Although occasional anxiety is part of everyday life for most Americans, 40 million adults are affected by an anxiety disorder. That said, 18 percent of the entire population in the United States lives with the nation’s most common mental illness: anxiety.

Anxiety and anxiety disorders occur and develop based on several factors:

  • Genetics
  • Personality
  • Brain chemistry
  • Life events

This mental illness is more than an anxious feeling before a life event, or a short-term worry or fear about an issue. Anxiety disorders can worsen as time goes on and the anxiety feelings don’t just fade away — they have a negative impact on day-to-day life.

The mental illness is known to cause a variety of symptoms, including but not limited to:

  • Restlessness
  • Feeling of being wound-up or on-edge
  • Getting tired easily
  • Difficulty focusing or concentrating
  • Irritable mood
  • Difficulty controlling worries
  • Problems with sleeping
  • Intense fear
  • Panic attacks
  • Sweating
  • Blushing
  • Trembling
  • Nausea
  • Difficulty with relationships
  • Excessive worry and fear

Sleep problems are a common symptom of anxiety and are closely associated with mental illness and anxiety disorders. It is important to understand the relationship between anxiety and sleep, especially when trying to combat this mental illness.

This guide will address each anxiety disorder, how it affects sleep and contributes to sleep loss, and how sleep plays an important role in treatment for anxiety.

Anxiety and lack of sleep

Anxiety and stress are known to cause sleeping issues and lack of sleep, which is a common symptom for those with anxiety. Lack of sleep actually helps activate the part of the brain that furthers worry and continuous worrying.

Scientists have found that areas of the brain — the amygdala and insular cortex — that are responsible for processing emotions become more active when sleep deprivation occurs.

Also, people who are chronic worriers and tend to be more naturally anxious are more prone to develop an anxiety disorder. They also suffer the most from sleep deprivation.

Psychologists have seen good results from using sleep therapy for mental illnesses, and believe that sleep disruption is a treatable factor for anxiety disorders, too.

Researchers and scientists haven’t confirmed that sleep loss is a byproduct of anxiety or that sleep disruption causes anxiety. However, the findings show how important sleep really is for mental health.

Sleep and anxiety are so closely related that a common question is “which comes first?” The Anxiety and Depression Association of America says that either one can come first.

Sleep deprivation can cause anxiety and anxiety can cause sleeping problems. The sleeping issues can lead to other health risks like heart issues, high blood pressure, diabetes, obesity, and stroke.

How different anxiety disorders affect sleep

Anxiety is further categorized into a variety of different disorders. Each disorder has its own characteristics and way of impacting sleep.

We will address symptoms, treatment, and resources for the following disorders:

  • Generalized anxiety disorder
  • Social anxiety
  • Phobia anxiety
  • Obsessive-compulsive disorder
  • Panic disorders
  • Post-traumatic stress disorder

Although these anxiety disorders and symptoms are treatable, the ADAA reports that only one-third of the people suffering from anxiety actually get treatment.

Generalized anxiety disorder

What is generalized anxiety disorder and how does it affect sleep?

Generalized anxiety disorder (GAD) is when a person has constant, excessive, and persistent worries about day-to-day things that occur. The disorder is accompanied by a feeling that the worst will happen even if there is no reason for worry.

People with GAD expect disaster and have frequent anxiety about work, money, health, family, and many other problems. A diagnosis is given if a person can’t get a handle on their worry on most days within a six month period and has three or more symptoms.

GAD, which is more commonly starts during childhood and middle age, is a disorder for 3.1 percent of adults in the United States. Women are twice as likely to experience the disorder.

Symptoms for generalized anxiety disorder include but are not limited to:

  • Restlessness
  • Getting tired easily
  • Difficulty concentrating
  • Mind goes blank
  • Muscle tension
  • Irritable mood
  • Issues falling asleep and staying asleep
  • Restless, unsatisfying sleep

Stress and anxiety associated with GAD can cause people to lose sleep and suffer from insomnia. Insomnia is characterized by difficulty falling asleep or staying asleep, early wake-ups, and a feeling of being unrefreshed when waking up.

Other sleep disorders associated with GAD could be:

To learn more about see our guide to Sleep Disorders, and to learn more about narcolepsy, see our Guide to Narcolepsy.

Benefits of sleep for treating symptoms

Getting good sleep can help reduce anxiety and stress, which can help decrease symptoms associated with GAD.

Healthy sleep can also help with many of the symptoms associated with GAD, including mood, memory, the ability to focus or concentrate, and with learning and retaining information.

To encourage healthy sleep habits, people with GAD can consider:

  • Lifestyle changes: quitting smoking or alcohol
  • Exercise: regular activity helps people sleep deeper and fall asleep faster
  • Sleep environment and schedule: regular sleep/wake hours set and a room that has no distractions and is dark and quiet
  • Relaxing activities: breathing, imagery, and meditation
  • Behavior therapy: to help change negative thoughts associated with sleeping

Treatment for symptoms and associated sleep issues

There are several ways to treat for generalized anxiety disorder and its symptoms— with medications, therapy, and alternative medicines. These treatments can be used together or separately, and a treatment plan and its success is specific to each person.

Note: people should consult a doctor before any treatment and some drugs mentioned may be habit forming.

