Cant Sleep Due To Anxiety 7 Tips From An Insomnia Expert
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During this time of extreme uncertainty, many of us are struggling to sleep. If youre like me, you fall asleep easily but wake up at about 3am thinking of whatever was on your mind during the day, or perhaps your subconscious decides to think about the state of the world. You might also struggle with falling asleep at all.
Trust us, youre not alone. So many of you have reached out about sleep struggles. Weve taken your questions and given them directly to Dr. Leah Farrell-Carnahan, a personal friend, trusted insomnia expert, and licensed clinical psychologist and founder and director of Atlanta CBT. Dr. Farrell-Carnahan has helped hundreds of people who struggle with insomnia, so if you cant sleep due to anxiety, this article is for you!
Please note that Dr. Farrell-Carnahan gives general advice, which is NOT meant to replace any specific advice or recommendations you have been given from your personal healthcare providers. It is always a good idea to consult with your personal physician if you notice that you are having trouble sleeping.
How Can You Treat Insomnia
There are both pharmaceutical and non-pharmaceutical treatments for insomnia that you can discuss with your doctor. You may need to try some different treatments before finding the most effective one for you.
The American College of Physicians recommends cognitive behavioral therapy for insomnia as the first route to treat chronic insomnia.
This process helps you recognize your emotions and attitudes that affect your sleep. You can then learn how to change them to get back some Zzzs.
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 : 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 and separation anxiety.
- Obsessive-Compulsive Disorder : 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 : 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.
Read Also: Does Exercise Help Anxiety And Panic Attacks
Tips For Beating Anxiety To Get A Better Nights Sleep
Many people with anxiety disorders have trouble sleeping. That’s a problem. Too little sleep affects mood, contributing to irritability and sometimes depression. Vital functions occur during different stages of sleep that leave you feeling rested and energized or help you learn and forge memories. Sleep usually improves when an anxiety disorder is treated. Practicing good “sleep hygiene” helps, too. Here are some steps to take:
For additional tips and strategies for living with anxiety, buy Coping with Anxiety and Stress Disorders, a Special Health Report from Harvard Medical School.
Why Is It So Hard To Sleep When You Have Anxiety
Lets start with a little about how sleep works.
Sleep happens by balancing two forces that oppose each other. The first force is called sleep pressure. Basically, the longer you are up, the stronger this force becomes. If you are up for 16 hours, youll be tired. After 24 hours of being awake, sleep is more likely. And after 72 hours, it becomes difficult to stay awake.
The second force resists sleep pressure by pushing you awake. This force is an alerting signal that cycles based on an internal clock. It gets stronger as the day progresses and then is supposed to drop off at night. When this force drops in the evening, all the sleep pressure you built up during the day pushes you to sleep.
So how does anxiety affect this? The alerting signal force runs off many of the same neurochemicals anxiety uses. This is likely a great adaptive trait that aided our survival in the past. Imagine you were being chased by a pack of wolves. That would be a really bad time to go to sleep. Anytime you feel anxious, worried or threatened, the alerting signal gets stronger. Its your brains way of saying, If this is a threat, you should stay awake and deal with it.
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Address Your Worries During The Day
Katy asked Dr. Farrell-Carnahan the following question: I have a really hard time shutting my brain off to fall asleep. How can I get over this to fall asleep better?
First off, I feel this deep in my soul. Second, Dr. Farrell-Carnahans answer isnt completely surprising to me, although it is definitely something I need to put into practice in my own life.
She explains that you should set aside time during the DAY to write out your worries and fears. While you are at it, you should also generate some solutions, if you can, to your worries.
It is advisable to set aside this time during the day or prior to winding down for the evening.
Dr. Leah Farrell-Carnahan
What Happens When Anxiety Interrupts Sleep
When anxiety causes inadequate sleep, it can go beyond the tiredness of a regular all-nighter. Poinsett says that anxiety can be a trigger for sleep deprivation, creating a vicious cycle that can further affect your sleep pattern.
