Insomnia and mental health: How the night shapes the day
If you’re struggling with your mental health, you’re probably no stranger to a night spent tossing and turning through the early hours.
Sleep isn’t always a side effect of poor mental health – although this is common – and it can be an active driver of it. The relationship between sleep and mental health works in both directions: mental health conditions disrupt sleep, and disrupted sleep worsens mental health.
Broken sleep can leave you feeling detached, isolated, irritable and in severe cases, dissociated from the world around you. Sleep disturbance ranges from difficulty falling asleep, to enjoying only short periods of deep sleep to complete insomnia. The result? Starting your day feeling groggy, unrested and unable to perform as you’d like to.
Breaking this cycle can be one of the most powerful steps in improving your overall wellbeing, from increasing stress tolerance and mood to benefitting self-esteem and productivity.
At The London Psychiatry Centre, we treat sleep disturbance as a window into the brain and nervous system as a whole, not just a symptom to manage in isolation. If you can’t seem to escape sleepless nights, we’re here to help – no matter how sleep disturbance manifests for you.
Here, we’ll explore what makes you more vulnerable to sleep disturbance, how far reaching the impacts can be when left unaddressed, and offer some practical steps you can take to reclaim the restorative sleep that your body and mind need to flourish.
Who does sleep disturbance actually affect?
The honest answer is: most of us, at some point. Up to 67% of UK adults suffer from disrupted sleep, with nearly a quarter reporting no more than five hours per night – and these figures rise significantly during periods of stress, life transition, or change at work.
Sleep problems aren’t confined to people with a diagnosed mental health condition. That being said, they can encourage deterioration in mental health, including the onset of depression, anxiety and cognitive impairment. Sleep problems cut across age, profession and circumstance.
So why is sleep still frequently treated as secondary to the ‘main’ mental health concern rather than integral to it?
Who is at the highest risk of sleep problems?
- People in high-pressure roles: deadline-driven work, financial stress, and feeling unable to mentally ‘switch off’ are common triggers for persistent insomnia
- Parents of young children: disrupted sleep becomes chronic in ways that significantly affect mood, patience and cognitive function
- People experiencing major life transitions: divorce, bereavement, redundancy, relocation and relationship breakdown are all strongly associated with acute sleep disruption
- Night shift workers and frequent travellers: circadian rhythm disruption from irregular schedules or time zone changes has measurable effects on mental health over time
- Women, particularly in perimenopause: hormonal fluctuation is one of the most underrecognised drivers of sleep disruption, frequently accompanied by anxiety and mood disturbance
If your sleep has deteriorated alongside a stressful period, a significant life event, or a shift in your mental health, that’s worth taking seriously.
Sleep and mental health: A two-way street
Dr Andy Zamar, Consultant Psychiatrist, has a wealth of knowledge treating sleep disturbance alongside mental health issues. Dr Zamar comments “insomnia is a phenomenon and not a diagnosis, and whilst we relieve the patient’s suffering by prescribing hypnotics in some cases, we always strive to treat the underlying causes which are sometimes medical and not psychiatric.”
That’s what our integrative healthcare approach is about.
Key things to know about the relationship between poor sleep and mental health:
- Poor sleep reduces emotional regulation capacity, making stress harder to manage
- Sleep deprivation increases cortisol and inflammatory markers which are linked to depression
- Insomnia is one of the strongest predictors of a future depressive episode
- Treating sleep problems often produces significant improvement in mood, anxiety and concentration
How screens and attention are affecting your sleep
The attention economy is also reshaping how our brains process rest. Constant context-switching during waking hours reduces our capacity for the sustained, low-stimulation states that precede sleep.
Many people find they can no longer simply “switch off” at bedtime, not because they don’t want to, but because the brain has been trained out of that mode.
As you’re probably aware, one of the most significant contributors to modern sleep disruption is screen use. Heavy social media and screen use in the evening has been consistently associated with delayed sleep onset and reduced sleep quality.
There are two distinct mechanisms at play:
- Blue light exposure: screens emit blue wavelength light that suppresses melatonin production, signalling to the brain that it’s still daytime and delaying the onset of sleep
- Cognitive arousal: scrolling, notifications and reactive content keep the brain alert and responsive, which is incompatible with the wind-down process the brain needs before sleep
What are the natural ways to improve sleep?
