"I woke up on the wrong side of the bed."
We have all heard this phrase and you probably have personal experience with how your own sleep affects your mood and mental state. But how does sleep affect our brains? And what is its connection to mental health disorders?
Americans are notoriously sleep deprived, but those with mental health conditions are even more likely to be yawning or groggy during the day. Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).
When thinking about getting the sleep that you need, it is normal to focus on how many hours of sleep you get. While sleep duration is undoubtedly important, it’s not the only part of the equation. It is also important to think about sleep quality and whether the time spent sleeping is actually restful.
During sleep, you should progress smoothly multiple times through the sleep cycle, composed of four separate sleep stages. Each sleep stage plays a part in allowing your mind and body to wake up refreshed. Understanding the sleep cycle also helps explain how certain sleep disorders, including insomnia and obstructive sleep apnea can impact a person’s sleep and health.
Sleep stages are important because they allow the brain and body to recuperate and develop. Failure to obtain enough of both deep sleep and REM sleep may explain some of the profound consequences of insufficient sleep on thinking, emotions, and physical health.
Mental health disorders tend to make it harder to sleep well. At the same time, poor sleep, including insomnia, can be a contributing factor to the initiation and worsening of mental health problems. A lack of sleep is especially harmful to the consolidation of positive emotional content. This can influence mood and emotional reactivity and is tied to mental health disorders and their severity, including the risk of suicidal ideas or behaviors.
Sleep and Specific Mental Health Problems
Depression
- Around 75% of depressed people show symptoms of insomnia.
- Many people with depression also suffer from excessive daytime sleepiness and hypersomnia, which is sleeping too much.
- Historically, sleeping problems were seen as a consequence of depression, but growing evidence suggests that poor sleep may induce or exacerbate depression. Thus, improving sleep may be an avenue for reducing symptoms of depression.
Seasonal Affective Disorder
- This condition is closely tied to the disruption of a person’s internal biological clock, or circadian rhythm that helps control multiple bodily processes, including sleep.
- People with seasonal affective disorder tend to sleep too much or too little or experience changes to their sleep cycles.
Anxiety Disorders
- Anxiety disorders have a strong association with sleeping problems.
- Worry and fear contribute to a state of hyperarousal in which the mind is racing, and hyperarousal is considered to be a central contributor to insomnia.
- Sleep problems may become an added source of worry, creating anticipatory anxiety at bedtime that makes it harder to fall asleep.
- Research has found an especially strong connection between PTSD and sleep. PTSD affects many veterans, and at least 90% of U.S. veterans have insomnia symptoms.
- Research indicates that poor sleep can activate anxiety in people who are a high-risk for it.
Bipolar Disorder
- In people with bipolar disorder, sleep patterns change considerably depending on their emotional state.
- Research has found that many people with bipolar disorder experience changes in their sleep patterns before the onset of an episode.
- Sleeping problems induce or worsen manic and depressive periods.
Schizophrenia
- People with schizophrenia are more likely to experience insomnia and circadian rhythm disorders.
- Sleeping problems may be exacerbated by medications that are used to treat schizophrenia.
ADHD
- People with ADHD may have difficulty falling asleep, frequent awakenings, and excessive daytime sleepiness.
- Rates of other sleeping problems, such as obstructive sleep apnea and restless leg syndrome (RLS) also appear to be higher in people with ADHD.
- Sleep problems may aggravate symptoms like reduced attention span or behavior problems.
Improve Sleep Habits
Improving sleep habits may be an effective way for reducing the symptoms of mental health disorders. Below are some examples of how you may improve your sleep habits.
- Find ways to wind-down, such as with relaxation techniques like breathing exercises and meditation/ mindfulness.
- Avoid alcohol, tobacco, and caffeine in the evening.
- Dim the lights and put away electronic devices for an hour before bed.
- Configure your devices to minimize blue light during use.
- Restrict time in bed to only sleeping and limit time awake in bed.
- Get regular exercise.
- Get some natural light exposure during the daytime.
- Maximize comfort and support from your mattress, pillows, weighted blanket, and bedding.
- Block out excess light and sound that could disrupt sleep.
Every individual’s situation is different, so the optimal treatment for mental health and sleep problems depends on the person and it may take some trial and error. Regardless, it is essential and worthwhile to prioritize your sleep.
