Mental health and sleep have an interdependent relationship. If you struggle with either, or both, therapy may be your path to feeling — and sleeping — better.
You’re tired and eager to sleep through the night, but as the minutes pass and the cool side of your pillow starts to warm, your thoughts race, leaving you restless. When you drag yourself out of bed the next day, you’re worn out and irritable, as if you didn’t get a wink of sleep. If this cycle of lousy sleep sounds familiar, it may be time to figure out the cause — and a new sleep routine.
According to Dr. Matthew Walker, the author of Why We Sleep, sleep provides overnight therapy like emotional first aid. When it’s difficult to sleep or you’re not experiencing enough deep and REM sleep, your brain misses out on the quality rest that helps consolidate memories, improve attention, and process and regulate emotions.
And many of us aren’t getting the zzz’s we need. A National Sleep Foundation poll found that the U.S. population has a C-average grade for sleep health and a D in sleep satisfaction. Adults who slept less than seven hours a night were three times more likely to experience mild to severe mental health problems compared to those who slept the recommended seven to nine hours.
Read more: When is it Time For a Sleep Study?
While insufficient sleep patterns can trigger and worsen psychological and emotional issues, depression, anxiety, and other mental health issues can cause sleep problems. Disordered slumber can lead a person to be less active, have less exposure to daylight, and have poor sleep hygiene. It’s a trap of sleep deprivation.
Whether you’re struggling with your mental health, sleep, or both, therapy can help. Working with a medical professional — like a primary care physician or mental health specialist — will allow you to determine your care plan and take it one step at a time.
Here’s where to begin.
Start with sleep hygiene and reducing stress.
When working with a healthcare provider “expect an accountability partner who will help you design and stick to a personalized sleep plan based on your unique sleep challenges,” says clinical psychologist Dr. Colleen Ehrnstrom.
To optimize your best chance for healthy sleep, the National Sleep Foundation recommends:
- Consistent sleep and wake times
- A quiet, cool, and dark sleeping environment
- Consistent meal times
- At least 30 minutes of exercise, five days a week
- No heavy meals, alcohol, caffeine, or nicotine close to bedtime
- No electronics at least 30 minutes before bed
- Seven to nine hours of sleep
With the help of a doctor, you can assess your current sleep habits and adjust accordingly based on your specific environment and lifestyle. Talk therapy is also an opportunity to unload some of your emotional burdens and learn stress-reduction techniques, such as deep breathing exercises, that can calm your mind before bedtime.
Read more: Easy Breathwork Techniques for Better Sleep
Identify potential underlying conditions.
Suppose your sleep isn’t improving after a consistent effort to get back on track. In that case, a specialist can perform an exam to diagnose whether there’s a more serious mental health or sleep disorder preventing you from the restorative sleep you need. Some common sleep disorders include sleep apnea, insomnia, excessive sleepiness, and narcolepsy.
Attend cognitive-behavioral therapy sessions.
There are different types of cognitive-behavioral therapy that use distinct methods to treat varying problems, and their core purpose is to help pinpoint, challenge, and change negative thoughts, beliefs, and behaviors. CBT-I is designed for those who suffer from a sleeping disorder like insomnia. Through this form of talk therapy, you’ll learn how to replace harmful patterns with new coping strategies and relaxation methods to help you fall asleep and stay asleep longer.
Every person’s body responds differently to CBT-I says Ehrnstrom, who also serves as an advisor for the CBT-I app Dawn Health. Typically a person will start noticing the positive impacts of sleep hygiene education and CBT between two and four weeks.
“Behavioral change always takes longer than we wish it would,” says Dr. Ehrnstrom. “This is ultimately a good thing, as we wouldn’t want our bodies to be constantly influenced by short-term choices.”
Read more: Tips for an Anxiety-Free Bedtime
Can medications help with sleep quality?
The short answer is, not really. As the Center for Human Sleep Science director at the University of California, Berkeley, Dr. Walker says current sleeping pills do not produce naturalistic sleep. “So they are all a broad set of chemicals that we call the sedative hypnotics, and sedation is not sleep; it’s very different,” he told NPR. “It doesn’t give you the restorative natural benefits of sleep.”
Sleeping pills aren’t recommended for long-term use — and evidence of their sleep benefits is weak — but for temporary relief doctors may prescribe medications like hypnotics (Ambien), benzodiazepines (e.g., Xanax and Valium), and sedative antidepressants.
There is a limit to sleep therapy.
Dr. Ehrnstrom believes sleep therapy has one potential limitation — feeling a sense of urgency for your need for sleep. She notes that some may opt to take medications, while others will take time off from work or other responsibilities to reduce stress.
“If you have any concerns about safety (e.g., operating heavy machinery, making important decisions, etc.), then you will want to augment a therapy program with something that can give you immediate relief,” says Dr. Ehrnstrom. “The number one priority is safety and stabilization. Without that, even the best sleep program will be a struggle.”
Read more: 7 Sleep Myths — Debunked
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