What Is the Link Between Anxiety and Insomnia?

Insomnia is the medical term for difficulty sleeping, which can include:

  • difficulty falling asleep
  • trouble staying asleep
  • waking up too early
  • waking up feeling tired

Anxiety is your body’s natural response to stress, where you feel apprehension or fear about what’s going to happen next. You may have an anxiety disorder if your feelings of anxiety:

  • are extreme
  • last for 6 months or longer
  • are interfering with your daily life and relationships

According to Mental Health America nearly two-thirds of Americans state that stress causes them to lose sleep. They also note that poor sleep habits have been linked to problems like depression and anxiety.

Anxiety and insomnia

According to Harvard Health Publishing, sleep problems affect more than 50 percent of adults with generalized anxiety disorder.

Does anxiety cause insomnia or does insomnia cause anxiety?

This question typically depends on which came first.

Sleep deprivation can elevate the risk for anxiety disorders. Insomnia can also worsen the symptoms of anxiety disorders or prevent recovery.

Anxiety can also contribute to disrupted sleep, often in the form of insomnia or nightmares.

The relationship between sleep and mental health

The relationship between mental health and sleep isn’t entirely understood yet. But according to Harvard Health Publishing, neurochemistry studies and neuroimaging suggests:

  • an adequate night’s sleep helps nurture both mental and emotional resilience
  • chronic sleep disruptions might generate negative thinking and emotional sensibility

It’s also implied that treating insomnia may help alleviate the symptoms associated with an anxiety disorder and vice versa.

Do I have insomnia?

If you think that you might have insomnia, talk to your doctor. Along with a physical exam, your doctor might recommend that you keep a sleep diary for a couple of weeks.

If your doctor thinks that a sleep disorder such as insomnia is a probability, they might recommend that you see a sleep specialist.

A sleep specialist might suggest a polysomnogram (PSG), also referred to as a sleep study. During the sleep study, various physical activities you go through during sleep are electronically monitored and then interpreted.

Treating insomnia

Although there are over-the-counter sleep aids and prescription medications for insomnia, many doctors will start treating insomnia with cognitive behavioral therapy for insomnia (CBT-I).

The Mayo Clinic has determined that CBT-I is, typically, either equally or more effective than medication.

CBT-I is used to help you understand, recognize, and change your attitudes that impact your ability to sleep and stay asleep.

Along with helping you control or eliminate worries or negative thoughts that keep you awake, CBT-I addresses the cycle that has you so worried about getting to sleep that you’re unable to fall asleep.

Suggestions for improving sleep

There are several strategies for helping you avoid behaviors that get in the way of good sleep. You can develop good sleep habits by practicing some of the below:

  • Relaxation techniques such as breathing exercises and progressive muscle relaxation can help reduce anxiety at bedtime. Other relaxation techniques include taking a warm bath or meditating prior to going to bed.
  • Controlling stimuli such as using the bedroom for sleep only and not allowing other stimuli such as electronics in. This will help you dissociate your bed as a place of busy activity.
  • Setting a consistent bedtime and wake-up time can help you train yourself for consistent sleep.
  • Avoiding naps and similar sleep restrictions can make you feel more tired at bedtime which can help improve insomnia for some people.
  • Avoiding stimulants such as caffeine and nicotine close to bedtime can help you be physically ready for sleep. Your doctor might also recommend avoiding alcohol close to bedtime.

Your doctor may suggest other strategies tailored to your sleep environment and lifestyle that will help you learn and develop habits that will promote healthy sleep.

Takeaway

Which comes first: anxiety or insomnia? Either one.

According to the Anxiety and Depression Association of America, anxiety causes sleeping problems, and sleep deprivation can cause an anxiety disorder.

If you think that you’re experiencing anxietyinsomnia, or both, talk with your doctor. A thorough diagnosis will help direct your treatment.

Everything You Need to Know About Insomnia

Definition of insomnia

Insomnia is a type of sleep disorder. Individuals with insomnia find it difficult to fall asleep, stay asleep, or both.

People with insomnia often don’t feel refreshed when they wake up from sleeping, either. This can lead to fatigue and other symptoms.

Insomnia is the most common of all sleep disorders, according to the American Psychiatric Association (APA).

In fact, the APA states that about one-third of all adults report insomnia symptoms. Between 6 to 10 percent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder.

The APA defines insomnia as a disorder in which people have trouble falling asleep or staying asleep. Doctors make a clinical diagnosis of insomnia if both of these criteria apply:

  • Sleep difficulties occurring at least three nights a week for a minimum of 3 months.
  • Sleep difficulties creating major distress or functional difficulties in a person’s life.

