A Hard Day's Night: Coping with Sleep and Anxiety

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Author:

Christine Haran

Medical Reviewer:

Vikram Tarugu, MD

Medically Reviewed On: April 29, 2004

During a long day, you often daydream about the moment when you can crawl into bed and quickly fall into a deep sleep. But once under the covers, you may find yourself being kept wide awake by anxieties that seem to rush into your brain all at once.

Anxiety is one of the most common causes of insomnia, and more than 19 million Americans suffer from an anxiety disorder. Unfortunately that means that stress and anxiety are likely to be responsible for the daytime drowsiness many Americans experience at the office or school.

Below, Dr. Richard Ross, a professor of psychiatry at the Philadelphia Veterans Affairs Medical Center, discusses strategies for coping with stress and anxiety so that you can get the sleep you need.

What is the impact of everyday stress on sleep?
Stress triggers a physiological response. If a human being or any organism is stressed, he or she wants to be able to cope with that stress, and it's important to be vigilant and aroused. This causes certain neurochemicals to be released in your brain, which can have a tremendous effect on your level of vigilance and arousal.


Fortunately the majority of time people are able to cope with everyday stressors, and they do not affect sleep. But if the stressor occurs right before you're going to sleep, it's possible that the release of stress chemicals could affect your ability to fall asleep. Very severe stressors can lead to nightmares and cause you to wake up.

How does your mental state affect sleep?
Most experts associate depression with middle-of-the-night awakening and early morning awakening. Early morning awakening is when you have to get up before you want to in order to get to work or school.

On the other hand, anxiety and anxiety disorders are more commonly associated with a difficulty in falling asleep and staying asleep.

What anxiety states can disturb sleep?
Generalized anxiety disorder is a common anxiety disorder characterized by exaggerated arousal. It can be manifested during sleep, particularly if a person lies awake worrying when he or she should be sleeping.

Panic disorder is an interesting form of anxiety disorder. It's characterized most specifically by unanticipated, spontaneous attacks of severe anxiety. These attacks build to a crescendo in a very short period of time, and they can be associated with a variety of physiological and psychological difficulties. A person feels their heart rate going up and they start to sweat. Psychologically, a person may feel so anxious that they are concerned about dying.

Probably about two-thirds of people with panic disorder will have panic attacks at one time or another during sleep. So a person typically awakens from what's called a nocturnal panic attack feeling quite anxious, and it can be quite disturbing.


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