My son recently went through a depressive episode. Treatment and a new prescription are helping, but he finds he still has trouble staying asleep. He will often have dreams that will wake him up, and he will not be able to get back to sleep. What are some things to try to help him better regulate his sleep cycle?

People who live with mood disorders often experience sleeping problems, which can be an early sign of a mood episode and the last problem to get better when other symptoms improve. Your son’s sleep problems will probably sort themselves out over time, but there are some practical things he can do to recover more quickly.

The most important step is to keep a regular sleep schedule—especially a regular time to get up in the morning. If you are sleeping poorly, it’s very tempting to sleep later to try to make up for lost sleep. But that can throw off your biological clock and interfere with sleep the next night. It’s best to set a regular waking time, not let it vary by more than an hour, and avoid naps during the day (which also interferes with sleeping the next night).

Don’t spend more than eight hours per day in bed. If you are having trouble sleeping, spending more hours in bed won’t actually lead to sleeping more.  It will actually lead to more sleep interruptions: more time spent in bed not sleeping.

Lying awake at night can also be self-reinforcing. If you lie in bed tossing and turning and feeling miserable, that can lead to more anxiety about sleeping—which leads to more tossing and turning and feeling miserable.  Some simple steps to break that cycle:

  • Don’t have a clock or watch (or phone with a clock) where you can see it. Checking to see how little you slept or how long you’ve been awake, or how soon you have to get up, will just make you feel worse.
  • If you’re lying in bed and feeling more restless and awake, get out of bed and sit somewhere else. Do something relaxing (or even boring) until you feel sleepy. And then get back into bed.

I realize that advice is sort of like advising your child to eat more vegetables. It doesn’t sound too appealing or tasty.  But—just like eating more vegetables—it really does work!

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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