The Intersection Of Insomnia And Mental Health
With one-third of the population reporting trouble sleeping, insomnia is considered the most common sleep disorder in the United States. This condition is characterized by poor sleep quality, including difficulty falling asleep, staying asleep, or both. If you have insomnia symptoms for at least three months, your doctor may also recommend an evaluation for a mental health condition.
In one systematic review published in Sleep Medicine Reviews, insomnia was proven a significant predictor for various mental health conditions and symptoms, including anxiety, depression, substance use disorders, and psychosis. Knowing how these two challenges can be addressed and treated might be valuable if you are struggling to sleep and are concerned about your mental health.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
Insomnia and mental health: An overview
Statistics on insomnia and mental health may vary depending on which mental health condition you're diagnosed with.
Research has also revealed that individuals with bipolar disorder experience changes in their sleep patterns before a manic or depressive episode begins. Schizophrenia, ADHD, autism spectrum disorder, and seasonal affective disorder also have a bi-directional relationship with sleep, where each affects the other. These statistics reveal that, while managing insomnia does not necessarily mean you have a mental health condition, you may be at risk of insomnia if you do.
Research on mental health and insomnia in college students
Community living, frequent social gatherings, and the strain of work and school can limit the amount of quality sleep college students get, with up to 60% of students living with poor sleep quality and at least 7.7% meeting the criteria for insomnia. Furthermore, sleep problems and mental health symptoms are often connected.
A group of researchers in Texas decided to look further into the connection between insomnia and mental health challenges in a focused study on college students. Below are the results of that study.
Participants
All the participants in the study were undergraduate students from a Southwestern university. They were recruited through in-class announcements, ads on campus, and an online listing with the psychology department's research participant pool, which was available to some psychology students for extra credit.
The final sample included 373 individuals, including 227 women and 146 men. Ethnicity was reported as 66.2% Caucasian, 15.3% African American, 9.1% Hispanic, 5.7% Asian American, and 2.7% undisclosed. Many participants were recruited through a core curriculum class, representing various majors, including psychology, social sciences, visual arts, education, and political science.
Methods
Once students registered for the study online, they downloaded and printed the consent form and questionnaires to complete and return, which consisted of a sleep diary, health questionnaire, and a symptom checklist. All documents were returned to the psychology research lab.
The checklist was a self-report assessment evaluating mental health symptoms using a Likert-type scale to measure how much distress events had caused over the past week for the students. The questions screened for nine types of mental health symptoms. The health questionnaire included questions about exercise, substance use, and chronic health, and three specific questions were included to establish the definition of insomnia in this study.
For one week before the study, the students completed a sleep diary, completing entries each morning about their sleep the night before. They were asked to include information about their bedtime, the time it took to fall asleep, and how long it took until they woke up.
Based on responses to the health questionnaire, the researchers defined people with insomnia as those who had trouble falling or staying asleep at least three times a week for six months or longer. They purposely excluded daytime complaints about sleep difficulties, creating a more rigorous definition of insomnia than in some other studies.
Results
Based on the researchers' insomnia definition, 9.4% of participants were experiencing the condition. 58.2% of participants were identified as people without insomnia. The remaining 32.4% were excluded from the analysis because they had a sleep disorder, displayed insomnia symptoms but didn't complain, or had insomnia but no symptoms.
The assessments revealed that students experiencing insomnia were more likely to be experiencing obsessive-compulsive disorder, depression, anxiety, and somatization (physical symptoms of mental stress). However, 30.6% of participants reported at least one other medical condition, including asthma, diabetes, migraines, or gastrointestinal issues. When researchers considered these conditions, obsessive-compulsive symptoms were the only difference in mental health between those who were and were not experiencing insomnia.
In summary
A study of 400 college students examined the link between insomnia and mental health. Almost 10% of the students reported experiencing insomnia symptoms, and those participants were more likely to be experiencing symptoms of obsessive-compulsive disorder, depression, anxiety, and somatization.
