Top 3 questions – Sleep and mental health with Doctor Ruth Vine

Hello, my name is Dr Ruth Vine, and I’m the Deputy Chief Medical Officer at the Department of Health for Mental Health. And today I’m gonna talk about the connection between mental health and sleep. Of course, first, I’d like to acknowledge the Traditional Owners of the lands on which we meet. Today, it’s the Ngunnawal people, and pay my respect to their Elders, past, present and emerging, and of course, extend that respect to any Aboriginal and Torres Strait Islander person or people joining us here today.

For this week’s shout out, I’d like to acknowledge those terrific people who volunteerfor organisations like Lifeline or Beyond Blue, and work on their crisis lines. Those lines operate 24 hours a day, seven days a week, and clearly that means across the middle of the night, and those amazing volunteers give up their own time, and often sleep, to ensure that people can access support and a really empathic and understanding ear.

So, on today’s topic. Sleep. Sleep is really important for everyone at all ages. Clearly, they change with age, most young people sleep more than as we get older, and often as we get really old, sleep becomes less important. But it’s very variable. What’s important, I guess, is to have a regular sleep wake cycle that suits you. And if you notice a change in your sleep pattern to sort of think about what that’s about, ’cause it can occur for all sorts of reasons. Maybe you’ve changed your diet, maybe you’re drinking more coffee or more alcohol, maybe you’re worrying about something, maybe you’ve changed where you’re sleeping. So, really do remember that we need sleep. Sleep is really important so that our mind and our body function properly. While we sleep, lots of things happen, we cogitate about all sorts of stuff, and it’s really important for how we get on. Good quality sleep encourages mental health and wellbeing. And if you don’t get enough sleep, for people who’ve seen mothers of very young babies who don’t get enough sleep, you can feel fuzzy, irritable, struggle with concentration, and it can have a really bad impact on your mood. And people with mental illness or mental ill health, such as depression or anxiety, often part of that presents as a disturbed sleep pattern. So, I’m often asked about sleep patterns and what the relationship is between sleep and mental illness. And it’s not really that changes in sleep predict mental illness. Although, if you have a tendency to have a mental illness that might recur, then often a change in sleep can be an early warning sign that your mental health is deteriorating. But a number of mental illnesses have change in sleep pattern as part of their presentation. And indeed, as I just mentioned, the lack of sleep can itself cause people to worry and feel grumpy and irritable and low in mood. So, as a few examples, in severe depression, there’s a thing called early morning awakening. People wake at about 4:00 in the morning and ruminate on negative aspects of their life, their self, their future. In people with post-traumatic stress disorder, often sleep is disturbed by, often, really vivid nightmares and remembering of difficult times.

In people with a really severe illness like psychosis or schizophrenia, the whole sleep wake cycle can change, people can sleep during the day and be awake during the night. And the same applies to people with mania or hypomania or an elevated mood. Often, again, one of the first signs is that sleep is disturbed and, indeed, people can get really, really, really sleep deprived during those sort of illnesses. And, of course, drug misuse is another thing, people who use amphetamines often don’t sleep for days.

And lastly, I guess, how much sleep do you need to stay healthy? And there’s not a right answer to that. I guess, most people would say you should try and get between six or seven hours sleep every night. But some people get by with less sleep, some people need more. And really, it’s more thinking about what your sleep pattern is like. So, go with what your body’s telling you. But really look after sleep hygiene. And that means set your daily structure to be a bit the same, go to bed at about the same time. Use your bedroom for sleeping in, not for eating or watching television in. And get up at about the same time. So, get up, get going with the day and structure your day like that. And, of course, establishing healthy sleep hygiene might be really important for shift workers, because they’re up during odd hours and they really need to try and work out how they’re gonna get enough sleep during the day. So, if you feel that sleep patterns are changing or they’re impacting you negatively, there are a few steps you can take. Look at what you’re doing when you’re going to bed. As I said, sort of not having coffee or alcohol before you go to bed, maybe having a hot drink of another kind. I think sleeping pills are the last answer, much better to look at structure, maybe even a bit of meditation, maybe some calming music or calming conversation before you go to bed. And if your sleep pattern does start to impact on your quality of life and those things aren’t working for you, then make an appointment with your GP or your health practitioner, and talk through what the issue might be and what other solutions might be.

And you can always, if you need tips to help you with your sleep, go to headtohealth.gov.au and just search for sleep, and you’ll find some good tips there. Thank you very much for listening.