The 7 Most Important Mental Health Effects of Insomnia

The brain is an organ that houses endless mysteries. Among all of them, sleep is one of the processes that has aroused the greatest curiosity since ancient times, where it was understood as a bridge between the earthly and the divine. Like an open door to the afterlife.

We spend between a third and a quarter of our existence tangled in its fine threads, basically yielding during the night to the slumber that guides us towards its most inhospitable territories. And it is that we all sleep, it is a universal need to survive (and a pleasure for most).

However, many people complain of poor quality sleep, because they either find it difficult to reconcile it 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 healthIt is known that commitment in this area is one of the most important indicators for the inference of psychological suffering. Let's see it in detail, then.

• Related article: "The top 7 sleep disorders"

What is insomnia?

It is understood by insomnia any alteration in the process of sleeping, both in its beginning (difficulty when accessing sleep), as in its continuation (constant interruptions) and / or its completion (to wake up too early); that limits the quality of life and substantially interferes with daily activity.

In this sense, three basic dimensions could be distinguished: duration (total time spent asleep, for which there is great variability in terms of differences interindividual), continuity (which is equivalent to the persistence of the process over a sufficient time to obtain benefits) and depth (associated with physiology and neural activation). Any of them can be acutely compromised at some point in the life cycle.

Roughly speaking, sleep tends to be divided into two distinct stages: REM and non-REM (nREM). The latter involves a series of phases (from 1 to 4) in which a progressive slowdown of the activity carried out by the central nervous system is observed. (CNS), while in the first (which extends 25% of the time) an increase or electrical hyperactivation similar to wakefulness (with movements eyepieces). Both alternate in 90-minute cycles throughout the night, in which the REM phase extends, and they are necessary for the pertinent neural rest to occur.

The three forms of insomnia that have been cited represent, in their most intimate nature, a difficulty accessing relevant to REM sleep (especially when it becomes difficult to stay asleep for the time required to complete successive cycles). As the situation drags on, a myriad of physical, cognitive and emotional complications arise. It is important to bear in mind that a third of people recognize specific problems when sleeping, and that 10% meet the criteria for the diagnosis of insomnia. As can be deduced, it is not a strange situation, since a significant percentage of the general population identifies with it.

Let us now see the concrete impact of insomnia on psychological health, gathering the seven most important consequences that can be derived from it. When any of them are present, 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 affects it, regardless of which is considered cause and which effect. These are complications that are sometimes quite serious, and even in some cases pose an objective risk to life. That is why the treatment of this problem is important, and it should never be considered as a minor or accessory matter. We delve into all of this in detail.

1. Emotional changes

One of the common consequences of having poor quality sleep is fluctuating mood, and there is evidence that insomnia and difficulties regulating emotion have common physiological bases.

In this way, poor sleep can be associated with depressive and anxious symptoms, as well as notable irritability. In fact, today we know that those who suffer from a picture of this nature see its intensity worsened when, in addition, they have problems to enjoy a good night's sleep. Pain as a symptom deserves special mention: its presence alters sleep, while insomnia promotes a reduction in the pain threshold (becoming a much more intense and difficult experience to control).

At the process level, it is known that people with insomnia tend to interpret adverse events in a more negative way with whom they are confronted, and who also have difficulties in trying to extract the positives from the experience daily. 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 "depend" the cognitive mechanisms through which to deal with the turbulence inherent in life. 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 evaluated through self-reports. From this it could be deduced a concrete erosion in the basic ability to identify, recognize and communicate what is going on within us; as well as inferring the states of others when interacting with them. In any case, it would be a reversible effect over time, as a restorative rest would restore your previous level of "functioning" (since intelligence is a relatively stable trait throughout life).

Finally, many studies indicate that people with insomnia can see the process altered cognitive decision-making and behavioral inhibition (both dependent on the cortex prefrontal); 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 when seeking solutions to a problem. That is why it is never recommended to address matters of great importance under the influence of insomnia or adverse emotional states.

2. Memory problems

Interference in memory domains is often a recurring complaint among those who have trouble sleeping. The most common is that 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 has been described (a function that allows the temporary storage of information for use during a specific task). In the latter case it is very common that difficulties arise in understanding a written / spoken text of a certain length, or to successfully carry out activities that require storing information in the background.

REM sleep is a key physiological process for maintaining memory, as it optimizes the neural process through which we consolidate information in the long-term warehouse and / or accessory data is eliminated and useless. It is therefore basic for learning; from which it is understood that spending a night awake to study is often an inappropriate and counterproductive strategy. In this way, a subject who finds it difficult to sleep may report difficulties when trying to acquire new knowledge, as well as when applying it later (as in an exam, for example).

