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Antidepressants and the Placebo Effect

Yet this 11% figure may overestimate the number of people who benefit from antidepressants. Antidepressants are also prescribed to people who do not qualify for the diagnosis of major depression. My neighbor’s pet dog died; his physician prescribed an antidepressant. A friend in the US was diagnosed with lumbar muscle spasms and was prescribed an antidepressant. I have lost count of the number of people who have told me they were prescribed antidepressants when complaining of insomnia – even though insomnia is a frequently reported side effect of antidepressants. About 20% of patients suffering from insomnia in the United States are given antidepressants as a treatment by their primary care physicians (Simon & VonKorff, 1997), despite the fact that “the popularity of antidepressants in the treatment of insomnia is not supported by a large amount of convincing data, but rather by opinions and beliefs of the prescribing physicians” (Wiegand, 2008, p. 2411).

New insights into how sleep helps the brain to reorganize itself -- ScienceDaily

Dr Julie Seibt, Lecturer in Sleep and Plasticity at the University of Surrey and lead author of the study, said: "Our brains are amazing and fascinating organs -- they have the ability to change and adapt based on our experiences. It is becoming increasingly clear that sleep plays an important role in these adaptive changes. Our study tells us that a large proportion of these changes may occur during very short and repetitive brain waves called spindles. "Sleep spindles have been associated with memory formation in humans for quite some time but nobody knew what they were actually doing in the brain. Now we know that during spindles, specific pathways are activated in dendrites, maybe allowing our memories to be reinforced during sleep. "In the near future, techniques that allow brain stimulation, such as transcranial magnetic stimulation (TMS), could be used to stimulate dendrites with the same frequency range as spindles. This could lead to enhance cognitive functions in patients with learning and memory disorders, such as dementia."

Lack of sleep could contribute to mental health problems, researchers reveal | Society | The Guardian

After taking into account effects not linked to treatment – as deduced from the no-treatment group – insomnia in the CBT group was found to have fallen by almost half 10 weeks into the study, while both anxiety and depression dropped by a fifth, and paranoia and hallucinations fell by 25% and 30% respectively. “Having insomnia doubles your chances of developing depression and we now know that if you treat the insomnia it reduces depression,” said Freeman.

Is ADHD really a sleep problem? -- ScienceDaily

"There is extensive research showing that people with ADHD also tend to exhibit sleep problems. What we are doing here is taking this association to the next logical step: pulling all the work together leads us to say that, based on existing evidence, it looks very much like ADHD and circadian problems are intertwined in the majority of patients. We believe this because the day and night rhythm is disturbed, the timing of several physical processes is disturbed, not only of sleep, but also of temperature, movement patterns, timing of meals, and so on. If you review the evidence, it looks more and more like ADHD and sleeplessness are 2 sides of the same physiological and mental coin."

The role of sleep in bipolar disorder | NSS

A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder.

Sleep, dopamine and memory

The study shows that increasing sleep, with either a sleep-promoting drug or by genetic stimulation of the neural sleep circuit, decreases signaling activity by dopamine, while at the same time enhancing memory retention. Conversely, increasing arousal stimulates dopamine signaling and accelerates forgetting. This signal activity isn’t constant but is tied directly to the animal’s arousal level. “Our findings add compelling evidence to support the model that sleep reduces the forgetting signal in the brain, thereby keeping memories intact,” Davis said. “As sleep progresses to deeper levels, dopamine neurons become less reactive to stimuli and this leads to more stable memories.

Loneliness in young adults linked to poor sleep quality -- ScienceDaily

Loneliness is defined by researchers as a distressing feeling that people experience when they perceive their social relationships to be inadequate. This is distinct from the concept of social isolation, as people can be socially isolated without feeling lonely, or feel lonely despite being surrounded by many people. While the effect of being lonely is well documented among the elderly, it is a common problem for young people too -- the Mental Health Foundation reports that loneliness is most frequent between the ages of 18-34. Despite this, little is known about health problems that are associated with loneliness among young adults, or the impact on sleep.

