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It’s complicated: The relationship between sleep and mental health

Published May 31, 2022 4:20 pm

Itulog mo ‘yan.

If you’ve ever been in a situation where you didn’t sleep well the night before and couldn’t think straight the next day without monopolizing the coffeemaker, somebody probably gave you this piece of advice one too many times. Or maybe you said it to yourself while choosing the perfect meme to encapsulate your puyat. Getting adequate sleep can actually help you regain focus and make better decisions–one of the reasons why you shouldn’t dismiss rest as a non-productive activity.

If only sleeping were that easy for everyone. According to 2021 data from the Philippine National Nutrition Council, 46% of Filipinos do not get enough sleep–the highest in Asia. As important as sleep is to overall well-being, it can be harder for people who are distressed or those who have mental health problems to fall asleep easily. In a 2018 study among undergraduate students in China, researchers found that normal sleep quality is linked to lower levels of mental problems, while poor sleep quality impacts mental health negatively

The COVID-19 global pandemic doesn’t help either. In the US, for instance, sleep deprivation became a bigger concern as demonstrated by the 14.8% increase in sleep disorder prescriptions in March 2020. Furthermore, 36% of Americans reported having difficulty in sleeping due to the stress caused by the pandemic. 

The lack of quality sleep, especially when prolonged, can put one at risk of serious physical illnesses like obesity, diabetes, and heart disease. It can also aggravate mental health problems.

Get to know the relationship between sleep and mental health, and the actions we can take for better sleep and mental care.

What does sleep have to do with mental health?

Our bodies work all day to make sure everything is working as it should and to fend off infections and viruses, but it is during sleep that our physical and mental recovery is optimized. As our brain continues to work during slumber, its activity levels vary depending on the stage of sleep we're in. We generally doze off at the beginning of NREM (Non-Rapid Eye Movement) where our brain activity slows down until NREM completes its cycle. According to experts, the repair and recovery activities of our bodies peak at the third stage of NREM, and that is crucial in the development of our critical thinking.

After NREM, we enter the REM (Rapid Eye Movement) stage of sleep where our brain’s activity picks up. In this phase, the brain actively processes emotional information that is vital to cognitive functions including learning and memory retention. It is also the stage where we dream–literally. When REM is disrupted constantly, our everyday moods may be affected as well as our emotional reactivity.

This brings us to our next point. Experts believe that there is a bidirectional relationship between mental health and sleep wherein sleep deprivation may either be the cause or the consequence of mental health problems. An example would be the beginning of mood irregularities or anxiety when people don’t get enough sleep frequently. On the flip side, people who have existing mental health problems may experience difficulty falling asleep, and when they do, it can lead to worsening their current condition.

What keeps us up at night?

Poor sleep quality may be caused by various factors such as sleep problems, disruptions in daily routine, lowered exposure to ample sunlight, and stress.

Insomnia is the most common sleep disorder and it is characterized by the inability to fall asleep or to stay asleep. While insomnia manifests in different ways and extent, some of the typical behaviors that may trigger this sleep problem include intake of caffeine and alcohol prior to bedtime, taking or coming off medications that can disrupt the sleep-wake cycle, physical discomforts such as needing to go to the bathroom in the middle of the night, and mental health problems such as depression.

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Some of us were forced to work and study at home due to the pandemic, while others opted to barely go outside. The thing with being inside all the time is that constant lack of exposure to sunlight can also disrupt our circadian rhythms and throw off our natural melatonin production. In addition, the lines between behavioral cues such as getting dressed, commuting, and transitioning to bedtime have been blurred for a lot of those who spend most of their time at home.

According to the Sleep Foundation, specific mental health problems prove to be inevitably related to sleep hygiene. Depression, a mood disorder that affects 300 million people across the globe, has been associated with insomnia and hypersomnia—a condition that causes people to sleep excessively. While studies have shown the connection between the two, evidence suggests that the co-existence of depression and sleep deprivation generally exacerbate each other

Aside from depression, the Sleep Foundation also listed anxiety disorders, bipolar disorder, ADHD, schizophrenia, and autism spectrum disorder in the list of mental health problems that have a bidirectional relationship with sleep. While these mental health disorders are distinct from one another and should be treated according to what is best for the patient's overall health, they may either result in sleep deprivation, intense depressive episodes, or aggravated lack of focus.

Ways to improve sleep hygiene

Having sleep problems isn’t tantamount to having a mental health disorder. If you are having difficulty sleeping, especially if you notice that it’s already affecting your mental health, you may follow these tips:

Build a bedtime routine. An effective bedtime routine isn’t a one size fits all plan, but there are key things that are commonly found in routines that help people sleep. Set a fair bedtime you can commit to and do your best to stick to it until it becomes natural to you. You can also do relaxation techniques such as meditation before bed, or do light exercises to signal your body that it’s time for rest. Avoid drinking alcohol or caffeinated beverages too close to bedtime and, if possible, do not eat heavy meals before going to bed so that digestion won’t keep you up. As your eyes and body transition to sleep mode, minimize exposure to blue light from screens and make your bedroom as comfortable as possible so that it’s easier for you to fall asleep.

Take melatonin supplements. Also known as the sleep hormone, melatonin is naturally released by our pineal gland to regulate our sleep-wake cycle. However, disruptions to melatonin production such as prolonged exposure to blue light or shift work can make it difficult to fall asleep even if you know it’s already bedtime. Taking melatonin supplements can help augment melatonin deficiency until you’re able to sleep easily on your own. Keep in mind that while melatonin supplements are generally safe for adults, it is best to consult with your physician before you take them, especially if you’re also taking medication for other health concerns.

Consider Cognitive Behavioral Therapy. Also known as talk therapy, Cognitive Behavioral Therapy (CBT) can help people process thoughts and emotions, especially negative ones, in a guided manner and address the impact of mental health problems like anxiety and depression. CBT has been proven to help reduce symptoms of mental disorders and, in turn, improve one’s psychological health and overall quality of life. 

As more research is done around the relationship between sleep hygiene and mental health, it helps to take on sleep deprivation before it results in more serious health problems.

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Editor’s Note: This article was provided by Sleepasil.