You’ve probably noticed that after a rough night of sleep, you don’t quite feel yourself. You may be a little slower to get out of bed in the morning, go for an extra cup of coffee, or even opt for a mid-afternoon nap. The physical effects of sleep deprivation are usually pretty clear, but the mental repercussions may not be as obvious.
What is Mental Health?
The term mental health is commonly used in our society and can refer to a variety of aspects that fall under the umbrella of psychological health. The National Institute of Mental Health (NIMH) defines mental health as emotional, psychological, and social well-being. It’s not simply the absence of mental illness, but rather the ability to live a life filled with joy, peace and happiness while managing the inevitable ups and downs you may face.
Emotional well-being is the first pillar of mental health. It is described as the ability to successfully handle life’s stressors, adapt to change, and generate positive emotions. When you’re emotionally healthy, you are better equipped to manage life’s challenges and the array of emotions that come with it, without feeling like you are out of control. Research suggests that people who experience more emotional distress are more vulnerable to physical illness.
The second pillar of mental health is psychological well-being, which describes a person’s ability to function in response to their emotions. Psychological well-being emphasizes positive emotions that help people function more effectively. But this doesn’t mean feeling “good” all the time. Painful emotions like grief and disappointment are a normal to experience, so being able to manage these kinds of emotions to prevent them from interfering with daily life is essential to promoting psychological well-being.
Social well-being is the final pillar of mental health as defined by the NIMH and is described as developing and maintaining positive, meaningful relationships with other people and the community. Social interactions have a short- and long-term impact on mental health. Studies show that the frequency of friend interactions (quantity) and satisfaction with those relationships (quality) have been positively associated with life satisfaction and higher levels of resilience.
What’s the Importance of Sleep?
Sleep is the only time your entire body gets an opportunity to rest, restore and repair different functions. It also gives the body a chance to allow hormones to stabilize, which is especially important if you’ve had a stressful day. Unfortunately, nearly one-third of American adults are sleep deprived, preventing their brains and bodies from functioning at its best.
Sleep deprivation means getting less than the required amount of sleep or getting poor quality sleep. Being sleep deprived for a few days typically has a less severe, short-term impact. You may be a little more irritable, tired, or unable to concentrate well. But if sleep deprivation persists for three months or longer, it is considered chronic and can have a more significant, long-term impact on physical and mental health. Studies show that long-term consequences of sleep deprivation include:
- Cardiovascular disease
- Weight-related issues
- Metabolic disease
Studies show that sleep and mental health go hand in hand, and nearly all mental health issues are associated with poor sleep. One study found that people with insomnia have a twofold risk of developing depression compared to those who do not have difficulty sleeping. Another study found that people with bipolar disorder and schizophrenia with sleep disturbances experience exacerbated disease-specific symptoms that reduce quality of life and bimpair daily functioning. Other studies have found that sleep plays a significant role in people with Post-traumatic stress disorder (PTSD). In fact, sleep disturbance is one of the earliest signs of PTSD and can often proceed a traumatic event. Once the disorder sets in, sleep problems can exacerbate PTSD symptoms.
How is Sleep Connected to Mental Health?
Sleep plays important role in the way the brain operates. During sleep, brain activity fluctuates depending on the different sleep stages within the sleep cycle. In non-rapid eye movement (NREM) sleep, brain activity slows but there are sudden bursts of energy. In rapid eye movement (REM) sleep, brain activity accelerates. Each stage allows activity in the brain to ramp up or slow down, which enables better thinking, learning and memory. It also has a significant impact on mental health.
Research shows that lack of REM sleep impairs the brain’s ability to process emotional information. Not enough sleep or poor quality sleep harms consolidation of positive emotional experiences. This influences mood and emotional reactivity, which is directly related to one’s mental health.
Depression is a severe mental health disorder marked by extreme feelings of sadness and hopelessness. About 1 in 6 adults will have a depressive episodes at least once in their life. Among those with depression, about 75% have difficulty falling or staying asleep. Researchers originally thought that depression caused poor or inadequate sleep. But further studies have shown that poor sleep can lead to depression. A meta-analysis of studies showed that at people who don’t get enough sleep, like those with insomnia, have two times higher risk of developing depression compared to those who get quality sleep.
The bidirectional relationship between sleep and depression create a negative feedback loop. Poor sleep makes depression worse, which further disrupts sleep. While this vicious cycle can leave people who suffer from sleep deprivation and depression feeling trapped, it also opens the door to another opportunity to treat both conditions.
