Mental Health & Sleep

Things you should know:

• Problems with sleep and mental health interactin both directions.
• Sleep disturbances can be a risk for later mental health problems.
• People with poor mental health are typically poor sleepers.
• Improving sleep will often help mental health.
• Improving sleep may prevent mental ill-health relapses.
• Sleep problems and mental health problems can be treated at the same time.
• Evidence-based treatments that improve sleep disturbances and sleep disorders are available.

Sleep and emotional wellbeing

The saying ‘they got out of the wrong side of the bed’ is often used to describe someone who is moody, irritable or hard to get along with on a particular day.  This saying shows that people understand that there is a relationship between how you slept and your emotional well-being.

This relationship becomes even clearer with people who are having ongoing mental health problems, as they often sleep poorly. In fact, it has been said that 'mental health problems and sleep problems can be two sides of the same coin’.  Thus, if you see one, the other often exists on the other side (which may be hidden or unrecognised).  

Which comes first – the emotional problems or the sleep problems?  We now know that disturbances with sleep and mental health can interact in either direction.

Frequent sleep disturbances can be associated with a higher risk of mental health problems down the track

Rigorous and large-scale studies have shown that chronic sleep disturbance is a significant risk factor for the development of mental health problems such as depression, paranoia, anxiety, post-traumatic stress disorder, hallucinations and even suicidal behaviours. The risk increases with insomnia, habitual sleep loss, Obstructive Sleep Apnoea (OSA) and other sleep disorders.  

People with poor mental health are typically poor sleepers too

Mental ill-health may be associated with persistent trouble falling asleep, having more fragmented sleep and/or waking too early in the morning. Nightmares, night terrors, or Rare sometimes a feature.

It’s not usual for people with hidden or unknown mental health issues to notice ongoing sleep problems first. They may even discuss these with their doctor before it is realised that they also have mental health problems that are affecting the way they deal with life.  

Seeking help for sleep problems can be an easier first step rather than seriously consider that they may have depression, anxiety or other mental health issues.  

Treatment

The good news is that improving sleep will often reduce the severity of mental health problems.  Getting better sleep is also a great strategy for helping to prevent mental health problems develop or reducing the chances of a relapse.  There are effective, evidence-based ways to improve your sleep, and these should be part of any treatment plan to help mental health where sleep is poor. Thus, there is now a push to treat both sleep problems and mental health problems at the same time.  Sometimes the same health professional can be skilled in both treatment areas. Carefully selected medications may be indicated in some instances, especially for more severe mental health conditions.

Sleeping problems are best recognised as needing treatment in their own right. Sleeping tablets are unfortunately, not a long-term solution. To learn more about possible reasons for sleep disturbances, and get helpful hints on what you can do, a good starting point is our fact sheet Understanding and Helping Poor Sleep. For help with persistent sleep problems talk to your GP. They may refer you to a sleep specialist, who will provide skilled diagnostic services (often involving a sleep study) and treatment options across a range of sleep disorders.

Individualised treatment for insomnia using Cognitive-Behavioural Therapy for Insomnia (CBT-i) principles can be provided by a specialised Sleep Psychologist, typically with a referral from your GP. Our insomnia fact sheet also provides information on low cost, online non-pharmacological treatment programs, including CBT-i, that are evidence-based and effective.  Mindfulness is also a helpful strategy to improve sleep, especially when the mind has trouble shutting down.

Sleep and its relationship to other health issues

Sleep disturbance is a common feature within anxiety and depression. There are a range of other medical/psychiatric issues that can also be associated with poor sleep. Importantly, finding ways of addressing sleeping problems can help to either prevent and/or improve these various conditions.

Further information

https://www.verywellmind.com/how-sleep-affects-mental-health-4783067

Download a PDF of this Fact Sheet

Other useful links:

• ADHD and Sleep in Children
• Anxiety and Sleep
• Autism in Children and Sleep
• Common Sleep Disorders
• Common Cause of Inadequate Sleep
• Depression and Sleep
• Delayed Sleep-Wake Phase Disorder (DSWPD)
• Insomnia
• Cognitive Behavioural Therapy for Insomnia (CBT-I)
• Mindfulness and Sleep
• Nightmares
• Obstructive Sleep Apnoea (OSA)
• Preventing Chronic Insomnia
• Post-Traumatic Stress Disorder (PTSD) and Sleep
• Restless Legs Syndrome (RLS)
• Schizophrenia and Sleep
• Sleep Hygiene: Good Sleep Habits
• Sleep/Night Terrors
• Sleepwalking
• Sleep Study
• Sleeping Tablets
• Understanding and Helping Good Sleep