Sleep-circadian disturbances trigger mental health disorders


A new study suggests that disturbances in our sleep patterns and circadian rhythms can trigger or exacerbate a variety of psychiatric disorders. The research emphasizes the potential for treating mental health issues by addressing sleep-circadian disturbances.

The experts reviewed recent evidence on sleep and circadian factors, focusing on adolescents and young adults with psychiatric disorders. This is a time when disruption to sleep and circadian rhythms are likely to occur. 

What are sleep-circadian disturbances?

Sleep-circadian disturbances involve disruptions in the natural sleep-wake cycle, impacting both sleep quality and timing. Such disturbances often lead to difficulty falling asleep, staying asleep, or waking up too early. 

Our bodies operate on a circadian rhythm. This internal clock dictates sleepiness and wakefulness throughout a 24-hour period. When this rhythm is off, it can affect mental health, leading to issues like depression or anxiety. 

Study significance 

“Sleep-circadian disturbances are the rule, rather than the exception, across every category of psychiatric disorders,” said Dr. Sarah L. Chellappa from the University of Southampton.

“Sleep disturbances, such as insomnia, are well understood in the development and maintenance of psychiatric disorders, but our understanding of circadian disturbances lags behind.”

“It is important to understand how these factors interact so we can develop and apply sleep-circadian interventions that benefit the sleep and mental health symptoms of patients.”

Insomnia and psychiatric disorders

Insomnia is a condition that is far more common in individuals with mental health disorders than in the general population. It is particularly prevalent during the early stages of psychosis, affecting over half of those individuals. 

Furthermore, a significant portion of people with mood disorders experience both insomnia and hypersomnia, leading to a challenging cycle of sleep difficulties at night and excessive sleepiness during the day. 

The study sheds light on circadian rhythm sleep-wake disorders (CRSWD). The findings suggest that a substantial percentage of patients with a mood disorder experience altered sleep-wake patterns. This highlights the profound impact of body clock processes on psychiatric conditions.

Underlying mechanisms

The review delves into the mechanisms behind sleep-circadian disturbances in psychiatric disorders. It identifies adolescence as a critical period due to physiological and behavioral changes that affect sleep. 

“This variability in the duration and timing of sleep can lead to a misalignment between our body clock and our sleep-wake rhythms can increase the risk of sleep disturbances and adverse mental health outcomes,” said Dr. Nicholas Meyer of King’s College London.

The researchers also investigated the roles of genetics, exposure to light, neuroplasticity, and other factors. They found that individuals with a genetic predisposition towards a reduced change in activity levels between rest and wake phases are more likely to experience depression, mood instability, and neuroticism. 

Innovative treatments 

The study not only identifies the problem but also points towards potential solutions. “Targeting sleep and circadian risk factors presents the opportunity to develop new preventative measures and therapies,” said Dr. Renske Lok from Stanford University.

“Some of these are population-level considerations, such as the timing of school and work days, or changes in the built environment to optimise light exposure. Others are personalized interventions tailored to individual circadian parameters.”

Cognitive behavioral therapy for insomnia (CBT-I) and light therapy were shown to have positive effects on mental health disorders. Additionally, the researchers found the timing of medication, meals, and exercise to be effective treatments.

“Collectively, research into mental health is poised to take advantage of extraordinary advances in sleep and circadian science and translate these into improved understanding and treatment of psychiatric disorders,” said Dr. Chellappa.

The research was funded by the Alexander Von Humboldt Foundation.

The study is published in the journal Proceedings of the National Academy of Sciences (PNAS).

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