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.)

The reason? The sleep hormone melatonin helps brain neurons function properly. “But the brain can’t produce melatonin if it detects light,” says study author Tracy Bedrosian, a Ph.D. candidate in neuroscience at The Ohio State University. Hamsters exposed to light at night had less complex neurons in areas of the brain, such as the hippocampus, which is associated with mood. (Diagnose any major sleep problem at the brand-new Men’s Health Sleep Center.)

Human studies are needed to confirm the findings, but there’s enough research connecting nighttime light with disease that it’s a good idea to keep light dim when the sun goes down, Bedrosian says. Her advice: Install black-out curtains if there’s light outside your bedroom window and turn off your computer monitor and TV screen when you go to sleep

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.

Researchers looked at nearly 800 teens and found that, compared with teens whose parents had no insomnia problems, those with insomnia parents were more than twice more likely to report insomnia, daytime sleepiness, and pill use.

These teens were also more likely to develop depression, anxiety, and possibly consider suicide.

2.     Pets and bugs can also suffer from insomnia

Other animals, such as bugs, can’t exactly complain of having insomnia, but some studies suggest animals suffer from sleep disorders just like humans.

In one study, researchers at Washington University School of Medicine in St. Louis bred insomniac flies, which only get a small fraction of the sleep of normal flies, and found they resembled people with insomnia in several ways.

After generations of breeding, researchers produced flies that spent only an hour a day asleep less than 10 percent of the 12 hours of sleep normal flies get.

These insomniac flies lost their balance more often, were slower learners and gained more fat all resembling symptoms that also occur in sleep-deprived humans.

3.     Social jet lag can be a drag

If you’re having trouble waking up on Monday morning, you could have “social jet lag,” a habit of following a different sleep schedule on weekdays versus the weekend.

A recent study showed that people with different weekday and weekend sleep schedules were three more times likely to be overweight. Previous research has also linked increased weight with sleep deprivation and irregular sleep schedules.

Even an hour difference in the time you get up or go to bed can affect your sleep, said Colleen Carney, a sleep psychologist at Ryerson University in Canada.

We’re like toddlers who need a consistent schedule, Carney said.

4.     Sleeping pills are still popular, despite their failure to cure insomnia

The rate of sleeping pills use in the U.S. continue to rise, studies show.
One in four Americans take some type of medication every year to help them sleep, according to the National Sleep Foundation.
But these pills may not be leading to better sleep.
There’s no evidence that proves sleeping pills can cure insomnia, said Jack Edinger, a sleep specialist at National Jewish Health hospital in Colorado.
In fact, only cognitive behavioral therapy> (“talk therapy”) has been shown to work, Edinger said.
In a study published in February journal BMJ Open, researchers found that people taking prescribed sleep medications were almost five times more likely to die over the 2.5-year study, compared with those who didn’t take sleep medication.

5.     Women’s hormones may play a role in insomnia

Women are two times more likely to have insomnia than men, according to the National Sleep Foundation.
Experts speculate that the reason may have to do with women’s hormones. Sleepless nights and daytime sleepiness have been linked with hormonal changes in a women’s life, including pregnancy, menopause, and the menstrual cycle.
According to a National Sleep Foundation’s 1998 poll, almost 80 percent of women reported more disturbed sleep during pregnancy than at any other time.
For women experiencing menopause, when hormone levels are erratic, sleep problems are a common complaint.
But along with hormone changes, insomnia has also been linked with conditions such as anxiety, depression, problems breathing while asleep and restless legs syndrome.

6.     In rare cases, people can die from insomnia

Fatal familial insomnia is a rare genetic disease that prevents a person from falling asleep, eventually leading to death.
Experts have identified it as a prion disease, caused by an abnormal protein developing from a genetic mutation, which affects brain function, causing memory loss, no control over muscle movements and hallucinations.
In 1986, researchers writing in the New England Journal of Medicine reported a case of a 53-year old man who suffered from lack of sleep getting only two to three hours per night.
Two months later, he could sleep only one hour per night, and was frequently disturbed by vivid dreams. After three to six months, normal sleep became impossible, causing him severe fatigue, body tremors and breathing difficulty.
After eight months, he fell into a stupor and eventually died.
The researcher’s analysis of the family’s history revealed the man’s two sisters, and many of his relatives, also died of a similar disease.

7.     Chronic insomnia left untreated increases risk of alcohol abuse

People who drink alcohol to help them get to sleep could wind up developing a drinking problem, research suggests.
People use [alcohol] to self treat, Edinger said. Over time, you need more alcohol to help you sleep.
According to a 2001 study published in the American Journal of Psychiatry, researchers looked at 172 men and women being treated for alcohol dependence.
They found that participants with insomnia were about twice as likely to report using alcohol to sleep, compared with those without insomnia.
Attempting to self-medicate insomnia with alcohol, however, will ultimately worsen insomnia, the study authors said.
Moreover, people will likely persist in their drinking, even if the insomnia worsens, because a person’s drinking behavior is ingrained and reinforcing, and they feel desperate for sleep.

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.