Sleep, Paranoia, And Psychosis

Medically reviewed by Corey Pitts, MA, LCMHC, LCAS, CCS
Updated September 18, 2024by BetterHelp Editorial Team

Not getting enough sleep can have significant impacts on your mental well-being. Occasional difficulty sleeping can be normal, but people with sleep disorders who experience sleep deprivation can face many challenges. Below, learn how sleep affects your mental health, how a lack of sleep can lead to paranoia and other symptoms, and how you can get help.

An elderly man in a blue shirt lays asleep on the couch in his home.
Getty/DjelicS
Poor quality sleep can have significant impacts on mental health

The importance of sleep for mental health

Research has found an association between mental health and sleep. Although many studies focus on links between depression and anxiety, evidence also shows that sleeping problems can be associated with other mental health conditions. For example, research has found that poor sleep may be related to various types of psychosis, including hallucinations and delusions.

One recent study looked at the effects of disturbed sleep and psychotic experiences in people who are at risk for paranoia and found that sleep disturbances may not only occur because of psychotic symptoms but can also affect how these symptoms are expressed in daily life. Psychotic symptoms like paranoia can contribute to sleep disturbances, and sleep disturbances can contribute to symptoms of paranoia. 

Non-REM and REM sleep

Understanding more about sleep, specifically rapid-eye movement (REM) and non-REM sleep, can help individuals understand how sleep, paranoia, and sleep disorders affect the brain. During non-REM sleep, people move between light sleep and deep sleep. Many processes in the body slow down, like brain activity, breathing rate, and eye movements. During REM sleep, the body repairs tissues, strengthens its immune response, and builds muscle and bone. Newer research also shows that non-REM sleep is important for rest and restoration, as well as learning and memory.  

REM sleep is associated with dreaming. Brain waves are similar to wakefulness, but the skeletal muscles are essentially paralyzed, and breathing becomes slightly erratic and irregular. The eyes also move behind closed lids, which is how this type of sleep gets its name. REM sleep is also thought to play a significant role in learning and memory.

Sleep disorders

Multiple types of sleep disorders can affect sleep quality, including the following. 

Sleep paralysis

People with sleep paralysis feel that they cannot move their bodies right before falling asleep or when waking up at night. This experience occurs when the body is between different stages of sleep. Some people with this condition experience hallucinations. Hallucinations caused by sleep paralysis fall into several categories, including the sense that there is an intruder in the room or pressure being applied to the chest. To get sleep paralysis diagnosed, a person may undergo a sleep study.

Those who experience multiple sleep paralysis episodes in a six-month period may be diagnosed with recurrent isolated sleep paralysis. Recurrent sleep paralysis can lead to significant anxiety surrounding sleep. Sleep paralysis is only temporary, lasting a few seconds or minutes, but this experience can be scary, affecting sleep quality and a person’s ability to function the next day.

Insomnia

Insomnia is the most common sleep disorder. As many as 10% of adults have a severe form of this condition. People with insomnia can have difficulty falling or staying asleep. Some people may experience short-term insomnia that lasts for a few days, but long-term, chronic insomnia can last for three months or longer and cause many challenges, including mental health conditions and a higher risk of long-term chronic health problems.

Hypersomnia

Hypersomnia occurs when people experience extreme sleepiness during the day, even though they have gotten enough sleep the night before. People with hypersomnia may fall asleep during the day and struggle to function in their daily lives. Hypersomnia is more common in women and affects up to 4% to 6% of the population.

A woman in an orange shirt sits curled up on the couch and looks at the phone in her hand with asad expression.
Getty/Prostock-Studio

Sleep apnea

There are two types of sleep apnea: central sleep apnea and obstructive sleep apnea. Although the causes are different, both conditions cause a person to periodically stop breathing while sleeping. This lack of breathing can cause a lack of oxygen, interfering with sleep quality.

