The Link Between Sleep and Depression

If you or someone you love is having trouble sleeping or struggling with symptoms of depression, you likely already have an intimate understanding of the link between sleep deprivation and depression. It’s no secret that not getting the sleep you need can bring down your mood, zap your productivity, and make it difficult to get through the day.

For the estimated 322 million people around the world living with depression, one of the most common symptoms is insomnia or trouble falling and staying asleep. Over 80% of people being treated for depression in the United States also experience difficulty sleeping. Research shows insomnia is also correlated with more severe cases of depression.

Disrupted sleep and low mood can make you feel as if you’re trapped in a vicious cycle as one problem feeds the other. However, the connection between sleep deprivation and depression also means understanding the relationship between the two could help you better manage both.

Sleep Deprivation and Depression Links

The relationship between sleep and mental health is well known. While it’s long been understood that mental health conditions like depression often trigger issues like insomnia or oversleeping, recent research suggests the relationship between sleep deprivation and depression is bidirectional.

This means a lack of sleep isn’t only a consequence of depression. Sleep deprivation or disrupted sleep in itself may also cause or worsen symptoms of depression.

Case in point: One 2011 meta-analysis of 21 studies showed that people with insomnia have a two times higher risk of developing depression in the future compared to those who don’t have trouble sleeping.

Since insomnia has been identified as a risk factor for depression, researchers believe diagnosing and treating sleep issues early on could possibly help lower the risk of developing depression or reduce symptoms of depression.

However, more studies are needed to further explore the potential impact of insomnia treatment on the risk of depression and symptom reduction. 

What Is Clinical Depression?

Clinical depression, often referred to as depression or major depressive disorder, is a common mood disorder that causes changes in your feelings and thoughts. We all feel down from time to time, but depression causes more intense and long-lasting mood changes and physical symptoms that make it hard to sleep, work, and function in daily life.

While everyone experiences depression differently, common symptoms may include: 

• Frequent feelings of sadness, anxiety, hopelessness, or emptiness
• Irritability 
• Loss of interest in activities that once brought joy 
• Lack of energy 
• Trouble concentrating or making decisions 
• Difficulty falling or staying asleep or oversleeping 
• Changes in appetite or eating habits 
• In some cases, suicidal thoughts or suicide attempts

Factors like your family history, major stressors or traumatic experiences, other medical conditions, or certain medications could increase your risk of developing depression.

Why Sleep Is So Important

Just like food, water, and air, restorative sleep is vital for your health. In terms of your mental health, sleep allows your brain to create new pathways and memories which help you learn, solve problems, pay attention, and make decisions. After a good night’s sleep, you’re more alert, able to think clearly and concentrate, and better control your emotions and behavior.

Sleep is also a necessity for your physical health as it helps your body grow, make repairs, maintain a healthy balance of hormones, and keep your immunity up. In light of this, it’s no surprise that sleep deprivation has been linked to a slew of chronic health issues including high blood pressure, heart disease, stroke, kidney disease, diabetes, and obesity. 

Psychological Effects of Sleep Deprivation 

Besides making you feel drowsy and out of it, sleep deprivation can have major effects on your mental health. Sleep deprivation has been associated with an increased risk of:

• Changes in mood and behavior such as increased irritability, anxiety, depression, and impulsivity 
• Issues with higher-level thinking like judgment, planning, and organization
• Trouble concentrating and lower reaction times linked to a higher risk of accidents and injury and decreased productivity and performance at work and school 
• Disorientation, paranoia, and hallucinations 
• Suicidal thoughts or suicide attempts 

Sleep Disorder Treatment

Sleep disorders associated with depression such as insomnia can be treated with a combination of medication, therapy, and lifestyle changes.  

Antidepressants That May Help With Sleep 

Certain antidepressants can help relieve symptoms of depression and in turn might reduce sleep disruptions, too. Your healthcare provider may prescribe one of the following depending on your individual needs and health history:

• Selective serotonin reuptake inhibitors (SSRIs) such as Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), Paxil (paroxetine), or Zoloft (sertraline)
• Serotonin/norepinephrine reuptake inhibitors (SNRIs) such as Khedezia or Pristiq (desvenlafaxine), Cymbalta (duloxetine), Fetzima (levomilnacipran), or Effexor (venlafaxine)
• Tricyclic antidepressants such as Elavil (amitriptyline) or Pamelor (nortriptyline)
• Sedating antidepressants to be taken at night such as Remeron (mirtazapine) or trazodone  

Hypnotics That May Help With Insomnia 

Hypnotics, also known as sleeping pills, can also be prescribed short-term to help you fall and stay asleep. These may include: 

• Ambien, Edluar, Intermezzo, or Zolpimist (zolpidem)
• Lunesta (eszopiclone)
• Rozerem (ramelteon)
• Sonata (zaleplon)

Cognitive Behavioral Therapy

It’s common for people living with depression and sleep deprivation to come to associate their bed with negative feelings and thoughts. A poor night’s sleep can feel like a natural extension of a bad day or downer mood, especially when it’s become a habit.

This is where meeting with a mental health professional may be important. Cognitive behavioral therapy (CBT) for insomnia can help you reframe these reactions in a more positive light and build your confidence that you can get a good night’s sleep. There is some evidence to support this type of CBT for insomnia, and it’s also a proven treatment method for depression.

Lifestyle Habits to Improve Sleep and Mental Health

Along with help and guidance from a healthcare provider, many coping mechanisms can help improve both your mood and sleep health. While it may take some time to sort out what works best for you, here are a few to consider adding to your life. 

Sleep Hygiene 

First, sleep hygiene—or basic steps you can take to support your sleep health—are a must. Here’s how to improve your sleep habits to combat insomnia and depression: 

• Create a sleep schedule. Set designated times to go to sleep and wake up in order to ensure you hit the sweet spot of seven to nine hours of sleep. 
• Avoid caffeine, alcohol, and large meals a few hours before you go to sleep.
• Darken your space one hour before bed. Tools like blackout shades, dimmed lights, an electronics-free bedroom, and a sleep mask could help. 
• Add comfort to your sleep space. Turning the air conditioning up for a cool bedroom and treating yourself to supportive pillows and crisp sheets could also support sleep.  
• Use the bedroom for only two things: Sleep and sex. This way, your bed serves as a cue for sleepytime rather than hours of stress and sleeplessness. 

Physical Activity 

A lack of sleep can make it difficult to show up for workouts or muster the energy for a long walk, but it’s worth it. Getting active can help you fall asleep faster, get more restorative deep sleep, and wake up less throughout the night.

If possible, include regular exercise outdoors such as a morning walk since natural light helps maintain your circadian rhythms or your internal body clock.

Relaxation Techniques 

Life with depression and insomnia can be so stressful, but relaxing is a skill you can practice to help ease yourself into bedtime. Progressive muscle relaxation, deep breathing exercises, meditation, and guided imagery are all worth trying out as you figure out your ideal wind-down routine. 

A Word From Verywell

Poor sleep and depression often strike at once, but you don't have to be condemned to either. With the guidance of a healthcare provider, you can learn how to rescue your mood and start getting the quality sleep you need to thrive again.