Tag Archives: Insomnia

Poor sleep? It could be affecting your negative thoughts

Ever heard of cognitive reappraisal? It’s where you take a negative thought or experience and recast it in a positive light. (Failed a test? At first maybe you dwell on your shortcomings, but then you “reappraise” and think of it as a chance to see where you can improve.)

A new study shows people with sleep problems have a harder time doing that than do their well-rested counterparts.

All participants in the study had a depression and/or anxiety disorder, which already puts them at a disadvantage for seeing the positive side of things. Researchers wanted to see if lack of sleep made that worse.

First, the scientists gave participants sleep trackers. After measuring how well they slept for six nights, they hooked the subjects up to an MRI and watched brain activity while the participants completed an emotional regulation task: They had to look at disturbing images and reappraise them in a more positive light. (For example, a subject might look at a picture of a battered woman and imagine her as a model wearing make-up instead of as a victim of violence.)

The region of the brain known to be involved in regulating emotions is called the dorsal anterior cingulate cortex (DACC), and it springs into action when you’re engaging in cognitive reappraisal.

Here’s what the scientists found: During the reappraisal task, people who had sleep problems had more activity in the DACC than did people who slept well. Researchers interpreted those findings to mean the sleep-deprived brains had to work harder to come up with a positive spin on images.

If you’re depressed or anxious, let’s talk about your sleep. If we can get you sleeping better, you could find it easier to see the world in a more positive way.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Alcohol intake effects sleep

There is an interesting article in the May 17th issue of The Journal of Alcohol and Alcoholism related to alcohol intake and its effect on sleep. The research showed that even small amounts of alcohol can alter the quality and amount of sleep a person gets per night.

This article is particularly relevant to those who are struggling with a mental illness who often have sleep difficulty. It is not a good idea to try to remedy that sleep issue with alcohol usage. Alcohol may initially cause a person to fall asleep but when that person’s blood alcohol drops that person becomes more and more alert. Alcohol is known to interfere with the brain’s sleep architecture. Some of the worst sleepers I’ve seen in my practice are people who have been drinking alcohol heavily for years. This research on even small amounts of alcohol causing problems is sobering. No pun intended!

So you might want to think twice before reaching for that night cap!

Insomnia: Who should I see for help?

When I see patients in my office I would say that 75% have as a major complaint of insomnia or having difficulty going to sleep and/or staying asleep. Many times the problem has been going on for years. How does one know who to see about their insomnia? The general practitioner? The Sleep Specialist? The Mental Health Specialist?

Questions to ask yourself: How long have you had this problem? If it’s only been a few days or weeks then I would say it would be ok to see your general practitioner or mental health practitioner. Both have the knowledge to help you get to sleep. If you say all your life or since I put on a lot of weight, that is work for the specialist. There could be a mental health disorder or a physical structural disorder that is causing a disorder called “Sleep Apnea.” This is a condition where a person stops breathing in the middle of the night sometimes thousands of times resulting in a restless or inadequate sleep. A major symptom of this is if a person snores loudly and a sleep partner observes the person actually stopping breathing for seconds at a time. Another major symptom is extreme fatigue during the day.

In the mental health category, if a person has been experiencing anxiety or depression and he/she is having trouble sleeping then a mental health evaluation may be appropriate.

Major Depression, General Anxiety Disorder, PTSD and Bipolar Disorder are all conditions that interfere with sleep. These are treated in different ways. In my practice I teach my patients “Sleep Hygiene.” This is a program to help the body cue itself that it is time for sleep. We often lose that cue with bad habits and lack of routine over time.

What kind of medications are the best for insomnia? I always start with the mildest remedies that are not addictive. Melatonin and antihistamines top my list. Second tier would include medications in the antidepressant class such as Trazadone. One does not
have to be depressed to use Trazadone. It is very effective. Third tier would be other antidepressants and mood stabilizers according to what are the diagnoses. I totally avoid the Benzodiazepine class. Benzodiazepines are only meant for the occasional sleep problem. If one has issues with addictions of any kind, or has it in their family, then I would recommend avoiding this class altogether.  The problem is Benzos can cause addictions but also can cause Depression when used long-term.