Do you find yourself tossing and turning in bed, unable to quiet your mind no matter how tired you are? If so, you are not alone. This is a common struggle for millions worldwide, especially people with anxiety disorders likeGeneralized Anxiety Disorder (GAD).
While it is normal to feel anxious from time to time, GAD takes worry to a whole new level, with thoughts that often spiral out of control and seem impossible to quiet.
This constant undercurrent of anxiety can make it difficult to quiet the mental chatter and achieve restful sleep.
Sleep anxiety, a common symptom of GAD, is a fear or apprehension about sleep itself. The act of trying (and failing) to sleep can become another source of worry, creating a vicious cycle that perpetuates the problem.
The physical sensations of sleep anxiety can be just as distressing as the mental turmoil. Your heart may race, your muscles may tense up, and you may feel a knot in your stomach that refuses to loosen.
While sleep anxiety feels overwhelming, there are effective strategies and techniques to calm your mind and drift off to sleep peacefully.
Body scans
Body scans are a common type of mindful meditation involving focusing your attention on different parts of your body, from your toes to the top of your head, and noticing any tension or discomfort.
Researchfound that incorporating deep breathing and body scan meditations combined with music into one’s bedtime routine improved sleep quality and quality of life in older adults.
Additionally, astudyfound that using body scans in a Cognitive Behavioral Therapy for Insomnia (CBT-I) intervention was effective for adolescents with insomnia and co-occurring anxiety.
You can do body scans alone, or there are phone apps available with sleep meditations that include body scans. One free app isInsight Timer. You can also researchother appsand find the best one for you. Remember to turn your phone brightness down to the lowest setting an hour before bed.
Body scans help to bring awareness to physical sensations and can be particularly helpful for individuals with GAD who experience somatic symptoms of anxiety, such as muscle tension or a racing heartbeat.
The key to body scanning is that it is just an observation and does not involve a reaction.
Progressive muscle relaxation
Progressive muscle relaxationinvolves tensing and then relaxing different muscle groups in your body, progressively moving through your whole body.
Starting with your toes and working your way up to your head, tense each muscle group for a few seconds before releasing the tension completely.
You can do this alone or use a guided sleep meditation that includes this technique. You can find sleep meditations on an app orYouTube, particularly if you have YouTube Premium to avoid ad interuptions.
Research found that progressive muscle relaxation reduced anxiety and improved sleep quality inpatients with COVID-19, who were experiencing significant anxiety and poor sleep due to being treated in isolation. The same results have been found forburn patients, who “experience a high level of anxiety and poor sleep quality.”
Furthermore,a study investigatingthe effects of progressive muscle relaxation on nursing students found that their anxiety levels significantly reduced
Mindfulness
Mindfulnessinvolves bringing your attention to the present moment without judgment. This practice can be particularly helpful if you have GAD and struggle with rumination and worry about the future.
Astudyfound that app-based mindfulness training decreases emotional reactivity, worry, and sleep disturbance. Thus, mindfulness-related apps can help people for whom worry disturbs their sleep.
Incorporating mindfulness into your nighttime routine can help to quiet racing thoughts and promote relaxation. Techniques such as breath awareness or guided meditations can help with this.
Another way in which you can incorporate mindfulness at bedtime is to focus on the physical sensations of lying in bed. Notice the way your body feels sinking into the mattress, the weight of the covers over you, and the contact of your head on the pillow.
Mindfulness can help anchor you in the present moment rather than past regrets or anxieties about the future, making it easier to fall asleep. It is about being fully present in your physical reality instead of staying trapped in anxious thoughts, worries, and what-ifs.
A key with mindfulness is to not fight the anxiety, but rather approach those anxious feelings with gentle, focused awareness.
Grounding techniques
Grounding techniques involve using your senses to anchor yourself in the present moment.
These techniques can be helpful for individuals with GAD who experience feelings of dissociation, detachment, or disconnection during periods of heightened anxiety.
One psychological approach for grounding and alleviating anxiety is the5-4-3-2-1 technique, which you can use before bed.
