Depression, Anxiety, and Insomnia: How They Are Connected

What Fuels Insomnia?

Insomnia rarely has a single cause. Experts use the “3P model” to explain why it happens and why it sticks around. 

Here’s a breakdown:

Predisposing factors

These are things that make your teen more vulnerable to insomnia, such as:

• A personal or family history of depression or anxiety  
• Childhood trauma 
• A tendency to overthink or ruminate 
• Existing sleep disorders (like sleep apnea or restless legs syndrome)

Precipitating factors

These are events that trigger sleep trouble, including:

• Major life stress  (a breakup, grief, moving)
• Relationship or parenting conflict
• Medical issues that cause pain or discomfort

Perpetuating factors

Even after the stressor fades, certain habits and thought patterns can keep insomnia going, like:

• Spending too much time in bed awake
• Worrying about stress or your ability to sleep
• Shifting your sleep schedule on weekends 

Eventually, your teen's brain starts to link their bed with wakefulness, frustration, or stress — not sleeping. 

How Do You Treat Insomnia?

Sleep isn’t just a side effect of mental health. It’s a core part of it.

When you treat insomnia and depression or anxiety together, you’re more likely to see lasting improvements. Studies show that targeting sleep can improve mood, even without changing anything else in your teen's mental health care. 

That’s why many providers recommend treating both at the same time.

What is cognitive behavioral therapy for insomnia (CBT-I)?

CBT-I is a structured, evidence-based treatment designed to help you retrain your mind and body for better sleep. It’s one of the most effective ways to treat chronic insomnia. A doctor, nurse, or therapist helps you change behaviors and beliefs that interfere with sleep. 

CBT-I is a short-term (usually six to eight weeks) skill-based treatment. 

Here’s how it works:

Stimulus control. The goal is to rebuild a healthy connection between your bed and sleep.

• Use your bed only for sleep.
• Don’t read, watch TV, or scroll through your phone in bed.
• If your teen can’t sleep after about 20 minutes, suggest they get out of bed and do something quiet in another room until they feel sleepy again.

Sleep restriction. Also called sleep compression, this technique helps consolidate sleep.

• Your teen temporarily reduces the amount of time they spend in bed to match how much they want to sleep.
• Over time, this increases sleep efficiency —so your teen spends less time awake and more time in restorative sleep.

Cognitive restructuring. Many people with insomnia develop unhelpful thoughts about sleep such as:

• I need a full eight hours or my day is ruined.
• If I wake up during the night, something must be wrong.
• I can’t function if I only sleep five hours. 

CBT-I helps replace these beliefs with more accurate and less anxiety-provoking ones. The goal is to get away from “trying really hard to go to sleep” to “letting sleep come naturally.” 

Sleep hygiene. Help your teen learn good sleep habits. This includes the basics like:

• Limit caffeine after mid-afternoon.
• Avoid alcohol or nicotine close to bedtime.
• Create a cool, dark sleep environment.
• Wake up around the same time every day — even on weekends.
• Get regular exercise, but do it five to six hours before bed.

Are Your Sleep Beliefs Making Things Worse? 

Many people with insomnia put too much pressure on themselves to sleep perfectly. But sleep is flexible, and your teen's body can handle less-than-ideal nights. 

It’s normal to: 

• Wake briefly during the night
• Feel groggy when you first wake up (called sleep inertia)
• Sleep fewer than seven to nine hours every now and then

Assure your teen it's not about flawless sleep, as that expectation can backfire. When they worry about how long they've been awake or how tired they'll be tomorrow, it only makes it harder to rest. 

Managing Mental Health for Better Sleep

No sleep strategy will fully work if your teen's ongoing anxiety or depression is left untreated. Here’s how to support your teen's sleep and mental health:

Talk to a mental health professional

You don’t have to wait until things get unbearable for your teen. A therapist can help them:

• Identify thought patterns that fuel worry
• Learn tools to handle overwhelming feelings
• Explore any trauma that may be affecting their sleep

Get the right diagnosis 

It’s important to rule out medical conditions or medications that could be affecting your teen's sleep. Some antidepressants, for example, may worsen their insomnia or cause restlessness at night.

Talk to their doctor if:

• Their sleep changes after starting a new treatment.
• They wake up often with their heart racing.
• Their legs feel twitchy or uncomfortable at night.
• They snore or gasp in their sleep.

These could be medication side effects or signs of panic attacks, restless legs syndrome, or sleep apnea.

Help your teen build a stress toolkit 

What About Sleep Medications for Insomnia?

Sleep aids like trazodone or zolpidem (Ambien) can be helpful short-term, especially when CBT-I isn’t an option or doesn’t provide full relief.

But medications don’t retrain sleep patterns the way lifestyle changes or CBT-I does. And they’re not meant to be a long-term solution for chronic insomnia.

When sleep disruption puts your teen's health at risk — such as in seizure disorders or when they're recovering from an illness or injury — their doctor may suggest medication as part of a broader plan. Some people may also benefit from targeted use of sleep aids.

Always talk to your teen's doctor about medications that may interfere with their sleep. Some antidepressants can worsen insomnia or trigger restlessness at night.   

Takeaways

Depression, anxiety, and insomnia are closely linked. Your teen's mood and sleep problems often reinforce each other. 

Insomnia isn’t just a side effect of mental health issues, it’s a condition that deserves its own treatment. CBT-I is the gold standard therapy for chronic insomnia and works well alongside mental health care.

Ask your teen's doctor how they might get a better night’s rest. They may suggest stress management techniques, medication, or healthy sleep habits. Free self-guided apps like CBT-I Coach can offer support.

If your teen is stuck in the cycle of poor sleep and worsening mood, they're not alone. Getting support for both sleep and mental health can help.

Depression, Anxiety, and Insomnia FAQs 

• How do I know if my teen is getting enough sleep?

If your teen feels alert, focused, and emotionally stable during the day, they're likely sleeping enough. But sleep varies naturally, so don’t stress if they don’t get the same amount every night. 

• Is it normal to wake up in the middle of the night?

Yes. Most people wake briefly during the night. What matters is whether your teen can fall back asleep within 15-20 minutes.

• Will napping during the day make it hard to sleep?

If your teen has chronic insomnia, naps usually aren’t recommended. They can reduce their sleep drive and make it harder to fall asleep at night. If they do nap, keep it short (15-30 minutes) and early in the day.

• What is social jet lag?

This happens when your teen's weekday and weekend sleep schedules differ. They may try to wake up around the same time every day (within an hour) to avoid disrupting their body clock (called circadian rhythm).

• Can anxiety alone cause insomnia?

Yes. People with anxiety disorders often have insomnia. Your teen's anxiety may also get worse if they don’t get enough sleep. 

• Can depression cause insomnia?

Trouble sleeping is one of the most common symptoms of depression, but the two likely affect each other. Almost everyone with depression has some kind of sleep problem, but having insomnia alone also raises your teen's odds of depression.