Review article
Sleep and Mental Health
Domagoj Vidović
Petrana Brečić
Marko Ćurković
Senka Repovečki
Abstract
Sleep disorders and psychiatric disorders are highly prevalent in clinical practice, and an increasing body of evidence suggests a complex bidirectional relationship between the two. The aim of this review is to synthesize current knowledge on the neurobiological mechanisms linking insomnia, as well as sleep disorders more broadly with mental health, with particular emphasis on models of hyperarousal, reward processing, and uncertainty, as well as the clinical implications of these findings. This literature review was based on two key studies: (1) a review by Hyndych et al., which examines the bidirectional relationship between sleep and psychiatric disorders, and (2) a review by Van Someren, which provides novel neurobiological perspectives on the causes and consequences of insomnia. Sleep disorders share neurobiological substrates with a broad range of psychiatric conditions, including major depressive disorder, anxiety disorders, bipolar disorder, and psychotic disorders. Van Someren proposes a three-component model of insomnia based on hyperarousal, disrupted reward processing (the “misery model”), and feelings of uncertainty (the “uncertainty model”). The neurobiological basis of these interactions includes dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, altered noradrenergic and serotonergic neurotransmission, changes in GABAergic and glutamatergic circuits, and dysregulation of the circadian system. Understanding the neurobiological mechanisms underlying the bidirectional relationship between sleep and mental health opens new therapeutic perspectives. The treatment of sleep disorders may have a protective role in the prevention or mitigation of psychiatric disorders, while personalized approaches integrating cognitive behavioral therapy for insomnia (CBT-I) and pharmacological interventions represent important priorities for future research.
Keywords
insomnia, sleep, mental health, hyperarousal, neurobiology, bidirectionality, psychiatric disorders
Hrčak ID:
349493
URI
Publication date:
10.7.2026.
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