How important is sleep for our mental health?
October 10th was World Mental Health Day. Being a therapist and running a sleep-related business, I felt a strong urge to write about the connection between our sleep and mental health. In my psychotherapy practice, I have observed that many clients who suffer from severe anxiety, depression and even mental illnesses like schizophrenia and paranoia are often also plagued with poor sleep. I will be exploring whether a lack of sleep is due to mental illness or if it contributes to mental illness. We’ll also look at what practices help and hinder a good night’s sleep.
What is Sleep?
We commonly understand sleep as inactivity of our bodies. However, on the contrary, our bodies are busy, carrying out fundamental jobs that our physical and mental health depends upon. Sleep is a necessity, just as food, water, and breathing are! In our sleep, when we are not connected to the outside world, we are busy maintaining and healing our body and mind.
It will be useful to briefly understand the process of sleep and how it may impact our mental health. Sleep has been divided into two general categories: Non-Rapid Eye Movement sleep (Non-REM sleep) and Rapid Eye Movement sleep (REM sleep). We go through five stages of Sleep - four of them occur in Non-REM and the fifth in REM sleep.
In the first four stages of sleep, we are progressing to deep sleep. Our body temperature decreases, muscles relax, heart and breathing rate go down too. Deepest sleep occurs in stages two and three. Here we experience physiological changes that help boost the immune system’s functioning. In the fifth stage, REM sleep, we dream - vivid imagery, intuition, and information beyond our normal conscious awareness comes to the fore. It’s where we hold our ‘stuff’, our fears, troubled history, and nightmares. Awareness, healing, and regeneration are stimulated in this state. Our body temperature, blood pressure, heart rate, and breathing increase as when awake.
Sleep and mental health
Studies report that REM sleep enhances learning and memory, and contributes to emotional health in complex and incompletely understood ways. Research is still ongoing to uncover the mechanism by which mental health is affecting our sleep and how insufficient sleep is causing mental health issues to arise. For example, insomnia may intensify the effects of psychiatric disorders and vice versa.
Past research has demonstrated that sleep does far more than simply consolidate memories in their factual order. During sleep, the brain can formulate new ideas. Sleep “leads to flexible restructuring of memory traces (pickup emotional details) so that (new) insights (creative thinking) can be made.” The brain reorganizes our memories and singles out emotional details, helping us to produce new insights and creative ideas.
Evidently, sleep is absolutely essential for our brain to process information effectively, and re-enforce our memories preparing us for the next day. Mental health and sleep are closely related. On the one hand, sleep deprivation affects our psychological state and mental health, and on the other hand, people with mental health problems are more likely to have insomnia or other sleep disorders. Sleep issues are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).
Sleeping better - from medicine to meditation
We can improve our sleep by making some lifestyle changes and adopting certain behavioural strategies; we have mediation, psychotherapies and all sorts of medication available to us. We should be mindful about what to start with.
Caffeine, Alcohol, Nicotine: It is well known that caffeine, alcohol, and nicotine disrupt our sleep. Alcohol firstly suppresses the nervous system, which helps some of us fall asleep, but when the effects wear off in a few hours we wake up and find it very difficult to fall asleep again. Nicotine is a stimulant that raises our heart rate and makes us alert and activates our cognitive processes. Can we stop them? We can prevent these effects by making an effort to not consume them close to bedtime. Having your last coffee at lunchtime can improve your sleep more than you think! (personal experience).
Movement: Regular brisk walking, swimming, and cycling during the day can help us fall asleep quicker. Exercise certainly helps on the quest for deeper sleep.
Sleep rituals or sleep hygiene: this means a regular sleep-and-wake schedule, staying in the bed only for sleeping, keeping the bedroom dark and without technology around (blue lights). Experts also recommend staying up longer (within reason) can ensure better sleep.
Meditative techniques: Deep breathing, guided imagery, and progressive muscle relaxation (alternately tensing and releasing muscles) can counter anxiety and racing thoughts.
Cognitive behavioural therapy (CBT): Cognitive behavioural techniques can help one to change negative expectations and build more confidence that one can have a good night's sleep. These techniques can also help to change the "blame game" of attributing every personal problem that may occur during the day on lack of sleep.
By Nisa Shah, co-founder Sleep Organic & psychotherapist
Payne JD & Kensinger EA (2010) Sleep's Role in the Consolidation of Emotional Episodic Memories. Current Directions in Psychological Science.
Mental Health Foundation Sleep Report 2010