How to Fall Asleep When Anxious? — Establish Good Sleep

How Can Anxiety Affect Sleep?

Few things are more excruciating than having trouble falling asleep or poor sleep. Imagine you've had a long, busy day, feeling physically tired, and when you finally hit the pillow, sleep seems out of reach. Your mind races; you remember that one time you wore your t-shirt upside down or went down the “what if” lane. Intrusive or meaningless thoughts keep you wired, and anxiety takes center stage – this is a reality for many. But how come?

This phenomenon of trouble sleeping and anxious, racing thoughts while wanting to sleep is often rooted in the complex dance of chemicals and hormones within your brain. Many people experience sleep problems or nighttime anxiety, and it is no wonder that they do. Our modern life keeps our minds occupied and overstimulated throughout the day – tasks at work, social relationships, app notifications, and everything in between keep our brains running on overload.

One of the most common ways your mind affects you trying to sleep is through persistent or intrusive thoughts. When you're anxious, your mind can be flooded with worries and what-ifs, making it hard to settle down and turn off your brain for sleep. These intrusive thoughts can keep you awake for hours, preventing the mental relaxation and brain chemistry necessary for sleep.

Do you not see yourself as anxious and still experience this sleeping trouble? You might notice that you're perfectly fine during the day, managing tasks and going about your routine without much worry. But when you settle into bed, trying to drift off to sleep, you suddenly find yourself grappling with anxiety and racing thoughts all of a sudden. This shift often happens because daytime activities and distractions help keep underlying stress and worries at bay.

Without these distractions, it becomes easier for suppressed anxieties and fears to surface in the stillness and quiet of the night. This pattern could be a sign of deeper emotional or mental health issues like chronic stress, anxiety, or even depression, which aren't as evident during your busy day. When external stimuli fade away at night, these underlying concerns can come to the forefront, making it challenging to fall asleep peacefully.

But what happens to you during the day or while trying to fall asleep to induce anxious thoughts or a restless mind in the evening?

Different circumstances can lead to this, but it all boils down to hormonal imbalances in brain chemistry and the disruption of your circadian rhythm (your sleep-wake-cycle). [1]

Understanding the interplay between hormonal brain balance and sleep is crucial. When you're anxious, your body goes into a state of heightened arousal due to increased levels of stress hormones. This biological response is part of your body's fight-or-flight mechanism, historically meant to protect you from danger. However, in our modern lives, this response can be triggered by everyday stressors, making it difficult to unwind and fall asleep. [2]

Let’s take a closer look at some circumstances that can affect the hormonal balance in your brain.

The Issue: Hormonal & Chemical Imbalance

Anxiety can disrupt the delicate balance of hormones that promote and regulate your sleep. But what happens in your brain when you are anxious, stressed, or having anxious thoughts?

When anxious, your body enters a state of hyperarousal or hyperactivity. [3] This state is characterized by increased production of stress hormones like cortisol and adrenaline. These hormones prepare your body to face perceived threats, part of the fight-or-flight response. It's challenging to relax in this heightened state, as your body is ready for action rather than rest.

Besides your stress hormones, adenosine, serotonin, and GABA are hormones and neuromodulators that impact your ability to fall asleep and influence your sleep quality as well. [3] [4] [5]

We will now take a look at all these different brain chemicals that play into your sleeping anxiety.

Anxiety Delays the Production of the Sleep Hormone – Melatonin

Melatonin, often called the “sleep hormone,” is produced by the pineal gland in response to darkness. It helps regulate your sleep-wake cycle by signaling to the body that it's time to sleep. Anxiety can delay melatonin production, as stress increases alertness, reducing the body's readiness for sleep.

Exposure to stress-inducing stimuli in the evening, such as emotionally charged thoughts or work-related news, can suppress melatonin production, making it harder to unwind and fall asleep. [1]

Avoid Caffeine & Catch Enough Sleep – Adenosine

Adenosine is an organic chemical (a neuromodulator) in your cells that induces sleepiness. It gradually increases throughout the day, peaking at bedtime to make you sleepy. During your sleep, adenosine gets broken down again, so you wake up refreshed and fit. So, how does anxiety affect this natural hormonal balance? [5]

If we suffer from anxiety or anxious thoughts, this typically leads to fatigue and low energy levels since our brain is constantly running and keeping us wired. Often, we then rely on coffee or caffeine-containing beverages during the day to combat our anxiety-induced fatigue. Unfortunately, this is highly counterproductive.

