Are you feeling low? Chronic lack of sleep may be the culprit. For years, researchers have been looking at the link between sleep and mental health. While they have not reached a full understanding of the matter, they’ve seen how the relationship between the two is complicated.
Sleep deprivation has been known to increase the risk of developing mental problems. But recently, studies have been looking into how psychiatric issues can keep you awake at night, thus causing sleep disorders. It’s the other way around. And this can shed light on co-managing problems like insomnia and apnea and conditions like anxiety, depression, and bipolar disorder.
Did that sound a bit complicated? Don’t worry. This article can help you get a good grasp of how sleep and mental problems are connected. We’ll have an overview of the effects of sleep on mental health. Then, we will zoom in on the sleep disorders associated with two of the most common issues Americans and the world face today: anxiety and depression.
Before we end, you can also find out how you can sleep better and become more resilient—mentally and emotionally.
Table of Contents
Sleep and Mental Health
For quite a while now, sleep deprivation has been seen as a symptom of various psychiatric disorders. This case may suggest that if you tick insomnia and a few other signs off the checklist, you are going through a depressive episode. Or you’re bogged down by an anxiety disorder.
Yet, more recently, researchers have been showing the complicated connection they’ve found. For example, if you have an existing sleep problem, you’re likelier to develop a psychiatric disorder than people who drift off without issues at night. Meaning, chronic lack of sleep is not only a symptom. It can also be a cause, raising your risk of having a mental problem.
How can sleep issues affect your mental health? Let’s try to understand this by looking at the humans’ sleep cycle.
The Sleep Cycle
When a person falls asleep, they go through two categories of sleep, the non-REM and REM (Rapid Eye Movement). Usually, the first REM sleep starts after 90 minutes of dozing off (NREM).
During NREM sleep, your body gradually goes into a deep sleep. Four phases mark this part of the cycle. You’re pretty easy to rouse in the first two phases. When you reach the third and last stages, it’s harder to wake you up. It’s what experts call the slow-wave sleep, wherein your muscles relax, and your heartbeat and breathing slow down.
The slow-wave sleep is responsible for repairing tissues and boosting the immune system, so you’ll feel refreshed when you wake up.
Then, after more than an hour, you transition into REM sleep. In popular culture, REM is known as the dreaming stage. Physiological activities change and then appear similar to when you’re awake. Your heartbeat and breathing speed up again while your temperature and blood pressure rise.
Sleep disruption or a missing stage can have negative effects on the way you think and feel. For instance, insomnia, the inability to fall or stay asleep, can increase negative thinking and emotional vulnerability. So it may intensify the effects of anxiety or depression even as it can also get worse because of psychiatric problems.
Depression
A major depressive disorder is a mood disorder that can cause you to feel sad for an extended period or lose interest in things that used to excite you. It can affect your thoughts, emotions, and behavior. It may interfere with your daily activities and sometimes make life seem to be not worth living.
Symptoms should occur for at least two weeks for a proper depression diagnosis. It is important to rule out other medical conditions to avoid misdiagnosis.
Associated Sleep Disorders
Sleep disorders can be a part of the core symptoms of depression. Here are some of the common problems to check if you suspect you’re suffering from depression.
Insomnia
Insomnia is one of the popular symptoms of depression. According to WebMD, about 80% of people with depression may be prone to this sleep issue, characterized by the difficulty of falling or staying asleep.
However, more current studies show that it’s not a simple matter of cause and effect. Insomnia may overlap with depression, implying they are two different conditions with the same biological root.
Some experts are even suggesting that chronic insomnia can trigger relapses among depression patients. So treating the psychiatric disorder may help in the management of insomnia. Likewise, treating insomnia may also ease the impact of depression.
Hypersomnia
Hypersomnia is a form of excessive sleepiness. No matter if you got a good night’s sleep or dozed off several times during the day, this condition still leaves you feeling tired. In fact, some experts call it excessive tiredness. It may also be hard to wake you up from a full sleep or a nap when you have this problem. It may cause poor performance at school or work.
While it is a neurological disorder, it may coexist with depression. One possible cause of hypersomnia is the high level of a depressant molecule in the brain. Another is histamine deficiency.
Obstructive Sleep Apnea (OSA)
OSA is one of the most recognizable types of sleep apnea. It could make your breathing shallow or halt it quickly altogether. When your breathing returns, you let out a loud gasp or snort. You may not be able to sleep well due to this disorder. But you are also not probably aware you’re experiencing its manifestations in your sleep.
Sleep apnea can cause or contribute to depression and vice-versa. In 2009, reviewers found 21 to 41% of OSA patients in sleep clinics showed signs of depression. An earlier study noted that patients with depression had an increased risk of developing breathing-related sleeping disorders.
