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Depression may be one of the most misunderstood mental health disorders. It is often equated with “feeling down” or a persistent sadness. While these are characteristics of depression, the disorder has a profound effect on multiple body systems, affecting emotional well-being, concentration, and energy levels.

Among the lesser-known consequences of depression, sleep disturbances stand out as a significant and often underestimated symptom. In the United States alone, 16 million people grapple with depression, and a staggering 75% of them experience some form of sleep disorder.


The Vicious Cycle

A woman sleeps at her desk. Depression causes sleep issues.Depression and sleep perpetuate a negative symbiotic relationship, forming a vicious cycle that can be difficult to break. Individuals facing sleep issues are ten times more likely to develop depression, while those already battling depression find themselves at a heightened risk of developing poor sleeping habits. Depression is linked to sleep disorders such as insomnia, hypersomnia, and obstructive sleep apnea.


How Depression Disrupts Sleep

Depression has been linked to insomnia, which is a difficulty falling asleep or staying asleep. Insomnia directly contributes to a lack of energy by robbing you of needed sleep. Insomnia increases feelings of fatigue and persistent lack of energy and can also contribute to a sense of hopelessness brought on by despair at not being able to obtain needed rest.

Hypersomnia is the persistent urge to sleep, especially with daytime sleepiness. Individuals with hypersomnia may struggle to stay awake during the day, causing significant impact on work, school, or family relationships. The constant urge to sleep further drains energy and increases the perceived fatigue level of individuals struggling with hypersomnia.

Obstructive sleep apnea, characterized by snorting, gasping and pauses in breathing during sleep, has been linked with depression. The disrupted sleep patterns caused by sleep apnea can intensify depressive symptoms, leading to a cycle of worsening mental health.

A study by the Centers for Disease Control and Prevention (CDC) found a clinically significant association between sleep apnea and depression.

“Snorting, gasping or stopping breathing while asleep was associated with nearly all depression symptoms, including feeling hopeless and feeling like a failure,” said Anne G. Wheaton, PhD, lead author of the study. “We expected persons with sleep-disordered breathing to report trouble sleeping or sleeping too much, or feeling tired and having little energy, but not the other symptoms [characteristic of depression].”  Source


How Depression Makes You Tired

While the association between depression and sleep issues is well-established, the exact mechanism by which depression impacts sleep is still being studied. The most probable theories for how depression causes lack of sleep include:

Neurotransmitter Imbalance. Depression disrupts neurotransmitters in the brain, such as serotonin, norepinephrine, and dopamine. These neurotransmitters play a crucial role in regulating mood, energy, and sleep-wake cycles. An imbalance can lead to symptoms of both depression and sleep disturbances.

Disrupted Circadian Rhythms. Depression can impact the body’s internal clock, known as the circadian rhythm. This rhythm regulates the sleep-wake cycle and other physiological processes. A disruption in the circadian rhythm can cause insomnia (difficulty falling or staying asleep) or hypersomnia (excessive daytime sleepiness), which are both linked to depression.

Hyperarousal. Individuals with depression often experience hyperarousal, a state of increased physiological and psychological activity. This heightened arousal, often characterized by persistent negative thoughts, can prevent you from being able to relax and fall asleep. Racing thoughts and worries can keep the mind active during the night, interrupting sleep and contributing to insomnia.

Lack of Physical Activity. In a cruel vicious cycle, depression saps your energy and makes you less inclined to engage in physical activity. Yet regular physical activity is closely linked to better sleep quality. By avoiding physical activity due to lack of energy, you feed back into the negative loop and further reduce your energy levels.

Medication Side Effects. In another cruel twist, some medications used to treat depression have side effects that may affect sleep patterns. For example, certain antidepressants can cause insomnia or drowsiness, influencing energy levels and overall well-being.


Breaking the Cycle: Getting Your Energy Back

The good news is that addressing and treating depression can directly improve sleep quality. Multiple, effective treatment options are available. However, for those who have undergone traditional treatments (such as antidepressants or therapy) without significant improvement in depression or energy levels, alternative options may be necessary.

Transcranial magnetic stimulation (TMS) is a newer depression treatment, first approved for use in treating depression by the FDA in 2008. TMS is an interventional psychiatric procedure that uses a medical device (the TMS machine) to directly target and stimulate areas of the brain. Brain areas targeted include the Left Prefrontal Cortex, which plays a pivotal role in mood regulation.

The TMS machine produces electromagnetic pulses which prod the brain in a stimulus/response mechanism. The brain responds to the stimulus by producing new, healthy neural pathways. By directly addressing the root causes of depression in the brain, TMS aims to overcome depression and improve overall mood.

Improved sleep and renewed energy are some of the side benefits of TMS treatment. Patients who complete TMS treatment often comment on their renewed energy, with many of them devoting renewed attention to hobbies, sports, or artistic pursuits they had previously abandoned.


Find Renewed Energy Through TMS Treatment

If you live in Utah and are struggling with lack of energy, poor sleep quality, or other symptoms of depression – come see your local depression experts at Ampelis Health. We are a local, Utah-based mental health clinic working to help people live fuller, more meaningful lives.

Call Ampelis Health today at 435-776-5909 to schedule a new patient appointment. At your appointment, you will receive a full evaluation and diagnosis, which will determine whether TMS is an ideal treatment option for you.


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