The To-Do List: A Sleep-Friendly Bedtime Activity?

If you’ve got insomnia, you’ve probably heard of “worry lists.” Sleep doctors for years have been urging insomniacs to write our worries down before going to bed, claiming this will alleviate anxiety and sleep will come more easily.

Really? Write about looming deadlines and all the upcoming functions I have to prepare for before I go to bed? That’s sure to send my anxiety through the roof! (not to mention keeping me up for hours).

But the idea may not be as counterproductive as it sounds.

Insomnia because you're worried about tomorrow? Make a to-do-list in the eveningIf you’ve got insomnia, you’ve probably heard of “worry lists.” Sleep doctors for years have been urging insomniacs to write our worries down before going to bed, claiming this will relieve anxiety and sleep will come more easily.

Really? Write about looming deadlines and all the upcoming functions I have to prepare for before I go to bed? That’s sure to send my anxiety through the roof! (not to mention keeping me up for hours).

But the idea may not be as counterproductive as it sounds, a new study suggests.

Nighttime Challenges for Insomniacs

No one likes arguments or bad days at work, but experiences like these can be doubly disruptive for people with insomnia. At night these upsetting events cycle over and over in your head, making it hard—sometimes impossible—to sleep.

Likewise, it can be hard to sleep when you’re looking at challenges ahead. Tests to study for, deadlines to meet, presentations to deliver, events to organize, flights to catch—any unfinished business, especially lots of it, can keep you wakeful long into the night.

Could making a to-do list before going to bed relieve anxiety about tasks ahead and enable sleep to come more quickly? The jury is still out concerning insomnia sufferers per se. But a new study of healthy, normal sleepers conducted at Baylor University and Emory University Medical School suggests it might be helpful.

Polysomnography and a Pencil-and-Paper Task

This study—the first part of a larger study—was simple in design. Participants were recruited on campus and screened for various disorders, including sleep disorders. Sixty participants aged 18–30 were chosen (three were later disqualified). They were randomly divided into two groups.

The evening of the study, participants in both groups went to a sleep lab, where technicians prepared them to undergo an overnight sleep study, wiring them up for polysomnography.

After that, participants in one group were given a sheet of paper and told to spend the next five minutes writing down everything they had to do the next day and in the next few days. Participants in the other group were given a sheet of paper and told to spend five minutes writing down everything they’d accomplished that day and in the past few days.

The sheets were then collected. Lights went out at 10:30 p.m., and participants’ cerebral activity was monitored through the night.

To-Do List More Helpful Than List of Accomplishments

The results were all significant:

  • Participants who made a to-do list at bedtime fell asleep faster than those who wrote about completed tasks. (On average, the to-do list makers fell asleep in about 16 minutes while the others who listed accomplishments fell asleep in about 25 minutes.)
  • Among participants who made the to-do list, the greater the number of items on their list, the faster they fell asleep.

So making a detailed to-do list might actually be a good activity to add to your wind-down routine at night.

Results in Perspective

Other studies suggest these findings aren’t as unusual as they may seem. Researchers studying adults in highly stressful situations, such as having a son or daughter diagnosed with cancer, found that the more specifically parents could map out concrete steps they were going to take to contend with the child’s problem, the less stressed out they felt. Another study showed that first-time pregnant women who could simulate in detail how their labor would go were less worried than women that were less successful in simulating labor.

But back to doctors’ advice about worry lists: It seems to me there’s a difference between a worry list and a to-do list. The one sounds problem focused while the other is focused on solutions—which may make a difference in their effects.

At any rate, if you have insomnia and at night your mind is constantly drifting toward tomorrow and all the things you have to do, try writing down the steps you’re going to take to make things happen before you get in bed. It might relieve your anxiety and slow your busy brain just enough to hasten sleep.

9 Ways to Keep Worry From Sabotaging Sleep

These days people are worried about jobs, health care, the environment, the possibility of worldwide war. Uncertainty about the future, and fear of negative outcomes, may rob even reliable sleepers of sleep from time to time.

But for many insomnia sufferers, worry and anxiety about sleep itself—“It’s two o’clock and I haven’t slept a wink!”; “If I don’t get to sleep now I’ll get sick!”—is an equally powerful enemy of sleep.

Here’s more about worry and insomnia and how to keep them from spoiling the night.

