Tossing and Turning How Anxiety and Poor Sleep Habits Feed on Each Other

Many of us toss and turn or watch the clock when we can’t sleep for a night or two. But for some, a restless night is routine.

More than 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million report sleeping problems occasionally, according to the National Institutes of Health. Stress and anxiety may cause sleeping problems or make existing problems worse. And having an anxiety disorder exacerbates the problem.

Sleep disorders are characterized by abnormal sleep patterns that interfere with physical, mental, and emotional function. Stress or anxiety can cause a serious night without sleep, as do a variety of other problems.

Insomnia is the clinical term for people who have trouble falling asleep, difficulty staying asleep, waking too early in the morning, or waking up feeling unrefreshed.

Other common sleep disorders include sleep apnea (loud snoring caused by an obstructed airway), sleepwalking, and narcolepsy (falling asleep spontaneously). Restless leg syndrome and bruxism (grinding of the teeth while sleeping) are also conditions that may contribute to sleep disorders.

But which comes first: anxiety disorder or sleep disorder? The answer is, either one. Anxiety causes sleeping problems, and new research suggests sleep deprivation can cause an anxiety disorder.

Research also shows that some form of sleep disruption is present in nearly all psychiatric disorders, and that people with chronic insomnia are at high risk of developing an anxiety disorder.

Health Risks

The risks of inadequate sleep extend way beyond tiredness. Sleeplessness can lead to poor performance at work or school, increased risk of injury, and health problems.

In addition to anxiety and mood disorders, those with sleep disorders are risk for heart disease, heart failure, irregular heartbeat, heart attack, high blood pressure, stroke, diabetes, and obesity.

If you suspect you have a sleep disorder, visit a primary care physician, mental health professional, or sleep clinic. Treatment options include medications and cognitive-behavior therapy, which teaches how to identify and modify behaviors that perpetuate sleeping problems.

Treatment options for an anxiety disorder also include cognitive-behavior therapy, as well as relaxation techniques and medication. Your doctor or therapist may recommend one of these treatments, or some combination.

Meanwhile, here are some steps to take to reduce anxiety and stress:

• Meditate. Focus on your breath — breathe in and out slowly and deeply — and visualize a serene environment such as a deserted beach or grassy hill.
• Exercise. Regular exercise is good for your physical and mental health. It provides an outlet for frustrations and releases mood-enhancing endorphins. Yoga can be particularly effective at reducing anxiety and stress.
• Prioritize your to-do list. Spend your time and energy on the tasks that are truly important, and break up large projects into smaller, more easily managed tasks. Delegate when you can.
• Play music. Soft, calming music can lower your blood pressure and relax your mind and body.
• Get an adequate amount of sleep. Sleeping recharges your brain and improves your focus, concentration, and mood.
• Direct stress and anxiety elsewhere. Lend a hand to a relative or neighbor, or volunteer in your community. Helping others will take your mind off of your own anxiety and fears.
• Talk to someone. Let friends and family know how they can help, and consider seeing a doctor or therapist.

To sleep more soundly:

• Make getting a good night’s sleep a priority. Block out seven to nine hours for a full night of uninterrupted sleep, and try to wake up at the same time every day, including weekends.
• Establish a regular, relaxing bedtime routine. Avoid stimulants like coffee, chocolate, and nicotine before going to sleep, and never watch TV, use the computer, or pay bills before going to bed. Read a book, listen to soft music, or meditate instead.
• Make sure your bedroom is cool, dark, and quiet. Consider using a fan to drown out excess noise, and make sure your mattress and pillows are comfortable.
• Use your bedroom as a bedroom — not for watching TV or doing work — and get into bed only when you are tired. If you don’t fall asleep within 15 minutes, go to another room and do something relaxing.
• Regular exercise will help you sleep better, but limit your workouts to mornings and afternoons.
• Avoid looking at the clock. This can make you anxious in the middle of the night. Turn the clock away from you.
• Talk to your doctor if you still have problems falling asleep. You may need a prescription or herbal sleep remedy.

This article was prepared by the Anxiety Disorders Assoc. of America.