What Is Sleep Anxiety, And How Can Sleep Patterns Affect Mental Health?
Quality sleep is an essential element of physical, mental, and emotional well-being. However, both anxiety and sleep disorders can significantly impact an individual’s nightly rest, causing interrupted or restless sleep. Sleep anxiety—when an individual is persistently worried about their ability to fall or stay asleep—can lead to chronic sleep deprivation, which may exacerbate or cause additional health challenges. Read on to learn more about what sleep anxiety is and how you may be able to address it.
What is sleep anxiety? Causes and symptoms
Anticipatory anxiety related to sleep can have different levels of intensity. If it’s persistent and interferes with life and health, it could be a sign of a diagnosable disorder, like generalized anxiety disorder, panic disorder, or somniphobia (the fear of sleep).
Sleep anxiety may be caused by a diagnosable anxiety disorder, and having a sleep disorder could also contribute to symptoms. Other elements, such as lifestyle habits, stress, and trauma, might also contribute to the development of sleep anxiety in some cases.
Symptoms of sleep anxiety can be psychological or physiological, and they can affect a person before bed or during the day—particularly when thinking about sleep. Some of the most common include:
- Feeling overwhelmed
- Irritability
- Restlessness
- A sense of impending doom
- Nervousness
- Inability to concentrate
- Tense muscles
- Trembling or shaking
- Sweating
- Increased heart rate
- Digestive issues
- Rapid breathing or hyperventilation
- Panic attacks
How sleep disorders can disrupt restful sleep
Some people with sleep anxiety already have a sleep disorder. This condition may be the source of their sleep anxiety or may exacerbate it. Some of the most common sleep disorders are:
- Insomnia, which is when a person has trouble falling and staying asleep
- Sleep apnea, which is related to breathing disruptions during sleep and has three main types: obstructive sleep apnea, central sleep apnea, and complex sleep apnea
- Restless legs syndrome (RLS), which is an intense and uncontrollable urge to move the limbs—particularly at night
Untreated sleep disorders can increase the risk factors for certain health concerns in the long term, such as cardiovascular diseases, cognitive decline, and mood disorders. Worrying about these potential effects may exacerbate sleep anxiety too.
How an anxiety disorder can affect sleep patterns
Worrying about sleep can make it harder to sleep, as it can be difficult to rest when the mind is in a worry loop. Constant rumination often leads to delayed sleep onset and fragmented sleep cycles. Plus, anxiety can cause physical effects like muscle tension and shallow breathing, which can make it harder to relax and rest.
Research suggests that individuals with anxiety disorders may also have dysregulated stress hormones that block the effective production of neurotransmitters like serotonin and gamma-aminobutyric acid (GABA). This effect may contribute to the development of sleep disorders in some cases. The body’s circadian rhythm, also known as the internal clock, can be hindered by anxiety too.
According to the Anxiety and Depression Association of America, anxiety disorders may cause sleep issues and vice versa. Long-term sleep deprivation may also increase anxiety symptoms, leading to a cycle of poor sleep and anxiety and affecting physical and mental health.
What is sleep anxiety’s link to mental health?
Sleep anxiety can make it hard for a person to get enough rest on a regular basis. Consistently poor sleep can lead to worsening anxiety that further disrupts sleep. Over time, sleep deprivation can also have a significant effect on an individual’s ability to regulate their mood and manage stress, potentially impairing cognitive function and emotional stability and putting a person at higher risk of developing other mental health conditions.
How are anxiety disorders and sleep anxiety diagnosed?
In some cases, sleep anxiety is diagnosed following a physical exam during which a healthcare provider reviews an individual’s medical history and asks about symptoms and how they affect daily life. Some providers will also recommend a sleep study to discover whether a sleep disorder might be at play.
Anxiety disorders can often be diagnosed in a similar way. Following a physical exam in which the provider asks about symptoms, they may recommend a blood test to rule out other potential causes of the concerns. If a medical doctor does not find a physical health concern that may be to blame, they will usually perform or recommend a psychological evaluation.
Panic attacks at night: panic disorder and sleep quality
As the name suggests, nocturnal panic attacks only happen at night, and they may awaken a person from sleep due to an overactive stress response. The symptoms of this kind of panic attack are similar to those of a typical panic attack. They may include a racing heartbeat, shortness of breath, and an overwhelming sense of fear.
