Feature Article

The bidirectional nature of sleep problems and psychopathology

Delwyn Bartlett, Melinda L Jackson



As sleep and psychiatric disorders are not only comorbid but also co-dependent, patients require individual and integrated attention. The benefits of treating sleep disorders in the context of psychopathology are likely to extend beyond improved sleep, with demonstrated improvements in mental health.
A correction for this article has been published in the May 2016 issue of Medicine Today. The full text PDF for this article (see link above) has been corrected.

Key Points

  • Most patients with psychiatric disorders experience sleep disturbance.
  • Patients with comorbid sleep problems have greater symptomatology and poorer treatment outcomes.
  • Obstructive sleep apnoea (OSA) and insomnia are associated with higher rates of depression and anxiety than community prevalence rates.
  • There is strong evidence indicating a bidirectional relation between sleep disorders and mental health.
  • Treatment of sleep problems may have additional benefits on mental health for patients with comorbid psychiatric illness, and may prevent the onset of psychiatric conditions in ‘at-risk’ individuals.
  • The night-to-night variability of sleep quality in both OSA and insomnia needs to be emphasised to help patients understand that good management is the key message along with the notion that ‘a bad night is just a bad night!’

    Picture credit: © Photographee.eu/Shutterstock. Model used for illustrative purposes only.