Sleep & Stuttering: Is There A Link?

by Team Stamurai

Sandra Merlo, a speech therapist from Brazil, observed that her speech became worse after a few consecutive nights of poor sleep.

She is someone who has been stuttering since childhood. As she attended sessions and learned more about speech therapy, she has better control over her involuntary repetitions and blocks. Nonetheless, Merlo notes that without proper rest, she sees a spike in her stuttering the next day.

Next, she began asking her clients if they have noticed a similar relationship between their sleep quality and stuttering. Most of their clients stated that they had not noticed any link. However, after observing for a couple of weeks, the same people reported that their stuttering did indeed become worse after a poor night’s sleep.

Poor sleep hygiene may keep the brain from its ability to repair stuttering.

So What Constitutes A Bad Night Of Sleep?

Several factors may contribute to poor quality of sleep, but how can you understand if you had a good night’s sleep?

You Are Sleeping For Fewer Hours than Necessary

It is the most common cause of a poor night’s sleep in this era. We keep busy schedules that demand late nights of work and early mornings as well. In between, we can only squeeze in around 6 hours of sleep.

While for some people, 6 hours may be more than enough, for the average adult population, it may be 2 hours too few.

Here’s how much sleep you should get each night –

  • Preschoolers – 14 hours
  • School-aged children and early teens – 10 hours
  • Teenagers and adults – 8 hours

If your child or you aren’t getting enough hours of shuteye, it is important to consider rearranging your schedule and limiting screen time. Research shows that using a blue light filter on your screens in the evening can help you fall asleep at night.

You Are Sleeping Out Of Phase

Some people are early sleepers and some stay up till late at night. When the same people have to stay up later or go to bed earlier than usual, they may not feel equally rested the next day.

That happens because their sleep cycle is not in the usual phase as their biological clock. Deviating from one’s biological clock can disrupt their sleep phase.

If you go to bed at a fixed hour, you should try to stick to that. It is probably your natural circadian rhythm and your body is tuned to it by now.

If you need to change your sleeping hours due to work-related demands, you may consider gradually changing it to the new hours.

People involved in shift-work, typically complain of feeling jet-lagged and excessively sleepy during the day, for similar reasons.

People who stutter, report experiencing worse blocks, prolongations, and repetitions when they experience sudden changes in their sleep schedule.

You Have an Irregular Sleep Schedule

You might be in deep trouble if you have an irregular sleep schedule. This is more common among teenagers and young adults.

An irregular sleep schedule may mean that on certain nights, you are going to bed at 10 PM and waking up at 6 AM, while on other nights, you are going to sleep at 2 AM and waking up at 10 AM.

Irregular sleep schedules create pressure on the brain areas involved in the processing and production of speech. Moreover, several studies have linked it to mental health diseases including depression and anxiety disorders.

You Have Signs of Sleep Apnea

Inadequate breathing may also contribute to poor quality of sleep. While it may be temporary, there are pieces of evidence of sleep apnea in the teen and young adult population as well.

Temporary causes may include upper respiratory tract infections and allergies. Long-term causes of sleep apnea may include disorders like nasal septum deviation, asthma, sleep apnea, and mouth breathing.

Not breathing properly while asleep may cause a person to wake up several times. Waking up several times disrupts the sleep cycles and causes the person to feel tired and sleep-deprived the next morning.

Can Insomnia Cause Brain Damage?

In 2010, Altena et. al. analyzed the brain images of adults with and without chronic insomnia. There were 24 adults in the group who had insomnia. They were between 52 and 74 years old. Results showed a significant reduction of grey matter in the precuneus and orbitofrontal cortex of the brain.

Research shows that lesions in the precuneus may have a negative impact on speech therapy. The orbitofrontal cortex connects to the entire brain and is responsible for assigning emotional values to experiences.

That would explain why some people (insomniacs) who stutter experience such intense negative emotions associated with social interactions.

Damage to both the precuneus and orbitofrontal cortex from persistent sleep deprivation may make recovery from stuttering extremely difficult. It may contribute to a quick relapse in stuttering after recovery.

While we sleep, our brain undergoes a deep detoxification process. Not getting enough or good quality sleep can cause our brains to retain the harmful free radicals.

Free radicals can cause oxidative stress. It can damage the cells irrespective of their function. It may result in structural damage of the neurons. Neuron damage is the first consequence of oxidative stress in the brain.

Persistent insomnia or poor quality of sleep may also alter the gene expression inside the brain. These genes may be responsible for the production, and control enzymes related to the speech pathways.

In 2002, Macey et al analyzed the brain morphology of 21 men with and 21 men without sleep apnea. The imaging study revealed multiple lesions in various parts of the brain of the group who had sleep apnea.

One of the unilateral lesions was in the Broca’s area, which is linked to speech production. The researchers also discovered that 8 of the 21 participants with sleep apnea also had a history of stuttering.

Another set of bilateral lesions, which may be consequences of sleep apnea, was visible in the posterior parietal cortex. Damage to the integrity of the posterior parietal cortex may affect speech rehabilitation.

Studies show that in mouse models wakefulness and sleep affected the function of over 2000 genes. Merlo's published work shows that there is a significant chance that sleep disorders disrupt the on/off function of the genes related to speech and stuttering in children with sleep disorders.

Sandra Merlo's research reveals a vicious cycle of sleep deprivation and stuttering. On one hand, people with inherent brain damage may develop sleep apnea and insomnia. On the other hand, the brain anomalies caused by sleep deprivation may worsen stuttering and pose challenges in speech therapy.

While getting 8 hours of sound sleep may not prevent stuttering, it may help those who stutter learn and practice speech exercise techniques during therapy. Getting enough rest may also reduce the stress on your muscles and allow you to relax your jaws, neck and throat muscles while you speak.

There is really no good reason to not squeeze 8 hours of sleep at night. If you are unable to sleep due to physical discomfort, anxiety or depression, you should not neglect it. Consult a doctor, sleep specialist or clinical psychologist as soon as possible.

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