FitBit's new sleep tracker is pretty darn cool

imagine what we’ll learn as warehouses worth of enhanced sleep data like get integrated into drug trials, therapy, physical exams, coaching, research and even education.

ADjusting the body's clock with light to counter depression

Researchers have developed a limited form of sleep deprivation that is euphemistically called wake therapy. It has been shown to have sustained antidepressant benefit in patients with bipolar disorder and major depression. The idea is to get up for the day halfway through the usual sleep period, which shifts the circadian clock to an earlier time. It’s thought that this works by realigning the sleep cycle with other circadian rhythms, like changes in levels of body temperature and the stress hormone cortisol, that are also out of sync with each other in depression. Studies show that it is possible to make wake therapy even more powerful by incorporating two additional interventions: early morning light therapy and what’s called sleep phase advance, in which the patient goes to bed about five to six hours earlier than usual and sleeps for about seven hours. This combination of treatments is called triple chronotherapy, and the typical course involves one night of complete sleep deprivation followed by three nights of phase-advanced sleep and early morning light. In one study of 60 hospitalized patients with bipolar depression who were taking antidepressants or lithium, 70 percent of those who did not have a history of drug resistance improved rapidly with sleep deprivation and early morning light, and 57 percent remained well after nine months. Encouragingly, 44 percent of patients who had failed to respond to at least one trial of anti-depressants also improved.

Gene mutation helps explain night owl behavior

Night owls are often diagnosed at sleep clinics with delayed sleep phase disorder (DSPD). This study is the first to implicate a gene mutation in the development of DSPD, which affects up to 10% of the public, according to clinical studies. People with DSPD often struggle to fall asleep at night, and sometimes sleep comes so late that it fractures into a series of long naps. DSPD and other sleep disorders are associated with anxiety, depression, cardiovascular disease, and diabetes. People with DSPD also have trouble conforming to societal expectations and morning work schedules. "It's as if these people have perpetual jet lag, moving eastward every day," says Young. "In the morning, they're not ready for the next day to arrive." Patke is a night owl and usually works late into the night. She, however, does not carry the CRY1 variant. Not all cases of DSPD are attributable to this gene mutation. However, Young and Patke found it in 1 in 75 of individuals of non-Finnish, European ancestry in a gene database search. "Our variant has an effect on a large fraction of the population," she says. Young, who has studied the genes involved in the circadian clock of the fruit fly, connected with clinical researchers at the Weill Cornell Medical College to understand the molecular underpinnings of human sleep disorders. By studying the skin cells of people with DSPD, he and Patke discovered a mutation in CRY1, which helps drive the circadian clock. The circadian clock is a fundamental element of life on Earth and has remained more or less the same, genetically, throughout the evolution of animals. "It's basically the same clock from flies to humans," Young says. Normally the clock begins its cycle by building up proteins, call activators, in a cell. These activators produce their own inhibitors that, over time, cause the activators to lose their potency. When all the activators in the cell have been silenced, inhibitors are no longer produced and eventually degrade. Once they've all gone, the potency of the activators surges, and the cycle begins again. The CRY1 protein is one of the clock's inhibitors. The mutation Young and Patke found is a single-point mutation in the CRY1 gene, meaning just one letter in its genetic instructions is incorrect. Yet this change causes a chunk of the gene's resulting protein to be missing. That alteration causes the inhibitor to be overly active, prolonging the time that the activators are suppressed and stretching the daily cycle by half an hour or more. In addition to their initial study of a multigenerational family in the U.S., Young and Patke collaborated with clinical researchers at Bilkent University to analyze the sleep patterns of six families of Turkish individuals, 39 carriers of the CRY1 variant and 31 non-carriers. The carriers had delayed sleep onset times and some had fractured, irregular sleep patterns. The mid-point of sleep for non-carriers was about 4 a. m. But for carriers, the mid-point was shifted to 6-8 a.m. Because the mutation does not disable the protein, it can have an effect on individuals whether they carry one or two copies of the gene. Of the 39 Turkish carriers studied, 8 had inherited the mutation from both parents, and 31 had inherited only one copy of the mutation. The circadian clock responds to external environmental cues, so it is possible for people to manage the effects of the mutation on sleep. For instance, one carrier in the study reported maintaining a sleep routine through self-enforced regular sleep and wake times and exposure to bright light during the day. "An external cycle and good sleep hygiene can help force a slow-running clock to accommodate a 24-hour day," says Patke. "We just have to work harder at it."

