Sleep anxiety is a common experience among people with insomnia. Learn how to recognize the symptoms of sleep anxiety and how to improve your sleep quality.

What is sleep anxiety?

Sleep anxiety is a common feature of insomnia. Sleep anxiety is being fearful or worried about going to sleep. It’s common to be anxious about not falling asleep or not being able to remain asleep. Less commonly, some people have phobias about sleep. They think bad things will happen when they sleep, or that they can’t sleep, because they need to remain watchful.

Anxiety disorders and insomnia commonly go hand in hand. For example, you may find your worry thoughts keep you awake or you may worry that you won’t get the rest you need to cope. One issue can make the other worse, so it can feel like an endless cycle.

What causes sleep anxiety?

Anxiety is an ordinary part of being human. It is normal to feel afraid when faced with a dangerous situation. However, in the case of chronic anxiety, you might feel tense or worry most of the time. Fear can be a part of everyday situations like going to school or falling asleep.

Consistently elevated levels of stress hormones around bedtime, make it hard for your body to relax, which means you may have difficulty falling asleep. In addition, you may wake during the night thinking anxiety-provoking thoughts, which can keep you awake.

Just as anxiety can disturb sleep, poor sleep can impact anxiety. Some people also experience nocturnal panic attacks. A panic attack is an unexpected, intense surge of extreme fear. These are not pleasant and often people fear their recurrence.

How is sleep anxiety treated?

• Psychological therapies such as CBT
• Healthy sleep habits
• Medication

How does cognitive behavioral therapy treat sleep anxiety?

• CBT teaches you how to alter your behavior by changing the way you think
• Helps you avoid behaviors or environmental factors that trigger your anxiety
• Educates you on how sleep and anxiety affect your brain and body
• Changes unhelpful thinking about sleep

In addition, relaxation skills and biofeedback can help you to counteract the stress and tension that can occur with sleep anxiety and insomnia.

What sleep habits support sleep anxiety?

• Minimise drinking excessive fluids before bed, particularly alcohol
• Undertake relaxing activities in the evening, such as meditation
• Minimise caffeine consumption
• Only go to bed when you feel sleepy
• Maintain a regular time to go to bed and to wake each day
• Get out of bed, if you are not asleep within 20 minutes
• Make sure your bedroom is dark, cool and quiet
• Don’t watch television or do work in bed
• Stop using electronic devices at least 2 hours prior to bedtime
• Try not to eat dinner within 2 hours of going to bed

If you are experiencing persistent insomnia and/or sleep anxiety, speak with your doctor so that any underlying medical conditions can be ruled out and you can begin the treatment of insomnia and sleep anxiety. A qualified lifestyle medicine practitioner can recommend ways to help your sleep anxiety so you finally feel well rested!