On March 27, 2025, Faith Best, LCSW, Director of Clinical Services at NeuroFlow, led an energizing 15-minute webinar, Invest in Rest, exploring the critical role sleep plays in overall wellbeing. This dynamic session offered practical insights to help participants recognize the signs of poor sleep and discover simple, effective strategies to improve bedtime routines.

Whether you joined us live or are catching up now, this recap highlights key takeaways from the session, empowering you to prioritize sleep to improve your daily life and long-term health. Let’s get started!

What is the connection between sleep and mental and physical health?

The importance of sleep cannot be overstated. Approximately one-third of Americans are chronically sleep-deprived, a number that continues to rise as screen time, working hours and stress levels increase. As a result, both the duration and quality of sleep are declining, impacting physical and mental health in expected and unexpected ways.

During sleep, the body undergoes essential maintenance processes that cannot occur while awake. This includes memory consolidation, cognitive processing, immune system strengthening and hormone regulation, including stress hormones.

Chronic sleep deprivation has been linked to health conditions such as heart disease, high blood pressure and stroke. It can impair brain function, decision-making and reaction time. The fogginess and fatigue from inadequate sleep are well known, and poor sleep has also been shown to increase anxiety and depressive symptoms. This can create a vicious cycle where heightened stress and low mood further disrupt sleep, worsening overall mental health.

A recent study by NeuroFlow found that deteriorating sleep was even associated with an increased risk of suicidal ideation. Sleep deprivation can feel torturous, and its effects on the body and mind are profound. Prioritizing sleep is essential for overall wellbeing.

What are some ways to improve sleep quality if getting more hours of sleep isn’t an option?

When it’s time to sleep, the mind can start racing, or restlessness can make it difficult to relax and take advantage of the time available. Here are two techniques—one focused on the mind and one on the body—that can help improve relaxation and sleep.

The first technique is called “worry time.” It’s common for anxious thoughts to surface at bedtime, even if they do not appear throughout the day. A proven method to reduce nighttime worry is to schedule a specific time to focus on those thoughts during the day. Choosing a consistent time, such as during a commute or another daily routine, can help. Setting a reminder can also reinforce this habit. During that scheduled time, allow worries to come, acknowledge them, and reflect on them. Then, if those thoughts arise at night, it becomes easier to remind the mind that time has already been set aside for them, reducing their intrusion at bedtime.

The second technique is progressive muscle relaxation, which helps the body release tension before sleep. Even when lying down, muscles may remain tense due to stress, pain or habitual posture. This method involves consciously relaxing different muscle groups one at a time. Starting from the toes and moving upward, tense each muscle group for a few seconds while inhaling, then release the tension while exhaling. Continuing this process through the entire body can significantly improve relaxation. For those new to the technique, guided videos can be found online to walk through the process. This practice not only helps relax the body but also serves as a mindfulness technique, increasing awareness of physical sensations and creating a sense of calm that prepares the body and mind for restful sleep.

How can I calm down for bed, so I wake up rested?

Many adults expect to easily fall asleep after a long day of working, parenting, watching TV or scrolling through social media. However, just like children benefit from a bedtime routine, adults also need a way to transition into restful sleep.

Consistency is one of the most important factors in quality sleep. While it’s widely known that seven to nine hours of sleep per night is recommended, the consistency and quality of that sleep are just as crucial. A regular bedtime and wake-up time help the body establish a rhythm, allowing it to function optimally.

Building a bedtime routine that promotes relaxation is key. Just as children wind down with a bath or bedtime story, adults can incorporate activities that calm the mind and body. This could include progressive muscle relaxation, stretching or other relaxation methods that work best for individual needs.

For those who experience discomfort, such as back or hip pain, incorporating a short stretching routine before bed can be beneficial. A simple 10-minute stretch can not only relieve physical tension but also help signal to the mind that it’s time to unwind. When a routine becomes a habit, the body begins to recognize the cues and prepares for sleep more effectively.

Preparing the mind for sleep is just as important as preparing the body. Activities like journaling, meditation or scheduling time to process thoughts can help clear the mind before bed. Writing down worries or reflections can create a sense of closure for the day, making it easier to relax.