Anxiety therapist Dr. Sarah Allen recommends seven “grounding techniques for calming down quickly”, including letting your thoughts come and go without responding to them. “For each thought that comes to mind, allow that thought to take its place on a leaf and watch it blow away in the wind.”
Visualization
Visualization involves imagining a peaceful and calming scene or experience in your mind’s eye. This can help you if you struggle with intrusive thoughts or worry at night.
Visualization exercises can stimulate your body’s natural relaxation response.The Sleep Foundationexplains that “these techniques rely on using mental images to create a sense of well-being in the body, which can reduce stress and help you fall asleep.”
You can visualize yourself in this peaceful setting, taking in the sights, sounds, and sensations around you. As you immerse yourself in the scene, allow yourself to let go of any worries or anxieties weighing on your mind.
Guided meditations often include soothing music, calming narration, and visualization exercises to help quiet the mind and induce a state of tranquility to promote sleep.
There are evensleep podcaststhat may include visualizations and that you can listen to when winding down before bed.
Environmental changes
The Sleep Foundationexplains that “a relaxing environment is essential for a good night’s rest. Studies have shown people simply sleep better when their bedroom is optimized for light and noise levels, temperature, and comfort.”
Invest in blackout curtains to block out light, use white noise or earplugs to mask disruptive sounds, and ensure your mattress and pillows are comfortable and supportive.
Furthermore, clutter and disorganization in your bedroom can disrupt your sleep without you realizing it. A messy room leads to longer sleep onset, as a cluttered environment affects mental calmness and sleep quality. Keeping your bedroom tidy or exploring storage solutions can promote better sleep.
Feng shui experts also do not recommend keeping anything under your bed, apart from sleep-related items like pillows (if necessary), as this can negatively impact sleep.Here is a checklist with further feng shui tips.
While these tips may be helpful for anyone, they can be particularly helpful if you have generalized anxiety and worry about bedroom clutter.
Sleep routines
Create a calming bedtime routine to signal to your body that it is time to wind down. Taking a warm bath, doing gentle yoga stretches, journaling, practicing relaxation techniques, or reading a book can all help to calm down the body if you struggle with an anxiety disorder.
Establishing a consistent sleep routine can help regulate your body’s internal clock and improve the quality of your sleep. This means setting a regular bedtime and wake-up time and sticking to it, even on weekends.
As previously explained, ensure that your bedtime routine does not include using electronic devices (unless you are briefly turning on a guided sleep meditation).
Research has found that using electronic devices for more than 30 minutes close to bedtime is linked to poorer sleep quality inuniversity students.
Furthermore, declutter your bedroom, use calming colors, invest in comfortable bedding, and switch to warm lighting a couple of hours before bed.
By establishing a consistent sleep routine, you can help train your body to recognize when it is time to sleep and improve your overall sleep quality. This should mean you are feeling less anxious before you even get into bed and can have a calming night.
Journaling
Set aside time each evening to write down your worries, fears, and concerns in a journal. If you do not wish to keep a journal, you could write your thoughts on a piece of paper and then tear it up.
Psychologist Dr. James Pennebaker advocates for a science-backed technique called “expressive writing,” where you free-write your worries without judgment.
Additionally, identify and challenge irrational or catastrophic thoughts commonly associated with GAD, such as excessive worry about future events or catastrophic thinking about worst-case scenarios.
Write down unhelpful thoughts, then challenge their validity with evidence and more positive interpretations. Use cognitive-behavioral techniques, such asreframing negative thoughtsor finding evidence to dispute irrational beliefs.
An example of an unhelpful thought is “I will never find a job–I am a failure.” This could be challenged with something like, “this is just my anxiety talking. I have skills and experience, and setbacks are temporary.”
Reading
Reading is a soothing and distracting activity to help calm anxiety at night. Engaging in a good book can transport your mind to a different world, providing an escape from the worries and stressors of daily life.
Research has found that reading before bedimproves sleep quality.
Clinical Psychologist and Sleep Medicine Expert Dr. Michael Breus recommends choosing paperbacks and hardbacks to avoid blue light exposure. If you must use an e-reader, apply a blue light filter.
Set aside dedicated time before bed to unwind with a book in a comfortable and cozy environment, such as your favorite armchair or nestled under the covers.
