Mike has been struggling with anxiety and has had trouble sleeping for years. As much as he tries to get a good night’s sleep, he often worries about things and wakes up during the night. Mike also struggles to fall asleep as he finds himself preoccupied with many of the issues that are anxiety-provoking for him. For Mike, his struggle with sleep has a significant impact on his ability to function on a day to day basis. He even notices that on days when he is really exhausted, his anxiety seems so much worse. For many people struggling with this condition, sleep disturbance is an accompanying feature of their condition. This article will explore the nature of the relationship between anxiety and sleep disturbance.
While sleep disturbance is a common feature of many psychiatric conditions, it is particularly prevalent in anxiety-based conditions. Up to 60-70 % of patents with GAD complain of trouble with sleeping. Such patients struggle to maintain their sleep and experience difficulty falling asleep. In patients who suffer from panic attacks, their quality of sleep is impaired, they spend more time awake and they take longer to fall asleep. In addition, 18 to 45% of people who suffer with panic experience night time panic attacks without a clear trigger.
Clearly the relationship between sleep and this condition is well established but the exact nature of the connection is somewhat less clear. Does sleep disturbance precipitate anxiety or does anxiety precipitate sleep disturbance? In other words, which comes first? This is a very difficult question to answer, although it is relevant to explore given its implications for prevention and treatment. If sleep disturbance precipitates or even maintains the development of anxiety disorders, then treatment of sleep disturbances can potentially have a preventative function and at the very least need to be incorporated as a component of treatment approaches for anxiety disorders.
Some studies do indeed support sleep disturbance and particularly insomnia as a risk factor for the later development of depression and anxiety disorders. Other studies, however, seem to indicate the opposite directionality with the presence of anxiety disorders preceding the onset of insomnia. Given our current knowledge base, perhaps the most accurate way to conceptualize the relationship between anxiety and sleep disturbance is as a bidirectional relationship with the interrelationships between these constructs being intertwined and highly complex.
A study by Ramsawh, Stein, Belik, Jacobi and Sareen (2009) offers one such attempt at starting to gain a morenuanced understanding of this complex interrelationship. In their large study of 4181 subjects, they explored the interrelationship between anxiety disorders, sleep quality and level of impairment. Their findings supported a moderate relationship between sleep quality and the prevalence of anxiety disorders. They also noted that individuals with both sleep disturbance and anxiety disorders experience significantly more impairment in their day to day functioning in contrast to those subjects who were only presenting with anxiety. The increased impact of poor sleep, combined with anxiety, points to the need for screening for sleep problems when treating anxiety, as well as specific interventions targeting sleep disturbance.
This above study highlights the significance of starting to fine tune our understanding of the relationship between sleep and anxiety. It points to the importance of recognizing and hence also treating the impact of sleep disturbance as a significant factor in managing anxiety disorders. Awareness of the link between sleep and anxiety is essential so that both professionals in the field and sufferers from anxiety can start to recognize and unpack the role of sleep as a feature of the effective treatment and prevention of anxiety disorders.
If you are suffering from anxiety and sleep disturbances, therapy is strongly advisable. Making sure you know how to find the right therapist or online therapy service with thousands of licensed therapists available is essential in helping to provide therapeutic and medical interventions.
Author Bio: Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. In addition to her private therapy practice, she currently runs E-counseling.com – a mental health resource with self-help guides on stress, anxiety, depression, and many other areas. During her spare time, Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.