Sleep vs. Anxiety

Train your brain to fall asleep--even if you struggle with anxiety!

We've all been there; tossing and turning for hours, unable to escape into sleep due to stressful thoughts unceasingly filling our minds. We watch the time go by and wonder how we will meet the demands of the next day, making us even more stressed than we already were. It's no secret that having anxiety is related to sleep problems. Lack of sleep also happens to be one of the things that can make anxiety worse. You see how this becomes a vicious cycle (and if you're reading this, you have probably experienced it). 

So how does one get out of it? One popular method is unfortunately sleeping pills, but they are habit forming and don't even work for people sometimes. I am about to share with you some tried and true sleep tips that can truly help. However, these tips are not an instant fix. It takes consistent work, so don't be discouraged if you try something once and your sleep issues aren't magically fixed.

As a child, I went through a stage where I had vivid nightmares almost every night and began to dread bed time. I also had a hard time 'shutting my mind down,' and therefore, I ended up with a racing mind that would take forever to drift into sleep. Adding to these sleep issues, I never really had a consistent bedtime routine or even an expected bed time growing up.

Spoiler alert: I was able to make habits and learn skills to put myself to sleep. Now I can basically fall asleep anywhere and any time! I can fall asleep in a noisy airport sitting upright on a hard chair, I can fall asleep on a bus full of people, I can fall asleep with an energetic toddler jumping all over me, and the list goes on. Occasionally, if something is stressing me out a lot, I will still have a hard time, but it doesn't happen nearly as much as it used to. Even when those times come up, I now have the tools to handle it.

With the following steps, I will share what helped me learn how to fall asleep despite anxiety as well as add on tips I have learned as a therapist.

1. Create a relaxing bedtime routine that works for you

One thing I did specifically to help with my nightmares was to read something comforting before bed. This put me in the habit of reading before bed every night, and I still do it now. I want to emphasize that any reading will not work, it needs to be something comfortable or relaxing. So avoid the news, scary novels, or anything stressful or fear-provoking.

Start your bedtime routine early! This isn't an easy habit to get into, I'm not going to lie. I suggest you plan what you want your routine to be, make an accurate estimation as to how long it will take, and then start a minimum of one hour before you would like to be asleep. If you currently take a very long time to sleep, try starting your routine earlier than an hour before your desired sleep time.

Example:

Goal sleep time 10:30
Routine:
9:15 change into comfortable pajamas, brush and floss teeth, wash face, etc.
9:30 light stretching and relaxing
9:45 reading (not in bed though, keep bed for sleep or sex only)
10:15 lights off and in bed starting to fall asleep

Bonus points for low lighting and avoiding screens during this time because lights communicate to your brain that it's time to be awake.

Although life and work schedules aren't always predictable, try your best to be to bed about the same time each night. We really are creatures of habit, and you will have much better luck training your brain to fall asleep if you time things right. That being said, timing is tricky because if you try to go to sleep before you are tired, it will be hard to fall asleep. On the other hand, if you try too late you will have had your 'second-wind,' and your body will be trying keep itself awake. Ever noticed that you will start to get hungry if you stay up longer than usual? That is your body trying to get energy and saying, 'If you won't let me sleep, then feed me more! I need energy somehow!'

2. Decide on a mental script and practice falling asleep to it.

A mental script can be specific to you but the goal is to keep your mind focused on relaxing and eventually falling asleep. A popular one is paying attention to each section of your body from bottom to top or top to bottom, and focusing on relaxing that part. You can also imagine it being warm and heavy, 'my feet feel warm and heavy, my ankles feel warm and heavy, etc.' Focus on trying to feel that sensation, but also don't try too hard and get frustrated with yourself. Progressive relaxation is also a great technique that involves tensing a body part, and then exhaling while releasing the tension. That way, you can feel the drastic difference between tension and relaxation. There are many other relaxation exercises you can get ideas from. Try them out and discover which ones work best for you. (Headspace is a great meditation app I have used and recommend, Dr. Michael Olpin also has a great youtube channel with lots of relaxation exercise options like this one: https://www.youtube.com/watch?v=ZdkjP2n9G4E)

There are other options for mental scripts as well. Some people will play a favorite movie in their head, scene by scene. I had an apartment complex manager that would go through the names of each tenant to put herself to sleep (although I don't know how that one worked because to me that might be stressful and too job-related). If you have a big extended family, you could start from the oldest and name them off in order while imagining yourself telling them good night. You could even just practice deep breathing while envisioning colors and numbers. The point is you want your mind focused on something structured and simple to keep yourself from getting off track into anxious thoughts.

What if the anxious thoughts prevent you from sticking to your mental script? I get this question a lot! Of course it will be hard to get your thoughts to stick to something rather than the anxiety, but that doesn't mean you can't try. Gently bring yourself back where you left off when your mind wanders. Don't expect perfection. If you do, you will end up getting too frustrated with yourself to fall asleep. Keep trying. Tell yourself that you will be asleep before you finish your mental script and really try to believe it. This is where some placebo affect comes in, you have to convince yourself that you can put yourself to sleep. Once you can convince your body that, you will be asleep before you know it. If the anxious thoughts persist despite your efforts, refer to the next step.

3. Get your stressful thoughts out on paper

Sometimes thoughts are stubborn and won't get out of your mind no matter how hard you try to fall asleep. This is when you get out of bed and write your thoughts out. Sometimes they're not even stressful thoughts, just a lot of ideas that seem so important at the time you can't get them off your mind. Rather than going over them again and again in your mind and preventing yourself from sleeping, take the time to get them out on paper. That way you don't have to worry about remembering them, you can deal with those thoughts the next day and put them away for the night.

If you want to take your thought recording to the next level, take a page out of the CBT (Cognitive Behavioral Therapy) book and make a thought log. This is especially helpful when strong emotions are keeping you from sleeping. I will probably do a more detailed CBT post later, but a quick summary is to help yourself understand how events affect your thoughts which then affect your feelings. In the first column, write down the event that took place. Next, write down the automatic thought. So what is the knee-jerk reaction to this event? The automatic thought isn't necessarily something you specifically remember thinking, but it is a conclusion your mind made without you consciously choosing that. For example, 'I am a loser because my boss pointed out a mistake I made.' Many times, these automatic thoughts are all-or-nothing thinking and full of assumptions. The next column is to identify the emotion you felt, so in the above mentioned example one might write down they felt worthless or rejected. The last column is a balanced thought which may take some therapy to get the hang of, but it is basically putting that automatic thought on trial and making it more rational. With practice and actually writing it down, you can catch yourself in thinking errors and understand your emotions more fully, thereby helping you handle them better.

4. Get up and do something productive. 

This is a step for if all else fails, or for people in manic or hypomanic states. You will get tired eventually (except for the above mentioned people experiencing mania). With sleeping, the harder you try to do it, the less likely it is to happen. It is something you have to let happen on its own. So once you are past the point of trying, you may as well get up and get something done while you're not sleeping. Or start reading a boring book and you will suddenly realize how tired you really are. Often times, the stressful thoughts are related to things you feel you need to get done. One great stress-relieving technique for those times is to get those things done! Once you have some things off your to-do list, your mind may be at ease and ready to rest.

Happy sleeping everyone!

Share your tips or tricks for sleeping in the comments.

Do you have any weird places you have been able to fall asleep?

What are some of your favorite relaxation exercises?