By: Sheila Kun RN, BSN, MS, CPN, FCCP
Salesian Cooperator

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I hope you enjoyed the first part of the  publication by Raymond J. Kotwicki, MD, MPH, Charles B. West Chief Medical Officer on Sleep and Brain Health. This week we will examine the stages of sleep, and how sleep affect the mood disorders.

Sleep Architecture

Deep stage sleep comprises three of five stages of sleep. Each night, the body cycles through the five stages of sleep four to six times, spending approximately 90 to 120 minutes in each stage.

Initially, you enter lighter sleep stages, followed by deeper, slow-wave sleep. Later in the night, you should enter the extremely important stage of sleep, Rapid Eye Movement (REM) sleep. During REM, your brain is actually very active despite your body being physically at rest. REM is the stage of sleep when you dream. REM sleep alternates with slow-wave sleep for several hours.

“Sleep architecture” is a term used to describe how someone moves through the stages of sleep each night, the order of the cycles, the time spent in each cycle, and any periods of wakefulness in between. The best kind of sleep for restoring and promoting brain health is when you cycle through the stages of sleep in a predictable way, uninterrupted, every night.

People who don’t cycle through the stages of sleep in a predictable way because, for example, they have sleep apnea, may appear to get eight hours of sleep every night, but they are not getting the full benefits of restorative sleep.

Sleep and Mental Health

Sleep and Mood Disorders

Sleep is particularly important for people with mood disorders. Research indicates that a combination of medication therapy, evidence-based psychotherapy, and behavioral changes yield the best results in preventing mood episodes. While important behavioral changes also include a healthy diet, exercise, and social interactions, a regular schedule of eight hours of sleep each night is highly correlated with improved mood.

For example, for someone with bipolar disorder who is experiencing a manic episode, getting three nights of eight hours of sleep in a row greatly improves the likelihood that the manic episode will break, whereas prolonging a pattern of sleeplessness may lengthen the duration of the manic episode.

Individuals with atypical depression often get too much sleep; they may sleep 12 to 14 hours a night. For these individuals, taking steps to limit sleep to just eight hours a night can help improve mood and end a depressive episode.

Many antidepressant medications, such as SSRIs, actually change the amount of time you spend in certain stages of sleep so that you spend more time in the deeper stages of sleep and REM. Some in the medical community think this function of SSRIs is one of the reasons the medications work to alleviate symptoms of depression.

Your homework from the Care Ministry this week: understand the stages of sleep and their effect on mood disorders.

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