Remember to dim the lights. Use a bedside lamp or reading app with warm lighting to avoid blue light exposure.
Choose reading material that is engaging but not overly stimulating or anxiety-inducing.
Avoid suspenseful thrillers, anything too emotionally charged, or intense subject matter that may heighten arousal or stimulate anxious thoughts. Instead, choose literature that captures your interest without triggering emotional arousal.
Non-sleep deep rest
Dr. Andrew Huberman, a Stanford University neuroscience professor, coined the term “non-sleep deep rest.
Non-sleep deep rest (NSDR) is a relaxation technique that induces a state of deep calmness and rest similar to sleep, but while awake.
It has been shown to provide mental and physical health benefits such as reducing stress, enhancing learning and memory, replacing lost sleep, and improving the ability to fall back asleep.
The steps to complete NSDR are:
In summary, NSDR uses breathwork, body awareness, visualization, and attention techniques to quickly induce a deeply relaxed yet awake restful state, providing regenerative health benefits.
When to seek additional help
If, despite your best efforts, anxiety continues to significantly impact your ability to sleep and function during the day, it may be time to seek additional help from a mental health professional.
Consider reaching out to a licensed therapist or psychiatrist who specializes in anxiety disorders and sleep disorders.
A mental health professional can provide personalized guidance and treatment options, such as cognitive-behavioral therapy (CBT) (including CBT-I), medication management, or other evidence-based interventions.
Additionally, if you experience symptoms beyond sleep anxiety, such as irritability or difficulty concentrating, seeking professional help is essential forproper diagnosis and treatment.
References
Allen, S. (2023, November 5). 7 simple grounding techniques for calming down quickly.Dr. Sarah Allen Counseling.https://drsarahallen.com/7-ways-to-calm/
Anzab, N. (2024, January 15). 6 Psychologist-Approved ways to getting perfect sleep every night.Bed Threads.https://uk.bedthreads.com/blogs/journal/psychologist-tips-for-perfect-sleep?redirected=true
Breus, M. (2024, January 18). How to fall asleep fast.Sleep Doctor.https://sleepdoctor.com/sleep-hygiene/how-to-fall-asleep-fast/
Eisler, M. (2020, August 24). 10 sleep podcasts that will elevate your zzzzz’s – mindful minutes.Mindful Minutes.https://mindfulminutes.com/10-sleep-podcasts-that-will-elevate-your-zzzzzs/
Finucane, E., O’Brien, A., Treweek, S. et al. (2021). Does reading a book in bed make a difference to sleep in comparison to not reading a book in bed? The People’s Trial—an online, pragmatic, randomised trial.Trials, 22, 873.https://doi.org/10.1186/s13063-021-05831-3
Gangadharan, M. P., & Madani, M. A. H. (2018). Effectiveness of progressive muscle relaxation techniques on depression, anxiety and stress among undergraduate nursing students.Int J Health Sci Res,8(2), 155-63.
Gao, M. B., Roy, A. B., Deluty, A. B., Sharkey, K. M. MD, PhD, Hoge, E. A. MD, Liu, T. PhD, & Brewer, J. A. MD, PhD. (2022). Targeting Anxiety to Improve Sleep Disturbance: A Randomized Clinical Trial of App-Based Mindfulness Training.Psychosomatic Medicine, 84(5), 632–642.https://doi.org/10.1097/PSY.0000000000001083
Harorani, M., Davodabady, F., Masmouei, B., & Barati, N. (2020). The effect of progressive muscle relaxation on anxiety and sleep quality in burn patients: A randomized clinical trial.Burns, 46(5), 1107–1113.https://doi.org/10.1016/j.burns.2019.11.021
Huberty, J., Puzia, M. E., Green, J., Vlisides‐Henry, R. D., Larkey, L., Irwin, M. R., & Vranceanu, A. (2021). A mindfulness meditation mobile app improves depression and anxiety in adults with sleep disturbance: Analysis from a randomized controlled trial.General Hospital Psychiatry, 73, 30–37.https://doi.org/10.1016/j.genhosppsych.2021.09.004
Insight Network, Inc. (n.d.). Insight Timer – #1 free meditation app for sleep, relax & more. Insight Network, Inc. Copyright (C) 2021.https://insighttimer.com/en-gb
Li, K., Chen, Y., Wu, D., Lin, R., Wang, Z., & Pan, L. (2020). Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19.Complementary Therapies in Clinical Practice, 39, 101132.https://doi.org/10.1016/j.ctcp.2020.101132
Mastroberte, T. (2020). The universe is talking to you: Tap Into Signs and Synchronicity to Reveal Magical Moments Every Day.
