Sleep and mood

A two-way street

Almost everyone knows what a bad night does: irritability, tiredness, less patience, more worry. The link also runs the other way: anxiety and sadness often disturb sleep, whether by making it hard to fall asleep or by waking you in the night.

A 2011 meta-analysis brought together 21 studies that followed people over time. People who had insomnia at the start, without depression, had about twice the risk of developing depression later. That does not prove insomnia causes depression, but it shows that sleep is worth taking seriously.

How much sleep, and when to worry

According to the UK health service, adults need 7 to 9 hours of sleep on average, and people vary. Insomnia that lasts three months or longer is called long-term insomnia. If poor sleep is affecting your days, or changing your habits has not helped, it is worth speaking to a health professional.

Your check-ins can show how sleep and mood connect for you. Tag sleep as a context when it weighs on your day and see in Patterns whether your mood differs on those days. Noting your bedtime and wake-up time in MyBook for a week or two also reveals patterns that are easy to miss.

Habits that help

Wake up and get out of bed at the same time every day, even after a bad night. Sticking to your routine, rather than making up for lost sleep, helps sleep settle.

Go to bed when you feel sleepy, not before. Give yourself at least an hour to wind down before sleep: a bath, some light reading, dimmer lights.

Keep your bedroom dark, quiet and comfortable. Avoid screens just before bed.

Avoid caffeine, alcohol and smoking in the six hours before bed, heavy meals late at night and intense exercise in the four hours before. During the day, on the other hand, moving helps.

Avoid naps, and avoid lying in to make up for a bad night.

When habits are not enough

For insomnia that drags on, the treatment with the strongest evidence is not medication but cognitive behavioural therapy for insomnia, known as CBT-I. NICE considers it the first treatment for long-term insomnia, after sleep hygiene advice. It combines schedule changes, a new relationship with your bed and work on the worries that show up at night.

A 2015 meta-analysis found that after CBT-I people took about 19 minutes less to fall asleep and spent about 26 minutes less awake during the night. In people with depression and insomnia, a 2022 review showed that CBT-I reduced both insomnia and depressive symptoms. It can be done face to face or through digital programmes.

Keeping worries out of bed

If your mind races when you lie down, try setting an earlier time for worries and writing them down before bed. One study of heavy worriers found that two weeks of a daily worry period improved not only worry but also insomnia. The piece “Worry time” explains how.

A few minutes of slow breathing before bed can also help you wind down. And if sleep stays difficult for weeks, get help: insomnia can be treated.