Depression and Sleep: An Overview of the Complex Connection

Last updated: September 7th, 2023

Depression and Sleep: An Overview of the Complex Connection

Depression is marked by persistent bouts of sadness, disappointment, and hopelessness, as well as other emotional, mental, and physical changes that lead to difficulties with daily activities. When difficult emotions remain present for more than two weeks, are felt nearly every day, and remain present for most of the day, they may be related to a group of mood disorders called depressive disorders.

Depression is often accompanied by sleep troubles. People with depression may find it difficult to fall asleep and stay asleep during the night or experience periods of excessive daytime sleepiness. Sleep problems can exacerbate depression, leading to a negative cycle between depression and sleep that can be challenging to break. Poor sleep may even provoke depression in some people.

Understanding the complex relationship between sleep and depression can be an important step in improving sleep quality and better managing depression. This article provides an overview of the common symptoms, sleep-related problems, and treatment options for people with depression.

Sleep Problems Associated With Depression

One of the most frequent effects of depression is disturbance in sleep patterns. Insomnia is usually the main complaint, which can include difficulty falling or staying asleep, or waking far too early with an inability to return to sleep. Some sufferers experience excessive daytime sleepiness and notice a decrease in energy levels.

Additionally, people with depression may find that they cannot concentrate, frequently wake up in the middle of the night, or that their cruel thoughts are amplified during night time hours, making useful sleep even more difficult. Sleep disturbances usually predate the onset of depression, and many people are able to predict a depressive episode because of the disruption of their normal sleep patterns.

Studies have shown that people with depression may be at an increased risk of sleep apnea, a sleep disorder where breathing is interrupted repeatedly during sleep. Sleep apnea can lead to serious health issues if left untreated, such as high blood pressure, stroke, heart failure, and other cardiovascular problems. In some cases, treating the sleep disorder can help to ease depression symptoms as well.

Symptoms of Depression

Depression is a diagnosable mental health disorder and the symptoms can vary from person to person. Some common symptoms include persistent feelings of sadness or guilt, loss of interest in activities once enjoyed, difficulty concentrating or remembering details, insomnia, fatigue, irritability, and changes in appetite.

Depression can lead to physical symptoms, such as headaches, digestive problems, and unexplained aches and pains. It can also lead to suicidal thoughts and feelings of worthlessness, hopelessness, or excessive guilt. It is important to seek professional medical help if you are experiencing any of these symptoms. Consulting a doctor can help determine whether the symptoms are related to depression or another medical condition.

Treatments for Depression

Depression is treatable and there are a number of treatment options available. Treatment is individualized, based on the severity and extent of the depression. Treatment may include medications, talk therapy, or a combination of both, depending on the needs of the individual.

Medications, such as tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAOIs), influence some of the brain's neurotransmitters and help to alleviate symptoms of depression. Talk therapy, either in an in-person setting or by telephone or computer, can also be used to treat depression. These therapies, such as cognitive-behavioral therapy or interpersonal psychotherapy, can help people manage their symptoms, overcome negative thought patterns, and improve overall functioning.

Tips for Sleeping Better With Depression

Since poor sleep can exacerbate depression symptoms, it is essential for people with depression to get enough quality sleep. Here are some tips to help get a good night's sleep:

  • Establish a consistent sleep schedule by going to bed and waking at the same time every day.
  • Avoid heavy meals, alcohol, caffeine, and other stimulants close to bedtime.
  • Create a sleep-promoting environment in your bedroom by keeping it dark and quiet and at a comfortable temperature.
  • Relax in a warm bath and stretch before bedtime.
  • Engage in calming activities, such as reading or writing, to help you fall asleep.
  • Exercise regularly during the day, but avoid vigorous exercise for several hours before bedtime.
  • If you find yourself lying awake for more than 20 minutes, get out of bed and engage in a quiet activity until you start to feel sleepy.
  • If you are still having trouble sleeping, talk to your doctor about medications to help you sleep.

Frequently Asked Questions About Depression and Sleep

Here are some answers to frequently asked questions about depression and sleep:

  • How do poor sleep and depression affect one another? Poor sleep can cause depressive symptoms to worsen. Poor sleep can impair thinking and increase feelings of sadness, irritability, and fatigue. It may also impede therapeutic progress by limiting an individual’s ability to absorb and follow through with treatment advice.
  • What should I do if I think I have depression? If you think you may have depression, it is important to seek help from a healthcare professional. A doctor can help diagnose depression and determine the least disruptive, most effective treatment plan for you.
  • What should I do if I am having difficulty sleeping? If you are having difficulty sleeping, talk to your doctor about medications to help you sleep. Additionally, there are lifestyle changes that can be made to improve the quality of sleep. Establishing a routine for sleeping, avoiding certain cues of alertness, using bright light therapy, and engaging in calming activities are all methods that may help you sleep better.


Depression and sleep are closely connected, with poor sleep often impacting depression symptoms and vice versa. It is important to seek help from a healthcare professional if you think you may have depression and to make lifestyle modifications to improve the quality of sleep. These changes, coupled with medications and/or talk therapy, can help to alleviate the symptoms of depression and improve overall quality of sleep.

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