Awake and Anxious? Tackling Insomnia and Anxiety

Everyone gets worried or stressed occasionally and there are times when that heightened alertness can be helpful. Bedtime is NOT, however, one of them. Continue reading to learn how to recognize anxiety and insomnia together and some tips to help calm your nerves and improve rest.

Defining Anxiety Disorders

When anxiety becomes disabling, overwhelming, uncontrollable, prevents normal functioning, causes dread over everyday situations, and lasts — it’s classified as an anxiety disorder.

Anxiety disorders are very common. In fact, according to the Anxiety and Depression Association of America, anxiety disorders are the most common and pervasive mental disorders in the United States with approximately 44 million people affected. Examples of anxiety disorders, typified by extreme fear or worry, include generalized anxiety disorder, panic disorder and panic attacks, agoraphobia (fear of public places, crowds, or of being trapped), social anxiety disorder (intense fear of social situations), separation anxiety (excessive distress about being away from home or loved ones), and certain phobias (extreme or irrational fears of specific things/situations).

Anxiety Disorders and Insomnia Together

Many of us have had nights where sleep won’t come because our minds are too busy worrying. When worry keeps you up for a night here and there, or for a few weeks while some stressful life event is going on, that’s to be expected. Usually, after circumstances get more under control or we adapt, our sleep pattern improves or goes back to normal. But if anxiety-related sleeplessness (or any sleeplessness) lasts for 4 weeks or more, it’s time to start thinking about getting insomnia treatment.

As you know, insomnia is the medical term used to describe a disorder in which a person has trouble falling asleep or staying asleep, wakes up too early in the morning, or wakes up feeling unrefreshed. As with insomnia and depression, insomnia and anxiety are often seen together and can contribute to one another: stress and anxiety may cause sleeping problems or make them worse while poor sleep can make anxiety more severe. Sleep also affects mood and how well (or not well) we deal with anxiety and stress. Additionally, according to Anxiety.org, lack of sleep acts as a chronic stressor and leads to hormone imbalances and adrenaline spikes that can increase anxiety. The National Institutes of Health (NIH) indicates that about 24% to 36% of those with insomnia also have an anxiety disorder. Which condition manifests first can vary:

• Insomnia before anxiety disorder: ~18% of cases
• Insomnia and anxiety at about the same time: ~38.6% of cases
• Anxiety before insomnia: ~43.5% of cases

Anxiety and insomnia are so frequently seen together, explains the Psychiatric Times,  that sleep disruptions are, indeed, a key criteria for diagnosis of a number of anxiety disorders, including generalized anxiety disorder and post traumatic stress disorder.

But, experts say treating anxiety — while very important — will not simply make insomnia go away. New thinking is that insomnia and anxiety need to BOTH be treated in their own right. The Psychiatric Times reports that successful treatment of insomnia will, in turn, help anxiety treatment to work better. They recommend cognitive behavioral therapy (CBT-i) for insomnia (with or without anxiety), noting that CBT-i has been shown in numerous studies to be highly effective for insomnia and as effective as prescription medications.

Unfortunately, CBT-i remains under-used with only about 1% of patients with chronic insomnia receiving it. Circady is aiming to change that through innovative telehealth technology. Thanks to hi-tech tools that are also easily accessible (such as mobile apps, video chat, and wearables similar to Fitbits), Circady will soon be able to deliver CBT-i anytime, anywhere. You can learn more at Circady.com.

In the meantime, if you are suffering from anxiety or worry that seems unusual, extreme, or debilitating, talk to your healthcare provider about it. There are effective treatments available.

Please also discuss any sleep issues you are having and ask about treatment options including CBT-i. To help you have a productive conversation with your healthcare provider about your sleep, use the Circady app to track sleep and related factors in your life. At the end of 1 week you’ll receive a useful detailed report you can take with you to your next appointment.

Tips for Lowering Anxiety for Easier Sleep

Ready to take action right away? There are ways you can be proactive about lowering your anxiety for better rest. The National Sleep Foundation recommends:

• Meditation: Learn to quiet your mind. Start with just a few minutes of sitting quietly and focusing on your breath as you inhale and exhale. Picture a tranquil scene. Need help? Look into mediation apps like Headspace.
• Exercise: Physical exertion in your day is a good stress reliever, releases mood-enhancing endorphins, and can help you to sleep better.
• A calming routine: Start a bedtime ritual that helps you to slow down before bed. Use at least 30 minutes to listen to relaxing music, take a bath, read, or do something else that soothes you.
• Stress avoidance before bed: Stay away from the news, bills, work, and social media as you wind down for sleep.
• Worry journal: Keep a notebook next to your bed and write down what’s worrying you. Try to “let it go” or “write your worries away” as you do so. You can also use the notepad to reassure yourself that you won’t forget those important to-do items, you’re just setting them aside for the night.

We hope that this information helps you to better understand the relationship between anxiety and insomnia and empowers you to find the help you need for both.

If you are in crisis or this is an emergency please call 911 or otherwise seek immediate medical attention from qualified professionals. Or contact the National Suicide Prevention Lifeline. Circady cannot provide emergency services or emergency counseling.