Can a Lack of Sleep Cause Psychiatric Disorders?

I also would like to refer folks to another article...

http://health.discovery.com/centers/sleepdreams/sleepdisorders/sleepdisorders.html

Delayed Sleep Phase Disorder

* What is it? When a person's biological clock gets out of sync with accepted norms, sleep disorders arise. In delayed sleep phase insomnia, the person falls asleep and awakens later than required for normal activities such as work and school. Once the person falls asleep, however, his or her sleep is restful and uninterrupted. Awakening at an acceptable time, even with an alarm clock, is extremely difficult. Resulting symptoms include daytime sleepiness, particularly in the morning; fatigue; impaired memory and concentration; low productivity, particularly in the morning.
* How common is it? Relatively rare (fewer than 2 percent of those seeking help at sleep disorder clinics are diagnosed with it). It frequently begins during childhood and is most common during adolescence. These symptoms are also seen in people suffering from depression.
* What's the treatment? Two therapies are used:
Chronotherapy—This technique re-sets the person's biological clock by having the person stay up and awaken three hours later each day over a several-day period until their sleep and awake times are in sync with others. During that time they cannot nap, and once they've changed their schedule they must maintain it even on weekends (varying it by no more than an hour) to prevent the return of the problem.
Light therapy—This technique uses bright lights (as bright as sunlight) for two hours in the morning and avoids bright light for several hours before bedtime to shift the sleep-wake cycle. Special light boxes for this purpose are available through medical supply sources and are similar to those used to treat people with seasonal affective disorder.


Is it at all possible that circadian rhythm disorder (can't remember the terminology), delayed sleep phase disorder and SAD are all strongly inter-related... perhaps even the SAME thing or just variations of the same thing?

I still don't understand how SAD is labeled as a mood disorder when light therapy is the treatment, and light therapy is also used in SLEEP disorders!

Are these rare folks (2%) who are showing up in sleep clinics suffering the same thing as more people who are showing up at their doctor's office with depression symptoms and Seasonal Affective Disorder?!

Sorry to go on a rant here, but I feel pretty strongly and want to provide others with the same information I've found helpful.

Thanks, folks, for hearing me out.

I think this week, I am going to go to the doctor and ask for a low-dose of wellbutrin... perhaps the slow-release version.

What I need to discuss with her:

1. how do I take it so that I'm less likely to suffer insomnia, which is listed as a possible side-effect? I think timing might help reduce insomnia.

2. IF the drug causes any MORE fatigue or drowsiness, I want to consider looking into sleep disorder meds. MORE sleep has not meant BETTER sleep for me, and Rosenthal's research seemed to suggest that there are measureable differences in brainwaves of SAD patients during sleep (was it less REM sleep?! Can't remember!)

3. I want to start out on the lowest possible dosage to see how it affects me.

4. I want to know how it works... I want to understand what effect it's having on my brain and any possible long-term effects.

5. I want to know if I can safely discontinue taking it when my SAD symptoms would naturally be subsiding

6. What effects can I expect with starting the drug, and what effects can I expect when discontinuing the drug.

7. Next year, when should I start taking it?

8. I have to know if I can take it with prednisone and how it could possibly interact.

Actually, before I see my doc, I think I want to research treatment to sleep disorders. Wellbutrin users are still reporting some side-effects that sound worrisome, but most of them are on high doses, are taking other meds (a lot have mentioned cymbalta as well) or seem to have started out with severe depression.

9. Folks are saying they had weight gain when switching to the generic formulation. Is it different than the brand name? Apparently, the generic is available as x-tended release

Pros to wellbutrin: recommended specifically for Seasonal Affective Disorder (want to know why!), potential weight loss, lower sexual side effects, increased energy

Cons: potential for insomnia (time of day and extended release formulation seem like it should make a difference), some folks reporting that it's not helpful with their depression but their depression may be much more severe than mine has been, some folks are reporting panic attacks and one fellow who already has a heart problem said it made it worse. One person reports excessive yawning but says she's not experiencing any tiredness. A handful of folks say dizziness and nausea.

It really seems to me that those folks who are reporting troubles are on the 300-450mg (max) dosages.

my GP has put me on imovain which helps you stay asleep but I still only sleep 5 1/2 hrs or there abouts. She gave me 60 tablets.

I'm getting really excited about new research that seems to be going on... Here's another article:

http://www.biopsychiatry.com/buporem.htm

Hay Paulst and amalthea I use the light box in the morning and then around lunch to 2pm just for a short time now I have been getting 6 hrs sleep instead of 5 1/2 which helps alittle with the moods.

PS - I also feel like my problem is a lack of deep sleep.

It's not that I'm waking during the night, though!

