Anxious Sleeping: Your Guide To A Good Night’s Rest
According to the American Psychological Association (APA), anxiety is an emotion where someone experiences worry, tension, and sometimes, even physical symptoms, such as high blood pressure or lack of sleep.
Anxiety is not the same as fear, which is an appropriate response to a threat, but it can still feel very real and affect how much rest we get each night. What can you do to keep the occasionally anxiety-filled night from messing with your sleep health?
This guide covers how anxiety and sleep are interrelated, change with age, and what you can do to manage both.
Anxiety and Sleep
Anxiety disorders are the most common mental illness in the U.S., with over 40 million diagnosed. Similarly, between 50 and 70 million Americans suffer from sleep or wakefulness disorders.
These numbers aren't a coincidence. On the contrary, the relationship between sleep and anxiety is significant – with sleep deprivation comes increased anxiety and vice versa.
It's a vicious cycle that many people with anxiety disorders and insomnia find hard to break. Anxiety symptoms like restlessness, increased heart rate, rapid breathing, and gastrointestinal (GI) problems make it difficult to fall asleep.
The Cause And Effect
Because insomnia and anxiety are so closely linked, it’s essential to try and identify which came first. For example, does sleep deprivation cause your anxiety, or is it the other way around? Mental health professional Brooke Sprowl explains it best:
“Sometimes, insomnia is secondary, in that it is caused by another primary disorder such as depression, anxiety, or a medical condition. In this case, usually treating the primary disorder [improves] insomnia.”
Whether insomnia and sleep deprivation are the primary cause or not, addressing them is worthwhile. Many experts recommend natural remedies like magnesium glycinate and melatonin to help restore a healthy sleep pattern.
Additionally, cognitive behavior therapy combined with helpful bedtime routines can also address most sleep issues.
Common Sleep Disorders
There are many forms of sleep disorders besides insomnia. All interrupt sleep, impact physical health, and increase nervousness and stress. Here are a few common ones:
Delayed Sleep Phase Syndrome
Approximately seven to 16 percent of young adults have delayed sleep phase syndrome (DSPS), which presents itself as not being able to get to sleep on time and having a hard time getting up in the morning. When your sleep and wake cycles don’t align with the current time zone, you’ll usually have a few sleep issues and may have trouble getting rest while the sun’s down. Luckily, DSPS usually corrects itself over time.
Obstructive Sleep Apnea
Obstructive sleep apnea is one of the most common sleep issues experienced by children and adults alike. An estimated 30 percent of men and 17 percent of women may have the condition, which obstructs a sleeper’s airways, resulting in difficulty breathing. These interrupted breathing episodes occur numerous times during sleep and are usually accompanied by snoring.
Obstructed airways result in lowered oxygen levels and increased carbon dioxide in the blood. Sufferers are often unaware they have the condition. Sleep apnea increases the risk of heart disease, stroke, diabetes, and cancer. Sleep studies are required to diagnose obstructive sleep apnea.
Forms of Anxiety
How do you know if you have garden-variety nervousness or a more severe anxiety disorder? Usually, the difference is how significantly your anxiety affects your life.
For example, the occasional anxiety pang is expected if you are in an uncomfortable or unfamiliar situation, such as showing up to a party without knowing anybody. However, if a person’s anxiety interferes with daily activities and social situations (e.g., making friends, school work, job performance), they may have a severe anxiety disorder.
Regardless of the cause, understanding different types of anxiety disorders can be the key to keeping sleep issues at bay. Below are descriptions of the five major anxiety disorders. If you’re experiencing any symptoms of anxiety, we recommend connecting with your healthcare provider as soon as possible.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is when people suffer from excessive anxiety and worry. Instead of one source of stress, sufferers tend to worry about multiple things simultaneously.
GAD symptoms last at least six months and negatively influence social situations like school, work, and family life. GAD affects 6.8 million adults (3.1 percent of the US population), yet only 43 percent of sufferers receive treatment.
