Scientists have clarified the disturbing connection between insomnia and mental problems

Sleep, circadian rhythm and mental disorders are links in the same chain

New research highlights the link between sleep, circadian rhythms and mental health disorders, suggesting that disruptions to the body’s internal clock may trigger or worsen mental health problems. The study highlights the prevalence of circadian sleep disruptions across all mental health disorders, highlighting the need for comprehensive treatment.

A review published in the Proceedings of the National Academy of Sciences (PNAS) suggests that a better understanding of the relationship between sleep, circadian rhythms and mental health could open up new holistic treatments to alleviate mental health problems.

“Circadian sleep disturbances are the rule rather than the exception in every category of mental disorder,” explains study author Sarah L. Chellappa. “Sleep disorders such as insomnia are well studied in the development and maintenance of psychiatric disorders, but our understanding of circadian disruption lags.”

She adds that it is now “important to understand how these factors interact so that we can develop and implement circadian sleep interventions that improve sleep and mental health symptoms in patients.”

An international team of researchers from the University of Southampton, King’s College London, Stanford University and other institutions examined the latest evidence on sleep and circadian factors, with a particular focus on adolescents and young adults with mental disorders. This is the time when people are most at risk of developing mental health problems and when sleep and circadian rhythm disturbances are likely.

Insomnia is more common in people with mental disorders than in the general population – during remission, acute episodes and especially in the early stages of psychosis, when more than half of people have difficulty falling asleep. About a quarter to a third of people with mood disorders have both insomnia and hypersomnia, in which patients have difficulty sleeping at night but are sleepier during the day. A similar number of people with psychosis experience this combination of sleep disturbances.

Meanwhile, several studies looking at circadian rhythm sleep-wake disorders (CRSWD) show that 32 percent of patients with bipolar disorder go to bed and wake up later than usual. It has been reported that the body’s biological clock runs seven hours ahead during manic episodes and four to five hours later during depressive phases.

Researchers have examined possible mechanisms underlying circadian sleep disturbances in psychiatric disorders. Dr. Nicholas Meyer that “variability in sleep duration and timing can lead to a misalignment between our body clocks and sleep-wake rhythms, which can increase the risk of sleep disturbances and adverse mental health outcomes.”

The study found that cognitive behavioral therapy for insomnia (CBT-I) reduced anxiety, depressive, and trauma symptoms in people suffering from post-traumatic stress disorder.

For unipolar and bipolar depression, light therapy was effective. Its use in combination with drug treatment was also more effective than using pills alone.

Taking melatonin in the evening may help people with slow sleep-wake disorder to shift their body clock toward a more normal sleep pattern and may have benefits for co-occurring psychiatric disorders. Working night shifts can take a toll on mental health, but eating during the day rather than at night may help, research suggests.

Sarah Chellappa notes: “Taken together, mental health research will take advantage of the outstanding advances in sleep and circadian science and use them to improve the understanding and treatment of mental disorders.”