Sleep Health for Adults
Better Sleep for a Better Tomorrow
Life is everchanging, and so are our everyday schedules and plans. One thing that can impact the quality of our day, is the quality of our sleep! Many people nowadays opt to skimp on sleep for many different reasons, including cramming more chapters before an important exam the next day, trying to rush some work so that you have fewer things to do tomorrow at the office or a simple revenge bedtime procrastination. However, people have to realise that sleep is one of the most crucial parts of our lives that can significantly affect how our next day goes. A good night’s rest can help with brain performance like memory, mood and health!
Sleep and Mental Health
Zooming in on mental health, there is actually a more complicated relationship between sleep and mental health. There are many conditions like insomnia that can affect sleep. However, research has shown that poor sleep can also affect the development and maintenance of mental health issues (Scott, Webb, & Rowse, 2017). This means that not only can mental health affect sleep issues, but mental health issues can also worsen with poor sleep.
✽ Sleep and Emotions
Have you ever felt that you were always in a bad mood or irritable, easily angered after a night of little or poor sleep? Research has shown that the lack of sleep prevents the brain from functioning normally, and this affects the amygdala, the emotional control centre of the brain. This in turn results in you being less able to control your emotions, leading to sudden mood changes or anger (Saghir, Syeda, Muhammad, & Abdalla, 2018). We might find ourselves having difficulty interacting with people or overreacting to simple mistakes done by other people.
✽ Sleep and Depression
Sleep problems like insomnia have been known to be symptoms of depression. Interestingly, recent studies have found that a lack of sleep can actually cause depression too. A study found that those who have insomnia are at twice the risk of having depression in the future compared to those who have no sleep issues (Baglioni, et al., 2011).
You might then be wondering if the opposite is true, does better sleep then reduce chances of depression? Fortunately, it is! Research has shown that improving sleep quality can improve mental health and reduce risk of depression (Scott A. J., Webb, James, Rowse, & Weich, 2021).
✽ Sleep and Anxiety
As with depression, the relationship between sleep and anxiety is also two-way. People with anxiety can indeed have sleep issues while the converse is true! Poor sleep plays a role in anxiety too. Sleep issues have been found to be a risk factor for developing anxiety disorders. A study showed that poor sleep was a predictor for generalized anxiety disorder (Shanahan, Copeland, Angold, Bondy, & Costello, 2014).
Having anxiety can also cause sleep issues as mentioned. It is a slightly more complex relationship but essentially, anxiety leads to stress, which leads to arousal that in turn, affects sleep (Staner, 2003). You could even be anxious about your sleep! For example, you could have an important event tomorrow like a big meeting or proposal, you tell yourself that you need to sleep early and well tonight. This can kickstart your anxiety especially if you find yourself not falling asleep quickly enough. The stress from this can arouse you instead and actually result in your being awake, alert and unable to fall asleep (Staner, 2003).
✽ Sleep and Post-Traumatic Stress Disorder (PTSD)
Poor sleep is a very common symptom of those suffering from PTSD. It affects around 80 to 90% of the people with this condition (Koffel, Khawaja, & Germain, 2016). Interestingly, this study also found that sleep is an important mechanism in the development and maintenance of PTSD (Koffel, Khawaja, & Germain, 2016). It shows the importance of identifying and treating sleep issues among those who are at risk or have experienced trauma.
✽ Sleep and Bipolar Disorder
Problems with sleep are a regular issue for those with bipolar disorders (Ng, et al., 2015). Common issues include insomnia, irregular sleep-wake schedules and nightmares.
However, sleep issues can also increase the severity of other bipolar disorder symptoms. Poor or reduced sleep can cause mania or hypomania, core symptoms of bipolar disorder (Lewis, et al., 2017). If you are suffering from bipolar disorder and are experiencing sleep issues, do seek a doctor to see if there is anything that can be done to help with that.