Keep reading to learn all about the:

  • symptoms
  • causes
  • types of insomnia

Insomnia causes

The causes of your insomnia will depend on the type of sleeplessness you experience.

Short-term insomnia, or acute insomnia, may be caused by a number of things including:

  • stress
  • an upsetting or traumatic event
  • changes to your sleep habits, like sleeping in a hotel or new home
  • physical pain
  • jet lag
  • certain medications

Chronic insomnia lasts for at least 3 months and can be primary or secondary. Primary insomnia has no known cause. Secondary insomnia occurs with another condition that can include:

Risk factors for insomnia

Insomnia can occur at any age and is more likely to affect women than men.

According to the National Heart, Lung, and Blood Institute (NHLBI)Trusted Source, people with certain risk factors are more likely to have insomnia. These risk factors include:

Having certain medical conditions, such as obesity and cardiovascular disease, can also lead to insomnia. Menopause can lead to insomnia as well.

Find out more about the causes of — and risk factors for — insomnia.

Insomnia symptoms

People who experience insomnia usually report at least one of these symptoms:

  • waking too early in the morning
  • unrefreshing sleep
  • trouble falling or staying asleep

These symptoms of insomnia can lead to other symptoms, including:

You may also have difficulty concentrating on tasks during the day.

Learn more about the effects of insomnia on the body.

Treating insomnia

There are both pharmaceutical and nonpharmaceutical treatments for insomnia.

Your doctor can talk to you about what treatments might be appropriate. You may need to try a number of different treatments before finding the one that’s most effective for you.

The American College of Physicians (ACP) recommends cognitive behavioral therapy (CBT) as a first-line treatment for chronic insomnia in adults.

Sleep hygiene training may also be recommended. Sometimes, behaviors that interfere with sleep cause insomnia. Sleep hygiene training can help you change some of these disruptive behaviors.

Suggested changes may include:

  • avoiding caffeinated beverages near bedtime
  • avoiding exercise near bedtime
  • minimizing time spent on your bed when you’re not specifically intending to sleep, such as watching TV or surfing the web on your phone

If there’s an underlying psychological or medical disorder contributing to your insomnia, getting appropriate treatment for it can alleviate sleep difficulties.

Discover more treatments for insomnia.

Insomnia medications

Sometimes, medications are used to treat insomnia.

An example of an over-the-counter (OTC) medication that can be used for sleep is an antihistamine, such as diphenhydramine (Benadryl).

Medications like this can have side effects, especially long term, so it’s important to talk to a doctor before starting yourself on an OTC medication for insomnia.

Prescription medications that may be used to treat insomnia include:

Talk with your doctor before using any medications or supplements to treat your insomnia.

There might be dangerous side effects or drug interactions. Not every “sleep aid” is appropriate for everyone.

Get more information on insomnia medications.

Making lifestyle changes or trying home remedies can help effectively manage many cases of insomnia.

Warm milkherbal tea, and valerian are just a few of the natural sleep aids you can try.

Meditation

Meditation is a natural, easy, drug-free method for treating insomnia.

According to a 2015 study, meditation can help improve the quality of your sleep, as well as make it easier to fall asleep and stay asleep.

Per the Mayo Clinic, meditation can also help with symptoms of conditions that may contribute to insomnia. These include:

Many apps and videos are available to help you practice meditation.

Melatonin

The naturally produces the hormone melatonin during the sleep cycle. People often take melatonin supplements in hopes of improving their sleep.

Studies are inconclusiveTrusted Source regarding whether melatonin can actually help treat insomnia in adults.

There’s some evidence that supplements may slightly decrease the time it takes you to fall asleep, but more research is needed.

Melatonin is generally thought to be safe for a short period of time, but its long-term safety has yet to be confirmed.

It’s always best to work with your doctor when considering taking melatonin.

Essential oils

Essential oils are strong aromatic liquids made from a variety of:

  • plants
  • flowers
  • trees

People treat a variety of conditions by inhaling oils or massaging them into the skin. This practice is called aromatherapy.

Essential oils that are thought to help you sleep include:

review of 12 studies published in 2015 found aromatherapy to be beneficial in promoting sleep.

Another study found lavender to be especially useful in promoting and sustaining sleep. The study reported that a mixture of essential oils reduced sleep disturbance and increased well-being in older adults.

Essential oils don’t generally cause side effects when used as directed. The Food and Drug Administration (FDA)Trusted Source has classified most essential oils GRAS (generally recognized as safe).

