Did you know that nearly all anxiety diagnoses list sleep disturbance or insomnia as potential symptoms? And that those with insomnia are much more likely to experience anxiety? The link between anxiety and insomnia is a cycle, and it’s time to break it.
It’s true. In a study of 10,000 adults, “people with insomnia were 20 times more likely to develop panic disorder,” a type of anxiety disorder, and according to Harvard MD, Lawrence J. Epstein: “Not only does sleep affect mood, but mood and mental states can also affect sleep. Anxiety increases agitation and arousal, which make it hard to sleep.
“Stress also affects sleep by making the body aroused, awake, and alert. People who are under constant stress or who have abnormally exaggerated responses to stress tend to have sleep problems.”
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A sleepless and anxious society
According to a study released by the CDC, one out of every three adults in the United States gets an inadequate amount of sleep.
Lack of sleep is often normalized or even encouraged in our society, but it shouldn’t be. Sleeping too little can lead to a multitude of serious physical consequences such as the increased risk of heart disease and stroke, high blood pressure, and trouble staying focused at work or school.
Lack of sleep can also cause trouble with completing daily tasks like driving, which puts us at a higher likelihood of getting injured – or injuring someone else.
Our culture makes us feel like we need to be working all of the time, even if it means running ourselves dry and putting ourselves at risk for physical and mental health challenges. This is harmful to all of us, but it can be particularly damaging to those who already struggle with mental health, anxiety and insomnia.
Understanding your own anxiety and insomnia cycle
Forty million adults in the United States have an anxiety disorder, and anywhere from fifty to seventy million people have a sleep disorder. These are serious problems, and the research is there to show that anxiety and insomnia are connected.
Insomnia can manifest as trouble falling asleep, but it can also present as trouble staying asleep or getting back to sleep. If you’re diagnosed with an anxiety disorder such as PTSD, Generalized Anxiety Disorder, or Panic Disorder, or if you suspect that you may live with an anxiety disorder, you’ve likely noticed that the condition impacts your sleep.
The good news is that you aren’t permanently stuck in the anxiety insomnia cycle. In honor of World Sleep Day, we’re going to talk about how to break the cyclic nature of sleep and anxiety so that you can maintain a better quality of life.
Start by getting a good view of your situation.
The AADA states that lack of sleep can actually cause anxiety. And we also know that anxiety itself can interfere with sleep. This brings up an important question for those who struggle with both insomnia and anxiety: Which struggle came first?
It’s not exactly fun to think about these things, but pinpointing when your trouble sleeping began can help you figure out how to fix it.
- When did my anxiety start?
- When did my sleep issues start?
- What if I get anxious about sleep?
- What if it’s just always been this way?
When did my anxiety start?
Think back to when your anxiety started. Maybe you’ve had it for your entire life. Or perhaps it started in your teenage years. Did your anxiety come before or after your struggles with sleep?
Many of us experienced anxiety as children, but had no name for the experience. Here are some symptoms of anxiety as often felt by children:
- excessive sweating
- unexplained tiredness
- avoidance of running and playing
- trouble concentrating
- feeling unable to yawn or take a big breath
- intense fear of natural disasters
- muscle clenching
- biting nails or lips, or pulling out hair
- trouble sleeping
When did my sleep issues start?
Once you’re able to gauge roughly when your anxiety began, think of when you first started to struggle with sleep.
If trouble sleeping came first for you, do you have ideas why that is? Was it during a high-stress time in your life, or was it random? Let’s say that you started to struggle with sleep after a traumatic event occurred in your life. You may have started having nightmares or flashbacks or nightmares that prevent you from sleeping.
If that’s the case, you may want to look into Post Traumatic Stress Disorder or PTSD (CPTSD is also a thing). If you need help with PTSD or GAD, that treatment might also be the key to better sleep because it would mean that you’re tackling the root problem underneath your sleep issues. Band-aid treatments like sleep medicine can only go so far if there’s an active cause of your sleep and anxiety issues.
I just get anxious ABOUT sleep!
Let’s think about why anxiety happens in the first place. Anxiety occurs when a threat is perceived. Stress responses are necessary for human survival because they help us in the face of genuine threats.
When it comes to anxiety issues, however, we experience stress responses when they’re not needed or helpful. Depending on how a person’s anxiety manifests, they might throw themselves into work or social activities during the day. The daytime provides us with opportunities to distract us from anxious thoughts.
When we’re in bed, though, those distractions are no longer present. We’re also more prone to think about tomorrow and all its uncertainty, looming on the other side of our dreams. This is why some people are more affected by their anxiety at night.
Others have anxiety that’s triggered specifically by nighttime hours or by sleeping itself. If someone experiences nightmares or sleep paralysis, they might be afraid to go to sleep because they want to avoid these things. Alternatively, it makes sense to worry about getting enough sleep, period, as inadequate sleep makes tasks the next day much harder.
Individuals might also have phobias that prevent them from falling asleep, such as a fear of home invasion or fear of a fire starting while they’re not awake.
