Health and Wellness

Why Poor Sleep is Horrible for Mental Illness

“And tell those crackheads on the corner to STFU and go the f**k to sleep, ‘cuz some of us have to work a 9 t’ gotdamn 5 tomorrow. Thanks.”

Ain’t nothing like hitting the sack after a long day of being… awake. The cool and clean pillow and sheets. The soft, comfortable (hopefully) mattress that cradles your sleeping form. The sweet darkness and silence that slowly envelopes you and kisses you goodnight.

My sleep for the past… I don’t know, since the start of my depression, I guess– so, around 10 years or so ago– has been horrible. (To be honest, I really can’t remember when it started or when it got as bad as it is.) I have never been able to get sleep that has been restful enough for me to function properly during the day. I imagine my weight has something to do with it (which I’m currently working on, don’t worry). Though, a lot of it comes from anxiety– so I have trouble falling asleep– and depression– which makes my dreams turn into nightmares. Sometimes I can fish out what’s bothering me by examining my nightmares, but most of the time I can’t.

When I wake up the next day, after about 8-12 hours of sleep, I’m incredibly tired of tons of body pains. During my time awake, I need at least one 30 minute nap to make it through the day. Usually, I can fight the urge to sleep, but if I do I am completely unable to function until I take one because I’m so tired.

Bad sleep, or no sleep, results in a sleep debt. In any situation, when you’re in debt, you must pay it back somehow. If you don’t, you’ll suffer in the long run. I’ll show you how amassing all sleep debt can affect all areas of your life after the jump.

As always, the conclusion with your actionable steps can be found at the end of the article. 🙂


Why Do We Need Sleep?

“SLEEP IS FOR THE WEEK… I MEAN… THE WEAK… SORRY, I’M TIRED.”

I know I’m supposed to sleep. Even if I didn’t I’d do it anyway, but why do I need to? Why can’t we just take something that completely negates the effects of being awake all day?

Well, I can’t answer the second question, but I can answer the first one. Mostly.

In an oversimplified sense, sleep is a naturally-occurring, restorative state of being wherein you become unconscious of and unresponsive to environmental stimuli. To expand on that, it’s a complex series of processes that are separated into physiological and behavioral categories that you cycle through. First, you have the signals that regulate the sleep-wake cycle– your circadian rhythm and sleep-wake homeostasis. Then, you have the sleep cycle, which describes all of the neurological processes that take place during sleep, like NREM and REM sleep (we’ll come back to this). You also have chemicals released to partially paralyze you so that you can’t act out your dreams. Sleep-walking is an infamous instance where there is a disturbance in that operation. Here is an in-depth article that explains all the ins and outs of sleep by the American Sleep Association.

But why exactly do we sleep? Well, we don’t have a solid reason, just a few theories. One is restoration. While you sleep, your body begins to heal itself (inside and out) and dispose of various wastes that build up during periods of wakefulness. Another is memory retention, as REM sleep enhances implicit memory (which are unconscious skills like riding a bike) and N-REM sleep enhances explicit memory (which are experiences, concepts, and factual information). The third is dreaming; in which it is theorized that this is a period where the brain tries to make sense of things that it learns throughout the course of the day.

Another thing of note is that an extreme lack of REM sleep will, in fact, lead to death. Scientists believe that REM sleep is such biologically necessary function that prolonged restriction may disrupt critical functions needed to sustain life. We don’t know why, but there are a few instances where someone or thing dies from a lack of REM sleep. Do also note that there isn’t an exact time until death from sleep deprivation.

This neat little infographic from Hack to Sleep shows the sleep deprivation timeline on their website.

OK, well now we know why we should sleep, though not super clear on the evolutionary necessity of it. And ultimately we know know that complete lack of sleep leads to death. But for the majority of us who only lose a few hours of sleep per night, how does it effect us? What the hell happens when you only get few hours of quality sleep?

Well, my dear Watson, I’m so glad you asked because that’s where I was heading.

Detrimental Effects of Sleep Deprivation

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Sleep Debt

Also known as sleep deficit, is the total amount of sleep lost over a period of time that sneakily affects overall health. It’s contested whether or not it’s a measurable phenomenon, but the effects are certain. This is more of a broad overview of the cumulative effects of sleep debt. You might have noticed that over a few days of missing out on a few minutes to a few hours of sleep, either due to a new baby or a new, farther job location, that you can be more irritable, prone to zoning out less engaged, aware, etc. But there are more things that happen.