Here are some examples of medications and how they help with sleep and other common symptoms:

Medications and drugs

Antidepressant serotonin reuptake inhibitor (SSRI) and Antidepressant serotonin norepinephrine reuptake inhibitor (SNRI) medications help improve both sleep and mood by allowing for more serotonin (and norepinephrine for SNRI drugs) in the brain.

Examples are:

  • Escitalopram (Lexapro)
  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor XR)
  • Paroxetine (Paxil, Pexeva)

Buspirone

Buspirone is used to help induce sleep and treat symptoms like fear, mood, dizziness, and other physical symptoms associated with anxiety. It may also help with more clear thinking and relaxation.

Sedatives and benzodiazepines

Benzodiazepines are used to help treat anxiety symptoms and can help with sleep and insomnia — and help people fall asleep and stay asleep. These medications are short-term anxiety treatments, and also help with relaxation, muscle tension, and physical symptoms of anxiety.

Examples are:

  • Alprazolam (Niravam, Xanax)
  • Chlordiazepoxide (Librium)
  • Diazepam (Valium)
  • Lorazepam (Ativan)

Therapy and alternative medicines

Treatments for generalized anxiety disorder can also include alternatives to drugs, like supplements, lifestyle changes, and daily activities. People with anxiety can include these alternatives into a daily routine in addition to any medications.

Here are some examples of alternative treatments and lifestyle activities and how they help with sleep and common GAD symptoms:

  • Meditation

Regular meditation can help people have less insomnia, depression, and fatigue through a mind-calming exercise that encourages people to focus on the present moment.

  • Psychotherapy

Talk therapy and counseling are helpful and effective for GAD. The focus is on teaching people specific skills to reduce anxiety symptoms and to learn how to use skills to regain a regular lifestyle.

  • Herbal remedies such as Melatonin, Kava, Valerian, Passionflower, Theanine, and St. John’s Wort

These supplements may help improve the quality of sleep, increase feelings of sleepiness and relaxation, and shorten the time it takes to fall asleep.

  • Acupuncture

Acupuncture has been known to help with anxiety and sleep problems, especially insomnia. The treatment works to increase serotonin in the brain to help promote sleep and relaxation.

  • Regular exercise and Yoga

These exercise routines are known for helping to increase the length of sleep, decrease the time it takes to fall asleep, improve mood, and decrease stress.

  • A healthy sleep routine and environment

Creating an environment where sleep is a priority and sticking to a sleep routine can help improve sleep and decrease anxiety.

  • Eating healthy foods and avoiding alcohol, nicotine, caffeine, and other drug substances

Eating a diet of healthy food may help with anxiety, sleep, and mood. Alcohol, nicotine, caffeine, and other drugs can make anxiety worse and interfere with sleep patterns, so avoiding them will help promote healthier sleep.

Online resources for more information on generalized anxiety disorder

Learn from these online resources about living with generalized anxiety disorder, as well as treatment, drugs, tips, and finding help and support groups.

  1. Read about treatments for generalized anxiety disorder from the National Institute of Mental Health.
  1. Find professional help for generalized anxiety disorder through the Anxiety and Depression Association of America. Plus, consider the ADAA’s therapist search tool.
  1. Read this article by Psychiatric Times on “Treatment of Insomnia in Anxiety Disorders.”
  1. Study this Anxiety and Depression Association of America’s page on understanding generalized anxiety disorder and sleep disorders and tips on reducing anxiety for sound sleep.
  1. Learn more about living with generalized anxiety disorder on the Mayo Clinic’s website.
  1. Consider these tips to manage anxiety and stress to get better sleep from the Anxiety and Depression Association of America.
  1. Find a local support group through the ADAA’s website.
  1. Consider these tips on finding support from The National Alliance on Mental Illness and learn about the National Support Group.
  1. Consider the American Sleep Association’s online forum for sleep issues related to insomnia.

Social anxiety

What is social anxiety and how does it affect sleep?

Social anxiety, the extreme fear of social situations and being judged by others in social settings, is an anxiety disorder that affects about 15 million Americans.

The disorder may begin around age 13 or in the early teens, and 36 percent of people may have symptoms for 10 years before they seek treatment or help.

People with social anxiety usually know that the fears are out of control, but they feel powerless and are afraid of embarrassing themselves in social situations. This fear inhibits people from having relationships and makes it difficult to perform in jobs, school, and daily routine tasks.

Some symptoms include:

  • Fear of being judged
  • Fear that you will humiliate yourself
  • Worry that you’ll offend another person
  • Intense worry that you’ll have to talk to new people or strangers
  • Physical symptoms like sweating, blushing, shaky voice, trembling, and upset stomach
  • Avoiding speaking to people or doing things
  • Lack of sleep or sleep deprivation before social events
  • Having the worst expectations for a social situation

There is a close connection between social anxiety and sleep. The disorder itself can cause a lack of sleep due to excessive worry and anxiety, and lack of sleep makes the symptoms of social anxiety even worse.

Benefits of sleep for treating symptoms

Stress, worry, and anxiety are all symptoms of social anxiety disorder that can impact sleep. These fears make falling asleep and staying asleep difficult, and a lack of sleep or sleep deprivation can cause people to have trouble concentrating and handling emotions.

