Sleep Is The Vital Sign Of Psychiatry

Yesterdays brief post, Just Go To Sleep, provoked and inspired many of us.  Perhaps it was its brevity, it’s mostly blank canvas in other words, that allowed for such freedom.  The comments ranged from major depressive disorder hypersomnia type, to insomnia related to anxiety.  We covered medication induced sleep, to parasomnias.  Some of us have to fight hard for our sleep time and others of us fight to get away from sleep.

I’ve covered a bit already on sleep in previous posts you can read if you want to review:

What I haven’t done is organize for you, as you did so well for me in your comments yesterday, the different reasons we sleep the way we do.  This isn’t a quick flick to show you but I will touch on Carl D’Agostino‘s question when talking about depression with increased sleep,

“Is our brain allowing us to escape the depression this way?”

English: Monitor of vital signs in intensive c...

(Photo credit: Wikipedia)

I love this question because it discloses simply by inquiry the full body involvement in the disease process of major depressive disorder.  Sleep is known as the vital signs of psychiatry.  It reflects what’s happening in the whole system, the whole person even down to a sore on your foot to the ravages of post traumatic stress disorder in your hypothalamus.  When sleep changes, we know to look into things.  There’s an investigation to be done.



We can, each of us, be part of the investigation:

  1. Maintain sleep hygiene.  Don’t indulge when we don’t want to go to bed.
  2. Observe our nights – is our sleep solid?
  3. If yes, is it restful?  Do we feel refreshed in the morning?  How is our day time energy?
  4. If not refreshing, why?  For example, do we snore?
  5. When do we have the most trouble – falling asleep, staying asleep, or falling back to sleep if we awaken?

When our sleep deteriorates, if nothing else has yet, we can bet it will soon if we don’t get our sleep restored.  Not everyone knows that during sleep, we heel, our hormones replenish and our memories consolidate.  Marie from blog-site, livingvictoriously, told us yesterday about her day time inattention after poor sleep,

“I have had nights with very little sleep that have left me feeling like I am unable to concentrate well the following day.” 

We all become a little drunk, disinhibited, inattentive and impulsive when we get little sleep.  Or opposite, as Carl described, with too much sleep we feel,

“vapid and uneventful.”  (Good word Carl, vapid.)

One of the sad times for me in clinic is when I meet a new patient who has suffered with insomnia for a long time along with another one or more combined brain illnesses and I fall into the, “what if’s?”  Knowing how much healing they would have gotten so long ago simply by getting sleep gets to me and I have to push it down and be grateful for the now, when I know they will find some relief.

Don’t minimize the role of sleep in our life.  Don’t minimize any changes in our sleep.  Take sleep seriously.  More serious than the rest of the stuff we usually ruminate over, like offenses taken, our appearance and the weight of our road bike.  If sleep changes, get a professional consultation.  If it doesn’t resolve, get another consultation and push and fight for your sleep.  It may be that health and lifestyle changes must happen.  Whatever it is, do it.  It is a friendly thing to do.

Questions:  What have you noticed about your whole body’s relationship to brain illness?  Has sleep been a part of it?  Did sleep harold any other important changes in your medical/emotional health?  Please tell us about it.

Self-Care Tip – Forget about sleep.  Just kidding.  Sleep well my friends.

26 thoughts on “Sleep Is The Vital Sign Of Psychiatry

  1. At night I wake up easily 4 or 5 times. I can go to sleep easily, but staying at sleep, or going back to sleep is difficult. This probably plays a role as to why I sleep some many hours every night-day. After about 8 hrs of very interrupted sleep, I get up and get a little breakfast. Soon after, I feel tired and go back to sleep for another 2 hours. Food seems to play a role on how much I sleep. Of course, I don’t do any type of exercise, so my body doesn’t have the typical need to be ‘restored’ at night. I remember I went hiking not too long ago and that night I slept all night thru without waking up once. It would have been great if it were not for all the aches and pains. LOL.

  2. Staying asleep is the issue.

    Falling asleep has become the best part of my day in the last few weeks. That falling period where my mind seems to float and drift coupled with the body giving way to relaxation is wonderful.

    When exposed to the stimulation of bright lights and noise at a function past bedtime I turn into a beast.

    What the heck am I doing? I am 30 minutes past my bedtime. Growl.

  3. I’m not a good sleeper. I used to take benadryl to help me sleep but now I just take what ever zzzz’s life offers at night. And yes, I do snore…have had surgery for deviated septum, but the problem is in my throat…not having more surgery, would rather do without sleep.

      • Yes, I do gasp…did the sleep study like fifteen years ago. Family history of apnea but even though I did stop breathing at times it was not enough to warrant a cpap.

        • hey dear suz. sounds reasonable. as an aside, not many people know that it is appropriate to be retested after a couple years if symptoms persist – especially because the airway relaxes more with age and worsens apnea. thank u for sharing this part of your story. i know many of us out here don’t know about these things and are suffering from them and u gave us the platform to air it out. keep on.

  4. We sleep a third of our lives away. That fact is shocking when pondered. I am filing a law suit in heaven to make God give us 33% more life span because sleep time should not be factored in to what age we are. I will keep you posted.

  5. “To sleep perchance to dream . . . ah, there’s the rub”. Please tell me someone has used this quote.

