By Jan Cheek, MSW, LCSW

Sleep deprivation can be both a cause and an effect of several mental health disorders and many physiological health concerns including, but not limited to:  cardiovascular issues, obesity, immune system deficiencies, and Type II Diabetes.  Anxiety can cause sleep problems and sleep loss can result in anxiety symptoms.  Depression and moodiness can cause sleep disturbances and sleep deprivation can cause result in mood dysregulation.

Medical professionals indicate that on average, adults require 7-9 hours of quality restorative sleep per night for optimal overall functioning and children (over the age of 3) and adolescents (13-18) function maximally with 10 plus hours per night. The Center for Disease Control reports that more than 35% of American adults get less than 7 hours sleep chronically. The obvious effect of this would be excessive sleepiness during the daytime hours and chronic fatigue, but there are many serious effects of getting less than recommended amount of quality sleep over time. 

Symptoms from sleep deprivation impacting mood include:  irritability, impatience, lack of motivation, increased anxiety, and increased depressive symptoms. Symptoms from sleep deprivation impacting overall functioning:  include lack of energy, fatigue, restlessness, diminished coordination, poor decision making, longer reaction and response time, lack of focus and concentration, compromised creativity, attention deficit, increased distractibility, increased likelihood of accidents due to inattentiveness (in the home, on the job, and automobile, for example), forgetfulness, increased errors and mistakes, hunger and excessive eating. Symptoms from sleep deprivation impacting health and physiological well-being include:  increased risk of obesity, increased blood pressure concerns, heightened risk for heart attacks, increased likelihood for Type II Diabetes, and potential for weakened immune system.  

Specific sleep cycles play a role in integrating memories and information in the mind.   In many cases without adequate sleep, people are unable to remember what was learned during the day and what happened during the normal course of daily activities. Hence, with chronic sleep disturbances or sleep disruption resulting in less than the optimal 7-9 quality hours of restorative sleep, the outcome can be diminished cognitive functioning.  Often when there is loss of sleep and the presence of cognitive impairment, a person becomes more anxious, moody and hyper-sensitive, defensive and easily frustrated in an effort to protect their own ego.  

When sleeping, the body produces proteins called cytokines which assist with fighting infections and inflammation.  Without enough sleep and effective number of cytokines, the immune system can become compromised and cannot ward off bacterial or viral invaders.  Sleep affects the levels of two important digestive hormones which control hunger and fullness, leptin and ghrelin. Leptin sends messages to the brain when the body has had enough to eat and when sleep deprived the brain reduces leptin and in turn increases ghrelin, an appetite stimulant. Thus, the result is an increase in wakeful eating during the hours when not sleeping.  In addition, when sleep deprived the body is unable to process glucose efficiently.  This results in increased insulin production and the promotion of fat storage, increasing the risk of both obesity and Type II Diabetes.  

There can be a number of factors that create difficulty in obtaining the recommended 7-9 hours’ sleep per night including, but not limited to: shift work and rotating shifts with employment, caretaking responsibilities of another person, acute illness (such as recent surgery, bronchitis resulting in severe and intrusive cough, etc.).  Yet, many people experience sleep disturbances as a symptom of chronic and acute mental health disorders, and medical illnesses. Or, as mentioned, people can be experiencing chronic and acute sleep deprivation that may result in negative effects impacting mood, cognitive functioning, physical health, social interactions, and overall performance in multiple environments.

“Sleep hygiene” means sleep routines practiced from night to night to prepare for bedtime and falling asleep. Improving sleep hygiene is known to increase the likelihood of successfully achieving 7-9 quality restorative hours of sleep consistently.  An inconsistent routine is believed to confuse the biological clock and reduce the production of melatonin which is the body’s natural sleep hormone.  It is recommended to stick to the same routine even on vacations, holidays, and weekends to help with establishing and restoring needed rest. The sleep hygiene should have a schedule that involves relaxing the mind and body beginning about the same time each evening and involve doing activities that signal winding down to the mind and body such as: making a to do list for tomorrow or writing in a journal as an effort to empty the mind, slow stretching muscle groups, taking a warm bath/shower, listening to soothing music, and reading a book.  The bedroom should be comfortably and consistently cool and designed for sleep and intimacy only. It should be peaceful, dark, and stress-free.   

Experts recommend turning clocks to a position such that they are impossible to read because knowing the time during nighttime waking increases stress. They also strongly recommend avoiding blue light electronics (computers, cell phones, tablets, televisions) in the bedroom and for approximately 2 hours prior to sleeping due to the highly stimulating nature of the devices. They suggest limit napping during the day to only 30 minutes maximum which can improve mood, alertness, and productivity. But, napping any longer interrupts nighttime sleep and creates sluggishness during the day.  In addition, aerobic exercise 4- 7 days per week is critical for improved sleep cycles. As little as 10 minutes per day will dramatically improve sleep quality according to experts.  It is also critical to limit caffeine consumption so that there is no caffeine within 6-8 hours prior to bedtime.  And, although alcohol is a sedative and depressant, it drastically disrupts the quality of restorative sleep and leaves a person feeling tired, groggy, and less productive the next day. Avoid alcohol use or limit use to one or two drinks only and not more than 3 hours before bedtime.

If you have difficulty with sleep deprivation; if you are uncertain whether the sleep loss you have known is the cause of the moodiness, anxiety, and cognitive impairment you have experienced or vice versa; and/or if you have tried to improve sleep by implementing routines on your own to no avail, Behavioral Healthcare Associates, LLC has trained therapists and a Board Certified Psychiatrist (Child/Adolescent and General Psychiatry) to assist with necessary diagnostic assessments to determine if there actually is an underlying mental health diagnosis, including a possible sleep disorder such as insomnia, and/or psychosocial stressors contributing to the complexity of quality sleep — all of which can be well managed with mental health treatment.  Call 919-292-1464 for additional information or to set up an appointment or look on the Behavioral Healthcare Associates, LLC website for more information:       www.behavioralhealthcareassociations.org