It's just that when I do get 8 hours of sleep, I wake up un-refreshed and sluggish. Something about my sleep is ineffective.

I went to see the doctor, and I'm discouraged. I'm pretty sure my doctor thinks I'm just some 'mental case.' She talks so quickly and rushes me along. Her attitude: "OK, I'll do whatever you want me to do."

She wrote me a script for the brand-name wellbutrin and cautioned me that my insurance may not pay for it. Indeed, a call into my insurance says I have to use only the generic.

I've got more work to do, and I feel a very disheartened. I don't know if the generic Wellbutrin SR is affected by the time-release problem... I do know that the XL is affected for certain.

I feel like I ought to find a new doctor. She acts like she's just a "dispenser" and won't offer me any discussion. She doesn't even know enough about SAD to do more than just say, "Ok, whatever you want."

I don't know how to find a doctor here who can treat SAD, if there is one. I doubt any of them will have the time to listen to my feelings that SAD is a sleep disorder.

Part of me just wants to slip back into not doing more than light therapy. I'm frustrated with the insurance co. as it looked like the brand name drug was covered.

Were are you located Amalthea. I do know how you feel. I talked to my Gp last week and her reaction was well do you want to keep going the route you are taking.Said she thought I might be bipolar. Symptoms of sad but bipolar. Sometimes I wonder were they get there licence from a cracker Jack box. I am glad that I did which is 30 mg of paxil and I have adivan which is for anxiety if I need it.I also started Omega 3s which seems to help alot with depression.I have Only taken the adivan once since I have it. I take if if I wake up to early 3 4 or 5 am. I know it is hard to find a doctor. See if there is something on line. or tell me were you are located and I will see what I can find. Insurance co. are a pain the butt sometimes if you phone them and tell them that this is the only drug you can take they will allow it. atleast thats what happened to a friend of mine. she couldn't take the generic.

Amalthea I live in Fort Erie, Ontario, Canada Just above Buffalo NY. I know there are a few in this area but the doctor can't tell you who. The closest support people are 45 mins away. I can't cope with the drive.

What is the SAD group you found last month and how do I get to the site. I would Like to check it out.

I remember you had said that about your pastor before. But He is there to help you and guide you. He may be more of a help than you think. Just try it. He might already know.

Also the book by Dr. Rosenthal Winter Blues Might help you some I have put in on my list of things to get after Christmas. Its only about $10 to $15 dollars and it might be worth getting.

Stained Glass Lady

Do you have a library there, I managed to get hold of Dr Rosenthals book in our local tiny library in the UK

Me

tried the library thing they don't have it. I guess I will have to do a bit of driving if tomorrow is sunny.

Whoopsies, lets hope it jolly well works!

Me x

Stained Glass Lady

In a Library here, we can order a book for a tiny fee to collect when ever it becomes available in another librbay and delivered to your library ready.

Could this help you.

Me x

Must be very popular then, I wonder why!!!!lol

Me x

Amalthea
Not got any info on small lamps chuck, leave that the experts.

Glad you are feeling brighter (what an apt phrase!). Couldnt have been my earlier post, they arnt that good!!lol

'Thats me gal, take control and sock it to em lass'.

Cheers

Me x

I'd use my light therapy lamp in the morning and when I get home in the evening. During the day, I think the little lamp will give me some boost.

My parents have one at their house that's very similar and I also feel drawn to that one. It's nice and bright and cheery.

I don't know what I'm going to do with this monster-of-a-lamp. It looks better than the one that's currently in my living room, but I still can't use it for work, and it cost me $190 with the extra bulb!

I'm pretty tight on cash for now and I wanted to get a dawn simulator. That would leave me with THREE lights at my small apartment AND a dawn simulator. And possibly a portable light eventually.

I guess I love light a bit much.

I've looked into other medicines tonight and I hate to say that I'm coming up empty-handed. I could call my online pharmacy and make sure they don't use the one manufacturer's generic pill (Tavo?).

Or, I could take this script the doc gave me for a sleep-study... She thought that because I snored, I must have sleep apnea. I've got asthma and allergies, but I feel much more energized in the summertime, so it's seasonal...

But I still have this sleep study script. I might contact the study center and see if they treat SAD at all. Or, what they could recommend to regulate sleep cycles.

For now, I think I'm going to concentrate on yoga at nighttime and self-care. And trying to find a new doctor. I don't know if I can go back to this one or not.

Apparently, the generic wellbutrin has been found to be less-effective than the brand-name pill because something is wrong with the way it's released into your system (a flawed coating?)... That's why I'm being particular. It's only with the pills manufactured by TAVO, but I hate to take the chance that my pharmacy would use that brand or switch.

I don't know if there are any drug options to help me be more alert during the day and get better quality sleep at night.

