Sleep Care

Seasonal Affective Disorder

For most people, the fall and winter months are filled with busy holiday schedules and good times with friends and families. Others, however, experience an unexplained depression or sadness, often accompanied by a decreased amount of energy. They may withdraw from others socially, have difficulty waking in the morning, and overeat, which often leads to weight gain. These individuals are likely experiencing something known as Seasonal Affective Disorder, or SAD.

According to statistics compiled by the American Academy of Family Physicians, about 6% of Americans develop SAD yearly, with another 10-20% experiencing mild symptoms of SAD each year. SAD typically doesn’t show up before twenty years of age, and becomes more common as individuals get older. Reduced exposure to sunlight does appear to be a major contributing factor as incidence of SAD increases in communities further and further from the equator, which results in longer nights and less exposure to sunlight. Medical professionals believe that reduced sunlight can lead to lower or unbalanced levels of vitamins and hormones in the body causing the depression symptoms. Other risk factors can include being female, a family history of SAD, and being diagnosed with bipolar disorder.

Seasonal Affective Disorder and Sleep

There is a significant relationship between SAD and sleep. In one study of self-reported sleeping habits of nearly 300 participants with SAD, 80% reported sleeping too much (hypersomnia) and 10% reported getting little if any sleep at all (insomnia).

Despite this relationship, sleep studies objectively investigating exactly how sleep is different for those with SAD have yielded mixed results.

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Some studies have found that people with SAD sleep significantly longer in the winter than in the summer; however, these studies also found that summer sleep periods tended to be less than normal. The actual sleep architecture (periods of NREM and REM sleep) of those with SAD is comparable to those who don’t have it.

Treatments for SAD

SAD typically occurs during the fall and winter months, when the amount of sunlight an individual is exposed to during the day is at a minimum. Since this is the case, one of the most effective therapies for SAD is called light box therapy (LBT). When using a light box, a person is exposed to a very bright fluorescent light—usually at least 10,000 lux, which is about 100 to 1000 times as bright as average indoor lighting. Typically a person will sit a few feet away from the light box in the morning when they get up for a prescribed length of time. Benefits of LBT can begin within two to four days of the start of therapy, and side effects are few (often just some eye strain and possibly headaches).

Antidepressants and psychotherapy may be helpful in situations where light box therapy proves ineffective. The goal of these treatments is to improve brain chemistry and thought patterns to alleviate the depressive symptoms of SAD.

Other common treatments, although with mixed results, include vitamin and hormone supplements, such as vitamin D and serotonin. These are elements that are commonly found to be deficient in individuals with decreased exposure to sunlight and have been linked to mood regulation.

Because SAD is a seasonal disorder, its symptoms typically go away in the spring and summer, as people become exposed to more natural sunlight. For some individuals, planning regular social interactions and outdoor exercise on the sunny days of the fall and winter may help get them through the season with no other treatments needed.

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