Sleep anxiety is a generalized worry about getting enough sleep or quality sleep. Like other types of anxiety it feeds on itself, so that the concerns end up reinforcing the problem. In the end, sleep anxiety becomes a self fulfilling prophecy.
What the experts say
The insomnia that results from sleep anxiety is very treatable and experts give us many useful suggestions. The first is to realize it is a problem, not just something that will go away on its own without taking action.
Treatment starts with a list of suggestions you can try on your own:
• When you aren’t falling asleep after twenty minutes or so, get out of bed. And keep the bedroom a place reserved for sleeping or intimacy. When you get up, leave the room. This helps train your mind to link the bedroom with sleep.
• Avoid naps or limit them to a short, scheduled time. Save the being tired feeling for bedtime and stick to a regular schedule of sleep. You are out to control your sleep patterns, rather than letting the need for sleep control you.
• Don’t eat, drink or smoke right before you lay down. Sleep is a gradual process that starts before you go to bed. You need a period of gradual relaxation. Television or reading is helpful for many, especially when it is a regular part of going to sleep.
• Reduce the pressure to fall asleep by removing clocks and other distractions. Rooms that are too noisy or too quiet can interfere with sleep. The sound of a fan or other “white noise” is helpful to many.
• Get out and move. Exercise several hours before bedtime is useful.
Beyond the basics
When the above suggestions do not help, therapists often look for other causes. For example, medications and disease conditions can interfere with sleep and contribute to anxiety. A review of medical conditions and prescriptions will be part of an initial evaluation.
If there is no apparent cause that can be addressed directly, therapists will turn to sleep aids and behavioral therapy. However, there is a trade-off when relying on medication to help you sleep. Since the goal of treatment is to get to a normal sleep pattern, artificial chemical aids should only be used short-term or intermittently. They run the risk of replacing one problem with another. All available medications have problems associated with them, ranging from addiction to not duplicating the quality of natural sleep.
Cognitive-behavioral therapy uses techniques designed to change the way you think about and approach sleep. Since anxiety and thoughts about not sleeping are part of the issue, these are dealt with by changing beliefs about sleep and retraining the mind to accept a normal sleep routine.
What is the prognosis?
Almost everyone who seeks treatment for anxiety related insomnia will see some benefit from a combination of cognitive behavioral therapy supplemented where appropriate with medication. Unfortunately, many won’t seek treatment, and many that do will give up before really letting it have a chance to help them.
Advances in sleep studies, new anxiety medications and therapies all make the outlook very good for anxiety driven insomnia – provided it is addressed as amedical problem. In many cases, a simple change in routine can make a world of difference. Therapists will look for just such things during an evaluation. They also have the skills to address more generalized anxiety issues.