The second in our series of guest blogs is Dr Andrew Mayers, principal academic at Bournemouth University. Andrew will be sharing his thoughts on how poor sleep is a major predictor of mental ill health and how to prioritise good sleep to maintain a mentally healthy lifestyle.
“In my work, I frequently see how sleep plays a major role in mental health. The link between poor sleep and mental illness is well-documented, but perhaps none more so than with depression. Poor sleep is a key feature when diagnosing major depressive disorder. One-third of patients with chronic sleep problems also report problems with mood and most patients with mood disorders experience insomnia. Sleep disturbance is common in patients reporting suicidal thoughts. Scientific evidence shows that depressed individuals take longer to get to sleep, have more fragmented sleep, and spend less time in sleep (including waking earlier).
“Rapid eye movement (REM) sleep is also a factor. This is a period of lighter sleep, often associated with dreaming. Non-REM sleep is deeper and associated with physical growth, restoration and repair. REM sleep is believed to be more related to psychological maintenance. While REM sleep is clearly important, it is better that we do not spend too much time in that phase, at the expense of deeper sleep. Evidence shows that depressed patients enter REM sleep more quickly than those not depressed, and spend more time in REM sleep overall. The very fact that many antidepressants suppress REM sleep, while lifting mood, illustrates the strong link here.
“New mothers inevitably experience compromised sleep. However, when that sleep is poorer than might be expected at this time, the risk for developing mental illness is increased dramatically (such as with postnatal depression and postpartum psychosis). One of the most significant precursors to postpartum psychosis is poor sleep.
“Other sleep disorders, such as sleep apnoea, narcolepsy and sleep-phase conditions have been associated with depression. This is often related to symptoms such as fragmented sleep or too much time spent in lighter sleep (as can be the case with sleep apnoea) or proportionately too much time in REM sleep (which can occur with narcolepsy). Sleep-phase problems can emerge when sleep occurs outside ‘typical’ times (usually in periods of darkness). Shift workers often sleep at untypical times; evidence shows that those engaging in shift work are more likely to experience mood disorders and other mental health problems.
“However, there are steps we can take to improve sleep and promote better mental health. We can probably all identify how a good night’s sleep can elevate our mood. One of the key tips is to maintain as much of a routine as possible (just like we do with our children). We can also aim to make changes to our bedding and bedrooms to promote sleep. Since poor sleep is often associated with anxiety (often about getting to sleep), there is much we can do relieve that stress.”
Here are a few tips that I recommend for better sleep:
• Try to go to bed at the same time every evening
• Have a wind-down before bedtime – so turn off that computer, put down the phone, and do something more relaxing
• Avoid large meals at least 2 hours before bedtime
• Avoid too much caffeine, especially later in the day
• Avoid too much alcohol – it may appear to help sleep, but too much can lead to shallower sleep
• Get some exercise during the day (climbing stairs, rather than taking the lift; go for a jog; walk a little further every day, etc.) – but don’t undertake strenuous exercise too close to bedtime
• Ensure that your bedroom is well-ventilated and neither too hot or too cold – keeping a window slightly open (even in Winter) can help
• Choose bedding that is better suited for sleeping – sometimes ‘luxurious’ sheets and pillows have a high cotton count. This might seem cosy, but it does not help with maintaining an optimum body temperature
• Keep the bedroom free of clutter and items not associated with sleep (such as work-related materials)
• Turn off your mobile phone, or leave it in another room!
• If you have trouble getting off to sleep (or wake for what appears to be a long period), try not to look at the clock – it will only make you more anxious
• To relieve the anxiety, try relaxing and breathing deeply. Use distraction (counting sheep really works!). You could listen to soothing music or other relaxing sounds
• If really cannot sleep, get up, walk around, do something relaxing, and then go back to bed
Andrew lectures in mental health at Bournemouth University. He is also a well-known mental health campaigner and educator, and works with charities locally and nationally. He is Patron for Dorset Mind, a Governor of Dorset Healthcare University NHS Foundation Trust, and Patron for the Samaritans of Bournemouth and District. You can see more about his work at www.andrewmayers.info or follow him on Twitter @DrAndyMayers