The Impact of Sleep on Mental Health

I once heard a quote that was amazingly spot on. “Americans are crazy.  They wind up with coffee and wind down with alcohol. They eat too much fast food and get too little exercise and then expect to be at peak performance for 10 to 12 hours per day. And they get very little off-season (vacation) for recovery.” - The Power of Full Engagement by Tony Schwartz and Jim Loehr.

It is very common in our society that we take sleep for granted, unaware of the crucial impact sleep has on our well-being. In our fast-paced society, sleep is often sacrificed in the pursuit of productivity. However, the significance of a good night's sleep goes far beyond simply feeling rested. Research has consistently demonstrated the profound impact of sleep on mental health. This also includes nutrition and exercise, but we will address those in later posts.

Typically, the recommendation is 7.5 to 8 hours for adults. Pediatricians have recommendations for children and adolescents based on their age (see article). Most of the time people will struggle with not being able to fall asleep; waking up throughout the night; being a “light sleeper”; staying up late; working third shift; or limiting the amount of sleep they are getting in general (7 hours or less). All of this is called Sleep Deprivation.

Sleep deprivation has been linked to an increased risk of mood disorders such as depression and anxiety. We also see that disruptions in sleep patterns are often observed in various psychiatric disorders such as bipolar and schizophrenia. Thus, improving sleep quality is recognized as a valuable adjunctive approach in the treatment of these conditions.

When sleep is impacted, there are disruptions in neurotransmitter and hormone regulation. Rapid Eye Movement (REM) sleep is one of the phases of the sleep cycle and is crucial for emotional regulation and processing. The lack of REM sleep may contribute to heightened emotional reactivity and difficulty in managing stress. Inadequate sleep can impair cognitive functions such as attention, memory, and problem-solving leading to difficulties in decision-making and increased vulnerability to stress. We sometimes overdiagnose mental disorders when in reality many behaviors and symptoms can be fixed by improving sleep.

So what do I do if I am not getting enough sleep? Practicing good sleep hygiene plays a pivotal role. Typically it takes 3-4 weeks to reset your body. Here are a few things to consider.

Establish a consistent sleep schedule. Go to bed at the same time every night and wake up at the same time every morning. You will want to adjust your sleep schedule in order for you to wake up on your own each morning (with an alarm as an aide). For instance, go to bed at 11 if you have to be awake by 8. This gives your body 9 hours of sleep as it is adjusting. After 2-3 weeks, you will naturally awaken when your body is rested.

Create a conducive sleep environment. Your room should only be used for sleep (and sex). Refrain from watching TV in the bedroom, reading or working in the bed, or doing any other awake activities. Your room should be dark, cold, and feel like a cave you go to that triggers your brain it is time to rest. For some people, you may benefit from sounds that are soothing.

Establish a bedtime routine. Similar to how we calm children down before bed, we must follow suit. Approximately an hour before going to sleep, establish a routine that is soothing and slows down you nervous system allowing you to feel relax. Turn off the phone, put away work, and turn down your lights. Read a book, go for a walk, sit on your stoop, take a bath, listen to soft music, watch a show (in your living room), or stretch or foam roll. Instead of drinking alcohol which disrupts sleep, drink calming teas. Try aroma therapy (eucalyptus or lavender). Find a combination that works for you.

Seek professional interventions. For more complex or challenging sleep concerns, seek professional help. We can employ interventions such as cognitive-behavioral therapy for insomnia (CBT-I) or Yoga Nidra or iRest to help with addressing problematic sleep concerns. We can explore the possible impact of hormonal imbalances, vitamin deficiencies, overall nutrition, exercise, stress, trauma, pain, or mental illness.

Prioritizing adequate and quality sleep is a fundamental aspect of maintaining optimal mental health. By understanding the intricate connections between sleep and mental well-being, individuals can make informed choices to promote both their physical and mental resilience. As the saying goes, a good night's sleep may indeed be a powerful prescription for a healthier mind.

References:

Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams.

Goldstein, A. N., & Walker, M. P. (2014). The Role of Sleep in Emotional Brain Function.

Walker, M. P. (2009). The Role of Sleep in Cognition and Emotion.

Harvey, A. G. (2015). Sleep and Circadian Functioning: Critical Mechanisms in the Mood Disorders?

Morin, C. M., & Espie, C. A. (2003). Insomnia: A Clinician's Guide to Assessment and Treatment.

Cheng, P., Kalmbach, D. A., et al. (2019). Treating Insomnia to Improve Mental Health: A Mechanistic Rationale.

Written with Diana Nelson, APRN, BC-PMHNP