Postcards from the Id

Sleep Improves Athletic Performance

I know this sounds common-sensical, but this article reviews research indicating that increasing sleep for a seven-to-eight week period improved college football player's sprint times, as well as increased energy level and reduced daytime drowsiness.  From the article:

Results indicate that football players' sprint times improved significantly after seven to eight weeks of sleep extension. Average sprint time in the 20-yard shuttle improved from 4.71 seconds to 4.61 seconds, and the average 40-yard dash time decreased from 4.99 seconds to 4.89 seconds. Daytime sleepiness and fatigue also decreased significantly, while vigor scores significantly improved.

The sample was small, so replication is necessary.  However, as the article notes, the results are consistent with research into the positive impact of sleep on performance in other sports.  It also covers the observation that while getting enough sleep is important, specifics are generally not provided as part of fitness routines.  The article provides a few details in that regard.  Bottom line - as I've posted about again and again, get enough sleep.  It will improve virtually any area of your life.

More Sleep Decreases Depression in Adolescents

I like this article simply because, like many others I've linked to, it documents the important role adequate sleep plays in the overall functioning of people.  In this case, the researchers examined the rates of depression and suicidal thinking among teens whose bedtimes were set either 10 pm and earlier, or 12 am and later.  The two groups differed in both rates of depression and suicidal thinking, with those sleeping more showing better mood functioning.  From the article:

Lead author James E. Gangwisch, PhD, assistant professor at Columbia University Medical Center in New York, N.Y., said that the results strengthen the argument that short sleep duration could play a role in the etiology of depression.

"Our results are consistent with the theory that inadequate sleep is a risk factor for depression, working with other risk and protective factors through multiple possible causal pathways to the development of this mood disorder," said Gangwisch. "Adequate quality sleep could therefore be a preventative measure against depression and a treatment for depression."

Some other data:

Seven percent of participants (1,050) were found to have depression using the Centers for Epidemiologic Study-Depression Scale, and 13 percent (2,038) reported that they seriously thought about committing suicide during the past 12 months. Depression and suicidal ideation were associated with later parental set bedtime, shorter sleep duration, self-perception of not getting enough sleep, female sex, older age and lower self-perception of how much parents care.

The article does not go into detail regarding whether other variables were controlled, such as whether parents who set earlier bed times (which the article suggested was the primary method ensuring the most sleep) also engaged in other activities that might also reduce the risk of depression.  However, the accumulating data seems pretty clear: better sleep means better functioning.  I don't doubt this applies to teens who typically require more sleep than an adult anyway (nine hours per night is recommended).

What I've encountered more than a few times since becoming a parent are other parents who indicate they've had difficulty getting their kids to adhere to bed time schedules.  These are not adolescents we are talking about; we are talking about kids as young as three or four.  In terms of the other variables I wondered about before, this would be one of them.  If a parent can't instill (for whatever reason) a habit of going to bed at a healthy, reasonable hour when their kids are young, getting an adolescent to comply with bed time rules will be exponentially more difficult.  On the other hand, there may also be variables associated with the compliance on the part of the kids.  Lots of fodder for further research!

Napping Important to Mental Health of 4 and 5-Year Olds

Interesting study here about the potential relationship between the sleeping patterns of four and five-years olds and hyperactivity, depression, and anxiety.  What the article doesn’t address is the “Chicken/Egg” conundrum; are some kids having trouble because they aren’t napping, or are they having trouble napping because they are experiencing depression, anxiety, and hyperactivity?  The researchers also acknowledge that sleep patterns can be very individualized in terms of needs, so the idea that a child is automatically at risk due to a lack of napping is not accurate.  Here is one quick excerpt from the article:

Results indicate that children between the ages of 4 and 5 who did not take daytime naps were reported by their parents to exhibit higher levels of hyperactivity, anxiety and depression than children who continued to nap at this age. 

On the flip side, I’ve noted repeatedly my belief that sleep is an important factor in overall well-being; it stands to reason that adequate sleep is at least as important for children.  In addition, it seems like many parents are allowing children to stay up later into the evening than when I was a lad, which may place additional importance on napping as a way for children to get enough sleep.  Clearly, more research would need to be done examining different sleeping patterns in order to come to more definitive conclusions (i.e. if a five-year old gets 12 hours of sleep at night, is that the equivalent of a child who sleep 10 hours at night, and also takes a nap?).  Still and all, any article that highlights the necessity of getting adequate shut-eye is fine by me. 

