Why Better Sleep Could Be the Missing Piece in Mental Health
Although mental health fundamentally shapes our quality of life, people often overlook the impact of sleep on mental health. Research increasingly reveals a two-way relationship: mental health can impact sleep, and sleep difficulties worsen mental health symptoms. Poor sleep is associated with poor cognitive functioning and poor emotional regulation. When we get less sleep, we have more difficulty dealing with day-to-day minor stressors, resulting in a variety of mental health symptoms, including stress and anxiety. It is no surprise that mental health symptoms are on the rise, and so are sleep difficulties. A study of more than 9,000 adults in the U.S. revealed that three in ten adults reported trouble sleeping, with more than 30% receiving 1 hour less sleep than their body needed (1). Because sleep and mental health influence each other, improving sleep is believed to impact mental health positively.
Let's explore ways sleep and mental health are related and how improving one could boost the other.
The Sleep-Depression Feedback Loop
It's common for poor sleep to worsen symptoms of depression, which, in turn, worsens sleep. While challenging to break, this cycle highlights a new way to treat depression symptoms. Improving sleep through sleep hygiene strategies or Cognitive Behavioral Therapy (CBT) can lead to a noticeable reduction in depressive symptoms. For instance, research has shown that addressing sleep difficulties could also decrease more severe depression symptoms (2).
Seasonal Affective Disorder and Circadian Rhythm
Seasonal affective disorder (SAD) is a type of depression that tends to happen during months with less sunlight. SAD is closely tied to disruptions in circadian rhythm—the body's internal clock that regulates sleep. People with SAD may find themselves sleeping more or less than usual, often experiencing changes in sleep patterns that can further impact mood. Addressing SAD's symptoms through Cognitive behavioral therapy (CBT), vitamin D, light therapy, and regular exercise can improve both mood and sleep.
Anxiety and Hyperarousal
Anxiety and sleep difficulties are close companions. Anxiety symptoms lead to a state of hyperarousal, which includes worry and fear. This heightened alertness can lead to sleep difficulties, including difficulty falling and staying asleep. Anticipatory anxiety about bedtime only compounds the problem, making it harder to get the restorative sleep needed to manage stress, including dealing better with everyday stressors.
ADHD and Sleep
People with ADHD often experience sleep problems. Difficulty falling asleep, frequently waking up, and feeling sleepy during the day are common. Improving sleep can help you manage and improve mental health symptoms.
Here are some steps to promote good sleep and mental health:
Stick to a Sleep Schedule: Going to bed and waking up at the same time can help regulate your body's internal clock.
Set a bedtime—Set a bedtime that allows you to get at least 7 hours of sleep. However, don't go to bed unless you are sleepy.
Wind Down Before Bed: Incorporate calming activities like reading and meditation into your bedtime routine.
Limit Evening Stimulants: Alcohol, tobacco, and caffeine can all interfere with sleep quality, so it's best to avoid them in the evening. Caffeine takes about 12 hours to metabolize in your body; avoid caffeine after 11 or 12 pm.
Power Down Screens: Blue light from phones and other devices can delay sleep and distribute circadian rhythm, so try to put them away at least an hour before bed.
Get Daytime Exercise and Sunlight: Regular exercise and exposure to natural light help keep your circadian rhythm on track, making it easier to fall asleep at night. Try to get about 15 minutes of sunlight in the morning.
Block Out Light and Sound: Darkness and quietness are key to restful sleep, so consider blackout curtains and earplugs if needed.
Cognitive Behavioral Therapy for Sleep and Mental Health
CBT is a talk therapy that is an effective tool for both mental health and sleep. CBT helps you identify and reframe negative thoughts that can cause mental health challenges. Specific types of CBT can cause sleep difficulties. CBT for Insomnia (CBT-I) can help you establish healthier sleep patterns and improve emotional well-being.
Our providers at Unknotted can help you manage mental health challenges and sleep difficulties. Please schedule a consultation for individualized treatment. If you are curious to learn more about your mental health now, take our mental health assessment for a comprehensive report.
References
Di H, Guo Y, Daghlas I, et al. Evaluation of Sleep Habits and Disturbances Among U.S. Adults (2017-2020). JAMA Netw Open. 2022;5(11):e2240788.
Bishop, T. M., Simons, K. V., King, D. A., & Pigeon, W. R. (2016). Sleep and Suicide in Older Adults: An Opportunity for Intervention. Clinical therapeutics, 38(11), 2332–2339).
