Sleep And Psychiatric Disorders
Sleep and psychiatric disorders such as schizophrenia and depression are closely related.
The main causes of insomnia and the inability to sleep are psychiatric disorders.
In addition to insomnia, people with psychiatric disorders have other sleep problems, including sleepiness during the day, fatigue, and nightmares.
Lack Of Sleep
Psychiatric problems such as paranoia and hallucinations are also caused due to lack of sleep. Difficulties with sleep can make psychiatric disorders worse by making the person confused or frustrated, as well as more sensitive to pain and other medical problems.
Constant sleep disturbances such as insomnia and extreme sleepiness have long served as prime symptoms of severe depression. Sleep disturbance may link most strongly to anxiety disorders among young adults
Primary care physicians who quickly recognize and treat sleep disturbances may help prevent the development of depression and other psychiatric problems.
Sleep Problems in Women
Women are 30% more possible than men to report their insomnia, and it is more likely to be more severe. Sleep problems in particular are common in pre-menopausal women and increase after age 40.
Sleep problems are also more related with medical and psychiatric disorders, which are more common, or at least more reported, in women. Women and men over 65 are 50% more likely to complain of insomnia than younger individuals.
The risk to sleep disruptions increases with chronic health problems and increased use of medications associated with aging.
Depressed people have a tendency to wake up early, and then cannot fall asleep again. This can make their depression terrible, since the amount of sleep a person gets has an effect on his or her illness.
People who suffer from insomnia but don’t have a psychiatric illness are more possible to develop a disorder like depression later in their life. Its important for people who have a psychiatric disorder to work personally with their doctor for a proper diagnosis and treatment that will allow them to get the sleep they need.
Psychiatric Disorders in Driving:
It is extremely difficult to evaluate the driving risks related with a psychiatric disability. Sleep and psychiatric disorders are severe enough over driving ability because the persons who are suffering with this problem get suicidal thoughts; do impulsive violent actions, hallucinations, or hallucinations may be very dangerous in a person in charge of an automobile.
The arrival of ambulatory long-term drug therapy has created a new challenge because most drugs used have some effect on driving ability. In therapeutic doses, these drugs can seriously harm driving ability, especially if they are combined with alcohol. A doctor should counsel the patient of the possible side effects of any prescribed medication on driving ability.
Patients who are receiving electroconvulsive therapy should not drive until their cognitive sensory and motor abilities have fully improved after each treatment. In addition, a patient's ability to drive safely is often completely dependent on his or her responsible use of the prescribed medication.
Temporary Stress/Dysfunction affecting sleep:
Many people who are emotionally stable become disturbed during periods of severe stress. This stress may affect the amount of sleep a person needs. Beyond that, there are persons who may exhibit careless and hazardous behavior.
If the interruption is severe enough to produce such symptoms as severe depression, slowed psychomotor activity, preoccupation, uncontrollable crying, or the loss of a sense of caution and good judgment, patients should be counseled not to drive until the problem has been addressed and they have made a sufficient recovery.
Due to the psychiatric disorders, the person may not be able to follow the regular schedule and this interrupts their sleep causing sleeplessness. The probable side effects of drug therapy also should be kept in mind.
Effects of psychiatric disorders:
- Sleep quality can vary during the menstrual cycle in pre-menopausal women.
- Insomnia is associated with quality of life, depression, anxiety, productivity, cognition, and even safety.
- Other symptoms include difficulty in falling asleep, early awakening, and frequent nighttime awakenings.
- Individuals with insomnia have significantly greater destruction in their daily life functions than people without insomnia.
- Psychomotor and cognitive performance, attention, response time, and work performance, are all disrupted and altered in patients with sleep disorders.
- Women can experience a longer time falling asleep and more awakenings after sleep onset as well as decreased sleep quality and efficiency during the premenstrual phase.
- Changes in sleep duration and quality are common during pregnancy and especially in the weeks right before delivery. As the pregnancy progressed, sleep became more disturbed.
- Exercise: Regular exercise can be helpful but not near bedtime.
- Sleep hygiene: This includes going to bed at the same time each night and avoiding or reducing naps. If the bedtime varies by necessity, then the waking times should remain the same in order to stabilize the sleep-wake schedule.
- Room conditions: A comfortable bed and room temperature along with low levels of light and noise contribute to better sleep hygiene.
- Avoid stimulants: Caffeinated drinks being the obvious, they may have to avoid altogether or at least none within 12 hours of sleep. Complex carbohydrates with protein can help maintain sleep through the night by regulating night time blood glucose levels.
- Relaxation techniques: Relaxation techniques such as biofeedback and progressive muscular relaxation can help sedate some people. Regular evening rituals such as warm baths, meditation, or soothing music may also reduce anxiety and stress.
- Behavioral interventions: Behavioral interventions such as sleep restriction therapy and/or cognitive-behavior therapy can also be a successful long term approach which especially targets those who have stress maladaptation problems, or cognitive patterns that perpetuate insomnia.
- Sleep Dairy: A sleep diary can be useful in identifying the sleep problems. The diary should indicate bed times, awakening times, timing and quantity of meals, use of caffeine, drugs, medications, alcohol, exercise and its timing, duration of sleep, and rating of the sleep quality.
- Melatonin: Melatonin is one of the better-known natural treatments for insomnia. 2 mg per day of melatonin was effective in improving sleep efficiency.
- Valerian: Valerian has been used for decades and centuries as a sedative, including as an aid for insomnia.
- Two primary goals: treatment of the specific underlying problem and treating the immediate insomnia in the short term. Patients may need to be referred to evaluate for sleep apnea, for treatment of psychological issues, or for pharmacological treatment.