Insufficient sleep has been linked to aggression, bullying, and behavior problems in children across a range of ages. A similar relationship between a lack of sleep and violence has been observed in adult prison populations; places that, I should add, are woefully poor at enabling good sleep that could reduce aggression, violence, psychiatric disturbance, and suicide, which, beyond the humanitarian concern, increases costs to the taxpayer.
Equally problematic issues arise from extreme swings in positive mood, through the consequences are different. Hypersensitivity to pleasurable experiences can lead to sensation-seeking, risk-taking and addition. Sleep disturbance is a recognized hallmark associated with addictive substance use. Insufficient sleep also determines relapse rates in numerous addiction disorders, associated with reward cravings that are unmetered, lacking control from the rational head office of the brain’s prefrontal cortex.
Psychiatry has long been aware of the coincidence between sleep disturbance and mental illness. However, a prevailing view in psychiatry has been that mental disorders cause sleep disruption – a one-way street of influence. Instead, we have demonstrated that otherwise healthy people can experience a neurological pattern of brain activity similar to that observed in many of these psychiatric conditions simply by having their sleep disrupted or blocked. In deed many of the brain regions commonly impacted by psychiatric mood disorders are the same regions that are involved in sleep regulation and impacted by sleep loss. Further, many of the genes that show abnormalities in psychiatric illnesses are the same genes that help control sleep and our circadian rhythms.
Preliminary but compelling evidence is beginning to support this claim (sleep and psychiatric disorders are 2-way street of interaction). One example, bipolar disorder. A research team in Italy examined bipolar patients during the time when they were stable, inter-episode phase. Next, under careful clinical supervision, they sleep-deprived these individuals for one night. Almost immediately, a proportion of the individuals either spiraled into a manic episode or became seriously depressed. The result supports a mechanism in which sleep disruption – which almost always precedes the shift from a stable to unstable manic or depressive state in bipolar patients – may well be a (THE) trigger in the disorder, and not simply epiphenomenal.
Thankfully, the opposite is also true. Should you improve sleep quality in patients suffering from several psychiatric conditions using a technical we will discuss later, called cognitive behavioral therapy for insomnia (CBT-I), you can improve symptom severity and remission rates.