Lack of sleep for people with social anxiety can prevent them from the benefits of healthy sleep like immune system repair, physical relaxation, and the enhancement of memory and learning. The benefits of getting a good night’s sleep are both physical and mental.

Treatment for symptoms and associated sleep issues

Treatment for social anxiety disorder includes both psychotherapy and medication. A combination of both treatments can be used, and when the social anxiety is limited to one situation, therapy may be the only necessary treatment. Alternative medicines can also be used to help treat social anxiety.

A treatment plan is based on each individual and his or her symptoms and ability to live day-to-day through different activities.

Note: people should consult a doctor before any treatment and some drugs mentioned may be habit forming.

Here are some examples of medications and how they help with sleep and other common symptoms:

Medications and drugs

There are several kinds of antidepressants used for social anxiety. Both medications can help improve both sleep and mood by allowing for more serotonin (and norepinephrine) in the brain.

The first type of medications used for social anxiety are Antidepressant serotonin reuptake inhibitors (SSRI). Medication examples include:

  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

The second kind of medications are serotonin norepinephrine reuptake inhibitor (SNRI). A medication example is Venlafaxine (Effexor XR).

Benzodiazepines

Benzodiazepines are used for symptoms of social anxiety and are known for helping with sleep and insomnia. They can help people fall asleep and stay asleep while reducing anxiety. These medications are short-term anxiety treatments, and should be taken before a person is in a social situation to know how they will affect them.

These drugs also also help with relaxation, muscle tension, and the physical symptoms of anxiety.

Examples are:

  • Alprazolam (Niravam, Xanax)
  • Chlordiazepoxide (Librium)
  • Diazepam (Valium)
  • Lorazepam (Ativan)

Beta blockers

Beta blockers are medications that block the effects of epinephrine or adrenaline, which are both stimulating brain chemicals. These drugs encourage a more sleepy feeling, relaxation, and can help reduce the physical symptoms that accompany social anxiety, like elevated heart rate, blood pressure, and trembling.

Therapy and alternative medicines

Alternative treatments besides medications include herbal remedies and lifestyle changes and activities. These alternative methods can be used along with traditional medication treatments for social anxiety:

  • Meditation

Mind-calming exercises that encourages people to focus on the present moment can help people with social anxiety have less insomnia, depression, and fatigue. Meditation can also help promote more relaxing and healthy sleep.

  • Psychotherapy, talk therapy, counseling, and cognitive-behavioral therapy

Counseling helps to uncover the anxiety and which situations cause it to happen. Methods of cognitive-behavioral therapy include exposure therapy, social skills training, symptom management skills, group or family therapy, and cognitive restructuring. Therapy can help with teaching skills to help with daily routines and lifestyle changes to promote healthy sleep.

  • Eating healthy foods and avoiding alcohol, nicotine, caffeine, and other drug substances

Eating a diet of healthy food may help with anxiety, sleep, and mood. Avoiding substances like alcohol, nicotine, and caffeine will help promote healthier sleep, because these substances can all worsen anxiety, symptoms, and interfere with sleep patterns.

  • Herbal remedies such as Melatonin, Kava, Valerian, Passionflower, Theanine, and St. John’s Wort

These supplements may help improve the quality of sleep, increase feelings of sleepiness and relaxation, and shorten the time it takes to fall asleep.

  • Acupuncture

Acupuncture has been known to help with anxiety, sleep issues, and insomnia. Acupuncture treatment can target points to help increase serotonin in the brain, which promotes relaxation and sleep.

  • Regular exercise and yoga

Regular and consistent exercise is helpful for increasing the length of sleep, decrease the time it takes to fall asleep, improve mood, and decrease stress.

  • Joining a support group

A support group can be beneficial for people with social anxiety so they know they are not alone and can talk to others who have similar symptoms and daily challenges.

  • Getting enough sleep and creating a healthy sleep routine and environment

Sleep is essential for the mind and body, and to help decrease anxiety. Creating an environment for good sleep where sleep is a priority and sticking to a routine can help improve sleep which elevates mood and concentration.

Online resources for more information on social anxiety

Learn more from these online resources about living with social anxiety, treatment, drugs, tips, and finding help and support groups.

  1. Read more about social anxiety disorder through the Anxiety and Depression Association of America and the difference between social anxiety and shyness.
  1. Learn more about treatment options for social anxiety from WebMD.
  1. Here are a few ways to find help from the Anxiety and Depression Association of America.
  1. Learn tips for social anxiety coping strategies from this Psychology Today article.
  1. Read more about how anxiety disorders can affect sleep and how sleep can affect anxiety disorders from ADAA.
  1. Consider learning about causes and risk factors for social anxiety from the Mayo Clinic.
  1. Know how to prepare for your doctor appointment and consider questions your healthcare provider may ask if you have social anxiety.
  1. Consider Social Anxiety Support to find groups and join the community and forums.
  1. Search for a local group through Social Anxiety Support.
  1. Learn more about ADAA’s resources, support group options, and phone and online resources.

Phobia anxiety

What is phobia anxiety and how does it affect sleep?

