Did you know that sleep difficulties go hand in hand with mental health disorders such as anxiety, depression, ADHD, schizophrenia, and bipolar disorder? In fact, between 60-90% of people with depression have insomnia.  We know that the pandemic has escalated levels of anxiety and depression, it is, therefore, safe to imagine that sleep will be impacted by Covid-19 as well.  

Sleep problems present themselves in different ways and some sleep issues are more likely to accompany specific mental health conditions. Insomnia, nightmares, night time panic attacks, hypersomnia (sleeping too much), or sleep apnea are more likely to co-exist with various mental health concerns. In addition, many of the stressors associated with the pandemic, such as increasing Covid-19 case rates, caring for an elderly or unwell family member, or financial pressures may lead to poor quantity or quality sleep. 

 Melatonin is the chemical in the body that is released from the pineal gland which modulates sleep patterns in both circadian and seasonal cycles; it is responsible for inducing sleep. Cortisol is the hormone released by the body in stressful situations, such as moments of worry or anxiety. Cortisol offsets the balance of melatonin, which can result in trouble falling or staying asleep. Depression has been linked to imbalances in the thyroid hormones which can also lead to sleep problems. With the Covid19 pandemic in its second wave, more people are experiencing feelings of depression, and with the winter months quickly approaching, Seasonal Affective Disorder mixed with the effects of isolation, the number of individuals who experience sleep problems due to depression is bound to increase.  

Sleep patterns typically cycle between two categories: Rapid Eye Movement (REM) and “quiet” sleep. “Quiet” sleep is when you are in a deeper sleep; during this time, your body temperature drops, your muscles relax and your breathing slows. This is the time that helps to boost your immune system. REM sleep is the part of sleep where people dream. During this time, your breathing, muscle tension, heart rate, and temperature are similar to the levels present when you are awake. REM sleep is critical in enhancing learning, memory, and emotional health. 

What can you do to ensure mental health doesn’t impact your sleep?

#1- Reduce or eliminate substances that interfere with sleep. 

Caffeine is a substance that many of us consume daily – it is a stimulant that helps to keep us awake and alert. However, if used too often or too close to bedtime, it can wreak havoc on our ability to get a good night’s sleep.  

Alcohol is another common substance that many of us consume regularly, however, not everyone is aware of the effect it has on our sleep.  While alcohol initially depresses our nervous system, eventually the effects wear off which causes the sleepy feelings to fade and sleep to be disrupted. For some, the pandemic has resulted in greater alcohol consumption, so it may be even more important to watch your drinking levels especially if your sleep has been disrupted.

#2- Increase physical activity. 

Physical activity is always recommended for a healthy lifestyle and mental health, as well, physical activity has been proven to improve sleep quality. For many of us who have been sitting in front of a screen more and moving our bodies less since Covid-19 became a threat, physical activity has never been more important than it is today. Plan your workout at least three hours earlier than bedtime to ensure that exercise doesn’t interfere with sleep. 

Activities such as yoga before bed may help to wind down after an eventful day. Home workouts are readily available on social media platforms such as Youtube or through specialty apps. Discovering the type of workout you enjoy will help to keep you motivated to get your active minutes completed each day. 

#3- Improve your sleep environment.

It is important that your brain associates your bedroom with sleep, so try to keep the area designated for just that. Many of us are working from home now, and some people need to use their bedroom as their home office.  This is understandable, but try to configure the room to have a designated zone for working and a designated zone for sleeping rather than working from your bed if possible.  Try to avoid screens as much as possible leading up to falling asleep as blue light has negative effects on sleep as well. Setting a schedule for yourself regarding wake up and bedtimes have also been shown to help improve sleep patterns.

#4- Talk to your doctor.

If nothing seems to be working speak to your doctor about supplements and or medications. Currently, medication is available that helps with depression and irregular sleep, however, the medication for one can often worsen the symptoms of the other. Speak to your doctor about the symptoms you have been experiencing, and work with your medical provider to find the medication or the alternative supplements that work best for you.

#5- Try CBT.

Cognitive Behavioural Therapy is recommended both for individuals who are having problems sleeping, and those suffering from mental health disorders. It is also recommended for anyone who needs an outlet during these uncertain times. CBT helps to reframe negative thoughts that contribute to depression or anxiety and poor sleep.  CBT-I is a specialization directly devoted to the treatment of insomnia. Ask your mental health professional if they have experience with CBT-I or if they know someone who does. 

References: 

Mental Illness and Sleep Disorders, June 2018, www.tuck.com/mental-illness-and-sleep/  

Sleep & Mental Health, February 2013, https://www.sleephealthfoundation.org.au/public-information/more/sleep-blog/sleep-and-mental-health.html

Sleep and Mental Health, Harvard Health, Updated June 2018, https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health

How Mental Health Affects Sleep and Vice Versa, Tuck Sleep, June 2018, https://www.tuck.com/mental-illness-and-sleep/