Dealing with Anxiety Symptoms: Insomnia
Insomnia can cause anxiety and anxiety can cause insomnia. For some people, problems sleeping can either cause or increase symptoms of anxiety. For others, the constant worrying can keep them up at night, creating both increased anxiety and other health problems. It can become a vicious cycle.
Insomnia is a sleep disorder. People with insomnia may have trouble falling asleep, staying asleep or may wake up too early each morning. People with insomnia often sleep poorly, even after falling asleep. According to DukeHealth.org, up to 30% of all adults in the United States have symptoms of insomnia at some time and 10% suffer from chronic insomnia. Insomnia can often be one of the first symptoms of anxiety.
When insomnia occurs because of a specific situation or stressor it is considered to be short-term or transient insomnia. Traumatic events, illness, injury or major life events can cause a short period of temporary sleep problems. Some people also may experience sleep problems during the change of season, when going through a difficulties at work or school or while traveling.
Normally, short-term insomnia does not require any medical treatment. Normal sleep patterns usually return once the event or situation has been resolved. However, if the insomnia lasts more than a few weeks or interferes with a person's ability to complete daily activities, treatment may be needed.
You are considered to have chronic insomnia if you have trouble falling asleep, staying asleep, wake too early or have a poor quality of sleep most nights for one month or more. There is some research to indicate that insomnia may be hereditary with 35% of people with chronic insomnia having a family history of trouble sleeping.
Anxiety and stress can be causes of chronic insomnia. There are, however, many other possible causes:
- Low levels of melatonin
- High levels of stress or growth hormones
- Problems with the immune system
- Emotional disorders such as depression or bipolar disorder
- Physical illness or other health problems
- Restless leg syndrome
- Use of alcohol or substance abuse
When insomnia is caused by one of these reasons, it is considered to be secondary or comorbid insomnia.
Chronic primary insomnia is when there are no other health conditions causing the problems sleeping.
Treatment of Insomnia
There are various medications that can be used to treat insomnia. These medications cannot cure insomnia nor provide long-term relief. Many of these medications can be addictive if used over extended periods of time. Medications can, however, provide temporary relief.
Behavioral programs are also available to help people learn to relax and improve the ability to fall asleep and improve the overall quality of sleep. Behavioral methods have been found to be effective in almost all people and for many, have cured insomnia. Behavioral techniques can include:
- Cognitive behavioral therapy
- Progressive muscle relaxation
- Stimulus control
- Paradoxical intention
- Use of imagery
Up to 80% of patients using behavioral techniques have reported improvement in sleep in as little as four weeks and the majority of patients using medication were able to reduce or eliminate the use of medication after participating in a behavioral program.
Five Tips to Getting a Good Night's Sleep
Incorporate exercise into your daily routine. Increasing the amount of exercise you get each day can help to improve your ability to fall asleep as well as the quality of sleep you get. In addition, exercise offers many health benefits. Thirty minutes of exercise a day, even if taken as 3 ten-minute spurts of exercise or doing yoga and stretching exercises while watching television in the evening.
Avoid taking naps during the day. Naps, especially when taken late in the afternoon can interfere with sleeping at night. Instead of taking a nap, try taking a brisk walk to help invigorate yourself. If you must take a nap, try to take one earlier in the day and limit your nap to 30 minutes.
Avoid alcohol, caffeine and nicotine. Alcohol may help put some people to sleep but the quality of the sleep is usually poor. Caffeine and nicotine are stimulants and can interfere with both falling asleep and staying asleep.
Go to bed at the same time each night and wake up at the same time each morning. Keeping to a set schedule will help tell your body that it is time to sleep. The longer you keep your routine, the easier you will find it is to fall asleep each night.
Create a bedtime routine to help you relax. Preparation for bedtime will help to alert your body that it is time for sleep. Think about the things that help you relax. It could be reading a book, listening to soft music, taking a warm bath or engaging in a quiet activity such as knitting. Spend some time each evening, right before bedtime to wind down, relax can help improve your ability to fall asleep.
"Insomnia", Reviewed 2007, March 14, Reviewed by Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy, A.D.A.M.
"A Vicious Cycle: Insomnia, Anxiety and Depression", 2004-2009, Duke University Health System