Wednesday 10 January 2018

Negative thoughts: are they related to quality and duration of sleep!


   Negative thoughts are cognitions about the self, others, or the world in general that are characterized by negative perceptions, expectations, and attributions and are associated with unpleasant emotions and adverse behavioral, physiological, and health outcomes. [1] complicated, isn’t it! In simple words, it is a thought process where people tend to expect the worst outcomes in everything or reduce their expectations to the worst possible end from anything they do, talk or even think. These are usually associated to psychological conditions like depression (most common), anxiety, loneliness, and hostility etc. Globally up to 20-25% women and 7-12% men are having clinically significant depressive negative thoughts in their lives. [2] But perhaps this problem affects almost all of us to some extents at some point of time of our lives.
Present management approach:
·         Cognitive-behavioral therapy, or CBT which include mainly [3]
o   Recognizing thought distortions
o   Challenging negative thoughts
o   Taking a break from negative thoughts
o   Releasing judgment
o   Practicing gratitude
o   Focusing on your strengths
o   Or Seeking out professional support
·         Drug therapy etc.
          But the outcome is unsatisfactory in most of the cases with limited good results or recurrence of symptoms. Hence scientists have tried to find out some effective solution for this universal problem from our day today practices. One of such effective findings is the role of quality and quantity of sleep in negative thought productions.
Scientific evidences:
·      Shorter sleep duration is associated with more rumination or deep thinking about unnecessary things and delayed sleep timing is associated with more obsessive–compulsive symptoms. [4]
·      Sleep disruption may be associated with a specific impact on cognitive resources that are necessary for the inhibitory control of attention to emotionally negative information. [5]
·    About three fourth of depressed patients have insomnia symptoms, and hypersomnia is present in about 40% of young depressed adults and 10% of older patients, with a predominance in female population. [6]
·     Numerous studies provide findings indicating the remarkable relationship between sleep alterations and depression. [7]
·   Chronic sleep deprivation rather than acute sleep loss may lead to depression that is potentially attributable to the neurochemical changes that occur in the brain & depression may lead to disturbed sleep. [8]
·      sleep disturbance may be a risk factor for development, an initial manifestation of the disorder, or a comorbid condition of unipolar depression. [9] 
            From above research findings, it is obvious that negative thoughts arising due to mental disorders are strongly associated to sleep disorder or disturbances & more so with long term conditions. But it is yet to find out through further researches, whether sleep disorders are cause of or result of psychological ailments. But one thing is clear that, a healthier and rhythmic sleeping habit will definitely have positive impact on our thought process.
Good sleeping habit: [10][11]
·  Be consistent at going to bed at the same time each night and get up at the same time each morning, including on the weekends
·   Make sure that your bedroom is quiet, dark, relaxing, and at a comfortable temperature
·.  Remove all electronic devices, such as TVs, computers, and smart phones, from the bedroom
· Avoid large meals, caffeine, and alcohol before bedtime
·  Get some exercise. Being physically active during the day can help you fall asleep more easily at night.
·  At least 7 hrs. of sleep for adults and 9hrs for young adults per night is recommended.
Healthy sleep requires adequate duration, good quality, appropriate timing and regularity, and the absence of sleep disturbances or disorders. [11] A good quality life needs good quality sleep too, which not necessarily means how much time we have spent on bed, rather how much time we have actually spent in having a healthy sleep to make the next day an energetic and positive one. Thank you, be healthy and keep smiling………..


References & further reading:
1.      Tiro J, Lee S, Lipshultz S, Miller T, Wilkinson J, Mestre M et al. Negative Thoughts. 2018.
2.      Wang J, Wu X, Lai W, et al. Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open. 2017;7(8):e017173. doi:10.1136/bmjopen-2017-017173.
3.      7 Ways to Deal With Negative Thoughts [Internet]. Psychology Today. 2018 [cited 10 January 2018]. Available from: https://www.psychologytoday.com/blog/women-s-mental-health-matters/201509/7-ways-deal-negative-thoughts
4.      Nota, J.A. & Coles, M.E. Cogn Ther Res (2015) 39: 253. https://doi.org/10.1007/s10608-014-9651-7
5.      Nota J, Coles M. Shorter sleep duration and longer sleep onset latency are related to difficulty disengaging attention from negative emotional images in individuals with elevated transdiagnostic repetitive negative thinking. Journal of Behavior Therapy and Experimental Psychiatry. 2018;58:114-122.
6.      Nutt D, Wilson S, Paterson L. Sleep disorders as core symptoms of depression. Dialogues in Clinical Neuroscience. 2008;10(3):329-336.
7.      Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry. 2005 Oct;66(10):1254-69.
8.      Al-Abri MA. Sleep Deprivation and Depression: A bi-directional association. Sultan Qaboos University Medical Journal. 2015;15(1):e4-e6.
9.      Wiebe ST, Cassoff J, Gruber R. Sleep patterns and the risk for unipolar depression: a review. Nature and Science of Sleep. 2012;4:63-71. doi:10.2147/NSS.S23490.
10.  CDC - Sleep Hygiene Tips - Sleep and Sleep Disorders [Internet]. Cdc.gov. 2018 [cited 10 January 2018]. Available from: https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

11.  Watson N, Badr M, Belenky G, Bliwise D, Buxton O, Buysse D et al. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of Clinical Sleep Medicine. 2015;.

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