The brain is an organ that conceals a myriad of mysteries. Of all, the dream is one of the processes that has aroused the most curiosity since Antiquity, when it was understood as a bridge between the earthly and the divine. Like an open door to the beyond.
We spend between a third and a quarter of existence entangled in its fine threads, basically giving way during the night to the drowsiness which guides us towards its most inhospitable territories. And it is that we all sleep, because it is a universal need to survive (and a pleasure for the most part).
However, many people complain about poor quality sleep because they have difficulty reconciling or waking up several times during the night. There are also those who wake up earlier than expected, and they all tend to feel very tired.
This article discusses them mental health consequences of insomniaIt is already known that engagement in this area is one of the most important indicators for the inference of psychological suffering. So let’s see this in detail.
What is insomnia?
It’s understood as insomnia any alteration of the sleep process, both in its beginning (difficulty in accessing sleep), as well as in its continuation (constant interruptions) and / or its end (Waking up too early); which limits the quality of life and considerably interferes with daily activity.
In this sense, three basic dimensions could be distinguished: duration (total time of sleep, for which there is great variability in terms of inter-individual differences), continuity (which is equivalent to the persistence of the process over a sufficient period of time for benefits) and depth (associated with neuronal physiology and activation). Each of them can be considered severely compromised at some point in the lifecycle.
About, sleep tends to be divided into two well-differentiated stages: REM and non-REM (NREM). The latter involves a series of phases (from 1 to 4) in which there is a progressive slowing down of the activity of the central nervous system (CNS), while in the first (which extends over 25% of the time) a electrical increase or hyperactivation similar to wake (with eye movements) would be appreciated. The two alternate in 90-minute cycles throughout the night, during which the REM phase is prolonged, and are necessary for relevant neural rest to occur.
The three forms of insomnia mentioned above represent, in their most intimate nature, difficulty in accessing REM sleep in a relevant way (Especially when it becomes difficult to stay asleep for the time needed to perform successive cycles). As the situation evolves, a myriad of complications arise in the physical, cognitive and emotional realms. It is important to note that a third of people recognize occasional sleep problems and 10% meet the diagnostic criteria for insomnia. As can be deduced, this is not a strange situation, as a significant percentage of the general population feels identified with it.
Next, let’s examine the concrete impact of insomnia on psychological health, by grouping together the seven most important consequences that can result from it. When any of these problems arise, it may be worthwhile to see a health specialist.
Main effects of insomnia on mental health
The relationship between insomnia and mental health is two-way: when one is affected, the other does the same, regardless of what is considered a cause and what effect. These are complications that are sometimes of some seriousness and in some cases even involve an objective risk to life. This is why treating this problem is important and should never be viewed as a minor or incidental problem. We go into all this in detail.
1. Emotional changes
One of the common consequences of poor quality sleep is mood swings, and there is some evidence that insomnia and difficulty regulating emotions have common physiological bases.
Thus, poor sleep can be associated with depressive and anxious symptoms, as well as noticeable irritability. In fact, we know today that those who suffer from a disease of this nature see their intensity worsen when, in addition, they have difficulty in enjoying a restful sleep. Pain as a symptom deserves special mention: its presence impairs sleep, while insomnia promotes a reduced pain threshold (becoming a much more intense and difficult experience to control).
At the process level, it is known that people with insomnia tend to interpret the adverse events they face more negatively, and also find it difficult to try to extract the positive aspects of the experience. daily. This problem is associated with hyperfunction of the amygdala (limbic region responsible for processing different emotions) and the functional decrease in its connection with the prefrontal cortex, On which depend the “cognitive mechanisms” to cope with the turbulence inherent in life. All of this facilitates a certain tendency towards frustration, in cases where the daily vicissitudes cannot be resolved with the desired immediacy.
On the other hand, there are a few studies in which it is suggested that the accumulation of sleepless nights significantly decreases emotional intelligence assessed by self-reports. From this could be deduced a concrete erosion of the basic ability to identify, recognize and communicate what is happening within us; as well as infer the states of others by interacting with them. Either way, this would be a reversible effect over time, as restful rest would restore its previous level of “functioning” (since intelligence is a relatively stable trait throughout life).
Finally, many studies point out that people with insomnia may experience impaired cognitive decision making and behavioral inhibition (both dependent on the prefrontal cortex); that would interact with depression, anxiety and / or irritability. The result implies the deployment of passive or impulsive action patterns, Which are associated with an increased likelihood of failure when seeking solutions to a problem. That is why it is never recommended to treat problems of great importance under the influence of insomnia or unfavorable emotional states.
2. Memory problems
Interference in areas of memory is often a recurring cause of complaints in people with sleep problems. The most common is that declarative memory, and in particular the procedural subtype, is particularly impaired, which would limit the ability to recall events from the recent past.
In turn, erosion of working memory related to insomnia has been described (a feature that allows temporary storage of information for use during a specific task). In the latter case it is very common that difficulties arise in understanding a written / spoken text of a certain length, Or to successfully develop activities that require storing information in the background.
REM sleep is a key physiological process for maintaining memory, as it optimizes the neural process by which we consolidate information into long-term storage and / or remove incidental and unnecessary data. It is therefore essential for learning; from what is understood, spending a night awake to study is often an inappropriate and counterproductive strategy. In this way, a subject who has difficulty sleeping may report difficulty trying to acquire new knowledge, as well as applying it later (such as in an exam, for example).