Future research
Like the chicken-egg paradox, this study raises the question of whether insomnia or mental health conditions came first. Researchers often consider both sides of the question, finding that insomnia can lead to mental illness and mental illness can lead to insomnia. The two may build on each other, so preventing the onset of one may aid the other.
How to treat insomnia and mental health conditions
Several options are available for treating insomnia. While medication may be an initial choice in treatment, cognitive-behavioral therapy has been shown to be more effective and longer-lasting results for some people. In a 2012 study, 164 British adults were provided six weekly sessions with an animated "virtual therapist" that taught them behavioral, cognitive, and relaxation strategies to improve their sleep.
Content included progressive muscle relaxation, sleep hygiene, and sleep restriction. All information was strategically provided based on baseline assessments and sleep diaries. Those who completed the intervention reduced the time it took them to fall asleep at night by 56%, compared to a 17% reduction in the control group. In addition, over 70% of the treatment group increased their sleep efficiency. 70% of their time in bed was spent sleeping, compared to approximately 20% of the control group.
The study's results found that sleep hygiene could be a significant way to reduce sleep challenges. Below are a few sleep hygiene strategies you can use at home to potentially reduce insomnia symptoms.
Increase your physical activity
Consistent exercise, 30 to 60 minutes three or more times a week, can help you fall asleep faster and experience deeper sleep. Since exercise stimulates your body, schedule your next workout session a few hours before bedtime. However, avoid strenuous exercise within an hour of going to sleep, as it may cause you to feel less tired.
Follow a routine
Sleeping in on the weekend can feel relieving, but it may quickly cut your daily routine progress. A consistent sleep schedule can remind your body of your usual wake and sleep times. Keep your bedtime and wake time to an hour's window, especially if you're at a higher risk for insomnia.
Nightly wind-down routines may also be beneficial in signaling to your body that sleep is soon approaching. Create a restful routine that helps you prepare mentally and physically for bed, shower, read a book, and limit stressors. Don't exercise or overindulge in screen time within an hour of going to sleep.
Limit screen time
The blue light of your phone, TV, and computer can suppress melatonin production and shift your circadian rhythms by up to 3 hours. However, removing this light completely may seem nearly impossible in a digitally oriented world. As a compromise, consider purchasing a pair of blue light glasses that block the problematic blue light. You can also download an app on your phone or change the settings to change the screen's underlying color. Create a cutoff time of 30 minutes to an hour before bed, during which you might read a book, tidy your home, or prepare for bed.
Soak up the sun
If blue light makes you less sleepy, sunlight may be part of the solution. Spending time in sunlight can be a mood booster. In addition, bright morning sunlight helps your body shift its circadian rhythm to an earlier bedtime so you can fall asleep faster at night. If you cannot make it outside, try to eat breakfast near a sunny spot in your house or spend an hour working on the patio.
Don't work in bed
It may feel tempting to lounge on your bed to study or work, but if you're having trouble sleeping, try to keep your bed limited only to sleep and intimate activities with a partner. Keeping your bed limited to a few activities trains your mind to understand that it isn't a place for productive or awake energy.
Try not to linger when you cannot sleep
On nights you struggle to sleep, laying in bed for hours may lead to negative associations with sleep, which can make it more difficult. If sleep has been eluding you for 30 minutes or more, get up and try another activity, like getting water, reading a book, or taking a bath. Then, try to come back and sleep again.
Talk to a professional
If you are concerned that your insomnia is related to an underlying mental health condition, consider contacting a licensed therapist for support. You can also talk to a professional if you believe your sleep disturbances are due to a temporary stressful situation or for reasons unknown. Therapists are trained in sleep psychology and can help you set up a healthy schedule and discover the potential causes of your insomnia.
For some people, setting up appointments and traveling to an office for therapy can be difficult due to barriers like cost or distance. In these cases, online therapy through a platform like BetterHelp may offer an alternative. Online, you can set up a time that is convenient for you and in a comfortable space of your choosing.
