May is Mental Health Awareness Month. If you’re looking for ways to improve your mental health, consider starting with your sleep. Improving your sleep can mean big benefits when it comes to feeling good.
What is the relationship between sleep and mental health?
A myriad of genetic and environmental factors play into mental health, and not all of them are fully understood. But what we do know is that sleep plays a crucial role in mental well-being. Sleep and mental health have a two-way relationship, meaning they impact each other.
“We know that people with mental health issues tend to have more difficulty sleeping; poor sleep also causes (and exacerbates) mental health issues,” says Richard Blackburn, a clinical psychologist in Cambridge, Minnesota, who focuses on sleep.
Sleep problems are listed as symptoms of many psychiatric diagnoses, Blackburn says. The DSM-5, the widely used diagnostic tool created by the American Psychiatric Association, lists sleep disorders as a symptom of depression, anxiety, and bipolar disorder among other disorders. Chronic insomnia is also associated with an increased risk of suicidal thoughts.
“Everything gets harder when you sleep poorly,” says Blackburn. Sleep is sometimes called an additional vital sign, he says, along with heart rate, breathing, temperature and blood pressure because it’s so important to health. In addition to mental health issues, people who regularly sleep less than six hours a night are at increased risk of heart attacks, strokes, and metabolic diseases like diabetes.
But the good news is that sleep issues can be managed. “When sleep goes bad, there’s usually a reason for it and that reason needs to be explored,” says Blackburn.
What can I do to improve my sleep and mental health?
Anyone with chronic insomnia or a serious mental health condition like depression should see a doctor. Insomnia exacerbates mental health problems, in part because people lose emotional regulation when they’re not sleeping, Blackburn says.
You can start with your primary care physician, who can help you decide if you need to see a sleep psychologist or a sleep specialist who can perform a sleep study or other treatment, suggests Blackburn. A form of counseling called cognitive behavioral therapy, for example, can be effective in improving insomnia, Blackburn says. Treating insomnia can improve other symptoms of mental health problems. Likewise, treating physical medical conditions like sleep apnea or hormonal imbalances can improve sleep issues that can be detrimental to a person’s mental health.
“The best treatment for coexisting sleep and mood disorders may require collaboration between different providers, the use of medications, treatment of associated sleep disorders, and psychotherapy,” says Dr. Brandon Peters, sleep physician at Virginia Mason Medical Center in Seattle, Washington. .
That said, for healthy people who are simply looking to sleep better at night, there are a few simple steps you can take yourself.
Create a bedtime routine
Doing the same set of relaxing, repetitive activities every night as your bedtime routine can train your brain to prepare for rest. Set a phone reminder an hour before bedtime to remind you to begin the transition to sleep, advises Peters. Take advantage of this time to relax and disconnect from your day. This means putting aside your work, emails, and social media, and reading or listening to soothing music instead.
Wake up at the same time every day
Having a consistent start to the day is just as valuable as a regular bedtime routine for keeping your sleep-wake cycle on track. You should set an alarm for the same time in the morning, regardless of what time you went to bed the night before, says Blackburn. Your internal clock sets itself when you get up and the sunlight shines in your eyes. If you spend waking up beyond sleep, it pushes your body’s clock back, which means it’ll be harder to fall asleep that night.
“Sleeping on the weekend disrupts your internal clock for several days,” he says. “It’s like having jet lag without ever leaving the house.”
Try not to stress in bed
Sometimes not being able to fall asleep once your head hits the pillow can make you anxious about not being able to sleep…a vicious cycle. If you’re lying in bed and unable to doze off for more than 15 to 20 minutes, get up and do something relaxing instead of tossing and turning, Blackburn says. If you lie there insisting that you can’t sleep, you’ll begin to associate your bed with stress instead of comfort and relaxation.
Likewise, try not to ruminate on your day or stress about your workload in bed. One option is to listen to a sleep story, like those produced by mediation apps like Headspace. These are relaxing adult stories designed to distract you from everyday anxiety and lull you to sleep. If you don’t want screens, you can try the Morpheus, a screenless meditation device with multiple options for relaxing. But if stress in bed becomes a recurring problem, consider seeking professional help.
Keep your bedroom comfortable
Your bed and bedroom should be both physically comfortable and emotionally comfortable. Keep your bedroom cool, dark and quiet, says Peters. Somewhere in the mid-60s is generally considered the ideal sleeping temperature.
Try not to bring screens into the room or at least use phone settings at bedtime, including not watching TV until you go to sleep.
If light is an issue in your bedroom, consider using blackout curtains to keep street lights from keeping you up at night or a sleep mask if your partner keeps a light on when you want to nap. If it’s too loud, try a white noise machine to drown out ambient sound or earplugs to stop, say, the barking neighbor’s dog from waking you up with a start.
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