Circadian rhythm disorders associated with mental illness

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Mental health disorders and circadian rhythm disruption are closely linked, according to a new analysis. NICK VISEE/SCIENCE PHOTO LIBRARY/Getty Images

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  • A new study finds a striking link between people who have sleep problems and people who have mental illness.
  • The study’s authors focused primarily on autism, ADHD and bipolar disorder, but believe their findings may apply to other mental health issues as well. as well.
  • Insufficient sleep has previously been linked to a number of health problems, including mental disorders.

Globally, only 1 in 10 people report that they sleep “extremely well,” according to the Philips Global Sleep Study 2019 Most adults in this study, about 62%, reported sleeping “somewhat or not at all well.”

Such sleep problems are associated with various mental disorders such as depression, anxiety, bipolar disorder, attention deficit hyperactivity disorder (ADHD), and bipolar disorder.

From 300 million people worldwide that have depression, research assumes that 75% also have insomnia.

A new study by researchers at the University of California, Irvine (UCI) examines the link between sleep difficulties and a number of mental disorders.

Amal Alachar, Ph.D., the study’s lead author, said in a news release, “The telltale sign of a circadian rhythm disruption — trouble sleeping — is present in any disorder.”

“Although our focus was on well-known conditions, including autism, ADHD, and bipolar disorder, we argue that the psychopathological factor hypothesis of CRD may generalize to other mental health problems, such as obsessive-compulsive disorder, anorexia nervosa, bulimia nervousness, food addiction and Parkinson’s disease,” continued Dr. Alachar.

The results were recently published in Translational psychiatry.

For the purpose of the study, the researchers examined the relationship between CRD and a number of different mental disorders and mental health conditions.

  • Autism Spectrum Disorder (ASD): The National Autistic Society describes autism as “a lifelong developmental disability that affects the way people communicate and interact with the world.” (Autism is not universally considered a mental disorder.)
  • Attention Deficit Hyperactivity Disorder (ADHD): ADHD is a condition in which a person, often a child, has difficulty concentrating, exhibits inappropriate physical movements, and acts impulsively without thinking about the consequences.
  • Bipolar disorder (BPD): People with bipolar disorder experience extreme mood swings lasting days or weeks, marked by periods of unusual happiness or irritability that alternate with periods of depressed sadness.
  • Tourette syndrome: Tourette syndrome is a neurological disorder in which a person produces “tics”: sudden, rapid, repetitive and unwanted movements or vocal sounds.
  • Schizophrenia spectrum disorder: Schizophrenia changes a person’s thinking, emotional state, and behavior to such an extent that it may appear to others that they have lost touch with reality.
  • Major Depressive Disorder (MDD): MDD refers to a condition in which a person experiences prolonged bouts of depression most of the time over a period of weeks, which interferes with their ability to function.
  • anxiety disorder: An anxiety disorder causes a person to live in a constant state of anxiety or fear.
  • Alzheimer’s disease (AD): As Alzheimer’s disease progresses, a person’s memory and thinking become severely impaired over a period of time.

“An interesting question we investigated is the interaction of circadian rhythms and mental disorders with sex,” senior author Pierre Baldi, Ph.D., study author and distinguished professor of computer science at UCI, said in a news release. “For example, Tourette syndrome is predominantly present in men, and Alzheimer’s disease is more common in women by a ratio of approximately two-thirds to one-third.

The body’s internal, 24-hour or circadian clock regulates important daily routines such as sleep and wakefulness, body temperature, feeding, digestion and hormonal activity.

The researchers reviewed the existing literature on circadian rhythm disruption (CRD), or sleep disorder, and noted that CRD at an early age can affect neurodevelopment and promote age-related mental disorders later.

According to a news release, the researchers hypothesized that “CRD is a psychopathological factor shared by a wide range of mental illnesses.” Researchers believe that studying the molecular basis of CRD could unlock better therapies and treatments for various mental disorders.

Jonathan Cedernais, PhD, a sleep specialist at Uppsala University who was not involved in the study, said Medical News Today:

“This review highlights the fact that sleep disturbances and circadian disruptions are very common in mental disorders. Based on animal data, it can also be speculated that circadian disruption during pregnancy may impair offspring outcomes, including mental health or psychiatric disease risk.

Stress or mental health issues can affect a person’s sleep-wake cycle, as can working the night shift, changing time zones, or simply being a “night owl.”

“It is important to note that there are [an] inter-individual variation in our sleep-wake patterns, so they don’t all look the same,” Dr Cedernais said. “This variation is partly related to biological preferences, but also partly due to work or social constraints.”

Alicia Roth, MD, of the Cleveland Clinic Sleep Disorders Center, who was not involved in the study, said MNT:

“It is interesting to investigate the relationship between circadian rhythm disturbances and mental health, especially in people with delayed circadian rhythm disturbance – ie. extreme night owls.”

“These are usually teenagers and young people. With a slow rhythm, their preferred sleep schedule (ie, early morning bedtime, late morning [or] early afternoon wake-up time) does not conform to what is socially acceptable.’

Dr. Roth suggests that mental health issues may be related to the stigma these people experience because of their schedule.

“In addition to biological influences, I think stigma plays a big role in people with slow rhythms developing adverse psychological outcomes related to their preferred sleep schedule.”

– Alicia Roth, Ph.D

An obvious question left unanswered by the study is whether CRD causes mental health problems, or whether mental health problems lead to CRD, or whether both are independently associated with similar underlying causes.

The authors suggest that future research can answer this question by examining CRD at the molecular level. They suggest gene expression research and metabolomic technologies in mice as a place to start.

“This will be a high-throughput process, with researchers sampling healthy and diseased subjects every few hours during the circadian cycle,” Prof Baldi said.

“This approach can be applied with limitations in humans, since only serum samples can really be used, but it can be applied on a large scale in animal models, especially mice, by sampling tissue from different brain regions and various organs, in addition to serum,” he continued.

If the causal link between CRD and mental health is supported by further research, one may one day avoid mental health problems by staying in sync with one’s own circadian rhythm.

“A person can keep a diary of their sleep-wake schedule. This can clarify whether the schedule is too erratic and possibly help to improve it,” suggested Dr. Cedernaes.

According to Dr. Roth, if people are left to their own devices with no responsibilities (i.e. no school, kids, work, or having to be on any schedule), how well do they sleep and what time do they naturally fall asleep and wake up?

“It’s important to try to capture what a person’s body wants to do when the restrictions and schedule are removed,” Dr. Roth said.

“One can [also] they have a fun rhythm, but bedtime works for them because they have [in]flexible school, work or life commitments,” she added. “Often they just need reassurance that their ‘unusual’ sleep time is okay as long as they are getting enough sleep and functioning as they would like.”

According to Dr. Cedernaes, “ideally, one would wake up and go to bed at the same time every day, and eat at the same time every day.”

“We also encourage basic good sleep habits,” Dr. Roth said. “The most important thing is: don’t try to force yourself to sleep, go to bed only when you feel sleepy, and don’t linger in bed in the morning and doze off.”

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