Before medication, and often alongside clinical treatment, there are well-evidenced approaches to improving sleep that don’t require a prescription. These natural approaches can have measurable neurological effects.
Breathing Exercises
Research shows that slow, controlled breathing exercises, particularly those extending the exhale, significantly improved sleep quality in adults with insomnia.
The mechanism is direct: slow exhalation reduces cortisol and heart rate variability in ways that prepare the body for deep sleep.
Effective techniques include:
- 4-7-8 breathing: inhale for 4 counts, hold for 7, exhale for 8
- Box breathing: equal counts of inhale, hold, exhale and hold again
- Slow diaphragmatic breathing: 6 breaths per minute for 10 to 20 minutes before bed
Melatonin
Melatonin isn’t a sedative. It’s a circadian signal, a hormone naturally released by the pineal gland in response to darkness that tells the brain the day is ending. In cases of delayed sleep phase, jet lag, or disrupted circadian rhythm, supplemental melatonin can help re-anchor the sleep-wake cycle.
Light Exposure and Sleep Hygiene
Light is the primary external cue your circadian rhythm is built around. Morning light exposure (ideally natural sunlight within the first hour of waking) anchors your internal clock and, in turn, brings forward the timing of melatonin release in the evening. Evidence-based sleep hygiene practices include:
- Keeping a consistent sleeping and waking time, even at weekends and avoiding naps
- Avoiding screens for 60 to 90 minutes before bed
- Keeping the bedroom cool, dark and used only for sleep
- Avoiding alcohol: it may induce sleep onset for some, but significantly disrupts deep sleep architecture
- Avoiding caffeine after 2pm if you’re sensitive to its effects
Treatments for sleep and mental health
At The London Psychiatry Centre, we offer a range of evidence-based approaches depending on your presentation.
Cognitive Behavioural Therapy for insomnia (CBT-I)
CBT-I is recommended by NICE as a first-line treatment for chronic insomnia, after sleep hygiene practice. It addresses the thoughts, behaviours and physiological patterns that maintain poor sleep. Unlike sleep medication, the benefits of CBT-I persist after treatment ends.
EMDR
Eye Movement Desensitisation and Reprocessing (EMDR) is particularly effective for sleep disruption rooted in trauma or post-traumatic stress. Nightmares, hyperarousal and difficulty feeling safe enough to sleep are common presentations in PTSD, and EMDR works at the level of memory processing to reduce the emotional charge of traumatic material.
Many patients report significant improvement in sleep quality, and a reduction in nightmares specifically, within the first few sessions of EMDR treatment.
rTMS
rTMS is a non-invasive brain stimulation treatment, pioneered in the UK at The London Psychiatry Centre. It has a growing evidence base for both depression and sleep regulation. rTMS works by delivering targeted magnetic pulses to specific cortical regions, modulating activity in circuits involved in mood, arousal and the sleep-wake cycle.
rTMS is particularly well-suited for patients who haven’t responded to medication or who are looking for a treatment that addresses both mood and sleep simultaneously.
When is it time to get professional help for sleep problems?
- If you’ve had difficulty falling or staying asleep for more than three nights a week, for at least three months
- Poor sleep is affecting your ability to function at work, in relationships or in daily life
- You’re relying on alcohol, over-the-counter sleep aids or other substances to sleep
- You’re experiencing nightmares, night terrors or intrusive thoughts at night
- Your sleep problems began or worsened alongside a change in your mental health
Sleep problems that persist are rarely “just” sleep problems. They’re a signal worth taking seriously.
The good news is that the science of sleep has advanced significantly, and there are now highly effective treatments, both self-directed and clinical, for even long-standing sleep difficulties.
Restful nights are within reach: whether you’re dealing with insomnia, sleep disrupted by anxiety or trauma, or simply a pattern of poor rest that’s eroding your quality of life, we’re here to offer compassionate care.
Contact us on 020 7580 4224 or info@psychiatrycentre.co.uk to book a consultation.