There is a definite link between lack of sleep and depression. In fact, experts say, one of the common signs of depression is insomnia, or an inability to fall and stay asleep. While sleep requirements vary slightly from person to person, most healthy adults need between seven to nine hours of sleep per night to function at their best. Sleep is where the body and mind is repaired, reordered and readied for the next day. Sleep restores hormones, skin cells, liver functions, heart health, and more. Similarly, going without enough sleep won’t just leave one tired and irritable, it can seriously deteriorate the quality of a person’s life. Untreated sleep disorders can also cause serious safety problems and medical issues, according to experts. Evidence suggests that the relationship between sleep problems and anxiety and depression is strong and goes both ways. This means sleep problems can lead to anxiety and depression, and vice versa. For example, worrying and feeling tense during bedtime can make it difficult to fall asleep, but having trouble falling asleep, and in turn not getting enough sleep, can also result in more anxiety. Dr Jean Damascene Iyamuremye, Director of Psychiatric Care Unit/Mental Health Department at Rwanda Biomedical Centre (RBC), says that for some people, symptoms of depression occur before the onset of sleep problems. For others, sleep problems appear first. “As people become depressed, they often identify insomnia as their main problem. Therefore, targeting sleep problems will not only improve sleep, but lower the risk of developing anxiety and depression. “People with a depressive disorder are less likely to respond to treatment and more likely to relapse if they have a sleeping problem like insomnia. If a person is insomniac, the lack of rest required for the body’s natural regeneration provokes a greater tendency to depression,” he says. He adds that insomnia and depression have almost similar symptoms. These may include trouble concentrating, remembering details, and making decisions, restlessness, aches, or cramps that won’t go away, suicidal thoughts or attempts, among others. Prof Eugene Rutembesa, a clinical psychologist/psychotherapist at University of Rwanda, Butare, says depression and insomnia are clinical syndromes and have a close bond, which can be very difficult to unravel. Over 80 per cent of people with major depressive disorder also report insomnia symptoms or sleep disturbances. “Both insomnia and depression symptoms are highly interrelated, and engage many similar brain areas and functions. Chronic sleep loss can lead to a loss of pleasure in life, one of the hallmarks of depression. “So it makes sense that some things you do to prevent or treat one may help the other. By treating both simultaneously, doctors have a better shot at improving a patient’s sleep quality, mood, and overall quality of life,” he says. HOW TO OVERCOME INSOMNIA AND DEPRESSION According to experts, the first-line to overcome insomnia is good sleeping habits and taking care of any underlying conditions that may be causing the problems with sleeping. Many of the skills learned in a sleep intervention, such as techniques for relaxation and reducing worry, can also be used to help with daytime symptoms of both anxiety and depression. One of the primary treatments today for insomnia and depression is cognitive behavioural therapy (CBT). This non-pharmacologic treatment addresses your sleep problems on behavioural and psychological levels. Part of the behavioural modification involves sleep hygiene, and the creation of proper and routine bedtime habits,” Rutembesa says. Rutembesa explains that good sleep hygiene includes things like establishing a regular go-to-bed and waking time (allowing for between seven and nine hours of sleep for adults), eliminating stimulants from your diet near bedtime, and c, among others. He adds that in some cases, doctors will prescribe drugs for the treatment. Chronic and more severe depression responds better to a combination of medication and CBT. Dr Iyamuremye counsels on how to get a good night’s sleep without having to use medicine. Create a bedtime routine, he says. “Get ready for bed, get into bed, and get up at the same time every day, even on weekends. Establishing a routine helps regulate your inner clock. Try not to take naps during the day.” He adds, “Take time to relax before getting into bed. Doing something you enjoy, like reading, taking a warm bath, or using other relaxation techniques can reduce stress and quiet your mind for sleep. “Your bedroom should be cool, dark, and quiet for sleeping. If lights shine into your room, or you need to sleep during the day because of your work schedule, put room-darkening shades, blinds, or drapes on the windows.” Iyamuremye also says that if you share a room or bed with someone who is restless, snores, keeps the light on late for reading, or steals your covers, make arrangements to sleep separately until you establish a regular sleeping pattern. He advises people to avoid too much mental or physical stimulation an hour or so before bed. “Don’t finish office work or get into a big discussion about finances or other stressful topics right before getting ready to sleep. “Get some exercise each day. You might find that exercising three to four hours before going to bed helps you to sleep better. However, don’t exercise vigorously later than three hours before your bedtime,” Iyamuremye cautions. Follow a healthy diet. Don’t drink beverages that have caffeine, even soft drinks, after 2pm, drinking alcohol, using tobacco, and taking certain medicines can also make it hard to fall asleep. If you drink alcohol before bed, you might have periods of wakefulness during the night, after the alcohol wears off. If, after 30 to 45 minutes of trying, you have trouble falling asleep or getting back to sleep, get up and leave the room for a while. Doing something relaxing in another room, such as reading, might help you feel sleepy so you can go back to bed, he says. editorial@newtimes.co.rw