Insomnia sufferers should incorporate a bath into their bedtime routineThese days people are worried about jobs, health care, the environment, the possibility of worldwide war. Uncertainty about the future, and fear of negative outcomes, may rob even reliable sleepers of sleep from time to time.

But for many insomnia sufferers, worry and anxiety about sleep itself—“It’s two o’clock and I haven’t slept a wink!”; “If I don’t get to sleep now I’ll get sick!”—is an equally powerful enemy of sleep.

Here’s more about worry and insomnia and how to keep them from spoiling the night.

Worrying Around the Clock

Worry and sleep don’t mix. Like anxiety, which is more intense, worry—or repetitive thinking about issues of concern—triggers the release of neurochemicals that prepare the body for action rather than for rest.

Some people are by nature inclined to worry day and night. Allison Harvey, in her cognitive model of insomnia (2002), hypothesized that round-the-clock worry about sleep led to arousal, resulting in the sleep problems experienced by insomniacs at night.

Worrying at Night

More recently, research has suggested that it’s worry in bed—rather than worry day and night, or trait-level worry—that is connected to trouble sleeping, and a new study published in Behavioral Sleep Medicine supports this conclusion. Researchers administered a series of questionnaires to 139 insomnia sufferers and had them complete sleep diaries every day for 10 days. Neither trait-level worry nor trait-level rumination (repetitive thinking about negative emotions) was shown to have a relationship with any aspect of sleep.

The researchers then conducted a similar study with another group of insomniacs. Sixty-four participants were asked to fill out two diaries: one at 6 a.m., to record the sleep-related worries experienced during the night, and the other at 7 p.m., to record sleep-related worry and stress experienced during the day.

The results? Nighttime sleep-related worry had a significant and negative effect on every aspect of sleep, including trouble falling asleep, being awake longer during the night, and sleeping less efficiently. In contrast, daytime sleep-related worry had a negative impact on sleep quality only.

“Cognitive activity during the day is relatively benign,” the study authors concluded, “but cognitive activity in bed plays an important role in development and persistence of sleep problems in insomnia.”

The Take-Away

Do your worrying during the daytime rather than at night!

Because that’s easier said than done, here are nine ways to check your worries—sleep-related or not—at the bedroom door.

  1. Write your worries down early in the evening. Preempt nighttime worrying by taking 10 or 15 minutes to write down the issues you’re worried about, whether or not they’re related to sleep. Beside each concern, write what action you’ve taken/you’re taking/you will take to deal with the problem. Some problems may be clearly outside your control (or feel that way), yet resolving to take some small action to manage the problem can afford relief.
  2. Share your worries with an empathic listener at dinner. Sharing your concerns with an empathic partner or friend over the evening meal can also help to preempt worry at night. And when it comes to figuring out how to deal with a problem, two heads are often better than one. Further, research suggests that regardless of who’s talking and who’s listening, interactions with friends and supportive family members help tone down stress.
  3. Create a pre-sleep routine. It’s important to end the day with a wind-down period (ideally, at least an hour) in the run-up to bedtime. Think of it as a time to indulge in self-care, incorporating activities that make you feel good—such as listening to slow jazz and bathing by candlelight. The aim is to create an end-of-day ritual that’s worry free. Doing the activities in the same sequence every night will establish a clear association between your wind-down routine and sleep.
  4. Train your attention on something outside yourself. Watch a movie or a sit-com. Read or listen to a novel with complex, interesting characters. Do a crossword puzzle or play a word game such as Scattergories (Pick a category: Food. Pick a letter of the alphabet: L. Think of all the foods that begin with the letter L.) If you can do so without disturbing others at home, play a musical instrument. Engaging your mind will free it from repetitive thinking and enable you to go to bed feeling more relaxed.
  5. Adjust your perspective with cognitive restructuring. Confront your worries head on by asking a series of questions to find out how realistic your repetitive thoughts about a worrisome situation really are. In the process you’ll often find your anxiety level going down. Click on cognitive restructuring to find out more.
  6. Do a low-key physical activity. Underlying worry and anxiety are neurochemicals that trigger the urge to fight or flee. Low-key physical activity, such as walking outside or around the house, enables you to work the stress out.
  7. Do a deep breathing exercise. Deep diaphragmatic breathing triggers the relaxation response, enabling the body to move out of fight-or-flight mode and into a relaxed and restful state. Sitting in a chair, slowly inhale to a count of 4, pause briefly, and exhale to a count of 4. Focus on your breathing. If you find your mind wandering, gently guide your attention back to your breathing. Repeat this cycle as many times as needed.
  8. Do progressive relaxation. Sitting or lying down, one by one, tense and release every group of muscles in your body. Start with the muscles in your toes and move upward through your trunk to your head. Then move downward through the arms to the fingers.
  9. Do a guided meditation. Allow someone else to lead you through meditations designed to quiet your mind and relax your body. Jon Kabat-Zinn, whose guided meditations are available on the internet, is a master at this.

