Anxiety in bed
What is it, Causes, Symptoms & Treatment
Overview
What is sleep anxiety?
Sleep anxiety is fear or worry about going to sleep. You may be apprehensive about not falling asleep or not being able to stay asleep. Some people also have a distinct phobia, or fear, about sleep called somniphobia. They may think something bad will happen to them while they sleep, or that they shouldn’t sleep because they need to stay alert and watchful.
Sleep and psychiatric disorders, such as anxiety, often go hand in hand. If you have an anxiety disorder, you may find it hard to fall asleep or stay asleep. Similarly, if you have a sleep disorder, you might feel anxious or fearful before bed because you’re afraid you won’t get the rest you need. One condition usually makes the other worse, so it can feel like a never-ending cycle.
Who gets sleep anxiety?
Sleep anxiety can affect adults, teens and children. You may be more likely to develop anxiety at night if you have a sleep disorder such as:
- Insomnia.
- Narcolepsy.
- Restless legs syndrome (RLS).
- Sleep apnea.
- Sleepwalking.
People with the following mental health disorders may also develop nighttime anxiety:
- Anxiety disorders.
- Bipolar disorder.
- Depression.
- Drug addictions or alcoholism.
- Panic disorder.
- Post-traumatic stress disorder (PTSD).
- Schizophrenia.
How common is sleep anxiety?
Anxiety is the most common mental health disorder in the U.S., affecting about 40 million people. Research suggests that most people with mental health disorders such as anxiety also have some form of sleep disruption.
Symptoms and Causes
What causes sleep anxiety?
Anxiety is a natural part of being human. We’re meant to feel afraid or worried in dangerous situations. 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 a anxiety and insomnia can also be caused by a condition where there isn’t enough thyroid hormone in your bloodstream and your metabolism slows down (hypothyroidism).
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.
What are the symptoms of sleep anxiety?
When you can’t sleep due to anxiety, you may experience behavioral changes, including:
- Feelings of being overwhelmed.
- Inability to concentrate.
- Irritability.
- Nervousness.
- Restlessness.
- Sense of impending danger or doom.
Physical effects of anxiety before bed may include:
- Digestive problems.
- Fast heart rate.
- Rapid breathing.
- Sweating.
- Tense muscles.
- Trembling.
Some people also have nocturnal panic attacks. A panic attack is a sudden, intense burst of extreme fear. Nocturnal panic attacks only happen at night, and often wake you from sleep.
Diagnosis and Tests
How is sleep anxiety diagnosed?
Your healthcare provider performs a physical exam, reviews your medical history and evaluates your symptoms. They may ask you questions like:
- Do you eat or drink anything before bed?
- Does your anxiety always occur before bed?
- How long does it take you to fall asleep?
- How often do you wake up during the night?
- What activities do you do before bed?
What tests help confirm a sleep anxiety diagnosis?
In some cases, your provider may do a sleep study to find out if you have a sleep disorder.
Also called polysomnography, a sleep study is a test where you stay overnight in a sleep lab. Your healthcare provider evaluates how your body works during sleep by checking your:
- Blood oxygen levels.
- Body positioning.
- Breathing.
- Electrical activity in your brain.
- Eye movements.
- Heart rates and rhythms.
- Leg movements.
- Sleep stages.
- Snoring or other noises you make during sleep.
Management and Treatment
How is sleep anxiety treated?
There are a variety of ways to manage sleep anxiety, including:
- Cognitive behavior therapy (CBT).
- Healthy sleep habits (sleep hygiene).
- Medication.
How does cognitive behavioral therapy treat sleep anxiety?
CBT is a form of psychotherapy, or talk therapy. It teaches you how to change your behavior by changing the way you think. It’s a common treatment for people with anxiety. A special form of CBT called cognitive behavior therapy for insomnia (CBTI) focuses on helping people who have insomnia.
This therapy can take anywhere from six to 12 weeks to produce results.
During CBT or CBTI, you may learn to:
- Avoid behaviors or environmental factors that trigger your anxiety or make sleeping difficult.
- Better understand how sleep and anxiety affect your brain and the rest of your body.
- Change negative or inaccurate thinking about bedtime or sleep.
Your therapist may teach you how to sleep with anxiety by using biofeedback. Biofeedback trains you to control your body’s functions. You learn to relax your muscles, regulate your breathing, lower your heart rate and focus your attention. Your therapist might use special sensors to measure these bodily functions, or they may give you exercises, such as deep breathing and meditation, to do at home.
