Everyone needs sleep, but many of us experience problems with it. Sleep difficulties might be seen as

  • finding it hard to fall asleep, stay asleep or wake up earlier than you’d like to

  • having problems that disturb your sleep

  • finding it hard to wake up or get out of bed

  • often feeling tired or sleepy sleeping a lot

Sleep disorders or sleep anxiety are characterized by abnormal sleep patterns that interfere with physical, mental, and emotional functioning. Sleep disorders affects mental heath and can increase anxiety and depression.

How do sleep disorders affect my mental health?

Nature of sleep problems in anxiety and depression

  • There is a bidirectional relationship between sleep and mental health

Presence of sleep problems in the context of anxiety and depression increases severity of these mental health disorders as well as reduces the rates of effective treatment (Baglioni et al., 2011; Harvey, 2001; Neckelmann, Mykletun, & Dahl, 2007; Taylor et al., 2005).

  • Anxiety related sleep difficulties may be seen as difficulty falling asleep or staying asleep due to excessive worry or restless energy.

  • Depression-related sleep problems may be seen as difficulty falling asleep, early morning wakening, and even excessive sleep. These sleep problems may be linked to underlying sleep neurobiological and circadian rhythm functioning (Thase, 1999).

How can I improve my sleep?

Here are a few tips and suggestions for improving sleep suggested by our mental health proffessionals. Some people find these ideas useful, but there are different things which work for different people at different times. Only try what you feel comfortable with, and try not to put too much pressure on yourself.

  • Establish a sleep routine

    • Try going to bed and waking up at around the same time every day. This helps us set the “internal clock” of our body. Even if you don’t sleep at the same time, try waking up at the same time. Try to also stick to this routine even on weekends to avoid Monday morning sleep hangover.
    • You can also try going to bed only once you feel ready to sleep, but still get up around the same time. If you are struggling to fall asleep even after 20 minutes in bed, get out of the bed, go to another room and do something relaxing like reading or listening to music. When you feel tired and your eyes are droopy, go back to bed.
    • If you are a person who takes regular naps in the afternoons, your sleep drive may have already been reduced which may lead to difficulty falling asleep. Try not-napping during the day-time. However, if you must nap, keep it short and before 5pm.

  • Relax before sleeping

    • Find a relaxation routine that can help you prepare for sleep. 
    • Try taking a bath (the rise and fall in temperature promotes drowsiness), reading a book or practicing relaxation exercises about an hour before your sleep time.
    • Avoid stressful or mentally and emotionally stimulating activities like working or discussing emotional issues right before bedtime. These activities increase secretion of stress hormone cortisol which in turn increases our alertness. 
    • Avoid caffeine (found in coffee, tea, chocolate, cola and some pain relievers) for four to six hours before bedtime. 
    • Alcohol may help in going to sleep but it reduces the quality of sleep as well as increases the awakenings in the middle of the night. So try to limit alcohol consumption to one or two drinks per day, or less, and avoid it at least three hours prior to sleeping time.
    • Finish dinner several hours before bedtime and avoid foods that cause indigestion. 
    • Drink enough fluids at night so that you don’t wake up thirsty- but not so much and so close to the bedtime that you need to wake up in the middle of the night for a trip to the bathroom.
    • Exercise helps in stimulating the body which releases stress hormone cortisol and it in turn alerts your mind. Of course, this will not help you sleep better. So try and exercise at least three hours prior to bedtime or earlier in the day.

  • Make your sleeping area more comfortable

    • Try different temperature, light and noise levels and find the one you can most comfortably sleep in. Usually a dark, cool and quiet environment helps promote better sleep. To achieve such an environment, lower external noises by using earplugs or “white-noise” appliances. Use heavy curtains, blackout shades or eye masks to block light. Keep the temperature between 60-70°F (15-21°C) and the room well ventilated. Also try comfortable bedding/ mattress and pillows.
    • If you have a pet who regularly wakes you during the night, you may consider keeping them out of the bedroom during the night. If you must sleep with your pet, training them or giving them mentally stimulating activities during the day can help them sleep soundly at night (which in turn lets you sleep peacefully!)
    • Limit the usage of bedroom only for sleep and sex. Keep out computers, TVs and work materials out of the bedroom which will help strengthen the mental association between your bedroom and sleep.

  • Screens and device settings

    • You could try cutting down on screen time, by an hour or two, before your sleep time.
    • You can also try adjusting screen settings like adjusting the brightness, using dark mode or such other settings.

Treatments for sleep problems

  • Cognitive Behavioral Therapy for Insomnia (CBT-I)

    • CBT-I is a behavioral intervention that teaches individuals how to manage the thoughts and worries that accompany insomnia, while also establishing healthy sleep habits.
    • It also helps improve anxiety and depression symptoms. 
  • Medication

    • You might be prescribed medication for other types of sleep problems by a psychiatrist or a general physician

There are some sleep disorders like sleep apnea, restless leg syndrome, narcolepsy and other sleep problems which may require a consultation from a physician or a psychologist.  

The Center for Mental Health is the best mental health center in India. Our top Clinical psychologists can help you with the treatment of anxiety, depression, or sleep problems. Feel free to reach out to us.