Evie Summers
Sleep anxiety, or somniphobia, is a feeling of stress or fear about going to sleep. It can manifest as a worry about not falling asleep or staying asleep. Sleep disorders and mental health disorders like anxiety often go hand in hand, with anxiety being the most common mental health disorder in the US. The good news is that there are many ways to tackle sleep anxiety, ranging from therapy and medication to natural remedies and lifestyle changes.
| Characteristics | Values |
|---|---|
| Medical treatments | Benzodiazepines, antidepressants, zolpidem, estazolam (ProSom), zaleplon (Sonata), suvorexant (Belsomra), lemorexant (Dayvigo), trazodone (Desyrel), melatonin supplements |
| Non-medical treatments | Therapy, sleep hygiene, exercise, diet, reducing caffeine intake, avoiding strenuous exercise before bed, going to bed at the same time, reserving bed for sleep, avoiding bright lights, drinking warm milk, chamomile tea, tart cherry juice |
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What You'll Learn
Sleep medications and their side effects
Sleep medications are often used to treat insomnia and severe anxiety. These medications can be over-the-counter or prescribed, and they work by making you feel drowsy and relaxed. However, it's important to note that sleep medications are typically recommended for short-term use only, as prolonged use can lead to dependence and other side effects.
Benzodiazepines
Benzodiazepines are commonly prescribed to treat severe anxiety and insomnia. They work by stimulating a chemical in the brain called GABA, which leads to sedation, muscle relaxation, and reduced anxiety. While benzodiazepines can be effective in the short term, they are potentially addictive and should not be used for more than four weeks. Chronic use can lead to dependence and withdrawal symptoms. Benzodiazepines may also cause side effects such as memory and attention problems.
Z-drugs
Z-drugs are prescription sleep medications that work by slowing down brain activity. They can be effective in treating insomnia and helping individuals stay asleep. However, like other sleep medications, Z-drugs can cause side effects such as constipation, muscle weakness, and digestive problems.
Over-the-counter Sleep Aids
Over-the-counter sleep aids, such as melatonin supplements and valerian, are also available. Melatonin is a hormone that promotes sleep by influencing when you fall asleep and wake up. Valerian has a natural calming effect on the nervous system. While these supplements are generally considered safe, they can still cause side effects such as daytime drowsiness and confusion. It's important to consult a healthcare professional before taking any sleep aid, especially if you are taking other medications or have underlying health conditions.
Natural Sleep Aids
Natural sleep aids, such as warm milk, chamomile tea, and tart cherry juice, can also be helpful in improving sleep. While there is limited scientific evidence for these remedies, they are generally safe to try. Additionally, reducing exposure to artificial light before bed and maintaining consistent sleep habits can improve sleep quality.
In summary, while sleep medications and aids can provide short-term relief from insomnia and anxiety, they should be used cautiously and under the guidance of a healthcare professional. It is important to explore non-pharmacological treatments, such as therapy and improving sleep hygiene, before resorting to medications.
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Natural sleep aids
Sleep anxiety is a feeling of stress or fear about going to sleep. It is often associated with mental health disorders like anxiety. If you have an anxiety disorder, you may find it challenging to fall asleep or stay asleep. Likewise, if you have a sleep disorder, you might feel anxious or fearful before bed because you're afraid you won't get the rest you need.
Melatonin Supplements
Melatonin is a hormone that is naturally released in the brain about four hours before we feel sleepy. It is triggered by the body's response to reduced light exposure, which usually happens at night. However, exposure to artificial light from phones, laptops, or TVs can prevent the release of melatonin, making it hard to fall asleep. Melatonin supplements are available over the counter and can help regulate your sleep-wake cycle. It is important to consistently buy the same brand of melatonin supplements as dosages and ingredients may vary across manufacturers.
