Even When Mental Health Problems Precede Disrupted Sleep The Lack Of Sleep Might Exacerbate A Person’s Difficulties
His colleague, the clinical psychologist Daniel Freeman, has called for sleep problems to be given a higher priority within mental health care. Because they are common across different diagnoses, they don’t tend to be viewed as central to a particular condition. He feels they are sometimes neglected, when they could be tackled.
Even when mental health problems precede disrupted sleep, the lack of sleep might exacerbate a person’s difficulties. After all, just one night of sleep deprivation has a well-established negative impact on mood and thinking.
The complex relationship between sleep and mental health is further reinforced by the finding that if you treat depression, the problems with sleep don’t all disappear. It’s easy to see how psychological treatments which help people reduce ruminating over negative thoughts could also result in them falling asleep more easily. But in 2020 Shirley Reynolds, a clinical psychologist at Reading University, and her team trialled three different psychological treatments for depression. They worked equally well in reducing depression, but only sorted out the sleep problems for half of the participants. For the other half, the insomnia persisted, suggesting it was independent of their depression and needed to be addressed separately.
A deficit of sleep has well-established negative effects, including a tendency to withdraw from friends and family
Before And After You Consult A Sleep Specialist On The Relationship Between Lack Of Sleep And Depression
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Does Depression Cause An Unusual Sleep Pattern Or Does An Unusual Sleep Pattern Cause Depression
Many people with depression experience poor sleep, either in the form of sleeping too little or too much.
In fact, when people seek treatment for poor sleep, many of them also exhibit symptoms consistent with depression2. Conversely, people seeking treatment for depression will often complain of poor sleep3.
‘Poor sleep’ can entail:
- Taking a long time to fall alseep
- Waking up frequently during the night
- Lying awake for a large period of the time spent in bed
- Not feeling refreshed after time asleep.
All of this can culminate in the low mood, difficulty concentrating, lethargy and daytime tiredness that people living with depression are all too familiar with2.
Even though the sleep that those with depression experience is poor, that’s not to say that depression causes a lack of sleep. In fact, many people living with depression experience hypersomnia, the condition of sleeping too much.
Nevertheless, if that sleep is poor quality sleep then it won’t help daytime functioning.
It’s also a sad fact that a link has been observed between extremes of sleep time and suicide risk but this may not be attributable directly to depression4.
At this point, it’s worth asking ‘why does depression affect sleep?’
Did You Know That Changes In Your Sleep Habits Are One Of The Most Common Effects Of Depression
Lack of sleep can be a symptom of depression, an effect of depression and a contributing factor to worsened depression.
Depression and sleep are closely related, which makes sense since depression affects many types of brain functions including the sleep-wake cycle of our body. Once our biological clock has been disturbed, our sleep patterns can be even more irregular and eventually this can become a vicious cycle for many people.
So Perhaps Persistent Issues With Sleep Need To Be Taken More Seriously In Teenagers And Adults
Foster is convinced that from a biological perspective, the best way to disentangle the web of correlation and causation is by studying the impact that disruption of circadian rhythms could be having on the brain. He says we need to look at the complex interactions between multiple genes, brain regions and neurotransmitters to understand what’s happening.
So perhaps persistent issues with sleep need to be taken more seriously in teenagers and adults. Sleep interventions are straightforward, and in some cases successful. What is already clear, from a meta-analysis of 49 studies, is that tackling poor sleep among those with insomnia, who are already experiencing symptoms of depression, not only helps them sleep better but also reduces the depression.
Insomnia and mental health issues can exacerbate each other
The large Oasis trial led by Daniel Freeman across 26 universities in the UK found that digital cognitive behavioural therapy for students with insomnia, not only helped them to sleep, but reduced the occurrence of hallucinations and paranoia, symptoms of psychosis.
Getting Better Sleep Won’t On Its Own Solve The Mental Health Crisis Of Course
Getting better sleep won’t on its own solve the mental health crisis, of course. But could it make a difference in the long run? Even if it doesn’t, as sleepy teenagers know, even for its own sake, there’s nothing better a good night’s sleep.
