Our sleep quality is more important than a lot of us give it credit for, and one of the leading factors in poor sleep quality is our worries<\/a><\/span>. The reason I wanted to write this article was that my partner is experiencing another round of sleep difficulties that are linked to worries<\/a><\/span> at work. Thus, I wanted a better understanding, and I thought I\u2019d share what I\u2019d learned with you, my readers, so they could also benefit from that.<\/p>\n We will all experience worry<\/a><\/span> and anxiety<\/a><\/span> during our lifetimes, because it\u2019s a normal, everyday human emotion and phenomenon (Thielsch et al.<\/a><\/span>, 2015). Whether it\u2019s work-related stress<\/a><\/span>, life events<\/a><\/span>, health<\/a><\/span> concerns, or something else that leads to anxiety<\/a><\/span>, it can all affect our sleep.<\/p>\n Thus, it\u2019s very common for people\u2019s worries<\/a><\/span> to make it difficult to fall asleep or to stay asleep. If this is a frequent issue, then this can be a significant sign of generalised anxiety disorder<\/a><\/span> (Fletcher<\/a><\/span>, 2024), also known as GAD.<\/p>\n GAD is based on our worry<\/a><\/span>\u00a0as a way to problem-solve<\/a><\/span>, in response to a feared stimulus, or as preparation for the worst. The issue is that such worrying<\/a><\/span> is often about unlikely or implausible events (Pillai and Drake<\/a><\/span>, 2015).<\/p>\n Over the decades, many studies have demonstrated the link between our worried<\/a><\/span> minds and our sleep quality. A study by Kelly<\/a><\/span> (2002) found that the more worries<\/a><\/span> we experienced, the bigger the effect on our quality of sleep. Simply put: More worry<\/a><\/span> = Shorter sleep. Interestingly, this was shown to be the case even if people didn\u2019t attribute their sleep issues to worrying<\/a><\/span>.<\/p>\n This is important because that means worrying<\/a><\/span> can affect our sleep quality in very different ways. For some, it might be a lot of overthinking<\/a><\/span> before bed, making it difficult to go to sleep, and potentially waking up throughout the night when the worries<\/a><\/span> pop back into their head. Or it could mean going to sleep and waking up in a state of anxiety<\/a><\/span>.<\/p>\n But it could also be like me. I can fall asleep with no issues; I routinely wake up during the night, but I don\u2019t experience anxiety<\/a><\/span> or any worry-based thoughts, and I can fall asleep again with ease. I do this several times a night, and it seems to coincide with switching to being a mental health therapist, rather than remaining an addiction<\/a><\/span> therapist, where I have the most training.<\/p>\n Therefore, it could be because of my impostor syndrome<\/a><\/span>, which I know I have. And although I am able to separate my work and personal life into two different areas of my life with ease, it seems it may still be affecting my sleep.<\/p>\n Also, according to the metacognitive model of GAD, negative metacognitive beliefs are key in maintaining excessive worrying<\/a><\/span> (Thielsch et al.<\/a><\/span>, 2015). This isn\u2019t too dissimilar to mapadated\/negative core beliefs<\/a><\/span> in cognitive behavioural therapy (CBT), which can do the same.<\/p>\n Not only can our sleep quality be affected by our worrying<\/a><\/span>, i.e. overthinking (rumination<\/a><\/span>), which is considered to be an indirect route (Kelly<\/a><\/span>, 2002), but there is also the more direct route, whereby subconscious physiological arousal occurs.<\/p>\n A journal article that supports the connection between worry<\/a><\/span>, anxiety<\/a><\/span>, and our sleep quality comes from Pillai and Drake<\/a><\/span> (2015). In their journal article, they argue that research supports that our rumination<\/a><\/span> is a critical factor in our sleep quality, and that this is a key feature of GAD. This is also supported by McGowan, Behar, and Luhmann<\/a><\/span> (2016).<\/p>\n They also argue that the indirect rumination<\/a><\/span>, planning, or struggling to control thoughts route is more significant than the direct subconscious physiological arousal route. This makes sense because pathological worrying<\/a><\/span> is excessive and perceived as uncontrollable (Thielsch et al.<\/a><\/span>, 2015).<\/p>\n Furthermore, there\u2019s also the possibility of worry<\/a><\/span> directly triggering hyperarousal, which is the state of elevated mental, emotional, and physical activation that keeps the body\u2019s threat response active when it should be winding down. So the direct and indirect routes work together.<\/p>\n There\u2019s nothing like being told to avoid stressful<\/a><\/span> situations (Fletcher<\/a><\/span>, 2024), which doesn\u2019t even seem possible in the world we live in. There\u2019s only so much we can avoid before avoiding it causes more stress<\/a><\/span> than it avoided. So this kind of advice can be very unhelpful.<\/p>\n But what is useful is what McGowan, Behar, and Luhmann<\/a><\/span> (2016) found in their study. That is, for people for whom worry<\/a><\/span> is a significant factor in their sleep quality, and with GAD in general, it\u2019s important to address and treat that worry<\/a><\/span>. This is also supported by Kelly<\/a><\/span>\u00a0(2002).<\/p>\n This is important because poor sleep quality can worsen our anxiety<\/a><\/span>, creating a very frustrating negative feedback loop (Fletcher<\/a><\/span>, 2024).<\/p>\n This is corroborated by Thielsch et al.