How Anxiety Affects Sleep (and what you can do about it)

by Dr Eidn Mahmoudzadeh

Poor sleep, worry and anxiety live together hand-in-hand, and so read on for Dr Eidn’s seven simple changes you can make that will improve your sleep and your mental health. 

Introduction

Anxiety and sleep problems often go hand-in-hand. You don’t need me to tell you that. If you've ever spent a night tossing and turning, feeling like a bag of cats in a washing machine, then you know the struggle. You know those nights when you're exhausted, but your brain decides it's the perfect time to remind you of every little thing you’ve ever messed up? Welcome to the vicious cycle of sleep and anxiety. The truth is, sleep and anxiety are like two peas in a pod. When one rears its head, the other usually isn’t far behind. In this article, we'll explore the connection between sleep and anxiety, share some common experiences, and give you some tips to help you get a good night's rest (without needing that G&T).

Why do sleep and anxiety go hand-in-hand?

The sleep-anxiety connection - it's a bit like the old chicken and the egg situation, which comes first? In truth, there's no single answer to that question. The connection between sleep and anxiety is complex and multifaceted, with many different factors coming into play.  But there are a few common factors that tend to contribute to the cycle of sleeplessness and anxiety. Let's take a closer look at a few of those.

One common cause of sleep difficulties in those with anxiety is overthinking and racing thoughts. When our brains are in overdrive, it can be challenging to quiet our minds enough to fall asleep naturally. Chronic stress is another significant contributor to sleep disturbances, and if you're dealing with a stressful situation (or several) on a regular basis, those elevated stress hormones and overactive nervous system are bad news for both your mental health and sleep quality.

Previous trauma can have a significant impact on sleep quality too. Traumatic events can leave a long-lasting impact on our mental and physical health, and post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after experiencing or witnessing a traumatic event. The symptoms of PTSD, including nightmares, flashbacks, and hyper-vigilance, can all make it difficult to fall asleep and stay asleep.

Lots of medications can interfere with sleep - including those commonly prescribed for anxiety (such as SSRIs and beta blockers) - and they can cause various side effects such as difficulty falling asleep, waking up through the night, and nightmares. Then there are some people who are prone to self medicating - but unfortunately alcohol and recreational drugs can also have a profoundly negative impact on sleep and mental health. Physical pain or discomfort is another common cause of sleep disturbances. When we're in pain, it can be challenging to get comfortable and relax, which can lead to difficulty falling and staying asleep. 

These are just some of the common causes of the sleep-anxiety connection, and there may be many other factors at play. Let’s move on now and have a look at how anxiety actually interferes with our sleep. 

Sleepless nights - how anxiety disrupts your sleep

Ah, the joys of being sleep deprived - it's like walking around in a perpetual fog. When you're dealing with sleep and anxiety issues, it can feel like you're barely functioning. Here are some of the most common ways people tend to experience sleep disruption:

• Difficulty falling asleep: You lay down in bed, ready to drift off into dreamland… and your brain decides it's time for a danceathon instead. Yep, we've all been there. When you're feeling anxious, it can be tough to shut off those racing thoughts enough for our natural sleep mechanisms to kick in.
• Waking up frequently throughout the night: Maybe you manage to fall asleep, but then you wake up a few hours later, wide awake and unable to go back to sleep. This can happen multiple times throughout the night, leaving you feeling exhausted in the morning.
• Vivid dreams or nightmares: When you do manage to sleep, your brain decides to go on a hair-raising adventure without you. Vivid dreams and nightmares are a common symptom of anxiety, and they can make it tricky to get good, restful sleep.
• Feeling tired and fatigued during the day: You finally drag yourself out of bed, only to feel like a zombie all day long. When you're not getting enough restful sleep, it's no surprise that you feel tired and fatigued during the day.
• Restlessness or irritability: When you're not sleeping well, it can make you feel like you're crawling out of your skin. Restlessness and irritability are common symptoms of anxiety, and they can make it tough to relax and get the rest you need. The worse your anxiety gets, the worse you sleep, and round and round it goes in the perfect storm.

