Sleep and Mental Health Relationship: What You Need to Know

Did you realize that one in three adults struggle to get sufficient sleep? This eye-opening statistic has significant implications for our mental well-being. As we explore the intriguing realm of sleep and mental health, you’ll discover just how this nightly routine influences our emotional state. Quality sleep plays a crucial role in enhancing our mood and improving cognitive functions, making it a vital component of mental health. So, snuggle up with a warm blanket, and let’s delve into the enchanting relationship between restful sleep and a thriving mind!

The Science Behind Sleep and Mental Health

Let’s explore the intriguing realm of sleep and its effects on our mental well-being. You may be amazed to discover just how essential those nightly hours of rest are for maintaining a healthy mind!

Understanding Sleep Cycles

First things first, let’s talk about sleep cycles. Our bodies go through several stages of sleep throughout the night, each playing a vital role in our overall well-being. These cycles typically last about 90 minutes and repeat several times during a good night’s sleep[1].

There are two main types of sleep:

1. Non-Rapid Eye Movement (NREM) sleep: This is divided into three stages, ranging from light sleep to deep sleep.
2. Rapid Eye Movement (REM) sleep: This is when most dreaming occurs.

Each stage serves a unique purpose in restoring our bodies and minds. For instance, deep NREM sleep is crucial for physical recovery, while REM sleep plays a significant role in emotional regulation and memory consolidation[2].

The Neurotransmitter Connection

Now, here’s where it gets really interesting. Sleep has a profound effect on the production and regulation of neurotransmitters in our brains. These chemical messengers are responsible for regulating mood, emotions, and cognitive function.

During sleep, our brains work hard to balance neurotransmitters like serotonin, dopamine, and norepinephrine. These chemicals are essential for maintaining a stable mood and promoting feelings of well-being[3]. When we don’t get enough sleep, this delicate balance can be disrupted, potentially leading to mood disorders and other mental health issues.

REM Sleep: The Emotional Regulator

Remember that REM sleep we mentioned earlier? It turns out that this stage is particularly important for our emotional well-being. During REM sleep, our brains process and consolidate emotional experiences from the day[4].

Think of it as your brain’s way of filing away emotional information and making sense of your experiences. This process helps us adapt to stressful situations and regulate our emotions more effectively when we’re awake.

The Stress Hormone Connection

Last but not least, let’s talk about stress hormones, particularly cortisol. Sleep plays a crucial role in regulating cortisol levels in our bodies. When we’re sleep-deprived, our cortisol levels can become imbalanced, leading to increased stress and anxiety[5].

A good night’s sleep helps keep cortisol levels in check, ensuring that we’re better equipped to handle stress and maintain good mental health. It’s like giving our bodies a natural stress-relief treatment every night!

Common Mental Health Issues Linked to Poor Sleep

Now that we understand the science behind sleep and mental health, let’s explore some common mental health issues that are closely linked to poor sleep. You might be surprised at just how interconnected our sleep patterns and mental well-being really are!

Depression and Sleep Disturbances: A Two-Way Street

Depression and sleep problems often go hand in hand, creating a challenging cycle for many individuals. It’s not uncommon for people with depression to experience sleep disturbances, such as insomnia or oversleeping. But here’s the kicker: poor sleep can also contribute to the development or worsening of depressive symptoms[6].

Think of it this way: when you’re not getting enough quality sleep, you’re more likely to feel fatigued, irritable, and less able to cope with daily stressors. These feelings can exacerbate depressive symptoms or even trigger a depressive episode in some individuals.

On the flip side, depression itself can make it harder to fall asleep or stay asleep throughout the night. People with depression may find themselves lying awake, ruminating on negative thoughts, or experiencing early morning awakenings. It’s a vicious cycle that can be challenging to break without proper intervention.

Anxiety Disorders and Insomnia: A Nighttime Tango

If you’ve ever lain awake at night, your mind racing with worries about the future or replaying events from the day, you’re not alone. Anxiety and insomnia often dance together in a frustrating nighttime tango.

