An Overview of the Link Between Mental Health and Sleep Disorders


If you are experiencing mental health issues, any changes in your sleep habits or patterns can negatively affect your health. In fact, sleep problems impact 50% to 80% of patients receiving mental health treatment.

Woman lying in bed awake

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This article will discuss the connection between mental health and sleep disorders, and the symptoms, prevention, and treatment methods.

The Connection Between Mental Health and Sleep Disorders

The quality of sleep that you get is closely connected with your mental health. Not getting enough sleep can interfere with your ability to function in your daily life and can have serious implications for your physical and mental health.

What Are Sleep Disorders?

Sleep disorders are conditions that cause you to not get enough sleep, known as sleep deprivation.

People with mental health problems are more likely to have sleep disorders. Sleep problems are particularly common in those with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).

As well as being a consequence of some mental health disorders, sleep is also thought to play a role in the development of different mental health problems.

Causes

Although sometimes the cause is unknown, there are a number of causes that have been linked to sleep disorders. These include:

  • Physical illnesses, such as heart disease, lung disease, nerve disorders
  • Pain
  • Mental health disorders
  • Certain medicines
  • Genetics

There are also some factors that can contribute to sleep problems. These are:

  • Caffeine
  • Alcohol
  • An irregular work schedule, such as working the night shift
  • Aging

Signs and Symptoms

There are many types of sleep disorders. These disorders can be grouped into the following categories:

  • Problems falling and staying asleep, such as insomnia, which is the most common sleep disorder.
  • Problems staying awake, such as hypersomnia, the inability to stay awake during the day, and narcolepsy, which causes extreme sleepiness
  • Problems keeping a regular sleep-wake schedule

Some of the signs you may have a sleep disorder include:

  • You regularly take more than 30 minutes to fall asleep.
  • You often wake up several times each night and then have trouble falling back to sleep.
  • You wake up too early in the morning.
  • You often feel sleepy during the day or fall asleep at the wrong times during the day.
  • You snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods while asleep.
  • You have creeping, tingling, or crawling feelings in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep.
  • Your legs or arms often jerk during sleep.
  • You have vivid, dreamlike experiences while falling asleep or dozing.
  • You have episodes of sudden muscle weakness when you are angry or fearful or when you laugh.
  • You feel as though you cannot move when you first wake up.

How Sleep Impacts Mental Health Disorders

The relationship between sleep and mental health is complex. Mental health conditions can not only worsen problems with sleep but some sleep problems are thought to lead to changes in mental health. The underlying reasons for this are not known.

ADHD

Children with ADHD may experience problems with sleep such as difficulty falling or staying awake, difficulty waking up, and daytime sleepiness.

It is also thought that issues with sleep may increase the risk of and even contribute to the development of symptoms that may mimic those of ADHD. Studies have found that sleep interventions can help improve the severity of ADHD symptoms and overall quality of life.

Anxiety Disorders

Sleep problems appear to be a risk factor for developing anxiety disorders. A 2014 study found that problems with sleep, such as restless sleep and difficulty falling asleep, were associated with an increased risk of the development of common psychiatric disorders, including anxiety disorders.

Autism Spectrum Disorder

Children and adults with autism spectrum disorder often experience difficulties with sleeping. Sleep problems are also thought to increase the risk of developing the disorder. It is thought that certain genetic abnormalities may impact the sleep system in the brain, which may contribute to symptoms of autism spectrum disorder.

Bipolar Disorder

Sleep disturbances are very common among people with bipolar disorder. Such problems can include insomnia, irregular sleep-wake cycles, and nightmares.

Lack of sleep can also cause symptoms of mania, with research suggesting that changes in the normal sleep cycle preceded the onset of a manic episode in 25% to 65% of participants.

Depression

Insomnia and other sleep problems are common symptoms of depression. More recently, research has implicated lack of sleep in actually causing depression.

A 2011 meta-analysis found that those who experience insomnia are twice as likely to develop depression than those who do not have problems sleeping.

Seasonal Affective Disorder

Seasonal affective disorder (SAD) can be associated with both insomnia (trouble with sleeping) and hypersomnia (oversleeping). Though its exact cause is unknown, SAD is thought to be linked to changes in circadian rhythm (the body's internal clocks), as less sunlight in the winter can change the body's wake-sleep cycle.

Schizophrenia

Disrupted sleep appears to be closely linked to schizophrenia. It may also be an early sign before the onset of the illness.

Insomnia is the sleep disorder most frequently experienced by those with schizophrenia. Studies have reported up to 80% of people with schizophrenia also report experiencing symptoms of insomnia.

Management and Prevention

Findings ways to improve how well and how long you sleep can help relieve the symptoms of some mental health disorders. This does not mean that getting more sleep is a cure or quick fix, but it can be an important part of a comprehensive treatment plan.

