Lecture 15: Sleep and Mental Health

Question 1

What are the consequences of insomnia for cortical arousal?

Answer 1

1. subjectively perceived increase in cognitive activity
2. spectral: higher freq power during REM and NREM
3. ERP: sensitivity to auditory stimuli at wake and sleep onset
4. EEG: 24hr hyperarousal

Question 2

What are the consequences of insomnia for physiological arousal?

Answer 2

1. autonomic variables - increased HR during sleep and pre-sleep; increased sympathetic, decreased parasympathetic activity at night
2. increased metabolic rate
3. elderly: core body temp up
4. neuroendocrine: night time cortisol up

Question 3

Explain the components of Cognitive Behavioural Therapy for Insomnia (CBTi)

Answer 3

• sleep hygiene education
• sleep restriction prior to therapy (to create new associations once started)
• stimulus control (e.g., get out of bed if not sleeping)
• challenge dysfunctional beliefs

Question 4

What % comorbidity between depression and insomnia?

Answer 4

50%. Insomnia a risk factor for development of depression. Bidirectional.

Question 5

How does sleep fluctuate for BD patient?

Answer 5

manic: reduced need
depressive: insomnia/hypesomnia
sleep deprivation can trogger episode

Question 6

What are the key relationships between schizophrenia and sleep?

Answer 6

• Sleep disturbances predispose to schizophrenia.

- circadian abnormalities common, and 1/2 persist despite treatment

Question 7

Why is sleep disturbance common for adolescents?

Answer 7

Vulnerable period; maturational changes in brain, sleep, lifestyle, etc.

Specifically:

• synaptic pruning
• homeostatic sleep drive falls
• EEG: delta and theta power falls
• circadian changes
• sociocultural factors supporting late nights, bounce back over weekend extends problem