Sleep Anxiety, Causes, Symptoms & Treatment
What is Sleep Anxiety?
Sleep anxiety isn’t an official medical diagnosis recognized by the Diagnostic and Statistical Manual of Mental Disorder (DSM), the catalog of psychological conditions widely used by clinicians to diagnose patients. However, it’s still worthy of attention. After all, not all problems have an official diagnosis. Anxiety is frequently connected to sleeping problems. Excess fear and worry make it more difficult to fall asleep and stay asleep through the night. Sleep deprivation can worsen anxiety, producing a negative cycle involving anxiety symptoms and insomnia.
Sleep anxiety is also linked to somniphobia, hypnophobia, or sleep dread. Feeling nervous about the thought of going to bed may mean you’re anxious about going to sleep — or just not being able to sleep as much as you would like to. This extreme sleep anxiety can be so intense, leading to one having panic attacks. Sufferers are unable to sleep or even go near the bed. The thought of sleeping can also induce fear. These acts of avoidance are repetitive, thus one can develop OCD in the future. This is so because the recurrent urge to avoid sleep can turn into compulsions.
Sleep deprivation can result in an actual imbalance within the brain, which makes it more difficult for people to think clearly. Because of this lack of sleep, one might not function properly academically or professionally. For some people, sleep anxiety actually comes before alcohol. They may self-medicate with alcohol or to other substances, such as marijuana, or even over-the-counter (OTC) medications. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia .
Alcohol and Insomnia are known correlated problems. Alcohol should not be used as a sleep aid, and regular use of alcohol as a sleep aid may result in alcoholism. Alcohol and insomnia can increase the risks of sleep apnea. Sleep apnea causes you to stop breathing periodically throughout the night, It’s really easy for people to fall into a vicious cycle, with sleep becoming more and more stressful.
What are the Types of Anxiety Disorders?
Anxiety is a core element of a number of specific disorders, although not all are categorized strictly as anxiety disorders.
- Generalized Anxiety Disorder (GAD): People with GAD have significant, looming worries about many different things that can cause an overarching sense of anxiety.
- Panic Disorder: Extremely intense episodes of fear, known as panic attacks, that usually last for a few minutes at a time are the defining feature of Panic Disorder.
- Social Anxiety Disorder: This disorder involves an extreme fear of social settings and potential embarrassment in front of other people.
- Specific Phobias: Specific phobias are intense fears caused by particular triggers. Some of the most common specific phobias include agoraphobia (a fear of open or enclosed spaces, being in a crowd, or being outside of home alone) and separation anxiety.
- Obsessive-Compulsive Disorder (OCD): In OCD, a person obsesses about an issue in a negative way such that it provokes anxiety, and this causes a compulsion, which is their attempt to control or eliminate that anxiety. Compulsions are repeated ritually and can directly impact everyday activities.
- Post-traumatic Stress Disorder (PTSD): This condition can arise after a person is exposed to a painful or disturbing situation. People with PTSD may relive the stressful event, feel on-edge, and have potentially debilitating anxiety.
Types of Insomnia
There are multiple levels to measure the severity of insomnia, as well as different types of insomnia. The severity of insomnia can be broken down into five categories.
The categories and types are broken down as follows:
Type 1: highly distressed, often struggling with neuroticism or prone to anxiety and feeling tense.
Type 2: moderately distressed but sensitive to rewards or positive events.
Type 3: moderately distressed and not sensitive to rewards or positive events.
Type 4: slightly distressed and high reactivity, or being very sensitive to stressful life events.
Type 5: slightly distressed and low reactivity, or being lowly sensitive to stressful life events.
Additionally, there are different forms of insomnia that a person may struggle with, including the following:
Acute insomnia: This is characterized by a brief experience with insomnia, often due to a stressful life event. It often resolves without the need for treatment.
Chronic insomnia: This is characterized by having difficulty falling asleep three or more nights a week, for longer than three months. There are many causes that may result in chronic insomnia, but chronic is distinguished by a long-term pattern of difficulty sleeping.
Comorbid insomnia: As mentioned previously, comorbid insomnia is the presence of insomnia alongside other medical conditions, either psychiatric or physical illnesses such as arthritis or chronic pain. In these cases, insomnia is not a side effect of the condition but exists independent of it.
