Beyond insomnia: mental health issues associated with sleep disturbance

Sleep is a fundamental aspect of our lives, and the lack of it can impact our well-being negatively, potentially leading to serious mental health issues.

While sleep disorders are seen as symptomatic of mental health issues, they can also be primary contributors to the development of mental health challenges. This intricate relationship can create a cycle where each condition exacerbates the other.

In this article, we explore the different mental health conditions that can arise from inadequate sleep and sleep disturbances.

1. Anxiety

While occasional anxiety is a normal part of life, it becomes an issue when it becomes persistent and affects your daily functioning, leading to disorders such as Generalised Anxiety Disorder (GAD).

Sleep disturbances including difficulty falling asleep, staying asleep, early morning awakenings, and nightmares, are often associated with anxiety and trauma-related disorders.

2. Depression

Major Depressive Disorder (MDD), or depression, is a prevalent global mental illness characterised by persistent feelings of sadness and loss of interest. Symptoms often reported by those with depression include difficulty falling asleep, increased awakenings at night, early morning awakenings, decreased total sleep time, nightmares, or unrefreshing sleep.

The relationship between sleep disturbances and depression is bidirectional, emphasising the need for comprehensive screening for both conditions. Concurrently treating sleep and depression is crucial for optimal outcomes, as sleep normalisation may not occur with depression resolution, and sleep patterns can predict depressive relapse.

3. Bipolar Disorder

Bipolar Disorder, a mood disorder characterised by extreme mood swings, is often associated with sleep and circadian disturbances including insomnia, hypersomnia, reduced need for sleep, delayed sleep phases, and irregular sleep patterns. Such sleep disorders not only serve as risk factors but can also contribute to relapse episodes.

Apart from having a negative impact on mood regulation and cognitive function, sleep dysfunctions can also have an impact on overall health due to the insufficient, irregular or inappropriate exposure to sunlight. Therefore, interventions that target sleep disturbances can improve patient outcomes1, reducing the duration, intensity and risk of bipolar episodes.

4. Schizophrenia

Schizophrenia is a neuropsychiatric disorder which can be devastating for both sufferers and their loved ones, with reports of disturbed sleep in 30 – 80% of patients2. Common sleep issues include difficulty falling asleep, staying asleep and fatigue the next day. Severe insomnia often serves as a warning sign for relapse episodes.

Regular monitoring of sleeping patterns and interventions to normalise sleep can positively impact the clinical outcomes and the recovery process for individuals with schizophrenia.

If you or someone you know is in mental distress or simply need a listening ear, don’t hesitate to reach out via the following helplines below:

• SOS 24-hour Hotline: 1-767
• Singapore Association for Mental Health: 1800-283-7019
• Institute of Mental Health: 6389-2222 (24 hours)
• Tinkle Friend: 1800-274-4788 (for 7-12 year old children)

References

1. Mayo Foundation for Medical Education and Research. (2022). Bipolar disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
2. Psychology Research and Behavior Management. (2022). The Management of Sleep Disturbances in Patients with Schizophrenia: A Case Series. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762406/