It is well known that depression can result in sleep problems. But can sleep problems cause depression? Although most of us realize that poor sleep can result in daytime fatigue and irritability, scientific studies have provided evidence that insomnia can cause clinical depression. So there appears to be a bidirectional association between the two: each increases the risk for the other, even when controlling for factors such as lifestyle, demographics, and anxiety level. This is why it is important to screen for and treat insomnia in those that show signs of depression. Early treatment of sleep problems may prevent or mitigate a depressive episode.
How do we treat sleep? There is a wide assortment of drugs available for treating insomnia which I will discuss in a later blog, but for now I will mention some of the simple steps we can take to treat insomnia on our own without medications.
7 Tips to Treat Insomnia
- Go to sleep and rise at about the same time every day, including weekends. The mind and body rely on and adapt well to this consistent cycle.
- Minimize stimulation. Keep the bedroom as dark as possible and minimize ambient noise (use earplugs if needed, turn off the TV or music).
- Use the bed only for sleep or sex.
- If you wake up in the middle of the night and can’t fall back to sleep within five minutes, leave the bed and go to another room or seat to read until sleepy.
- Avoid meals at least three hours before sleep.
- Don’t use alcohol as a sleep aid. Alcohol may help you fall asleep initially, but it distorts your sleep architecture and ultimately robs you of the refreshing process your brain needs.
- Find a mantra to help you fall asleep. You’ve probably heard of “counting sheep.” However, a more functional and successful version is to think of non-stimulating topics that interest you, such as a song lyric or a movie plot. My favorite technique is based on mindfulness meditation: pay attention to the feeling, sound, and rhythm of your breathing and gently redirect your mind back to that each time it veers off to another thought.
Doing all of the above on a consistent and prolonged basis will significantly decrease the odds of having a sleep problem.
Sivertsen B et al. The bidirectional association between depression and insomnia: the HUNT study. Psychosom Med 2012 Sep; 74:758.