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  • Mariam Daneshgar

Sleep Anxiety: What Is It And How To Address It?

A man struggling with sleep anxiety laying in bed awake late in bed with arm over his head visibly anxious and deep in thoughts.
Sleep Anxiety and Insomnia

As the world drifts into slumber, the battle with sleep anxiety often extends far beyond the boundaries of our bedrooms. Sleep anxiety, at its core, is an intricate dance between the mind and the night. It's more than the occasional tossing and turning—it's a persistent companion that wraps the idea of sleep and bedtime in a cloak of unease. To truly grasp sleep anxiety, we must unravel its definition and delve into the labyrinth of symptoms that define this nighttime struggle. This guide is created to illuminate the intricate landscape of sleep anxiety.


Picture this: it's bedtime, a time most associated with rest and rejuvenation. Yet, for those grappling with sleep anxiety, this sacred moment is a battleground. It's not merely the act of falling asleep; it's the looming dread, the worry that sleep won't come easily or that the night will be fraught with unsettling dreams.


The mind, normally a haven for dreams and quiet contemplation, transforms into a bustling marketplace of concerns. Thoughts race, worries multiply, and the silence of the night amplifies every anxious whisper. It's the anticipation, the fear of the unknown that transforms bedtime into an ordeal rather than a respite.

Definition and Symptoms of Sleep Anxiety

Sleep anxiety is more than the occasional worry about difficulty in falling asleep; it encompasses a persistent and often overwhelming worry about the act of sleeping itself. Individuals grappling with sleep anxiety find themselves caught in a web of anxious thoughts and fears as bedtime approaches.


One of the hallmark symptoms is the anticipatory anxiety leading up to bedtime. The mere thought of going to bed becomes a source of stress, creating a negative association with the very act of sleeping. This anticipation can create a self-fulfilling prophecy, as the anxiety itself becomes a barrier to restful sleep.


The symptoms of sleep anxiety are diverse, manifesting both mentally and physically. Clients may describe a gradual increase in anxiety and apprehension as the night approaches. At bedtime there can be an inability to quiet their minds as they attempt to sleep, with racing thoughts dominating the quietness of the night. This mental unrest often translates into physical symptoms such as muscle tension, restlessness, and an increased heart rate, further complicating the process of falling asleep. These physical manifestations, intertwined with the mental uproar, create a challenging landscape for anyone seeking a peaceful and restful sleep.


Moreover, sleep anxiety is not confined to the nocturnal hours. Its repercussions extend into the daytime, influencing mood, cognitive function, and overall well-being. The fatigue of a sleepless night spills into the day, translating into daytime lethargy and irritability and impacting mood, cognitive function, and the ability to navigate daily life. It's a relentless cycle where nighttime worries breed daytime challenges, creating a pervasive struggle that extends far beyond the bedroom.

The Dance with Insomnia


Now, let's turn our attention to insomnia, a companion intertwined with sleep anxiety. Insomnia, often a consequence of sleep anxiety, further complicates the delicate dance with the night. It's a scenario where the quest for rest becomes elusive, marked by difficulty falling asleep, frequent awakenings during the night, or waking up too early and struggling to go back to sleep.

Sleep anxiety and insomnia form a symbiotic relationship, each feeding into the other. The worries that characterize sleep anxiety become the seeds of insomnia, as the racing thoughts and anticipatory anxiety make it challenging for individuals to find the peace needed for restful sleep.

Insomnia, in turn, amplifies the impact of sleep anxiety on daily life. The fatigue deepens, concentration wanes, and the emotional toll intensifies. This intricate dance between sleep anxiety and insomnia creates a formidable challenge for those seeking reprieve in the quietude of the night.

Triggers of Sleep Anxiety


Understanding sleep anxiety requires an exploration into the triggers that set the stage for the restless nights. These triggers, diverse and individualized, play a pivotal role in amplifying the anxiety surrounding bedtime. Here, we explore the multifaceted landscape of sleep anxiety triggers:


A. Stress and Life Events:

Life is a dynamic tapestry woven with various stressors, and often, these threads extend into the realm of sleep. Major life events, work-related stress, relationship challenges, or financial concerns can act as powerful triggers for general anxiety, as well as sleep anxiety. The anticipation of bedtime becomes a stage where the weight of daily stressors intensifies, creating a fertile ground for nighttime restlessness. And if excessive pressure and expectation is placed on good sleep, in order to tackle the stressors, then the possibility of disrupted sleep further increases the sleep anxiety levels.  


