Sleep is vital to not only physical health, but mental wellness as well. Think how tired you’ve felt whenever you stayed up too late the night before, or woken up earlier than usual. On those days, you have probably found that you have a harder time processing information or working through tasks and problems. You might even feel a bit grumpier, or experience mood swings more than usual.
Irregular sleep here and there won’t cause significant problems, but when it happens on a consistent basis, your health may suffer. Too much or too little sleep isn't always the result of bad bedtime habits; sometimes it’s a sign of an underlying condition.
What Happens In Your Brain When You Sleep?
Many athletes will tell you how important cooldown exercises are. After they’ve worked out and pushed their bodies, they do much gentler activities and stretch in order to recover from exertion.
This is what sleep is for your brain—it’s a cooldown or recovery period. When you sleep, your brain doesn’t press “pause” on keeping your body healthy. Rather, most brain activity slows down in order to recuperate.
Too much or too little sleep isn't always the result of bad bedtime habits; sometimes it’s a sign of an underlying condition.
Just like a recovery from a workout might involve walking and stretching, sleep involves different “activities.” These activities are called stages. A full sleep cycle involves each of the four stages, and happens about four-to-five times each night.
Stage 1—Falling Asleep
This is the transition phase, or the act of falling asleep. Stage one is the shortest of the four phases, and happens before you are fully asleep, when your body is transitioning out of wakefulness.
Stage 2—Initial Sleep
The second stage is when you are just initially asleep. At this point, the body and brain significantly “pump the brakes” on activity and start to slow down functions.
Stage 3—Deep Sleep
Referred to as ‘deep sleep,’ stage three is the most important to recovery. Your brain activity is the slowest, and your heart rate and breathing follow suit.
While a person can be woken easily in the first two stages, the brain actively prevents someone from waking up during this stage. This is the stage where some say memories are established.
Stage 4—REM sleep
REM sleep is where dreams happen. While sleep scientists are continually working out why we dream what we do, we know that brain and body activity in this sleep stage look the same as when you are awake.
How do these sleep cycles begin? Your body's 24 hour clock—called the circadian rhythm—determines these cycles. About two hours before you fall asleep, your body releases the hormone melatonin, which starts to slow brain activity.
The circadian rhythm is dictated by exposure to light. Humans, for the most part, naturally sleep at night and wake when the sun comes up.
Common Sleep Disorders
Knocking any of the phases of sleep or the circadian rhythm “out-of-whack” can lead to more than one night of bad sleep. Many with sleep disorders experience them for weeks, months, or even years. Some are caused by health problems. Regardless of how it developed, constantly interrupted sleep cycles can lead to additional health problems and other sleep disorders.
If a person notices that they have trouble falling asleep or staying asleep, and the resulting fatigue affects their day-to-day activities, they may have insomnia. Chronic insomnia occurs in about 10% of US adults, and lasts for at least three months. Short-term insomnia occurs in upwards of 20% of US adults, and isn’t as frequent or as long-lasting as chronic insomnia.
Insomnia comes in several varieties. The type of insomnia a person might be dealing with depends on its cause and effects.
Narcolepsy And Hypersomnia
The antithesis of insomnia would be hypersomnia, or extreme fatigue and too much sleep. Hypersomnia could be primary or secondary. Primary hypersomnia means it is given as the initial, first, or principal diagnosis. A secondary hypersomnia diagnosis might be applied if a doctor determines a person is experiencing symptoms as a result of a health disorder or medication.
One subtype of hypersomnia is narcolepsy. Narcolepsy is often portrayed in movies as someone who randomly falls asleep, but this isn’t accurate.
This misconception is probably based on one variation of narcolepsy, called or narcolepsy with cataplexy, or Type 1 narcolepsy. Cataplexy is sudden muscle weakness. Since narcolepsy is the inability to regulate wakefulness and sleepiness, the body reacts like it would if it were asleep with slowed-down body functions.
Narcolepsy Type 2 involves only the primary symptom of both narcolepsy types, which is excessive daytime sleepiness. "Sleep attacks’ are another symptom. This is where a person’s fatigue becomes so overpowering, that they have a significantly reduced ability to fight sleepiness.
When the body enters REM sleep, it is more or less paralyzed in order to keep you safe if you try to act these dreams out. However, some peoples’ bodies aren’t super effective doing this, which results in parasomnia.
Most people know this as sleep walking, sleep talking, night terrors, even wetting the bed and nightmares. Sleep walking and talking are both REM sleep behavior disorders. Those who experience any of these behaviors aren’t properly paralyzed during the last two cycles of sleep.
Everyone experiences these to some extent during childhood, or even occasionally throughout their adult life. However, for some people, parasomnia symptoms are more extreme, causing them to carry out strange behaviors like leaving the house in the middle of the night.
Circadian Rhythm Disorders
Some people’s body clocks are naturally set a few hours off, preventing them from being able to fall asleep during "normal" bedtimes. Because your circadian rhythm is tied to daylight, it can be easily disrupted. (You’ve probably experienced this in the form of jet lag from crossing multiple time zones during travel). However, other factors like stress, staying up overnight for school projects, or shift work can contribute to circadian rhythm disorders.
Knocking any of the phases of sleep or the circadian rhythm “out-of-whack” can lead to more than one night of bad sleep.
