Sleep Disorders and Mental Health

Reviewed by: HU Medical Review Board | Last reviewed: June 2020

Sleep disorders and mental health have a chicken and egg relationship. People with sleep disorders often have depression, anxiety, and other mental health issues. And, people with mental health issues often have insomnia, narcolepsy, restless legs syndrome, or sleep apnea.1-6

Plenty of evidence exists to prove that sleep disorders and mental health are closely tied, including:1-6

  • Doctors know that a bout of insomnia often begins in the days and weeks before a serious psychiatric episode.
  • Insomnia is one of the 9 symptoms used to diagnose major depression.
  • Substance use disorder is common in people with insomnia. People with insomnia and substance use issues are more likely to relapse.
  • Between 70 and 90 percent of people with post-traumatic stress disorder (PTSD) also have trouble falling asleep or staying asleep.
  • About 4 of every 10 people with RLS also have a psychiatric condition like depression, anxiety, or post-traumatic stress disorder (PTSD).
  • RLS can cause insomnia and insomnia is one of the 9 symptoms used to diagnose major depression.
  • People with narcolepsy have higher rates of depression, anxiety, attention deficit hyperactivity disorder (ADHD), bipolar disorder, and schizophrenia.
  • The worse the RLS symptoms, the more likely someone is to be diagnosed with a serious mental health issue.
  • People with sleep apnea are more likely to have depression, anxiety, and post-traumatic stress disorder (PTSD) than people without the sleep disorder.

Living better with a sleep disorder

It is possible to take steps to improve your mental health and your sleep disorder at the same time. It may take some trial and error to find which combination of lifestyle changes, relaxation techniques, and medicine work best for you.

Treating both sleep disorder and mental health

Doctors used to believe that mental health issues get better just by treating the sleep disorder. However, now they believe that most people should be treated for both conditions to find long-term healthy sleep. That means that taking your medicine for depression, anxiety, or bipolar disorder may help you get more sleep.

That said, some antidepressants make some sleep disorder symptoms worse, so your doctor will need to be careful which one you are prescribed. You also will likely need to include non-drug options like cognitive behavioral therapy, exercise, and lifestyle changes to find lasting results.2,7

Know yourself

You can learn what makes your sleep disorder symptoms worse, or better, by paying attention to your body. You may discover that you need to cut out caffeine or alcohol completely to be able to fall asleep each night. Or, you may find that a 30-minute walk and warm baths work for you, while cold medicine makes it worse. Self-awareness can be the first step in taking control of your symptoms.8

Exercise and massage

Regular, moderate exercise has been shown to improve symptoms of sleep disorders. Exercise that uses the legs, such as walking, running, biking, or swimming can be especially helpful for RLS. But any exercise can help improve your mood, release stress, and help you sleep better at night. Exercise releases endorphins that improve your mood and energy levels.8

Relaxation, meditation, and mindfulness

Deep, slow breathing is a good place to start if you find yourself tense and unable to sleep. Other relaxation techniques include taking a warm bath or practicing muscle relaxation. Guided meditation is another way to help you release anxiety and stress so that sleep comes more easily. However, learning meditation and relaxation skills take time. Be patient with yourself as you explore which mindfulness or meditation techniques work for you.

Increase social connections

People with sleep disorders sometimes isolate themselves at home because they feel tired and depressed. This is a reasonable reaction to a lack of sleep but isolation can make depression worse. Try to break the isolation by connecting with others online, through a hobby, sports, or volunteer work.

Stress reduction

Stress, worry, grief, and trauma make depression and anxiety worse. These feelings also make it hard to get a good night’s sleep. Finding help to process these underlying emotions can help you sleep better and lift your mood.2

Educate yourself

The more you understand about your sleep disorder and your mental health, its treatments, and your triggers, the more you can advocate for yourself and educate others. Consider attending a conference to learn more about the connection between mental health and sleep, and the latest treatments.

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