Sleep is an important biologic mechanism that is important for daily healthy functioning. It is a behavior found throughout the animal kingdom and it occupies approximately a third of our lives. The preservation of this vulnerable state attests to its importance, yet we still do not fully understand its functions and mechanisms. Anyone who has experienced a sleep disorder will confirm the importance of good sleep to health and quality of life. This is particularly true in mental healthcare, where sleep disorders are significant concerns for many patients.
How Sleep Affects Mental Health
Every 90 minutes, a normal sleeper cycles between two major categories of sleep, quiet sleep, and rapid eye movement (REM) sleep. A person progresses through four stages of increasingly deep sleep during quiet sleep. Body temperature drops, muscles relax, and heart rate and breathing slow. There are physiological changes that help boost immune system functioning in the deepest stage of quiet sleep. While REM sleep is the period when people dream. REM sleep enhances learning and memory, and contributes to emotional health. Scientists have reported that sleep disorders affect levels of stress hormones, neurotransmitters and wreak havoc in the brain, impairing thinking and emotional regulation.
Common Sleep Disorders
Sleep disorders are common clinical problems encountered in medicine and psychiatry. Inadequate sleep can notably impair a patient’s quality of life. Sleep disorders are characterized by abnormal sleep patterns that affect physical, mental, and emotional functioning. Stress or anxiety can cause a serious night without sleep and a variety of other problems. Sleep disorders may be primary or may result from a variety of psychiatric and medical conditions. Primary sleep disorders result from an endogenous disturbance in sleep-wake generating or timing mechanisms, often affected by behavioral conditioning. They may be divided into two categories, parasomnias, and dyssomnias.
These are unusual experiences that occur during sleep. They include sleep terror disorder and sleepwalking and nightmare disorder which occur during REM sleep.
Dyssomnias are characterized by abnormalities in the amount, quality, or timing of sleep. They include primary insomnia and hypersomnia, narcolepsy, breathing-related sleep disorder, and circadian rhythm sleep disorder. Insomnia is the clinical term for people who have trouble falling asleep, difficulty staying asleep, waking too early, or waking up feeling unrefreshed.
Treatment of Sleep Disorders
Treatment options include cognitive-behavior therapy (CBT) and sleep medicine. CBT teaches how to identify and modify behaviors that perpetuate sleeping problems. Examples of this therapy include relaxation therapy and biofeedback (using medical monitoring instruments to help patients learn to relax by controlling their vital signs). CBT, typically provided by an experienced psychologist, is a structured and focused treatment for insomnia. A variety of behavioral strategies are used to correct harmful or negative thought patterns and behaviors that can worsen insomnia. This type of therapy is not only effective, but its benefits outlast those of conventional medications. Novel medications that target orexin are now being used as alternatives to more conventional agents.
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