How can healthier sleep habits treat sleep anxiety?
Sleep habits, or sleep hygiene, are your routines around bedtime that can affect your sleep. Your healthcare provider may ask you to keep a sleep diary for several weeks.
This is a daily log of your sleep habits. It can help identify things that might make it harder for you to fall asleep or stay asleep.
Some common ways to improve your sleep hygiene include:
- Avoid drinking lots of fluids before bed, especially alcohol.
- Do relaxing activities before bed, such as meditation or listening to soft, peaceful music.
- Don’t consume caffeine in the late afternoon or evening.
- Don’t go to bed unless you feel sleepy.
- Go to bed and wake up at the same time each day.
- If you don’t fall asleep within 20 minutes, get out of bed.
- Make sure your bedroom is comfortable, quiet and softly lit.
- Only use your bed for sleep and sex. For example, avoid watching television or doing work in bed.
- Set a goal of getting at least seven hours of sleep every night.
- Stop using electronic devices at least 30 minutes before bedtime.
- Try not to eat right before bedtime. If you’re hungry, have a light snack and not a big meal.
How can medication treat sleep anxiety?
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. Don’t start any medication for anxiety or sleep without your healthcare provider’s supervision.
Prevention
How can I prevent sleep anxiety?
You may be able to reduce your risk of sleep anxiety by:
- Eating a healthy diet.
- Exercising regularly.
- Practicing good sleep hygiene.
- Taking medications for mental health disorders or sleep disorders as prescribed by your healthcare provider.
Outlook / Prognosis
What’s the prognosis (outlook) for people with sleep anxiety?
Most people can successfully manage their sleep anxiety with the right treatments.
But remember that some treatments, such as medication or CBT, can take time to be effective. Don’t stop treatment prematurely if you think it isn’t working.
Are there long-term complications of sleep anxiety?
Prolonged anxiety or lack of sleep can affect your body in many ways. Sleep anxiety puts you at a higher risk for the following long-term complications:
- Diabetes.
- Heart attack.
- Heart disease.
- Heart failure.
- High blood pressure.
- Arrhythmia (irregular heartbeat).
- Obesity.
- Stroke.
Living With
How can I make living with sleep anxiety easier?
Anxiety or sleep problems can affect every aspect of your life, from your performance at work to your interactions with others. It may help to talk about your sleep anxiety with a therapist, co-workers, friends or loved ones. Support groups can also connect you to a community of people dealing with similar experiences.
A note from Cleveland Clinic
Sleep anxiety is a feeling of fear or stress about falling asleep or staying asleep.
Sleep problems and mental health disorders such as anxiety are closely intertwined. One can often make the other worse, so it can feel like a never-ending cycle. But anxiety and sleep problems are both treatable. Talk to your healthcare provider about your symptoms and work together to build the right treatment plan. Common treatments include cognitive behavioral therapy (CBT), good sleep hygiene and medication.
What is it, Causes, Symptoms & Treatment
Overview
What is sleep anxiety?
Sleep anxiety is fear or worry about going to sleep. You may be apprehensive about not falling asleep or not being able to stay asleep. Some people also have a distinct phobia, or fear, about sleep called somniphobia. They may think something bad will happen to them while they sleep, or that they shouldn’t sleep because they need to stay alert and watchful.
Sleep and psychiatric disorders, such as anxiety, often go hand in hand. If you have an anxiety disorder, you may find it hard to fall asleep or stay asleep.
Similarly, if you have a sleep disorder, you might feel anxious or fearful before bed because you’re afraid you won’t get the rest you need. One condition usually makes the other worse, so it can feel like a never-ending cycle.
Who gets sleep anxiety?
Sleep anxiety can affect adults, teens and children. You may be more likely to develop anxiety at night if you have a sleep disorder such as:
- Insomnia.
- Narcolepsy.
- Restless legs syndrome (RLS).
- Sleep apnea.
- Sleepwalking.
People with the following mental health disorders may also develop nighttime anxiety:
- Anxiety disorders.
- Bipolar disorder.
- Depression.
- Drug addictions or alcoholism.
- Panic disorder.
- Post-traumatic stress disorder (PTSD).
- Schizophrenia.
How common is sleep anxiety?
Anxiety is the most common mental health disorder in the U.S., affecting about 40 million people. Research suggests that most people with mental health disorders such as anxiety also have some form of sleep disruption.
