Insomnia and Mental Health
Reviewed by: HU Medical Review Board | Last reviewed: June 2020 | Last updated: April 2023
Insomnia and mental health have a chicken and egg relationship. People with insomnia often have depression, anxiety, and other mental health issues. And, people with mental health issues often have insomnia.
Plenty of evidence exists to prove that sleep and mental health are closely tied, including:1,2
- Doctors know that a bout of insomnia often begins in the days and weeks before a serious psychiatric episode.
- Insomnia is one of the 9 symptoms used to diagnose major depression.
- Substance use disorder is common in people with insomnia. People with insomnia and substance use issues are more likely to relapse.
- Between 70 and 90 percent of people with post-traumatic stress disorder (PTSD) also have trouble falling asleep or staying asleep.
Living better with insomnia
It is possible to take steps to improve your mental health and your insomnia at the same time. It may take some trial and error to find which combination of lifestyle changes, therapy, relaxation techniques, and prescription or over-the-counter drugs works for you.
Get treated for both conditions
Doctors used to believe that insomnia would get better just by treating the mental health condition. However, now they believe that most people should be treated for both conditions to find long-term healthy sleep. That means that taking your medicine for depression or bipolar disorder may help you get more sleep. But, you will likely need to include cognitive behavioral therapy for insomnia to find lasting results.2
Good sleep habits and CBT-I
Cognitive behavioral therapy for insomnia (CBT-I) teaches you good sleep habits that can last a lifetime. CBT-I helps you learn the routines and thought processes that will help you fall asleep or get back to sleep. It also teaches you to have realistic expectations for sleep and how to worry less about your sleep. Some studies show that CBT-I helps improve both insomnia and mental illness while others do not.2
You can learn what makes your insomnia worse, or better, by paying attention to your body. You may discover that you need to cut out caffeine or alcohol completely to be able to fall asleep each night. Or, you may find that melatonin works for you. Writing down your worries in a notebook may help you fall back to sleep when you wake in the night. Self-awareness can be the first step in taking control of your symptoms.3
Relaxation, mindfulness, and meditation
Deep, slow breathing is a good place to start if you find yourself tense and unable to sleep. Other relaxation techniques include taking a warm bath or practicing muscle relaxation. Guided meditation is another way to help you release anxiety and stress so that sleep comes more easily. However, learning meditation and relaxation skills take time. Be patient with yourself as you explore which mindfulness or meditation techniques work for you.
Regular exercise can help improve your mood, release stress, and help you sleep better at night. Exercise releases endorphins that improve your mood and energy levels. However, you should not exercise within 2 hours of bedtime or this extra energy may keep you awake.3
Increase social connections
People with insomnia sometimes isolate themselves at home because they feel tired and depressed. This is a reasonable reaction to a lack of sleep but isolation makes depression worse. Try to break the isolation by connecting with others online, through a hobby, sports, or volunteer work.
Stress, worry, grief, and trauma make depression and anxiety worse. These feelings also make it hard to get a good night’s sleep. Finding help to process these underlying emotions can help you sleep better and lift your mood.2
The more you understand about insomnia and your mental health, its treatments, and your triggers, the more you can advocate for yourself and educate others. Consider attending a conference to learn more about the connection between mental health and insomnia and the latest treatments.
Has insomnia affected your mental health?