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Biological and psychological factors of the sleep issue of Dany P.
Dany Perreault
MACP Program, Faculty of Behavioural Sciences, Yorkville University
PSYC 6104: A Biopsychosocial Approach to Counselling
Dr. Jake Protivnak
June, 4 2023
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Biological and psychological factors of the sleep issue of Dany P.
My name is Dany P., and I have difficulties sleeping. Quantitatively, I don't sleep enough
(6 hours or less), and qualitatively, my sleep is not very recuperative since I feel tired and
exhausted in the morning. I have been struggling with this condition for 20 years now, and I have
more and more difficulties keeping up with the symptoms because I am getting older. I fall
asleep, especially when I am not engaged in active activities, and sometimes while driving. I
have also occasionally experienced episodes of insomnia.
I have asked for help from different professionals, such as doctors and therapists, but they
seem to have difficulties identifying the causes and factors of my condition. I have tried sleep
medication, but I quickly stopped using it due to its poor effectiveness and the fear of becoming
addicted, which could worsen my condition. I was also referred to a sleep clinic, where I was
diagnosed with mild sleep apnea and recommended to start a treatment with a continuous
positive airway pressure (CPAP) machine. The treatment is not very comfortable or convenient,
but I have been able to be consistent and have seen a slight improvement.
I need to admit that my occupation as a military member implies exposure to stress due to
the nature of the job, performance pressure, and constant changes of environment. However,
since my condition started before, I joined the service, I cannot solely blame my profession. I
feel the need to delve deeper to understand the factors that can have a negative impact on my
sleep.
Since I have been unsuccessful in assessing and understanding the biological and
psychological factors of my condition on my own, I have started to have regular sessions with a
therapist in the hope of improving my situation.
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Biological Factors
As mentioned before, the first biological factor (maintaining) of my lack of sleep was
physical fatigue and exhaustion. It was difficult for me to complete my daily tasks, and I felt
lacking in energy. I would also fall asleep during sedentary activities such as studying, reading,
or watching TV. Sleep deprivation disrupts hormones that regulate metabolism and energy. It
increases cortisol, the stress hormone, and decreases melatonin, the sleep hormone (Spaeth et al.,
2018). The second biological factor (facilitating) was a decrease in cognitive performance,
particularly in tasks requiring sustained attention (Riemann et al., 2020; Kirszenblat and van
Swinderen, 2015). I started making more mistakes at work due to inattention. The third factor
(contributing) was mood disorders. According to studies (Krause et al., 2017), lack of sleep
creates imbalances in the levels of serotonin and other neurotransmitters responsible for mood
regulation. I found myself becoming more prone to anger and less patient with people around
me, which also had an impact on my relationships and social interactions.
Following our discussion, my therapist kindly recommended that I continue my CPAP
therapy and make an appointment with my general practitioner to rule out any underlying
medical conditions that may negatively affect sleep quality and its recuperative benefits. Given
the imbalances in serotonin and the disruption of hormones like melatonin caused by sleep
deprivation, we explored implementing changes to my routine. My therapist advised me to avoid
screens and bright lights before going to bed, as this would increase my melatonin levels and
improve the quality of my sleep. Additionally, incorporating at least 30 minutes of physical
exercise into my daily routine would help decrease cortisol levels and increase serotonin levels,
mitigating the negative effects of sleep deprivation and aiding in mood regulation.
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Psychological Factors
The first psychological factor (maintaining) of my sleep issue was stress. The tasks that I
usually approached with confidence and competence suddenly appeared challenging (Lo et al.,
2016), and at times, even insurmountable. I was trapped in a feedback loop where increased
stress further disrupted my sleep, leading to a perception of life as more and more stressful. The
second factor (facilitating) was depression (Wassing et al., 2016). I had difficulties waking up in
the morning and experienced a diminished ability to enjoy activities that used to bring me
pleasure. Pervasive pessimism clouded my judgment and perception. The third factor
(contributing) was the degradation of my social interactions. All the emotions I experienced
made me feel ashamed and led me to withdraw from social interactions (Palagini et al., 2021). I
also noticed a lack of empathy, which significantly impacted my relationships with clients and
coworkers. As a result, I missed work more frequently than usual.
My therapist was very open-minded and empathetic about my situation. He gave me the
time to tell my story and develop trust between us. Being respected (Slay-Westbrook, 2017) and
listened to in a non-judgmental way made me feel less ashamed and provided me with the
courage and strength to work on myself. We had already addressed changes in my routine and
implemented physical activities. Now, we have decided to focus on the psychological aspects,
particularly stress. While we acknowledged the importance of discussing feelings of depression
and the social environment, we agreed that to be effective, we needed to address one element at a
time, starting with stress (Pinel, 2020, p. 383) that was the maintaining factor issue. We already
established that stress was negatively affecting the quantity and quality of my sleep, creating a
feedback loop. In the next sessions, we will work on identifying and addressing the thoughts and
perceptions that contribute to this stress, aiming to reduce its impact.
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References
Kirszenblat, L., & van Swinderen, B. (2015). The yin and yang of sleep and attention. Trends in
Neurosciences, 38, 776–786.
Krause, A. J., et al. (2017). The sleep-deprived human brain. Nature Reviews Neuroscience,
18(7), 404-418. doi:10.1038/nrn.2017.55
Lo, J. C., et al. (2016). Cognitive effects of sleep deprivation: Emphasis on neurobehavioral
deficits. Comprehensive Physiology, 7(3), 1015-1039. doi:10.1002/cphy.c160003
Palagini, L., et al. (2021). Sleep loss and social interactions: A reciprocal relationship. Sleep
Medicine Reviews, 55, 101409. doi:10.1016/j.smrv.2021.101409
Pinel, J. P. J., & Barnes, S. J. (2021). Biopsychology (11th ed.). Pearson.
Riemann, D., et al. (2020). Neuroimaging the sleeping brain: Insights into cognition in sleep.
Sleep Medicine Reviews, 52, 101310. doi:10.1016/j.smrv.2020.101310
Slay-Westbrook, S. (2017). Respect-focused therapy: Honoring clients through the therapeutic
relationships and process. Routledge. ISBN:9781138906907
Spaeth, A. M., et al. (2018). Sleep and metabolic function. Pflügers Archiv-European Journal of
Physiology, 470(7), 1061-1075. doi:10.1007/s00424-018-2143-7
Wassing, R., et al. (2016). Slow dissolving of emotional distress contributes to hyperarousal.
Proceedings of the National Academy of Sciences, 113(9), 2538-2543.
doi:10.1073/pnas.1518370113