Good sleep is essential for our mental well-being. Just one night of disturbed sleep can leave us feeling cranky, flat, worried, or sad the next day. So it’s no surprise sleeping problems, like , , or regularly disrupted sleep patterns, are associated with anxiety and depression.
Anxiety and depression, which can range from persistent worry and sadness to a diagnosed mental illness, are .
Understanding the many interacting factors likely to cause and maintain these experiences is important, especially for developing effective prevention and treatment interventions. And there is sleep problems may be a key factor.
Which problem comes first?
The majority of suggests the relationship between sleep problems and anxiety and depression is strong and goes both ways.
This means sleep problems can lead to anxiety and depression, and vice versa. For example, worrying and feeling tense during bedtime can make it difficult to fall asleep, but having trouble falling asleep, and in turn not getting enough sleep, can also result in more anxiety.
Sleep disturbance, particularly insomnia, has been shown to in some people, but it is also a common symptom of both disorders.
Trying to tease apart which problem comes first, in whom, and under what circumstances, is difficult. It may depend on when in life the problems occur. Emerging evidence shows sleep problems in adolescence might (and not the other way around). However, this pattern is not as strong in adults.
The specific type of sleep problem occurring may be of importance. For example, anxiety but not depression to predict excessive daytime sleepiness. Depression and anxiety also commonly occur together, which complicates the relationship.
Worrying and feeling tense during bedtime can make it difficult to fall asleep, but having trouble falling asleep, and in turn not getting enough sleep, can also result in more anxiety.
Although the exact mechanisms that govern the sleep, anxiety and depression link are unclear, there is overlap in some of the underlying processes that are more generally related to .
Some aspects of sleep, like the of a person’s sleep patterns and their impact on functioning and health, are still relatively unexplored. More research could help further our understanding of these mechanisms.
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Sleep interventions
Disentangling which problems come first, and under what circumstances, is difficult. The good news is we have effective interventions for many sleep problems, like .
So there is the possibility that targeting sleep problems in people who are at risk of experiencing them—like teenagers, new mothers and people at risk for anxiety—will not only improve sleep but also lower their risk of developing anxiety and depression.
Online interventions have the potential to increase cost-effectiveness and accessibility of sleep programs. A found a significantly improved both insomnia and depression symptoms. The program included sleep education and improving sleep thoughts and behaviors, and participants kept sleep diaries so they could receive feedback specific to their sleep patterns.
to improve and even prevent physical and mental health problems early in life by . Using smart phone and activity tracker will also help tailor mental health interventions in the future.
So there is the possibility that targeting sleep problems in people who are at risk of experiencing them—like teenagers, new mothers and people at risk for anxiety—will not only improve sleep but also lower their risk of developing anxiety and depression.
General improvements to sleep might be beneficial for a person with anxiety, depression, or both. Targeting one or more features common to two or more mental disorders, like , is known as a approach.
that target transdiagnostic risk factors for anxiety and depression, , have already shown some success.
A good foundation
For many people, treating sleep problems before treating symptoms of anxiety and depression is less stigmatizing and might encourage people to seek further help. Addressing sleep first can develop a for further treatment.
For example, people with a depressive disorder are to treatment and more likely to if they have a sleep problem like insomnia.
Many of the skills learned in a sleep intervention, such as techniques for relaxation and reducing worry, can also be used to help with daytime symptoms of both anxiety and depression. And this is not to mention the of getting a good night’s sleep!
For many people, treating sleep problems before treating symptoms of anxiety and depression is less stigmatizing and might encourage people to seek further help.
If you’re concerned about your or , speak to a health care professional such as your GP. There are already a number of effective treatments for sleeping problems, depression and anxiety, and when one is treated, the other is likely to improve.
And with research in this area expanding, it’s only a matter of time before we find more ways to use sleep improvement interventions as a key tool to enhance our mental health.
Professor Emeritus John Trinder contributed to this article.
