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Brandon Peters, M.D.

30 Days to Better Sleep: Address Underlying Mood Disorders Including Anxiety and Depression

By January 22, 2013

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Sleep walks hand in hand with mood. Anyone who has tried to go to bed upset knows that time is spent tossing and turning instead of sleeping. It is good advice to not go to bed angry, but what about other negative feelings? Mood problems such as anxiety and depression can severely affect sleep. Consider how addressing these psychiatric conditions may help you to sleep better.

In order to sleep, we have to ensure that certain conditions are meant. It is a rich tapestry with the integration of distinctive elements. Some of these are physical; we have to have been awake long enough to feel sleepy, for instance. Some of these are behavioral; we have to go to a place where we will be comfortable to sleep, typically our bedroom. Other conditions imperative to sleep depend on our thoughts or moods, sometimes referred to as the cognitive element of sleep. Interplay exists between all of these factors, and mood is particularly powerful.

If we are in a state of stress, we are unlikely to fall asleep easily. This is protective. If we have witnessed something that we find emotionally distressing, the resulting anxiety provokes us to stay awake to ensure our personal safety. Once the anxiety fades without further being incited, our state of arousal remits and we can rest. Psychiatric problems that lead to persistent disturbances in our moods, such as anxiety or depressive disorders, can also lead to chronic difficulties sleeping. In fact, these disorders can change the very structure of sleep.

People with depression often suffer from early-morning awakenings. Rather than waking with an alarm clock, people with depression may wake several hours before intending to. Depressed people also have a quicker onset of rapid eye movement (REM) sleep during the night.

In contrast, anxiety problems such as generalized anxiety disorder are commonly associated with insomnia that may impact the entire night. It takes longer to fall asleep. There is more wakefulness after sleep onset, with nighttime awakenings followed by prolonged periods awake. The total amount of sleep is reduced. In addition, people with anxiety may also experience early-morning awakenings, similar to what occurs in depression.

There appears to be a clear relationship between mood and sleep problems. Not only do mood problems often result in sleep disorders like insomnia, but people with insomnia are more likely to develop anxiety or depression. The combination increases the risk of suicide. People with sleep apnea often have depression as well.

These facts should lead us to a comprehensive conclusion: in order to sleep better at night, it may be necessary to address any coexistent mood disorders. When symptoms of anxiety or depression are present, these must be improved in order to fix the difficulty sleeping. By tackling each factor that contributes, it will be possible to improve your sleep so that you can face your day fully rested and feeling your best.

Check out the entire series, "How to Sleep Better in 30 Days."

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