Sleep and mental health

We all need to sleep well to help our bodies recover from the day and to allow healing to take place.

*Last updated 17 March 2021

But a lot of us struggle to get a good night’s sleep. One in three of us suffers from poor sleep, and the consequences can be more serious than feeling grumpy or unfocused. Sleep and mental health are closely related: living with a mental health condition can affect your sleep, and poor sleep can affect your mental health.

Lack of sleep can also make us feel physically unwell. It’s linked to heart disease, diabetes, premature ageing and road accident deaths.

What kind of problems might I have with sleep?

We all have nights when it’s hard to fall asleep or we find ourselves waking up several times. Most sleep problems sort themselves out within a month, but longer stretches of bad sleep can seriously affect our lives.

Self-help techniques can get you back to a more normal sleeping pattern. But sleep problems can be symptoms of other conditions such as depression or thyroid problems, so speak to your GP if they continue.

Here are some sleep problems people experience.

Insomnia

Insomnia is the most common sleep disorder, affecting around one in five people. You may have insomnia if you find it hard to go to sleep, wake up several times during the night or wake up too early. During the day you may feel sleepy, anxious, irritable, and unable to concentrate or remember things.

Narcolepsy

Narcolepsy can cause you to suddenly fall asleep at inappropriate times. It’s caused by the brain being unable to regulate your sleeping and waking patterns. If you have narcolepsy, you may feel very drowsy throughout the day and fall asleep suddenly and without warning – for example, while at work, talking, or driving. There is no cure but the symptoms can be controlled by medication and by lifestyle adjustments such as changing your sleeping routine, improving your diet and exercising.

Sleep apnoea

Sleep apnoea is when your breathing stops and starts when you sleep, constantly interrupting your rest. If you have sleep apnoea, you will often snore loudly or make gasping or choking noises while you sleep. During the day, you will feel very tired, find it hard to concentrate, have mood swings, and have a headache on waking.

Losing weight and sleeping on your side can help mild sleep apnoea. You can also be prescribed special devices to help keep your airway open during sleep.

What can cause sleep problems?

Many different things that can affect our sleep. They include:

  • stress or worry
  • a change in the noise level or temperature of your bedroom
  • a different routine, for example because of jet lag
  • too much caffeine or alcohol
  • shift work
  • physical or mental health problems
  • side effects from medicines.

How can mental health problems affect sleep?

Mental health problems can affect your sleep in different ways.

Anxiety can cause your thoughts to race, which can make it hard to sleep.

Depression can lead to oversleeping: either sleeping late or sleeping a lot during the day. It can also cause insomnia if you have troubling thoughts.

Post-traumatic stress disorder (PTSD) can cause nightmares or night terrors. These may wake you up and/or make you feel anxious about falling asleep.

Mania can make you feel elated or energetic so you might not feel tired or want to sleep. You may also have racing thoughts that make it hard to sleep.

Medication can have side effects including insomnia, nightmares or oversleeping. Coming off medication can also cause sleep problems.

How can I improve my sleep?

There are many things you can try to help yourself sleep well.

  • Establish a regular, relaxing bedtime routine that lets you unwind and sends a signal to your brain that it's time to sleep.
  • Create a restful environment: bedrooms that are dark, cool and quiet are generally easier to fall asleep and stay asleep in.
  • Try to go to sleep and wake up at the same time each day.
  • Exercise regularly but avoid vigorous exercise near bedtime if it affects your sleep.
  • Avoid caffeine and alcohol before bed. They can stop you falling asleep and prevent deep sleep.
  • Only use your bed for sleep or sex. Your bed should be associated with sleep.
  • Avoid using screens in the evening, including on smartphones and tablets. The light from the screen can have a negative effect on sleep, and social media, news and games can all stimulate your brain and make you feel anxious.
  • Write down your worries if you lie awake worrying about tomorrow. This can help put your mind at rest.
  • If you can't sleep, don't worry about it. Get up and do something relaxing like listening to music or reading until you feel sleepy.

Treatment to help with sleep problems.

If sleep problems don't respond to self-help, talk to your doctor. It may be worth keeping a sleep diary for 10 days before your visit so you can explain the problem. Doctors will generally look for any underlying medical or psychological reason for the problem and may suggest further changes to your routine or lifestyle to help improve your sleep.

If these don't work, your doctor may suggest sleeping pills for insomnia. Sleeping tablets can help in the short term but quickly become less effective and can even make your sleeping problems worse. They can also be very addictive. For all these reasons, sleeping pills are generally prescribed at the lowest dose and for a short period of time.

If your problems persist, your doctor may refer you to a specialist sleep disorder clinic.

What if my child has sleep problems?

Children need long periods of uninterrupted sleep for their growth and development, but sleep problems are common – especially among younger children. This can have a big impact on the whole family. Children may be reluctant to go to sleep, wake in the night, have nightmares or sleepwalk. Some children with disabilities such as autism seem to have particular difficulty establishing a consistent sleep pattern.

Some of the self-help measures above can be adapted for children. It’s also a good idea to keep a sleep diary to show their doctor. Excessive sleeping or a continued reluctance to get up could suggest depression or another mental health problem. If your child has sleep problems, make an appointment with their doctor to see what help is available.