According to the Centers for Disease Control and Prevention (CDC), a third of adults in the United States report that they get less than the recommended amount of sleep each night. Because of this, it is important to understand how sleep affects mental health and well-being.
How Does Lack of Sleep Affect Mental Health?
It’s no secret that sleep plays an important role in good physical health. Lack of sleep is linked to a number of unfavorable health consequences including heart disease and type 2 diabetes. But how does sleep affect mental health? Research suggests that the relationship between sleep and mental health is complex. While lack of sleep has long been known to be a consequence of many psychiatric conditions, more recent views suggest that lack of sleep can also play a causal role in both the development and maintenance of different mental health problems. In other words, sleep problems can lead to changes in mental health, but mental health conditions can also worsen problems with sleep. Lack of sleep may trigger the onset of certain psychological conditions, although researchers are not completely certain of the underlying reasons for this. Because of this circular relationship between your sleep patterns and your mental state, it is important to talk to a doctor if you are having problems falling or staying asleep.
Brain Fog
Our brains need sleep to operate at full capacity. Lack of sleep can lead to brain fog, which often feels like confusion or trouble concentrating. You may find it’s more difficult to recall certain memories or find the right words for what you want to say when you didn’t get enough sleep the night before. You will probably find it difficult to be productive—the idea of certain tasks can feel completely overwhelming when your brain hasn’t had a full night’s rest.
Mood Changes
Not getting enough sleep may cause mood changes, including increased irritability. Participants in one study also experienced feelings of anxiety and depression as a result of sleep deprivation. Research finds that lack of sleep can lead to increased levels of anger and aggression. This is because when sleep-deprived, the brain cannot function normally, which means it can’t suppress the reactivity of the amygdala (the emotional center of the brain).
Behavior Changes
Along with mood changes may come unusual behaviors. Lack of sleep can lead to increased impulsivity, hyperactivity, and emotional outbursts. We might notice that we struggle to interact with other people when we’re sleep-deprived. You may act erratically and feel like you have a short fuse—maybe you yell at someone for making a mistake at work, or leave the room completely if someone says something that annoys you.
Stress
Poor sleep can make it much more difficult to cope with even relatively minor stress. Daily hassles can turn into major sources of frustration. You might find yourself feeling frazzled by everyday occurrences. Thinking about your poor sleep quality can even be a source of stress. You know that you need to get a good night’s sleep, but then find yourself worrying that you won’t be able to fall or stay asleep (which can also keep you up at night).
Psychotic Symptoms
Severe sleep deprivation is linked with the development of temporary psychotic symptoms. One study found that some participants who went 24 hours without sleep experienced hallucinations and other perceptual changes; others who went 60 hours without sleep experienced both hallucinations and delusions.
Impact of Sleep on Mental Health Conditions
Sleep can greatly impact symptoms of mental health conditions. Though more research is needed on the subject, researchers also suspect that sleep can contribute to the development of mental health conditions.
Depression
Insomnia and other sleep problems can be a symptom of depression, but more recently, research has implicated lack of sleep in actually causing depression. One analysis of 21 different studies found that people who experience insomnia have a two-fold risk of developing depression compared to those who do not have problems sleeping. The question, then, is whether helping people improve their sleep might actually lessen their chances of developing depression.
Anxiety
As with many other psychological conditions, the relationship between sleep and anxiety appears to go in both directions. People with anxiety tend to experience more sleep disturbances, but experiencing sleep deprivation can also contribute to feelings of anxiety. This can become a cycle that perpetuates both sleep and anxiety issues. Additionally, sleep problems appear to be a risk factor for developing anxiety disorders. One study found that problems with sleep were a predictor for generalized anxiety disorder in children and teens between the ages of nine and 16. Those who struggle with sleep problems may be more likely to develop an anxiety condition, particularly if their sleep problems are prolonged and left untreated.
Post-Traumatic Stress Disorder
Sleep deprivation is not only a common symptom of post-traumatic stress disorder (PTSD) affecting between 80% to 90% of people with the condition, but it is also believed to play a role in both the development and maintenance of this disorder.
Bipolar Disorder
Sleep disturbances are very common among people with bipolar disorder. Such problems can include insomnia, irregular sleep-wake cycles, and nightmares. Reduced sleep can also cause symptoms of mania or hypomania. If you have bipolar disorder, be sure to talk to a doctor about any sleep difficulties that you may be having.
ADHD
Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric condition, affecting as many as 5.3% of children between the ages of six and 17 years old. ADHD is associated with sleep problems, and research also suggests that sleep disturbances may be a predictor or even a contributor to symptoms of the condition. Studies have found that between 25% and 55% of children who have ADHD also experience sleep disturbances.