Maternal Depression and Infant Sleep Disturbance

This article discusses the recent finding that infants born to mothers with depression exhibit sleep difficulties as soon as two weeks after birth.  This finding, though preliminary (this initial research only had 18 subjects) is important, in that early sleep difficulties are associated with the later development of early-onset depression.  From the article:

Results indicate that infants born to mothers with depression had significant sleep disturbances compared to low-risk infants; the high-risk group had an hour longer nocturnal sleep latency, shorter sleep episodes and lower sleep efficiency than infants who were born to mothers without depression. Although average sleep time in a 24 hours did not differ by risk group at eight two or four weeks, nocturnal total sleep time was 97 minutes longer in the low-risk group at both recording periods. High-risk infants also had significantly more daytime sleep episodes of a shorter average duration.

The article also discusses the potential reversibility of these sleep difficulties as a way of potentially reducing or eliminating the later development of depression.  I've posted several articles regarding the importance of sleep, and the assocation of sleep problems with other issues, and it is no surprise that sleep problems at infancy is associated with later mood difficulties.  Hopefully further research will allow for early detection and intervention.

Anxiety and Insomnia Increase Risk Of Diabetes in Men

According to this research, men who experience psychological distress (including anxiety and insomnia) part significantly greater risk for developing Type 2 diabetes. Anxiety and depression have already been implicated in the development of heart disease, and were suspected of playing a role on the development of diabetes as well. From the article:

The men were tested for diabetes eight to ten years later and it was found that the men with the highest levels of psychological distress were 2.2 times more likely to develop Type 2 diabetes than those with the lowest levels. Altogether 103 men developed Type 2 diabetes.

Interestingly, women were not found to be at greater risk. In addition, the mechanism for this association will require further research. However, one important point to take away from this article is the ongoing documentation that one’s mental health functioning is significantly related to one’s overall functioning. This includes the observation of the impact of insomnia, which I’ve discussed previously as a simple barometer for assessing one’s overall level of functioning. In other words, if your sleeping well your doing well, and vice versa. I continue to expect that as research like this comes out, there will be an increased priority on addressing issues such as insomnia. Hopefully, the general public will also increase its willingness to address such issues, and not simply through the use of sleeping medication, but by actually addressing the problem. Not only will people function better, their health will improve.

What the Heck, Let’s Do a Sleep Round-Up

Funny, I do one post on sleep, and then find more interesting sleep-related articles. They all confirm just how important getting your zzz’s can be:

1) This article discusses research showing that poor sleep among adolescents increases the risk for all kinds of emotional and behavioral difficulties, including ADHD. From the article:

According to the results, students reported sleeping, on average, 7.6 hours per school night, with 48 percent reporting less than eight hours. Hours of sleep per school night were significantly positively associated with GPA and level of motivation, and significantly negatively associated with clinically significant levels of emotional disturbance and ADHD. Each additional hour of sleep on school nights lowered the odds of scoring in the clinically significant range of emotional disturbance and ADHD by 25 percent and 34 percent, respectively.

Now, I don’t think getting fewer hours of sleep causes ADHD; this association is correlational rather than causal. But the findings are still important. First, are the behavioral and emotional difficulties causing the sleep problems, or making them worse? Will you experience a reversal of sorts if you increase your amount and quality of sleep, or at least make your symptoms more manageable? I think so, and it especially applies to adolescents, who require more sleep than adults (recommended nine hours per night).

2) Related to the first article is an older article suggesting an association between poor sleep among adolescents, and an increased willingness to initiate smoking and drinking. Again, the study is of associations rather than causes, but poor sleep is associated with all sorts of unhealthy things.

3) This article examines the relationship between poor sleep in college students with depression and symptoms of suicide. One of the hallmark efforts of anyone treating people with depression should be to improve their sleep. With college students, the academic and interpersonal demands of their current life situation would make this even more paramount. Unfortunately, getting quality sleep in college is often difficult, even if the client is willing. Dorms can be extremely loud, even on weekdays, and the pressure by peers to stay up late (and not just for parties, but all sorts of reasons) and then “sleep in” makes improving one’s quality of sleep through the typical “sleep hygiene” methods that much harder. Throw in alcohol use, the use of stimulants to stay awake and cram, etc. , and it’s amazing anyone in college ever gets a decent night’s sleep.

4) Anyone working with veterans ought to be asking about the quality of their sleep as well. According to this study, returning vets are reporting sleep problems on a level equal to people with significant insomnia. Their re-adjustment, I would imagine, would fare significantly better if they are getting better sleep.

Marital Happiness Equals Better Sleep for Women

This article finds another link between higher overall functioning in life, and better sleep. In this case, the researchers were examining the relationship between the level of marital happiness in women, and the quality of sleep. The results suggest (at least for Caucasian women), that a happier marriage is related to better sleep.

