How Sleep Affects Mental Health (and How to Improve It)

 How Sleep Affects Mental Health (and How to Improve It)

Although sleep is vital to human health, it is one of the most neglected aspects of our lives. In our busy, modern world, when something has to give, sleep is often the first thing that goes. Work, entertainment, stress, and the belief that “I can always catch up on sleep later” lead many of us to ignore our need to sleep. However, we must remember that sleep is a biological requirement, not a luxury. One of the areas that sleep profoundly impacts is mental health.

Sleep plays an important role in mental health, emotional balance, cognitive performance, mood stability, and our ability to deal with stress. Sleep influences our mental health as much as it supports it. When sleep is frequently disrupted, the resulting disturbances affect every aspect of a person's internal experience.

This article will examine how sleep contributes to mental health, how disrupted sleep may lead to emotional and psychological challenges, and, most importantly, as outlined in this article, how to create a good night's sleep to maintain good mental health.

Why Sleep Is Essential for Mental Health

Sleeping is not exclusively resting. The brain carries out a multitude of processes critical to our emotional and psychological functioning during SLEEP:

Emotional Processing

Memory Consolidation

Stress Recovery

Hormonal Regulation

Neural Repair/Detoxification

Cognitive Organization

All these functions occur in distinct stages of SLEEP (mainly SLOW WAVE and REM). To clarify mentally HOW SLEEP relates to mental health it would be beneficial to discuss the specific ways that SLEEP AFFECTS both Cognitive Functioning AND Emotional Functioning.

1. Sleep Regulates Emotional Processing

The brain does many things while we're asleep; however, one of its primary responsibilities is emotional regulation. The information from days emotional experiences is played back in REM sleep but during this playback process, the emotional energy or intensity is reduced.

This process can be thought of as an overnight therapy session for the brain.

Sleep also helps us.

- Keep our emotions under control.

- Gives us perspective on things that upset us during the day and help us to feel less overwhelmed by those things.

- Helps us to approach new challenges with greater composure and resiliency.

- Improves the emotional stability of our moods.

When we don't get enough sleep, we feel the opposite of all of the above.

- Emotions feel more intense.

- Stress levels are usually increased, and we find it more difficult to cope with them.

- Unpleasant events stay with us for a longer period of time.

- Our moods shift from one extreme to another more frequently.

That is why after we have had a very poor night's sleep, even the simplest annoyance can feel much more demanding or stressful than it would normally feel.

Chronic Loss of sleep affects the way that our brain regulates emotions. The areas of the brain that play the most significant roles in regulating emotions are the amygdala for fear and emotional reaction, and the prefrontal cortex for logic and emotional control. The end result is that when one or both of these areas of emotional processing in your brain suffer from almost everyday chronic Loss of sleep, you are at a higher risk of having:

• Anxiety

• Irritability

• Excessive worry

• Depressed Mood

• Emotional Reactivity

2. Sleep Is Crucial for Stress Recovery

A good night sleep is not only about emotional processing; it's an opportunity for physical recovery from stressors on your body.

The body's adrenal glands produce cortisol, the main stress hormone, in response to stressful experiences. When people receive healthy amounts of sleep, their cortisol levels decrease; the nervous system gets time to recharge. 

When you don't get enough sleep, your cortisol levels do not drop and this leads to: 

Chronic stress

Burnout

Irritability

Problems with memory

Immune system dysfunction

A well-rested brain reacts to stressful situations in a more resilient fashion, while someone who has not had enough rest can react in an obsessive-compulsive manner and be continuously in a state of heightened anxiety.

3. Lack of Sleep Impairs Cognitive Functioning

There have been many studies which indicate the cognitive effects of inadequate sleep are vast and include:

Reaction Times Slowed Down

Difficulties Remembering Things

Inability To Concentrate On Tasks

Lack Of Creativity

Reduced Ability To Solve Problems

Poor And Impaired Decision Making

While these cognitive issues can negatively impact a person’s ability to be productive and successful, they also negatively impact the overall mental well-being of individuals. When someone cannot think clearly, they find it difficult to manage their emotions, to cope with stress and challenges effectively, and to keep life in a proper perspective. Everyday tasks seem much more difficult than they should be, their frustration level rises much faster than usual, and their confidence levels drop (which leads to anxiety and/or depression).

