What is the relationship between depression and sleep?

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According to one scientific journal, sleep loss might contribute to neurochemical changes in the brain, which can result in depression. The researchers also suggest that depression may lead to disrupted sleeping patterns.

According to an article in the journal BMC Psychiatry, lack of sleep or poor quality sleep may cause changes in a person’s thinking, mood, and emotions.

Researchers in this study also reported that sleep disturbances might activate a person’s stress response more frequently. This stress may contribute to the development of depression.

According to the NSF, because symptoms of sleep disorders and depression overlap, misdiagnosis is possible.

Many sleep disorders may contribute to a person experiencing depression. However, depression can result in a person feeling excessively tired. This condition is known as excessive daytime sleepiness (EDS).

According to a study in females that was a 10-year follow-up from baseline research, depression is an important factor in causing EDS.

EDS may have adverse effects on people’s cognitive and behavioral functions. These knock-on effects can interfere with a person’s quality of life.

Poor sleep can affect a person’s ability to think clearly and cause an individual to have greater difficulty controlling their emotions. All these things can contribute to depression.

Sleep apnea and depression

Obstructive sleep apnea (OSA) is a medical condition that causes a person to have problems breathing while they are asleep. OSA and depression appear to have a link.

According to researchers, 18% of those experiencing major depressive disorder also experience OSA, and 17.6% of those experiencing OSA also have depression.

OSA may also cause someone to feel extremely tired during the day because they have not slept well at night. EDS and waking up feeling unrested may all be signs that a person could be experiencing OSA.

An article in the journal Sleep Medicine Reviews reports that people with OSA are likely to report anxiety and depression as well.

Insomnia and depression

Insomnia is a sleep disorder where a person has difficulty going to sleep or staying asleep. An estimated 20–35% of the population experiences insomnia symptoms at some point in their life.

According to the NSF, people with insomnia are also 10 times more likely to develop depression compared to people who report sleeping well.

The NSF also suggest that those who have problems going to sleep, which doctors call sleep onset insomnia, and maintaining sleep, or sleep maintenance insomnia, are the ones most likely to experience depression.

A meta-analysis of 34 studies that included 172,077 participants found a positive relationship between insomnia and depression. The researchers concluded that insomnia could lead to depression and suggested that preventing insomnia had the potential to reduce depression.

A 2019 review suggests that there is a two-way relationship between sleep disorders, such as insomnia and depression. They believe that sleep problems can predict the onset of depression.

Treatment for sleep disorders and depression-related symptoms can vary, depending on the type of sleep disorder.

Research from the journal Dialogues in Clinical Neurosciences suggests that if a person’s sleep problems do not improve after treatment for depression, they should tell their doctor and look for other treatments.

Those with OSA may benefit from using a continuous positive airway pressure (CPAP) machine that reduces the likelihood of problems breathing while sleeping.

The NSF report that when a person with OSA uses a CPAP mask for 1 year, they experienced an improvement in their depression symptoms as well.

Medications

Doctors may prescribe medications to treat sleep problems and depression. A doctor will select the type of medication after assessing the person and their symptoms.

Medications may include:

• mood stabilizers, such as carbamazepine
• selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine or sertraline
• tricyclic antidepressants, such as amitriptyline or nortriptyline

Doctors do not often give sedating antidepressants to those experiencing OSA, as they may affect a person’s breathing and make OSA worse.

Therapy

A person can get cognitive behavioral therapy (CBT) to treat depression and insomnia. CBT is a therapy approach that involves identifying thoughts and behavior that can contribute to or worsen depression.

While lifestyle changes alone may not be enough to improve depression and sleep disorders, some lifestyle changes may help a person sleep or feel better.

These include:

• consuming warm drinks before bed, including milk
• exercising more during the daytime but not close to bedtime
• taking melatonin supplements
• keeping the bedroom cool
• sleeping in a dark room
• eating a healthful diet
• practicing meditation
• reducing alcohol intake

A person can also talk to their doctor or therapist about individual interventions that may help improve their sleep.

A person should always seek immediate medical attention if they experience thoughts of suicide or self-harm.

A person should seek help if they are:

• experiencing EDS
• experiencing changes in mood or personality
• experiencing feelings of helplessness or hopelessness

Depression and sleep problems are two conditions that commonly occur together, and one can sometimes contribute to the other.

If a person is struggling with symptoms of either condition or both, they should see their doctor. Help is available that can improve a person’s overall quality of life.