What is the connection between sleep and anxiety?
There may be a connection between sleep and anxiety. It is possible for a lack of sleep to cause anxiety. Similarly, anxiety can affect a person’s sleep. Treatments can include lifestyle changes, therapies, and medication.
According to research, 10–30% of the population do not sleep well.
This article will examine the close connection between anxiety and sleep and ways a person can enhance their sleep.
Does anxiety affect sleep?
According to an article in the journal Sleep, anxiety can cause problems with sleeping and vice-versa. Doctors have found there are some common brain pathways between sleep problems and anxiety.
According to an article in Current Opinions in Psychiatry, about 90% of young people who struggle with anxiety report sleep problems.
An article in the journal Innovations in Clinical Neuroscience notes that symptoms of generalized anxiety disorder (GAD) include difficulty in falling asleep and staying asleep, restless, unsatisfying sleep, and sleep disturbance.
Modern technology may also play a role in anxiety affecting sleep. A study published in the Journal of Adolescence looked at 467 adolescents in Scotland and found that using social media at night increased anxiety as well as feelings of depression and low self-esteem.
Does sleep affect anxiety?
A 2020 study in China of nearly 4,000 people aged 60 and older found that people with affected sleep quality and duration were at higher risk for anxiety.
The researchers studied those who reported poor sleep quality and adjusted their results based on other possible risk factors, including socioeconomic status, health status, and social support.
They found higher odds ratios that a person with poor sleep would have a higher chance of experiencing anxiety.
It is not clear if lack of sleep causes anxiety, or if anxiety causes an inability to sleep. However, researchers typically regard the two conditions as inter-connected and closely linked.
What is insomnia?
Insomnia is a sleep disorder where a person cannot get to sleep or has difficulty staying asleep.
A person with insomnia may experience:
- problems going to sleep, even when they are lying in bed and feel like they are ready to go to sleep
- waking up frequently throughout the night and not being able to go back to sleep
- waking up much earlier in the morning than intended
- waking up and feeling like they have not had a refreshing sleep
Some of these symptoms can overlap with other sleep disorders, such as sleep apnea. Sleep apnea is when a person’s breathing stops and starts while they are sleeping. Anyone who suspects they have sleep apnea should see a doctor for evaluation.
There are two types of insomnia:
- Acute insomnia: Stress can cause acute insomnia. It typically lasts for days or weeks. This insomnia type will resolve without any treatment interventions. Some lifestyle changes may also help promote sleep.
- Chronic insomnia: Medication, medical conditions, or sleep disorders can cause chronic insomnia. It typically lasts for a month or more. Cognitive-behavioral therapy (CBT) and medications may help this type of insomnia.
According to an older 2010 article in the Annals of Indian Academy of Neurology, those who struggle with chronic insomnia are more likely to experience a mental health condition, such as anxiety, substance abuse, suicide, and depression.
What is anxiety?
Anxiety is a symptom that occurs when a person perceives a more significant threat or stress from a situation or event than it would typically warrant. Anxiety causes a person to feel stressed, worried, and even fearful.
Doctors have identified different types of anxiety conditions, which include:
- GAD: GAD is a condition that causes excessive anxiety and worry. A person finds it difficult to control their worry and can experience physical manifestations, including problems sleeping.
- Separation anxiety disorder: This condition is common in young people and may occur due to the fear of being away from a family member, such as a parent, or far from home. Adults can experience separation anxiety disorder, and the fear of separation can affect their abilities to sleep well.
- Social anxiety disorder: This condition causes a person to feel overwhelming anxiety related to social situations other people may consider to be commonplace. Examples of behaviors doctors associate with social anxiety include eating in front of others, speaking in public, or attending a meeting.
Treatment for anxiety can be similar to those for sleep disorders. They include a blend of lifestyle changes, taking medications, and CBT.
Making lifestyle changes can create an overall sense of well-being that promotes sleep and may help a person reduce their anxiety levels.
Examples of ways to accomplish this include:
- Avoiding stimulants before bed: Stimulants, such as caffeine, nicotine, and strenuous exercise, can affect the body’s natural rhythm.
- Setting a bedtime routine: Going to bed and waking up at regular times while also avoiding daytime napping may “train” the body to go to sleep and wake up more rested.
- Following bedtime rituals: Adopting a regular bedtime routine that includes visual cues, such as starting to turn the lights lower, may encourage sleep. These routines can start to signal the body that it is time to wind down and that the time to sleep is getting close.
- Finding a distraction: Getting out of bed and doing something else that may make a person sleepy — such as reading a book. A person should only return to bed when they feel as if they could fall asleep.
Ensuring that the bedroom is a cool, dark, and comforting place may also help.
Doctors have also investigated alternative therapies for relieving anxiety and promoting sleep.
Cannabidiol (CBD) oil.
A study published in The Permanente Journal conducted a study on CBD oil applications in 72 adults with anxiety and poor sleep. Over 3 months, about two-thirds of participants reported improved sleep scores, although this fluctuated.
While this is only a small study, this alternative therapy may show promise in helping people improve their sleep. However, additional studies are required.
Learn more about CBD and anxiety here.
Meditation may also help a person who struggles with sleep. Instead of trying to control their thoughts, meditation can help them focus on more positive thoughts or to key in on other aspects of their body, such as their breathing.
Learn more about meditation here.
Doctors may prescribe medications to treat underlying mental health conditions, such as anxiety and depression. It is worth noting that, while medication can help relieve the symptoms of anxiety it does not provide a cure.
Examples of these medications include:
- Benzodiazepines: Alprazolam (Xanax) and diazepam (Valium), which doctors may prescribe to promote sleep. However, doctors prescribe benzodiazepines less frequently now, due to concerns about the risk of misuse and dependency.
- Nonbenzodiazepines: Examples include zolpidem (Ambien), zaleplon, and eszopiclone. These can help a person to sleep.
- Selective serotonin reuptake inhibitors (SSRIs): Examples include paroxetine (Paxil), trazodone (Desyrel), or escitalopram (Lexapro). These can help with anxiety as well as insomnia.
Doctors must carefully evaluate a person who is struggling with sleep before prescribing medication.
CBT is an effective treatment for both insomnia and anxiety.
CBT aims to teach people to alter their adverse patterns of thought. It can help people replace harmful thoughts with more realistic and positive thoughts. This can lead to less anxiety as it means they can attach less importance to distressing thoughts and thought processes.
According to a 2015 randomized controlled trial using CBT in group therapy as well as a course on the internet, found that CBT is an effective treatment for insomnia.
Learn more about CBT here.
When to see a doctor
A person should see a doctor if they find their anxiety is affecting their happiness and interfering with daily life.
If a person is experiencing intense, vivid dreams or lack of sleep that significantly affects their ability to function in their daily life, they should see a doctor as soon as possible.
In addition to prescribing medications and discussing lifestyle changes, a doctor may also recommend therapy.
CBT can help a person identify thoughts that may affect their ability to sleep at night.
Anxiety and poor sleep are closely connected. Both are treatable with interventions to promote better sleep and help a person adapt their way of thinking about sleep.
Through lifestyle changes, CBT, and medications, a person can start to live a healthier, more well-rested life.