How sleep health affects your mental health

July 13, 2021 in Complementary & Integrative Medicine  •  By Michael Scott, ND, MSA
sleep health

You may be familiar with the connection between sleep and physical health, but did you know that sleep can also significantly affect your mental health and wellness? We talked with sleep specialist Dr. Michael Grandner to learn more.

Dr. Grandner is Director of the Sleep and Health Research Program at the University of Arizona (UA), Director of the Behavioral Sleep Medicine Clinic at the Banner-University Medical Center, and an Associate Professor in the Department of Psychiatry at the UA College of Medicine, as well as a faculty member of the Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs. He is certified in Behavioral Sleep Medicine by the American Board of Sleep Medicine and is a Diplomate in Behavioral Sleep Medicine by the Board of Behavioral Sleep Medicine. Dr. Grandner’s research focuses on how sleep and sleep-related behaviors are related to cardiovascular disease, diabetes, obesity, neurocognitive functioning, mental health, and longevity.

PinnacleCare (PC): Can you describe the relationship between sleep and mental health?

Dr. Michael Grandner (MG): The connection between sleep health and mental health goes back decades. The relationship in particular between insomnia and depression is one of the most robust and reliable relationships in all of medicine. Insomnia is a better predictor of depression than cholesterol is for heart disease.

Sleep health is important for mental health for a number of reasons. First are the benefits of sleep for the brain. When you’re getting enough restful sleep, your brain is able to do the maintenance and processing work it’s built to do. If you’re not able to do that, it isn’t. Then, what happens is you get problems focusing, paying attention, and retaining, organizing, sorting, and recalling information.

Your decision making process and ability to weigh risks and benefits and make judgements becomes impaired too. Although we tend to be good at being able to tell if we’re having trouble focusing, we’re not very good at telling how impaired we are in terms of our thinking and decision-making. You can’t caffeinate the impairment away. Caffeine has been shown to improve things like speed and reaction time, focus of attention, sleepiness, and fatigue, but it doesn’t fix the more complex cognitive impairments due to sleep loss.

When sleep is impaired, your ability to regulate emotions and understand emotions is also impaired. Show me someone with a short emotional fuse, and I’ll show you someone who’s not sleeping well. Lack of restful sleep impairs our ability to develop positive relationships with people, work as a team, and be a leader.

Emotion is also critical for memory and integrating information and learning. Emotion can serve as a memory filter because it helps us sort information and understand the context of information, how we feel about information, and how other people are feeling. When our emotional perception and emotional recognition are thrown off, our ability to process events becomes distorted.

Sleep also plays roles in helping us regulate our own emotions. Ongoing sleep problems can negatively affect our mental health. We have data that show that the link between insomnia and depression isn’t just through lack of sleep. It’s how the lack of sleep impacts your ability to function during the day—how it impacts your appetite, your ability to focus, your feelings of failure, optimism, and pessimism. Sleep impacts quality of life, over and above how it impacts the brain.

PC: What are some of the signs that you’re not get enough good quality sleep?

MG: There are some big signs and some smaller signs. See a sleep specialist if it’s taking you more than a half an hour to fall asleep or you’re awake for more than a half an hour during the night, trying to sleep, at least three nights a week. If you are snoring loudly and feeling very tired during the day, especially if anyone has ever seen you stop breathing during sleep, even once or twice, get tested for sleep apnea.

If you’re getting six hours or less of sleep on average, that’s probably not enough. That’s the amount that’s linked to higher rates of heart disease, diabetes, poor performance, missed days at work, decreased efficiency, and so on.

If you have trouble staying awake during the day, that’s a sign that your sleep is broken up or shallow or insufficient at night. If you wake up feeling terrible, that could just be normal sleep inertia. But if that feeling lasts more than 10 to 20 minutes, that’s a sign that your sleep wasn’t restful or wasn’t long enough.

And if you fall asleep within three minutes of your head hitting the pillow, you waited too long to get to bed. That’s a sign you were a little sleep deprived. Another lesser-known sign that you should be going to bed earlier is that you’re really hungry at night a few hours after dinner. Your body’s craving energy that it doesn’t need because you’ve stayed up too late.

A lot of us live “paycheck to paycheck” with our sleep. We wait to go to bed until we feel like we can’t possibly do any more. And then, we ask the question, “How much time do I have left in my day to spend on sleep?” That’s backwards. We shouldn’t see sleep as a cost. We should see it as an investment in our next-day’s mental and physical performance. That perspective will take you to a place of balance, so that when you do have occasional sleep issues, you’ll be much more resilient.

We shouldn’t decide when to go to sleep based on how much time we have left in our day. We should be deciding when to go to sleep based on how productive, efficient, and effective we want to be tomorrow.


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