Introduction
The recent “Radiography of Sleep” survey, conducted by 40dB for the SER radio station and EL PAÍS newspaper, reveals that nearly half of Spanish adults do not sleep well on a daily basis, with the majority getting fewer hours of sleep than they would like. These findings align with those provided by the Spanish Society of Neurology, indicating that 10% of the Spanish population suffers from some form of sleep disorder, and another 30% wakes up each day feeling unrested or ends the day very tired.
With these figures in mind, it’s not surprising that sleep problems are becoming a societal concern that also keeps us awake. There is increasing scientific evidence demonstrating the relationship between chronic sleep deprivation and the development of numerous diseases, including obesity, diabetes, cardiovascular diseases, neurodegenerative disorders, and certain types of cancer.
Insights from a Meta-Analysis
Now, an important meta-analysis published in the scientific journal of the American Psychological Association has synthesized over 50 years of research on sleep deprivation and its relationship with our mood. The results leave no room for doubt: all forms of sleep loss (total sleep deprivation, partial sleep loss, and sleep fragmentation) lead to emotional changes the following day. The most significant and consistent effects are a reduction in positive mood and an increase in anxiety levels.
Joanne Bower, the author of the study and a researcher at the University of East Anglia (Norwich, UK), explains that previous research had already demonstrated that sleep deprivation reduces connections between the emotional regions of our brain and the regions that should help us control these emotions. What is novel about this meta-analysis is that it shows this association even after losing just one or two hours of sleep in a night. At that point, participants already exhibit a decrease in positive mood and an increase in anxiety. Bower emphasizes that emotions govern almost every aspect of our daily lives, so depriving ourselves of sleep seems to be the best way to choose the worst possible driver.
Psychologist Nuria Roure, a member of the Insomnia Working Group of the Spanish Sleep Society (SES), points out that the research results validate what specialists see every day in their consultations. Emotional imbalance, along with physical fatigue, is the symptom most commonly reported by people in consultations, she emphasizes. Roure expresses satisfaction that more and more research is focusing on the emotional impact of lack of sleep, an aspect that is generally less studied than the relationship between rest and certain pathologies.
Roure explains that if emotions were the pedals of a car, adequate rest would allow for a proper balance between using the accelerator and the brake. However, sleep deprivation would be the equivalent of driving without brakes: “When we don’t sleep well, we are more driven by our most primitive instincts and less by the rational part of our brain, which is why we tend to engage in more impulsive behaviors, lose our temper, experience more anxiety, eat more calorie-dense foods, or binge-watch series.” The problem, according to the psychologist, is that this often leads to a vicious cycle for emotional health: if we sleep little, the next day we are more sensitive to emotions and generate higher levels of anxiety, which when night falls again will make us sleep worse because our brain does not disconnect, leaving us even more tired the next day. And so on in an infinite loop. This circular mechanism explains why insufficient sleep, according to a study, is one of the main predictors in the development of burnout (professional burnout syndrome).
Long-Term Impact on Mental Health
As Joanne Bower explains, the meta-analysis only analyzed the immediate effects (the following day) of sleep deprivation on emotional health, so it would still be necessary to study the long-term effects, although the scientific evidence in this regard is quite clear: prolonged periods of sleep deprivation could be associated with worse long-term mental health. “Exploring whether this is related to changes in our emotional functioning due to lack of sleep is an important future direction for research,” suggests the British researcher.
Francesca Cañellas, a psychiatrist at the Sleep Multidisciplinary Unit of Son Espasses Hospital in Palma de Mallorca, shares her opinion, adding that scientific evidence points to a bidirectional relationship between sleep disorders and mental health problems: “It is estimated that eight out of ten patients with mental disorders during the acute phase and around three out of ten during follow-up have insomnia. Other studies have also shown that insomnia precedes depression.”
The expert believes that the data from this meta-analysis should be taken into account by policymakers to implement actions that prioritize the population’s rest and promote more rational schedules. Especially important in this regard, according to Cañellas, is the case of the adolescent population, whose school and extracurricular schedules push them into chronic sleep deficits.
“In a country that lives late and sleeps late, having adolescents start classes at eight in the morning condemns them to sleep deprivation. I see boys and girls in consultations who finish training at 10:30 PM. If we say that it is advisable to wait about three hours before going to bed after intense physical exercise, we are talking about young people who fall asleep at 1:30 AM and then have to wake up at seven in the morning to get to class,” reflects the psychiatrist, who points out that the study demonstrates that the anxiety-inducing effects of sleep deprivation are even more evident among young adults. “Articles like this, so well-founded, should have an impact on policies because we are already seeing the terrible epidemic of mental health affecting young people. And yes, it’s fine to hire more psychiatrists and psychologists, but perhaps investing in prevention would be much better,” she adds.
Nuria Roure expresses a similar sentiment, noting the need for investment in training medical professionals in cognitive-behavioral therapy, “which has been shown to be the most effective in improving sleep and more in the long term.” According to the psychologist, medications can be helpful initially (“like a crutch in those moments when we are emotionally overwhelmed”), but afterward, non-pharmacological therapies are needed to address the root problem of sleep deprivation: “Otherwise, we will end up as we are now, being world leaders in the consumption of benzodiazepines, anxiolytics, and hypnotics, which have no long-term efficacy because the underlying problem persists.”
Joanne Bower believes that this and other studies reinforce the idea that sleep should be a public health priority and promoted in the same way that healthy eating or regular physical exercise are promoted. “If we can help improve the population’s sleep health, it is likely to improve many other aspects of physical and mental health and well-being,” she concludes.
Conclusion
The impact of sleep deprivation on emotional health is profound and far-reaching. As evidenced by recent research, even minor sleep disturbances can have significant effects on mood and anxiety levels the following day. This not only affects individual well-being but also has broader implications for societal health and productivity.
Addressing sleep issues requires a multifaceted approach, including both individual interventions and systemic changes. Investing in education and awareness about the importance of sleep, promoting healthy sleep habits, and ensuring that policies support adequate rest for all segments of society are crucial steps.
Furthermore, integrating cognitive-behavioral therapy into medical practice and reducing reliance on pharmacological interventions can provide more sustainable solutions for sleep problems. By prioritizing sleep as a public health issue, we can potentially mitigate the risk of various physical and mental health conditions, ultimately fostering a healthier and more resilient society.