Memory problems and insomnia often present in older people, And they may share some physiological basis (such as pineal gland calcification, which could also contribute to cortical dementias). Finally, the strong relationship between insomnia and memory decline may be due to the use of sedative / hypnotic psychotropic drugs (e.g. benzodiazepines) which are prescribed for the treatment of sleep disorders, as we know that their prolonged administration or excessive precipitates adverse effects. in such an area (anterograde-type amnesia or severe blockage during the generation of new memories).
3. Attention problems
Along with memory, attention is the process most often compromised when complicating Restful Sleep. The orientation response to stimuli that suddenly burst into the perceptual field is usually fundamentally injured, which increases response times (the person appears abstracted and slowed down). Deterioration in alternating attention, that is, the ability to ‘change’ focus when two tasks occur (one after the other) over short periods of time, has also been observed.
To finish, this decline can be generalized to the sustained and selective subtype. In this case, explicit problems would be posed to maintain the attentional resources during the development of a task which the long extension thus necessitates, as well as to discriminate in a complex environment which stimuli are relevant to the desired goal and which not. Thus, when the person is immersed in an environment saturated with various elements competing for his attention, a feeling of overflow would appear (appreciable in the management of the volume of information).
Attention deficits also imply a higher risk of accidentsAs there would be an increase in distractibility and a loss of reflexes. For this reason, anyone who drives a vehicle regularly should take special care when suffering from insomnia.
4. Sexual problems
Insomnia can be linked to deficits in the sexual sphere, especially in men. The most common is that it is expressed at the erectile level, with problems reaching a firm swelling of the penis that allows penetration. The most notable difficulty is when the person coexists with other additional clinical symptoms; such as sleep apnea, ‘delayed’ circadian rhythm (falling asleep and waking up too late) or restless legs syndrome (urgent and painful need to move the legs to relieve the apparent tension that builds up in them ).
Some hypotheses suggest it as a possible cause of erectile dysfunction a noticeable reduction in testosterone in the bloodstreamThis has been shown in men who have difficulty sleeping properly or who wake up several times during the night (especially in the second half).
And there is evidence that this hormone increases its production at the onset of sleep (reaching its peak in the first REM phase), and that its levels are higher while remaining asleep than during waking hours. Insomnia is said to hamper its synthesis, which affects erection (as it is essential for this process), and also contributes to the increase in heart disease. in this population (a risk that is accentuated in the case of insomniacs by making comparisons with those who are resting well).
Hallucinations are abnormal perceptions in which stimuli are involved that are not in the perceptual field, in any sensory modality. Many studies point out that insomnia in extreme cases can occur with very different hallucinations, even in people without pathology of any kind.
Some of the most accumulated evidence is hypnagogic (awakening from sleep) and hypnopompic (sleeping upon awakening), as well as those that occur against the background of sleep paralysis. all they are much more common when you have not fallen asleep properly on the previous days.
In people with a psychotic disorder, such as schizophrenia, insomnia is considered a risk factor for the onset of an acute episode or its onset. In fact, it is one of the main symptoms of the prodromal stage, which precedes the articulation of the “final” picture (and which lasts for months or even years). Such insomnia would make it possible to anticipate the onset of paranoid delusions in certain patients, which could be explained by an increase in dopamine levels after the first sleepless night (a compensation mechanism to cushion the deficit in cognitive functions generally competing with this moment).
6. Reduced vitality
The loss of vitality, in the extreme is fatigue, has for elementary cause (in the general population) poor quality sleep. This is a common circumstance, which coincides with the total percentage of people who occasionally have difficulty sleeping fully (between 20% and 40%, especially among women). The problem leads to high daytime sleepiness and loss of productivity, and is even associated with depressed feelings and impaired memory or attention (which we discussed above).
Fatigue associated with insomnia is accompanied by intense perception loss of energy, general weakness, feeling unwell and eroded performance in daily tasks. Of all the problems that disrupt the integrity of sleep or its structure, it is perhaps apnea that causes it to explode the most systematically (respiratory blockage that causes a series of brief micro-awakenings, which interrupt the sleep cycle. active before reaching the REM repair phases).
7. Increased risk of Alzheimer’s disease
The relationship between insomnia and Alzheimer’s disease has been known since the 1990s, although it is during the last decade that knowledge on this issue has increased. Thanks to neurophysiological studies, and with the invaluable help of neuroimaging techniques or post-mortem analysis of brain tissue, we have come to the conclusion that a function of sleep is to “clean up” wasted neuronal activity. Throughout the day, being awake involves the production of proteins in the central nervous system, the persistence of which is toxic, but which “empties” each time you sleep to avoid excess or accumulation.
Of all these, the beta amyloid protein has been found to be arguably the most explanatory, given that it is one of the elementary pathological bases of such frequent cortical dementia. Well, it has been corroborated that insomnia promotes its accumulation in the medium / long term, reinforcing one of its most important physiological risk factors (according to the available evidence).
- Cunnington, D., Junge, M. and Fernando, A. (2013). Insomnia: prevalence, consequences and effective treatment. The Medical journal of Australia, 199 (8), 36-40.
- Fernandez-Mendoza, J. and Vgontzas, A. (2013). Insomnia and its impact on physical and mental health. Current Psychiatric Reports, 15 (12), 418.
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