We probably all have first hand knowledge of how a bad night's sleep can affect us the next day: we're irritable, in a bad mood, and it can be hard to concentrate. It may not be all that surprising then, that how we sleep can be a very big part of depressive disorders, an incredibly interesting topic covered by Dr. Roseanne Armitage in the most recent installment of the IWHR's Women's Health Research Monthly Forum.

Dr. Roseanne Armitage Photo:www.med.umich.edu

Dr. Roseanne Armitage

Dr. Armitage began her talk by discussing how men and women, even those who do not have depression, sleep in very different ways. Possibly because of the different numbers of hormone receptors  or the over 650 genes that are expressed differently in the brains of males and females, the types of sleep we have also differs. For example, before puberty, boys have more slow wave sleep (stage 3 and 4 sleep, the deep, restorative kind that makes you feel refreshed in the morning) than girls do. After puberty, this changes, and girls are the lucky receivers of more slow wave sleep. Most interestingly, while men have a very slow loss of the amount of slow wave sleep over their lifetimes, women's amount stays relatively level and then drops precipitously during the peri-menopausal years. This is one reason why menopausal women really notice the sudden change in their sleep patterns. In general, women are also more likely to suffer from insomnia and sleep fragmentation than men.

The depression that Dr. Armitage really focused on was untreated MDD (major depressive disorder). MDD is twice as likely to occur in women than in men. Social withdrawal and feelings of worthlessness and guilt are more common in females with depression than in males with depression, who tend to complain more of lack of goal-oriented behavior. Around 80% of people with MDD report sleep problems, and for many people, sleep disturbance is the first presenting symptom of MDD. In adults with MDD, there are increased arousals and episodes of wakefulness, increased stage 1 sleep (the very light sleep), decreased total sleep time, and decreased stage 3 and 4 sleep.

Depression further exacerbates the sex differences in sleep between men and women when faced with a serious change to their normal sleep patterns (such as being asked to stay up for 40 hours consecutively), women with MDD overresponded, staying in slow wave sleep for too long, while men with MDD underresponded.  Sleep in healthy adults also shows a high level of coherence, or a very close association in the activity patterns of the right and left hemispheres of the brain. Women with MDD, however, have a lower coherence during their sleep than other healthy females, healthy males, AND males with MDD.

Dr. Armitage's work also demonstrates the ability to tie sleep disturbances to the likelihood of depression in very young girls. She finds that coherence scores can be a very good predictor of future depressive disorder; girls who were at high-risk for depression because their mothers were depressed demontrate lower coherence in their sleep...even before they have any sign or symptom of depression. Young girls in this high-risk group also had very disorganized sleep-activity patterns, even as disorganized as same aged girls who already suffered from depression. Shockingly, even babies (2 to 30 weeks) of depressed mothers take longer to fall asleep, have decreased total sleep time and sleep efficiency, and spend less time in bright light (known to produce necessary vitamins) than babies of non-depressed mothers.

Our thanks to Dr. Roseanne Armitage for such an eye-opening talk! We encourage you to look at some of Dr. Armitage's published work on the topic:

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Comments

Great summary Candace! I found Dr. Armitage's infant study and just how early in life circadian rhythm is set up to be fascinating. It amazes me that as early as 2 weeks of life, children born to depressed mothers have sleep issues. Maybe we shouldn't be so quick to blame colic for everything and need to dig deeper.

This brings up not only the necessity of women getting treated for post-partum depression, but also a good reason why women depressed DURING pregnancy should seek help. Not only for themselves, but for the potential risk to their child.

The discussion section from Dr. Armitage's paper states, "Although there are many environmental and social factors that can influence infant sleep and behavior, this study is a first step toward characterizing the influence of maternal depression. Future work with a larger sample size is necessary to evaluate what other factors influence sleep in infancy and whether those high-risk infants with the most disturbed sleep go on to develop early-onset depression."