Keeping routines as simple as possible increases the likelihood of sticking to them. Mobile applications can be valuable tools for guiding activities like stretching or relaxation, eliminating the burden of planning your next steps. The NeuroFlow app is particularly effective, offering guided videos for yoga, meditation and breathing exercises to support relaxation. For those seeking structured sleep improvement techniques, digital cognitive behavioral therapy programs like Magellan Healthcare’s Restore provides step-by-step guidance, including proven techniques and exercises designed to improve sleep quality. Finding the right tools to simplify and support a sleep routine can make all the difference in achieving restful, restorative sleep.

How does technology like screen time impact our ability to get quality rest and what can we do to minimize its quality?

Many apps and videos are designed to be engaging and stimulating, encouraging continued use rather than promoting relaxation. This can make it more difficult to fall asleep. The most effective approach is to avoid screens for about 30 to 60 minutes before bed. Utilizing phone settings to limit notifications or restrict access to certain apps can help minimize distractions and reduce the temptation to use screens at bedtime.

The connection between sleep and both mental and physical health is undeniable. Quality sleep is essential for the body to perform vital maintenance processes, from cognitive functioning to immune support and stress regulation. Chronic sleep deprivation can lead to a range of serious health issues, both physically and mentally, including heart disease, impaired brain function and mood disorders like anxiety and depression. While factors such as stress and screen time may disrupt sleep, there are strategies to improve both the quantity and quality of rest. Techniques like “worry time” and progressive muscle relaxation, along with consistent bedtime routines, can significantly enhance relaxation and readiness for sleep. Reducing screen time before bed further supports this process. Prioritizing and improving sleep habits is an investment in overall wellbeing, making it essential to incorporate restful practices into daily life for better health outcomes.

If you missed the Magellan Minute, listen to the recording here.

Source: CDC

Obstructive sleep apnea (OSA) has been linked to an increased risk of physical health problems, including high blood pressure, heart disease, stroke, and diabetes. But how does OSA affect your ability to think clearly, learn and remember, and your emotional psychological, and social wellbeing?

If you have ever worked a 24-hour shift or experienced back-to-back days of poor sleep, it probably comes as no surprise to hear that OSA has been linked to cognitive and mental health issues. OSA causes frequent breathing interruptions, or apneas, while you sleep—as many as 30 per hour. OSA is associated with:

1. Trouble concentrating—OSA can lead to significant changes in two important brain chemicals, gamma-aminobutyric acid (known as GABA) and glutamate. Together, these two chemicals help maintain balance. People with OSA may have decreased levels of GABA and elevated levels of glutamate. GABA is a chemical messenger that acts as an inhibitor in the brain. It slows things down and helps you remain calm. Glutamate, on the other hand, speeds things up. When your glutamate levels are high, your brain is working in a state of stress and does not function as effectively.[1] Glutamate in high amounts has also been shown to contribute to brain damage.
2. Memory problems—Throughout the night your body fluctuates through different sleep stages, allowing your brain to process and sort out all the information it has gathered throughout the day. OSA stops the flow of oxygen to your brain or completely cuts it off multiple times during the night, robbing your ability to reach deep and restorative sleep These frequent disruptions can contribute to memory loss and have a negative impact on overall brain performance.[2]
3. Poor decision-making—Sleep is essential in maintaining brain health and contributes to your ability to learn and recall information. A lack of sleep caused by OSA can cause frequent problems with attention and concentration. If you suffer from OSA, you may have trouble focusing at work or school, being creative, solving problems, and making decisions.[3]
4. Depression and stress—OSA can cause hundreds of interruptions in your breathing during the night, which can set off a constant fight-or-flight response. You may wake up suddenly with your heart racing, sweating, and a feeling of doom. This can carry over into the daytime, causing you to feel run-down and sleepy and your body to be without the energy it needs to protect you against depression and stress.[4]

The good news about obstructive sleep apnea’s impacts on cognitive and mental health

While OSA can negatively impact your day-to-day life, there is hope. The harmful cognitive and mental health effects of OSA can be reversed with treatment. For some, this may mean lifestyle changes. For others, it may mean continuous positive airway pressure, or CPAP—a machine that helps you sleep easier.

Want to learn more about obstructive sleep apnea?

Find the recording of our webinar, “Obstructive sleep apnea: Impacts, diagnosis and treatment,” to hear board-certified somnologist and neurologist, Dr. Karen Jablonski, physician clinical reviewer, Magellan Healthcare, and I discuss the mental and physical health impacts of OSA, and OSA diagnosis and treatment here.

