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How Sleep Debt Causes Serious Anxiety

Micah Abraham, BSc
How Sleep Debt Causes Serious Anxiety

It's said so often it has become cliche, but the truth is that the mind and body are greatly connected. The way your body feels affects the way your mind feels, and vice versa.

One of the most important tools for managing anxiety is good quality sleep. That's why not getting enough sleep for multiple days in a row also known as "sleep debt" can be a serious problem for those living with anxiety and anxiety disorders.

Sleep Debt Can Cause Unusual Anxiety Problems

Sleep debt can cause increased anxiety even in those that do not experience anxiety regularly. When you don't get enough sleep, several issues affect your body that can ultimately lead to trouble with anxiety and stress. But sleep debt can particularly affect those that already have anxiety, making it harder to cope with symptoms.

The Causes of Anxiety From Sleep Deprivation

What's most interesting about sleep debt is that it doesn't just cause anxiety in one way. It causes multiple different issues that can all lead to an increase in your overall level of anxiety. Just some of the causes include:

Body Stress

The most important cause is simply stress on your body. But it's not just stress created by sleep debt. It's also the inability of your body to relieve the stresses of the day during sleep.

Sleep is where your body is thought to repair itself and relaxes the muscle tensions and other physical issues that are created by stress. Without sleep time to recover, that stress may start to build up. This may lead to further issues coping with stress the next day.

Remember, the mind and body connection is very real, and research has found that stress on the body is associated with increasing stressful thoughts. So it's no surprise that when your body doesn't have an opportunity to heal, that stress starts to build up dramatically.

Brain Stress

It's not just muscular stress either. Studies have shown that sleep deprivation is associated with poorer thinking (“cognitive”) skills and altered perception, that can cause further anxiety. In fact, extreme sleep deprivation can lead to usual sensory experiences (hallucinations) and symptoms that mimic mental health difficulties.

The reason this occurs is not entirely clear, but one theory supported by research is that during sleep the brain engages in processes of repair and recovery. Toxic substances that build up in the brain are also believed to be drained away during sleep. When you don't sleep, these processes will not have the same opportunity to take place. Research has suggested that this can lead to reduced activity in certain areas of the brain of the sleep deprived person. sleep.

The process described may contribute to anxiety in a couple of ways. First, evidence suggests that sleep deprivation is associated with reduced activity in the pre-frontal cortex of the brain. This is an important area involved in planning and decision making, so plays a key role in how we cope with difficult situations and stress. Secondly, following sleep deprivation it may require more energy for the brain to function, particularly compensating for areas with reduced activity. This greater expenditure of energy may leave fewer resources available for coping with anxiety. 

Hormonal Changes

Sleep is also thought to affect hormonal levels. Your body is able to regulate hormones both during sleep and when your body is healthiest (which occurs only after you experience enough sleep), and when you become more sleep deprived you increase the risk of developing unbalanced hormones, which in turn affect your overall anxiety levels.

Physical Symptoms

When the body doesn't get enough sleep, it can have some very unusual physical symptoms. You may find that your nerves seem to fire in weird ways, your legs and arms may tingle at different times, you may get headaches or back aches, and you may find that you experience weird pains and sensations in different parts of your body.

For those with anxiety especially those with panic attacks this can be extremely stressful. Physical symptoms often mimic more serious diseases, and those with anxiety may misinterpret these are a sign of concern and become further anxious. In this way those with anxiety may tend to feel at their worst when they've racked up sleep debt.

This is especially problematic for those that are getting "some" sleep and may think that they are  rested, but aren't getting enough sleep and are progressively increasing their "sleep debt." They may show more subtle physical signs of sleep deprivation, which they may also be at risk of misinterpreted as serious health concerns. 

Anticipatory Anxiety

The mind can experience what is known as "anticipatory anxiety," which is a natural type of anxiety that occurs when the brain anticipates a stressful or frightening situation. In these cases, the stress response can begin even before the situation has been encountered. Studies showed that those with sleep debt, and especially those that already suffered from anxiety, tended to rate themselves as having greater anticipatory anxiety. This is associated with greater overall anxiety and distress.  

Stress Over Lack of Sleep

Sometimes the the connection between sleep and anxiety can be quite straight forward. One common issue for those with sleep debt is stress over the fact that they're not getting enough sleep. Whilst worrying about not getting enough sleep and what the consequences of sleep deprivation will be, the brain remains active and may struggle to relax. This can contribute to greater difficulty in falling and staying asleep. The overall consequence is poorer sleep, and a vicious circle of sleep deprivation and anxiety about lack of sleep can develop. 

