Dream Practice: Are Bad Sleep Habits Driving Us Mad? (article)

Note: this is a very interesting article that suggests much mental illness is actually just bad sleep. And it has interesting studies with implications that support Tao Dream Practice.
excerpt:
“Traditional models of sleep involve a top-down control centre that tells the
entire brain when it’s time to doze off. James Krueger of
Washington State University in Pullman argued that parts of the brain fall
asleep independently, and what we call the state of “sleep” only occurs when
enough parts “drop off” to change our state of consciousness.

He and his colleagues believe sleep starts in individual cortical columns —
assemblies of neurons that are thought to be a basic processing unit of the
brain — which become tired as a result of use. Only later is it
consolidated by central mechanisms.

This insight could explain disorders such as sleepwalking, where it is
possible to negotiate objects yet be unaware of your actions, and “sleep
inertia”, the first drowsy half-hour or so after waking up. “It is easy to
envision an explanation for these phenomena by imagining parts of the brain
awake and parts being asleep simultaneously,” says Krueger.”

This is very similar to multiple shen theory trying to integrate into one original shen.
-Michael

ARE BAD SLEEPING HABITS DRIVING US MAD?
By Emma Young
New Scientist
February 18, 2009

http://www.newscientist.com/article/mg20126962.100-are-bad-sleeping-habits-d
riving-us-mad.html

Take anyone with a psychiatric disorder and the chances are they don’t sleep
well. The result of their illness, you might think. Now this long-standing
assumption is being turned on its head, with the radical suggestion that
poor sleep might actually cause some psychiatric illnesses or lead people to
behave in ways that doctors mistake for mental problems. The good news is
that sleep treatments could help or even cure some of these patients.
Shockingly, it also means that many people, including children, could be
taking psychoactive drugs that cannot help them and might even be harmful.

No one knows how many people might fall into this category. “That is very
frightening,” says psychologist Matt Walker from the University of
California, Berkeley. “Wouldn’t you think that it would be important for us
as a society to understand whether 3 per cent, 5 per cent or 50 per cent of
people diagnosed with psychiatric problems are simply suffering from sleep
abnormalities?”

First, we’d need to know how and to what extent sleep disorders could be
responsible for psychiatric problems. In the few years since sleep
researchers identified the problem, they have made big strides in doing just
that.

Doctors studying psychiatric disorders noticed long ago that erratic sleep
was somehow connected. Adults with depression, for instance, are five times
as likely as the average person to have difficulty breathing when asleep,
while between a quarter and a half of children with attention-deficit
hyperactivity disorder (ADHD) suffer from sleep complaints, compared with
just 7 per cent of other children.

Until recently, however, the assumption that poor sleep was a symptom rather
than a cause of mental illness was so strong that nobody questioned it. “It
was just so easy to say about a patient, well, he’s depressed or
schizophrenic, of course he’s not sleeping well — and never to ask whether
there could be a causal relationship the other way,” says Robert Stickgold,
a sleep researcher at Harvard University. Even when studies did seem to
point in the other direction, the findings were largely overlooked, he says.
The assumption that poor sleep was a symptom rather than a cause of mental
illness was so strong that nobody questioned it

In 1987, for example, Patricia Chang and colleagues at Johns Hopkins
University in Baltimore reported a study of 1053 male medical students who
had been followed for an average of 34 years after graduation. During that
time, 101 of them developed clinical depression and 13 of these committed
suicide. It turned out that students who had reported suffering from
insomnia were twice as likely to develop depression as those with no trouble
sleeping. The team concluded cautiously that insomnia was “indicative of a
greater risk” of problems later. Stickgold goes further. He believes the
study shows that insomnia can predispose people to depression.

He’s not the only one to be persuaded both by findings such as Chang’s and
by the growing realisation that some sleep problems generate symptoms that
mimic those of certain psychiatric disorders.

In 2006, Paul Peppard at the University of Wisconsin-Madison and his team
studied the relationship between depression and sleep-disordered breathing.
In sleep apnoea, the most common form of SDB, a blockage or narrowing of the
windpipe causes a steep drop in oxygen levels, temporarily waking the
sleeper. The team randomly selected about 800 men and 600 women from a
working population and evaluated them in the lab for SDB and depression.
There are four categories of SDB and for each increase in a person’s SDB
category — from “minimal” to “mild”, for example — their odds of getting
depressed almost doubled, the team found (Archives of Internal Medicine, vol
16, p 1709). Depression cannot have been the main cause of the poor sleep,
since we know SDBs stem from physical factors such as excess fat thickening
the windpipe or a large tongue or tonsils relative to the size of the
windpipe opening. Instead, this work suggests that sleep disorders lead to
the depression.

