On the importance of sleep for your mental heath

I often say that the importance of sleep should be covered in Volume 1 of So You've Decided to go to Therapy. 

The link between sleep and mood has been seen over and over in research. People with insomnia are 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety as those who sleep normally. ​We have long known that sleep difficulties are symptomatic of depression, anxiety, and other mental health conditions. New research is revealing that the relationship between sleep and our physical and mental health is much more complex -- and malleable.  For example, the more a person experiences difficulty sleeping and the more frequently they wake at night as a result, the higher the chances of developing depression even if they did not struggle with depression before.

More research is being conducted on factors that contribute to difficulty falling and staying asleep, or to shifting nighttime routines. Many studies have explored the connection between screen time (i.e., blue light exposure) and sleep difficulties. The readily available connection to work, social connections, entertainment, and distraction that come from our computers and phones carries with it implications for our sleep and thereby our physical and mental health. ​

Some clever IT professionals and start-ups have found a way to turn technology in our favor when it comes to sleep. Apps like Headspace and Calm have skyrocketed to the top of the Apple App and Google Play stores, due in no small part to their audio features that aid users in falling and staying asleep.

If you find that you struggle with getting good quality sleep, consider these sleep hygiene recommendations from the National Sleep Foundation:

• 1. Stick to a sleep schedule of the same bedtime and wake up time, even on the weekends. This helps to regulate your body's clock and could help you fall asleep and stay asleep for the night.
  2. Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep.
  3. If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can't fall asleep at bedtime, eliminating even short catnaps may help.
  4. Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
  5. Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool – between 60 and 67 degrees. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner's sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, "white noise" machines, humidifiers, fans and other devices.
  6. Sleep on a comfortable mattress and pillows. Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up during the night.
  7. Use bright light to help manage your circadian rhythms. Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms in check.
  8. Avoid alcohol, cigarettes, and heavy meals in the evening. Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime. 
  9. Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep, because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.
  10. If you can't sleep, go into another room and do something relaxing until you feel tired. It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.

Think about (or discuss in therapy!) ways in which you can actively work to prioritize your sleep to help improve your physical and mental health.