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How To Control Sleep Anxiety

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How Can I Overcome Anxiety At Bedtime

5-HTP for Appetite Control, Sleep & Anxiety

If anxiety or disrupted sleep occurs often in your day-to-day life, these simple strategies can help you relax your body and mind and ease yourself into sleep. Changing your pre-sleep habits takes time and patience, but adapting to these changes may help you fall asleep with less sleep anxiety over time. 

The Next Day And Beyond

Someone who just had a first nocturnal panic attack is likely to find himself worrying about having another one. The thought “what if I have one tonight?” is likely to occur to you the next day. That’s a natural, ordinary response. It’s just you experiencing a little nervousness, and it will be best to allow yourself to notice that thought without getting into a struggle with it.

People often respond to this worry by focusing more on their prospects for sleep. They think a lot about what time to go to bed; try to tire themselves out during the day; think about taking sleeping medication, or alcoholic beverages, to ensure sleep; review all the important activities they have scheduled at work, home, or school, and worry that they’ll be unable to function if they don’t sleep, and so on.

It’s these very efforts which lead to more trouble with sleep anxiety.

Behavioral Techniques Used In Cbt For Sleep Disorders

As well as changing the way you think about sleep, CBT also works to change the habits and behaviors that can prevent you from sleeping well. Depending on your specific symptoms and needs, your therapist may employ some of the following techniques:

Sleep restriction therapy reduces the time you spend lying in bed awake by eliminating naps and forcing you to stay up beyond your normal bedtime. This method of sleep deprivation can be especially effective for insomnia. It not only makes you more tired the next night but builds a stronger association between bed and sleep rather than bed and lying awake.

Stimulus control therapy helps to identify and change sleep habits that prevent you from sleeping well. This means training you to use your bedroom for just sleep and sex, rather than working or watching TV, and maintaining consistent sleep-wake times, even on weekends.

Improving your sleep environment and sleep hygiene. Your sleep environment should be dark, quiet, cool, and comfortable, so your therapist may recommend blackout shades, earplugs, or a sound machine to block out noise. Sleep hygiene involves improving your daytime habits to include exercising regularly, avoiding nicotine and caffeine late in the day, and learning to unwind at night.

Biofeedback uses sensors that measure specific physiological functionssuch as heart rate, breathing, and muscle tension. Biofeedback teaches you to recognize and control your bodys anxiety response that impacts sleep patterns.

Take A Tip From Your Kids With A Strict Bedtime Routine

We know how important it is for children to have a nighttime routine as it creates a sensed of structure and security, well the same goes for adults especially if you suffer from anxiety, says Bianca L. Rodriguez, a psychotherapist and spiritual coach. A bedtime routine can help you self soothe and act as a container for your anxiety. I recommend taking a warm bath or shower before bed to relax your muscles as the state of your body impacts the activity in your mind. Imagining frustrations, negative energy or worries flowing down the drain can help you approach sleep feeling more clear and calm.

What Do My Habits Have To Do With It

Insomnia Causes. Sleep Problem, Anxiety Nightmare Reasons ...

Some people lay in bed staring at the ceiling in part due to chronic pain, depression, medications or other substances that can interfere with sleep. When you treat those issues, often it will naturally help improve your ability to sleep. 

However, despite addressing other medical or psychiatric conditions, sleep difficulties often will persist. People who have chronic insomnia worry excessively about sleep and the effects of insomnia. They also become more and more agitated and tense as bedtime gets closer.

If youre very worried about getting good sleep, you can put a lot of effort into getting sleep and have a lot of anxiety at night, says Dr. Drerup. This makes you more alert and can keep you lying in bed wide awake.

Visualize The Good Things In Your Life

The power of your imagination can help get you to a place of ease when youre fretting.

Visualization of positive events and relationships in your life will help you increase your connection to positive emotions that are also lying around within you, but you have to work at accessing them when the anxious feelings or thoughts have already shown up, says Cummins.