Please share any strategies you’ve found to cut down on worry at night.

A Different Pathway to Chronic Insomnia

Let’s say you grow up in a family of champion sleepers, yourself included. At college, you sail through rowdy dormitory life sleeping like a log. Job interviews, stressful to some, don’t faze you. By 27, you’ve landed a good job and in a few years earned enough for a down payment on a house. Sleep is still dependable and stays that way for a decade.

Then, coinciding with a move and the birth of a second child, you find yourself wide awake at your normal bedtime, staring at walls. Soon this becomes the rule rather than the exception. Before you know it you’ve developed chronic insomnia. How can sleep go from good to bad so quickly?

Stress and poor sleep can lead to chronic insomnniaLet’s say you grow up in a family of champion sleepers, yourself included. At college, you sail through rowdy dormitory life sleeping like a log. Job interviews, stressful to some, don’t faze you. By 27, you’ve landed a good job and in a few years earned enough for a down payment on a house. Sleep is still dependable and stays that way for a decade.

Then, coinciding with a move and the birth of a second child, you find yourself wide awake at your normal bedtime, staring at walls. Soon this becomes the rule rather than the exception. Before you know it you’ve developed chronic insomnia. How can sleep go from good to bad so quickly?

How Insomnia Develops

For decades sleep scientists have been trying to work out how chronic insomnia develops. The main model they’ve proposed looks something like this:

  1. Predisposing factors are presumed to exist in everyone who develops chronic insomnia. They include such observable factors as (a) parental history of insomnia, (b) high sleep reactivity (a tendency to sleep poorly before and after stressful events such as giving a speech or having an argument; and to be highly reactive to caffeine, jet lag, and interpersonal stressors), and (c) poor health—all associated with biological challenges to sleep.
  2. Precipitating factors come next: major life stressors that often trigger an episode of insomnia such as a job loss, marriage, or relocation to a different town.
  3. Perpetuating factors are the habits some people then adopt for insomnia relief—taking naps, going to bed early, sleeping in on weekends—that actually make their sleep worse.
  4. Conditioned arousal of the cerebral cortex is the final step in in the process. Lying awake for long stretches of the night opens the door to worry and rumination. This brain activity can spill over into sleep and keep insomnia going indefinitely.

This may be how chronic insomnia develops in some people. There may also be alternative pathways to insomnia. A large community-based study (Evolution of Pathways to Insomnia Cohort) was recently conducted to figure out what those alternative pathways might be. Working with data from that study, Michigan researchers have concluded that even people who have no evident predisposition to insomnia may develop chronic insomnia through a process involving sleep system sensitization. Here’s more on what they found.

From Normal Sleep to Insomnia in Just One Year

In this prospective study, thousands of participants filled out a series of questionnaires at the start of the study and one and two years later. The Michigan researchers looked at the 262 participants who did not have insomnia at the start of the study but who, by year 1, had developed it.

These participants might be expected to have characteristics predisposing poor sleep from the start (a mother with insomnia, for example, or high sleep reactivity). But not all of them did. A total of 60 participants tested low for sleep reactivity at the start of the study (on the Ford Insomnia Response to Stress Test, or FIRST). But by year 1, these 60 people had jumped an average of 4 points on the FIRST, indicating a significant increase in sleep reactivity. Over two-thirds went from low sleep reactivity to very high sleep reactivity following major life stress and the onset of insomnia in the space of just one year. At year 2, the high sleep reactivity persisted regardless of whether their insomnia was chronic or not.

