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Insomnia is a common problem throughout the world. According to estimates, it is believed to affect approximately 33% of the world’s population. Even people without chronic insomnia often struggle with sleep problems. According to the Centers for Disease Control and Prevention (CDC), a third of adults in the U.S. report that they get less than the recommended amount of sleep each night. Because of this, it is important to understand the potential impact that lack of sleep may have on health, including mental health and well-being.
The Relationship Between Sleep and Mental Health
It’s no secret that sleep plays an important role in good physical and mental health. Sleep deprivation can leave you feeling irritable and exhausted in the short-term, but it can also have serious long-term health consequences as well. Lack of sleep is linked to a number of unfavorable health consequences including heart disease, type 2 diabetes, and depression.
Some psychiatric conditions can cause sleep problems, and sleep disturbances can also exacerbate the symptoms of many mental conditions including depression, anxiety, and bipolar disorder.
Research suggests that the relationship between sleep and mental health is complex. While sleep has long been known to be a consequence of many psychiatric conditions, more recent views suggest that sleep can also play a causal role in both the development and maintenance of different mental health problems.1
In other words, sleep problems can lead to changes in mental health, but mental health conditions can also worsen problems with sleep. Lack of sleep may trigger the onset of certain psychological conditions, although researchers are not completely certain of the underlying reasons for this. Because of this circular relationship between your sleep patterns and your mental state, it is important to talk to your doctor if you are having problems falling or staying asleep.
Stress
If you’ve ever struggled to get through the day after a night of tossing and turning, you are well-acquainted with the disruptive effects of sleep deprivation. Mood changes including increased irritability and anger can make it much harder to cope with even the minor stresses of daily life.
Poor sleep can make it much more difficult to cope with even relatively minor stress. Daily hassles can turn into major sources of frustration. You might find yourself feeling frazzled, short-tempered, and frustrated by everyday annoyances. Poor sleep itself can even turn into a source of stress. You might know that you need to get a good night’s sleep, but then find yourself worrying that you won’t be able to fall or stay asleep each night.
Depression
Insomnia and other sleep problems can be a symptom of depression, but more recently, research has implicated lack of sleep in actually causing depression.
One analysis of 21 different studies found that people who experience insomnia have a two-fold risk of developing depression over those who do not have problems sleeping.2 The question then is whether helping people improve their sleep might actually lessen their chances of developing depression.
Researchers suggest that addressing insomnia early-on may be an effective preventative measure to help reduce the risk of depression, although more study into this possibility is needed.
Treating insomnia is obviously an important way to help improve psychological health and the possibility that such treatments may also be an effective tool for preventing or even treating mental health problems is promising.
In a study looking at more than 3,700 participants, researchers investigated the impact of poor sleep on symptoms of depression, anxiety, and paranoia.3 Some of the participants were treated with cognitive-behavioral therapy (CBT) for their insomnia, while others did not receive any treatment. The researchers found that those who had received CBT also showed significant reductions in depression, anxiety, paranoia, and nightmares. They also reported improved overall well-being, including their ability to function at home and work.How Cognitive Behavior Therapy Works
Anxiety
As with many other psychological conditions, the relationship between sleep and anxiety appears to go both directions. People with anxiety tend to experience more sleep disturbances, but experiencing sleep deprivation can also contribute to feelings of anxiety. This can become a cycle that perpetuates both the sleep and anxiety issues.
Additionally, sleep problems appear to be a risk factor for developing anxiety disorders. One study found that problems with sleep were a predictor for generalized anxiety disorder in children and teens between the ages of 9 and 16.4 Those who struggle with sleep problems may be more likely to develop an anxiety condition, particularly if their sleep problems are prolonged and left untreated.
Coping with feelings of anxiety can be that much more difficult when you are tired from chronic sleep disturbances. Because of this, poor sleep can make the symptoms of anxiety disorders much worse. For example, sleep deprivation is not only a common symptom of post-traumatic stress disorder (PTSD) affecting between 80% to 90% of people with the condition, it is also believed to play a role in both the development and maintenance of this disorder.
However, even otherwise healthy people can experience negative mental health effects of poor sleep. For example, one study found that acute sleep deprivation led to an increase in anxiety and distress levels in healthy adults.5 So while you might not even if you normally do not experience a great deal of anxiety, poor sleep may leave you feeling agitated and distraught.
Bipolar Disorder
Sleep disturbances are very common among people with bipolar disorder. Such problems can include insomnia, irregular sleep-wake cycles, and nightmares. Bipolar disorder is characterized by alternating periods of depressed and elevated moods.
Sleep changes can be a symptom of the condition, but sleep problems can also play a role in the course of the condition, treatment outcomes, and the individual’s overall quality of life.
Reduced sleep can also cause symptoms of mania or hypomania. Research suggests that changes in the normal sleep/wake cycle preceded the onset of a manic episode in 25% to 65% of participants.6 If you have bipolar disorder, be sure to talk to your doctor about any sleep difficulties that you may be having.How Sleep and Bipolar Disorder Interact
ADHD
Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric condition, affecting as many as 5.3% of children between the ages of six and 17 years old. ADHD is associated with sleep problems, and research also suggests that sleep disturbances may be a predictor or even a contributor to symptoms of the condition. Studies have found that between 25% and 55% of children who have ADHD also experience sleep disturbances.7
Children with ADHD may experience a number of sleep-related problems including difficulty falling or staying asleep, difficulty waking, sleep breathing issues, night waking, and daytime sleepiness.
ADHD treatment frequently begins with an assessment of current sleep habits and patterns in order to address underlying sleep problems. Studies have found that sleep interventions can help improve the severity of ADHD symptoms in addition to improving overall quality of life.8
Getting Help
The good news is that because sleep problems are usually considered modifiable risk factors for many conditions, findings ways to improve sleep quality and quantity can be helpful in relieving the symptoms of these mental disorders. This does not mean that getting more sleep is a cure or quick-fix, but getting better sleep can be an important part of a comprehensive treatment plan.
It is the bidirectional relationship between sleep and mental health that offers some promise—researchers hope that finding ways to improve sleep may have a beneficial impact on a number of conditions. In practical terms, if improving sleep could improve mental health, interventions designed to help people sleep could be a useful tool during psychological treatment.
While more research is needed to learn more about the effectiveness of such treatments, but there is some evidence that treatments that focus on sleep improvements can relieve some symptoms. For example, one study found that targeted sleep treatments were useful for reducing the symptoms of PTSD.9
Research has also shown that psychological treatments can be helpful for treating some sleep disorders. One study, for example, found that internet-based cognitive-behavioral therapy (CBT) was helpful for relieving symptoms of insomnia.10
If you have been struggling with a sleep problem or are experiencing excessive daytime sleepiness, talk to your doctor about your treatment options. Your doctor may want to conduct a sleep study in order to get a better look at your nighttime sleep patterns. They can then recommend treatments that are appropriate for any underlying sleep disturbance that might be impairing your ability to rest. Treating your sleep issues early is important for protecting both your physical and mental well-being.
