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.
The Link Between Sleep And Mood
You probably know firsthand that sleep affects mood. After a sleepless night, you may be more irritable, short-tempered, and vulnerable to stress. Once you sleep well, your mood often returns to normal.Studies have shown that even partial sleep deprivation has a significant effect on mood. University of Pennsylvania researchers found that subjects who were limited to only 4.5 hours of sleep a night for one week reported feeling more stressed, angry, sad, and mentally exhausted. When the subjects resumed normal sleep, they reported a dramatic improvement in mood.1Not 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.
Sleep and Mood
Practice Good Sleep Hygiene
Sleep hygiene is a term thats used to describe good sleep habits. Much like being organized and consistent can help with your grades, work performance and physical health, maintaining good habits can help you nab a better nights sleep.
The CDC recommends the following techniques to maintain good sleep hygiene:
This guide to science-based methods for falling asleep faster shares more tips to help you improve your sleep habits and enjoy better, deeper sleep.
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Get Up At The Same Time Daily
Creating a routine can be an effective way to combat sleep anxiety and insomnia. By getting up at the same time every day, your body will naturally start to adjust your internal clock or circadian rhythm.
One sleep study, highlighted in the Guardian as A Cure for Insomnia, found that getting up at the same time every day helped the participants body feel sleepy around the same time every night. Over time, this helped the participants bedtimes become consistent.
However, creating a nighttime routine can also have similar effects. Winnie Yu for WebMD suggests creating a nightly routine can help relax your body as it starts to anticipate and expect sleep as you follow through each step. It can also help relieve anxiety, as you know what to expect each night and each morning.
Practise Good Sleep Hygiene
There are a number of things you can do more generally to help you get a better nights sleep.
The first is to try and keep a consistent sleep routine. Try going to bed and waking up at the same time each day, even at weekends. This helps your body get into a routine and makes it more likely that youll be able to fall asleep each night.
You should also try to limit your intake of caffeine, sugar and alcohol late at night. These substances can make you feel wide awake and jittery, which will only fuel your anxiety. Also, try limiting the amount of fluid you drink before bed so youre not waking in the night needing the toilet.
Also avoid using electronic devices, such as your mobile or tablet, within 30-60 minutes of your target bedtime. Electronic devices give off a bright light which can be overly stimulating and stop you getting to sleep
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How To Get Rid Of Anxiety So You Can Sleep Better
If youre struggling to fall asleep due to anxiety, it could be that treating the anxiety will help solve your insomnia and lack of sleep as well. Anxiety disorders should only be diagnosed by a licensed therapist or medical professional, and these professionals can also help you find treatment regimens as well as, potentially, medications to control the condition. You should not try to self-medicate for anxiety disorders, and should only medicate per the medical advice and supervision of a psychiatrist.
One of the most common and effective treatments for anxiety disorders is continued and guided therapy with a professional counselor or therapist.
The branch of therapy known as Cognitive Behavioral Therapy can be effective for many people, as it helps patients suffering from anxiety disorders create new, positive thought pathways that can help when in anxious situations. There are three different types of CBT, each with an individualized approach in treatment, including interpersonal therapy, thought records, and modern exposure therapy.
Another form of therapy is Acceptance and Commitment Therapy, also known as ACT. This form of therapy is more focused on mindfulness training and taking action based on personal values, and is unique in that it is not focused on symptom reduction.
Shifting Your Perspective
Anxiety & Sleep Apnea
Studies on anxiety and sleep apnea have also indicated that the two conditions are linked. A 2014 study on the correlation of anxiety and depression and obstructive sleep apnea examined 178 adults diagnosed with OSA who had a range of sleep apnea severity, from mild to severe. The participants were assessed according to the Beck Anxiety Inventory and the Beck Depression Inventory.
Relating to the frequency of anxiety and depression symptoms, the study showed that 53.9% of the participants had some degree of anxiety, while 46.1% demonstrated depressive symptoms. Additionally, the studys results showed that the anxiety of the patients with OSA was higher than in the general population regardless of gender. Its clear that anxiety and sleep deprivation are closely linked, and that for those with OSA, anxiety, as well as depressive symptoms, are likely. Sleep apnea treatment can improve quality sleep and reduce sleep deprivation, possibly leading to a decrease in anxiety levels.
Patients who experience anxiety combined with loud, persistent snoring or waking up with a gasping or choking sound should consider seeking out professional help. If a physician diagnoses you with obstructive sleep apnea, Dr. Jeff Rodgers can provide sleep apnea treatment with comfortable, effective oral appliances. If youre interested, you can schedule a free consultation at our website or contact us through phone or email.
