The complex relationship between depression and sleep: Insights and solutions

What Is the Relationship Between Depression and Sleep Quality?

The relationship between sleep and depression is complex, but sleep and depression can be closely related. Depression commonly causes sleep problems, and in turn, sleep problems can contribute to or exacerbate depression. In fact, both oversleeping and difficulty sleeping are common symptoms of depression.

While depression symptoms vary, many people experience sleep disruptions like difficulty falling or staying asleep, sometimes waking early in the morning. Others may struggle with chronic fatigue and difficulty getting out of bed, often causing them to oversleep or take multiple naps during the day.

Not every person with depression will experience sleep disruptions. Even so, a disrupted sleep schedule can be a sign of or precursor to a depressive episode, so it’s important to track noticeable changes in your sleep patterns if you are struggling with depression or have in the past.

Does Depression Make You Sleep More?

Yes, depression can make people sleep more. On the outside, this symptom can look to others like “laziness” or a lack of motivation, something to get over or power through. The truth, though, is that those with depression are not in control of the fatigue and listlessness they experience. This kind of acute sleepiness or oversleeping is also known as hypersomnia, a real condition characterized by an inability to stay awake or alert during the day.

Depression-related hypersomnia requires treatment from a mental health professional, otherwise both hypersomnia symptoms and other depressive symptoms may worsen.

Despite the association, hypersomnia alone is not a sign of depression—it must occur alongside other symptoms and within developmentally appropriate ages. For example, a teenager who sleeps more than average would not necessarily be depressed, as teens typically need more sleep.

The Impact of Depression on Sleep Quality

Depression can worsen sleep quality — for example, waking in the middle of the night or getting up earlier than usual. This can also mean that depressed people’s sleep is shallower, preventing necessary REM sleep.

Whether depression causes an excess of sleep or a lack thereof, the resulting longer or shorter sleep cycles negatively impact sleep architecture, which can lead to worse sleep, deeper depression, and mood instability.

Why Is Sleep Very Important for People Who Have Depression?

Sleep disturbances in people with depression can exacerbate depressive symptoms, quickly worsening depression. This is why an emphasis on good sleep hygiene and quality rest is so important in treating depression. Improved sleep patterns can have a positive impact on depression symptoms and stave off negative symptomatic spirals.

How Sleep Disturbances Affect Depression Symptoms

When depression causes a lack of sleep, it impacts mood, affecting emotional stabilty. It also makes coping with existing symptoms even more difficult. A lack of sleep means less energy, causing coping skills like thought reframing and therapy harder to engage in. 

Coupled with depressive symptoms like low self-esteem, guilt, and negative self-talk, difficulty coping and taking care of oneself can create a negative cycle of self-loathing and worsening symptoms. In more extreme cases, depression-related sleep disturbances can even contribute to suicidality.

How to Establish Healthy Sleep Habits: Tips for Improving Your Sleep Hygiene

If you are depressed, establishing your circadian rhythm is one of the best things you can do to help yourself. There are many ways to do this, so consider talking with a mental health professional who can help you find the best strategies for you and assist you with your other symptoms. Some examples of healthy sleep habits to engage in on your own include:

• Creating a bedtime routine: Though it might just be brushing your teeth or reading a book, having a simple, consistent nighttime routine helps get our bodies in the mindset that it’s time for bed.
• Keeping electronic devices out of the bedroom: The technology we often use before bed (computer, TV, phone, etc.) emits a harmful blue light that can actually keep us awake. Watching TV or surfing the web until you feel sleepy can disrupt the secretion of a natural sleep hormone called melatonin, leaving you to a night of restless sleeping. If you can, store your phone out of the room overnight and invest in an analog alarm clock.
• Limiting caffeine: Even morning caffeine can linger in your system when it’s time to sleep. Our body clears about half of the caffeine in our system every 4-7 hours. Although most coffee from breakfast is out of our system by bedtime, traces of caffeine can be present at night. Coffee, tea, dark sodas, and dark chocolates are the main culprits.
• Establishing reasoning/goals: It can be helpful to keep in mind why you’re doing this and what goals you are trying to reach by ensuring good rest. By clarifying what you want to get out of your sleep habits (e.g. more energy, decreased symptoms, more time to spend with friends, etc.), you can call your reasoning to mind when you consider slipping and more easily convince yourself to keep it up.
• Organizing a support system: Having friends or family members check in with you and keep you accountable can be very helpful when adjusting sleep patterns. Arrange to meet someone in the morning, work with your partner to go to bed and wake up at the same time, or tell your roommates your plan so they can help you stick to it. An accountability buddy who’s doing the schedule with you can also help you feel less like you’re bothering someone and more like you’re helping each other.
• No napping: Sleep needs to occur at night when it’s dark in order to effectively establish a circadian rhythm. Plus, napping can contribute to trouble sleeping at night, so try your best to limit the naps you take.
• Moving around: Daytime exercise can lead to sound nighttime sleep. If you exercise late and have difficulty falling asleep, consider moving your workout to earlier in the day. The increase in body temperature from exercise tends to be prolonged, sometimes making it hard to fall asleep. Moving around outside and getting some sun can also help with your circadian rhythm.
• Rewarding yourself: Try to set up a reward system for yourself upon waking up, such as going somewhere you like or getting a treat for yourself. This can help give you the push you need to get out of bed in the morning.
• Shower and slumber: Our body temperature drops when we fall asleep. Taking a hot shower just before bedtime can lower your body temperature, helping you fall asleep faster.

Remember that changes will start small— circadian rhythms shift slowly, adjusting just 15 minutes at a time, so it will take a while for your new habits to reap rewards. That said, consistency is key. Take on just one or two new habits at a time to ensure you stick with them, and add new habits to increase your progress.

If you are experiencing symptoms of depression, such as a lack of sleep and energy, consider starting depression counseling today. The above tips might help improve your sleep hygiene, but often a professional must step in to help you manage your depression.