Bidirectional Connection Between Sleep and Mental Health

Mental Health and Sleep - The Connection 

We have heard a lot of them saying they sleep all the time with depression or when they are sad. This sign can be of mental shutdown. Sleep can show you how active your mental well-being is. Research shows a strong connection between mental and emotional health and sleep. Poor sleep has a connection to conditions like depression, anxiety, and bipolar disorder. This two-way street means that sleep problems can worsen mental health issues, and mental health issues can disrupt sleep.

"Sleep is one of the three pillars that balances life. Sleep is important to hold that minute thread of life in place. Not having enough sleep can create havoc in your mind, if not immediately, at least in the long run."

• Dr Isra Ismail, Senior Ayurveda Consultant

When you hear someone saying, "a good night's sleep', you feel pleasant. You understand how good the person must feel - relaxed, stress-free, and full of mental clarity.

That is what sleep does to your mental well-being.

Sleep is essential for many of our brain and body functions that help regulate daily activities, emotions and behaviours. 

Stages of Good Sleep for a Better Mental Health

When you sleep, your brain goes through different levels or stages of sleeping. 

Experiencing each level without interruption is unimportant in building the correct blocks in your brain.

The NREM (Non-rapid Eye Movement)

This sleep stage occurs when you are transiting into a deep sleep, and all the body connections start to repair and reconstruct. All your brain activities dealing with healing regeneration, immune modulation, and memory construction start working at this stage. 

Having improper or insufficient NREM sleep is associated with different neurodegenerative diseases like Alzheimer's and mental illnesses like schizophrenia.

The REM (Rapid Eye Movement)

This stage of sleep helps the brain process emotional information. When you are asleep, your brain remembers thoughts and memories. When you lack sleep, this information processing, especially positive memories, becomes difficult.

So this, in turn, can lead to an influence on more emotional reactivity tied to mental health disorders.  Your brain stops recognising different emotions, and ultimately, it leads to different types of mental health issues.

A good night's sleep at the proper time will give you both these stages.

In short, you need good quality sleep for the following:

• Improved positive memory consolidation.
• Good mood and emotional quality
• An improved and robust immune system
• Regeneration and recovery of tissues
• Better cognitive function

Qualitative and quantitative sleep that occurs at the proper time is appreciated in Ayurveda as it rejuvenates and re-energises the body and mind. At the same time, improper, reduced and an excessive sleep gives rise to harmful effects on mental as well as physical health.

Wait! It doesn't mean sleeping just a little bit more makes you mentally unhealthy. Read on to know how sleep relates with each mental health conditions.

Sleep and Specific Mental Health Problems

Knowing that sleep has a significant influence on mental health and brain functioning, let's go through some specific mental health problems related to sleep.

Bipolar Depression and Insomnia

Just as it sounds, bipolar has two poles. There are two poles of mood - extreme mood swings, ranging from manic highs to depressive lows.  Insomnia accompanies these episodes often. Those with bipolar depression find it difficult to fall asleep. 

Even though insomnia itself is not a direct cause of bipolar disorder, persistent sleep problems contribute to the onset or worsening of mood disorders.

Poor sleep disrupts the chemicals in your brain called neurotransmitters. In turn, they impact the hormones that help regulate mood. 

A person with bipolar can have increased stress, irritability and difficulty in coping with daily challenges with insufficient sleep.

How to Treat it?

Treating insomnia in bipolar disorder can help a lot in managing the unwanted increase of symptoms. 

Sleep Apnea and Mental Health

Sleep apnea is a sleep disorder where your breathing stops and starts repeatedly. The main characteristic of sleep apnea is loud snoring. Due to this, someone with sleep apnea struggles to maintain a consistent pattern of sleep.

A combination of sleep apnea and insomnia leads to daytime fatigue, cognitive impairment and a reduction in overall quality of life. 

When you are constantly irritable throughout the day, it can leave you anxious and depressed. It can also worsen any pre-existing mental health conditions. 

How to Treat it?

Therapies like continuous positive airway pressure therapy may help with sleep apnea. It involves wearing a mask that can deliver a continuous stream of air, which keeps your airway open.

To know more about how to manage this condition, read our detailed blog on sleep apnea. (link Dev's sleep apnea blog)

Psychosis and Sleep Deprivation

You already know that sleep deprivation has a significant effect on mental health. Having less or no sleep in the long term can lead to another mental health condition called psychosis.