Anxiety disorders can make it difficult to quiet your mind and relax enough to fall asleep. You might find yourself tossing and turning, unable to shut off the constant stream of anxious thoughts. The problem is, this lack of sleep can then fuel more anxiety during the day, creating a self-perpetuating cycle[7].

Moreover, the anticipation of another sleepless night can create additional anxiety, making it even harder to fall asleep. It’s like your brain is stuck in a loop of worry about not getting enough sleep, which ironically keeps you from sleeping!

ADHD and Sleep: More Connected Than You Might Think

Attention-Deficit/Hyperactivity Disorder (ADHD) and sleep problems have a complex relationship that’s often overlooked. Many individuals with ADHD experience difficulties with sleep, which can, in turn, exacerbate their ADHD symptoms[8].

Common sleep issues in people with ADHD include:

• Difficulty falling asleep due to racing thoughts or restlessness
• Trouble waking up in the morning
• Daytime sleepiness
• Irregular sleep patterns

The connection works both ways: ADHD symptoms can make it harder to establish good sleep habits, while poor sleep can worsen attention problems, impulsivity, and hyperactivity. It’s like a feedback loop that can be challenging to break without addressing both the sleep issues and the ADHD symptoms.

Bipolar Disorder: When Sleep Patterns Go Haywire

Bipolar disorder is another mental health condition that has a strong connection to sleep patterns. In fact, changes in sleep can often be an early warning sign of a mood episode[9].

During manic or hypomanic episodes, individuals with bipolar disorder may experience:

• Decreased need for sleep
• Difficulty falling asleep despite feeling tired
• Waking up earlier than usual and feeling energized

Conversely, during depressive episodes, they might experience:

• Oversleeping (hypersomnia)
• Difficulty getting out of bed
• Poor quality sleep that doesn’t feel refreshing

These sleep disruptions can not only signal an oncoming mood episode but can also trigger or worsen mood symptoms. It’s like sleep acts as both a canary in the coal mine and a potential trigger for bipolar episodes.

How Quality Sleep Boosts Mental Well-being

Now that we’ve explored the darker side of sleep and mental health, let’s shine a light on the positive impact that quality sleep can have on our mental well-being. Trust me, you’ll want to prioritize your sleep after learning about these amazing benefits!

Improved Mood Regulation and Emotional Stability

Ever notice how everything seems a bit brighter after a good night’s sleep? That’s not just your imagination at work. Quality sleep plays a crucial role in regulating our emotions and stabilizing our mood[10].

When we get enough restorative sleep, our brains are better equipped to process and respond to emotional stimuli. This means we’re less likely to overreact to minor frustrations and more capable of maintaining a positive outlook throughout the day.

Think of sleep as your emotional reset button. Each night, it helps calibrate your emotional responses, ensuring you’re ready to face the day with a more balanced perspective. It’s like giving your emotions a fresh start every morning!

Enhanced Cognitive Function and Memory Consolidation

Quality sleep isn’t just about feeling rested; it’s also about giving your brain the opportunity to perform some essential maintenance and upgrades. During sleep, particularly during the deeper stages, our brains are hard at work consolidating memories and enhancing cognitive function[11].

Here’s what happens:

1. Short-term memories are transferred to long-term storage
2. Important information is prioritized and strengthened
3. Unnecessary details are pruned away
4. Neural connections are reinforced, improving learning and problem-solving abilities

It’s like your brain is doing a nightly backup and optimization routine, ensuring that you wake up with a sharper mind and better access to the information you’ve learned.

Increased Resilience to Stress and Daily Challenges

Life can be stressful, but quality sleep acts as a buffer, helping us better cope with the challenges that come our way. When we’re well-rested, we’re more resilient in the face of stress[12].

