Anxiety and Sleep
If you’ve had recent difficulty falling asleep, you’re not the only one. Right now, it is easy to feel anxious and uncertain about the world and future. We frequently wake up to negative news stories and are adjusting to life in isolation. This worry about the pandemic is affecting our bodily responses with the fight or flight anxiety response.
How does stress effect sleep?
Our body is designed to keep us up at night if it thinks we need to – if it feels there is a looming threat. Historically speaking, that threat was often regarding predators. However, in modern times, our body interprets threats as stressful situations. Our brain can register anything from online work meetings to our worries about family health and financial stability, as an impending threat that we need to be alert for. Frustratingly, our survival system, the fight or flight response, does not recognise that these issues can wait until the morning.
Why is sleep important?
Quality sleep is essential for our daily functioning and to regulate our mood. A lack of sleep heightens anxiety and stress, with one night of poor sleep increasing anxiety levels for the next day. This also occurs if you do not get the required hours of sleep, with people who sleep for only four or five hours a few nights in a row, experiencing an increase in anxiety. This is because, when we don’t get enough sleep, the prefrontal cortex within the brain cannot communicate effectively with the amygdala (the emotional centre of the brain), in other words, we cannot limit the amygdala’s anxiety response to plan and control our reactions.
Sleep improves mood and bolsters the immune system; it also improves memory and increases your energy levels for the day ahead. A recommended seven to nine hours of sleep is necessary for an adult’s health and wellbeing (8-13 hours for children depending on age). Getting less than seven hours of sleep a night is related to harmful outcomes such as hypertension, diabetes, stroke, cardiovascular disease and obesity, as well as various mental health issues. For children, sleep improves attention, learning and memory, behaviour and overall mental wellbeing. Children who get quality sleep have better problem-solving skills, are more creative, more social, and are able to make positive choices throughout the day.
Signs You’re Not Getting Enough Sleep
- Physical Symptoms
- Difficulty waking up in the morning or falling asleep after being woken
- Frequent yawning
- For children: complaining of being tired throughout the day
- Wanting to lie down during the day
- Falling asleep or feeling drowsy at work or school
- Wanting to consume stimulants to stay awake, such as caffeine and sugar
- Weight gain
- Getting sick more frequently as the immune system is not functioning optimally
- Blurred vision
- Emotional symptoms
- Increased stress
- Moodiness and irritability
- Increased negative emotions
- Cognitive symptoms
- Lack of motivation and interest in everyday tasks
- Limited attention span
- Difficulty retaining new information
It is imperative that you calm your mind before trying to fall asleep. Activities like reading, listening to music, taking a shower or bath, or watching TV can help calm your mind and body before bed. Meditation can also be beneficial, with apps like Smiling Mind or Calm, which can assist in slowing breathing and relaxing muscles. Having chamomile tea or being surrounded by calming scents, such as lavender, may also help your body and mind relax.
I’m sure we all know the frustration of waking in the middle of the night and being unable to fall back asleep as we stare at the clock. Rather than staying in bed feeling uncomfortable and worried, it is best to get out of bed and do another relaxing activity until you feel tired again. These activities could be similar to the ones mentioned above, or things like stretching and journaling. This way, the bed itself is still associated with relaxation and tiredness rather than anxiety.
Melatonin is the vital hormone that regulates the sleep-wake cycle (or circadian rhythm), in other words, it is the hormone that tells the body to get tired. Given the importance of this hormone, it is important to limit screen time as blue light in electronics suppresses the natural release of melatonin. This means the body will not feel tired after looking at technology and you will be unable to easily fall asleep. Research suggests not looking at your phone for an hour or two before bed, or if that is impossible, turning your phone to night mode which stops blue light, and turning the brightness down.
Keep a Routine
If possible, go to bed and wake up every day at the same time (yes, this includes weekends!). If you sleep in, you may notice that you are unable to go to sleep at your normal bedtime, and if you wake too early, you may want to sleep before your usual bedtime. Doing the same thing each night conditions our bodies and minds to relax. A night-time routine should start at least 30 minutes before you go to bed, including relaxing activities and hygiene practices. Additionally, in the mornings it is recommended that you expose yourself to natural light to help your brain register that it is daytime and increase alertness.
