David A. Wright, MD, MBA, MHSA, GCP, CRT, PHRP, CSM, CSM, CHRM
Board Certified Hypnotherapist, Board Certified NLP Practitioner
You don't have to be a Scientist or a Physician to understand that our world has been changing rapidly over the past couple thousand years. And, You don't have to be a Historian to realize that it's been "REALLY" Changing over the past 100 Years. Furthermore, You don't have to be a Psychiatrist, a Psychologist, a Sociologist, or an Anthropologist to understand how much our society has changed over the past several decades… However, You might want to consult one in order to understand "WHY" it is that you've been having problems either falling or staying asleep. Specifically, you might want to consult a Psychiatrist, a Psychologist, or a Hypnotherapist to find out "HOW" you can start getting to sleep much easier. Insomnia, the clinical term for difficulties falling &/or staying asleep, has been a silent epidemic in America for the past few decades. And, it's Only Getting WORSE.
Sleep is "CENTRAL" to the Human Experience. Sleep is "CENTRAL" to Mental Health and Wellness. Sleep is "ESSENTIAL" to Health Living, Clear Thinking, and Daily Success‼! There's no way around it… Often times our society focuses on the WHY? While the "WHY" of things is important, the "HOW" of things often times offers up better solutions. So, in discussing Sleep, Mental Health, & Insomnia, I'm going to explore BOTH the "WHY" and the "HOW." Of course, we'll also explore the "What's."
First, let's talk about "WHY" Sleep is important.
Why is sleep important? According to the US Department of Health & Human Services, An estimated 35% of U.S. adults report less than seven hours of sleep during a typical 24-hour period. Sleep and wakefulness disorders affect an estimated 15-20% of US adults who are more likely to suffer from chronic disorders including depression, substance abuse, hypertension, diabetes, cancer, stroke, and all-cause mortality. Resilience to stress, emotional regulation, and inter-personal relationships are impaired by sleep deficiency. Recent findings suggest that investing in sleep health contributes to maintaining brain health, and ultimately protecting cognitive functions necessary for aging-in-place. (HHS, 2014)
The American Psychological Association suggests that at least 40 million Americans suffer from over 70 different sleep disorders and 60 percent of adults report having sleep problems a few nights a week or more. Most of those with these problems go undiagnosed and untreated. (American Psychological Association, 2016)
Clearly, problems with sleep lead to problems in other areas. But, Why specifically do sleeps problems lead to problems with other bodily functions and processes? The reason is that hundreds of hormones, metabolic substances, and biochemical pathways participants are either produced during, affected by, or have an effect on the sleep cycle. They include the following: Melatonin, Serotonin [5HTP], Human Growth Hormone [Growth Hormone][GH], Norepinephrine [NE], Adenosine, Leptin, Ghrelin, Glucose Metabolism [Diabetes], Cortisol, Etc. These pathways, substances, hormones and chemicals help regulate processes ranging from the metabolism of sugars (Growth Hormone) to the processing of body fat (Leptin) to the maintenance of attention and a positive outlook & our responses to stress (Serotonin, Cortisol, NE).
What are Some of the Brain Chemicals involved in Sleep?
- Serotonin is a chemical that affects mood, emotion, sleep and appetite. Many antidepressants affect the amount of serotonin in the brain, and can also affect a person’s sleep.
- Norepinephrine is another brain chemical that affects stress response, heart rate, blood pressure, breathing and metabolism. Antidepressants may also work on the activity and levels of norepinephrine.
- Adenosine is a chemical that builds up in the blood when a person is awake and causes drowsiness. Adenosine is formed when the larger compound, adenosine triphosphate (ATP) breaks down and releases energy. Caffeine blocks the action of adenosine and keeps a person awake. Studies for future sleep medications focus on ways to affect a person’s adenosine levels. Adenosine also affects the heart and circulatory system.
(Depression and Bipolar Support Alliance, 2016)
Scientists have explored the question of why we sleep from many different angles. Despite decades of research and many discoveries about other aspects of sleep, the question of why we sleep has been difficult to answer. There are 4 prominent sets of theories about why we sleep: (1) Inactivity Theory (2) Energy Conservation Theory (3) Restorative Theory(ies) (4) Brain Plasticity Theory.