This increased resilience manifests in several ways:

• Better emotional regulation, allowing us to respond to stressors more calmly
• Improved cognitive flexibility, helping us find solutions to problems more easily
• Enhanced physical stamina, giving us the energy to tackle challenges head-on
• Stronger immune function, keeping us healthier and better equipped to handle stress

Think of good sleep as your secret weapon against stress. It’s like putting on a suit of armour each night, preparing you to face whatever challenges the next day might bring.

Better Decision-Making and Problem-Solving Abilities

Have you ever tried to make an important decision when you’re exhausted? It’s not easy, is it? That’s because sleep plays a crucial role in our ability to think clearly, make sound decisions, and solve problems effectively[13].

When we’re well-rested:

• Our prefrontal cortex (the brain’s decision-making centre) functions more efficiently
• We’re better able to weigh the pros and cons of different options
• Our creativity is enhanced, allowing us to come up with innovative solutions
• We’re less likely to make impulsive decisions based on emotions

It’s like sleep gives our brains a fresh perspective each morning, allowing us to approach problems with renewed clarity and insight.

Sleep Disorders and Their Impact on Mental Health

While we’ve talked about the benefits of good sleep and the consequences of poor sleep, it’s important to address sleep disorders specifically. These conditions can have a profound impact on mental health and overall well-being. Let’s take a closer look at some common sleep disorders and how they can affect our minds.

Common Sleep Disorders: More Than Just a Bad Night’s Sleep

Sleep disorders go beyond the occasional restless night. They are persistent conditions that can significantly disrupt your sleep patterns and, consequently, your mental health. Here are some of the most common sleep disorders:

1. Insomnia: This is perhaps the most well-known sleep disorder, characterized by difficulty falling asleep, staying asleep, or both. Insomnia can be short-term (acute) or long-term (chronic)[14].
2. Sleep Apnea: This condition causes repeated pauses in breathing during sleep, leading to poor sleep quality and daytime fatigue. It’s often associated with loud snoring[15].
3. Restless Leg Syndrome (RLS): RLS causes an uncomfortable sensation in the legs and an irresistible urge to move them, often disrupting sleep[16].
4. Narcolepsy: This neurological disorder affects the brain’s ability to control sleep-wake cycles, leading to excessive daytime sleepiness and sudden sleep attacks[17].
5. Parasomnias: These include disorders like sleepwalking, sleep talking, and night terrors, which involve unwanted events or experiences during sleep[18].

The Mental Health Ripple Effect

Sleep disorders don’t just affect your night; they can have far-reaching consequences on your mental health. Here’s how:

Triggering or Worsening Mental Health Conditions

Sleep disorders can act as a trigger for various mental health conditions. For example:

• Chronic insomnia has been linked to an increased risk of developing depression and anxiety disorders[19].
• Sleep apnea can contribute to mood disorders and cognitive impairment[20].
• RLS has been associated with higher rates of depression and anxiety[21].

It’s like these sleep disorders create a perfect storm for mental health issues to develop or worsen.

Exacerbating Existing Symptoms

For those already dealing with mental health conditions, sleep disorders can amplify symptoms:

• In bipolar disorder, sleep disturbances can trigger manic or depressive episodes[22].
• For individuals with ADHD, sleep problems can worsen attention difficulties and impulsivity[23].
• In anxiety disorders, poor sleep can increase feelings of worry and tension[24].

Think of it as adding fuel to the fire – sleep disorders can intensify the challenges of managing mental health conditions.

Cognitive and Emotional Impacts

Even if you don’t have a diagnosed mental health condition, sleep disorders can still affect your cognitive function and emotional well-being:

• Impaired concentration and memory
• Increased irritability and mood swings
• Reduced ability to cope with stress
• Decreased motivation and productivity

It’s like trying to run a high-performance computer on low battery – your brain simply can’t function at its best without proper sleep.

The Importance of Early Diagnosis and Treatment

Given the significant impact sleep disorders can have on mental health, early diagnosis and treatment are crucial. Here’s why:

1. Breaking the Cycle: Addressing sleep disorders can help break the cycle of poor sleep and worsening mental health symptoms.
2. Improved Treatment Outcomes: Treating sleep disorders can enhance the effectiveness of mental health treatments[25].
3. Prevention: Early intervention can potentially prevent the development or worsening of mental health conditions.
4. Quality of Life: Addressing sleep disorders can lead to significant improvements in overall quality of life and daily functioning.

