Can a good night’s sleep improve your mental health? Here’s what an expert says

ACCORDING to the World Health Organisation (WHO), an estimated one in eight people globally was living with mental disorders in 2019 before the COVID-19 pandemic struck.

While the pandemic has and continues to take a toll on our mental health, we have the opportunity to strengthen our efforts to protect and improve mental health. 

In conjunction with World Mental Health Day 2022 on Oct 10 (Monday), Sunway Medical Centre encourages everyone to start paying attention to their mental health by first improving their sleep.

Everyone may have experienced sleep problems – difficulty in falling asleep, difficulty in maintaining sleep, and/or early awakening. But did you know that sleep issues may affect your sleep duration and sleep quality?

As a result (of sleep issues), you may feel sleepy and tired during the day, experience headache, be easily irritable, have difficulty in attention and memory and show poor judgment,” said Sunway Medical Centre clinical psychologist Yap Chee Khong.

In turn, longstanding insomnia may lead to a negative impact on one’s physical and mental health, safety, relationships as well as performance.

Yap Chee Khong (Photo credit: The Star)

“Why can’t I go to sleep at night?”

According to Yap, higher stimulation at night increases the likelihood of being awake despite physical tiredness.

Stimulants such as caffeine and nicotine, strenuous exercise, excitement, anxiety and excessive thoughts may induce the mind and body’s level of alertness.

Moreover, overthinking about the consequences of sleepless nights and anxiety may form a vicious cycle that prolongs stimulation. 

“You may be experiencing insomnia due to conditioned stimulation, a learnt reaction,” Yap explained.

“When you are repeatedly exposed to the vicious cycle between overthinking and stress in bed, association with the bed, unhelpful thoughts and negative emotions are established. As a result, you may learn to anticipate distress when going to bed, which automatically triggers stimulation.”

He added that a dysregulated circadian rhythm due to jet lag and shift work may result in an active mind at night as well.

Yap noted that who suffer from insomnia might demonstrate behaviours that are not helpful to improve sleep. These include: 

  • Going to bed very early without a strong sleep drive: Given the mind and body are not ready to sleep, you may end up tossing and turning in bed and trigger arousal.
  • Checking the time frequently during midnight: Knowing how little sleep you have just gotten or how little time left to continue sleeping may contribute to stress.
  • Sleeping in and long nap: This may disrupt the biological clock, resulting in delayed sleepiness at night.
  • Eating too much before sleep: A heavy meal before sleep may increase risk of indigestion and heartburn, while drinking a lot of water in the evening may lead to frequent urination throughout the night.
  • Drinking alcohol: Alcohol may be helpful for sleep onset. However, it may affect sleep quality and cause sleep disruptions.
  • Relying on sleeping pills: Long-term use of sleep medicine may contribute to a risk of drug dependence.
  • Doing things other than sleep in bed: Worrying, planning, problem solving or doing work in bed may condition the brain to be stirred in bed.

“How can I sleep better then?”

(Photo credit: Getty Images)

Yap advises those living with insomnia to take the following steps to reduce stimulation and conditioned stimulation:

  • Avoid caffeine in the afternoon.
  • Avoid tobacco and alcohol, strenuous exercise and overeating three hours before bedtime.
  • Organise your thoughts one hour before bedtime. List down worries and their solutions. For items that have no solution, write down when to revisit the issues.
  • Engage in relaxing activities before sleep and only go to bed when there is a clear sign of sleepiness. Relaxation activities include personal enjoyment (eg. reading and listening to music) and relaxation techniques (eg. abdominal breathing, progressive muscle relaxation and meditation).
  • Avoid stressful or emotionally charged activities such as work, unpleasant conversations and watching horror movies. 
  • Get up and do a relaxing activity if you cannot fall asleep within 30 minutes.
  • Avoid checking the time and tossing and turning in bed. Go back to bed only when you feel sleepy. 
  • Get up on time regularly. Avoid sleeping in and napping.
  • Ensure your bed is only for sleep and sex.

“Sleep improvement certainly requires self-discipline,” said Yap, adding that it may take a few weeks to observe the effects.

As longstanding insomnia could be contributed by biological, psychological and social factors, Yap recommended seeing a clinical psychologist so an assessment and non-pharmacological intervention can be done to address psychological factors related to one’s sleep issues. 

“A clinical psychologist may also use Cognitive Behavioural Therapy for Insomnia (CBT-I), an evidence-based approach to assist patients in managing chronic sleep problems,” he said.

“If the sleep problem is related to severe psychiatric issues or physical condition (eg. chronic pain or menopause), a referral to a psychiatrist may be made,” he added. – Oct 8, 2022


Main photo credit: iStock

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