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Ask the expert

Is it true that you can make up for missed weekday sleep over the weekend?

This happens frequently in people suffering from delayed sleep phase disorder. It’s hard to get them out of bed for school and then they can’t fall asleep at night, so they accumulate a lot of sleep debt and try to catch up during the weekend. This irregular sleep schedule or sleep restriction during weekdays and sleep regulation during the weekend is called “social jet lag.” There is a good book on this topic by a researcher named Till Roenneberg. The greater the irregularity, the worse it is for your health. One tip is to try to stick to as regular a schedule as you can.

-Diane B. Boivin, MD, PhD, Mini-Psych School 2013

Is sleep before midnight more beneficial than sleep after midnight?

No. It depends on whether you are an early riser or a night owl. If your biological clock makes you go to bed at 2:00 a.m. and wake up at 10:00 a.m., you won’t sleep before midnight. You naturally don’t go to bed before midnight, so that’s not good for you. But if you’re an early bird who goes to bed at 9:00 p.m., then sleep before midnight is good for you, but this isn’t true for everyone.

-Diane B. Boivin, MD, PhD, Mini-Psych School 2013

Are individuals with mental health problems more prone to sleep disorders than others?

Sleep disorders are highly prevalent for any mental illness. Studies have revealed that insomnia and sleep disturbances can occur years before the onset of depression in one third of patients, and that’s a lot. More and more, we are seeing sleep disturbances as a pathology in itself and not only as a symptom of sleep disorders. Patients with bipolar affective disorder are taught to look at their sleep patterns to determine when they are at risk of relapsing into the manic phase of their condition. Typically, the manic phase is preceded by a reduced need for sleep. In seasonal affective disorder, patients tend to sleep more during their depressive phase. In schizophrenia, patients tend to have an abnormal sleep schedule, and their sleep patterns can drift, i.e., they go to bed late and they wake up lat

-Diane B. Boivin, MD, PhD, Mini-Psych School 2013

What is seasonal affective disorder?

Some people are very sensitive to the amount of light in the environment. The main hypothesis is that light and reduced light exposure throughout the day does affect mood regulation. The light that hits the retina is thought to affect the neurotransmitter systems of serotonin and dopamine, which are important for mood regulation in the brain. It seems that humans have a range of susceptibility to these changes of light exposure in the environment. Some people are really fragile. And at a certain time of the year, they may start developing depressive symptoms that can culminate into full blown depression.

-Diane B. Boivin, MD, PhD, Mini-Psych School 2013

What do you think about melatonin replacement therapy for sleep problems?

Melatonin sleeping pills can have two effects on the human brain: they can promote sleep or shift the circadian system into another internal rhythm. The sleep promoting effect is usually not observed when you are already secreting melatonin. So if you take a melatonin pill at night and you are already sleeping well, there will be no effect. For the moment, melatonin pills are not recommended for chronic insomnia. However, melatonin is one treatment that we may use for circadian system disorders. Some patients have a hard time with their sleep schedule: when they go to bed, they fall asleep and wake up too late. This is called “delayed sleep phase disorder.” Usually we treat these patients with melatonin pills in the evening and with bright light in the morning. This happens in about 50% of kids with ADHD (attention deficit hyperactivity disorder). We can use melatonin in specific situations, but for chronic insomnia in general, there isn’t solid evidence that it has a strong effect.

-Diane B. Boivin, MD, PhD, Mini-Psych School 2013:


How does menopause affect sleep?

Menopause is associated with hot flashes. Women may sleep under some sheets, then kick them off in their sleep, and then have to open or close a window. It does disturb sleep. If the problem is severe and results in serious sleep deprivation, you can talk to your doctor about hormone replacement therapy. As we get older, our sleep tends to be more fragile.

-Diane B. Boivin, MD, PhD, Mini-Psych School 2013

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