If you liked this story, , called “The Essential List”. A handpicked selection of stories from BBC Future, Culture, Worklife, and Travel, delivered to your inbox every Friday.
Depression Can Look Different Depending On A Persons Cultural Background
Signs and symptoms of depression can look different depending on the person and their cultural background. People from different cultures may express emotions, moods, and mood disorders — including depression — in different ways. In some cultures, depression may be displayed as physical symptoms, such as aches or pains, headaches, cramps, or digestive problems.
The Health Risks Associated With Depression And Sleep Disturbances
Depression and sleep disturbances can take a toll on your physical health if left untreated. One 2010 study found that lack of sleep was associated with a higher risk of early death.?? Lack of sleep increases the risk of heart disease and failure, heart attacks, high blood pressure, stroke, diabetes, and obesity.
Depression can constrict blood vessels, which may increase your risk of heart disease. People with depression may experience a weakened immune system, aches and pains, and fatigue.
Why Do I Sleep So Much Understanding The Proper Amount Of Sleep
The ideal amount of sleep varies from person to person.
According to the National Sleep Foundation , the average sleep time is seven to nine hours. Although there is nothing wrong with extending your hours of sleep, an underlying condition may be making you fall asleep longer than expected. It is also possible that your sleep style is not that effective, so you wind up adding an hour or two to compensate. There is also a category of people known as “long sleepers” who sleep for nine to 10 hours and still function well. Long sleepers feel groggy when they sleep less .
The NSF also states that sleeping for seven to nine hours is considered normal and healthy for people 18 to 64 years old.
Mechanisms Of Sleep Regulation And Disturbances In Depression
Research over the past 25 years has revealed that the sleep-wake cycle is regulated by two separate but interacting processes, the circadian process and the homeostatic , or recovery process.
The C process is that which regulates the daily rhythms of the body and brain. Circadian patterns of activity arc found in many organs and cells, and the main circadian pacemaker is found in a group of cells in the suprachiasmatic nucleus of the hypothalamus. These cells provide an oscillatory pattern of activity which drives rhythms such as sleep-wake activity, hormone release, liver function, etc. This drive from the SCN is innate, self-sustaining, and independent of tiredness or amount of sleep. It is affected markedly by light and to some extent by temperature. Bright light in the evening will delay the clock, and bright light in the morning is necessary to synchronize the clock to a 24-hour rhythm; in constant light or darkness the cycle length is about 24.3 h. All animals have such a clock, and the period and timing appear to be dependent on particular genes, which are similar in fruit flies and mammals.
How Treating Depression Can Affect Lack Of Sleep In Patients
Treating insomnia can also help patients exhibit reduced symptoms of depression. But researchers warn that it is important to address the depression that exists independently of the sleep issues, to ensure that the patient will have less trouble getting restful sleep.
Researchers say it’s a chicken or the egg question when it comes to figuring out what came first- the insomnia or the depression.
Why Depression Makes You Tired And How To Deal With Fatigue
- Fatigue is one of the most common symptoms of depression.
- If you are depressed, it’s likely that you will lack energy and feel tired physically, emotionally, and cognitively.
- Depression can also make sleep less restful and restorative — here’s how to get better sleep and feel less tired.
- This article was medically reviewed by David A. Merrill, MD, PhD, psychiatrist and director of the Pacific Brain Health Center at Pacific Neuroscience Institute at Providence Saint John’s Health Center.
- This story is part of Insider’s guide to Depression.
For people with depression, feeling tired is an all-too-common symptom. “Tiredness or fatigue is one of the hallmarks of depression,” says Amy Ricke, MD, of Your Doctors Online.
With depression, energy levels dip, and many of the symptoms, such as profound sadness and loneliness, can further exacerbate fatigue. Here’s why depression makes you tired, how to tell if it’s the cause of your fatigue, and how you can feel more refreshed and well-rested.
