Depression can present itself in ways that aren’t always obvious—especially when it comes to sleep. Sleeping too much or too little is often a sign of depression, even if it's not immediately recognized as such.

Interestingly, sleep problems don’t just result from depression; they can also increase the risk of developing it. Issues like insomnia—difficulty falling or staying asleep—can disrupt the balance of brain chemicals and hormones, which may worsen symptoms of depression.

Depression is one of the most common mental health conditions in the United States. In fact, nearly 80% of people with depression report having trouble sleeping. Here’s what you need to know about the connection between depression and sleep.

What Is Major Depressive Disorder?

Major depressive disorder, also known as clinical depression, is a mental health condition marked by persistent feelings of sadness, hopelessness, guilt, or worthlessness. This condition is more than just feeling sad or down occasionally—it lasts longer and affects daily functioning.

Other symptoms of major depression may include:

  • Anger, irritability, or agitation

  • Changes in appetite or weight

  • Trouble focusing

  • Constant fatigue

  • Social withdrawal or isolation

  • Loss of interest in once-enjoyable activities

  • Feeling restless

  • Sleeping too much or not enough

  • Thoughts of death or self-harm

The Relationship Between Sleep and Depression

Depression can interfere with sleep in different ways, including sleeping less than usual (insomnia) or sleeping too much (hypersomnia). These effects are closely tied to how depression influences the nervous system and hormone regulation.

Several hormones are involved in sleep and wake cycles, such as:

  • Cortisol

  • Melatonin

  • Thyroid-stimulating hormone (TSH)

  • Ghrelin and leptin (appetite-regulating hormones)

  • Growth hormone

Melatonin and cortisol help regulate the body’s natural sleep-wake cycle, or circadian rhythm. When these hormones are out of sync, sleep issues can arise. For example, increased TSH or ghrelin and decreased growth hormone or leptin can lead to trouble sleeping—or result from it.

There’s growing evidence that sleep and depression are linked in a two-way relationship. Depression may lead to poor sleep, and poor sleep may increase the risk of depression. This cycle can make symptoms of both conditions worse.

Insomnia

People with depression commonly experience insomnia, which includes difficulty falling asleep, staying asleep, or waking up too early. You may be dealing with insomnia if you:

  • Lie awake for long periods before falling asleep

  • Wake up multiple times during the night

  • Sleep in short, fragmented periods

  • Feel as if you didn’t rest at all

  • Wake up far earlier than planned

Insomnia is both a symptom and a potential risk factor for depression. It’s also associated with problems in concentration and memory.

Hypersomnia

Hypersomnia is excessive sleepiness and is often a symptom of atypical depression. This form of depression can be harder to detect because it doesn’t always include classic signs like a low mood or trouble sleeping.

With atypical depression, you might:

  • Sleep more than usual

  • Eat more than usual

  • Experience temporary mood boosts after positive events

These symptoms can be overlooked or dismissed, especially when you're still able to feel good temporarily.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a sleep disorder that causes breathing to repeatedly stop during sleep due to blocked or narrowed airways. Symptoms like fatigue and low energy in OSA can resemble those of depression.

OSA can reduce oxygen levels, impairing brain function and potentially contributing to mood changes. It may also trigger inflammation in the body, which could increase depression risk. Researchers are still studying the exact nature of this link.

How To Treat Depression and Sleep Problems

If you're experiencing symptoms of depression and sleep disturbances, it’s important to talk to a healthcare provider. They will likely ask when your symptoms began and whether any recent changes or stressors may be related.

Common treatments for depression include medication and talk therapy. For sleep-specific issues, cognitive behavioral therapy for insomnia (CBT-I) can help change unhelpful thoughts and behaviors related to sleep. Mental health professionals may also teach relaxation techniques to promote better rest.

Some helpful sleep hygiene practices include:

  • Avoiding caffeine late in the day

  • Keeping a consistent bedtime and wake time

  • Creating a cool, quiet, and calming sleep environment

  • Avoiding large meals or alcohol close to bedtime

  • Turning off electronic devices at least 30 minutes before bed

  • Staying active during the day and eating nutritious meals

Not all sleep issues point to depression. Fatigue or sleep difficulty could also be symptoms of other health conditions, such as anemia or thyroid problems. A full evaluation by a healthcare provider can help identify the root cause.

A Quick Summary

Sleep disturbances—either too much or too little sleep—are common signs of depression. In some cases, these sleep issues may even contribute to developing depression. The balance of brain chemicals and hormones plays a central role in this connection.

If you're struggling with depression or sleep problems, speak with a healthcare provider. Treatment options may include medication, therapy, or both to help improve both your mood and sleep quality.