Insomnia

Have you ever wondered where that old wives tale about “counting sheep” as a cure for insomnia comes from?  Well, I think I have a pretty good idea.  Today I want to talk about sleep, because, as it turns out, good quality sleep is at the very foundation of health and happiness.  In order to have really good sex, it is helpful to start out with healthy emotions and a positive outlook on life.

One of the very first things that early sleep researchers noticed was that there are times when the eyes appear to be darting from side to side under the closed eyelids of a sleeper (Knott, Goodenough, Shapiro, Holden, & Steinschriber, 1959; Knott, Gibbs, & Henry, 1942) so they called this REM sleep or Rapid Eye Movement sleep.  This is when dreaming occurs.  It turns out that normal sleep is characterized by alternating cycles of REM sleep and non REM sleep, also known as “slow wave sleep.”

There are four stages of slow wave sleep that alternate with REM sleep, each stage progressively deeper (Thase, 2006; M.P. Walker, 2009; Matthew P. Walker & VanderHelm, 2009).  During the normal course of a night’s sleep, non REM sleep alternates with REM sleep roughly every 90 minutes or so.

The ratio of REM to non REM sleep changes over the course of the night such that stages 3 and 4, the deepest stages of slow wave sleep, predominate early on and the lighter stages—stages 1 and 2 predominate closer to morning.  During the cycles of REM and deep sleep, the brain appears to be carrying out something analogous to a computer’s defrag program in a complex and elegant mechanism for consolidating memory and maintaining emotional equilibrium.

This elaborate interplay of REM and deep sleep is apparently necessary for both remembering and forgetting—remembering facts and forgetting unpleasant emotions.  It now seems that REM sleep is the process the brain uses to consolidate: to organize and store facts as memories while deconstructing, taking apart, and parsing emotions from memories (Riemann, Kloepfer, & Berger, 2009).

In fact, laboratory research shows that good quality sleep helps humans overcome conditioned fear responses which may be why it is so very important in the development and maintenance of PTSD (Pace-Schott et al., 2009).

Thus, the brain is pre-wired to heal itself from unpleasant, fearful memories and associations – if only we can get enough good quality sleep.

Unfortunately, one of the most prominent symptoms of depression, as well as anxiety disorders and PTSD, is insomnia. And in turn, sleep deprivation exacerbates all manner of emotional distress and mental illness because it selectively impairs the brain’s ability to retain positive and neutral events while allowing the brain to hold on to memories of negative events, especially those associated with strong negative emotions.

Because positive memories are more likely to be those of interpersonal relationships, sleep deprivation sucks up all the good stuff in life, leaving your brain with all the gunk—the negative emotions, negative memories, and the disconnects from other people, the loneliness.

There is a particular pattern of sleep disturbance that is associated with depression, which involves  (1) a shortened REM latency, (2) increased REM density and (3) less deep, slow wave sleep (Berger, VanCalker, & Riemann, 2003).

The linchpin to this pattern appears to be a ruminative coping style—that “money brain” that keeps turning over problems looking for a solution.  Grandma called it worry.  If you can learn to stop “monkey brain,” the fretful ruminations known as worry, you can improve your sleep and begin the process of breaking the pattern of brain activity that is at the root of depression.  Counting sheep is one way to focus you mind.  But there are others.  Learning to stop ruminations is a foundational skill.

Berger, M., VanCalker, D., & Riemann, D. (2003). Sleep and manipulations of the sleep-wake rhythm in depression. Acta Psychiatria Scandanavica, 418(418), 83-91.

Goodenough, D. R., Shapiro, A., Holden, M., & Steinschriber, L. (1959). A comparison of “dreamers” and “nondreamers”: Eye movements, electroencephalograms, and the recall of dreams. Journal of Abnormal & Social Psychology, 59(3), 295-302. doi:10.1037/h0040532

Knott, J. R., Gibbs, F. A., & Henry, C. E. (1942). Fourier transforms of the electroencephalogram during sleep. Journal of Experimental Psychology, 31(6), 465-477. doi:10.1037/h0058545

Pace-Schott, E. F., Milad, M. R., Orr, S. P., Rauch, S. L., Stickgold, R., & Pitman, R. K. (2009). Sleep promotes generalization of extinction of conditioned fear. Sleep: Journal of Sleep & Sleep Disorders Research, 32(1), 19-26.

Riemann, D., Kloepfer, C., & Berger, M. (2009). Functional and structural brain alterations in insomnia: implications for pathophysiology. European Journal of Neuroscience, 29, 1754-1760. doi:10.1111/j.1460-9568.2009.06721.x

Thase, M. (2006). Depression and sleep: pathophysiology and treatment. Dialogues in Clinical Neuroscience, 8(2), 217-226.

Walker, M. P. (2009). The role of sleep in cognition and emotion. The Year in Cognitive Neuroscience 2009: Annals of the  N.Y. Academy of Science, 1156(Mar), 168-197.

Walker, M. P., & VanderHelm, E. (2009). Overnight Therapy? The Role of Sleep in Emotional Brain Processing. Psychological Bulletin, 135(5), 731-748. doi:10.1037/a0016570

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