At one point or another, everyone has experienced a restless night of tossing and turning, watching the clock, and adjusting pillows. For some, however, this is a regular way of life. In fact, more than 40 million Americans can’t quite figure out how to sleep better at night, according to the Anxiety and Depression Association of America.
One of the most common culprits — and consequences — for sleeping disorders is everyone’s favorite feeling: anxiety. Yes, this widespread issue has a “chicken and egg” role when it comes to sleep. San Francisco-based physician Shoshana Ungerleider says, “It is worth noting that anxiety causes sleeping problems, and research suggests sleep deprivation can cause anxiety.” That said, any way you approach the matter, it’s debilitating, and can make simple daily functions impossible.
“For some people, the symptoms of anxiety, which can include excessive fear or worrying, feelings of panic, and restlessness can get worse in the evening ... due to the lack of daytime distractions,” says Dr. Ungerleider. Christine Hansen, certified sleep science coach, concurs, adding that bedtime is when the brain lets its guard down. "In general, when you are in REM sleep and you dream, you deal with things that maybe you didn’t understand and that you didn’t want to deal with during the day.”
While some cases of anxiety require more medical attention, there are simple courses of action you can take to alleviate the symptoms and promote better sleep. For starters, regular exercise is key, says Dr. Ungerleider. According to the American Psychological Association, “Biologically, exercise seems to give the body a chance to practice dealing with stress. It forces the body's physiological systems — all of which are involved in the stress response — to communicate much more closely than usual: The cardiovascular system communicates with the renal system, which communicates with the muscular system … This workout of the body's communication system may be the true value of exercise; the more sedentary we get, the less efficient our bodies in responding to stress.”
Hansen says diffusing things that trigger stress during the day as much as possible is incredibly important. “Become aware of what kind of thoughts you tend to want to push aside,” she explains. “And just before you do that, just acknowledge them. Tell them, ‘I see you. You’re not comfortable. You’re negative.’ And then, let them go.” Writing these thoughts down is another mode of defense against anxiety-inducing thoughts, she adds. Just jotting down key words or phrases will do. One thing to note, however, when verbalizing and putting thoughts to paper, is to not do them right before you go to bed, as this can perpetuate nighttime anxiety.
So what should you do once bedtime hits? Dr. Ungerleider recommends adopting routines that promote complete relaxation and avoiding overstimulation. “Don't watch TV, look at your phone or tablet, or even read in bed,” she says. In fact, try making your bedroom a quiet, comfortable technology-free zone so your body and mind have a sanctuary in which to relax and completely recharge. “It is very likely our obsession with screens contributes to nighttime anxiety,” explains Dr. Ungerleider. “This is partially because blue light from electronic gadgets can confuse the body about when it needs to sleep and impact melatonin production. I recommend turning off electronics two hours before going to sleep.”
And while this may seem like an obvious tip, Dr. Ungerleider notes to proceed with caution when drinking coffee or caffeinated drinks after 12 p.m., especially if you struggle with nighttime anxiety. Also, “avoid recreational drugs and alcohol as they can interfere with sleep,” she adds. (Yes, that includes wine.)
And just as you would with any habit you’re trying to pick up or get rid of, focus on keeping things consistent. “Try to maintain a regular sleep routine,” says Dr. Ungerleider. “Go to sleep at the same time and wake up at the same time each day.” The same goes for your pre-bedtime regimen: Dr. Ungerleider recommends a warm bath or shower, meditation, or quiet time and warm milk.
And, if all else fails and/or your case is quite severe, always consult with a professional. Says Dr. Ungerleider: “If your nighttime worry is leading to ongoing insomnia, impacting your daily tasks of living, or leading to persistent daytime anxiety, the best thing to do is seek medical attention.”