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Mental Health and Sleep

The more we learn about sleep, the more we realize how central it is to our overall wellness.

While we all know that sleep plays a big role in our health, the specifics sometimes get lost in the shuffle. As researchers have investigated particular elements of sleep and health, the link with mental health has become increasingly apparent.

Studies have demonstrated a clear connection between mental health and sleep. According to Harvard Health, chronic sleep problems plague between 50% to 80% of mental health patients but only 10% to 18% of adults without mental illnesses.

Sleep issues can include reduced total time spent asleep, fragmented sleep, and sleeping too much, and these problems can be associated with a range of psychiatric conditions.

While the connection between sleep and mental health is undeniable, the exact relationship is complex and still not fully understood. Traditionally, sleep problems were understood as symptoms of mental health conditions, but it appears to not be so simple.

In fact, lack of sleep may be contributing or even causing psychiatric problems. For this reason, a growing number of psychiatrists and therapists are including a focus on improving sleep as a component of their patient care.

In this guide, we’ll explain the background behind this trend including an exploration of the ways that sleep and mental health are related and a discussion of concrete ways to try promoting better sleep.

Why Do Therapists Promote the Importance of Sleep?

Psychiatrists and psychologists work with patients with a diverse set of mental health problems, but a common theme that runs through many of these cases is abnormal sleep.

One way of viewing this connection is by seeing sleep problems as simply a consequence of a psychiatric condition. A more nuanced view of the evidence shows that sleep has a more significant role. For example, in people with depression, unresolved insomnia can increase the likelihood of a major depressive episode.

Enhanced understanding of the brain through neurochemistry and neuroimaging shows that sleep helps build the cognitive power that we need in numerous aspects of life. Limited or fragmented sleep hurts our executive function and emotional resilience.

Understanding the connection between sleep and mental illness as a two-way street opens new avenues for helping patients who struggle with these issues. A patient who is well-rested is generally less likely to suffer from more severe mental health episodes and is more emotionally equipped to take on the challenges that they face.

This doesn’t mean that getting more sleep is a cure for mental illness, but it does explain why a growing number of therapists are integrating sleep considerations into treatments for their patients.

What is the Relationship Between Sleep Problems and Mental Illness?

A significant number of people with mental illness report having problems with sleepInsomnia, — difficulty falling asleep, staying asleep, or waking up too early — is a common complaint of patients with a broad range of mental health conditions. It is often reported even during periods when mental illness is in remission.

Hypersomnia, which involves chronic daytime sleepiness and often excessive amounts of sleep, can be an issue for many people with psychiatric conditions. Some patients experience both insomnia and hypersomnia, which poses even greater barriers to any type of consistency with regard to sleep.

The correlations between mental illness and disturbed sleep are extensive and can be found with conditions such as depression, anxiety disorders, post-traumatic stress disorder (PTSD), bipolar disorder, attention-deficit hyperactivity disorder (ADHD), and others.

The impact on sleep may be felt more strongly during intense periods of mental illness. One study found that 92% of patients in a major depressive episode reported suffering from insomnia, hypersomnia, or both.

At the same time, the relationship is bidirectional and can be negatively reinforcing.

Poor sleep can impact the inner workings of the brain including the function of hormones and neurotransmitters, the means of communication between cells in the brain. Without quality sleep, it is harder for the brain to manage all types of tasks, including those relating to emotional regulation.

This dynamic can worsen the severity and consequences of mental illness. Evidence is mounting that sleep disruptions are a risk factor for suicidal behaviors, and this risk may be amplified for patients who experience both insomnia and hypersomnia.

What Mental Illnesses Are Known To Be Related to Sleeping Problems?

Every individual’s situation is unique, so it is important to remember that having a mental illness does not guarantee that a person will have sleeping problems. That said, mental illnesses of different types have established connections to sleeping problems.

Depression has one of the most well-known relationships with sleeping problems. The majority of patients with depression complain of insomnia, obstructive sleep apnea, or other sleeping issues. Evidence points to insomnia as a risk factor for developing depression or for worsening symptoms of this condition.

In bipolar disorder, most patients experience insomnia during the manic phases of the disorder. During depressive phases, hypersomnia is more common. Sleeping problems may be an indication of the impending onset of a manic or depressive period.

Anxiety disorders are frequently accompanied by sleep problems. Sleep problems can be associated with general anxiety disorder (GAD), social anxiety disorder, phobias, panic disorder, separation anxiety, and obsessive-compulsive disorder. There is less clear evidence that sleep issues can cause anxiety disorders, but it is believed that lack of sleep may worsen symptoms.

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder tied directly to a traumatic event. People with PTSD have considerable sleep problems: 90% to 100% of U.S. veterans with PTSD have reported having insomnia. Hyperarousal, or feeling permanently on alert, can foster profound sleep problems for people with PTSD. These sleep issues can then further anxiety and negative thinking about sleep.

Many children and adolescents with ADHD suffer from insomnia or have abnormal sleep schedules. In some cases, medications for ADHD can cause or intensify sleeping problems. For children with and without ADHD, reduced sleep commonly leads to hyperactivity, reduced attention span, and greater propensity for emotional challenges.

Does Mental Illness Cause Sleep Problems or Do Sleep Problems Cause Mental Illness?

In some ways, the relationship between sleeping problems and mental illness poses a chicken-egg quandary. Because they so often occur together, it can be challenging to parse out the exact “cause,” especially when taking into account the complexity of the brain and its multitude of functions.

Even the world’s most renowned neuroscientists acknowledge that there are many mysteries that remain about how the brain works. New investigative tools and studies help shed light on these mysteries, but definitive answers about complicated issues like mental illness are hard to come by.

Not everyone with a mental illness has sleep problems, and not everyone with sleep problems has a mental illness. As a result, the cause for any person may depend on their specific situation including their condition, sleep troubles, genetics, environment, and other factors.

What can be clearly stated is that these health issues can complicate each other. Abnormal or disturbed sleep can intensify symptoms or hinder efforts to address mental illness and vice versa.

As a result, an important conclusion is that health care providers must recognize these interrelationships and work with their patients to treat them accordingly.

Can Improving Sleep Help Treat Mental Illness?

Improving a patient’s sleep can have beneficial effects on the severity and frequency of symptoms of mental illness. Sleep doesn’t cure mental illness, but studies have shown that it can improve cognitive function, reduce the worst mental health episodes, and can increase overall well-being.

For example, treating insomnia has been shown to reduce the time that it takes to effectively treat depression. In older people, improved sleep through behavioral therapy has shown signs of reducing symptoms of depression.

Sleep-focused care has shown some positive results in helping patients with other mental health conditions as well including those with PTSD, anxiety, and bipolar disorder.

In addition, because sleep disturbances may portend worsening episodes of mental illness, there is some indication that insomnia-directed treatment may be a viable preventive mental health strategy.

The benefits of quality sleep extend far beyond just mental health. Sleep is critical for repair of the body and internal organs. Sleep is linked to virtually all aspects of wellness, and lack of sleep can sow the seeds of a huge range of afflictions.

Because the body operates with many complex and interrelated systems, these wellness benefits should not be overlooked in recognizing how sleep-focused care can meaningfully improve quality of life for people with mental health problems.  At AMR Mental Health Therapy, we can utilize various techniques to help you sleep better with the intent to improve mental health.  Reach out to learn more. Thanks to for the information provided.

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