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A Surprising Finding: Sleep Apnea Is Linked With Depression!

If you have sleep apnea, you’re more likely to suffer from depression. I can’t help but to be amazed that theses type of studies are still performed. I know that in the name of science, you have to show that there are statistical associations between two conditions that are thought to be related. But it’s like doing a study that shows that if you cut your hand, you’re more likely to bleed, or if you trip over an uneven sidewalk, you’re more likely to fall.

You don’t have to be a doctor to know that not sleeping well for extended periods can definitely cause you to feel depressed. The skeptics will then point out that there’s only a strong association between depression and sleep apnea, and that it doesn’t show that sleep apnea actually causes depression. Knowing how prevalent sleep apnea is in our society (most of it undiagnosed), it makes sense to at least think about obstructive sleep apnea before you make a diagnosis of depression and prescribe antidepressants. Unfortunately, even if a randomized placebo-controlled prospective study of thousands of patents showed that having untreated sleep apnea leads to higher rates of clinical depression, it’s unlikely that physicians will change the way they diagnose and treat depression.

Interestingly, most antidepressants suppress REM sleep. Coincidentally, REM sleep is when you’re most likely to have obstructions and apneas, due to complete muscle relaxation in your throat. So anything that lowers REM sleep will by definition lower your rate of apneas. In fact, there are published studies showing that REM sleep deprivation can be helpful for depression. Not having as many apneas could make you feel better during the day. I realize this may be an overly simplistic explanation, but it’s definitely something that the scientific community should think more about.

Come to think of it, there are no prospective randomized double-blinded placebo-controlled trials showing that drinking water cures dehydration. Millions of mothers are giving their children water every day to treat dehydration without FDA approval. 

Is Nocturnal Asthma Really Sleep Apnea?

Having an asthma attack in the middle of the night can be a frightening and terrifying experience. Typically, these attacks happen in the early morning hours, just before awakening. 

Now there’s research showing that poorly controlled asthma during pregnancy can increase a woman’s chances of developing preeclampsia (50%) and premature births (25%). Furthermore, infants born to mothers with poorly controlled asthma delivered babies that were about 0.2 pounds less than those born to mothers without asthma.

We typically think of asthma being a separate, distinct condition from obstructive sleep apnea, and it’s treated in completely different ways. However, it’s not just coincidence that nocturnal awakenings from asthma and the most intense periods of apnea occur at the same time in the middle of the night—the early morning hours. The early morning hours are when REM sleep is most prominent, and this is the time when throat muscles are most relaxed. Having an apnea also is known to cause reflex, which is known to reach the throat as well as the nose and the lungs. In one small study in people with sleep apnea and asthma, treating sleep apnea with CPAP significantly improved nocturnal asthma symptoms. 

We know that any degree of stress on the mother’s body can lead to a higher rate of pregnancy-related complications and low birth rates. Even snoring by the mother alone was found to result in lower Apgar scores in newborn infants. Apneas are also known to raise blood pressure and promote insulin resistance. Stress hormones are also known to increase when you have apneas.

In light of all these findings, it’s not surprising that pregnant women with poorly controlled asthma have higher complications rates. This is another great example of “connecting the dots” between two seemingly unrelated conditions, which only adds to support my sleep-breathing paradigm.

 

 

Understanding Your Sleep Study Report

Sleep Your Way To Better Creativity

There’s a common phrase that’s used when people are searching for creative answers: "Let’s sleep on it." A new study that was summarized in the New York Times shows that this is literally true. By sleeping more, we now know that you’ll be more creative. However, this study revealed that the type of sleep stage was more important than the length of time in sleep. In particular, researchers found that napping which included time in REM sleep lead to significantly better in word association test scores. REM sleep (rapid eye movement) is the sleep stage when you’re dreaming. 

 

Although napping without REM sleep resulted in slightly better test scores, naps that included REM sleep resulted in close to a 40% improvement over pre-nap scores.

 

This study is interesting in that we know that most of our REM sleep is in the second 1/2 of the night. If you’re only getting the bare minimum 5 hours, you’ll get enough of the non-REM deep sleep stage, but you’re probably missing out on most of your REM time. 

 

Plus, if you have a sleep-breathing problem, REM sleep is most commonly the time when you’re most likely to stop breathing and wake up. This will prevent you from staying in REM sleep, and more likely to have strange dreams or nightmares (since you’re waking up while dreaming). 

 

Even more reason to prioritize your sleep time.

Q: How many hours should I sleep?

 

A:  It depends. Assuming that you don’t have any sleep-breathing problems and no other medical issues exist, the general range is about 5-8 hours. Everyone is different, with various sleep requirements. If you do have a sleep-breathing problem, then since your sleep quality is not as good, you’ll need more.

It’s been shown that the bare minimum "core" sleep that one needs is about 5 hours. By 5 hours, you’ll have gotten most of your non-REM deep sleep. Studies have shown that people who sleep less than 5 hours or more than 9 hours have higher rates of depression and heart disease. In short sleepers, this makes sense. But why is sleeping extra long a problem? Sleeping longer than 9 hours means that you’re not sleeping efficiently, for whatever reason. The most common problem will be a sleep-breathing problem, such as obstructive sleep apnea or upper airway resistance syndrome. If you can’t sleep on your back, or feel tired no matter how long you sleep, get evaluated by a sleep specialist.
 

 

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