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The Cool Calm

Sorting Out Sleep’s Connection to Crisis

 

Sleep. We all need it. The average person sleeps 8 hours a day, amounting to more than 26 years in a lifetime. This time spent recovering and reseting each night is critical; studies have shown a close link between our mental health and sleep.

“Sleep and mood affect each other,” says Avelino Verceles, Director of the University of Maryland’s Sleep Medicine Fellowship. “It’s not uncommon for people who don’t get enough sleep to be depressed or for people who are depressed to not sleep well enough.”

So, no surprise, sleep is on the minds of many of our texters. What we didn’t expect, though, was just how often the topic appears in conversations. A robust 36% of our conversations mention sleep.

Let’s take a closer look at what our data says about these conversations:

Context: Roughly 4% of these conversations discuss sleep as a coping mechanism. 27% use the concept of sleep as a proxy for suicidal ideations: “I just want to sleep forever.” The other 69% talk about sleep in more general terms, especially in respect to their own sleeping habits.

Issues: Conversations that mention sleep are…

  • 1.5x as likely to include talk of depression.

  • 1.8x as likely to include talk of isolation.

  • 2x as likely to include talk of school problems.

Severity: These conversations are 10% less likely to result in emergency services being contacted. (Note: this happens in less than 1% of all conversations).

Time of Day: Conversations about sleep are more likely to occur at night, between 9PM and 5AM. (Makes sense, right?)

Crisis Counselor Responses: Here are the most common phrases our Crisis Counselors use in positively-rated sleep conversations.

  • Validation: “strong person,” “you deserve,” “relax for sleep”

  • Goal identification: “[How can I] best support you?”

  • Collaborative Problem Solving: “work together”, “brainstorm ideas”

Academic literature reinforces some of the links we’re seeing in our dataa:

  • A 2011 study from the American Academy of Sleep Medicine found that stronger feelings of loneliness are associated with increased restlessness. Such a conclusion could explain why conversations discussion sleep are 1.8X more likely to include talk of isolation.

  • A series of studies from 2015 found that issues with sleep negatively impacted students’ performance at school. This could serve as one explanation for why conversations about school are twice as likely to include talk of school problems.

Did a lack of sleep cause heightened feeling of depression & anxiety? Or did feelings of depression & anxiety lead to problems sleeping? It’s difficult to know for sure. The reality is, causality likely flows in both directions. Looking beyond the difficult question of causality, our data suggests that those seeking to understand the root causes of mental illnesses should consider exploring an individual’s sleeping behaviors.

We didn't expect to find that more than 1 in 3 texters discuss sleep with our Crisis Counselors, but, given how connected sleep is to a lot of what we do in our day-to-day lives (and, by  extension, our mental health), it makes sense. Yes, whether you’re getting too much, too little, or just the right amount, crisis moments often involve thought about our zzz’s.

Next time you’re trying to decide between staying up late to watch a movie or play video games, and turning in early to catch up on some rest, you might consider opting for some sleep and hitting that natural reset button.

Scotty Huhn

Scotty is a Data Scientist at Crisis Text Line.