5 Tips to Help You Fall Asleep If You're Feeling Anxious, According to Sleep Experts
You lie down in the evening after a long day. You're tired and need to rest, but your brain has other ideas. It's wide awake, revisiting every aspect of your day, overanalyzing every tiny detail and thinking about everything that needs to be done tomorrow. Or maybe you fall asleep easily, but around 3 a.m. you wake up and your mind is spinning. If these scenarios sound familiar to you, you're not alone: more than 50 million Americans suffer from some type of sleep disorder.
In recent months, many people are experiencing sleep issues for the first time due to anxiety brought on by the COVID-19 pandemic. In fact, "COVID-somnia" is a term used by specialists to describe acute insomnia due to the added stress of the pandemic.
Psychiatrist Howard Maziar, M.D., says that barring underlying medical conditions, most sleep disturbances are related to stress. "Most often sleep disturbances are anxiety-related," he says. "There are different patterns of sleep disturbance: For some it's difficulty falling asleep, for others it's waking up very early, for others it's both. And most of the time, it's related to anxiety."
The good news is that there are some easy ways that you can reduce stress and anxiety to get a better night's sleep.
Scott Leibowitz, M.D., FAASM, who is a sleep medicine specialist, explains the relationship between anxiety and sleep disturbances and provides us with some of the things we can do to help with acute sleep issues caused by stress and anxiety. "Anxiety and insomnia go hand in hand. Anxiety activates your waking pathways in your central nervous system, so the more anxious you are, the more awake and alert and aroused you become. It is extremely common for people with insomnia to also have anxiety, because anxiety creates a hyper-awake state," Leibowitz explains.
Leibowitz also says that many people don't feel like they have anxiety until they lie down at night: "One of our coping mechanisms is distraction. That's how we survive. If we sat around and thought about the reality of life, now especially with COVID, we wouldn't leave our house! But we have defense mechanisms and coping mechanisms that allow us to deal with things during the day."
At night that's a different story. When we lie down to go to sleep or when we wake up in the middle of the night, we don't have access to those coping mechanisms—they go "offline" at night. So you are left awake, in the dark, with nothing to do but think.
How do we get ourselves out of this spiral of anxious thinking that keeps us from sleeping? Leibowitz recommends that we take these five steps to reduce anxiety and improve sleep.
How to Sleep Better When You're Feeling Anxious
1. Set a regular wake time.
Instead of setting a regular bedtime, set a regular wake time. When people tell themselves that they have to go to bed at a certain time, they create anxiety for themselves. They think they need to go to bed at a certain time, even if they aren't sleepy. They lie down, they can't fall asleep, and then they start to worry that they aren't falling asleep, which only exacerbates the problem.
The better option would be to set a consistent wake time and figure out how much sleep we actually need—the normal range for adults being between six and nine hours a night. The regular wake time acts as an anchor so that your sleep timing can unfold, allowing you to figure out how much sleep you truly need to wake up and feel good!
2. Go to bed when you're sleepy.
If you are not sleepy when you lie down, you are almost guaranteed to have trouble falling asleep. Leibowitz says that he has fixed many patients' sleep issues by simply suggesting that they go to bed later.
He says, "We all have a clock in our brain that controls when sleep and wake should happen. That is a trait. People who are night owls are night owls. People who are morning people are morning people. And, contrary to popular belief, we can not train ourselves to be morning people by going to bed early and getting up early."
Many problems with sleep come simply because we tell ourselves that we have to be a morning person when we aren't, and we try to be a morning person by going to bed early when we aren't sleepy.
Here's an example: If you are someone who needs seven hours of sleep and you go to bed at 10 p.m. and set your alarm for 7 a.m., you're giving yourself a nine-hour window for sleep. Those extra two hours are going to show up somewhere—either at the beginning of the night, in the middle of the night or in the early morning. So if you go to bed at midnight and wake up at 7 a.m. and you feel refreshed, you may be a night owl who is a seven-hour sleeper, and that's OK!
By setting your wake time and knowing the number of hours of sleep you generally need each night, you'll be able to better know the time to go to bed when you will actually be sleepy.
3. Unplug and disconnect.
Going to sleep requires us to get ourselves into a calm, meditative state. Leibowitz suggests that we set some distinct boundaries to allow ourselves to unplug and disconnect before we lie down to go to sleep. "Internet, computers, TV, news—all of those things are the opposite of what we need for sleep. So you have to draw some boundaries and have a hard stop of when you are going to disconnect."
He suggests that we think of our bedroom and our bed as a protected cave: "When you walk in there, the world can't get in." To create this protective cave, you have to disconnect prior to going to bed so that you can get into a calm and quiet state. Leibowitz suggests reading a book, listening to calming music, meditating and avoiding the news, your phone and computer.
4. Create a "worry time."
If you haven't stopped to rest all day until you lie down to go to sleep, you also haven't been able to reconcile the day's events to create a plan for tomorrow. This would lead almost anyone down the path of worry.
Instead of trying to resolve all of these issues when you're trying to go to sleep, create a designated "worry time." Sit down and write a list of every possible thing that you could worry about—big or small. Then write a solution or plan to deal with each worry.
Now you have an action plan for every single worry that you've identified. All your problems may not be magically solved, but this means that you do have a plan!
5. Choose the path toward sleep.
When you've taken all of the steps outlined above, you've done everything you can do to set yourself up for successful sleep. Now you have to choose the right path.
To be able to sleep, you must allow your brain to get into a quiet, meditative state. "The quiet meditative state that we all get into before we fall asleep creates a neurobiologic change in our brain which is conducive for the sleep process to really start to engage," says Leibowitz. Taking this path toward a quiet, meditative state is a choice.
The other path is the path of worry. If you haven't grounded your worries during your designated "worry time," your brain is going to be looking for every single worry it can find, which will only make it harder to relax and fall asleep.
Leibowitz reminds us, "You can choose a path toward sleep or you can choose a path toward wake. Creating a quiet, meditative state is choosing a path toward sleep. Engaging all of your worries and concerns and fears is choosing a path to stay awake. It is a choice!"
When Should You See a Sleep Specialist?
It's important to note that if you have been having insomnia more than three days a week for more than 30 days or if your sleep disturbances are causing you distress, it is time to go and see a specialist. You may be dealing with a true sleep disorder or an underlying medical condition and in those cases, it's important to seek the advice of a medical professional.