Remember, seeking help for sleep issues is just as important as addressing mental health concerns directly. It’s like tackling both sides of the equation – sleep and mental health – to achieve optimal well-being.

Strategies for Improving Sleep Quality

Now that we understand the crucial link between sleep and mental health, let’s explore some practical strategies for improving your sleep quality. These tips can help you create the perfect environment and habits for a restful night’s sleep, ultimately supporting your mental well-being.

Establishing a Consistent Sleep Schedule

One of the most effective ways to improve your sleep quality is to maintain a consistent sleep schedule. Your body thrives on routine, especially when it comes to sleep. Here’s how to do it:

1. Set a fixed bedtime and wake-up time, even on weekends. This helps regulate your body’s internal clock, known as the circadian rhythm[26].
2. Aim for 7-9 hours of sleep per night, as recommended for most adults[27].
3. If you need to adjust your sleep schedule, do it gradually. Shift your bedtime by 15-30 minutes every few days until you reach your desired schedule.
4. Avoid naps late in the day, as they can interfere with your nighttime sleep. If you must nap, keep it short (20-30 minutes) and before 3 pm.

Think of your sleep schedule as a commitment to yourself. Just like you wouldn’t constantly reschedule important meetings, treat your sleep time with the same respect.

Creating a Sleep-Friendly Environment

Your bedroom environment plays a crucial role in the quality of your sleep. Here are some tips to transform your bedroom into a sleep sanctuary:

1. Keep it dark: Use blackout curtains or an eye mask to block out light, which can interfere with your body’s production of melatonin, the sleep hormone[28].
2. Maintain a cool temperature: The ideal bedroom temperature for sleep is around 60-67°F (15-19°C)[29].
3. Reduce noise: Use earplugs or a white noise machine if you live in a noisy environment.
4. Invest in a comfortable mattress and pillows: Your sleep surface can significantly impact your sleep quality.
5. Use your bed primarily for sleep: This helps your brain associate your bed with sleep, making it easier to fall asleep when you lie down.

Think of your bedroom as your personal sleep oasis. The more comfortable and conducive to sleep it is, the better quality rest you’ll get.

Relaxation Techniques for Better Sleep

Sometimes, even with a perfect sleep environment, our minds can keep us awake. That’s where relaxation techniques come in handy. Here are some methods to try:

1. Progressive Muscle Relaxation: Systematically tense and then relax different muscle groups in your body, promoting physical and mental relaxation[30].
2. Deep Breathing Exercises: Practice slow, deep breaths to calm your mind and body. Try the 4-7-8 technique: inhale for 4 seconds, hold for 7, exhale for 8.
3. Mindfulness Meditation: Focus on the present moment, acknowledging thoughts without judgment. This can help quiet a racing mind[31].
4. Visualization: Imagine a peaceful, calming scene to help distract your mind from stressful thoughts.
5. Gentle Yoga or Stretching: Light, relaxing movements can help release physical tension and prepare your body for sleep.

Remember, relaxation is a skill that improves with practice. Don’t get discouraged if it doesn’t work immediately – keep at it, and you’ll likely see improvements over time.

The Role of Exercise in Promoting Quality Sleep

Regular exercise can be a powerful tool for improving sleep quality. Here’s how it helps:

1. Increases sleep duration: Regular exercisers often report longer, more restful sleep[32].
2. Enhances sleep quality: Exercise can increase the amount of deep, restorative sleep you get each night.
3. Reduces stress and anxiety: Physical activity helps lower stress hormones, making it easier to relax and fall asleep.
4. Regulates circadian rhythm: Outdoor exercise, in particular, can help reinforce your natural sleep-wake cycle.

