14 Mar Catching Up on ZZZ’s Can Help with Long-term Mental Well-being

We spend roughly one-third of our lives asleep – and for good reason. Quality sleep is integral to feeling – and functioning – well across our waking hours. During sleep, we relax and recover while our mind and body recharges. A national study seeking to understand the relationships Americans have with sleep reported that the average individual spends 8 hours and 42 minutes asleep each night. During this time, while unconscious, our bodies are at work. Our brain stores and processes memories from the day, we build our immune system, and we heal and protect against future injury, disease, or ailment. Research shows that sleep is essential for almost all areas of life, from protecting both your immediate and long-term physical health, quality of life, personal safety, social interactions, and decision making, to preserving your mental health. 

To celebrate and call attention to the multitude of ways sleep protects, heals, and replenishes us, the National Sleep Foundation sponsors Sleep Awareness Week each March. This year, from March 13th – 19th, the organization will celebrate the importance of sleep and share information on healthy habits to promote quality sleep for long-term health and well-being. Each Sleep Awareness Week, the NSF releases new results and a theme from its annual Sleep in America® Poll. Last year, the organization explored the connection between Daylight Savings Time and sleepiness, and in 2019, they revealed a connection between sleepiness, moodiness, and the impact on energy levels for daily life. The organization announced this year’s theme is becoming your Best Slept Self. Making the case that small changes towards achieving a deep and rejuvenating sleep can support overall health and more restful nights. 

In this blog, we’ll explore the variety of sleep disorders that disrupt or limit quality sleep, the connection between quality sleep and a healthy mental state, and steps you can take to build healthy sleep habits. 

Disruptive Sleep Disorders

While seven to nine hours of sleep is recommended, an estimated 21.3% of Americans – or  70 million people – suffer from sleep disorders. The struggle to feel rested can include quality, timing, or amount of sleep, and can have an impact during waking hours in the form of sleepiness, distress, or impairment in daily activity. Insomnia is the most common sleeping disorder, although obstructive sleep apnea, parasomnia, narcolepsy, and restless leg syndrome also affect millions.

Individuals who would like to sleep, but have trouble falling asleep and remaining asleep are experiencing insomnia. While restless nights can impact individuals from time to time, chronic insomnia is long-lasting – it is diagnosed when individuals experience insomnia several nights per week, over a period of at least three months. Unfortunately, insomnia is all too common – it is estimated to impact up to one-third of all adults in America. As a category, insomnia limits and disrupts sleep, but there are varying forms: 

• Sleep-onset insomnia prevents individuals from falling asleep, even when they are truly tired and attempting to drift off. 
• Sleep maintenance insomnia is when individuals wake frequently over the course of a night.
• Mixed insomnia is a mix of the above two forms, characterized by both a difficulty falling asleep and an inability to stay asleep.

 
Stress, irregular sleep schedules, poor sleeping habits, anxiety and depression, illness, chronic pain, certain medications, and neurological problems can cause insomnia. Often, a combination of several factors contributes to insomnia and worsening cases. The connection between poor sleep quality and mental illness is bi-directional. An estimated 40% of individuals with insomnia also are diagnosed with a mental health disorder, such as anxiety or depression. In return, early studies indicate that insomnia can worsen existing mood and anxiety disorders. 

Sleep apnea is a disorder characterized by a difficulty breathing while asleep, due to a blockage of the upper airway. Individuals with sleep apnea typically snore heavily; their sleep is often disrupted as they regularly wake up choking or gasping for air. Due to a poor quality of sleep, individuals often experience excessive drowsiness and fatigue during waking hours. 

Obstructive sleep apnea most often occurs in overweight or obese individuals, as excess soft tissue in the mouth and throat can block the airway during rest. While this form of sleep disorder can impact individuals of any age, an estimated 10% of individuals over the age of 65 experience it. Because it limits an ability to attain quality sleep, obstructive sleep apnea is associated with serious long-term complications, such as cardiovascular disease and premature death.  

Rather than a physical obstruction, central sleep apnea occurs when, during sleep, the brain does not send regular signals to the muscles that control breathing. Individuals with central sleep apnea regularly stop and restart breathing while asleep. Heart failure and stroke may contribute to the onset of central sleep apnea, although physical environment can also play a role – individuals who live at higher altitudes experience the disorder more frequently.

Narcolepsy is experienced as a “sleep attack,” or an irrepressible urge to sleep, regardless of place or time. Individuals with narcolepsy feel excessively tired during waking hours, even after a full amount of quality sleep the night before. Because of its regular disruptions to circadian rhythm and sleep habits, narcolepsy can contribute to other sleeping issues. It can also leave a fuzzy feeling during the daytime; symptoms include mental fogginess, poor memory, and hallucinations. An estimated 1 in 2,000 individuals suffer from narcolepsy across the United States and Europe combined. 

Restless Leg Syndrome is a sleep-related movement disorder that affects 7-10% of Americans. While resting, individuals experience throbbing, itching, and other painful feelings in the legs that contribute to an overwhelming “need” to move the legs. The disruption to sleep often contributes to other sleep-onset and sleep maintenance disorders. Researchers are not certain what causes RLS, although it is hereditary in some cases, especially when onset occurs prior to age 40. Lifestyle factors may also contribute; it is hypothesized that an unbalanced level of dopamine may send unnecessary signals to the muscles that control leg movement.  Iron deficiency, kidney failure, Parkinson’s disease, and other neuropathic diseases may contribute to the onset of RLS. 