A Different Path to Chronic Insomnia

In a nutshell, here’s the take-away:

  • People with apparently low vulnerability to insomnia (like the person described at the beginning of this blog post) can develop high sleep reactivity in conjunction with major life stress and an episode of insomnia.
  • Stress exposure leading up to insomnia appears to sensitize the sleep system. This lends support to the idea that insomnia itself may be a perpetuating factor in chronic insomnia. Every episode may trigger neurobiological changes that increase the risk of subsequent bouts of insomnia, just as every experience of depression increases the risk of future depression.
  • High sleep reactivity, once it develops, is persistent.

No matter how or why your insomnia develops, don’t wait to look for help. Take action right away.

Easing Worry and Anxiety about Sleep

Insomnia sufferers write to me often with complaints about sleep-related worry and anxiety.

“The more important the next day is to me, the harder it is for me to sleep,” Jessica says. “So I worry about not sleeping and then it turns into a self-fulfilling prophecy.”

Finding a solution to this problem can be tricky. It may require experimentation before you home in on a strategy that works.

Insomnia characterized by worry and anxiety about sleep can be alleviated using psychological and physiological strategiesInsomnia sufferers write to me often with complaints about sleep-related worry and anxiety.

“The more important the next day is to me, the harder it is for me to sleep,” Jessica says. “So I worry about not sleeping and then it turns into a self-fulfilling prophecy.”

“I finally had about 4 good nights after starting sleep restriction (about 11 days ago) but had a horrible night of anxiety last night,” Stacy says. “I was anxious about not being able to continue my good nights of sleeping. I find it hard to practice relaxation exercises when I’m that anxious.”

Achieving a relaxed state conducive to sleep can seem impossible with a mind that’s racing from one fraught thought to another. Likewise, the physiological changes that accompany worry and anxiety—the release of stress hormones, a faster heart rate, bodily warming, tensing muscles—are a better preparation for fight and flight than for relaxation and disengagement.

How to stop obsessing about sleep and sleeplessness is the main concern of many insomniacs, yet finding a solution can be tricky. It may require experimentation before you home in on a strategy that works.

Different Schools of Thought

Research backs a handful of approaches to managing the problem, but even among sleep experts there is no consensus as to which works best. It may depend on the nature of your insomnia and which approach you find more appealing.

Some experts promote a type of talk therapy–called “cognitive restructuring–as effective in reducing worry and anxiety related to sleep. The idea behind it is that sleep-related anxieties develop in part due to the misconceptions people have about sleep and catastrophic thinking about insomnia. Replacing these ways of thinking with attitudes that are more realistic and sleep-supportive should help.

Cognitive restructuring is normally presented as part of cognitive-behavioral therapy for insomnia (CBT-I). It usually involves work with a therapist, who helps you learn to talk yourself out of worries and anxieties about sleep and sleeplessness.

Mind/Body Approaches to Curbing Arousal

Other experts suggest that psychological treatments for sleep-related anxieties may not be as effective as treatments that simply help insomniacs learn to relax. Physiological hyperarousal is the main cause of poor sleep, they say, with sleep-related anxiety and worry developing as a result. Treatment should focus on tamping down arousal that gives rise to these sleep-related worries, enabling a stronger and more dependable relaxation response.

  • Relaxation training is recommended as helpful to sleep by the American Academy of Sleep Medicine. It may involve progressive muscle relaxation and/or autogenic training (guided visualization).
  • Mindfulness-based therapies enable people to become more accepting of unpleasant feelings and sensations and, in so doing, alleviate them. Mindfulness meditation has been shown in a handful of studies to help insomnia sufferers by cutting down on pre-sleep arousal, reducing wake time at night, and enhancing sleep quality.
  • Yoga has now been shown in several studies to help insomnia sufferers learn to manage stress and get more sleep. Not only does yoga practice effectively deactivate the stress system. Yoga postures, breathing, and meditation exercises also help people develop more resilience to stress.

Exercise, Anxiety, and Sleep

Still other experts advocate exercise as the best way to relieve the anxious arousal that sabotages sleep. There’s now solid evidence that regular exercise promotes sounder sleep and preliminary evidence that exercise is effective in reducing anxiety. A meta-analysis published in April shows that even a single bout of exercise has a small but significant anxiety-alleviating effect.

Strenuous exercise is the way I calm myself down in times of stress, especially when my old fear of sleeplessness threatens to stage a comeback. The minute I feel that happening, I push myself to work out longer and harder and, most of the time, it helps.

