ISLAMABAD, Feb 11 (ABC): Poor sleep may be more than just a nightly inconvenience — it could be a key driver and early warning sign of mental health problems, according to experts featured in a recent Medical News Today podcast.
In an episode of Medical News Today’s “In Conversation” series titled “Is sleep the missing piece in mental health?”, sleep specialists explained that sleep and mental health share a complex two-way relationship. Insomnia and sleep deprivation not only worsen mood and anxiety but may also precede depression and other psychiatric conditions.
Consultant psychiatrist Dr. Lauren Waterman of North London NHS Foundation Trust, who specializes in insomnia, said sleep disturbances can significantly affect emotional regulation, thinking ability, and daily functioning.
“Sleep affects how we feel, think, and function, and is more interconnected with our mental health than people assume,” the podcast noted.
Insomnia and sleep deprivation not the same
Dr. Waterman stressed that insomnia and sleep deprivation are often confused but represent very different conditions.
Sleep deprivation occurs when external factors prevent sleep, such as noise, caregiving responsibilities, or environmental disruption. Long-term deprivation can increase risks of serious health outcomes, including heart disease and premature death.
Insomnia, however, stems from internal brain mechanisms that prevent sleep even when adequate time and opportunity exist.
“With insomnia, something inside your brain is stopping you from sleeping,” she explained. “The brain gradually adapts, meaning people may function on fewer hours, but still experience fatigue and poor quality of life.”
Why poor sleep worsens mood
Experts said lack of sleep disrupts emotional processing in the brain, making people more reactive, impatient, and vulnerable to low mood or anxiety.
Studies cited in the discussion show that sleep problems frequently accompany depression and anxiety disorders. In some cases, insomnia appears before other symptoms emerge, suggesting it may act as an early warning sign.
People with chronic insomnia often feel “tired but wired,” meaning they lack energy but do not feel sleepy enough to fall asleep easily.
This mismatch stems from overactive “wakefulness pathways” in the brain, which keep the mind alert even when the body feels exhausted.
Frequent waking is normal
Contrary to popular belief, waking multiple times at night is normal, Dr. Waterman said.
“Everyone wakes up about 10 to 15 times an hour,” she explained, describing this as an evolutionary safety mechanism. Most people simply fall back asleep so quickly that they do not remember it.
The problem, she added, is not waking — but worrying.
Anxiety about being awake can trigger racing thoughts that prevent returning to sleep, creating a cycle that sustains insomnia.
Sleep cycles matter
Deep sleep occurs mostly in the first few hours of the night, while lighter and dream sleep dominate later stages.
Because of this, some people with insomnia still obtain condensed periods of restorative sleep early in the night, which may explain why they function better than expected on fewer hours.
However, fragmented or irregular sleep patterns can still harm overall well-being.
Melatonin supplements may not work as expected
The episode also raised questions about the effectiveness of melatonin supplements, widely used to aid sleep.
Dr. Waterman warned that in countries where melatonin is sold as a dietary supplement rather than a regulated medication, products may contain inconsistent or negligible active ingredients.
Exposure to light can also deactivate melatonin tablets, particularly gummies stored in transparent bottles.
“As long as people believe something helps, placebo can sometimes work,” she noted, but cautioned consumers to be aware of quality issues.
Behavioural therapy recommended
Rather than relying on pills, specialists emphasized cognitive behavioural therapy for insomnia (CBT-I) as the most effective long-term treatment.
Key strategies include:
• Using the bed only for sleep
• Avoiding prolonged time awake in bed
• Getting up at the same time daily
• Limiting naps
• Reducing light exposure before bedtime
• Leaving bed temporarily if unable to sleep
Regular wake-up times, experts said, are more important than fixed bedtimes because they help regulate the body’s internal clock.
When to seek help
Occasional poor sleep is normal during stress or illness. However, problems lasting more than three months may indicate chronic insomnia that requires professional care.
Dr. Waterman advised people whose sleep difficulties persist or worsen to consult healthcare providers or insomnia specialists.
Medical News Today hosts Yasemin Nicola Sakay and Maria Cohut concluded that understanding how sleep works can itself reduce anxiety and improve rest.
Experts say recognizing sleep as a foundation of mental health — rather than an afterthought — may help many people break the cycle of fatigue, low mood, and insomnia.