B. Trauma and Nightmares:

For individuals who have experienced trauma, bedtime can evoke a unique set of anxieties. Sleep may become a battleground haunted by nightmares or distressing dreams, acting as a constant reminder of past experiences. Trauma-related triggers (and the anticipation of them) can amplify sleep anxiety, intertwining past and present in the quiet hours of the night.


C. Health Conditions:

Physical health conditions, chronic pain, or ailments that impact sleep quality can act as significant triggers for sleep anxiety. The fear of exacerbating symptoms or struggling with discomfort during the night creates a heightened sense of anticipation, contributing to a restless relationship with sleep.


D. Work-Related Pressure:

The demands of a fast-paced, competitive work environment can infiltrate our restful hours. The pressure to perform, meet deadlines, or navigate professional challenges can cause some to place a heavy reliance on good sleep in order to achieve success. So when the possibility of disrupted sleep is present it can cause sleep anxiety to rise as the bedtime gets closer and make this time a source of stress rather than respite. In addition, the anticipatory anxiety about the next day’s performance and the stressors themselves add to the general anxiety experienced at bedtime.


E. Environmental Factors:

Our surroundings play a crucial role in shaping the quality of our sleep. Environmental triggers, such as excessive noise, uncomfortable bedroom conditions, or disruptions in the sleep environment, can contribute to sleep anxiety. An uneasy sleep setting becomes a breeding ground for nighttime worries.


F. Medication and Substance Use:

Certain medications or substances, including stimulants or certain antidepressants, can interfere with sleep patterns and in turn act as triggers for sleep anxiety. The fear of sleep disturbances or side effects becomes a prominent concern, adding another layer to the nocturnal struggle.


G. Disrupted Sleep Patterns:

Irregular sleep schedules, frequent napping during the day, or consistently inconsistent sleep-wake patterns contribute to a disrupted circadian rhythm. These disrupted sleep patterns become triggers, creating a sense of unpredictability and anxiety surrounding bedtime.


Understanding these triggers is the first step in unraveling the complexities of sleep anxiety. By identifying and addressing these catalysts, individuals and therapists can develop targeted strategies to mitigate the impact of triggers, creating a more conducive environment for restful and rejuvenating nights.

Common Patterns Associated with Sleep Anxiety


As the night approaches, a series of thoughts and behaviours begin to play in the realm of sleep anxiety. Certain recurring trends emerge, forming the basis of nighttime struggles. These patterns, both in thoughts and behaviours, play a significant role in shaping the challenges faced when trying to rest. Identifying and understanding these recurring patterns will help in deciphering the nighttime struggles, anticipation, and worries.


Cognitive Patterns


At the core of sleep anxiety lie cognitive patterns — the patterns of thought that unfold as bedtime approaches. These thoughts, ranging from anticipatory worries to persistent fears about the night ahead, contribute significantly to the complexity of our nocturnal experience. Here are a few examples of the most common thoughts associated with sleep anxiety:


"What if I can't sleep at all tonight?"

"I need to fall asleep now; otherwise, I won't get enough rest,"

"I've been awake for hours; tomorrow will be terrible."

"I have to sleep well to function tomorrow,"

"Why can't I do something as simple as sleeping properly?"

"If I don't sleep well tonight, my entire week will be ruined,"

"I never sleep properly; it's always a disaster."

"What if I have a panic attack while I'm asleep?"

"I'm afraid of losing control when I'm not fully conscious."

"I've never slept well; why would tonight be any different?"

"I always have trouble sleeping."

"I should be able to sleep like everyone else,"

"If I don't get eight hours, it's a failure."

"As soon as it's bedtime, my anxiety spikes,"

"I dread going to bed because I know I'll struggle."

