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Why can’t I sleep?


Sleep is supposed to be simple and easy, right? What gives? I talk to clients about sleep a lot. It’s one of the first things that anxiety likes to steal from us. And poor sleep just makes our anxiety and other emotional experiences worse. It’s a frustrating double whammy.


Most adults need 7-8 continuous hours of quality sleep for optimal functioning the next day. It’s our body's time to recharge and refresh. You can think of sleep just like charging a phone...if you start your day with only a 24% charge on your phone, you’re not going to be able to do a whole lot with it that day (don’t even think about using Maps or YouTube) until you get it charged up. Our human bodies are the same, and yet we often expect ourselves to be able to function well all day without a full charge of sleep.

Let’s understand some basics about sleep.

We sleep in different stages and cycle through these stages in chunks of time. The two sleep stages are NREM (non-rapid eye movement) and REM (rapid eye movement). When we don’t get our necessary amounts of NREM and REM, the body and brain and our emotional selves are unable to restore and refresh for the next day.


NREM sleep has less brain activity and includes very light sleep and very deep sleep. During the course of a night, ideally we will receive several periods of NREM sleep, which accounts for 75-80% of our night's rest. It includes the periods of falling asleep, light sleep, and then very deep sleep where restorative processes for mental relaxation and physical repair occur. NREM deep sleep plays a major role in maintaining your overall health.


REM sleep has more brain activity and accounts for about 20-25% of our night’s rest. REM sleep is where dreams occur. REM sleep affects our moods, performance, and behavior by processing information we gathered during the day and by resolving any emotional distress.


What are some common symptoms of poor sleep?

  • Trouble going to sleep (taking longer than 10-15 minutes to fall asleep)

  • Falling asleep as soon as your head hits the pillow

  • Waking up frequently during sleep

  • Waking up during sleep and unable to fall back asleep

  • Sleeping lightly and you have trouble relaxing as you sleep

  • Waking up feeling tired

  • Waking up feeling aches and pains

  • Waking up feeling emotionally down

  • Waking up feeling tense and it’s difficult to calm down

  • Sleeping less than 6 hours or more than 9 hours on a regular basis

  • Feeling drowsy and/or foggy all day

So now let’s look at some ways to improve your sleep!


Daytime habits to improve your sleep:

  • Expose yourself to bright light/sunlight soon after waking up. This helps to regulate your body's natural biological clock. Likewise, try to keep your bedroom dark while you are sleeping so that light doesn’t interfere with your rest.

  • Exercise earlier in the day. Exercise is strongly connected with good sleep, but aim to exercise in the morning or afternoon. For most people, exercise stimulates the body and aerobic activity before bedtime may make falling asleep more difficult.

  • Avoid naps during the day. If you struggle with sleep at night, try your best not to nap during the day, which can throw off your body clock and make it even more difficult to sleep at night. If you’re feeling especially tired, and feel as if you absolutely must nap, try to nap for only 30-45 minutes, early in the day.

  • Limit caffeine and alcohol. Avoid drinking caffeinated or alcoholic beverages for several hours before bedtime. Although alcohol may initially act as a sedative, it can interrupt normal sleep patterns.

  • Avoid smoking. Nicotine is a stimulant and can make it difficult to fall asleep and stay asleep.


Assess your sleep environment:

  • Make sure your bed is comfortable. Sleep in a bed rather than on the couch (unless it’s your only option). Test different types of mattresses. If you’re disturbed by a restless bedmate, switch to a larger bed if possible or investigate stabilizing mattress pads. Try pillows that cradle your neck or extra pillows that help you sleep on your side. Get comfortable sheets. These items are worth the investment!

  • Make your bedroom primarily a place for sleeping. Let your body recognize that this is a place for two things: sleep and sex. It’s not ideal to use your bed for studying, TV, paying bills, doing work, etc. You want your brain to connect the bed location with positive, calm, and restful experiences.

  • Keep your bedroom peaceful and comfortable. Make sure your room is well ventilated (if it’s stale or stuffy, try a fan). Most bodies prefer a colder temperature for optimal sleep. Try to keep the room quiet. You can use a fan or a "white noise" machine to help block outside noises.

  • Reconsider your alarm clark. A big, illuminated digital clock may make you anxious. Place your clock so you can't see the time while you're in bed or cover it with something.

