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Anxiety and Sleep Deprivation: The Not-So-Strange Bedfellows

Is your anxiety keeping you up at night?

“Get some rest!” So goes the advice commonly dispensed to those of us who struggle with anxiety. If we tend to respond with a bit of an eye-roll if only on the inside, there’s a good reason for it: We know we need to get sleep and there’s nothing we’d want more than that!

Alas, as many between 50 and 70 million American adults who chronically suffer from a sleep disorder know, sleep does not come easily to sufferers of insidious worry. And when it does come, slumber does not tend to grace us for long. Middle-of-the-night wake-ups, inability to fall asleep, sleepwalking, daytime drowsiness—they are all types of sleep deprivation we know all too well.

Seven out of 10 adults who report persistent stress or anxiety have trouble sleeping. According to The Cleveland Clinic, two-thirds of patients referred to sleep disorders centers have a psychiatric disorder. Anxiety and sleep deprivation are not-so-strange, codependent bedfellows. One frequently triggers the other. There are scientifically established reasons why people living with anxiety have a hard time sleeping—and why people who suffer from sleep deprivation tend to struggle with worry and anxiety. In sum, anxiety wakes us up and not getting enough sleep makes us anxious. Let’s take a look at how that happens.

Anxiety wakes us up.

The reality that anxiety sufferers are saddled with is the curse of what sleep researchers and psychologists call anticipatory anxiety. The more you give in to worry, the more likely you are to lose sleep over it. This is even more insidious with worry over not being able to sleep. You start fretting that you won’t be able to get rest—after all, it happened many nights before—and then, the prophecy of worry fulfills itself. You do not get much rest, which only reinforces your stress and worry and adds to the power of anxiety over your future nights. Insufficient sleep worsens anticipatory anxiety by “firing up the brain’s amygdala and insular cortex, regions associated with emotional processing.” The results resemble neural activity seen in anxiety disorders.

“Anxiety is an emotion that actually wakes us up,” says Dr. Steve Orma, who wrote Stop Worrying and Go to Sleep: How to Put Insomnia to Bed for Good. “There are all kinds of physical changes happening that ramp you up, which is the exact opposite state of what you need to be in when you’re trying to fall asleep.”

Sleep deprivation makes us anxious.

Healthy rest facilitates self-awareness and mindfulness. It gives us the ability to put negative experiences in context and resist exaggerating them and giving them too much power. Researchers at the University of California Berkeley’s Sleep and Neuroimaging Laboratory found that sleep deprivation makes our brains revert back to more primitive patterns of activity. The study participants who were kept awake were less likely to put emotionally challenging information in context. And vice versa: Getting healthy sleep enables us to discount the fearful exaggerations introduced by stress and worry.

“By restoring good quality sleep in people suffering from anxiety, we may be able to help ameliorate their excessive worry and disabling fearful expectations,” says Allison Harvey, one of the authors of a sleep study published in the Journal of Neuroscience.

How do you break this vicious cycle?

Tell yourself that just like more anxiety means less sleep and less sleep means more anxiety, the reverse is also true. Less anxiety means better chances of sleeping soundly and getting good rest means less anxiety. Zero in on the power of your own thinking—and appreciate it. Since your niggling worries can keep you up, your peaceful and centered thoughts can have a calming effect. Interrupt either anxiety or sleep deprivation, and you’re well on your way.

How to do that? There’s no overestimating the benefits of healthy sleep hygiene—sleep in a dark, cool, room on a well-chosen comfortable mattress, with no alcohol or exposure to blue light two hours prior to bedtime, etc. In addition, use the remedies that are proven to work against both anxiety and insomnia, such as mindfulness meditation and exercise. The “mind-calming practice that focuses on breathing and awareness of the present moment” has been demonstrated to diminish anxiety and enable anxiety sufferers to get rest at night. And exercise (aerobic earlier during the day and strength training later during the day) promotes a healthy sleep schedule by decreasing arousal, anxiety, and depression in the long run.

There’s no use pretending that taking charge of anxious thoughts is easy. It may well be that the help of a behavioral therapist or a medical doctor might be required. But sleep medicine has shown us that it is sometimes possible, to some degree, to think yourself into drowsiness and to “sleep yourself” into a calm, centered state of mind. Try it tonight.

Agnes Green is a researcher for the sleep science hub She holds two master’s degrees in the social sciences from the University of Chicago and Northwestern University. She sleeps most soundly after a kettlebell workout, on a medium-firm mattress, to the sound of a drizzle wafting in through a cracked window in Portland, Oregon.
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