Insomnia and mental health: how a restless night causes a restless mind

Insomnia is a condition that causes sleep deprivation. It can manifest as difficulty getting to sleep or difficulty staying asleep.

It is caused by hyperarousal. This means there is overactivity in your brain or your thoughts that are preventing you from sleeping. This overactivity can be triggered by many things like poor sleep hygiene, medications or other health conditions.

The key difference between insomnia and occasional sleep problems is that it impacts your daily life. It can affect concentration, memory, your physical health, social life and overall quality of life.

It also affects your mental health.

The main objective of sleep is to help your brain function. Each sleep stage helps different brain functions, many of which can influence mood.

Each night, your brain evaluates and remembers thoughts and memories. When this is disrupted, your brain is unable to recover from and adapt to distress.

One sleep stage closely linked to mood is Rapid eye movement (REM) sleep. It is the final stage where your brain activity is almost as high as it is when you’re awake. It is known as the stage where you have vivid dreams, but it also helps the brain process emotional information.

Research Trusted source Cell Press Peer-reviewed Journals Biological Science Research Go to source shows that restless REM is especially harmful to how your brain processes positive emotions. This affects your mood and your emotional reactivity. It can affect your mood.

Lack of sleep also affects concentration, memory, decision-making and many other cognitive functions. These can affect your work performance, social life and other things in your life. It also means you may be more susceptible to emotional stressors.

All of these factors may affect your mood.

Insomnia is categorised as a sleep disorder. But, it is closely linked to mental health disorders. Experts are not sure which causes which. However, it is believed that there is a bi-directional relationship.

Insomnia and depression

Clinical depression is a mental disorder that causes feelings of unhappiness, low self-esteem and hopelessness.

Up to 90% of people with depression have at least one insomnia symptom.

Insomnia is a recognised symptom of depression. One study Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source found that 83% of patients with depression had at least one insomnia symptom. They found the rates were higher in older adults at 90%.

It can also be a risk factor for depression. Another study showed that insomnia patients without depression had a 6.2 odds ratio of developing it in later life.

Some studies Trusted source The Journal of Clinical Psychiatry Peer-reviewed Journals Go to source have also shown that people with insomnia and depression are more likely to have suicidal thoughts. Sometimes, people with insomnia have intense suicidal thoughts even if they have no history of a mental disorder.

Insomnia and anxiety

Anxiety is a group of disorders that cause you to feel worried or nervous about something. In people with these disorders, the feelings are intense, hard to control and interfere with your daily life.

Like depression, insomnia is recognised as a clinical sign of most anxiety disorders. It is usually shown as a decreased total sleep time and duration. Many patients with both disorders also struggle with daytime sleepiness, sleep disturbance and restless, unsatisfying sleep.

Insomnia is particularly common in those with social anxiety. It is estimated that it occurs in two-thirds Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source of patients with social anxiety. It also co-occurs with panic disorder, phobias, generalised anxiety disorder (GAD) and many others.

Insomnia and schizophrenia

Schizophrenia is type a of psychotic disorder that can cause you to hear, see or believe things that are not real.

Sleep abnormalities are common in patients with schizophrenia. As many as 80% Trusted source Springer Peer-reviewed Journals Multidisciplinary Research Go to source of schizophrenia patients struggle with insomnia. Experts Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source believe it is caused by circadian rhythm problems.

Circadian rhythms are like a biological clock. They govern several processes, including sleep. They use light to help tell your body when to rest and when to be awake.

In people with schizophrenia, their circadian rhythms do not work properly. It may be due to lack of light exposure, issues with the brain responsible for maintaining the sleep-wake cycle or problems with melatonin production (the hormone that induces sleep).

Insomnia is also often an early sign of schizophrenia and plays a role in identifying at-risk patients.

As we mentioned, the relationship between the two conditions is bi-directional. This means that not only can insomnia cause mental health problems, but also that mental health can cause insomnia.

One way that it disrupts your sleep is with negative thoughts. Most people with mental illness will be up at night with what’s causing them to be depressed, anxious or stressed.

Many people struggling with their mental health may also engage in lifestyle habits that cause insomnia. For example, staying in bed all day may break the association that your bed is for sleeping. This may make it harder to fall asleep. Drugs, alcohol and smoking are common coping mechanisms, but also cause insomnia.

In addition, some medications cause sleep problems as a side effect. The most common culprits are SSRIs like sertraline or citalopram and SNRIs like venlafaxine or duloxetine.

Admitting you need help can be tricky for some. However, it’s important to seek help, especially if it’s causing you trouble sleeping.

The first step is to talk to your GP or access any mental health services from your school, university or workplace. They may be able to give you the advice you need.

Your GP may also be able to refer you to a specialist mental health service for advice and treatment. This may include medication or specialist talking therapies. This is beneficial if you have a more complicated mental illness.

Once your mental health improves, you should notice improvements in your sleep. However, if your problems persist, you may need to make some lifestyle adjustments.

If insomnia is the cause of your mental health problems, treating your sleep problems will help.

Sleep hygiene

Having good sleep hygiene is the first step when trying to treat insomnia.

This involves making sure your sleeping environment and routine are consistent and optimal for better sleep.

• Routine - have a consistent bedtime routine, go to sleep and wake up at the same time each day and avoid naps during the day.
• Environment - wind down 30 minutes before bedtime, cut out any light or noise that might keep you up and keep your room to the right temperature.

Getting sunlight during the day and using your bed only for sleeping will help reinforce your sleep-wake cycle.

Medication

For insomnia, an effective treatment is Melatonin.

It is a prescription medication that increases the levels of the hormone melatonin. Melatonin is the hormone that is produced when your brain recognises it’s time to sleep.

Increasing the levels of melatonin helps aid your natural sleep cycle. It also is a better alternative to traditional prescription treatment options which can often cause addiction.