How Does Sleep Affect Mental Health?

By Guest Blogger Heidi Bitsoli, Editor at Sunshine Behavioral Health

Most people have had mornings defined by “waking up on the wrong side of the bed.” These experiences leave lasting insights into how sleep (or the lack thereof) impacts mental health.

The physical need for sleep is evident. The impact on emotional and mental health is not as apparent. It often shows up as anxiety or depression or a myriad of other conditions, some of which can be debilitating. According to Harvard University, chronic sleep problems impact up to eight of 10 patients who see psychiatrists. This compares with chronic sleep issues affecting 10% to 18% of the adult U.S. population.

Research consistently shows how sleep and mental health are intimately connected and further characterized as a bidirectional relationship or mutually reinforcing – being both a cause and consequence of mental health problems. Mental health conditions often create poor sleep patterns. And sleep disturbances, like insomnia, can potentially contribute to new or existing mental health issues.

Given the emerging connection between sleep and mental health, studies now suggest that improving one’s sleep will have an advantageous (and long-term) impact on one’s mental health. An study published in Lancet Psychiatry noted that better sleep led to an improvement in several things, including:
•Depression
•Anxiety
•Psychological well-being
•Nightmares

How Mental Health Relates to Sleep?

During the night, brain activity fluctuates as you pass through cycles of REM (Rapid Eye Movement) and NREM (Non-Rapid Eye Movement) sleep. During each sleep cycle, your brain and body act differently and perform different functions.

Sufficient sleep, especially during the REM sleep cycle, enables the brain to process emotional data. During the night, the brain works to evaluate and file away thoughts, memories, and positive experiences.

Obstructive Sleep Apnea (OSA), which most commonly manifests as sleep apnea, is a condition that reduces an individual’s oxygen level due to disrupted breathing during the night. OSA has also been linked to mental health issues.

Sleep and Mental Health Conditions

Depression

The World Health Organization notes that about 5% of adults across the world suffer from depression and that this slice of the population is over-represented in those who suffer from sleep disorders.

This interconnectedness of sleep and mental health can easily develop into a negative feedback loop with no off-ramp. For example, a poor sleeper will find their depression worsens, which then further disrupts sleep.

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder is a type of depression that is related to changes in the number of daylight hours due to changing seasons. It’s connected to one’s circadian rhythm or internal body clock – which regulates sleep. As such, sleep issues are common for those with SAD.

Anxiety Disorders

According to the Anxiety & Depression Association of America, anxiety is the most common type of mental illness in the U.S. – impacting more than 18% of the population. Anxiety, characterized by excessive and incessant fear and worry, can impact physical and mental health. It also often co-occurs with depression. There are various types of anxiety-based disorders, including:
•Generalized anxiety disorders (GAD)
•Social anxiety
Panic disorders
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
Phobias
•Major and persistent depressive disorder

Anxiety (even anticipatory anxiety) is known to cause one’s mind to race, and this state of hyperarousal can cause insomnia. There is also a strong connection between PTSD and sleep. Approximately nine of 10 veterans with combat-related PTSD have some form of insomnia. Unfortunately, depression and anxiety can combine to make sleep worse.

Bipolar Disorder

Bipolar disorder is characterized by high (mania – with restfulness, wakefulness, and less sleep) and low (depression – usually feeling tired and wanting more sleep) moods that shift back and forth to disrupt someone’s life. Sleep patterns vary significantly in those with bipolar depending on the current emotional state.

ADHD

Attention-deficit/hyperactivity disorder is a neurodevelopmental disorder. It involves a decrease in impulse control and the inability to pay attention. It can impact children and adults. Unfortunately, those with ADHD are more prone to sleep problems. Sleep and ADHD have been shown to have a bidirectional relationship.

Autism Spectrum Disorder

Autism spectrum disorder (ASD) refers to several neurodevelopment disorders that impact one’s ability to communicate and read social situations. These symptoms can be lifelong. Studies reveal a correlation between sleep disorders and autism.

How to Improve Sleep Habits

Creating and cultivating good sleep habits can go a long way in mitigating a disruption in one’s sleep. Each individual is unique. So give a few of these a try. It can pay big dividends in the long run:
•Try to set a steady sleep schedule that allows you to meet your daily objectives.
•Be proactive when winding down. Consider relaxation techniques like breathing, gentle yoga,
meditation, and mindfulness.
•Put electronic devices away at least 60 minutes before retiring.
•Dim the lights.
•Avoid stimulants at night, like tobacco, caffeine, or alcohol.
•Exercise regularly and get vitamin D from your diet or a bit of time outside during daylight hours.
•Block out distracting light or sounds that may awaken you.

The Take-Away

Mental health issues can cause sleep disruption, and too little sleep impacts mental health. Their interconnectedness may provide an opportunity to find one method to treat both simultaneously. Research confirms that proactively taking measures to improve sleep may be one of the foundations of a preventive mental health plan. It can also provide a healthier way to get needed rest rather than resorting to medications and risking addiction.

Every individual’s situation differs, so the optimal treatment for mental health and sleep problems will be contingent on the afflicted individual. Poor sleep habits or insufficient rest require proper care. Start by speaking with a trained health professional. 

Sources

health.harvard.edu - Sleep and Mental Health
pcpcc.org - Sleep and Mental Health: Why Our Brains Need Sleep
ncbi.nlm.nih.gov - A Systematic Review Assessing Bidirectionally between Sleep Disturbances, Anxiety, and Depression
mayoclinic.org - Insomnia 
ncbi.nlm.nih.gov -The effects of improving sleep on mental health (OASIS): a randomized controlled trial with mediation analysis
my.clevelandclinic.org - Sleep Basics
sleepfoundation.org -Obstructive Sleep Apnea
pubmed.ncbi.nlm.nih.gov - Sleep apnea, psychopathology, and mental health care
pubmed.ncbi.nlm.nih.gov - Clinical Characteristics of Obstructive Sleep Apnea in Psychiatric Disease
who.int - Depression
pubmed.ncbi.nlm.nih.gov - Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications
nigms.nih.gov - Circadian Rhythms
daa.org - Anxiety Facts & Statistics
mayoclinic.org - Anxiety disorders
adaa.org - Anxiety Facts & Statistics
nimh.nih.gov - Panic Disorder
nimh.nih.gov - Obsessive-Compulsive Disorder
nimh.nih.gov - Post-Traumatic Stress Disorder
nimh.nih.gov - Specific Phobia
pubmed.ncbi.nlm.nih.gov - Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective
pubmed.ncbi.nlm.nih.gov - Hyperarousal and sleep reactivity in insomnia: current insight
sleepfoundation.org - PTSD and Sleep
ptsd.va.gov - Sleep Problems in Veterans with PTSD
pubmed.ncbi.nlm.nih.gov- Prevalence and functional consequences of severe insomnia symptoms in mood and anxiety disorders: results from a nationally representative sample
pubmed.ncbi.nlm.nih.gov - The role of sleep in bipolar disorder
nimh.nih.gov - Attention-Deficit/Hyperactivity Disorder
pubmed.ncbi.nlm.nih.gov - Prevalence of sleep problems and their association with inattention/hyperactivity among children aged 6-15 in Taiwan
pubmed.ncbi.nlm.nih.gov - Associations of sleep disturbance with ADHD
pubmed.ncbi.nlm.nih.gov - Autism and sleep disorders
pubmed.ncbi.nlm.nih.gov - Insomnia as a Precipitating Factor in New Onset Mental Illness
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