Sleep problems send psychiatric signals.Sleep problems send psychiatric signals
Persistent sleep disturbances such as insomnia and excessive sleepiness have long served as cardinal symptoms of severe depression. But these sleep problems may also provide an early warning that a full-blown depression or an anxiety disorder anxiety disorder
Any of various psychiatric disorders in which anxiety is either the primary disturbance or is the result of confronting a feared situation or object. is brewing, according to a new epidemiologic study epidemiologic study A study that compares 2 groups of people who are alike except for one factor, such as exposure to a chemical or the presence of a health effect; the investigators try to determine if any factor is associated with the health effect .
Primary care physicians who quickly recognize and treat sleep disturbances may help prevent the development of depression and other psychiatric problems, say Daniel E. Ford of Johns Hopkins Hospital
Interviewers asked a total of 10,534 people, representing part of a random national sample gathered by the National Institute of Mental Health The National Institute of Mental Health (NIMH) is part of the federal government of the United States and the largest research organization in the world specializing in mental illness. for a study of psychiatric disorders, whether they had trouble falling asleep or had slept too much over a period of at least two weeks during the prior six months. Interviewers also inquired about symptoms of psychiatric disturbances. They conducted follow-up sessions one year later with 7,954 study participants.
Overall, one in 10 persons reported insomnia and about one in 35 reported excessive sleepiness (hypersomnia) at the first interview. Women, the unemployed, low-income individuals and those widowed or separated from a spouse reported the most insomnia. Subjects who were unemployed, younger than 24 or never married had higher rates of hypersomnia.
About half of those initially reporting insomnia and two-thirds of those with hypersomnia had a psychiatric disorder at that time or one year later, compared with approximately one-quarter of those without a sleep complaint, Ford and Kamerow report in the Sept. 15 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. .
The most important finding, the researchers maintain, is that subjects reporting insomnia or hypersomnia at both interviews had significantly higher rates of new cases of both severe depression and anxiety disorders at the follow-up, compared with people whose sleep problems cleared up after one year and those with no sleep complaints.
The relationship of sleep problems to anxiety disorders, which include panic disorder, obsessive compulsive disorder Obsessive compulsive disorder (OCD)
Disorder characterized by persistent, intrusive, and senseless thoughts (obsessions) or compulsions to perform repetitive behaviors that interfere with normal functioning.
Mentioned in: Tourette Syndrome and phobias Phobias Definition
A phobia is an intense but unrealistic fear that can interfere with the ability to socialize, work, or go about everyday life, brought on by an object, event or situation. , is not clear, the investigators note. The official manual of psychiatric diagnoses does not cite sleep disturbance as a symptom of those particular anxiety disorders.
Sleep disturbance may link most strongly to anxiety disorders among young adults, whereas a link to depression and bereavement Bereavement Definition
Bereavement refers to the period of mourning and grief following the death of a beloved person or animal. The English word bereavement appears more likely among older individuals, writes psychiatrist Charles F. Reynolds III of the University of Pittsburgh School of Medicine The University of Pittsburgh School of Medicine is the medical school of the University of Pittsburgh, located in Pittsburgh, PA.
As of 2007, the University of Pittsburgh School of Medicine consists of 589 medical students - 53% men and 47% women. in an accompanying editorial. Further epidemiologic work is needed to address this question, he says.
Nevertheless, routine inquiry about sleep disturbances would probably lead to greater recognition of depression and anxiety disorders by primary care physicians, Ford and Kamerow conclude.
Insomnia can result from numerous factors other than a psychiatric disturbance, Reynolds adds. Behavior changes, such as setting a regular wakeup time and limiting time in bed to six or seven hours nightly, show promise as early treatments for insomnia, he says.