REM versus deep sleep

I was just going to comment that there's also evidence that suggest that deeper sleep, that what we call slow-wave sleep, non-REM sleep, might be more involved in sort of strengthening memories in a way that they're for REM. So for example, if you want to remember someone's name or phone number that might be where that non-REM sleep is valuable. And that REM sleep seems to be more involved in memory processing where you're not trying to exactly remember it in the form that you first saw it but rather to extract meaning from it. So to get patterns or to figure out the rules of something or to extract just to get the sort of the executive summary. But that seems to be more of what REM sleep that's about and that would fit in with the emotional piece too because, of course, if something had happens during the day, you don't simply want to remember it better than next morning. You want to understand it.

REM launders emotion

One of the things that's been emerging over the past five or six years in the literature is that REM sleep seems to serve an almost sort of overnight therapy benefit in terms of our emotional well-being and our mental health. And what's interesting is that REM sleep chemically, in terms of the anuric transmitters that swirl around the brain, REM sleep is perhaps the only time during the 24-hour period where a particular stress neurochemical called norepinephrine or noradrenaline is actually suppressed and it's completely shut down from the brain. And it seems to be that REM sleep is a perfect chemical environment, almost like a therapy session, where you can take emotional events from the prior day and perhaps just smooth the sharp edges off those experiences, and almost like an overnight soothing balm, as it were.

Magical napping

I just want to add that we've done some studies looking at naps in terms of the memory processing and have been rather stunned, really, by the fact that in almost every experiment that we've tried, an hour-and-a-half nap seems to do as much good for memory processing as an entire night of sleep, and we continue to ponder that and sort of conclude that OK, we just don't get it yet. But in studies where six hours of sleep at night seems not enough to lead to consolidation of memory of a particular task, an-hour-and-a-half nap will. So there's something, at least from the memory perspective, rather magical and unusually efficient about napping as opposed to nocturnal sleep.

Deep sleep may act as fountain of youth in old age | EurekAlert! Science News

"The parts of the brain deteriorating earliest are the same regions that give us deep sleep," said article lead author Mander, a postdoctoral researcher in Walker's Sleep and Neuroimaging Laboratory at UC Berkeley. Aging typically brings on a decline in deep non-rapid eye movement (NREM) or "slow wave sleep," and the characteristic brain waves associated with it, including both slow waves and faster bursts of brain waves known as "sleep spindles." Youthful, healthy slow waves and spindles help transfer memories and information from the hippocampus, which provides the brain's short-term storage, to the prefrontal cortex, which consolidates the information, acting as the brain's long-term storage. "Sadly, both these types of sleep brain waves diminish markedly as we grow old, and we are now discovering that this sleep decline is related to memory decline in later life," said Winer, a doctoral student in Walker's lab. Another deficiency in later life is the inability to regulate neurochemicals that stabilize our sleep and help us transition from sleep to waking states. These neurochemicals include galanin, which promotes sleep, and orexin, which promotes wakefulness. A disruption to the sleep-wake rhythm commonly leaves older adults fatigued during the day but frustratingly restless at night, Mander said. Of course, not everyone is vulnerable to sleep changes in later life: "Just as some people age more successfully than others, some people sleep better than others as they get older, and that's another line of research we'll be exploring," Mander said. Meanwhile, non-pharmaceutical interventions are being explored to boost the quality of sleep, such as electrical stimulation to amplify brain waves during sleep and acoustic tones that act like a metronome to slow brain rhythms.

