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Sleep and mental health

February 24, 2020

We all have restless nights now and again. Things like stress, the temperature in our bedroom and something we’ve eaten or drunk can all have an effect on how well we sleep. Some people, however, do have a specific problem with their sleep.

People with depression and anxiety disorders can experience difficulties – and these can actually be an early sign that there’s a mental health problem they’d benefit from addressing. It’s also possible for factors such as pain, physical health issues, medication and substance use to have an impact on someone’s sleep. Others can have stand-alone difficulties with sleep that aren’t related to an underlying issue.

Some people may have trouble getting off to sleep, while others get off to sleep okay and then wake up regularly during the night, or wake up too early. It is possible for the same person to experience all of these difficulties.

Not getting enough rest can have a significant impact on your life and your mental health. As well as being tired and lacking in energy, you may become irritable and more easily upset, or find it hard to concentrate. A lack of sleep over a period of time can potentially contribute to a decline in mental health.

Often, people experience a ‘vicious cycle’ in relation to sleep difficulties. If someone has an appraisal at work coming up, for instance, and they’re apprehensive about it, they may find they’re not sleeping well. They feel tired, but as soon as they lie down they start worrying that they are not going to be able to sleep enough to face their appraisal. Their mind whirls. The more anxious they become the harder it is to sleep. They stay in bed – thinking that they must continue trying to drop off – but instead they lie awake worrying about how tired and upset they’ll be tomorrow.

Cognitive behavioural therapy (CBT) can help people with a sleep issue, either as part of treatment for anxiety or depression or by tackling it as a stand-alone problem. In CBT sessions, the therapist will work with the individual to ‘formulate’ the vicious cycle they are experiencing. They’ll then work together on a strategy for changing the patient’s beliefs, thoughts and behaviours around sleep. This could involve doing experiments at home in between sessions!

For instance, it’s generally suggested that we need between seven and eight hours of sleep per night – and this can make us feel under pressure to get our ‘full quota’. In fact, there’s no such thing as a ‘normal’ amount of sleep. It varies for everyone, sometimes depending on how active we are and our age, as we generally need less sleep the older we get.

If you can’t sleep you might feel you need to stay in bed and keep trying – but this will only make you focus more on the fact that you’re having problems. You can test this belief, and try to break the cycle, by getting up if you haven’t fallen asleep within half an hour and doing something else, then coming back to bed when you feel sleepy.

Another belief you can challenge is the assumption that if you’ve had a bad night’s sleep you’ll be too tired to function properly the next day. Sitting on the sofa and avoiding activities such as work or exercise could mean you find it harder to sleep the next night too, as you haven’t expended enough energy to feel tired. Do what you need to do anyway – and see what happens.

Getting a sleep problem in perspective can also help. It’s easy for it to loom large in our lives, and become something that preoccupies us all day. This can make anxiety and depression worse, and cause struggling with sleep to become a self-fulfilling prophecy. CBT can help you learn to focus on other things that are important to you – making sleeping difficulties just one part of your life, rather than the biggest thing in it.

If you’d like to refer yourself for online CBT, you can get started by registering here.

ieso Online Therapy
This blog has been written by a member of the clinical team at ieso.
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