Skip to main content

Anxiety and Depression Due to Sleep Deprivation? Exploring the Links Between Lack of Sleep and Mental Health

English

 

The link between sleep and mental health has been seen and studied for decades by doctors and researchers. People who don’t get their regular 7-9 hours of sleep per night are at 10x greater risk of depression and 17x greater risk of anxiety. To go one step further, the more frequently one wakes in the night due to insomnia, the higher the chances of developing depression (1). Before considering pharmaceutical sleeping aids, it is important that we consider all aspects of health that can be contributing to a sleep disorder.

RISKS OF POOR SLEEP

Sleep is largely an underrated aspect of maintaining proper health. Sleep lowers stress, reduces inflammation in the body, improves memory and focus, supports digestion and can even result in healthy weight loss. Sleep deprivation studies have demonstrated significantly increased risks of cardiovascular diseases, including coronary artery disease, hypertension, and arrhythmias. Short sleep duration over a long period of time has increased the risks of diabetes and obesity.

 

Anxiety and depression due to sleep deprivation

In 2019, and many years before this, a study surfaced looking at the effects of sleep deprivation and the development of Alzheimer’s Disease. Disruptions in circadian rhythm impair the body’s ability to clear tau protein and B-amyloid. The accumulation of these two proteins in the brain has been linked to the development of memory loss and cognitive declines associated with Alzheimer’s Disease and dementia (2).

For many people, a change in sleep routine is a necessary part of maintaining their livelihood. Nurses, hospital staff, security guards and other shift workers are faced with an inconsistent work-sleep schedule. People who travel across time zones frequently are also at risk of circadian rhythm disruption. These individuals have been the focus of many research articles around the long-term effects of sleep, mood and metabolism. What has been found, is that short sleep duration elicits a physiological stress response in the form of inflammatory mediator production overnight. This physiological stress disrupts the healthy functioning of the intestinal gut microbiome. Unhealthy bacteria overgrow and create an inflammatory state, which alters metabolism. This means that shift workers are at a higher risk of developing obesity and Type 2 Diabetes (3). 

SLEEP DEPRIVATION AND DEPRESSION

The relationship between sleep and mood is hard to measure and has so many complicating factors that make every case unique. New mothers are sleep deprived, but also face a drastic hormone shift that can aggravate post-partum depression. Loss of a loved one or a job can create a shift in sleep and mood due to grief. These effects cannot be measured or compared.

Because the symptoms of depression overlap with symptoms of sleep disorders, many cases are often misdiagnosed. Depression is often a downstream effect of Obstructive Sleep Apnea, Narcolepsy and Restless Legs Syndrome. But when these sleep disorders go undiagnosed, the depression becomes more evident and is often the only concern that gets treated. A European study of Obstructive Sleep Apnea found that people with depression were five times more likely to suffer from sleep disordered breathing at night. Those who used a CPAP for one year found improvements in mood that were significant and lasting (4).

SEASONAL AFFECTIVE DISORDER AND SLEEP

Anxiety and depression due to sleep deprivation

Winter proves to be an additional challenge for those struggling with sleep and depression. The extended night hours and lack of daylight create an imbalance between serotonin and melatonin which make us feel down. Serotonin and melatonin are on the same family line and serotonin helps us make melatonin. In winter, the longer nights create a higher demand for melatonin. This demand takes from the pile of serotonin and reduces the amount of available serotonin for mood balance. This means we are more likely to feel sluggish, less motivated and less happy. While we should be sleeping more at this time of year, our lifestyles don’t allow it. With too many things to get done before the end of the day, we end of sleeping later and struggling to wake up in the morning.

SLEEP DEPRIVATION AND CHILDHOOD DEPRESSION

Childhood mental illness may be the most significant health concern of the 21st century. Children communicate differently and are not always able to convey their emotions to their adult counterparts. The combined effects of excessive screen time, over-involvement in extra curriculars and an active household often lead to insufficient sleep and downtime. Many children are not able to properly decompress at the end of a busy day and this can lead to disruptions in sleep, mood disorders and poor focus at school. The National Sleep Foundation American Sleep Poll in 2006 showed that among children aged 11-17 who reported being unhappy, 73% also reported not sleeping enough (4).

SLEEP DEPRIVATION AND ADHD

 Children and adults display sleepiness very differently. While adults seem to slow down when tired, children tend to overcompensate and speed up. Sleep deprivation can show up as moodiness, explosive emotions and aggression in children. Many of these children can often be diagnosed as ADHD. While ADHD is linked with a variety of sleep disorders, it is difficult to determine which came first. Children with ADHD have higher rates of daytime sleepiness than children without ADHD. 50% of children with ADHD demonstrated disordered breathing and other sleep disorders such as Restless Legs Syndrome (5). Perhaps managing sleep problems could be enough to eliminate or significantly reduce ADHD symptoms in adults and children.

SLEEP DEPRIVATION AND ANXIETY

Anxiety can cause sleeping problems and lack of sleep can exacerbate an anxiety disorder. Over the course of the day, we produce the hormone Cortisol in response to stressful events. In a very primal way, our bodies perceive danger and keep us on edge by creating anxiety. In order for our melatonin to rise at the end of the day, cortisol needs to decrease. This means the evening hours before bed are crucial opportunities to lower the stress response, clear out excess cortisol and calm the nervous system for sleep. If we are not able to properly calm the stress response at night, we end up with restless sleep, frequent waking and overactive mental activity.

As mentioned above, inadequate sleep results in a 17x increased risk of clinical anxiety. The series of false alarms that we experience as stress and anxiety during the day leads to a state of dysfunctional arousal. This means we are always anticipating a stressful event and are always in fight-or-flight mode. As this pattern persists, we are more prone to sleep-wake difficulties and sleep disturbance. 

HYPERSOMNIA

Anxiety and depression due to sleep deprivation

Along with not sleeping enough, sleeping too much can also indicate a mood disorder. Hypersomnia, or excessive daytime sleepiness, is strongly linked to depression and other mood disorders. It is characterized by sleeping more than 11 hours in a 24 hour day over a span of at least 3 months. This excessive sleepiness can be confirmed by polysomnography and is generally non-restorative sleep. While there seems to be a certain genetic metabolic link that is at higher risk of hypersomnia, the majority of cases are temporary and often associated with lifestyle factors. Emerging research shows that hypersomnia can be the result of a number of factors, including altered circadian pacemaker, side effects of medication and high levels of inflammation in the body (6).

SO HOW MUCH IS CONSIDERED ADEQUAT ?

To date, the current sleep guidelines suggest that adults require 7-9 hours of sleep per night. Most children require more than 10 hours of sleep per night, but the recommendations vary based on the age of the child. As we age, the amount of required sleep declines but not by much. Older adults are still recommended to get 7-8 hours of sleep per night and no more than 9 hours of sleep per night (7). Many books, podcasts and documentaries have provided life-changing stories on the importance of sleep and the detrimental effects of not getting enough. Here we have touched on the effects of sleep deprivation on mood. In reality, the effects of sleep disturbance extend to the gastrointestinal tract, the immune system and the reproductive system. Irritability, frustration and sadness are common signs of lack of sleep. Lack of sleep lowers energy levels, imbalances hormones and alters food cravings. Regardless of a pre-existing mental health condition, even small levels of sleep deprivation can cause a decline in happiness over time. The profound impact that sleep can have on relationships is hard to ignore and should not be underestimated.