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The Sleep Cycle

Running head: THE SLEEP CYCLE

The Sleep Cycle:

Normalcy, Insomnia, and its Relationship to epression

!manda "a#er

$ni%ersity o& E%ans%ille, Indiana

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Personal Rele%ance Pre&ace

(y educational goal is to pursue a graduate degree either

in the &ield o& clinical social )or# or clinical psychology* !s

a pro&essional, I hope to )or# in a clinical setting* In either

o& the pro&essions that I plan to pursue, I )ill treat a %ariety

o& clients )ith pro+lems ranging &rom children eperiencing

ad-ustment pro+lems in school to older adults &acing their o)n

mortality* .ne need that all o& my clients )ill share is the

need &or ade/uate, /uality sleep*

(y goal in researching insomnia and depression )as to learn

)hat researchers ha%e &ound regarding the need &or sleep* I

eamined the normal sleep cycle and discussed the nature o&

insomnia* I also descri+ed the correlations +et)een insomnia and

depression to gain a +etter understanding o& the relationship

+et)een the t)o* 0inally, I eamined the most prominent

treatment options &or +oth insomnia and depression so that I

)ill +e +etter prepared to treat my clients*

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!+stract

Se%eral disciplines ha%e contri+uted to our )or#ing

understanding o& sleep* !s researchers in this &ield,

psychologists are typically most interested in studying sleep

distur+ances* .ne o& the most pre%alent o& these distur+ances is

insomnia, a condition that is o&ten accompanied +y other

psychological pro+lems, including depression* ! thorough re%ie)

o& the eisting literature )ill pro%ide the +asis &or

conclusions regarding the relationship +et)een insomnia and

depression* Speci&ically, this paper )ill address the

connections among the human sleep cycle, insomnia, depression,

and success&ul methods o& treating patients )ith +oth insomnia

and depression*

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Ta+le o& Contents

Personal Rele%ance Pre&ace*************************************1

!+stract*******************************************************2

Ta+le o& Contents**********************************************3

Physiology o& Sleep********************************************4

Human "iological Cloc#************************************5

Stages o& Sleep Cycle*************************************6

Insomnia*******************************************************7

Classi&ication*******************************************''

E&&ects o& Sleep epri%ation*****************************'1

Clinical iagnosis***************************************'2

Relationship +et)een epression and Insomnia******************'3

The Role o& Serotonin************************************'4

Cause and E&&ect Relationship****************************'4

8ia+le Treatment .ptions**************************************'6

Conclusion****************************************************'7

Re&erences****************************************************1'

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The Sleep Cycle

The Sleep Cycle:

Normalcy, Insomnia, and its Relationship to epression

Sleep is a +iological need shared +y all humans, yet it is

only %aguely understood +y researchers* 9e do #no) that healthy

sleep patterns are related to other signs o& physical and mental

)ellness* Con%ersely, pro+lems sleeping are symptomatic o& other

health ris#s* In etreme cases, disordered sleep can +e

attri+uted as the cause o& other serious disorders* It can lead

to disastrous accidents* There&ore, the importance o& sleep, and

o& understanding sleep, is %ital*

Physiology of Sleep

The theory o& sleep as a +iological process is relati%ely

ne), dating +ac# to the '74;s )hen RE( sleep )as &irst

disco%ered leitman, '742?* $ntil that time, there

)ere a couple o& central misconceptions regarding the sleep@)a#e

cycle* Sleep )as commonly thought to +e a mechanism through

)hich the +ody compensated &or a daily +uild@up o& hypnotoins*

! person )as thought to &all asleep )hen the le%el o&

hypnotoins in the +lood +ecame too high* The person )ould then

a)a#en )hen these toins )ere epelled* ! second pro+lem )ith

early sleep research )as the &aulty notion that the sleep@)a#e

cycle )as not endogenous* That is, some researchers attri+uted

the sleep@)a#e cycle to en%ironmental &actors that acted upon a

person rather than a person;s intrinsic +iological rhythm* They

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thought that &actors such as le%els o& light caused the cycle to

occur, )hen in reality this is not the case

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regulation o& the sleep@)a#e cycle