Nocturnal panic attacks may cause significant sleep disturbances and lead to the development of other sleep disorders. Fear of having another panic attack may also cause anxiety that further disrupts sleep. Managing nocturnal panic attacks with stress reduction and relaxation techniques may help reduce their occurrence. Receiving treatment from a mental health professional is also typically recommended for signs of panic disorder.
Relaxation techniques for anxiety disorder symptoms like panic attacks
Symptoms of a diagnosable condition like an anxiety disorder will typically not resolve without professional treatment. In addition to seeking care, the following approaches may prove helpful in managing sleep-related anxiety symptoms:
- Deep breathing and progressive muscle relaxation exercises can help release physical tension from the body and encourage restfulness.
- A gentle yoga routine or stretching session before bed can help bring a person out of their head and into their body, priming them for better sleep.
- Guided meditations, mindfulness practices, and grounding techniques can help calm the mind before bed.
- Aromatherapy and white noise can contribute to a soothing sleep environment that promotes better sleep health.
Tips for managing a sleep-related anxiety disorder
Practicing positive sleep hygiene habits may encourage better quality rest, which could help reduce anxiety in some cases. Here are some examples of good sleep hygiene practices:
- Get regular exercise. Getting active during the day may help you fall asleep more easily at night, as long as you don’t work out too close to bedtime.
- Keep a consistent sleep schedule. Experts recommend going to bed and waking up at the same times each day.
- Create a calming bedtime routine. Engaging in a regular “wind-down” routine before bed can help signal to your body that it’s time to sleep. For example, you might take a warm bath, drink a cup of tea, do some gentle stretching, or read a relaxing book in the hour leading up to bedtime.
- Try relaxation exercises. Deep breathing, visualization, and body scans might help you calm both your body and mind before sleep.
- Optimize your environment. Adjust the temperature, lighting, and noise level in the room for maximum comfort.
The role of exercise in sleep and anxiety disorder management
Physical exercise may be critical in promoting sleep and reducing anxiety. A 2024 study suggests that exercise can enhance blood flow and oxygen delivery, dopaminergic activity, sleep, and pain relief, potentially improving multiple aspects of a person’s life.
However, timing workouts so there is enough time off before sleep can also be crucial, as working out too close to bed can increase heart rate and make relaxation and sleep more difficult. Instead, yoga, progressive muscle relaxation, and deep-breathing exercises can help prime the body for sleep close to bedtime.
How cognitive behavioral therapy can help with both sleep and anxiety
In addition to meeting with your doctor and implementing healthy lifestyle habits, talk therapy can be helpful in managing both sleep disorders like insomnia as well as sleep anxiety and related anxiety disorders. For example, research suggests that cognitive behavioral therapy for insomnia (CBT-I) can be the most effective non-pharmacological intervention for insomnia. Types of talk therapy like CBT and others are also typically the first-line treatment for anxiety.
When to seek professional help for poor sleep and anxiety disorder symptoms
In general, it may be time to seek professional support if your sleep problems or anxiety symptoms are persistent and causing distress and/or interfering with your daily life. For example, if ongoing symptoms of a sleep disorder are causing you to experience daytime sleepiness and trouble functioning, it may be time to meet with a doctor or behavioral sleep medicine specialist. Or, if persistent anxiety is making it hard to sleep at night or function during the day, meeting with a therapist can be advisable. Although sleep problems can sometimes seem overwhelming, help is available.
Exploring online therapy for sleep and anxiety disorders
While people experiencing sleep problems and/or anxiety symptoms can often benefit from talk therapy, it’s not always easy to receive this type of care. Online therapy can be a more convenient alternative to in-person care for those who don’t have many therapists in their area or who don’t have time to commute to and from in-office sessions.
With a platform like BetterHelp, you can get matched with a licensed therapist who has experience in your areas of concern by simply filling out a brief online questionnaire. You can then meet with your provider remotely through video, audio, and/or in-app messaging from home or anywhere you have an internet connection.
The effectiveness of online therapy for sleep quality and mental health
Multiple studies indicate that internet-based cognitive behavioral therapy may be effective in treating certain sleep disorders as well as anxiety symptoms. For example, one study published in 2023 suggests that both in-person and online CBT may lead to reductions in symptoms of anxiety, depression, insomnia, and distress as well as improvements in sleep efficiency and total sleep time. More research may be required to confirm and expand upon these initial findings.
Takeaway
Why am I having sleep anxiety?