Symptoms and Causes
What causes sleep anxiety?
Anxiety is a natural part of being human. We’re meant to feel afraid or worried in dangerous situations. 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 a anxiety and insomnia can also be caused by a condition where there isn’t enough thyroid hormone in your bloodstream and your metabolism slows down (hypothyroidism).
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.
What are the symptoms of sleep anxiety?
When you can’t sleep due to anxiety, you may experience behavioral changes, including:
- Feelings of being overwhelmed.
- Inability to concentrate.
- Irritability.
- Nervousness.
- Restlessness.
- Sense of impending danger or doom.
Physical effects of anxiety before bed may include:
- Digestive problems.
- Fast heart rate.
- Rapid breathing.
- Sweating.
- Tense muscles.
- Trembling.
Some people also have nocturnal panic attacks.
A panic attack is a sudden, intense burst of extreme fear. Nocturnal panic attacks only happen at night, and often wake you from sleep.
Diagnosis and Tests
How is sleep anxiety diagnosed?
Your healthcare provider performs a physical exam, reviews your medical history and evaluates your symptoms. They may ask you questions like:
- Do you eat or drink anything before bed?
- Does your anxiety always occur before bed?
- How long does it take you to fall asleep?
- How often do you wake up during the night?
- What activities do you do before bed?
What tests help confirm a sleep anxiety diagnosis?
In some cases, your provider may do a sleep study to find out if you have a sleep disorder. Also called polysomnography, a sleep study is a test where you stay overnight in a sleep lab. Your healthcare provider evaluates how your body works during sleep by checking your:
- Blood oxygen levels.
- Body positioning.
- Breathing.
- Electrical activity in your brain.
- Eye movements.
- Heart rates and rhythms.
- Leg movements.
- Sleep stages.
- Snoring or other noises you make during sleep.
Management and Treatment
How is sleep anxiety treated?
There are a variety of ways to manage sleep anxiety, including:
- Cognitive behavior therapy (CBT).
- Healthy sleep habits (sleep hygiene).
- Medication.
How does cognitive behavioral therapy treat sleep anxiety?
CBT is a form of psychotherapy, or talk therapy. It teaches you how to change your behavior by changing the way you think. It’s a common treatment for people with anxiety. A special form of CBT called cognitive behavior therapy for insomnia (CBTI) focuses on helping people who have insomnia. This therapy can take anywhere from six to 12 weeks to produce results.
During CBT or CBTI, you may learn to:
- Avoid behaviors or environmental factors that trigger your anxiety or make sleeping difficult.
- Better understand how sleep and anxiety affect your brain and the rest of your body.
- Change negative or inaccurate thinking about bedtime or sleep.
Your therapist may teach you how to sleep with anxiety by using biofeedback. Biofeedback trains you to control your body’s functions. You learn to relax your muscles, regulate your breathing, lower your heart rate and focus your attention. Your therapist might use special sensors to measure these bodily functions, or they may give you exercises, such as deep breathing and meditation, to do at home.
How can healthier sleep habits treat sleep anxiety?
Sleep habits, or sleep hygiene, are your routines around bedtime that can affect your sleep. Your healthcare provider may ask you to keep a sleep diary for several weeks. This is a daily log of your sleep habits. It can help identify things that might make it harder for you to fall asleep or stay asleep.
Some common ways to improve your sleep hygiene include:
- Avoid drinking lots of fluids before bed, especially alcohol.
- Do relaxing activities before bed, such as meditation or listening to soft, peaceful music.
- Don’t consume caffeine in the late afternoon or evening.
- Don’t go to bed unless you feel sleepy.
- Go to bed and wake up at the same time each day.
- If you don’t fall asleep within 20 minutes, get out of bed.
- Make sure your bedroom is comfortable, quiet and softly lit.
- Only use your bed for sleep and sex. For example, avoid watching television or doing work in bed.
- Set a goal of getting at least seven hours of sleep every night.
- Stop using electronic devices at least 30 minutes before bedtime.
- Try not to eat right before bedtime. If you’re hungry, have a light snack and not a big meal.
How can medication treat sleep anxiety?
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. Don’t start any medication for anxiety or sleep without your healthcare provider’s supervision.
Prevention
How can I prevent sleep anxiety?
You may be able to reduce your risk of sleep anxiety by:
- Eating a healthy diet.
