I guess I would say that my initial problems with sleep started to surface following the death of a loved one.
At the time I probably didn’t fully realize it, as I had sunk into an incredibly low state, a constant cycle of grief and extreme sadness.
In fact, I would go as far to say it wasn’t until many years later that it dawned on me that perhaps my highly charged emotions at the time were the catalyst for my sleep deprivation.
This is what led me to research this topic further – Does depression affect your sleep?
The Facts About Depression and Sleep
It is estimated that approximately 75% of people with depression typically struggle with some form of sleep disorder. The most common issue being insomnia.
Insomnia isn’t just about not being able to sleep as many people may assume. If you suffer from insomnia this could encompass having difficulties in falling asleep, staying asleep (i.e. waking up numerous times throughout the night), and also waking up far too early and being unable to go to sleep again.
We are aware that people suffering with depression typically take far longer to fall asleep when compared to a non-depressed person. They are also likely to wake up more frequently during the night and have extreme difficulty in falling asleep again.
Another issue with sleep that you may experience alongside depression is hypersomnia or excessive/extreme daytime sleepiness disorder (EDS).
It is estimated that every 4 out of 10 people with depression also suffer from EDS.
Excessive daytime sleepiness can be considered both a primary or secondary condition, but as a secondary condition it is most commonly associated with mental health disorders, such as depression.
It is also interesting to note that women with depression are more likely to experience problems with sleeping than men.
The Role Sleep Plays In Depression
For many years, medical experts believed that if we could deal with a primary condition, such as depression, then the secondary condition (insomnia) would eventually dwindle and peter out.
However, further research into this matter quite clearly shows that if we don’t treat the sleep problems first then it becomes far more difficult to treat depression. In fact, someone is likely to relapse and their depression is inclined to return if the insomnia isn’t dealt with initially.
So, it actually makes far more sense to consider the role insomnia is playing in depression rather than vice versa.
The Centers for Disease Control and Prevention (CDC) conducted a telephone survey (via the Behavioral Risk Factors Surveillance System) in 2012.
The survey asked a total of 20,851 (50.4% were women) participants (average age 47.5 years) a number of questions related to health subjects, such as exercise, sleep habits, etc.
The participants were asked how many hours sleep they would typically get in a 24-hour period, and this should include naps.
Furthermore, they were also asked whether they felt nervous, fidgety, restless, hopeless or depressed at any point in the preceding 30 days. Plus how many days they would consider that they would rate their mental health as “not good”.
Only 60.6% of the participants reported sleeping the optimum number of hours, i.e. 7-9 hours a night. So, in effect, almost 2 out of every 5 people surveyed did not get what is considered a good amount of sleep.
The overall findings concluded that by losing just one hour of sleep a night there is a 60%-80% increased chance of experiencing nervousness, feeling fidgety or restless, hopelessness, or depression.
Did You Know That Depression Actually Changes the Way That You Sleep?
I always assumed that depression stopped me from sleeping properly because I was feeling stressed out, worried or anxious whenever I went to bed.
Okay, admittedly this is partly true, but what I didn’t know is that depression actually changes the way we sleep, more specifically it has an impact on our sleep cycles.
Allow me to explain.
I know at one point in my life (many, many moons ago) I thought sleep was just a constant state.
I got into bed at night, fell asleep, and woke up again in the morning (that actually sounds like heaven, doesn’t it?)
However, nothing could be further from the truth.
We tend to sleep in cycles (no, this has nothing to do with pedaling) that last approximately for 90 minutes at a time.
For some of us, a sleep cycle may last for as little as 60-70 minutes, whereas for others they may go on for as long as 120 minutes. You would generally enter deep sleep and very deep sleep around three-quarters of the way into a sleep cycle.
Therefore, if you’re someone who constantly finds themselves waking up during the night, you may actually be missing out on some essential deep sleep.
You see our sleep cycle generally goes through 5 stages (you will often see this described as 4 stages by many people, but I like to separate stages 3 and 4 into two separate entities).
So, firstly we have very light sleep, just as you’re about to drop off. Then we have light sleep whereby you have been asleep for around 10-15 minutes. This is followed by deep sleep, very deep sleep, and finally REM sleep.
The sleep cycles are sometimes referred to as Non-REM sleep and REM sleep.
REM sleep is undoubtedly the most “famous” of all the sleep stages and is characterized by its name Rapid Eye Movement and is typically when we dream.
In fact, our most vivid dreams occur when we are in REM sleep and it is during this period of sleep that we process our experiences and emotions. Therefore, you could say that REM sleep is extremely important in terms of our mental and emotional health.
REM sleep is occasionally called paradoxical sleep (seems absurd to me, sorry I couldn’t resist), due to the fact that our brain waves and patterns are very similar to when we are awake. I would hazard a guess this is how we actually dream during this stage of sleep, as our brain is very close to “being awake”.
During the first cycle, REM sleep tends to be fairly short, say no more than about 10 minutes, but the length of REM sleep increases with each subsequent sleep cycle.
It is fairly unlikely that we will dream during the non-REM sleep stages, and this is when we usually consolidate our memories (light sleep) and heal and grow physically (deep and very deep sleep).
However, the severity of depression can impact on how quickly we enter REM sleep, sometimes this can be as little as 30-45 minutes into a sleep cycle. This means that we are spending less than half the usual time in the stages of sleep where both the body and mind are being “cared for”.
In fact, the early emergence of REM sleep generally replaces the first stage of deep sleep, which is when human growth hormone (HGH) is normally released, and it is this release of hormones that allows the mind and body to heal and grow.
Unfortunately, this loss of HGH being released cannot be made up for later in the night. So, if you are suffering from depression and you’re entering REM sleep too early, the body will find it much more difficult to repair itself.
This is also true for some people who have overcome depression, and they still miss out of this initial spurt of HGH, which continues to cause issues with the brain and body being able to heal.
There is a theory as to why someone who is depressed tends to have a longer initial period of REM sleep when compared to someone who isn’t depressed – they basically have a far higher level of emotional activity to deal with.
Makes perfect sense to me.
We Should Be Looking At Improving Sleep to Help With Depression
So, if depression is changing our sleep cycles this will usually have a knock-on effect on our everyday life.
The body will struggle to repair and heal itself, the mind is not being given ample time to also go through the healing process either, and this will eventually have an impact on our overall mood.
Therefore, if we are able to treat insomnia and sleep deprivation then we have a far greater chance of reducing the symptoms of depression.
I think we all know that the better we sleep, the better we are likely to feel, and this is no different for somebody who suffers with depression.
By improving the quality of our sleep we generally:
- Feel happier
- Reduce feelings of anxiety
- Feel calmer
- Improve the functioning of the immune system, which helps us to ward of colds and flu
- Can protect against dementia
- Lower our risk of heart attacks
- Can reducing food cravings
- Lower our levels of stress
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And believe it or not, better sleep actually makes us more attractive and can contribute to helping us live longer.
To be honest, the list of benefits of a good night’s sleep goes on and on
So, in my mind we should always be prioritizing good sleep, and this is true whether you have depression or otherwise.
The link between sleep and depression is obvious when you think about it.
However, as the above evidence shows, we shouldn’t simply view an ongoing problem with sleep as being down to depression.
Yes, of course, as I have alluded to, depression will definitely affect the way you sleep, but in my mind we should look to deal with our sleep issues first.
It appears that medical experts and sleep researchers alike are coming round to the same way of thinking.
Now don’t get me wrong – I’m not saying that if you deal with your problems with insomnia then your depression will magically disappear.
Nevertheless, I think we can all agree that by improving the quality of our sleep we stand a far better chance at the merciless hands of depression.