Afraid to go to sleep? Let's talk about sleep anxiety.

There's a sense of relief when you go to bed at night after working hard all day, right? But sometimes you don't feel that way? When you go to bed, things come to mind, your chest tightens, "Will I still be unable to sleep today?", "I have to go to work tomorrow, what will I do if I can't sleep?" Do you have thoughts like this and lose sleep completely? If you have had this experience, you are not alone. Today we are going to talk about this problem that many people have, but don't talk about it much, that is, sleep anxiety.

What exactly is sleep anxiety?

Simply put, Sleep Anxiety is a fear, worry, or anxiety about going to sleep or staying asleep. You may be afraid that you won't be able to sleep, or you may be afraid that you will wake up in the middle of the night. For some people, this can be even more severe. This means that they develop a phobia about going to sleep. In medicine, we call this ``Somniphobia.'' They may feel that something bad will happen to them while they are sleeping, or that they don't want to sleep because they want to stay awake.

Imagine, this is like a never-ending cycle. You have anxiety and you can't sleep well. Because you don't sleep well, you get more anxious. The next night when you go to bed, you feel even more afraid, "Will I be able to sleep like I did yesterday?" This way, one thing leads to the other, and the situation gets worse. This is what we call Sleep Anxiety.

How common is this condition?

Anxiety is one of the most common mental health problems in the world. Research has shown that many people with mental health problems like anxiety also have some form of sleep problem. So if you are feeling this way, don't take it for granted, and don't think you are alone. There are many people in Sri Lanka who suffer from this condition.

What does a person with sleep anxiety feel like?

When anxiety strikes before going to bed, you can experience a number of symptoms, both mental and physical. Let's take a look at what these are.

Some people may also experience a condition called nocturnal panic attacks . This is when you suddenly wake up from a sound sleep with a sudden onset of intense fear. Your chest may pound, you may sweat, you may have difficulty breathing, and you may feel like you are going to die. This can be a very frightening experience.

What causes this? Why is this happening?

Anxiety is actually a natural thing that helps us survive. Imagine if you were walking on the road and suddenly a car came at you at high speed, you would get scared, wouldn't you? With that fear, you would quickly move off the road. At that time, our body releases certain hormones (stress hormones). Those hormones are what give us the strength and speed we need to escape from that danger.

However, if you have chronic anxiety, your body keeps these hormones high all the time. It's like you're always ready for some danger. So even when you go to sleep at night, your body is in this "fight or flight" state, so it's hard for your body to relax and calm down. That's why you can't sleep.

In addition, some medical conditions, such as hyperthyroidism, can cause sleep problems and anxiety. Research has also found that anxiety affects our REM sleep. It is during this REM sleep that we often dream. So when you have anxiety, these dreams can turn into nightmares and wake you up.

Who is most at risk for this condition?

Sleep Anxiety can affect adults, young children, and even young adults. People with the following sleep disorders or mental health problems are at higher risk:

What complications can occur if left untreated for a long time?

Suffering from anxiety and lack of sleep for a long time can have a very negative impact on our bodies. This increases your risk of developing the following serious illnesses:

• Diabetes
• Heart attack
• High blood pressure
• Heart failure
• Heartbeat irregularities `(Arrhythmia)`
• Stroke
• Obesity

How does a doctor accurately diagnose this condition?

When you go to see your doctor to talk about this problem, he or she will examine you and ask you about your symptoms. You may typically be asked questions like these:

• Do you eat or drink anything before going to bed?
• Does this anxiety occur every night before going to bed?
• How long does it take to fall asleep after going to bed?
• How many times do you wake up at night?
• What do you do before bed? (e.g., looking at your phone, watching TV)

Sleep Study

In some cases, your doctor may recommend a sleep study to find out if you have another sleep-related condition. This is also called a polysomnography. This involves keeping you in a special room in the hospital overnight and checking how your body works while you sleep.

What are the treatments for this? How do we get out of this?

There are several treatments for sleep anxiety. We mainly divide these into two categories.

1. Cognitive Behavioral Therapy for Insomnia (CBT-I)

This is the first-line and most effective treatment for insomnia. Many people think of it as just talk therapy. But CBT-I is much more than that.

What this means is that you change the wrong attitudes and associations you have about sleep and your bed. For example, if you go to bed every day thinking, "I'm not going to sleep tonight," your brain associates the bed with anxiety and fear. CBT-I therapy breaks that association and retrains your brain to think of the bed as a place to sleep . It uses specific behavioral techniques. This therapy can usually be completed in 4 to 8 sessions.

2. Medication

Depending on your condition, your doctor may decide to prescribe medication for anxiety or sleep problems.

How to develop good sleep habits? (Improving Sleep Hygiene)

In addition to taking treatment, changing your daily habits is also very important to improve the quality of your sleep. We call this 'Sleep Hygiene'. Let's look at the table below to see what are good and bad habits for sleep.