Sleep and Mental Health

I always tell people that sleep and anxiety are the perfect bed partners. They are one of those really toxic couples that always find a way back to each other, despite bringing out the absolute worst in each other. The same can be said for pretty much every other psychological problem: sleep always enters into the equation and usually in really negative ways.

This is why it is so critical to address sleep problems right away rather than letting them linger. The longer insomnia continues, the worse your mental health gets. Treating sleep problems, on the other hand, can have such a positive impact on so many areas of your life.

Let’s break down how treating sleep problems can help improve symptoms of anxiety, depression, and chronic pain.

Sleep and Anxiety: Calming the Nervous System

Like I said, anxiety and insomnia often go hand in hand, feeding off each other in a vicious cycle. Poor sleep heightens the brain’s sensitivity to stress (you can read more about that in my previous blog), making it harder to manage anxious thoughts. At the same time, anxiety keeps the mind racing at night, ramping up alertness and driving insomnia.

Here’s an example that I see so often in my work: a client who has been dealing with insomnia for months (sometimes even years) has noticed a recent uptick in anxiety.

They said that they have typically been able to cope decently with a bad night here and there, but the bad nights have started stacking up recently and they’re noticing that they’ve gotten to the point where just laying down in bed at night causes their heart to pound. They feel sweaty and tense as they are anticipating another sleepless night. Pretty soon, these problems aren’t just happening at night, but during the day. They’re dreading nighttime because it’s associated with so much stress. The mere thought of the sun going down fills them with dread. Even seeing someone in bed on a TV show can cause them to spiral.

Anxiety feeds off of poor sleep and then it becomes even harder to sleep. Most people in this situation feel utterly alone and feel like they are the only ones with these experiences. I want you to know that this is so much more common than you think and there are really effective treatments.

Research shows that when we use Cognitive Behavioral Therapy for Insomnia (CBT-I), people not only fall asleep faster and stay asleep longer; they also experience a reduction in anxiety symptoms. Why? Because sleep stabilizes the nervous system, improves emotion regulation, and helps the brain process and make sense of stressful experiences. In other words, when sleep improves, your brain is better equipped to handle what life throws at you.

Sleep and Depression: Restoring Mood and Motivation

It’s no secret that chronic sleep problems increase the risk of developing depression. In fact, time and time again, research has shown that insomnia is one of the strongest predictors of future depressive episodes. The relationship works both ways: depression can disrupt sleep, and poor sleep can worsen depression, creating a downward spiral.

Here’s how I often see this play out. Something in life isn’t going right, maybe it’s an unhappy work situation, a loss, a breakup, or maybe just a pattern of disappointments. Maybe at first this person was able to cope, but it started to feel like one bad thing after another started happening. They start thinking that no matter what they do, life finds a way to knock them down. They start feeling tired and unmotivated. Maybe they start to seek comfort from these terrible feelings by getting into bed and zoning out on social media. This escape helps in the short term, and they start to spend more and more time in bed and less time doing the things that used to make them happy. But sure enough, insomnia starts to rear its ugly head. They start waking up throughout the night or start waking up hours before their alarm. The logical next thought is something like, “I’m such a failure that I can’t even accomplish an incredibly basic thing like sleep.”

Treating insomnia can break this loop. Studies show that people who undergo CBT-I report improvements in both their sleep and depressive symptoms, sometimes even when antidepressants or other treatments haven’t been effective on their own. By restoring a regular sleep-wake rhythm, you support the brain chemicals involved in mood regulation, like serotonin and dopamine. Sleep also boosts energy levels, making it easier to engage in daily activities that help lift depression. Perhaps most importantly, CBT-I also changes habits that may be inadvertently driving both insomnia and depression: i.e., lingering in bed as an escape or means of coping, which only reinforces a negative relationship with the bed (i.e., the bed becomes associated with feelings of worthlessness, guilt, sadness, etc.).

Sleep and Chronic Pain: Easing Sensitivity and Improving Recovery

Pain and poor sleep often form a brutal partnership. When you’re in pain, it’s harder to fall and stay asleep. But here’s what many people don’t realize: poor sleep actually amplifies pain sensitivity, lowers your pain threshold, and reduces the body’s ability to heal.

A good portion of my clients come in with chronic pain. This makes sense because pain is a huge sleep disrupter. Here’s an example: a once very active person injures their knee while working out. The first piece of advice that they receive (likely from the experts over at WebMD - ha!) is to rest the knee and stay off of it for a time.

Great, they do that but alas the pain only worsens. It takes several weeks to get in to see a doctor and even longer to figure out what the actual problem is. So they’ve now been “resting” the knee for weeks. Whereas they were once active and received enjoyment from exercise, they’re now stuck in bed at home and stationary. The lack of activity does nothing for their sleep and they end up struggling to fall asleep and stay asleep. They also find that they’re waking up throughout the night in pain, which further disrupts sleep. Now they’re in a terrible pattern of poor quality sleep which then causes increased pain, which then further drives sleep disruption. Sounds terrible, right?

By treating sleep disorders, we can help disrupt this painful feedback loop. Better sleep improves the body’s pain regulation systems, reduces inflammation, and enhances tissue repair. People with chronic pain conditions like fibromyalgia, arthritis, or migraines often report that once their sleep improves, their pain feels more manageable and their daily functioning improves.

The Takeaway: Sleep Is Foundational to Mental and Physical Health

It’s easy to think of sleep as just one piece of the puzzle when it comes to health. But the reality is, sleep is foundational. It supports your mood, your stress response, your physical healing, and your overall resilience.

If you’re struggling with anxiety, depression, or chronic pain and haven’t yet addressed your sleep, you might be missing a key part of the treatment equation. The good news? Evidence-based treatments like CBT-I are highly effective and can set off a cascade of positive changes across your mental and physical health. Learn more about how we treat anxiety and depression here.

Remember, improving sleep isn’t just about feeling less tired. It’s about giving your mind and body the best chance to heal, grow, and regulate.

If you’re ready to explore how treating your sleep issues could improve your quality of life, reach out today. Better sleep might just be the missing piece you’ve been looking for. Click Here to schedule a free consultation call.