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Is Insomnia An Anxiety Disorder

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Start By Getting A Good View Of Your Situation

3 Major Signs Insomnia Is Leading to an Anxiety Disorder

The AADA states that lack of sleep can actually cause anxiety. And we also know that anxiety itself can interfere with sleep. This brings up an important question for those who struggle with both insomnia and anxiety: Which struggle came first?

Its not exactly fun to think about these things, but pinpointing when your trouble sleeping began can help you figure out how to fix it.

  • biting nails or lips, or pulling out hair
  • trouble sleeping

When did my sleep issues start?

Once youre able to gauge roughly when your anxiety began, think of when you first started to struggle with sleep.

If trouble sleeping came first for you, do you have ideas why that is? Was it during a high-stress time in your life, or was it random? Lets say that you started to struggle with sleep after a traumatic event occurred in your life. You may have started having nightmares or flashbacks or nightmares that prevent you from sleeping.

If thats the case, you may want to look into Post Traumatic Stress Disorder or PTSD . If you need help with PTSD or GAD, that treatment might also be the key to better sleep because it would mean that youre tackling the root problem underneath your sleep issues. Band-aid treatments like sleep medicine can only go so far if theres an active cause of your sleep and anxiety issues.

I just get anxious ABOUT sleep!

Individuals might also have phobias that prevent them from falling asleep, such as a fear of home invasion or fear of a fire starting while theyre not awake.

How Common Are Anxiety Disorders

Anxiety disorders are the most common type of mental illness, affecting the lives of around 20% of American adults and 25% of teenagers each year.

Adults Affected in U.S.Percentage of U.S. Adult Population
Generalized Anxiety Disorder
7.7 million3.5%

Not all people with anxiety disorders have the same degree of symptoms or impact from anxiety on their everyday life. In one large survey, around 43% of adults described having mild impairment of their life from anxiety. Around 33% said it was moderate, and nearly 23% said it was severe.

Treatments Of Insomniaa Chance For Prevention Of Depression

As mentioned before, presently Cognitive-Behavioral Treatment for Insomnia is acknowledged to be the first-line treatment for insomnia thus opening the possibility for large-scale studies to test whether early and adequate treatment of insomnia may prevent psychiatric sequelae, i.e., depression or psychosis. First studies targeting this issue showed that online delivered CBT-I seems to be able to reduce insomnia and depression scores in subclinically depressed patients with insomnia . In a similar vein, advances in the field of chronobiology have led to a renaissance of chronotherapeutic approaches for mental disorders . These strategies are useful non-pharmacological preventive implementations into everyday lifestyleregular sleep-wake rhythmicity, season-adapted daily food and physical activity, day structure, correct light exposure at the right time in indoor lightingall strategies showing depression-preventive properties, which started to be empirically tested and confirmed but need replication.

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How Can Anxiety Cause Insomnia

If you go to bed feeling anxious, whether youre worried about work, or something in your personal life, lying in bed without any distractions gives your mind the time to go over and over your worries.

This can lead to your anxiety building, and your bodys fight or flight response being activated. This is our bodys way of protecting us in threatening situations and causes physical changes, including an increase in heart rate and the release of adrenaline, which are designed to help us be stronger or run faster . If your anxiety triggers your fight or flight response while youre in bed, these changes can over-stimulate your body, so that you can find it impossible to drop off to sleep.

Unfortunately, the link between anxiety and insomnia can act like a vicious circle. If you cant sleep because youre feeling anxious, this lack of sleep can make you tired, irritable and even more anxious the next day. You may struggle to get to sleep again the following evening, resulting in the cycle starting all over again.

If youve reached the stage where your anxiety is leading to insomnia and your insomnia then leads to more anxiety, its time to take steps to stop the cycle and achieve positive mental wellbeing again.