By focusing on sleep, some people may see an improvement in their mood or vise versa. In addition, some of the same therapies that are used to treat depression, can also be used to treat sleep disorders. Selective serotonin re-uptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) are two methods commonly used to treat depression that have also been found to be effective in improving sleep.
Anxiety is one of the most common mental health disorders that effects nearly 40 millions adults in the United States. Excess worry and fear associated with anxiety makes it harder to fall and stay asleep. Likewise, sleep deprivation can make anxiety worse.
While worry and fear are helpful emotions that provide important information on how to respond to specific situations, too much of these emotions and in response to irrational circumstances can lead to a state of hyperarousal, or racing thoughts. Hyperarousal is a primary contributor to insomnia. Lack of sleep may add to the already elevated levels of worry, making anxiety worse and even more difficult to fall asleep.
One study found the chronic insomnia is significantly more prevalent in people with anxiety disorders, like obsessive compulsive disorder (OCD), panic disorder, and generalized anxiety disorder (GAD). The study analyzed sleep and anxiety of a random sample of 1200 people between the ages of 21 and 30 over the course of three years. Researchers found that insomnia remained a significant predictor of various anxiety disorders.
Another study looked at the prevalence of insomnia and anxiety in almost 15,000 people. The study revealed that over 90% of people had chronic insomnia, and 28% of those people had a current anxiety diagnosis. They also found that insomnia appeared before mood disorder symptoms om nearly 40% of people and at the same time as about 38% of people.
Stress usually gets a bad rap, but it’s an important part of the human response which enables people to respond quickly and appropriately in the face of challenging or dangerous situations. Feeling low to moderate levels of stress is beneficial. The problem begins when stress gets too high, leading to negative repercussions like poor sleep and mental well-being.
Sleep and stress a bilateral relationship, meaning they both have an impact on the other. High levels of stress over a prolonged period of time can contribute to poor sleep while insufficient sleep can cause a maladaptive stress response. Chronic stress causes interruptions in the circadian clock, which is a 24-hour biological clock that is run by the sun’s light and dark cycle and regulates the sleep-wake cycle. This cycle tells us when it’s time to sleep and when it’s time to be awake. Too much stress during waking hours can cause people to have difficulty feeling asleep or have poor sleep quality that night.
Attention-deficit hyperactivity disorder is a neurodevelopment disorder that begins during childhood and often lasts into adulthood. About 6.1 million children in the united states between the ages of 2 and 17 are estimated to have been diagnosed with ADHD. This condition presents with symptoms like inattention, hyperactivity, and impulsivity which can have a significant effect on daily tasks, like school, work, activities and sleep.
An estimated 25-50% of people who have ADHD experience sleep disturbances, like insomnia, restless leg syndrome, narcolepsy, and nightmares. For people without ADHD sleep disturbances often result in increased feelings of fatigue or slowed thought process the follow day, but for people with ADHD, it can cause symptoms to be exacerbated. When symptoms become worse, it can make it even more challenging to sleep the next night, creating a cycle that’s difficult to break.
The exact connection between sleep disorders and ADHD is unclear, but some researchers believe sleep problems due to ADHD can be a side effect of impaired arousal, alertness and regulation circuits in the brain. Other researchers believe it may be tied to a delayed circadian rhythm and a later onset of melatonin production. In addition, different sleep problems have been reported depending on the type of ADHD. Studies show that individuals who are the inattentive type are more likely to have difficulties falling asleep, while those with the hyperactive-impulsive type are more likely to have insomnia.
Support Mental Health by Improving Sleep
Sleep interventions are not only essential to improving sleep, but can also help improve mental health. Studies show that sleep interventions have a significant effect on mental health and can reduce feelings of depression, anxiety and stress. If you have a mental illness and experience difficulty sleeping, you should consult your doctor. You may need to adjust medications and supplements, or implement a sleep routine. You may also consider some lifestyle adjustments like:
- Reduce caffeine, sugar and alcohol intake a few hours before bed
- Avoid napping too close to bedtime
- Avoid screen time an hour before bed
- Avoid stimulating activities or projects that require focus in the evening
- Get enough sunlight during the day
- Exercise regularly
If you struggle with sleep deprivation and a mental health disorder, know you are not alone. There are thousands of members at PatientsLikeMe who know exactly what you are going through. Join the community today to connect with others who can share their experience so you can get the good night’s rest you need to improve your mental health.