Anxiety vs. Physical Discomfort: A Guide for Young Adults - Family Medicine

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Unsure if it's anxiety or genuine discomfort?


Hello, doctor.
I am currently 22 years old.
Recently, for the past two or three days, I have been feeling a bit bloated while awake, as I often feel the urge to burp or pass gas to relieve the pressure.
However, when I go to sleep, I experience a sensation of increased heart rate just as I'm about to fall asleep, which prompts me to take slow, deep breaths to calm myself.
I find myself wanting to change positions because I feel like I can't breathe comfortably in one position, whether lying on my back or side.
Yet, I eventually fall asleep without any issues and wake up feeling fine.
However, upon waking, I sometimes feel like I haven't fully recovered, but after sitting for a while, I feel somewhat better.
I have been considering whether my irregular sleep schedule might be contributing to these feelings.
I often stay up late, usually going to bed around 5 or 6 AM, but I might not actually fall asleep until 6 or 7 AM, and then I wake up around 2 PM.
Sometimes, if I feel sleepy, I might go to bed at 10 PM, but I often wake up around 1 or 2 AM and then stay awake until 9 or 10 AM.
Additionally, I haven't been exercising lately; due to the pandemic, I haven't been going out much, not even for walks, so I have been even less active.
I would like to ask if the issues I described could be related to my discomfort.
If so, how should I adjust my sleep schedule? Given the recent severity of the pandemic, I feel anxious whenever my body feels a bit off, but as of now, I have no known exposure.
Even when I go out, it's just to buy meals from nearby convenience stores or shops, which takes only 1 or 2 minutes.
I live in Tamsui, but it's not in the more severely affected areas like Tamsui Old Street, so I believe I should be safe.

I am also concerned about the so-called "happy hypoxia," which sounds frightening and serious.
I worry that I might be experiencing something more severe, but I try to reassure myself that it’s just bloating and not a lack of oxygen.
However, the sensation of difficulty breathing before sleep makes me anxious about the possibility of asymptomatic sudden death or similar issues.
I want to comfort myself and not overthink things, which is why I am seeking your professional advice.
Could you please explain how I should take care of myself? Thank you!

Xinxin, 20~29 year old female. Ask Date: 2021/06/09

Dr. Ye Qianyu reply Family Medicine


Hello! Based on your description, your schedule is indeed not very appropriate.
While there is no strict standard for sleep habits, it is recommended that you sleep at least between 11 PM and 3 AM.
As long as you get enough sleep (7-9 hours), you should feel alert during the day.
Since the symptoms you mentioned are nonspecific, I suggest you first adjust your schedule and maintain good dietary habits, then observe for a while.
If you experience any discomfort, please seek medical attention at a healthcare facility.

Reply Date: 2021/06/09

More Info


Understanding the interplay between anxiety and physical discomfort is crucial, especially for young adults navigating the complexities of life. Your experience of bloating, irregular breathing patterns, and heightened anxiety during sleep can be indicative of several underlying issues, including lifestyle factors, anxiety disorders, and the effects of sleep deprivation.

Firstly, let's address the physical symptoms you're experiencing. Bloating and the urge to relieve gas can often be linked to dietary choices, stress, and anxiety. When we are anxious, our body can react in ways that may lead to gastrointestinal discomfort. Stress can alter gut motility, leading to symptoms like bloating and gas. Additionally, if you are consuming foods that are hard to digest or high in sugar and fat, this can exacerbate feelings of discomfort. It might be beneficial to keep a food diary to identify any potential triggers that could be contributing to your bloating.

Your sleep patterns also play a significant role in your overall well-being. The irregular sleep schedule you described—staying up late and waking up in the afternoon—can disrupt your circadian rhythm, which is essential for regulating various bodily functions, including digestion and mood. Poor sleep quality can lead to increased anxiety, which in turn can create a cycle of discomfort and distress. It’s important to establish a consistent sleep routine. Aim to go to bed and wake up at the same time every day, even on weekends. This consistency can help regulate your body's internal clock, improve sleep quality, and reduce feelings of anxiety.

The sensation of your heart racing as you drift off to sleep is not uncommon, especially in individuals who experience anxiety. This can be a physiological response to stress, where your body is in a heightened state of alertness. Practicing relaxation techniques before bed, such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation, can help calm your mind and body. These techniques can lower your heart rate and promote a sense of calm, making it easier to fall asleep.

It's also worth noting that the pandemic has heightened anxiety levels for many individuals, leading to increased health concerns and fears about physical symptoms. While it’s natural to feel concerned about your health, especially in the current climate, it's essential to differentiate between anxiety-induced symptoms and actual health issues. If you find that your anxiety is overwhelming or persistent, seeking support from a mental health professional can provide you with coping strategies and tools to manage your anxiety effectively.

In terms of physical activity, incorporating regular exercise into your routine can significantly benefit both your physical and mental health. Exercise releases endorphins, which are natural mood lifters, and can help alleviate feelings of anxiety. Even simple activities like walking, stretching, or yoga can make a difference. Given the current pandemic situation, consider finding safe ways to incorporate movement into your day, whether it's at home or in your neighborhood.

Lastly, it's essential to be kind to yourself during this time. Acknowledge that it's okay to feel anxious and that you're not alone in these feelings. Many young adults are navigating similar challenges, and reaching out for support—whether from friends, family, or professionals—can be incredibly beneficial.

In summary, addressing your physical discomfort involves a holistic approach that includes managing anxiety, improving sleep hygiene, maintaining a balanced diet, and incorporating regular physical activity. If your symptoms persist or worsen, don't hesitate to consult a healthcare professional for further evaluation and support. Remember, taking small steps towards better health can lead to significant improvements in your overall well-being.

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