Symptoms of sleep disorders like sleep paralysis and insomnia

Symptoms of sleep disorders can vary depending on the type, but common symptoms relate to not getting enough rest and may include the following: 

  • Taking a long time to fall asleep at night
  • Waking up several times throughout the night
  • Having difficulty falling back asleep after waking up during the night
  • Desiring naps during the day
  • Feeling tired throughout the day

Signs of sleep deprivation

Research shows that sleep deprivation can have significant effects on a person’s mental health. One review found that sleep deprivation had many effects on mental health, including persecution delusions or paranoia. Sleep deprivation can also impact physical health, causing challenges like hypertension and a risk of heart disease. 

Treatment for sleep disorders

Sleep disorder treatments can vary depending on the cause, type, and severity. Possible treatments can include the following. 

Light therapy for sleep disorders and mental health symptoms 

Light therapy involves sitting in front of a light that produces rays similar to sunlight. Light therapy can help adjust the levels of natural melatonin in the body to encourage a more regular sleep cycle. Using this option 30 to 60 minutes after waking up may regulate your body’s circadian rhythm. 

Medication for falling asleep

A doctor may prescribe medication to someone with a sleep disorder to help them sleep or make them more alert during the day. Medication is often a temporary option. The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Orofacial therapy

Orofacial therapy can be an effective treatment for some people with sleep apnea as it can help with tongue positioning and strengthen the muscles that control the upper airway and lips. This option should be discussed with your primary care physician or a sleep specialist, as it is a medical intervention. 

Cognitive-behavioral therapy for insomnia and REM sleep issues 

Cognitive-behavioral therapy for insomnia (CBT-I) is a type of CBT that aims to help people learn how to fall asleep faster and stay asleep longer. CBT-I can be an effective treatment for people with chronic insomnia. The therapy may also be effective in combination with other approaches, like medication. 

Tips for falling asleep

Changing your sleep routine if you have a sleep disorder may help you get more rest. Below are tips for getting better sleep:  

  • Minimize stress during the day: Reducing stress throughout the day may help you get a higher quality sleep at night. Stress-relieving strategies you can try include yoga, meditation, progressive muscle reaction, or breathing exercises.
  • Create an environment that supports sleep: Keep your bedroom cool, dark, and as quiet as possible. Consider using black-out curtains, and if noise keeps you awake, try wearing earplugs or investing in a white noise machine.
  • Start a bedtime routine: Before bed, engage in activities that will help you unwind and get ready for sleep, like listening to calming music, taking a bath, or reading a book. Try to go to bed and wake up at the same time every day, even on your days off.
  • Get regular exercise: Exercising may help you prepare for sleep. Exercising makes individuals physically tired and may also improve mental health and overall well-being, which can lead to better quality sleep.
Poor quality sleep can have significant impacts on mental health

Get support from a mental health professional

If you are having trouble sleeping or experiencing symptoms of sleep deprivation like paranoia, therapy may help you overcome the challenges affecting your sleep. A therapist can help you identify any stressors or underlying issues that may be affecting your sleep or guide you through CBT techniques you can use at home. However, if you’re experiencing sleep disruptions, driving to an appointment or meeting with someone face-to-face may dissuade you from seeking help. Online therapy can be a convenient, flexible alternative to in-person treatment. 

With an online therapy platform like BetterHelp, you can work with a licensed mental health professional from the comfort of your home at a time that works for your schedule. In addition, you can access support resources like support groups and worksheets. Research shows that online therapy can be an effective treatment for insomnia. One study found that online interventions result in significant improvements in insomnia severity, sleep quality, and daytime fatigue.

Takeaway

Sleep can have a significant impact on mental health. In severe cases, sleep deprivation can lead to psychotic symptoms like paranoia. If you experience sleep paralysis, insomnia, signs of sleep deprivation, or a sleep disorder, connecting with a therapist may help you receive support in overcoming challenges that may be affecting the quality of your sleep.
For additional help and support with your concerns
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started