When Sleep Fails, Mental Health Suffers

By Dr. Rachel Hoffman, Chief Clinical Officer, Zeera

Last night I was up from 3am to 5am. That’s not so uncommon for me. Insomnia has impacted my life and, in turn, my mental health, for years.

Approximately 10-30% of adults suffer from chronic insomnia, with some studies suggesting that the prevalence could be as high as 35%. People with insomnia are 10x more likely to develop depression and 17x more likely to develop anxiety disorders.

Insomnia doesn’t only impact our health but also our livelihoods. It costs the U.S. economy an estimated $63 billion annually in lost productivity. People with insomnia are more likely to miss work, report lower job performance, and have more workplace accidents.

It’s certainly a chicken and egg story: is anxiety and stress causing insomnia, or is insomnia causing anxiety and stress? Sleep deprivation is associated with an increase in cortisol levels, the body’s primary stress hormone. Elevated cortisol levels due to lack of sleep can have several adverse effects on health, including impaired cognitive function, weakened immune response, increased blood pressure, and a higher risk of developing conditions like depression, anxiety, and metabolic disorders.

I’m a clinician myself, and yet, I have found there’s no clear “fix” when it comes to insomnia. I’ve tried going to doctors, taking medications, and explored holistic treatments such as acupuncture. However, what has helped me the most is utilizing CBT-I techniques to help me cope when insomnia strikes—for me personally, relief requires an ongoing practice or tool I need to revisit, rather than a one-time fix. This highlights a common misconception about mental health in general: We often try to fight the symptoms with a one time fix, when instead, maintaining our mental health requires ongoing care and support. Here are a few methods that I implement to help me navigate through my sleep issues:

  1. Reading before bed: I’ve replaced scrolling on my phone with reading a book for at least 10 minutes before trying to sleep. Our phones are filled with anxiety-inducing information, people to compare ourselves to, and stimulation, which is not what we need before bed. Reading allows us to quiet our minds before we try to sleep. If my mind starts to race as soon as I close my eyes, I sometimes pick up my book again and continue reading.
  2. Visualizing a white wall: When thoughts are persistent, I practice a meditative act of picturing a plain white wall. When thoughts return, I simply continue to shift my focus back to the white wall. This works as a way to distract the mind from the unhelpful, racing thoughts. 
  3. Grounding exercise: If I wake up and can’t fall back asleep after a while, I get out of bed, go to another room, and practice a quick senses grounding exercise. I name five things I see and their colors, listen for something I hear, and pay attention to something I smell. This is followed by a box breathing exercise. This is another tactic that calms the body and the mind. 
  4. Self-compassion: If all else fails and I don’t get good sleep, I remind myself that I’ll be okay. I might be tired, but I’m human. I’ll get through the day, perhaps with an extra coffee or by washing my face with cold water. Instead of beating yourself up, try thinking through a couple ways you are going to take care of yourself that day, knowing you didn’t get the amount of sleep you hoped for.

Living with insomnia can be challenging, and I’ve learned the hard way that our healthcare system is not designed to adequately support those who suffer from this condition. Despite the prevalence of insomnia and its significant impact on mental health and productivity, many of us find ourselves navigating this struggle largely on our own.

This realization led me to explore alternative methods and develop my own toolkit of coping strategies. Additionally, as we push for better recognition and treatment of insomnia within the medical community, it’s important for those of us struggling with sleep to remember that we’re not alone. Sharing our experiences, strategies, and support can make a significant difference. That’s why I’m especially proud of the work we are doing at Zeera. These coping strategies should not be gatekept and people should not feel alone in their journey. By fostering a community of support and openly sharing effective techniques, we can empower each other to better manage our sleep challenges. 

If you’re dealing with insomnia, I want you to know that you’re not alone, you’re not defined by it, and things can get better – hang in there.