It’s common to toss and turn sometimes as you try to catch sleep, especially when in a new environment. Unfortunately, this is an everyday struggle for some people. According to estimates, over 40 million people¹ in the US suffer from sleep disorders that hinder daily functioning and adversely affect short-term and long-term health.
Anxiety can play a role in causing sleeping problems, and having an anxiety disorder can worsen the situation. But getting adequate sleep is important. Abnormal sleep patterns may affect your emotional, mental and physical functioning.
This article discusses how to get a better night's sleep.
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We all get anxious once in a while over even the smallest of things. Anxiety is a normal human response characterized by worry and fearful feelings in dangerous or unknown situations. Stress and anxiety cause the body to produce hormones that help us react fast and escape harm.
When these hormones reach high levels, particularly before sleep, it becomes difficult for the body to relax. You will find it difficult to fall asleep, and if you manage to sleep, stressful or worrisome thoughts may wake you up during the night.
When this happens over a couple of days, you would, and understandably so, not look forward to nighttime. As a result, you may develop sleep anxiety.
Sleep anxiety is the worry or fear of going to sleep. An individual becomes apprehensive about being unable to stay asleep or even fall asleep. Some people may also fear that something bad may occur to them while asleep and instead choose to stay awake and watchful, rather than sleeping.
Anxiety disorders can also make it more difficult to fall asleep and stay asleep. When someone has trouble sleeping due to their anxiety, they can also develop sleep anxiety. One condition may worsen the other, and it may feel like a continuous cycle.
Sleep anxiety causes behavioral changes such as:
Difficulty concentrating on things other than sleep-related worry
Overwhelmed feeling when thinking about sleep
Sense of impending doom or danger.
Sleep anxiety may also cause physical symptoms such as:
Individuals who are diagnosed with an anxiety disorder often have trouble with their sleep. If a person worries a lot, the anxiety may keep them from falling asleep.
While anxiety makes it difficult to fall asleep, the distress that arises from such a situation complicates matters. It can cause sleep anxiety which strengthens an individual's sense of preoccupation and dread. This anticipatory anxiety when falling asleep interferes with healthy sleeping patterns.
Anxiety may cause you to wake up throughout the night. This anxiety is exacerbated by a racing mind and it becomes difficult to go back to sleep. Consequently, you'll have fragmented sleep that reduces the quality and quantity of your rest.
At the same time, sleeping problems such as sleep deprivation² can provoke symptoms of anxiety or worsen anxiety disorders. Insufficient sleep affects mood and emotional health, which may also aggravate the effects of anxiety disorders. This is seen in obstructive sleep apnea, a sleep disorder that leads to repetitive lapses in breathing and interrupts sleep. Those that have sleep apnea may experience increased rates of mental health problems³ such as anxiety, panic disorder, and depression.
Consider seeing a doctor for diagnosis or treatment of sleep disorder if:
You have experienced difficulties sleeping and this is impacting your daily functioning.
You have tried coping techniques and good sleep habits, but sleep problems persist.
You feel drowsy or doze off during the day, experiencing impaired alertness, concentration, or memory.
There are several ways to help treat sleep troubles. Generally speaking, when you first see your doctor they will determine whether your sleep issues are caused by a medical condition or medication. For example, if you are diagnosed with sleep apnea your doctors may recommend Continuous Positive Airway Pressure (CPAP) breathing devices.
Once you have been assessed and medical causes of sleep troubles have been excluded your doctor will advise you on good sleep hygiene and other non-pharmacological treatments to help.
Cognitive behavioral therapy (CBT) helps manage or eliminate negative actions or thoughts that are causing sleeping problems. It is a popular and effective treatment plan for sleeping disorders.
CBT's cognitive aspect teaches techniques to establish and change beliefs and thoughts that cause sleep troubles. The behavioral aspect teaches practices that enhance positive sleeping patterns and avoid tendencies or behaviors that cause sleep problems.
Periods of sleep restriction
Stimulus control therapy
This training will teach you the relaxation response techniques to deal with anxiety and stress. Relation response refers to a state of rest that a person experiences after practicing regularly.
The techniques include:
Here the strategy focuses on relaxing a particular area of the body at a time.
This is a meditative technique that disengages the mind from stress by taking long, slow, deep breaths.
Yoga involves several movements or poses to distract the mind and body from negativity and stress.
This technique involves sitting comfortably and concentrating on the present time, and not future or past situations.
Guided imagery is a meditative state you obtain by imagining a vivid and soothing experience, place, or scene to enhance relaxation.
Oftentimes, using a combination of treatments is more effective in addressing sleep disorders than a single treatment. Your health care provider can help combine the right healthy habits and psychological treatments to restore a healthy sleep pattern.
There are also some other coping techniques that can help you overcome your sleeping problem and sleep better. These include:
Scripting your worries on paper
You can calm pre-bed anxiety by writing down your worries on paper. It keeps you accountable to yourself, your feelings, purpose, and plan. Do not let your troublesome thoughts swirl in your mind. Pick a notebook and write whatever comes to your mind. Journaling⁴ helps your mind have a game plan for the next day and can help you fall asleep faster.
Avoiding stressful activities before sleep
A smooth transition from daytime to sleep helps reduce anxiety at night. Allow your brain to transition instead of expecting it to go to sleep on demand. You can do that by leaving the office, newsroom, or social media platforms earlier in the day to set a buffer time between work and sleep, thus setting yourself for a better night's sleep.
Avoiding lying in bed awake
Consider a do-over anytime you find yourself lying in bed for over 20 minutes without falling asleep. You can leave the bedroom and perform a sleep-inducing activity such as reading a book. The stimulus control⁵ reduces the time it takes to sleep and gives you a mental reset so you can try to fall asleep again.
Limiting screen time
Electronic gadgets such as phones, tablets, and laptops produce blue light that suppresses⁶ melatonin and makes your brain think the sun is up. Minimize sleep interruptions by trying to avoid screens for 1-2 hours before bedtime.
If you find it difficult to keep the phone away before going to sleep, consider having a blue light filter to reduce the stimulating light.
Maintain a consistent sleeping schedule
A consistent sleep schedule can help improve your sleep. Go to bed at a regular time to prevent fragmented and poor-quality sleep.
If these strategies are not successful your doctor may recommend medications. The medications used in treating sleep troubles include:
Medications that treat an underlying anxiety disorder that may be causing your poor sleep
Prescription sleeping pills - these are often only used for a short period
While you may use other over-the-counter medications, you should be careful as they may cause unwanted side effects. You should consult your doctor before considering any over-the-counter sleeping aid as it could interfere with your treatment plan or cause negative reactions when used together with prescription medications.
To some people, falling asleep comes easily. But others find it a challenge to get adequate sleep and may need medical intervention or lifestyle changes. If you have sleeping problems caused by anxiety, it is important to seek medical help.
Your healthcare provider will discuss solutions and may refer you to a sleep medicine specialist for a complete diagnosis and evaluation. With medical assistance, it is possible to get a better night's sleep.
Blue light has a dark side | Harvard Health Publishing
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