People who have specific phobias of things, creatures, places, or situations that cause extreme fear and anxiety suffer from phobia anxiety. Examples of phobias include, but are not limited to:

  • New places
  • Elevators
  • Bridges
  • Spiders
  • Sleep
  • Animals
  • Germs
  • Driving
  • Flying
  • Medical procedures

People who have phobia anxiety feel that they don’t have any power to stop the anxiety or fear. About five to 12 percent of Americans have phobias — and that’s about 6.3 million adults in the United States.

Phobia anxiety usually starts in the adolescent years (average age-of-onset is 7), and can affect people at all ages.

When people who have a phobia are faced with the specific thing that causes them fear and anxiety, they may experience many of the following symptoms:

  • A feeling of needing to escape
  • A feeling of danger or doom
  • Avoiding a situation or object because of fear
  • Accelerated heart beat
  • Sweating
  • Fear of dying
  • Feeling lightheaded
  • Trembling
  • Losing control
  • Tingling
  • Nausea
  • Heat flashes
  • Chills
  • Choking
  • Chest pain
  • Trouble breathing
  • Anticipated anxiety before a situation
  • Trouble sleeping

The stress, anxiety, and worry caused by phobia anxiety can prevent people with phobias from sleeping well and performing well on a day-to-day basis. Constant anxiety can also cause nightmares, which lead to sleep disruptions and sleep deprivation.

Benefits of sleep for treating symptoms

Sleep problems are common for people with phobia anxiety disorder, too. A lack of sleep can be attributed to the anxiety disorder, which causes people with phobia anxiety to miss out on the benefits of restful and healthy sleep.

Physical and emotional benefits of a good night’s sleep for people with phobia anxiety include, but are not limited to:

  • Muscle relaxation
  • Slower heart rate and breathing
  • Body temperature cooling
  • Boost immune system
  • Enhancement of learning and memory
  • Better emotional processing and health

These sleep benefits are essential for both mind and body health and can help people with phobia anxiety with overall health, concentration, focus, and mood.

Treatment for symptoms and associated sleep problems

There are several ways to treat phobia anxiety, and those include medications, and therapy and alternative medicines. Treatments can be used together or separately, and a treatment plan and its success is specific to each person.

Note: people should consult a doctor before any treatment and some drugs mentioned may be habit forming.

Medications and drugs

The two main kinds of drugs used to treat phobia anxiety are beta blockers and benzodiazepines or sedatives.

Beta blockers

These drugs block adrenaline, which stimulates the body and causes elevated blood pressure, trembling, shaky voice, and increased heart rate. Beta blockers help people with phobia anxiety feel more sleepy, relaxed, and help with the physical symptoms, too.

Sedatives or benzodiazepines

Drugs like Xanax, Valium, and Ativan are considered to be benzodiazepines or sedatives that are helpful for people with sleep trouble and insomnia. They help people reduce anxiety for people with phobia, and result in better sleep. The drugs can help people fall asleep and stay asleep.

These drugs are used for short-term anxiety treatments, and should be used with caution as they can be addictive (especially for those with substance or alcohol issues.)

Therapy and alternative medicines

Psychotherapy and alternative medicines can be used in conjunction with drugs for phobia anxiety. The most successful way to treat phobia anxiety is actually with psychotherapy. Here are some examples of therapy and alternative medicines for phobia anxiety:

  • Psychotherapy

Two kinds of therapies are used for phobia anxiety:

  • Exposure therapy focused on helping a person change a response to the fear caused by something or a situation. It’s a gradual process with repeated exposure that can help people manage the anxiety.
  • Cognitive behavioral therapy uses several techniques that teach skills for coping and redefining the fears and symptoms and the impact they have on the individual.

Psychotherapy help people with phobia anxiety learn skills to help with day-to-day life and routines and managing anxiety, plus lifestyle changes to create a healthy sleep environment.

  • Yoga

The combination of physical movement, breathing, and meditation can be beneficial for helping reduce heart rate and blood pressure, and even anxiety. Some tests have found that yoga may help improve these areas of sleep: sleep efficiency, total sleep time, total wake time, the amount of time it takes to fall asleep, and wake time after sleep starts.

  • Acupuncture

This ancient Chinese method has been successful in helping people with both anxiety and sleep issues, like insomnia. Treatment focuses on targeting points to help increase serotonin in the brain, which promotes relaxation and sleep.

  • Meditation and relaxation techniques

Meditation and deep breathing are mind and body calming methods that can help reduce anxiety and promote sleep. By making the mind focus on the current moment, it brings relaxation to the mind and body. The same method can be used at night before sleep or when people have trouble falling asleep.

  • Herbal remedies such as Melatonin, Kava, Valerian, Passionflower, Theanine, and St. John’s Wort

Herbal supplements can help improve sleep and reduce the amount of time it takes to fall asleep. They also help to naturally increase feelings of sleepiness and relaxation.

  • Eating healthy foods and avoiding caffeine, alcohol, and nicotine

Eating a diet of healthy food may help with anxiety, sleep, and mood. Caffeine, alcohol, and nicotine are substances that can worsen anxiety and interfere with sleep patterns.

  • Joining a support group

A support group can be beneficial for people with phobia anxiety because they are paired with others with similar issues who understand how difficult the anxiety is for day-to-day life.

