Sleep Deprivation & Psychosis: What's The Connection?

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 12/28/2020

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Sleep is essential for every function in the body, especially your mental health. You've probably experienced the negative effects of a lack of sleep the previous night, such as moodiness and irritability, but if it goes beyond this, it can have severe implications. One of the possible consequences is psychosis, and this article will discuss how sleep deprivation can cause it.

Sleep is essential for every function in the body, especially your mental health. You've probably experienced the negative effects of a lack of sleep the previous night, such as moodiness and irritability, but if it goes beyond this, it can have severe implications. One of the possible consequences is psychosis, and this article will discuss how sleep deprivation can cause it.

What Is Psychosis?

The term "psychosis" is not an actual medical condition; rather, it signifies a much larger underlying issue.

When someone is experiencing psychosis or a psychotic episode, it refers to two different symptoms - hallucinations and delusions.

Hallucinations can affect any human senses, such as visual, auditory, tactile, olfactory (smell), or gustatory (taste). People will perceive things that aren't there. This a sign that they are losing touch with reality.

For example, someone who is hallucinating may see or hear things that are not real. Still, it will seem incredibly real to them - it's not unusual for someone who is currently in a psychotic episode to try to interact with these hallucinations, such as talking and responding to the things the hallucinated being might say or do. Because of this, incoherent speech is an associated symptom as well.

Next, psychosis also indicates someone has delusional beliefs, which can be even broader than hallucinations.

In general, delusions are beliefs that are considered to be false and disconnected from reality. Delusional beliefs tend to be extremely exaggerated, but not always, and there are times when the thoughts aren't unrealistic but are still false and incongruent with reality.

Here are some examples of some delusions that a person can believe:

  • They are God or that they have superpowers that no one else has
  • Their existence is being broadcast on television
  • There is a conspiracy that someone is trying to kill them
  • A loved one deceived them
  • They are being placed under mind-control
  • They have a special connection or relationship with someone famous

As you can see, some delusions can be bizarre, and others can have the possibility of occurring, but they are still not true and aren't based on any real evidence.

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These psychotic symptoms are most often associated with schizophrenia, which is a severe and chronic mental illness. However, this is not always the case, and other mental health conditions, like bipolar disorder, can also cause it.

Psychosis also isn't always permanent, and additional factors can cause the onset of a psychotic episode. Substance abuse is one of them, along with sleep deprivation, and these two issues sometimes go hand-in-hand with one another.

The remainder of this article will focus on why a severe lack of sleep can cause psychosis and create symptoms like sleep deprivation hallucinations and the additional ones mentioned above.

What Is Sleep Psychosis & How It Happens

In the United States, chronic sleep issues are a significant problem. More and more people are working longer hours and balancing their lives with their families and hobbies and other forms of entertainment. Because there are only so many hours in a day, some things will usually be put on the back-burner, and typically, the first thing to go is sleep.

Many people are willing to sacrifice sleep to catch up on more work or other aspects of their lives so that they can try to feel more content with their lives; however, this tends to have the opposite effect, and people who skip out on sleep tend to feel the consequences the next day by feeling groggy, irritable. The daytime sleepiness is a sign that something is wrong.

Sleep issues are linked to depression, anxiety, and many other psychiatric concerns, because it can interfere with the neurotransmitters that affect your moods, such as serotonin and dopamine. [1]

Additionally, losing sleep will reduce your cognitive functioning, such as the ability to focus, form and store memories, and your decision-making abilities, to name a few other examples.

It is estimated that 50 to 80 percent of people receiving psychiatric care for various conditions like depression, anxiety disorders, bipolar disorder, and post-traumatic stress disorder struggle with sleep difficulties, and insomnia is a common symptom in these mental health issues. [2]

However, insomnia can also cause symptoms to be more persistent and severe. The lack of sleep accumulates it can create additional symptoms that are not typical of these conditions.

On the other hand, one study shows that even when mentally healthy people go at least 24 hours without sleep, they can begin to show early signs of psychosis. So, can sleep deprivation make you experience psychosis? Research suggests that it can.

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In this study, which involved 21 eligible case studies (out of 476 possible ones), the effects of sleep loss were observed on individuals for an average of 72 to 98 hours of being awake.