Why Sleep Deprivation Alleviates Depression In Some People
Posted July 17, 2011
Ever since Vogel’s studies in the 1970s it has been known that acute sleep deprivation, particularly deprivation of REM sleep, produces a positive effect on people with depression. The extremely depressed person feels much better if he goes without REM sleep for a night or two. The suicidally depressed patient may forget the idea of suicide for a few hours or days if he is deprived of REM for a night or two. These basic observations have been confirmed many times since the 1970s but the question as to how REM deprivation helps depression has been left unanswered.
Despite the dramatic beneficial effects on serious depression we still have no idea as to why REM deprivation alleviates, at least temporarily, major depression. This is a very surprising fact. You would think that any clue or lead on what kinds of treatment work for major depression would be followed up on with major pushes in the research arena backed up by major funding streams from the National Institutes of Health. But the voices of depressed people, apparently, are not as loud as the voices of other health-related interest groups so funding for depression studies has never been adequate to the scale fo the problem.
A recent study, however, has managed to throw some fascinating light on the relations between acute sleep deprivation and alleviation of depression.
Why Do I Sleep So Much Insomnia Role In Sleep Deprivation
A lot of people have this sleep disorder.
Difficulty falling asleep at night or trouble staying asleep can be frustrating and affect your circadian rhythm. Not treating your insomnia can lead to long-term negative effects. You may find yourself oversleeping to make up for lost sleep. If you suffer from insomnia medical professionals may recommend medications for a good night’s sleep.
Reduced Rem Sleep Latency And Increased Rem Sleep Density
There’s a link between REM sleep and depression as well. Patients who are struggling with depression often have a reduced REM sleep latency as well as increased REM sleep periods in the early night which leads to an increase in REM sleep quantity. Additionally, depressed patients’ REM sleep is marked by a greater frequency of rapid eye movements than in control patients’ REM sleep.
This increase in rapid eye movements does become normal when the individuals go into remission, whereas the reduced REM sleep latency continues. Also, reduced REM sleep latency has been found in first-degree relatives not impacted, which suggests a potential genetic link between major depressive disorder and REM sleep latency.
This extra REM sleep appears to come at the expense of slow-wave sleep or stage N3 sleep. There is not only a decrease in time spent in slow-wave sleep in individuals with depression compared with control patients, but the slow-wave activity distribution, an SWS intensity marker, is irregular.
Iii What Happens When I Am Referred To A Sleep Specialist
It is a good idea to fill out a daily sleep diary for two weeks before you visit a sleep specialist. This will serve as an aid to help the doctor see your pattern of sleep. It may also provide clues as to what is causing your sleep problem.
The specialist will also complete an interview with you. This will cover both your sleep habits and your medical history. You can look over the Evaluation Tools on this site for examples of the kinds of questions you may have to answer. The information you provide during this visit will help the specialist detect any sleep or depression problems you may have.
The specialist may determine that your troubles are the result of a sleep disorder. Further evaluation at a sleep center would then pinpoint the cause of the problem. If depression seems to be the source of your sleep problems, then testing in the sleep center may still be helpful.
People with depression tend to show abnormal deep sleep and dream sleep patterns. This would clearly show up during work done at a sleep center. These results would help insure that you are prescribed what you need to solve your problem. The sleep center can then begin your treatment and also refer you to other doctors as needed.
So What Does Sleep Or The Lack Of It Have To Do With It
Just like many of the reasons listed above, losing sleep or having a sleep disorder can either cause or make the condition worse. In fact, nearly all psychiatric disorders are linked to some sort of sleep issue.
The Harvard Health Newsletter points out that sleep disorders were traditionally considered symptoms of a condition. However, recent studies have concluded that these sleep issues “may raise the risk for, and even directly contribute to, the development of some psychiatric disorders.” This is evident across both sleep health and mental health studies.
“Sleep disturbances-(particularly insomnia – are highly prevalent in anxiety disorders and complaints such as insomnia or nightmares have even been incorporated in some anxiety disorder definitions, such as generalized anxiety disorder and posttraumatic stress disorder,” Staner said.
Harvard Health agrees with this describes but they go further by describing the neurological connection between the two:
“Sleep disruption — which affects levels of neurotransmitters and stress hormones, among other things — wreaks havoc in the brain, impairing thinking and emotional regulation. In this way, insomnia may amplify the effects of psychiatric disorders and vice versa.”