Caffeine blocks adenosine receptors, meaning that it gets disrupted, and the natural drowsiness usually induced by adenosine is diminished. This leads to difficulties in winding down and achieving restful sleep when you go to bed. [5]

Another factor is the amount of good sleep quality you get. If you do not catch enough sleep (at least 7-9 hours), the adenosine that builds up during the day in your brain does not get broken down entirely, and you will still feel tired when you wake up.

Stress Is Detrimental for Sleepiness – Cortisol & Adrenaline

When you're under stress, your body releases two essential stress hormones: cortisol and adrenaline.

Adrenaline, released in acute stress situations, rapidly prepares your body for action, increasing your heart rate, blood pressure, and alertness. While this response is crucial for survival situations, it's often unnecessarily triggered by everyday stressors or anxiety in our modern lives. [6]

Anxiety, whether it's due to chronic stress, specific worries, or generalized anxiety disorder, triggers the release of cortisol and adrenaline. This creates a heightened state of alertness in your brain that's counterproductive to sleep, leading to a vicious cycle where anxiety induces adrenaline release, which in turn exacerbates your anxiety. While adrenaline is released in highly stressful situations, cortisol is more your “everyday stress hormone,” it is also relevant to your natural wake-sleep cycle. [1] [6]

Cortisol follows a daily rhythm and is naturally higher in the morning to get you out of bed. In the evening, your cortisol levels naturally drop, allowing your body and brain to prepare for sleep. Chronic stress and coffee consumption can lead to elevated cortisol levels, delaying your sleep cycle and disrupting your natural cortisol balance. Furthermore, anxiety or anxious thoughts can cause spikes in cortisol, leading to heightened alertness when you should be winding down. [1]

When it comes to these two stress hormones, lifestyle choices like consuming caffeine or exposing yourself to stress regularly can exacerbate the effects of these hormones.

Happiness Makes You Sleepy – Serotonin

Have you ever watched children enthusiastically play together and squeal out in happiness, and someone said, “They will sleep well tonight.”? They were right.

Serotonin, a natural mood stabilizer and “happy hormone,” is a neurotransmitter that contributes to feelings of well-being and happiness. Serotonin is also a precursor to melatonin and, therefore, connected to your circadian rhythm. [3] When it gets dark, your body turns serotonin into melatonin, the hormone that makes you sleepy, linking how you feel during the day to how well you sleep at night.

Furthermore, low serotonin levels are linked with anxiety. Neglecting your self-care, such as regular exercise, healthy eating, and exposure to natural light, can lower your serotonin levels. If your serotonin levels are low, you naturally feel less happy, affecting your ability to fall asleep. [3]

Be Mindful of Alcohol Consumption – GABA (Gamma-Aminobutyric Acid)

GABA, an amino acid, is an inhibitory neurotransmitter that helps to calm your nervous system. By inhibiting neural activity, GABA facilitates sleep, reduces mental and physical stress, lowers anxiety, and creates a calm mood. This is extremely important for relaxing and getting quality sleep. As GABA is an inhibitory neurotransmitter, decreased concentration of it would produce a feeling of anxiousness. [4] [7]

Specific circumstances in life, like frequent exposure to stress, early-life stressors, or drinking alcohol, which mimics the calming effects of GABA but disrupts the natural balance in the long term, can affect how your brain releases and reacts to GABA. Therefore, be mindful of drinking alcohol in general and never drink alcohol to get sleepy. You should be aware of stressful situations and avoid stressors to allow your brain healthy and balanced GABA regulation. [7]

A lack of GABA is also associated with several mental health disorders like schizophrenia, major depression, and insomnia. [7] [8]

The Result: Disrupted Sleep-Wake Cycle

As you can see, anxiety, stressful situations, and certain lifestyle habits lead to an imbalance in your brain chemistry. If your brain chemistry is thrown off balance, this will affect your circadian rhythm and consequently make it more difficult for you to fall asleep, stay asleep, and wake up at the right time after enough rest. [1] [2]

The disruption in your circadian rhythm can also affect the quality of REM (Rapid Eye Movement) sleep, a critical phase for emotional and cognitive processing, further exacerbating your feelings of anxiety. Sleep is like the clean-up of your brain, and it is vital for your mental and physical health. Therefore, prioritizing enough and good quality sleep should be on top of your list. [1]

Now that you understand the biological processes behind your trouble sleeping while experiencing racing thoughts or anxiety, let’s take a look at the one-million-dollar question: How to get a good night's sleep with anxiety?