  • Getting enough sleep and creating a healthy sleep routine and environment

Creating an environment free of distraction and potential phobias is key. Sleep should be treated as a priority and creating a good sleep routine can help improve sleep.

Online resources for more information on phobia anxiety

Here are some online resources that will help you learn about specific phobia anxiety, treatment, what it’s like living with the disorder, tips, and support group information.

  1. Read more from the Mayo Clinic about drugs and treatment for phobia anxiety.
  1. Download a PDF from the American Psychological Association about understanding anxiety disorders and effective treatment.
  1. Learn the difference between everyday anxiety and phobias from the Anxiety and Depression Association of America.
  1. Read tips for managing anxiety and stress from the Anxiety and Depression Association of America.
  1. Consider WebMD’s article about living with and dealing with phobias and anxiety.
  1. Learn more about the phobia of going to sleep.
  1. Research support groups through the Anxiety and Depression Association of America.
  1. Consider the benefits of support group therapy for anxiety.
  1. Consider a phobia support website and online forums.

Obsessive-compulsive disorder

What is obsessive compulsive disorder and how does it affect sleep?

People who have obsessive-compulsive disorder (OCD) have uncontrollable thoughts and behaviors that causes a cycle that makes them feel they must repeat something over and over again. This is a long-lasting mental health disorder and is quite common.

The disorder can affect anyone — no matter the age, sex, background, race, or ethnicity. Most adults know that the fears are out of control, but they don’t have the power to stop them.

Symptoms are different for each person, and examples of the thoughts or obsessions (unwanted thoughts) are:

  • Bodily fluids, diseases, and germs
  • Chemicals and environmental contaminants
  • Fear of harming oneself or others
  • Fear of stealing
  • Fear of violent images
  • Feeling responsible for something awful happening
  • Fear of not being careful enough and hurting someone
  • Fear of losing things or forgetting important information
  • Concern about exactness, perfectionism
  • Difficulty deciding to keep or throw something out
  • Obsessions about sexuality
  • Fear of unwanted sexual thoughts or images and thoughts about others
  • Concern with right/wrong and morality
  • Fear of getting an illness
  • Superstitious about numbers, colors, and objects

Examples of compulsions (ritualistic behaviors) are:

  • Excessive washing and cleaning of self and house
  • Avoiding things that have contact with contaminants
  • Excessive checking that you didn’t harm self or others
  • Checking that you didn’t make a mistake
  • Checking body parts and physical condition
  • Repeating activities or body movements
  • Rereading and rewriting
  • Counting to end on a safe number
  • Cancelling or undoing and replacing words to cancel the other word out
  • Rearranging things
  • Review of events to prevent harm and praying to prevent harm
  • Avoiding situations that trigger obsessions

Sleep can be disrupted by OCD, when a person is not able to sleep because of the obsessive thoughts and behaviors that can actually make the person leave the sleeping environment to check or repeat something. The disorder makes it difficult for people to fall asleep and stay asleep.

Benefits of sleep for treating symptoms

Insomnia can worsen the symptoms of OCD and other anxiety disorders. Good sleep can help reduce anxiety and allow for clearer thinking, concentration, focus, and an improved mood.

Healthy sleep can also help with processing emotions, judgement, memory, and overall health. Chronic sleep deprivation can lead to health issues such as obesity and high blood pressure, to name a few.

Treatment for symptoms and associated sleep issues

Treatment for symptoms of OCD are antidepressant medications, psychotherapy, and alternative medicines. Medications or drugs and therapy and alternative medicines can be used together or separately, and a treatment plan and its success is specific to each person.

Note: people should consult a doctor before any treatment and some drugs mentioned may be habit forming.

Medications and drugs

Medications include antidepressants that can help control obsessions and compulsions of OCD, and other symptoms like disturbed sleep, by helping improve sleep and mood.

Some medication examples include:

  • Clomipramine (Anafranil)
  • Fluoxetine (Prozac)
  • Fluvoxamine
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)

Therapy and alternative medicines

Counseling and therapy and alternative medicines can be effective for people with OCD, too. Here are some examples of alternative medicines and kinds of therapy used:

  • Psychotherapy

Cognitive behavioral therapy is used commonly, especially for children, and as the initial treatment for OCD. It can be combined with a drug treatment. Exposure and response prevention is also used. It focuses on exposing a person to the thing they fear gradually, and teaching skills to cope with the fear and anxiety.

  • Eating healthy foods and avoiding substances and smoking

A healthy diet may help with anxiety, sleep, and mood. Alcohol, caffeine, nicotine, and drugs can make anxiety issues worse and interfere with sleeping patterns.

  • Yoga and regular exercise

Yoga promotes mindfulness and relaxation, which are techniques that can help with sleep. Exercise is helpful for increasing the length of sleep, decreasing the time it takes to fall asleep, improving mood, and decreasing stress.

  • Acupuncture

Acupuncture has been known to help with anxiety, as well as sleep issues like insomnia. Acupuncture treatment can target points to help increase serotonin in the brain, which promotes relaxation and sleep. Plus, the treatment removes blocks that cause obsessive thoughts by targeting the liver, stomach, and spleen.

