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This post is by Monica Velici of Sparta Health

Sleep and mental health are closely connected. Sleep deprivation affects your psychological state and mental health. And those with mental health problems are more likely to have insomnia or other sleep disorders.

Key points

  • Sleep problems are more likely to affect patients with psychiatric disorders than people in the general population.
  • Sleep problems may increase the risk for developing particular mental illnesses, as well as result from such disorders.
  • Treating the sleep disorder may help alleviate symptoms of the mental health problem.
  • Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder.

How is mental health related to sleep?

Brain activity fluctuates during sleep, increasing and decreasing during different sleep stages that make up the sleep cycle. In NREM (non-rapid eye movement) sleep, overall brain activity slows, but there are quick bursts of energy. In REM sleep, brain activity picks up rapidly, which is why this stage is associated with more intense dreaming.

Each stage plays a role in brain health, allowing activity in different parts of the brain to ramp up or down and enabling better thinking, learning, and memory. Research has also uncovered that brain activity during sleep has profound effects on emotional and mental health.

Sufficient sleep, especially REM sleep, facilitates the brain’s processing of emotional information. During sleep, the brain works to evaluate and remember thoughts and memories, and it appears that a lack of sleep is especially harmful to the consolidation of positive emotional content. This can influence mood and emotional reactivity and is tied to mental health disorders and their severity, including the risk of suicidal ideas or behaviours.

As a result, the traditional view that sleep problems were a symptom of mental health disorders, is increasingly being called into question. Instead, it is becoming clear that there is a bidirectional relationship between sleep and mental health in which sleeping problems may be both a cause and consequence of mental health problems.

What are the most common sleep disorders?

There are more than 80 different sleep problems listed in the medical textbooks, ranging from the inability to get to sleep (insomnia) to the inability to stay awake (narcolepsy). Many sleep problems are temporary, and you may find the self-help measures below help get you back to more normal sleeping pattern. But sleep problems can also be a symptom of other conditions, such as a problem with your thyroid gland or depression, so it is worth seeing your GP if your sleeping problems continue.

Insomnia

Insomnia is the most common sleep disorder, affecting an estimated 20% of people.

Typical symptoms are:

  • problems falling asleep
  • problems staying asleep (so that you wake up several times each night)
  • waking up too early
  • daytime sleepiness, anxiety, impaired concentration and memory and irritability

Short-term insomnia, lasting for a few nights or a few weeks, generally affects people who are temporarily experiencing one or more of the following:

  • stress
  • change in environmental noise levels
  • extreme change in temperature
  • a different routine, perhaps due to jet lag
  • side effects from medicines

Chronic insomnia, lasting for a month or longer, often results from a combination of factors that sometimes include underlying physical or mental health problems. It can also be due to behavioural factors such as too much caffeine or alcohol or a long-term disruption to your routine such as shift work.

Narcolepsy

Narcolepsy is a brain disorder that upsets how the body regulates your sleep patterns. One of the main symptoms is excessive sleepiness - sufferers can fall asleep at work, talking or driving a car. These 'sleep attacks' can last from 30 seconds to more than 30 minutes, regardless of how much sleep you are getting at night.

Sleep apnoea

Sleep apnoea is a breathing disorder during sleep, typically accompanied by loud snoring. The person will stop breathing briefly at intervals during the night, which wakes them up briefly - constantly interrupting their rest. People with sleep apnoea wake up to breathe hundreds of times during the night, which makes them very tired during the day. Usually they are not conscious of these brief awakenings. In one form of sleep apnoea, called Obstructive Sleep Apnoea, the upper airway is restricted, making this a potentially life-threatening condition needing urgent medical attention.

Helping yourself

There are many things we can try to help ourselves sleep well.

  • Exercise regularly, but at least three hours before bedtime.
  • Avoid tea and coffee and do not drink a lot of alcohol before bed.
  • Try to go to sleep and wake up at the same time each day.
  • Only use your bed for sleep or sex. Your bed should be associated with sleep.
  • Establish a regular, relaxing bedtime routine that lets you unwind and sends a signal to your brain that it is time to sleep.
  • If you cannot sleep, do not worry about it. Get up and do something relaxing like listening to music or reading until you feel sleepy.

The brain basis of a mutual relationship between sleep and mental health is not yet completely understood. But neuroimaging and neurochemistry studies suggest that a good night's sleep helps foster both mental and emotional resilience, while chronic sleep deprivation sets the stage for negative thinking and emotional vulnerability.

About Monica Velici

Monica joined Sparta Health in February 2020 as part of the rehabilitation service support team. She has a degree in Psychology, an MSc in Clinical Neurodevelopmental Sciences, and a keen interest in dementia and mental health. Monica aims to become a fully accredited therapist.

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