What’s The Link Between Sleep Disorders And Depression
An inability to sleep is one of the key signs of clinical depression. Another sign of clinical depression is sleeping too much or .
Having a sleep disorder does not in itself cause depression, but lack of sleep does play a role. Lack of sleep caused by another medical condition, a sleep disorder, or personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.
Depression Acts On Neurotransmitters To Make You Tired
Depression is likely associated with changes in brain neurotransmitters, such as dopamine, norepinephrine, and serotonin. “These neurotransmitters play important roles in regulating energy levels, sleep, appetite, motivation, and pleasure,” Ricke says.
According to Harvard Health Publishing, depression is a complex disease with many possible and interlinked causes, including genetics, medical conditions, stressful life events, and brain chemistry. And it can be challenging to tell the difference between everyday tiredness and depression-related fatigue.
“Fatigue and depression can look quite similar,” says Alex Dimitriu, MD, psychiatrist and sleep medicine expert, and founder of Menlo Park Psychiatry & Sleep Medicine.
How Do You Know If Its Sleep Deprivation Or Depression
Since there is a connection between sleep disorders and clinical depression, some people might have trouble distinguishing the two, especially if they have never been diagnosed.
Sleep deprivation is quite common. Many people regularly go through episodes of sleep deprivation when they are pulling all-nighters for work or studying, when taking care of a newborn, or when jet lagged. Sleep deprivation’s main symptom is daytime sleepiness, excessive yawning, irritability, feeling “fuzzy”, depressed mood, short-term memory loss, clumsiness, sluggishness, and increased appetite.
The good news is, sleep deprivation and its symptoms are relatively easy to treat. First and foremost, you must get your sleeping habits back on track. This might require some lifestyle adjustments or even medication, like over the counter drugs like melatonin or possibly even a prescription drug.
Depression typically includes a prolonged period where the person loses interest in their usual activities and are unable to experience pleasure in things they used to enjoy. The person may experience sudden weight loss or unexpected weight gain. Insomnia and hypersomnia are also common. Expect fatigue, exhaustion, and lack of energy and motivation as well.
Managing sleep your sleep problems can have positive effects in alleviating your depression. Below are some tips that can alleviate your symptoms.
The Treatment Of Insomnia Disorder Without Depression
Sedative-hypnotic drugs are commonly used for the treatment of insomnia, but long-term use of such drugs may lead to tolerance and even exacerbate sleep disturbances., Sedating antidepressants at low dosages are often prescribed to insomnia patients. The TCA amitriptyline, trimipramine and doxepin, the serotonin antagonist and reuptake inhibitor trazodone and the tetracyclic antidepressant mirtazapine have been found to improve total sleep time and sleep efficiency and reduce wake after sleep onset and latency to persistent sleep., However, due to the lack of randomized clinical trials, only doxepin is approved by FDA and recommended for the treatment of insomnia. Moreover, different antidepressants may in turn cause different sleep disturbances, such as RLS, sleep bruxism, REM behaviour disorder and nightmares, as well as weight gain, which is contraindicated in patients with obstructive sleep apnea., – In our opinion, sedative antidepressants are safe in low doses, for example, for doxepin as low as 3-6 mg, which can be applied in patients when hypnotics are contraindicated, for example, elderly patients, patients with sleep apnea and patients with a history of alcohol and substance abuse.
Talk To Your Doctor About Depression And Sleep Issues
If you’re experiencing depression, sleep disturbances, or both, it’s important to seek help.
It’s also important to talk to your doctor if you’re experiencing depression and hypersomnia, or excessive sleepiness. The Centers for Disease Control and Prevention found that fewer than 20 percent of Americans who had moderate depressive symptoms had seen a mental health practitioner in the previous year. Medicines and therapy usually can help reduce depression and improve sleep.
It’s also possible there’s a more direct link between sleep and depression. People successfully treated for obstructive sleep apnea experienced lasting and reduced depression symptoms, according to the NSF. A sleep study can determine whether or not you have sleep apnea.