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Taking a look at this article from Somnosure, it tells us more about the behavioral and physiological effects of sleep debt. It notes the behavioral problems as “irritability, poor judgment, attention deficit, drowsy driving, memory issues, emotional stress, daytime sleepiness, poor risk management, depression and workplace accidents.”

While the physical problems manifest as “physical stress, immune system dysfunction, worsened vision, reduced motor dexterity, weight gain, advanced aging, cerebral shrinkage and systemic inflammation. The last problem—systemic inflammation—leads to major health problems like diabetes, cardiovascular disease, and stroke.” Most of which, we’ll talk about as we go along.

The taglines to each of the chapters in my life.
Microsleep and Accidents

A few years ago while traveling cross-country, I had a terrifying experience. I fell asleep at the wheel. Unfortunately, this was the first time that I realized that driving for long periods of time (like 2-3 hours) made me sleepy. Coupled with the comforting silence of the car and the darkness of the night, at some point during my shift, I fell asleep. I don’t know how long I was gone, but I shot awake and terrified that I could have killed us both. I think I might have switched a lane, edging closer to the ditch next to the road. Thankfully, I was let off with a very strong warning from the universe and that was all I needed to pull over after that.

Microsleeps are short, spontaneous bursts of sleep that happen without the subject being aware. They last around a fraction of a second to 2 minutes and during that time the subject is basically unconscious and unresponsive to stimuli. When you body gently moves or falls, that’s when you jerk awake and realize that you may not be all the way here.

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Funnily enough, your eyes don’t have to be closed in order for you to have a microsleep episode; more often than not, your eyes are open. And it usually occurs among those with a sleep disorder, who are sleep deprived or work night shifts.

Unfortunately, tons of accidents are caused during this time. Anything that requires your attention doing monotonous tasks for extended periods of time while you’re sleep deprived puts you at risk for unintended microsleep at the worst time.

Risk of Obesity, CHD, Hypertension, and Diabetes

I know. You might be desperately trying to piece together what you’ve learned in a middle school science class to figure out how the hell sleep deprivation can put you at risk for all of these things?

Let’s be clear it is a risk factor, not a definite cause. According to a WebMD article on this subject, there is a link between getting less than 6 hours of sleep a night and heart disease. There’s as much as a 48% increased risk that someone could get or die from coronary heart disease (CHD); as well as a 15% increased risk to get or die from a stroke. Confusingly enough, those who slept more than 9 hours were also at a slightly decreased risk at 38% of getting or dying from CHD, but a whopping 65% risk of developing stroke

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Well, what the hell am I supposed to do?

Poor sleep (too much or too little) can create insulin resistance. More specifically, it was found that being awake during your biological night increased your insulin resistance, which is a risk factor for the development of type-2 diabetes.

It was also a good predictor of worsening high blood pressure. This 2010 study hints that when blood pressure doesn’t drop at night like it typically should, due to extended sleep deprivation, your risk for hypertension increases. Additionally, this more recent 2018 study, asserts the same findings.

And to put the cherry on top, it puts you at a greater risk for obesity. Generally speaking, “children and adults who get too little sleep tend to weigh more than those who get enough sleep,” says this Harvard article. “In the Nurse’s Health Study, researchers followed roughly 60,000 women for 16 years, asking them about their weight, sleep habits, diet, and other aspects of their lifestyle. At the start of the study, all of the women were healthy, none were obese; 16 years later, women who slept 5 hours or less per night had a 15% higher risk of becoming obese compared to women who slept 7 hours per night.”

Unfortunately, all of these things are said to create an increased risk, but no one seems to know the cure. At best, we seem to have some ideas. Some of which are reaching for more of those really bad foods in the middle of the night and not wanting to exercise, on top of not getting enough sleep.

Poor Memory, Cognition, and Concentration

These are a few things you might notice immediately upon waking up. Trying to do anything that necessitates more than an automated action when you’re tired (e.g. breathing, blinking, etc.) requires way more effort to do than normal. You’re slow and sluggish, there’s a heavy fog that has infiltrated your poor brain, and trying to make coffee ends up with a flippant realization that you added way too much water… And now your coffee is on the floor. Whoops.

This article from Nature.com shows that the brain has a notably decreased efficiency at the cellular level when you’re sleep deprived. Neurons in your brain fire more slowly and weakly when you’re tired. These effects primarily show up as a problem with memory and cognition. Researchers observed that when you’re really tired “slow, sleep-like patterns appeared disrupting brain activity,” and from there it is suggested that certain parts of your brain basically fall asleep, causing a mental lapse, while other parts stayed awake.

