Better sleep improves mental health: evidence from 65 trials
SleepKey points
- 65 randomized trials with more than 8,600 participants.
- Better sleep led to moderate reductions in depression and anxiety.
- A dose-response effect: bigger sleep improvements, bigger mental health benefits.
- Sleep should be treated as part of mental health care.
What the research shows
Meta-analysis of 65 trials. Researchers pooled 65 randomized trials with 8,608 participants in which sleep was improved, mostly through CBT for insomnia. Improving sleep led to moderate reductions in depression and anxiety, and smaller reductions in stress, rumination and other symptoms. Greater improvements in sleep were linked to greater improvements in mental health (Scott et al., 2021).
The OASIS trial. In a large randomized trial of 3,755 university students with insomnia, digital CBT-I reduced insomnia, paranoia and hallucinatory experiences, and also improved depression and anxiety (Freeman et al., 2017).
CBT-I is effective on its own for chronic insomnia (Trauer et al., 2015).
In practice
- Treat sleep problems seriously; they are not just a symptom.
- Ask your clinician about CBT-I, especially if you have depression or anxiety.
- Keep a regular wake time and get morning light.
Frequently asked questions
Which sleep treatment was used in the trials?
Most trials used CBT for insomnia, delivered in person or digitally.
Should I treat sleep or depression first?
Often both at the same time. Treating insomnia can make depression treatment more effective; discuss it with your clinician.
Sources
- Scott et al. (2021). Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Medicine Reviews 60:101556. doi:10.1016/j.smrv.2021.101556
- Freeman et al. (2017). The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. The Lancet Psychiatry 4(10):749-758. doi:10.1016/S2215-0366(17)30328-0
- Trauer et al. (2015). Cognitive Behavioral Therapy for Chronic Insomnia. Annals of Internal Medicine 163(3):191-204. doi:10.7326/M14-2841
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