Sleep and Circadian Rhythm Disruption in Social Jetlag and Mental Illness

doi:10.1016/B978-0-12-396971-2.00011-7

Progress in Molecular Biology and Translational Science

Volume 119, 2013, Pages 325-346

https://doi.org/10.1016/B978-0-12-396971-2.00011-7 Get rights and content

Abstract

Sleep and wake represent two profoundly different states of physiology that arise within the brain from a complex interaction between multiple neural circuits and neurotransmitter systems. These neural networks are, in turn, adjusted by three key drivers that collectively determine the duration, quality, and efficiency of sleep. Two of these drivers are endogenous, namely, the circadian system and a homeostatic hourglass oscillator, while the third is exogenous—our societal structure (social time).

In this chapter, we outline the neuroscience of sleep and highlight the links between sleep, mood, cognition, and mental health. We emphasize that the complexity of sleep/wake generation and regulation makes this behavioral cycle very vulnerable to disruption and then explore this concept by examining sleep and circadian rhythm disruption (SCRD) when the exogenous and endogenous drivers of sleep are in conflict. SCRD can be particularly severe when social timing forces an abnormal pattern of sleep and wake upon our endogenous sleep biology.

SCRD is also very common in mental illness, and although well known, this association is poorly understood or treated. Recent studies suggest that the generation of sleep and mental health shares overlapping neural mechanisms such that defects in these endogenous pathways result in pathologies to both behaviors. The evidence for this association is examined in some detail.

We conclude this review by suggesting that the emerging understanding of the neurobiology of sleep/wake behavior, and of the health consequences of sleep disruption, will provide new ways to decrease the conflict between biological and societal timing in both the healthy and individuals with mental illness.

Section snippets

The Biology of Sleep

Sleep is a highly complex behavior arising from an interaction between multiple neural circuits, neurotransmitters, and hormones, none of which are exclusive to the generation of sleep.¹ The major brain structures and neurotransmitter systems involved in the sleep/wake cycle are summarized in Fig. 11.1.

The sleep systems illustrated in Fig. 11.1 are controlled by three key drivers that interact and collectively determine the duration, quality, and efficiency of sleep. Two of these drivers are

Sleep and Circadian Rhythm Disruption Arising from Social Timing

As described above, efficient sleep depends upon complex biological drivers in the form of the circadian system and the homeostatic hourglass oscillator (Fig. 11.2). In real life, however, an additional critical factor—social timing—influences sleep opportunities and thereby sleep duration, quality, and efficiency, potentially resulting in sleep and circadian rhythm disruption (SCRD). A large database (≈ 150,000 entries) has been established on sleep-activity behavior in the general population²

SCRD and Psychoses

SCRD is a common comorbidity in numerous psychiatric disorders.¹ The greatest focus has been on mood disorders, especially unipolar and seasonal affective subtypes, yet SCRD is also prominent in the more severe, psychotic disorders such as schizophrenia.19, 20, 21 The relationship between schizophrenia and abnormal sleep was first described in the late nineteenth century by the German psychiatrist Emil Kraepelin.²² Today, SCRD is reported in 30–80% of patients with schizophrenia and is

A Conceptual Framework for SCRD in Psychiatric Illness

The association of mental illness and SCRD has until recently been considered to arise from exogenous factors including social isolation, antipsychotic medication, and/or activation of the stress axis.¹ Such a linear relationship between psychosis and SCRD is illustrated in Fig. 11.7A. Some recent studies²⁰ have addressed this hypothesis by examining SCRD in patients with schizophrenia and unemployed control subjects (Fig. 11.6) and showed that severe SCRD exists in schizophrenia and persists

Conclusions

In this chapter, we have considered the exogenous and endogenous origins of SCRD with reference to social time and mental illness. The association between SCRD and mental illness is well recognized, but the causes, correlates, and effects of SCRD in mental illness have been poorly understood and its treatment often neglected. Recent advances in our appreciation of the endogenous mechanisms that generate sleep and circadian rhythms, and in the emerging understanding of the neurobiology of

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Chapter Eleven - Sleep and Circadian Rhythm Disruption in Social Jetlag and Mental Illness

Abstract

Section snippets

The Biology of Sleep

Sleep and Circadian Rhythm Disruption Arising from Social Timing

SCRD and Psychoses

A Conceptual Framework for SCRD in Psychiatric Illness

Conclusions

Curr Biol

Curr Biol

Curr Biol

Neurosci Lett

Psychiatr Clin North Am

Schizophr Res

J Psychiatr Res

Curr Opin Genet Dev

Schizophr Res

Compr Psychiatry

J Affect Disord

Neuron

Biol Psychiatry

Am J Hum Genet

Neuropharmacology

Schizophr Res

J Psychiatr Res

Biol Psychiatry

Biol Psychiatry

Curr Biol

Curr Biol

Brain Res

Brain Res Bull

Biol Psychiatry

Neurosci Lett

Schizophr Res

Schizophr Res

Biol Psychiatry

Clin Psychol Rev

J Behav Ther Exp Psychiatry

Sleep and circadian rhythm disruption in psychiatric and neurodegenerative disease

Nat Rev Neurosci

Life between clocks: daily temporal patterns of human chronotypes

J Biol Rhythms

The rhythm of rest and excess

Nat Rev Neurosci

The art of entrainment

J Biol Rhythms

What is chronotype?

Sleep Biol. Rhythms

An hPer2 phosphorylation site mutation in familial advanced sleep phase syndrome

Science

Circadian temperature and melatonin rhythms, sleep, and neurobehavioral function in humans living on a 20-h day

Am J Physiol

Social jetlag: misalignment of biological and social time

Chronobiol Int

Evaluating the links between schizophrenia and sleep and circadian rhythm disruption

J Neural Transm

Adverse metabolic and cardiovascular consequences of circadian misalignment

Proc Natl Acad Sci USA

Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients

J Pers Assess

Depression scores associate with chronotype and social jetlag in a rural population

Chronobiol Int

Sleep and psychiatric disorders. A meta-analysis

Arch Gen Psychiatry