Anxiety and Sleep | Sleep for Better Mental Health
Sleep.
We all have to do it, yet for many of us, getting a full and rested night's sleep is more of a dream than a reality.
So, how did you sleep last night?
We've all heard of the classic- 8 hours of sleep that we all *should* get. Yet some people claim to feel rested and good after only 6 hours. What is the "right" amount of sleep?
Is it okay to "catch up" on sleep by naps or sleeping in on the weekend?
What about when we wake up and can't fall back asleep?
How does sleep impact my mental health?
Read on to learn about the answers to these questions and more!
Sleep Basics
According to The National Sleep Foundation, adults need an average of 7- 9 hours of sleep. Older adults (65 and older) need 7-8 hours of sleep, teens need 8- 10 hours of sleep and children between 10- 14 hours (depending on their age).
Yet 40% of Americans get less than 7 hours of sleep each night, with the average amount of sleep at just 6.8 hours.
Getting the recommended amount of sleep is one thing, but getting restful, quality sleep is another. About 35% of Americans report that their sleep quality is "poor" or "only fair."
Why We need At Least 7 Hours of Sleep
Does it really matter if we are getting a less than 7 hours of sleep?
Yes. That last hour plus is very important.
To understand why that last hour is so important, we first need to talk more about the sleep cycle and what is happening in each stage.
As we sleep, we go through different stages of Light Sleep, Deep Sleep and REM Sleep. Each stage is important for our overall wellbeing.
We also go through several "cycles" of sleep during the night where we progress through each stage of light sleep, deep sleep, and then REM sleep.
The majority of our time is spent in light sleep. During this stage of sleep our brain is still showing some activity. As a person sleeps, this stage of sleep will get longer and longer.
During deep sleep our body and brain is in a deeply relaxed state. We are much harder to be awaken during this time. We get the most amount of deep sleep during the first half of a our sleep and then over time this stage will lessen as our REM sleep will start to increase. Deep sleep is thought to be helpful for insightful thinking, memory and creativity.
REM sleep, or Rapid Eye Movement sleep is characterized by a lot of brain activity and it is named due to our eyes moving rapidly back and forth. It is during REM that we will have our most vivid dreams. An interesting aspect of REM is that while our brains will be under a lot of activity our body will experience a temporary paralysis, where we are unable to move our muscles. It is thought that this is a protective measure so that we do not "act out" our dreams and accidentally get injured.
Typically we don't enter the REM stage of sleep until we've been asleep for about 90 minutes. The first stages of REM sleep are short and may only be a couple of minutes, but as the night goes on, our REM stage of sleep becomes longer and longer. The majority of REM happens during the last couple hours of sleep. REM typically makes up about 25% of our total sleep.
When we cut our sleep short, then that will typically mean we get less REM sleep. REM sleep is responsible for important cognitive functions such as memory, learning and creativity. REM sleep is also really important for emotional regulation and the expression of our emotions. When we have less REM sleep, we are more likely to be reactive and have a harder time emotionally responding to our everyday life experiences.
Basically less overall amount of sleep leads to less REM sleep, which leads to more emotional reactivity and difficulties, including an increase in Anxiety.
When we have disrupted sleep- where we are woken up frequently, our sleep cycle gets out of whack and we have a more difficult time cycling through the stages of Light, Deep, and REM sleep as we are meant to be. Each time we get woken up, we "start over" in the cycle of sleep back to Light sleep. This ultimately leads to less Deep and REM sleep.
When you are under stress or experience Anxiety, sleep commonly takes a big hit. Sleep is also very important in stress and anxiety management.
When a client comes to me with Anxiety and/or under a lot of stress, sleep is one of the first things I address due to its importance in this area.
Less Sleep = More Anxiety
I know what you are probably thinking…
"Great, now that I know my lack of sleep is adding to my anxiety, I feel more anxious about my lack of sleep!"
Luckily, there are things we can do to put in place and create better sleep habits, or what is called sleep hygiene.
First, it's helpful to take an honest and hard look at your sleep and your habits around sleeping.
Take a moment and answer the following questions:
Do you get less than 7 hours of sleep on a typical night?
Do you drink alcohol close to the time before going to bed?
Do you snack close to bedtime?
Do you use your bed for work?
Do you watch TV or scroll on your phone/computer/tablet from bed?
