Daytime Sleep And Anxiety: A Complex Relationship

Sleep and anxiety are closely linked. Anxiety can be a cause of sleep disruption, and sleep disruption can also cause anxiety. Sleep anxiety is a feeling of stress or fear about going to sleep. People with anxiety may find it hard to fall asleep or stay asleep, and those with sleep disorders may feel anxious before bed because they fear they won't get enough rest. This can create a never-ending cycle of anxiety and insomnia.

Anxiety can be caused by a variety of factors, including stress, trauma, insomnia, and genetics. It can get worse at night as people find themselves focusing more on their worries once they are lying in bed without the distractions of the day. This can lead to difficulties falling asleep or staying asleep, and can cause physical symptoms such as headaches, stomachaches, tense muscles, increased heart rate, sweating, and shortness of breath.

If you are experiencing anxiety that is disrupting your sleep, there are several strategies that can help manage it, including deep breathing exercises, progressive muscle relaxation, writing, exercise, therapy, and medication.

Night-time anxiety can be caused by daytime stress

Anxiety is a hard-wired response built into the nervous system, alerting you to threats in your environment. In modern society, feelings of anxiety can last for a few moments or up to several days, weeks, or more. This can upset your sleep schedule and become an ongoing distraction.

Daily stressors, such as taking on a new project or meeting a new person, can trigger feelings of stress and uncertainty. When you feel stressed, your senses can feel flooded, and you may feel restless, irritable, and overwhelmed as waves of anxiety come over you. This can make it very difficult to get a restful night's sleep.

Stressful life events, like work troubles, illness, or the death of a family member, can cause a person to feel distressed and anxious. In some people, anxiety disorders may develop after a particularly difficult or stressful life event.

Additionally, lack of sleep can cause more mental distress, including stress and anxiety. Studies show that when a person gets less sleep than they are used to, they experience heightened anxiety the next day. This creates a cycle where anxiety disrupts sleep, creating a sleep debt that worsens anxiety symptoms, which further disrupts sleep.

If you are experiencing anxiety at night, it may be helpful to try deep breathing exercises before bed, listening to relaxing music, reducing or eliminating substances such as alcohol, nicotine, and caffeine, and discussing possible medication side effects with your doctor.

Sleep anxiety can be caused by traumatic experiences

Traumatic events can be re-experienced in nightmares, which can cause sudden awakenings. The fear of having further nightmares can make relaxing and falling asleep much harder. Traumatic experiences can also lead to hyperarousal, where even small events can trigger the body's alarm system. Many people struggle to feel safe after experiencing a traumatic event, which can make it challenging to feel calm enough to fall asleep.

Childhood trauma can have a significant impact on sleep throughout a person's life. Adults with adverse childhood experiences are more than twice as likely to have trouble falling asleep and often feel tired after a full night's sleep. Trauma can also affect how the body cycles through sleep stages, limiting the amount of rapid eye movement (REM) sleep. REM sleep is directly linked to storing and processing memories, impacting how the traumatic event is processed.

Getting enough sleep and addressing sleep disorders after a traumatic event can reduce the risk of developing post-traumatic stress disorder (PTSD). However, people may not know how to improve their sleep after such an event. Building healthy sleeping habits, maintaining a sleep routine, creating a comfortable sleeping space, practising relaxation techniques, and paying attention to diet can all help.

Sleep anxiety can be caused by genetics

Genetics plays a role in determining whether a person is a "lark" or an "owl", a morning or a night person. Genes influence how fast or slow our internal clocks tick and, as a result, how closely they align with the 24-hour day. Changes in these genes, known as mutations, from one generation to the next can affect the clock's timing. For example, if your circadian clock runs faster than 24 hours, you may tend to be a "lark", and if it runs slower, you tend to be an "owl".

Additionally, there is a strong genetic component to restless leg syndrome, with up to 60% of cases reporting affected family members and high concordance in monozygotic twins. Genome-wide association studies have revealed a surprising role for developmental regulatory factors in restless leg syndrome. These transcription factors likely affect spinal cord regulation of sensory perception and locomotor pattern generation and may also interact with brain iron homeostasis.

Familial advanced sleep phase syndrome (FASPS), a condition where individuals have a lifelong tendency to wake and sleep at very early times, is caused by mutations in human clock-related genes. Underlying mutations in two pedigree populations point to defects in phosphorylation of PER2 as the core issue, with mutations identified in both the PER2 and Casein Kinase 1 genes.