Memory problems and insomnia often occur together in older people, and it is possible that they share some physiological basis (such as calcification of the pineal gland, which could also contribute to cortical dementias). Finally, the strong relationship between insomnia and memory decline may be due to the use of sedative / hypnotic psychotropic drugs (benzodiazepines, for example) that are prescribed for the treatment of sleep disorders, as we know that its prolonged or excessive administration precipitates harmful effects in that area (antegrade amnesia or serious blockage when generating new regards).

• You may be interested: "Memory problems: their 3 types and possible causes"

3. Attention problems

Along with memory, attention is the process that is most commonly compromised when restorative sleep is difficult. The orientation response to stimuli that abruptly interrupt the movement is usually fundamentally impaired. perceptual field, which increases response times (the person seems self-absorbed and slowed down). It has also been possible to observe a deterioration of alternating attention, that is, of the ability to "change" focus when two tasks are succeeded (one after the other) in short periods of time.

By last, this decline can be generalized to the sustained and selective subtype. In this case, problems would be made explicit to maintain attentional resources during the development of a task whose long extension so required, as well as to discriminate in a complex environment which of the stimuli are relevant to the intended objective and which not. In this way, when the person is immersed in an environment saturated by various elements that compete between yes, due to their attention, a feeling of overflow would emerge (appreciable when managing the volume of information).

Attention deficits also imply that there is a greater risk of accidents, as there would be an increase in distraction and a loss of reflexes. For this reason, those who are a regular driver of any vehicle must take special caution when suffering 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 at the erectile level, with problems to achieve a firm swelling of the penis that allows penetration. The most notable difficulty is found when the person lives with other additional clinical symptoms; such as sleep apnea, "delayed" circadian rhythm (falling asleep and waking up too late), or restless legs (pressing and distressing need to move the legs to relieve an apparent tension that builds up in they).

Certain hypotheses suggest as a possible cause for erectile dysfunction a marked reduction in 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 in production during the beginning of sleep (reaching peak in the first REM phase), and that its levels are higher while asleep than when awake. Insomnia would hinder its synthesis, which would affect the 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 making comparisons with those who rest well).

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 lead to very different hallucinations, even in people without pathology of any kind.

Some of those that accumulate the most evidence are hypnagogic (in the process from waking to sleep) and hypnopompic (in the transition from sleep to wakefulness), as well as those that occur in the context of paralysis of the dream. All they are much more frequent when you have not slept adequately in the previous days.

In people with a psychotic disorder, such as schizophrenia, insomnia is considered a risk factor for the flare-up of an acute episode or its onset. In fact, it is one of the main symptoms of the prodromal stage, which precedes the articulation of the "definitive" picture (and which lasts for months or even years). Such insomnia would anticipate the onset of paranoid delusions in some patients, which could be explained by an elevation in the level of dopamine after the first sleepless night (a compensatory mechanism to cushion the deficit in cognitive functions that usually occurs in this moment).

• You may be interested: "Hallucinations: definition, causes, and symptoms"

6. Reduced vitality

The loss of vitality, at the extreme of which is fatigue, has as its basic cause (in the general population) poor quality sleep. It is a common circumstance, which coincides with the total percentage of people with specific difficulty sleeping fully (between 20% and 40%, especially in women). The problem translates into high daytime sleepiness and loss of productivity, and is even associated with with depressive feelings and with impaired memory or attention (to which we refer previously).

The fatigue associated with insomnia is associated with a perception of intense loss of energy, general weakness, feeling unwell, and erosion of performance in everyday tasks. Of all the problems that disturb the integrity of sleep or its structure, apnea is perhaps the one that most consistently triggers it (block that causes a series of brief micro-awakenings, which interrupt the active sleep cycle before reaching the restorative phases of the REM).

7. Increased risk of Alzheimer's

The relationship between insomnia and Alzheimer's has been known since the 90s, although it has been in the last decade that knowledge about 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 one function of sleep is to "cleanse" debris from neural activity. Throughout the day, being awake involves the production of proteins in the nervous system central whose persistence is toxic, but which is "emptied" every time we sleep to avoid an excess or accumulation.

Among all of them, it has been shown that the amyloid beta protein is undoubtedly the most important explanatory has, given that it is one of the elementary anatomopathological bases of such frequent dementia cortical. Well, it has been confirmed that insomnia promotes its accumulation in the medium / long term, enhancing one of its most important physiological risk factors (according to the available evidence).

Bibliographic references:

• Cunnington, D., Junge, M. and Fernando, A. (2013). Insomnia: Prevalence, consequences and effective treatment. The Medical journal of Australia, 199 (8), 36-40.
• Fernandez-Mendoza, J. and Vgontzas, A. (2013). Insomnia and Its Impact on Physical and Mental Health. Current psychiatry reports, 15 (12), 418.
• Marin, A., Franco, A., Vinaccia, S., Tobon, S. and Sandin, B. (2008). Sleep Disorders, Health and Quality of Life: A Behavioral Sleep Medicine Perspective. Suma Psicologica, 15 (1), 57-64.