Herbie Murray
Sleep anxiety is a common condition where anxiety and insomnia coexist in a vicious cycle. People with anxiety disorders often struggle to fall asleep or stay asleep, and those with sleep disorders may develop anxiety due to the fear of not getting sufficient rest. This can lead to physical complications such as heart disease and high blood pressure. Treatment options include medication and lifestyle changes. Medications like benzodiazepines, zolpidem, and trazodone can be prescribed to reduce anxiety and promote sleep, but they carry risks of dependence and withdrawal symptoms. Lifestyle changes, such as improving sleep hygiene, adopting relaxation techniques, and consuming natural sleep aids like warm milk, chamomile tea, and melatonin supplements, can also help improve sleep quality.
| Characteristics | Values |
|---|---|
| Medical causes | Hyperthyroidism, cardiac problems, endocrine illnesses, other organ system dysfunctions |
| Medicine use | Caffeine, cocaine |
| Withdrawal | Alcohol, opiates, benzodiazepines |
| Psychiatric disorders | Depression |
| Treatment | Zolpidem (Ambien), Estazolam (ProSom), Suvorexant (Belsomra), Lemorexant (Dayvigo), Trazodone (Desyrel), Melatonin, CBT-I, Meditation, Exercise |
| Side effects | Drowsiness, muscle weakness, sleep paralysis, complex sleep behaviors, lightheadedness, dizziness, fainting, withdrawal |
| Lifestyle changes | Reducing screen time, limiting caffeine intake, drinking warm milk, chamomile tea, tart cherry juice, melatonin supplements |
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What You'll Learn
- Natural sleep aids, such as warm milk, chamomile tea, and tart cherry juice
- Melatonin supplements, which can be purchased over the counter
- Zolpidem (Ambien) and Estazolam (ProSom), which are sedative-hypnotics
- Benzodiazepines, which reduce anxiety at lower doses and induce sleep at higher doses
- Lifestyle changes and behaviour therapies, such as CBT-I, which can help to break the association between sleep and anxiety
Natural sleep aids, such as warm milk, chamomile tea, and tart cherry juice
Warm milk is a well-known home remedy for sleep troubles that has been passed down through the ages. While there is limited scientific evidence to support this, some studies have shown that drinking warm milk and honey before bed can improve sleep. Another study found that drinking fermented milk over three weeks reduced nighttime awakenings in adults over 60. Milk's sleep-promoting properties may be due to the amino acid tryptophan, which has been shown to improve sleep and mood in older individuals. Tryptophan is involved in the production of serotonin and melatonin, which influence mood, cognitive reasoning, and memory. However, those with dairy allergies, lactose intolerance, or irritable bowel syndrome triggered by dairy should avoid drinking milk before bed.
Chamomile tea is another popular natural sleep aid that has been used globally since ancient times. The herb, which has small, daisy-like flowers, is believed to promote relaxation and sleep. Some studies suggest that chamomile tea induces drowsiness quickly, making it ideal for consumption before bedtime. The scent of chamomile alone is thought to have a relaxing effect, and the essential oil can be vaporized and inhaled to help with anxiety and depression. While more research is needed, chamomile has been regarded as an anti-inflammatory, a diuretic, and an analgesic.
Tart cherry juice, specifically Montmorency tart cherry juice, has been found to have a positive effect on insomnia in older individuals. It increases sleep time and efficiency, possibly due to its melatonin and tryptophan content. A placebo-controlled study involving subjects over 50 with insomnia found that drinking 240ml of cherry juice twice a day for two weeks improved sleep quality. Cherry juice also has anti-inflammatory properties and may help treat insomnia by reducing inflammation.
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Melatonin supplements, which can be purchased over the counter
Melatonin is a hormone that is available as a dietary supplement and can be purchased over the counter. It is often recommended for people with DSWPD (Delayed Sleep-Wake Phase Disorder) who have trouble falling asleep at usual times and wake up late in the morning. Melatonin supplements have been found to reduce the time it takes for people with DSWPD to fall asleep.
Melatonin supplements have also been found to reduce anxiety before surgery in both adults and children. A 2015 review of 12 studies found strong evidence that melatonin is better than a placebo in reducing pre-surgery anxiety. The review also suggested that melatonin may be as effective as standard treatment (antianxiety medicine midazolam). However, the results of melatonin's benefits for reducing anxiety after surgery were mixed.
While melatonin supplements are available over the counter, it is best to consult a healthcare provider before taking them, especially for children. There is uncertainty about the appropriate dosage, long-term effects, and whether the benefits outweigh the potential risks. As melatonin is a hormone, it may affect hormonal development, including puberty, menstrual cycles, and the overproduction of the hormone prolactin.
If you are experiencing sleep anxiety, it is important to seek help if your symptoms persist, worsen, or begin to negatively affect your life. Besides medication, there are other treatment options, including cognitive-behavioral therapy (CBT-I) and lifestyle changes.
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Zolpidem (Ambien) and Estazolam (ProSom), which are sedative-hypnotics
Sleep disorders and mental health disorders like anxiety often go hand in hand. If you have an anxiety disorder, you may find it difficult to fall asleep or stay asleep. Similarly, if you have a sleep disorder, you may feel anxious or fearful before bed due to the fear of not getting adequate rest. This can become a never-ending cycle.
