Sleeplessness at Night: Reasons, Solutions, and Additional Insights
In the quiet of the night, anxiety can be a relentless foe. But fear not, for there are various strategies to help alleviate nighttime anxiety.
Causes
Nighttime anxiety is often triggered by factors such as the absence of daytime distractions, which can make anxious thoughts more noticeable. Other causes include shifts in brain chemistry after dark, overthinking, increased nervous system sensitivity due to physical exhaustion, stress, unresolved emotional tension, and poor sleep habits [1][3].
Symptoms
Typical symptoms of nighttime anxiety include intrusive, repetitive thoughts; physical signs like a fast heartbeat, rapid breathing, muscle tension; difficulty falling asleep or staying asleep; waking up with a racing heart; and feeling mentally wired despite physical tiredness [1][3][5]. These symptoms often overlap with insomnia signs such as tossing and turning and feeling unrefreshed after sleep [2][4].
Treatment Options
- Cognitive Behavioral Therapy (CBT): Especially CBT for insomnia (CBT-I), which targets negative thought patterns and the anxiety-sleep cycle [2][5].
- Mindfulness and Meditation: To calm the nervous system and regulate emotions before bedtime [5].
- Trauma-informed therapies and EMDR: For anxiety rooted in trauma [5].
- Medication: Such as SSRIs, beta blockers, or sleep aids, usually combined with therapy for better outcomes [5].
- Lifestyle Changes: Like reducing screen time before bed, improving sleep hygiene, and establishing a consistent sleep routine [2][3][5].
Alternative and Complementary Medicine
Alternative and complementary medicine, including acupuncture, massage, and chiropractic therapy, may help alleviate chronic pain due to anxiety [6].
Lifestyle Changes
Reducing caffeine intake before bed and in the afternoon can help alleviate nighttime anxiety. Uncontrolled thoughts can also be a symptom of nighttime anxiety, and adopting stress management strategies like developing new time management strategies, seeking help with housework, and seeking professional help to manage financial or legal issues may help manage nighttime anxiety [6].
Medication
Beta-blockers, typically used to treat high blood pressure, can also be prescribed to help alleviate the physical symptoms of anxiety. Antidepressants and benzodiazepines are medications that can help manage anxiety. Antidepressants affect chemical messengers in the brain, while benzodiazepines change the body's physical response to anxiety [6].
Other Considerations
Certain foods can cause nighttime anxiety symptoms. People can identify problematic foods by keeping a log of what they eat and any symptoms they experience. Nightmares can trigger anxiety and difficulty sleeping. If anxiety causes physical health problems, does not respond to home remedies, is so severe that the person is unable to sleep, or recurs while undergoing treatment for anxiety, a person should see a doctor [6].
Exercise can help ease symptoms of anxiety and depression, with high-intensity exercise programs potentially being more effective. Relaxation exercises, such as box breathing, progressive relaxation, and guided meditation, can help manage nighttime anxiety. Sleeping pills may help reduce nighttime restlessness, but they only reduce the time it takes to fall asleep by 8 to 20 minutes, and can be addictive. They should be used sparingly and not combined with other drugs, including alcohol [6].
It's essential to address both the mental and physical factors that worsen anxiety at night for effective management [1][3][5]. If nighttime anxiety or insomnia persist and impair daytime functioning, consulting a healthcare professional or sleep specialist is recommended for tailored diagnosis and treatment [2].
[1] Mayo Clinic. (2021). Nighttime anxiety. Retrieved from https://www.mayoclinic.org/diseases-conditions/anxiety/in-depth/nighttime-anxiety/art-20048329
[2] National Sleep Foundation. (2021). What is insomnia? Retrieved from https://www.sleepfoundation.org/insomnia
[3] National Health Service (NHS). (2021). Nighttime anxiety. Retrieved from https://www.nhs.uk/conditions/stress-anxiety-depression/night-time-anxiety/
[4] National Institute of Mental Health (NIMH). (2021). Insomnia. Retrieved from https://www.nimh.nih.gov/health/topics/insomnia/index.shtml
[5] American Psychological Association (APA). (2021). Cognitive Behavioral Therapy for Insomnia (CBT-I). Retrieved from https://www.apa.org/topics/cognitive-behavioral-therapy-insomnia
[6] National Center for Complementary and Integrative Health (NCCIH). (2021). Acupuncture. Retrieved from https://www.nccih.nih.gov/health/acupuncture [6] National Center for Complementary and Integrative Health (NCCIH). (2021). Massage Therapy. Retrieved from https://www.nccih.nih.gov/health/massage-therapy [6] American Chiropractic Association. (2021). What is chiropractic? Retrieved from https://www.acatoday.org/Patients/What-is-Chiropractic-Care
- Some individuals with Alzheimer's disease may experience increased anxiety and sleep disturbances, making it crucial to seek guidance from health-and-wellness professionals for appropriate treatment strategies.
- Science suggests that certain asthma medications could potentially have a side effect of causing anxiety in some patients, thus requiring close monitoring and adjustments if necessary.
- For those suffering from MDD (Major Depressive Disorder), attending regular therapy sessions, especially those focusing on cognitive behavioral therapy, can help alleviate symptoms such as anxiety.
- In some cases, an underlying medical condition like UC (Ulcerative Colitis) can contribute to feelings of anxiety and poor sleep quality, making it essential to consult with a medical professional for proper diagnosis and treatment.
- Incorporating sleep supplements, such as melatonin or valerian root, into one's bedtime routine may help regulate sleep patterns and reduce anxiety symptoms associated with difficulty sleeping.
- Alongside mental-health treatments, it is crucial for individuals with anxiety disorders to maintain a healthy lifestyle, including adhering to a balanced diet, regular exercise, stress management techniques, and good sleep hygiene, to promote overall well-being and better manage anxiety symptoms.
