Depression and Sleep Disorders

March 6, 2024

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The relationship between sleep disturbance and depression is deeply intertwined. Those suffering from insomnia face a risk of developing depression that is ten times higher than those who enjoy restful sleep. Beyond this, among those diagnosed with depression, a striking 75% experience difficulties either initiating sleep or maintaining it throughout the night. Read on to learn more about depression and trouble sleeping and discover strategies to combat both issues.

How Does Depression Affect Sleep?

NIMH (National Institute of Mental Health) report that people with depression often have trouble with their sleep. This can mean either not getting enough sleep or sleeping too much, and even waking up much earlier than intended, a problem called early morning awakening. These issues with sleeping and depression are connected because of certain hormones and the way the central nervous system works.

Sleeping and waking are controlled by various hormones, including:

  • Growth hormones
  • Melatonin
  • TSH (thyroid-stimulating hormone)
  • Cortisol
  • Ghrelin
  • Leptin

Melatonin and cortisol are especially important because they help manage the sleep-wake cycle. If these hormones are not balanced properly, sleeping issues can develop. Also, if there’s too much TSH or ghrelin or not enough growth hormone or leptin, it could lead to not being able to sleep properly, and this issue can also work the other way around.

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Our nervous system uses chemicals called neurotransmitters to send messages between nerve cells. Some of these neurotransmitters, like acetylcholine and GABA, help control waking and sleeping. If there’s something wrong with these neurotransmitter systems, it can disrupt the sleep-wake cycle and even lead to depression.

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Depression and Insomnia

Depression and insomnia are closely interconnected. Depression insomnia often exists in a cycle where each condition inflames the other. Insomnia, characterized by difficulty falling asleep, staying asleep, or experiencing non-restorative sleep, is one of the most common sleep disturbances associated with depression. Here’s a closer look at how depression and sleep disorders like insomnia can interact:

  • Bidirectional relationship: For many people, insomnia can be both a precursor and a symptom of depression. The stress and anxiety of sleepless nights can elevate the risk of developing depression. Conversely, the pervasive feelings of sadness, hopelessness, and lack of interest typical of depression can make it significantly harder to achieve restful sleep.
  • Biological links: Research suggests that there are biological underpinnings that link depression and sleep disorders like insomnia. Alterations in neurotransmitter levels, such as serotonin and norepinephrine, play a role in both mood regulation and sleep. Additionally, the dysregulation of the HPA (hypothalamic-pituitary-adrenal) axis, which is often observed in depression, can contribute to sleep disturbances.
  • Cognitive behavioral impact: Depression is associated with a range of cognitive and behavioral changes that can disrupt sleep patterns. Ruminative thought patterns, excessive worry, and negative thinking can make it difficult for people to relax and fall asleep. Similarly, poor sleep hygiene practices like irregular sleep schedules and engaging in stimulating activities before bedtime can be both a cause and a consequence of depression.
  • Treatment considerations: Addressing insomnia is a crucial component of treating depression. CBT-I (cognitive behavioral therapy for insomnia) is a highly effective treatment that focuses on changing sleep habits and misconceptions about sleep and insomnia. It works by identifying and modifying behaviors and thoughts that contribute to sleep difficulties, so improving sleep quality and reducing symptoms of depression.
  • Medications: In some cases, medications may be prescribed to help manage insomnia in the context of depression. Approach this with caution, though, as some sleep medications can potentially exacerbate depressive symptoms or lead to dependency. Antidepressants that have sedative effects can sometimes be used to treat both conditions simultaneously.

The interrelationship between depression and insomnia highlights the importance of treating both conditions to improve overall well-being. By addressing sleep issues as part of depression treatment, individuals can achieve better outcomes and enhance their quality of life.

Depression and Sleeping Too Much

Excessive sleepiness often signals atypical depression, a variant of the mood disorder that can be difficult to recognize due to the absence of certain traditional symptoms. Unlike the typical presentation of depression, which may include insomnia and decreased appetite, atypical depression is characterized by oversleeping and overeating. Additionally, those with atypical depression might not always feel persistently low – their mood could temporarily improve with positive events or good news. This unique aspect can lead to underestimating other symptoms, such as frequently hitting the snooze button and experiencing a general lack of motivation to begin the day.

Depression is commonly associated with changes in sleep patterns, which can swing from one extreme to another, including sleeping too much (hypersomnia). Hypersomnia in the context of depression is not just about prolonged sleep durations – it’s about the quality and restorative effect of sleep, which often remains poor despite spending extended hours in bed.

Excessive sleep can significantly impact daily living, affecting a person’s ability to perform tasks, maintain social relationships, and fulfill responsibilities. It can lead to feelings of guilt, worthlessness, and a deepened sense of depression due to the perceived waste of time and a lack of productivity.

Sleeping too much can also have physical health consequences, including:

  • Increased risk of cardiovascular disease
  • Diabetes
  • Obesity

These health issues can further complicate the experience of depression, creating a cycle of worsening physical health and deepening depressive symptoms.

Excessive sleep can dull cognitive functions, leading to impaired memory, concentration, and decision-making abilities. Emotionally, it can amplify feelings of detachment, isolation, and disconnection from the environment and social circles, further isolating people from potential support systems.

Addressing excessive sleep in depression involves a multi-pronged approach, including adjusting medication if necessary, engaging in cognitive-behavioral therapy, and implementing good sleep hygiene practices. Lifestyle interventions, such as regular physical activity and exposure to natural light, can also help regulate sleep patterns.

Developing and maintaining good sleep hygiene includes:

  • Establishing a regular sleep schedule
  • Creating a comfortable sleep environment
  • Avoiding stimulants and screens before bedtime
  • Practicing mindfulness and relaxation techniques

By addressing both the mental health and sleep-related aspects of depression, individuals can work towards achieving a more balanced and healthful sleep pattern, which in turn can contribute to overall well-being and recovery.


Can depression lead to insomnia?

Yes, depression can lead to insomnia. Depression and difficulty sleeping commonly co-occur, and those with depressive disorders often struggle to fall asleep, stay asleep, or experience restful sleep – the condition can disrupt normal sleep patterns and lead to increased nighttime wakefulness.

Can depression cause people to sleep too much?

Yes, depression can cause people to sleep too much – a condition known as hypersomnia. Individuals with depression might find themselves sleeping for extended periods yet still feeling tired.

Why do depressed people sleep so much?

Depressed people might sleep too much due to the body’s attempt to escape from distressing feelings, the impact of depression on the brain’s chemical balance affecting sleep regulation, and as a coping mechanism for dealing with low energy and motivation.

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Get Inpatient Treatment for Depression at Connections

If you or a loved one needs help addressing depressive episodes, we treat all types of depression at Connections Mental Health in Southern California.

By choosing inpatient treatment at Connections, you can access a personalized array of therapies in a welcoming and inclusive environment away from the stressors and triggers of everyday life.

With intake capped at six individuals at any one time, you can benefit from the powerful support of peers tackling similar issues, while still enjoying one-to-one therapy sessions during a month at our beachside facility.

Call 844-759-0999 today and start living unconstrained by depressive episodes.

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