The Sleep-Wake Cycle: Circadian Rhythm And Depression
Sleep can play a critical role in your state of well-being, both physically and emotionally, but the quality of your sleep often depends on your circadian rhythm. The sleep-wake cycle, otherwise known as the circadian rhythm, helps determine when you feel awake, alert, or tired, which can impact your quality of sleep and restfulness throughout the day.
Natural circadian rhythm disruptions can negatively impact your mental health, influencing mood disorders and overall well-being. This article explores how circadian rhythm influences sleep, mood, and mental health, as well as strategies you can implement that may help to regulate sleep and improve emotional resilience.
The sleep-wake cycle or circadian rhythm
The circadian rhythm – run by internal organisms or clock genes – is heavily influenced by your exposure to light and darkness, which signal when it's time to be awake or asleep. Disruptions in the circadian rhythms' natural cycle are known as circadian locomotor output cycles, which can contribute to inefficient sleep and mood instability.
Factors that can influence the sleep-wake cycle
Since light exposure can influence your sleep and circadian rhythm, screen time in bed has been shown to negatively affect sleep quality. Irregular sleep schedules, shift work, or mental health conditions are other disruptions that may also impact your sleep quality and general mood. However, when functioning effectively, your circadian rhythm can help to ensure restorative sleep, which can support mental, physical, and emotional well-being.
Connection between circadian rhythms and mental health
While regulating sleep, circadian rhythms can also play a major role in mental and emotional stability. Misaligned or impaired sleep-wake cycles are commonly observed in individuals with psychiatric disorders such as major depressive disorder (MDD), anxiety disorder, bipolar disorder (BD), or schizophrenia. However, practices that support sleep can reduce symptoms and can prevent the onset of various mental health conditions in some cases.
Symptoms of circadian rhythm disruption
When your circadian rhythm is misaligned, you may experience mental health symptoms that can impact your daily life. For some, disturbed sleep can lead to mental health symptoms, which in turn can make it harder to maintain healthy sleep habits, creating a negative cycle. Some of these symptoms may include:
- Difficulty falling or staying asleep – Being in a restful state – which is often conducive to sleep – can be difficult, especially if you have an irregular sleep schedule.
- Fatigue or brain fog – Prolonged wakefulness and insufficient sleep can lead to fatigue, which can impact everyday interactions and work productivity.
- Anxiety or depression – When you have a sleep disturbance regularly, you may be susceptible to symptoms of anxiety and depression, such as persistent low mood or social anxiety.
- Appetite and weight changes – Hormones that control appetite may be impacted by sleep, which can lead to overeating or loss of appetite.
Strategies to improve sleep
There are lifestyle choices and habits that you can implement that may be effective in helping you optimize your circadian rhythm, reset the sleep-wake cycle, and improve both sleep quality and mental health. These habits are known as sleep hygiene practices since they promote quality sleep.
What can you do?
By implementing sleep hygiene practices, you may be able to regulate your circadian rhythm and support healthy sleep patterns. Some evidence-based practices include:
- Keep a consistent sleep schedule – Going to bed and waking up at the same time every day can help to regulate your circadian clock.
- Create a relaxing bedtime routine – Reading, meditation, or an evening face mask can signal to the body that it's time to relax and wind down for the evening.
- Limit light exposure at night time – Since screen time before bedtime can interfere with sleep quality, you can try turning off devices 30 minutes before sleeping.
- Exercise regularly – Exercising frequently can improve the quality of sleep, so playing sports, going to the gym, jogging outdoors, or any other form of movement can help you expend your energy in a healthy way.
Light therapy
If you are experiencing difficulties sleeping, light therapy can be a useful tool for regulating sleep and mood. Light therapy uses artificial light (typically through light boxes) to stimulate regions of the brain that affect mood, sleep, and appetite. Since light exposure can have an impact on your circadian rhythm, light therapy can help to reset the sleep-wake cycle, improve symptoms of seasonal affective disorder (SAD), and reduce morning sluggishness.
Because of these benefits, light therapy is a commonly recommended treatment for people experiencing circadian rhythm disturbances, seasonal mood fluctuations, or depression.
Mood disorders, circadian rhythms, and depression
Circadian rhythm disruptions are associated with various mood disorders, such as seasonal affective disorder (SAD), major depressive disorder (MDD), and bipolar disorder. However, targeted circadian rhythm treatments can stabilize mood. Some of these treatments include light therapy, agomelatine (an antidepressant medication), and social rhythm therapy.
Circadian rhythms and depression, seasonal affective disorder, and other mood disorders and mental health conditions
Treatments such as light therapy, agomelatine, and social rhythm therapy can be especially effective for various mood disorders. Below are some common mood disorders that are targeted during medication and therapy interventions.