In a review published in the Cureus Journal of Medical Science, researchers evaluated the efficacy of online cognitive-behavioral therapy (CBT) to manage the symptoms of stress-related conditions and mental illness. The study revealed that online therapy could be cost-effective and as effective as in-person options.
Takeaway
Is insomnia a mental or physical disorder?
Insomnia is a sleep disorder that affects both mental and physical health. While it is often characterized as a mental disorder because it primarily involves disruptions in sleep patterns and difficulties falling asleep or staying asleep, it can also have profound physical consequences.
Chronic insomnia, a specific form of insomnia characterized by persistent sleep disturbances, can lead to physical symptoms such as fatigue, headaches, muscle tension, and gastrointestinal problems. Prolonged sleep deprivation due to chronic insomnia can weaken the immune system, increase the risk of cardiovascular issues, and even impair cognitive functions.
Insomnia is often linked to mental health conditions such as generalized anxiety disorder, depression, and stress. Conversely, these mental health issues can also contribute to the development or exacerbation of insomnia. The relationship between insomnia and mental health is often bidirectional, meaning one can worsen the other.
While insomnia is one of many sleep disorders that can have both mental and physical components, it is important to address both aspects to effectively manage and treat the condition. Poor quality sleep can significantly impact an individual's daily functioning and overall well-being, so seeking professional help is crucial.
How does insomnia affect the mind?
Insomnia can significantly impact the mind and overall mental health. Sleep and mental health are closely interconnected, and disruptions in sleep patterns, such as those experienced in insomnia, can have various effects on the mind.
During sleep, the brain undergoes essential processes for mental well-being. It reorganizes and recharges itself, consolidates memories, and clears away toxic waste byproducts through the glymphatic system, a process crucial for brain health. When insomnia disrupts this rejuvenating process, it can lead to cognitive impairment, difficulty concentrating, and memory problems.
Healthy sleep habits play a crucial role in restoring and rejuvenating the brain. Practicing good sleep hygiene allows you to manage sleep patterns and improve mental health. As a neuroprotective measure, it is important to prioritize and maintain adequate sleep for optimal mental functioning. A well-rested brain is better equipped to handle daily challenges and maintain emotional balance than a sleep-deprived one.
What does insomnia mean in mental health?
In mental health, insomnia refers to a sleep disorder characterized by persistent difficulty falling asleep, staying asleep, or experiencing non-restorative sleep despite having the opportunity for adequate rest. Insomnia can have a serious impact on mental health, as sleep and psychological well-being are closely intertwined.
Various factors can contribute to insomnia, including psychiatric disorders like anxiety, depression, and post-traumatic stress disorder (PTSD). These conditions often result in disturbed sleep patterns, making it challenging for individuals to obtain the restorative sleep they need for optimal mental health. Additionally, hormonally-driven conditions like pregnancy or menopause can also contribute to the development of insomnia.
One tool commonly used to assess the severity of insomnia is the Insomnia Severity Index (ISI). The ISI is a self-report questionnaire that measures the nature, impact, and severity of insomnia symptoms on an individual's daily life. This assessment helps clinicians and researchers gauge the extent of insomnia-related distress and impairment.
Addressing insomnia within the context of mental health can have significant benefits for overall well-being. Treatment may include a combination of therapy, lifestyle changes, and medication to improve sleep quality and manage underlying psychological issues. However, only a trained healthcare professional can determine the most appropriate course of treatment for an individual's specific needs.
How do you overcome mental insomnia?
Overcoming mental insomnia, which is often associated with mental health disorders like anxiety disorders, can be challenging without professional help. However, there are several things that individuals can do to manage and improve sleep quality, which in turn can have positive effects on mental health.
- Seeking professional help: If you're experiencing persistent insomnia related to mental health issues, it's helpful to consult a mental health professional. They can assess your condition, identify any underlying mental health disorders, and develop a tailored treatment plan.
- Cognitive Behavioral Therapy for Insomnia (CBT-I): CBT-I is an evidence-based approach that focuses on changing thought patterns and behaviors contributing to insomnia. CBT-I can be particularly effective in addressing the sleep disturbances associated with anxiety disorders.
- Medication: In some cases, medication prescribed by a healthcare provider may be necessary to manage insomnia. These medications can help manage sleep patterns, but they should be used under professional guidance and only when other strategies are insufficient.
- Stress management: Practicing stress-reduction techniques such as mindfulness, meditation, deep breathing exercises, or yoga may help alleviate anxiety and improve sleep quality.
- Establishing a sleep routine: Creating a consistent sleep schedule by going to bed and waking at the same times each day can help manage your body's internal clock.
- Limiting stimulants: Reducing or eliminating the consumption of caffeine, nicotine, and alcohol, especially close to bedtime, can have a positive impact on sleep.
- Creating a relaxing sleep environment: Ensuring your sleep space is comfortable, quiet, and dark can contribute to better quality sleep. Avoiding electronic devices before bedtime can also be helpful. The blue light emitted from screens can interfere with the body's natural production of melatonin, a hormone that modulates the sleep-wake cycle.
- Physical activity: Engaging in frequent physical activity can help reduce anxiety and improve sleep. However, you should avoid strenuous exercise close to bedtime, as it may have the opposite effect.
- Winding down before bed: Engaging in calming activities, such as reading or listening to soothing music, can help to relax the mind and promote sleep.
By taking steps to address insomnia and improve sleep quality, individuals can significantly impact their mental health. Overcoming insomnia often requires a comprehensive approach, so your individualized treatment plan may include a combination of strategies.
Is insomnia linked to mental illness?
Yes, insomnia is closely linked to mental illnesses, and conditions such as post-traumatic stress disorder (PTSD) and panic disorder are prime examples of this connection.
- Post-traumatic stress disorder (PTSD): Individuals with PTSD often experience nightmares, flashbacks, and heightened anxiety, which can significantly disrupt their sleep patterns. The intrusive thoughts and hyperarousal associated with PTSD can make falling and staying asleep challenging.
- Panic disorder: People with panic disorder may experience panic attacks, which can occur unexpectedly, even during sleep. These attacks can jolt individuals awake and cause significant sleep disturbances. The fear of experiencing panic attacks during the night can also contribute to chronic insomnia.
- Anxiety disorders: Anxiety is a broad category of mental health disorders that can manifest in various ways, including excessive worrying, restlessness, and irritability. These symptoms can lead to difficulty falling or staying asleep.
Insomnia and mental illness often have a cyclical relationship, where one condition exacerbates the other. Poor sleep quality can worsen physical and mental health symptoms, while mental health disorders can contribute to sleep disturbances. Therefore, addressing insomnia within the context of mental health is often crucial for overall well-being and improving quality of life.
Seeking treatment for both sleep disturbance and mental health concerns can lead to significant improvements in both areas. While there is no one-size-fits-all approach to managing insomnia, getting enough sleep can help reduce the symptoms of mental disorders and improve your physical health.
What is the main cause of insomnia?
The main cause of insomnia often involves a combination of factors. While co-occurring disorders like anxiety and depression can certainly contribute to insomnia, one significant underlying cause is obstructive sleep apnea (OSA).
OSA is a sleep disorder where the upper airway becomes partially or completely blocked during sleep, leading to brief awakenings to restore breathing. These awakenings can be so frequent that they disrupt the normal sleep cycle, resulting in poor sleep quality and daytime sleepiness. OSA is a common and often undiagnosed condition that can significantly contribute to insomnia.
Other factors that can cause or worsen insomnia symptoms include stress, anxiety, depression, chronic pain, medications, caffeine or alcohol consumption, abnormal sleep patterns, and medical conditions.
Effective treatment for insomnia often requires addressing its root causes. This approach may involve lifestyle changes, stress management techniques, therapy, and, in cases where sleep apnea is suspected, a sleep study and treatments like continuous positive airway pressure (CPAP) therapy. Identifying and addressing the specific factors contributing to insomnia before they become chronic can lead to better outcomes and help prevent the development of other mental health concerns.
What causes insomnia in mental illness?
