Sleep Disorders & Mental Health

How Connections Between The Two Impact Treatment

There’s a strong connection between mental health and sleep disorders, but it’s hard to tell what comes first—do mental health issues negatively impact sleep or does sleep contribute to issues with mental and emotional wellness? How pervasive is the connection? In this article, we sought to look at some common sleep disorders that are linked with mental health conditions and vice versa to explore some of the interesting ways these comorbid challenges are currently treated.

According to this article from Harvard Health, “Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).” And in fact, the article goes on to explain that, “studies in both adults and children suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders.” As a result, this article suggests that treatment of a sleep disorder could potentially help alleviate some of the symptoms of co-occurring mental health problems.

Looking at the more common sleep disorders—such as sleep apnea, insomnia, narcolepsy and parasomnias (sleep walking, talking or irregular movements during sleep)—there’s much crossover between these issues and some of the more common mental health disorders in the US, like depression, anxiety, bipolar and ADHD. From the perspective of this article, it’s less that sleep issues cause mental health disruptions or vice versa, and more that sleep disorders and mental health conditions are two sides of the same coin.

For example, individuals with depression often experience insomnia and in this case, it is often the sleep deprivation that gives way to the depressive thinking. Insomnia can help a clinician recognize the risk for depression, in some ways it can be a precursor. So in treating insomnia, it might be possible to reduce some of the depressive symptoms in a patient.

However, for an individual already diagnosed with bipolar, a bout of  insomnia can be an indicator that a manic episode is coming. In that case, disordered sleep becomes more of a symptom than a cause. If a doctor is able to recognize that that sleep issue could be leading up to the more disruptive effects of bipolar disorder, treating the insomnia can help make an individual’s mental health issues more manageable, mitigate the severity of a manic episode or avoid a full psychiatric break.

While examples of comorbid sleep disorders and psychological conditions could go on and on, the circular nature of the link between them is really hopeful, because regardless of what causes what, most times treating one side of the issue or the other can greatly improve an individual’s overall wellbeing. And, due to this intrinsic link, it makes sense that certain therapeutic approaches can be applied to both psychological and sleeping disorders.

In the instance of insomnia, the most common sleep disorder, there are two main types of therapies that are often employed:

1. Cognitive Behavioral Therapy

The main therapeutic approach used for sleep disorders is called Cognitive Behavioral Therapy (CBT). CBT is an umbrella name for a collection of therapeutic techniques that focus on breaking and redirecting negative thought and behavioral patterns by establishing new and healthier  routines and rituals.

This type of therapy challenges participants to identify both negative thoughts and behaviors, challenge them, then replace them with new and healthier ones. Some specific techniques within the approach that are specifically used for insomnia include:

Stimulus control therapy: This serves as a means to think through and identify certain stimuli patterns that might be preventing an individual from relaxing for sleep (like watching TV or working in the bedroom). Controlling stimuli can help people learn to relax in a space by simply altering the way it is used.

Relaxation training: Using a series of muscle relaxation techniques, mindfulness meditation and breathing exercises, individuals can learn to relax their bodies and minds in an effort to get better sleep.

2. Light Therapy

Using brighter light in the morning and more calming light exposure when it’s time to go to bed, light therapy is a way to ensure that individuals are getting healthy exposure to the types of light that signal when the brain should be active and alert and when it’s time to relax. Blue light is a brighter kind of light, and so for many people the regular exposure to blue light late at night brought on by phone, computer and television usage can delay the brain’s natural sleep cycles.

The link between sleep and mental health disorders is a salient reminder that no matter what is ailing a person, taking a holistic approach to understanding and treating the issue is normally the best bet. This is because there are so many factors that come into play when it comes to mental health, sleep disorders and other physical ailments including sleep hygiene, diet, exercise, work life balance and social wellbeing. Taking these factors and more into consideration will lead to more thorough and long lasting treatment plans.

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