Onset insomnia: This type of insomnia is characterized by difficulty falling asleep initially at the beginning of a sleep cycle.
Maintenance insomnia: This type of insomnia is characterized by difficulty staying asleep, though typically without issue falling asleep initially. Rather, the problem arises due to the afflicted waking up and being unable to fall asleep later at night.
Effects of Insomnia
Sleep is a vital function that the body needs in order to heal, recuperate, and maintain energy. However, if someone is struggling with sleep anxiety, insomnia, or a mix of both, this can have some harmful side effects on the body if left untreated for an extended period of time.
Lack of sleep can lead to increased chances of anxiety, but anxiety can also cause a lack of sleep. Unfortunately, the two can intertwine, causing one to exacerbate the other. Anxiety can have a negative effect on your body’s ability to fall asleep as your brain is in “fight or flight” mode, thinking of all potential outcomes for whatever is causing the anxiety.
Furthermore, anticipatory anxiety and specific anxiety about sleep can lead to sleep disturbance and insomnia, which then creates a feedback loop that can make both conditions worsen.
Long-term insomnia can lead to other medical issues such as:
- Asthma attacks
- Increased risk of stroke
- Increased risk of seizures
- Weakened immune system functions
- Increased sensitivity to pain
- Heightened blood pressure
- Increased risk of inflammation
- Increased risk of diabetes mellitus
- Increased chance of unhealthy weight fluctuation
- Increased risk of heart disease
Additionally, insomnia can cause adverse mental health side effects, including:
- Feelings of confusion, irritability, or frustration
- Emotional instability
Lack of sleep could impair the brain’s ability to process negative experiences or emotions, which can increase a person’s risk of developing mental illnesses such as anxiety or depression. In addition, lack of sleep could affect the amygdala’s processes, which is the primary part of the brain responsible for emotion and memory.
Who Gets Sleep Anxiety?
Sleep anxiety can affect people from all walks of life. You may be more likely to develop anxiety at night if you have a sleep disorder such as:
- Restless legs syndrome (RLS)
- Sleep apnea
People with the following mental health disorders may also develop nighttime anxiety:
What Causes Sleep Anxiety?
The relationship between sleep and anxiety is directly linked to a person’s adaptive stress response. Stress and anxiety trigger our bodies to release hormones that help us react quickly to escape harm. But if you have chronic anxiety, you might feel stress or worry all the time. You may feel fearful of everyday situations like driving to work or even falling asleep.
Chronically high levels of these hormones, especially before sleep, can make it hard for your body to relax. You may have difficulty falling asleep. If you do fall asleep, you may wake up during the night with stressful or worrisome thoughts and not be able to fall asleep again.
The combination of insomnia and anxiety can also be caused by hypothyroidism, a condition where there isn’t enough thyroid hormone in your bloodstream, and your metabolism slows down.
Research suggests that anxiety can affect rapid eye movement (REM) sleep. This is the phase of sleep when you tend to have vivid dreams. If you have anxiety, the dreams may be disturbing or turn into nightmares that wake you.
Just as anxiety can affect sleep, sleep can affect anxiety. Sleep anxiety is a common characteristic of insomnia, wherein the individual begins to experience anxiety during the day and evening about poor sleep, which may help cause another night of bad sleep.
Sleep Anxiety Symptoms
When you can’t sleep due to anxiety, you may experience behavioral changes, including:
- Feelings of being overwhelmed
- Inability to concentrate
- Sense of impending danger or doom
Physical symptoms of anxiety before bed may include:
- Digestive problems
- Fast heart rate
- Rapid breathing
- Tense muscles
Sleep Anxiety Tips
If anxiety or disrupted sleep often occurs in your day-to-day life, these simple strategies can help you relax your body and mind and ease yourself into sleep. Changing your pre-sleep habits takes time and patience, but adapting to these changes may help you fall asleep with less sleep anxiety over time.
Practice Good Sleep Hygiene
If you have a routine and engage in appropriate sleep hygiene on a consistent basis, your mind will be less likely to experience anxious thoughts.
Practicing meditation before bedtime can help calm anxiety. diaphragmatic breathing relaxation techniques can lead to significant reductions in anxiety.