Yes I agree with above Candace. And, yes women NEED TO SEEK help during pregnancy as I know all too well with the suffering of my sister and her (then) not-so-understanding husband. Upon repeatedly explaining her situation it took the birth of a (now) saddened/ deppressed child for him to take appropriate action. A harsh but all too real becoming.

SK

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I am particularly interested in the observation that slow-wave sleep patterns change for the different genders at certain points in their lives. Slow-wave sleep refers to the Delta wave form that tends to dominate during this period, exhibiting a frequency between 0.5 and 3.5 Hertz on an EEG.

The deepest period of Delta sleep is generally the first sleep cycle of the night, and people who have trouble falling asleep often fail to enjoy sufficient time in the Delta state. Delta waves have been linked to the production of human growth and anti-aging hormones, as well as DNA repair activities on a cellular level. It is common to see a lot of Delta activity in infants, for whom growth is obviously a top priority. Dr. Armitage's study makes me wonder whether post-pubescent females need more Delta sleep to prepare their bodies for the possibility of pregnancy, or at least the not inconsiderable burden of the menstrual cycle.

I suffered from sleep issues for years and have tried anything and everything. This article was very insightful to the problems linked to sleep issues.

As someone who has suffered from depression and whacked out sleeping patterns for nearly 30 years, I usually assumed that the bad sleep I got was in relation to being depressed, or anxious. Looking at the information presented here it seems that maybe depression could be agitated/kicked-off by bad sleep patterns?

Not sure if I'm reading it the right way. One thing I can say, having dealt with this all of my adult life, is that it is a vicious cycle. I'm not sure where it starts, but long periods of getting poor quality sleep definitely doesn't help when you are going through a depressive episode.

Through it all I've never visited a sleep clinic, could there be some help for depression if a sleep disorder is diagnosed? Could lack of deep, restful sleep be the actual cause of some people's depression?

My wife suffered post natal depression and spent hours/days in bed but not sleeping. I had no idea what to do and her doctors weren't very helpful.

She has since recovered but still can not sleep properly and spends hours on the couch watching tv instead.

I am going to show her this article and folow up on some more of Dr Armitage's work.

Thanks for sharing Dr Armitage's research with us. It's really fascinating how hormones affect the brain, mood and sleep. I'm personally really interested in the affect that hormones have on depression and mood- so really appreciate this summary of Dr Armitage's work.

It's amazing how much of an effect the hormones can have on sleep deprivation. I studied quantam neuro physics and the revelations re how the brain functions, that are available today, with modern scanning possibilities, is absolutely mind boggling.

This is interesting research the links between depression and sleep which throws more light into how we can help clients in reshaping their lives.

There are a number of comments here linking depression, pregnancies, babies, adolescent and mental illness together and it would be intersting to know if there is any research into depression and high achievers in the corporate world. Or are these conditions kept at bay by the use of drugs?

At Reshaped Lives we seek to help clients rebuild their finances, health and relationships after having it torn apart by the issues of life and set to not to change the course of such with an onset of depression.

I'm afraid my jury is out on this one slightly. I have some reservations around predicting potentially serious mental health illnesses in babies and young people. Could their sleep pattern not just be 'irregular' because they are sensitive to their mother's mental health issues rather than it being a pre-disposed hereditary condition about to descend upon them at some stage in their lives?

I struggled with low grade depression for years and was finally able to seek treatment last December. While I believe my depression started when I was a teenager, it was definitely stronger during my two pregnancies. I cannot stress how important sleep has been during my recovery. I find using meditation and visualization techniques has helped.

The number one thing that has helped pull me closer to joy has been having a creative project that I work on a few hours a day.

Sleep is most important aspect of everyday life. Nevertheless, many of us suffer due to lack of quality sleep. Probably, our lifestyles has strong effect on how we sleep. Drinking, caffeine, for example, known to disturb our sleep. It is everybody's dream to sleep like a baby. Nonetheless, regular fitness, and active life will help to get a good restful sleep.

My husband suffered from sleep disorders, but as noted in this article I have seen more of my female freinds with this condition.

I have found though that both sleeping difficulities and depression can often be greatly aided with nutrition, exercise and deep breathing.