  • Joining a support group

Support groups for individuals with OCD can be beneficial because individuals can find a sense of community and be more connected with people who understand the disorder and its effects on daily life.

  • Creating a healthy sleep place

Healthy sleep starts with the sleep environment, which should be free of distractions and items that would interfere with sleep.

  • Herbal remedies such as Melatonin, Kava, Valerian, Passionflower, Theanine, and St. John’s Wort

These supplements may help improve the quality of sleep, increase feelings of sleepiness and relaxation, and shorten the time it takes to fall asleep.

Online resources for more information about OCD

Consider these online resources for more information about OCD, living with the disorder, tips, support groups, and more.

  1. Learn how OCD is treated through the International OCD Foundation.
  1. Read about the different medications for OCD, how they work, and side effects.
  1. Consider reading an article about one woman’s story about living with OCD on the Anxiety and Depression Association of America website.
  1. Learn about How to Beat OCD Without Drugs from this Psychology Today article.
  1. Learn more about how sleep is affected by anxiety and how anxiety is affected by sleep and these tips on how to reduce anxiety and sleep soundly.
  1. Read 25 Tips for Succeeding in Your OCD Treatment from the International OCD Foundation.
  1. Consider an OCD support group and search for one on the International OCD Foundation website.
  1. Learn about online and phone support groups for OCD through the International OCD Foundation.
  1. Learn about finding help, support groups, and more resources from the Anxiety and Depression Association of America.

Panic disorders

What is panic disorder and how does it affect sleep?

When a person experiences a spontaneous panic attack and has excessive worry about a recurring panic attack, he or she is diagnosed with panic disorder. Each year, about 6 million American adults experience panic disorder.

Although many people who have panic disorder are afraid or embarrassed to tell anyone about it, the disorder is highly treatable. Panic disorder usually starts in early adulthood, and women are more likely than men to experience panic disorder.

Panic disorder can strike at anytime and anywhere (and majority of people suffer from nocturnal panic attacks). The disorder can coincide with other mental and anxiety disorders like OCD, PTSD, and phobia anxiety, among others. If the fear becomes too big and intense, people with panic disorder can also suffer from agoraphobia — and are afraid to even leave the house.

Symptoms vary from person to person, but may include and are not limited to:

  • Accelerated heart rate, palpitations, or pounding heart
  • Shaking and trembling
  • Sweating
  • Trouble breathing, shortness of breath
  • Feeling like you’re being smothered or choking
  • Chest discomfort
  • Nausea
  • Feeling faint or dizzy
  • Cold or hot sensation
  • Numbness and tingling
  • Fear of going crazy or dying
  • Sleep issues
  • Feelings of being detached from reality or oneself

Disrupted sleep and insomnia are common for people with panic disorder. Nocturnal panic attacks and ongoing sleep deprivation can increase anxiety and anxious feelings about falling asleep. These sleep issues may also impact the ability to concentrate or focus the following day.

Benefits of sleep for treating symptoms

Panic disorder and its symptoms can disrupt sleep and cause restless sleep or insomnia, which prevents people from getting the benefits of good sleep.

A good night’s sleep can help with:

  • Promoting emotional regulation and mood
  • Body relaxation and rejuvenation and body functions
  • Memory and learning
  • Reducing anxiety and stress
  • Mind focus and concentration

Sleep may help reduce the level of anxiety and symptoms for people with panic disorder, while helping to promote more positive thinking.

Treatment for symptoms and associated sleep issues

Panic disorder can be treated with medication, psychotherapy, and alternative medicines.

Treatment is different for each person, and methods are used to prevent panic attacks, help with symptoms from attacks, and to help relax the mind and body to reduce anxiety.

Note: people should consult a doctor before any treatment and some drugs mentioned may be habit forming.

Medications and drugs

Several kinds of medications and drugs can be used to treat for panic disorders, including benzodiazepines and antidepressants.

Sedatives or benzodiazepines

Benzodiazepines are used to help treat panic attacks while they are happening. They also help with sleep and insomnia by promoting falling asleep faster and staying asleep.

They are short-term anxiety treatments, and also help with relaxation, muscle tension, and physical symptoms of anxiety.

Examples of benzodiazepines include:

  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Lorazepam (Ativan)

Antidepressants

Antidepressants used to treat panic disorder are either serotonin reuptake inhibitors (SSRI) or serotonin norepinephrine reuptake inhibitor (SNRI). They can help prevent and reduce the intensity and how often the attacks occur. Examples include:

  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Celexa
  • Lexapro
  • Sertraline (Zoloft)
  • Venlafaxine hydrochloride (Effexor XR)

Therapy and alternative medicines

Psychotherapy and other alternative medicines have been used to treat for panic disorder. Learn some of these methods and how they can help with symptoms and sleep problems:

  • Psychotherapy

Talk therapy is usually the first counseling method used for panic disorder. The goal for talk therapy is to learn skills to cope with panic attacks and to understand them. Cognitive behavioral therapy can also be used — and is focused on recreating the symptoms of an attack (in a safe place) repetitively until the physical symptoms don’t feel as threatening.

