Widely Underappreciated Factor of Anxiety Disorders

Anxiety disorders represent the most common mental illness in the U.S., with 40 million U.S. adults affected.¹ Meanwhile, one-third of U.S. adults usually do not get enough sleep² — a factor that can make mental health, including anxiety, worse.

It may seem overly simplistic, or even cliché, to suggest that getting proper sleep could help relieve the sometimes-debilitating effects of anxiety, but research continues to show that the connection is not only relevant but significant. In fact, if you struggle with anxiety, tending to your sleep should be a primary part of your treatment plan.

'Overanxious and Underslept' — Poor Sleep Affects Anxiety

Writing in the journal Nature Human Behaviour, researchers with the University of California (UC), Berkeley, delved into the connections between sleep and anxiety, finding many strong links. In their study, "Overanxious and Underslept," it's noted:³

"Here, we investigate the basic brain mechanisms underlying the anxiogenic [anxiety-causing] impact of sleep loss. Additionally, we explore whether subtle, societally common reductions in sleep trigger elevated next-day anxiety. Finally, we examine what it is about sleep, physiologically, that provides such an overnight anxiety-reduction benefit."

For the first part of the study, brain scans were conducted on 18 young adults as they watched emotional videos, both after a good night's rest and a sleepless night.

Questionnaires were used to gauge anxiety levels in the study participants, while the brain scans revealed that lack of sleep dampened activity in the medial prefrontal cortex (mPFC), a brain area known to help quell anxiety, and amped up emotional centers.⁴

Meanwhile, those who slept well demonstrated notable declines in anxiety, with slow wave nonrapid eye movement (NREM) sleep appearing particularly beneficial. It's during slow-wave NREM deep sleep that neural oscillations become synchronized and heart rate and blood pressure drop.

"Deep sleep had restored the brain's prefrontal mechanism that regulates our emotions, lowering emotional and physiological reactivity and preventing the escalation of anxiety," Eti Ben Simon, the study's lead author, said in a news release.⁵

The results were confirmed in a second set of experiments involving another 30 people, and an online survey of 280 people, which asked questions about sleep and anxiety levels over a period of four consecutive days, and further revealed that even minor sleep disruptions could affect anxiety.

"Of societal relevance," the researchers wrote, "we establish that even modest night-to-night reductions in sleep across the population predict consequential day-to-day increases in anxiety."⁶

Deep Sleep Inhibits Anxiety

If you've ever had a poor night's rest, you're probably familiar with the heightened emotional state it can contribute to the following day. The featured study revealed one reason for this may be due to the anxiety-relieving effects of deep sleep. Speaking with UC Berkeley News, senior study author Matthew Walker, a UC Berkeley professor of neuroscience and psychology, explained:⁷

"We have identified a new function of deep sleep, one that decreases anxiety overnight by reorganizing connections in the brain … Deep sleep seems to be a natural anxiolytic (anxiety inhibitor), so long as we get it each and every night."

Lack of sleep could increase anxiety levels by up to 30%, the study found, with Walker noting, "Without sleep, it's almost as if the brain is too heavy on the emotional accelerator pedal, without enough brake."⁸ If you regularly feel emotionally off-kilter, too little sleep could be to blame. In a separate study, Walker and colleagues revealed that sleep deprivation fuels feelings of loneliness, for instance.⁹

In short, the more sleep-deprived you are, the less social you become, and others pick up on this largely subconscious cue to be left alone, essentially turning people into "social lepers" and fueling an epidemic of loneliness, as Walker put it.¹⁰

Lack of Sleep Can Make You Rude

A short temper and unwanted behaviors such as rudeness can also be the result of a poor night's rest. Research conducted by Laura M. Giurge from Rotterdam School of Management, Erasmus University in the Netherlands, found that even one night of too little sleep may lead to unwanted behavior at work the next day.¹¹

Giurge conducted the study by sending out text messages to employees, who rated their sleep quality and reported on unwanted behaviors at work, such as acting rude toward co-workers, going home early without notifying their boss or taking a longer lunch break than allowed.

Sleep quality was found to influence behavior at work the next day, especially in people with a low "moral identity." These people put less value on moral traits like fairness and kindness overall, and were also more likely to engage in unwanted behaviors at work after a night of poor sleep.

" … [D]isplay of unwanted behavior is not a fixed character trait," said Giurge, adding that such behaviors can vary from day to day. Poor sleep may make it harder for people to stop engaging in such behaviors, as well as to overcome feelings of failure when displaying the undesirable behaviors. In turn, Giurge said, "This can lead into a possibly destructive cycle."¹²

It could be that poor sleep lessens a person's self-control, which in turn increases the rate of selfish impulses leading to unwanted behaviors — even workplace theft.¹³ According to the Rotterdam School of Management, employees' "misbehaving" at work adds up to the tune of $200 billion a year in the U.S. alone.¹⁴

Sleeplessness May Shorten Your Life

In the video above, you can view Walker, who also wrote the book "Why We Sleep: The New Science of Sleep and Dreams," share reasons why lack of sleep is easily one of the greatest public health challenges, one that is causing premature death and disability.

