CHAPTER 19

Get Some Sleep

PART 1 Depression and Sleep Ailments

More than 80% of people with depression may have problems with sleep. Usually the trouble is not getting enough sleep (about 7-8 hours of sleep is considered necessary for most people). If you have depression, you may find it difficult to go to sleep, you may wake up frequently during the night, or you may wake up early in the morning and not be able to get back to sleep. Even if you do sleep, you may still feel tired and unrested the next day. READ MORE

On the other hand, sometimes the problem is getting too much sleep. People with depression may spend most of the day in bed—but they can feel as tired as though they hadn’t slept at all. LESS

PART 2 What’s the Link Between Depression and Sleep Problems?

Depression can interfere with normal sleep patterns for both emotional and physiological reasons.

When you’re depressed, the world can seem a threatening, gloomy place and your situation may appear hopeless. You may go over certain problems and situations again and again, unable to find any resolution. READ MORE

Moreover, a vicious circle is created in which lack of restful sleep causes you to feel more even more anxious and overwhelmed, and your feelings of anxiety keep you from getting enough sleep. LESS

PART 3 Melatonin Matters

Physiological changes related to depression can also interfere with sleep. In many cases, insomnia is caused by the body’s failure to produce enough melatonin. Melatonin is a hormone produced the brain’s pineal gland. READ MORE

Melatonin has a number of effects on your body, including helping to regulate your sleep-wake cycle. The timing of melatonin secretion is tied to the 24-hour cycle of darkness and light; your brain normally secretes melatonin at about the same time every night. Melatonin has a rapid, mild, sleep-inducing effect.

Melatonin is produced from the neurotransmitter serotonin—in chemical terms, serotonin is melatonin’s forerunner. Depression is associated with low levels of serotonin, and low levels of serotonin may result in low levels of melatonin in people with depression. The association between low levels of serotonin and melatonin may well play a big role in depression sleep disorders. LESS

PART 4 Helpful Habits

Here are some things you can do to improve the quality of your sleep.

Set a routine. Go to bed and get up at the same time each day, even if you’re not sleepy or haven’t had a good night’s sleep.

Associate your bedroom with sleep. Don’t watch TV in bed or listen to music (unless the music is very calming).

Avoid alcohol and caffeine. Don’t drink alcohol in the evening and before going to bed—you’re more likely to wake up during the night if you do. Alcohol also interferes with restful sleep. Don’t drink beverages with caffeine (such as coffee and tea) in the afternoon or evening. Doing so can affect your sleep as much as 12 hours later.

Drink relaxing beverages before you go to bed. Herbal teas (chamomile tea is a good choice) and warm milk have sleep-inducing effects.

Eat dinner several hours before bedtime so that your stomach isn’t full when you go to bed. Avoid having heavy, spicy meals.

Exercise during the day. It will help you to sleep better at night. Don’t do strenuous exercise at night, because exercise stimulates the nervous system. However, relaxing forms of physical activity, like gentle stretching or yoga, can be helpful.

Avoid watching disturbing films or TV shows before going to sleep.

Practice relaxation routines at bedtime, such as progressive muscle relaxation or visualizing yourself in a pleasant locale. A warm bath may help. Try using relaxing essential oils, like lavender, in your bath or on a scented pillow.

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PART 5 Deal with Problems

If you find that certain problems are keeping you awake at night, try this technique. Well before bedtime (at least 2 hours), write down the problem in detail. Then, write down the next step you are going to take to deal with the problem. If you find yourself thinking about it again when you are in bed, remind yourself that you have done everything you can do about that problem for now. Remind yourself, too, that you can deal with problems more capably during the day, and that sleeplessness always magnifies problems.