Too Stressed to Sleep: Is Stress Keeping You Up at Night?
By Nicola Cann - We’ve all been there. It’s 3am and you’re wide awake. You’ve been trying to sleep for hours but your brain keeps taking you back to that tricky conversation you need to have with a colleague tomorrow. Or to the disagreement you had with your partner over dinner. Before you know what’s happening your thoughts are spiralling out of control. No hope of sleep now.
These experiences are common, but for people experiencing acute or chronic stress the sleepless nights accumulate and lead to even more stress. You become stuck in a cycle of sleepless nights and daytime tiredness, which of course makes the stress even worse.
We all experience stress differently but you’ve probably experienced some of these common symptoms of stress:
Elevated heart rate
Faster breathing
Tense muscles
Racing thoughts
Getting stuck on negative thoughts and feelings (ruminating)
Excessive worry (catastrophising)
When we’re stressed levels of cortisol, adenosine and adrenaline in our bodies are increasing. These are all associated with anxiety, alertness and sleep-wake timings. As these hormones are coursing through your body the regions of your brain involved in emotion regulation are starting to take over and the decision making regions are losing control. Your emotions are becoming heightened and your brain and body is going into ‘safety mode’.
Stress in itself isn’t a problem. In fact it can be helpful. When we encounter a stressful situation our brains and bodies become more alert, making us ready for action. This process evolved to keep us safe. It’s a sign that something in our environment is potentially dangerous, and this stress response increases our readiness to respond. This was helpful when we were hunter gatherers and needed to be on the lookout for predators. However, if we experience extreme or chronic stress our bodies get used to being on high alert and this can become our default response.
When Stress Takes Over
When we experience a stressful situation we have a stress response. For most of us most of the time we manage the situation and our stress response subsides. However, if the stressful situation is extreme, or we experience ongoing stress, our stress response can become maladaptive. We find ourselves experiencing those feelings of stress even in seemingly non-stressful situations. The more our bodies and brains experience a particular way of doing things, the more likely they are to default to those ways in the future. So if you felt stressed out last time you were buying coffee in your favourite cafe, you’re more likely to get stressed out next time you’re in that same environment doing that same activity. At this point we are no longer responding to something stressful in our environment but are reacting automatically.
Unfortunately poor sleepers are more likely to struggle with anxiety, and anxious people are more likely to be poor sleepers. Here’s why.
Stress leads to poor sleep
If you’re stressed then you’re probably having trouble falling asleep. Our stress response can kick in at bedtime because we no longer have the distractions of the day to keep our mind busy. We go to bed ‘tired but wired’ after stressful experiences during the day and before we know it we’re lying in bed ruminating and catastrophising and telling ourselves we’ll never sleep again.
Once that stress response kicks in, getting to sleep can be really tricky. Our brain and body are doing all they can to keep us alert. After all, you wouldn’t want to be falling asleep if there was a tiger prowling nearby! When we’re already tired and stressed we also have less resources for sticking to our planned bedtime, so we’re more likely to stay up late doom scrolling or watching Netflix.
Poor sleep leaves us with less capacity for stressful events the following day, leading to more stress when we’re trying to fall asleep the following night. Once we’re in this cycle it can be hard to get out. We start to associate bed and sleep with stress, so that our brains and bodies start to expect stress and sleeplessness whenever we get into bed.
Poor sleep leads to more stress
Even after a single night of poor sleep we are more likely to:
Experience more negative feelings like anger and frustration (heightened negative reactivity)
Focus more on the negatives (negative attentional bias)
Respond in more extreme ways to stressful situations (emotional regulation)
Over-react to stress (exaggerated stress response)
Underestimate how much sleep we’ve had (subjective sleep is a good predictor of how tired we feel, regardless of how much actual sleep we’ve had)
Be more sensitive to the negative effects of poor sleep
Why does this happen? Neuroimaging studies suggest that just like stress, sleep deprivation amplifies activity in the amygdala, and diminishes cognitive control, leaving us at the mercy of the emotional parts of our brain.
Research tells us that people with irregular sleep timings are more likely to struggle with anxiety, and that people who experience less Slow Wave Sleep are also more prone. So it’s not just about how much you get, but also when you sleep, and the quality of that sleep.
How to Disrupt the Cycle
The good news is that just as our brains get stuck in a negative cycle, we can create a positive cycle. Humans are wired to automatically look for the negatives, and our brains tend to take us down pathways that are familiar, so shifting from familiar negative to new positive pathways requires effort and practice, but with time these new pathways can become your default.
Before You Start
It’s important to consider whether there is an external stressor maintaining your poor sleep and anxiety. If this is the case, you can still benefit from the strategies below, but you should also try to improve your situation however you can.
You should also make sure you’re getting the basics right when it comes to sleep. Good sleep hygiene includes things like sleeping at regular times, exercising regularly, getting out into the daylight in the morning. For more sleep hygiene strategies take a look at my free Sleep Sheet.
Strategies
The goal here is to convince your brain and body that there’s nothing to fear. You do this by creating new patterns of thinking and behaving when you’re experiencing stress, and by managing the physiological and psychological stress response through relaxation. Every time you practise these skills these new pathways become stronger.
Here are my favourite tried and tested strategies. You don’t need to do everything at once. Pick five strategies below that you haven’t tried before and give them a go.
Find a relaxation technique that works for you. It could be a breathing exercise, meditation, body scanning, reading, stretching… practise throughout the day as well as before bed and when you’re feeling stressed. This will help you regulate your emotions throughout the day and night.
Control your worry. For example constructive worry time i.e. setting aside a time for when you worry, or making a list of what’s worrying you and putting items into categories of ‘can control’ and ‘can’t control’.
Take back cognitive control at bedtime by disrupting the thoughts that are leading you to spiral. You can do this by repeating a simple word or phrase every five seconds until you fall asleep. If this isn’t working for you try doing simple sums or word puzzles in your head instead.
Get meta - ‘This too shall pass’. Take a mental step back from the situation and remind yourself that this is just a moment in time, and you will sleep again.
Challenge automatic thoughts. Will you really never sleep again? Will you really be completely useless at work tomorrow?
Don’t worry in bed - The more time you spend worrying in bed the more you will expect to feel worried when you get into bed. Break this connection by getting out of bed when you start to feel worried and doing something enjoyable and relaxing instead. Don’t worry about lack of sleep. You’re not sleeping anyway. The goal is to reduce worry, which in turn will lead to sleep.
Don’t give airtime to your sleep anxiety. If you’re talking about it and thinking about it a lot you are reinforcing the old negative cycle. Try focusing instead on the times you weren’t anxious and the times you slept well.
Stop trying to sleep. The more you try to sleep the less likely you are to sleep. Instead aim to relax. Sleep will come once you’ve mastered this so try and forget about your sleep deprivation for now!
Making these changes can be tough so be patient with yourself. If your sleep difficulties and stress are well established and difficult to shift you may need more support. Cognitive behavioural therapy for insomnia is one of the best approaches for dealing with insomnia, and has a high success rate for people struggling with sleep-related stress and anxiety. Typically you follow a programme of six to eight sessions, where you are helped to manage sleep-related stress and challenge any automatic negative thoughts you have about sleep, whilst learning more about your individual sleep needs. CBTi works for around 80% of people, so if you think this is for you please get in touch.