How Can You Cope With Sleep Anxiety

Sleep anxiety is a feeling of worry or stress about being able to sleep. The anxiety over how much and how well you will sleep can itself interfere with the quantity and quality of your sleep, creating a seemingly never-ending cycle of worry and sleep problems.

Thankfully, there are ways to cope with sleep anxiety. The method you use to calm your anxiety and get the sleep you need can depend on what’s causing your sleep anxiety. Lifestyle changes, therapy, and medication are treatments that may be helpful. What’s important to do first is to recognize you have sleep anxiety and figure out why you have it.

Signs of Sleep Anxiety

Occasional anxiety or stress at night is normal. But when worry starts frequently impacting your ability to fall asleep and stay asleep, this can be a sign of sleep anxiety.

Sleep anxiety can be experienced differently from person to person, though it generally involves feeling worried about being able to fall or stay asleep. You may feel this worry closer to bedtime or as you are lying in bed trying to go to sleep.

The worry can cause you to lose sleep because you are unable to fall asleep, are restless while sleeping, or wake up earlier than you’d like.

As you get less sleep, you might also find that your anxiety—whether during the night or day—gets worse. Sleep problems can also make depression and negative thought patterns worse.

What causes sleep anxiety?

Research has found links between sleep anxiety and several conditions. Sleep and anxiety disorders can have a hand-in-hand role when it comes to sleep problems and sleep anxiety—they can contribute to or exacerbate each other.

Insomnia

One of the most common conditions linked to sleep anxiety is insomnia. Insomnia is a sleep disorder that makes it hard for you to fall or stay asleep or get good-quality sleep. In the short term, insomnia can be caused by schedule changes or by stress from big life events like a new job or a move to a different location. In the long term, insomnia could be caused by factors like medical conditions or medications.

Having insomnia can make you worry about the sleep you’re getting. And as insomnia continues, it’s possible for your anxiety about your sleep to worsen.

Besides insomnia, other sleep disorders can affect your sleep too. Regardless of which disorder is causing you to not get enough sleep, you can experience an increase in levels of certain stress markers, like the hormone cortisol. These increased levels lead you to have further trouble falling or staying asleep. That means sleep disorders and sleep anxiety can be a cyclical relationship, with lack of sleep making anxiety worse and your sleep anxiety preventing you from getting the sleep you need.

Anxiety Disorders

Sleeping issues are common for people with certain mental health conditions, like generalized anxiety disorder, depression, or post traumatic stress disorder (PTSD). Getting poor-quality sleep can intensify brain reactions that are associated with anxiety, opening the door for sleep anxiety.

Others might have anxiety about sleep because they fear of what sleep can bring. People with PTSD who try to block traumatic memories during the day may worry about what their dreams at night can bring in terms of nightmares and flashbacks. Someone with PTSD might also be on alert while sleeping or falling asleep and unable to relax for a deep sleep.

Risk Factors for Sleep Anxiety

Anyone can experience sleep anxiety. Besides a history of sleep disorders, anxiety disorders, or both, there are other factors that may make it more likely that you’ll feel the pressure to get the sleep you need while the clock ticks by.

People with sleep anxiety might anticipate that they’ll have trouble sleeping, leading to more anxiety and sleep loss. This cycle can be triggered by factors such as:

• Daily stress: Feeling stressed out or worried about daily tasks has been linked to having a disruptive night’s sleep.
• Traumatic events: Chronic or severely stressful life events can lead to a heightened fight-or-flight response and disturbed sleeping patterns.
• Lifestyle habits: Habits or routines that get in the way of a restful night’s sleep can prompt hormone levels that make it likely you’ll suddenly wake up at night with anxiety.

Age might also play a factor in whether you experience sleep anxiety. Sleep patterns shift with age, and older adults often find themselves waking up more frequently throughout the nighttime or having a more difficult time falling asleep. As we age, less time is spent in the deep sleep phase due to factors like anxiety, discomfort, pain, or a need to go to the bathroom, which could trigger a sleep anxiety spiral.

When to Contact a Healthcare Provider

It’s not uncommon to experience a night of not-so-great, anxious sleep once in a while—or even frequently over a short period of time if you’re in a time of stress.

But if you’re finding yourself experiencing sleep anxiety for a month or longer, this may be a chronic (long-lasting) issue that requires medical treatment.

In general, it’s probably a good idea to check with a healthcare provider if:

• You have trouble with sleeping on a regular basis.
• You frequently feel tired during the daytime.
• You are finding it difficult to complete daily activities due to lack of sleep.

How is sleep anxiety diagnosed?

Sleep anxiety isn’t an official medical condition. Rather, a healthcare provider can diagnose anxiety, a sleep disorder, or both by reviewing your medical history, performing a physical exam, and asking questions about your sleeping patterns and anxiety-related symptoms.

Because some medications and supplements can add to both sleep issues and anxiety symptoms, you should also expect to answer questions about anything you’re currently taking. This can help rule out certain causes.

A sleep study, which is known as a polysomnogram, may also be ordered. This test monitors data from your brain waves, eye movements, blood pressure, breathing rate, and heart rate during a full night’s sleep.

The sleep study won’t confirm that you have sleep anxiety. Rather, it can help diagnose obstructive sleep apnea or a movement condition, both of which can impact your sleep quality and, in turn, may lead to sleep anxiety. Diagnosing the condition behind your sleep anxiety can help address the sleep quality and, hopefully, sleep anxiety.

How do you overcome sleep anxiety?

Regardless of what’s causing you sleep anxiety, experts generally recommend regular sleep and lifestyle habits to help you cope. Some of these habits include:

• Creating a healthy sleep schedule
• Engaging in regular exercise
• Keeping your sleeping area dark, cool, quiet, and comfortable
• Trying relaxation techniques like reading, meditating, and staying away from screens close to bedtime
• Avoiding caffeine, alcohol, and heavy meals before bedtime
• Writing out your worries before bedtime

Beyond improving your sleep and lifestyle habits, your treatment may include therapy, medication, or a combination of both. The cause and severity of your sleep anxiety can dictate your treatment plan.

Cognitive behavior therapy (CBT) is a form of therapy that can help reduce sleep anxiety. It involves sessions with a mental healthcare provider to identify and modify the behaviors and thought patterns that prompt sleep anxiety.

With CBT, behavioral changes might include going to bed and waking up at the same times every day, getting out of bed when anxiety is preventing you from falling asleep, and only spending time in your bed when you’re sleeping (or having sex).

CBT will also help you think about sleep differently. You might be encouraged to address things like unrealistic expectations for how many hours of sleep you should get and misguided beliefs about how sleeplessness will affect you.

Medications—whether over-the-counter (OTC) or prescription—might help calm your sleep anxiety, as well. Some of the OTC medications contain the allergy medicine ingredient antihistamine, which may not be recommended for long periods of time since it can become less effective over time. And some of the prescription medications can be habit-forming, so you and your healthcare provider will want to keep a close eye on the drug’s effect on you over the course of your treatment.

You can also ask your healthcare provider about melatonin supplements. While they have been found to be an effective sleep aid for some, more research about their safety in the long term is needed.