Chronic Elevated Levels of Adrenaline

Finally, one of the things that we know about anxiety is that the physical symptoms can be increased when levels of adrenaline in the body are high. These physical symptoms, such as racing heart and hyperventilation, can actually lead to greater feelings of anxiety themselves. Anxiety has been associated with chronic adrenaline release. The body, for whatever reason, seems to release adrenaline too quickly and too easily even when there is no stress present, and this rush of adrenaline causes the entire body to feel on edge.

So what's interesting is that scientists have shown that those with sleep debt often have chronically elevated levels of adrenaline. One interpretation of these findings is that when you don't get enough sleep, adrenaline may start to course through your veins more often. For those without anxiety this may not be too big a problem. However, those with anxiety are likely to respond to the the adrenaline increase  and thus experience an increase in overall anxiety levels.

Anxiety Can Lead to Sleep Debt

One of the "Catch-22s" of sleep debt anxiety is that it's not uncommon for the anxiety caused by sleep debt to lead to further sleep issues. Many people struggle to sleep with anxiety, and unfortunately even when that anxiety is caused by a lack of sleep it can be hard to turn off your mind and get rest. This is entirely normal, and something that you can reduce if you to manage your anxiety.

But keep this in mind when you're going to sleep. If you have anxiety because of sleep debt and it disrupts your sleep causing more sleep debt, you're not alone. This problem affects millions of those with sleep deprivation, and is something you will learn to work on in the future as you start to address both your sleep and your anxiety issues.

When sleep debt causes or contributes to anxiety, the solution is simple: take steps to get more sleep. If you're able to go to sleep earlier then you can ease the problem by simply taking it upon yourself to get longer periods of sleep, and allowing that sleep to refresh your body.

Don't expect this to stop your anxiety right away. Sleep debt issues tend to linger, and you may need to have a good night's sleep for a few weeks in a row if you want to improve. Taking responsibility for your health and aiming to go to bed earlier can have a positive impact on your levels of anxiety. 

For those who can't seem to get enough sleep and find that their sleep deprivation anxiety causes them to continue struggling to rest, here are several techniques you can try:

Often when anxiety keeps you awake it's because you have a thought in your head that cannot seem to be ignored. It may not be a stressful thought, but it's something you focus on that you can't stop focusing on, and it ultimately keeps you awake. One strategy is to write out these thoughts in a journal near your bed. This technique tells your brain it's okay to forget your stressful thought because it's in a permanent place. Some people find this strategy calms their active minds down a bit.

When you struggle with stress and sleep for a long enough period of time, your bed may stop representing the comfortable place that it represented in the past. It may instead become associated with stress, and so you need to try your best to break the association. One way to do this is to take a break from your bed. Find another place to sleep like a couch or comfy chair, and sleep there for a while until you're comfortable enough to go back to bed.

Having a regular pre-sleep routines can be valuable. For at least 30 minutes before bed, turn off all bright lights and technology, engage in some relaxed activity such as reading a book or meditating, and prepare for bed. Make sure you do the same things every day until they develop into a "routine." After a few weeks, your mind will get used to the idea that that routine means you're about to go to sleep, and you should find some relaxation in the process.

Many people with anxiety find very mild distractions to be helpful at shutting off their brain and going to sleep. An example that you can try is using some type of smartphone or computer to download podcasts you're _not_ interested in listening to, and then turning on these podcasts before bed at a volume low enough that you can make out a few words if you listen closely, but otherwise the volume is too quiet to listen to. This type of noise can be mentally distracting, which is useful for blocking out unwanted thoughts that may keep you awake.

You do need to try your best to get more sleep, because sleep debt can increase anxiety even in those that do not have an anxiety disorder. But if anxiety and stress are keeping you awake or if you already had an anxiety issue that sleep debt makes worse, then reducing your anxiety can be one of the best ways to manage it.

Article Resources
  1. Thomas, Maria, et al. Neural basis of alertness and cognitive performance impairments during sleepiness. I. Effects of 24 h of sleep deprivation on waking human regional brain activity. Journal of sleep research 9.4 (2008): 335-352.
  2. McEwen, Bruce S. Sleep deprivation as a neurobiologic and physiologic stressor: allostasis and allostatic load. Metabolism 55 (2006): S20-S23.
  3. Roy-Byrne, Peter P., Thomas W. Uhde, and Robert M. Post. Effects of one night's sleep deprivation on mood and behavior in panic disorder: Patients with panic disorder compared with depressed patients and normal controls. Archives of General Psychiatry 43.9 (1986): 895. 
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