"I can't stop thinking about every little sound,"


Recognizing and challenging these thought patterns is a crucial component of cognitive-behavioural interventions for sleep anxiety. Therapeutic approaches often involve restructuring these thoughts to create a more realistic and positive mindset surrounding sleep. Addressing these cognitive aspects is integral to breaking the cycle of sleep anxiety and improving overall sleep quality.


Behavioural Patterns


Beyond our thoughts, our actions leading to and during the night play a critical role in the landscape of sleep anxiety. In the world of sleep anxiety, our nightly struggles are often shaped by recurring behavioural patterns, which are described as actions, routines, and responses surrounding bedtime. These actions and responses, particularly in the moments leading up to bedtime, contribute significantly to the challenges we face with sleep anxiety and in achieving restful sleep. Here are some of the most common behavioural patterns associated with sleep anxiety:


Procrastinating bedtime, often engaging in activities to delay the actual act of going to bed.

Example: Prolonged screen time, excessive cleaning or organizing, or finding reasons to stay awake.

Spending an excessive amount of time in bed, trying to force sleep.

Example: Going to bed much earlier than necessary, staying in bed even when unable to sleep, leading to frustration.

Modifying daytime behaviour to prevent or aid nighttime sleep.

Example: consuming or avoiding certain ingredients, cancelling plans to prevent disruption of bedtime routine

Inconsistency in sleep-wake times, contributing to circadian rhythm disruption.

Example: Going to bed and waking up at different times each day, creating a lack of predictability.

Dependence on sleep medications or over-the-counter remedies to induce sleep.

Example: Regular use of sleep aids without addressing underlying causes or seeking professional guidance.

Constantly checking the clock or sleep-tracking devices during the night.

Example: Waking up multiple times to check the time, leading to heightened anxiety about the hours left to sleep.

Developing rigid bedtime rituals or engaging in specific behaviours perceived as necessary for sleep.

Example: Requiring specific conditions (e.g., certain pillows, specific sleepwear) for sleep to occur.

Developing negative associations between the bedroom and sleep.

Example: Spending extended periods awake in bed, associating the bedroom with frustration and restlessness. 


Modifying these patterns is key in creating healthier sleep behaviour, which will lead to a more conducive environment for restful sleep. Therapeutic guidance assists individuals in breaking these habits, promoting healthier sleep behaviors, and transforming bedtime into a more positive and relaxing experience.


Addressing Sleep Anxiety


Confronting sleep anxiety involves a multifaceted approach aimed at addressing both sleep difficulties, as well as anxieties surrounding sleep. Recognizing and challenging cognitive patterns, such as anticipatory worries or persistent fears, is a crucial first step. Equally important is unraveling behavioural patterns, modifying actions and routines that may be contributing to sleep anxiety, as well as the sleep difficulties present. Additionally, implementing relaxation techniques and mindfulness exercises can further aid in reducing physiological arousal (from both general anxiety and sleep anxiety) and promoting a more relaxed state conducive to sleep. For individuals who are battling chronic insomnia, Cognitive Behavioural Therapy for Insomnia (CBT-I) is an effective structured and evidence-based framework that not only helps break the cycle of sleep anxiety but also cultivates lasting habits that pave the way for sustained, restful nights.


For those seeking comprehensive support, sleep therapy emerges as a transformative avenue. By providing a trusting and non-judgmental space clients are able to openly discuss their sleep-related concerns with a sleep expert and explore the underlying issues contributing to their sleep anxiety. A comprehensive sleep assessment will provide an in-depth understanding of the client's sleep patterns, triggers, and the severity of their sleep anxiety and shed light on the intricate relationship between their sleep and anxiety. This information guides the development of a personalized treatment plan that can address both sleep-related anxiety and sleep disturbances present and offer strategies that address both the mental and physical aspects of the sleep experience.


As we conclude this exploration into various aspects of sleep anxiety, it is evident that understanding the intricacies present is a crucial step toward reclaiming restful nights. Whether entangled in cognitive or behavioural patterns, acknowledging the factors that shape our nocturnal experiences empowers us to chart a course toward better sleep. If the nighttime symphony of thoughts or the behavioural rhythms have left you seeking a more harmonious relationship with sleep, consider the support of sleep therapy. A sleep therapist can help transform bedtime from a battleground into a sanctuary, and sleep from a source of anxiety into a haven of peace.



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