The brain is an organ that harbors endless mysteries. Among all of them, the dream is one of the processes that has aroused most curiosity since ancient times, where 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 the existence entangled in its fine threads, yielding fundamentally during the night to the drowsiness that guides us to its most inhospitable territories. And we all sleep, it is a universal need to survive (and a pleasure for most).
However, there are many people who complain about a poor quality dream, because they either find it difficult to fall asleep or they wake up many times throughout the night. There are also those that are revealed earlier than expected, and all of them tend to feel very tired.
This article addresses the consequences of insomnia on mental health , as it is known that commitment in this area is one of the most important indicators for the inference of psychological suffering. Let’s see, then, in detail.
- Related article: ” The 7 main sleep disorders“
What is insomnia?
Insomnia is understood as any alteration in the sleep process, both in its beginning (difficulty in accessing sleep), and in its continuation (constant interruptions) and / or its completion (waking up too early); which limits the quality of life and substantially interferes with daily activity.
In this sense, three basic dimensions could be distinguished: the duration (total time that falls asleep, for which there is great variability in inter-individual differences), continuity (which is equivalent to the persistence of the process throughout sufficient time to obtain benefits) and depth (associated with physiology and neural activation). Any of them can be compromised acutely at some point in the life cycle.
Roughly, sleep tends to be divided into two distinct stages: REM and non-REM (nREM) . The latter implies a series of phases (from 1 to 4) in which a progressive slowdown in the activity of the central nervous system (CNS) is observed, while in the first (which extends 25% of the time ) an increase or electrical hyperactivation similar to wakefulness (with eye movements) would be appreciated. Both alternate in cycles of 90 minutes throughout the night, in which the REM phase is extending, and are necessary for the relevant neural rest to occur.
The three forms of insomnia that have been cited represent, in their most intimate nature, a difficulty in accessing relevant REM sleep (especially when it becomes difficult to stay asleep for the time required to complete the successive cycles). As the situation continues, a myriad of complications arise in the physical, cognitive and emotional fields. It is important to keep in mind that one third of people recognize specific problems when sleeping, and that 10% meet the criteria for the diagnosis of insomnia. As it is deduced, it is not a strange situation, since an important percentage of the general population feels identified with it.
Let’s look at the concrete impact of insomnia on psychological health, gathering the seven most important consequences that can be derived from it. When you attend any of them, it may be interesting to visit a health specialist.
Main effects of insomnia on mental health
The relationship between insomnia and mental health is bidirectional: when one of them is affected the other also does, regardless of which is considered cause and which effect. These are complications that are sometimes serious, and even in some cases involve an objective risk to life. That is why the treatment of this problem is important, and should never be considered as a minor or accessory matter. We delve into all this in detail.
1. Emotional changes
One of the usual consequences of having a poor quality sleep is the fluctuation of mood, and there is evidence that insomnia and difficulties in regulating emotion have common physiological bases .
In this way, sleeping badly can be related to depressive and anxious symptoms, as well as to a remarkable irritability. In fact, today we know that those who suffer from a picture of this nature are aggravated by their intensity when, in addition, they have trouble enjoying a restful sleep. Pain as a symptom deserves special mention: its presence alters sleep, while insomnia promotes a reduction in the allergic threshold (becoming a much more intense and difficult to control experience).
At the process level, it is known that people with insomnia tend to interpret in a more negative way the adverse events they face, and that they also have difficulties in trying to extract the positive aspects of daily experience. This problem is associated with the hyperfunction of the amygdala (limbic region responsible for processing different emotions) and the functional decrease of its connection with the prefrontal cortex , on which “cognitive mechanisms” depend on which to deal with the turbulence inherent in the lifetime. All this facilitates a certain tendency to frustration, in cases where 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 substantially reduces the emotional intelligence assessed through self-reports. This could lead to a concrete erosion in the basic ability to identify, recognize and communicate what is happening inside us ; as well as inferring the states of others by interacting with them. In any case, it would be a reversible effect with the passage of time, since a restful rest would restore its previous level of “functioning” (since intelligence is a relatively stable trait throughout life).
Finally, many studies indicate that people with insomnia may see the cognitive process of decision making and behavioral inhibition altered (both dependent on the prefrontal cortex); which would interact with depression, anxiety and / or irritability. The result implies the deployment of passive or impulsive action patterns , which are associated with a greater probability of failure during the search for solutions to a problem. That is why it is never recommended to address issues of great importance under the influence of insomnia or adverse emotional states.
2. Memory problems
Interference in memory domains is usually a recurring complaint among those who have trouble sleeping. Most commonly, declarative memory is especially altered, and especially the procedural subtype, which would limit the ability to evoke events from the recent past.
In turn, an erosion in working memory linked to insomnia (a function that allows temporary storage of information for use during a specific task) has been described. In the latter case, it is very frequent that they have difficulties to understand 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 to maintain memory, since it optimizes the neural process by which we consolidate information in the long-term store and / or eliminate accessory and useless data. It is basic, then, for learning; It is understood that spending a night awake to study is usually an inappropriate and counterproductive strategy. In this way, a subject who has trouble sleeping may report difficulties when trying to acquire new knowledge, as well as when applying them later (as in an exam, eg).
