• Sleep problems can be both a symptom and cause of poor overall mental health

  • Dave Gibson, who runs sleep clinics in London, shares his top 5 sleep tips

  • If you are struggling with insomnia, find a therapist here 

Adults who suffers from psychiatric conditions have over double the incidence of sleep problems compared to the population as a whole. Whilst the traditional clinical view is that sleep disorders and insomnia are symptoms of mental illness, recent studies have shown that the relationship between sleep and psychiatric disorders is complex and bi-directional. Both conditions can often affect the other, with poor sleep influencing both the onset and the severity of a mental condition. Conversely, mental illness leads to sleep problems, the level of which can be exacerbated by the severity of the particular psychiatric episode.  

What’s more, recent research has shown that treating sleep disturbances can have positive effects on the outcome of treatment of psychiatric conditions, and it’s now suggested that sleep problems may even raise the risk for, and even contribute to, the development of episodes of psychiatric disorders.

Whilst the detailed neurochemistry of the relationship between mental health and sleep isn’t completely understood, recent research has shown that lack of sleep effects the amygdala (the brain’s emotional control centre). Disruption to REM (dream) sleep in particular has been shown to lead to a decrease in emotional control and an over-reaction to negative stimuli. Conditions such as bipolar, depression, anxiety disorders, ADHD, schizophrenia and psychosis all are associated with sleep problems.

Certainly, those who have been diagnosed with a mental illness, find that looking after their sleep, and developing a healthy sleep routine helps reduce the severity of their condition. However, science is yet to determine cause and effect - it is still to be proven that long-term sleep deprivation leads to mental illness.

With regards to mental health, sleep is part of what I call the ‘health triad’ with diet and exercise the other core components, both of which have a direct effect on your sleep as well as your overall physical and mental health.

Here are my 5 top sleep tips:

  • Routine: Your brain loves routine so make sleep a ritual. Keeping regular hours will make it easier to get to sleep. Try to maintain this pattern even at weekends, as it helps strengthen your circadian rhythm, or body clock. 
  • Relax before bed: Meditation, breathing exercises, muscle relaxing techniques, taking a bath and reading a book will all help get your mind and body ready for sleep.
  • Technology: Switch it off an hour before bed, as blue light and mental stimulation will keep you awake. Don’t take any technology, including your mobile phone, into your bedroom.
  • Bedroom and light: A bedroom should be like a cave, cool, dark and quiet. Getting a good comfortable mattress is also a key component.
  • Keep a sleep diary: To work out what affects your sleep both positively and negatively.  Typical things to note down include; the time you go to bed, the quantity and quality of sleep you get,  ranking it 1-5 for example. If you awake at night, the number of times, the length of time, and what you do should all be recorded for example, sleepwalking, going to the toilet, any nightmares, night terrors etc.. Keep a record if you sleep in the day too, and for how long. Other things to note is what you eat and drink (especially caffeine) and how late. The amount of exercise you take, and any medication you are taking should also be noted. Finally log your general mood and feelings and scale of anxiety from 1-5 too.

How diet contributes to healthy sleep

Food and sleep are inextricably linked with what you eat affecting your sleep and your sleep affecting your food choices. Lack of sleep creates a switch in hormones which produce cravings for the wrong type of food, and a carbohydrate dense diet, sugary foods, alcohol, a deficiency in certain minerals such as magnesium, drinking too much caffeine are all likely to make it harder to get to sleep. Eating a balanced ‘Mediterranean’ diet is the best way of ensuring you get the correct balance of nutrients, which are vital for mental and physical health. One Vitamin in particular is key to both mental health and sleep is Vitamin D. Fatty fish (salmon, sardines, tuna) and egg yolk are a great source of Vitamin D. It’s especially important to include foods which are rich in Vitamin D in the darker winter months, as Vitamin D is also be produced in the skin from sunlight, which we get less exposure to in the winter.

The importance of exercise for good sleep

Getting regular exercise has a huge influence on our mental health. It reduces anxiety levels, burns off adrenalin and stress, produces endorphins (the feel good hormones), and is proven to help improve sleep quality and quantity. Exercising outdoors is particularly beneficial as it boosts your intake of Vitamin D. Vigorous exercise, which raises your heart rate, is regarded as best for sleep, and as little as 20-30 minutes of activity helps. However, a brisk walk, a bicycle ride or a run is also time well spent. 

Exercise does not have to be done all in one 30-minute session to aid sleep. It is suggested that those with insomnia exercise earlier in the day as a rise in body temperature right on top of bedtime could prevent the lowering of the body’s temperature which is part of the signalling process to the brain that it’s time to sleep, and with the endorphins produced during exercise also potentially keeping the insomniac awake.

Further reading

Struggling to sleep? Bedtime yoga might be the answer

10 ways to beat insomnia

Can you sleep yourself healthy?

How CBT can help you overcome insomnia

How sleep affects our diet