Sleep anxiety: Learn everything you need to know

When we are stressed and feeling anxious, we all probably toss and turn at night finding it hard to sleep. However, for some people, that tossing and turning is a nightly occurrence. That lack of precious dream time can be caused by sleep anxiety. What is sleep anxiety? What are the signs, symptoms, and causes of sleep anxiety? What happens when you’re too scared to sleep? What is the difference between sleep disorders and sleep anxiety?  And how does sleep anxiety compare to chronic insomnia? How does sleep anxiety affect our sleep? What are some tips to better manage our sleep anxiety?

Sleep anxiety- a state of being unable to sleep due to excessive worry, stress, and anxiety

What is sleep anxiety?

There aren’t many things as frustrating as feeling exhausted all day and feeling completely awake at night. When your brain doesn’t care that your home safe under your cozy blankets and keeps working on your to-do list or worrying about random things, that’s known as sleep anxiety. Sleep anxiety is a state of being unable to sleep due to excessive worry, stress, and anxiety. Over 40 million Americans deal with long-term sleeping disorders while an additional 20 million Americans have reported having occasional sleeping issues according to the National Institute of Health. That’s about 18% of the population. Stress and anxiety can be two of the biggest causes for a lack of sleep- especially since the two go hand-in-hand. Anxiety in itself isn’t a bad thing, like pain it simply signals that something isn’t right. Anxiety is an emotion that wakes up us and feeling well-rested has shown to help us fight against anxiety. However, the opposite is also true- a lack of sleep and insomnia feeds anxiety which keeps us awake at night.

Symptoms and signs of sleep anxiety

Common symptoms of sleep anxiety include:

• A complete lack of sleep, insomnia
• Sleeping in chunks
• Depression
• Having nightmares about stressful situations often
• Irritability
• Feeling too anxious and worried to sleep
• Feeling tired all day, but completely awake at night

Causes of sleep anxiety

There are multiple causes for anxiety and a lack of sleep and often, the two go hand-in-hand. It’s hard to have one without the other. However, here is a list of a few most common causes:

• You’re juggling too much. You bit off too much. Placed too much on your shoulders. Phrase it as you wish, but doing too much with not enough time leads to extreme stress and anxiety which will make it hard to sleep when you’re doing too much to be able to rest at all.
• Genetics. If your family is prone to anxiety or insomnia, you might have the genes to suffer from them, too. It’s hard to have one without a bit of the other, too.
• Everyday triggers. There are loads of environmental factors that could lead to anxiety. It could even be something simple, such as what this study found, like the connection between high altitudes and anxiety (due to an oxygen shortage)
• Brain chemistry. One study found that some people have gaps in their brain chemistry that cause them to be more susceptible to anxiety.
• Withdrawal from alcohol or drugs can cause a lack of sleep and/or anxiety.

Sleep anxiety: the fear of sleep

Somniphobia, the fear of falling asleep or being asleep, and hypnophobia, the fear of being hypnotized or in a dream-like state, are conditions that cause someone to be too scared to fall asleep because they are scared of what might happen when they fall asleep. This means their bodies have so much anxiety about falling asleep that they are kept awake by their fears. Often, people are scared that they won’t hear their loved ones calling them (perhaps their baby crying at night) or they are scared or being out of control (sleepwalking, for example) or having terrifying nightmares.

Sleep anxiety- it helps to read a book (not a thriller, horror, or super exciting book, though) before bed in order to help the brain calm down and distract you from your everyday worries. Reading is also proven to reduce stress levels by 68%!

Sleep disorders and sleep anxiety

Over 70 types of sleep disorder exist. The most common being insomnia, movement syndromes, obstructive sleep apnea, and narcolepsy. There is an incredibly strong biological connection between sleep disorders and sleep anxiety. With people who suffer from a generalized anxiety disorder (GAD), 50% also have sleep disorders. Children who suffered from GAD took longer to fall asleep and had a harder time staying asleep.

⅔ of patients who go to sleep disorder clinics suffer from a psychiatric disorder such as depression or anxiety. So, which comes first? Does sleep anxiety cause the sleep disorder or does the sleep disorder cause the sleep anxiety? Well, it can go either way. Anxiety has been proven to cause sleeping problems. Recent research has shown that a lack of sleep and sleep deprivation can also lead to an anxiety disorder. It makes sense considering that sleep disruption and disturbances are common in almost all psychiatric disorders. Studies have shown that people who have the tendency to over-worry are more prone to sleep disorders.

Sleep anxiety and sleep depression are two closely linked conditions that are both associated with poor sleep and psychiatric disorders. 

