Overcoming Sleep Anxiety: Strategies to Combat Insomnia Fears

Q: Overcoming Sleep Anxiety: Strategies to Combat Insomnia Fears

Hello Cheryl： It seems that your main concern is about sleep, which is making it even harder for you to fall asleep. <br>In such situations, you can focus your attention solely on your breathing. <br>When other thoughts arise, gently bring your focus back to your breath. <br>This

Difficulty falling asleep?

Hello Dr.
Lin,
I have always had good sleep quality, able to sleep through the night with few dreams, and I usually fall asleep within 10 to 15 minutes.
However, since last Friday (January 7th), there have been some changes.
My time to fall asleep has increased, and it now takes about 30 minutes.
At first, I thought it was due to a cold and the medication I took, but even after recovering from the cold, the situation persisted.
Since it hasn’t affected my daytime functioning and once I fall asleep, I sleep soundly without waking up, I thought it was manageable.
However, on Tuesday (January 11th), I experienced noticeable insomnia.
I went to bed around 12:30 AM and couldn’t fall asleep until 3 AM.
Each time I felt like I was about to drift off, something seemed to interrupt me, and despite being close to sleep, I would wake up again, tossing and turning until 3 AM.
I couldn’t stand it anymore, so I got up, did some homework, and went back to sleep around 4 AM.
This episode of insomnia made me worry about "insomnia."
I identified the cause of my insomnia on January 11th as the stress of having to release grades the next day.
Once that pressure was lifted on January 12th, I didn’t experience insomnia that night; I fell asleep within half an hour after going to bed at 11:30 PM and slept until after 7 AM the next day.
I thought I wouldn’t have insomnia again, but unexpectedly, on the night of January 13th, I had difficulty falling asleep again.
I went to bed around 12:15 AM, feeling sleepy and clearly sensing that I was about to fall asleep with my breathing becoming more relaxed.
However, at that moment, thoughts like "I should be falling asleep soon" and "Why am I still awake?" popped into my mind, leading to a fear of "insomnia." This anxiety even appeared before I went to bed, and whenever I was close to sleeping, those thoughts would emerge.
I am aware that my fear of insomnia is causing my insomnia, but I can’t convince myself to relax.
I even feel anxiety and pressure, and it wasn’t until 2 AM that I finally fell asleep.
Doctor, how can I overcome my fear of insomnia? I am well aware that I have academic pressure, but I seem to be numb to it.
Some time ago, I practiced mindfulness due to anxiety and health concerns, but I stopped for a while.
Should I resume mindfulness practice to alleviate stress? I apologize for the lengthy consultation, and I appreciate your time in responding.

Cheryl, 20~29 year old female. Ask Date: 2022/01/14

Dr. Lin Mianzhang reply Psychiatry

Hello Cheryl: It seems that your main concern is about sleep, which is making it even harder for you to fall asleep.
In such situations, you can focus your attention solely on your breathing.
When other thoughts arise, gently bring your focus back to your breath.
This is actually a mindfulness technique, which can help stabilize your thoughts.
Once your thoughts are stabilized, both your mood and body will find it easier to relax, and naturally, you will be able to fall asleep.
Additionally, during the day while you are awake (note that this is not about lying in bed thinking when you are trying to sleep), you can reflect on the reasons you fear insomnia.
Are you worried about not feeling refreshed the next day? Or do you dislike the feeling of being awake in the middle of the night? Or are there other reasons? Some negative, irrational thoughts can be adjusted through rational reflection, which is part of cognitive behavioral therapy.
If you find this challenging, you may want to seek professional help from a mental health specialist.
Wishing you peace and health!

Reply Date: 2022/01/14

More Info

Overcoming sleep anxiety can be a challenging journey, especially when it becomes intertwined with academic pressures and personal expectations. Your experience of having previously good sleep quality, only to face sudden difficulties, is not uncommon. The anxiety surrounding sleep can create a vicious cycle, where the fear of not sleeping leads to increased stress, which in turn makes it even harder to fall asleep.
Firstly, it’s important to recognize that the anxiety you are experiencing is a common response to changes in sleep patterns. When you start to worry about sleep, your body can react in ways that make it even harder to relax and fall asleep. This is often referred to as "performance anxiety" regarding sleep. The more you think about needing to sleep, the more pressure you place on yourself, which can lead to a heightened state of alertness rather than relaxation.

Here are several strategies that may help you combat this sleep anxiety:
1. Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems. It is often more effective than medication for long-term management of insomnia. A therapist trained in CBT-I can help you develop coping strategies and change your perception of sleep.

2. Mindfulness and Relaxation Techniques: Since you mentioned having practiced mindfulness before, it may be beneficial to reintroduce these techniques into your routine. Mindfulness meditation can help you focus on the present moment and reduce anxiety. Techniques such as progressive muscle relaxation or guided imagery can also be effective in calming your mind and body before sleep.

3. Sleep Hygiene: Establishing a consistent sleep routine can signal to your body that it’s time to wind down. This includes going to bed and waking up at the same time every day, creating a restful environment (dark, quiet, and cool), and avoiding screens at least an hour before bed. Limiting caffeine and heavy meals in the evening can also help.

4. Journaling: If racing thoughts are keeping you awake, consider keeping a journal by your bedside. Write down any worries or tasks that are on your mind before you go to bed. This can help clear your mind and reduce anxiety about forgetting something important.

5. Gradual Exposure: If you find yourself feeling anxious about going to bed, try gradually exposing yourself to the situation. Spend time in your bedroom doing relaxing activities that are not sleep-related, such as reading or listening to music. This can help create a more positive association with your sleep environment.

6. Limit Naps: While it can be tempting to catch up on sleep during the day, long or irregular napping can negatively affect your nighttime sleep. If you need to nap, try to keep it short (20-30 minutes) and earlier in the day.

7. Seek Professional Help: If your anxiety about sleep continues to interfere with your daily life, it may be beneficial to consult a mental health professional. They can provide tailored strategies and support to help you manage your anxiety and improve your sleep.

In conclusion, overcoming sleep anxiety is a process that requires patience and practice. By implementing these strategies, you can gradually reduce your anxiety about sleep and improve your overall sleep quality. Remember, it’s important to be kind to yourself during this process and recognize that it’s okay to seek help when needed.

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