Sleep and mental health: an expert’s opinion
Anyone who’s experienced a bout of poor sleeping will be familiar with the impact this can have on their state of mind. Irritability, low mood and the feeling that your brain is just not functioning properly - these are all common side-effects of sleep deprivation, and although these might seem manageable in the short-term, the longer-term consequences of poor sleeping habits on our mental health can be much more detrimental.
We asked Professor Adrian Williams, a world-renowned sleep doctor and a member of our esteemed multidisciplinary team at Montrose, to explain why quality sleep plays such a crucial role in the maintenance of our mental health and well-being.
Why do we need to sleep?
The relationship between our physical health and sleep is well-documented - we know that animals deprived of sleep will die before they are deprived of water, for example, but it wasn't until the development of the EEG in the mid-1950s that scientists were able to analyse what actually happens to our brains when we're not awake. Until then, sleep was considered a suspension of activity, passive unconsciousness, a luxury; but it is actually an active process and necessary for memory.
Our sleep cycle consists of various sleep stages with two distinct types of sleep: non-REM (rapid-eye movement) sleep, during which brain activity slows, and REM sleep, which is when we dream. We transition between these stages roughly every 90-100 minutes, and it's during these stages that our brains set to work processing memories and consolidating learning, which improves our ability to function when we're awake.
There's also considerable evidence to suggest that healthy sleep plays a significant role in our emotional regulation systems. Researchers have found that our brains re-process recent emotional experiences during sleep, and that a lack of sleep can have a negative effect on our mood and our ability to cope with emotional challenges during the day.
How much sleep do we need?
The amount of sleep each individual needs is genetically determined, and families tend to sleep for the same amount of time. The average sleep requirement is 8.1 hours a night, although some people need as little as six hours and some more than ten! Put another way, half of us need more than eight hours, and it's not possible for us to alter how much we need.
People who manage fewer than six hours of regular sleep a night - those who do shift work, for example - are at much greater risk of health complications including high blood pressure, heart disease and even the potential for developing cancer than those who maintain a healthy sleep schedule.
Age also plays a part; as we get older, we're less able to stay asleep but our genetic requirement stays the same, leading to an increased tendency to nap during the day.
How does sleep affect mental health?
Mental health and sleep disorders go hand-in-hand. In fact, it's difficult to identify any psychiatric mood disorder where sleep disturbance is not a listed formal symptom or a common feature of the condition. Insomnia was for a long time thought of as an irritation, rather than having health implications.
We now know that the impact of poor sleep on emotional and mental health is huge, and there has been a shift in recent years away from the belief that difficulty sleeping was simply a consequence of mental health problems.
Research increasingly points to a bi-directional relationship between the two, meaning that chronic sleep problems can exacerbate existing mental health issues and play a causal role in the development of stress, anxiety and depression. This leads to the 'chicken-and-egg' question: does anxiety and stress cause insomnia or is insomnia caused by stress and anxiety? This is an active area of research for sleep scientists, but we know that the relationship between sleep disturbances and mood disorders is significant and complex.
Anxiety disorders are characterised by excessive worries or fears that can inhibit a person's ability to function in day-to-day life and include generalised anxiety disorder, PTSD, phobias and panic disorders. Restlessness, agitation and persistent negative thoughts often mean sufferers are kept awake at night, leading to increased anxiety in the day - often about the prospect of another poor night's sleep - which, in turn, leads to insomnia.
This negative feedback loop leads to a state of hyperarousal (when the mind is overwhelmed with racing thoughts) which contributes to existing worries and makes it difficult to fall asleep.
Affecting around one in six adults in the U.K and over 300 million people worldwide, depression is one of the most prevalent mental health conditions, and data suggests that levels of depression have increased over the past two years as a result of the global pandemic.
Both insomnia and hypersomnia (sleeping too much) are common symptoms of depression, with increasing evidence to suggest that poor sleep can precipitate or even induce a depressive episode.
Lack of sleep can increase the body's levels of the hormone cortisol, which plays a part in our fight-or-flight response. This compounds existing stress levels, making it hard for those under significant amounts of stress to relax, even when they feel tired.
Sleep loss also affects the amygdala - the part of the brain responsible for processing emotions. When the brain isn't given sufficient time to repair itself and process our emotional experiences, our ability to cope with stress on a daily basis is affected.
Both drug and alcohol addiction can have a significant impact on sleep, and - as with other mental health conditions - this relationship is often bidirectional. Problems sleeping can often lead to people self-medicating with substances, particularly depressants such alcohol, marijuana and prescription drugs, whereas stimulants such as cocaine and amphetamines can severely disrupt our circadian rhythm (the body clock responsible for maintaining a healthy sleep-cycle).
As well as often contributing to substance addiction, insomnia is also a common symptom of drug and alcohol withdrawal. Lack of sleep can lead to lower inhibitions, meaning self-control and will power are reduced, which can be contributing factors in a relapse. Improving sleep quality is an essential part of recovery if new coping-strategies are to be successfully embedded in the brain.
What can I do to improve my sleep?
Maintaining good sleep hygiene is the single most important thing you can do for your health and well-being. At Montrose, we offer proven methods to help guests improve their sleep, guided always by an individual's specific needs. These include:
Yoga and meditation - using breathing and relaxation techniques, our practitioners can lower stress levels by reducing cortisol and slowing the heart rate as well as equipping you with the mental resources to cope with life's challenges
Tailored exercise programmes - our personal trainer and exercise coach can optimise your fitness routine, which has been proved to reduce sleep onset and increase body temperature before bedtime, creating optimal conditions for sleep
Biotech - using wearable technology, we can collect your sleep data in order to create a bespoke programme built around your body's needs
Lifestyle changes - by connecting you with our experienced team of clinicians and therapists, we can help you address factors that are contributing to issues around mental health as well as problematic sleep patterns
Nutrition - our in-house dietitian and chef will create a meal plan designed to aid sleep and ensure you have the tools to maintain a balanced, healthy lifestyle that supports your sleep routine
If you are struggling with any of the issues described above, please get in touch to discuss how we can help you. You can call 01433 350500 or email email@example.com
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