Before seeing a doctor about depression and sleep issues, it’s helpful to track your sleep for a few weeks so you can share examples of your sleep schedule, sleep quality, and how you felt emotionally during that time.
The doctors at UPMC can help you sleep better and tackle your depression. Whether you’re suffering from depression and sleeping a lot or not getting nearly enough rest, there’s no need to suffer alone.
Ii If I Don’t Sleep Well Does That Mean I’m Depressed
There are many things that can keep a person from sleeping well. Depression is only one of these causes. Young people under the age of 30 or 40 often have a hard time falling asleep when they are depressed. It affects older people in a different way. People over 40 are more likely to wake up during the night when they are depressed.
Many times, depression is not the cause of sleepless nights. Instead, feelings of depression can be the result of having a problem with your sleep. People often have a hard time sleeping at night due to a sleep disorder. Obstructive sleep apnea is one of the most common sleep disorders. It causes you to stop breathing many times as you sleep. These pauses in breathing wake you up through the night. This makes you very sleepy the next day.
Periodic limb movement disorder also disrupts your sleep. It makes your leg muscles tighten or flex in a way that you are unable to control. This can also wake you up through the night. These are just two examples of the many sleep disorders that can keep you from getting a good night’s sleep.
You should talk to your doctor if you struggle with feelings of depression for more than two weeks. If it appears that a sleep disorder is the source of your problem, then a visit with a sleep specialist will also be helpful.
Why Do I Sleep So Much How Sleep Apnea Affects Sleep
Sleep apnea is another disorder that can lead to longer sleeping hours. Symptoms include snoring and gasping during sleep because the airways are obstructed. This disrupts the sleep cycle and creates a need for more sleep.
Medical professionals can help diagnose, monitor, and treat this condition. When you have sleep-disordered breathing, it is important to get it checked as soon as possible.
The Connection Between Sleep Disorders And Depression
One of the more common and pronounced symptoms of people suffering from depression is erratic sleeping patterns. In its simplest terms, people manifesting this symptom either sleep too little or sleep too much. Irregular sleeping patterns can directly affect our mood and disposition, exacerbating any signs of depression.
The human body is a complex machine. Our different bodily systems, our psychology and physiology, interact with one another in such a way that the “cause” and “effect” of something might not be so clear-cut. An excellent example of this is the relationship between sleep and our physical and psychological health. Sleeping returns the body to a much-needed restorative state.
Loss of sleep, no matter how minimal, will affect your immunity. Thus, getting enough sleep is essential for a healthy immune system. Chronic lack of sleep will put you at higher risk for many health issues such as heart disease and diabetes. Having a good night’s sleep can improve your memory retention, ability to concentrate and focus, and will help your logical reasoning and overall cognitive ability.
It’s hard to feel motivated and enthusiastic about your everyday life when you are in a depressive funk. This is a chemical imbalance, a real impairment of the brain. People cannot just snap out of it or will themselves out of depression.
The Rem Theory Of Sleep And Why Its Not Quite Right
Sleep consists of a number of stages, one of which is termed REM sleep. The REM stage of sleep is linked to dreaming. Strangely enough, when in REM sleep, our brain activity levels are similar to what they would be when we’re awake.
There are a few non-REM stages as well and the most important is slow-wave sleep. That’s the type of sleep we need to feel refreshed in the morning.
When we sleep, we alternate between REM and non-REM stages. But it’s been found that people living with depression spend a greater amount of their sleep time in the REM stages of sleep56. This altered sleep behaviour persists in people who have a history of depression but are not currently suffering an episode7.
This has led to the idea that increased REM sleep leads to depression. This is something you’ll often see written on other sleep websites and in earlier scientific literature but it isn’t strictly true.
A more helpful way to understand the sleep disturbances those with depression experience is to think of their sleep cycle being somewhat ‘shifted’. This disruption leads to mood disturbances like depression.
As a result of this ‘shift’ it would seem that depressed populations experience less restorative slow-wave sleep during their time in bed, which may lead to a mood disturbance.
It also means that people living with depression experience REM sleep earlier in their night. That may have led earlier researchers to the conclusion that increased REM sleep leads to depressive illness.