For mental health, don’t let sleep fall by the wayside

May is Mental Health Awareness month. If you’re looking for ways to improve your mental health, consider starting with your sleep. Improving your slumber can mean big benefits when it comes to feeling good.

What is the relationship between sleep and mental health?

A myriad of genetic and environmental factors play into mental health, and not all of them are fully understood. But what we do know is that sleep plays a crucial role in mental wellbeing. Sleep and mental health have a bidirectional relationship, meaning they impact each other.

“We know people with mental health problems tend to have more difficulty with sleep; poor sleep also causes (and exacerbates) mental health problems,” says Richard Blackburn, a clinical psychologist in Cambridge, Minnesota who focuses on sleep.

Sleep issues are listed as symptoms for many psychiatric diagnoses, says Blackburn. The DSM-5, the widely used diagnostic tool created by the American Psychiatric Association, lists sleep disturbances as a symptom of depression, anxiety, and bipolar disorder among other disorders. Chronic insomnia is also associated with increased risk for suicidal ideation.

“Everything gets harder when you sleep poorly,” says Blackburn. Sleep is sometimes called an extra vital sign, he says, along with heart rate, breathing, temperature, and blood pressure, because it’s so important for health. Besides mental health problems, people who routinely get fewer than six hours of sleep a night are at increased risk of heart attacks, strokes, and metabolic conditions like diabetes.

But the good news is sleep problems can be managed. “When sleep goes badly there’s usually a reason for it and that reason needs to be explored,” Blackburn says.

What can I do to improve my sleep and mental health?

Anyone who’s experiencing chronic insomnia or a serious mental health condition like depression should seek medical help. Insomnia exacerbates mental health issues, in part, because people lose emotional regulation when they aren’t sleeping, says Blackburn.

You can start with your primary care physician, who can help you decide whether you need to see a sleep psychologist or a sleep specialist who can perform a sleep study or another course of treatment, Blackburn suggests. A form of counseling called cognitive behavioral therapy, for example, can be effective for improving insomnia, says Blackburn. Treating insomnia can alleviate other symptoms of mental health conditions. Likewise, treating physical medical issues like sleep apnea or hormonal imbalances can improve sleep problems that may be taking a toll on a person’s mental health.

“The best treatment for coexisting sleep and mood disorders may require collaboration among different providers, the use of medications, treatment of associated sleep disorders, and psychotherapy,” says Dr. Brandon Peters, a sleep physician at Virginia Mason Medical Center in Seattle, Washington.

All of that said, for healthy people who are just looking to get a better night’s rest, there are some simple steps you can take on your own.

Create a bedtime routine

Doing the same set of relaxing and repetitive activities every evening as a bedtime routine can train your brain to get ready for rest. Set a phone reminder for an hour before bedtime to remind yourself to begin transitioning to sleep, advises Peters. Use that time to relax and unplug from your day. This means putting aside your work, email, and social media, and reading or listening to calming music instead.

Wake up at the same time every day

Having a consistent start to your day is just as valuable as a regular bedtime routine for keeping your sleep-wake cycle on track. You should set an alarm for the same time in the morning regardless of what time you went to bed the evening before, says Blackburn. Your internal clock gets set when you get up and get sunlight in your eyes. If you snooze past your alarm, it pushes back your body’s clock, meaning it’ll be more difficult to fall asleep that night.

“Sleeping in on the weekend messes up your internal clock for multiple days,” he says. “It’s like getting jet lag without ever leaving the house.”

Try not to stress in bed

Sometimes not being able to fall asleep once your head hits the pillow can cause you to feel anxious about not being able to sleep… a vicious cycle. If you’re lying in bed unable to doze off for more than 15 to 20 minutes, get up and do something relaxing instead of tossing and turning, says Blackburn. If you lie there stressing about how you can’t sleep, you’ll begin to associate your bed with stress instead of comfort and relaxation.

Similarly, try not to ruminate about your day or stress about your workload while in bed. One option is to listen to a sleep story, like the ones produced by mediation apps like Headspace. These are relaxing bedtime stories for adults designed to take your mind off of daily anxiety and lull you to sleep. If you don’t want screens involved, you can try the Morphée, a screenless meditation device with multiple options for winding down But if stressing in bed is becoming a recurring issue, consider seeking professional help.

Keep your bedroom comfortable

Your bed and bedroom should be a physically comfortable space as well as an emotionally comfortable one. Keep your bedroom cool, dark, and quiet, says Peters. Somewhere in the mid-60s is generally considered the ideal sleep temperature.

Try not to bring screens into the room—or at least use bedtime phone settings, including not watching TV before you doze off.

If light is an issue in your room, consider using blackout curtains to keep streetlights from keeping you up or a sleep mask if your partner keeps a light on past when you want to be snoozing. If it’s too noisy, try a white-noise machine to drown out ambient sound or earplugs to keep, say, the barking neighbor’s dog from startling you awake.

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