Find out why th­ese con­di­tions are of­ten linked

Great Health Guide - - CONTENTS - Dr Tammra Warby

Have you ever wit­nessed the down­ward spi­ral of an over­tired child from seem­ingly happy and alert to sud­denly cranky? You may be aware of how a cou­ple of nights of poor sleep af­fects your mood. Per­haps you be­come snappy and feel like just drag­ging your­self around. Tem­po­rary bad moods can im­prove after a good night’s sleep, but what are the links be­tween in­som­nia and the com­mon­est mood dis­or­der, de­pres­sion? Past stud­ies have var­i­ously ex­plored in­som­nia as part of de­pres­sion, in­som­nia as a cause of de­pres­sion and de­pres­sion as a cause of in­som­nia. So, which comes first the chicken or the egg? It’s com­pli­cated. The an­swer is ei­ther one. Some­times they come to­gether. How­ever, they are de­fined as sep­a­rate dis­or­ders. Al­though in­som­nia can be part of de­pres­sion, de­pres­sion is char­ac­terised by per­sis­tent low mood, feel­ings of hope­less­ness and loss of en­joy­ment af­fect­ing all parts of a per­son’s life. Chronic in­som­nia does seem to in­crease vul­ner­a­bil­ity to fu­ture de­pres­sion and oc­cur per­haps as a marker be­fore de­pres­sion. How­ever, the jury is still out as to if and how in­som­nia may cause de­pres­sion. More stud­ies are needed. Con­versely, de­pressed peo­ple have trou­ble fall­ing asleep, stay­ing asleep or they may wake up in the early hours of the morn­ing. Th­ese sleep prob­lems can be the first rea­son why de­pressed peo­ple present to their phar­ma­cist or doc­tor, even if they don’t re­alise they are de­pressed. Un­for­tu­nately, in­som­nia that is a part of de­pres­sion, of­ten does not re­spond to in­som­nia treat­ment alone, such as over the counter treat­ments or other sleep med­i­ca­tion. If a per­son has both in­som­nia and de­pres­sion, the fact that they are sep­a­rate dis­or­ders means that treat­ing only the in­som­nia will not nec­es­sar­ily fix the de­pres­sion. It also means that even when de­pres­sion is treated, in­som­nia can per­sist.

So, what can you do to­day if you’re suf­fer­ing in­som­nia or sus­pect it’s lead­ing to a low mood? To en­sure that sleep qual­ity is al­ways a pri­or­ity, im­ple­ment the sim­ple tech­niques out­lined in the ar­ti­cle, Do You Strug­gle with In­som­nia? in the Jan­uary/Fe­bru­ary is­sue of Great Health GuideTM. A QUICK UP­DATE OF TH­ESE TECH­NIQUES: 1. Limit the use of smart­phones, tablets and com­put­ers for an hour be­fore bed. 2. Have some wind down time, to be­come sleepy be­fore at­tempt­ing to sleep. 3. Reg­u­late body tem­per­a­ture in readi­ness for sleep. 4. Keep a con­sis­tent bed­time and bed­time rou­tine. 5. Stop check­ing the clock, this only adds to the frus­tra­tion. 6. Limit caf­feine and al­co­hol for sev­eral hours be­fore bed­time. 7. Don’t sac­ri­fice your sleep time for work. If you are suf­fer­ing per­sis­tent in­som­nia or low mood, make an ap­point­ment to see your lo­cal doc­tor. Un­der­stand that if in­som­nia is part of de­pres­sion, it will rarely re­spond to iso­lated in­som­nia treat­ment. Also, if you are treated for de­pres­sion with an anti-de­pres­sant and yet still have in­som­nia, talk to your doc­tor as you may re­quire ad­di­tional ad­vice to ad­dress each sep­a­rately.

Dr Tammra Warby is a Gen­eral Prac­ti­tioner with a PhD, who works at Foxwell Med­i­cal. She is on the FRACGP Fu­ture Lead­ers pro­gram 2018 and man­ages chronic dis­ease such as asthma and di­a­betes, with fur­ther qual­i­fi­ca­tion in skin can­cer surgery. She can be fol­lowed on Twit­ter.

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