However, timing is important. Here are some tips:

• Aim for at least 30 minutes of moderate exercise most days of the week.
• Try to finish vigorous exercise at least 3 hours before bedtime to allow your body to wind down.
• If you prefer evening workouts, opt for gentler activities like yoga or stretching.

Think of exercise as a natural sleep aid. It’s like giving your body a reason to need that restorative sleep each night.

The Role of Technology in Sleep and Mental Health

In our modern, always-connected world, technology plays a significant role in our lives – including our sleep and mental health. While technology can sometimes be a double-edged sword when it comes to sleep, understanding its impact can help us make informed decisions about our digital habits.

The Blue Light Dilemma

One of the most talked-about issues regarding technology and sleep is the impact of blue light. But what exactly is blue light, and why does it matter?

Blue light is a high-energy, short-wavelength light that’s emitted by many digital devices, including smartphones, tablets, computers, and LED TVs. Here’s why it’s a concern:

1. Melatonin Suppression: Blue light can suppress the production of melatonin, the hormone that regulates our sleep-wake cycle[33]. This can make it harder to fall asleep and disrupt our natural circadian rhythm.
2. Increased Alertness: Exposure to blue light, especially in the evening, can increase alertness when we should be winding down for sleep[34].
3. Delayed Sleep Onset: Using blue light-emitting devices before bed can delay the onset of sleep, reducing overall sleep duration[35].

To mitigate these effects, consider:

• Using blue light filters or night mode on your devices in the evening
• Avoiding screens for at least an hour before bedtime
• Investing in blue light-blocking glasses for evening use

Think of blue light as your brain’s wake-up call. It’s great during the day, but you want to avoid that signal when you’re trying to sleep.

Sleep Tracking: Friend or Foe?

The rise of sleep-tracking apps and devices has given us unprecedented insight into our sleep patterns. But are they helping or hurting our sleep?

Potential Benefits:

1. Increased Awareness: Sleep trackers can help you become more aware of your sleep patterns and habits.
2. Motivation for Change: Seeing your sleep data can motivate you to improve your sleep hygiene.
3. Identification of Issues: Trackers might help identify potential sleep problems that warrant further investigation.

Potential Drawbacks:

1. Sleep Anxiety: Obsessing over sleep data can lead to increased anxiety about sleep, a phenomenon dubbed “orthosomnia”[36].
2. Inaccuracy: Consumer-grade sleep trackers may not always provide accurate data, potentially leading to misguided concerns or false reassurance[37].
3. Overreliance on Technology: Relying too heavily on trackers might make you lose touch with your body’s natural signals.

The key is to use sleep tracking tools as one part of a broader approach to sleep health, rather than the be-all and end-all. Think of them as a helpful tool, not a definitive measure of your sleep quality.

Digital Detox: Unplugging for Better Sleep

In our hyper-connected world, the concept of a “digital detox” – taking a break from electronic devices – has gained popularity. When it comes to sleep, implementing a digital detox strategy can be particularly beneficial:

1. Create a “No-Tech” Bedroom: Keep smartphones, tablets, and other devices out of the bedroom. This helps reinforce the association between your bedroom and sleep.
2. Establish a Digital Curfew: Set a time each evening (ideally 1-2 hours before bed) when you stop using electronic devices.
3. Find Alternate Evening Activities: Replace screen time with relaxing activities like reading a physical book, listening to calming music, or practising meditation.
4. Use “Do Not Disturb” Mode: Enable this feature on your devices to prevent notifications from disturbing your sleep.
5. Gradually Reduce Screen Time: If a full digital detox feels overwhelming, start by reducing screen time by 30 minutes each evening and gradually increase.

It’s important to keep in mind that the aim isn’t to cut technology out of your life entirely but rather to establish healthier boundaries that promote better sleep habits. Consider it as allowing your brain the opportunity to transition into “sleep mode” without the ongoing distractions from digital devices.

