Anxiety while trying to fall asleep
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.
How to Overcome Sleep Anxiety
If you deal with anxiety or sleep disturbances on a regular basis, there are a few simple strategies that can help calm your mind, relax your body, and make it easier for you to sleep. Changing bedtime habits takes time and patience, but over time they can help reduce anxiety.
1. Practice good sleep hygiene
Sleep hygiene refers to various habits that are essential for good quality sleep. Best practices include reducing daytime sleep to 30 minutes, limiting stimulants like coffee and alcohol closer to the night, and going to bed and waking up at the same time.
2. Practice meditation
Begin by sitting quietly for a few minutes and focusing on your breath. Learning to quiet your mind and meditate can help you deal with stress, both during the day and before bed. If meditation is difficult for you, try relaxing yoga poses to help your body prepare for sleep.
3. Exercise
Regular exercise has been found to help people fall asleep faster and sounder. Even moderate-intensity exercise, such as brisk walking, can improve sleep for those with chronic insomnia.
4. Take time to relax
Proper sleep preparation will allow your mind and body to slow down before you go to bed. Take at least 30 minutes to take a bath, read a book, listen to a podcast, or listen to soothing music. These transitional rituals can set your brain to associate certain activities with getting ready for bed.
5. Avoid stress before bed
Leave office, work, news and social networking for daytime.
Experts suggest creating a transition time between work and sleep, which will help you tune in to a good rest.
6. Write down your worries on paper
Instead of letting thoughts and to-do lists go round and round in your head, write them down so your brain has a plan for the next day. Research shows that it may help you fall asleep faster.
7. Stay out of bed if you can't sleep
If you've been in bed for more than 20 minutes and still can't sleep, reset. Get up, get out of the bedroom and engage in a sleep-inducing activity like having a cup of tea or reading a book. This action on conditioned reflexes, known as stimulus control, can help shorten the time it takes to fall asleep.
8. Limit Gadget Use
Our laptops, phones and tablets emit blue light that suppresses melatonin, making the brain think the sun has risen. Try not to use gadgets one or two hours before you plan to go to bed so as not to disrupt your circadian rhythm.
9. Maintain favorable sleep conditions
Controlling light, sound, and temperature can increase your chances of calming your mind and falling asleep easily. The bedroom should be dark, quiet and cool. Pink noise can also help you focus on your sleep.
10. Get a mattress that suits you
When you sleep on an uncomfortable mattress, pressure builds up and pain points build up on your body, causing you to toss and turn. The right mattress and pillow will help support your body and neck, and keep you cool and comfortable while you sleep. You can order a Kitami mattress with a test drive for 101 nights and not be afraid that you will make the wrong choice. If the mattress does not suit you, Kitami will take it for recycling and refund 100% of the cost. You can choose a mattress here.
Insomnia, anxiety and lack of sleep. Therapist of the Central Medical Unit Yulia Ramazanova told how to cope with sleep disorders
Insomnia, anxiety and lack of sleep.
Yulia Ramazanova, a therapist at the Central Medical Unit, told how to cope with sleep disturbances Stress, anxiety and insomnia are what accompanies the busy life of a modern person. Insomnia, or simply insomnia, is a serious pathological condition of the body that does not allow a person to gain strength, energy and simply relax. How to achieve harmony with yourself and sleep? This will be told by the general practitioner of polyclinic No. 2 of the Central Clinical Medical and Sanitary Unit named after the Honored Doctor of Russia V.A. Egorova Yulia Ramazanova.
- How much sleep does a person need to be healthy and energetic?
Sleep is our physiological need, and the amount of sleep depends on age. Babies sleep 17-18 hours. Older children sleep 10-12 hours. And it should be 10-12 hours of uninterrupted sleep. Teenagers sleep less - up to 10 hours. Middle-aged people already need 7-8 hours of sleep, sometimes up to 9, and older people need even less.
- What time is best to go to sleep and wake up?
It is better to go to bed earlier, in the first half of the night, optimally before 11 pm, this is due to the production of the sleep hormone melatonin. And waking up, respectively, is better at five or six in the morning. Then the person will be more cheerful.
- Is systemic insomnia normal? That is, in a certain period of time a person cannot sleep, and then sleep is restored by itself.
Normal is episodic insomnia, situational, when we changed the time zone or we had a stressful situation, or an important meeting, and we worry and worry. If insomnia is systemic, it is a sign of a disease, either of a somatic nature, or of the endocrine system. And often the cause of insomnia is an anxiety or depressive disorder.
- How do you know when to see a doctor?
In general, there are several types of violations. These are difficulty falling asleep, frequent awakenings at night and reduced need for sleep when a person wakes up earlier, even before the alarm clock.
If such violations occur within one or two weeks, help should be sought, because there may be a violation behind this.
- Are there any methods for healthy sleep?
Sleep hygiene itself is one of the techniques for healthy sleep. That is, before going to bed, hiking in the fresh air, a warm shower or bath are recommended, there are people who love aromatherapy. It is recommended to listen to relaxation music - either classical or jazz, preferably quiet. You can read a light book that will not force the brain to work actively. Also, don't go to bed hungry. It is better to have dinner three hours before bedtime. You can drink soothing mint tea.
Room temperature recommended between 20 and 24 degrees. Although there are people who are comfortable sleeping at 18-19degrees. And in general, before going to bed, we should slow down the rhythm of our lives, do everything much more slowly.
- Basically, insomnia is associated with anxiety, which does not allow you to sleep.
What are the symptoms of systemic anxiety?
An extreme manifestation of systemic anxiety is a panic attack, when a person has a heartbeat, anxiety, fear of upcoming events or meetings, fear of being in an unknown place with unknown people. For a person, this is really scary, he is lost, does not know what to do.
- What should be done in such cases to get rid of this condition? Is there some kind of magic pill?
If there is anxiety, we can manage it ourselves. First of all, relax and, again, breathe deeply. Deep breathing signals that our body produces less adrenaline. When this anxiety arises, we can imagine a "button" - on/off - and instruct ourselves to send a signal to our adrenal glands to stop releasing adrenaline. Also, people should understand that this condition is not life-threatening, it is short-term, passes, it is episodic - and translate all their negative thoughts into a positive direction. I am a healthy person, I will get through this.
If a person has fears, you should definitely undergo a preventive examination, if these are complaints about the work of the heart - shortness of breath, palpitations - contact a therapist or cardiologist. If there is a feeling of tremor in the body, a lump in the throat, you should also contact a therapist, endocrinologist or neurologist.
- Antidepressants? Can you prescribe these drugs to yourself?
Self-treatment is definitely not worth it. Antidepressants should be prescribed by a doctor who can correctly select the required dosage and duration of administration.
- How to protect yourself from poor sleep and systemic anxiety?
Set up a daily routine. Day, if it is a working one, we plan: we wake up in the morning, perform all the procedures, physical exercises, go to work. Separate work and family matters. Further, I recommend active leisure, planning for the next day, meeting with friends, communication. It is important to choose a positive environment that will pull us up.
