How to Fall Asleep When You're Stressed

Here's what to do when you have anxiety-induced insomnia.

Anxiety can have a serious impact on sleep. Who hasn't tossed around at night with worries racing through their brain?

If you are preoccupied and restless, you need a new strategy when you hit the sack, said Nancy Foldvary-Schaefer, DO, director of the Sleep Disorders Center at Cleveland Clinic. "Acute insomnia is super common and can be the result of any life stressor."

How do you deal? Here's a nighttime slowdown plan.

Identify Your Stress Trigger

If you can figure out the source of your worries, do it well before bedtime, said Dr. Foldvary-Schaefer. "You want to work on it early, away from the bedroom. Ruminate, think through the stressor. A lot of my patients keep a 'worry journal' to write out their feelings. This helps put away your anxiety before bed." If you can quiet your mind before you lie down, you're less likely to toss and turn. "The habit of ruminating in bed can turn acute insomnia into chronic insomnia," she said.

Modify Your Bedroom Atmosphere

Especially when you're struggling to sleep, you want the perfect environmental conditions to get a good rest. Make sure the temperature is just right—it's not too hot, not too cold, and you have a comfortable mattress and pillow. If you're dealing with anything that could be disrupting your sleep, "like a spouse who snores or a pet that likes to climb into bed," you'll need to make adjustments, said Dr. Foldvary-Schaefer. Even if minor distractions weren't bugging you before, they may be keeping you awake now, so invest in earplugs or buy Spot his own bed.

Cut Out Caffeine and Alcohol

Some people are more sensitive to jolts of caffeine than others, so watch how much you're consuming and when. Our bodies quickly absorb this natural stimulant, which blocks a sleep-promoting chemical in our brain, adenosine, according to the Sleep Foundation. Your body makes adenosine throughout the day, making you progressively more tired. When it is blocked, you remain alert.

"Coffee is the most potent and most consumed caffeinated beverage," according to the Sleep Foundation, but many other foods and drinks contain the stimulant too, including chocolate, green and black teas, cocoa beans, some pain relievers, energy drinks, and soda.

So you might need to put a freeze on coffee at 2 p.m.—or even earlier if you're still struggling to sleep after making adjustments. Dr. Foldvary-Schaefer said to also check hidden sources of caffeine and stop consuming those at 2 p.m. as well.

Alcohol is another chemical that disturbs sleep patterns. In a 2018 study published in Psychology, alcohol was shown to disrupt "sleep through multiple mechanisms, such as disrupting electrophysiologic sleep architecture, triggering insomnia, and contributing to abnormalities of circadian rhythms and short sleep duration (SSD)."

"It's deceiving," said Dr. Foldvary-Schaefer. "A lot of people feel it's helping them to fall asleep, and while it can cause sleep onset, research also shows alcohol fragments sleep." This is especially true for women.

If You Wake Up at Night, Don't Stay in Bed Too Long

In addition to making it hard to fall asleep, stress may cause you to wake up in the middle of the night. Avoid lying in bed for more than 20 minutes trying to drift off; this may cause you to ruminate on your worries or simply stress over your sleep issues, said Dr. Foldvary-Schaefer.

She suggested getting up and doing something boring. Don't turn on the TV, which can be stimulating. Don't read a book that will be a page-turner. Maybe read a slow section of the newspaper or iron some clothes. When you start to feel sleepy again, go back to bed. Whatever you do, said Dr. Foldvary-Schaefer, just do not watch the clock. "This is what you learn in cognitive behavioral therapy for insomnia: Create productive habits, set the right expectations, clear your mind, and relax."

If Your Insomnia Keeps Up, See Your Healthcare Provider

Sleep disruptions contribute to a variety of medical problems, including cognitive impairment, reduced immune function, metabolic imbalance, and exacerbation of psychiatric conditions, according to a 2019 study published in the American Journal of Lifestyle Medicine.

Check with a healthcare provider if you're having trouble sleeping at night, you've tried self-management strategies, and you just can't catch enough z's. "Some people wait too long," said Dr. Foldvary-Schaefer. "I've had some patients come in after 20 years of insomnia. A clinically significant problem exists if insomnia lasts more than three months, so call your primary care provider (PCP) if you can't sleep after that time."

Many PCPs have sound strategies for dealing with insomnia. Some may refer you to a sleep disorders specialist or cognitive behavioral therapist.

While people may want a quick-fix sleeping pill, behavioral adjustments should be made first. "Some people want a way out of doing the work when they haven't done any of the basics," said Dr. Foldvary-Schaefer.

In addition, the American Journal of Lifestyle Medicine article found that although sleep medication can be an effective short-term treatment for insomnia, it can cause side effects such as amnestic episodes, cognitive impairment, and morning hangover. Also, some patients continue to experience sleep disturbance even when they are taking these medications, leading to higher doses, which eventually cause dependence on and tolerance for the drugs.

To get your stress and sleep under control, try out a pre-bedtime game plan and a few changes best suited for you. It might be all it takes to cure your insomnia.

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