If you haven’t experienced it first-hand, it may be difficult to connect sleep-related issues to mental health concerns. Studies show that about 40% of patients who seek out medical help for their sleeping problems have a psychiatric condition, and between 60-90% of people with depression have insomnia. Commonly, sleep disorders go hand in hand with mental health disorders such as anxiety, depression, ADHD, schizophrenia and bipolar disorder. Sleep problems present themselves in different ways depending on which disorder the patient suffers from; for example, patients with anxiety disorders such as PTSD and OCD tend to experience insomnia, nightmares and nocturnal panic attacks, and people suffering from depression tend to experience hypersomnia or sleep apnea.

Melatonin is the chemical in the body that is released from the pineal gland which modulates sleep patterns in both circadian and seasonal cycles; it is responsible for inducing sleep. Cortisol is the hormone released by the body in stressful situations, such as moments of worry or anxiety. Cortisol offsets the balance of melatonin, which can result in trouble falling or staying asleep. Depression has been linked to imbalances in the thyroid hormones which can also lead to sleep problems.

Sleep patterns typically cycle between two categories: Rapid Eye Movement (REM) and “quiet” sleep. “Quiet” sleep is when you are in a deeper sleep; during this time, your body temperature drops, your muscles relax and your breathing slows. This is the time that helps to boost your immune system. REM sleep is the part of sleep where people dream. During this time, your breathing, muscle tension, heart rate and temperature are similar to the levels present when you are awake. REM sleep is critical in enhancing learning, memory and emotional health.

How to Make Improvements

Be aware of substance intake. Caffeine is a substance that many of us consume daily - it is a stimulant that helps to keep us awake and alert. Try to cut out as much as possible, even if it is just one less cup a day. Alcohol is another common substance that many of us consume regularly, however not everyone is aware of the effect it has on our sleep; while alcohol initially depresses our nervous system, eventually the effects wear off which causes the sleepy feelings to fade and sleep to be disrupted. Nicotine is another commonly used substance. Nicotine is a stimulant, so consumption before bed should be avoided in order to obtain a good night’s rest.

Increase physical activity. Physical activity is always recommended for a healthy lifestyle and mental health, as well, physical activity has been proven to improve sleep quality. Make it a habit to include 30 minutes of aerobic activity into your daily routine. Activities such as yoga are also recommended before bed to help wind down after an eventful day. Home workouts are readily available on social media platforms such as Youtube, as many of us are opting out of entering gyms in order to avoid others and potentially contracting Covid19. Discovering the type of workout you enjoy will help to keep you motivated to get your active minutes completed each day.

Improve your sleep environment. It is important that your brain associates your bedroom with sleep, so try to keep the area designated for just that. Many of us are working from home now, and some people need to use their bedroom as their home office. This is understandable, but try to configure the room to have a designated zone for working and a designated zone for sleeping rather than working from your bed if possible. Try to avoid screens as much as possible leading up to falling asleep as blue light has negative effects on sleep as well. Setting a schedule for yourself regarding wake up and bedtimes has also been shown to help improve sleep patterns.

Speak to your doctor about medication. Currently, medication is available that helps with depression and irregular sleep, however the medication for one can often worsen the symptoms of the other. Speak to your doctor about the symptoms you have been experiencing, and work with your medical provider to find the medication that works best for you. Remember to be open and honest with your doctor- they want to help you but they need your 100% honesty as far as substance use and current routines go when prescribing medication.

Try CBT. Cognitive Behavioural Therapy is recommended both for individuals who are having problems sleeping, and those suffering from mental health disorders. It is also recommended for anyone who needs an outlet during these uncertain times. CBT helps to reframe negative thoughts that contribute to depression or anxiety and poor sleep. CBT-I is a specialization directly devoted to the treatment of insomnia. Ask your mental health professional if they have experience with CBT-I or if they know someone who does.

References:

Mental Illness and Sleep Disorders, June 2018, www.tuck.com/mental-illness-and-sleep/

Sleep & Mental Health, February 2013, https://www.sleephealthfoundation.org.au/public-information/more/sleep-blog/sleep-and-mental-health.html

Sleep and Mental Health, Harvard Health, Updated June 2018, https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health

How Mental Health Affects Sleep and Vice Versa, Tuck Sleep, June 2018, https://www.tuck.com/mental-illness-and-sleep/

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