If you have sleep anxiety, you know how daunting bedtime can be. The constant tossing and turning. Feeling like you have a million things on your mind. Remembering those pesky tasks that you forgot to do throughout the day. No matter what you do, you can never seem to get comfortable and fully shut your mind off.
Anxiety can help the body stay alert and focused, but there are situations where you have an anxious reaction to a seemingly normal life event, like sleeping. Anxiety with racing thoughts and physical symptoms can make it difficult to sleep. Anxiety in and of itself is a temporary experience but consistent anxiety symptoms can fully develop into an anxiety disorder. Luckily, you can learn about the causes of your nighttime anxiety and techniques on how to lessen your anxiety at night by working with a sleep therapist at Anchor Therapy.
Anchor Therapy is a counseling center in Hoboken, NJ with mental health therapists specialized in helping children, teens, adults, couples, and families with anxiety, depression, relationship issues, trauma, life transitions, and more. Anchor Therapy is accepting new clients and is now providing in-person sessions and teletherapy sessions to residents of New Jersey, New York, and Florida.
Defining Sleep Anxiety
Sleep anxiety refers to the fear someone has before going to sleep. You may be worried that you will not be able to fall asleep or stay asleep the whole night. You may even have a phobia about sleep, also known as somniphobia.
Somniphobia is the fear of falling asleep which occurs when your anxiety turns into an extreme phobia. A phobia is an anxiety disorder where there is an intense fear of a specific thing, situation, or activity. With general anxiety, your worries are broader, but a phobia is focused on a particular trigger. According to Medical News Today, roughly 8 to 12% of adults living in the United States have a particular phobia.
Some symptoms of somniphobia include the following:
Mood changes
Having a hard time concentrating due to a lack of sleep
Avoiding sleep for as long as possible
Constantly thinking about sleep
Experiencing physical anxiety symptoms (e.g., racing heartbeat, stomach problems, dizziness, sweating, etc. - For more information, check out our blog “3 Ways to Manage Physical Anxiety Symptoms”)
If you have somniphobia, your trigger is sleep and, generally speaking, you may try to avoid it at all costs. Your fear becomes so intense that it is difficult to engage in your daily life.
Since somniphobia may vary in severity and impact, the long-term effects of this phobia may vary. Your circumstance and exactly how avoidant of sleep you are will play a role. If your somniphobia is left untreated, your welfare can take a downturn.
Some long-term consequences of untreated somniphobia are:
Anxiety (Take our Anxiety Quiz to find out more)
Depression (Take our Depression Quiz to find out more)
Stress (Check out our blog “Everything You Need to Know About Stress Management Therapy”)
A lessened quality of life
Psychological distress
Social isolation
If left untreated, a phobia can persist for many years.
While somniphobia is a very real and serious phobia, you do not have to have somniphobia to have serious sleep anxiety. You may think that something bad will happen to you while you are sleeping. Or, you may think that you should not sleep because you need to stay on alert for someone or something.
More often than not, sleep disorders and psychological disorders, like anxiety for example, occur at the same time. If you have an anxiety disorder, you may find it difficult to go to sleep and stay asleep throughout the night and into the morning. Likewise, a sleep disorder may leave you feeling on edge and afraid that you are not receiving the adequate amount of sleep you need. Your anxiety and sleep problems may begin to feel like a cycle where both conditions are worsening.
What causes nighttime anxiety?
Your bedtime anxiety can occur no matter the time of the day, from trying to lay your head down at night to trying to squeeze in an afternoon nap. Your anxiety is nothing but a reaction to a possible threat that your body has identified. There are many possible causes of bedtime anxiety.
Here are some causes of anxiety at night:
Life stressors - Major life stressors, like financial troubles, a family death, or other major life transitions, can easily cause feelings of distress and/or anxiety. An anxiety disorder can be triggered by a very difficult life stressor.
Lack of sleep - Research has shown that, if you do not get the recommended 7 to 8 hours of sleep a night, you have a higher chance of experiencing emotional distress, encompassing both stress and anxiety. When you get less sleep than you are used to receiving, it is not uncommon to experience higher anxiety levels the following day.
Genetics - Anxiety does have a genetic component. If you are genetically predisposed to have an anxiety disorder, you may develop one after major life stressors or a traumatic experience.
Trauma - Following a traumatic event, such as a natural disaster or accident, it is common to feel anxious. As an adult who experienced childhood trauma, you are more likely to experience panic attacks and excessive, anxiety-related thoughts.
Anxiety can get bad at night because, in the evening, you are able to focus more on your anxieties than you were throughout the day due to not having a busy schedule or any distractions present.
For instance, if you have insomnia, you may worry throughout the day if you will be able to fall asleep at night or not. These worries may worsen your insomnia, furthering your sleep difficulties. For more information, read our blog by licensed therapist Rebecca Bischoff, LCSW “Unlocking the Secrets of Quality Sleep: A Therapist’s Perspective on Sleep Hygiene and Insomnia.” If you are looking for more information on specific therapeutic modalities to achieve good sleep, read our blog “How CBT Can Help With Your Insomnia.”
Other conditions can cause anxiety flare-ups at night, like Post-Traumatic Stress Disorder or PTSD. If you have PTSD, your sleep may often be disrupted and include nightmares. Nocturnal panic attacks, panic attacks that occur at night for no particular reason that cause you to wake up out of your rest, can occur and leave you with a feeling that something bad will happen when you are sleeping. Read our blog “How to Handle a Panic Attack” for more information.
