Did You Know May is Better Sleep Month and Mental Health Month?

I didn't either.

But I should. I am chronically sleep-deprived. Now I've always suffered from insomnia, since my teen years, but I honestly think I would sleep normally now if it weren't for two external factors: a night owl S.O. and a early morning cat.

I get squeezed at both ends. My S.O. is a night owl. This means he goes to work at an hour far later than average, gets home far later than average, pleads with me to stay up "just a little later" with him, which I end up doing so we can spend some time together. Then he wakes me up when he comes to bed a few hours later. Meanwhile my cat consistently wakes me up at 6AM, even when the  clocks are changed, she hits 6AM. I don't know how she does it, really. And she will not be denied.

So when I got an email from a representative for the Better Sleep Council I did read it with interest:

Americans seem to be willing to do almost anything to cope with sleep-deprivation and emotional stress, but when push comes to shove, they are turning to quick fixes in lieu of obvious solutions. According to the findings of the 2006 Better Sleep Month survey, Americans are ignoring the fundamental steps to improve quality sleep and mood.

It is well-known that sleep problems can be a key sign of depression. What people may not realize is that the reverse is also true — sleep disorders can actually trigger mood disorders and depression. As researchers learn more about the underlying cyclical connection between sleep and our mental health, the important balance is becoming even more apparent.

According to the 2006 Better Sleep Month survey, better sleep did result in better mood among respondents. When asked to rate their sleep quality, quantity, and overall mood over the course of one week, people who obtained seven or more hours per night were more likely to rate their general mood as excellent (57 percent), as opposed to those receiving an average of six hours of sleep or less (45 percent). Only 25 percent of respondents rated the quality and quantity of their sleep as excellent. That means that 75 percent need to take action to improve their sleep.

If experiencing trouble sleeping over a period of time, Americans report that they are most likely to change their sleeping schedule (51 percent) and build in time for more sleep (56 percent) to improve their sleep. However, this may not be a viable first-step solution, according to many experts.

More sleep doesn’t necessarily mean better, especially if underlying factors that contribute to poor sleep, such as an inadequate sleep environment or sleep-depriving behaviors, are not properly addressed. It may just mean that you end up tossing and turning in your bed for a longer time.

“The survey results show that people overlook some of the most obvious components of quality sleep,” said Nancy Shark, executive director of the Better Sleep Council. “Take for example the reluctance, even if needed, to replace an old mattress (66 percent say they are not likely). The mattress is literally the foundation of our sleep. Comfort and support aside, we spend an average of four entire months every year entirely on our bed. Given that kind of usage, your sleep surface cannot be an afterthought.”

Accordingly, additional consumer data from 2005 indicates that nearly half of Americans (47 percent) keep mattresses longer than many experts recommend. “As a rule of thumb, after five-to seven years of use, it’s a good time to evaluate your sleep set,” adds Shark. “You can get used to a bed long after it stops providing you with the optimal comfort and support you need.”

They also provided me with a Q&A with sleep expert and 2006 Better Sleep Month Spokesperson, Dr. Amy Wolfson, which you will find in the extended entry.

I know I don't get enough sleep, and I feel quite frusrtated about it on a regular basis. Because one can't "explain" to a cat why one is ignoring what I'm sure she considers her desperate physical requirement to be fed right now, I have been trying to go to bed earlier, despite the S.O.'s whining about it. Come to think of it, he doesn't seem to comprehend either: no matter how many times I explain that I'm constantly exhausted, and therefore no, I can't watch any more of our built up TiVo Now Playing list!

But I digress.

For more information about the Better Sleep Council and Better Sleep Month, please visit: http://www.bettersleep.org. And don't forget to check the extended entry for the Q&A.

Sleep Expert and 2006 Better Sleep Month Spokesperson Dr. Amy Wolfson answers common questions about sleep and emotional well-being.  Dr. Wolfson is a sleep researcher, Professor of Psychology at the College of Holy Cross, and authored the authored the book "The Woman's Book of Sleep: A Complete Resource Guide.”

Q: Is it a myth that we can “catch up” on sleep? Does “sleep debt” really exist?

