Sleep and its impact on Mental Health

One night of poor sleep can leave us feeling grumpy, irritable, and fatigued and often restricts social and work activities the next day.

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Consecutive nights of poor sleep, on the other hand, can often leave us wondering if there is a deeper complexity at the heart of it, like depression.

But is depression and anxiety a by-product of poor sleep or is it the other way around? The answer is, it could be true either way.

According to Dr Alison Bentley, sleep expert and chairperson of the South African Society for Sleep and Health, sleep and mental health are very closely linked.

“One may experience daytime symptoms like those of depression when we sleep poorly and experience anxiety when we battle to fall asleep.

“If we get a good night’s sleep, we feel much better during the day and our anxiety about falling asleep fades,” said Bently.

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“The anxiety is usually very specific to lack of control of sleep and not associated with anything else. In this case, good treatment of insomnia tends to resolve depressive and anxiety symptoms.

“Up to 70% of people who have major clinical depression or generalised anxiety disorder will have insomnia as a secondary symptom of those mental health problems.

Most mental health disorders present with poor sleep as a symptom, including post-traumatic stress disorder (PTSD) and bipolar disorder.

In these cases, a few nights of good sleep will not solve the depressive or anxiety symptoms.

Trying to ‘treat’ insomnia alone in these cases is unlikely to resolve any of the symptoms – and insomnia may become resistant to treatment.

“It’s important to understand that there are different types of insomnia. When we are exposed to sudden stress it causes a few nights of bad sleep and is called short-term insomnia. Most people, once the stress has worn off, will go back to sleeping normally,” said Bently.

“Chronic insomnia, on the other hand, is defined as sleep difficulties for more than three months. It is maintained by anxiety about falling asleep as well as a change in sleep behaviours which seem logical, but promote worsening sleep,” added Bentley.

The treatment protocols for insomnia start with understanding the quantity of sleep and the collection of data to monitor sleep.

Since none of the laboratory tests like blood tests or X-rays can be used to diagnose insomnia, having a detailed sleep journal becomes critical.

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By learning details about your sleep and changing some of your sleep behaviours you can start to build good sleep habits.