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The Impact Of Sleepiness On Mood And Mental Health
Lack of sleep can alter your mood significantly. It causes irritability and anger and may lessen your ability to cope with stress. According to the NSF, the Ã¢walking tiredÃ¢ are more likely to sit and seethe in traffic jams and quarrel with other people. Sleep-deprived people polled by the NSF were also less likely than those who sleep well to exercise, eat healthfully, have sex, and engage in leisure activities because of sleepiness.
Ã¢Over time, impaired memory, mood, and other functions become a chronic way of life,Ã¢ says Siebern. Ã¢In the long term, this can affect your job or relationships.Ã¢
Chronic sleepiness puts you at greater risk for depression. They are so closely linked that sleep specialists arenÃ¢t always sure which came first in their patients. Ã¢Sleep and mood affect each other,Ã¢ says Verceles. Ã¢ItÃ¢s not uncommon for people who donÃ¢t get enough sleep to be depressed or for people who are depressed to not sleep well enough.Ã¢
Lack Of Sleep And Anxiety
Typically, adults need at least seven hours of sleep every day to function well. Teenagers need an average of nine hours of sleep since they are still in the development stage with a variety of education and extra-curricular activities. Without enough sleep, anxiety and stress may emerge which can directly affect their everyday mood and performance.
According to studies, people who have sleep disorders will most likely develop anxiety in the long run. And clinically diagnosed patients with anxiety usually exhibit symptoms like sleep disruption. The correlation between these two is yet to be determined.
Research shows that lack of sleep causes the same brain operations that make an individual vulnerable to anxiety. While its not the major cause of anxiety, it can highly trigger its other signs and symptoms, adding intensity to the anxiety and fueling it to progress more.
So how exactly does sleep affect our mental health?
If you are a normal sleeper with no sleep disorders at all, your sleep cycle changes every 90 minutes. Every night, you experience two different sleep categories. The quiet sleep and the rapid eye movement sleep.
The first one refers to the calm type of sleep where our body temperature decreases, muscles are being relaxed, and the heart rate and breathing slow down, more like a hibernating period. This is where you are asleep deeply. Quiet sleep is important in boosting the immune system.
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Practice Anxiety Management On Your Own
Whether you’re working with a therapist or not, there are some anxiety-reducing techniques you can perform on your own. These tactics are easy to follow and help curtail sleep-related anxiety.
- Take time to wind down before bed: An active mind is an anxious mind just waiting to sabotage sleep. This is why a wind-down routine is non-negotiable in the 1-2 hours before your target bedtime. Give yourself sufficient time to slow down and let go of the day’s stressors. Sliding into the right frame of mind for sleep means less tossing and turning in bed later.
- Do a brain dump: To break the bad habit of rumination, pen down your fretful thoughts on a piece of paper. Add the “Brain dump” habit to your Energy Schedule to jot down your worries or be productive by planning your next-day to-do list. What you’re essentially doing is taking a load off your mind, making it easier for you to doze off.
- Engage in relaxation techniques: Relaxation techniques help nip your body’s stress response in the bud before it progresses to full-blown anxiety. The RISE app offers four types of relaxation techniques â progressive muscle relaxation, autogenic training, diaphragmatic breathing, and relaxing sounds. You can perform them at any time of the day and at night. Experiment and see which one work best for you.
If you’d like to learn more about how to dial down your nighttime anxiety levels, check out our in-depth guide to “How to calm anxiety at night.”
Whats The Link Between Sleep Disorders And Depression
Having a sleep disorder does not in itself cause depression, but lack of sleep does play a role. Lack of sleep caused by another medical condition, a sleep disorder, or personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.
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This Is Your Body In Anxious Mode
When you’re stuck in anxious mode, chances are your heart races, your underarms sweat, and your muscles tense up. But these are just the tip of the iceberg when detailing symptoms of anxiety. Other common examples include:
- Breathlessness or rapid breathing
In more serious cases of anxiety, you may even encounter sensations like:
- Chest pain or pressure
- Dizziness or feeling faint
- Tingling or numbness in the arms and legs
To understand why you’re feeling these physical effects, we need to dive down to the biological level.
When you’re stressed, the hypothalamus in your brain releases corticotropin-releasing factor . This hormone is the main driver of the hypothalamic-pituitary-adrenal axis. CRF prompts the pituitary gland to release the adrenocorticotropic hormone into the bloodstream. When the adrenocorticotropic hormone reaches the adrenal glands, stress hormones, like cortisol and adrenaline, are released into your system.
