Anxiety and Sleep

Anxiety disorders are the most common category of mental health disorders, affecting 18% of the population. Individuals that suffer from disturbances in anxiety are prone to sleep disruption. But is that because anxiety can worsen sleep or because lack of sleep worsens anxiety? It is a mystery that researchers are trying hard to solve. The link between anxiety and sleep is quite complex, so let’s explore how they interact.

How Anxiety Affects Sleep

The process of falling asleep may seem simple; a baby can do it, after all. But as we get older, and we begin to deal with more stressors, a process which was once easy can become more difficult. Anyone that has experienced difficulty falling asleep before a big test or presentation knows just how difficult it can be. For those that suffer from anxiety, the bedroom can become a chronic battleground. Laying down to bed may stir up various thoughts and worries that prevent the brain from quieting down and falling asleep.

Those that have difficulty falling asleep due to intrusive and unwelcome thoughts have a problem known as psychophysiological insomnia. It is a long medical name, but at its core, it means that the bed has become the place where you think and worry, not the place where you relax and sleep. Those that suffer from daytime anxiety are more prone to this problem at night, thereby leading to limited sleep and the effects of sleep deprivation the next day.

How Sleep Affects Anxiety

It is clear that anxiety can decrease sleep, but does a decrease in sleep affect anxiety? Research is finding that lack of sleep can in fact increase our anxiety levels. In a study published in the Journal of Neuroscience, researchers looked at 18 healthy adults and compared anxiety levels when sleeping well and when sleep-deprived. They induced anxiety by showing them pictures that were either neutral or disturbing. They found that prior to seeing the image, sleep-deprived adults experienced more anxiety in anticipation of the image. These individuals did not have an anxiety disorder at baseline.

Since sleep is affected by and can affect anxiety it is easy to see how lack of sleep can turn into a vicious cycle if not addressed. Thankfully there are a variety of ways to treat lack of sleep due to anxious tendencies. The answer to psychophysiological insomnia is not typically found in a sleeping pill, but instead comes from working with a counselor or therapist that knows how to use Cognitive Behavioral Therapy, a treatment that aims to reduce the anxiety someone feels at bedtime. Be sure to talk to your doctor if you need help. Working on both sleep and your anxiety together is critical to putting you back on the right track.

About The Author

Dr. Sujay Kansagra Sujay Kansagra, MD is an associate professor at Duke University Medical Center, a paid contributor of the The Daily Doze and Mattress Firm's Sleep Health Expert. He is also the Program Director of the Pediatric Neurology Residency Program and Director of the Duke Pediatric Neurology Sleep Medicine Program. Dr. Kansagra is double board certified in both Child Neurology and Sleep Medicine. He has published over 30 peer-reviewed articles in scientific journals and is the author of numerous book chapters and books on the topic of sleep, including My Child Won’t Sleep. He’s been featured on Huffington Post, Elite Daily, Bustle, SheKnows, Thrillist, CNN, and Reader’s Digest, among others and can be found regularly discussing sleep, medicine and education with his 129K+ Twitter followers via his accounts, @medschooladvice and @PedsSleepDoc. Best Night’s Sleep: Not just a sleep expert, but also an expert sleeper, Dr. Kansagra can sleep almost anywhere, thanks to years of sleep deprivation during medical school and residency call nights. But his best sleep is at home with his family, on a mattress he purchased at Mattress Firm long before he joined our team. He recently upgraded it with an adjustable base.

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