However, in the United States, no laws are in place to regulate aromatherapy, and no license is required for practice. Therefore, it’s important to select practitioners and products carefully.

Find out more about safe and healthy home remedies for insomnia.

Insomnia and pregnancy

Insomnia is common during pregnancy, especially in the first and third trimesters.

Fluctuating hormones, nausea, and an increased need to urinate are some of the bodily changes that may keep you awake in early pregnancy.

You may face emotional stressors, such as anxiety about the increasing responsibilities you’ll face as a mother. Pain — such as cramps and back discomfort — may also keep you awake.

Your body is undergoing many changes, like an active metabolism and increase in progesterone, to accommodate the new life growing in you. It’s normal for your sleep patterns to change, too.

Lifestyle changes that may help include:

Contact your doctor about any new exercise routinesmedications, or supplements you might be interested in. You’ll want to ensure that they’re safe for someone who’s pregnant.

The good news is that pregnancy-related insomnia usually passes, and it doesn’t affect your baby’s development.

Get more information on insomnia during early pregnancy.

Insomnia testing

In order to arrive at a diagnosis, your doctor will ask questions about your:

  • medical conditions
  • social environment
  • psychological or emotional condition
  • sleep history

This information can help them determine the underlying causes of your sleep problems. You might be asked to:

  • keep a sleep log
  • record when you fall asleep
  • note the instances when you wake up repeatedly
  • report what time you wake up each day

sleep log will give your doctor a picture of your sleep patterns. The doctor may also order medical tests or blood work to rule out medical problems that can interfere with your sleep.

Sometimes a sleep study is recommended not for the diagnosis of insomnia but for confirmation if the clinician suspects an underlying sleep disorder such as obstructive sleep apnea.

There are two ways a sleep study may be carried out. One option involves an overnight stay at a sleep center. The second option would allow you to do the study at home, in your own bed.

Both sleep study options involve having electrodes placed on your body in various places, including your head.

The electrodes are used to record your brainwaves to help categorize the states of sleep. They’ll also help detect body movements while you’re asleep.

The results of your sleep study will provide your doctor with important neuroelectrical and physiological information.

Learn which types of doctors may be able to help diagnose insomnia.

Insomnia in children

Children can have insomnia, too — often for the same reasons as adults. These reasons might include:

If your child has trouble falling asleep or staying asleep, or if they wake up too early, insomnia may be the reason.

According to the Cleveland Clinic, symptoms of insomnia in children may include:

Treatment for children is often the same as treatments for adults.

Children will benefit from a consistent sleep schedule and good sleep hygiene. Reducing stress and avoiding screen time near bedtime will help as well.

Discover more ways to help your child sleep better.

Insomnia in children

Anxiety can cause insomnia, and insomnia can cause anxiety. This can result in a self-perpetuating cycle that may lead to chronic insomnia.

Short-term anxiety develops when you worry frequently about the same specific issue, such as work or your personal relationships.

Short-term anxiety usually goes away once the issue is resolved. Your sleep should return to normal as well.

People can also be diagnosed with an anxiety disorder, such as generalized anxiety disorder (GAD) or panic disorder. These disorders can result in varying degrees of insomnia.

The causes of anxiety disorders aren’t completely understood. Treatment is usually long term and includes a combination of therapy and medications.

The same lifestyle and behavioral practices recommended for other forms of insomnia help diminish anxiety-related insomnia, such as restricting stressful topics of conversation to the daytime.

Learn more about the connection between mental health issues and insomnia.

Insomnia and depression

According to an early studyTrusted Source, not only does insomnia make you more likely to develop depression, but depression can also make you more likely to develop insomnia.

meta-analysis of 34 studies concluded that poor sleep — especially during times of stress — significantly increased the risk of depression.

Another study found that as insomnia persisted and symptoms worsened, subjects developed an even greater risk for depression.

For other people, symptoms of depression may precede insomnia.

The good news is that the same treatments often help both depression and insomnia, no matter which condition comes first.

The most common treatments are:

These lifestyle changes can include:

  • developing better sleep habits
  • exercising in the daytime
  • eating a balanced diet

Complications of insomnia

Not getting enough sleep can take a toll on your health. Insomnia can increase your risk for a number of conditions including:

Insomnia can also:

  • increase your risk for an accident
  • affect your performance at school or work
  • lower your sex drive
  • affect your memory

Takeaway

Insomnia isn’t just a nuisance or a small inconvenience. It’s a real sleep disorder, and it can be treated.

If you think you have insomnia, talk to your doctor. They can help explore possible causes and develop a safe and appropriate treatment plan based on your healthcare needs.

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