Sleep issues influence almost every aspect of medicine from general practice to many specialty services.  Even the specialty of psychiatry has been impacted.  The most talked about psychiatric problems that are impacted by sleep dysfunction involve our military. A recent study found that soldiers experiencing major depression frequently had insomnia.  The prevalence of insomnia in this group was found in 85% of the cases.  High rates of insomnia were also found in those soldiers with generalized anxiety disorder and PTSD.

Researchers have now found a significant association between poor sleep quality and alexithymia.  Alexithymia is a condition characterized by difficulty identifying and expressing one’s emotions.  How this condition affects sleep quality remains unclear but may include nighttime awakenings as a result of an inability to verbalize emotions leading to increased light sleep.

Rising rates of alexithymia are being seen in a number of psychiatric conditions including autism, eating disorders, and schizophrenia, along with alcohol and substance abuse.  The condition has also been seen in some neurologic conditions such as multiple sclerosis and traumatic brain injury.

Sleep problems seem to be pervading modern life. Although some data suggests that we are getting more sleep than a decade ago, the improvement is small. Obstructive sleep apnea gets much of the attention when we discuss sleep disorders, but many other issues either impact sleep or are influenced by it. Treatments may vary and change with time and some may be more effective than others, but there is no substitute for an accurate diagnosis.