Child Mental Health Forum: Robert Stickgold, Ph.D.
Sleep and Psychiatric Disorders: Cause or Effect?
Robert Stickgold, Ph.D.
Associate Professor of Psychiatry
Beth Israel Deaconess Center
Harvard Medical School
Most of the major psychiatric disorders, including all of the DSM-IV axis one disorders, list dysregulations of sleep as one of their defining characteristics. Invariably, the assumption has been that the sleep disorder is a consequence of the psychiatric disorder. But a range of studies now raises the question of the extent to which independent sleep disorders can contribute to, or even cause, psychiatric illness.
Studies of children with both sleep apnea and ADHD indicate that correcting the apnea with adenotonsillectomy can reduce or eliminate ADHD symptoms. Similarly, treatment of sleep apnea comorbid with major depression in adults with CPAP can reduce or elminate the depression. But perhaps the most provocative hypothesis is that post-traumatic stress disorder (PTSD) is a memory disorder, and, more specifically, a consequence of defective sleep-dependent memory processing. Recent studies demonstrating sleep's role in the normal processing of emotional memories, as well as in the extraction of gist representations and "rules" from larger sets of memories, provide evidence for the proposed role of sleep in normal trauma processing.
Together, these wide ranging investigations suggest that sleep should be considered more seriously both in the etiology and treatment of psychiatric disorders.
Target Audience: Physicians (psychiatrists, pediatricians, child neurologists), psychologists, social workers, other mental health clinicians and researchers, and students and trainees.
Upon completion of this activity, participants will be able to:
- Describe several examples of sleep-dependent memory processing
- Describe the impact of sleep apnea on ADHD in children
- Describe the role of sleep-dependent memory processing in normal trauma resolution
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