Calming your body is integral to calming your mind.

Joy Rains, a certified life coach and the author of “Meditation Illuminated: Simple Ways to Manage Your Busy Mind”, recommends a progressive relaxation exercise you can do in bed.

The Conventional Approach Falls Short With Insomnia & Anxiety At Night

As a layperson with a passion for health, one of my biggest frustrations with the conventional philosophy in Western medicine is their unwillingness to look at the big picture. In general most health & wellness complaints are treated as single, isolated problems.

This leads our healthcare to be both reactive and surface level .

Im really thankful that I decided to start digging in and asking questions over a decade ago, which continues to this day.

In my experience, most conventional doctors offer just two options for a patient with anxiety at night and sleep trouble:

  • 1) Do nothing, or tell you to try relaxing
  • 2) Pharmaceutical medications

In reality, there are SO many other options to try.

Engage In Mindfulness Practices During The Day

There are several things that you can do throughout your day that encourage better sleep at night. For instance, Harris recommends people meditate during the day in order to strengthen their brains to use meditation at night. Remember, practice makes perfect when it comes to meditation, and the more you learn to recognize and regulate busy thoughts at night, the more you will be able to let them go. 

Additionally, Miller suggests scheduling in worry time to your day. This is an exercise where you designate a specific time of day to dump out any thoughts, stresses, or issues on your mind. This can be done first thing in the morning or during the afternoon, as long as you dont do it right before you shut off the lights. 

After your worry time is over, put the stressful things aside and remind yourself that its not time to worry right now and move onto other things, Miller says. Your brain will eventually get used to this new routine and it will start to be able to let worry and stress go more easily.

Have A Bedtime Routine If Youd Like But Dont Freak Out If Its Different Each Night

Anxiety & Insomnia: Control Anxiety With These 5 Bedtime Routines

A routine establishes a positive conditioning for sleep, says Tal. When you start your routine, your body gets the “hint” and starts to initiate the mechanisms for sleep.

It was important for me, however, to realize that Im someone who might be unmoored by obsessing over the ritual of what I do each night. During treatment, I liked to take a shower, have a warm glass of milk with honey and do some type of relaxing activity. Early on I found that if I didn’t do something exactly as I’d done it the night before, I would grow anxious over my ability to fall asleep that night. And then boom, no sleep. Instead, I now keep the overall framework of a nighttime routine but have let go of the specifics. One night, I may watch 20 minutes of a TV show, another I might read 10 pages of a book. I’ve done this so my brain doesn’t associate the particular ordering of activities with sleep. For me, the ritual was about relaxation, not rigidity.

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.

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.

Shop for the Hatch Rest+ and Restore.

Fears Related To Sleep Apnea

Still others are fretful about sleep because they have health conditions. People who have sleep apnea for example, sometimes fear that theyâll stop breathing in their sleep.

Harris says that fear is rare, but may occur when someone first learns that he or she has sleep apnea and is waiting for a CPAP device to treat the condition.

âOnce the apnea is under control, people sleep better knowing theyâre not waking up multiple times a night,â Harris says.

So what can you do to eliminate the fear of sleep? Hereâs what experts suggest:

How Can I Tell If Its Anxiety Or A Sleep Disorder

Anxiety Super Greens by VitaPharm Nutrition

Sleep disorders are very common in anxious people. Anxiety makes it difficult to quiet your mind and body to go to sleep. Not long ago, we believed that if the sleep problem was caused by another medical or mental health condition like anxiety, you would treat the cause and the sleep problem would go away. We now know this isnt true. If the anxiety is treated, the sleep problem may remain. The current belief is that you must treat both problems.

