Depression and Sleep: What’s the Connection?

Depression and sleep are linked in an interesting way. Depression symptoms can affect your sleep, and symptoms of sleep disorders like sleep apnea or insomnia may also lead to depression.

Does depression affect your sleep?

The effect that depression has on sleep is well-documented. One of the most common symptoms of depression is sleep disturbance. Up to 70 percent of people with depression have some sort of sleep disturbance. This can take the form of either:

• Insomnia. This sleep disorder makes it difficult to fall sleep or stay asleep for long periods of time.
• Hypersomnia. Also called excessive daytime sleepiness (EDS), hypersomnia causes you to feel abnormally sleepy throughout the day, even if you’ve gotten plenty of sleep.

Does sleep have any effect on depression?

The link is becoming clearer. For example, a 2005 study found that insomnia increased your likelihood of depression symptoms nearly 10 times. A 2009 review of sleep apnea studies noted a strong correlation between obstructive sleep apnea (OSA) and depression symptoms.

Perhaps less well understood is the link in the other direction: The effect that sleep has on depression.

Let’s go a little deeper into this connection. First, it’s well known that insomnia is a common symptom of depression.

But research increasingly shows that the connection between insomnia and depression is a two-way street. A 1997 study found that both insomnia and hypersomnia were connected to a higher rate of suicidal thoughts and behaviors. Insomnia itself increases your risk of developing depression symptoms 10 times over.

And a 2006 study of nearly 25,000 people drew a clear link between depression and getting too little sleep (less than 6 hours), as well as too much sleep (more than 8 hours).

Obstructive sleep apnea (OSA) is also linked to depression.

A 2003 study of nearly 19,000 participants found that depression increased the risk of developing a sleep disorder with breathing symptoms by five times. A 2009 review noted that in samples of people being treated at sleep clinics for OSA, anywhere from 21 percent to 41 percent also showed depression symptoms. And a 2017 sleep study of 182 people found that, out of 47 participants who had depression, 44 had mild to severe OSA.

The risk of developing depression from OSA may also increase as you get older. A 2005 study suggests that at least 26 percent of people over 65 with OSAhave notable symptoms of depression.

If you have depression and are experiencing sleep-related symptoms, it’s best to seek treatment for your depression. If you have a sleep disorder and are noticing signs of depression, it’s more helpful to treat the sleep disorder to reduce the resulting depression.

Some effective treatments for depression include:

• medications, including antidepressants like citalopram (Celexa) or fluoxetine (Prozac)
• seeing a therapist to help cope with your emotions, feelings, and behaviors through talk therapy or Cognitive Behavioral Therapy (CBT)
• getting exposed to white light to help regulate your mood
• herbal supplements, such as fish oil and St. John’s wort, may be helpful, but the results of studies are mixed.

Some treatments for OSA include:

• using a continuous positive airway pressure (CPAP) — research also shows that CPAP machines can help with depression
• using a bilevel positive airway pressure (BiPAP or BPAP) machine
• taking nasal decongestants
• losing excess weight to relieve pressure on your lungs and diaphragm
• uvulopalatopharyngoplasty (UPPP) to remove excess tissue from the back of your throat

Sleep deprivation therapy

Sleep deprivation therapy consists of staying awake for long periods of time. For example, you might stay awake for an entire night until the next day, or wake up at 1 a.m. and stay awake for the entire next day. A 2015 study found that this treatment can give you temporary relief from depression symptoms.

Here are some steps you can take to help improve your sleep and relieve symptoms of depression:

• Eat a healthy, regular diet. Try getting regular servings of fruits, vegetables, whole grains, low-fat dairy, and lean meats to maintain your overall health.
• Get at least 30 minutes of moderate exercise every day. Try making a routine out of going on walks, jogging, or visiting the gym.
• Go to bed and wake up at the same time every day. Having a consistent sleep schedule can help reduce some of the symptoms of depression and sleep disorders.
• Stop using electronic devices at least two hours before bed. Blue light and stimuli from phones, tablets, or TVs can interrupt your circadian rhythm and make it harder to sleep.
• Limit your time online and on social media. The deluge of information from social media can make you feel overwhelmed, and research suggests a link between social media use and low self-esteem. Keep your use to a minimum, especially right before bed.
• Keep your friends and family close. Having strong personal relationships can help reduce the effects of depression and contribute to your feelings of personal fulfillment, which can also help you sleep.
• Try meditating. Close your eyes, clear your mind, and breathe slowly in and out whenever you feel stressed or depressed.

Seek medical attention right away or mental health services if you experience one or more of the following symptoms:

• constant sadness for entire days, for more than two weeks
• regular thoughts of suicide, cutting yourself, or harming yourself
• abnormal pain, aches, or digestive problems that don’t respond to medical treatment
• inability to sleep for several days straight
• consistent inability to focus, concentrate, or remember things clearly.
• waking up suddenly during the night gasping for air or having trouble catching your breath
• persistent headaches
• feeling anxious or irritable
• feeling abnormally sleepy during the day
• loss of interest in sex
• abnormal swelling in your legs (edema)

Depression and sleep are connected to each other in various ways. While depression may make you want to sleep more often and longer, it can also keep you awake at night with insomnia. And conditions like insomnia and sleep apnea increase your risk of developing symptoms of depression.

The links here aren’t all conclusive, and more research is currently being done to better understand how these conditions are related.

Reach out to a mental health professional if you’re:

• feeling hopeless
• constantly tired
• having suicidal thoughts
• concerned that you might be experiencing depression

You can also call one of the following hotlines:

• Suicide Prevention Hotline at 1-800-273-8255
• MentalHelp hotline at 1-888-993-3112

Read this article in Spanish.