Sleep Anxiety: Causes, Symptoms and Coping Strategies
Sleep anxiety is a feeling of worry or stress about one's ability to fall asleep. The anxiety about sleep duration and quality itself can affect the quantity and quality of sleep, thus forming a seemingly endless cycle of worry and sleep problems.
Fortunately, there are ways to deal with sleep anxiety. The methods used to calm anxiety and get the needed sleep may depend on the causes of sleep anxiety. Lifestyle changes, therapy and medication may be helpful. The first thing to do is to recognize that you have sleep anxiety and figure out why you have it.
1. Signs of Sleep Anxiety
It is normal to feel occasional anxiety or stress at night. But when the worry starts to frequently affect your ability to fall asleep and stay asleep, it may be a sign of sleep anxiety.
The symptoms of sleep anxiety vary from person to person, but generally they are related to concerns about whether one can fall asleep or stay asleep. You may feel this worry when it is close to bedtime or when you are lying in bed trying to fall asleep.
This worry may lead to insomnia, such as being unable to fall asleep, being restless during sleep or waking up earlier than you would like.
With less sleep, you may find that your anxiety - both at night and during the day - becomes more severe. Sleep problems can also exacerbate depression and negative thinking patterns.
2. Causes of Sleep Anxiety
Research has found a connection between sleep anxiety and various diseases. The occurrence of sleep problems and sleep anxiety disorders is closely related to sleep disorders, and they can promote or aggravate each other.
(1) Insomnia
One of the most common disorders associated with sleep anxiety is insomnia. Insomnia is a sleep disorder that makes it difficult for you to fall asleep, stay asleep or get a good quality of sleep. In the short term, insomnia may be caused by changes in schedule or stress from major life events (such as a new job or moving to a new place). In the long term, insomnia may be caused by factors such as medical conditions or medications.
Insomnia can make you worry about your sleep quality. As insomnia persists, your anxiety about sleep may increase.
In addition to insomnia, other sleep disorders can also affect your sleep. Regardless of which disorder causes your sleep deficiency, you may experience an increase in the level of certain stress indicators (such as the hormone cortisol). These increased levels can further lead to difficulties in falling asleep or staying asleep. This means that sleep disorders and sleep anxiety may have a circular relationship, where lack of sleep aggravates anxiety and sleep anxiety prevents you from getting the needed sleep.
(2) Anxiety Disorders
Sleep problems are common among people with certain mental health disorders, such as generalized anxiety disorder, depression or post-traumatic stress disorder (PTSD).
Poor sleep quality can exacerbate the brain's reaction related to anxiety, leading to sleep anxiety.
Some people may be anxious about sleep because they are afraid of the consequences of sleep. People with PTSD who try to suppress traumatic memories during the day may worry that their dreams at night will bring nightmares and flashbacks. People with PTSD may also be in an alert state when sleeping or trying to fall asleep and cannot relax into a deep sleep.
3. Risk Factors for Sleep Anxiety
Anyone can experience sleep anxiety. Besides a history of sleep disorders, anxiety disorders or both, there are other factors that may increase the likelihood of feeling the pressure to get the needed sleep over time.
People with sleep anxiety may anticipate that they will not be able to fall asleep, which leads to more anxiety and sleep deficiency.
The following factors may trigger this cycle:
Daily Stress: Feeling stressed or worried about daily tasks is related to poor sleep quality at night.
Traumatic Events: Long-term or severe stressful life events may lead to an enhanced fight-or-flight response and disrupted sleep patterns.
Lifestyle Habits: Habits or routines that interfere with a good night's sleep can cause changes in hormone levels, resulting in sudden waking up due to anxiety at night.
Age may also be a factor that affects whether one will experience sleep anxiety. Sleep patterns change with age, and older people often find that they wake up more frequently at night or have more difficulty falling asleep. As people age, due to factors such as anxiety, discomfort, pain or the need to use the toilet, the time spent in the deep sleep stage decreases, which may lead to sleep anxiety.
4. When to Contact a Healthcare Provider
It is not uncommon to experience a night of poor sleep quality with anxiety occasionally - or even experience it frequently in a short period of time when under stress.
But if you find that you have sleep anxiety symptoms that last for a month or longer, it may be a chronic (long-term) problem and requires medical attention.
Generally speaking, it is best to consult a healthcare provider if:
You have sleep problems.
You often feel tired during the day.
You find it difficult to complete daily activities due to lack of sleep.
5. Diagnosis of Sleep Anxiety
Sleep anxiety disorder is not a formal disease. Instead, healthcare providers can diagnose anxiety disorders, sleep disorders or both by looking at your medical history, conducting a physical examination and asking about your sleep patterns and anxiety-related symptoms.
Since some medications and supplements may aggravate sleep problems and anxiety symptoms, you should also answer questions about any medications you are currently taking. This helps to rule out certain causes.
A sleep study, namely polysomnography, can also be arranged. This test monitors brain waves, eye movements, blood pressure, breathing rate and heart rate data during a whole night's sleep. A sleep study cannot confirm whether you have sleep anxiety. Instead, it can help diagnose obstructive sleep apnea or movement disorders, both of which can affect sleep quality and may lead to sleep anxiety. Diagnosing the underlying diseases of sleep anxiety can help solve sleep quality problems and hopefully solve sleep anxiety problems.
6. Overcoming Sleep Anxiety
Regardless of what causes sleep anxiety, experts usually recommend developing regular sleep and lifestyle habits to deal with it. These habits include:
Establishing a healthy sleep schedule.
Exercising regularly.
Keeping the sleeping area dark, cool, quiet and comfortable.
Trying relaxation techniques such as reading, meditation and staying away from screens before bedtime.
Avoiding caffeine, alcohol and large meals before bedtime.
Writing down your worries before bedtime.
In addition to improving sleep and lifestyle habits, treatment may also include therapy, medication or a combination of both. The causes and severity of sleep anxiety can determine your treatment plan.
Cognitive Behavioral Therapy (CBT) is a therapy that helps reduce sleep anxiety. It involves having sessions with a mental health service provider to identify and change the behavior and thinking patterns that trigger sleep anxiety.
Through CBT, behavior changes may include going to bed and getting up at the same time every day, getting up when anxiety prevents you from falling asleep, and only staying in bed when sleeping (or having sex). CBT can also help you view sleep from a different perspective. You may be encouraged to address issues such as unrealistic expectations about sleep time and false beliefs about how insomnia will affect you.
Medications (both over-the-counter and prescription) may also help relieve sleep anxiety. Some over-the-counter medications contain antihistamines, which are not recommended for long-term use as their efficacy decreases over time. Some prescription medications may be habit-forming, so you and your healthcare provider need to closely monitor the effects of the medications during the treatment process.
You can also consult your healthcare provider about melatonin supplements. Although they have been found to be an effective sleep aid for some people, more research is needed on their long-term safety.
In conclusion, sleep anxiety is a feeling of worry about sleep time or sleep quality. You may worry about your ability to fall asleep and stay asleep, as well as the quality of your sleep. Anxiety about sleep usually worsens the sleep experience, forming a vicious cycle of anxiety and insomnia, and insomnia and anxiety. If you already have a sleep disorder (such as insomnia) or a mental health problem (such as generalized anxiety disorder), you may be more likely to experience sleep anxiety. If you think that your sleep or waking time is negatively affected by sleep anxiety, consider talking to a healthcare provider. They may recommend sleep hygiene habits, lifestyle changes, therapy or medications to help you cope.
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