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What is SAD and how does it impact your sleep?

With winter months ahead, we get in the spirit of festivities, we begin planning holidays and family gatherings. Regrettably, fall and winter are not as joyful for those who suffer from seasonal affective disorder( SAD).
SAD is a type of depression that is related to change in seasons. Those suffering from it usually experience the symptoms around the same time each year. According to September 2021 statistics^[1] “more than 1 in 20 people in the UK have been diagnosed with Seasonal Affective Disorder.” The study also revealed that, during autumn and winter, women tend to suffer more from depressive moods than men.

What are the symptoms?

If you have SAD you are likely to experience :

• Low mood, feeling sad and/or hopeless
• Irritability
• Fatigue, lack of energy, sluggishness
• Changes in appetite; eating less or more than usually
• Loss of interest in activities that you normally enjoy
• Withdrawal from social activities/ interactions
• Trouble concentrating
• Sleep problems; sleeping less or more than normally

What causes the seasonal affective disorder?

Although some people experience symptoms of SAD during spring or summer, the majority suffers from it throughout the course of fall and winter. Seasonal affective disorder, which impacts people during the winter season, has been linked to reduced exposure to sunlight. With days being shorter and darker, there isn’t enough sunlight reaching your skin so your body might be deficient in Vitamin D, which is associated with depression.^[2]

On the flip side, due to reduced sunlight, there is an increased production of melatonin, the sleep-regulating hormone. This can throw your circadian rhythm^[3]out of whack, making you feel groggy and lethargic during the day.
The majority of SAD sufferers struggle to maintain healthy sleep patterns.
Research ^[4] involving 293 SAD patients reported that 80% of participants experienced hypersomnia.^[5]
People with hypersomnia find it difficult to function during the day due to lack of energy, low concentration and tiredness. They also sleep longer at night and tend to drift off during the day. Researchers found a link^[6] between increased sleep duration and decreased efficiency of it.
They’ve discovered that SAD patients spend less time in deep sleep and therefore, sleep longer to compensate for it. Deep sleep, also called a non–rapid eye movement phase, is very important to your physical and mental wellbeing. One study^[7] has found a link between reduced deep sleep and Alzheimer’s disease. Hence, not only sleep length but also the quality of your sleep is relevant.

You probably understand the disadvantages associated with lack of sleep or bad sleep quality but what about sleeping too much? Surprisingly, sleeping more than it is recommended does as much damage to your body as not sleeping enough. The study^[8] found that deviating from the optimal 7-8 hours of sleep is associated with a higher risk of cardiovascular diseases and consequently, increased mortality.

How can you treat SAD and improve your sleep?

The most common treatment for the seasonal affective disorder is light therapy. It involves exposure to an artificial light that mimics natural sunlight. The objective of light therapy is to balance brain chemicals responsible for regulating both mood and sleep. Cognitive Behavioural Therapy ( CBT)^[9] has also been found effective in the treatment of SAD and is commonly used to treat various sleep and mood disorders, like insomnia, anxiety, panic disorder and many others.

Over and above that, there are some things that you can do yourself in order to ease the symptoms of your SAD and sleep more efficiently:

1. Regular exercise.

There are a number of benefits coming from exercising regularly. Exercise lowers the risk of cardiovascular diseases, diabetes, or even cancer. It helps lower blood pressure, eases symptoms of anxiety and depression, and helps you sleep better. It has been found that moderate-intensity aerobic exercise helps regulate sleep by increasing the length of deep sleep.^[10] Regular exercise also balances the levels of serotonin in the brain. Higher levels of this chemical are associated with better mood, increased appetite and better sleep. Additionally, during exercise, your body temperature goes up and consequently decreases afterwards. This imitates the pattern your body goes through when preparing for sleep and may eventually help you sleep better.^[10]

2. Healthy diet.

You ought to know that a healthy, balanced diet plays a major role in mood regulation as well as it can help with sleep. If your dietary choices are poor you are likely to see the consequences in your cognitive abilities( learning, understanding, thinking) but also in the way you perceive situations and feel. Diet rich in processed foods and sugars is damaging to the brain, which works 24/7 and to be the most efficient, requires a good ‘fuel’. The right eating patterns as well as a diet rich in protein, fibre and healthy monounsaturated fats not only help to balance the mood but also regulate sleep. You should opt for a diet with lots of vegetables, olive oil, whole grains, fish and seafood. Fish, such as salmon, tuna, mackerel, herring or sardines are a good source of Omega-3 fatty acids, which are very important when it comes to battling depression and sleep problems. You can obtain them through a diet( fish, nuts and plant oils, like flaxseed oil or canola oil) or via supplements( fish oil). Omega 3’s have been recognised to not only lower symptoms of depression but also boost sleep. Research,^[11] involving 170,000 people from different countries, has indicated that fish consumption is linked to a lower prevalence of depression. The same study also disclosed that in Asian countries, where fish consumption is very high, people tend to suffer relatively little from depression, in comparison to other countries. On the flip side, researchers observed that “subjects having low fish consumption (lower than once per week, including seafood) present high scores of depression.”
Scientists also studied a relationship between fish consumption and sleep and found that eating fish regularly may improve the quality of one’s sleep and reduce sleep onset( time to fall asleep)^[12]

3. Spending time outdoors.

Exposure to natural sunlight is very important for SAD sufferers. During the day, whenever you can, step outdoors to get some sunlight. Even in small doses, it can boost levels of serotonin and help you feel better. If you’re not a fan of going to the gym to get your exercise, do it outdoors, whilst basking in the morning light. Schedule your outdoor time so that you get some sunlight on your skin every day. Go for walks, exercise or do some work around your garden, anything would do. During cold or rainy days, when being outdoors isn’t particularly pleasant, make sure to increase the amount of light in your home or workplace. Open the curtains or put the lights on. You may also invest in some light therapy tools, such as a SAD lamp or a sunrise alarm clock.

4. Boosting your sleep hygiene.

Sleep hygiene refers to optimizing your sleep pattern, your daily bedtime routine and your sleep environment. If due to seasonal affective disorder your sleep pattern has become irregular, look into making some adjustments in your daily habits. One of the things that may help is setting a fixed time for going to bed and for getting up in the morning. Your bedtime should be consistent regardless of weekends, holidays etc. The body needs to get used to a specific sleep schedule in order to shape your biological clock. Once you get used to sleeping and waking up at the same time every day your body will adapt to it, and it will help you fall asleep on your set time.
Around your bedtime, make sure to dim your bedroom. Remember, that melatonin, the sleep-inducing hormone, is produced in the absence of light so keeping your bedroom dark will help with your sleep.
Additionally, keep in mind that using electronic devices about 30 mins before bed is not recommended as exposure to blue light has been linked to a reduction in secreted melatonin.

For more tips on the sleep hygiene visit our article here.

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Research references

1. https://www.microbizmag.co.uk/seasonal-affective-disorder-statistics/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/
3. https://nigms.nih.gov/education/fact-sheets/Pages/Circadian-Rhythms.aspx
4. https://pubmed.ncbi.nlm.nih.gov/8064650/
5. https://www.nhs.uk/conditions/excessive-daytime-sleepiness-hypersomnia/
6. https://pubmed.ncbi.nlm.nih.gov/8064650/
7. https://www.science.org/doi/10.1126/scitranslmed.aau6550
8. https://www.ahajournals.org/doi/10.1161/JAHA.118.008552
9. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/
10. https://www.sleepfoundation.org/insomnia/exercise-and-insomnia
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087749/
12. https://pubmed.ncbi.nlm.nih.gov/26847986/