Stress and Sleep Disorders.pdf

Thursday, March 21, 2024 Stress and Sleep Disorders Sleep While you sleep you cycle through four different stages of sleep; 1. NREM (Non-Rapid Eye Movement) Stage 1 2. NREM Stage 2 3. NREM Stage 3 4. REM Sleep (Rapid Eye Movement) - In a full night’s sleep we experience about six sleep cycles, each...

Thursday, March 21, 2024 Stress and Sleep Disorders Sleep While you sleep you cycle through four different stages of sleep; 1. NREM (Non-Rapid Eye Movement) Stage 1 2. NREM Stage 2 3. NREM Stage 3 4. REM Sleep (Rapid Eye Movement) - In a full night’s sleep we experience about six sleep cycles, each lasting around 90 minutes - Adults should get ~7-8h of sleep (but on average get ~5-6h) SLEEP STAGES: NREM STAGE 1 - Occurs when you first fall asleep; half asleep/half awake Lasts for around 10 minutes (5%) Very easy to be woken up when in Stage 1 of sleep In this stage brain activity goes from Alpha waves to Theta waves SLEEP STAGES: NREM STAGE 2 - Lasts for about 30 to 60 minutes Accounts for 50% of total sleep time Harder to be woken up from in this stage of sleep May begin to see Delta waves in this stage SLEEP STAGES: NREM STAGE 3 - Deep sleep stage - Hardest stage to wake up from - Lasts for about 20 to 30 minutes during the rst cycle of sleep and then less and less in each - cycle Accounts for about 20% of total sleep time RAPID EYE MOVEMENT SLEEP (REM SLEEP) - REM sleep is the final stage in a sleep cycle - During this stage your heart rate, breathing, and blood pressure all fluctuate, your eyes move - rapidly, and your muscles twitch A fast pattern of brain waves can be observed Dreaming occurs Most muscles are paralyzed during this stage so that you can’t act out your dreams During the rst sleep cycle REM sleep may only last a few minutes but during the last cycle of sleep it can last up to an hour Accounts for 25% of total sleep time fi fi 1 Thursday, March 21, 2024 CIRCADIAN RHYTHMS Circadian rhythm: Your circadian rhythm is almost like a biological clock that helps control many aspects of your body including your sleep/wake cycle. It controls the timing of sleep-wake patterns and the duration of sleep If body temperature doesn’t drop = risk for heart disease Affected by: - jet lag - Daylight savings - Shift work Takes days to adjust SLEEP THEORIES: WHY DO WE SLEEP? Restoration - The proper functioning of our immune system is dependent upon sleep - Sleep restores the body Without sleep = collapse Ontogenesis - REM sleep allows for the development of brain through preventing apoptosis in the developing brain The more REM sleep = less brain cell death - REM sleep helps with brain maturation through neural activity in the developing brain Learning and Memory - Many studies have shown that sleep affects memory, mainly that sleep deprivation hinders working memory 2 Thursday, March 21, 2024 Sleep Disorders Sleep disorders are divided into 3 categories 1. Dyssomnias 2. Parasomnias 3. Sleep Disorders Associated with Mental, Neurologic, or Other Medical Disorders DYSSOMNIAS Dyssomnias: the disorders that produce either difficulty initiating or maintaining sleep or excessive sleepiness - This section is divided into three groups of disorders: 1. intrinsic sleep disorders 2. extrinsic sleep disorders 3. circadian rhythm sleep disorders Related to stress PARASOMNIAS Parasomnias: the disorders that intrude into the sleep process and are not primarily disorders of sleep and wake states per se - They’re manifestations of central nervous system activation. This section is divided into 3 subgroups: 1. Arousal Disorders 2. Sleep-Wake Transition Disorders 3. Parasomnias Usually Associated with REM Sleep 4. Other Parasomnias Not affected by stress , related to nervous system INSOMNIA 3 Mild Insomnia Moderate Insomnia Severe Insomnia Insufficient sleep and not feeling rested Almost Nightly Nightly Nightly Social / Occupational Impairment Very Little or None Mild to Moderate Severe Restless, Irritable, Daytime Fatigue Sometimes Always Severe Thursday, March 21, 2024 ***Psychophysiologic Insomnia Physiological/psychological arousal preventing sleep - stress and worry about being able to go to sleep inhibits sleep from occurring - Sleep is now associated with stress - Bed is now associated with place where you cannot relax - No phone, no tv HYPERSOMNIA - Characterized by periods of extreme somnolence; 18 to 20 hours a day - Can last several days to several weeks - More common in males than females BRUXISM - Grinding and clenching teeth while sleeping - Results in tooth wear, jaw pain, headaches, and complaints from co-sleepers - 5% of population grind their teeth Related to stress SLEEP ENURESIS - Also know as “Bed-Wetting” - Must be persistent after the age of 5 - Very rare in adults Bidirectional Relationship of Stress & Sleep - HPA axis regulation and changes in sleep have a bidirectional relationship. - Daytime stress leads to poor sleep, which can lead to increased daytime stress. - This cycle can create a downward spiral Study — Bidirectional Relationship of Stress & Sleep Stress and sleep problems can interact in contributing to illness Allostatic load: measure of the capacity of our body; how much the body can handle When body capacity is lower due to stress, it becomes easier to get sick 4 Thursday, March 21, 2024 Study — HPA Axis & Sleep Increased corticosterone and ACTH following sleep deprivation Study by Capaldi et al. (2005) predicted that sleep problems would lead to higher cortisol levels in response to a stressor. ✓ Results: daytime sleepiness and sleep-wake problems related to a decrease in cortisol reactivity to stress STRESS & SLEEP - Research confirms our subjective experience that stressful daytime events affect our sleep - Independent from depression - Impacts on sleep physiology Study — stress & sleep Participants watched a film with disturbing content prior to going to bed ✓ Pre-sleep emotion was linked to REM-density and duration as well as arousals that interrupted sleep Participants told they would be evaluated on a public speech the following morning ✓ Increase in REM density. Study — Job Stress & Insomnia High-strain work ! poor sleep quality Study — Marital Stress & Sleep Problems Sleep is facilitated by feelings of safety. Trust and security in sleep partner leads to better sleep. Hypothesis: If sleep partner provokes anxiety, sleep will be worse. Results: Psychological abuse at time 1 predicted more sleep problems at time 3. STRESS & HYPERSOMNIA Usually hypersomnia is comorbid with symptoms of depression ✓ Found a relationship between hypersomnia and extreme physical stress in soldiers ✓ Brain might try to shut itself off STRESS & BRUXISM Self-reported bruxism sufferers reported more stress symptoms than those who do not suffer from bruxism ✓ Increased negative coping strategies related to bruxism ✓ Bruxers have a deficit in positive coping strategies ✓ Only anticipated stress was significantly related to bruxism ✓ Stress that already happened and was resolved may lead to better sleep 5 Thursday, March 21, 2024 STRESS & NOCTURNAL ENURESIS - Stress has not been shown to contribute to primary nocturnal enuresis (PNE) in children. - For those for those who have tentatively recovered from PNE, stress can cause a return to bedwetting ✓ Experimentally induced emotional stress lead to bladder contractions in children with psychogenic, but not organic, nocturnal enuresis ✓ Similar to adults: most likely results in going to the bathroom during the night ✓ Nocturnal enuresis was one of the reactions observed following a traumatic lightning strike Personality & Sleep Problems - Personality may mediate the relationship between stress and sleep - Neuroticism (N) is the personality trait which most closely resembles the construct of anxiety - High neuroticism is linked with: poor coping with stress poor sleep more daytime sensitivity to poor sleep Study — Personality & Sleep Problems Hypotheses: Daily hassles would mediate relationship between personality and sleep C would mediate the consequences of N and bad sleep, with high-N, low-C individuals being most sensitive to effects of bad sleep Results: ✓ N predicted bad sleep and C predicted better sleep, especially on measures of sleep latency, sleep disturbances, and daytime dysfunction ✓ Relationship between N, C, and sleep was mediated by daily hassles ✓ High-N, low-C individuals with bad sleep reported more social and academic problems RUMINATION & SLEEP Rumination: Continuously thinking about problems that have occurred - Similar to worry Worry is known to have a negative impact on sleep Study — Rumination & Sleep Hypothesis: High-trait ruminators in rumination condition would report poor sleep quality Results: ✓ No difference in distraction condition ✓ High trait ruminators in rumination condition reported more sleep disturbances ✓ Low-trait ruminators did not differ between conditions. Cognitive pre-sleep activity may increase arousal levels 6