Sleep anxiety can occur for many reasons, including mental health disorders, negative thought patterns, traumatic events, health anxiety, sleep issues, difficulty falling asleep, poor sleep quality, and worries about the events of the following day. If you have a job or relationship that causes you extreme stress, you might also have sleep difficulties, as you may be trying to avoid facing the next day. Talking to a therapist or doctor about these challenges may be helpful for getting a restful night's sleep. Practicing good sleep hygiene and relaxation strategies can also help, especially if you experience insomnia alongside your nighttime anxiety.
What does sleep anxiety feel like?
Sleep anxiety can be different for each person and depending on the cause. However, you might experience both emotional and physical symptoms of anxiety, such as racing thoughts, shakiness, restlessness, headaches, stomach problems, extreme fear, a sense of impending doom, negative thoughts, and other challenges. Some people may have panic attacks, too. Anxious sleep can involve nightmares, night terrors, sleepwalking, or frequently waking up in the night, which can lead to not getting enough sleep or having poor quality sleep. Experiencing sleep anxiety may be more common in people with anxiety disorders and other mental disorders.
How do you stop anxiety when trying to sleep?
Practicing anxiety reduction techniques before bed alongside your sleep hygiene routine may help you reduce sleep problems related to anxiety. For example, you could listen to a sleep meditation podcast or video made specifically for people with anxiety. You can also try techniques like deep breathing or sleep differently by changing your schedule and ensuring your sleep environment is comfortable. If your sleep habits tend to be chaotic, look for ways to reduce distractions, sound, and distress at night in your home. You might also consider sleep anxiety treatment with a doctor, such as sleep medications that also reduce anxiety.
The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.
What is the best therapy for sleep anxiety?
Mental health conditions that make sleep anxiety worse are often treated using modalities like cognitive-behavioral therapy (CBT), which is one of the most evidence-based therapeutic modalities for anxiety. With a therapist, you can learn several techniques to reduce anxiety, such as keeping a sleep diary, practicing mindfulness, and looking at the underlying causes of your anxiety. Other modalities may also be helpful, as well as anxiety medication from a licensed medical doctor. Do not start, change, or stop a medication without consulting your doctor.
How do doctors treat sleep anxiety?
Doctors often treat sleep anxiety by pinpointing the cause and then choosing a treatment that is effective for that condition or cause. For example, if an anxiety disorder causes sleep anxiety, they may prescribe an anti-anxiety medication. If sleep anxiety is caused by sleep apnea, they may prescribe a CPAP machine to treat the apnea. Every client is different, so what works for one person might not be effective for another.
How long does sleep anxiety last?
Depending on the cause of sleep anxiety, symptoms may be temporary and only last a few nights. Some people experience sleep anxiety for years without relief. If you experience sleep anxiety every night or frequently, talk to a therapist or doctor about your symptoms and potential treatment options.
How do you break the sleep anxiety cycle?
You may be able to break the sleep-anxiety cycle by addressing the underlying cause and making differences in your nightly schedule. If you have tried several previous techniques, keep trying new options until one seems to work. Give each coping mechanism a few weeks, as getting used to its effects might take time. If you struggle with this process on your own, a therapist or doctor may be helpful.
Why does my body feel so uncomfortable when trying to sleep?
You might be uncomfortable when trying to sleep due to an uncomfortable environment. Ensure your mattress is as comfortable as possible. If you can’t afford a better mattress, you might be able to buy a mattress topper that is more comfortable for your body. You can also control the temperature in your room by getting a fan or air conditioner if you’re too warm or putting more blankets on your bed if you frequently get cold. In addition, avoid using too many pillows or bulky blankets that might make you uncomfortable. You can also improve your environment by focusing on other senses, like scent. Consider having a nice-smelling wax melter or air freshener in your room while you sleep.
How do I know if I have anxiety or am just nervous?
Nervousness and anxiety can be similar sensations in the body. However, nervousness tends to occur for a reason and is temporary. Anxiety can occur without reason and frequently arises throughout one’s day or at night. Anxiety is often a sign of an anxiety disorder, especially if it causes physical symptoms and severe distress.
What is the best medication for anxiety and insomnia?
The best medication for anxiety and insomnia depends on your unique body and necessities. Your doctor can talk to you about options. Don’t start or stop an anxiety medication without speaking to your doctor in depth about your symptoms and the potential causes. Other treatments, such as therapy, may sometimes be recommended in place of or in combination with medication.
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