Staff Perspective: The Nightly Struggle - Untangling Rumination and Sleep
You're in bed. The lights are off, the world outside is quiet, but your mind refuses to wind down. You've done everything you're meant to do, hidden your phone, kept the room cool, perhaps even tried the deep breathing trick, but sleep simply won't come. Instead, your mind insistently keeps cycling through something that is already in the past: an awkward conversation, a missed opportunity, some annoying regret. This is rumination, a repetitive thinking pattern defined by the passive and repeated reliving of past negative events or emotions.
Although repetitive thinking can take many different forms, such as worry (i.e., centered on potential future events), rumination is distinct in its focus on what has already transpired (Watkins, 2008). Chronic rumination can wear down both emotional well-being and cognitive ability. It also amplifies negative moods, so it becomes more difficult to deal with stress or return to a level head. This kind of repeated thinking also displaces more helpful or goal-centered thinking, so it's difficult to focus and make sense. Consequently, rumination has been found to make individuals more vulnerable to developing and maintaining various mental health conditions (e.g., depression, anxiety, substance misuse; Watkins & Roberts, 2020).
It’s no surprise that these cycles of thought actually affect your ability to relax and sleep. Given repetitive thinking has long been a confirmed risk factor for insomnia (Morin, 1993), research has also found associations between rumination and several aspects of sleep, such as staying asleep, waking at night, and the quality of sleep (Clancy et al., 2020). Your mind gets into hyperdrive when you are stuck in the cycle of rumination. Psychologically, rumination keeps racing thoughts going, while physically, it boosts stress hormones such as adrenaline and cortisol, building increased levels of arousal that act against the relaxation required to sleep (Watkins, 2008; Brosschot et al., 2006; Zoccola et al., 2014). The fatigue experienced even after sleep due to rumination (Carney et al., 2010) suggests that the consequences of poor sleep extend beyond mere nighttime effects.
Interestingly, the relationship between rumination and sleep goes both ways. Just as those repetitive, stuck thoughts can keep you awake, not getting enough quality of sleep can actually make you more prone to rumination. Specifically, research has shown that insufficient sleep can reduce activity in the prefrontal cortex: a key area of the brain involved in higher-order thinking and emotion regulation (Alhola & Kantola, 2007). When you’re sleep-deprived, it affects the brain’s ability to manage thoughts and emotions effectively (Gruber & Cassoff, 2014). This can make those negative thoughts feel more persistent and harder to dismiss, creating a negative feedback cycle between poor sleep and rumination.
So why is this connection important? When someone lies awake night after night, it's simple to focus on the sleep issue itself, but perhaps rumination is one of the things that keeps the brain awake long after the body is in sleep mode. But it’s not just a nighttime thing. Rumination can occur during the day, depleting mental resources, accumulating stress, and setting the stage for sleepless nights. Together, research suggests that rumination and sleep are intertwined in a complex way that underscores the need for further investigation. If worries or regrets keep replaying in your mind, exploring strategies to manage these thoughts could be a crucial step in improving sleep. Research has shown promise with treatment approaches that include mindfulness-based and cognitive behavioral interventions for reducing rumination (Querstret & Cropley, 2013). Through these methods, individuals can develop skills to reshape their thought patterns and manage their emotional responses.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Linda Thompson, Ph.D., is a Postdoctoral Fellow with the Center for Deployment Psychology. Dr. Thompson earned her doctorate in Behavioral Science, Psychology from the University of North Texas and a master’s degree in Psychology from San Diego State University.
References
Alhola, P., & Polo-Kantola, P. (2007). Sleep deprivation: Impact on cognitive performance.
Neuropsychiatric disease and treatment, 3(5), 553–567.
Brosschot, J. F. C., Gerin, W., & Thayer, J. F. (2006). The perseverative cognition hypothesis: A review of
worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research,
60(2), 113–124.
Carney, C. E., Harris, A. L., Moss, T. G., & Edinger, J. D. (2010). Distinguishing rumination from worry in
clinical insomnia. Behaviour research and therapy, 48(6), 540-546.
Clancy, F., Prestwich, A., Caperon, L., Tsipa, A., & O’connor, D. B. (2020). The association between worry
and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health
Psychology Review, 14(4), 427-448.
Gruber, R., & Cassoff, J. (2014). The interplay between sleep and emotion regulation: conceptual
framework empirical evidence and future directions. Current psychiatry reports, 16, 1-9.
Morin, C. M. (1993). Insomnia: Psychological assessment and management. Guilford press.
Querstret, D., & Cropley, M. (2013). Assessing treatments used to reduce rumination and/or worry: A
systematic review. Clinical psychology review, 33(8), 996-1009.
Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological bulletin, 134(2),
163.
Watkins, E. R., & Roberts, H. (2020). Reflecting on rumination: Consequences, causes, mechanisms and
treatment of rumination. Behaviour research and therapy, 127, 103573.
Zoccola, P. M., & Dickerson, S. S. (2012). Assessing the relationship between rumination and cortisol: A
review. Journal of psychosomatic research, 73(1), 1-9.