Possibly, just getting the better quality sleep at night and using the light therapy may help me feel normal again! But, to find a sleep pill that isn't habit-forming and doesn't leave you groggy... I don't think a sedative is the answer unless they know it works on the brain chemistry that makes you sleep... I don't know much about sedatives or how they work.

-- Or if I could even take anything as an asthmatic that wouldn't affect lung function. I don't know how related they are to anesthesia, but I have to be careful with anesthesia and asthma because depressed breathing causes asthma attacks.

The sleep clinic might be the best bet, but I bet they'll want me on an antidepressant, too.

I read something a little scary about SSRI's that I was hesitant to share. I don't know how true it is, but I heard that the way they work is that they bombard your brain with extra serotonin so that the receptors, which are desensitized to it have a better chance of "scooping up" some of the excess serotonin.

But the problem with that is that eventually, the receptors become overwhelmed and can burn out... meaning they will stop picking up serotonin in the long run...

I think that's why people end up switching drugs, but I could be wrong. I don't want to have any long-term damage that could mean I will never be able to get off antidepressants.

Hate to say it, but I don't really believe they know how all this stuff works. Not that I do, but I'm trying to learn a little, just to find out what my options are.

Jeanne, I'm not saying that I'm wary of it just because it's a generic. I found information about the TAVO manufactured generic wellbutrin that said that there was something wrong with the coating or another problem that made people report that they were wondering if it was working at all... they had set-backs, they felt like they hadn't taken their medication for the day.

I'm happy with the lamps I have at home. I think I have found a lamp that I may purchase if it's still available at Home Depot. I'll have to check this weekend. Looks like a regular desk lamp, but with bright, white light.

There's a lightbox on in the office across the hall! I don't know if it's for some photography thing or not. I know the folks who work there, and there's a fellow who I thought might have SAD. I don't want to make him feel weird or anything, though... or to make the wrong assumption.

It's a big lightbox, sitting right next to a computer screen and I noticed it through our workroom window. Too bad I can't go over and hang out there!

Heather

Heh. Do you think they'd notice?

I just took a benedryl. That should help me sleep. I hope I don't wake up groggy. I figured I'd take it a little over an hour before I have to go to bed and see how I am in the morning. This cold/chest congestion makes me wake up three or four times a night!

I've never heard of it. It doesn't make you groggy in the morning? I don't know if they sell it here in the US.

Oh, that's motion sickness meds. I know it as Dramamine. I don't recall feeling much drowsiness from it, myself. Actually, it kind of makes me nervous that it apparently has something to do with theophylline, now that I read about it. I was on theophylline when I was little, for asthma, and it seemed to always be interacting with something or causing me side-effects. One time, they thought I was allergic to chocolate, and here it was just my theophylline levels that were off!

That's the drug that made me despise carob and actually killed a good bit of my chocolate cravings. The other thing that killed my choc cravings is going to college in a place close to a choc. factory (M&M, Mars Co.). The air smelled of chocolate. Not so bad, right? It was especially strong-smelling on hot days.

If the wind changed or the temperature changed (esp. cold mornings -- aka WINTERTIME), the smell from the cow pastures would move in to campus from the other direction. Just think what happened when the smells mixed...

I'm not a chocoholic. ;)

Anyhow, the benedryl made me sleep soundly with just one night-time waking because of my cold. Only thing is, my limbs feel heavy and my mind just a tad bit slow. Not bad. I know I am sleep-deprived from the past week of being sick, tho.

I think I'm going to use this thread to help me keep track of information that I dig up on the subject that I can take with me to the doctor, and maybe someone else will find these articles useful:

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4T-43FW6HM-5&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b03642f4f4fc1009be370f65ee95d178

This article does not refer specifically to SAD, but here are some key points:

Polysomnographic sleep research has demonstrated that besides disturbances of sleep continuity, in depression sleep is characterized by a reduction of slow wave sleep and a disinhibition of REM sleep, with a shortening of REM latency, a prolongation of the first REM period and increased REM density.

Interestingly, most of the effective antidepressant agents suppress REM sleep.Furthermore, manipulations of the sleep–wake cycle, like sleep deprivation or a phase advance of the sleep period, alleviate depressive symptoms. These data indicate a strong bi-directional relationship between sleep, sleep alterations and depression.

Okay, the sleep study place is at a hospital I can access. It looks like I'll have to be late for work and it will involve two overnight stays. So, probably, I'd come into work for 1/2 days, but I'll have toiletries, a robe, and I'll be packed for an overnight stay at the hospital!

How awkward. Hrm!


They say that they treat "circadian rhythm disorders" but don't specifically mention SAD. I still feel that may be promising. Maybe they'll hear me out! I may contact them to ask if they've ever seen SAD patients before and see how they respond.