How to Deal With Sleep Anxiety

Feeling anxious about your lack of sleep can be a vicious cycle leading to yet more sleepless nights, not to mention serious health concerns. Our experts can help you break out of the nightmare and catch some much-needed zzzs.

Struggling to sleep is one thing. Struggling to sleep because you’re anxious about struggling to sleep? That’s a whole new wrinkle you don’t need.

According to the Sleep Foundation, “anxiety and pre-sleep rumination may affect vivid dreaming during rapid eye movement (REM) sleep” as well as provoking nightmares that can create further tension around going to sleep.

It goes both ways: a study published in the journal Dialogues in Clinical Neuroscience found that 24 to 36 percent of people suffering from insomnia also have anxiety disorders.

Want to break out of the cycle and finally start looking forward to bedtime again? Here’s how.

What is sleep anxiety

“Sleep anxiety refers to fear of not getting enough sleep each night, often characterised by difficulty falling or staying asleep during the night,” says Edward Gorst, also known as the London Sleep Coach and a sleep expert for Panda London.

“People experiencing sleep anxiety may find themselves caught in a vicious cycle where anxiety about sleep prevents them from sleeping, which in turn heightens their anxiety around how they’ll sleep in the future,” Gorst adds.

You know what it’s like: a few bad nights’ sleep and you’ll spend the entirety of the next day wondering if you’re going to sleep tonight. It might be kids keeping you up, noisy neighbours, early sunlight, stress about your to-do list or any number of things, but once the worry of a bad night’s sleep gets into our brains, it can be difficult to get out.

Ruchir P. Patel, medical director and founder of the Insomnia and Sleep Institute of Arizona, expands on this snowballing effect:

“Sleep-related anxiety is a very common phenomenon,” he says. “Individuals start overthinking the act of sleeping, usually with a focus on trying to fall asleep quickly. This invariably results in a heightened fight or flight response, which in turn paradoxically awakens the brain even more, thus perpetuating the difficulty initiating sleep."

Ever felt anxious? That’s your fight or flight response in action. If you want to get scientific about it, it’s your parasympathetic nervous system flooding your system with stress hormones to keep you alert in response to an often imagined threat – i.e. there’s unlikely to be a saber-toothed tiger at the end of your bed. Either way, the damage is done, and instead of catching forty winks, you’re now ‘safely’ awake – whether you want to be or not.

“The neurotransmitter gamma-aminobutyric acid (GABA) plays a crucial role in promoting relaxation and sleep,” Gorst adds. “When there’s an imbalance in GABA this can lead to heightened arousal and anxiety, further disrupting sleep.”

If you do manage to nod off, your night’s kip might not be as restful as usual, either. “Being in this state also results in an easily arousable brain that triggers more frequent interruptions throughout the night,” says Patel.

What are the causes?

The causes of sleeplessness can be difficult to pin down, with Patel pointing to everything from a change in routine like staying in a hotel to other new sleep routine variables like staying up later than usual or drinking alcohol.

“Sleep anxiety is mainly triggered by stressors including work pressures, personal relationship issues, substance abuse, shift work or major life changes,” adds Gorst.

As Patel explains, sleep anxiety can occur in individuals with pre-existing anxiety disorders and depression, and in those without pre-existing mood disorders. In other words, all of us.

Environmental factors like excessive noise, heat waves, an uncomfortable sleep environment, or inconsistent sleep schedules, e.g. due to jet lag, can also contribute to sleep anxiety.

And, like trying not to think of a pink elephant and immediately thinking of a pink elephant, the more you stress about not being able to sleep, the more elusive sleep becomes.

Why is sleep anxiety such a problem?

As well as the obvious issue of falling asleep during your boss’s powerpoint presentations, sleep anxiety and the resulting lack of sleep can have a significant impact on your wellbeing and ability to function.

“A lack of sleep can exacerbate anxiety and depression symptoms, impair cognitive function, and decrease the ability to concentrate, thus affecting daily productivity,” warns Gorst.

But it isn’t all in your head. “Physically, chronic sleep deprivation is linked to an increased risk of obesity, cardiovascular diseases, diabetes, and weakened immune function,” Gorst adds.

The Nurses’ Health Study, followed 68,000 middle-aged women for up to 16 years and found that compared to women who slept seven hours a night, those who slept five hours or less were 15 percent more likely to become obese. Meanwhile, according to Mount Sinai hospital, a chronic lack of sleep can negatively affect immune cells.”

As mentioned above, sleep anxiety can become a self-fulfilling prophecy, with Patel explaining that “sleep-related anxiety and chronic insomnia results in the development of negative cognitions and behaviors towards sleep, which further fuels the chronic insomnia and anxiety.”

Patel warns that people in these positions often develop “dysfunctional beliefs and maladaptive techniques that they start to convince themselves are necessary to help them sleep, when in reality they are mostly all counterproductive and perpetuating the issue.”

A study published in the Indian Journal of Psychological Medicine earlier this year explains that examples of these ‘maladaptive techniques’ could be “evading commitments and reducing daytime activities”, behaviours which not only impact your waking life, but ironically also serve to affect sleep quality.

Is there any way sleep anxiety can be useful?

While sleep anxiety is generally detrimental, Gorst says there are scenarios where the body's natural alertness mechanisms might be beneficial. For instance, “during critical times such as during emergencies, when caring for a newborn, or when undertaking tasks requiring heightened vigilance.”

Struggle to sleep when you know you have to be up early the next morning? You could look at it as your body’s way of making sure you don’t miss your alarm.

“In these moments the body's response to anxiety can temporarily enhance alertness and performance, which enables someone to react appropriately given the specific circumstances,” Gorst adds.

Clearly, though, these situations are the exception, not the norm.

What can I do to be less anxious about sleep?

If you struggle to sleep, you likely know all about creating a comfortable sleep environment. So we won’t waste your time here by telling you to try white noise machines, not look at your phone, meditate, or leave a window open to create a cooler bedroom temperature. We’re assuming you’ve tried all that and it didn’t work, otherwise you wouldn’t be here. So what’s next?

For Patel, it might be as simple as changing your diet. We’re not talking about not eating two hours before bed and cutting back caffeine and alcohol in the day, but adjusting your macros entirely.

“Foods high in carbohydrates and sugars can impact quality of sleep,” he says. “Further, eating foods that trigger acid reflux could also result in sleeplessness, which can lead down the rabbit hole of developing sleep-related anxiety.”

In fact, a study published in 2021 found that diet and sleep “may well influence one another” with diets rich in fruits, vegetables, and other sources of dietary tryptophan and melatonin shown to aid sleep. Patel also points to plentiful evidence that cherry extract can result in greater production of the sleep hormone melatonin.

Outside of diet, both Gorst and Patel are proponents of tackling the main cause of sleep anxiety – your brain – head on.

“Several innovative strategies can help manage sleep anxiety and improve insomnia,” says Gorst. "Acceptance & Commitment Therapy (ACT), is a drug free approach based on mindfulness, self compassion and values based living. Another method is cognitive behavioural therapy for insomnia (CBT-I) which addresses negative thoughts and behaviours related to sleep.”

Patel favours Vagal nerve stimulation devices, which send regular, mild pulses of electrical energy to the brain via the vagus nerve which “results in lowering the heightened sympathetic nervous system, thereby reducing anxiety and initiating sleep,” he explains.

If all else fails, keep a good book to hand and embrace restless nights as a way to catch up on your reading. You’ll likely drop off in seconds…

Words: Tom Ward