- Exercising regularly.
- Practicing good sleep hygiene.
- Taking medications for mental health disorders or sleep disorders as prescribed by your healthcare provider.
Outlook / Prognosis
What’s the prognosis (outlook) for people with sleep anxiety?
Most people can successfully manage their sleep anxiety with the right treatments. But remember that some treatments, such as medication or CBT, can take time to be effective. Don’t stop treatment prematurely if you think it isn’t working.
Are there long-term complications of sleep anxiety?
Prolonged anxiety or lack of sleep can affect your body in many ways. Sleep anxiety puts you at a higher risk for the following long-term complications:
- Diabetes.
- Heart attack.
- Heart disease.
- Heart failure.
- High blood pressure.
- Arrhythmia (irregular heartbeat).
- Obesity.
- Stroke.
Living With
How can I make living with sleep anxiety easier?
Anxiety or sleep problems can affect every aspect of your life, from your performance at work to your interactions with others. It may help to talk about your sleep anxiety with a therapist, co-workers, friends or loved ones. Support groups can also connect you to a community of people dealing with similar experiences.
A note from Cleveland Clinic
Sleep anxiety is a feeling of fear or stress about falling asleep or staying asleep. Sleep problems and mental health disorders such as anxiety are closely intertwined.
One can often make the other worse, so it can feel like a never-ending cycle. But anxiety and sleep problems are both treatable. Talk to your healthcare provider about your symptoms and work together to build the right treatment plan. Common treatments include cognitive behavioral therapy (CBT), good sleep hygiene and medication.
Erection anxiety - Mental Health Center
Erection anxiety.
If your erection does not behave well during sex, but it persists during masturbation, and doctors say that everything is in order on the organic side, then you are in luck. This is erectile dysfunction of psychogenic origin. The psychological mechanism of this most often lies in the fact that it is so important for you to flaunt an excellent erection that, as luck would have it, everything falls down.
Where does erection anxiety come from?
Erection anxiety comes from the stereotype of the all-powerful and all-powerful man. If you don't live up to this image, then your self-esteem and need to be loved is at stake.
You are afraid of being inferior and of being abandoned.
What does anxiety do?
Alarm is our security service. It helps us prevent every horror and nightmare. What do you think anxiety can do to avoid the danger of sexual failure?
Of course, during sex, you need to closely monitor the level of erection, in which case you can instantly notice the impending fiasco and direct your efforts to make the erection stronger. And if it does not work out, then leave the sexual arena to avoid shame. And try not to come back. Great plan!
What are the implications of this plan?
Sorry, but this plan will prevent you from enjoying intimacy. As long as the focus is on signs of danger, the input of sexual cues is reduced and the warning signals are exaggerated. Attempts to mentally influence the quality of erection or the subsequent withdrawal from the situation of sex lead to a feeling of helplessness and reinforce the illusion of a catastrophic failure, making it difficult to convince yourself of the opposite.
You will calm down a little at the moment, but next time you will be even more anxious.
What to do about this anxiety?
Transfer attention from erection to sensations, noticing and studying sensory nuances.
To think what such a terrible thing you expect from the fact that at the right moment you will not have an erection. And instead of avoiding an undesirable outcome, turn to face fear and intentionally enter into a situation that worries. Compare expectations and reality. Have you really been ridiculed, condemned, stopped talking? If this happened, does it say something about you or the person who does it? By repeating this experience over and over again, let the brain get used to the fact that nothing catastrophic happens.
It is obligatory to practice sex without an erection, to explore the space of alternative possibilities. This will give you a feeling of freedom and confidence.
Instead of self-criticism, think about whether you really like your partner or what he does in bed.
Think about whether you want him to change the pace, the nature of the touch, scratch your back, or maybe you want to scratch his back yourself. Ask for what and who you really want at the moment.
Remember that anxiety is exacerbated if success in bed is too important a value in your life. Then, in the event of a threat of failure, your self-esteem has nowhere to really find support. Think about the things in life that are more valuable to you.
Anxiety also increases in situations where the importance of sexual self-presentation is higher. Like when you're trying to sleep with someone you don't know. Usually, erectile function improves as trust in a relationship grows, and when it is lost, the opposite happens.
Or maybe you came across someone who is especially critical, and for some reason you really need to be with this person. An erection loves when its owner is praised and respected. Try not to associate with overly critical people.
Or you are trying to have sex with several people at the same time.