While the impact of sleep anxiety is largely individual, some common effects of sleep anxiety include:
- Negatively impacts your mood
- Increases chance of depression
- Reduces cognitive reaction times
A small study even found that those who have insomnia are four times more likely to develop depression.
In addition to mental health issues, those with sleep disorders can be at risk for other health problems, including heart disease, high blood pressure, stroke, diabetes, and obesity.
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Build A Sleep Routine To Transition From Day To Night
What that routine looks like really depends on you and your needs. For some people, its meditation. For others, its as simple as taking a bubble bath before bed, lighting a scented candle, petting your cat, or reading a good book.
Whats important is that you take some time to wind down.
This means stepping away from stressful activities like paying bills, listening to the news, talking about politics, scrolling through your phone in the time leading up to you going to bed.
Its especially important to limit your screen exposure because blocking blue light at night can help you sleep.
What To Do When You Cant Sleep: 9 Tips
Prioritizing a good nights sleep isnt just important for your general health, it can also help with feelings of anxiety, as your body is less likely to feel overwhelmed or on edge when youve slept well.
However, falling asleep can be difficult, so its important to build a strategy for a better nights sleep. Below are some tips to try in order to improve your chances of falling asleep naturally.
What To Do When Anxiety Makes It Hard To Sleep
So what can you do if you are in the middle of a cycle of not sleeping because you are anxious and feeling even more anxious because you can’t sleep?
In my experience, the key is in calming your nervous system to help you settle into sleep. I use calming techniques, such as mindfulness meditation. Practicing mindfulness is something that I have found calms my anxious brain in many situations.
It is also helpful for me to watch my caffeine consumption. In these situations, it is important that I reduce the coffee that I drink since I have noticed that caffeine exacerbates my anxiety. Because of this, I will reduce any caffeine that I drink, which is usually coffee.
Something else that can be helpful is a calming distraction. I find that reading a book before I go to sleep can calm me, and sometimes calming music or sounds can be helpful as well.
Lastly, I find it beneficial to focus on my breathing. Taking slow, deep breaths can help to slow the heart rate. Since this is so important for settling into sleep, I find it helpful to concentrate on it. When my mind starts to wander — especially to something that I know will make me increasingly anxious, I bring my mind back to my breath and focus on it moving in and out of my body.
I have found this to be helpful for me in times of heightened anxiety and can’t sleep. Share any strategies you use in the comments below.
What Causes Anxiety Before Sleep
According to clinical psychologist Emily Knott, Anxiety before bedtime often takes the form of a phenomenon referred to in psychology as pre-sleep arousal.
Knott says that pre-sleep arousal may cause the body and nervous system to enter a state of heightened awareness that may take the form of problem-solving, thinking about your own thoughts, focusing on stimuli in the environment such as noise and light, and ruminating about the consequences of not being able to sleep.
While there hasnt been extensive research conducted on sleep and anxiety, there are a few reasons why your anxiety may be worse at night. Here are possible causes.
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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.
- Dont consume caffeine in the late afternoon or evening.
- Dont go to bed unless you feel sleepy.
- Go to bed and wake up at the same time each day.
- If you dont 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 youre hungry, have a light snack and not a big meal.
Avoid Stressful Activities Before Bed
Amber Weiss, licensed psychotherapist and founder of Transformative Mindset, says, Creating some form of a transition from daytime to sleeping is highly recommended. According to Weiss, you cant 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. This can entail leaving the office, work, news, and social media exchanges for earlier in the day to create buffer time between work and sleep, setting yourself up for better rest.
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What Are The Health Risks Of Not Getting Enough Sleep
Short sleep and fragmented sleep are linked with increased risk of heart attack, stroke, obesity, accidents, memory problems, diabetes, difficulty with concentration and impaired learning. Sleep is sometimes referred to as the third pillar of health: Sleep, nutrition, and exercise. In order to be healthy, all three must be managed well.