[1] https://newsroom.ucla.edu/releases/sleep-apnea-takes-a-toll-on-brain-function#:~:text=They%20found%20that%20people%20with,calm%20%E2%80%94%20like%20a%20brake%20pedal.

[2] https://goodsomnia.com/blog/snoring-sleep-apnea/can-sleep-apnea-cause-memory-problems/

[3] https://www.sleephealthsolutionsohio.com/blog/sleep-apnea-and-brain-health/

[4] https://www.everydayhealth.com/sleep/sleep-apnea-link-depression-anxiety/

Trouble sleeping? You are not alone. Sleep problems and insomnia affect nearly 40 percent of Americans each year. Not only is insomnia very common, it is also associated with increased risk of stroke,^[1] diabetes,^[2] obesity,^[3] alcohol misuse,^[4] depression^[5] and anxiety.^[6]  When individuals have insomnia and another one of these conditions, it can be particularly problematic. Cognitive behavioral therapy (CBT) is widely recognized as the gold standard for long-term management of insomnia.^{[7],[8],[9],[10]} However, CBT can be difficult to access and is relatively inaccessible for individuals with limited economic security.

Through increasing access to quality, well-studied CBT programs, Magellan seeks to reduce the overall cost-of-care and improve individual health outcomes. Team members at Magellan recently collaborated with academic researchers on a project to make Magellan’s computerized CBT programs, referred to as Cobalt, accessible to patients with insomnia in a community health setting. Participants included individuals who lived in shelters and community homes, as well as individuals with serious mental illness.

Participants received access to RESTORE^TM, one of several data-driven programs in the Cobalt suite, which has been shown to be effective in randomized controlled trials. RESTORE^TM has also won praise from the American Academy of Sleep Medicine ^[11] and received the highest rating from the Substance Abuse and Mental Health Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices. The research findings, published in the Journal of Clinical Sleep Medicine, demonstrated significant improvements in sleep quality. This suggests that implementing RESTORE^TM in a community mental health center setting may make accessing effective tools for improving sleep a straightforward process.[12]

Magellan continues to lead in the healthcare field through collaborations like this one, where academic partners are collecting real-world data that demonstrate how its industry leading Cobalt programs can help increase access, lower costs, and improve individual health outcomes. We are excited by the power of technology to improve care and access to care for individuals regardless of their economic status, as we work to lead humanity to healthy, vibrant lives.

[1] Elwood, P., Hack, M., Pickering, J., Hughes, J., & Gallacher, J. (2006). Sleep disturbance, stroke, and heart disease events: evidence from Caerphilly cohort. Journal of Epidemiology Community Health 0:69-73.

[2] Cappuccio, F., D’Elia L., Strazzullo P., & Miller, M.A. (2010). Quantity and quality of sleep and incidence of type 2 diabetes. Diabetes Care; 33:414-20.

[3] Gangwisch, J., Malaspina, D., Boden-Albala, B., & Heymsfield, S.B. (2005). Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep; 28:1289-96.

[4] Crum, R.M., Storr, C.L., Chan, Y-F., Ford, D.E. (2004). Sleep disturbance and risk for alcohol-related problems. American Journal of Psychiatry;61:1197-203.

[5] Riemann, D., Voderholzer, U. (2003). Primary insomnia: a risk factor to develop depression? Journal of Affect Disorder; 76:255-9.

[6] Breslau, N., Roth, T., Rosenthal, L., Andreski, P. (1996). Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults.  Biological Psychiatry;39:411-8.

[7] Schatzberg, A. F., & Nemeroff, C. B. (2009). The American Psychiatric Publishing textbook of psychopharmacology. Washington, D.C: American Psychiatric Pub.

[8] American Psychological Association. (2004). Getting a Good Night’s Sleep with the Help of Psychology.

[9] American Academy of Sleep Medicine (2013). Evaluation and Management of Chronic Insomnia in Adults.

[10] Agency for Healthcare Research and Quality. (2013). Clinical practice guidelines for the management of patients with insomnia in primary care.

[11] American Academy of Sleep Medicine. (2009). Online Cognitive Behavioral Therapy is Effective in Treating Chronic Insomnia.

[12] Feuerstein, S.D., Hodges, S. Keenaghan, B.C., Bessette, A., Forselius, E., & Morgan, P.T. (2016). Computerized Cognitive Behavioral Therapy for Insomnia in a Community Health Setting. Journal of Clinical Sleep Medicine.