Sleeping or dozing in bed does not lead to recovery in some people with depression, but makes their depressive symptoms worse. (Image: Prostock-studio / stock.adobe.com)
Long sleep can make depression worse
Years ago, experts reported that people who get too little sleep for a long period of time can increase their risk for depression. But not only too little, but also too much sleep can have negative effects and worsen depressive symptoms, according to a new study.
There is a strong link between sleep and depression: sleeping or dozing in bed does not lead to a cure in some patients, but to a worsening of depressive symptoms. This is what the latest study from the Depression Research Center of the German Depression Support Foundation shows. Sleep deprivation in clinics or a slight reduction in bedtime, which affected people can do at home, are therefore supportive treatment options.
Worsening of depression
According to a recent announcement, a new analysis of longitudinal data collected by the Deutsche Depressionshilfe Foundation in collaboration with IT partners shows just how close the relationship between sleep and mood is. In a pilot project funded by the Federal Ministry of Education and Research (STEADY project), 22 study participants with depression documented their average bed and sleep time and depressive symptoms. 173 days using an app. It shows that a longer bed or sleep time is associated with a statistically significant worsening of depression in eleven of these sufferers. In six of them, a longer bedtime ahead of time leads to more depressive symptoms and these can even be caused.
“If those affected understand the link between depression and bedtime, then, in consultation with the practitioner, individual treatment recommendations may arise. If a patient finds, for example, that he feels even more exhausted after long periods of bed or sleep, it may make sense to shorten the bedtime to around 8 hours, ”says Prof. Ulrich Hegerl, President of German Depression Aid Foundation and Senckenberg Professor at the University. Frankfurt / M. Results which were published in the journal “JMIR Mental Health”.
As the German Depression Support Foundation writes on its website, around one in four women and one in eight men are affected by depression in their lifetime. In terms of symptoms, depression is quite similar in both sexes. According to experts, depressed people always feel exhausted and crave restful sleep. For some, however, sleep has a depressive effect. Second, reduced sleep can have an antidepressant effect.
The underlying mechanism can be illustrated using the example of tired children: tired children suddenly become hyperactive and are full of energy. The body really needs sleep, but the tired child counteracts this by creating a stimulating environment that prevents falling asleep. Studies have shown that people with Attention Deficit Hyperactivity Disorder (ADHD) are also more likely to fall asleep. In a calm environment, for example at school, the body tends to fall asleep and counteracts this by creating an environment with intense stimulation through hyperactivity and distraction – similar to that of exhausted children.
Why depressed people seek rest
Depression is the opposite: depressed people are often affected by chronically increased alertness. Patients constantly feel tense as before an exam, cannot relax, and find it difficult to calm down despite fatigue. Affected people take countermeasures by withdrawing and avoiding all other external stimuli such as social contact or loud music. They tend to go to bed earlier, lie down longer in the morning, and lie down during the day – always hoping to relax and regain their strength. However, this is where a vicious cycle begins: sleep leads to increased depression in many affected people, because after sleep wakefulness is enhanced and tension is particularly high. For many people with depression, symptoms are strongest in the morning.
Sleep deprivation can have antidepressant effects
For many patients, behavior that thwarts heightened alertness and promotes sleep is very helpful. Sleep deprivation is an established form of treatment for depression that is now available in many clinics. Affected people stay awake all night or the second half of the night and should not sleep the next day either. The majority of patients find that in the early hours of the morning, the mood suddenly clears and the exhaustion and hopelessness that has often existed for months disappears. This effect only lasts until the next sleep. “Sleep deprivation shows patients that depression can be broken and thus gives hope,” Hegerl says. Exercise is also a good supportive measure for depression, as exercise tires you out and counteracts high levels of alertness.
Anyone can do it themselves
Patients can observe how bedtime and depression are related. To do this, you need to write in a table how long you were in bed (0-10 hours) and your mood or motivation the next day (0-10). “It is helpful for patients to notice that their mood is generally worse when they are in bed longer. You can clarify with the doctor whether it would be wise to go to bed later despite feeling exhausted and to get up earlier in the morning and limit the bedtime to around 8 am ”, advises Prof Ulrich Hegerl. (a d)
Author and source information
This text complies with the requirements of specialized medical literature, medical directives and ongoing studies and has been verified by healthcare professionals.
Stiftung Deutsche Depressionshilfe: Study: Sleep and Longer Bedtime May Worsen Depressive Symptoms, (accessed October 11, 2020), Stiftung Deutsche DepressionshilfeNoah Lorenz, Christian Sander, Galina Ivanova, Ulrich Hegerl: Temporal Associations of Daily Changes in Symptoms of Depression basis of sleep and depression in patients with major depressive disorder: idiographic time series analysis; in: JMIR Mental Health, (published: April 23, 2020), JMIR Mental HealthStiftung Deutsche Depressionshilfe: What is depression? Frequency, (accessed October 11, 2020), German Depression Aid Foundation
This article is provided for informational purposes only and should not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor.