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Want to improve your mental health? Focus on this.

People make time for their mental health in a variety of ways, from meditation, to therapy, to yoga and exercise. As it turns out, there’s a huge opportunity for boosting mental health that many miss out on: sleep.

Conditions like insomnia and other sleep problems are more common in people with depression, anxiety, and other mental health disorders.

The overlap can be difficult to tease apart. What comes first? Sleep clinicians have hypothesized about the link between sleep disorders and mental health for decades. Ongoing, chronic sleep problems affect 50 to 80 percent of adults under psychiatric care, compared to just 10 to 18 percent of those in the general U.S. population.

Clinicians are now closer than ever to being able to identify the biological root that joins mental health and sleep together, showing how each is correlated to and influences the other.

Root causes

Traditionally, clinicians treating patients with psychiatric disorders have viewed insomnia and other sleep disorders as symptoms of the state of their patients’ psychiatric health. But more recent studies suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders. As an example, two different studies involving 300 sets of twins and over 1,000 teenagers found that sleep disorders were the first to appear, before depression set in later.

In a recent study—a collaboration between Warwick University in the U.K. and and Fudan University in China—researchers analyzed data from 10,000 patients, and paid close attention to the mechanisms within the brain that affect the relationship between depression and sleep. This study found that three parts of the brain of those patients with symptoms of depression exhibited specific characteristics.

These connections are especially significant for the mental health field because of what those specific sections of the brain manage and regulate. One section of the brain is responsible for short-term memory, another governs reflections of the self, and the third section is responsible for negative emotion.

Sleep apnea, depression, and the brain

A study conducted by the CDC found that 63 percent of patients with sleep apnea also have symptoms of depression. Other studies have estimated that 65 to 90 percent of adult patients with depression endure at least some kind of sleep disorder, and as many as 90 percent of patients suffering from major depressive disorder experience hypersomnia or insomnia.

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Sleep apnea is a fairly common sleep disorder, and roughly 54 million Americans have it, though an estimated 80 percent of those remain undiagnosed.

During sleep, you need to be breathing well enough to ensure your blood is adequately saturated with oxygen. Quality breathing while you sleep provides cells and tissues with a sufficient amount of oxygen to function properly. When we stop breathing repeatedly while we’re asleep, it reduces the amount of oxygen available to our bodies for recuperation and repair. Sleep apnea also causes the body to briefly go in and out of sleep.

Restorative sleep helps the body repair and maintain itself and allows the brain to clear out waste and enter deeper, slow-wave activity. A good night’s sleep also helps people stay emotionally balanced during the day. And during REM sleep, the brain processes events from the day before, causing vivid dreams to form. REM sleep also helps the mind stay sharp by consolidating memories.

But with sleep apnea, the opportunity for the brain to enter these deeper phases of REM sleep is lost, due to repeated awakenings. Sleep apnea also disrupts our circadian rhythms, causes imbalances in body and brain chemistry, interrupts cardiac and respiratory function, elevates blood pressure, and speeds up the heart rate.

Sleep as treatment

To be clear, the correlation between mental health and sleep health is still not fully understood. Yet, the evidence grows increasingly stronger in favor of treating the sleep disorders that patients face.

Whether it’s sleep apnea, insomnia, or something else, taking a closer look at sleep habits may help alleviate symptoms of mental health issues the patient is suffering from.

If you find your sleep patterns are noticeably different from how they once were (i.e., you are getting far more or less sleep than you usually require), speak with your doctor about it.

Brandon R. Peters, M.D., is board-certified in both neurology and sleep medicine and currently practices atVirginia Mason Medical Center in Seattle. He is also a Clinical Affiliate at Stanford University's School of Medicine in the Department of Psychiatry and Behavioral Sciences. His latest book,Insomnia Solved, is available on Amazon.

August 20, 2018