Insomnia can be a common symptom of various mental illnesses, and several factors contribute to this relationship:
- Psychological factors: Mental health conditions such as anxiety, depression, post-traumatic stress disorder (PTSD), and bipolar disorder can lead to racing thoughts, worry, and emotional distress that make it difficult to relax and fall asleep.
- Neurobiological changes: Mental illnesses can affect brain chemistry, leading to imbalances in neurotransmitters that modulate sleep, like serotonin and melatonin. These imbalances can disrupt the body's internal clock and sleep-wake cycle.
- Hormonal dysregulation: Mental health disorders may also disrupt hormone levels, particularly the stress hormone cortisol. Elevated cortisol levels, common in individuals with anxiety or chronic stress, can interfere with the ability to fall asleep and maintain restful sleep.
- Medications: Some medications prescribed for mental health conditions can have side effects that interfere with sleep. For example, certain antidepressants or stimulant medications for ADHD can lead to insomnia.
- Lifestyle factors: Unhealthy lifestyle choices that can result from mental illness, such as overconsumption of caffeine or alcohol or lack of physical activity, may significantly impact sleep quality and contribute to insomnia.
Addressing insomnia in the context of mental illness often involves a comprehensive approach that addresses these underlying factors. While insomnia may present differently depending on the mental health condition, seeking treatment for both insomnia and the underlying mental health concern is crucial for managing symptoms and improving overall well-being.
Can your brain recover from insomnia?
Yes, your brain can recover from insomnia, but the process may take time and dedication. Insomnia can have adverse effects on cognitive and emotional functioning, but the brain has a remarkable ability to bounce back with the right interventions.
One key aspect to understand is that sleep is cumulative. As a result, consistently improving your sleep patterns and getting adequate rest over time can help reverse the effects of insomnia. Sleep debt is a real phenomenon, and it can take weeks or even months of improved sleep to fully repay the accumulated sleep debt from chronic insomnia.
Additionally, addressing underlying factors contributing to insomnia, such as mental health conditions or lifestyle habits, can also aid in brain recovery. Effective treatment for these issues can improve brain function and reduce symptoms of insomnia over time. Establishing healthy sleep habits and maintaining a consistent sleep schedule can also help retrain the brain to recognize when it's time to sleep and promote more restful sleep.
It's important to be patient and persistent in your efforts. Recovery from insomnia varies from person to person, so what works for one individual may not work for another. As you alleviate the cognitive and emotional impacts of insomnia, your brain can recover and regain its normal functioning.
What type of mental disorder is insomnia?
While insomnia itself is classified as a sleep disorder, it's essential to recognize its significant impact on mental health and vice versa. Insomnia can be both a symptom and a risk factor for various mental disorders, including depression, anxiety disorders, bipolar disorder, and substance use disorders.
Insomnia may also be considered as its own mental disorder when it persists without an apparent underlying cause or in cases of severe chronic insomnia. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), primary insomnia is characterized by difficulties initiating or maintaining sleep without any other medical, psychiatric, or environmental factors that could explain the symptoms.
In some cases, treating underlying mental health conditions can improve symptoms of insomnia, but in others, insomnia may require separate treatment methods. No matter the classification, it's essential to address insomnia and its potential impact on mental health to promote overall well-being.
Is insomnia a type of depression?
Insomnia is not a type of depression, but it can be a symptom of depression. Major depressive disorder (MDD) is a distinct mental health condition characterized by persistent low mood, loss of interest or pleasure in activities, and varying physical and cognitive symptoms.
While insomnia is not a form of depression, it frequently co-occurs with MDD. Insomnia, as a symptom of depression, may present as difficulty falling asleep, waking up too early and being unable to fall back asleep, or simply feeling unrefreshed after sleep.
If you experience insomnia along with other symptoms of depression, it's crucial to seek professional help and address both concerns simultaneously. Focusing solely on treating insomnia without addressing underlying mental health issues may not lead to long-term improvement. A mental health professional can help determine the best course of treatment for your unique situation.
- Previous Article
- Next Article