Lastly, you may have nightmare disorder or parasomnia. This is a type of sleep disorder where you have the unpleasant experience of a nightmare just as you are about to fall asleep, during sleep, or just as you are about to wake up. After a nightmare, it is normal to feel distressed.
How do I know if I have sleep anxiety?
If you have sleep anxiety, it is likely that you will experience some or all of the symptoms associated with bedtime anxiety. Generally, the symptoms and severity of your nighttime anxiety can vary from person-to-person.
Nighttime anxiety comes along with the following symptoms:
Dizziness
Fear of the future
Shortness of breath
Increased heart rate
Sweating
Tense muscles
Headaches
Stomachaches
Restlessness
Trembling
Chills
Tingling sensations
Traumatic flashbacks
Nightmares
How exactly is anxiety impacting my sleep schedule and quality?
As we all know, anxiety and worry can impact our sleep levels, but you may not know the exact cause of it. Anxiety triggers your body’s stress response which triggers many bodily effects that can leave you feeling annoyed or even physically energized. In other words, you are not in a state of sleep.
Anxiety can even impact you while you are sleeping which affects the quality of the rest you are receiving. As you rest, you are moving through all of the phases of sleep.
Here are the five stages of sleep:
First Stage - Non-Rapid Eye Movement 1
The transition between being awake and being asleep. In Stage 1, you are experiencing a light sleep where a faint noise could wake you out of your rest.
Second Stage - Non-Rapid Eye Movement 2
A somewhat deeper sleep than Stage 1. Your body temperature drops while your heart rate and breathing become stable.
Third Stage - Non-Rapid Eye Movement 3 & Fourth Stage - Non-Rapid Eye Movement 4
These stages are known as a period of deep sleep where slow-wave sleep occurs. Your brain produces delta waves during this period of rest which makes it more difficult to wake you up from sleeping.
Fifth Stage - Rapid Eye Movement (REM) Sleep
Most dreaming occurs during REM sleep. Your eyes move quickly in numerous directions and your brain activity resembles that of your awakened brain. Nightmares usually occur in the REM sleep phase. REM sleep has actually been shown to assist in emotional regulation by offering memory processing and stress hormone regulation.
If you are a very anxious person, you may actually spend less time in the REM phase of sleep. Generally speaking, anxiety is linked to less time deep sleeping which is important for both a rested mind and body.
So, how can I calm my anxiety down at night?
Trying to figure out what techniques work in lessening your bedtime anxiety will take some trial-and-error. You should view this as a type of experiment where you are learning what works for you, what does not work for you, and even what techniques worsen your anxiety.
Progressive Muscle Relaxation
Progressive muscle relaxation is when you purposefully tighten and then relax the muscles in your body one group at a time. This technique is typically used for treating insomnia, anxiety, and panic attacks.
Here is an example of a progressive muscle relaxation exercise:
Find a comfortable place to sit down and close your eyes
Take a few deep breaths through your nose and exhaling through your mouth
Begin with your hands - Clench your fists for 15 seconds and feel the difference between tension and relaxation
Move to your shoulders - Shrugging them up and down
Move to your face - You can squint your eyes, clench your jaw, or crease your eyebrows
Move to your chest and torso - Take a deep breath while you expand your chest and tighten your stomach, then release
Move to your legs and feet - Pointing your toes up and down → curling your toes
After you complete this sequence, feel the relaxation present in your body and open your eyes
2. Breathing Exercises
Slow and deep breathing patterns can help you manage your anxiety and fight off your insomnia. A good breathing exercise can even calm down your nervous system, thus enhancing your sense of relaxation.
Here is an example of a box breathing tactic you can employ:
Sit down in a comfortable position with your eyes closed
Take a slow deep breath through your nose, counting to four
Hold your breath for a count of four
Slowly exhale through your mouth, counting to four
Hold your breath for a count of four
Repeat the above steps for 5-10 minutes
3. Attend Sleep Therapy
Attending therapy for sleep issues is important because you will learn to get to the root of your underlying issues. Perhaps you are dealing with stress, trauma, unresolved feelings, negative thought patterns, and more that may be contributing to your sleep concerns.
A sleep specialist will create a customized plan for you in your therapy sessions to address your needs and causes for concern. This may include Cognitive Behavioral Therapy (CBT), relaxation techniques, additional evidence-based interventions, and sleep hygiene strategies.
In CBT for insomnia, you will learn coping skills to manage and lessen your anxiety. You will experience cognitive restructuring to challenge your negative, anxious thoughts. You will also be able to pinpoint your behaviors that are adding to the sleep anxiety you are experiencing. Perhaps you use an electronic device right before bed which causes an irregular sleep schedule.
When you address your sleep anxiety in a therapeutic environment, you can experience long-lasting improvements in the quality and duration of your sleep. Eventually, you will develop healthy sleep habits to create a positive relationship with rest.
A sleep therapist at Anchor Therapy can improve your bedtime anxiety in the following ways:
Identifying your triggers
Offering CBT
Teaching relaxation techniques
Sleep hygiene education
Collaboration with other professionals (e.g., primary care physicians to figure out if there is an underlying cause for your sleep concerns)
Anxiety or sleep problems can impact a lot of aspects of your life, from your social connections to your work performance. Working with a sleep therapist will allow you to find relief from your sleep anxiety symptoms so you can get the rest you need and deserve!
Victoria Scala
is the Social Media Manager and Intake Coordinator at Anchor Therapy in Hoboken, New Jersey. She is a graduate of the Honors College of Rutgers University-Newark. In her roles, Victoria is committed to managing the office’s social media presence and prioritizing clients' needs.
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