A:  We can’t really catch up on sleep as we continue to accumulate a sleep debt over our lifetime.  However, just as the effects of sleeping longer for several nights can improve alertness, the negative effects of getting too little sleep accumulate over time. Getting an inadequate amount of sleep each night for a week can make you vulnerable to a number of problems: excessive sleepiness, irritability, reduced motivation, impaired performance, limited ability to think creatively, and so forth.

Q: What happens when your body doesn’t get the amount of sleep it needs? What are the implications?

A:  The timing and quantity of sleep and the onset of illness may be associated. New research suggests that if you are coming down with some sort of bug, sleep will probably have a preventive effect. Lack of sleep can impair an individual's physical health and emotional well-being. Inadequate and irregular sleep/wake schedules influence the body's defenses by weakening the immune system, straining the organs, and, therefore, making people more susceptible to illness.

Q: Do women need more sleep than men, and if so, why?

A:  No, both adult men and women need about 7.5 to 8.5 hours/sleep each night.

Q: Are women more like to be affected emotionally from sleep deprivation than men?

A: Women certainly are more likely to report that they feel depressed when they are unable to obtain an adequate or quality night of sleep. It is unclear; however, if this is a reporting bias or that a woman’s mood is more affected by insufficient sleep.  Overall, about 2 times more women report depression than men.

Q: What times in life are most important for a good night’s sleep

A:  A good, sufficient night of sleep is always important.  Sleep is as important as nutrition and exercise.  It is most important to pay attention to getting a sufficient night of sleep, however, when one is responsible for driving, operating machinery and/or responsible for taking care children.

Q: Is it true that sleep can have an effect on our emotional “performance” during the day? Is it just psychosomatic because you know you didn’t get enough sleep or is there really a neurological impact and explanation?

A:  Sleep definitely has an effect on our emotional well-being.  It is not merely psychosomatic; sleep results from changes in the balance of major neurotransmitters in the brain, such as serotonin, norepinephrine, dopamine, melatonin and others. Many of these neurotransmitter systems are also responsible for multiple brain functions, including those related to mood and other cognitive/emotional behaviors. It is not surprising that significant interactions occur between sleep and depression and/or depressed mood.

Q:  If sleep deprivation is impacting your mood one day, can you fix it immediately by just getting a good night’s sleep or are there residual or more long-term effects?

A:  One will find that as they begin to obtain a consistent sleep schedule and get an adequate amount of sleep, close to 8 hours per night, they will experience a better daily mood.  However, individuals diagnosed with clinical depression may require other interventions in addition to getting an adequate amount of sleep. 

Q: Does your sleep surface really make a difference in how well you sleep

A: Absolutely.  It is important to evaluate your sleep surface on a regular basis.  If you walk every day or every other day for exercise, you probably check to make sure that your walking shoes are in good shape and are not worn out.  Similarly, if you are having difficulty getting a quality night of sleep, it is important to evaluate your bed and sleep environment.

Q: When considering sleep disorders and depression, are sleep problems a result of depression, or is the depression a result of the sleep problems.

A:  Sleep problems and depression are associated with each other.  It can be difficult to tease the two apart.  Individuals who regularly get an insufficient amount of sleep for a variety of reasons may be more susceptible to feeling depressed.  On the other hand, individuals who are diagnosed with depression may have coexisting sleeping problems such as insomnia and/or chronic sleepiness.  Undoubtedly, if you are depressed and/or concerned about a sleeping problem, it is important that you seek attention from a health care provider who has expertise in both depression and sleep disorders.

Comments

[Trisha]

That's a nice post about sleep. Sleep issues don't get nearly the amount of attention that they should. Many people still act like those who go without enough sleep are just 'tougher', or willing to work harder or something. And that those who make sure they get enough sleep are just wimpy, not self disciplined, not trying hard enough, etc. When the reality is that the people who aren't getting enough sleep are just hurting their health, and those that are, are trying to stay as healthy as they can.

Trisha
My blogs:
Women's Health Research News
Butterfly Gardening Blog

[dr peg]

Good post, thanks. With helpful links. I'm going to email a link to your post to our clinic staff.

[potentillla]

Good grief. Why let your long-term health and possibly your relationship be affected by a cat?