Rem Sleep And Depressionearly Hopes

Anxiety and Insomnia: Understanding the Connection and How to Treat It

The discovery of phases of REM during sleep in 1953 and the ensuing interest in sleep research led to the establishment of psychiatric sleep research utilizing polysomnography . Kupfer et al. from Pittsburgh were among the first to suggest that changes of REM sleep, i.e., shortened REM sleep latency , increased total REM sleep duration and increased REM density , are typical sleep characteristics of patients with primary vs. secondary depression . Furthermore, polysomnographically measured sleep continuity was disturbed and Slow Wave Sleep reduced. These findings were met with enthusiasm at the time and promoted the idea, later known as biomarkers , to identify functional subtypes within and across diagnostic categories by which treatment could be stratified and response predicted for each patient in order to achieve remission.

Comparison of the polysomnographic profile of a good sleeper and a patient hospitalized for severe depression according to DSM-IV criteria . Both subjects have been free from intake of any psychotropic drug for at least 14 days. The y-axis lists arousal , wake and sleep stages and eye movements). The x-axis is the time axis. Sleep in depression is characterized by alterations of sleep continuity , a decrement of SWS and a disinhibition of REM sleep: this encompasses shortening of REM latency, prolongation of the first REM period and increase of REM density. Original data from Freiburg sleep lab, hitherto unpublished

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Understand And Improve Sleep To Help Anxiety

Whether you have anxiety or not, we can all benefit from fine-tuning our sleep hygiene. Sleep hygiene refers to routine behaviors that help people get a better nights sleep and form healthy sleep patterns.

The brain is programmed to only be able to sleep well in certain situations. So give your brain the sleeping conditions that it needs. Here are some key sleep hygiene practices to integrate into your life:

  • Make sure that the area you sleep in is dark and noise-free
  • Try to go to bed and wake up at roughly the same time daily
  • Keep your sleeping area at a comfortable temperature
  • Avoid caffeine after 2 pm
  • Stay away from screens before bed including your phone, TV, and computer
  • Reserve your bed for sleep and sex only
  • Have a bedtime routine this can be anything from drinking a caffeine-free tea at night to meditating. Its all about what works for you. Even implementing a skin-care regimen or setting aside time to read can be part of your routine. Pick something that you can stick to on a nightly basis because when you do, completing these tasks will start to signal to your brain that its time to go to bed.

Staying connected to your thoughts and needs

If you suffer from sleep anxiety, it can be particularly helpful to be mindful of your thoughts at night. Are you thinking about work before bed? Are you often up all night trying to finish a project or task?

Respecting your limits

How Does Anxiety Affect Sleep

It is no secret that symptoms of anxiety can significantly impact your sleep. However, many people may not know that it is anxiety that is affecting their rest. Many individuals that have sleep problems typically think physical health is the culprit, but anxiety is one of the most common causes of sleep disturbance. By learning how anxiety affects sleep and vice-versa, you can begin to notice if this disorder is to blame for your sleep problems. From there, you can start to take steps towards managing in in a healthy manner that will not only help you sleep better but improve your anxiety in general.

What is Anxiety? What Does It Feel Like?

First and foremost, it is essential to outline anxiety and its symptoms. This way, you can begin to notice if they are currently present in your own life. Anxiety is a part of life, with many people feeling anxious from time to time due to external life circumstances. These can come from work, school, or significant life changes. However, anxiety can become a problem when it is persistently present and seemingly has no cause. When this happens, it is classified as an anxiety disorder and can affect your daily life from professional performance, grades, and interpersonal relationships.

Common symptoms of these various disorders include:

  • Muscle tension
  • Problems in interpersonal relationships

âEffects of Anxiety on Sleep

Lack of Sleep on Anxiety

Managing Anxiety For A Good Nightâs Sleep

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Use Medication To Fall Asleep Easier

If you have severe insomnia, your healthcare provider may prescribe medication to help you fall asleep faster and stay asleep throughout the night.