But which kinds of exercise will give you the most bang for the buck? University of Pennsylvania researchers, analyzing data from a huge survey of behaviors affecting health, have found that while walking is associated with better sleep compared with getting no exercise at all, aerobics, calisthenics, biking, gardening, golf, running, weight-lifting, yoga and Pilates are associated with even better sleep.

Consider these strategies if worry and anxiety are feeding your insomnia. Continuing to obsess about sleep and sleeplessness is surely worse than making a good-faith effort to try some of these practices out.

Worry, Insomnia and Alcohol

Worry is the most common reason people cite for sleep problems, and worry and sleep disturbance invite the use of alcohol. Worried insomnia sufferers are twice as likely as people without sleep disturbances to become problem drinkers.

But I’ve spoken and corresponded with quite a few people who say an occasional drink or two before bedtime gives them a good night’s sleep. Here’s a look at the effects of alcohol on the brain and differences in how people respond to it.

worry-insomnia-alcoholWorry is the most common reason people cite for sleep problems, and worry and sleep disturbance invite the use of alcohol. About 30 percent of the people with persistent insomnia report using alcohol to get to sleep, and 13 percent take their last drink within 30 minutes of bedtime. Worried insomnia sufferers are twice as likely as people without sleep disturbances to become problem drinkers. (Find links and sources for this blog below.)

The possibility of developing alcohol dependence should give pause to insomniacs who drink, particularly those prone to drinking right before bed. It’s better to abstain within three hours of turning in.

That said, I’ve spoken and corresponded with quite a few people who say an occasional drink or two before bedtime gives them a good night’s sleep. Here’s a look at the effects of alcohol on the brain and differences in how people respond to it.

Under the Influence

Why does alcohol make people sleepy? Not a great deal is known about how and where alcohol acts to promote sleep. At least three key substances are involved.

  1. GABA is the main inhibitory neurotransmitter in the central nervous system, crucial to shutting the brain down at night. When GABA neurons are firing, the lights in the rest of the brain go out. Popular sleeping pills like Ambien and Lunesta work by enhancing the action of the GABA system. Studies have shown that alcohol does, too, especially at low doses.
  2. Glutamate is the main excitatory neurotransmitter in the brain, responsible for keeping us awake and alert. Studies have shown that alcohol interferes with activity at a particular glutamate receptor. This, too, would have a calming effect on the brain.
  3. Adenosine is a substance that affects the signalling of neurotransmitters like GABA and glutamate. In a recent study of alcohol’s effects on rats, alcohol increased the amount of adenosine available in an area of the brain important to sleep and waking. This inhibited the firing of orexin neurons, which are normally active during periods of wakefulness. The sleep-wake system in humans is very similar to that of rats. So the increased levels of adenosine that occur with alcohol use would tend to promote sleep.

Alcohol in People without Sleep Problems

Alcohol has somewhat different effects on insomniacs and normal sleepers. The average person who has a couple drinks before bedtime

  • falls asleep more quickly than usual
  • may sleep more deeply in the first half of the night
  • experiences disrupted sleep in the second half of the night, characterized by prolonged periods of dreaming, light sleep, and wakefulness.

Tolerance to alcohol’s sedative effects develops within three nights. The only way to continue getting the same effects is to increase the amount of alcohol consumed.

Alcohol in People with Insomnia

When insomniacs, who on average get less deep sleep than normal sleepers, drink near bedtime, research shows we

  • fall asleep more quickly
  • get more deep sleep than we normally would, even as much as normal sleepers
  • may not experience disrupted sleep in the second half of the night.

No wonder we head for the Chardonnay when the going and the sleeping get tough. Alcohol tends to improve our sleep at first. But insomniacs, too, habituate in less than a week. Just like normal sleepers, we have to drink more and more to keep getting the same effect and we risk developing alcohol dependence. Also, regular use of alcohol for sleep eventually degrades sleep quality and worsens insomnia.

So if you’ve got persistent sleep problems and you like to drink, use alcohol in the same way you would any other drug with serious side effects: with caution.

How does drinking at night affect your sleep?

References

1) David Armstrong and Alex Dregan, “A Population-Based Investigation into the Self-Reported Reasons for Sleep Problems, PLoS One 9 (2014).

