Sleep is essential to the maintenance of mental health. Sleep helps to regulate mood and process emotional information and experiences into memory. Insufficient sleep is associated with increased emotional reactivity and emotional disturbance. Research indicates that REM sleep may play an especially significant role in maintaining emotional well-being and psychological balance.
Sleep problems occur substantially more frequently in people with psychiatric conditions than in the general population. Often, sleep and mental health disorders exist in bi-directional relationship to each other, with each condition influencing the other. Poor sleep can contribute to the onset and severity of mental health disorders, and mental health problems can create and exacerbate sleep issues. Treating sleep problems may deliver therapeutic help for mental health conditions, just as sleep may improve as mental health disorders are treated.
Sleep problems may affect the following conditions:
Attention deficit hyperactivity disorder (ADHD)
Sleep problems are associated with ADHD in both children and adults. Children with ADHD are more likely to suffer from daytime tiredness, as well as sleep-disordered breathing. In children, symptoms of sleep deprivation may appear similar to symptoms associated with ADHD.
In adults, symptoms of ADHD may appear similar to symptoms of certain sleep disorders, including narcolepsy and hypersomnia.
Anxiety disorders and sleep problems are frequently present together. Sleep problems occur often in people with panic disorders, generalized anxiety disorder, and post-traumatic stress disorder, among others.
Anxiety contributes to disrupted sleep, often in the forms of insomnia and nightmares. Sleep deprivation elevates the risk for anxiety disorders. One mechanism by which sleep induces anxiety, according to research, is by increasing activity in the centers of the brain responsible for emotional regulation. This same research suggests people who are naturally prone to worry are especially vulnerable to the anxiety-producing effects of poor sleep.
Sleep problems are a symptom of bipolar disorder. During manic episodes, people often sleep very little, and feel a diminished need for sleep. In depressive episodes, people with bipolar disorder may experience insomnia as well as hypersomnia — excessive tiredness during waking hours, which may be accompanied by prolonged periods of sleep.
Research indicates that bipolar disorder is accompanied by changes to the structure of sleep, known as sleep architecture. In particular, bipolar disorder is associated with alterations to the timing and duration of rapid eye movement (REM) sleep.
Sleep and depression have a complex relationship, with sleep disruption contributing to depressive symptoms and depression interfering with sleep. Roughly 75 percent of people with depression also experience symptoms of insomnia. Hypersomnia also is common among people with depression. Antidepressant medications also may interfere with sleep.
Insomnia is not only a symptom of depression, but also is a contributor to the mood disorder. People suffering chronic insomnia are five times more likely to develop depression, according to research.
Psychosis is frequently accompanied by disrupted sleep. People who experience psychosis may sleep excessively or very little. They may sleep inconsistently, without a regular schedule. Changes to sleep patterns can be an early signal of psychosis among people with schizophrenia.
People who experience psychosis are at higher risk for certain sleep disorders, including obstructive sleep apnea. Lack of sleep can increase the risk of psychosis and of paranoia. Sleep deprivation can generate symptoms of psychosis even in healthy adults. Research indicates that a 24-hour period of sleep deprivation results in signs of psychosis that resemble the symptoms of schizophrenia.
Understanding the interplay between mental health disorders and sleep problems can aid in correct diagnoses and improved treatments for both conditions.
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