Several prescription sleeping pills are used to treat insomnia, including Lunesta® , Ambien® , Silenor® and others.

Although these medications are effective at promoting sleep, they can cause side effects. Findings are also mixed on their potential effects on rapid eye movement sleep and deep sleep, or slow-wave sleep.

Make sure to closely follow your healthcare providers instructions if youre prescribed any type of sleep medication.

Present Management Of Sleep/ Circadian Disorders In Depression

Anxiety Disorder and Insomnia!

Subjectively reported sleep disturbances typically manifest in various forms, such as difficulties falling asleep and maintaining sleep, waking up too early and feeling worn, fatigued and sleepy during the day. Although these symptoms are described by DSM-5 as insomnia disorder, they are rarely investigated properly by general practitioners or mental health professionalsunfortunately at present it is far more probable that both insomnia and symptoms of circadian dysfunction are still more or less viewed as symptoms of an underlying mental disorder, which will, at best, remit when the primary disorder is properly treated or, at worst, treated with the wrong drugs. A main reason for this is that there is a serious lack in the knowledge about basic sleep and chronomedicine across fields in the medical professions, maybe because these disturbances are transdiagnostic. Insofar, there still is a strong need for further education of health professionals, in particular in psychiatry , in the domain of sleep and chronomedicine to enable them to recognize, properly diagnose and treat individuals with sleep problems . Specific evidence-based treatment strategies incorporating chronomedicine for these disorders are available and might offer not only to improve the underlying sleep/circadian disorder but concomitantly ameliorate the outcome and course of mental disorders compared to standard psychiatric treatment.

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Insomnia As A Transdiagnostic Symptom/ Syndrome For Psychopathology

A further boost for the field came from DSM-5 with the establishment of the category of insomnia disorder, thus ascribing independent value to this symptom complex instead of considering it mainly a symptom of any kind of mental disorder. Still, in DSM-5, separation of condition by categories is current practise but clinical research inspired by RDoC is supporting a dimensional approach using constructs and domains to understand pathophysiology. RDoC has suggested a major domain named arousal and regulatory systems with the constructs arousal, circadian rhythms and sleep-wakefulness with a detailed listing of areas of interest for research from the level of molecules to circuits, behavior and paradigms. Two recently published meta-analysis on PSG derived sleep variables in insomnia and all different types of mental disorders support this concept and stress a transdiagnostic approach of sleep continuity disturbances/ insomnia towards mental illness. Instead of adhering to an approach, which sought to identify disease-relevant mechanisms through identifying biological markers for specific mental disorders, we postulate that sleep and circadian rhythm disturbances occur independently of and predict/coincide with affective disorders, clinical psychopathological syndromes do not necessarily reflect homogenous pathophysiological origin, neuropsychiatric syndromes like depression and sleep/circadian disturbances are linked through common mechanistic origins .

But No Increased Risk Seen In Kids Whose Insomnia Improved Over Time

byJudy George, Senior Staff Writer, MedPage Today June 13, 2021

Insomnia symptoms that persisted since childhood were strong determinants of mood and anxiety disorders in young adults, a 15-year longitudinal study showed.

Difficulty initiating or maintaining sleep that continued from childhood through adolescence and into young adulthood was tied to a three-fold increased risk of internalizing disorders , reported Julio Fernandez-Mendoza, PhD, of Penn State College of Medicine in Hershey, Pennsylvania, at SLEEP 2021, a joint meeting of the American Academy of Sleep Medicine and the Sleep Research Society.

Incident insomnia symptoms that developed over the course of the study were associated with a two-fold increased risk of developing internalizing disorders in young adulthood , Fernandez-Mendoza said.

A waxing-and-waning trajectory of insomnia symptoms also was linked with internalizing disorders in young adulthood . No increased risk of internalizing disorders was seen in children whose insomnia symptoms remitted during the study period .

“We found that about 40% of children do not outgrow their insomnia symptoms in the transition to adolescence and are at risk of developing mental health disorders later on during early adulthood,” Fernandez-Mendoza said.

A limitation of the study was its reliance on self-reported data.

Disclosures

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Think You Have Insomnia

If you find youre having trouble sleeping at least three times a week, try talking with your doctor about your options.

Theyll probably perform a physical exam and have you keep a sleep journal for a few weeks. From there, they might refer you to a sleep specialist who can complete a sleep study.

Also known as a polysomnogram, a sleep study electronically monitors your sleep activities so a specialist can interpret whats going on with your brain and body while you sleep.

The Effect Of Anxiety And Depression On Sleep Quality Of Individuals With High Risk For Insomnia: A Population

Generalized Anxiety Disorder: Causes and Risk Factors
  • 1Division of Endocrinology and Metabolism, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam-si, South Korea
  • 2Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
  • 3Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea

Introduction: One of the most common sleep disorders, insomnia is a significant public health concern. Several psychiatric disorders, such as anxiety disorders and depression, have shown strong relationships with insomnia. However, the clinical impact of the combination of these two conditions on insomnia severity and sleep quality remains unknown. We investigated the relationship between sleep disturbance and psychiatric comorbidities in subjects with high risk for insomnia.

Methods: We analyzed data from a nation-wide cross-sectional survey of Korean adults aged 19 ~ 69 years conducted from November 2011 to January 2012. The survey was performed via face-to-face interviews using a structured questionnaire. We used the insomnia severity index to evaluate insomnia and defined respondents with ISI scores of 10 were considered to be at high risk for insomnia. To diagnose anxiety and depression, we used the Goldberg anxiety scale and Patient Health Questionnaire-9 , respectively.

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How To Treat Anxiety And Insomnia

Self-awareness is an important first step in breaking the cycle of anxiety and insomnia. What factors, other than insomnia, increase your anxiety? What things, other than anxiety, contribute to insomnia? Among the common contributors to both are

  • caffeine,
  • alcohol use, even in small amounts,
  • medical conditions,

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.

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Antidepressants And Sleep In Depression

An important impetus for the field of sleep research in depression was the observation that almost all antidepressants influence sleep, notably by strongly suppressing REM sleep , whereby the extent of REM sleep suppression covaried with clinical ratings indicating therapeutic efficacy of antidepressants response . Thus, REM suppression appeared as a promising early predictor of subsequent treatment response. Identifying such early predictor that could function as a biomarker would be of high clinical value given the long latency to response and the limited response rate of ~60% of depressed patients. Insofar, the suppression of REM sleep seemed to constitute a window to the brain reflecting therapeutic efficacy of antidepressant substances. Table summarizes the effects of antidepressants on different aspects of polysomnographically recorded sleep .

Vicious Cycle Of Insomnia

Insomnia and Anxiety Help

Anxiety and insomnia work in a cyclical way – essentially, it’s a two-way street. “One of the consequences of not being able to go to sleep is that it generates anxiety,” Morgan explains.

“For people who have got daytime commitments, not being able to go to sleep – when you relentlessly cannot initiate sleep – this generates anxiety specific to sleep. We refer to it as a vicious cycle of insomnia.

“If you can’t go to sleep, you start anticipating the impact the sleeplessness will have on your performance the next day,” he explains.

The anxiety triggered may encourage you to emphasise your efforts to get to sleep, which is futile.

“If you try to go to sleep, you will almost certainly keep yourself awake. And the reason for that is that trying to go to sleep generates arousal. It makes you more alert,” Morgan says.

“If we focus on the arousing qualities of anxiety, then breaking the vicious cycle of insomnia becomes the strongest tool for fixing insomnia.”

Not everybody needs eight hours of sleep a night, as some people function well on less and others find they need more. But if you aren’t sleeping well, there are steps you can take to address the problem.

The link between anxiety and insomnia

  • 5min

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