A good night’s sleep is the first step to a better mood – 02/25/2024 – Balance

It started with mild anxiety. Emily, who asked to be identified only by her first name, had just moved to New York City after college to start a marketing job at a large law firm. She knew it was normal to feel a little nervous. But she wasn’t prepared for what came next: chronic insomnia.

Getting just three or four hours of sleep a night, it didn’t take long for her anxiety to spike: By age 25, she was “nervous all the time. A disaster.”

One day, when a lawyer in her office yelled at her, she had the first of many panic attacks. A doctor’s suggestion led her to try taking a sleeping pill in hopes that she could “reset” her sleep cycle and improve her mood. Did not work.

Americans are chronically sleep deprived: One-third of adults in the United States say they sleep less than 7 hours a night. Teenagers fare even worse: About 70% of high school students don’t get enough sleep on school nights. And this is having a profound effect on mental health.

An analysis of 19 studies found that because sleep deprivation worsened a person’s ability to think clearly or perform certain tasks, it had a greater negative effect on mood. In 2021, the National Sleep Foundation conducted a survey in which half of those who said they slept less than 7 hours each weekday also reported having depressive symptoms. Some research even indicates that addressing insomnia can help prevent postpartum depression and anxiety.

Clearly, sleep is important. But despite the evidence, there is still a shortage of psychiatrists or other doctors trained in sleep medicine. So what happens to our mental health if we’re not getting enough sleep and what can be done about it?

How does poor sleep quality affect mood?

When people have trouble sleeping, it changes how they deal with stress and negative emotions, says Aric Prather, a sleep researcher at the University of California, San Francisco, who treats patients with insomnia. “And for some, this can have a feedback effect — feeling bad, ruminating, feeling stressed can carry over into our evenings.”

North Carolina resident and full-time mother Carly Demler, 40, says she went to bed one night and couldn’t sleep. From then on, she would stay up at least once a week until 3 or 4 in the morning. This continued for over a year. She became irritable, less patient and much more anxious.

Hormonal blood tests and a sleep study at a university lab didn’t explain it. Even after taking zolpidem, she was awake most of the night. “It was like my anxiety was a fire that somehow jumped the fence and somehow ended up expanding into my nights,” she says. “I just felt like I had no control.”

In the end, cognitive behavioral therapy for insomnia, or CBT-I, brought Demler the most relief. Studies have found CBT-I to be more effective than sleep medications over the long term: Up to 80 percent of people who try it see improvements in their sleep.

Demler learned not to just “lie in bed and freak out.” Instead, she gets up and reads so she doesn’t associate her room with anxiety, then goes back to bed when she’s tired. “The feeling of gratitude I have every morning when I wake up and feel well-rested, I don’t think will ever go away,” she says.

Adults need between 7 and 9 hours of sleep per night, according to the Centers for Disease Control and Prevention. Teenagers and young children need even more. It’s not just about quantity. Sleep quality is also important.

If it takes you longer than 30 minutes to fall asleep, for example, or if you regularly wake up in the middle of the night, it’s harder to feel rested, regardless of the number of hours you spend in bed. But some people “tend to think they’re functioning well even if they’re drowsy during the day or have a harder time focusing,” says Lynn Bufka, a clinical psychologist and spokeswoman for the American Psychological Association.

Symptoms include impatience, prone to anger, having more negative thoughts, or feeling more anxious or depressed. Do you find it more difficult to deal with stress? Do you find it difficult to do your work efficiently? If so, it’s time to act.

How to break the cycle

We’ve all heard how important it is to practice good sleep hygiene, and adopt daily habits that promote healthy sleep. It’s important to speak with your doctor in order to rule out any physical problems that need to be treated, such as a thyroid disorder or restless legs syndrome. But this is only part of the solution.

Conditions such as anxiety, post-traumatic stress disorder and bipolar disorder can make it difficult to sleep, which can then exacerbate symptoms of mental illness, which in turn makes it more difficult to sleep well. “It becomes very difficult to break this cycle” , says Bufka.

Certain medications, including psychiatric drugs like antidepressants, can also cause insomnia. If one medication is to blame, talk to your doctor about switching to another, taking it earlier in the day, or reducing the dose, according to Ramaswamy Viswanathan, professor of psychiatry and behavioral sciences at the State University of New York Downstate Health Sciences. and president-elect of the American Psychiatric Association.

The cycle can also affect those without mental health disorders, when worries worsen sleep and lack of sleep worsens mood. Emily, who worked at a large law firm, was so worried about her inability to sleep that she didn’t even want to go to bed.

“You really start to believe you’ll never be able to sleep again,” she said. “The adrenaline is so high that you just can’t do it.” Eventually, she found the book “Say Good Night to Insomnia” by Gregg D. Jacobs.

According to her, the book, which uses CBT-I techniques, helped Emily reshape the way she thought about sleep. She started writing down her negative thoughts in a journal and then turning them into positive thoughts.

For example: “What if I can never sleep again?” would become “Your body was made for sleep. If you don’t get enough rest one night, you eventually will.” These exercises helped her stop catastrophizing. Once she started sleeping again, she felt “much happier.”

Now, at age 43, almost 20 years after moving to New York, she still relies on the techniques she learned and takes the book with her whenever she travels. If she doesn’t sleep well outside, “I’ll catch up on her sleep for a few days if necessary,” she said. “I’m much more relaxed about it.”