What Causes Sleep Anxiety and How Can You Cope?
Medically reviewed by Daniel Combs, MD
Sleep anxiety is when you experience fear or stress about falling asleep. Even the thought of bedtime can lead to feelings of anxiousness. About 40% of people with anxiety also experience insomnia (difficulty falling or staying asleep), and there is a connection between the two.
Sleep anxiety is not a condition on its own but can be part of insomnia or generalized anxiety disorder. The best coping method depends on the underlying cause.
This article discusses what causes sleep anxiety and how to cope.
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Signs of Sleep Anxiety
Anxiety and insomnia are two different conditions that can occur together. Both anxiety and insomnia may involve worry at bedtime and while trying to sleep and thoughts about difficulty sleeping. This means that sleep anxiety can occur with both anxiety and insomnia.
In addition to difficulty falling or staying asleep, you may experience other physical or mental signs of sleep anxiety. Physical signs include:
Aches and pains (e.g., stomachaches, headaches)
A fast heartbeat
Dizziness
Muscle tension
Restlessness
Shortness of breath or chest pain
Sweating
Trembling, chills, or tingling
Mental signs include:
Flashbacks or nightmares (often related to trauma)
Worry or fear of the future
Related: Difficulty Sleeping
What Causes Sleep Anxiety?
While sleep anxiety isn't a standalone diagnosis, factors that contribute to generalized anxiety disorder and insomnia can affect your ability to fall asleep or stay asleep. Causes of anxiety and insomnia differ from person to person. However, some common contributing factors include the following:
A history of trauma: Whether recent or not, traumatic experiences can contribute to anxiety and adversely impact your sleep.
Genetics: Some people may have a family history of anxiety, making them more susceptible to developing a form of anxiety themselves.
Lack of sleep: Getting less than the recommended seven to eight hours of sleep each night can lead to a cycle of anxiety and sleeplessness.
Some medications: Anxiety is a side effect of certain drug classes such as steroids (e.g., prednisone), amphetamines (e.g., Evekeo, which contains amphetamine sulfate), or antihistamines (e.g., Claritin, a micronized loratadine).
Caffeine and nicotine: Both substances can contribute to anxiety and disrupt sleep.
Stress: Life events can contribute to short- or long-term stress, affecting sleep.
Insomnia
Nearly one-third of adults experience chronic insomnia. This may include difficulty falling asleep or staying asleep, waking up and not being able to return to sleep right away, or not getting enough quality sleep.
Experiencing insomnia, especially long term, can lead to discouraging thoughts related to sleep and decreased confidence in your ability to sleep. When combined with feeling the adverse effects of sleep loss during the day, insomnia can lead to sleep anxiety.
Anxiety Disorders
About 40 million American adults experience anxiety disorders. Feeling stressed or anxious, even if those anxious thoughts and feelings are unrelated to sleep, can make it difficult to sleep. When anxiety negatively impacts sleep, it can lead to sleep anxiety.
Other Risk Factors for Sleep Anxiety
Over half of Americans experience stress. While stressful events and feeling stressed at times are typical, long-term and high levels of stress can lead to anxiety and insomnia, especially when left untreated.
For this reason, stress and stressful events or situations are risk factors for sleep anxiety. Additionally, anxiety risk factors and insomnia risk factors are also risk factors for sleep anxiety.
Sleep anxiety risk factors include:
Doomscrolling (spending excessive time scrolling online content that can cause anxiety, anger, or sadness)
Eating unhealthy foods
Experiencing significant daily stress
Not getting enough exercise
Not having enough practical or emotional support
Relationship challenges
Stressful work situations
Traumatic events
Watching too much TV
Related: An Overview of the Link Between Mental Health and Sleep Disorders
Effects of Sleep Anxiety on Health
Anxiety, including sleep anxiety, can disrupt your sleep and increase your anxiety levels. This creates a cycle of decreased sleep and increased anxiety that adversely impacts your health.
Sleep anxiety may also increase the risk of other health concerns, such as:
Chronic anxiety
Chronic insomnia
Daytime sleepiness
Depression and other mental health challenges
Physical health challenges such as pain
Weakened immune system
Related: How Sleep Deprivation Affects the Human Body
How Sleep Anxiety Is Diagnosed
There currently is no diagnosis specifically for sleep anxiety. If you're experiencing symptoms of sleep anxiety, you may be diagnosed with anxiety, insomnia, or both.
A healthcare provider such as a primary care provider, psychologist, or sleep specialist begins the diagnosis process through an evaluation using various assessment tools.
The Beck Anxiety Index (BAI), the Generalized Anxiety Disorder Assessment (GAD-7), and the Insomnia Severity Index (ISI) are standard screening protocols. Your provider may also evaluate you for other sleep disorders, such as obstructive sleep apnea, to rule them out.
How Is Sleep Anxiety Treated?
Treating sleep anxiety involves treating insomnia, anxiety, and any other underlying conditions contributing to sleep anxiety. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended treatment for insomnia.
Additionally, one of the most effective anxiety treatments is cognitive behavioral therapy (CBT), which is also a great option for those experiencing sleep anxiety.
Sleep anxiety treatment options include:
CBT
CBT-I
Medications for anxiety
Supplements such as vitamin D
How to Cope With Sleep Anxiety
Sleep hygiene is a set of tips or habits for good sleep that can help to cope with insomnia, including sleep anxiety. These behaviors make it easier to fall asleep and sleep well. Additionally, having a bedtime routine can help you feel more empowered and in control of the situation, lowering the stress related to sleep.
Habits to help with sleep anxiety include:
Avoiding caffeine, especially later in the day
Connecting with supportive friends and family members
Creating a sleep-friendly environment
Eating a well-balanced diet
Establishing a regular sleep schedule
Exercising daily
Relaxation techniques
Sleep anxiety coping habits can also help to prevent sleep anxiety, insomnia, and anxiety.
Related: How to Improve Your Sleep Habits
What Are the Long-Term Complications of Sleep Anxiety?
Not getting enough quality sleep and long-term sleep deprivation can lead to a wide range of health complications, such as:
A weakened immune system
mental health challenges
Pain
Weight gain
Similarly, long-term stress and anxiety can adversely impact immune health, cardiovascular health, mental health, and more. Since sleep anxiety involves both sleep loss and anxiety, it is essential to seek support to prevent these adverse effects.
When to Contact a Healthcare Provider
If you're experiencing signs of sleep anxiety, insomnia, or anxiety, seek the support of a healthcare provider, especially when symptoms are affecting your daily life or have persisted for three months or longer.
If you notice any of the following signs, you should reach out to a healthcare provider:
You are avoiding certain situations.
You are experiencing adverse relationship effects.
You are making decisions that prevent you from living well.
These signs can lead to depression and other health complications.
Summary
Sleep anxiety is fear or stress related to sleep or going to bed. It can be part of anxiety or insomnia but is not a diagnosable condition on its own. If you or someone you know is experiencing signs of sleep anxiety, insomnia, or general anxiety, help is available. It is essential to seek the support of a healthcare provider to manage symptoms and prevent other health challenges.
Read the original article on Verywell Health.