✽ Sleep and Eating Disorders (ED)
Again, sleep has been intertwined with ED as well! Sleep issues are related to an increased risk of EDs, while EDs are also related to worse sleep quality (Cooper, Loeb, & McGlinchey, 2020). However, it is important to note that research regarding this relationship has on this relationship between sleep and EDs are not concrete enough as they only scratch the surface (Cooper, Loeb, & McGlinchey, 2020).
That said, a study has shown that poor sleep like insomnia is linked to poorer treatment outcomes for EDs (Allison, Spaeth, & Hopkins, 2016). This suggests that treatment on those suffering from EDs could focus more on improving sleep to better the main treatment outcomes. As they say, sleep well, eat well and live well!
Now that we know the importance of good sleep, how do we achieve that? There are a couple of nifty facts that could better your understanding of how and what good sleep is.
✽ Quantity of Sleep
The most basic but usually foregone factor of a good night’s rest. Different age groups, starting with newborns, tend to have different recommended hours of sleep each night. For adults, this would be between 7 to 9 hours of rest per night, and we mean consecutive uninterrupted sleep. Taking 18 naps, 30 minutes each, is not the same!
Of course, with differing requirements from work, people tend to skimp on sleep. One myth people have about sleep is that they can “owe” sleep and pay it back over the weekend or on days off. A study showed that people with this sleep routine had the same detrimental effects as those who have a consistent lack of sleep. This means that trying to “pay back” sleep does not remove the negative effects of skipping it.
Interestingly, having more sleep is also bad. As the saying goes, too much of anything is bad. Those who always feel tired and unrefreshed even after 9 hours of sleep are recommended to go for a check-up as there may be some underlying medical issues.
✽ Consistency of Sleep
Just having the required hours of sleep is not sufficient in having good sleep. We require a consistent sleep schedule too! It helps maintain our internal body clock, also known as circadian rhythm. Many of our bodily functions, like hormone secretion, heart rate and blood pressure, follow circadian patterns. For example, the secretion of human growth hormones (HGH) which help burn fats and build lean muscles can be disrupted by inconsistent sleep patterns. This means that people who lack or have inconsistent sleep can end up having slower metabolism and weight gain.
You might have also heard of the myth from parents that you must sleep before 11 pm for a “kidney detox” or health benefits. This is untrue! Sufficient duration and consistent hours of sleep are enough. This means that if you always go to sleep at 2 am, wake up at 10 am and you feel super rested, feel free to continue! Vice versa if you sleep at 10pm, wake up at 6am and it works for you, there is no issue there.
Of course, you may be wondering how strictly you should follow a regular schedule. A physician at Cleveland Clinic’s Sleep Disorders Centre mentioned that if your schedule varies about one hour, once a week, there shouldn’t be any issues. However, if your schedule varies between multiple hours and multiple instances a week, you might want to check in with yourself or see a doctor as there could be an underlying issue causing it.
Small & Simple Tips
✽ Regular Exercise
Get some exercise done daily but do avoid working out close to bedtime. Exercising can increase blood flow as your heart rate increases, and this could keep you very alert, which is not what one would want when preparing for bed.
✽ Go Outside
Get your daily dose of sunshine outside every day if possible. Getting exposure to sunlight helps your body produce melatonin. This hormone helps you sleep at night as it accumulates during the day. A lack of this hormone could result in you being unable to feel ready for bed.
✽ Avoid Nicotine and Caffeine
These substances are considered stimulants. As the name suggests, they keep you awake. These can take 6-8 hours to be cleared from our system. Avoid drinking too much and too close to bedtime. Of course, we are not suggesting you ban yourself from coffee. You could count backwards when your last cup of coffee should be and avoid drinking any caffeine or smoking after said timing.
✽ Avoid Alcohol and Large Meals Before Bed
Both of these can increase blood flow in the body which affects your sleep negatively. Your body would be unable to regulate the rhythm with the irregular flow of blood and activation of the different systems in your body like the digestive system after a large meal.
✽ Avoid Electronics Before Bed
Electronics can keep our mind awake and stimulated, and also suppress the production of melatonin that helps us get ready for bed. Try to limit or avoid your phones, tablets or laptops before bed. Listening to some relaxing music or reading a calming book would help!
