How does sleep relate to mental health?
There’s a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health.
What problems might I have with sleep?
Everyone needs sleep, but many of us have problems with it. You might recognise some of the experiences listed below, or have other difficulties with sleep that aren’t mentioned here.
- find it hard to fall asleep, stay asleep or wake up earlier than you’d like to (also known as insomnia – find out more on the Department of Health/Centre for Health Protection website and the Institute of Mental Health Castle Peak Hospital website)
- have problems that disturb your sleep, such as panic attacks, flashbacks, nightmares or psychosis
- find it hard to wake up or get out of bed
- often feel tired or sleepy – this could be because you’re not sleeping enough, not getting good quality sleep or because of health problems
- sleep a lot – which could include sleeping at times when you want, or need, to be awake.
“When I get depressed, I sleep so much – at its worst it was 18 hours a day, because it was the only way that I could stop thinking and stop my mind from saying awful things to me.”
If you’re having problems sleeping, you might:
- be more likely to feel anxious, depressed or suicidal
- be more likely to have psychotic episodes – poor sleep can trigger mania, psychosis or paranoia, or make existing symptoms worse
- feel lonely or isolated – for example, if you don’t have the energy to see people or they don’t seem to understand
- struggle to concentrate, or make plans and decisions
- feel irritable or not have energy to do things
- have problems with day to day life – for example, at work or with family and friends
- be more affected by other health problems, including mental health problems.
“During the day, my brain is fuzzy, my memory is noticeably affected. I barely have energy to function.”
What causes problems with sleep?
The things that affect our sleep differ for everyone. They can include:
- stresses or worries – for example, issues with money, housing or work
- problems with where you sleep – for example, if you sleep somewhere uncomfortable or you’re easily disturbed
- health conditions relating to sleep, also known as sleep disorders
- being a parent or carer
- taking medication, including starting or coming off medication
- recreational drugs and alcohol
- working at night or being a shift worker
- current or past trauma
- mental and physical health problems, many of which can affect your sleep.
“It’s not possible to relax if you don’t have anywhere comfortable and safe at night. This leads to not sleeping and worrying most of the night.”
If problems with sleep are worrying you or affecting your day to day life, it’s a good idea to see a family doctor who can give you a health check and help you access treatment and support. If you fill in a sleep diary, you could take this to your appointment to show your doctor.
“My sleep problems are […] more a case of bedtime procrastination than insomnia as such and, as a consequence, being too tired the next morning. I still haven’t found out what works for me as I can get to sleep once I do get to bed.”
How could mental health problems affect my sleep?
If you live with a mental health problem, this could affect your sleep in lots of ways. For example:
- Anxiety can cause racing or repetitive thoughts, and worries that keep you awake. You may also have panic attacks while you’re trying to sleep.
- Depression and seasonal affective disorder (SAD) can make you sleep more, including staying in bed for longer or sleeping more often. Depression can also cause insomnia.
- If you’ve gone through trauma, this can cause flashbacks, nightmares or night terrors that disturb your sleep. You might feel unsafe or uncomfortable in bed or in the dark.
- Paranoia and psychosis may make it difficult to sleep. You may hear voices, or see things you find frightening or disturbing.
- Mania often causes feelings of energy and elation, so you might not feel tired or want to sleep. Racing thoughts can also keep you awake and cause insomnia.
- Psychiatric medication can cause side effects including insomnia, disturbed sleep, nightmares and oversleeping. Stopping psychiatric drugs can also cause sleep problems.
“I feel safe sleeping during the day but the world isn’t geared that way.”
How my sleep pattern highlighted my failing mental health
“My sleep was the first red flag that started waving wildly to warn me that something was wrong.”