As a Japanese woman I have always enjoyed the benefits of both western and eastern style medicine. It was a shock to me when I married my American husband found that in America natural or Eastern Medicne is looked upon as quackery or snake oil.

I would hope as doctors consider this serious condition that they would remember the benefits that good nutrition, exercise and other forms of natural medicine such as deep breathing and meditation can bring to helping over come such conditions.

Great post Candace! I really found the circadian rhythm with infants part to be fascinating. I'm writing a piece on pregnancy and the harmful effects of aspartame which is the sweetener used in all diet and sugar free drinks. What I found is that aspartame is responsible for either triggering or worsening cancers like lymphoma, leukemia, other illnesses like insomnia, anxiety attacks, seizures, nausea, muscle spasms, depression and here is the big surprise: chronic weight gain! Yet, the FDA approved it in the 80s and its still being consumed by millions around the world because its so highly profitable. What does that tell you? Always do your research before you put things on your skin or in your stomach.

I'd be interested to learn more about the light effects on depression. Why it is depressed people tend to not be in the light more? Good post, enjoyed reading, Thank You.

I suffered from sleep issues for years and have tried anything and everything. This article was very insightful to the problems linked to sleep issues.

I'd like to read more about the link between sleep disorder and depression in young girls. I showed symptoms of several sleep disorders as a child, and then went through a period of depression. Thinking back to that time, I often searched for any outside events that could have triggered the depression...could the cause really be as simple as my sleep disorders?!

I have to agree with Kaz that good nutrition, exercise and deep breathing (yoga is a great method of achieving this) help immensely with regulating the body and allowing a deep sleep.

In my experience there are many recommended drugs to assist with getting a deep sleep but this is merely a "band aid" approach with out lasting healthy results.

Most people just don't understand the importance of getting enough rest. Getting enough sleep is just as important and getting a balanced diet. Not getting sleep, will eventually take it toll and cause many problems. I think that you have hit here and I look forward to reading more of what you have to say regarding sleep.

Good information here. I first ran across this while gathering information about my husbands sleep patterns, or rather lack of, and was surprised when I saw myself in the post! I did not realize that my disturbed sleep patterns of late could possibly have anything to do with menopause.

Although I haven't suffered from clinical depression, there are times in our lives when we worry about something or feel down.

This mood impacts our sleep patterns and as stated further exacerbates the problem because fatigue is added to the equation.

I found exercise, specifically getting off my butt and going for a jog to be a great way to "clear away the cobwebs" of a poor state of mind.

I am not talking about running a marathon and you don't need to jog, just do something for 30 mins that increases your heart rate and makes you get a bit of a sweat up - you could skip etc.

Then have a hot shower. OK this may not totally cure the mood, but if you do it before tea say, it will help you sleep better. For further sleep assistance put some lavender oil on a tissue and place it under your pillow.

A really interesting read. I've bookmarked it and will link to it - sleep and rest is such a vital part of our energy system. It's nice to have an expert viewpoint. We can no doubt all appreciate that a bad day tends to follow a bad nights sleep. Yet until we have a problem with sleep ourselves, it can be easy to underestimate just how much it can affect other parts of our lives.

Our overall energy can be so depleted and soon we lump on anxiety to not being able to sleep and create an ever increasing problem. All the while, someone else can simply lay their head on the pillow and seem to immediately drift off to enjoy a wonderful nights rest!

This sleep phenomenon in babies born to depressed mothers seems to illustrate how attachment (as defined in attachment theory), or the lack thereof, influences brain development. Because depression significantly hampers the mother's ability to effectively reflect the child's inner state, thereby contributing to the child's lack of feeling 'felt' by its mother, the brain areas related to fear and anxiety (particularly the amygdala) may become over-sensitized until anxiety becomes 'hardwired' into the child's neural circuitry. This could also explain why anxiety is so highly correlated with depression.

Most people don't associate feelings of sadness to sleep deprivation even when they become extreme. Sleep deprivation can actually be caused by depression itself, which is what a friend of mine went through. What really helps is journaling and meditation. Facing the issue rather than running away from it.