Eating Disorders
Research suggests that most people with eating disorders (EDs) experience disrupted sleep; however, more information is needed to understand the relationship between EDs and sleep. While insomnia may increase the risk of developing an ED, having an eating disorder may also cause disrupted sleep. One study found that participants with anorexia binge-eating/purging type had significantly worse sleep quality than did participants with anorexia restricting type, suggesting that treatment for eating disorders should focus on improving sleep—especially for those who purge.
Getting Help
Getting better sleep isn’t a cure or a quick fix for mental health disorders, but it can be an important part of a comprehensive treatment plan. The bidirectional relationship between sleep and mental health offers some promise—researchers hope that finding ways to improve sleep may have a beneficial impact on a number of conditions. In a study looking at more than 3,700 participants, researchers investigated the impact of poor sleep on symptoms of depression, anxiety, and paranoia. Some of the participants were treated with cognitive-behavioral therapy (CBT) for their insomnia, while others did not receive any treatment. The researchers found that those who had received CBT showed significant reductions in depression, anxiety, paranoia, and nightmares. They also reported improved overall well-being, including their ability to function at home and work. Another study found that internet-based cognitive-behavioral therapy (CBT) was helpful for relieving symptoms of insomnia. Additional research found that sleep interventions are effective at reducing symptoms of PTSD, lessening the severity of ADHD symptoms, and improving the overall quality of life for people with both conditions. If you have been struggling with a sleep problem or are experiencing excessive daytime sleepiness, talk to a doctor about your treatment options. A doctor will likely perform a physical exam to rule out other conditions that can cause poor sleep (such as a thyroid disorder). A doctor may also recommend:
Cognitive behavioral therapy for insomnia (CBT-I): CBT-I is similar to CBT, except it’s focused on relieving insomnia. A therapist will help you address the thoughts and feelings that may keep you from falling/staying asleep. You’ll learn relaxation techniques to prepare you for rest. Sleep studies: A sleep study is when you sleep in a controlled environment that is set up like a bedroom; doctors monitor your brain waves, heartbeat, eye movements, and more. They can also determine whether you have a sleep condition such as sleep apnea or restless legs syndrome. Over-the-counter sleep aids: There are over-the-counter (OTC) sleep aids such as melatonin that some people find helpful. However, melatonin should only be used for a short time period. Be sure to consult with a doctor prior to use and report any unusual side effects (like dizziness or confusion) to a doctor right away. Sleep medicine: In some cases, a doctor may prescribe a prescription sleep medicine to help you get a full night’s rest. Generally, it’s recommended you don’t use these medications for more than a few weeks, due to potential side effects and dependency, so be sure to use them only under a doctor’s supervision and report any unusual side effects.
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Coping
In addition to seeking help from medical professionals, there are also steps that you can take on your own to improve your sleep and well-being. Having good sleep hygiene, or practices that support sleep, is critical to staying rested and avoiding daytime sleepiness. Some things you can do include:
Limit napping. Too much sleep during the day can have an effect on your ability to fall or stay asleep at night. Naps of 20 to 30 minutes a day can help you feel more alert and rested without interrupting your nightly sleep. Establish a nightly routine. Stick to a set of habits that help prepare you for rest each night. Take a bath, read a book, or practice a few minutes of meditation to calm your body. Repeat these routines each night to help set the mood for a solid night’s sleep. Avoid caffeine or stimulants too close to bedtime. Consuming coffee, soda, or other caffeinated products in the late afternoon or evening can make it difficult to fall asleep. Nicotine is another stimulant that often causes poor sleep. Limit alcohol: Drinking alcohol, especially before bed, may cause you to wake up many times throughout the night or too early in the morning. Try limiting or avoiding alcohol completely to see how it changes your sleep quality. Turn off your devices. Watching television or playing on your phone at bedtime can make it more difficult to relax and settle down for sleep. Try setting limits on how long you use devices before bed.
Talk to a mental health professional if you suspect that your sleep problems might be caused by or contribute to a mental health condition. Depression, anxiety, and other psychiatric disorders can interfere with sleep—but addressing your sleep problems may also have a positive impact on your psychological symptoms.
A Word From Verywell
The negative effects of poor sleep are well-documented, including the profound impact on mental health and emotional well-being. Poor sleep may often be a symptom or consequence of an existing psychological condition, but sleep problems are also thought to cause or contribute to the onset of different mental disorders including depression and anxiety. For this reason, addressing sleep problems early on is important to help protect your overall health and wellness. Making lifestyle changes that promote good sleep can help, but talk to a doctor if your sleep problems persist. An underlying sleep disorder or a medical condition might be playing a role in your sleep issues.
