Relationship Between Sleep Disorder and Anxiety

# Relationship Between Sleep Disorder and Anxiety ## Anxiety Anxiety is a *normal* and often *healthy emotion*. However, when a person regularly feels disproportionate levels of anxiety, it can interfere with daily life. People with anxiety disorders may experience symptoms such as: * Constant worrying or obsessive thoughts * Difficulty sleeping * Difficulty concentrating * Fatigue * Irritability * Muscle tension * Difficulty controlling feelings of panic * Difficulty with social situations * Avoiding things that trigger anxiety Anxiety disorders can also lead to physical symptoms such as an increased heart rate, sleep disorders, and gastrointestinal problems. As a person who has experienced sleep disorders and moderate level of anxiety, by writing this article, I aim to both understand the relationship between these two and help someone who has experienced them by writing down what I have found. ## Sleep Disorder A sleep disorder is a medical condition that disrupts a person's normal sleep patterns. There are many different types of sleep disorders, including insomnia, sleep apnea, restless leg syndrome, and narcolepsy. **Insomnia** is a common sleep disorder that involves difficulty falling asleep or staying asleep. People with insomnia may have trouble falling asleep at night, wake up frequently during the night, or wake up too early in the morning. **Sleep apnea** is a serious sleep disorder in which a person's breathing is interrupted during sleep. This can cause loud snoring and can lead to poor quality sleep and daytime fatigue. **Restless leg syndrome** is a sleep disorder that causes an irresistible urge to move the legs, often accompanied by a tingling or crawling sensation. This can make it difficult for a person to fall asleep or stay asleep. **Narcolepsy** is a rare sleep disorder that causes excessive daytime sleepiness and sudden episodes of sleep. People with narcolepsy may fall asleep suddenly, even while engaging in activities such as driving or talking. ## What Happens in our Bodies During Sleep? During sleep, the heart rate and blood pressure vary. Decreased heart rate and blood pressure are noted in the *NREM* phase, but sudden movements and arousal during sleep may cause an increase in heart rate and blood pressure. Respiration and ventilation in sleep also differ depending on the phase of sleep. During *REM*, there is erratic ventilation and respiration. In *NREM*, a decrease in ventilation and respiration is noted. Several factors, such as reduced ribcage movement increased upper airway resistance, and reduced pharyngeal tone, contribute to this hypoventilation. *(1)* Cerebral blood flow is also significantly reduced in *NREM*. Metabolic rates are also decreased in *NREM*. On the contrary, during REM, there is increased blood flow in certain regions of the brain, like in a state of wakefulness. *(1)* **Hormone secretion** is influenced by sleep. Late in the evening, thyroid hormones are secreted, while for growth hormones, it occurs in the early phase of sleep. *(1)* The circadian rhythm governs the sleep-wake cycle, and it synchronizes the body to daytime and nighttime. Aside from the sleep-wake cycle, physical activities, thermoregulation, and hormone secretion are also influenced. One main hormone affected by the circadian rhythm is cortisol. **Cortisol** is the main glucocorticoid of the body. It is widely known as the stress hormone, and its release follows the circadian rhythm. *(2)* The hypothalamic–pituitary–adrenal axis (HPA axis) is the pathway of both sleep and stress response. Disruptions that affect the HPA axis will also disrupt sleep and cortisol secretion. Dysfunctions in cortisol secretion would also cause sleep disturbances. *Another function of sleep is its ability to regulate our emotions.* Inadequate sleep takes a toll on our psychological well-being leading to mood disorders. Disturbance in sleep has long been associated with mental health difficulties. At the same time, mental health problems create subsequent sleep disturbances making it a difficult cycle to stop. One mental health problem affected by sleep disturbances is anxiety. More than a quarter of U.S. adults experience anxiety at some time in their life. (*3)* Women are more affected by anxiety disorders than men. In the year 2001 to 2003, 23.4% of females in the U.S. adult population were affected, while 14.3% of males were affected. *(3)* Anxiety is defined as a psychological, physiological, and behavioral state that is induced in humans in anticipation of a future threat. It is part of our daily life. In cases where the mind fails to cope with the daily stresses, anxiety becomes pathologic, resulting in anxiety disorder. ## Relationship Between Sleep and Anxiety There is a strong relationship between sleep disorders and anxiety. Anxiety can cause sleep problems, and sleep problems can cause or exacerbate anxiety. As I mentioned above, people with anxiety may have difficulty falling asleep or staying asleep due to racing thoughts, worry, or physical symptoms such as muscle tension or an increased heart rate. This can lead to insomnia, which is a common sleep disorder that involves difficulty falling asleep or staying asleep. Insomnia can, in turn, worsen anxiety, as a lack of sleep can leave a person feeling tired and less able to cope with stress. On the other hand, sleep disorders such as sleep apnea, which is a condition in which a person's breathing is interrupted during sleep, can cause anxiety. Sleep apnea can lead to poor quality sleep, which can leave a person feeling tired and anxious during the day. ## How to deal with Anxiety and Sleep Disorder The most important step is not to ignore the problems you have experienced and to start getting help by accepting, which is the first step to understand your body, emotions to fix those. Second important thing is to seek help from a mental health professional or a sleep specialist. Treatment for anxiety and sleep disorders may include a combination of the following approaches: **Therapy:** Different types of therapy, such as cognitive-behavioral therapy (CBT) or mindfulness-based therapy, can be effective in treating both anxiety and sleep disorders. **Medication:** There are several types of medications that can be used to treat anxiety and sleep disorders. These include antidepressants, anti-anxiety medications, and sedatives. It is important to work with a healthcare professional to determine the most appropriate medication and dosage. **Lifestyle changes:** Making changes to your daily routine and habits can also be helpful in managing anxiety and sleep disorders. This may include establishing a regular sleep schedule, reducing caffeine and alcohol consumption, and engaging in relaxation techniques such as deep breathing or meditation. **Sleep hygiene:** Good sleep hygiene refers to the habits and practices that can promote healthy sleep. This may include avoiding screens before bed, creating a comfortable sleep environment, and avoiding large meals and intense exercise close to bedtime. It is important to remember that treatment for anxiety and sleep disorders is often most effective when *it is tailored to the individual.* Working with a mental health professional or a sleep specialist can help you develop a plan that addresses your specific needs and concerns. In conclusion, while anxiety and sleep disorders can be challenging conditions to manage, with the right treatment and self-care strategies, it is possible to improve quality of life and find greater peace and well-being. Peace and Love Müjgan Armağan Türközü ### References 1. Brinkman, J.E., Reddy, V., & Sharma, S. (2020) Physiology, Sleep. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482512/ 2. Thau, L., Gandhi, J., & Sharma, S. (2020).Physiology, Cortisol. [Updated 2020 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538239/ 3. National Institute of Mental Health. (2017). Any anxiety disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml