Blue Zone’s website says sleep is incredibly important for your overall health and well-being. To get 7 to 8 hours of quality rest every night like your BZ heroes, you can survey your pre-bedtime ritual for the following criteria.

The 11 healthy sleep habits for Blue Zone-approved slumber

1. You know your “snore score.”
2. You have to have a cozy mattress and pillows.
3. Your room is cooled to the proper temperature (65°F!).
4. You dim the lights an hour before bed.
5. No light disrupts your sleep (looking at you, digital alarm clocks)
6. You own light-blocking window shades or an eye mask
7. No electronics. That means your computer, TV, and cellphone should all be out of the room.
8. Your phone counts! Your phone’s not allowed!
9. You have a lavender plant or lavender essential oil next to your bed.
10. Your windows are double-paned or you’ve made other efforts to block noise from interrupting your REM.
11. You only use the bedroom for sleep and sex.

Pssst, you can also see how your sleep hygiene stacks up with an online quiz. Depending on your score, you’ll see what it’ll take to start transforming your routine for the better. Even by making some small changes to your healthy sleep habits, you’ll be sleeping like a baby again—and you’ll be feeling like a new person because of it.