Better Sleep

There are some things you can do on your own that may help you get better sleep. These are:

  • Limiting napping during the day
  • Establishing a nightly routine
  • Avoiding caffeine or stimulants too close to bedtime
  • Turning off your devices before you go to bed

Cognitive-Behavioral Therapy


Research has shown that psychological treatments can be helpful for treating some sleep disorders. The American College of Physicians strongly recommends the use of cognitive behavioral therapy for insomnia (CBTI) as the first-line treatment for chronic insomnia.

Exercise

Exercise has, for a long time, been linked to better sleep. There is now a growing amount of evidence that supports exercise as an efficient way of helping to treat those with issues sleeping.

A 2020 randomized controlled trial found that moderate-intensity exercise training improved the quality of sleep for middle-aged and older adults with poor sleep quality.

Herbal Remedies

Melatonin is a hormone that helps with sleep. Melatonin supplements may help with jet lag and sleep problems related to shift work.

However, the effect of melatonin on insomnia is small compared to that of other treatments. While it appears to be relatively safe for short-term use, its long-term safety has not been established.

There are also herbal remedies that many think help with sleep when in fact, there is little to no evidence to support that claim. These include:

  • Chamomile tea: There is no conclusive evidence that it is helpful.
  • Kava: Very little research has been conducted on this plant extract supplement. It has also been linked to a risk of severe liver damage.
  • "Sleep formula" supplements: These combine valerian with other herbs, such as hops, lemon balm, passionflower or kava, or other ingredients such as melatonin.

Precautions With Supplements

Some herbal supplements react with prescription medications. If you use herbal remedies for a sleep problem, make sure you tell your doctor.

Light Therapy

Light therapy, also known as phototherapy and bright light therapy, is the first-line treatment for SAD.

It involves using a lightbox, usually in the mornings, for exposure to bright, artificial light. This light mimics the sun and is believed to regulate neurotransmitters and circadian rhythms, thereby reducing feelings of depression.

Medication

Prescription medications may form part of a treatment plan for sleep disorders. There are two main classes of sleeping pills, those that are in the family of medicines called benzodiazepines and those that are not.

In order to find the right medication for you, discuss the possible medications as well as their benefits and drawbacks with your doctor. Many people with insomnia can learn to sleep normally without the use of sleeping pills, and this form of treatment may not be the right one for you.

Sleepiness and sleep problems can also be side effects of some medications. Speak to your doctor if you think a medication you are taking may be affecting your sleep.

Relaxation Techniques

There is evidence that relaxation techniques may be effective in treating chronic insomnia.

Techniques that might help those with sleep disorders include:

  • Progressive relaxation, which involves tensing different muscles in your body and then releasing the tension
  • Music-assisted relaxation, which aims to produce a deep state of relaxation through the use of live or recorded music and spoken instructions

Relaxation techniques can also sometimes be part of psychological treatments, such as CBT. There is also preliminary evidence that relaxation techniques might help reduce stress and anxiety, both symptoms of sleep disorders.

When to Seek Professional Treatment

If you have been struggling with the signs of sleep disorders or are worried that difficulty in sleeping is impacting your mental health, talk to your doctor about your symptoms.

They may conduct a sleep study in order to get a better look at your sleep patterns and recommend treatments that are appropriate for any sleep disorders that might impair your ability to rest.

Getting Help

If you or a loved one are experiencing difficulty sleeping and are worried about its impact on your mental health, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Summary

Changes in your normal sleep can be a symptom of certain mental health conditions. Sleep problems can also play a role in the development of those conditions. They can also affect how effective treatments are for mental health conditions.

Sleep disorders may be treated by developing better sleep habits, exercise, relaxation techniques, cognitive-behavioral therapy, medications, light therapy, and herbal remedies.

A Word From Verywell

Experiencing a sleep disorder can be very challenging and it can affect your ability to function in your daily life. If you are struggling with a lack of sleep or other issues with your sleeping, speak to your doctor. They will be able to help you find out why your sleep is disrupted.

Frequently Asked Questions

  • Can mental health and sleep disorders lead to other health conditions?

    As well as being linked to mental health disorders, research has found that insufficient sleep is linked to an increased risk for the development of certain conditions, including type 2 diabetes and a number of cardiovascular diseases. There is also thought to be a link between short sleep duration and excess body weight.

  • How do I know if I am experiencing a sleep disorder or sleep deprivation?

    Sleep deprivation is where you do not get enough sleep. For most adults, enough sleep means getting seven to eight hours of sleep a night.

    Sleep deprivation is not a specific disease itself, rather it is a symptom of some sleep disorders, such as insomnia.

  • What do you need to do to permanently cure a sleep disorder?

    There is no sure-fire way to definitely cure a sleep disorder and many people with sleeping disorders find that medication is not the best way to treat their condition.

    There are things you can do to help improve your sleep. These include improving your sleep routine, not drinking alcohol or caffeine, exercising frequently, and developing techniques that help you cope with stress or anxiety.

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