✽ Avoid lying in bed awake
Some of you might have the “I will never surrender!” attitude with everything, including sleep. This means you might end up trying your best to sleep but you just toss and turn in bed to no avail. This actually can frustrate you, increasing blood pressure and flow which in turn inhibits sleep while making you mad. If you are unable to fall asleep after 20 minutes or so, get up and do a relaxing activity until you feel sleepy and try again! In this case, make a tactical retreat before trying again!
These are some things that are good to know about sleep and how to get a good night’s rest. Try the tips! If your problem persists, it would be wise to seek a doctor for a check as there may be some underlying medical conditions that prevent your quality sleep like sleep apnea.
Something very important to note! If your sleep problems have caused or are caused by a mental health issue, it is strongly recommended that you seek help from a professional instead of trying to solve it at home on your own. The tips above are for generic sleep hygiene but they are likely not applicable to sleep issues related to mental health issues.
On a lighter note, if you wear spectacles or contact lenses, do not forget to remove them before you sleep! Your dreams will not be any clearer.
Allison, K. C., Spaeth, A., & Hopkins, C. M. (2016). Sleep and Eating Disorders. Current Psychiatry Reports, 18(92). doi:https://doi.org/10.1007/s11920-016-0728-8
Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., . . . Riemann, D. (2011). Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. Journal of Affective Disorders, 135(1-3), 10-19. doi:https://doi.org/10.1016/j.jad.2011.01.011
Cooper, A. R., Loeb, K. L., & McGlinchey, E. L. (2020). Sleep and eating disorders: current research and future directions. Current Opinion in Psychology, 34, 89-94. doi:https://doi.org/10.1016/j.copsyc.2019.11.005
Koffel, E., Khawaja, I. S., & Germain, A. (2016). Sleep Disturbances in Posttraumatic Stress Disorder: Updated Review and Implications for Treatment. Psychiatric Annals, 46(3). doi:https://doi.org/10.3928/00485713-20160125-01
Lewis, K. S., Gordon-Smith, K., Florio, A. D., Craddock, N., Jones, L., & Jones, I. (2017). Sleep loss as a trigger of mood episodes in bipolar disorder: Individual differences based on diagnostic subtype and gender. The British Journal of Psychiatry, 211(3), 169-174. doi:https://doi.org/10.1192/bjp.bp.117.202259
Ng, T. H., Chung, K.-F., Ho, F. Y.-Y., Yeung, W.-F., Yung, K.-P., & Lam, T.-H. (2015). Sleep–wake disturbance in interepisode bipolar disorder and high-risk individuals: A systematic review and meta-analysis. Sleep Medicine Reviews, 20, 46-58. doi:https://doi.org/10.1016/j.smrv.2014.06.006
Saghir, Z., Syeda, J. N., Muhammad, A. S., & Abdalla, T. H. (2018). The Amygdala, Sleep Debt, Sleep Deprivation, and the Emotion of Anger: A Possible Connection? Cureus, 10(7). doi:https://doi.org/10.7759/cureus.2912
Scott, A. J., Webb, T. L., & Rowse, G. (2017). Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials. BMJ Open, 7. doi:http://dx.doi.org/10.1136/bmjopen-2017-016873
Scott, A. J., Webb, T. L., James, M. M.-S., Rowse, G., & Weich, S. (2021). Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Medicine Reviews, 60. doi:https://doi.org/10.1016/j.smrv.2021.101556
Shanahan, L., Copeland, W. E., Angold, A., Bondy, C. L., & Costello, E. J. (2014). Sleep Problems Predict and Are Predicted by Generalized Anxiety/Depression and Oppositional Defiant Disorder. Journal of the American Academy of Child & Adoloscent Pychiatry, 53(5), 550-558. doi:https://doi.org/10.1016/j.jaac.2013.12.029
Staner, L. (2003). Sleep and anxiety disorders. Dialogues in Clinical Neuroscience, 5(3), 249-258. doi:https://doi.org/10.31887/DCNS.2003.5.3/lstaner
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