People with insomnia often have a mental health condition or vice versa.

Sleep is extremely important for your mental health. During sleep, your body is able to repair itself. Your brain sorts through information, and your nervous system gets a much-needed break.

If you live with insomnia — meaning you consistently have trouble falling or staying asleep — your body misses out on these healing processes.

Insomnia and mental illness commonly occur together. A significant lack of sleep can trigger or worsen mental health symptoms. In turn, mental health conditions can lead to insomnia.

Insomnia has a complex relationship with mental illness.

Research from 2018 suggests that 50–80% of adults with mental health conditions have difficulty falling or staying asleep in a typical year.

The link between insomnia and mental health can run both ways. A psychiatric disorder can lead to insomnia, and insomnia can worsen or trigger a mental health condition.

However, in many cases, there is no direct cause-and-effect, but rather a situation where both conditions are different symptoms of the same condition. For instance, unbalanced blood sugar levels in people with type 2 diabetes can lead to both insomnia and anxiety.

Occasionally, short-term insomnia can be an isolated condition or the result of a certain lifestyle or work schedule (for instance, working the night shift).

Often, the particular characteristics of your insomnia and other symptoms can be helpful in determining the role of mental illness in your inability to sleep.

Insomnia can be a primary or secondary condition.

  • Primary insomnia isn’t caused by another medical or psychological condition.
  • Secondary insomnia is the result of other conditions, such as depression, thyroid problems, or asthma.

Below are some mental health conditions that are commonly seen with insomnia or other sleep disturbances:

  • Depression: Insomnia is a core symptom of depression. In a 2018 study, more than 90% of people with major depressive disorder (MDD) reported insomnia-related sleep disturbances. People with insomnia may develop depression more often compared to those who sleep well.
  • Anxiety: According to a 2020 study, up to 36% of participants with insomnia had anxiety.
  • Obsessive-compulsive disorder (OCD): A Swedish population study in 2020 found that people with OCD are nearly 7 times more likely to receive an insomnia diagnosis or be given medication for insomnia.
  • Post-traumatic stress disorder (PTSD): Disrupted sleep is a core component of PTSD. This may be related to anxiety or nightmares.
  • Substance use disorder (SUD): Substance use, intoxication, and withdrawal can disturb sleeping patterns.
  • Schizophrenia: A 2012 study suggests up to 80% of people with schizophrenia have disturbed sleep.
  • Bipolar disorder: Sleep problems can be linked to depression or mania. Mania in bipolar disorder is often directly related to a sudden and dramatic decreased need for sleep.

The hallmark symptoms of insomnia are:

  • trouble falling or staying asleep
  • waking up too early
  • feeling exhausted or sleepy during the day

Insomnia disorder was added to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as a stand-alone disorder. In the DSM-4, it was categorized as either a primary or secondary disorder.

According to the DSM-5, symptoms of insomnia must:

  • cause significant functional distress or impairment
  • be present for at least 3 nights per week, for at least 3 months

Research in 2016 suggests that the consequences of insomnia are significant. It can lead to impaired work performance, accidents, depression, and overall poorer quality of life.

Everyone is different, so each person living with insomnia may have a different set of factors that lead to their sleeping difficulties.

Some evidence suggests insomnia may be partially genetic. However, there isn’t any single insomnia gene. Instead, there are genetic factors that make some people more likely to develop insomnia.

The following factors may trigger or worsen insomnia:

  • mental health conditions
  • medical conditions like obstructive sleep apnea, cardiovascular disease, diabetes, asthma, and migraine
  • pain (back pain, fibromyalgia, arthritis)
  • neurological problems
  • substance use
  • medication
  • stress
  • an irregular work schedule

Some researchers characterize insomnia as a “disorder of hyperarousal” that may happen due to chronic activation of your body’s stress response.

Poor sleepers have higher levels of both cortisol and adrenocorticotropic hormone (a hormone that stimulates the production and release of cortisol).

Treatments for insomnia may involve:

Research in 2018 shows that among people with both a mental health condition and insomnia, treating the mental health condition can help improve sleep — and treating sleep disturbances can have a beneficial effect on mental health treatments, too.

Insomnia is a sleep disorder where you have trouble falling or staying asleep or wake up too early. If you have insomnia, you often feel exhausted or sleepy during the day.

Insomnia has a complex relationship with mental illness. The link between the two has many factors.

Insomnia can lead to or worsen mental health conditions, such as depression, as vice versa. Insomnia and depression may also be two different symptoms of the same condition, like diabetes or chronic pain.

Depending on what’s causing your insomnia, treatment may target your insomnia symptoms, the underlying condition, or both.

Insomnia can significantly reduce your quality of life. If you live with insomnia, consider reaching out to a trusted healthcare professional to discuss your treatment options.