What You Need to Know about Depression and Sleep

A good night’s sleep is vital for both your physical and mental health, but can sleep issues contribute to depression and anxiety?

Depression is a common mental disorder that impacts millions of Americans each year. According to the Centers for Disease Control, about 8 percent of U.S. citizens 20 or older— more than 25 million people— suffer from depression. Over the course of a person’s life, about one out of six people— or around 16 percent— suffer from depression at least once.

When it comes to sleep and depression, it can be a vicious cycle. Sleeping less leads to more irritable moods— who hasn’t felt a little cranky after a night of disturbed sleep? But someone with depression may also find it harder to sleep, making the problem worse. That’s especially true for anyone suffering from a sleep disorder like sleep apnea or insomnia.

So if you have depression or a sleep disorder, what can you do to protect your sleep health and your mental health? First though, let’s look at how sleep problems can increase your risk of a depressive disorder.

Poor Sleep Increases Your Risk of Depression

Your overall mood depends heavily on how well you sleep each night. Anyone who has stayed up late cramming for a test, preparing for a big day at the office, or had the bad luck of sitting near a crying baby on a red-eye flight knows this all too well.

You don’t have to worry if these situations pop up every now and then— it’s normal to get less than stellar sleep on rare occasions. But if it happens consistently over a span of a few weeks or a few months, a lack of sleep can add up and take its toll on your mental health.

A 2017 nationwide survey conducted by Dr. Kelly Sulivan of Georgia Southern University suggested a strong link between chronic sleep deprivation and depression. Of the 20,000 adults polled, participants getting a minimum of 7 hours of sleep each night— or at least one hour less than “optimal sleep—” were 60 to 80 percent more likely to show depressive symptoms and related issues, including nervousness and hopelessness.

Researchers continue to investigate the exact reasons why sleep helps decrease the risk of depression. One hypothesis is that your brain stops producing cortisol— often called the “stress hormone—” when you’re in the deep non-REM sleep stage, also known as slow-wave sleep. But that process is hampered when you don’t get good sleep each night— which can lead to increased stress levels and a harder time coping with depressive triggers.

At the same time, one 2017 study from the U.K. showed those suffering from mental health disorders— particularly depression— reported significant improvements in their condition when they received both more hours of sleep and better sleep quality, which is characterized by a minimal amount of sleep disruption during the night.

Sleep quality could be the real key here— even more than total sleep time. About 90% of people suffering from depression report problems with sleep quality. Avoiding nighttime interruptions allows your body to work through the four stages of sleep, and receive the calming, rejuvenating benefits that come with it.

Sleep Apnea and Depression

While poor sleep quality can worsen your depression, one sleep disorder— sleep apnea— is especially problematic. According to a study from the journal Sleep, 63 percent of people suffering from untreated sleep apnea— particularly obstructive sleep apnea— also suffer from depressive symptoms. This was consistent for both men and women.

Another multi-year study led by a Stanford University researcher found people suffering from depression were five times more likely to suffer from sleep-disordered breathing, including sleep apnea.

Compounding matters, depression and sleep apnea share several of the same symptoms, including:

• Fatigue and excessive daytime sleepiness— even after a full night’s sleep
• Irritability
• A decreased sex drive
• Difficulty focusing
• Headaches
• Poor sleep quality

So if you suffer from sleep apnea and depression, what can you do to improve your symptoms? Thankfully, in treating one disorder, you can actually improve the symptoms for both.

CPAP Treatment for Sleep Apnea and Depression

CPAP— or continuous positive airway pressure— is a very popular and effective treatment for sleep apnea. It works by generating a continuous stream of air that keeps your airways open, allowing you to breathe easily and normally while you sleep. Many underlying health problems can be worsened by sleep apnea, and treating them is much more difficult if you’re not treating your sleep apnea as well. Studies have found that treating sleep apnea with CPAP therapy has been shown to significantly reduce depressive symptoms.

One study from The Journal of Clinical Sleep Medicine found that 73 percent of participants with untreated sleep apnea also exhibited signs of depression. However, after just three months of CPAP therapy, researchers discovered some remarkable results. The number of participants who reported depressive symptoms dropped from 73 percent to 4 percent— other studies have recorded similar results.

Ultimately, identifying sleep apnea early on— and seeking treatment for it— can help reduce or even eliminate the causes of your depressive symptoms.