But not all sleep problems start with another condition like anxiety. Some people only have anxiety about sleep. Their anxiety is caused about worrying about sleep or how they will function after a night of bad sleep. If this struggle continues night after night, they start to dread the bed. During the day, they arent anxious, but once they start thinking about going to bed, their anxiety rises. Other people are anxious about sleep because of something that happens during sleep. It could be nightmares, fear of sleep walking or other behaviors that only occur when the person is asleep and unaware, or waking up gasping for air due to untreated sleep apnea. Sometimes its fear of the dark. Additionally, about 40 percent of people who have panic attacks will have nocturnal panic attacks. Essentially, they wake up from sleep in a panic. All these things make sleep something to be feared, and if you dread your bed, youll have problems sleeping.

Addressing Sleep Problems Makes A Difference

If you sleep poorly and feel depressed, anxious, or less emotionally responsive, there are many treatments that can help. First, look at your sleep habits and see if there are steps that you can take on your own to improve the quantity and quality of your sleep. See Adopt Good Sleep Habits for tips on how to improve your sleep. If problems persist, you may wish to see a medical provider and ask about an evaluation for sleep problems and mental health concerns. After an evaluation and diagnosis, your provider can advise you on the best course of treatment. Options may include behavioral or other forms of therapy and/or medications. You can read about and watch a video of a behavioral sleep consultation in the Healthy Sleep module.Even if you do not have underlying sleep problems, taking steps to ensure adequate sleep will lead to improved mood and well-being. Sheila, a Boston district attorney and mother, became sleep deprived due to the conflicting demands of a full-time job and caring for her young children. She began to feel cranky, irritable, and uncharacteristically depressed. When she got both of her children on a consistent sleep schedule, she herself started sleeping an average of seven to eight hours a night and her mood improved considerably. Read more and watch a video about this in Sheila’s Balancing Act.

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 , good sleep hygiene and medication.

Last reviewed by a Cleveland Clinic medical professional on 06/13/2021.

References

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
  • accidents

Whether your doctor makes a diagnosis of anxiety, insomnia, or both, reaching out is the first step in the treatment process.

How Does Cognitive Behavioral Therapy Treat Sleep Anxiety

How Celia improved her sleep by abandoning all attempts to control sleep, thoughts & anxiety (#29)

is a form of psychotherapy, or talk therapy. It teaches you how to change your behavior by changing the way you think. Its a common treatment for people with anxiety. A special form of CBT called cognitive behavior therapy for insomnia 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 bodys 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.

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

How To Get The Sleep You Need

Is your anxiety making it hard to fall asleep? Establishing and committing to a healthy sleep schedule to provide quantity and healthy sleep hygiene to provide quality can really help. Here are nine more tips that can provide both:

1. Set a consistent sleep schedule

Once you have found your optimal bedtime, try your best to go to bed at that set time each night and to get up at the same time each morning, 365 days a year. As tempting as it may be, try not to sleep in on weekends; it will make it harder to wake up early on Monday morning because you will have reset your sleep cycle for a later wake up time.

2. Exercise early in the day

Set aside 20 to 30 minutes each day to exercise. Among other health benefits, it can help you sleep better. That being said, a workout right before bedtime could interfere with sleep. It’s best to exercise about five to six hours before bedtime.

3. Schedule meals appropriately

Try to be consistent with your meal times. If you wait too long to eat, you can trigger the nervous system, making it harder to sleep later. Also, try to schedule dinner at a time that leaves three hours between dinner and bedtime. If you have a problem with low blood sugar, you could try a small bedtime snack that is high in tryptophan, such as nuts, eggs, chicken, cottage cheese, or turkey.

4. Avoid caffeine, drugs, cigarettes, and alcohol

5. Create a relaxing bedtime routine

6. Create a sleep sanctuary

7. Don’t just lie there

8. Find a comfortable room temperature

Simple Ways To Help Insomnia

While theres no one magic trick for getting the deep sleep your mind and body need, following a few simple tips can help you get good rest.

If youve found yourself unable to sleep after 20 minutes, try again, advises Dr. Fareed. Get up for a few minutes and read or sit quietly until you feel sleepy. Then go back to bed.

