The Times Australia
The Times World News

.

Insomnia and mental disorders are linked. But exactly how is still a mystery

  • Written by Ben Bullock, Senior Lecturer, Psychology, Swinburne University of Technology
Insomnia and mental disorders are linked. But exactly how is still a mystery

This article is the next in The Conversation’s six-part series on insomnia, which charts the rise of insomnia during industrialisation to sleep apps today. Read other articles in the series here[1].

The 2004 movie The Machinist[2] gives us a striking depiction, albeit a fictional one, of the psychological effects of chronic insomnia.

When people don’t have enough sleep, their[3] memory and concentration are impaired in the short term. They are also less able to regulate their emotions.

If sleeping difficulties continue, longer-term psychological effects can include[4] anxiety, depression, mania and psychosis. Indeed, Christian Bale’s character in The Machinist has increasingly vivid visual hallucinations and paranoid delusions as his insomnia deepens.

The relationship between insomnia and mental disorders is complex. It’s not just a case of “which comes first, the insomnia or the mental disorder?” Insomnia and mental disorders are interrelated in ways we don’t yet fully understand.

Read more: A short history of insomnia and how we became obsessed with sleep[5]

What is insomnia? Is it a mental disorder?

Insomnia is, by far, the most common disorder of sleep. An estimated 12-15%[6] of Australian adults at any one time meet criteria for insomnia.

People with insomnia have frequent and ongoing difficulties in falling and staying asleep, and/or going back to sleep after early waking. Insomnia not only affects people’s quality of sleep, but how they function the next day.

Many of the factors that trigger insomnia and help maintain its negative long-term effects are psychological or behavioural. These include:

  • psychosocial stressors (such as money, work or family problems)

  • attentional bias and worry about sleep (the more we think and worry about sleep, the worse it gets)

  • poor sleep habits (such as irregular sleep and wake times).

Insomnia is not a mental disorder in the same way that, say, depression and anxiety are mental disorders. Insomnia is a recognised sleep disorder[7] that nonetheless has close links to a wide variety of mental disorders.

Read more: What's insomnia like for most people who can't sleep? You'd never know from the movies[8]

Many people have both insomnia and a mental disorder

Around half[9] of all people diagnosed with insomnia also have an associated mental disorder. The most common ones associated with insomnia are depression, anxiety, bipolar disorder, post-traumatic stress disorder, and substance-related disorders.

We don’t (yet) know why we see such high levels of mental disorders in people with insomnia. But there are several leading theories, including:

  • a shared genetic risk[10] for insomnia and a mental disorder. In other words, some people’s genes may predispose them to both conditions

  • a shared neurobiological[11] response. How the brain responds to sleep loss may be connected to how systems in the brain control cognition, emotion and reward. Disturbances of these brain functions are implicated in a range of mental disorders

  • inflammation[12] and/or dysfunction of the immune system may underlie both insomnia and mental disorders.

Read more: How dangerous is insomnia? How fear of what it's doing to your body can wreck your sleep[13]

Which comes first?

Further complicating the picture is evidence[14] showing insomnia can occur before someone develops a mental disorder, or afterwards. Researchers call this a “bidirectional” relationship.

We can’t say one causes the other. We can only say there is a clear link between them.

This link means diagnosis and treatment of one can have implications[15] for diagnosis and treatment of the other. For instance, if you don’t adequately treat insomnia, this can worsen symptoms of someone’s mental disorder, increasing[16] both the severity and risk of relapse.

A type of talking therapy known as cognitive behavioural therapy for insomnia (CBTi[17]) aims to change the unhelpful thoughts, feelings, emotions and behaviours that contribute to insomnia. And, in many cases, successful treatment of insomnia with CBTi can also treat[18] someone’s mental disorder (and vice versa).

CBTi is particularly effective[19] at treating insomnia plus depression, substance use or post-traumatic stress disorder. But it is less effective at treating insomnia plus psychosis or bipolar disorder.

Man having counselling or therapy, with therapist filling in questionnaire on clipboard
Fixing the sleep problem can often resolve the mental disorder (and vice versa). Shutterstock[20]

Filling the gaps

There’s much we don’t know about the link between insomnia and mental disorders. Last year an international panel of experts outlined[21] the research needed to plug the knowledge gaps. Recommendations included:

  • longer-term studies starting in childhood and adolescence that collect data on sleep and mental health using wearable or smartphone technologies. The aim is to provide more objective measurement of insomnia and mental health in these younger age groups, and to intervene early if needed

  • more studies involving people from diverse[22] social and cultural backgrounds. Sleep practices are often culturally-determined[23]. So researching diverse populations would provide a more comprehensive picture of insomnia and mental disorders

  • a greater recognition of people’s daytime behaviours and environmental exposures, and their contribution to insomnia and poorer mental health. This includes[24], eating fast food, having disrupted sleep routines (for example, shift work) and using technology excessively.