Warm Milk
Warm milk has long been believed to contain chemicals that simulate the effects of tryptophan on the brain. Tryptophan is a chemical building block for serotonin, which plays a role in the sleep-wake transition. While there isn't extensive scientific proof that warm milk improves sleep, it is a harmless option to consider.
Chamomile Tea
Chamomile tea is believed to contain flavonoids that interact with benzodiazepine receptors in the brain involved in the sleep-wake transition. Additionally, chamomile tea is caffeine-free, making it a better choice than other types of tea. Chamomile is also available as an aromatherapy oil, traditionally used to reduce muscle tension and anxiety, which may aid in inducing sleep. However, it is important to note that clinical trials have not shown chamomile to be effective for insomnia.
Tart Cherry Juice
Tart cherry juice may support melatonin production and promote a healthy sleep cycle. While there isn't definitive proof that it improves sleep quality, it is worth trying as it does no harm.
Magnesium Supplements
Magnesium is a natural sedative, and research indicates that magnesium supplements can help with insomnia. Magnesium supplements come in various forms, including magnesium oxide, citrate, glycinate, and chloride. It is recommended to consult a healthcare provider before starting any magnesium supplement to determine the appropriate form and dosage.
Exercise
While the link between exercise and improved sleep is not fully understood, it is known that moderate aerobic exercise increases the amount of nourishing slow-wave (deep) sleep you get. However, it is crucial to time your workouts correctly, as aerobic exercise releases endorphins that can keep you awake.
In addition to these natural sleep aids, maintaining good sleep hygiene is essential. This includes practices such as going to bed at the same time each night, reserving your bed for sleep, reducing caffeine intake, and minimizing light exposure during the night.
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Therapy and lifestyle changes
Sleep anxiety is a feeling of stress or fear about going to sleep. It can affect adults, teens, and children. Those with sleep anxiety may fear not falling asleep or staying asleep. Sleep anxiety can also cause worry about staying alert and watchful. 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.
Therapy is an effective way of treating the underlying problem rather than just the symptoms, helping you develop healthy sleeping patterns for life. Cognitive Behavioural Therapy for insomnia (CBT-I) is considered a first-line treatment for insomnia and is often misrepresented as talk therapy or sleep hygiene. CBT-I teaches patients how to break the association between their bed and worry and distress. It also teaches them how to retrain their body and mind to see the bed as a place for sleeping by focusing on limiting total time in bed, getting out of bed when awake, and keeping regular sleep and wake times. CBT-I may also include relaxation strategies and mindfulness techniques.
Therapy can be supported by making positive lifestyle choices that benefit your ability to sleep. Exercise relieves stress and anxiety and improves sleep, so make time for regular exercise. Aim for 30 minutes or more on most days, but not too close to bedtime. Avoid late meals within two hours of bedtime. Stop drinking caffeinated beverages at least eight hours before bed. Like caffeine, nicotine and sugary foods are stimulants, and while alcohol can make you sleepy, it interferes with the quality of your sleep and can make sleep disorder symptoms worse.
Sleep hygiene involves improving your daytime habits to include exercising regularly, avoiding nicotine and caffeine late in the day, and learning to unwind at night. Relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and breathing exercises can help you relax at night, relieving tension and anxiety and preparing you for sleep. Your sleep environment should be dark, quiet, and cool, so consider blackout shades, earplugs, or a sound machine to block out noise.
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Sleep hygiene
Sleep anxiety is a feeling of stress or fear about going to sleep. Sleep disorders and mental health disorders like anxiety often go hand in hand. Sleep hygiene is about having healthy sleep habits. Your behaviours, both during the day and at bedtime, can affect the quality of your sleep.
Stick to a schedule
Try to go to sleep and wake up at the same time every day, even on weekends. This reinforces your body's sleep cycle (your internal clock), making it easier to fall asleep and wake up every day. Having a set schedule normalises sleep as an essential part of your day and gets your brain and body accustomed to getting the full amount of sleep that you need.
