How to Fall Asleep When You're Too Stressed Out
What to do when you have anxiety-induced insomnia
An uptick in anxiety levels—whether due to the never-ending negative news cycle, long hours at work, family drama, or something else—can have a serious impact on sleep. (Who hasn't lain awake at night with worries racing through their brain?) If you find yourself tossing and turning, you need a new strategy when you hit the sack, says Nancy Foldvary-Schaefer, DO, Director of the Sleep Disorders Center at Cleveland Clinic. "Acute insomnia is super common, and can be the result of any life stressor," she says.
How do you deal? Here's Dr. Foldvary's nighttime slowdown plan.
Identify your stress trigger and deal with it early in the day
If you can figure out the source of your new worries, do it. This way, you can mentally handle it in a productive way well before bedtime—say, right after dinner, says Dr. Foldvary. "You want to work on it early, away from the bedroom," she says. "Ruminate, think through the stressor. A lot of my patients keep a ‘worry journal' to write out their feelings. This helps put away your anxiety before bed." If you can quiet your mind before you lay down, you're less likely to toss and turn. "The habit of ruminating in bed can turn acute insomnia into chronic insomnia," says Dr. Foldvary.
Pay attention to your bedroom atmosphere
Especially when you're struggling to sleep, you want the perfect environmental conditions to get a good rest. "Make sure the temperature is just right—not too hot, not too cold," Dr. Foldvary says. "Make sure you have a comfortable mattress and pillow. You may have to deal with anything that could be disrupting your sleep, like a spouse who snores or a pet that likes to climb into bed." Even if these tiny elements weren't bugging you before, they might suddenly be keeping you awake. Time to adjust the temperature dial, invest in earplugs, pick out more comfortable bedding, or kick Spot out of the sheets.
Eliminate all sources of caffeine and alcohol
Some people are more sensitive to jolts of caffeine than others, so watch how much you're consuming and when. You might need to put a freeze on coffee at 2pm, or even earlier if you're still struggling to sleep at night after making adjustments. Dr. Foldvary says to also check hidden sources of caffeine, and stop consuming those at 2pm, too. They include chocolate, hot chocolate, green and black tea, some pain relievers, and soda.
"Alcohol is another big one," says Dr. Foldvary. "It's deceiving. A lot of people feel it's helping them to fall asleep, and while it can cause sleep onset, research shows also shows alcohol fragments sleep." This is especially true for women: A 2011 study found that women slept more fitfully and for less time after a night of drinking than when they were sober, and that they slept less soundly than men with the same blood-alcohol content.
If you wake up in the night, don't stay in bed too long
It's possible that stress may cause you to fire awake in the middle of the night, too, and not just block your ability to fall asleep. Dr. Foldvary says you should never lay in bed for more than 20 minutes trying to drift off; this may cause you to ruminate on your worries, or simply stress over your sleep issues. "Get up, and do something relaxing or boring," she says. "Don't turn on the TV, which can be stimulating. Don't read a book that will be a page-turner. Maybe read a slow section of the newspaper, or iron some clothes. When you start to feel sleepy again, go back to bed." Whatever you do, just do not watch the clock. "This is what you learn in cognitive behavioral therapy for insomnia," Dr. Foldvary explains. "Create productive habits, set the right expectations, clear your mind and relax."
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If your insomnia keeps up, see your doc
Check in with a doctor if you're having trouble sleeping at night, you've tried self-management strategies, and you just can't catch enough z's. "Some people wait too long," Dr. Foldvary says. "I've had some patients come in after 20 years of insomnia. A clinically significant problem exists if insomnia lasts more than three months, so call your primary care doctor if you can't sleep after that time." Many PCPs have sound strategies for dealing with insomnia. Some might refer you to a sleep disorders specialist or cognitive behavioral therapist.
While Dr. Foldvary says many tend to want to resort to a quick-fix sleeping pill, she'd suggest trying behavioral changes first. "Some people want a way out of doing the work, when they haven't done any of the basics," she explains. In actuality, a pre-bedtime game plan and a few changes might be all it takes to cure your acute insomnia.