Do you sleep with your pets or co-sleep with children?
Do you allow for enough time for sleep before you have to wake up (at least 8-9 hours of time)?
If you answer yes to any of the above, it's likely you are not getting enough quantity and quality sleep.
Creating Better Sleep Habits
Here are some tips for creating better sleep habits.
Mind your caffeine use, try to not drink anything with caffeine after 2pm.
Stop late night snaking and alcoholic beverages at least an hour before bed.
Turn off screens an hour before bed (or at least 30 minutes).
Dim your lights in the evening.
Create a relaxing routine, this can include have a cup of herbal tea (make sure it’s caffeine-free), taking a hot bath or shower, listening to soothing music, etc.
If your bed time is typically later than 10 pm, start heading to bed earlier (not counting those that work swing or graveyard shifts). You can just move it up 15 minutes at a time.
Go to bed and get up the same time every day, and yes, even on the weekends. Reasonably this may be hard and it can be okay if you want to stay up a little later on weekends and sleep in a little later in the morning, but try not to have this swing too much.
Don’t take naps. While naps can help us feel less sleepy, we don’t get restorative sleep, like the stages of Deep and REM sleep that we need. Taking a nap can then decrease our night sleep if we then stay up later and/or continue to keep the cycle of less overall night sleep.
If you can’t fall asleep after 30 minutes, get up out of bed and do something (but keep it mellow). Try reading a book (but keep the lights as low as you can). Then if you start to feel tired again, get back into bed and try again.
When Your Mind Won’t “Shut-Off”
How to Deal with Anxious Thoughts When Trying to Sleep
Sometimes we can’t fall asleep as our mind won’t quiet down. We think about all the things we need to do. We worry about how the next day is going to go. We continually replay the current day in our head and think about how we could have done things different.
If this sounds like you, there are things you can do to help with this.
Schedule a “Worry” or “Dump List” Time
If you have a hard time with racing thoughts at night try the following, in the evening (but not right before bed), take some time to write out your “to do” list or other things that are on your mind. You can also think of it as a “dump” session and just write out anything and everything that is on your mind. After you are done, when your mind goes back to those items remind yourself that you have already “released” it all and wrote it out and anything else that comes up you will have time the next day to write it all out.
Listen to Soothing Voices
Music can be a great way to help settle down for sleep, but many times it may not be “enough” to quiet down your mind. If music doesn’t work, try to listen to an audio book, a podcast or a “sleep story” (found on many meditation apps). Make sure to pick something that is not *too* interesting so that you are able to drift to sleep.
Another option is to put on a TV episode that you’ve seen a million times (Friends is my favorite). The key here is not to watch it but to listen to it. If you can, wear a sleep mask, so that it blocks out the light and set your TV (or phone/tablet) to a timer to shut off after 30 minutes or so.
For these type of strategies, there is something about listening to other people’s voices that can be soothing and help get us out of our heads.
Exercise for Sleep
Exercise can be another great tool to help with sleep. Exercise is a great stress-reducing and it can help tire out our bodies and our minds. The important aspect to take note is the timing of exercise. Exercising too close to bed can actually increase our alertness and make it difficult to settle back down to sleep due to the surge of adrenaline that exercise can produce.
If you tend to exercise in the evening, just monitor if you have a hard time feeling tired at bedtime and if so, try moving your exercise to earlier in the day. There are also some kinds of exercise that can actually be calming/soothing such as an easy-flow yoga by candlelight.
Sleep for Our Wellbeing
Sleep is very important for our mental health. Too little sleep and lack of good quality sleep can increase our anxiety and depression, not to mention our ability to concentrate, focus and learn.
It can take time to build up good sleep habits/ sleep hygiene.
By taking the time and effort to make sleep a priority, we can experience improvement in our overall wellbeing.
If you are struggling with anxiety and/or depression and sleep has been difficult for you, it may be helpful to seek out additional help through therapy. Along with address symptoms of anxiety and depression, I also work with my clients of identifying and implementing good sleep habits.
This can be hard to do on our own and having that additional support of a therapist to help guide you along can make a real difference.
If you live in California and are interested in my therapy services, please reach out. I offer a free 15 minute consultation to make sure my services are the right fit.
Disclaimer: This is not a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. If you are in California and looking for a professional therapist feel free to use the contact me to request an appointment or search Psychology Today for local therapists in your area.