Managing Anxiety and Sleep Issues During Exam Preparation: A Comprehensive Guide

Q: Managing Anxiety and Sleep Issues During Exam Preparation: A Comprehensive Guide

Hello： For insomnia, it is indeed recommended to first use non-pharmacological treatments, such as physical therapy, psychotherapy, and occupational therapy. <br>If medication is absolutely necessary, it is also advised to avoid long-term use of sleep aids to prevent physiologica

Psychological anger, national examinations, masturbation, and related lifestyle issues?

Hello, doctor.
I used to have very few issues with insomnia, but this year, as I prepare for the national exam, I encountered obstacles at the beginning of the year with family needing my help, which delayed my study time.
It wasn't until two or three months ago that I decided to actively prepare.
The first few months were quite relaxed, and my study efficiency wasn't great, leading to feelings of anger.
I struggled with the inability to refuse help in a timely manner, fearing that rejecting my family would lead to resentment towards me.
Consequently, I hurriedly prepared each day, knowing I shouldn't dwell on my frustrations, but I unconsciously generated complaints and anger.
Additionally, when helping out, I became lazy and sometimes played video games until 2 or 3 AM, making it difficult to adjust my sleep schedule.
Normally, even if I stayed up late, I could manage to reset my routine, such as staying awake the next day until nightfall to sleep again.
However, this year has been less than ideal; I sometimes can't sleep at night and end up watching TV or playing on the computer.
While I can eventually fall asleep, I often sleep until 10 or 11 AM the next day, and on good days, I wake up at 8 or 9 AM.
I set my phone alarm for 7:30 AM, but if I indulge in sleeping in, I might wake up at 8 AM.

There are times when I go several days without masturbation, and I notice my brain generating a lot of sexual thoughts and images, making it harder to sleep.
I wonder if I need to release regularly to ensure better sleep.
I'm unsure if it's appropriate to ask you about masturbation.
As I age, I feel my libido has decreased; in the past, I would feel the urge to masturbate every two to three days, but now I can go over three days without much sexual desire.
I think this is a good thing, but I'm uncertain if it's beneficial for my brain or body.

In the two or three months leading up to my exam in July, I visited a well-known sleep disorder clinic near my home, where the doctor prescribed me Alprazolam and Zolpidem for sleep.
Alprazolam helped me sleep well, but after a few days, my sleep schedule became irregular again, so I had to return to the doctor.
By the second or third week, I realized I only needed to take it when my sleep was disrupted.
I had previously seen other doctors who prescribed me anxiety medications for one to two months, which left me with some psychological trauma.
Additionally, having had heart surgery as a child, I sometimes feel like the doctors are experimenting on me.

I researched online and found that taking Alprazolam for more than a month can lead to dependence, so I'm afraid of developing a medication addiction and have opted to take it only as needed.
I have other family members studying for a PhD in biochemistry in the U.S.
who suggested I exercise regularly.
I have tried walking and jogging for two to three hours at a nearby elementary school playground for a couple of days.
In the past, exercising until I was tired helped me sleep well, but now it seems less effective.
Is it better to establish a daily exercise routine rather than relying on medication? If you need me to provide more information, please let me know.
Thank you.

Chang, 30~39 year old female. Ask Date: 2024/07/07

Dr. Li Zhengfeng reply Psychiatry

Hello: For insomnia, it is indeed recommended to first use non-pharmacological treatments, such as physical therapy, psychotherapy, and occupational therapy.
If medication is absolutely necessary, it is also advised to avoid long-term use of sleep aids to prevent physiological or psychological dependence.
While preparing for national exams, it is recommended to maintain a regular routine and approach your studies with a calm mindset, avoiding excessive external distractions.
It is normal for sexual desire to decrease with age, so there is no need to worry too much.
Wishing you success in your exams.

Reply Date: 2024/07/07

More Info

Managing anxiety and sleep issues during exam preparation can be a significant challenge, especially when compounded by external pressures and personal expectations. Your situation reflects a common struggle faced by many students and professionals alike, particularly when preparing for high-stakes exams. Here’s a comprehensive guide to help you navigate these challenges effectively.

Understanding Anxiety and Its Impact on Sleep
Anxiety is a natural response to stress, but when it becomes overwhelming, it can lead to sleep disturbances. The physiological effects of anxiety can include increased heart rate, muscle tension, and a racing mind, all of which can make it difficult to fall asleep or stay asleep. This cycle can create a feedback loop where anxiety about not sleeping leads to more anxiety, further exacerbating the problem.

The Role of Sleep in Academic Performance
Sleep is crucial for cognitive function, memory consolidation, and overall mental health. Lack of sleep can impair your ability to concentrate, process information, and perform well on exams. It’s essential to prioritize sleep hygiene, which includes creating a conducive sleep environment, maintaining a consistent sleep schedule, and engaging in relaxing pre-sleep activities.

Strategies for Managing Anxiety
1. Cognitive Behavioral Techniques: Cognitive Behavioral Therapy (CBT) is an effective treatment for anxiety. It helps you identify and challenge negative thought patterns and develop healthier coping mechanisms. Consider seeking a therapist who specializes in CBT.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety levels. These techniques encourage you to focus on the present moment and can be particularly helpful before bedtime.

3. Physical Activity: Regular exercise is a powerful stress reliever. It can improve your mood, reduce anxiety, and enhance sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like walking, jogging, or yoga can be beneficial.

4. Time Management: Break your study material into manageable chunks and create a study schedule. This can help reduce feelings of being overwhelmed and allow you to focus on one task at a time. Setting realistic goals can also alleviate pressure.

5. Limit Stimulants: Reduce your intake of caffeine and nicotine, especially in the hours leading up to bedtime. These substances can interfere with your ability to fall asleep and stay asleep.

6. Sleep Hygiene: Establish a calming bedtime routine. This could include activities like reading, taking a warm bath, or listening to soothing music. Ensure your sleep environment is dark, quiet, and cool.

Medication Considerations
While medications like Alprazolam and Zolpidem can be effective for short-term relief of anxiety and sleep issues, they come with risks, including dependency and withdrawal symptoms. It’s wise to use them under the guidance of a healthcare professional and to explore non-pharmacological options as well.

If you’re concerned about dependency, discuss these fears with your doctor. They can help you create a plan that may include tapering off medication while integrating behavioral strategies to manage anxiety and improve sleep.

Addressing Sexual Health Concerns
Regarding your concerns about sexual health and its impact on anxiety and sleep, it’s important to understand that fluctuations in libido are normal and can be influenced by various factors, including stress and anxiety. If you feel that your sexual health is affecting your mental well-being, consider discussing this with a healthcare provider who can offer guidance tailored to your situation.

Conclusion
In summary, managing anxiety and sleep issues during exam preparation requires a multifaceted approach. By incorporating cognitive-behavioral strategies, mindfulness practices, regular exercise, and good sleep hygiene, you can create a supportive environment for both your mental and physical health. If medication is necessary, ensure it is part of a broader treatment plan that includes lifestyle changes and therapeutic support. Remember, it’s essential to be kind to yourself during this process and recognize that seeking help is a sign of strength.

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