Social Anxiety Disorder
Here's a fact you may not find too surprising: public speaking and death are ranked as America's two biggest fears. But while some nervousness and anxiety (like the feeling of butterflies in your stomach) go hand-in-hand with most big social events, it becomes a real problem with social anxiety disorder.
People with social anxiety disorder struggle when meeting new people, making friends, interacting with teachers, or buying items at a checkout counter.
Obsessive-Compulsive Disorder (OCD)
People with obsessive-compulsive disorder (OCD) have recurrent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions). Individuals often perform repetitive “rituals” like washing their hands, checking, counting, or cleaning.
The rituals are intended to lower anxiety levels, but the result is temporary. Obsessive-compulsive disorder is often associated with poor sleep, especially if repetitive behaviors involve waiting until rituals are done to settle in or cause them to get out of bed.
A panic attack is an unexpected episode of intense fear followed by physical symptoms like chest pain, heart palpitations, and shortness of breath. These episodes of extreme anxiety are the direct result of panic disorder. Because panic attacks manifest without warning, the worry of having another one is a significant source of fear itself. This fear can lead to long-term sleep deprivation.
In the past year, 2.7% of U.S. adults have had a panic disorder, with females (3.8%) more likely to have one than males (1.6%). Less than 5% of U.S. adults will have a panic disorder in their lifetime. However, anyone who has panic attacks frequently enough to fear having another one may want to connect with a mental health provider about a panic disorder.
Post-Traumatic Stress Disorder (PTSD)
Everyone who experiences a traumatic or stressful event feels a certain level of anxiety. Our natural fight-or-flight instinct kicks in to keep us safe from any perceived danger. As a result, some residual tension is expected once the event is over, and this usually wanes with time.
However, for some people, this never happens. Instead, they develop post-traumatic stress disorder (PTSD), an anxiety disorder where sufferers re-experience the fear of a traumatic event(s) long after it has passed. One of the most common symptoms of PTSD is intense nightmares, which is a major sleep disruptor.
Although PTSD causes sleep disorders, sleep deprivation can also contribute to developing PTSD. One sleep study of National Guard members demonstrated this causal relationship.
In the study, National Guard members were screened for sleep disturbances a few months before deployment to Iraq. A year later, they came back and were tested for PTSD. Researchers found that soldiers who had sleep disorders before they were deployed were more likely to have PTSD upon returning.
Sleep and Anxiety as We Age
Generally speaking, a person’s anxiety tends to spike around adolescence (32%) and wanes as people grow into adults (19%).
While anxiety in general improves with age, sleep quality gets worse. One explanation is that our sleep patterns change as we get older. Another probable explanation is chronic age-related aches and pains. In addition to this, our brain chemistry also changes as we age. Levels of melatonin, the chemical responsible for beginning the sleep cycle, decline as we get older.
If we don’t take steps to improve our sleep as we age, we can counteract the positive gains we get from lowered levels of anxiety. We need to understand how anxiety and sleep affect us at critical points in our lives to do that.
Children and Adolescents
Our sleep patterns change dramatically for the first few decades of our lives. After that, our bodies and brains grow, and our sleep needs change along with our sources of anxiety.
Infants need the most sleep and have frequent sleep-wake episodes throughout the day. At around six months, babies begin sleeping through the night. They achieve the average adult sleep requirement of 7 to 10 hours per day by adolescence.
Sleep deprivation symptoms for children and adolescents include:
- Behavior problems
- Poor academic performance
- Automobile accidents
- Napping (teenagers)
Sleep disorders like snoring and sleep apnea are rare in children and adolescents, while others like delayed sleep phase syndrome (DSPS) or behavior insomnia are more common.
The sleepless night after watching a scary movie is a familiar experience for most of us. But children with anxiety disorders feel intense nervousness and fear during everyday activities.