Zolpidem (Ambien) and Estazolam (ProSom) are sedative-hypnotics that can help treat insomnia and anxiety. Zolpidem is a non-benzodiazepine that primarily targets the alpha-1 subtype of the GABA-A receptor. It is available in immediate-release and extended-release formulations. The immediate-release tablet helps you fall asleep faster, while the extended-release tablet helps you stay asleep throughout the night. Zolpidem comes in tablet, sublingual, and oral spray forms. It is important to note that Zolpidem should be taken only when you can get a full 7 to 8 hours of sleep to avoid feeling drowsy the next day. Similar to other sedative-hypnotics, Zolpidem can cause side effects such as drowsiness, dizziness, and changes in behaviour.
Estazolam (ProSom) is a benzodiazepine that works by slowing brain activity to induce sleep. It acts on specific receptors in the brain to enhance the effects of GABA, producing a calming effect and aiding sleep. Doctors typically prescribe this drug for short-term treatment due to its tendency to cause dependence and addiction. Benzodiazepines are generally recommended for treating severe and disabling anxiety or insomnia that is causing extreme distress. However, they should be used with caution due to their potential for dependence and withdrawal symptoms. Estazolam should not be taken with alcohol or other central nervous system depressants, as this can increase the risk of respiratory depression and sedation.
It is important to consult a healthcare professional before taking any medication for sleep anxiety. They can help determine the underlying causes of your sleep and anxiety issues and recommend the most suitable treatment options, which may include medications like Zolpidem and Estazolam, lifestyle changes, or other therapeutic approaches.
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Benzodiazepines, which reduce anxiety at lower doses and induce sleep at higher doses
Benzodiazepines are a group of medications that can help reduce anxiety and make it easier to sleep. They are also used as muscle relaxants, to induce sedation for surgery and other medical procedures, and in the treatment of seizures and alcohol withdrawal. They are the most widely prescribed psychoactive drugs in the world.
Benzodiazepines enhance the activity of the neurotransmitter GABA (gamma-aminobutyric acid)—a chemical in the brain that helps you feel calm. Their effect also produces drowsiness, making it easier to fall asleep and sleep through the night. They reduce anxiety when given at low doses and induce sleep at higher doses.
The calming effects of benzodiazepines can often be achieved without drugs. Various kinds of exercise, such as walking, running, yoga, or tai chi can help, as can reducing the stress in your life and taking time for relaxing activities such as meditation, reading a book, or having a warm bath. Talking with a trusted friend, family member, or therapist and working out the problems that are troubling you can also help. Whenever possible, these approaches should be tried first, before benzodiazepines.
While benzodiazepines can be effective in treating sleep anxiety, they are associated with dependence liability and withdrawal symptoms. They are generally viewed as safe and effective for short-term use of two to four weeks. However, long-term use can result in a worsening of the very symptoms they are meant to treat. Therefore, it is recommended that they be taken intermittently and at the lowest effective dose for the shortest period of time (maximum four weeks).
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Lifestyle changes and behaviour therapies, such as CBT-I, which can help to break the association between sleep and anxiety
Cognitive behavioural therapy for insomnia (CBT-I) is an effective treatment for chronic insomnia and short-term sleep issues. CBT-I is an evidence-based approach that focuses on restructuring thoughts, feelings, and behaviours that contribute to insomnia. The therapy involves stimulus control, sleep restriction, and relaxation training.
During CBT-I, patients learn relaxation techniques to reduce racing thoughts and tension when lying in bed awake. These techniques include breathing exercises, involving slow, deep breaths, which can be incorporated into a nightly routine. Meditation is also taught, which helps to reduce stress and anxiety, and increase relaxation. Meditation can also involve movement, such as yoga and tai chi.
Cognitive restructuring is a key component of CBT-I, which helps to break the cycle of insomnia. This involves identifying, challenging, and altering the thoughts and beliefs that contribute to insomnia, such as anxiety about past experiences of insomnia, unrealistic expectations of sleep time and quality, and worry about daytime fatigue.
Good sleep hygiene is also an important aspect of CBT-I. This involves educating patients about practices that encourage and support sleep, and those that discourage it. This includes advice on diet, exercise, and the sleeping environment. Patients are advised to go to bed and wake up at the same time every day, spend time outdoors in the daylight, and avoid caffeine.
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Frequently asked questions
Sleep anxiety is when a person has trouble falling asleep or staying asleep due to anxiety. Similarly, a person with a sleep disorder may develop anxiety due to the fear of not getting adequate rest.
Sleep anxiety can affect a person's emotional and physical health. It can negatively impact memory, concentration, and mood, and increase the risk of depression, obesity, type 2 diabetes, heart disease, and high blood pressure.
There are several medications that can help with sleep anxiety, including Zolpidem (Ambien), Estazolam (ProSom), Suvorexant (Belsomra), Lemorexant (Dayvigo), and Trazodone (Desyrel). Benzodiazepines are also commonly prescribed for short periods (3-4 weeks) to reduce anxiety at lower doses and promote sleep at higher doses. Antidepressants may also be considered for long-term therapy.
Yes, there are natural remedies that can help improve sleep. These include drinking warm milk, chamomile tea, or tart cherry juice. Melatonin supplements can also aid in regulating sleep by mimicking the body's natural response to reduced light exposure. Additionally, practicing good "sleep hygiene" is important, such as limiting screen time before bed and maintaining regular sleep and wake times.
Besides medication and natural remedies, addressing sleep anxiety involves making lifestyle changes. This includes adopting habits that promote sleep, such as exercising, and avoiding behaviours that trigger anxiety or disrupt sleep. Relaxation techniques, mindfulness practices, and cognitive-behavioural therapy (CBT) can also help manage sleep anxiety.