  • Relaxation techniques, meditation, and yoga

Stress management is really important for people with panic disorder. Learning how to quiet and calm the mind and body can help with symptoms and can be applied to a sleep routine. Meditation specifically may help people experience less insomnia, depression, and fatigue.

  • Acupuncture

Acupuncture can help with anxiety, anxiety symptoms, and sleep issues like insomnia. Treatment targets points to help increase serotonin in the brain, which promotes relaxation and sleep.

  • Support groups

A group of people who face the same issues can be helpful for those who suffer from panic disorder.

An oral supplement that may reduce the intensity of attacks by balancing certain chemicals in the body to help with panic disorder.

  • Being active physically with exercise

Aerobic activity can actually help calm the mood and reduce stress. Plus, regular and consistent exercise may help increase the length of sleep and decrease the time it takes to fall asleep.

  • Eating healthy foods and avoiding caffeine, smoking, alcohol, and drugs

Substances like caffeine, nicotine, alcohol, and other drugs can actually make anxiety worse and can trigger panic attacks.

  • Getting enough sleep

Sticking to a routine and creating a healthy sleep environment are key to getting the right amount of sleep.

Online resources for more information about panic disorder

Look at these online resources for more information about panic disorder, treatment, tips, living with the disorder, support groups, and more.

  1. Consider reading an article on Anxiety and Depression Association of America’s website: How I Achieved My Cure of Panic Disorder and Agoraphobia.
  1. Learn more about panic disorder and panic attacks from the Mayo Clinic.
  1. Read about common drugs used for panic disorder on WebMD.com.
  1. Find out more about how stress and anxiety interfere with sleep from The Anxiety and Depression Association of America.
  1. Here are some tips from the Mayo Clinic about how to prepare for a doctor appointment and what questions to ask.
  1. Read these tips for managing stress on WebMD.com.
  1. Find help and treatment for panic disorder through the Substance Abuse and Mental Health Services Administration and National Institute of Mental Health.
  1. Search for a support group through the Anxiety and Depression Association of America.

Post-traumatic stress disorder

What is post-traumatic stress disorder and how does it affect sleep?

Post-traumatic stress disorder affects more than 7 million adults in the United States who are age 18 and older. It can develop after a terrible life event or tragedy takes place, and was first realized by the medical community with war veterans.

PTSD can affect anyone, and the disorder impacts each person differently. It is diagnosed after a person experiences symptoms for at least a month after a traumatic experience. Some symptoms may not occur until months or years later, however.

Here are the main types of symptoms that affect people with PTSD:

  • Re-experiencing the trauma through flashbacks, nightmares, and unwanted memories of the event
  • Feeling numb emotionally and avoiding people, places, thoughts, and daily activities that are reminders of the traumatic experience
  • Feeling jumpy, easily irritated, angered, and having a difficult time sleeping and concentrating
  • Bad mood with feelings of blame, memories of the event, and estrangement

Sleep problems and nightmares are extremely common for people who suffer from PTSD. When the body is overstimulated, chemicals like epinephrine and adrenaline keep people awake and winding down becomes really difficult.

Here are a few reasons why sleep problems are so common for people with PTSD:

  1. People with PTSD are on alert and they feel a need to be on guard to protect, causing issues falling asleep or waking up easily.
  2. Worry and bad thoughts make it difficult for people with PTSD to sleep, and the thoughts and the worry about not being able to sleep keep them awake.
  3. Drugs or alcohol may help people cope with PTSD but they affect sleep patterns and quality, restful sleep.
  4. Bad dreams or nightmares may wake people with PTSD up in the middle of the night, and they impact the quality of restful sleep and cause people trouble falling asleep.
  5. Medical problems and conditions like pelvic-area problems, chronic pain, and stomach issues may also make going to sleep difficult.

Benefits of sleep for treating symptoms

Although sleep problems are common for people with PTSD, the benefits of sleep could help with some symptoms of the disorder.

Good and restful sleep may help people with PTSD with overall mental and physical health. Physical and emotional benefits of a good night’s sleep include, but are not limited to:

  • Body and muscle relaxation
  • Slower heart rate and breathing
  • Body temperature cooling
  • Boost immune system
  • Enhancement of learning and memory
  • Better mood and emotional processing
  • Better focus and concentration

Treatment for symptoms and associated sleep issues

There are several ways to treat PTSD. Medication, therapy, and alternative medicine are used when treating this disorder. Treatment is specific for each person, so some treatment methods may be used in conjunction with others.

Note: people should consult a doctor before any treatment and some drugs mentioned may be habit forming.

Medications and drugs

There are two main kinds of drugs that may be prescribed for PTSD. Those include Antidepressant serotonin reuptake inhibitor (SSRI) and sedatives or benzodiazepines.

Antidepressants SSRI

SSRI medications help improve both sleep and mood by allowing for more serotonin in the brain.

Examples of medications are:

  • Citalopram
  • Fluoxetine (Prozac or Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

Sedatives and benzodiazepines

These drugs are short-term anxiety treatments and can help treat physical anxiety symptoms of PTSD and help with sleep and insomnia. They can assist in falling asleep faster and a longer time staying asleep.