- Seasonal Affective Disorder (SAD) – A type of depression that occurs during colder months of the year, when there is less sunlight exposure, which can affect the body's natural rhythm
- Major Depressive Disorder (MDD) – Characterized by persistent sadness, major depressive disorder can develop in individuals with insomnia, which further interrupts the sleep-wake cycle
- Bipolar Disorder – Individuals with bipolar disorder can experience intense fluctuations in mood, which can be triggered by sleep disturbances
Poor sleep quality can heighten symptoms of major depression and other mood disorders; however, circadian rhythm treatment can be beneficial, reducing depressive symptoms and improving mood stability.
Can childhood trauma and anxiety influence sleep?
Sleep disruptions are common consequences of childhood trauma and stress, which can further lead to emotional dysregulation. Individuals who experience trauma during their childhood may have difficulty falling asleep, even years after the event.
Healing from childhood trauma and anxiety
For some, stressful or traumatic childhood experiences can have a lasting impact on their sleep and circadian rhythm. Individuals may experience hyperarousal before bedtime, which refers to a state of heightened alertness and anxiety. This can make falling asleep difficult. However, certain strategies can be helpful to ease tension and induce relaxation.
Healing from childhood trauma and anxiety-related sleep disturbances usually requires a combination of therapy, mindfulness techniques, and structured bedtime routines, which can create a sense of stability and safety. Oftentimes, individuals will practice mindfulness exercises such as deep breathing before bed to foster relaxation, while attending therapy sessions on a regular basis.
Online therapy for sleep disturbance
For those living with persistent sleep disturbances or symptoms of mental health conditions – which can often be experienced together – online therapy can be an opportunity to receive healthcare treatment from a mental healthcare professional. Sessions with a therapist can be booked on a flexible basis, with offerings at various times during the week. Also, companies like BetterHelp offer sliding-scale pricing, which can make healthcare more affordable.
Sleep disturbances can interrupt daily life, so having online therapy within easy reach can be supportive of mental, physical, and emotional health.
The research on online treatment for circadian rhythm and depression
Scientific studies show that internet-based cognitive behavioral therapy is effective for individuals with insomnia. Also, for treatments such as light therapy – which can support people with mood disorders and depressive symptoms – there are portable devices that can be used at home. When combined with online therapy, these treatment systems can help to alleviate depressive symptoms, which in turn can support your circadian rhythm and sleep quality.
Takeaway
Is depression linked to the circadian rhythm?
According to a 2023 article, there is a clear link between circadian rhythm disruptions and mood disorders like depression. One potential piece of evidence for this is the fact that many people with depression experience a diurnal mood variation in which depression symptoms are milder at nighttime.
How do you reset your circadian rhythm?
According to the National Institute of Health, employing healthy lifestyle changes is often helpful for those with circadian rhythm disorders. Bright light therapy, as well as some supplements and medications, can be beneficial as well.
How do you know if your circadian rhythm is off?
Common symptoms related to circadian abnormalities or issues include the following:
- Decreased alertness
- Extreme sleepiness in the daytime
- Decision-making and memory challenges
Talk to your doctor if you think you may be living with a sleep disorder or a problem with your circadian system, such as shift work disorder. They may run a sleep study to determine a diagnosis and treatment options.
How do you correct a circadian rhythm disorder?
Lifestyle changes like light exposure in the early morning (which enables retinal ganglion cells to communicate with core clock genes), regular exercise, and a consistent bedtime routine can be helpful. Light therapy and melatonin supplements may also be valid treatment options. Always talk to your doctor before adding any type of supplement or medication to your regimen.
Which hormone is often associated with depression?
Many believe that serotonin is associated with depression, but recent research disputes this, suggesting there is no consistent evidence for this association. Others suggest that cortisol could play a role in depressed mood.
What psychiatric disorders affect circadian rhythms?
Mental disorders classified as mood disorders are frequently associated with circadian rhythm disruption. Mood disorders involve various types of depression, including bipolar depression, as well as disruptive mood dysregulation disorder and premenstrual dysphoric disorder. Circadian rhythm disruption often leads to poor sleep, which can worsen mood symptoms.
Do people with anxiety have a later circadian rhythm?
Mood and anxiety disorders, as well as mental health disorders like post-traumatic stress disorder, often involve sleep disturbances and problems with endogenous circadian rhythms. This doesn’t necessarily mean they have a later circadian rhythm, but they may struggle to get quality sleep, including slow-wave sleep and REM sleep.
What is the most common sleep disturbance associated with major depression?
Many major depressive disorder patients experience secondary insomnia, or insomnia that results from depression. In addition, although updated evidence is needed, older research suggests that individuals with primary insomnia are more likely to develop depression.
What is the best treatment for circadian rhythm disorders?
The best treatment to regulate the physiological processes associated with sleep and “reset” the master clock, which influences processes like changes in body temperature and melatonin secretion, is to maintain a consistent schedule. Exercising regularly and engaging in light exposure shortly after waking up can also be helpful. Doctors may prescribe medications and supplements in some cases.
What is the best time to go to sleep for circadian rhythm?
In general, it’s best to go to sleep somewhat early in the night and wake up early in the morning. However, this isn’t necessarily feasible for everyone. Instead, it may be best to maintain a consistent schedule that works for you each day.
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