    Sleep, I love sleep. My husband jokes as he comes to bed a few minutes later than me, “the melding process has begun”. I love my bed,my pillows, my blankets and sheets I love my lamp I read by. I love everything about my bed and sleep. I love going to sleep.

    This has not always been easy for me. I have had bouts of insomnia off and on for years as a young adult. I chose to begin with positive affirmations at bed time. “I would wake up refreshed and peaceful in the morning. I had all the adequate sleep I needed to feel this way.” I didn’t like to wake up and face my day, but I couldn’t go to sleep. My wakefulness at night was a reprieve from the days overwhelming events. I could have time to myself, and to wake was to put me back into the overwhelming days events (read new mother and healing abuse and addition at the same time with no help from anyone) I was also stressed about pretty much everything so sleep alluded me. I loved my life and my children but I felt quite suffocated as well!

    I had to make conscious decisions after reading sleep help books and use prayer at bedtime with good sleep hygiene (like I did with my very young children) to create a place of sleep.

    As I have aged into my forties, sleep alludes me in the middle of the night.
    Hormones, stress, a daughter almost dieing, all these things come to haunt in the middle of the night. I can keep busy during the day, so the “things” in life I could or should be having a look at well, they wait and come out to play at night. In the dark, when I am alone and everyone else is asleep. Is there a lonelier time in the life or in the world than being awake in the middle of the night.

    And when we tell people this they laugh and say “we should have called each other I was awake too!” Are their websites for insomniacs in the middle of the night? We think we are alone when actually there are millions not sleeping.

    I use the same techniques in the middle of the night often with success, and some times not, breathing in God, Jesus and the Holy Spirit, exhaling fear, confusion, chaos, whatever my body and mind want to let go off. I breath in peace and tranquility. I thank my organs (some one taught me that!), I count my blessings. I try very hard to be in the moment, fully present. And as the “demons” come up I try my hardest to look them in the eye, really live in the fear of them in the dark and usually they vanish.

    Sleeplessness is so hard. The exhaustion, the cycle sleeplessness creates during the day and into the evening of fearing not to sleep again or broken sleep. Also, I have found Chinese herbs from my local Chinese physician have helped with hot flashes and sleeplessness. Also, eating properly and not having so many extra calories to burn off during the night.

    Did I mention I love my bed?!

    • the “melding process”. that is funny. what skills you’ve cultivated for your sleep routine! There’s a lot out there about breathing and meditation helping and i celebrate w u that u have found them. “breathing in God” is quite lovely. keep on.

  6. I’ve been unwell for about a month and have taken a variety of medications prescribed by my general physician and a physician at an urgent care facility. It’s a urinary thing and, among other things, even taking Lunesta and 1mg of Klonopin, I am up every hour and a half to two hours all night long. Although I don’t see a Urologist until next Friday (I’ve been waiting three weeks to get in!!), my doctor has diagnosed me with Intertitial Cystitis. If that is actually what it is, from what I’ve read about it, things aren’t going to change a lot even seeing a specialist. As a result, I’m scared and depressed and absolutely exhausted. Lack of sleep has me walking around in a fog and I find it almost impossible to concentrate on anything. It certainly effects the entire body – or the entire body effects sleep – or depression makes it worse – or worry doesn’t help – or……….. Suffice it to say, I’ve been too sick, too depressed and way too tired to respond to blogs recently, but I’m trying today just in case anyone else is having similar problems. Good subjects, recently…or as always. Just wish I felt like doing anything about them.

  7. Great post, Doc: I have always slept like a log: I love to wake every now and then and chart the passing of the hours though, and feel cheated if I haven’t. Phil used to have terrible sleeps and then cut out caffeine, and started listening to stories as he slept. The ipod story, usually very familiar, trains his mind away from worries towards sleep.

    • thank u kate dear. u nailed it w the caffeine thing. amazing how a stimulant can really stimulate :). i know how that feels. it also triggers irritability and anxiety. i’ve seen people’s anxiety almost completely resolve just getting off of caffeine on occasion. keep on.

  8. Hi Dr. Sana, I am oh so familiar with this. I went through years of not sleeping, and do understand how it feels. I can see the depression that I had to overcome, and see the importance of restorative sleep. I also know now when I’m not sleeping to stop and ask myself what’s going on. What happened today? Did I get upset? Do I need to let gdo of offenses? Am I angry? Do I need to pray an release? But I know there is something off. It can be hormones lately. Nevertheless, I am aware, but try to stay calm, instead of fearful…that really helps.

    • dear determined, fear is corrosive isn’t it. your insights speak to all of us. hormones and body changes can definitely jack our circadian rhythms up. this is a time for you to coddle yourself with allowances if ever u do. keep on.

  9. Oh my,I’m facing an emotional and mental disruption in my life at the moment…and I’m not sleeping, I’m not even dreaming…I fighting contiously in my sleep and I must admit I’m exhausted all day! Yes, I’m angry, yes I’m emotional and yes I’m tired of it. It’s like every night I’m trying really hard to relax before falling a sleep, but even so after a couple of hours I’m wide awake and solving all sorts of problems in my mind. Can we ever relax the mind, so that it’s happy and I’m happy!

    • yvette, i’m so sorry u’ve been hurting. many of us recognize that exhaustion you tell us about, the anger and emotional fluxes leaking into your days and nights. it’s not unreasonable to ask for happiness. keep on lady courage.

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