When You're Drowsy, Is Your Brain Partly Asleep? - Neuroskeptic

This restgram shows that over the space of about an hour, this patient (“SC553”) gradually went from being awake to being asleep. But the sleep-like “inactive” pattern of activity (blue) didn’t arrive all at once. Some points in the brain (i.e some electrodes) ‘fell asleep’ before others. And most electrodes went through several cycles of ‘waking’ and ‘sleeping’ over the course of the 50 minutes.

Chronic sleep deprivation suppresses immune system: Study one of first conducted outside of sleep lab -- ScienceDaily

"The results are consistent with studies that show when sleep deprived people are given a vaccine, there is a lower antibody response and if you expose sleep deprived people to a rhinovirus they are more likely to get the virus," Watson said. "This study provides further evidence of sleep to overall health and well-being particularly to immune health. The researchers, citing data from the Centers for Disease Control, said that over the past century people in the United States are sleeping an estimated 1.5 to two hours less, and about one-third of the working population sleeps less than six hours per night. "Modern society, with its control of light, omnipresent technology and countless competing interests for time, along with the zeitgeist de-emphasizing sleep's importance, has resulted in the widespread deprioritization of sleep," they wrote.

Synapses shrink 20% every night?!

The team deliberately did not know whether they were analyzing the brain cells of a well-rested mouse or one that had been awake. When they finally "broke the code" and correlated the measurements with the amount of sleep the mice had during the six to eight hours before the image was taken, they found that a few hours of sleep led on average to an 18 percent decrease in the size of the synapses. These changes occurred in both areas of the cerebral cortex and were proportional to the size of the synapses. The scaling occurred in about 80 percent of the synapses but spared the largest ones, which may be associated with the most stable memory traces.

Provocative New Insights From the Largest Consumer Sleep Study Ever Released | The Huffington Post

• Exercise is good for sleep: Any amount is helpful, but the optimal amount is 30 minutes, which correlates to 14 minutes of extra sleep per night. • Caffeine: Good news here! Three or fewer cups of coffee didn’t notably affect average sleep time much, but those who drank four cups or more slept 26 minutes less. • Alcohol: Surprisingly, those who had one or two drinks slept an average of 16 minutes more than people who had more than two drinks (or none at all).

Sleep Deprivation Mimics Psychosis

"A single night of sleep deprivation may not at first seem like a particularly drastic intervention, and can for instance occur with students out partying or people working through the night; therefore, we were surprised to see such statistically significant increases in self-ratings of all 3 dimensions of schizophrenia ― thought disorder, perceptual aberrations, and negative symptoms."

Portions of the brain fall asleep and wake back up all the time, Stanford researchers find | EurekAlert! Science News

The team used what amounts to sets of very sensitive pins that can record activity from a column of neurons in the brain. In the past, people had known that individual neurons go through phases of being more or less active, but with this probe they saw for the first time that all the neurons in a given column cycled together between firing very rapidly then firing at a much slower rate, similar to coordinated cycles in sleep. "During an on state the neurons all start firing rapidly," said Kwabena Boahen, a professor of bioengineering and electrical engineering at Stanford and a senior author on the paper. "Then all of a sudden they just switch to a low firing rate. This on and off switching is happening all the time, as if the neurons are flipping a coin to decide if they are going to be on or off." Those cycles, which occur on the order of seconds or fractions of seconds, weren't as visible when awake because the wave doesn't propagate much beyond that column, unlike in sleep when the wave spreads across almost the entire brain and is easy to detect.