You're in bed. The lights are off, the world outside is quiet, but your mind refuses to wind down. You've done everything you're meant to do, hidden your phone, kept the room cool, perhaps even tried the deep breathing trick, but sleep simply won't come. Instead, your mind insistently keeps cycling through something that is already in the past: an awkward conversation, a missed opportunity, some annoying regret. This is rumination, a repetitive thinking pattern defined by the passive and repeated reliving of past negative events or emotions.
Although repetitive thinking can take many different forms, such as worry (i.e., centered on potential future events), rumination is distinct in its focus on what has already transpired (Watkins, 2008). Chronic rumination can wear down both emotional well-being and cognitive ability. It also amplifies negative moods, so it becomes more difficult to deal with stress or return to a level head. This kind of repeated thinking also displaces more helpful or goal-centered thinking, so it's difficult to focus and make sense. Consequently, rumination has been found to make individuals more vulnerable to developing and maintaining various mental health conditions (e.g., depression, anxiety, substance misuse; Watkins & Roberts, 2020).
It’s no surprise that these cycles of thought actually affect your ability to relax and sleep. Given repetitive thinking has long been a confirmed risk factor for insomnia (Morin, 1993), research has also found associations between rumination and several aspects of sleep, such as staying asleep, waking at night, and the quality of sleep (Clancy et al., 2020). Your mind gets into hyperdrive when you are stuck in the cycle of rumination. Psychologically, rumination keeps racing thoughts going, while physically, it boosts stress hormones such as adrenaline and cortisol, building increased levels of arousal that act against the relaxation required to sleep (Watkins, 2008; Brosschot et al., 2006; Zoccola et al., 2014). The fatigue experienced even after sleep due to rumination (Carney et al., 2010) suggests that the consequences of poor sleep extend beyond mere nighttime effects.
Interestingly, the relationship between rumination and sleep goes both ways. Just as those repetitive, stuck thoughts can keep you awake, not getting enough quality of sleep can actually make you more prone to rumination. Specifically, research has shown that insufficient sleep can reduce activity in the prefrontal cortex: a key area of the brain involved in higher-order thinking and emotion regulation (Alhola & Kantola, 2007). When you’re sleep-deprived, it affects the brain’s ability to manage thoughts and emotions effectively (Gruber & Cassoff, 2014). This can make those negative thoughts feel more persistent and harder to dismiss, creating a negative feedback cycle between poor sleep and rumination.
So why is this connection important? When someone lies awake night after night, it's simple to focus on the sleep issue itself, but perhaps rumination is one of the things that keeps the brain awake long after the body is in sleep mode. But it’s not just a nighttime thing. Rumination can occur during the day, depleting mental resources, accumulating stress, and setting the stage for sleepless nights. Together, research suggests that rumination and sleep are intertwined in a complex way that underscores the need for further investigation. If worries or regrets keep replaying in your mind, exploring strategies to manage these thoughts could be a crucial step in improving sleep. Research has shown promise with treatment approaches that include mindfulness-based and cognitive behavioral interventions for reducing rumination (Querstret & Cropley, 2013). Through these methods, individuals can develop skills to reshape their thought patterns and manage their emotional responses.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Linda Thompson, Ph.D., is a Postdoctoral Fellow with the Center for Deployment Psychology. Dr. Thompson earned her doctorate in Behavioral Science, Psychology from the University of North Texas and a master’s degree in Psychology from San Diego State University.
References
Alhola, P., & Polo-Kantola, P. (2007). Sleep deprivation: Impact on cognitive performance.
Neuropsychiatric disease and treatment, 3(5), 553–567.
Brosschot, J. F. C., Gerin, W., & Thayer, J. F. (2006). The perseverative cognition hypothesis: A review of
worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research,
60(2), 113–124.
Carney, C. E., Harris, A. L., Moss, T. G., & Edinger, J. D. (2010). Distinguishing rumination from worry in
clinical insomnia. Behaviour research and therapy, 48(6), 540-546.
Clancy, F., Prestwich, A., Caperon, L., Tsipa, A., & O’connor, D. B. (2020). The association between worry
and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health
Psychology Review, 14(4), 427-448.
Gruber, R., & Cassoff, J. (2014). The interplay between sleep and emotion regulation: conceptual
framework empirical evidence and future directions. Current psychiatry reports, 16, 1-9.
Morin, C. M. (1993). Insomnia: Psychological assessment and management. Guilford press.
Querstret, D., & Cropley, M. (2013). Assessing treatments used to reduce rumination and/or worry: A
systematic review. Clinical psychology review, 33(8), 996-1009.
Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological bulletin, 134(2),
163.
Watkins, E. R., & Roberts, H. (2020). Reflecting on rumination: Consequences, causes, mechanisms and
treatment of rumination. Behaviour research and therapy, 127, 103573.
Zoccola, P. M., & Dickerson, S. S. (2012). Assessing the relationship between rumination and cortisol: A
review. Journal of psychosomatic research, 73(1), 1-9.