Chronic sleep deprivation can produce symptoms similar to the following reported conditions of mental illness:

Inability To Focus (Very Much Like ADHD)

Memory Deficits (Very Much Like Dementia)

Mood Changes (Very Much Like Bipolar Disorder)

Lack Of Emotion (Very Much Like Depression)

Although chronic sleep deprivation does not directly cause these conditions, it can exacerbate symptoms If you are diagnosed with mental illnesses, you need to provide your health care professional with this information when seeking treatment.

4. Poor Sleep Worsens Symptoms of Depression

There is a bidirectional relationship between sleep and depression:

Sleeping poorly increases the likelihood of experiencing depression, and being depressed often leads to sleeping poorly.

Chronic insomniacs have been demonstrated to present with significantly higher rates of;

2–3 x greater likelihood of developing depression

Increased likelihood of experiencing prolonged episodes of depression

Greater time taken to respond to treatment unless their sleep problems are properly addressed

The question is why?

The reason for this is as follows;

Sleep has an effect on;

The hormone system responsible for regulating mood, specifically serotonin and dopamine;

The neural pathways responsible for regulating motivation;

Cognitive processes involved in the perception of negative thoughts;

Stress response systems

Lack of adequate sleep creates barriers to the effective regulation of negative emotions and a distortion of thought patterns, resulting in a greater likelihood of;

Feelings of hopelessness;

Levels of rumination (regarding interpersonal relationship);

Levels of exhaustion (regarding emotional regulation);

Feelings of lack of motivation (due to increased levels of exhaustion);

Social withdrawal.

For many, including some of the most severely depressed people, improving the quality and quantity of sleep has proven to be the most effective method of alleviating symptoms of depression; in some cases, improving the quality and quantity of sleep has proven to be more effective than using antidepressant medications.

5. Sleep and Anxiety Are Deeply Interconnected

Anxiety has a reciprocal relationship with sleep similar to that of stress and depression.

Sleep deprivation causes increased anxiety; on the other hand, anxiety can impair your ability to get a good night's sleep.

The amygdala becomes overly active when you are sleep deprived; therefore, you may experience:

Increased worrying

Increased sensitivity to stress

Difficulty calming yourself

Racing thoughts

In addition, the amount of time that you have been awake, combined with your emotional/cognitive state (when you are unable to regulate your emotions), diminishes neurochemical activity in the prefrontal cortex (this is the area of your brain that helps you to regulate anxious thoughts and behaviours).

Sleep deprivation can also affect (impair) your ability to manage your thoughts (and behaviour) in response to anxiety.

Anxiety will therefore lead you to feel "jittery," overwhelmed, unfocused and stuck in a cycle of worrying.

By gaining an adequate amount of sleep, anxiety can be greatly reduced and treatment results of anxiety disorders can improve significantly.

6. Sleep Supports Memory and Learning

Sleep plays an important role in:

- Short term memory

- Long term memory

- Learning new things

- Creativity and problem solving

When someone has a poor sleep or when they go through periods of sleep disruption, that individual may become forgetful and have mental fog. This can cause them to feel:

- Frustration

- Negative self talk

- Lack of self-confidence

- Increased stress

- Decreased motivation

All of these cognitive issues can cause cognitive impairments on an ongoing basis, which can have a major negative impact on an individual’s mental wellbeing if they feel they are unable to meet the demands of their everyday lives.

7. Sleep Disorders Are Strongly Linked to Mental Health Disorders

Many sleep disorders have a negative effect on your mental health, such as: 

Insomnia. 

Insomnia is the most prevalent sleep disorder; it is often due to stress, anxiety and/or depression. Chronic insomnia can exist for months or years before the person develops mental health problems. 

Sleep Apnea 

Disrupts your breathing while sleeping; it also breaks up your sleep pattern. People who have sleep apnea tend to be irritable and have problems with mood changes, depression, and cognitive functioning. 

Circadian Rhythm Disorders 

Circadian rhythm disorders include delayed sleep phase disorder, which is often seen in teenagers and young adults; shift work disorder; and jet-lag-related disorders. When your body's internal clock is out of alignment with your external environment, you can suffer from deterioration of your mental health.

Restless Legs Syndrome 

Restless legs syndrome is associated with anxiety, Attention Deficit/hyperactivity Disorder (ADHD), and/or depression. 

