The Relationship between Seasonal Affective Disorder and Sleep Problems

One of the most common questions I get in the office during the winter months has to do with seasonal affective disorder: What is it? Do I have it? And what can I do about it? Seasonal affective disorder is a very real form of depression that may affect six out of every 100 people in the United States, according to the American Academy of Family Physicians.

Symptoms of SAD generally manifest in late fall, when the days become shorter and colder, and people enjoy less natural sunlight. Symptoms include, but are not limited to, feelings of sadness, hopelessness and helplessness, lack of energy, loss of sexual interest and usual pleasurable activities, irritability and restlessness, cravings for carbohydrates and overeating (which can lead to weight gain and compound negative and depressive feelings), trouble concentrating, difficulty sleeping and/or insomnia and at the extreme end—thoughts of death or suicide. Symptoms of SAD are usually most intense during the darkest months of the year, so it stands to reason that the farther a person lives from the equator, the higher the incidence of SAD occurs.

These sleep-related symptoms are of particular interest to me, and are usually the catalyst for a person with SAD to come see me for a consultation and treatment. A person with SAD who suffers from sleep problems may go to sleep early and stay in bed for nine or ten hours, but not experience refreshing sleep.  Because of a lack of restful sleep, people with SAD are often drowsy and have trouble concentrating and working during the day.

The relationship between sleep and depression is a bit of a “chicken or the egg” relationship. Which came first? SAD-related depression, or the sleeping problems? It depends. For some, symptoms of SAD occur first—for others, sleep problems appear first. Depression may cause the sleep problems, and sleep problems may cause or worsen the other SAD symptoms.

There is a common link between people with depression and insomnia. Studies have shown that people with insomnia have a ten-fold risk of developing depression compared with people who sleep well. Further, developing depression is highest among those with both sleep onset and sleep maintenance insomnia.

People with depression may also experience insomnia symptoms, including difficulty falling asleep, difficulty staying asleep, experiencing restful sleep and daytime sleepiness. People who suffer from depression are also five times more likely to have a breathing-related sleep disorder than non-depressed people, according to a study at the Stanford University School of Medicine. The 2003 study by Stanford researcher Maurice Ohayon, MD, PhD, found that people with depression were found to be five times more likely to suffer from obstructive sleep apnea (OSA), the most common form of sleep disordered breathing. This was one of the first studies to make the connection between depression and sleep disorders.  More current research has confirmed the connection.

So, if you believe you are experiencing SAD-related depression and/or sleep disorders, please see a psychiatrist or sleep specialist about it. There are treatments such as morning light therapy that can offer some relief, so you don’t have to suffer unnecessarily through the winter blues. Call me—I’m happy to help.

Spring Allergies: Itchy Eyes, Sneezing… Snoring?

With the stretch of warm weather we’ve had this spring in the North East, nature is blooming in abundance. And I’m seeing an abundance of people seeking help for their snoring. Coincidence? Not likely. Every year at this time, it’s common for the simple reason that many people suffer from seasonal allergies. Allergic reactions can lead to symptoms that include suffering from snoring.

Allergies, as well as asthma, cold and sinus infections (sinusitis) can cause blocked airways. So, people who regularly sleep with their mouths closed with no symptoms of snoring, have to open their mouths to breathe while they sleep if they have reactions to allergies. The blocked airways make inhaling difficult and cause people to sleep with their mouths open, creating a vacuum in the throat that leads to snoring.

Allergic reactions can mimic sinusitis (sinus infection), which is an inflammation of the sinuses and nasal passages that is characterized by a headache or pressure in the eyes, nose, cheek area, or one side of the head. Patients with a sinusitis may also have a cough, a fever, bad breath, and nasal congestion with nasal secretions.

Nasal allergies, which are either seasonal or constantly recurring, increase nasal congestion and can lead to sinusitis. Numerous treatments are available to provide identification and avoidance of allergens. For example, this time of year dust allergies are common, whereas in the fall, mold allergies are more prevalent. Exposure can be reduced with the use of non allergenic bedding, removal of carpeting or upholstery, and the use of an air cleaner with a High Efficiency Particulate Air (HEPA) filter.

Additional treatment for nasal allergies include:

• Prescription Nasal Steroid Sprays which decrease allergic and non allergic inflammation in the nose and can be safely used for a long period of time.
  
  
• Non Sedating Antihistamines reduce allergic nasal congestion when used alone or with nasal spray.
  
  
• Allergy Injections are for patients with long-standing identifiable allergies (that may be identified through skin or blood tests). Allergy injections gradually reduce symptoms and the need for medication.

This time of year, with the many trees and flowers blooming, symptoms that lead to snoring are common, even in those who throughout the rest of the year don’t snore. If you’ve recently been snoring, and wish to know the reason why as well as get the appropriate treatment, contact the Manhattan Snoring and Sleep Center today.