Coping With Sleep Disturbances During Depression

Sleep disturbances worsen depression.
 Frederic Cirou / Canopy / Getty Images

Dealing with sleep disturbances when you’re feeling depressed can seem like a vicious circle. The more depressed you feel, the harder it is to sleep. And the more exhausted you feel, the harder it is to fight depression.

It can feel like there’s no way to break the cycle. And it’s frustrating to feel tired yet be unable to fall or stay asleep.

The Link Between Sleep Disturbances and Depression

Approximately 80 percent of individuals with depression experience sleep disturbances.

While some individuals with depression have trouble falling asleep, others have difficulty staying asleep. And some individuals with depression sleep too much.

Both depression and insomnia involve chemicals in the brain. Changes in neurotransmitters and hormonal imbalances may affect both sleep and mood. For many years, researchers studied which came first; depression or insomnia. It was clear that the two issues often go hand-in-hand and exacerbate one another.

But, studies show that sleep disturbances often occur before depression begins. Experiencing insomnia prior to feeling depressed may increase the severity of depression.

The American Academy of Sleep Medicine now encourages treatment providers to pay close attention to whether insomnia needs to be identified as a separate condition as opposed to viewing it as a symptom of depression only.

The Health Risks Associated With Depression and Sleep Disturbances

Depression and sleep disturbances can take a toll on your physical health if left untreated.

Lack of sleep increases the risk for heart disease and failure, heart attacks, high blood pressure, stroke, diabetes, and obesity.

Depression can constrict blood vessels, which may increase your risk of heart disease. People with depression may experience a weakened immune system, aches and pains, and fatigue.

Talk to Your Physician

Difficulty sleeping may stem from an underlying medical condition, such as obstructive sleep apnea. Restless leg syndrome and bruxism (teeth-grinding) can also interfere with sleep. These medical issues may cause sleep problems that worsen or cause depression.

It’s important to talk to your physician about any sleep problems or depressive symptoms you’re experiencing. Your physician can assess whether you have underlying health issues contributing to your conditions.

See a Therapist

Talk therapy can be of assistance in managing symptoms of depression, including sleep disturbances.

Cognitive behavioral therapy is effective in treating insomnia and depression. For sleep issues, a therapist may assist you in changing your habits, such as getting out of bed when you aren’t able to sleep and getting up at a certain time each morning to help you sleep better in the evening.

Cognitive behavioral therapists can also help you change your self-talk. Thinking you are helpless and hopeless, for example, can compound your symptoms. Reframing your negative self-talk can help you feel better and help you sleep better.

Consider Medication Options

Medication can be used to treat insomnia as well as depression.

A physician or a psychiatrist can help determine what type of medication will work best for you—as well as which symptoms should be treated first.

Develop Good Sleep Hygiene Habits

Good sleep hygiene habits can also help you sleep longer and more soundly. A few changes to your daily habits and your bedtime routine can make a big difference.

Avoid Alcohol

A glass of wine or finger of brandy is often used as a tool for relaxation, as well as a way of coping with anxiety or depression. However, alcohol consumption disrupts your sleeping pattern, so you are more likely to wake up during the night.

While a glass of vino might help when you’re falling asleep, it’s not going to do much for staying asleep throughout the entire night or feeling rested the next day.

Meditate and Relax

Depression can cause you to ruminate—thinking about the same things over and over—which can keep you up at night. Meditation strategies or other relaxation exercises can help calm your mind and get you ready to fall asleep.

This might include yoga or deep-abdominal breathing. Take about an hour before bedtime to unwind by turning off all electronics, taking a warm shower or bath and decompressing in preparation for sleep.

Journal About Your Worries

If your worries or repetitive negative thoughts aren’t going away with relaxation strategies, find a notebook and write down the troubling thoughts. This contains the thoughts that might keep you awake as your brain goes over them again and again.

You might even designate a bit of time before bedtime as your designated “worry time,” so you can really clear your mind.

Get Out of Bed

If you’re not tired, don’t just lie there tossing and turning. Get out of bed, go into another room and engage in some light activity, such as reading.

Avoid using anything with a screen, such as your phone or laptop, as the blue light that it emits can cause further sleep disturbances. When you feel drowsy, go back to bed for what will hopefully be a more successful attempt at sleeping.

Spend Time Outside During the Day

Spending time in natural light during the day can help regulate your circadian rhythm. The internal biological clock that regulates the sleep-wake cycle is influenced by light; when there’s less light at night, your body releases melatonin.

In the morning, the sun cues your brain and body to wake up. If you’re spending all your time indoors in the dark, you might suffer from sleep problems. Regular exercise can also help with sleep issues, as well as depression, provided it’s not done immediately before bed.

A Word From Verywell

Depression and sleep difficulties are definitely a challenge. But, seeking professional help is key to feeling better.

You might find you sleep better when you are feeling less depressed. Or, you may find sleeping better eases your depression. Both conditions are treatable and they can get better with professional support.

Sources

Cunningham JE, Shapiro CM. Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic reviewJournal of Psychosomatic Research. 2018;106:1-12. 

Haynes P. Application of Cognitive Behavioral Therapies for Comorbid Insomnia and DepressionSleep Medicine Clinics. 2015;10(1):77-84. 

Mason EC, Harvey AG. Insomnia before and after treatment for anxiety and depression. Journal of Affective Disorders. 2014;168:415-421. 

Wheaton AG, Perry GS, Chapman DP, Croft JB. Sleep Disordered Breathing and Depression among U.S. Adults: National Health and Nutrition Examination Survey, 2005-2008Sleep. 2012;35(4):461-467.