Prioritise sleep
It might be tempting to skip sleep to work, study, socialise or exercise, but it's vital to treat sleep as a priority. Calculate a target bedtime based on your fixed wake-up time and be ready for bed around that time each night.
Make gradual adjustments
If you want to shift your sleep times, don't try to do it all at once, as this can throw your schedule off.
Have a relaxing bedtime routine
A relaxing bedtime routine helps you unwind so you're ready to sleep. Keeping the routine consistent helps your body recognise that it's bedtime when you start the routine. This may help you fall asleep more quickly. The best time to start your routine is about 30 to 60 minutes before you go to bed. Your routine can include whatever makes you feel most relaxed, as long as it doesn't involve a device that emits blue light.
Limit blue light exposure before bed
Blue light from mobiles, tablets and computers can stop you from falling asleep. So, avoid electronic devices at least an hour before bed.
Keep your bedroom dark
Good curtains or blinds can help to keep a room dark and avoid unwanted lights. If you need to get up during the night, use a flashlight instead of turning on the lights.
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Underlying medical causes
Sleep anxiety is a feeling of stress or fear about going to sleep. It is important to identify the underlying medical causes of sleep anxiety before deciding on a treatment plan. Here are some potential underlying medical causes of sleep anxiety:
Medicine Use and Substance Withdrawal
The use of certain medications or substances can contribute to sleep anxiety. Caffeine, for example, is a stimulant that can interfere with sleep patterns. Additionally, withdrawal from certain substances, such as alcohol, opiates, or benzodiazepines, can induce insomnia and anxiety.
Endocrine Illnesses
Endocrine illnesses, such as hyperthyroidism, can disrupt the body's hormone balance and contribute to sleep anxiety. Hormonal imbalances can affect sleep patterns and mood regulation, leading to anxiety about sleep.
Cardiac Problems
Cardiac issues can also play a role in sleep anxiety. Sleep is a critical period for cardiovascular regulation, and any disruptions can have negative consequences. Additionally, the anxiety associated with cardiac problems can further contribute to sleep anxiety.
Organ System Dysfunctions
Dysfunctions in other organ systems, such as the respiratory or digestive systems, can also impact sleep. For example, people with obstructive sleep apnea (OSA) have interrupted sleep due to breathing lapses, which can increase anxiety and worry about sleep.
Psychiatric Disorders
If no underlying medical cause is identified, it is important to consider the presence of psychiatric disorders. Depression, phobias, and other anxiety disorders can contribute to sleep anxiety. Addressing these underlying disorders through therapy or medication can help improve sleep patterns.
It is important to consult with a healthcare professional to properly diagnose and treat the underlying medical causes of sleep anxiety. Each individual is unique, and the best treatment plan may vary depending on personal factors.
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Frequently asked questions
Sleep anxiety is a feeling of stress or fear about going to sleep. People with sleep anxiety may be scared about not falling asleep or not being able to stay asleep. Sleep anxiety can affect adults, teens and children.
Sleep anxiety can be caused by an anxiety disorder, a sleep disorder, or both. Anxiety disorders, such as panic disorder and post-traumatic stress disorder (PTSD), can make it hard to fall asleep or stay asleep. Sleep disorders, such as narcolepsy, sleep apnea, and restless legs syndrome (RLS), can also cause sleep anxiety.
Sleep anxiety can cause behavioural or emotional symptoms, such as feelings of being overwhelmed, inability to concentrate, irritability, nervousness, restlessness, and a sense of impending danger or doom. It can also cause physical symptoms, such as digestive problems.
Treatment for sleep anxiety can include therapy, medication, and improving sleep hygiene. Medications such as benzodiazepines, zolpidem, and trazodone may be prescribed for short periods of time to reduce anxiety and promote sleep. However, these medications can be addictive and should be used with caution. Improving sleep hygiene involves adopting habits such as having a regular sleep routine, avoiding stimulants before bed, and engaging in relaxing activities if you can't sleep.
