In February the National Sleep Foundation announced the publication of new guidelines for the amount of sleep that we should be getting based on a rigorous review of the literature. The guidelines suggested that adults should be getting between seven and nine hours of sleep. The results were widely distributed and commented on. It was noted that many people in our …
Getting Up Early
Getting up early is one of the best ways of counteracting depression. And having a strong circadian rhythm is especially important for people with bipolar depression because their internal “clock” may be less powerful. But it can be a challenge making a change in your sleep cycle, especially if you have always been a late riser. This article will talk about …
Sleep and Learning
What is the point of sleep? We have a page on this blog devoted to the question but in the last couple of years there’s been an outpouring of research pointing to the critical importance of sleep in sorting out memories (getting rid of unuseful ones) and generally “tuning up” the brain. A fascinating article last year pointed to evidence …
Chronic Insomnia Treatments
A recent study confirms that cognitive behavioral therapy is effective for chronic insomnia and is often more effective than medications. “What surprises us is that there isn’t more awareness of this treatment’s effectiveness and that there haven’t been more attempts to make the treatment more available to patients,” James M. Trauer of the Melbourne Sleep Disorders Centre in Australia told …
Chronotherapy for Depression
Chronotherapy for depression was recently shown to be effective in a fairly large and well designed study from New Zealand. What is chronotherapy? As discussed in the article, which appeared in Acta Scandanavica Psychiatrica, chronotherapy involves some combination of three separate sleep and wakefulness related interventions: Wake therapy. Wake therapy (previously known as “sleep deprivation” therapy, a harder sell to patients) …
CBT for Insomnia Reduces Suicidal Thoughts
CBT for insomnia (CBTi) is clearly preferable to taking sleeping medications for most people. Studies show that cognitive behavioral therapy is associated with greater improvements in sleep quality than sleeping medications, and that those improvements are more durable, and, particularly in the elderly, sleeping medications are associated with significant adverse effects, including an increase in mortality. But it can be a hard …
Sleep Fatigue and Depression
Yesterday I gave a presentation at UCSF to the Mood Disorder Clinic psychiatrists and residents: An Update on Bipolar Depression. Much of that material is focused on psychopharmacology and so I will be writing about that on the gatewaypsychiatric.com blog. However, one important pearly derives from a series of studies that identify a strong link between sleep and depression. There is frequent …
Sleeping at the Right Time
Sleeping can become a major preoccupation at times of stress, or when one is depressed, or when the seasons change, as they are doing now. We tend to think about sleep as being something that is good for you. The more sleep and the better the quality of that sleep the better off you are. Elsewhere in this blog I’ve …
Fatigue and Depression or Bipolar
Fatigue is a common symptom in people with recurrent depression or bipolar. And in fact a common symptom in the general population. It is estimated that up to 10% of otherwise healthy people suffer from fatigue. And it is a more common symptom in women than in men. Sometimes fatigue may persist well beyond other symptoms of depression. First, it …
Natural Supplements and Insomnia
There are two herbs or supplements that have the best data supporting their effectiveness. Both appear to be safe but have modest effectiveness. Melatonin Valerian (Alone or Combined with Hops or Melissa) Melatonin: Rapid Effect on Sleep The body uses melatonin as part of the way it regulates the sleep-wake cycle. Levels of melatonin increase as light decreases (at …
Spring into Summer: Light and Sleep Changes
Many people have been noticing the very long days of late Spring and early Summer. There is more energy to get things done, although that energy can end up being challenged into anxiety and irritability if you aren’t careful and don’t get at least a few hours of sleep every night… I often think about my trips to Alaska a …
Sleep and the Lunar Cycle
One of our readers wondered if bipolar people are more sensitive to lunar cycles. I could not find any evidence for that, but I did run across a recent research report suggesting that everyone (bipolar or not) may have a sleep cycle that corresponds to the phase of the moon. Researchers at the University of Basel studied 33 people and …
Internet Therapies Generate Interest
There is increasing interest in “apps” that can support mental health (one of our most enthusiastic readers recently posted a query on this topic on the forum). Apps are rarely intended to deliver “therapy” – they are usually not written by mental health professionals (although mental health professionals may be consulted along the way). Their goal is to be appealing …
Smart Phones May Disrupt Sleep
There is no “off” switch for our brains. Going to sleep, for most people, involves a process of “coming down” from our hectic and sometimes stressful lives. In the past, when there was no electricity, the sun went down and we went through a natural process of getting tired and then falling asleep. But now we can keep the lights …
Sleep Deep Cleans Your Brain
Beep, beep, beep, beep! Snooze……Beep, beep, beep, beep! You open your eyes, roll out of bed and start wondering why you stayed up so late to watch another episode of your favorite TV series, play another video or computer game, or catch up with your friends, etc. We have busy and full lives, which results in less and more disrupted …
The Evils of the Snooze Button – Why Sleeping In Makes You Feel Tired
Winter is the time of year that the snooze button on your alarm clock can wreck havoc with your mood. Just as waking up early and getting light and exercise is the fastest way to improve depression, trying to sleep in, or lying in bed thinking about why you don’t want to get up, is the best way to make …
Using a Therapy Light
Christmas vacation is ending, It has been wonderful to spend some relaxing time with family, getting up later in the day, lounging around and playing games, reading, or watching TV… and eating too much good food. Now the challenge is getting back to a more productive schedule. For many of us, our bodies are in a “hibernating” mode that makes …
Sleep Therapy and Depression
What would you do if you could double the effectiveness of your antidepressants? Let’s say that this new treatment also had no known side effects, and was completely safe. That is what four studies have suggested could happen if people who were started on antidepressants received cognitive behavioral therapy for insomnia (CBTi). However, this treatment is not widely available. We …
“Normal” Sleep
One of the justifiable criticisms of psychiatry is that it has a tendency to define a relatively narrow range of behavior as normal. We often tell the psychiatry residents to watch out for this tendency, and try to avoid it. Certainly sleep medicine is at least as prone to this tendency as psychiatry, as we are reminded by a fascinating …
Mood and the Brain’s Clock
As we slowly move from summer to fall, it may be timely that the issue of Biological Psychiatry that arrived in the mail today is devoted to how the brain’s clock affects mood. It points to growing evidence that part of what drives mood cycles are disruptions in the brain’s daily (circadian) rhythms. It appears that people who are vulnerable …