Serious sleep disturbances, including insomnia, have long been recognized as a common symptom of anxiety disorders. People who are plagued with worry often ruminate about their concerns in bed, and this anxiety at night can keep them from falling asleep. In fact, a state of mental hyperarousal, frequently marked by worry, has been identified as a key factor behind insomnia. People with anxiety disorders are inclined to have higher sleep reactivity, which means they are much more likely to have sleeping problems when facing stress.
Sleeping difficulties have been found for people with various types of anxiety including generalized anxiety disorder, OCD, and PTSD.
Distress about falling asleep can create a sleep anxiety that reinforces a person’s sense of dread. These negative thoughts about going to bed, a type of anticipatory anxiety, can create challenges to healthy sleep schedules and routines. Research indicates that anxiety and pre-sleep rumination may affect vivid dreaming during rapid eye movement (REM) sleep. Anxiety can provoke nightmares and disturbing dreams that create a higher likelihood of sleep disruptions and may reinforce fear around going to sleep.
At the same time, strong evidence indicates that sleep deprivation can instigate or worsen anxiety disorders. Researchers have found that people who are prone to anxiety are especially sensitive to the effects of insufficient sleep on mood and emotional health. The bidirectional relationship means that anxiety and sleep deprivation can be self-reinforcing; worrying causes poor sleep, while further sleep difficulties cause greater anxiety.
People with obstructive sleep apnea (OSA), a sleep disorder that causes repeated lapses in breathing and interrupted sleep, have been found to have higher rates of mental health problems, including depression, anxiety, and panic disorder.
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