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Reviewed by Vicky Davis, FN
Written by Our Editorial Team
Remember, as a little kid when you’d watch something scary and you’d be afraid to fall asleep? Or how about when you’d be so worried about something the next day you didn’t want to sleep?
Most of us at some point have experienced some version of this, and for many of us, there is a grown-up version of this, as well — the often-dreaded sleep anxiety.
Discover what sleep anxiety is, why you might be impacted by sleep anxiety and how you can overcome it.
This could mean fear of falling asleep, difficulty staying asleep or worry about the inability to wake up feeling refreshed.
You may be asking yourself at this point…. Do I have anxiety? Or am I experiencing insomnia? Or sleep anxiety? Or both?
According to one review, the best available evidence is that insomnia and anxiety can go both ways.
Meaning you may have anxiety contributing to insomnia, or your insomnia may be contributing to anxiety.
Another relationship you may want to learn about is anxiety and depression.
The same research referenced above outlines the nitty-gritty scientific version of how anxiety impacts sleep.
But here’s the thing — sleep anxiety isn’t actually what might be happening at work or in your life, for example, but is how your body and mind respond chemically.
Anxiety sets off a sense of fear or stress (whether real or perceived) in our body that increases our arousal or alertness.
This, in turn, triggers specific hormones that interact with our nervous system.
When our nervous system is on alert due to this, it can interrupt your sleep quality.
Sleep anxiety can contribute to poor sleep and sleep deprivation, which can take a toll on your mental health.
The specific cause of sleep anxiety will vary for everyone. It could be situational or rooted in an anxiety disorder.
Specifically, generalized anxiety, panic disorder, OCD or PTSD may have some impact on your sleep, which could be one reason why you’re anxious about falling sleep.
A panic disorder is a term for those who experience frequent anxiety attacks (also known as panic attacks) that are unpredictable.
The most common symptoms are often the physical feeling of a panic attack (shortness of breath, palpitations, sweating, etc.) and are sometimes accompanied by a fear of losing control, death or going mad.
It’s common for those with panic disorder to experience disturbances in their sleep, with a fear of either falling asleep or staying asleep.
In addition, in some cases, those with panic disorder may experience nocturnal panic attacks, meaning a panic attack brought on in sleep.
Generalized anxiety disorder is a persistent state of anxiety.
The symptoms of GAD consist of anxiety and worry about many events, accompanied by an impact on motor tension, ultimately resulting in restlessness, fatigability, muscle tension or an effect on vigilance resulting in sleep disturbances, restlessness and difficulty concentrating.
Given the symptoms, one can see how sleep anxiety is quite common for those with GAD. It’s even estimated that about 60 percent to 70 percent of patients with GAD experience sleep issues.
Obsessive-compulsive disorder often referred to as OCD, is rooted in extreme obsessions or compulsions that disrupt everyday life.
Most commonly, these are anxieties around contamination, aggression, sexual nature or compulsions related to checking, cleaning or counting.
Those that suffer from OCD have been found to complain of sleep anxiety due to compulsive behavior.
Post-traumatic stress disorder, often referred to as PTSD, is the term for neuropsychological problems following a traumatic event.
PTSD is commonly grouped into different ways one might experience it, most commonly those that relive the trauma or fear reliving it, those preoccupied trying to avoid memories, and those that are generally hypervigilant.
A common symptom of PTSD is vivid nightmares of a traumatic event.
Unlike other anxieties, where sleep anxiety is a shared experience, PTSD can even be discovered and diagnosed based on sleep anxieties like nightmares.
For those of you who may be lying in bed right now experiencing some type of sleep anxiety, the information above may help you understand what you're experiencing, but it doesn’t help you fall back asleep at this moment.
Here are a couple of tips for falling asleep if you're lying awake…
If you can’t sleep, it may seem counterintuitive, but try getting up. Do something relaxing until you feel tired enough to fall asleep.
Make your room quiet and cozy. Try to keep it dark with minimal distractions.
Put away your electronics.
If you’re hungry, eat something light.
Sleeping medication can be helpful to sleep. However, it should be used sparingly and most often if you are experiencing a routine change.
For example, perhaps you are traveling or shifting your work schedule to nights.
Side effects of sleeping pills can be severe, and you should consult a healthcare professional before you take anything.
In medical speak, often referred to as sleep hygiene, is the routine and habits that we can shift to support healthy sleep. This could mean:
Creating a sleep schedule
Scheduling a bedtime
Trying to get up at the same time every day
Establishing a bedtime routine (without screens!)
Trying to eat dinner at least a couple of hours before bed
Implementing physical activity and exercise into your day-to-day
Avoiding caffeine in the afternoon or evening
Avoiding alcohol right before bed
Although good sleep hygiene can be helpful, some more severe sleep anxieties — or anxiety disorders in general — may need anxiety treatment or additional support.
In the same research that studied the relationship between sleep and anxiety, the sleep laboratory outlined specific treatment options for some anxiety disorders- including psychotherapy and medication.
Psychotherapy can be beneficial for almost any anxiety disorder. Some may choose to solely do psychotherapy, while some may combine it with the use of medication.
The types of psychotherapy treatment typically vary based on the anxiety disorder or healthcare provider.
For example, for PTSD, some individuals might benefit from individual or group psychotherapy.
Medication has also been shown to help with a variety of anxiety disorders.
Specific medication will vary depending on the anxiety you are experiencing. Selective serotonin reuptake inhibitor (known as SSRIs), tricyclic antidepressants (TCAs), benzodiazepines (BZDs)
buspirone and antidepressants are all used in some cases of anxiety.
Talk with a healthcare provider about what medication would be best for you and your symptoms.
You can also specifically mention your concern about how anxiety is impacting your sleep.
The specific treatment option you decide on will depend on what you and your doctor determine is best. Just know there are options out there, including natural remedies as well.
Because feelings of fear and stress are common with sleep anxiety, it may feel daunting to try and make things better.
But at the same time, the importance of sleep on your mental health and wellbeing can greatly impact your day-to-day.
Finding out what’s going on and your treatment options (or just lifestyle changes) may help you overcome your fear of sleep.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is also an active member of the American Academy of Nurse Practitioners.