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What is the connection between depression and sleep?

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What is the connection between depression and sleep?

The most effective sleep strategies for improving depression

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The majority of depressed people struggle with sleep and non-depressed people who are deprived of sleep will soon start to display depressive symptoms. This article aims to explain the complex relationship between depression and sleep and show you how to use this relationship to your advantage. By making a few lifestyle changes at home, you can improve sleep quality and decrease depressive symptoms in the process. 

fall asleep on computer
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The link between depression and sleep

There is an important connection between depression and sleep, which has interested researchers for decades. According to a research study conducted in the Department of Psychology at the University of North Texas, people who suffered from the sleeping disorder insomnia had a ten-fold risk of becoming depressed compared with people who didn’t have sleeping problems. So, poor sleep increases the risk of depression. Healthy people who are deprived of sleep will soon start to experience depressive symptoms, such as:

  • Concentration difficulties
  • Low mood
  • Feelings of hopelessness
  • Changes in appetite
  • Lack of energy

What is most interesting about the connection between depression and sleep is that the relationship is two-way. Not only does poor sleep increase the risk of depression, but depression leads to poor sleep (you may have noticed that some people with depression sleep too much and others don’t get enough sleep). The good news is that we can use this two-way relationship to our advantage when dealing with depression. Because depression and sleep affect each other, changes in one will change the other. For instance, sleeping better may improve your depressive symptoms and treating your depression will most likely improve your quality of sleep. The next section teaches you more about insomnia, how to treat it and where to seek help. Later on, this article will tell you how to improve your sleep quality at home.

Depression and sleep

Depression and insomnia

When do sleeping problems turn into a disorder?

As mentioned above, people with sleeping problems are at much higher risk of becoming depressed compared to people without those problems. Insomnia is the name of a sleeping disorder where the sufferer lacks good-quality sleep and it’s common for depressed people to experience this condition. People with insomnia have severe and long-term difficulties falling asleep and staying asleep. Here is a list of typical symptoms of insomnia (if you’re going through depression, you’ll probably recognize a few of them):

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Waking multiple times during the night
  • Daytime sleepiness
  • Irritability
  • Low concentration

This video from TED-Ed will tell you more about the causes of insomnia and what you can do to improve sleep quality: Show video

How to treat insomnia and depression

Is there a #1 cure?

Due to the connection between sleep and depression, sometimes, simple lifestyle changes are enough to improve sleep quality and decrease depressive symptoms (the next two sections will tell you all about this). In more severe cases, professional guidance may be an absolute necessity.

sleeping moon

CBT for Insomnia. A type of psychological treatment called CBT (Cognitive Behavioural Therapy) is recommended by the National Sleep Foundation as a treatment for insomnia. In addition, Dr. Matthew Walker, Professor of neuroscience and psychology at the University of California recommends CBTI (Cognitive Behavioural Therapy for Insomnia) as the number one treatment for insomnia. The treatment includes regular visits to a clinician, sleep assessments and using a sleep diary and other tools to help you change the way you sleep. 

Online clinics. If you’re interested in online psychological treatment, there are some clinics who provide remote consultations with health care professionals via video messaging through their apps. Here are two of the most popular online clinics:

  • For people living in the UK – contact Babylon
  • For people living in Sweden – contact Kry

Depression app based on behaviour therapy. If you want to make changes right away, that is, change your sleeping habits to decrease depressive symptoms, the 100% free depression app from Flow Neuroscience will get you started. It includes a complete sleep module where a virtual therapist guides you through the process and even gives you homework assignments to help you stay on the right track. Download now. 

Sleep hygiene. In addition to psychological treatment, there are a number of things that you can do at home to take advantage of the relationship between depression and sleep, change your sleeping habits and decrease depressive symptoms. The next sections will focus on simple lifestyle changes to improve your quality of sleep.

Depressed and can't sleep

How to improve depression and sleep at home

Stop trying so hard

Have you ever been in bed at night, finding it impossible to fall asleep? 
Seeing that you’re reading this article, presumably you have. The tricky thing about falling asleep is that you’ll never succeed as long as you’re trying to succeed. Frustrating, isn’t it? The best sleepers in the world are those who’ve never even thought about sleep. To them, sleep is something that just happens. Why is this? Well, falling asleep is an involuntary process and any attempt to control it will make it more difficult. When we put effort into something, whatever it may be, we are telling our brains to become more alert – the exact opposite of what we need to do to fall asleep. So, a first step towards better sleep is to stop trying so hard. Here are a few tips to get you started:

1. Get out of bed

If you find yourself in bed, not sleeping or having sex – get up! When you stay in bed, tossing and turning and making an effort to fall asleep, the brain will start associating the bed with wakefulness. So, your brain may automatically become aroused every time you approach the bed because it reacts to the bed as a place for activity and struggle. The solution is to get out of bed if you haven’t fallen asleep after about 20 minutes and do something relaxing until you feel sleepy again. Avoid looking at screens, screens are not relaxing (more on this later). Instead, read a book, fold your laundry, meditate, cuddle with your pet or try a relaxation exercise. Don’t return to bed until you feel sleepy. Also, only use your bed for sleeping. Don’t use it for other activities during the day, such as eating, studying, watching TV etc. If you do, the brain may start associating your place of rest with wakefulness.  