Sleep anxiety vs. sleep depression

Just like with sleep anxiety, depression and sleep can go hand-in-hand. A lack of sleep may lead to depression while depression can also lead to a lack of sleep. Also, like with sleep anxiety, insomnia is a common symptom of depression. The biggest difference between the two conditions, sleep anxiety and sleep depression, is that sleep anxiety is caused by worry and the sympathetic nervous system is activated which causes our bodies to have hormone releases that keep us awake in case of danger. Sleep depression (too much sleep or insomnia), on the other hand, is found to be caused by too many negative emotions bouncing around in the precuneus (the part of the brain that is linked with self-image), the dorsolateral prefrontal cortex, (short-term memory), and the lateral orbitofrontal cortex (responsible for negative emotions). It’s hard to sleep with the brain bouncing around.

How does anxiety affect our sleep

When we feel anxious, our bodies begin a stress response which can kick in wherever, whenever. When it comes to sleep anxiety, though, our subconscious is really the culprit. During the day, our minds are always busy thinking about the next family vacation, that big work deadline, or our fantasy football team. However, our brains take those stressors, mimic that stress pattern, and put us into a stressed state even after we have been removed from the immediate stressor. What does that mean? It means that we wake up panicked and stressed in the middle of the night after we had the chance to relax. Once awake, the problem multiplies by feeding on itself. You wake up stressed and anxious, you feel anxious about being awake, can’t go back to sleep because you were too anxious. It could also mean that we weren’t able to fall asleep in the first place due to feeling too much anxiety.

Sleep anxiety and chronic insomnia

According to the Sleep Health Foundation, about 1 in every 3 people suffer from insomnia. People who sleep less than 8 hours a night on average are way more likely to suffer from anxiety, according to many studies (here’s one!). A lack of sleep plays a huge role in activating the parts of the brain that trigger worry- especially excessive worry, according to a study done by UC Berkeley. Furthermore, people who have the tendency to over-worry are more prone to sleep disorders. This means that people who are more anxious and worry by nature are the people who will suffer the most with sleep deprivation and insomnia. Studies have also shown that people who have chronic insomnia are more prone to developing an anxiety disorder.

One study found that sleep-deprived brains revert back to more primitive patterns. What does that mean? It means that when the amygdala (the part of the brain in charge of emotions and the part of the brain that prepares the body to protect itself against danger) senses danger, it sends a message to the prefrontal cortex which activates the sympathetic nervous system and turns on our fight-or-flight mode. Normally, the amygdala and the prefrontal cortex work together in order to appropriately respond to danger while keeping the person’s emotions in check. However, when sleep deprived, the amygdala and prefrontal cortex stop working together. The study found that people’s amygdalas were 60% more active, but had more irritation, issues with concentration and focus, slower reflexes, and higher feelings of anxiety while sleep deprived.

Sleep anxiety- one of the best ways to prevent sleep anxiety is to lower your caffeine intake- both during the afternoon and overall. 

Some people feel anxiety about a lack of sleep which leads them to their insomnia. This anxiety provokes sleep loss which in turn brings about more anxiety. It can be a never-ending circle. This is known as anticipatory anxiety. How does it work? Well, the neurotransmitter (brain hormone and chemical) that deals with worry fires up the amygdala and insular cortex which actually mimics the neural activity that is seen in anxiety disorders.

Tips to manage sleep anxiety

• Try to avoid caffeine. According to Harvard Health, some types of caffeine can take up to eight hours to wear off. If you suffer from panic attacks, avoid caffeine completely- many people who are prone to panic attacks are extra-sensitive to caffeine.
• Try going to bed at the same time daily to help your body become used to the schedule and feel tired around bedtime and awake in the morning.
• Exercise regularly. However, avoid exercise close to bedtime. Try to exercise in the afternoon or early morning.
• Avoid using electronics for at least an hour before going to bed. The blue light from screens tricks the brain into thinking that it’s daytime.
• Avoid large meals, smoking, and alcohol (a natural depressant) a few hours before bed.
• Try reading before bed to take your mind to a different place than the present. Reading is also proven to reduce stress levels by 68% and help you fall asleep in no time!
• Some medications cause insomnia and sleeping issues. Review your medications with your doctor and see if one of the medication you’re taking could be the culprit.
• If you’re unable to fall asleep within 20 minutes of laying in bed, get out of bed and do something that is relaxing until you feel sleepy again.

How do you sleep with anxiety? Let us know what you think in the comments below!

Anna Bohren

Anna is a freelance writer who is passionate about translation, psychology, and how the world works.