Karl Doghramji, MD: Consequences of Insomnia

The consequences of untreated poor sleep can manifest over days, weeks—even years. In patients with insomnia, some of the consequences are still not well-defined.

In an interview with MD Magazine®, Karl Doghramji, MD, a professor at Thomas Jefferson University, explained the systemic burdens of sleep conditions and poor sleep in the most affected patients—from cardiovascular event risk, to even major depression.

These expert insights and more will be highlighted at the 1^st annual International Congress on the Future of Neurology, a two-day event in Manhattan which will cover a litany of expert insights into neurology while providing attendees and opportunity to gauge and meet with practice-leading clinicians and researchers including Doghramji.

Doghramji will be moderating the “Beyond Counting Sheep: Effective Therapies for Sleep Disorders” session on the weekend of September 27-28 during the Congress.

For more information on the Congress and to register, click here. Receive 25% off registration fees with code Neuro19SI.

MD Mag: What are some of the most significant consequences of poor sleep due to insomnia?

Doghramji: Insomnia and poor sleep in general seems to be related to a number of consequences which are still being worked on and defined, both in older and younger individuals. From a neurocognitive standpoint, we know that poor sleep is related to memory decline—especially working memory, and episodic memory, and memory about one's own recent life. Older individuals, as you know, are afflicted by memory problems, and poor sleep seems to augment that memory decrement.

Secondly, motor abnormalities—so, falls. Interestingly, many studies have shown that in older individuals, one of the strongest predictors of falls, which we worry about a great deal, is poor sleep and short sleep time independently of hypnotic medications or sleep medications. So, the impairment in motor behavior in older people could be related to the way they've slept the night before.

In the context of the hospital setting, poor sleep is also associated with the risk of with the risk of delirium, and some studies have shown that by treating poor sleep after admission to a hospital, we can actually diminish the risk of delirium after admission to a hospital. From a systemic standpoint, we know that individuals who sleep more poorly over the course of time have a higher likelihood of developing hypertension and metabolic abnormalities, or glucose intolerance, which is very interesting. And that really suggests that insomnia may have significant systemic effects, as well as neural cognitive effects.

Going back to the cognitive aspects for a moment: the consequence of cognitive decrements in insomniacs may be along the lines of motor vehicle accidents, which seem to be higher in rates with older individuals—as I mentioned before, falls as well. Insomnia seems to contribute to mood decline over the course of many years.

Insomniacs saw a higher risk of developing major depression, and interestingly, people who have had treatment of depression—successful treatment after achieving remission—have a higher rate of having another depressive episode if insomnia persists.