By: Sheila Kun RN, BSN, MS, CPN, FCCP
Abstracting from Raymond J. Kotwicki, MD, MPH, Charles B. West Chief Medical Officer, let us continue to explore the topic of sleep and thought disorders.
Sleep and Thought Disorders
Some researchers point to a potential correlation between lack of restorative sleep and thought disorders like schizophrenia (a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.) For individuals with a genetic predisposition for schizophrenia, sleep disruption may contribute to the development of symptoms like hallucinations and delusions.
Without regular deep stage sleep, the brain is unable to “prune” the connections between neurons that have associated a thought with an image or sound, for example. Over time, the association becomes hardwired and may manifest as a visual or auditory hallucination or a delusion, which are cardinal symptoms of schizophrenia.
Sleep and PTSD
People who have experienced trauma sometimes experience night terrors, which are especially frightening and vivid nightmares. During a night terror, a trauma survivor might re-experience the trauma or a more generalized terrifying scenario. In fact, sleep disturbance is the most common medical complaint among veterans with PTSD.
Night terrors can drive an unhealthy pattern of behavior in which a trauma survivor is anxious about falling asleep because they don’t want to experience a night terror. After falling asleep, they have a night terror and wake up in a highly stimulated and emotional state. They often are unable to fall back asleep, and some individuals may use alcohol or other unhealthy strategies to cope with the resultant anxiety. Without deep sleep, the frightening memories and associations continue to become hardwired in the brain and start to affect thinking and behaviors, which can impact an individual’s ability to function.
Exposure with response prevention (ERP treatment) may be indicated to help alleviate PTSD symptoms, including night terrors. As the night terrors fade, individuals with PTSD can focus on developing healthy sleep habits and start benefiting from restorative sleep.
Now that we have examined the effect of sleep related disorders, we look forward to treatment recommendations next week for these sleep related issues.
Your homework from the Care Ministry this week: do an inventory of your sleep habit. This would be a good preparation for our topic from next week.
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