<\/a><\/span> (2015), who conducted a study into the role of metacognitions and found a mutually maintaining relationship between worry<\/a><\/span> and sleep quality. They found that worry<\/a><\/span> leads to poor sleep quality, and poor sleep quality leads to worry<\/a><\/span>.<\/p>\n One way this can manifest is in the form of sleep anxiety, whereby we worry<\/a><\/span> about not getting enough sleep, which is like being kicked when we\u2019re down. Therefore, interventions aimed at breaking this cycle would be useful in both the treatment of insomnia<\/a><\/span> and GAD.<\/p>\n This is further validated by Narmandakh, Oldehinkel, Masselink, de Jonge, and Roest<\/a><\/span> (2021). Their study discussed the notion of daily unpleasant affect and pleasant affect in regard to sleep quality. If we have a poor night\u2019s sleep, then we\u2019re more likely to experience unpleasant affect, experience worry<\/a><\/span>, and less likely to experience pleasant affect. They also found that our daytime experience with pleasant affect, unpleasant affect, and worry<\/a><\/span> could predict sleep issues the following night.<\/p>\n So in short, instead of allowing the brain to transition naturally into sleep, worry<\/a><\/span> keeps the nervous system on high alert, creating a cycle that disrupts both getting to sleep and staying asleep.<\/p>\n<\/div>\n For some people, they may find that frequent worrying<\/a><\/span> in bed may result in their brain undergoing a classic conditioned response. This is where our brains begin to associate our beds with frustration and hyperarousal rather than rest. Stimulus control can help break that association.<\/p>\n Intrusive thoughts<\/a><\/span> love to find quiet times to flood our minds with thoughts and reminders, and trying to sleep is one of those times because things get quiet and there\u2019s much less to distract us.<\/p>\n One way to overcome this is to have a dedicated worry<\/a><\/span> time, so that we can go through this process at a time that suits us. To do this, all we need to do is schedule a dedicated worry<\/a><\/span> time, which might be daily for 15 minutes or weekly for 30 minutes. Being consistent with this will increase it\u2019s effectivesness.<\/p>\n If a worry<\/a><\/span> pops up while we\u2019re trying to sleep, just remind ourselves: \u201cI have a dedicated time for this (add our scheduled worry time here)\u201d. It can also be useful to note a quick keyword on a notepad by the bed if needed.<\/p>\n<\/div>\n<\/div>\n A strategy I found useful when my brain would bring up all my trauma<\/a><\/span> as I was trying to sleep was to keep a journal<\/a><\/span> by my bed. Before bed, I could write about anything that was on my mind, which allowed me to offload it. If I woke up during the night, I would write down whatever would flood into my mind in those moments of temporary wakefulness. I found it really helped improve my sleep quality.<\/p>\n This also ended up helping me overcome the continued harm my trauma<\/a><\/span> caused me, because it forced me to process it, turning those burning hot traumatic memories into cold memories. It worked like narrative exposure therapy (NET)<\/a><\/span>.<\/p>\n As mentioned before, sleep quality issues often lead to sleep anxiety, which just sucks. We can experience thoughts like, \u201cIf I don\u2019t get eight hours tonight, I won\u2019t be able to function tomorrow\u201d. Although for me, it was four hours, not eight. As long as I got four, I could function, and my psychosis<\/a><\/span> was a lot more manageable. Such thinking before sleep can work as an activator to our body, and thus, further worsen our sleep quality.<\/p>\n<\/div>\n<\/div>\n If we experience thoughts like this, try reframing<\/a><\/span> to thinking like, \u201cI\u2019ve managed with a poor night\u2019s sleep before. I may feel tired, but I\u2019ll get through the day\u201d, or, \u201cOne bad night\u2019s sleep isn\u2019t the end of the world\u201d.<\/p>\n It appears we can swap out the unwanted mental chatter by engaging the brain\u2019s visual cortex. We can do this by vividly picturing a detailed, non-emotional scenario or images, such as mentally walking through a familiar park. This takes up our cognitive bandwidth needed for worrying<\/a><\/span>. My inner eye sucks, so I\u2019ve struggled to test this one out.<\/p>\n When we have worries<\/a><\/span>, it\u2019s one thing to write them down so we can clear our minds to sleep. But all of this is moot if we can\u2019t overcome the cause of our worries<\/a><\/span>.<\/p>\n So whatever route we take to manage our worries<\/a><\/span> so we can get better sleep quality, we all have to make time to figure out the cause of the worry<\/a><\/span> and \u00a0<\/h6>\n
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The Relationship Between Worry And Sleep Quality<\/h2>\n
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How To Overcome Our Worry And Anxiety Ruining Our Quality Of Sleep<\/h2>\n
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Stimulus control therapy<\/b><\/h4>\n
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Worry time<\/b><\/h4>\n
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Journaling<\/strong><\/h4>\n
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Cognitive restructuring and decatastrophising<\/b><\/h4>\n
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Imagery distraction<\/b><\/h4>\n
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Problem-solving<\/strong><\/h4>\n
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