Sound familiar? If you're nodding your head along with some or all of these experiences, you're definitely not alone. The good news is that there are plenty of things you can do to help manage your sleep and anxiety. From lifestyle changes to therapy to medication, there are options available to help you get back to feeling like yourself again.

7 Simple Changes to Improve Your Sleep and Mental Health

If you're struggling with sleep and anxiety issues, there are several lifestyle and behaviour modifications that you can make to improve your sleep hygiene. Here are a few things to consider:

1. Stick to a sleep schedule: Try to go to bed and wake up at the same time every day, even on weekends. This can really help regulate your body's natural sleep-wake cycle known as your circadian rhythm, and this can make it much easier to fall asleep and stay asleep, and it also improves the quality of your sleep. What’s not to love?
2. Create a bedtime routine: A relaxing bedtime routine can help signal to your body that it's time to wind down and prepare for sleep. This could include taking a warm bath, reading a book, or practising a relaxation technique. For bonus points dim the lights to let your body clock (which receives light from your eyes) know that it’s nearly bedtime. 
3. Limit caffeine and alcohol: Caffeine in your system can disrupt your sleep and make it more difficult to fall asleep or stay asleep. Try to limit your intake to the morning time, but remember that it isn’t just tea and coffee that contain caffeine, chocolate and energy drinks are also hidden sources! Alcohol can help some people to drift off to sleep initially, but overall it has a vastly negative impact on your sleep as it causes you to have fragmented and poor quality sleep through the night, and it heavily suppresses your dream (REM) sleep which is essential for processing of emotions. So if possible avoid alcohol completely as it’s terrible for both your mental health and your sleep.
4. Exercise regularly: Regular exercise can improve both your physical and mental health, which can help reduce anxiety, but it also independently improves sleep both in terms of duration and quality. Morning exercise is perhaps the best, as it helps to solidify your natural circadian rhythm, but really exercise at any time of day is great. Just try and make it something you enjoy as doing it regularly -  a few times a week at least - is the best way to get the benefits of exercise for mental health and sleep.
5. Practice relaxation techniques: Techniques like deep breathing, progressive muscle relaxation, and meditation can help calm your mind and reduce anxiety, making it easier to fall asleep and stay asleep. They have become increasingly popular in recent years, are backed by scientific evidence, and are freely available in the form of apps and YouTube videos.
6. Create a comfortable sleep environment: It’s really important to cultivate the best conditions for sleep, so make sure your bedroom is cool, quiet, and dark to create a comfortable sleep environment. You may also want to invest in a comfortable mattress and pillows to support good sleep posture. If you have problems with light or noise where you live, ear plugs and eye masks work a treat and are cheap-and-cheerful to boot!
7. Limit screen time before bed: The blue light emitted by electronic devices like phones and computers can interfere with your body's production of melatonin, a hormone that helps regulate sleep, but it doesn’t have as direct an impact on our sleep as is often made out. Instead it’s often the fact that these devices stimulate and alert us, coupled with the fact that constant doom-scrolling ends up pushing our bedtime later and later. Try to limit your screen time before bed, and consider having a cut off time for putting your devices away. 

Conclusion

Sleep and anxiety are closely linked, and it's important to address both issues to achieve overall health and well-being. If you are having severe difficulties you should always seek professional help, but there are also many things that people can do for themselves to break the cycle of poor sleep and anxiety. Try one or two simple changes, such as the ones we’ve mentioned above, and you’ll see the benefits they can bring both in improving sleep quality and reducing anxiety levels.  With a little effort and some creative problem-solving, you can get the restful, peaceful sleep you deserve. But remember, everyone's experience with sleep and anxiety is different, so it may take some trial and error to find the methods that work best for you. 

Sometimes, making small adjustments to your routine and environment aren't enough to fully address your sleep issues. That's where The Sleep Project comes in. We offer a variety of online sleep programmes and one-to-one consultations with experts who can help you develop a personalised plan for improving your sleep quality and overall well-being. Visit our Adult Sleep page for more information. If you have a little one you can get help with Baby Sleep too, or visit our Free Stuff page download free sleep tools and guides, and find the support you need to get the best night's sleep possible.

Thanks for reading, and sweet dreams!