Restless Leg Syndrome (RLS)
Those who deal with RLS describe the sensations as an itching, tingling, “bugs crawling on your skin” feeling combined with pain in the legs. RLS can lead to insomnia or other sleep disorders, since the uncomfortable sensation in their legs makes restful sleep difficult, if not impossible.
Another contributor to insomnia is sleep apnea, or interrupted breathing during sleep. Everybody snores sometimes, but those with sleep apnea often have fully blocked airways that cause them to temporarily stop breathing during sleep. The brian recognizes this and wakes them up so that they can catch their breath.
A person with sleep apnea may not even be consciously aware of these brief periods of wakefulness, but they can cause significant drowsiness during the day.
What Can Cause Sleep Disorders?
Because sleep is so integrated into day-to-day brain and body functions, minor sleep disturbances are also “normal.” Sleep disorders, however, are often a result of biology or long-term habits.
Have you ever had trouble falling asleep after having that last cup of coffee in the afternoon to get you through the day? You’re certainly not alone.
While caffeine may not be the primary offender in severe cases of insomnia or other sleep disorders, doctors usually recommend cutting back as a first step to getting more restful sleep.
Alcohol is a depressant and can cause fatigue, but it also can disrupt sleep cycles, resulting in further fatigue the next day. Studies have shown that alcohol use inhibits REM sleep, keeping you in deep sleep longer than normal.
However, once the alcohol begins to metabolize, the body has trouble entering deep sleep, and stays in Stage 1 or 2 of the sleep cycle for the second half of the night . This also contributes to fatigue.
Forced, Significant Changes to Sleep Patterns
Life changes such as having a baby, moving to a new time zone, or extended travel can result in disrupted sleep.
Shift work in particular is a major sleep disrupter. In fact, The Sleep Foundation classifies shift work disorder as its own sleeping disorder. Moving shifts not only forces you to be on a new schedule, but second and third shifts completely disregard the body’s natural 24 hour clock. While many people can adapt to night work, it takes time and schedule consistency to allow the body to adjust so it can maintain healthy rhythms.
The Role Of Sleep In Overall Health
One fundamental component of sleep disorders—particularly insomnia and hypersomnia—is physical health. Sleep and your body’s wellbeing are so interlinked that it’s hard to say which one causes problems with the other. Changes to your overall health both contribute to and are caused by changes in sleep quality.
Many medications (especially their initial side effects) can prompt changes in sleep patterns that might result in tiredness and moodiness. Alternatively, it might be the condition the medication addresses that affects sleep.
Chronic pain is one of the most common issues linked with sleep disorders. It’s a vicious cycle. Feeling pain prevents sleep. However, the National Library of Medicine (NLM) found that a lack of sleep, or low-quality sleep, increases a person’s sensitivity to pain the next day.
Interrupted sleep cycles are also connected to:
- High blood pressure
- Increased risk of diabetes
- Heart disease
- Lowered immune function
Studies are still being conducted to find the exact reasons sleep disorders cause these ailments. Currently, it’s suspected that a lack of sleep inhibits not only your brain, but also your body’s ability to recover from daily wear and tear.
Sleep and your body’s wellbeing are so interlinked that it’s hard to say which one causes problems with the other.
Sometimes, the physical conditions linked to sleep disorders also contribute to mental health disorders.
Sleep Disorders And Mental Health Disorders
The connection between sleep disorders and mental health disorders isn’t direct enough to be able to conclude cause-and-effect, but the correlation is too great to be ignored.
One thing for certain is that these two categories of disorders create a feedback loop, where they each cause—or even worsen—each other. Insomnia, hypersomnia, and circadian rhythm disorders are the primary sleep disorders linked to mental health.
Depression and insomnia are particularly closely connected. Nearly half of those with insomnia are also diagnosed with depression.
Disturbed sleep is often the first symptom of depression to appear, and those with insomnia were three to four times more likely to develop depression than those without. The NLM also published a study that found half of chronic pain patients also had major depressive disorder (MDD).
Anxiety and depression share in common the symptoms of fatigue and trouble sleeping. Those with anxiety frequently describe it as their brains not being able to shut off. It’s most often associated with insomnia, but over-stimulated brains can also cause nightmares, panic attacks, and sleep paralysis.
Substance Use Disorders
Alcohol isn’t the only substance that can hurt sleep. Other depressants have similar effects, where they interrupt the natural sleep cycles and keep you in deep sleep for too long.
One way that someone can abuse alcohol is by using it to fall asleep. Yes, the depressant effects can send you into stage three quickly, but it doesn’t equate to restful sleep. When someone builds up a tolerance to alcohol, more of it is required to feel the same effect, which reinforces the cycle of substance abuse.
Other methods of self-medication relating to sleep are also common. This might be using depressants to fall asleep or taking stimulants to wake you up after a bad night’s sleep.
Many stimulants increase dopamine release. Not only does dopamine make you feel euphoric, but it also increases alertness. It’s how stimulants make you feel wide awake, and also why you have trouble sleeping while they are in your system.
Ready To Feel Better?
Treatment for mental health disorders and sleep problems are more effective when they’re addressed in tandem. Restful sleep is one of the best things you can do for your health.
Our inpatient program at Sequoia Behavioral Health uses multiple approaches to treat a variety of mental health concerns that can contribute to sleep disorders. We’ll take a holistic approach to help you heal your mind, body and spirit. Call us today to schedule a consultation, so you can get your sleep back on track.