Hatch Rest+ Sound Machine And Nightlight
Full disclosure: The Rest+ is technically designed for kids but hear me out. When I used it, it helped me sleep better than it helped my son sleep.
My brother bought it for my son for Christmas and at the time, my son was still sleeping in a bassinet in our room, so I set up the Rest+ near my bed and it didnt take long for me to become dependent on it.
I found the sound machine features incredibly soothing, though other people might find the white noise feature more soothing.
Sound machines can give your brain something for your racing thoughts to focus on and listen to as you lay down to sleep.
The color night light might also be helpful, as you can program it to match your bedtime routine and program the light to slowly dim as you drift off to sleep.
If you prefer not to get a product meant for kids, the company also recently came out with the Hatch Restore aimed at adults specifically. It has many of these same helpful features to create a bedtime routine without any of the baby-focused ones.
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When To See A Doctor
Constant anxiety that makes it difficult to sleep at night can affect your daily quality of life. Your work or school performance may worsen, and you may find it hard to complete your normal daily tasks.
If anxiety and lack of sleep are affecting your life in this way, its important to reach out to a doctor or mental health specialist for help.
For some people, nighttime anxiety can lead to insomnia. Insomnia is defined as persistent trouble falling or staying asleep. Chronic insomnia can have negative health effects, including an increased risk of:
- health conditions, such as high blood pressure and a weakened immune system
- mental health conditions, such as depression
Whether your doctor makes a diagnosis of anxiety, insomnia, or both, reaching out is the first step in the treatment process.
Dont Become Fixated On A Specific Bed Time
This tip closely follows #1. Dr. Farrell-Carnahan notes that people tend to get fixated on bed times, probably because parents aim to get kids into bed at a specific time.
It turns out that, when you are having difficulty falling asleep, in general, a consistent bedtime is less important than a consistent wake time.
Dr. Leah Farrell-Carnahan
Dr. Farrell-Carnahan suggests setting an alarm for the same time every day and getting out of bed at that time, or within a few minutes of it. Dont play the snooze game, either.
That way your circadian rhythm will begin to regulate, and you will notice that you will be more likely to get sleepy around the same time at night.
Of course, this is as long as you are providing yourself a nice, long wind down time where you allow your mind to quiet, your body to calm itself, and your whole self time to prepare for sleepiness to come.
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Can Lack Of Sleep Cause Panic Attacks
When it occurs alongside other anxiety risk factors, a lack of sleep can contribute to panic attacks. A panic attack is a sudden episode of intense fear or anxiety that occurs unexpectedly.
Someone who is not sleeping well is more prone to physical changes related to nervous system activation, Kogan says.
When theres an increase in the nervous system activation, people breathe shallower and more rapidly, and this change in breathing can trigger a panic attack when the person is at risk for panic attacks.
The good news is that there are ways to help reduce anxiety and stress and sleep more soundly. Consider following these tips:
Screen Out The Screens
Watching TV or using a computer or other digital device can also affect your ability to fall asleep. Increased screen time can negatively impact sleep for people of all ages. For teens and children, who need more sleep than adults, increased screen use is associated with delayed bedtimes and less sleep overall.¹
You can designate at least a half hour before going to bed as screen-free time. Don’t use your phone in bed if you’re trying to fall asleep. Make a rule for kids that they can’t use devices before bedtime.¹
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Avoid Alcohol Before Sleep
Alcohol has become a popular coping mechanism during this pandemic mostly because there isnt much else to do, and getting pleasantly buzzed is a nice alternative to the fact that the world is mostly a raging dumpster fire.
However, and we know this is hard to hear, alcohol can interfere with the quality of your sleep. Ouch.
The bad news is that alcohol blocks REM sleep , meaning that you might feel drowsy and fall asleep quickly when you drink, but youre much less likely to fall into deep REM cycle sleep.
So have that glass of wine when the school day is over for your kids, but dont overindulge. Your sleep cycle will thank you.
Watch this video to hear about other activities, environments, or health conditions that could prevent you from getting good quality, restorative sleep.