Insomnia and Depression

If you have trouble falling asleep, staying asleep, or getting back to sleep, you could be one of the 50 to 70 million Americans suffering from insomnia. Sometimes insomnia goes away as quickly as it arrives, but it’s possible to experience insomnia for an extended period of time. This is even worse if depression contributes to this serious sleep problem.

I’m sure you don’t need me to tell you how total sleep deprivation can harm your health. All of us have a bad night now and then, but if you consistently sleep poorly or barely at all over the course of several weeks— or even months— then you likely have chronic insomnia. Going that long without a good night’s sleep can really take a toll on your health— your brain isn’t firing on all cylinders, you’re exhausted, and you’re more likely to be injured in an accident.

Unfortunately, chronic insomnia is often a contributing factor for depression, and vice versa.

Research from the journal Sleep has found that people suffering from insomnia are 9 to 17 times more likely to exhibit significant signs of clinical depression or anxiety disorder.

Interrupted sleep, sleep disturbance, or problems even getting to sleep stand in the way of getting sufficient rest. Remember what I wrote above— poor sleep hinders your brain’s ability to reduce cortisol production, elevating stress levels and contributing to depression.

Stressing over your sleep or your mental health isn’t productive though. Instead, try making some healthy lifestyle changes not only for your rest, but for your health.

6 Easy Steps for Better Sleep

The relationship between sleep and depression is complex, but your sleep hygiene— or good sleep habits— can make a huge difference between a good night’s sleep and another night of poor sleep. Whether you’re experiencing a mood disorder or not, consider giving some of these simple changes a try tonight if you’re hoping to get a better night’s rest.

1. Follow a Consistent Bedtime: 

Going to bed at the same time every night and waking up at the same time each morning is one of the best steps you can make for better sleep. It’s not always easy to get into the habit, but sticking to it will help your body prepare itself for sleep by your selected bedtime, and help you be more rested when you wake up. Consistency is key though— make sure you do this every day, even on days where your schedule is less structured.

2. Sleep According to Your Chronotype

Your chronotype is your body’s natural disposition to be awake or asleep at certain times. Working with your circadian rhythm, your chronotype helps determine your ideal timeframes for not only when you should sleep, but your best productivity windows, and even the best times for you to have sex! To learn more about chronotypes— and to find yours— check out my chronotype guide.

3. Practice Relaxation Techniques

It’s difficult to sleep when your mind is racing. To help you clear your mind and sleep better, I recommend doing something relaxing before bed. This could be whatever you want— but some of my personal recommendations include breathing exercises, taking a warm bath, or meditating. I also recommend recording your thoughts-good or bad— in a sleep journal, like the ones from Best Self. Any of these relaxation techniques can help you unwind at the end of your day, calm your mind, and prepare your body for a restful night’s sleep.

4. Get Tested for Sleep Disorders

If you suspect a sleep disorder like insomnia or sleep apnea is causing or worsening your depression, the first thing to do is to get checked out by a medical expert. You can reach out to your doctor or a sleep specialist, and they can help you schedule a sleep study. A sleep study will provide you with an accurate diagnosis so that you can get the treatment you need. On that note…

5. If You Have a Sleep Disorder, Seek Treatment

Remember, sleep disorders won’t go away on their own. If you’ve been diagnosed with a sleep disorder, now’s the time to invest in proven treatment. Research-backed sleep supplements, like Jigsaw Health magnesium, can also help you get better rest when used alongside traditional treatments like CPAP.

6. See a Mental Health Specialist

While I’ve focused on how sleep disorders affect your mental health, it’s just as important to also address any underlying mental health issues that are worsening due to poor sleep. Make sure you see a qualified psychologist or therapist to see what treatment options are best for you. Treatments like talk therapy or cognitive behavioral therapy, or even medication, can be very helpful in improving your mental health and helping you sleep better. However, some antidepressants can actually contribute to insomnia, so be sure to talk to your doctor if you think your prescriptions may be harming your sleep.

Don’t Let Sleep Disorders— Or Depression— Ruin Your Sleep

It’s normal to have occasional sleep complaints, or even to feel blue every once in a while. But it’s not normal to experience them for an extended period— especially together.

Remember, your physical health, mental health, and sleep health are all connected. The relationship between depression and sleep disorders can be frustrating, drawing parallels to the chicken or the egg metaphor— are you depressed because of poor sleep, or are you sleeping poorly because of depression?

No matter what came first for you, there are solutions out there. So don’t get discouraged— this is a problem that can be solved!

Sweet Dreams,

Michael J. Breus, PhD, FAASM

The Sleep Doctor