Performing in front of an audience is always more exciting. This is where practice will help.
If your erection suddenly stopped working in normal situations, and before that everything was fine, then perhaps you are upset about something, you are under great stress and tired. Think of it like a strike. Erection terribly loves when you have a good rest, but at the same time have success in business.
It is important to polish all this with the right belief that a man can have any erection or none and his masculinity is not determined by the strength of the erection. Think about what else defines your masculinity. Understand that it is absolutely normal if an erection is present not 100% of the time of sex and not with every partner. And belief in the stereotype of male sexual omnipotence is considered harmful.
Author of the article: clinical psychologist, sexologist at Mental Health Center - Eugene Saprykin .
Anxiety and sex: ru_psiholog — LiveJournal
Sexual arousal from the point of view of psychology is a multifaceted issue.
Kernberg and others like him have written a lot of interesting things on this topic. Physiology is even more complex. At the same time, there is one factor that is completely on the surface and at the same time, many people do not know about it or know exactly the opposite. Question.
Erection - is it a reaction of the "exciting" (sympathetic) part of the nervous system or "calming" (parasympathetic)?
Erection itself is a parasympathetic reaction. (Orgasm is sympathetic, but that's not what the story is about). It sounds paradoxical. Because if we ignore the nervous system, then sexual arousal is a completely stable and understandable phenomenon.
But if you think about it, there is a certain logic in this. The brain knows how to prioritize at critical moments. If we are talking about danger, then the body is mobilized for salvation - energy is concentrated in those areas that are needed for salvation and is turned off (slowed down) in all the others. In case of strong fear, this is the reaction of the amygdala, HPA axis, there is a release of cortisol and adrenaline, the fight-or-flight reflex - an increase in blood pressure, sweating, dilated pupils; at the same time, digestion and other functions that are not needed right now slow down.
The body does not care - if there is a real danger or not, the reaction is identical. Therefore, “idle” anxiety, when a person is worried without a real objective reason for anxiety, eats up resources and has side effects.
When it's scary, there's no time for sex.
Anxiety is less than fear in amplitude and the fight-or-flight reflex is not fully triggered. At the same time, part of the reactions is preserved - the HPA axis works, the level of sortizol and adrenaline is increased, and the reaction is generally sympathetic.
Why is it all. There are men who are more concerned with how they performed than with enjoying sex and the pleasure a woman experiences. The duration of an erection and its other parameters, the reaction of a woman they need, first of all, as feedback for evaluating their performance, for perceiving themselves as a good lover. This does not exclude the fact that a woman may like the process - a man who strives to perform well can give her pleasure.
This is not the question. As a rule, in parallel with the concern about the image of oneself as a lover, anxiety appears. But what if? Anxiety can be somewhat different, and all of them physiologically activate the sympathetic part of the NS.
A vicious circle may occur. Anxiety about erection can affect this very erection negatively.
It is possible to work with anxiety - both in life in general and in the bedroom in particular. Although in practice, few people identify anxiety itself as the cause. This is taboo, not in line with the socially accepted narcissistic image of the ideal macho. At the same time, compensatory mechanisms that “work” for a person in this situation very often work precisely with anxiety. For example alcohol. By class of drug, alcohol is a depressant, it slows down a variety of processes in the nervous system, including anxiety, although it simultaneously reduces sensitivity.
If the anxiety is persistent (lasting for several months), frequent, directed at various objects in life and affects life quite strongly, then psychotherapy is very reasonable.
Often such anxiety occurs in parallel with episodes of depression. Anxiety is a non-trivial phenomenon. Cognitive-behavioral therapists can be absolutely sure that a person can take on himself and prohibit anxiety. Straight flint. And if it doesn't work, then it's not flint. There are many factors outside a person's control that influence anxiety, it's not a matter of will or suppression of thoughts.
If anxiety occurs from time to time and for a specific reason, then there are means of varying degrees of effectiveness for different people. The bath, within reasonable limits, remarkably regulates the nervous system and the state after the bath is quite parasympathetic. Yoga. Sport. Massage. These methods work with anxiety and do not have the side effects of alcohol. Alcohol within reasonable limits can be beneficial. Cabernet Sauvignon and red wine in general, when consumed in moderation (!) work as a prevention of Alzheimer's disease and cardiovascular diseases. At the same time, it is very well known that alcohol, when consumed in large quantities for a long time, exacerbates anxiety and depression, and does not help.
