Your Sleep Problem and your Brain

Is that sleep problem mostly in your head? Dr. Bill Yates explains relationships between the brain and insomnia, sleep apnea and other sleep disorders.

I found Dr. Yates during a search for information on the connections between mood disorders like depression and anxiety and sleep problem origins. He highlights brain research that he finds important in his blog called Brain Posts. I find it all fascinating. He graciously took time off from his incredibly busy schedule share his insights in this interview here on

Dr. Yates, tell us a bit about your background and how you became interested in the brain.

sleep problem, dr bill yatesI am a physician trained in family medicine and psychiatry. I have been involved in research related to mood, anxiety and substance abuse for 25 years. My science training is in epidemiology and preventive medicine. My interest in the brain stems from my interest in the diagnosis and treatment of common mental disorders.

I have held academic appointments at the University of Iowa College of Medicine and the University of Oklahoma College of Medicine. I currently contribute as a research investigator with a new brain imaging program in Tulsa, Oklahoma called the Laureate Institute for Brain Research.

When should we seek medical help for a sleep problem?

Sleep disorders are relatively common and can range in severity from mild, transient problems to more severe and potentially life threatening conditions. Medical consultation for these problems should be considered whenever there is a persistent problem that is distressful and impacts function during the day.

Some common symptoms or signs that might prompt seeing a physician would include persistent insomnia, excessive day time sleepiness or frequently falling asleep during the day, loud snoring, or restless legs during the night time.

What are the most common brain disorders that can lead to a sleep problem?

Primary insomnia is insomnia not related to another medical or mental disorder. Secondary insomnia (insomnia in the context of a medical or mental disorder) is common.

Depression, anxiety and substance abuse commonly lead to problems. Depression may be associated with increased or decreased sleep duration. Additionally, middle of the night and early morning awakening are common in depression.

Anxiety disorders can produce initial insomnia as individuals with anxiety disorders have anxiety about insomnia and difficulty letting anxiety and worry go at night.

Although alcohol intake may aid falling asleep, it is a relatively short-duration sedative and can produce rebound insomnia in the middle of the night.

Stimulant abuse, i.e. methamphetamine, can be associated with prolonged sleeplessness.

Who has more brain related sleep problems, men or women? And what are the most common ones in each sex?

Primary and secondary insomnia are the most common sleep disorders. Women have higher rates of depression and anxiety and they therefore tend to have higher rates of secondary insomnia. Men are more likely to have substance abuse problems that contribute to secondary insomnia. Sleep apnea appears to be more common in men than in women.

Many of us care for elderly parents. How can we help them improve their sleep?

Aging commonly is associated with a decrease in sleep duration and increased periods of awakening during the night.

Recent research suggests that a single nap of less than ninety minutes per day can improve cognition in the elderly. I have discussed some of this research in one of my Brain Post blogs (Naps Boost Cognitive Performance in Seniors)

Medications can have adverse effects on sleep. A new problem with sleep in an elderly individual should prompt a review of medications and the possibility of a medication-induced sleep problem. Chronic pain can contribute to sleep problems and so management of pain in the elderly is important.

What's the best advice that you can give us to help prevent or ease an age related sleep problem?

Sleep changes related to aging highlight the importance of maintaining good sleep hygiene behaviors. Sleep hygiene principles include having a comfortable bed in a quiet room. Additionally, caffeine and alcohol should be limited prior to bedtime. It is best not to spend long periods in bed attempting to fall asleep.

The American Academy of Sleep Medicine has a nice summary of what you should do in an article titled Healthy Sleep Habits

I'd like to thank Dr. Yates for sharing his knowledge of the connections between the brain and sleep disorders here on Be sure to look for new articles on his Brain Posts blog.

Your Sleepy Brain

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