I read Walker's book and strongly agree that sleep is profoundly important — perhaps even more so than diet and exercise. There are practical consequences to too little sleep, such as an increased risk of motor vehicle accidents and falls, and sleeplessness has also been shown to contribute to chronic illnesses such as dementia, including Alzheimer's disease, cancer, diabetes, heart disease and obesity.

As for its effects on your brain, lack of sleep heightens anxiety and may contribute to depression. It's also known to affect areas of the brain involved with concentration and problem-solving, making them sluggish.¹⁵

Further, in one animal study, sleep-deprived mice lost neurons located in their locus coeruleus, a nucleus in the brainstem associated with wakefulness and cognitive processes.¹⁶ The research also showed that "catching up" on sleep on the weekend will not prevent this damage.

In the video, Walker further highlighted sleep's connections to mental health, stating, "We are now finding significant links between sleep disruption and depression, anxiety (including post-traumatic stress disorder), schizophrenia and, tragically, suicide as well. In fact, we cannot find a single psychiatric condition in which [the subject's] sleep is normal." He also cites the following brain-related effects from lack of sleep:

• Due to your hippocampus shutting down, you will experience a 40% deficit in your brain with respect to its ability to make new memories
• Your emotional and mental health become destabilized because the emotional circuits in your brain become hyperactive and irrational due to lack of sleep
• Your amygdala, one of your brain's centerpiece regions for generating strong emotional reactions, including negative ones, becomes about 60% more reactive than usual, resulting in increased emotional intensity and volatility

Sleeping Your Way to Better Mental Health

Making sleep a priority is the first step to better mental health. It's truly a necessity, not a luxury, and if you struggle with anxiety, sleeping for a solid eight hours or so could make a major difference in your quality of life. If racing thoughts are problematic and you find yourself in bed unable to shut them off, try keeping a journal nearby and writing down the thoughts as they come.

Paying attention to sleep hygiene — items like darkness and proper temperature in your bedroom and shutting off electronics early — is also important. For instance, avoiding exposure to blue light, including LEDs, after sunset can help you get a good night's rest and is easily achievable by wearing blue-blocking glasses after sunset.

If you need help improving your sleep hygiene, check out my "33 Secrets to a Good Night's Sleep" for tips to help you fall asleep and stay asleep all night. In the short term, natural sleep remedies, such as melatonin, valerian root, chamomile, cannabidiol (CBD) oil and 5-hydroxytryptophan (5-HTP) can also be helpful.

However, stay away from prescription sleep aids including benzodiazepines (Valium, Ativan) and "Z-drugs" (Ambien, Sonata, Lunesta), which are associated with an increased risk of hip fracture, one of the most serious fall injuries, in older adults¹⁷ along with other health risks.

Got Anxiety? Natural Strategies May Help

While sleep is emerging as an essential tool in the fight against anxiety, it's only one component of a comprehensive treatment plan.

There are many natural strategies that can help, including lavender aromatherapy, which has a calming effect. "Several animal and human investigations suggest anxiolytic [anxiety reducing], mood stabilizer, sedative, analgesic and anticonvulsive and neuroprotective properties for lavender," researchers explained.¹⁸

What's more, lavender is also an effective sleep aid. One study showed orally administered lavender oil is effective in the treatment of subsyndromal (or preclinical) anxiety disorder, improving sleep quality and duration along with general mental and physical health, without causing any unwanted sedative or other side effects, making it doubly useful.¹⁹

Anxiety is a normal response to stress, but in some people the anxiety becomes overwhelming and difficult to cope with, to the point that it affects their day-to-day living.

Another strategy for dealing with this is to reframe anxiety as excitement — an emotion that's not that different from anxiety, although it's generally regarded as a positive emotion instead of a negative one, like anxiety. Harvard Business School professor Alison Wood Brooks conducted a series of experiments in 2014 to evaluate reappraising anxiety as excitement, writing in the Journal of Experimental Psychology:²⁰

"Compared with those who attempt to calm down, individuals who reappraise their anxious arousal as excitement feel more excited and perform better.

Individuals can reappraise anxiety as excitement using minimal strategies such as self-talk (e.g., saying 'I am excited' out loud) or simple messages (e.g., 'get excited'), which lead them to feel more excited, adopt an opportunity mind-set (as opposed to a threat mind-set), and improve their subsequent performance."

Using a combination of natural tools, along with tending to your body's sleep needs, may resolve anxiety for many people. However, if your anxiety is so severe that it's interfering with your daily life, speak with a holistic health care provider who can help you develop a comprehensive plan for healing.