Leveraging Technology for Better Sleep

While we’ve discussed some of the potential negative impacts of technology on sleep, it’s worth noting that technology can also be used to support better sleep habits:

1. Sleep-Enhancing Apps: There are numerous apps designed to promote relaxation and sleep, offering features like guided meditations, sleep stories, and calming sounds.
2. Smart Home Integration: Use smart home technology to automatically dim lights, adjust thermostats, and create an optimal sleep environment.
3. Wearable Tech: Some wearable devices offer features like sleep cycle alarms, which aim to wake you during lighter stages of sleep for a more refreshed feeling.
4. Online Resources: The internet provides access to a wealth of information about sleep health and strategies for improvement.

The key is to use technology mindfully, leveraging its benefits while being aware of its potential drawbacks. Think of it as making technology work for your sleep, rather than letting it work against it.

By understanding the complex relationship between technology, sleep and mental health, we can make informed decisions about our digital habits. Whether it’s managing blue light exposure, using sleep tracking tools wisely, implementing digital detox strategies, or leveraging technology for better sleep, these approaches can contribute to improved sleep quality and, by extension, better mental health.

Conclusion

In our journey through the complex relationship between sleep and mental health, it becomes evident that getting quality rest is essential, not just a luxury. Prioritizing sleep allows us to recharge physically while also caring for our mental well-being, enhancing our resilience and fostering better mental health. Keep in mind that a restful night can be the first step toward a happier, more balanced version of yourself. So, why not settle in a bit earlier tonight and treat your mind to the restorative sleep it deserves? Your mental health is definitely worth the investment!

Reference

[1] Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner.

[2] Diekelmann, S., & Born, J. (2010). The memory function of sleep. Nature Reviews Neuroscience, 11(2), 114-126.

[3] Nutt, D., Wilson, S., & Paterson, L. (2008). Sleep disorders as core symptoms of depression. Dialogues in Clinical Neuroscience, 10(3), 329-336.

[4] Goldstein, A. N., & Walker, M. P. (2014). The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, 679-708.

[5] Leproult, R., Copinschi, G., Buxton, O., & Van Cauter, E. (1997). Sleep loss results in an elevation of cortisol levels the next evening. Sleep, 20(10), 865-870.

[6] Franzen, P. L., & Buysse, D. J. (2008). Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues in Clinical Neuroscience, 10(4), 473-481.

[7] Alvaro, P. K., Roberts, R. M., & Harris, J. K. (2013). A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression. Sleep, 36(7), 1059-1068.

[8] Hvolby, A. (2015). Associations of sleep disturbance with ADHD: implications for treatment. ADHD Attention Deficit and Hyperactivity Disorders, 7(1), 1-18.

[9] Harvey, A. G. (2008). Sleep and circadian rhythms in bipolar disorder: seeking synchrony, harmony, and regulation. American Journal of Psychiatry, 165(7), 820-829.

[10] Tempesta, D., Socci, V., De Gennaro, L., & Ferrara, M. (2018). Sleep and emotional processing. Sleep Medicine Reviews, 40, 183-195.

[11] Stickgold, R. (2005). Sleep-dependent memory consolidation. Nature, 437(7063), 1272-1278.

[12] Minkel, J. D., Banks, S., Htaik, O., Moreta, M. C., Jones, C. W., McGlinchey, E. L., … & Dinges, D. F. (2012). Sleep deprivation and stressors: evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion, 12(5), 1015-1020.

[13] Harrison, Y., & Horne, J. A. (2000). The impact of sleep deprivation on decision making: a review. Journal of Experimental Psychology: Applied, 6(3), 236-249.

[14] Morin, C. M., & Benca, R. (2012). Chronic insomnia. The Lancet, 379(9821), 1129-1141.

[15] Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136-143.

[16] Allen, R. P., Picchietti, D. L., Garcia-Borreguero, D., Ondo, W. G., Walters, A. S., Winkelman, J. W., … & Lee, H. B. (2014). Restless legs syndrome/Willis–Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria–history, rationale, description, and significance. Sleep Medicine, 15(8), 860-873.