Bad timing is depressing: Disrupting the brain's internal clock causes depressive-like behavior in mice -- ScienceDaily

Inherent circadian clocks help us function throughout the day, by telling us when to sleep, wake and eat, as well as by synchronizing our bodily processes. "It is perhaps not surprising that disruptions of our natural synchronization can have heavy impacts on our physical and mental health," Dr. Landgraf added. However, until now researchers did not know if disturbed circadian rhythms were a cause or consequence of mood disorders. In the new study, a team led by David K. Welsh has shown for the first time a causal relationship between functioning circadian clocks and mood regulation.

Placebo sleep affects cognitive functioning. - PubMed - NCBI

↓ Full text Placebo sleep affects cognitive functioning. Draganich C, et al. J Exp Psychol Learn Mem Cogn. 2014. Show full citation Abstract The placebo effect is any outcome that is not attributed to a specific treatment but rather to an individual's mindset (Benson & Friedman, 1996). This phenomenon can extend beyond its typical use in pharmaceutical drugs to involve aspects of everyday life, such as the effect of sleep on cognitive functioning. In 2 studies examining whether perceived sleep quality affects cognitive functioning, 164 participants reported their previous night's sleep quality. They were then randomly assigned to 1 of 2 sleep quality conditions or 2 control conditions. Those in the "above average" sleep quality condition were informed that they had spent 28.7% of their total sleep time in REM, whereas those in the "below average" sleep quality condition were informed that they had only spent 16.2% of their time in REM sleep. Assigned sleep quality but not self-reported sleep quality significantly predicted participants' scores on the Paced Auditory Serial Addition Test and Controlled Oral Word Association Task. Assigned sleep quality did not predict participants' scores on the Digit Span task, as expected, nor did it predict scores on the Symbol Digit Modalities Test, which was unexpected. The control conditions showed that the findings were not due to demand characteristics from the experimental protocol. These findings supported the hypothesis that mindset can influence cognitive states in both positive and negative directions, suggesting a means of controlling one's health and cognition.

Rumor: Doctor Prescribes Donald Trump "Cheap Speed"

Rumors of Trump’s predilection for stimulants first started really popping up in 1992, when Spy magazine wrote, “Have you ever wondered why Donald Trump has acted so erratically at times, full of manic energy, paranoid, garrulous? Well, he was a patient of Dr. [Joseph] Greenberg’s from 1982 to 1985.” At the time, Dr. Greenberg was notorious for allegedly doling out prescription stimulants to anyone who could pay.

Improved sleep can help addicts recover

Study participants either received a placebo or 400 mg of modafinil — a mild stimulant drug often used to treat narcolepsy or shift-work-induced daytime fatigue. Compared to the group that received the placebo, cocaine addicts who received the 400mg of modafinil had more consecutive cocaine-free days during outpatient treatment and higher daily rates of abstinence. The study found that these protective effects were associated with increased slow-wave sleep, which modafinil promotes, suggesting that improved slow-wave sleep can help treat addiction.

Important associations between genetics, sleep behavior identified by study -- ScienceDaily

The focus of the CPMC paper was to identify the genes associated with sleep duration and validate the connection between sleep and several demographic and lifestyle factors, including age, gender, weight, ethnicity, exercise, smoking and alcohol. Analysis implicated genes involved in ATP metabolism, circadian rhythms, narcolepsy, sleep cycles in mice, and bear hibernation.

Circadian rhythm of genes in brain changes with aging, research shows

A 24-hour circadian rhythm controls nearly all brain and body processes, such as the sleep/wake cycle, metabolism, alertness and cognition,[…]"Studies have reported that older adults tend to perform complex cognitive tasks better in the morning and get worse through the day," Dr. McClung said. "We know also that the circadian rhythm changes with aging, leading to awakening earlier in the morning, fewer hours of sleep and less robust body temperature rhythms."[…] Using the information they had about the time of death, they identified 235 core genes that make up the molecular clock in this part of the brain. "As we expected, younger people had that daily rhythm in all the classic 'clock' genes," Dr. McClung said. "But there was a loss of rhythm in many of these genes in older people, which might explain some of the alterations that occur in sleep, cognition and mood in later life."