Research shows that an inadequate night of sleep can increase your levels of anxiety by 30%, so sleep anxiety can be a truly vicious cycle for some; you stay up because you’re anxious, and you’re more anxious due to the lack of sleep.
If you’re ever tempted to stay up studying or working on a project, try to remember that statistic and get some shuteye.
It’s always been this way. I don’t know when either issue started.
Alternatively, you may have struggled with sleep, anxiety, or sleep anxiety for your entire life without any marked changes taking place. That doesn’t mean that there’s no hope; there absolutely are ways to treat sleep or anxiety issues as stand-alone items, and we will go over them, too.
Anxiety doesn’t always come from a large event, and it’s okay if yours doesn’t. Some people have emotional struggles like anxiety and lead otherwise happy lives. It doesn’t mean that you’re ungrateful, broken, or that you’re not trying enough.
Your experience is valid no matter what you find in this reflection. Thinking back will simply help you to identify relevant information or rule out possibilities that might hinder you from finding the root cause.
What can I do to feel better?
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Rule out other conditions
Mental health conditions aren’t the only diagnoses that can affect your sleep, and health conditions that aren’t psychological can sometimes contribute to, or mirror, anxiety symptoms.
Here are some examples of physical health problems that can impact both sleep and your mental state:
- Thyroid conditions
- GI issues
- Chronic pain
If you experience the symptoms of any of the above health conditions, or if they run in your family, it’s worth considering getting tested for that condition. Comorbid or co-occurring health conditions are common to both anxiety and sleep issues. So if you’re working to get to the bottom of your troubles with sleep and are struggling to understand the cause, it’s worth looking at other potential factors.
Note, too, that hormones have an impact on sleep and psychological health; if you experience PMS, for example, or if you are going through hormonal changes due to menopause, your sleep might be affected.
Below, you’ll find a list of anxiety conditions that can cause sleep issues, their other symptoms, and ways to improve the anxiety symptoms that block your sleep.
When trauma affects sleep
PTSD is a disorder that develops after a traumatic event. The symptoms of PTSD include but aren’t limited to flashbacks and intrusive or disturbing memories affiliated with the traumatic event, nightmares, hypervigilance, and severe nervousness.
Studies show that up to 91% of those living with PTSD experience issues falling asleep or staying asleep throughout the night. This could be due to the nightmares that many trauma survivors with PTSD face, or it could be due to other symptoms like hypervigilance.
Though PTSD is often affiliated with those who have been in the military, it can stem from trauma from many different sources, with some of the frequent contributors being trauma affiliated with sexual assault, physical violence, and car accidents. With treatment, symptoms of PTSD can improve tremendously.
Types of anxiety conditions that can affect sleep
Here are some of the anxiety conditions discussed in this article that can affect sleep and your life overall. All anxiety issues are challenging and can impact a person’s ability to engage in daily life activities – due to sleep disturbances or not. But addressing the root of your anxiety may help you avoid insomnia.
Generalized anxiety disorder
Generalized anxiety disorder, or GAD, is categorized by seemingly uncontrollable and excessive worry that surrounds a variety of topics. It can severely affect a person’s ability to function and can cause challenges in all areas of a person’s life.
An individual living with GAD might have feelings of impending doom or danger, tension, and being on edge, irritable, or hypervigilant. They may also experience intrusive thoughts, trouble focusing, and GI symptoms.
This all comes on top of the pervasive worrying they undergo as a result of their condition. This worry and feeling out of control may seriously interfere with sleep.
Social anxiety disorder
Social anxiety disorder, or SAD, which is also referred to as social phobia, is categorized by distress and worry surrounding social situations. A person with social anxiety might fear embarrassment or judgment that leads to ruminating over or limiting interactions with others. And both of these symptoms can encourage insomnia.
Obsessive-compulsive disorder or OCD is categorized by obsessive thoughts and compulsive behaviors. A person with OCD might latch onto a topic thought-wise and feel as though they’re unable to let go of it; the obsession could be anything from a relationship, to germs, to feeling like a fraud in the workplace. These uncontrollable ruminations lead a person with OCD to perform compulsive behaviors or rituals. These behaviors usually help a person feel more in control of their out-of-control fears.
The intrusive thoughts and rituals affiliated with OCD can take over an individual’s life. Some people experience a form of OCD that is sometimes referred to as “Pure O” where they experience obsessions and intrusive thoughts but don’t experience the compulsions typically affiliated with OCD. While it is now diagnosed outside of the umbrella of traditional anxiety disorders, OCD can cause extreme anxiety and sleep loss.
Panic disorder is characterized by recurring panic attacks that often happen without notice. During a panic attack, one might experience shortness of breath or trouble breathing, loss of touch with reality, rapid or irregular heartbeat, nausea, sweating, shaking, overheating or getting the chills, lightheadedness, chest pain, fear of death, and severe nervousness with or without cause. People with other anxiety disorders like GAD or SAD may also experience panic attacks.
A phobia is a fear of something specific. Someone with a phobia might go to great lengths to avoid what they’re afraid of, and while it doesn’t always impede someone’s ability to function, certain phobias absolutely can. Since a person can have a phobia related to almost anything, there’s an infinite number of phobias that one might experience. Some common phobias are related to medical or dental settings, heights, animals, pregnancy, bugs, vomiting, and more.