Memory and insomnia problems usually occur together in older people , and they may share some physiological basis (such as calcification of the pineal gland, which could also contribute to cortical dementias). Finally, the solid relationship between insomnia and mnesic decline may be due to the use of sedative / hypnotic psychoactive drugs (benzodiazepines, eg) that are prescribed for the treatment of sleep disorders, since we know that their prolonged or excessive administration precipitates harmful effects in such area (anterograde amnesia or serious blockage when generating new memories).
- You may be interested: ” Memory problems: their 3 types and possible causes“
3. Attention problems
Together with memory, attention is the process that is most commonly compromised by making a restful sleep difficult. The orientation response to stimuli that suddenly break into the perceptual field is usually damaged, which increases response times (the person seems absorbed and slowed down). It has also been observed a deterioration of alternating attention, that is, the ability to “change” the focus when two tasks are succeeded (one after the other) in short time periods.
Finally, this decline can be generalized to the sustained and selective subtype . In this case, explicit problems would be made to maintain the attentional resources during the development of a task whose length is so required, as well as to discriminate in a complex environment which of the stimuli are relevant to the intended objective and which are not. In this way, when the person is submerged in an environment saturated by several elements that compete with each other for their attention, a sense of overflow would emerge (appreciable when managing the volume of information size).
Attention deficits also imply that there is a greater risk of accidents , as there would be an increase in distractions and a loss of reflexes. For this reason, whoever is a regular driver of any vehicle has to take special caution when he suffers from insomnia.
4. Sexual problems
Insomnia can be related to deficits in the sexual sphere, especially in men. The most common is that it is expressed on an erectile level, with problems to reach a firm swelling of the penis that allows penetration. The most notable difficulty is when the person lives with other additional clinical symptoms; such as sleep apnea, the “delayed” circadian rhythm (falling asleep and waking up too late) or restless legs syndrome (pressing and distressing need to move the legs to relieve an apparent tension that builds up on them).
Certain hypotheses suggest as a possible cause for erectile dysfunction a marked reduction of testosterone in the bloodstream , which has been evidenced among men who have difficulty falling asleep properly or who wake up many times throughout the night (especially In the second half).
And there is evidence that this hormone is increased production during the beginning of sleep (reaching the peak in the first REM phase), and that their levels are higher while staying asleep than when awake. Insomnia would hinder its synthesis, which would affect erection (since it is essential for this process), and would also contribute to the increase in heart disease in this population (a risk that is accentuated in the case of insomniacs when drawing comparisons with those who rest all right).
5. Hallucinations
Hallucinations are anomalous perceptions in which stimuli that are not in the perceptual field are involved, in any sensory modality. There are many studies in which it is pointed out that insomnia in extreme cases can occur with very different hallucinations, even in people without pathology of any kind.
Some of the most evidence accumulate are the hypnagogic (in the process of wakefulness to sleep) and the hypnopompic (in the transition from sleep to wakefulness), as well as those that occur in the context of sleep paralysis. All are much more frequent when you have not slept properly in the previous days .
In people with a psychotic disorder, such as schizophrenia, insomnia is considered a risk factor for the resurgence of an acute episode or for its onset. In fact, it is one of the main symptoms of the prodromal stage, which precedes the articulation of the “definitive” picture (and that extends over months or even years). Such insomnia would come to anticipate the emergence of paranoid delusions in some patients, which could be explained by an elevation in the level of dopamine after the first sleepless night (a compensation mechanism to cushion the deficit of cognitive functions that usually occurs in this moment).
- You may be interested: ” Hallucinations: definition, causes, and symptoms“
6. Vitality reduction
The loss of vitality, at the end of which is fatigue, has as its elementary cause (in the general population) a poor quality dream. It is a common circumstance, which coincides with the total percentage of people with specific difficulty in sleeping fully (between 20% and 40%, especially in women). The problem translates into high daytime sleepiness and a loss of productivity, and even comes to be associated with depressive feelings and impaired memory or attention (which we referred to earlier).
The fatigue that is associated with insomnia is associated with a perception of intense energy loss, generalized weakness, feeling of discomfort and erosion of performance in daily tasks . Among all the problems that disturb the integrity of the dream or its structure, perhaps apnea is the one that most consistently triggers it (respiratory blockage that causes a series of brief micro-wakeups, which interrupt the active sleep cycle before reaching the phases REM repairers).
7. Increased Alzheimer’s Risk
The relationship between insomnia and Alzheimer’s disease has been known since the 1990s, although it has been in this last decade that knowledge on this issue has been increased. Thanks to neurophysiology studies, and with the invaluable help of neuroimaging techniques or postmortem brain tissue analysis, we have concluded that a sleep function is to “clean” the residues of neuronal activity . Throughout the day, the fact of being awake implies a production of proteins in the central nervous system whose persistence is toxic, but that is “emptied” every time we sleep to avoid excess or accumulation.
Among all of them, it has been shown that beta amyloid protein is undoubtedly the one that has more explanatory importance, 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, enhancing one of its most important physiological risk factors (according to the available evidence).
