You Know You Need More Sleep, This May Be the Way to Get It
The powerful connection between anxiety and insomnia, and how to overcome it.
Posted Jun 07, 2016
Sleep deprivation. It’s the one physiological problem that, according to media reports, is creating all of our other problems, both psychological and physical. If you don’t get enough sleep, you harm your health in numerous ways, from destroying your immune system to setting yourself up for a bout of depression. We’re constantly reminded to improve our sleep habits, with the experts providing a stream of new data about the need for sleep. We’re also led to believe that our harried world makes it impossible for us to get enough shuteye, interfering with our productivity and well-being.
There’s no doubt that we have a need for sleep, even though researchers don’t know exactly why this is so. There’s also no doubt that people who don’t get enough sleep are more likely to make mistakes—sometimes deadly ones. Not sleeping enough affects your immune system and upsets neurotransmitters and hormones as well. People who sleep after learning something new are more likely to remember it than people who don’t, regardless of whether the sleep occurs at night or in the afternoon. We are meant to sleep; when we don’t, we suffer.
However, this recognition is the crux of the problem: When you know you need to sleep, and worry about not getting enough of it, it can become a preoccupation. On a sleepless night, you lie there imagining how badly things will go the following day. If the insomnia persists, you’ll be able to think about nothing other than the sleep you’re missing, while fearing the anxious nights ahead of you will consume your daily thoughts.
Researchers have ample evidence documenting the effect of sleep deprivation on anxiety. A literature review performed by Universidade Federal de São Paulo neuroscientist Gabriel Natan Pires and associates (2015) concluded that, of 21 studies of the effects of anxiety on sleep deprivation, 71 percent supported the relationship at a level of statistical significance. The other studies produced nonsignificant findings, but sleep deprivation-produced anxiety occurred to some degree in every study. The levels of anxiety produced weren’t enough to constitute an anxiety disorder; the result of sleep deprivation in these studies was a condition called “acute anxious state(s)” (p. 622).
In other words, the more sleep deprivation you experience, the more you can make yourself anxious. Because this is an acute state, you can get over it once you’re able to restore your sleep. The effects described by the Brazilian team weren’t necessarily consistent across studies, given variations in samples, methods of producing sleep deprivation, and measures of anxiety. As a result, the Pires et al. authors believe that there are still some important “uncertain points” (p. 622).
To try to determine what mechanisms are responsible for the relationship between sleep deprivation and anxiety (to the extent that it’s observed) in humans, Pires and his collaborators turned to experimental evidence provided in animal studies. By studying lab animals, it’s possible to provide more control over the conditions that produce sleep deprivation as well as more controlled ways to measure anxiety. The basic paradigm in these studies involves sleep-depriving animals, such as rodents (or in some studies, cats), and then observing their behavior for signs of anxiety during a lab task.
In the rodent studies, an elevated maze is used. The animal is placed in a wooden rectangular structure that has an opening with a platform in the middle. An “anxious” animal will find one end of the enclosed structure and remain there. A “non-anxious” animal will explore the entire maze, including the open part of the structure. However, in addition to anxiety, mania and impulsivity (two results of sleep deprivation) may also result in explorative behaviors. This possibility limits the conclusions that animal researchers can draw from sleep deprivation.
It is perhaps due to this methodological cloudiness that animal models of sleep deprivation don’t produce results as reliably as studies of humans do. In studies of humans there are variations in the way that anxiety is measured as well as the way participants interpret their own mental states after they’ve been deprived of sleep. However, it’s interesting to speculate that one reason animals don’t show effects of sleep deprivation as reliably as humans do is because they don’t (to the best of our knowledge) “think” about whether they’re getting enough sleep.
So let's assume that you—a human and not a lab rat—are one of the unlucky individuals to be anxious and distraught after a series of sleepless nights. The American Sleep Association provides a set of valuable tips about ways to improve your sleep to overcome this. Many of these are directed toward changing the behaviors that produce sleeplessness—e.g., don’t drink caffeine before bed, and keep your room free of noise and light. They also recommend that you avoid associating your bedroom with work, or with tossing and turning. Rather than laying there wishing you could sleep, they argue, it’s better to get up and (in the dark) sit in a chair. Don’t read or distract yourself: You need to focus on turning down your brain.
This is good advice, but there’s one area the American Sleep Association is failing to acknowledge: There’s a condition called “paradoxical insomnia” (Geyer et al., 2011) in which you perceive yourself to be having insomnia when objective sleep measures say you’re not. Perhaps you’ve got a Fitbit that you’re using to track your sleep. After what, in your mind, seemed like a bad night of sleep the device announces you reached your target goal of seven or eight hours of sleep. Not all fitness trackers produce accurate recordings of bodily states, but it’s intriguing to think that you might be sleeping better than you realize.
It’s the anxiety about not sleeping, then, that can produce the sleep deprivation you fear the most. Rodents may not consistently show anxiety when they’re sleep deprived, but people do, because we can consciously perceive our own internal states. In extremes, you can develop paradoxical insomnia, but short of that, if it’s worry about sleep that’s causing your fitfulness, you need to take control of your anxiety.
Some behavioral researchers suggest that the best way to fall asleep is to tell yourself not to. However, I believe that this method is flawed because it still focuses your thinking on sleep. The one habit you need to break is to stop thinking about sleep altogether. Do what you can to promote sleep hygiene but then let nature, and your bodily regulatory systems, take their course. Sometimes the more you think about something the better you become at it, but in the case of sleep, your best solution is to think less.
Follow me on Twitter @swhitbo for daily updates on psychology, health, and aging. Feel free to join my Facebook group, "Fulfillment at Any Age," to discuss today's blog, or to ask questions about this post.
Geyer, J. D., Lichstein, K. L., Ruiter, M. E., Ward, L. C., Carney, P. R., & Dillard, S. C. (2011). Sleep education for paradoxical insomnia. Behavioral Sleep Medicine, 9(4), 266-272. doi:10.1080/15402002.2011.607022
Pires, G. N., Tufik, S., & Andersen, M. L. (2015). Sleep deprivation and anxiety in humans and rodents—Translational considerations and hypotheses. Behavioral Neuroscience, 129(5), 621-633. doi:10.1037/bne0000076
Copyright Susan Krauss Whitbourne, 2016