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How to improve sleep (even with anxiety)


gray cat sleeping on pavement

Most clients are used to me inquiring about their sleep. It's an essential building block to our overall daily functioning.


And our sleep is one of the first areas negatively impacted when something is amiss in our lives. The canary in the coal mine.


Stress, physical pain, mood fluctuations, and life circumstances (that we want to control but can't) all chip away at our ability to get quality sleep.


When we do sleep, our physical and emotional selves are able to recharge and refresh. Proper sleep fuels us to handle the next day with the energy and motivation we need. Those hours of sleep also give your brain time to synthesize all the information and experiences from your day and file them appropriately for later use.


We really should respect our sleep more! Most adults need 7-9 hours for optimal emotional and physical health. It's is a process that deserves careful attention, but often sleep is the first need we sacrifice when life demands more time from us. If you're ready to make some changes, below are strategies for you to explore to improve your sleep.


We'll look at three areas for you to assess and tweak ...

1. your daytime habits

2. your nightly routine

3. your sleep environment


And at the end there are some specific ideas for what to do when anxiety keeps you awake.



Daytime habits that will improve your sleep


Expose yourself to bright light/sunlight soon after waking up.

  • Viewing sunlight within 30-60 minutes of waking up helps to regulate your body's natural circadian rhythm.

  • Getting 10-20 minutes of sunlight is ideal, but any amount is a good amount.

  • If sunlight is unavailable and you struggle with sleep, consider an artificial "light therapy" lamp.

  • Heading outside again around sunset also helps to reinforce your natural sleep cycle.


Be physically active early in the day.

  • Physical activity and intentional exercise are both strongly connected with restorative sleep.

  • Aim to get your movement in the morning or afternoon, rather than the evening.

  • Note that for many people, exercise stimulates the body, so late-day activity may make falling asleep more difficult.


Limit naps during the day.

  • Your body's tiredness level naturally decreases as the day wears on, preparing it to sleep well when it's time.

  • Naps during the day can throw off sleep patterns, making it even more difficult to sleep at night.

  • If you must, try to nap for only 30-45 minutes, early in the day.


Limit caffeine and alcohol.

  • Caffeine stays in the system for an average of 10 hrs (this can vary individually from 3 to 20 hours).

  • Adenosine is a naturally occurring element that builds up in the brain throughout the day. Adenosine promotes your body's drive for sleep.

  • Caffeine blocks the natural process of adenosine build up, making sleep more difficult for the body.

  • Test out your body's caffeine tolerance and limit caffeinated drinks in the afternoon possible.

  • Avoid alcohol for 3 hours before bedtime. Although alcohol may initially act as a sedative, it can interrupt normal your sleep rhythms later in the night.


Avoid nicotine use.

  • Nicotine is a stimulant, making it more difficult to fall/stay asleep.

  • People who ingest nicotine may take around 5–25 minutes longer to fall asleep.

  • People who ingest nicotine tend to sleep for shorter amounts of time and experience more sleep disturbances.


Which of these daytime options do you want to try?



Create a nightly routine to improve your sleep


Keep a regular sleep schedule.

  • Try to fall asleep and wake up at about the same time everyday, even on the weekends.

  • At most, vary your weekend sleep schedule by about an hour.

  • Our bodies respond very positively to routine and predictability.

  • Go to sleep when you first get drowsy, rather than fighting it.


Eat no more than a light snack before bed.

  • Eating a heavy meal or excess snacks interferes with the sleep cycle because your body focuses energy on digestion instead.


Avoid doing anything stimulating right before bedtime.

  • Steer clear of reading anything work or school-related.

  • Avoid watching stimulating shows (i.e. crime dramas or news updates).

  • Remember your brain will need to process the information you give it.


Avoid bright lights in the evening.

  • Light sends a cue to your brain that it’s time to be awake and take in information.

  • Dim your inside lighting within 2-3 hours of your bedtime. Limit overhead lights and switch to lamps if possible.

  • Use settings on your devices that allow you to shift to "night mode." Consider blue light blockers or anything that reduces your exposure to bright lights.

  • Research suggests that it’s best to avoid devices that emit light starting about 1 hour before trying to sleep (i.e., turn off the TV and put down your device).


Relax for 30 mins to an hour before going to bed.

  • Wind down your system by stretching, taking a warm bath, reading a book, doing relaxation/breathing exercises, etc.

  • Try some recorded relaxation or guided imagery audios specifically designed to improve sleep. Some folks really like the Calm app for its free 7-day sleep course and handful of free sleep meditations.


Drink something warm before bedtime.

  • In addition to being soothing, warm liquid can temporarily increase your body temperature, and the natural body cooling that follows may hasten sleep.

  • Chamomile tea contains apigenin, a chemical compound that induces sleepiness when it binds to the GABA receptors in the brain.


Incorporate bedtime rituals.

  • Create a soothing routine you can follow most nights.

  • For example: get up from the couch, make a cup of herbal tea, turn on some calming music, change your clothes, brush your teeth and get into bed for some reading.

  • Rituals cue your brain to start a known process. Nightly rituals send a message that it's time to slow down the body & brain and prepare for sleep.


Which of these nighttime routine ideas do you want to try?



Adjust your sleep environment to improve your sleep


crisply made bed with teddy bear and a white lamp on bedside table
Make your bed very comfortable. 
  • Sleep in a bed rather than on the couch.

  • Test different types and sizes of mattresses to find one that allows you to sleep well and wake up without aches & pains. Invest in this.

