How our sleep, body clock and mental health are linked

How our sleep, body clock and mental health are linked

by Dr Sarah Chellappa

Problems with our sleep and internal body clock can trigger or worsen a range of psychiatric disorders, according to a new review of recent research evidence.

Our latest review, published in Proceedings of the National Academy of Sciences (PNAS), suggests gaining a better understanding of the relationship between sleep, circadian rhythms and mental health could unlock new holistic treatments to alleviate mental health problems.

Sleep and circadian rhythm issues can impact psychiatric disorders, as per a recent review in Proceedings of the National Academy of Sciences (PNAS) explained. Understanding this link may lead to new holistic treatments for mental health problems.

Sleep-circadian disturbances are the rule, rather than the exception, across every category of psychiatric disorders. Sleep disturbances, such as insomnia, are well understood in the development and maintenance of psychiatric disorders, but our understanding of circadian disturbances lags behind.

It is important to understand how these factors interact so we can develop and apply sleep-circadian interventions that benefit the sleep and mental health symptoms of patients.

Our international research team studied the impact of sleep and circadian factors on adolescents and young adults with psychiatric disorders. Insomnia is common across mental health problems, and is particularly problematic for over half of people experiencing in early psychosis. Mood disorders often involve both problems sleeping at night (insomnia) and feeling sleepy in the day time (hypersomnia). Some patients with bipolar disorder experience Delayed Sleep-Wake Phase Disorder. Body clock processes can be disrupted and run up to 7 hours ahead during manic, and around 5 hours behind during depressive phases, but normalise with treatment.

How does this happen?

During adolescence, changes in sleep patterns and behaviors contribute to sleep-circadian disturbances in psychiatric disorders, as explored by researchers.

Dr Nicholas Meyer, from King’s College London, who co-led the review said: “This variability in the duration and timing of sleep can lead to a misalignment between our body clock and our sleep-wake rhythms can increase the risk of sleep disturbances and adverse mental health outcomes.”

Genetic predisposition affects activity levels, influencing mood and neuroticism. Being outdoors correlates with lower mood disorder risk. Sleep is crucial for forming neural connections and emotional memory processing.

How can this be treated?

Dr Renske Lok, from Stanford University, who co-led the review said: “Targeting sleep and circadian risk factors presents the opportunity to develop new preventative measures and therapies. Some of these are population-level considerations, such as the timing of school and work days, or changes in the built environment to optimise light exposure. Others are personalised interventions tailored to individual circadian parameters.”

Cognitive Behavioural Therapy for Insomnia (CBT-I) can reduce anxiety, depression, and trauma symptoms. Light therapy is effective for depression, especially when combined with medication. Timings of medication, meals, and exercise can impact circadian phases. Melatonin helps with Delayed Sleep-Wake Phase Disorder. Daytime eating may prevent mood impairment from nightshift work. Multicomponent interventions like Transdiagnostic Intervention for Sleep and Circadian dysfunction (Trans-C) address various sleep and circadian issues in mental health disorders.

Collectively, research into mental health is poised to take advantage of extraordinary advances in sleep and circadian science and translate these into improved understanding and treatment of psychiatric disorders.

The research was funded by the Alexander Von Humboldt Foundation.

The sleep-circadian interface: a window into mental disorders is published in Proceedings of the National Academy of Sciences (PNAS).

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