You don't say whether you youself are naturally a lark or an owl, but you make it sound as though you would sleep longer in the morning if allowed to.

Shut her up at night so she can't wake you. And/or if all she wants is breakfast, get one of those mechanical food bowls on a timer (see below; random example from first Google hit) which will revolve automatically at 6am and let her at the food you filled it with the previous night.

http://www.gooddeals.com/shopexd.asp_Q_id_E_39

I just parachuted in from Grand Rounds, so excuse me if there is any relevant back-history I would know if I'd read the rest of your blog.

[Elisa Camahort]

Suffice to say I have tried many combinations of solutions over the many years I have had cat (19 years) and boyfriend (6 years.) It wouldn't make a very interesting post. Thanks for your concern.

[Trisha]

I'm not expert on cats - the experience I've had with them is watching my husband take care of his. And what I've learned from that is that isn't so easy to 'Shut her up at night'. There's no way a mechanical food bowl would work. For example, with our one cat, I think he likes the ritual and predictability of having someone feed him: getting his bowl and putting food in it. Closing the bedroom door doesn't work, he'd just scratch and claw it. As far as I can tell its just the way some cats are and there's not a lot you can do about it.

[Elisa Camahort]

Yes, true enough Trisha. Perhaps if I had a real big house I might not hear her yowling and scratching at the door from the only other room I have to "shut her up" in :)

Also, I agree it's not just the food...it's the attention.

[gumba61]

What about putting the cat in one of those cages at night?

As for the S.O. - what if you wore ear plugs to bed?

[Kitty City]

This is coming rather late to the discussion, but as someone with chronic, intractable insomnia, I just wanted to say I appreciated this post.

I've had cats as bedmates for more than 20 years. My current cat likes to share my pillow, and during the colder winter months she wraps herself around my head. On the rare occasions when I am away from home overnight, it doesn't feel right. In fact I find it harder to sleep when she's not there with me.

A 19-year-old cat is the equivalent of a 90-something human. At this point it would be distressing and inhumane for her to be shut in a room or caged in a kennel during the night. Her early-morning wakefulness is probably long-standing behavior that has been reinforced by Elisa's response. Kitty meows; Elisa gets up and feeds her; kitty thinks, "Oh wow, this worked! I'll try this again tomorrow!" Animal personality and preferences also can contribute to creating a pattern that can be hard to change.

Elisa, I'm wondering if she is an exotic breed, e.g. Siamese or Himalayan. Many of the exotics can have personalities that are a little more demanding. Given her age, it's also possible she has developed some age-related cognitive dysfunction, aka senility, that might be exacerbating her behavior.

I commend you on having a 19-year-old cat. Obviously you are taking good care of her and are committed to her. I volunteer at an animal shelter, and you'd be dismayed at how many kitties get chucked to the curb because they aren't perfect or because their owner simply gets tired of their behavior.

IMHO, it would make far more sense to retrain your S.O. ;)

[Elisa Camahort]

Hi Kitty City: Yes, I call her my amazing geriatric kitty. Or sometimes my little old lady kitty.Her sister died 3 years ago, and I actually think she prefers being the one and only.

Samantha also sleeps on my pillow...until she starts in on her morning torture :)

She is a plain old domestic short hair. We had a siamese growing up, so I know about their vocal stylings.

I (and my vet) do believe it has worsened as she ages due to something that elderly humans get too called Sundowner's Syndrome (?) They get more disoriented at night. For a while I was giving her anti-anxiety meds, which actually seemed to help, but the transdermal application in her ear was too corrosive (literally her ears went bald) and the liquid suspension made her foam at the mouth and spit it out. I could try the liquid again or a pill, but I confess that sometimes the stress of trying to force meds on her doesn't seem kind to inflict on a little old lady. At least when I give her sub-cutaneous fluids for her kidneys she doesn't mind at all.

Thanks for the kind words...my cat has been with me nearly my entire adult life, and she is a purring adorable creature for 22 hours a day. Annoying the other two...what are you gonna do!?

[Kitty City]

Wow, I'm impressed - both with your cat's longevity and with your care.

I would say your little old lady kitty has earned the right to be indulged during her golden years. ;)