Promoting Mental Health — 3

Let’s consider some of the less surprising lifestyle+ factors that bear on our mental health.

Many of us have noticed and research has confirmed that after a good night’s sleep, exercise performance is enhanced, glucose regulation is improved, and mood is uplifted. Digging a little deeper, inflammation is reduced, partly mediated by the gut microbiome and the gut-brain crosstalk. Chronic sleep deficiency increases the risk of metabolic syndrome and obesity. Sleep and circadian rhythm are tightly interlinked, and recent work with continuous wearable sensors has demonstrated a causal relationship between sleep or circadian disturbance and bad moods.

Although I previously reviewed the role of sleep health for promoting cardiovascular, metabolic, and neurologic health in part 2, its interconnection with mental health is fundamental. A key mechanism is the clearance of metabolic waste products during sleep. Unfortunately, sleep disturbance increases in older adults and is a risk factor associated with late-onset dementia. That’s one of many factors that affect sleep health, as shown in figure 11.2, which include lack of physical activity, alcohol and stimulants, poor diet, inappropriate light exposure, and genetic variation. In people with mental health conditions, objective sleep metric alterations are characteristic. There are many ways to improve sleep health, as the graphic (lower panel) summarizes: increasing physical activity, decreasing alcohol and caffeine, keeping on a regular schedule of bedtime and awakening, timing of eating, and optimizing exposure to natural daylight while blocking out all light during sleep. Avoidance of late-night screen time is another key component of optimal light management. Darkness is a prompt for the pineal gland to produce melatonin. There are limited data to support taking a melatonin supplement to get to sleep; more evidence exists for its help reducing jet lag. No supplements or medications have been shown to be effective and safe for chronic use, and particularly none have been demonstrated to promote metrics of high-quality sleep, such as the most restful, non–rapid eye movement kind. Sleep metrics can be accurately monitored with wearable sensors such as the Oura ring, which has been assessed in multiple small, randomized trials and summarized by my team at Scripps Research. Even though such data correlates with formal sleep lab studies, it remains unproven that daily monitoring will durably improve sleep health. But sensors may be useful for a person to understand the specific factors that influence their sleep, like seeing the reduction of alcohol intake or late-night screen time having a positive impact.