For decades, researchers conducted hundreds of clinical studies and laboratory experiments to figure out the adverse effects of poor sleep on mental health.
This led to identifying numerous mental disorders that get triggered by poor sleep, including depression, anxiety, and cognitive decline.
With that said, achieving this purpose is no easy task since it’s quite challenging to attribute any organic or psychiatric illness to poor sleep alone. This is because individuals with mental disorders often have other concurrent medical conditions that may play a role in this ordeal.
In this article, we will discuss the effects of poor sleep on mental health and how it can predispose to several psychiatric disorders.
Before we dig into more details about this issue, we first need to define healthy and poor sleep.
The definition of healthy sleep
According to the National Sleep Foundation, the definition of healthy sleep includes several elements, including:
- The short duration between lying on the bed and falling asleep
- Regular sleep that lasts 7–9 hours every day
- Non-interrupted sleep during the night
- Feeling energized in the morning
- Being able to be productive on the next day
- The absence of any abnormal behaviour associated with sleep, such as snoring, sleep apnea, or restlessness
Insomnia is a widespread condition that affects a large portion of the population. The exact causes of insomnia are multifactorial and involve several components, including stress, anxiety, and poor sleep hygiene.
In fact, researchers estimate that around 24-36% of insomniacs also have some anxiety disorder.
The second type of sleep disorder is hypersomnia, which refers to sleeping excessive hours every night. These patients also experience daytime sleepiness that negatively impacts their professional and personal lives.
Of course, insomnia is way more prevalent than hypersomnia. It could lead to serious health complications, such as an increased risk of several ailments and the weakening of the immune system (insert the link of the previous article).
People often associate insomnia with facing difficulties when trying to fall asleep; however, the definition of insomnia extends beyond that.
For instance, if you fall asleep easily but wake up multiple times during the night, it is called maintenance insomnia, which means you’re unable to maintain sleep.
In summary, there are several types of sleep disorders that wreak havoc on the entire body, including your cognitive function. Insomnia, hypersomnia, and obstructive sleep apnea are by far the most common.
How do you know if you have insomnia?
According to the Diagnostic and statistical manual of psychiatric disorders V, or DSM-V for short, insomnia is part of a broad spectrum of sleep disorders that also entails narcolepsy and sleepwalking.
For most people, insomnia is synonymous with difficulty falling asleep; however, the DSM-V also classifies insufficient sleep and difficulty maintaining it as types of insomnia.
Here are some signs and symptoms of insomnia:
- Difficulty falling asleep
- Difficulty maintaining sleep
- Feeling exhausted and drowsy during the day
- Non-refreshing sleep (exhaustion even after sleeping)
- Distractibility and reduced concentration
Insomnia is further divided into two types depending on its duration. We have acute insomnia, which lasts for several nights to weeks and can often be attributed to certain life events, such as stress and anxiety.
On the other hand, we have chronic insomnia, which must occur at least three nights a week for longer than three months.
Chronic insomnia is challenging to deal with since the underlying cause is usually unidentified.
What is the relationship between anxiety and insomnia?
The relationship between anxiety and insomnia is intertwined. In other words, one can cause the other and vice versa.
How anxiety causes insomnia?
During the night, everything is quiet, and as a result, your brain would have more time to overthink every aspect of your life, such as how your day went, what mistakes you committed, and what could have been done differently.
This constant overthinking can be very disruptive to sleep as it puts you on edge.
Moreover, the sympathetic nervous system (i.e., fight or flight system) is always activated when you’re anxious, which leads to high levels of catecholamines (e.g., epinephrine, norepinephrine, dopamine) circulating in your bloodstream, and as we all know, epinephrine is the last hormone you want in your blood if you to fall asleep.
How insomnia causes anxiety?
Many individuals report dealing with insomnia way before their anxiety kicked in.
This is partially due to the vicious cycle created by the two conditions. You are facing difficulties falling asleep, which makes a sense of fear whenever you go to bed. As a result, you start experiencing “anticipatory anxiety” when you think about sleep.
Eventually, anxiety will develop, and the two conditions start to feed on each other in a vicious cycle.
Poor sleep and stress
Sleep deprivation is a significant trigger of stress, which could become a chronic condition with devastating consequences.
This issue can make it very challenging to deal with day-to-day stressors, turning daily hassles into a great source of frustration. You will start experiencing irritability, short temper, grumpiness, and other mood disturbances.
According to estimates, over 300 million people worldwide deal with depression, which is a type of mood disorder.
Out of these patients, 75% show symptoms of insomnia or hypersomnia. In fact, sleep disturbance is a key symptom to diagnose depression.
In the past few decades, researchers believed that sleep disorders were the consequence of depression; however, recent evidence suggests that poor sleep itself can trigger or at the very least exacerbate depression.
Since we cannot find a cause-effect relationship between sleep disorders and depression, many experts settled on considering these two conditions to have a bidirectional relationship, where the first one triggers the other and vice versa, creating a negative feedback loop.
This could potentially open a new avenue in the treatment of depression. For instance, focusing on improving sleep quality in depressed people may benefit their symptoms of depression.
Seasonal Affective Disorder
Seasonal affective disorder, or SAD, is a common subtype of depression that affects people during the autumn and winter seasons, where daylight becomes shorter.
