Nancy Mitchell, APRN

Did you know that sleep comprises one-third of our life? If something takes up a third of our life, don’t you think it’s a pretty darn important aspect of our being?

When is the last time someone asked you about your sleep or encouraged you to talk about it?

At Cardinal Counseling, our medication provider, Nancy Mitchell, APRN, wants to actively listen to your sleep problems and help you develop an individualized treatment plan to address these problems.

There are three pillars that are a fundamental part of our overall health and wellbeing: nutrition, physical activity, and sleep. Sadly, the overall state of sleep in the US is pretty dismal. In 2020, 14.5% of adults reported difficulty falling asleep, and in a 2022 Gallup survey, 33% of adults reported their sleep was “fair” or “poor.” Sleep disorders affect members of every race, ethnicity, socioeconomic status, age, and sex.

Which came first—the sleep problems or the mental health issue? Unfortunately, our crystal ball isn’t functioning these days, so we don’t have an answer for that question. We do know that sleep dysfunction, including insomnia, can be a symptom of various mental health issues such as depression and anxiety. Conversely, sleep problems can increase the risk for developing and worsening of mental health issues such as depression, anxiety, and suicidal ideation. Research indicates that sleep is critical not only to our mental health but also our physical health.

Lack of sleep in adults affects vigilance, reaction times, learning ability, concentration, mood, hand-eye coordination, and short-term memory accuracy. Poor or insufficient sleep has been found to decrease positive emotions and increase negative emotional responses to stressors. Sleep, and sleep dysfunction, is tied to a number of mental health disorders, as well as neurodevelopmental disorders, such as: Depression, Anxiety, Seasonal Affective Disorder, Borderline Personality Disorder, Bipolar Disorder, Schizophrenia, Attention-Deficit/Hyperactivity Disorder, and Autism Spectrum Disorder.

Excessive daytime sleepiness has been identified as a leading cause of automobile wrecks, on-the-job accidents, unintentionally falling asleep, decreased work productivity, and decreased academic performance. Long-term sleep problems have also been linked to a higher risk for developing high blood pressure, heart disease, weight gain, obesity, cancer, and diabetes. Sleep problems in children and adolescents may affect development and school performance. As we get older, untreated sleep problems can lead to an increased risk for falls, cognitive impairments, memory loss, and mortality.

Although there is a high prevalence of sleep disorders, most go undiagnosed and untreated. More than 60% of adults have never been asked about the quality of their sleep, and fewer than 20% of adults have initiated a discussion about their sleep. Sleep is affected by your thoughts, emotions, and behaviors, and it affects all aspects of your health—both physical and emotional. That’s why sleep problems and solutions must be looked at in the context of YOU!

We at Cardinal Counseling recognize that sleep has a lot to do with it! Our medication provider is going to ask a lot of questions about your sleep, as well as ask screening questions for obstructive sleep apnea. The medication provider is glad to collaborate with your PCP and urge a referral for a sleep study, if necessary.

Keep following our blogs, as our current medication provider, Nancy, will soon share tips for practicing good sleep hygiene, as well as appropriate treatment options.

American Sleep Apnea Association at

Excessive Sleepiness: What it is, its causes and consequences, and how it’s diagnosed and treated. Pacheco, D and Rehman, A. Sleep Foundation at August 2023.
How Sleep Deprivation Impacts Mental Health. Zakarin, E. Columbia University of Psychiatry at March 2020

Institute of Medicine (US) Committee on Sleep Medicine and Research. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Colten HR, Altevogt BM, editors. Washington (DC): National Academies Press (US); 2006. PMID: 20669438.

Sleep Difficulties in Adults: United States, 2020. Adjaye-Gbewonyo, D, Ng, A., Black, L. NCHS Data Brief No. 436, June 2020.