Results of this research will have profound implications for accurate diagnosis of both insomnia and mental disorders, and their treatment. The aim is to reduce the burden[25] when these conditions occur together, both for individuals and society[26] more broadly.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. Free information[27] about insomnia and mental health is available from the Sleep Health Foundation.

References

  1. ^ here (theconversation.com)
  2. ^ The Machinist (www.imdb.com)
  3. ^ their (doi.org)
  4. ^ can include (doi.org)
  5. ^ A short history of insomnia and how we became obsessed with sleep (theconversation.com)
  6. ^ An estimated 12-15% (www.sleephealthfoundation.org.au)
  7. ^ sleep disorder (aasm.org)
  8. ^ What's insomnia like for most people who can't sleep? You'd never know from the movies (theconversation.com)
  9. ^ Around half (doi.org)
  10. ^ shared genetic risk (doi.org)
  11. ^ shared neurobiological (doi.org)
  12. ^ inflammation (doi.org)
  13. ^ How dangerous is insomnia? How fear of what it's doing to your body can wreck your sleep (theconversation.com)
  14. ^ is evidence (doi.org)
  15. ^ can have implications (doi.org)
  16. ^ increasing (doi.org)
  17. ^ CBTi (doi.org)
  18. ^ can also treat (doi.org)
  19. ^ effective (doi.org)
  20. ^ Shutterstock (www.shutterstock.com)
  21. ^ outlined (wellcome.org)
  22. ^ diverse (doi.org)
  23. ^ culturally-determined (doi.org)
  24. ^ includes (doi.org)
  25. ^ the burden (www.sleephealthfoundation.org.au)
  26. ^ individuals and society (www.health.gov.au)
  27. ^ Free information (www.sleephealthfoundation.org.au)

Read more https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106

Times Magazine

Headless CMS in Digital Twins and 3D Product Experiences

Image by freepik As the metaverse becomes more advanced and accessible, it's clear that multiple sectors will use digital twins and 3D product experiences to visualize, connect, and streamline efforts better. A digital twin is a virtual replica of ...

The Decline of Hyper-Casual: How Mid-Core Mobile Games Took Over in 2025

In recent years, the mobile gaming landscape has undergone a significant transformation, with mid-core mobile games emerging as the dominant force in app stores by 2025. This shift is underpinned by changing user habits and evolving monetization tr...

Understanding ITIL 4 and PRINCE2 Project Management Synergy

Key Highlights ITIL 4 focuses on IT service management, emphasising continual improvement and value creation through modern digital transformation approaches. PRINCE2 project management supports systematic planning and execution of projects wit...

What AI Adoption Means for the Future of Workplace Risk Management

Image by freepik As industrial operations become more complex and fast-paced, the risks faced by workers and employers alike continue to grow. Traditional safety models—reliant on manual oversight, reactive investigations, and standardised checklist...

From Beach Bops to Alpine Anthems: Your Sonos Survival Guide for a Long Weekend Escape

Alright, fellow adventurers and relaxation enthusiasts! So, you've packed your bags, charged your devices, and mentally prepared for that glorious King's Birthday long weekend. But hold on, are you really ready? Because a true long weekend warrior kn...

Effective Commercial Pest Control Solutions for a Safer Workplace

Keeping a workplace clean, safe, and free from pests is essential for maintaining productivity, protecting employee health, and upholding a company's reputation. Pests pose health risks, can cause structural damage, and can lead to serious legal an...

The Times Features

Tricia Paoluccio designer to the stars

The Case for Nuturing Creativity in the Classroom, and in our Lives I am an actress and an artist who has had the privilege of sharing my work across many countries, touring my ...

Duke of Dural to Get Rooftop Bar as New Owners Invest in Venue Upgrade

The Duke of Dural, in Sydney’s north-west, is set for a major uplift under new ownership, following its acquisition by hospitality group Good Beer Company this week. Led by resp...

Prefab’s Second Life: Why Australia’s Backyard Boom Needs a Circular Makeover

The humble granny flat is being reimagined not just as a fix for housing shortages, but as a cornerstone of circular, factory-built architecture. But are our systems ready to s...

Melbourne’s Burglary Boom: Break-Ins Surge Nearly 25%

Victorian homeowners are being warned to act now, as rising break-ins and falling arrest rates paint a worrying picture for suburban safety. Melbourne residents are facing an ...

Exploring the Curriculum at a Modern Junior School in Melbourne

Key Highlights The curriculum at junior schools emphasises whole-person development, catering to children’s physical, emotional, and intellectual needs. It ensures early year...

Distressed by all the bad news? Here’s how to stay informed but still look after yourself

If you’re feeling like the news is particularly bad at the moment, you’re not alone. But many of us can’t look away – and don’t want to. Engaging with news can help us make ...