Management and Medication
Treating an underlying sleep disorder may help in easing depression in an individual. And vice-versa. Here are some ways to deal with both problems:
Cognitive-Behavioral Therapy
If you want to go organic, learning a new set of skills to fall asleep is the best way to go. Such is possible through cognitive cognitive-behavioral therapy (CBT-I). This kind of therapy takes time, with sessions spanning 8 to 12 weeks. But studies show it is more effective than popping sleeping pills to beat insomnia.
You will basically adopt or step up to new practices, such as hitting the sack at the same time each night and removing distractions during bedtime. Finding a mental health expert who can help you build healthier habits at night is crucial.
Medications
Antidepressants
Some medications prescribed for people with depression can also help in managing sleep disorders. Sedating antidepressants can make you fall asleep, so it is like hitting two birds with one stone. Mirtazapine (Remeron), Silenor, and Trazodone are some examples.
However, SSRIs are effective in easing depressive symptoms in a patient, except for insomnia. These drugs may even exacerbate the issue. Thus, people are advised to take SSRIs in the morning. If taken at night, this group of antidepressants usually go with meds that can fight off insomnia.
Melatonin
Known as the Dracula of hormones, melatonin is a natural hormone that comes out only at night. It induces sleep in humans with regular circadian rhythms. Those who are melatonin-deficient can then use this to aid their sleep onset.
Read: Should You Use Melatonin for Sleep?
Anxiety Disorders
Anxiety disorders are an umbrella term for different conditions. The anxiety a person with this condition feels can be overwhelming, interfering with their daily activities. Some of the illnesses in this group are panic disorder, social anxiety disorder, and generalized anxiety disorder. When you have one of these issues, you may experience any of these symptoms, among others:
- Restlessness
- Sleep problems
- Shortness of breath
- Heart palpitations
- Tense muscles
A number of factors and how they interact with one another can cause anxiety disorders. The most common are brain chemistry, environmental stress, and genetic disposition.
As you can see, sleep disorders can be a symptom of an anxiety disorder. But, as we keep pointing out, it’s also possible a sleep disorder may have brought an anxiety disorder.
Associated Sleep Disorders
Insomnia
Insomnia may also increase the risk of developing an anxiety disorder, but not as high as its impact concerning depression. In a study that observed teenagers, insomnia and other sleep issues occurred before 27% of anxiety disorder episodes.
Chronic lack of sleep can trigger an onset or relapse. It can also prevent rehabilitation. Negative emotions may be heightened, such as in the case of individuals with PTSD (post-traumatic stress disorder). Such effects can get in the way of therapies that aim to deal with extreme anxieties and fears.
Hypersomnia
Anxiety may go hand-in-hand with low energy, irritability, and loss of appetite. But the main symptom of hypersomnia is constant tiredness, as mentioned in the previous section. Feeling fatigued even after a night’s sleep or a nap can impair cognitive functions.
This sleep disorder is not as common a trigger as insomnia. Yet, it’s important to watch out if it’s coexisting with an anxiety disorder. It may not be curable in some people, but it can be managed when properly diagnosed. The main treatments are lifestyle changes and medications.
Management and Medication
Lifestyle Changes
A sleep specialist will ask you to log habits or instances that can impact your sleep quality. The items of focus include the time you go to bed, how long it takes you to fall asleep, and how many times you wake up at night. You will log those details as soon as you get up in the morning.
The items in your sleep diary can be used to identify certain behaviors that you must change to improve your sleep quality. This method can be effective in reducing insomnia, hypersomnia, and other sleep issues in a patient with a coexisting anxiety disorder.
Medication
A faster way to treat sleep disorders, particularly insomnia, is through medication. Their quick-acting solution is felt within a few days or weeks of use. The Food and Drug Administration (FDA) has approved the following drugs or group of drugs to treat insomnia:
- Nonbenzodiazepines: eszopiclone, zolpidem, zolpidem ER, and zaleplon
- Benzodiazepines: estazolam, flurazepam, quazepam, temazepam, and triazolam
- A tricyclic antidepressant: low-dose Sinequan
- A melatonin agonist: ramelteon
Mindfulness
Complementing either or both solutions above, you may also practice meditation before your bedtime. If you’re not into meditation, you can try other mindfulness activities, such as yoga. The goal of mindfulness is to help you focus on one thing at a time, which can help reduce anxiety. In turn, it can sleep you more soundly at night.
Conclusion
What does the overlap mean to individuals with vulnerability to both conditions? It means treating one disorder can help manage or treat the symptoms of the other. However, more studies need to be done to pinpoint their roots. By dealing with the root, we can raise our chances of treating both disorders more effectively.
Are you experiencing any of the sleep and mental problems mentioned in this article? Here’s a gentle reminder to reach out for help and support. Proper diagnosis can get you started on the right track.
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