  • Keep your room dark at bedtime. Try “blackout” curtains, close the door to shut out lights, put a towel over the door crack….whatever you can do to achieve darkness.

Create or improve your sleep routine:

  • Keep a regular sleep schedule. Try to go to bed and wake up at approximately the same time everyday, even on the weekends. At most, vary your weekend sleep by about an hour. Our bodies respond happily to routine and predictability.

  • Eat no more than a light snack before bed. Eating a large, heavy meal or too many snacks can interfere with your normal sleep cycle because your body will be focusing energy towards digestion.

  • Avoid doing anything stimulating right before bedtime. Steer clear of reading anything job-related or watching a stimulating TV program (i.e. dramatic shows and news updates).

  • Relax for a while before going to bed. This may look like reading a book, doing relaxation and/or breathing exercises or taking a warm bath before bedtime. Try some recorded relaxation or guided imagery audios specifically designed to improve sleep.

  • Avoid exposing yourself to bright light near bedtime (like going to sleep with the TV on). The light sends cues to your brain that it’s time to be awake and take in information. Recent research about the impact of the light from our phones and devices also suggests that it’s best to avoid using these an hour before going to bed.

  • Drink something warm before bedtime. In addition to being soothing, the warmth may temporarily increase your body temperature and the subsequent temperature drop may hasten sleep.

  • Incorporate bedtime rituals. As you are heading toward bedtime, create a routine you can follow. Get up from the couch, listen to soft music, sip a cup of herbal tea, brush your teeth and change your clothes, etc. Rituals cue your brain to start a known process. By doing a nightly ritual, you can send a message that it's time to slow down and begin preparing for sleep.

When anxiety is causing you to lose sleep...


Generally, if you have persistent sleep problems, your stress response is likely being activated at night by anxiousness (fear). Usually at bedtime, our anxious brain is replaying the day and what we think we did wrong or worrying about the next day and what we need to do or what might go wrong.


Sometimes the anxiety has been bubbling all day with no outlet and although you can’t identify specific worry thoughts at night, your brain senses these anxious feelings and they go to bed with you. This activates the stress response, which causes adrenaline to be released into your system. In turn, the stress response prevents your natural sleep cycle from working effectively because our stress response and our sleep response are absolute opposite reactions in the body.

try taking stock of some positives from the day to shift your brain into a non-anxious state for sleep

To offset this, try taking stock of some positives from the day to shift your brain into a non-anxious state for sleep. What did you do well or make progress on or handle with strong effort? You can also try a gratitude practice, either mentally or in writing. Focus on the things and people that you are grateful to have and that help you feel safe or connected or calm or supported. Spend some time getting your brain into a zone of safety rather than fear.


Additional sleep improvement strategies to combat anxiety:

  • Jot down your concerns and worries. Think about your worries and possible solutions before you go to bed, so you don't need to ruminate in the middle of the night. Writing them in a journal or making a quick "to do" list may be very helpful in letting you put away these concerns until the next day when you are fresh. Keep paper by your bedside for use in the middle of the night too if needed.

  • Try breathing and visualization activities. Focus all your attention on your breath and count your inhales and exhales, or visualize walking down an endless stairwell. Thinking about repetitive or mindless things will help your brain to shut down thoughts and adjust to sleep.

  • 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. There are plenty of guided muscle relaxation audios online to learn how to do this.

  • Try sex or masturbation. This is a great distraction from worries and sleep anxiety. It’s also a natural way to calm and relax your body.

  • Get out of bed if you’re unable to sleep for more than 30 minutes. Go into another room and do something relaxing or sleep-inducing (not engaging) until you start to feel sleepy. It’s best to avoid creating an ongoing association between lying in bed and having anxiety about falling asleep.


Sleep issues are an indicator that something else is afoot. In addition to anxiety causing us problems, sleep struggles can be caused by many other factors, like: physical ailments, unpleasant situations experienced as a child that were connected to sleep, traumatic situations endured at nighttime, biological issues like narcolepsy, shift work, etc.


Please consult with a medical professional or counselor if you experience persistent sleep problems (disrupted sleep happens frequently or persists for longer than a two-week period). Your body is craving a full charge!

© 2017 Heather M. McKenzie, Therapist LCMHC PLLC

(919) 744-8335

heather@mckenziecounseling.org

all areas of North Carolina, United States​