Around 5.8 million children (9.8%) ages 3-17 have a diagnosed anxiety disorder, which is often accompanied by depression. Here are some common symptoms of childhood and adolescent anxiety that are possible sleep disruptors:
- Change in eating habits
- Anger or irritable mood
- Substance abuse
College Students/ Young Adults
The college years are when we’re the most anxious and most sleep-deprived. All-night cram sessions, midnight social gatherings, and 8:30 AM classes take their toll on college-aged students' physical and mental well-being. Sleep studies of college-aged students show up to 60 percent suffer from poor sleep quality, while almost 8 percent have an insomnia disorder.
Poor sleep quality affects grades, too. For example, one study of student sleep patterns showed that students who get more than 9 hours of sleep tend to have higher average GPAs (3.24) than those who got less than 6 hours of sleep (2.74).
College students also demonstrate high rates of anxiety disorders. Anxiety in this population is growing, with 63% of college students having felt overwhelming anxiety in the past year, and 23% receiving a diagnosis for it.
Test anxiety is something most college students have already experienced in primary and secondary school. But in college, the stakes are even higher for students managing their own grades. Test anxiety is particularly pernicious because it affects many students and is a common causal factor for sleep deprivation.
Students with test anxiety are more susceptible to inadequate sleep hygiene from staying up late to cram for tests. The general anxiety they feel weighs on their ability to fall asleep.
College students may suffer from sleep disorders, too, with one college estimating 25% of the student body is affected by a lack of sleep.
But why does this happen? College students may be more likely to develop DSPS given their penchant for late-night study sessions and other activities. They’re awake more during the night and may nap to “catch up” during the day.
Over time, their internal clocks (circadian rhythms) begin to slip out of sync with the regular day-and-night cycle. What results is a type of “academic jet lag” that can last for semesters, causing long-lasting sleep issues and impacting both mental and physical health.
Getting Better Sleep in College
We know that a lack of sleep can severely impact a person’s day-to-day life, but what can you do? Here are some tips for changing your daily college routine to improve your quality of sleep and lower your anxiety levels.
- Get out of your head. If you can't fall asleep because you can't turn off your thoughts, get out of bed and do something “mindless”. Go for a walk. Do push-ups. Doodle on paper. Try yoga. Turn your focus to your body and not your mind.
- Get into the sunlight. Your circadian rhythm is sensitive to light and darkness. Get a good dose of natural light every day. Walk around campus. Eat lunch on the lawn.
- Don't “catch up” on weekends. Keep a consistent sleep schedule. Don't sleep for more than an hour on weekends.
- Save your bed for sleeping. Don't do anything else in bed but sleep. Watch TV and do homework somewhere else. Train your brain and body to expect sleep when you lay down, and don't make a habit of sleeping anywhere else besides your bed (e.g. couch, recliners).
- Don't drink alcohol before bed. You may think alcohol helps you sleep, but it actually disrupts your sleep cycle throughout the night. Avoid alcohol at least 4 hours before bed.
Diagnosing anxiety disorders in seniors is notoriously tricky. Factors like changes in medication and age-onset dementia make it hard to diagnose older adults, and social stigma around mental illness makes seniors hesitant to report issues. However, a mental health screening is a relatively quick and easy way to determine if anxiety symptoms impact your life enough to warrant medical attention.
Although aging usually involves a drop in anxiety levels, the stress and fears of adult life still pose a real barrier to getting a good night’s sleep. In addition, the elderly tend to have more interruptions during sleep and therefore get less rest overall. Fewer hours mean the amount of quality sleep they get becomes even more critical.
Tips for Sleeping With Anxiety
Your nightly rituals and routines make up your sleep hygiene habits. Having good sleep hygiene increases your chances of getting quality sleep and relieves anxiety.
Some changes to your sleep habits are relatively easy to make, others not so much. That said, each adjustment is well worth the effort. Here are a few things you can do to keep sleep deprivation at bay and get adequate, good-quality sleep.