Don’t try to shut off your thoughts
Have you ever wished for a switch inside your head that would turn off all your thoughts? Most people struggling with depression and sleep probably have. The frustrating thing about worrying thoughts, the to-do-list and existential speculations that come up before bedtime, is that when you’re trying to erase them, they usually fight back even harder. This 1-minute exercise demonstrates the impossible task of erasing negative thoughts before bedtime:

If we can’t erase disturbing thoughts, what are we supposed to do? All experienced meditators know the secret to calming your mind: notice your thoughts and let them pass. This, of course, takes practice. So, the next time your thoughts keep you up at night, get out of bed and do this meditation exercise:

You’ll find this and many other meditation exercises in the free depression app from Flow Neuroscience, which includes a complete at-home treatment programme for depression. 

7 strategies for improving sleep and depression

Increase your chances of a good night’s sleep

So far we’ve learned that we can’t decide when to fall asleep and that worrying about sleep only makes matters worse. So, what can we do? Quite a lot actually. It’s true that we can’t control exactly how much we sleep, but we can increase the chances of falling asleep with the following sleep tools (the strategies are useful, no matter if you sleep too much or too little):

  • Start unwinding 90 minutes before bedtime

    Make sure that your brain is nice and relaxed, perhaps read a book (maybe not a thriller though), meditate, take a shower, listen to relaxing music or do other calming activities for 90 minutes before you go to bed. An alert brain that has just been exposed to very interesting stimuli, for example your favourite TV-series, needs more time to fall asleep than an already relaxed brain. So, make sure your brain is not exposed to alarming or new information late at night. A tip: set an alarm for when your unwinding time begins so that you don’t forget to turn off your screens, avoid reading the news, mute your phone etc. If you want, you can try unwinding with this 5-minute meditation exercise from Flow Neuroscience:

This meditation practice is one of many in Flow Neuroscience’s at-home treatment programme for depression. The depression app, including a mindfulness meditation module, is 100% free to download.

  • Have a fixed wakeup time

    One thing regarding sleep that we actually can control is when to wake up. Creating a regular sleep routine is the most powerful sleep tool of all. So, wake up at the same time every day, even during weekends. Even though it’s challenging, with time your body will adjust to this regular sleep routine, making it worth the trouble. A tip: place your alarm clock at the other end of the room, as far away from your bed as possible. 

  • Give yourself 8 hours of sleep ‘opportunity’ every night

    It’s true that we can’t control when to fall asleep, but we can make sleep a priority by at least giving our bodies an opportunity to sleep for 8 hours. Most people need 7-9 hours of sleep every night to stay healthy. So, try to turn off the TV and go to bed 8 hours before you’re supposed to get up.

  • Sleep in a dark bedroom
sleep in dark bedroom

Darkness triggers the release of the sleep-hormone melatonin in the body. Melatonin signals to the body that it’s time for sleep and helps you fall asleep faster. That’s why it’s better to sleep while it’s dark, turn off the lights in the house and use blackout curtains or a sleeping mask.

  • Avoid LED-lights 📱💻
    Researchers, such as Dr. Matthew Walker, Professor of neuroscience and psychology at the University of California, teaches us that humans are especially sensitive to the blue-wavelength LED-lights, used in screens. iPad reading before bedtime delays melatonin release for up to 3 hours, making it more difficult to fall asleep. Also, it affects the quality of sleep. People who read on iPads before sleep feel significantly less refreshed the day after, compared to those who read a book. The lesson here is, of course, to avoid screens 90 minutes before bedtime.
  • Set your bedroom temperature to about 18 degrees
    In one experiment, explained in the book Why we sleep, researchers found that an average bedroom temperature of 18.3 degrees would help insomniacs fall asleep 25% faster than usual. The reason for this is that humans are designed to sleep at night and before modern air conditioning, it would get colder at night. So, a drop in temperature will trigger the sleep-hormone melatonin, which signals to the body to go to sleep.
  • Take a hot bath before bedtime
hot bath before bedtime

Taking a hot bath before bedtime could actually improve your sleep quality. A hot bath or shower can be relaxing, but that’s not the main reason for this strategy’s effectiveness. Taking a bath decreases your body temperature and, as mentioned above, a drop in temperature will trigger the release of the sleep-hormone melatonin. When you get out of a hot shower or bath, the blood will rush to the surface of your skin, away from the core of your body. So, the hands, the face and the feet will radiate the heat out, while your core gets nice and cold. In conclusion, this is an excellent way to spend your unwinding time before bed.

As we have learned, the relationship between sleep and depression is complex and two-way. Treating your depression will improve your sleep quality and sleeping better can decrease depressive symptoms. A number of treatments and strategies will help you use this relationship to your advantage, including Cognitive Behavioural Therapy (CBT), Flow Neuroscience’s depression app, unwinding 90 minutes before bedtime, having a fixed wakeup time and having a cool and dark bedroom.

Thank you for your attention and sweet dreams!

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