Insomnia and Mental Health - Symptoms and Treatment

How does sleep relate to mental health?
There's a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health.
What problems might I have with sleep?
Everyone needs sleep, but many of us have problems with it. You might recognise some of the experiences listed below, or have other difficulties with sleep that aren't mentioned here.
You might:
find it hard to fall asleep, stay asleep or wake up earlier than you'd like to (also known as insomnia - find out more on the NHS website)
have problems that disturb your sleep, such as panic attacks, flashbacks, nightmares or psychosis
find it hard to wake up or get out of bed
often feel tired or sleepy - this could be because you're not sleeping enough, not getting good quality sleep or because of health problems
sleep a lot - which could include sleeping at times when you want, or need, to be awake.
If you're having problems sleeping, you might:
be more likely to feel anxious, depressed or suicidal
be more likely to have psychotic episodes - poor sleep can trigger mania, psychosis or paranoia, or make existing symptoms worse
feel lonely or isolated - for example, if you don't have the energy to see people or they don't seem to understand
struggle to concentrate, or make plans and decisions
feel irritable or not have energy to do things
have problems with day to day life - for example, at work or with family and friends
be more affected by other health problems, including mental health problems.
What causes problems with sleep?
The things that affect our sleep differ for everyone. They can include:
stresses or worries - for example, issues with money, housing or work
problems with where you sleep - for example, if you sleep somewhere uncomfortable or you're easily disturbed
health conditions relating to sleep, also known as sleep disorders
being a parent or carer
taking medication, including starting or coming off medication
recreational drugs and alcohol
working at night or being a shift worker
current or past trauma
mental and physical health problems, many of which can affect your sleep.
How could mental health problems affect my sleep?
If you live with a mental health problem, this could affect your sleep in lots of ways. For example:
Anxiety can cause racing or repetitive thoughts, and worries that keep you awake. You may also have panic attacks while you're trying to sleep.
Depression and seasonal affective disorder (SAD) can make you sleep more, including staying in bed for longer or sleeping more often. Depression can also cause insomnia.
If you've gone through trauma, this can cause flashbacks, nightmares or night terrors that disturb your sleep. You might feel unsafe or uncomfortable in bed or in the dark.
Paranoia and psychosis may make it difficult to sleep. You may hear voices, or see things you find frightening or disturbing.
Mania often causes feelings of energy and elation, so you might not feel tired or want to sleep. Racing thoughts can also keep you awake and cause insomnia.
Psychiatric medication can cause side effects including insomnia, disturbed sleep, nightmares and oversleeping. Stopping psychiatric drugs can also cause sleep problems.
Treatments to help with sleep problems
Any treatments you're offered for sleep problems will depend on what type of problems you're having and any particular causes.
Talk therapies
Cognitive behavioral therapy for insomnia (CBT-I) is a type of CBT designed to help with insomnia. You may also be offered talking therapy to help with mental health problems that are affecting your sleep. See our pages on talking therapy and counseling for more information.
Medication
You might be offered sleeping pills to help with short periods of severe insomnia, or you might be prescribed medication for other types of sleep problems. See our pages on medication for more information.
Referral to a sleep clinic
Sleep clinics are used to assess sleep problems, which can include using equipment at home or staying overnight for an assessment. To access a sleep clinic, you'll usually need a referral from your GP.

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