But CRF’s realm of control also extends to emotional regulation and cognitive functioning. Specifically, CRF downplays serotonin secretion, a neurotransmitter that controls your moods and is also known as your body’s feel-good chemical. Low serotonin levels, courtesy of an anxious mind, allow negative emotions to breed, like depression, frustration, and fear.
- Dilated pupils
- Increased production of blood glucose and fatty acids for energy metabolism
- Increased cognitive activity
What Causes Anxiety Disorders
The exact cause of anxiety is unknown. In fact, researchers believe that there is not one single cause but rather an interplay of factors that include a persons genetics, family history, and exposure to negative life events. Some health problems and drugs can also contribute to symptoms of anxiety.
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Does Lack Of Sleep Cause Anxiety
Just about everyone has felt a little high-strung after a bad nights sleep, and more and more, researchers are finding that a lack of sleep can contribute both to short-term irritability and to a higher risk of developing anxiety disorders over the long term.
In a 2013 study published in the Journal of Neuroscience, researchers found that poor quality sleep amplifies reactions in parts of the brain associated with anxiety, such as the amygdala and anterior insula.
Interestingly, these reactions were strongest in people who displayed high levels of trait anxiety, suggesting that those who are already prone to anxiety may experience the largest increase in anxiety if their sleep is affected.
Other research has found that people who are affected by sleep issues such as insomnia may have an elevated risk of developing anxiety.
Put simply, sleep deprivation doesnt just affect your mood it appears to cause physical brain reactions that can trigger anxiety.
How To Calm Anxiety And Get Better Sleep
Although the impacts of anxiety disorders can be substantial, they are one of the most treatable mental health disorders. This doesnt mean that reducing anxiety is always simple, but there are treatments that can help.
Any person who has persistent or significant anxiety and/or sleeping problems should talk with a doctor who can best assess their situation and discuss the benefits and downsides of the potential treatment options in their case.
Cognitive behavioral therapy is a common treatment for anxiety disorders. It is a type of talk therapy that works to reorient negative thinking, and it has had success in decreasing anxiety. Studies have found that CBT can often reduce anxiety even in people who have insomnia. Addressing anxiety can pave the way for better sleep, but severe cases of insomnia may persist after CBT for anxiety. CBT for insomnia may be a useful next step in these cases.
Several different types of medications are approved to treat anxiety disorders including anti-anxiety drugs, antidepressants, and beta-blockers. These medications are intended to mitigate symptoms rather than cure the underlying anxiety.
Because of the multifaceted relationship between anxiety and sleep, getting better rest may help combat feelings of anxiety. Building healthy sleep habits can make going to bed a more pleasant experience and facilitate a consistent routine to enhance sleep.
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Limit Caffeine And Other Stimulants
For many people, cutting out caffeine from their diet can be very difficult, but caffeine can greatly hamper your ability to fall asleep. Additionally, as a stimulant, caffeine can make your anxiety much more pronounced, and you may have a difficult time calming down if you drink excessive amounts of coffee.
It could also be getting in the way of you achieving a good nights sleep. Try avoiding caffeine at least four to five hours prior to when you want to go to bed.
If you know of any other forms of stimulants that you may be taking, try avoiding those at least a few hours before bedtime, as well.
Additionally, some recent studies, such as one conducted by Harvard Health, have come to find that blue light can keep the brain active, stimulated, and awake, as it suppresses the secretion of the hormone melatonin. This is the hormone responsible for helping you fall asleep, so try avoiding blue light, or wearing amber glasses to suppress the effects of the light, at least two hours prior to bedtime.
Anxiety And Sleep Disorders
As mentioned above, the relationship between sleep and anxiety isnt a one-way street. Not only does research show a clear link between not getting enough sleep and increased anxiety it also shows that anxiety itself can keep you awake and prevent you from maintaining healthy sleep habits.
Chronic insomnia can vary in severity from mild and temporary to chronic and severe. Common symptoms of insomnia include:
Lying awake for a long period of time after you get into bed
Spending a large percentage of the night awake, unable to sleep
Only being able to sleep for short periods of time before waking
Waking up early in the morning, before your alarm goes off
Feeling tired during the daytime, as if you havent slept
In addition to its link with insomnia, anxiety is also associated with sleep reactivity, which is the degree to which people develop sleep disturbances in response to stress.
This two-way relationship means that anxiety can worsen your sleep, which in turn may worsen your anxiety symptoms.
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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.