Sleeps Role in Mental Health Explored

When the brain won’t shut off

Dr. Lauren Waterman, a consultant psychiatrist specializing in insomnia, distinguishes between sleep deprivation and insomnia. Sleep deprivation occurs when external factors—such as a crying baby or loud traffic—prevent rest. Insomnia, however, is internal; the brain resists sleep even when conditions allow it.

The difference carries significant implications. Chronic sleep deprivation increases risks like heart disease. Those with long-term insomnia often adapt, condensing restorative sleep into shorter periods.

Most people don’t recall brief awakenings because they return to sleep immediately. For individuals with insomnia, this cycle fails. Instead of drifting off, they focus on their wakefulness, dreading the next day’s fatigue and spiraling into anxiety. The issue isn’t the waking itself but the inability to fall back asleep.

Cognitive behavioral therapy for insomnia (CBT-I) addresses this mental pattern. The first step involves education. Learning that brief awakenings are normal can reduce the fear that worsens sleeplessness.

The placebo effect of sleep aids

Melatonin supplements are often promoted as a natural solution for sleep, though their effectiveness remains unclear. In the U.S., melatonin is classified as a dietary supplement, not a drug, so the FDA does not regulate it. Studies reveal many over-the-counter products contain little or no active ingredient, while others exceed labeled amounts. Light exposure can also degrade the hormone, making gummies or improperly stored pills ineffective.

Waterman points out that even if supplements lack biological effects, the placebo response can still help. While research on their benefits is limited, rituals like drinking lavender tea can signal relaxation to the brain.

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CBT-I uses this principle through sleep stimulus control. The method retrains the brain to link the bed with sleep rather than wakefulness. For someone with insomnia, lying in bed while anxious reinforces the wrong association. The solution involves getting up after 15 minutes of restlessness, engaging in a relaxing activity elsewhere, and returning only when drowsy. Over time, the brain relearns that the bed is for sleep.

This approach also corrects a common error: spending excessive time in bed. People with insomnia often try to compensate by going to bed earlier or napping, but this further disrupts sleep. Waterman suggests compressing the sleep window—delaying bedtime while maintaining a consistent wake-up time, even on weekends. The focus isn’t on the amount of sleep in a single night but on regularity. Waking at the same hour daily, such as 7 a.m., helps regulate the body’s internal clock, making it easier to fall asleep the next night.

When to seek help

Occasional sleepless nights are normal, triggered by stress, illness, or environmental factors. However, if worry about sleep becomes a nightly fixation, or if behaviors like napping or oversleeping develop as coping mechanisms, short-term insomnia can become chronic. Waterman recommends seeking help before three months pass, particularly if unhelpful thoughts or habits take hold.

Many doctors lack training in CBT-I. Medical schools often treat insomnia as a secondary issue rather than a primary condition, leading clinicians to offer generic sleep hygiene advice. For persistent cases, specialized treatment proves more effective. Waterman hopes awareness will increase among both patients and providers so insomnia receives the attention it requires.

The simplest rule may also be the most difficult: stop trying so hard to sleep. The more effort put into it, the more elusive it becomes.

For those noticing persistent breast lumps alongside sleep disturbances, consulting a healthcare professional can help rule out underlying conditions.