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Anxiety and Sleep: A Case of Cause & Effect

Anxiety and Sleep: A Case of Cause & Effect

Anxiety and Sleep: A Case of Cause & Effect

Sleep quality may be greatly impacted for individuals with anxiety disorders. To better understand how anxiety disrupts sleep patterns, one must first understand what’s causing the anxiety, the physiological effects of anxiety, and how anxiety differs from an anxiety disorder. After exploring the perpetual pattern of anxiety and sleep interference there are strategies suggested to combat anxiety and improve sleep quality.

Anxiety’s Effect on the Body

Anxiety is a normal reaction to stress. In fact, all individuals have anxiety states. In an anxious state, individuals prepare to cope with a future stressor or dilemma. It may be an upcoming job interview, an exam, or a call from your doctor’s office regarding lab results. Once the stressor is resolved or removed, the anxiety state subsides.

While a state of anxiety is typically short-lived and non-interfering with daily life, an anxiety disorder may impact daily functioning. Anxiety disorders include generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), specific phobia, and social anxiety disorder (SAD).

Individuals diagnosed with anxiety disorders exhibit anxiety traits. Anxiety traits are shaped by genetics, developmental influences, and early life experiences. Anxiety traits commonly increase an individual’s arousal and alertness when assessing both real and overvalued or implied threats.

Individuals with anxiety disorders exhibit a prolonged sense of heightened arousal and perform behaviors to ensure safety, even when there is no actual threat. These compensatory behaviors may interfere with an individual’s daily functioning. A common compensatory behavior of all anxiety disorders is avoidance.

In addition to these behaviors, anxiety traits also cue physiological responses within the body. When the brain anticipates a threat, even if overvalued or implied, it sends messages to various parts of the body through nerves. These messages tend to constrict use of certain parts of the body and expand the use of other parts, including the heart, lungs, and certain muscles.

Hormones, including adrenaline, are released into the bloodstream. These physiological responses often present as physical symptoms of anxiety, including increased heart rate, nausea, dry mouth, chest pain, sweating, shaking, and headaches.

Anxiety’s Effect on Sleep

When individuals feel constant anxiety, perform avoidant behaviors, and experience these physical symptoms frequently, their overall quality of life may be impacted. A span of anxiety disorders affects sleep quality. Difficulty sleeping encompasses problems falling asleep, problems staying asleep, and waking up feeling tired.

Difficulty sleeping may result from any combination of emotions, thoughts, and behaviors. When experiencing a prolonged sense of fear or worry, the body is perpetually preparing to defend against a threat at any moment and cuing certain parts of the body to increase production.

If this state of anxiety persists into the night, it may be challenging to fall asleep due to these altered physiological states, such as rapid heart rate and increased adrenaline. Chronic anxiety often results in muscle tension, restlessness, and chest pain. Any one of these symptoms affects an individual’s ability to fall asleep.

Even when asleep, anxious individuals are prepared to combat a threat. As a result, they are often more alert, and may be described as “light sleepers.” Often, it is difficult to fall back asleep once awake due to anxiety. In addition to poor sleep quality, the body is exerting more energy to remain alert at all times. These factors combined often lead to the feeling of fatigue the next day.

Anxiety presents as a perpetual pattern affecting sleep quality. Anxious thoughts and emotions may arouse the body while individuals are attempting to fall asleep. As a result, physiological cues and bodily sensations interfere with the ability to relax and inevitably fall asleep. Inability to fall asleep may allow for increased production of anxious thoughts and emotions and the pattern endures.

This pattern may be interchangeable at times, and can also be applied in instances where individuals wake up from sleep and are unable to fall back asleep. Individuals with persistent anxiety may experience prolonged sleep impairment, which results in chronic fatigue.

Strategies to Improve Sleep

Improved sleep quality and an overall better quality of life are possible for individuals with anxiety disorders. A critical step in managing anxiety is breaking the perpetual pattern. While there are specific therapeutic tactics developed for each specific anxiety disorder, cognitive behavioral therapy (CBT) techniques may be utilized to break the perpetual pattern regarding the perceived threat of all anxiety disorders.

In addition to therapy, the following strategies may be used to combat anxiety and further improve sleep quality:

  • Make a good night’s sleep your priority. Block out seven to nine hours for a full night of uninterrupted sleep, and try to wake up at the same time every day, including weekends.
  • Establish a bedtime routine. Avoid stimulants like coffee, chocolate, and nicotine before going to sleep, watching TV, or using the computer. Instead, try reading a book or listening to calming music.
  • Feel comfortable in bed. Make sure your bedroom is cool, dark, and quiet. Consider using a fan or sound machine to drown out excess noise.
  • Use your bedroom as a bedroom — not for watching TV or doing work — and get into bed only when you are tired. If you don’t fall asleep within 15 minutes, go to another room and do something relaxing.
  • Avoid looking at the clock. This can make you anxious in the middle of the night. Turn the clock away from you.
  • Practice deep breathing. Breathe slowly and deeply, and focus on the act of breathing. Count your breaths in and out, in seconds.

If you or someone in your life is suffering from anxiety, please reach out for help. You can contact Fairmount Behavioral Health System 24-hours a day for a mental health assessment from a team of multi-disciplinary professionals.

Author: By Hillary Ammon, M.A.


Anxiety and Depression Association of America, ADAA (2016). Stress and anxiety interfere with sleep. Retrieved from http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/stress-and-anxiety-interfere

Staner, L. (2003). Sleep and anxiety disorders. Dialogues in Clinical Neuroscience, 5(3), 249–258.

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