Weakened immunity

This study by UC of California found that people who slept 6 hours or less a night were four times more likely to catch a cold when they came in contact with the virus. This is because when we are sleep deprived, our body begins to suppress immune function. This, in turn, means that inflammatory cytokines go up; they’re like the… children of T-cells and macrophages that go around spray painting inflammation all over your body trying to help, but all they do is cause more trouble.

Once again, scientists aren’t super sure why this happens, but they have a few hunches. They’re pretty much the same things we’ve said before, though.

Hurts Mood and Mental Well-being

So, you wake up and walk into work and then you’re extremely chipper coworker starts to talk your ear off about stupid stuff that no one cares about. Like how their weekend was or how your night was or how the auditor is coming in like… 5 minutes… That actually sounds… pretty important.

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Anxiety, irritability, and flattened affect (mood) are all things that can be caused by a lack of sleep. According to this article on Sleepio, The Great British Sleep study found that a flattened mood was the second most reported daytime consequence of chronic poor sleep. And it was the difference between waking up the next day with a less positive or more negative mood rating.

To add insult to injury, when your mood is ALSO poor, you will have difficulties with sleep as well. Ever been too mad or sad to sleep? That’s exactly what I mean. That can turn into a vicious cycle if one or the other isn’t controlled. And all that can mean for the future is more problems.

Can I Reverse the Effects of Poor Sleep? How?

First, you have to asses your current sleep health. Do any of these things apply to you?

  • Do you wake up feeling tired?
  • Do you feel tired and sleepy throughout the day?
  • Is your cognitive performance where you want it to be from morning to night?
  • Is your memory, concentration, or attention causing trouble at work?
  • Are you feeling irritable throughout the day?

If you answered yes to any of these, you may be at least a little sleep deprived. Also, here’s another test you can take for measuring your current sleep health. It’s a subjective measure, so make sure to be as accurate as possible.

So, here are some things that you can do:

      • Repay your sleep debt – just a few hours extra a week, spread out over a few days (e.g. an extra hour a night for 5 nights) will help you to get yourself back on track. Or even spend a few extra hours sleeping in on the weekend.
      • Maintain a sleep schedule and avoid racking up more sleep debt – Make a schedule and stick to it.
      • Take a few steps to cultivate a healthy sleep hygiene regimen – No blue lights while in bed. Your bed is only for sleeping. Do not keep lights on in your room. Go to bed on time and wake up on time.
      • Avoid food and drinks that will disrupt your sleep – Alcohol, caffeine, nicotine all of these mood-altering substances can create problems for you when it comes to going and staying asleep. Take a look at this article from the Sleep Health Foundation in Australia. You’ll see that people have more difficulty, past the developmental traits that come with age, with their sleep.
      • Don’t extend daytime naps past 30 minutes – A nap is just that– a nap; not a full block of sleep. Taking more than 30-minute naps can keep you up longer than intended.
      • Exercise frequently – The heating up and subsequent cooling down after a work out is a great way to prepare your body for bed. It also may help to reduce insomnia, while definitely helping depressive and anxious moods.
      • Establish a bedtime routine to help you wind down before bed – When you have a routine, you’re preparing your body and mind to wind down. It’s sort of like a mind game to trick yourself into feeling sleepy.
      • Try Melatonin capsules – Melatonin is a hormone that your body naturally produces at night and helps you to fall asleep. Melatonin capsules help regulate your sleep and wake cycles. When you take melatonin, it quickly raises the amount of melatonin in your body and helps you to fall asleep. If you decide to use melatonin capsules, contact your doctor first to see if it’s right for you. Furthermore, try the smallest dose possible first and work your way up, as melatonin can make you incredibly groggy when you wake up or keep you up outright. You can use a pill cutter, as well, to help lessen the dose.


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Conclusion

Well, the actionable steps aren’t here this time, as a felt it was less appropriate here. But right above there are things that you can do to help yourself to keep a regular, restorative, and healthy sleep schedule. Obviously, there are those who might need a bit more help than others in making this work, by the use of medication or a medical machine (a CPAP machine, for instance). For those people, I do recommend following the orders that your doctors give you, as they know you best and this is just a generalized information.

I hope that your sleep problems work out if you decide to take a few notes from here. Let me know how it goes and tell me what are some things that you do to help you get to sleep in the comments below!

Peace and peace,

Althia.

Hi, I'm Althia! I love psychology have a particular obsession with promoting mental health. That being said, I have one specific goal that I want to achieve. I want to help millennials to finess mental illness and inspire personal growth one motivational & informational post at a time.

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