One of the reasons why these case studies were used, rather than direct observations, is that sleep deprivation beyond 48 hours is considered unethical by today's research standards. Therefore, historical accounts needed to be used. [3]

Here are some of the findings:

  • 24 to 48 hours without sleep showed perceptual distortions, anxiety, irritability, depersonalization, and temporal disorientation
  • 48 to 90 hours without sleep added complex hallucinations, disordered thinking, and delusions (after 72 hours)

All of these would indicate that the individuals showed signs of acute psychosis or toxic delirium, and sleep could resolve these symptoms in most, but not all, of the individuals involved in these studies.

Nonetheless, these studies confirm that psychosis can develop the longer someone stays awake, especially after 24 hours without sleep, and people will experience sleep deprivation and hallucinations.

While we know that sleep is crucial in allowing the brain to rest, repair, and recover and prepare you for the next day, understanding all of the exact mechanisms of why there is such a strong connection between sleep and mental health is still somewhat unknown.

We know that it has a profound effect on neurochemistry, which does have a clear connection to psychiatric symptoms, hence why medications that target various neurotransmitters provide symptomatic relief.

In the next section, you can learn about how sleep deprivation can be treated so that psychosis and other symptoms of mental disorders can be addressed.

Treating Sleep Problems

For many people, fixing sleep debt or deprivation isn't always simply a matter of going to bed early. Like adhering to a strict bedtime, committing to good sleep habits can certainly help, but additional help is often required for people with disorders.

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In cases where people have insomnia hallucinations, sleep medication may be helpful. Prescription medication can be very effective in treating insomnia. Still, you must have a valid diagnosis, and you will work with a doctor or psychiatrist to manage your dosages to help ensure they are being consumed responsibly. There are over-the-counter options that can get the job done as well.

People should also avoid substances, regardless of legality. Many drugs, especially stimulants, are known to keep people awake for extremely long periods, leading to psychiatric concerns. Many of them are incredibly addictive, and chronic use can lead to psychosis, particularly hallucination from sleep deprivation.

Amphetamine-induced psychosis is a prime example of this because they inhibit dopamine reuptake, causing psychotic symptoms. [4] To support this, schizophrenia is believed to be caused by excessive dopamine levels, and antipsychotic medications aim to restore balance.

Suppose substance abuse is a factor in one's psychotic symptoms. In that case, inpatient treatment at a detox facility is highly recommended so that the individual can safely withdraw from drugs and let the psychosis pass.

Even caffeine should be used in moderation because it can disrupt sleep, especially if consumed too often and too close to bedtime.

Lastly, therapy can also be valuable because it can get to the root of what people may be having sleep problems in the first place, like depression and anxiety. Cognitive-behavioral therapy is a popular method that can help resolve these issues, and since sleep and mental health are all interrelated, you can notice significant progress quite quickly.

Does Your Loved One Have Psychosis?

Because psychosis inherently indicates that someone has lost touch with reality, it can be difficult for individuals with these symptoms to recognize that there is an issue.

Most of the time, treatment requires intervention from friends and family members, who can get them diagnosed and treated.

A doctor or psychiatrist will try to figure out why someone is experiencing psychosis, influencing the treatment protocol. Still, most of the time, antipsychotic medication will be prescribed regardless of the condition.

 

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If you are unsure if someone is dealing with psychosis, you can take this brief psychosis test as well. It's completely free, and it can help give some extra confidence to reach out to a mental health professional and get the help necessary to address psychosis.

Conclusion

Hopefully, this article has shown you the correlation between sleep deprivation and psychosis and has given you a better perspective on the importance of sleep as well. If you or someone else close to you struggle with chronic sleep issues, they are very treatable, and people can start getting much-needed rest and improve their physical and mental health.

References

  1. Breus, M. (2018, April 17). Here's Why You Can't Think Straight When You're Sleep Deprived. Retrieved from https://thesleepdoctor.com/2018/04/17/heres-why-you-cant-think-straight-when-youre-sleep-deprived/
  2. Harvard Health Publishing. (2019, March 18). Sleep and mental health. Retrieved from https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health
  3. Waters, F., Chiu, V., Atkinson, A., &Blom, J. D. (2018). Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward Psychosis With Increasing Time Awake. Frontiers in psychiatry, 9, 303. https://doi.org/10.3389/fpsyt.2018.00303
  4. Bramness, J. G., Gundersen, Ø. H., Guterstam, J., Rognli, E. B., Konstenius, M., Løberg, E. M., Medhus, S., Tanum, L., & Franck, J. (2012). amphetamine-induced psychosis--a separate diagnostic entity or primary psychosis triggered in the vulnerable?. BMC psychiatry, 12, 221. https://doi.org/10.1186/1471-244X-12-221