In many cases, these disorders have not been diagnosed, so individuals think that their mental health problems are a result of their mental health; when in fact, their lack of sleep is one of the major causes of their mental health problems.

How Poor Sleep Impacts Specific Mental Health Conditions

Inadequate sleep can have negative effects on people suffering from the following mental health conditions.

1. Depression

Inadequate or disrupted sleep may lead to the following effects on depressive symptoms:

Increased negative thoughts

Increased feelings of sadness or emotional numbness

Decreased motivation and Increased fatigue and low levels of energy

Disruption in eating patterns

Slower thinking/processing

Decreased ability to enjoy the things we used to enjoy

By effectively treating the sleep challenges associated with depression you should see an improvement in depressive symptoms as well.

2. Anxiety Disorders

Lack of sufficient sleep may increase the following symptoms of anxiety disorders:

Increase in worry/concern

Anxiety about relaxation

Physical symptoms: muscle tightness, palpitations, etc.

Catastrophizing

Increased sensitivity to stress

Increased frequency of panic attacks

Getting restorative sleep is vital to calming the (fight-or-flight) nervous system and decreasing physical responses to anxiety.

3. Post-Traumatic Stress Disorder (PTSD)

Sleep problems worsen:

Nightmares

Replaying experiences

Hypervigilance

Easily upset

Emotional reactivity

Sleeping better will allow for more effective processing of the traumatic experiences that happened to them.

4. Attention Deficit Hyperactivity Disorder (ADHD)

Sleep issues can adversely affect people with ADHD regardless of age. For example, the effects of inadequate or disrupted sleep result in an increase in the following symptoms of ADHD:

Impulsiveness

Difficulty focusing

Difficulty managing emotions

Hyperactivity

Forgetfulness

Addressing sleep issues may improve functioning significantly.

5. Bipolar Disorder

Sleep disturbance is both a symptom and a precursor for mood episodes of bipolar disorder. Lack of sleep can be the trigger for:

Manic episodes

Hypomania

Depressive episodes

To have the greatest positive long-term management results regarding bipolar disorder, maintaining proper sleep schedules is extremely important.

How to Improve Sleep for Better Mental Health

The most effective method of improving your mental health is to enhance your sleeping habits. Here are some strategies, altogether backed by scientific evidence.

1.) Develop a Sleep Routine

Having a set routine is extremely helpful for our bodies, especially with sleep patterns. Continually following a regular schedule of going to bed and waking up at the same hours helps with the regulation of our circadian rhythm. There are several functions regulated by the circadian rhythm:

Hormones

Body Temperature

Mood

Cognitive Functioning

Energy Levels

Recommendations for the Sleep Routine

- Go to bed and get up at the same time every day.

- Don’t drastically change your schedule from weekdays to weekends.

- If you have an irregular schedule, try gradually changing it back to a more consistent routine.

If your daily schedule varies by as little as 30-60 minutes, it can have an impact on your sleep and mood.

2.) Practicing Good Sleep Hygiene

Sleep hygiene is our everyday habits that can make or break your ability to have quality slumber. Examples of good sleep hygiene include:

- Establishing a relaxing pre-sleep routine

- Reducing light levels

- Minimized distraction from noise

- Less stimulation before sleep

- Taking a warm shower or bath

- Performing a light stretch before going to bed

Limit Screen Time

The blue light emitted from screens inhibits the production of melatonin and makes it harder for your body to fall asleep. The recommended way to reduce screen time is to avoid using your phone, tablet or computer 2 hours before you get into bed.

Make Your Bedroom a Sleep-Friendly Environment

- Keep Your Bedroom Cool (60-67°F / 15-19°C)

- Use a Comfortable Pillow and Mattress

- Keep Your Bedroom Dark

- Use Soft Sounds or Use White Noise to Help Block Out Any Disturbing Sounds

Avoid Caffeine & Heavy Meals Late in the Day

Caffeine or heavy meals late in the evening can delay sleep onset.

3.) Stress Management Prior to Bedtime

Stress is one of the greatest hindrances that exist to sleep.

4. Separate Work Hours from Leisure Hours

Working from home can prevent an individual from separating the hours of work from the hours of leisure. This can create confusion in the brain and makes it difficult to settle down at the end of the day.