Aromatherapy And Essential Oils

Manage Stress, Donât Eliminate It

Essential oils, the extract from plants, have been used for thousands of years to treat a number of conditions, including anxiety. Essential oils activate certain areas of your brain and release feel-good chemicals such as serotonin. They have been found to ease symptoms of anxiety, stress, and depression, improve mood, and improve sleep.

Recommended use includes diffusing, inhalation, or topical treatment which can aid with anxiety symptoms. When diffusing an essential oil or essential oil blend you will need an essential oil diffuser to fill your space with the desired scent. Inhalation is used by deeply smelling the essential oil straight from the bottle or by applying a drop or two of the oil on something such as a diffuser pad or lava bead that is connected to a bracelet, necklace, or even keychain. You can also place a drop or two of essential oil into your hands, rub them together, then cup your hands and take a few deep inhalations to get the desired effect.

You should be sure that the essential oils you use are pure oils and not mixed with chemicals. Some good brands to use include: Mountain Rose Herbs, Plant Therapy, Young Living, Doterra. You can do your own research to find a brand that will best work for you and your budget. Remember that a bottle of essential oil will last a long time since you typically use only a few drops at a time.

Essential oils that are great for treating anxiety include:

  • Lavender
  • Vetiver

How Does Cbt Work For Sleep Disorders

CBT addresses negative thoughts and behavior patterns that contribute to insomnia or other sleeping problems. As the name suggests, cognitive behavioral therapy involves two main components:

Cognitive therapy teaches you to recognize and change negative beliefs and thoughts that contribute to your sleep problems.

Behavioral therapy teaches you how to avoid behaviors that keep you awake at night and replace them with better sleep habits.

Using a sleep diary in CBT

To identify patterns in your sleeping problems and decide on the best treatment approach, your therapist may start by asking you to keep a sleep diary. The details can be important, revealing how certain behaviors are ruining your chance for a good nights sleep. You can download or print HelpGuides sleep diary and take it to your therapist to help pinpoint your specific problems.

The Different Faces Of Anxiety

All of us experience anxiety from time to time. When in moderation and for the right reasons, anxiety can be a timely alarm system, alerting you to potential hazards.

Let’s say you’re feeling anxious about a challenging work project. That spurs you to put in extra time to go over the details, conduct relevant research, and draft up proposals. In this case, anxiety is useful in helping you produce exceptional work and knock the socks off your managers and clients. What’s not so useful is when you constantly worry about the project to the point that you have mild panic attacks and sleepless nights.

As you can see, once you give anxiety free rein, it quickly develops into something unmanageable. If you’re anxious most of the time â if not all of the time â and have been feeling this way for at least six months, you may be dealing with an anxiety disorder.

Anxiety disorders come in various forms that react to different triggers. Here are some of the most common ones:

There are also anxiety-related disorders such as:

  • Post-traumatic stress disorder : Personal experience or observation of a traumatic event can give rise to this psychiatric disorder.
  • Obsessive-compulsive disorder : Repetitive, unwelcome thoughts, ideas, or feelings drive the need to do a specific behavior repeatedly.

The Effects Of Sleep Deprivation

A sleep debt can have serious ramifications on your anxiety levels. One study shows that severe sleep deprivation increases one’s state of anxiety, depression, and general distress relative to those who had a normal night of sleep. Another study shows that sleep deprived individuals reported a greater increase in anxiety during tasks and rated the likelihood of potential catastrophes as higher when sleep deprived, relative to when rested.

How much you sleep each night also determineshow well you can deal with anxiety and stress. When a person gets too little sleep, the deprivation acts as a chronic stressor that impairs brain functions and contributes to an overload on the body’s systems. This overload contributes to memory loss, brain fog, confusion, and depression, making it more difficult for a person to deal with stress. Furthermore, sleep deprivation creates an imbalance in hormone levels that drive anxiety levels higher. Too little sleep also boosts adrenaline levels that can exacerbate existing anxiety issues.

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