Have you ever heard the expression that someone who is in a bad mood “woke up on the wrong side of the bed?” There is a lot of science that supports this statement. Sleep is a very important part of our lives. Our bodies are actually quite chemically active during sleep and perform many important restorative and reparative functions. The quality and length of time we sleep can serve as an important indicator of our physical health and emotional wellbeing.
Physicians often refer to a person’s sleep hygiene and sleep hygiene practices during assessments and in making recommendations for treatment of many conditions. Emotional health has demonstrated links to depression, anxiety, bipolar disorder, and other conditions. Psychiatric disorders tend to make it harder to sleep well. At the same time, poor sleep, including insomnia, can be a contributing factor to the initiation and worsening of mental health problems.
Individuals experience several different stages of sleep that influence thinking, learning, memory and emotional health. Each stage helps with many restorative and regenerative functions. During sleep, the brain works to evaluate and remember thoughts and memories. A lack of sleep, or poor sleep, is especially harmful to the consolidation of positive emotional content. This deficit can influence mood and emotional reactivity and be a contributor to mental health disorders and their severity, including the risk of suicidal thoughts and behaviors.
As we sleep, our bodies cycle through Rapid Eye Movement (REM) and non-REM sleep. REM is a stage of sleep that is helpful in processing emotional information and evaluating and remembering different thoughts and memories. It is this stage where most dreams occur. Sufficient sleep, especially REM sleep, facilitates the brain’s processing of emotional information. A lack of REM sleep is associated with poor emotional and behavioral functioning.
One of the more common health problems that occurs with poor sleep is obstructive sleep apnea (OSA). Individuals with OSA experience pauses in their breathing while sleeping which reduces the oxygen level in their system. This lack of oxygen causes fragmented and disrupted sleep, influencing both physical and mental health. Other disorders linked to poor sleep include depression, seasonal affective disorder, anxiety disorders, bipolar disorder and psychotic disorders. Many individuals who suffer from depression experience poor sleep and have difficulties initiating and maintaining sleep. Some individuals with depression sleep excessively, a condition referred to as hypersomnia. Seasonal Affective Disorder (SAD) is a mood disorder influenced by the decrease in the amount of natural light that occurs during the winter months. People with SAD experience symptoms such as fatigue, depression, feelings of hopelessness, and social withdrawal.
Bipolar Disorder is a mental disorder that is highly influenced by sleep. Individuals with this disorder experience periods of depressed mood (where they may sleep too much) alternating with, or combined with, periods of mood elevation (where they often experience the need for less sleep without feeing fatigued). Many individuals with anxiety disorders suffer from insomnia and hypersomnia, as well as nightmares and nighttime panic attacks regarding traumatic experiences.
Sleep disturbances are also prevalent in persons suffering from psychotic disorders. The lack of sleep, or lack of quality sleep, further accentuates their difficulty in distinguishing between what is real and what is not real. Alternations in their natural circadian rhythm compromise their body’s ability to rest, restore and regenerate their emotional and physical functioning.
As previously mentioned, many mental and emotional challenges themselves make it difficult to sleep. Many children with ADHD do not sleep well, which negatively impacts their ability to pay attention. Simply put, when we do not sleep well our brains do not make enough of the chemicals we need to function well emotionally. Sleep training is particularly important for children in general, but especially for children with attention challenges.
What can we do to help with sleep problems? We can practice having good sleep hygiene. This means getting needed rest and allowing our body to undergo regenerative and restorative processes that occurs during sleep. Simple steps can have a big impact. Start with making a concerted effort to get plenty of rest. Our bodies work best with a regularly maintained schedule. Set a bedtime and awake time that will work for you daily that provides you with enough sleep time for you to be refreshed. Start to quiet your day a few hours before bedtime. Turn off electronic devices such as computers, cell phones and other devices at least an hour before bedtime. Electronic devices emit blue light that keeps us awake. Avoid exercising too close to bedtime. While an important part of good health, exercising before bedtime will increase the bodies’ core temperature, making it more difficult to feel sleepy. Room temperature plays an important role in sleep. Research has demonstrated that people who sleep in a cool dark room tend to sleep better that those who do not. Avoid having caffeine late in the day and be careful of cold and cough remedies that contain ephedrine. Many people are sensitive to caffeine and to ephedrine products. Avoid alcohol. While it might help you fall asleep, you often wake later in the night because it interferes with REM sleep.
Relaxation techniques are very beneficial in most aspects of our lives. Learning to power down our mind and body helps us ward off stress and anxiety and trains our bodies to prepare for rest and regeneration. You can also talk to your doctor or therapist about any sleep concerns you may be experiencing. Good sleep hygiene is a learned activity that takes time and commitment. Better sleep increases our ability to focus and concentrate, regulate our emotions and gain better balance in our day-to-day lives.
Lynn Feldman, DO, MPH is an adult and child/adolescent psychiatrist treating patients at Brook Lane’s Frederick outpatient office. She is certified by the American Board of Psychiatry and Neurology in general psychiatry, child and adolescent psychiatry and addiction medicine. She treats patients with a variety of disorders including autistic spectrum disorders, attention deficit hyper activity disorder, and anxiety, mood and psychotic disorders.