See a psychiatrist or your general physician for a diagnosis of any of these conditions. Anxiety disorders sometimes overlap and can be co-occurring with other conditions, so pinpointing where your symptoms are coming from can help you treat them in the most effective way.
Understand and improve anxiety to help insomnia
If it turns out that you’re in the cycle of poor sleep and anxiety, you’re not alone. Try the following anxiety-reducing techniques in order to sleep better.
Try talk therapy
CBT or Cognitive Behavioral Therapy is documented as the most effective form of therapy for anxiety disorders at this time (though it doesn’t always help).
CBT can be useful for those looking to combat sleep issues. Many people find that a combination of medication, talk therapy, and self-care is the way to go. Improving your quality of life when it comes to both sleep and anxiety can be a multi-step process.
Especially for those of us with a diagnosable anxiety disorder or those of us who tend toward perfectionism, we might feel a constant need to progress in life and worry that we aren’t doing enough. This is actually counterintuitive to our struggle, though!
Perfectionism can lead to burnout and an increased risk of depression – neither of which help your productivity. One of the reasons that talk therapy can have such a positive impact on anxiety is that, using neuroplasticity, we can change our thought patterns. With the help of someone else, we can develop self-compassion that allows us to succeed, thrive, and lead a happy, healthy life.
A support system is essential for everyone, and building community is a big factor in anxiety treatment. You can find support in a variety of places: friends, support groups, a therapist, or even an anonymous online community.
Anxiety can often make you feel like you’re alone; it can be debilitating and isolating, and it can make you feel like no one gets it. Even if you know others with anxiety, it might feel like no one else struggles to the extent that you do. You might feel like the world around you is functioning so much better than you are, and wonder why you can’t operate the way that everyone else seems to be able to.
But the truth is that anxiety is a very common condition, which we just aren’t so open about. So if you’re battling an anxiety disorder, you’re not on your own. Anxiety disorders are highly treatable, and people who are going through the same thing or who have made it through what you’re going through are abundant (for example, there are a lot of these kinds of people, here).
Choose self care
Here are some self-care choices to get better sleep and manage anxiety:
- Maintaining a work-life balance
- Prioritizing stress management
- Positive self-talk and affirmations
- Making rest and relaxation time a priority
- Challenging unhelpful thinking styles
It’s known that a night of poor sleep can raise anxiety levels substantially, and that insomnia is correlated with mental health struggles. So it’s no surprise that the opposite is true; deep sleep is shown to improve anxiety.
Understand and improve sleep to help anxiety
Whether you have anxiety or not, we can all benefit from fine-tuning our sleep hygiene. Sleep hygiene refers to routine behaviors that help people get a better night’s sleep and form healthy sleep patterns.
The brain is programmed to only be able to sleep well in certain situations. So give your brain the sleeping conditions that it needs. Here are some key sleep hygiene practices to integrate into your life:
- Make sure that the area you sleep in is dark and noise-free
- Try to go to bed and wake up at roughly the same time daily
- Keep your sleeping area at a comfortable temperature
- Avoid caffeine after 2 pm
- Stay away from screens before bed including your phone, TV, and computer
- Reserve your bed for sleep and sex only
- Have a bedtime routine; this can be anything from drinking a caffeine-free tea at night to meditating. It’s all about what works for you. Even implementing a skin-care regimen or setting aside time to read can be part of your routine. Pick something that you can stick to on a nightly basis because when you do, completing these tasks will start to signal to your brain that it’s time to go to bed.
Staying connected to your thoughts and needs
If you suffer from sleep anxiety, it can be particularly helpful to be mindful of your thoughts at night. Are you thinking about work before bed? Are you often up all night trying to finish a project or task?
It’s great to be productive, but we all need downtime. If you’re a student, an important part of sleep hygiene would be setting study times during your day or evening and sticking to them.
The same goes for working professionals that have work to do at home. You can only function well within your body’s limits, and studies show that people benefit both at work and school from getting a good night’s rest. Time to stop twiddling your thumbs and actually start prioritizing sleep!
Respecting your limits
When you’re up at night stressing over what you need to get done, remind yourself, “there is nothing that I can do about that right now.” Or try a more blanket statement of: “Now is the time for sleep only.” When you find the statement that that works for you, make it your before-bed mantra for when you’re feeling anxious.
The same is useful for those who ruminate about social interactions or other events that took place during the day. Consciously give yourself permission not to think about those things at night.
Often, things really do look better in the morning; you can’t do anything about it right now anyway; and the chances are, that overthinking before bed will not benefit you.
Beating anxiety and insomnia is possible. Try to implement some of the sleep hygiene and self-care tips in this article, and see if they help you.
Share the importance of sleep with those around you, and be gentle with yourself. It can be hard to prioritize relaxation in a culture that’s always telling us to work more, work harder, and work faster. But it is vital that we shift this idea and start prioritizing sleep and balance in our lives.