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.

A Winter Sore Throat

If you’ve ever awoken with a dry scratchy throat, you’ve likely felt that twinge of anxiety that signals something is coming – and it’s probably going to lay you out for a couple of days. Sore throat is a symptom of many different things – from viral infections such as the flu or mono, to bacterial infections like strep throat, allergic reactions more.

However, it is common for those living in the northern climates to get sore throats during the winter due to just their surroundings. During the winter months, houses and offices are locked up tight, and the dry heat is constantly running. Outdoors isn’t much better, as there is no humidity in the air, with even the most humid summertime areas mimicking the arid dryness of a desert climate. 

Dry indoor air can make your throat feel rough and scratchy, especially when you first wake up in the morning. Nasal congestion, also common in the winter can cause people to sleep with their mouths open, further aggravating the dryness and causing sore throat. Chronic nasal congestion can cause you to breathe through your mouth or snore, aggravating the throat and causing it to become sore and tender.

Here are some ideas to help keep you from getting a sore throat due this winter:

Moisten the Air. Adding much needed humidity into the air may be enough to prevent sore throat caused by dryness. Running the humidifier or vaporizer near your bed at night is especially important to help keep congestion in the sinuses from drying out and clogging, allowing you to comfortably breathe through your nose.

Blow Your Nose. To keep the congestion out of your sinuses, it is important to blow frequently so that drainage doesn’t drip down your throat, or clog your nose causing you to breathe with your mouth open.
 
Sleep with Your Head Elevated. This will help your sinuses drain properly, and keep you breathing properly through your nose and not your mouth. 

Drink Plenty of Water. In the winter we run the risk of becoming dehydrated because many of the triggers we have to drink plenty of water are related to hot weather, but it is just as important to keep the body hydrated properly in the winter as it is in the summer.

Home Treatment
Since sore throat can be a symptom of a condition that needs to be treated medically, it is important that if it is severe or prolonged, it is diagnosed by a doctor. However there are treatments that you can do at home to ease your discomfort:

Gargle with Saltwater. It is a tried and true method of numbing a sore throat. Dissolve a few teaspoons of salt in a glass of warm water, gargle and your throat will feel better almost immediately.

Drink Tea with Honey and Lemon. This threesome has qualities to numb and soothe the throat.

Take Vitamin C and Zinc Lozenges. It will not just soothe the dryness and irritation, but may help you fight a cold that’s coming on if you notice symptoms.

Rest Your Voice. Cheering, yelling or singing will just aggravate your throat. Hold off on using your voice loudly until your feeling better.
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David Volpi, M.D., P.C., F.A.C.S. is the founder and co-director of Otolaryngology Associates, Manhattan’s comprehensive diagnostic and treatment practice for conditions of the ear, nose, throat (ENT) and related conditions of the head and neck. The practice specializes in treating patients with ENT diseases and disorders through using the latest treatments and technology. He is also founder of  The Manhattan Snoring and Sleep Center, the premier treatment center for snoring and sleep apnea in New York City. He and his medical staff at Otolaryngology Associates are board-certified surgeons and members of New York’s finest teaching hospitals.
 
This article is intended for general information only is in no way intended to be a substitute for receiving direct medical advice and care from a medical professional, their diagnosis or treatment. If you have any questions regarding a medical condition, or if you suspect you may be ill, contact your physician. If you think you may have a medical emergency, call 911 immediately.