(Harvard Medical School, 2007)
The Inactivity Theory suggests that we need periods of conscious inactivity so that unconscious processes can take center stage and to allow more active areas a period of rest. The Energy Conservation Theory suggests that sleeps helps us to conserve energy for the activities associated with daily work. The Restorative Theories suggest that sleep allows the body and the brain to complete repair and maintenance activities. Finally, The Brain Plasticity Theory suggests that during sleep the brain processes, consolidates, organizes, and stores information that we have acquired during the day so that it can be integrated into the brain's existing neural networks and fabrics in order to facilitate learning, adaptation, growth, and evolution…
So, What role does each state and stage of sleep play? There are roughly 5 stages of sleep, ranging from light sleep (Stage 1) to Deep Sleep (REM). According to the National Sleep Foundation (2016), Most tissue repair and regenerative processes occur during Stages 3 & 4 of sleep, while most brain consolidation and reorganization processes occur during REM sleep.
(The National Sleep Foundation, 2016)
So, What are Circadian Rhythms?
Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism's environment. The study of circadian rhythms is called chronobiology. Are circadian rhythms the same thing as biological clocks? No, but they are related. Our biological clocks drive our circadian rhythms. What are biological clocks? The biological clocks that control circadian rhythms are groupings of interacting molecules in cells throughout the body. A "master clock" in the brain coordinates all the body clocks so that they are in synch. What is the master clock? The "master clock" that controls circadian rhythms consists of a group of nerve cells in the brain called the suprachiasmatic nucleus, or SCN. The SCN contains about 20,000 nerve cells and is located in the hypothalamus, an area of the brain just above where the optic nerves from the eyes cross. Circadian rhythms are produced by natural factors within the body, but they are also affected by signals from the environment. Light is the main cue influencing circadian rhythms, turning on or turning off genes that control an organism's internal clocks. Circadian rhythms can influence sleep-wake cycles, hormone release, body temperature and other important bodily functions.
(National Institute of General Medical Sciences, 2016)
So, What are the Long-term Health Impacts of Sleep Disorders?
Some people might say that it’s a fair trade-off to skimp on sleep now and then, saying that a day or two of tiredness and crankiness is worth the extra time they earned. But while returning to a regular sleeping pattern can restore the negative short-term effects of one night of poor sleep, the long-term consequences of regular sleep deprivation that arise under the surface are much more dangerous. Long-term effects of poor sleep include:
- Heightened risk factor for Type III Diabetes
- Increased risk for Breast Cancer
- High Blood Pressure [Hypertension]
- Decreased Immune Function [Immunosuppression]
- Major Depression
(Taking Charge Of Your Health & Wellbeing, 2016)
HOW do Sleep Issues affect Mental Health & Wellness?
More than 70 types of sleep disorders exist. The most common problems are insomnia (difficulty falling or staying asleep), obstructive sleep apnea (disordered breathing that causes multiple awakenings), various movement syndromes (unpleasant sensations that prompt night fidgeting), and narcolepsy (extreme sleepiness or falling asleep suddenly during the day). Type of sleep disorder, prevalence, and impact vary by psychiatric diagnosis. But the overlap between sleep disorders and various psychiatric problems is so great that researchers have long suspected both types of problems may have common biological roots.
- Depression. Studies using different methods and populations estimate that 65% to 90% of adult patients with major depression, and about 90% of children with this disorder, experience some kind of sleep problem. Most patients with depression have insomnia, but about one in five suffer from obstructive sleep apnea. Sleep problems also increase the risk of developing depression. Sleep problems affect outcomes for patients with depression.
- Bipolar disorder. Studies in different populations report that 69% to 99% of patients experience insomnia or report less need for sleep during a manic episode of bipolar disorder. Longitudinal studies suggest that insomnia and other sleep problems worsen before an episode of mania or bipolar depression, and lack of sleep can trigger mania. Sleep problems also adversely affect mood and contribute to relapse.
- Anxiety disorders. Sleep problems affect more than 50% of adult patients with generalized anxiety disorder, are common in those with post-traumatic stress disorder (PTSD), and may occur in panic disorder, obsessive-compulsive disorder, and phobias. They are also common in children and adolescents. One sleep laboratory study found that youngsters with an anxiety disorder took longer to fall asleep, and slept less deeply, when compared with a control group of healthy children. Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression. But insomnia can worsen the symptoms of anxiety disorders or prevent recovery. Sleep disruptions in PTSD, for example, may contribute to a retention of negative emotional memories and prevent patients from benefiting from fear-extinguishing therapies.
- ADHD. Various sleep problems affect 25% to 50% of children with ADHD. Typical problems include difficulty falling asleep, shorter sleep duration, and restless slumber. The symptoms of ADHD and sleeping difficulties overlap so much it may be difficult to tease them apart. Sleep-disordered breathing affects up to 25% of children with ADHD, and restless legs syndrome or periodic limb movement disorder, which also disrupt sleep, combined affect up to 36%. And children with these sleeping disorders may become hyperactive, inattentive, and emotionally unstable — even when they do not meet the diagnostic criteria for ADHD.
