We explore the link between lack of sleep and depression, and explain how can you ensure good-quality shut eye.
Struggling to sleep at night can be stressful. And whatever the cause of your disturbed rest – be it noise or anxiety – the stress you experience as a result often adds to the problem. But how much does lack of sleep really affect your mental health? And just what can you do to ensure a more restful night’s sleep?
We speak to Niels Eék, psychologist and founder of personal development and wellbeing app Remente, about the link between sleep quality and poor mental health (including depression) and how to resolve those bad nights in bed:
What causes sleep problems?
If you’ve ever had to endure a disrupted night’s sleep, the reasons behind unexpected insomnia are often frustrating. ‘There are so many factors that can contribute to a poor night’s sleep, from temperature to stress, anxiety and discomfort,’ says Eék. ‘It might feel as though you are completely unable to switch off your brain.’
External sleep disruption
Examples of physical, external causes of poor sleep include:
- Noise disruption
- Being a carer, such as for young children or the elderly
- Physical discomfort
- Jet lag
- Certain medicines
- Eating a heavy or spicy meal
Internal sleep disruption
Examples of mental, internal causes include:
- Anxiety, depressionor another mental health problem
- Stress or worry
Poor sleep and mental health
So, how can regular bouts of poor sleep affect the way you feel and behave? ‘If you were to occasionally stay awake for 24 hours straight, it would likely not have too great an impact on how you managed daily tasks,’ says Eék, ‘although you would likely feel tired, and maybe even unmotivated and jittery.
Poor-quality sleep for a sustained period of time can lead to depression and other mental health conditions.
‘If you were to stay awake for several days and nights, it would result in you falling into so called “micro sleeps”, for example while you were eating dinner or going for a bike ride. It would also become harder and harder to concentrate and make decisions,’ he adds.
‘Of course, most people aren’t awake for several days in a row. Most commonly, people with sleep problems actually do sleep regularly, but find that the sleep is of bad quality or often broken.’
Poor sleep negative symptoms
Eék reveals that symptoms of consistent bad-quality, broken sleep can include:
- Difficulty concentrating
- Feeling tired and sluggish
- Cravings of sugary or high-fat foods, such as cookies, sweets and crisps
- Low mood, including feeling grumpy, downhearted, angry or emotional
‘Poor-quality sleep for a sustained period of time can, in some instances, lead to depression and other mental health conditions, such as seasonal affective disorder (SAD), paranoia and anxiety,’ reveals Eék.
One 2017 study, carried out by the Sleep and Circadian Neuroscience Institute at the University of Oxford, investigated the link between insomnia and the occurrence of a variety of mental health problems, including paranoia, anxiety, hallucinatory experiences and depression. Researchers found that when individuals received cognitive behaviour therapy (CBT) to treat their insomnia, they experienced sustained reductions in paranoia and hallucinatory experiences, and improvements in depression, anxiety, nightmares, psychological wellbeing, daytime work and home functioning.
‘Studies have shown that sleep deprivation can affect cognitive performance, including perception, memory and executive functions,’ agrees Eék. ‘While decision making and planning tasks are relatively unaffected by sleep loss, more creative and innovative thoughts do appear to be impacted by lack of sleep. I would recommend that if you’ve had a bad night’s sleep and feel a bit groggy, you should consider making the following day an admin day.’
How much sleep do we need?
So when it comes to getting a healthy amount of sleep and keeping your mental health in check, how much shut-eye is enough?
‘According to the National Sleep Foundation, adults aged between 26 and 64 need an average of seven to nine hours of sleep per night,’ says Eék. ‘Of course, everyone is different and there are always exceptions, with about 20 per cent of the adult population needing less than six hours of kip per night. It’s therefore important to find your own circadian rhythm and a sleeping pattern that suits your personal needs.’
Adults aged between 26 and 64 need an average of seven to nine hours of sleep per night.
Eék also points out that, while getting too little sleep is often highlighted as a cause for concern, getting too much sleep can equally be a problem.
‘We usually focus on not getting enough sleep, but it is also a problem to sleep too much. People who sleep for more than nine hours a day are more likely than others to fall ill. As always, this isn’t true for everyone, but for most people, more than nine hours is too much sleep,’ he says.
‘Many people think it’s important to sleep for eight hours per night, but remember, it isn’t how much sleep you get that’s important – it’s the quality of your sleep that matters. Also remember, the need for sleep varies from person to person.’
Top tips to create positive sleep habits
If you’re struggling to enjoy an uninterrupted night’s sleep and feel this is beginning to impact your mental health, there are steps you can take to help. Eék offers the following advice to help promote good-quality, restful sleep:
✔️ Practice good sleep hygiene
In the final hour before going to sleep, avoid blue light from your phone screen, avoid caffeine and practise meditation. Studies have shown that as little as two minutes of mindfulness meditation before bed can have a marked improvement on your sleep.
✔️ Exercise – but not too late in the day
One way to enhance the likelihood of a good night’s sleep is by doing regular aerobic exercise. As little as ten minutes of aerobic exercise, such as walking or cycling, can dramatically improve the quality of your nighttime sleep, especially when done on a regular basis.
However, don’t try to squeeze your fitness routine in just before bed. Exercise will activate a host of bodily functions, which will then need to recuperate. If you exercise too close to bedtime, the endorphins released can keep you awake, but if you have enough time to cool down (around two hours beforehand) it can help tire out your body.
✔️ Avoid alcohol and drugs
Substances such as alcohol and cannabis can have a short initial effect on sleep, making it easier to fall asleep. But this effect always diminishes after some period of use, as the body gets used to the substance. Your sleep quality will also worsen – you’ll find you experience less deep sleep and wake more easily in the night – because your body has to decompose the added substance.
✔️ Stop screen time
Your brain will start to wind down and become tired if you engage it in activities such as reading, writing or listening to music. On the other hand, watching a TV show or scrolling through social media is too passive and will, therefore, keep your brain engaged and awake.
✔️ Consider your diet
It’s worth considering your food and drink choices. Consuming stimulants, such as caffeine and sugar, before bed will make it hard for you to relax and fall asleep. Caffeine, for example, blocks the receptors in your brain that make you drowsy, preventing you from reaching deep sleep.
✔️ Seek professional support
If you suspect you suffer from insomnia, I recommend you seek professional help from a cognitive behavioural therapist who works with sleep restriction therapy combined with stimulus control, which is the most efficient therapy for insomnia over a sustained period.
✔️ Be careful with sleep medication
Remember that sleep medications are only recommended to use in an acute situation, for the first two to three weeks. We don’t have evidence that sleep medications are effective for a longer period of time, but we do know that some sleep medications can be addictive, physiologically or psychologically.