Again, I have to admit this isn’t all that surprising, except for the fact the results may not apply to women of color. Sleep is often effective as a sort of “Life Satisfaction Barometer,” in that the better you are functioning, the better you sleep, and vice versa. I would imagine, for example, people would rate their marriages better if their sleep improved. In some cases, sleep is the chicken, in other cases, the egg; in some cases we don’t know. But in any event, improving sleep generally helps someone do better in general, and doing better in general helps someone sleep better at night.

Another Informative Article Discussing the Link Between Insomnia and Depression

This is a very informative article discussing how insomnia is not always just a symptom of depression, but often it is a precursor for depression. In other words, it is not always the result, it may be the cause, or at least a signal of what’s coming. Lots of information is packed in here, so if you or anyone you know has trouble with sleep, please check this out. Statistics are provided, as well as the specific problems associated with insomnia for adults, older adults, as well as children. Here is one paragraph:

"For many years, it was assumed that insomnia was produced by depression or, in diagnostic parlance, secondary to the depressive disorder," says Dr. Spielman. "This view was first challenged by a research study in the late 1980s that showed that individuals with insomnia and free of depression that were untreated were more frequently depressed one year later. Following this paradigm-shifting study, there have been seven other studies that have reached similar conclusions. It is now well established that insomnia is a risk factor for depression."

And another:

"Once depression has occurred, insomnia typically precedes recurrent bouts of depression," says Dr. Arand. "In addition, insomnia is a predictor of acute suicide among people with mood disorders. However, both depression and insomnia are treatable, and individuals experiencing either symptom should seek treatment."

And here is a part of the article providing recommended amounts of sleep, based on age:

It is recommended that infants (three to 11 months) get 14 to 15 hours of nightly sleep, while toddlers get 12 to 14 hours, children in pre-school 11-13 hours and school-aged children between 10-11 hours. Adolescents are advised to get nine hours of nightly sleep and adults seven to eight hours.

Many more facts and statistics are provided, more than enough to get people to take this seriously. Also included are sleep improvement recommendations. Once again, I cannot emphasize how good this article is. Please read it, and encourage others to as well.

Sleep Problems Associated with Behavioral Difficulties in Children

This article reviews recent research into the relationship between insomnia (and other sleep problems) and behavioral problems, in children. According to the article, the researchers assessed the children based on weight, sleep-disordered breathing (SDB), other sleep-related difficulties, as well as their behavior.  The study determined the additional sleep disorder, such as insomnia, was the greatest predictor of behavioral difficulties:

“Somewhat surprisingly, the strongest predictor of adverse behavioral outcomes and CBCL scores was the presence of at least one additional sleep diagnosis, especially insomnia - not the measure of SDB disease severity, which researchers thought would play a more significant role.”

However, the authors cautioned against interpreting the results to mean SDBs did not have an impact. It may just be the impact is not quite as strong as the other factor. Weight also played a factor, with the largest difference between weight groups on measures of behavioral conduct being between the overweight versus average-weighted children.

Overall, the results indicate less sleep equates with more behavioral difficulties. To me, this isn’t surprising at all. If you’ve read this blog, you’ve seen numerous posts where I suggest how you sleep is an effective rough estimate of your overall functioning. In children, it makes complete sense that difficulties in functioning will manifest as conduct-related problems. What I’d like to do at some point is to examine the literature on treatment of sleep-related problems in children. If anyone has any suggestions, please leave me a comment!

Infants Who Sleep Less at Increased Risk for Childhood Weight Gain

Here is an interesting review of research into weight gain in childhood. The researchers found infants who slept, on average, less than 12 hours per day were more likely to be overweight than their peers, even when other factors were controlled. In fact, the average amount of television watching was examined, and was found to have a minimal effect on weight gain, except when combined with less sleep. That combination actually led to the highest average weight gain. From the study:

The infants as a group slept an average of 12.3 hours per day. At the age of three, 9% of the children in the study (83) were overweight. After adjusting for other factors that influence a child's weight, such as the body mass index of the mother before pregnancy, the infants who slept less than 12 hours per day had a higher body mass index for their age and sex, a higher skinfold thickness, and were more likely to be overweight at the age of three.

The authors indicated the precise relationship between sleep and later weight gain is not completely understood. Hormone levels, less activity due to fatigue, and simply more time available to eat are all considered possibilities. It is also suggested techniques continue to be developed to aid parents in ensuring their infants and children get enough sleep.