Understanding Anxiety and Insomnia

Anxiety can cause sleep issues, while insomnia can also intensify anxiety symptoms. Difficulty falling or staying asleep can lead to physical and emotional stress, impacting daily life. Seeking help from a doctor and starting cognitive behavioral therapy are among the best strategies for improving sleep.

What Is Insomnia?

Insomnia is a medical condition defined as having trouble falling asleep, staying asleep, or waking up too early and not feeling refreshed. You may have insomnia if you experience:

• Difficulty falling asleep
• Trouble staying asleep
• Waking up too early
• Waking up feeling tired

What Is Anxiety?

Anxiety is your body’s natural reaction to stress, often involving feelings of fear or worry about future events. You may be dealing with an anxiety disorder if:

• The anxiety is severe
• It lasts for six months or longer
• It interferes with your daily activities and relationships

According to Mental Health America, nearly two-thirds of Americans report that stress disrupts their sleep. Poor sleep has also been linked to increased risk of anxiety and depression.

Anxiety and Insomnia: A Two-Way Relationship

Research indicates that up to 36% of people with an anxiety disorder also experience insomnia. But which comes first?

Does anxiety cause insomnia, or does insomnia cause anxiety? The answer often depends on individual experiences. Sleep deprivation can increase the risk of developing an anxiety disorder, while existing anxiety can lead to sleep disruption, including insomnia and nightmares.

The Mental Health and Sleep Connection

A 2021 study found that improving sleep had measurable effects on anxiety, depression, stress, and rumination. Sleep plays a crucial role in:

• Decision-making
• Problem-solving
• Emotional regulation
• Learning and memory
• Maintaining attention

When you’re sleep-deprived, these functions are impaired—potentially leading to a feedback loop where poor sleep worsens anxiety, and anxiety reduces sleep quality.

Diagnosis: Do You Have Insomnia?

If you suspect that you may have insomnia, it’s essential to consult a doctor. A physical exam and sleep history are typically the first steps. You may be asked to keep a sleep diary for 1–2 weeks.

If a sleep disorder is suspected, a referral to a sleep specialist may follow. Tests such as a polysomnogram (PSG), or overnight sleep study, can help identify physical factors impacting your sleep.

Insomnia Treatment Options

While medications and supplements exist, most doctors start with non-drug interventions, especially Cognitive Behavioral Therapy for Insomnia (CBT-I).

CBT-I helps you identify and change thoughts and behaviors that interfere with sleep. It also addresses the anxiety about not sleeping, which can itself worsen insomnia.

Sleep Improvement Tips

These healthy habits can help support better sleep and reduce anxiety:

1. Practice Relaxation

Techniques like deep breathing, progressive muscle relaxation, warm baths, or guided meditation before bed can help your body wind down.

2. Control Your Environment

Reserve the bedroom for sleep. Avoid using electronics in bed to break the mental association with activity. Darkness, quiet, and cool temperature can also aid sleep.

3. Set a Consistent Bedtime

Going to bed and waking up at the same time every day—even on weekends—trains your internal clock and promotes better rest.

4. Avoid Daytime Naps

Napping can disrupt your sleep drive at night. If you’re experiencing insomnia, avoiding naps might help your sleep cycle reset.

5. Avoid Stimulants and Alcohol

Caffeine and nicotine are known to interfere with sleep and should be avoided after the early afternoon. While alcohol may make you sleepy, it disrupts deep sleep stages.

6. Get Comfortable

Use supportive pillows and a comfortable mattress. Your bed should be a place that invites rest, not discomfort.