Snooze, in­ter­rupted

> Why a lack of sleep can some­times make us de­pressed – and what we can do about it

The Sun (Malaysia) - - LIFESTYLE - BY ALICE M. GRE­GORY

HIS­TOR­I­CALLY, in­som­nia has been thought of as sec­ondary to other dis­or­ders, such as de­pres­sion. The idea was that you be­came de­pressed first, and that your sleep got messed up as a con­se­quence.

This might in­volve dif­fi­culty fall­ing asleep, ex­ces­sive time awake at night, or wak­ing up ear­lier than hoped.

This may make sense to those who have ex­pe­ri­enced de­pres­sion and found that thoughts of dis­tress­ing events, per­haps of a de­ceased loved one or pre­vi­ous fail­ures, keep them awake at night.

The pos­si­bil­ity that de­pres­sion leads to in­som­nia is also con­sis­tent with cer­tain re­search where it was found that adults with in­som­nia were more likely than oth­ers to have ex­pe­ri­enced anx­i­ety and de­pres­sion ear­lier in life.

But could things re­ally be the other way around? Could poor sleep be mak­ing you de­pressed?

Over the past decade or so it has be­come in­creas­ingly clear that dis­turbed sleep of­ten comes be­fore an episode of de­pres­sion, not af­ter­wards, help­ing to do away with the no­tion that sleep prob­lems are sec­ondary to other dis­or­ders.

So why does poor sleep lead to de­pres­sion? To give just a few ex­am­ples, let’s start by think­ing about our be­hav­iour.

Peo­ple would be more likely to can­cel an evening out with friends, or a planned ex­er­cise class, af­ter a poor night’s sleep.

This could be part of the prob­lem, as such events are ex­actly those that may help to keep de­pres­sive symp­toms at bay.

If we think about what hap­pens to the brain when we miss sleep, there are clues as to why sleep and de­pres­sion are linked.

One study on this topic fo­cused on an area of the brain called the amyg­dala.

This is an al­mond-shaped struc­ture lo­cated deep in the brain that is be­lieved to play an im­por­tant role in our emo­tions and anx­i­ety lev­els.

It was found that par­tic­i­pants who had been sleep deprived for ap­prox­i­mately 35 hours showed a greater amyg­dala re­sponse when pre­sented with emo­tion­ally neg­a­tive pic­tures when com­pared to those who had not been sleep deprived.

In­ter­est­ingly, links with parts of the brain that reg­u­late the amyg­dala seemed weaker, too, mean­ing that the par­tic­i­pants were per­haps less able to con­trol their emo­tions.

Such find­ings could help to ex­plain how poor sleep may ac­tu­ally cause dif­fi­cul­ties such as de­pres­sion.

When try­ing to ex­plain the link be­tween sleep and de­pres­sion, re­searchers were also in­trigued by re­cent work on the im­mune sys­tem and de­pres­sion.

Stud­ies have found that those suf­fer­ing from, or at risk of, de­pres­sion may show high lev­els of in­flam­ma­tion in their bodies.

Their im­mune sys­tems ap­pear to be in hy­per-drive as if they’re fight­ing in­fec­tion or heal­ing from in­jury.

When we dis­turb or re­strict sleep we may also ex­pe­ri­ence in­flam­ma­tion, so per­haps in­flam­ma­tion could also help to ex­plain the link be­tween sleep and de­pres­sion.

So what can we do about it? It has been pro­posed for some time now that by im­prov­ing sleep we can per­haps pre­vent or treat de­pres­sion.

Re­cently, data have started to emerge from stud­ies sug­gest­ing that this may in­deed be the case.

For ex­am­ple, re­searchers at the Univer­sity of Ox­ford in col­lab­o­ra­tion with the psy­cho­log­i­cal ther­apy provider Self Help Manch­ester eval­u­ated whether an on­line treat­ment for in­som­nia re­duces symp­toms of anx­i­ety and de­pres­sion.

They ad­vised peo­ple with th­ese dif­fi­cul­ties to take steps such as keep­ing a con­sis­tent wake time, get­ting out of bed when they can’t sleep, and chal­leng­ing be­liefs that a bad night’s sleep is in­ca­pac­i­tat­ing.

They found that both anx­i­ety and de­pres­sion symp­toms were re­duced af­ter in­som­nia treat­ment. Other groups are cur­rently look­ing at whether, by im­prov­ing our sleep, we can re­duce other types of psy­chi­atric dif­fi­cul­ties, too.

But even be­fore this work is com­plete, the take-home mes­sage from re­search to date is clear: we need to be­gin to pri­ori­tise our sleep. – The In­de­pen­dent

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