Keep a Tight Sleep Schedule
The more you stick to a sleep routine, the faster you’ll fall asleep. But, like any other habit, sleep is highly sensitive to change. For example, sleeping only in your bed (not the recliner) or waking up at the same time on weekends are both effective sleep rituals. These send strong signals to your brain when it’s time to sleep and wake. Alter your routine, and your sleep will suffer.
Sleep schedule consistency also helps lower anxiety levels. Anxiety is about the fear of the unknown. Adhering to a strict sleep schedule reinforces a strong sense of control and predictability in your life.
Regular exercise is often touted as one of the best ways to get a good night’s sleep, relieve tension, and eliminate stress. However, if you want to benefit from exercise, do it at the correct times.
Regular exercise releases endorphins and revs up your body and brain. Doing it too late in the evening or just before bedtime makes it harder to fall asleep. Instead, plan your exercise regimen for the morning or afternoon. Give your body time to cool down and soak in the relaxing afterburn of physical exercise.
Meditation is a treatment for insomnia that helps lower anxiety. Mindfulness meditation brings your attention to the present experience by eliminating thoughts about the past and future. It helps you “focus on the now” by eliminating backward, revisionary thoughts and forward-looking worries. Since the past and future are the subjects of most concerns, mindfulness helps eliminate those anxiety-producing thoughts.
A study of middle-aged adults showed that six weeks of mindfulness-awareness meditation resulted in less insomnia, fatigue, and depression compared to a control group.
Dampen Distracting Noises
Sounds slightly above a whisper (30 decibels) can interrupt our sleep. With sleep disruptors this quiet, you may not even know they’re affecting you. So, here are a few ways to cut out unwanted nightly noise:
- Try earplugs designed for sleeping.
- Soften hard surfaces like floors and walls with rugs or acoustic foam.
- Soundproof curtains for windows.
- Don't run dishwashers and washing machines at night.
- Plant thick hedges outside your bedroom window to block exterior noises.
Mind The Light In Your Sleep Environment
Light impacts sleep quality, and “blue light” keeps us awake. The sun is the primary source of blue light in our daily lives, and it signals when it's time to get up. Conversely, dim amber-colored lighting is a sign that it’s almost time for sleep.
A bright street lamp outside your bedroom window may counter your brain’s signal to go to bed. However, you can fight light pollution by following these tips:
Improve Sleep-Space Lighting
Use a thick window covering to block out external light. Adjust your alarm clock to a lower intensity setting. Unplug non-essential electronics that contain bright LED indicator lights. Keep your sleep environment as dark as possible, and use strategically placed night lights for safe travels to the bathroom.
Block Blue Lighting Before Bed
Some lights disrupt your sleep before you lay down. For example, laptops, tablets, and cell phone screens emit a blue light that tricks your brain into thinking the sun is still up. They also inhibit the release of melatonin.
Avoid staring at screens an hour or two before bedtime. If digital device abstinence isn’t an option, set your displays to “night mode”. This automatically changes screen colors from blue to amber at sunset.
You can also try wearing “blue-blocking” glasses during the day or anytime you interact with screens. These are available without a prescription, but if you wear prescription glasses, ask about having your next pair specially-coated with this technology.
Get a Mattress and Pillow That Fits You
Pressure points build on our sides, back, and neck when we lay on an unsupportive mattress or overly stuffed pillow. These pressure points cause us to toss and turn in an attempt to find a comfortable position all night.
Relieve pressure points by getting a mattress and pillow that conforms to your body. Most modern memory foam, latex, and elastic polymer mattresses are designed to fit your body while also supporting it.
Get The Sleep You Need
The connection between sleep and anxiety is profound, and addressing one side of the problem also smooths things out for the other. But making lasting changes requires a significant upheaval in a person’s daily life, which can be challenging if you are already struggling with the effects of insufficient sleep.
That’s where the proper bedding and mattresses can come into play. Check out our selection of top-of-the-line mattresses and get the sleep your body (and mind) deserves.