Sleep Anxiety

What Is Sleep Anxiety?

Anxiety is an experience of everyday life. It typically functions as an internal alarm bell that warns of potential danger and, in mild degrees, anxiety is serviceable to the individual. In anxiety disorders, however, the individual is submitted to false alarms that may be intense, frequent, or even continuous. These false alarms may lead to a state of dysfunctional arousal that often leads to persistent sleep-wake difficulties. Indeed, population surveys indicate that the prevalence of anxiety disorder is about. 24% to 36% in subjects with insomnia, complaints and about 27% to 42% for those with hypersomnia. [1]

Types Of Anxiety

Effects Of Insomnia

Insomnia is a disturbance of normal sleep patterns, with adverse daytime consequences. It affects up to 50% of all adults at some point in their life. The prevalence of insomnia seems to be higher in women and in late life. Individuals with insomnia report difficulty falling asleep or remaining asleep, and usually feel non-restored from sleep.

Who Gets Sleep Anxiety?

Sleep Anxiety Symptoms

Some people also have nocturnal panic attacks. A panic attack is a sudden, intense burst of extreme fear. Nocturnal panic attacks only happen at night, and often wake you from sleep.

Anxiety Sleep Medication

Preliminary assessment and initial sleep anxiety management strategies:

• In evaluating patients with anxiety and/or sleep disorders health care providers should initially consider possible underlying medical causes, including hyperthyroidism and other endocrine illnesses, cardiac problems, and other organ system dysfunctions. Medicine use (caffeine, cocaine) and medicine or substances withdrawal (alcohol withdrawal, opiates withdrawal, benzodiazepines withdrawal) can cause anxiety and insomnia. If medical disorders, medicine use or withdrawal is a plausible reason for anxiety, the underlying cause should be removed or treated.
• If medical disorders, medicine use or withdrawal is not a plausible reason for anxiety or insomnia, health care providers might investigate whether major depression or other psychiatric disorders are present. If another psychiatric disorder is present, health care providers should treat that disorder first.
• In individuals with sleep disorders, if no psychiatric comorbidities are present, health care providers may suggest educational interventions, such as going to bed at the same time, reserving the bed for sleep, reducing caffeine intake, and avoiding strenuous exercise or mental activities near bedtime.
• In individuals with anxiety disorders, if no psychiatric comorbidities are present, health care providers may explain to the patient that chest pain, indigestion, sweating, and sexual dysfunction are symptoms of anxiety.

Short-term sleep anxiety treatment with benzodiazepines:

• Health care providers should initially consider non-pharmacological treatment strategies. Empathic listening, reassurance and guidance should always be offered. Additionally, specific psychotherapeutic techniques, such as cognitive-behavioral therapy, are effective measures to reduce anxiety and insomnia, and non specific supportive therapy may initially be offered to patients with uncomplicated generalized anxiety or sleep disorders. Relaxation techniques may additionally be offered.
• Benzodiazepines are a group of structurally-related compounds that reduce anxiety when given at low doses and induce sleep at higher doses. Clinical guidelines generally recommend to prescribe benzodiazepines to treat anxiety or insomnia that is severe, disabling and causing extreme distress. Health care providers should consider that benzodiazepine use is associated with dependence liability and withdrawal symptoms, and should therefore be used at the lowest effective dose for the shortest period of time (maximum 4 weeks).
• The use of benzodiazepines is under international control. These agents are internationally regulated by the Convention on Psychotropic Substances, 1971 (United Nations).
• Health care providers should consider that, in addition to international control, benzodiazepine use may be under national control. Health care providers must therefore comply with national, regional and local regulations.