Indeed, Daniel Buysse, medical director of the Sleep and Chronobiology
Program at the University of Pittsburgh, Pennsylvania, has found that
treating depressed patients’ sleep problems with a drug such as
benzodiazepine can produce a dramatic turnaround in their mood disorder.
Buysse does not provide an estimate for the proportion of depressed patients
who fall into this category — but he has gone on the record saying that for
some patients insomnia seems to cause depression.

Poor sleep may also explain some of the characteristic behaviours associated
with other mental illnesses. For example, there is plenty of evidence to
suggest that impaired sleep can induce the manic episodes suffered by people
with bipolar disorder, according to a review published last May (American
Journal of Psychiatry, vol 165, p 830). Stickgold even thinks that it can
cause a common problem associated with schizophrenia, namely, the failure to
master rote tasks such as how to use a piece of machinery. While healthy
people improve overnight on tasks that require such motor skills,
Stickgold’s team has found that people with chronic schizophrenia do not.
“We have identified a failure specifically of the sleep-dependent component
of procedural learning,” the researchers write (Biological Psychiatry, DOI:
10.1016/j.bps.2004.09.012). So, in theory, improved sleep should help with
this symptom.

Sleep-deficit disorder

It also seems that behavioural problems resulting from lack of sleep may be
misdiagnosed as attention-deficit disorder (ADD) and ADHD. In 2005, Clifford
Risk, director of the Marlborough Center for Sleep Disorders in
Massachusetts, presented a study to the annual meeting of the American
College of Chest Physicians. Of 34 adults with sleep apnoea that he
investigated, 16 had scores that suggested a moderate or severe impairment
of attention. Subsequent treatment for the apnoea led to substantial
improvements in attention scores for 60 per cent of these individuals —
suggesting that for this sub group, at least, the sleep apnoea caused the
difficulties with attention.

Likewise, in an analysis of 83 children with ADHD, David Gozal from the
University of Louisville, Kentucky, and colleagues found that a quarter of
those diagnosed with mild ADHD suffered from sleep apnoea, compared with
just 5 per cent of those with strong ADHD and 5 per cent of healthy
controls. “SDB can lead to mild ADHD-like behaviours that can be readily
misperceived and potentially delay the diagnosis and appropriate treatment,”
the team concluded (Pediatrics, 2007, vol 111, p 554). What’s more, a study
of children undergoing surgery to remove their tonsils and adenoids (a
common treatment for snoring and sleep apnoea) found that before the
operation, one-quarter had a diagnosis of ADHD compared to 7.4 per cent of
healthy controls. But a year after the operations, half of these children no
longer met the criteria for ADHD (Archives of Otolaryngology — Head & Neck
Surgery, vol 133, p 974). Mark Kohler from the Women’s and Children’s
Hospital in Adelaide, Australia, who has studied links between ADHD and
sleep, suspects that some children are being treated with drugs such as
Ritalin while their true problem, a sleep disorder, goes unrecognised.
Some children are being treated with drugs such as Ritalin while their true
problem, a sleep disorder, goes unrecognised

So how does poor sleep lead to behavioural and psychological problems? Some
of the links are apparent. For example, every parent knows that tired
children usually become hyperactive rather than sleepy. Sleep disruption
also bumps up stress hormone levels, which could contribute to daytime
anxiety, a component of many psychiatric disorders. More intriguingly, it
now seems sleep disruption can fundamentally interfere with the brain’s
ability to process emotion and to react to an emotional stimulus in an
appropriate way (see “Feeling emotional? Take a nap”).

While it is common knowledge anecdotally that a poor night’s sleep is likely
to make you more irritable the next day, Walker and his colleagues uncovered
key evidence for why this should be so. The team showed a set of
increasingly disturbing images to people who had slept normally and people
deprived of sleep for 35 hours. In the sleep-deprived group, the gruesome
images produced 60 per cent more activity in the amygdala — a primitive,
emotionally reactive part of the brain — than in well-rested people.
Further scans revealed that in those deprived of sleep the amygdala was
failing to communicate with the prefrontal lobe, which normally controls and
sends inhibitory signals down to the emotional brain. “The reason we don’t
blow our top when someone says something we don’t like is because we have a
highly developed prefrontal cortex, which acts as an emotional brake,” says
Walker. A loss of communication between the amygdala and the prefrontal lobe
is one way that sleep loss could create psychiatric symptoms, he thinks. “In
a number of psychiatric disorders, such as depression, it has been
demonstrated that the frontal lobe’s activity becomes disrupted. There’s
also preliminary evidence [of this] for ADHD and post-traumatic stress
disorder,” Walker says.

In another strand of research, evidence is growing that sleep — and
dreaming, REM sleep, in particular — helps the brain to process memories.
Disrupt this mechanism, and you could end up with psychological problems
such as PTSD.

In August 2008, Stickgold and colleagues reported that when people are
presented with pictures of an emotional or neutral object or scene, their
memory for these scenes decreases during the day. After a night’s sleep,
they forget pretty much everything except the things that roused their
emotions, for which their memories stay the same, or even improve
(Psychological Science, vol 19, p 781). Cast your mind back, says Walker,
and you will appreciate that almost all of your memories are emotional ones.
He thinks this is because emotions act as a red flag for important things
that we should be remembering. But, crucially, if you recall them now you
don’t re-experience the visceral reaction that you had at the time. Somehow,
the brain has retained the memory while stripping away the visceral emotion.
Both Stickgold and Walker believe this stripping process occurs during REM
sleep.

They note that during REM, production of serotonin and noradrenalin shuts
down in the brain. Noradrenalin is the neurochemical associated with stress,
fear and the flight response; it translates to adrenalin in the body.
Serotonin modulates anger and aggression. “You get this beautiful biological
theatre during REM sleep, where the brain can go back over experiences it
has learned in days past, but can do so in a situation where there are none
of these hyping-up neurochemicals,” Walker says. So although dreams can be
highly emotional, he thinks that they gradually erode the emotional edges of
memories.

In PTSD this process seems to fail, so that traumatic memories are recalled
in all their emotional detail. It is not clear yet why this happens, but
there is evidence that people with PTSD have higher waking levels of
noradrenalin and serotonin. This might mean that neurotransmitters cannot be
damped down sufficiently during REM sleep for the emotional intensity of the
memories to be stripped away, says Walker.

Clearly there is still a lot of work to be done in untangling the ways in
which sleep disruption might create psychiatric symptoms. Among the
anomalies that need explaining is the fact that antidepressant medications
reduce REM sleep and yet can be very effective. Then there is the puzzling
finding that many people with depression say they feel happier after a night
deprived of sleep (Biological Psychiatry, vol 149, p 471).

Nevertheless, when it comes to exactly how and to what extent sleep
disorders could be responsible for psychiatric problems, Walker says: “We’re
getting there. Five years ago, that question wasn’t on the radar for anyone
— scientists or lay people. The fact that we’re aware of it now and asking
those questions means it’s inevitable we’ll find out.”

………….

Feeling emotional? Take a nap

If you find your working relationships deteriorate as the day wears on, take
a nap. In a study yet to be published, Matt Walker from the University of
California, Berkeley, and colleagues showed people pictures of faces
expressing different emotions, including fear, anger, sadness and happiness,
and asked them to rate how emotional they thought these faces were. They did
this at midday and again at 6 pm. Participants were significantly more
sensitive to angry and fearful faces at the second session.

However, this change did not happen if volunteers were allowed a 90-minute
lunchtime nap during which they managed to achieve REM sleep. What’s more,
these people also became more receptive to happy faces. Walker concludes
that REM sleep refreshes our civilising emotional reactions. “Sleep is
essentially changing the magnetic north of your emotional compass, in a good
way,” he says.

…………

When is asleep not asleep?

When people say they feel half-asleep they could be right.

Traditional models of sleep involve a top-down control centre that tells the
entire brain when it’s time to doze off. But last year, James Krueger of
Washington State University in Pullman argued that parts of the brain fall
asleep independently, and what we call the state of “sleep” only occurs when
enough parts “drop off” to change our state of consciousness (Nature Reviews
Neuroscience, vol 9, p 910).

He and his colleagues believe sleep starts in individual cortical columns —
assemblies of neurons that are thought to be a basic processing unit of the
brain — which become tired as a result of use. Only later is it
consolidated by central mechanisms.

This insight could explain disorders such as sleepwalking, where it is
possible to negotiate objects yet be unaware of your actions, and “sleep
inertia”, the first drowsy half-hour or so after waking up. “It is easy to
envision an explanation for these phenomena by imagining parts of the brain
awake and parts being asleep simultaneously,” says Krueger.

Although sleep researchers have not been very receptive to the idea, he
believes a big rethink is called for. “In my opinion, the textbooks should
be rewritten.”