How Can I Get Better Sleep With Anxiety?

Achieving better sleep despite anxiety involves understanding and working with your body's natural processes in the future. How can you fall asleep fast with anxiety or racing thoughts?

CARE has curated some tips and tricks that are backed up by science:

Establish a Pre-Sleep Routine

Preparing your mind and body for sleep and unwinding with certain habits or routines before bedtime is beneficial. Establish a pre-sleep or bedtime routine that signals to your body that it's time to wind down, such as dimming lights and reducing screen time (especially social media) to decrease blue light exposure, which can interfere with melatonin production. [9]

You can also incorporate elements like an evening skincare routine or tidying up your living room to “end” the day and prepare yourself for the next day.

Create a Conducive Sleep Environment

Creating a conducive sleep environment is also key to good sleep hygiene. A decrease in temperature and light at night cues your pineal gland to produce melatonin, so keeping your bedroom cool and dark can significantly enhance sleep quality. The perfect temperature for sleep is 60–68 degrees Fahrenheit (ca. 16-20 °C).

If you experience anxiety and have anxious thoughts, you can also try a white noise machine to calm your mind.

Try Relaxation Techniques

Relaxation techniques such as progressive muscle relaxation and deep breathing can lower cortisol levels, reducing the physiological symptoms of anxiety. Slow, deep breathing can even promote the production of the sleep hormone melatonin. [10] Relaxation practices activate the parasympathetic nervous system, which promotes relaxation and counteracts the body's stress response.

Specific techniques like guided imagery or mindfulness meditation can also effectively redirect your thoughts away from anxieties.

Additionally, gentle yoga or stretching exercises before going to bed can alleviate physical tension, promoting a state of bodily relaxation conducive to sleep. Try to use some of these relaxation techniques before taking sleep medicine.

Avoid Stress Before Going to Bed

Engaging in anxiety-inducing activities before bed, like checking work emails, social media, or watching intense TV shows, can lead to a spike in cortisol, hindering your ability to fall asleep. You should establish some rules before going to bed to limit your exposure to stressful influences. [1]

For example, you could limit your access to social media in the evening and read a book instead of watching TV.

Support Your Circadian Rhythm

Establishing a consistent sleep-wake cycle and having a nighttime routine helps synchronize your internal clock, facilitating a more natural production of melatonin and allowing the adenosine to break down before you wake up. [9]

Remember, your sleep hygiene isn't just about what you do in bed; it's also about how you manage stress and anxiety during the day and before going to bed.

Difference Between Anxiety and a Sleep Disorder

Distinguishing between sleep disturbances caused by anxiety and those caused by sleep disorders is vital. These days, the term “anxiety” is used quite widely, and it is often misused.

Many people use the term anxiety equivalent to “anxiety disorder” to refer to having anxious thoughts or feeling momentarily insecure about certain aspects of their lives. While we all feel anxious sometimes, people with anxiety disorders experience fear and worry that is both intense and excessive. Sleep disorders like insomnia are highly prevalent in people with anxiety disorders. [11]

Anxiety-related sleep issues are typically linked to specific stressors and often resolve as the stress diminishes. If you have generalized anxiety disorder (GAD), your brain is kept in a constant state of heightened alertness, which interferes with the natural relaxation process necessary for sleep. The chronic stress associated with GAD disrupts the balance of neurotransmitters and hormones, further impacting sleep patterns and the ability to achieve restful sleep. [11]

In contrast, sleep disorders, such as insomnia or sleep apnea, have distinct biological and physiological causes. For instance, insomnia may be related to underlying neurological imbalances or other health conditions. Sleep apnea, characterized by interrupted breathing during sleep, is linked to physical obstructions or neurological issues affecting respiratory control. These conditions can lead to a chronic state of sleep deprivation, exacerbating anxiety. [2] [6]

If you're facing persistent sleep difficulties, it's essential to consult a healthcare professional for a comprehensive evaluation and medical advice. This may include sleep studies, cognitive behavioral therapy, or assessments for underlying health issues like generalized anxiety disorder, social anxiety, post-traumatic stress disorder, or panic disorder.