(Harvard Health Publications, 2009)
So, How Much Sleep do we Need?
- Babies: 16 hours per day
- Children: 9-16 hours per day
- Teenagers: 9 hours per day
- Adults: most need 7-8 hours, but some may need as few as 5 or as many as 10
- Pregnant women may need more sleep than usual
- Older adults may sleep for shorter periods of time, more often.
(Depression and Bipolar Support Alliance, 2016)
HOW Do you know IF you have a Sleep Dilemma? You might have a sleep problem IF:
- You consistently don’t get enough sleep or have poor quality sleep
- You wake up feeling like you didn’t get enough rest
- You have trouble staying awake while driving or working
- You struggle to stay awake while inactive, such as sitting reading or watching TV
- You yawn or blink frequently
- You have difficulty paying attention or concentrating
- You have disconnected thoughts or frequent daydreams
- You have performance problems at work or school
- You are told by others that you look tired
- You have memory problems
- You have a slow reaction time
- You have mood swings
- You need naps often
- You start dreaming right away when you fall asleep
(Depression and Bipolar Support Alliance, 2016)
HOW do you fix your Sleep Problems?
- Stop using all technology about 30 minutes to an hour before bed- no cell phone- no lap top- no kindle. A 30 min wind down with relaxation and reading (a paper book) can make it easier to fall asleep. Relaxation & Meditation excercises also help because the can tap into brain waves that help induce sleep states. (CampusMindWorks, 2016)
- Turn Off Internet Routers and Wireless Networks.
- Stop using caffeine products and other stimulants after 1PM.
- Sleep only an hour longer during the weekend than your latest weekday wake-up time.
- Try natural remedies like milk, sleep inducing herbal teas, and all-natural sleep aids like Somnapure, Calms Forte, Valerian Root, or Melatonin.
- Create and Maintain a Consistent Sleep Routine.
- Schedule an Appointment with a Hypnotherapist, a Psychiatrist (an MD), a Naturopathic Physician (an ND), or a Psychologist (a PsyD or PhD).
Conclusions & Take Home Points:
The foods that we eat, the personal and professionals stressors that we endure, the ways that we live, and the technologies that we use all help contribute to our inablities to initiate sleep, maintain sleep, and obtain the appropriate quality & quantity of sleep. We all have a combination of variables and factors that contribute to our sleep dilemmas. Most importantly, sleep dilemmas can become chronic, they can lead to a host of other health problems, and they ultimately lower our quality (and, perhaps our quantity) of life. If you begin to have sleep problems, then try conservative measures. If conservative measures fail or if you have had longstanding sleep problems, then schedule an appointment with a trained professional. Specifically, I use Hynotherapy to help patients to obtain healthy, normal sleep. Hypnotherapy allows me help remove the worrying feelings, anxious thoughts, and troublesome emotions that prevent and contribute to states that prevent rest, relaxation, and sleep. This tends to lead to significant levels of improvement in other areas of their life. Life is too short to lose sleep over, both figuratively and literally…
Dr. Wright is the CEO and Medical Director of Medical Legal Consultants of Greater Atlanta. MLC of Greater Atlanta specializes in helping patients who have been diagnosed with the following disorders and conditions, among others: Anxiety Disorders, Obsessive Compulsive Disorder, Sleep Disorders, Panic Disorders, Phobias, Mood Disorders, Mild to Moderate Depression, ADD/ADHD, PTSD, Borderline Personality Disorder, Dyslexia, Dissociative Identity Disorder, Personality Disorders, Learning Disabilities, and Childhood and Adolescent Behavioral Issues. MLC of Greater Atlanta also specializes in helping patients who desire to lose weight, quit smoking, and make permanent, long-lasting positive life changes. Finally, MLC of Greater Atlanta provides executive, business, personal, and life coaching to professionals and individuals who truly desire to significantly improve in one or more life areas. MLC of Greater Atlanta also offers weeknight and weekend appointments.
Dr. Wright is a Physician, a Board Certified Hypnotherapist, & a Board Certified NLP Practitioner who specializes in Non-Pharmacologic, Psychoanalytic Methods of helping patients to achieve positive changes and breakthroughs. Dr. Wright is presently accepting new patients, and he offers all prospective patients a free initial consultation. Dr. Wright believes that the Best Method of helping patients to achieve their goals is by gaining access to the Subconscious [Unconscious] Mind. It is there that the answers to lasting change reside. If working with the Conscious Mind (which is what most modern talk therapies employ) were the Best Method of Achieving Change, then more people would already be living the lives they've consistently desired…
Medical Legal Consultants (MLC) of Greater Atlanta, LLC
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