Struggling with Sleep: Anxiety and Its Effects

Q: Struggling with Sleep: Anxiety and Its Effects

Hello, Raccoon： Based on your description, I believe the diagnosis of anxiety disorder made by the psychiatrist at Chang Gung Memorial Hospital is reasonable. <br>It can be challenging at first to associate certain physical discomforts with anxiety. <br>However, you made a good c

I have been unable to fall asleep at night recently?

I sometimes experience difficulty breathing and a feeling of tightness in my chest when I am anxious.
Last year, I visited a psychiatrist at Chang Gung Memorial Hospital who diagnosed me with anxiety disorder.
I have always been prone to nervousness; whenever it’s my turn for something, my heart starts racing and I feel tense.
For example, when a teacher announces that they will call on someone for a quiz, I begin to feel anxious.
Recently, my sleep has not been very good.
I decided to see a doctor after hearing about a previous case where someone got sick, which prompted me to research these issues online before ultimately deciding to seek medical help due to neck tightness, chest discomfort, difficulty breathing, and insomnia.

I still experience these symptoms occasionally, especially due to work and classes.
At night, I often struggle to fall asleep and find myself thinking about the day’s events.
Lately, I have been having trouble sleeping at night, sometimes waking up in the middle of the night and then falling back asleep.
Additionally, I have noticed bubbles in my urine, which I mentioned to my traditional Chinese medicine doctor, and I have been taking herbal medicine from a local herbal shop.

For example, just yesterday, I lay in bed around 10 PM trying to sleep, but I couldn’t; I closed my eyes and suddenly it was past midnight, then 3 AM, and finally dawn came, and I had to go to work the next day.
I still have some medication from the psychiatrist that I haven't finished; I only take it when I feel unwell.
Because of all this, I have lost quite a bit of weight and now weigh 54 kg at a height of 170 cm.
Please help me, doctor!

huàn xióng, 20~29 year old female. Ask Date: 2002/05/30

Dr. Chen Wenke reply Psychiatry

Hello, Raccoon: Based on your description, I believe the diagnosis of anxiety disorder made by the psychiatrist at Chang Gung Memorial Hospital is reasonable.
It can be challenging at first to associate certain physical discomforts with anxiety.
However, you made a good choice in seeking the right specialty, although your treatment has not been continuous.
The symptoms of anxiety can indeed be quite varied.
You should be somewhat aware that you tend to get nervous and worry about many things, which can directly affect your daily life and the quality of your sleep.
Poor sleep can further impact your mood at work or school, and in severe cases, it can lead to depression, making sleep very important for you.
Essentially, your understanding of sleep is not correct.
There are many causes of insomnia, but if you can patiently address the core issues, it should not be too difficult.
I have the following suggestions that I hope will help you:
1.
If you have been lying in bed for more than 15 minutes without falling asleep, please do not continue to lie in bed.
It is better to get up, sit in a chair, or engage in some relaxing activities until you feel sleepy again before returning to bed.
Why do this? Mainly because if you frequently lie in bed awake, it will only increase your anxiety and fear of sleeping in bed.
2.
It is best to keep your mind clear for at least one hour before bedtime.
If you often think about troubling matters right before or in bed, it will undoubtedly put you in a situation conducive to insomnia.
3.
I recommend keeping a sleep diary to record your sleep patterns and discussing it with your doctor.
I believe your doctor will provide some medication treatment options based on your situation.
4.
Appropriate medication treatment can also help with your anxiety and insomnia.
Many people feel worried and fearful about medication treatment, fearing they will become dependent on it.
However, as long as you use the medication correctly according to your doctor's instructions, it should not lead to dependency.
I hope these suggestions are helpful to you.
Thank you for your email.

Reply Date: 2002/05/30

More Info

It sounds like you are experiencing a significant amount of anxiety that is affecting your sleep quality and overall well-being. Anxiety disorders are quite common and can manifest in various ways, including physical symptoms like chest tightness, rapid heartbeat, and difficulty breathing, especially in stressful situations. The fact that you have been diagnosed with anxiety disorder by a psychiatrist indicates that your symptoms are recognized as part of a broader mental health issue.

Understanding Anxiety and Its Effects on Sleep
Anxiety can significantly disrupt sleep patterns. When you are anxious, your body is in a heightened state of alertness, which can make it difficult to relax and fall asleep. This hyperarousal can lead to racing thoughts, restlessness, and an inability to quiet your mind, which you described as thinking about your day or worrying about upcoming events. This cycle can create a vicious loop: anxiety leads to poor sleep, and poor sleep can exacerbate anxiety, leading to further sleep disturbances.

Common Symptoms of Anxiety
You mentioned feeling tightness in your chest and difficulty breathing, which are common physical symptoms of anxiety. Other symptoms can include:
- Increased heart rate: This can happen during moments of stress or anticipation, such as when you are called upon to answer questions in class.

- Sleep disturbances: Difficulty falling asleep, waking up frequently during the night, or experiencing restless sleep.

- Physical tension: This can manifest as tightness in the neck, shoulders, or chest, which you have noted.

- Gastrointestinal issues: Anxiety can also affect your digestive system, leading to symptoms like stomach discomfort or changes in bowel habits.

Strategies for Managing Anxiety and Improving Sleep
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety and insomnia. CBT helps you identify and change negative thought patterns and behaviors that contribute to anxiety and sleep problems.

2. Relaxation Techniques: Practices such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation can help calm your mind and body before bed.

3. Sleep Hygiene: Establish a regular sleep schedule by going to bed and waking up at the same time every day. Create a restful environment by keeping your bedroom dark, quiet, and cool. Avoid screens (phones, computers, TVs) at least an hour before bedtime, as the blue light emitted can interfere with your ability to fall asleep.

4. Limit Stimulants: Reduce or eliminate caffeine and nicotine, especially in the hours leading up to bedtime. These substances can increase anxiety and disrupt sleep.

5. Physical Activity: Regular exercise can help reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week, but try to avoid vigorous workouts close to bedtime.

6. Medication: Since you have been prescribed medication for your anxiety, it’s essential to follow your doctor's guidance regarding its use. If you feel that your current medication is not adequately addressing your symptoms, discuss this with your psychiatrist. They may adjust your dosage or suggest alternative medications.

7. Dietary Considerations: Pay attention to your diet. Eating a balanced diet can help stabilize your mood and energy levels. If you are experiencing gastrointestinal symptoms, it may be worth discussing this with your healthcare provider to rule out any underlying conditions.

When to Seek Further Help
If your symptoms persist or worsen, or if you find that your anxiety is significantly impacting your daily life, it may be beneficial to seek further evaluation from a mental health professional. They can provide tailored strategies and support to help you manage your anxiety and improve your sleep.

In summary, anxiety can have profound effects on sleep and overall health. By implementing strategies to manage your anxiety and improve your sleep hygiene, you can work towards better sleep and a more balanced emotional state. Remember, you are not alone in this, and seeking help is a positive step towards feeling better.

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