Sleep, Sex, and Bullying
Some connections superficially look strange. Why should sleep disordered breathing be associated with bullying and conduct disordered kids – as well as adult males with erectile problems? Is not breathing during sleep, or simple lack of sleep, affecting both aggressive behavior and our capacity for sex?
Let’s take a look.
The Unhappy Children of Ypsilanti
The recent University of Michigan study looked not at sleep disordered breathing, but symptoms brought on by sleep disordered breathing. Ypsilanti elementary school students who were noted for bullying or conduct disordered problems complained of lots of daytime sleepiness along with snoring (http://www.sciencedirect.com/science/article/pii/S1389945711001572). The authors felt that sleeplessness itself was the most strongly associated finding in the data. The bullies really did not sleep well.
Whether sleeplessness was the cause of aggressive behavior is another tale.
The Middle Aged of New York
Mt. Sinai prospectively followed 870 cardiac patients (http://consumer.healthday.com/Article.asp?AID=652915). The majority turned out to have sleep apnea, and their average BMI, 30.2, put them in the obese category (the average for US adults is 28.1). The more severe their erectile dysfunction, the more severe their sleep apnea. The authors felt that men with erectile dysfunction often deserved screening for sleep apnea as yet another factor potentially increasing their chances for ED. However, what really correlated with more erectile dysfunction was lack of sleep.
The Common Thread
Sleep disordered breathing does a number on much of human physiology. Many kids with sleep apnea develop signs of Attention Deficit Disorder. With any kid who does show signs of ADD, it’s worthwhile asking if they snore at night and taking a long look down their throat searching for large tonsils. In kids with sleep disordered its long been known that problem may cause many behavioral problems during the day, including mood changes and impulsive actions. Fix the cause, and much of the time the errant behaviors disappear.
Similarly, it’s been known for a long time that sleep disordered breathing adults also have additional behavioral problems. Work in the 1980’s showed that panic disorder could disappear in patients once their sleep apnea was treated. Similar results occurred with sleep apnea patients whose long standing depression had been “unresponsive” to standard treatment – until they got a CPAP machine that nixed both their apnea and their depression.
Sleep disordered breathing can cause hypoxic damage to the brain. Not getting enough oxygen generally leads to a mix of cellular injuries which may enhance the tendency of adults with sleep apnea to more heart attacks and strokes.
Moreover, adults with sleep apnea often suffer from metabolic syndrome – a combination of belly fat, hypertension, diabetes/insulin resistance that along with their sleep apnea disorders life physiologically and psychologically.
What’s Cause and What’s Effect?
At this stage of research, it could well be both. Disorder breathing at night and you disorder the brain night and day. Do bullies have more mood problems? Yes. More problems at home? Yes. Do they use more electronic media at night? There are new studies stating just that.
Certainly sleep apnea in adults is not good for one’s overall health. Yet what’s chicken and what’s egg may have a common thread.
Sleeplessness, Aggression and Sex
Sleep is a part of rest required for normal human regeneration. Worsen sleep and many other parts of life become more difficult.
Though testosterone peaks during REM sleep, sleep deprivation generally increases impulsiveness and aggressiveness. Chronically sleepy people tend to be tetchy and irritable – not what you want on the job or school – even if the “problem” belongs to someone else.
And that sleep apnea would affect sexual function is no great surprise. Potential hypoxic brain damage is one problem you don’t need to have. And not getting enough REM sleep will decrease testosterone, which does not aid adult sexual function.
Yet the critical connecting factor may be sleeplessness itself. Many studies show that sleep apnea’s effects are mediated by the amount of time people wake up at night.
Wake up a lot, and you don’t get continual sleep. Less continual sleep means less time for the deeper stages of sleep like REM and deep sleep – stuff you need for learning and memory.
For better mood. For rewiring the brain. For normal physiological function.
Interfere with sleep and you interfere with much of your body’s normal regeneration.
That the effects may vary from behavioral impulsiveness to problems with sexual function should surprise few. Rest is very much like food.
You need both to live.
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