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higher &re/uency )a%es* EEF studies re%eal mied +rain acti%ity

during stage t)o sleep, )hich lasts approimately '@14 minutes

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Variations in the cycle*Slo) )a%e sleep is most prominent

early in the night* Indi%iduals )ill spend gradually less time

in slo) )a%e sleep and more time in RE( sleep as they cycle

through the sleep stages* The &irst RE( period during the night

lasts only a &e) minutes, )hile the last one or t)o periods may

last up to an hour

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the $nited States each year* Estimates o& its pre%alence %ary

)idely* Some sur%ey studies indicate complaints o& insomnia in

2@34G o& adults* Primary insomnia occurs in '@'G o& adults and

accounts &or '4@14G o& cases o& chronic insomnia

Psychiatric !ssociation, 1?* Insomnia is more common in )omen

than in men

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eight hours a night to &eel ade/uately rested* The important

thing to remem+er is that insomnia is not strictly de&ined

according to the num+er o& hours a person sleeps each night

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detrimental e&&ects on society as a )hole, including loss o&

producti%ity, increased occurrence o& accidents, and e%en rising

costs o& healthcare

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mentioned, Lichstein et al*

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correlation does not gi%e us any insight into the cause@e&&ect

relationship

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(any studies ha%e &ound a direct correlation +et)een

depression and some type o& sleep distur+ance* !llgo)er, 9ardle,

and Steptoe

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.ne study

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through the same types o& therapies* Cogniti%e@+eha%ioral

therapy

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sleep* This &inding is puDDling +ecause it seems to suggest that

insomniacs )ill respond +etter to this &orm o& treatment i& they

also su&&er &rom dys&unctions in mood* Yet, )hy should this +e

the case !gain, &urther research must +e done to address the

comple relationship to ans)er this /uestion*

C"T need not +e completed &ace to &ace to +e success&ul* !

recent study indicated that telephone consultations )ere as

success&ul as +oth indi%idual and group &ace@to@&ace sessions in

treating insomniacs

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There&ore, a re%ie) o& the sleep@)a#e cycle is necessary )hen

eamining the cycle;s most prominent dys&unction: insomnia* The

pre%alence o& insomnia is great enough to )arrant in%estigation

o& the )ays it de%elops*

! diagnosis o& insomnia is o&ten made in con-unction )ith a

diagnosis o& depression* These disorders are intricately

related* The relationship is comple enough to ha%e a%oided

causal eplanation +y researchers* Ho)e%er, )ith e%ery study

conducted, )e are one step closer to unra%eling the connection*

espite the tendency to %ie) insomnia as merely a result o&

depression in depressed patients, clinicians should eamine each

case care&ully +e&ore determining any cause@e&&ect relationship*

Studies indicate that depression o&ten leads to insomnia and

other sleep disorders* Ho)e%er, in some cases, insomnia can +e

the cause o& depression and other disorders* This distinction

must +e made in order to ensure proper treatment o& each

disorder* 9hile medication remains the most popular treatment

choice, C"T can +e a success&ul and cost e&&ecti%e alternati%e*

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Re&erences

!llgo)er, !*, 9ardle, *, = Steptoe, !*

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o+-ecti%e sleep distur+ances among adults )ith and )ithout

insomnia complaints ,ournal of Consulting an! Clinical

Psychology' 2+'4A5@472*

Edinger, * *, Hoelscher, T* *, (arsh, F* R*, Lipper, S*, =

Ionescu@Pioggia, (*

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Re"ie% of Psychology' 0('166@22*

Lichstein, >* L*, urrence, H* H*, Riedel, "* 9*, "ayen, $* *

* (*

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rip#e, * 0*, ean@Louis, F*, Langer, R*

*, Elliott, * !*, = Tuunainen, !*