  • Use extra pillows to cradle or prop your body parts for comfort.

  • Invest in comfortable sheets and explore the need for a cooling or heating blanket.

  • Consider a weighted blanket for an increased feel of safety.

  • Acknowledge that not everyone can sleep effectively when sharing a bed and strategize options for this.


Keep your bedroom peaceful and comfortable.

  • Make your room well-ventilated (if it’s stale or stuffy, try a fan).

  • Most bodies prefer a cooler temperature for optimal sleep and need a 1-3 degree drop in body temp to fall and stay asleep. Set up your thermostat and blanket situation accordingly.

  • Keep the room quiet: use a fan or a "white noise" machine to block noises.


Reconsider your alarm clark.

  • An illuminated or visible clock can make you anxious. Consider putting a washcloth over the numbers to avoid anxiety in the middle of the night.

  • Place your clock/device so you can't check the time while in bed.

  • Time checking increases the fear of not getting enough sleep. And then fear activates your body and makes sleep harder to obtain. An awful cycle.


Keep your room as dark as possible at bedtime.

  • Make adjustments so that pockets of light don't interfere with your rest.

  • Try “blackout” curtains, close the door to shut out lights, put a towel over the door crack….whatever helps to achieve darkness.

  • Avoid sleeping with the TV on. Your eyes and ears perceive the "data" and keep your brain activated rather than winding down.


What changes can you make to your sleeping environment?



What to do when anxiety keeps you awake


Jot down your concerns and worries.

  • Think intentionally about worries and possible solutions before going to bed, to decrease rumination.

  • Write them in a journal or create a "to manage" list for the next day to help you let go of concerns until you have a fresh mind.

  • Keep paper & pen by the bedside for use in the middle of the night too.

  • After you write items down, tell yourself "I'll be able to address those better with a clear mind tomorrow."


Try breathing and visualization activities.

  • Focus your attention on your breath, counting your inhales & exhales.

  • Breathe in on the number 10, out on 9, in on 8, out on 7 etc. until you get to zero. Then count down again, starting instead with 9...all the way to zero, then start back again with 8. Keep repeating.

  • Why this works: Slowing your breathing sends a message of calm & safety to the brain. Counting the numbers acts as a distraction from your worry thoughts.

  • Visualize a peaceful or calm memory or location. Try to transport yourself there, focusing your attention on all the details. Linger and deliberate.

  • In your mind, flip through positive memories of events, accomplishments, happy moments, etc. Imagine turning the pages of a scrapbook of these enjoyable times.


Give your brain a task to focus on instead of worry thoughts.

  • Think of something you know pretty well (movie titles, athletes, cars, authors, animals, plants, etc.) and try to name items from the category alphabetically from A to Z. Repeat or switch to a different topic when you reach Z.

  • Walk yourself through the steps of something you enjoy doing (cooking a recipe, building something, hiking a path, playing a game, driving a route, etc.). Visualize the steps or imagine telling someone the steps.


Use a progressive muscle relaxation routine.

  • Starting at the top of your body and working your way down, focus on each muscle area one at a time.

  • Tighten it, hold it, and release it. Find a guided audio online to learn the progressive muscle relaxation method.


Try sex or masturbation.

  • This helps in 2 ways: it distracts you from the worries and is a natural way to relax and soothe your body.


Aim to avoid worrying about getting "enough" sleep.

  • You will function even on minimal sleep. Trust your body.

  • Your body will eventually take the rest it needs, even if not tonight.

  • Resting is helpful and important, even if it's not actual sleep.


Get out of bed if you’re unable to sleep for more than 30-45 minutes.

  • It’s best to avoid creating an ongoing association between lying in bed and having anxiety about falling asleep.

  • Go into another room and do something relaxing, boring, or sleep-inducing until you start to feel sleepy.

  • Keep the lights low and avoid devices.

  • Avoid doing anything very engaging. Tax law journals anyone?


Try supplements that are proven to help with sleep.

  • Consult with your doctor first. Try just one of these at a time to see what fits you best. Each of these, you can take 30-60 minutes before bedtime.

  • Magnesium Threonate - 145mg

  • Magnesium Bisglycinate - 200mg

  • L-Theanine - 100 to 400mg

  • Apigenin (Chamomile) - 50mg

  • Melatonin - 1 to 10mg (start with a low dose)


For chronic sleep problems/insomnia, talk to a professional and/or try a structured program.

  • The VA (Veteran's Affairs) has some free high quality and research-based mental health apps. Their Insomnia Coach app has sleep education, exercises, and even coaching to help you improve sleep.

  • Some therapists are trained in CBT-I (Cognitive Behavioral Therapy - Insomnia) and can take you through a structured treatment protocol for chronic sleep issues. The VA also has a CBT-I app to complement those in CBT-I therapy.

  • Your medical doctor can refer you to get a sleep study, which can assess for irregular breathing, narcolepsy, or other underlying issues impacting your sleep quality.


Which of these anxiety-reduction strategies can you test out?



The bottom line: there are a lot of options you can employ to help improve your sleep. You may only need a few tweaks, or you may need to have an overhaul of your current approach. Either way, if you aren't getting good sleep, it's time to prioritize it. Future you is counting on it!


 

If anxiety and other strong emotions are keeping you up at night and plaguing you during the day, take a look at my 8-week online course to learn new ways to manage intense emotions and see if it's a fit for you.


Image credit in order of appearance: marcinjozwiak and Engin_Akyurt on Pixabay

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