If you’re having trouble sleeping, an additional tip is to do various activities throughout the day at the same time each day. This assists the body and mind to get into a routine that makes it easier to fall asleep when the time comes. For instance, eating, exercising and socialising around the same time each day, if possible. It is also advised that you avoid long naps during the day, especially in the late afternoon or evening, as it will also affect how you fall asleep at bedtime.
Go to Bed when Tired
We are always encouraged to keep a routine around bedtimes and wake-up times. However, if you go to bed before you are tired you may be giving yourself time to ruminate over anxieties and frustrations as you wait to fall asleep. Distraction is vital here. We can read or do other previously mentioned, relaxing activities until we feel tired. For instance, we can read until we simply can’t stay awake anymore. As we do this our natural rhythms will step in and we will get the sleep the body requires.
We all feel tired at different times. For instance, some people are night owls, others are morning larks (and some fall somewhere in between). This is called a chronotype. It is important to recognise which category you fall into and embrace a routine that suits. For instance, go to bed early if you are a morning lark so that you are alert as you naturally awaken.
Alcohol and Caffeine
I’m sure we’ve all heard the news that alcohol sales have increased during the pandemic; however, alcohol has a negative impact on sleep. It is suggested that we should stop alcohol consumption three hours before bed while drinking in moderation. These guidelines can be hard to follow, especially after a stressful day, but the following will explain why it is important to consider.
Having an alcoholic beverage before bed seems relaxing as when alcohol is first metabolised it has a sedating effect – making us feel tired. However, as time passes and the body starts eliminating alcohol, it has a more alerting affect – meaning sleep will be difficult. Additionally, alcohol is a diuretic meaning that bathroom trips will be more frequent throughout the night. Research also suggests that alcohol negatively affects REM sleep, which is the deep sleep that allows us to feel rested upon awakening.
Drinking one fewer cup of coffee each day, or not drinking caffeine after lunch can improve sleep. Caffeine is a stimulant that can keep us awake for longer than ideal. It is important to avoid over-caffeinating throughout the day, as well as drinking coffee too close to bedtime. Instead, try to stay awake using water, as dehydration makes us tird, or have herbal tea (such as peppermint) which provides an energy boost.
Sleep hygiene is so important during these stressful times. Sleep hygiene is simply behaviours and environmental factors that promote quality sleep. This includes doing things such as turning down lights to ensure melatonin is naturally released and making sure the room is an appropriate temperature. Research suggests that the best temperature for sleep is approximately 18 degrees. Additionally, it is important to have comfortable bedding and pillows to allow you to relax and fall asleep.
Research has consistently shown that exercise improves both sleep and stress levels. Any form of exercise relieves stress and anxiety, helping us sleep better at night. However, it is suggested that we steer clear of high intensity exercise before sleep, as the energy and adrenaline afterwards will make it more difficult to fall asleep. While exercise is important it is not necessary to adopt a new, high intensity routine. It is more important to do what feels comfortable and take care of ourselves.
Outlets for Stress and Anxiety
Working through your stress in the daytime may help your relaxation and thought patterns in the night-time. Process your fears and anxiety in the day, and dependent on the content, you may be able to problem-solve and come up with solutions for your worries. There are numerous ways to do this. Seeking social support or doing mindfulness activities may assist in working through your stress as you live in the moment rather than ruminating on an uncertain future.
With so much happening and changing right now, there is no right way of coping. It is normal to lie awake in bed or wake up during the night and have difficulty falling back asleep. It is better to accept this than stress about it even more. These are truly unprecedented times and our bodies will respond in different ways. There is no ‘wrong’ way to sleep, whether you want to sleep in, go to bed late, or prioritise work over sleep. Every day is a chance to be kind to yourself and start fresh with you goals in mind.