This is such an important topic. In my research, I have found much overlap in natural cures for both insomnia and depression. Lack of sleep can surely lead to depression and anxiety.
I found Dr. Armitage's research on infants and maternal depression quite interesting! My personal experience has been that my babies sleep as well as I do. If I sleep well, restfully, and soundly, so did my children as infants. However, if I had restless sleep or insomnia, they suffered as well.

Interesting read. I cannot believe that hormones have an effect with one's sleeping pattern. Does that have the same effect for pregnant women? I experienced the same symptoms during my pregnancy. I never bothered to ask my OB since I used to have the same irregular pattern when I was still in college. I hope you can answer my question since my partner and I are already talking about another kid - although I would like it very much that this is resolved before that. Thanks so much!

I would have to definitely agree that sleep disorders have a huge impact on the depression levels in your life. Because sleep is just as important to our health as food, water, and oxygen. It's crucial to us as human beings to get the proper amounts of sleep, which in turn will help to decrease depression in our lives.

Thanks for this great article on sleep problems.

One of the most effective methods to induce sleep is to undertake some mild exercise like taking a 30 minutes walk just before bedtime. One gets tired and have a tendency to fall asleep soon. This helps alot.

thank you for interesting article. I think also that meditation music or similar can help with sleep also. Also this music can help when you feel depressed. Even if these thing are not right in your life remember there are many people the same.

Peace,
Jade

I have a secret formula for sleep: Baroque music. Classical music that is largo or speed (60 beats per minute) has a natural soporific effect upon the mind. It causes the mind to be sharpened (I use it for study also) but relaxes the body. Bach's Goldberg Variations is one of my favorite sleep inducing pieces of classical music compilations. I really like Glenn Gould's version. Certainly nutrition is important -- tryptophan is a natural sleep-inducing amino acid. It's found in abundance in turkey. That works too!

Hope this helps someone.

Glen Ryan

I'm a middle aged man who had sleep problems for many years. I tried a lot of different things, but none of them helped much. When I found outI had low testosterone and began increasing my testosterone levels, I noticed I started sleeping better. Maybe it was because I had more energy to exercise or because I had less anxiety and experienced feelings of well being I hadn't felt in years. Since low testosterone is related to depression in middle-aged men, and increasing testosterone improves mood and mental attitude, it makes sense that raising testosterone levels could help men sleep better.

So many things can affect the sleeping pattern of an individual. I know about snoring and sleep apnea, but I didn't know about the effects of hormones at different stages of life for boys and girls. That will help me comprehend why sometimes I am more tired in the morning.
Thanks.

Both of my parents have sleep issues, to the extent to where they both actually have to use the aid of a machine while they sleep. This was a very interesting article. Who knew you could learn so much from the way an individual sleeps. Fortunately I haven't had any sleep problems myself.(at least to my knowledge)At I know some possible causes if that ever happens. Thanks for the info. Great article.

The biological & chemical differences between the sexes are really fascinating, as is the fact that even the mental state of the mother during childbirth can alter a baby's sleeping pattern! Women really do have it badly when it comes to sleep -- the odds are really stacked against them (increased odds of insomnia, increased odds of depression, etc)

Dr.Armitage,
I find sleep very intriguing. Maybe because my family of nine is divided into those who have sleep issues and those who decidedly do not. Those with the issue feel it is a family curse which can be traced back for generations.

At the end of your post you mentioned a correlation between a mother's depression and a young girl's (but not boy's?). Could the depression of one's primary caregiver at a tender age be the instigator?

I cannot remember what it's like to have a decent night's sleep.

I have been this way since about 1996. I go to be tired and wake up knackered. I have aches and pains and I have become very edgy.

I hear the slightest sounds and lose concentration at the drop of a hat.

Being tired makes me a very miserable person. I used to be so happy and energetic. Now I am tires ALL the time.

I have been taking Zopiclone - prescribed by my GP - but they are of no value anymore.

