Have you ever heard the old saying, “it sounds like someone woke up on the wrong side of the bed”? It is no secret that sleep, or a lack of sleep, can significantly affect a person’s mood — but why? The human brain relies on sleep to regulate a person’s emotional and mental health and well-being.
With one in five adults in the United States alone suffering from some type of mental health issue, it is more important than ever to understand the link between sleep and mental health. Keep in mind, seek the evaluation from a medical professional as this content is for informational purposes only, and is not to be considered advice.
Common Mental Health Disorders
Mental illness is not something to be ashamed or embarrassed about, but it is important to understand the predictors and risk factors associated with mental health conditions, including poor sleep quality. Common mental health conditions include:
Anxiety is classified as a feeling of fear or uneasiness, resulting in restlessness, sweating, tachycardia, and a sudden loss of interest in activities that previously sparked joy in your life. Poor sleep quality and chronic sleep disturbances have been linked to an increased risk of anxiety. Anxiety can be a normal response to stressful situations, and may be temporary; however, with more than 40 million Americans suffering from anxiety disorders, it is often more than just a temporary stressful situation.
Obsessive Compulsive Disorder
OCD is a common, chronic condition affecting more than 200,000 people each year in the United States alone. It is characterized by unreasonable excessive thoughts that lead to compulsions (repetitive behaviors). Many people living with obsessive-compulsive disorder have extreme fears that seem rational to them, but appear irrational to those around them, such as the need to turn the light off x amount of times before leaving a room.
More than two million Americans are living with bipolar disorder. This mood disorder significantly impacts a normal sleep-wake cycle, resulting in poor sleep quality, nightmares, and insomnia. Bipolar disorder is marked by periods of mania (elevated moods) and hypomania (depressed moods). Though bipolar disorder causes mania and hypomania, poor sleep quality has been linked to an increased risk of these significant mood changes.
There are many forms of depression, both short-term and long-term. Seasonal Affective Disorder is a form of depression that occurs at the same time every year, rather than clinical depression, which is classified as a persistently depressed mood. Depressive symptoms include sleep issues such as difficulty falling asleep, or staying asleep; however, sleep issues can also cause depression due to an irregular sleep-wake cycle. The risk of depression increases when there is a family history, drug addiction or alcohol abuse, the use of certain prescription medications, and other various health issues.
Post-Traumatic Stress Disorder
PTSD is a medical condition accompanied by anxiety, depression, nightmares, and situational avoidance following exposure to a traumatic event. Post-traumatic stress disorder can last months to years with triggers that bring back memories of the traumatic event that was either witnessed or experienced. PTSD has been linked to sleep problems, including insomnia and sleep deprivation.
Attention Deficit Hyperactivity Disorder is a very common condition affecting about 4% to 5% of adults in the United States alone. ADHD is the result of differences in brain activity and brain development causing hyperactivity, impulsiveness, and attention deficits. Attention Deficit Hyperactivity Disorder most often begins in childhood, and is carried throughout adulthood, affecting home life, school, and work.
How are Sleep and Mental Health Linked?
The human body relies on many autonomic functions throughout the day and night, from your circadian rhythm to sleep cycles, allowing the brain to “trigger” the body to change from awakeness to sleep.
As bedtime approaches, the body naturally increases melatonin production, which acts as a sleep aid, allowing you to drift off to sleep easier. Once asleep, the brain goes through specific sleep patterns and cycles through four sleep stages:
- Light sleep - body movement and brain activity begins to slow
- Deep sleep - the most crucial in feeling well-rested the following day
- Non-rapid eye movement sleep - body activity and brain activity are drastically reduced
- Rapid Eye Movement sleep (REM sleep) - brain activity and eye movement increases, and dreams occur
A good night’s sleep allows for optimal learning abilities, memory formation, and emotional regulation; however, sleep disruption affects a person’s mental well-being, leaving them at an increased risk of certain mental health issues, excessive daytime sleepiness, and poor physical health.
Many sleep disorders, including obstructive sleep apnea and chronic insomnia, have been linked to an increased risk of poor mental health, as well as suicidal thoughts and behaviors. Obstructive sleep apnea results in sporadic pauses in breathing throughout the night and drastic changes in oxygen levels, leaving the sleeper to wake frequently, causing significant problems sleeping.
Sleep deprivation from receiving poor sleep can leave you feeling overly exhausted and irritable in the short-term; however, it can lead to more serious medical conditions, including depression, cardiovascular disease, and Type 2 Diabetes.
Ways Sleep can Impact Mental Health
Sleep and mental health go hand-in-hand, as poor sleep can lead to poor mental health, and a mental health condition can exacerbate or worsen sleep disorders. When a person experiences disturbed sleep, or cannot fall asleep easily, they experience an increased risk of mental illnesses, such as increased anxiety disorder and depression.
Disturbed sleep has also been linked to worsened bipolar disorder symptoms of mania and hypomania, leaving one more likely to experience a psychotic episode than if they were to have good quality sleep.
Too Much Sleep
Certain mental illnesses, including persistent clinical depression, can leave a person to sleep too much. While sleep health is important, too much sleep can have a negative effect on the brain. Further research suggests that too much sleep (considered by some as more than 9 hours of sleep) holds a risk factor of heart disease, diabetes, stroke, and death.
