One of the most common sleep disorders is insomnia and according to a recent report published in the Journal Sleep, it may be linked to sleep apnea. Researchers in Albuquerque interviewed 20 men and women with chronic insomnia, all of whom denied having any sleep breathing disorders. The researchers found that chronic insomniacs woke on average 30 times a night. Hypoxia or a brief drop in the volume of oxygen inhaled caused by a narrowed airway closely followed 90 percent of those interruptions.

In the study, sleep researchers asked participants about their causes of their nightly awakenings. Surprisingly, none of the participants mentioned breathing as a reason for their awakening. Of the most popular responses were racing minds, nightmares, a need for the bathroom and pain.

However, after analyzing their sleep, it became clear that their awakenings were triggered by a respiratory event.  Each participant underwent a polysomnography test while spending a night at a sleep clinic. Using wired sensors that tracked brain waves and breathing, researchers and lab technicians were able to chart and monitor every awakening, when brain waves shifted to a waking state for at least 16 seconds, and every breathing issue causing oxygen intake to dip well below normal.

Read more here: https://www.soundsleepinstitute.com/insomnia/is-insomnia-linked-to-sleep-apnea/

In the study, researchers separated hamsters into two groups: one group experienced a standard light/dark cycle, while the other group was exposed to a dim light at night—on par with city lights outside your window or the glow of a TV screen. After four weeks, hamsters who slept with some light showed signs of depression. (Depressed hamsters? Yup. Researchers tell by observing the rodents’ interest in sugar water.)

1.     Insomnia can be hereditary

Sleep problems could run in families. In a 2007 study published in the journal Sleep, researchers found that out of 953 adults who said they were good sleepers, had insomnia symptoms or suffered from insomnia, about 35 percent of those with insomnia had a family history of insomnia. According to a 2008 study, teens with parents who have insomnia have an increased risk for using prescribed sleeping pills, and having mental problems.

Question:

I have a patient who has opted to seek counsel with their physician regarding a sleep study. She has tremendous daytime drowsiness among other symptoms.

Originally, her doctor persuaded her to not visit a sleep center for reasons I can only imagine. In the meanwhile, at my prodding, she has visited her doctor again and he wrote a script for a PSG study at her local hospital. However, the doctor also prescribed Lexapro to ‘keep her alert’ during the day so that she would have a nice sleep the nite of the study. If I remember from your class, that class of drugs limits or reduces REM sleep. Do I recall correctly?

Dr. Smith:

Lexapro and other anti-depressants will remove REM sleep, which indirectly improves the AHI, but at the expense of a valuable segment of sleep. They will sleep better if their anxieties are preventing sleep initiation, so it can be helpful, but will not give a true picture of the patient’s sleep architecture. That may or may not matter to the sleep physician, but I would ask the expert before deferring to the general MD.