Narcolepsy, a sleep disorder resulting in excessive daytime sleepiness, is also influenced by genetics. While the disease in humans is sporadic, resulting mostly from a loss of hypothalamic neurons producing hypocretin, there is a strong genetic component. Concordance is low in monozygotic twins, but recurrence risk in first-degree relatives is increased by 20-40 fold. HLA and T-cell receptor variants have strong effects on predisposition, and nearly all cases carry two specific and tightly linked class II gene alleles.

In summary, sleep anxiety can be caused by genetics, with multiple genes increasing the likelihood of developing an anxiety disorder. Additionally, genetics plays a role in determining sleep patterns such as whether someone is a morning or night person, and specific sleep disorders such as restless leg syndrome and narcolepsy have been linked to specific genetic variations.

Sleep anxiety can be caused by medication side effects

Sleep anxiety is a feeling of stress or fear about going to sleep. It is a common problem, with anxiety being the most prevalent mental health disorder in the US, affecting around 40 million people. Sleep anxiety can be caused by medication side effects, and certain medications can produce side effects that include anxiety. For example, starting or increasing the dosage of steroids, amphetamines, or antihistamines has been linked to anxiety and panic-like symptoms.

Additionally, over-the-counter sleep aids and supplements can interfere with other medications or worsen existing health conditions. It is always advisable to consult a healthcare professional before taking any new medications or supplements.

Prescription sleeping pills are stronger than over-the-counter options and are typically recommended for short-term relief. They can be addictive and are not a cure for insomnia. Common types of prescription sleeping pills include benzodiazepines and Z-drugs such as zolpidem (Ambien) and eszopiclone (Lunesta). While these medications can be effective in treating insomnia, they may also cause side effects such as constipation, digestive problems, and worsened snoring and sleep apnea.

Medications for anxiety and insomnia include sleep aids, antidepressants, and melatonin-like medications. Sleep aids are widely used by individuals with insomnia and help people fall and stay asleep. Antidepressants such as amitriptyline (Elavil) and trazodone (Desyrel) are also prescribed to help with sleep. Melatonin-like medications, such as ramelteon (Rozerem), mimic the body's natural sleep-wake cycle and promote sleep.

It is important to note that some medications may increase anxiety or make sleeping more difficult when first starting to take them. If you experience these side effects, consult your healthcare provider. Do not start any new medications without proper medical supervision.

Sleep anxiety can be caused by mental health disorders

Sleep anxiety is a feeling of fear or stress about falling asleep or staying asleep. It is often connected to mental health disorders such as anxiety, which is the most common mental health disorder in the US, affecting about 40 million people. Research suggests that most people with mental health disorders experience some form of sleep disruption.

Anxiety disorders can occur alongside other mental health problems like depression. According to the Anxiety and Depression Association of America (ADAA), nearly 50% of people with depression are also diagnosed with an anxiety disorder. Sleep deprivation can also instigate or worsen anxiety disorders.

People with anxiety disorders may experience symptoms such as:

• Extreme nervousness and restlessness
• Irritability
• Fear or a sense of impending doom
• Rapid breathing and heartbeat
• Gastrointestinal distress

Anxiety disorders can be caused by a variety of factors, including:

• Genetics: Research has found that multiple genes may make a person more likely to develop an anxiety disorder.
• Life stressors: Stressful life events, like work troubles, illness, or the death of a family member, can cause temporary distress and anxiety.
• Traumatic experiences: People often feel anxious in the weeks after a traumatic event, such as a natural disaster or act of violence.
• Medication side effects: Certain medications, such as steroids, amphetamines, or antihistamines, can produce side effects that include anxiety.

If you are experiencing sleep anxiety, there are several treatment options available, including:

• Cognitive behavioral therapy for insomnia (CBT-I): This is a type of therapy that helps individuals change negative thought patterns and behaviours that interfere with sleep.
• Medications: Your healthcare provider may recommend medication to treat anxiety or other mental health disorders.
• Lifestyle changes: Improving sleep habits, such as avoiding caffeine and alcohol before bed, establishing a relaxing bedtime routine, and creating a comfortable sleep environment, can help reduce sleep anxiety.

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