[17] Scammell, T. E. (2015). Narcolepsy. New England Journal of Medicine, 373(27), 2654-2662.

[18] Howell, M. J. (2012). Parasomnias: an updated review. Neurotherapeutics, 9(4), 753-775.

[19] Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., … & Riemann, D. (2011). Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. Journal of Affective Disorders, 135(1-3), 10-19.

[20] Saunamäki, T., & Jehkonen, M. (2007). Depression and anxiety in obstructive sleep apnea syndrome: a review. Acta Neurologica Scandinavica, 116(5), 277-288.

[21] Winkelmann, J., Prager, M., Lieb, R., Pfister, H., Spiegel, B., Wittchen, H. U., … & Trenkwalder, C. (2005). “Anxietas tibiarum”. Depression and anxiety disorders in patients with restless legs syndrome. Journal of Neurology, 252(1), 67-71.

[22] Gruber, J., Harvey, A. G., Wang, P. W., Brooks III, J. O., Thase, M. E., Sachs, G. S., & Ketter, T. A. (2009). Sleep functioning in relation to mood, function, and quality of life at entry to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Journal of Affective Disorders, 114(1-3), 41-49.

[23] Owens, J. A. (2005). The ADHD and sleep conundrum: a review. Journal of Developmental & Behavioral Pediatrics, 26(4), 312-322.

[24] Staner, L. (2003). Sleep and anxiety disorders. Dialogues in Clinical Neuroscience, 5(3), 249-258.

[25] Krystal, A. D. (2012). Psychiatric disorders and sleep. Neurologic Clinics, 30(4), 1389-1413.

[26] Duffy, J. F., & Czeisler, C. A. (2009). Effect of light on human circadian physiology. Sleep Medicine Clinics, 4(2), 165-177.

[27] Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., … & Neubauer, D. N. (2015). National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health, 1(1), 40-43.

[28] Gooley, J. J., Chamberlain, K., Smith, K. A., Khalsa, S. B. S., Rajaratnam, S. M., Van Reen, E., … & Lockley, S. W. (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. The Journal of Clinical Endocrinology & Metabolism, 96(3), E463-E472.

[29] Okamoto-Mizuno, K., & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of Physiological Anthropology, 31(1), 14.

[30] Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press.

[31] Ong, J. C., Ulmer, C. S., & Manber, R. (2012). Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia. Behaviour Research and Therapy, 50(11), 651-660.

[32] Kredlow, M. A., Capozzoli, M. C., Hearon, B. A., Calkins, A. W., & Otto, M. W. (2015). The effects of physical activity on sleep: a meta-analytic review. Journal of Behavioral Medicine, 38(3), 427-449.

[33] Cajochen, C., Münch, M., Kobialka, S., Kräuchi, K., Steiner, R., Oelhafen, P., … & Wirz-Justice, A. (2005). High sensitivity of human melatonin, alertness, thermoregulation, and heart rate to short wavelength light. The Journal of Clinical Endocrinology & Metabolism, 90(3), 1311-1316.

[34] Chang, A. M., Aeschbach, D., Duffy, J. F., & Czeisler, C. A. (2015). Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proceedings of the National Academy of Sciences, 112(4), 1232-1237.

[35] Figueiro, M. G., Wood, B., Plitnick, B., & Rea, M. S. (2011). The impact of light from computer monitors on melatonin levels in college students. Neuro Endocrinology Letters, 32(2), 158-163.

[36] Baron, K. G., Abbott, S., Jao, N., Manalo, N., & Mullen, R. (2017). Orthosomnia: Are Some Patients Taking the Quantified Self Too Far?. Journal of Clinical Sleep Medicine, 13(2), 351-354.

[37] de Zambotti, M., Rosas, L., Colrain, I. M., & Baker, F. C. (2019). The Sleep of the Ring: Comparison of the ŌURA Sleep Tracker Against Polysomnography. Behavioral Sleep Medicine, 17(2), 124-136.