| What About
Sleep and Disease?
Sleep and sleep-related problems play a role in a large
number of human disorders and affect almost every field
of medicine. For example, problems like stroke and asthma
attacks tend to occur more frequently during the night
and early morning, perhaps due to changes in hormones,
heart rate, and other characteristics associated with
sleep.
Sleep also affects some kinds of epilepsy in complex
ways. REM sleep seems to help prevent seizures that
begin in one part of the brain from spreading to other
brain regions, while deep sleep may promote the spread
of these seizures. Sleep deprivation also triggers seizures
in people with some types of epilepsy.
Neurons that control sleep interact closely with the
immune system. As anyone who has had the flu knows,
infectious diseases tend to make us feel sleepy. This
probably happens because cytokines, chemicals our immune
systems produce while fighting an infection, are powerful
sleep-inducing chemicals. Sleep may help the body conserve
energy and other resources that the immune system needs
to mount an attack.
Sleeping problems occur in almost all people with
mental disorders, including those with depression and
schizophrenia. People with depression, for example,
often awaken in the early hours of the morning and find
themselves unable to get back to sleep. The amount of
sleep a person gets also strongly influences the symptoms
of mental disorders.
Sleep deprivation is an effective therapy for people
with certain types of depression, while it can actually
cause depression in other people. Extreme sleep deprivation
can lead to a seemingly psychotic state of paranoia
and hallucinations in otherwise healthy people and disrupted
sleep can trigger episodes of mania (agitation and hyperactivity)
in people with manic depression.
Sleeping problems are common in many other disorders
as well, including Alzheimer's disease, stroke, cancer,
and head injury. These sleeping problems may arise from
changes in the brain regions and neurotransmitters that
control sleep, or from the drugs used to control symptoms
of other disorders. In patients who are hospitalized
or who receive round-the-clock care, treatment schedules
or hospital routines also may disrupt sleep.
The old joke about a patient being awakened by a nurse
so he could take a sleeping pill contains a grain of
truth. Once sleeping problems develop, they can add
to a person's impairment and cause confusion, frustration,
or depression. Patients who are unable to sleep also
notice pain more and may increase their requests for
pain medication. Better management of sleeping problems
in people who have other disorders could improve these
patients' health and quality of life.
About the Author
Chris Read, An associated editor to Hateweight.com.
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