What is psychosis? The condition psychosis refers to a collection of symptoms that affect the mind of a person who loses contact with reality. The person finds difficulty in recognising what is real and what is not. 

With sleep deprivation, someone with psychosis will have;

• An increased severity of symptoms such as hallucinations, delusions and disorganised thinking.
• Lack of enough sleep disrupts normal cognitive functioning. The memory, attention and problem-solving skills worsen further. 
• Emotional instability worsens, and there's an increased vulnerability towards unnecessary stress.
• With sleep disrupting the normal functioning of the brain, regular medications for psychosis may be less effective.

How to Treat it? 

Effective cognitive behavioural therapy for insomnia may help in conditions of psychosis sleep deprivation.

Schizophrenia and Sleep Problems 

Schizophrenia is a mental health condition related to sleep challenges. Those with schizophrenia will have the following sleep problems. 

• Disrupted sleep architecture with alterations in sleep stages, reduced sleep time and increased sleep latency.
• Some medications for schizophrenia will have some side effects that impact sleep. Sometimes, it may be prolonged sedation and, at times, insomnia.
• Social withdrawal, apathy and reduced motivation may also contribute to irregular sleep patterns.
• Those with schizophrenia also experience hallucinations and nightmares. 

How to Treat it? 

Managing sleep problems in schizophrenia may be difficult. Good sleep hygiene, physical activity, a structured routine, cognitive behavioural therapy, and social support improve sleep-related issues in schizophrenia to a large extent.

Sleeping in Depression

It's normal to sleep when you are sad. Sometimes, sleep can take away all of your sadness. Sleep can make you feel relaxed as the brain relaxes. 

But what if this sleep itself becomes a significant symptom of depressive disorders?

Excessive sleeping or no sleep can be one of the first symptoms of depression.

If you have depression, daily issues such as financial problems and other life issues lead to nighttime wake-ups and trouble getting back to sleep.

You must approach your doctor if you;

• Need help falling asleep.
• Excessive daytime sleep (Hypersomnia)
• Feel tired during the day.
• Vivid dreams and nightmares (Due to troubled REM sleep)
• Have physical pain, discomfort or other complaints like sleep apnea.

With that, what you must take note of are the symptoms of depression, such as ;

• Feeling of hopelessness
• Feeling helpless or sad all the time.
• Finding trouble concentrating and remembering things.
• Loss of energy 
• Daytime sleepiness
• Loss of interest in activities that once gave you pleasure
• Repeated thoughts of suicide or death.

"There's some evidence that chronic sleep problems in people undergoing depression treatment increase the risk of a slide back into depression. So it's always best to go for sleep treatments with depression treatment."

• Dr Naveen, Chief Medical Officer at Nirva Health

Treating Insomnia in Psychiatry 

Falling asleep, staying asleep, and achieving sound restorative sleep have a significant place in psychiatry, as we have seen in the above section, how common mental disorders are affected by disrupted sleep or insomnia. 

Let us see how these problems are overcome in the field of psychiatry.

• Addressing underlying conditions and symptoms like sleep patterns, history of illness and sleep disorders, medication use, and lifestyle. Improving the underlying psychiatric condition will positively impact improving sleep quality.
• Cognitive behavioural therapy for insomnia is considered the gold standard for treating insomnia, which may have a significant impact on daily functioning.
• Stress management and relaxation therapies have the best impact on mental health. Adopt holistic methods to relax your mind. Yoga with mindful breathing exercises works well. 
• Lifestyle modifications that improve mental functioning with the help of regular exercise and a mindful diet have a significant impact. It's always best to eat for your brain to improve your cognitive development and the health of your neurotransmitters. 
• Ayurvedic treatments like Shirodhara with medicated oils, medicated buttermilk, and other mind-relaxing medicated liquids help in calming your mind in mental health issues. They are also the best treatment for sleep-related issues. 

Talk to our Ayurveda experts to learn how adopting a holistic approach towards mental health and sleep disorders can majorly impact your well-being. 

Conclusion

Sleep connects the wires of your brain. Keeping them intact paves the way towards better mental health.

With appropriate sleep hygiene and lifestyle, sleep will benefit the building of positive mental health. In addition, with the same, you can combat sleep problems faced in mental health conditions.