A Self-perpetuating Cycle: Sleep Disorders and Mental Health

Sleep and mental health are intricately connected. Living with a mental health issue can impact your ability to sleep well, and not sleeping well can negatively impact your mental health. On one hand, certain mental health issues are known to contribute to poor sleeping patterns and longer term chronic sleep disorders, such as insomnia and restless leg syndrome. Stress, worry, anxiety, depression, medication, and current or past trauma can all have a bearing on one’s ability to sleep well.

On the flip side, sleep is a natural mood, energy, and health regulator. Without quality sleep, certain mental health conditions are likely to be exacerbated. Poor sleep is associated with feelings of anxiety, depression, pyschotic episodes, or even suicidal thoughts. Sleep disruptions often impact energy levels and the ability to socialize, which can contribute to long-term feelings of chronic loneliness, social isolation, or feeling misunderstood. Sleepiness can cause brain fog, difficulty concentrating, lack of interest in making plans, and difficulty making decisions. These disruptions to everyday life are more likely to contribute to feelings of low self esteem and worthlessness, that contribute to cycles of anxiety, depression, and other mental health problems. Long periods of sleeplessness have been documented to trigger mania, psychosis, or paranoia.  

With the COVID-19 pandemic, stress about health, finances, nutrition, schooling, current and future uncertainty, and safety increased exponentially, resulting in tangible disruptions to sleep patterns worldwide. Certain sleep disorders, such as insomnia, were diagnosed at rates double that of pre-pandemic levels. In a study published in November 2021, 36.7% of respondents experienced symptoms synonymous with clinical insomnia and 17.4% met the criteria for an insomnia disorder. In turn, this is thought to have helped fuel the mental health crisis, as individuals who regularly experience poor sleep quality are twice as likely to experience mental health disorders.

Building Healthy Sleep Habits

While quality of sleep is highly important to health and happiness in waking life, disruptions and chronic disorders are unfortunately all too common. Even though prescription drugs are advertised to create restful nights of sleep, research shows that in actuality, they only add up to about 20 minutes of additional total sleep time. Healthy sleep habits are the best way to earn quality rest and safeguard long-term health and mental well-being.

Lifestyle changes can have an outsized impact. Developing a regular exercise routine – especially one that includes weight training – has been shown to positively impact one’s ability to sleep. A recent study following previously sedentary, overweight individuals showed that adopting a consistent strength training plan helped them fall asleep faster at night, stay asleep longer, and wake up the next morning feeling rested and refreshed. Outside of regular exercise, a healthy balanced diet can contribute to quality sleep patterns. Balancing macronutrients, with vitamins and minerals keeps the body functioning optimally, including helping maintain the circadian rhythm and hormone production that regulates sleep. In fact, deficits of important nutrients such as calcium, magnesium, and vitamins A, C, D, E, and K have been shown to contribute to hormonal pathway disruptions that can create issues sleeping.

Environment can also play a role in the quality of your nightly zzz’s. The National Sleep Foundation recommends curating a bedroom that is free of electronics and external stimuli, conducive to relaxing and optimized for sleep. Light delays the body’s natural, nightly production of melatonin, which can interrupt the journey to dreamland. Installing dark curtains, dimming lights, and reducing blue light exposure in the two hours leading up to bedtime can help. Other optimal settings include lowering the room temperature to between 60 and 67 degrees, reducing noise, and selecting a mattress, sheet, duvet, and pillow combination that is most comfortable for you.

Tips to Build Healthy Habits that Promote Quality Sleep

• Create a regular sleep schedule. Commit to recurring bedtimes and waking- times, even on weekends. This will help train your body to grow drowsy, fall asleep, and wake up rested. 
• Develop a pre-bed ritual. Whether it’s a cup of chamomile tea, meditating, or taking a warm bath, a nightly ritual signals to your body that it is time to unwind and prepare for rest. 
• Shut off electronics two hours before bed. Electronics emit blue light that has been shown to disrupt sleep patterns. Two hours before your bedtime, switch off your phone, laptop, tablet, or TV and opt for a printed material instead. 
• Limit caffeine consumption. It can take up to ten hours for your body to completely process caffeine. That being said, reducing or eliminating that afternoon cup of coffee or caffeinated tea should make enough of an impact. 
• Create a peaceful atmosphere. Whenever possible, eliminate exposure to noise before bed. Shut off loud music or the television, and try putting on a “white noise” app, rain sounds, or peaceful music to help you relax. 
• Keep it dark + cool. Prepare your body for rest by setting the thermostat to somewhere comfortable between 60 and 67 degrees, and closing all curtains, dimming lights, and installing dark or blackout curtains. 

 
How you feel during the day and how you sleep at night are intimately connected. Developing healthy sleeping habits will have a long-term impact on your overall physical health and mental well-being. A relaxing bedtime routine, regular exercise, a healthy, balanced diet, and healthy outlets or therapy to help manage stress and anxiety are all wonderful ways to cultivate restful, quality nights of sleep. 

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