Mirzanah, S., Yona, S., & Dahlia, D. (2020). EFFECT OF PROGRESSIVE MUSCLE RELAXATION ON SLEEP QUALITY AMONG PATIENTS WITH CHRONIC DISEASES: A LITERATURE REVIEW.Belitung Nursing Journal,6(2), 30–34.https://doi.org/10.33546/bnj.1060
Nanthakwang, N., Siviroj, P., Matanasarawoot, A., Sapbamrer, R., Lerttrakarnnon, P., & Awiphan, R. (2020). Effectiveness of Deep Breathing and Body Scan Meditation Combined with Music to Improve Sleep Quality and Quality of Life in Older Adults.The Open Public Health Journal, 13(1), 232–239. https://doi.org/10.2174/1874944502013010232
Newsom, R. & Rehman, A. (2023, December 22). Relaxation exercises to help fall asleep. Sleep Foundation.https://www.sleepfoundation.org/sleep-hygiene/relaxation-exercises-to-help-fall-asleep
Pacheco, D., & Pacheco, D. (2023, November 8). The bedroom environment.Sleep Foundation.https://www.sleepfoundation.org/bedroom-environment
Peterson, T. (2022, December 7). Mindfulness for Anxiety: How it Works & Techniques to try.Choosing Therapy.https://www.choosingtherapy.com/mindfulness-for-anxiety/
Peterson, T. (2024, February 14). Progressive muscle relaxation: How it works, benefits, & tips.Choosing Therapy.https://www.choosingtherapy.com/progressive-muscle-relaxation/
Pham, H. T., Chuang, H.-L., Kuo, C.-P., Yeh, T.-P., & Liao, W.-C. (2021). Electronic Device Use before Bedtime and Sleep Quality among University Students.Healthcare, 9,1091.https://doi.org/10.3390/healthcare9091091
Salako, L. (2023, July 12). The 5-4-3-2-1 grounding technique for better sleep.The Sleep Matters Club.https://www.dreams.co.uk/sleep-matters-club/5-4-3-2-1-grounding-technique
Sissons, C. (2022, November 11). 7 of the Best Apps for Sleep Meditation.Medical News Today.https://www.medicalnewstoday.com/articles/best-apps-for-sleep-meditation#_noHeaderPrefixedContent
To Sleep or Not to Sleep: Body Scan Effectiveness in Adolescents with Insomnia and Cooccurring Depression and Anxiety Symptoms within CBT-i Treatment – University of Twente Student Theses. (n.d.).https://essay.utwente.nl/85630/
Therapist Uncensored (2024, February 19). A Neuroscience-Proven Expressive Writing Protocol with Dr. James Pennebaker (225).https://therapistuncensored.com/episodes/neuroscience-proven-writing-protocol-james-pennebaker-225/#:~:text=James
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Haddi BrowneMental Health Writer, Mental Health Researcher, ProofreaderEducation BSc (Hons) Psychology, MSc Mental Health StudiesMiss Haddi Browne is a freelance mental health writer and proof-reader with over seven years of experience working as a professional researcher with a diverse range of clients across the lifespan, including young adults with post-traumatic stress disorder (PTSD) and depression.
Haddi BrowneMental Health Writer, Mental Health Researcher, ProofreaderEducation BSc (Hons) Psychology, MSc Mental Health Studies
Haddi Browne
Mental Health Writer, Mental Health Researcher, Proofreader
Education BSc (Hons) Psychology, MSc Mental Health Studies
Miss Haddi Browne is a freelance mental health writer and proof-reader with over seven years of experience working as a professional researcher with a diverse range of clients across the lifespan, including young adults with post-traumatic stress disorder (PTSD) and depression.