Here are some helpful ideas to also keep everything separate:

Do Not Work in Your Bedroom

Designate a Work Area

Change Lighting to Distinguish Between Daylight and Nighttime

Set Specific Work Hours

Your brain requires specific signals to make the transition from "work mode" to "rest mode".

5. Engage in Physical Activity on a Regular Basis

Exercising regularly has several advantages when it comes to sleeping.

Exercising reduces stress

It helps balance hormones

It consumes energy

It improves mood

However, you should avoid exercising too close to going to sleep, since performing high-intensity exercises too close to going to bed may create too much excitement.

You should work out for:

20–30 minutes daily

At least 5 times a week.

Calm activities (e.g., yoga, walking, or stretching) before bedtime can contribute to relaxation.

6. Refrain from Using Alcohol or Nicotine Before Sleeping

Many people have misconceptions about alcohol helping them sleep; while it does make falling asleep easier, it will also interrupt cycles of restorative sleep (deep and REM sleep), therefore creating patterns of interrupted sleeping.

Nicotine can interrupt sleep because it is a stimulant and will create intervals of waking up at night.

By reducing or eliminating both of these substances (ideally not using them in the 4 hours prior to going to bed), an individual will be able to improve their sleeping experience dramatically.

7. Use Light for Effect

Light is the strongest external cue for establishing a circadian rhythm; it is the primary method that our body uses to differentiate between day and night.

In the morning, it is natural for us to feel more awake when we first wake up, but we also must spend time outside and increase the intensity of sunlight as much as possible.

Cognitive Behavioral Therapy for Insomnia, (CBT-I) is considered the most effective approach to treating insomnia. It is more effective than any prescription medication or over-the-counter sleep aid and creates long-term improvement in your sleep patterns and overall health.

CBT-I therapy includes:

- Identifying negative thoughts regarding sleep and refuting them.

- Limiting the amount of time you are awake in bed and limiting the number of naps taken.

- Re-developing a healthy nightly sleep pattern that works well for you.

- Learning techniques to relax.

CBT-I is effective for individuals who experience anxiety/depression/PTSD and/or for individuals suffering from chronic insomnia.

***Medication (where appropriate)***

Sleep medications should always be used with caution and ideally, only under a doctor’s supervision.

Available sleep medications include:

- Short-acting sedative medications.

- Melatonin supplements.

- Prescription sleep medication.

- Medications for an underlying mental health condition.

Although medications may help improve your sleep, medications should not be relied upon as a long-term solution; if medications are combined with good sleep habits, they may have the best chance for a successful outcome.

***Determining whether you have an underlying sleep disorder***

If you continue to have severe sleep issues despite appropriate lifestyle changes, it is possible that an underlying sleep disorder exists.

Some possible symptoms of an underlying sleep disorder are:

- Loud snoring.

- Snoring cessation with pauses in breathing.

- Restless legs.

- Insomnia lasting longer than 3 months.

- Inability to fall asleep multiple nights per week.

- Waking up gasping or choking for breath.

- Daytime sleepiness (regardless of how much sleep you got at night).

Consult with a qualified sleep specialist for the diagnosis and treatment of sleep-related conditions, such as sleep apnea, insomnia, or disorders of the circadian rhythm.

How Improving Sleep Can Transform Mental Health

When you improve your sleep, you are doing a lot for your mental health, and thus the following benefits come with it:

Reduced stress

Increased emotional resilience

More positive mood

Greater levels of motivation

Lower levels of anxiety

More clear thinking

Improved memory

More positive relationships

Better decision-making

Increased productivity

In many cases, once individuals improve their sleep, an overall positive effect can be seen. For example, when someone has a good night's sleep, it is easier for them to have motivation to exercise, eat a healthy diet, handle stress, continue with healthy habits, etc.

Sleep is the base. The stronger the base, the easier it is for everything above it to grow.

Conclusion: A Well-Rested Mind Is a Healthier Mind

There is a direct correlation between sleep and mental health. As mental health decreases as a result of lack of sleep, it will improve through a better night's sleep.

Sleep will also alleviate stress, depression, anxiety, and burnout, and increase balance and energy.

You can create an entirely different and healthier lifestyle by establishing consistent sleep schedules, improving sleep hygiene, helping reduce stress, and addressing any root causes which may be contributing to your lack of restful sleep.

Healthy sleeping is the first step to living a healthy life.