The Complex Relationship Between Sleep and Psychiatric Disorders

Psychiatric and sleep disorders can be difficult to tease apart, Sam A. Kashani, MD, shared with Psychiatric Times.

"The relationship between sleep and psychiatric disorders is very complex and quite extensive. It goes beyond just pining a sleep difficult to a person's anxiety or depression," said Kashani.

According to a survey completed by the American Academy of Sleep Medicine, 12% of Americans have been diagnosed with chronic insomnia.¹ Overall, it is estimated that insomnia affects 25 million individuals in the United States.² This common sleep disorder can be extremely difficult to differentiate as a pure sleep problem vs sequelae of a psychiatric disorder vs medication adverse effect. For example, insomnia is seen in more than 90% of patients with clinical depression, and is common in the prodromal phase of psychosis.²

Kashani, an expert in sleep medicine and the president of the California Sleep Society, acknowledges this challenge. "We have difficulty in teasing apart what is the psychiatric component of the problem vs what is just the pure sleep component of the problem. Teasing apart that chicken from the egg can be very, very difficult. It is probably one our biggest diagnostic challenges in sleep medicine."

Dr Kashani is a board-certified sleep medicine physician who practices in Santa Monica, Porter Ranch, and Santa Clarita. He is currently president of the California Sleep Society and is an assistant clinical professor of medicine at the David Geffen School of Medicine at UCLA.

References

1. AASM Sleep Prioritization Survey: Chronic Insomnia. American Academy of Sleep Medicine. 2024. Accessed May 6, 2025. https://aasm.org/wp-content/uploads/2024/06/sleep-prioritization-survey-2024-chronic-insomnia.pdf

2. Khurshid KA. Comorbid insomnia and psychiatric disorders. Innov Clin Neurosci. 2018;15(3-4):28–32.