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What Mental Health Issues Can Affect Your Sleep?

Sleep is essential for both physical and mental health. Unfortunately, many mental health conditions can disrupt normal sleep patterns and lead to insomnia or other issues. Understanding the connection between mental health and sleep is important, as poor sleep can then further worsen some mental health problems.


Depression often goes hand-in-hand with insomnia or other sleep disturbances. The symptoms of depression, including lack of energy, sadness, low motivation, and anxiety make it difficult to fall and stay asleep. Excessive sleep can also be a sign of depression. Disrupted REM sleep from depression may reduce restorative deep sleep stages. This impaired sleep then creates a vicious cycle where worsening depression leads to poorer sleep.


Anxiety disorders are also strongly linked with sleep struggles. Nervous thinking and rumination keep the mind too active for restful sleep. Many people with anxiety experience racing thoughts at bedtime. Anxiety can also cause physical symptoms like a rapid heart rate and trembling that make relaxing into sleep difficult. Insomnia is common for those with generalized anxiety disorder, panic disorder, PTSD, and other anxiety issues.

Bipolar Disorder

Bipolar disorder involves alternating periods of high energy with depressive lows. During manic episodes, reduced need for sleep is common, with the person feeling rested after just a few hours. However, too little sleep can worsen mania. Coming down from manic periods often leads to “crash” times of excessive sleep. Medications for bipolar can also interfere with sleep. Sticking to a regular sleep/wake schedule is recommended.


Schizophrenia frequently goes along with disturbed sleep from an erratic circadian rhythm. The affected person may stay up very late and sleep during the day. Strange dreams or nightmares as well as sleepwalking and talking can also occur. Lack of sleep appears to intensify schizophrenia symptoms like hallucinations, delusions, and paranoia. Getting adequate sleep is an important part of treatment.

Eating Disorders

Eating disorders like anorexia, bulimia, and binge eating disorder tend to disrupt normal sleep. Limited or excessive food intake, purging behaviors, compulsive exercise, and negative body image often keep individuals awake with rumination and guilt. Poor nutrition from eating disorders can also impair sleep. Recovering balance around eating and self-image is key to improving sleep.


Many children and adults with attention-deficit/hyperactivity disorder struggle with sleep. ADHD symptoms like hyperactivity, trouble focusing, and impulsivity make it hard to settle down for bed. Racing thoughts and restlessness can delay sleep onset. Then morning drowsiness from poor sleep interferes with functioning the next day. Melatonin supplements or medication adjustments may help.

Post-Traumatic Stress Disorder (PTSD)

PTSD often includes nightmares and flashbacks that create disruptive nocturnal awakening and anxiety around sleep. Some cope through avoiding sleep. Hypervigilance and exaggerated startle reflex cause light, restless sleep. Insomnia is common, worsening other PTSD symptoms like irritability and concentration problems. Relaxation therapy can help with sleep onset.

Substance Abuse

Substance abuse and addiction frequently cause sleep problems. Stimulants like cocaine and methamphetamine are energizing to the point of causing acute insomnia. Depressants like alcohol help initiate sleep but lead to disrupted second-half sleep cycles. Withdrawal from some substances also impairs sleep. Achieving sobriety is essential for restoring healthy sleep patterns.


Dementia from Alzheimer’s disease and similar conditions often includes confusing day and night cycles. Sundowning agitation in the evenings makes sleep difficult. Nighttime waking and wandering are also common dementia sleep issues. Checking for pain, negotiating comfortable bedtime routines, and avoiding overstimulation can help manage sleep challenges.

Sleep Apnea

This condition of airway obstruction or impaired breathing during sleep has strong ties to mental health. Sleep apnea increases risks for depression, anxiety, and cognitive decline. Poor sleep from apnea may be misdiagnosed as a psychiatric disorder. Treating the apnea, often with CPAP devices, is important for improving both sleep and mental health.

Tips for Better Sleep

If you struggle with both mental health issues and sleep problems, these steps may help improve rest:

  • Maintain a regular sleep schedule, even on weekends
  • Develop a calming pre-bedtime routine
  • Limit stimulating screens before bedtime
  • Avoid caffeine, alcohol, and large meals near bedtime
  • Make your bedroom comfortable, cool, and dark
  • Do relaxing stretches or meditation before bed
  • If you wake up, avoid clock-watching
  • Reduce worrying and racing thoughts by journaling earlier

Addressing any mental health or sleep issues is wise for your overall health and wellbeing. Talk to your doctor if you regularly have trouble sleeping. Therapies and medications may help, along with making positive lifestyle changes. Prioritize sleep by making it a nightly sanctuary that supports your mental health.