• In individuals with insomnia, if short-acting agents such as lorazepam are available, these are generally used when residual sedation is undesirable, if falling asleep is a problem, or, when necessary, in elderly patients. Longer-acting benzodiazepines such as diazepam are indicated when early waking is a problem and possibly when an anxiolytic effect is needed during the day or when some impairment of psychomotor function is acceptable.
• Health care providers should consider that in recent years non-benzodiazepine hypnotics such as zopiclone and zolpidem have progressively become widely used in individuals with insomnia. However, these agents may be as likely as the benzodiazepines to cause rebound symptoms, dependence and other adverse reactions.
• In individuals with generalized anxiety disorder health care providers may consider using a benzodiazepine only for a limited course of time. The main objective may be to reduce symptoms enough to allow the patient to engage in treatments based on cognitive-behavioral techniques. A short course (maximum 4 weeks) started at the lowest possible dose for a pre-defined duration of treatment may be used for initial management. Diazepam may be indicated when an anxiolytic effect is needed during the day and a hypnotic effect is required at night.

Considering that major depression often complicates anxiety symptoms, health care providers should consider using antidepressants. Some tricyclic antidepressants (imipramine, clomipramine) and selective serotonin reuptake inhibitors have been shown to be effective for treating patients with generalized anxiety alone or in association with depression. Antidepressants may be prescribed at low doses initially, and then treatment may be up-titrated into the normal antidepressant dosage. Treatment response should be assessed after six weeks.

In the pharmacological treatment of insomnia that is severe and disabling a benzodiazepine may be considered only for a short period of time (maximum 4 weeks). In patients with generalized anxiety, health care providers may prescribe a benzodiazepine to rapidly relieve symptoms, and consider antidepressants when depression is present or when long-term therapy is needed. [2]

How To Sleep With Anxiety Tips

Sleep usually improves when an anxiety disorder is treated. Practicing good “sleep hygiene” helps, too. Here are some steps to take:

• Go to bed and wake up at the same time every day, even on weekends.
• Daylight helps set sleep patterns, so try to be outdoors while it’s light out for 30 minutes a day.
• Exercise regularly (but not too close to bedtime). An afternoon workout is ideal.
• Keep naps short — less than an hour — and forgo napping after 3 p.m.
• Avoid caffeine (found in coffee, many teas, chocolate, and many soft drinks), which can take up to eight hours to wear off. You may need to avoid caffeine entirely if you have panic attacks; many people who experience panic attacks are extra-sensitive to caffeine.
• Review your medications with a doctor to see if you are taking any stimulants, which are a common culprit in keeping people up at night. Sometimes it’s possible to switch medicines.
• Avoid alcohol, large meals, foods that induce heartburn, and drinking a lot of fluid for several hours before bedtime.
• If you smoke, quit. Smoking causes many health problems, including compromising sleep in a variety of ways.
• Keep your bedroom cool, dark, and quiet, without distractions like TV or a computer. Avoid using an electronic device to read in bed; the light from the screen can trick your brain into thinking it is daytime. If your mattress is uncomfortable, replace it.
• Reading, listening to music, or relaxing before bed with a hot bath or deep breathing can help you get to sleep.
• If you don’t fall asleep within 20 minutes of turning in (or if you wake up and can’t fall back to sleep in 20 minutes), get out of bed and do something relaxing until you feel sleepy. [3]

Co-Occurring Treatment

Mental health and substance use disorders affect people from all walks of life and all age groups. These illnesses are common, recurrent, and often serious, but they are treatable and many people do recover. Mental disorders involve changes in thinking, mood, and/or behavior. These disorders can affect how we relate to others and make choices. Reaching a level that can be formally diagnosed often depends on a reduction in a person’s ability to function as a result of the disorder. For example:

Receive treatment for co-occurring disorders today.

As the addiction treatment community begins to realize that addiction is itself a mental disorder, the relationship between substance abuse and mental disorders becomes more complicated. The greater treatment community largely lacks a proper understanding of dual diagnosed conditions, so these conditions are still treated separately, or worse–not treated or diagnosed at all. We Level Up dual diagnosis treatment center in TX have professionals trained to help treat co-occurring disorders concurrently. This type of tandem treatment provides some of the best success rates. 

Get dual diagnosis treatment for individuals struggling with substance abuse and mental health disorders. Call We Level Up TX today for more information about sleep anxiety treatment!