Researchers believe that the cause of SAD relates to the low levels of melatonin and serotonin due to poor sunlight exposure.
There is also a relationship between Seasonal Affective Disorder and lower levels of vitamin D.
Interestingly, SAD is closely connected to the circadian rhythm, which explains why these patients either sleep too much or too little.
Bipolar disorder describes frequent episodes of mood shifts that range in the extremes:
- Mania – feeling euphoric and hyper
- Depression – feeling sad and down
Unfortunately, switching between these two moods can wreak havoc on the patient’s quality of life and day-to-day activity.
According to research, people with bipolar disorder tend to experience considerable sleep pattern changes depending on their emotional status.
For instance, during manic episodes, these individuals sleep less and rather focus on other activities. Conversely, depressive episodes trigger an irresistible need for prolonged sleep.
Researchers also found that bipolar disorder presents with specific sleep patterns before the onset of a manic/depressive episode.
Furthermore, some evidence suggests that sleep problems worsen the symptoms of mania and depression.
Schizophrenia is a mental disorder characterized by a distorted view of reality. These patients suffer from the inability to distinguish what is and what is not real.
Schizophrenic individuals also tend to have sleeping problems, such as insomnia, which becomes worse with the antipsychotic medications used to treat this condition.
Poor sleep and the severity of schizophrenia symptoms are most likely to be mutually reinforcing, meaning that one condition can exacerbate the other.
Attention-deficit/hyperactivity disorder (ADHD) is a common medical condition that affects cognitive abilities, such as focus, attention, and behavioural control.
In general, this condition gets diagnosed during childhood, relying on three characteristics:
Sleeping problems are very common in ADHD. Consequently, patients may face difficulties falling asleep, waking up during the night, and daytime sleepiness.
Researchers also found that the incidence of obstructive sleep apnea and restless leg syndrome (RLS) is higher in ADHD patients relative to the general population.
Similar to other conditions on our list, there seems to be a bidirectional relationship between poor sleep quality and ADHD. In other words, sleep deprivation can be the result of ADHD and can also be a triggering factor of symptom exacerbation.
Autism Spectrum Disorder
Autism spectrum disorder (ASD) is an umbrella term that encompasses several neurodevelopmental conditions, which negatively impact communications skills and social interaction.
Like ADHD, ASD is mostly diagnosed during childhood, with symptoms persisting into adulthood.
The prevalence of insomnia and sleep disorders among children with ASD is higher than the general population, which suggests an underlying connection between the two conditions.
In fact, one crucial component of caring for patients with ASD is to address their sleep hygiene in an attempt to improve their sleep quality.
Eventually, the measures taken will lessen the frequency of behavioural problems.
Sleep, snoring, and social relationships
As you may know, snoring is a common sign of poor sleep, which can interfere with the quality and duration of your sleep. However, when you are in a relationship, this effect extends to affect your partner as well.
Consequently, you will have to deal with morning crankiness, poor judgment, and diminished thinking skills. You will also be irritated, short-tempered, and lose the ability to manage conflicts.
According to researchers, a lack of sleep also leads to less appreciation between couples, which means both partners will become more selfish.
Over time, this can become a focal point of frustration, blame, and shame in the relationship. Even more, the person who’s kept awake because of snoring may develop feelings of resentment toward their partner. Conversely, the snorer will be filled with feelings of guilt, shame, and helplessness.
All of these negative feelings could eventually push the couple to sleep in separate bedrooms to avoid affecting each other. While some couples don’t mind sleeping in separate bedrooms, others find this habit of being extremely damaging. After all, this means diminished sexual and emotional intimacy.
COVID-19 and sleep
While millions of people have to deal with snoring and its associated problems, COVID-19 may have just exacerbated the situation.
Now that most people have to work from home, the crankiness and feelings of resentment have only increased.
In the past, going to work and leaving the house served as a breather from all those negative feelings of shame, irritability, and blame. Today, you will have to deal with your partner all day, which may precipitate further gaps in the relationship.
For this reason, you need to be ready for steps that improve your sleep quality, prevent snoring, and slowly heal your relationship.
To make matters worse, a study conducted by Rush University Medical Center found that couples with one snoring partner argued more often than those without the snoring issue.
One participant from this study woke up eight times during the night because of her husband’s snoring. This severely impacted her ability to function during the next day.
The study also noted that couples with a snoring partner had higher rates of divorce.
According to Rosalind Cartwright, PhD, founder of the Sleep Disorders Center at the Medical Center, the lack of sleep creates a hostile environment that puts a strain on the marriage.
In another study by Paracelsus Private Medical University, researchers found that dealing with sleep disorders is often linked to more trouble in the relationship. Consequently, the chances of conflict the very next day of a sleepless night are relatively high.
Note that if you have any health problems that revolve around poor sleep quality, mental health disorders, or physical consequences of insomnia, you should contact your primary care physician for tailored medical care.
Poor sleep quality can severely impact your mental health by predisposing you to depression, anxiety, and other psychiatric disorders.
Hopefully, this article simplified the complicated relationship between sleep and mental health. If you still have questions about today’s topic, please don’t hesitate to ask in the comment section below.
To learn more about the benefits of healthy sleep, check out this comprehensive guide