To be fair, even when they did work to some small degree - theymade mouth dry and they taste disgusting.

I'm 53 years of age now and I don't foresee my sleep problem getting better.

I have read and heard that we require less sleepas we get older, but that certainly is not the case for me.

Any ideas?

I will bookmark and return to see if anyone can help.

Kind regards.

Tony

I think the idea of a good night sleep (or lack of) is really under-appreciated, at least in terms of the impact it can have. Like you say, most people realize they feel a bid 'fuzzy' after a bad night, but I bet few people really understand the potential long term impact it can have if they don't sort it out.

One of the things I look at on my website is night sweats in women (and men), which can really contribute to a poor night's sleep too. This kind of problem occurs for a number of reasons, but the result for women can still be the same - less sleep, and the potential negatives which that involves.

Getting a better understanding, and raising awareness, of the effects of sleep disorders is definitely a health issue to focus on. Great post.

I am bipolar and I am actually fairly shocked at the difference a good night sleep can make on those of us who are bipolar. A lack of sleep has driven me in to mania quite a few times. I also find that I get depressed in some cases due to a lack of sleep.

It's interesting to note your specific research on depression in young girls. I'd be curious to see if your findings can also be applicable to those of us with bipolar disorder. I could definitely see it going either way as depression may not always be purely genetic whereas many psychiatrists feel that bipolar disorder is almost exclusively based on heredity. Would your research ever extend to people with bipolar disorder or other diseases like schizophrenia?

I often find it difficult getting a good night's rest. Many times I just lay away in bed as thoughts go round in my head. Even when I'm able to drift off to sleep I find that I frequently wake up during the night. I'm thinking about taking Yoga because I heard it can help me get a better nights sleep.

Nice to be visiting your weblog once more, it has been months for me. Properly this post that i’ve been waited for so lengthy. I will need this article to complete my assignment within the college, and it has exact same subject together with your article. Thanks, excellent share.

Wow, I'm really blown away with the info you have here. This could spice up my relationship. We are going well but I'd love to make it a bit more exciting. Nice!

I absolutely need a good night sleep or I'm next to useless. My mind just feels foggy and I can't think well. It also makes me more irritable as well.

The best solution I found for myself when this reoccurs is exercise. A good workout really helps knock me out at night and I sleep nice and deep.

Sleep disorder can be a big issue once you get to a certain age and I know this first hand. This is an awful problem to have and it is very difficult to find good posts on this issue. Well done for having such an
informative post.

Cheers,

Mark

People find snoring amusing but I remember staggering around in a haze during the day after a night of poor quality sleep and know first hand there's nothing funny about it.

I suffer bad nights and looking for a side sleeper pillow,is that any good advice for me?

Hi Candace!
Great article, thorough, insightful, informative. In general, women are also more likely to suffer from insomnia and sleep fragmentation than men. This is very true

Thanks very much for this post. I've always had moderate insomnia - even as a child I would be the last one to fall asleep at sleep overs, and my mum has suffered from severe insomnia ever since I was born. We're also both prone to depression, and it makes more sense now that I have read your article.

Regarding chemical changes in the body as women go through the menopause, melatonin is often very useful, my mum has benefitted from it, and as far as we know now, there doesn't seem to be any problematic side effects. (Although be aware that many people including pregnant or depressed people should either avoid it or talk to the doctor first).

Fantastic article which I can fully relate to.I suffer from sleep disturbance and this article has been very interesting to read.

I found it interesting that Dr. Armitage says “... babies (2 to 30 weeks) of depressed mothers take longer to fall asleep, have decreased total sleep time and sleep efficiency, and spend less time in bright light (known to produce necessary vitamins) than babies of non-depressed mothers.” There is a direct correlation between depression and vitamin D deficiency. Vitamin D is naturally created when sunlight hits your skin. Dr. Armitage mentions babies of depressed mothers don't spend as much time in sunlight but I would be interested to know if there has been investigation to determine if both the mothers and babies are deficient in vitamin D and if increasing vitamin D would decrease their depression and in turn improve sleep patterns.

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