What is sleep anxiety, and how does it trigger insomnia?

Spent the night awake, staring at the ceiling, becoming more and more anxious about the fact that you can’t sleep? You’re not alone—45 per cent say they only sleep well a couple of times a week. But what happens when this becomes your routine every night?

Sleep deprivation can have a huge impact on your health and wellbeing, and sleep anxiety can make it difficult, even impossible, to have get a good night’s sleep.

Whether your lack of sleep is making you anxious, or it’s anxiety about actually letting yourself fall asleep, sleep expert Martin Seeley at MattressNextDay has some advice—from what causes sleep anxiety, to how to manage it. 

Sleep anxiety is very common, and is often a manifestation of day to day stresses that cause your mind to race when you're trying to unwind.

When you experience stress, the hormone cortisol is released, and high levels of cortisol can cause you to have trouble falling asleep, or sleeping through the night. This can lead to a nightly worry that you won’t get enough sleep.

Somniphobia, however, is an extreme fear of sleep, which goes beyond sleep anxiety. It can stem from trauma, like someone close to you dying in their sleep, a house fire in the middle of the night, an accident while sleepwalking, or even recurring nightmares and sleep paralysis that make you too scared to fall asleep.

Aside from the main symptom of not being able to fall asleep, or constantly waking up throughout the night, sleep anxiety has very similar symptoms to general anxiety disorders.

These include a continual feeling of unease, increased heart rate, restlessness, sweating, and tensed muscles. 

Rapid eye movement, or REM, sleep is when you have the most vivid dreams. Anxiety and stress hormones like noradrenaline can affect your REM sleep, causing you to have nightmares which either wake you up, or cause your sleep to be disrupted and fitful.

You don’t sleep, you feel anxious about not sleeping, so it makes it more difficult to sleep the next night, so you get more anxious, so you can’t sleep the next night…and the vicious cycle continues on and on. 

Studies have shown that singular stressful events, like taking an exam, have little impact on your cortisol levels and they soon return to normal, but chronic stress and anxiety can make the increase in the hormone last a long time.

This suggests that a night of tossing and turning the day before a job interview might be a one off, but facing stress every day—like being stressed about lack of sleep—has a significant impact on your sleep cycle. 

The first step is to identify what’s causing your lack of sleep. Is it stress at work, or in your relationship? Is it past trauma? Is it bad dreams making you want to put off sleeping so they don’t keep recurring?

Trying to understand why you struggle to sleep can help you deal with the anxiety surrounding it, and in turn, begin to end the vicious cycle.

Cognitive behavioural therapy, CBT, teaches you to change the way you think in order to change your behaviour.

CBT could help you understand how sleep anxiety is affecting your body and brain, in ways that might not be immediately obvious, avoid things that trigger your anxiety and make sleep impossible, and help change the negative way you view sleep. 

Sometimes, less is more, and perhaps trying too hard to force yourself to sleep with a 20-step bedtime routine could be adding to the pressure and anxiety you're feeling, and have the opposite affect that you want. If it’s not working, it’s time to try something new. 

If you usually try to sleep in a warm room with a hot water bottle, try lowering the temperature. Sleeping in a colder room prevents cortisol levels rising, and helps your body release melatonin instead, which helps you sleep—this is why it’s often so difficult to sleep during a heatwave. 

If your sleep is continually disturbed by the person you’re sharing a bed with, consider a sleep divorce. Try sleeping in different beds, or even different rooms, so you can each have the bedtime routine that suits you, and improve your quality of sleep. 

If nightmares and sleep paralysis are stopping you from sleeping, you might think there’s nothing you can do to calm your subconscious—but there are things you can try that can make your dreams more positive. 

Try some mindfulness techniques and meditation, not only as part of your bedtime routine but throughout the day. Studies have shown that people with a better "peace of mind" have more positive dreams, whereas symptoms of anxiety related to negative dreams.

Try a new sleeping position, ideally on your back; studies have shown than 40 per cent of people who sleep on their left side suffer from nightmares, compared to just 14.6 per cent who sleep on their right.

A glass of wine before bed might not have the relaxing effect you think it will—drinking alcohol, as well as alcohol withdrawal, can cause vivid and disturbing dreams, especially after binge drinking and drinking excessively.

Alcohol can lead to higher anxiety and emotional dysregulation, which can continue into the dream phase of sleep, making you more likely to have bad dreams than good.