Examples of these drugs are:

  • Lorazepam (Ativan)
  • Alprazolam (Xanax)

Therapy and alternative medicines

Therapy and other alternative medicines have been known to be effective in the treatment for PTSD. Here are some examples of different kinds of therapy and alternative medicines that are used to treat the disorder:

  • Psychotherapy

Cognitive behavioral therapy has been effective for PTSD. This therapy is centered on a person changing the way they think about a trauma after it has already happened and to understand thoughts that cause anxiety and worsen symptoms. Another form of therapy that is used is exposure therapy, which is based on talking about the trauma repeatedly until the person learns that they don’t have to have fear of the memories.

Therapy can help people sleep better through addressing habits and behaviors in bed and teaching new habits that promote good sleep. Over time, therapy can help people overcome some of the issues that are causing sleep problems.

  • Mind and body techniques

These alternative methods are all meant to relax the mind and body and to help people with PTSD learn skills for coping. The relaxation in these methods may help promote better sleep.

Eye movement desensitization and reprocessing (EMDR): a process in which a person moves their eyes back and forth very rapidly from side to side at the same time they are remembering the traumatic event.

Biofeedback: a machine that helps gauge stress and how the body reacts (elevated heart rate and temperature). The goal is to try to teach yourself how to control the reactions to stress.

Hypnosis: may help people with PTSD feel more safe and less anxiety by putting them in a state of relaxation. This is usually done with a therapist who is licensed.

Emotional freedom technique EFT: a process of tapping acupuncture points while remembering trauma.

Meditation, deep breathing, and relaxation methods: these mind and body calming methods can help reduce anxiety and promote sleep.

  • Group therapy

Sharing may help people with PTSD feel more comfortable talking about the traumatic experience — which can help with coping with the memories, symptoms, and daily life.

  • Acupuncture

Acupuncture may be effective for people with PTSD and sleep problems, especially insomnia. This treatment helps increase levels of serotonin in the brain, which promotes sleep and relaxation.

  • Herbs and supplements

These herbs and supplements may help people with PTSD: kava kava, green tea, bacopa, holy basil, melatonin, and theanine. Some of these herbs and supplements are meant to help with stress and anxiety and to promote healthy sleep, while others are specific for the immune system.

  • Eating healthy, avoiding substances, and exercising regularly

A healthy diet and regular exercise may help people with PTSD. Substances like alcohol, caffeine, tobacco, and other drugs should be avoided as they may worsen symptoms of PTSD, which can have an additional negative impact on sleep and sleep patterns.

Online resources for more information on post-traumatic stress disorder

Consider these resources available online to learn more about PTSD, treatment, living with the disorder, tips, support groups, and more.

  1. Learn more about PTSD and the disorder from the U.S. Department of Veteran Affairs National Center for PTSD.
  1. Read a Clinician’s Guide to Medications for PTSD and find out what the medications are targeting, including sleep problems.
  1. Find out how you or a family member of friend can get help for PTSD from the National Center for PTSD.
  1. Consider self-help tips and tools and ways to cope from the National Center for PTSD.
  1. Learn some tips for people with sleep problems on how to create an environment that’s ready for good sleep.
  1.  Here are some tips on how to set yourself up for better sleep from the National Sleep Foundation.
  1. Look for a support group online through the Anxiety and Depression Association of America.
  1. Learn more about support groups, how to find them, and what other resources there are for people with PTSD and families.

Top 10 tips for sleep when you have anxiety

Here’s a list of the top 10 things you can do to reduce anxiety, worry, and stress to get a good night’s sleep.

  1. Make sleep a priority. Create a routine that commits at least 7-9 hours of your day to sleeping, and set a sleep time and awake time to wake up and go to bed at the same times each day.
  1. Create a relaxing sleep routine. Dim the lights and grab a book and relax. Choose activities that are relaxing and avoid those that cause stress or excitement.
  1. Sleep on a supportive and comfortable mattress and pillow, and maintain them regularly. Make sure your mattress is both supportive and comfortable enough for you and your desired sleeping position(s). Also ensure you are washing bedding regularly and cleaning your mattress to reduce allergens, bedbugs, and other health risk hazards.
  1. Exercise often. Physical activity can help promote better sleep. Morning or afternoon workouts are best.
  1. Look at your sleep environment.  Make sure your room is cool, dark, quiet, and free from distractions. Consider a fan or white-noise maker to block out external noises.
  1. Make your bedroom for a few activities only. Bedrooms should be for sleep, sex, and relaxation. Avoid having electronics, screens, and TVs in your room, and do work in other rooms of the house.
  1. If you can’t sleep right away, get relaxed and come back. Only get into your bed when you’re actually tired. If you can’t fall asleep right away, or within about 15 minutes, leave the room and go do something relaxing until you feel tired.
  1. Avoid substances that interfere with sleep. Caffeine, alcohol, nicotine, and other drugs can mess with sleep patterns and disturb sleep. Avoid these substances and try to only have caffeine four to six hours before bedtime. Drink alcohol earlier in the day (after work) and replace caffeine with water after lunch time.
  1. Don’t watch the clock. Try to fall asleep on your own and if you wake up, don’t look at the clock. Turn the clock away so it’s not easy to see.
  1. Take short naps. Limit naps to 20 to 30 minutes. They can be helpful in rejuvenation but won’t interfere with getting a good night’s sleep later on.