Using exercise to calm sleep anxiety reduces the production of stress hormones. Regular exercise has been shown to help people fall asleep faster and more soundly. You should avoid vigorous activity for at least one hour before bedtime. If you’ve been struggling to fall asleep, you may want to skip the late-night sweat session and opt for a morning or afternoon workout instead.
Set Aside Time for Winding Down
Create a routine that winds you down and gets you in the mood for sleep. This can include things like dimming the lights, listening to calming music, or taking a warm bath. The best nighttime routine allows your mind and body time to slow down before you turn off the lights.
Avoid Stressful Activities Before Bed
Creating some form of transition from daytime to sleeping is highly recommended. you can’t expect the mind to go to sleep on demand. Instead, you need to allow time for the brain to transition, just like we transition to go outside or when we get home. The goal is to reduce the nervous thoughts in your head so your mind is clear, calm, and positive before you head off to sleep.
Write Down Your Worries on Paper
This will help us remain accountable to ourselves, our feelings, our purpose, and our plan. Write them down so that your brain has a game plan for the following day. Writing whatever comes to mind can help ease sleep anxiety.
Avoid Lying in Bed Awake
If you’re lying in bed for more than 20 minutes and still can’t fall asleep, it might be time to give yourself a do-over. Leave your bedroom to do a sleep-inducing activity, like having a cup of tea or reading a book. This conditioning, known as stimulus control, can reduce the time it takes to fall asleep.
Set Your Environment
Controlling light, sound, and temperature in your bedroom can increase your chances of calming your mind and falling asleep easily. A sleep-friendly environment should be quiet, dark, and cool — between 60 to 67 degrees Fahrenheit, to be exact.
Anxiety Sleep Medications
Your healthcare provider may recommend medication to treat anxiety or other mental health disorders. Medication can also help improve the symptoms of sleep-related disorders such as restless legs syndrome or insomnia.
But some medications might actually increase your anxiety or make sleeping harder when you first start taking them. If you experience these side effects, talk to your healthcare provider. Many over-the-counter sleep aids can also be habit-forming.
Someone who has significant or persistent anxiety and sleeping problems should talk with a medical professional who can best assess their situation and discuss the downsides and benefits of the possible treatment options.
Most common mental illnesses, including depression, anxiety, and PTSD, are related to sleep disorders, and alcohol and drug abuse disorders are not left out. However, the correlation may be complicated and bidirectional. Alcohol and drug use can lead to sleep anxiety, but sleep anxiety can also increase the risk of substance abuse and addiction.
A person with a dual diagnosis has both an alcohol or drug problem and a mental disorder. These conditions happen together frequently. About half of people who have a mental illness will also have a substance use disorder at some point in their lives and vice versa. The interactions of the two conditions can worsen both. People with a dual diagnosis require an integrated treatment plan that addresses both disorders as interconnected issues.
Individuals who struggle with mental health conditions such as sleep anxiety either seek clinical medication or self-medicate with drugs and alcohol. People who get prescriptions for their condition are less likely to develop abuse disorders, but often the medications they get access to have high abuse potential, creating more risk. People that self-medicate for their mental illnesses often start early, and the use of drugs or alcohol as a way to escape becomes a natural part of life.
Self-medication is dangerous because it can lead to addiction or even an overdose. It also makes treatment harder because the person has to treat addiction and mental illness. If they do not treat both problems at a dual diagnosis treatment center, they are more likely to have a relapse.
Treating dual diagnosis clients is a critical aspect of our inpatient treatment experience because co-occurring disorders are strongly connected with instances of substance abuse. Creating a treatment plan that addresses the physical aspects of withdrawal, the psychological connection with drug use, and addressing underlying mental health disorders is all a part of setting clients up for success.
At We Level Up NJ, we believe that if the client can identify the underlying issue and treat it simultaneously with their treatment for addiction, the client’s chances of a successful, relapse-free recovery are much improved. In fact, once we can identify and properly begin treatment on the underlying issue that’s driving or co-occurring with the dependency on alcohol or other drugs, clients will have reached a major milestone and will be that much closer to long-term sobriety. Sleep anxiety can occur alongside addiction and can present complex and similar symptoms.