Because sleep and mental health are so closely related, too much sleep in a person with mental illness can make it increasingly difficult to get out of bed, or perform normal activities such as housework - just as it would if they were experiencing sleep deprivation or chronic insomnia.
As you sleep, several sleep cycles occur, including non-rapid eye movement sleep and REM sleep. During REM sleep, dreaming occurs as brain activity increases; however, there is also the chance of experiencing nightmares during REM sleep. Nightmares can lead to panic disorder, anxiety, and sleep loss, resulting in excessive daytime sleepiness, and difficulty functioning appropriately.
Studies Linking Mental Health and Sleep
Self-Reporting Sleep Trends Study Among Adults
In 1985, 1990, and 2004 to 2012, a study was conducted among 324,242 adults over the age of 18 years evaluating self-reporting sleep trends. Since 1985, the age-adjusted sleep duration has shown a significant decrease, while the percentage of adults sleeping less than six hours per night has greatly increased by 31 percent. Though there was a significant change between 1985 to 2004, after the study conducted in 2004, there has been little change reported in sleep habits among self-reporting adults.
Science Direct Longitudinal Epidemiological Study Among Young Adults
Science Direct conducted a study among young adults beginning in 1989 with 1,007 participants, then again in 1992 with 979 participants. This study of 1,200 total participants between the age of 21 to 30 years of age was conducted on a group of individuals that were all members of a large health maintenance organization in Michigan. Throughout the study, researchers determined that 16.6 percent reported lifetime insomnia symptoms, often worsening with a predictor of depressive moods and suicidal thoughts or behaviors.
Parent-Reporting Early Childhood Sleep Problems
A 2020 Jama Network study report was conducted on 7,155 early childhood participants whose parents reported sleep problems in early childhood, resulting in psychosis and Borderline Personality Disorder into adolescence. The research found that frequent night wakings at 18 months of age were linked to episodes of psychosis beginning from ages 5 to 8 years old into adolescence.
Tips to Improve Mental Health and Sleep
The first step to improving mental health and sleep is to see your physician, who can provide a diagnosis and treatment, if called for. But, there are also some things you can try to improve sleep quality, as sleep plays a crucial role in mental illnesses. Several things can be done to improve sleep quality, and aid in treating mental disorders such as:
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT), commonly referred to as “talk therapy”, is often the first-line treatment of mild mental illnesses and post-traumatic stress disorder. Through CBT, a licensed therapist helps you to examine patterns of negative behaviors and thinking, and offers suggestions to change the negative behaviors into a positive pattern.
Cognitive Behavioral Therapy for certain mental health conditions may be used alongside prescription medications for optimal results.
Cognitive Behavior Therapy for insomnia is a specialized treatment option for treating insomnia without the use of sleep medicine or other prescription or over-the-counter medications. It can take several weeks to see improvement, however, CBT-I has been proven to be the most effective treatment for insomnia.
Good Sleep Hygiene
When you hear the word “hygiene”, the mind automatically goes to cleanliness, however, practicing good sleep hygiene is significantly different. The body and mind thrive on routine, and the key element to good sleep hygiene is implementing and sticking with a sleep schedule.
Go to bed and wake up at the same time each morning and night, allowing your body to better regulate sleep hormones. Ensure your bedroom is a cool, dark, comfortable space, without light from a television or cell phone, as blue light from devices disrupts the brain’s ability to signal the production of key sleep hormones.
Do you find yourself taking several small naps or even one large nap during the day? Some sleep specialists recommend limiting the amount of time you are sleeping throughout the day to as little as 30 minutes to avoid sleep disruptions when it comes to bedtime. A 20 to 30-minute nap allows enough sleep to provide an energy boost without altering the body’s ability to fall asleep at night. Though 30 minutes does not seem like much, a nap throughout the day is not designed to perform the same functions as a full 8 hour night of sleep; it is simply to help you power through to bedtime.
Many people find themselves tossing and turning for hours night after night regardless of other sleep techniques they have tried. Sleep medicine is an option for those struggling to sleep, and on the hunt for relief. There are several over-the-counter sleep medicine options on the market today that can be found at most local stores, as well as prescription medication following a consultation with your primary care physician.
Discomfort while sleeping is one of the most common causes of poor sleep quality among sleepers. Maybe you cannot sleep because your pillow is too flat from frequent use, or the mattress you are sleeping on needs to be replaced?
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Our mission is to make a better mattress, change the way America sleeps, and use our voice to inspire change to help the environment using sustainable materials.
Sleep specialists recommend the average adult receive 7-9 of sleep per night; however, sleep is often the first thing sacrificed to get a few more hours out of the day. Remember, if we do not care for ourselves, including making sleep a priority, we simply cannot remain healthy enough to care for those around us.
Mental health and sleep go hand-in-hand, one worsening symptoms of the other. Sleep plays a crucial role in many necessary functions, including memory formation, emotional processing, and hormone regulation — much of which also plays a crucial role in mental health. If you find yourself having increasing difficulty falling asleep, staying asleep, or are experiencing worsened symptoms of a psychiatric condition, contact your primary care doctor for a consultation and recommendations for the next steps.
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