2) C.D. Jefferson et al., “Sleep Hygiene Practices in a Population-Based Sample of Insomniacs,” Sleep 28 (2005): 611-5.

3) R.M. Crum et al., “Sleep Disturbance and Risk for Alcohol-Related Problems,” American Journal of Psychiatry 161 (2004): 1197-203.

4) Timothy Roehrs and Thomas Roth, “Sleep, Sleepiness, and Alcohol Use,” National Institute on Alcohol Abuse and Alcoholism.

5) R. Sharma, P. Sahota, and M.M. Thakkar, “Role of Adenosine and the Orexinergic Perifornical Hypothalamus in Sleep-Promoting Effects of Ethanol,” Sleep 37 (2014): 525-33.

 

Go Paleo for Better Sleep

Occasionally I hear from an insomnia sufferer who can tell me precisely the times she woke up the previous night. “Went to sleep at 11:30, up again at 12:55. Lay awake for an hour. Got back to sleep but woke up again to go to the bathroom at 2:40. Woke up again at 4:40 and stayed awake until the alarm rang at 6. What should I do?”

This person—let’s call her Judith—doesn’t sound like she’s getting much sleep: little more than 4 hours if you tally up the numbers. Few of us could thrive on a steady diet of 4-hour nights, and Judith is no exception. She works full time and cares for her family in the evening. When the alarm rings, she’s got to be up and on her toes all day until she crashes at 10 p.m. No wonder she has a lot of anxiety about sleep and is desperate for more of it.

I’ve blogged about various ways to improve sleep, but one small change of habit I’ve mentioned deserves more attention.

Flintstone-napOccasionally I hear from an insomnia sufferer who can tell me precisely the times she woke up the previous night. “Went to sleep at 11:30, up again at 12:55. Lay awake for an hour. Got back to sleep but woke up again to go to the bathroom at 2:40. Woke up again at 4:40 and stayed awake until the alarm rang at 6. What should I do?”

This person—let’s call her Judith—doesn’t sound like she’s getting much sleep: little more than 4 hours if you tally up the numbers. Few of us could thrive on a steady diet of 4-hour nights, and Judith is no exception. She works full time and cares for her family in the evening. When the alarm rings, she’s got to be up and on her toes all day until she crashes at 10 p.m. No wonder she has a lot of anxiety about sleep and is desperate for more of it.

I’ve blogged about various ways to improve sleep, but one small change of habit I’ve mentioned (Clocking the Hours at Night) deserves more attention.

You’ve Heard of the Paleo Diet?

I’d like to propose that all of us who worry about not getting enough sleep adopt a more Paleolithic approach to the night.

I’m not suggesting we should sleep communally or in caves or anything like that. I don’t assume our distant ancestors experienced less stress and anxiety and therefore slept better than we do. They didn’t have jobs or mortgages to worry about . . . but they were mincemeat if they didn’t worry about predators and human enemies at night. The idea that they slept more peacefully than we do is probably a myth.

“In the ancient world,” says Eluned Summers-Bremner, author of Insomnia: A Cultural History, “sleep was by no means an event to which individuals felt they were entitled, or, like hunting for food, one that was always easily achieved.”

Yet one thing our Paleo forebears almost certainly did not worry as much about was time: time enough to do everything that needed to be done during the day, and time enough to sleep at night. Back then, the concept of time as measurable except through natural phenomena—the alternation of daylight and darkness, the waxing and waning of the moon, the changing of the seasons—likely did not exist. People worked as long as needed to complete a task and they slept when they felt sleepy. End of story.

Moving Forward in History

But time began to be measured in hours and minutes, and associated with work and money, with the introduction of the clock in the merchant economy that arose in Europe in the fourteenth century, Summers-Bremner says. The Late Middle Ages is when mention of time- and work-related sleeplessness began to crop up in works of literature: something resembling our experience of insomnia today.

We Can’t Go Back

We can’t actually approach the night with the mindset of a Fred Flintstone. When we think of time we think of a clock ticking away, constantly moving forward by minutes and hours. And every passing second shrinks our sleep opportunity down.

But if we can’t adopt a Paleo mindset with respect to time, at least we can take care to avoid staring time in the face. We may not be able to turn back the clock, but at night we can turn our clocks to the wall.

Resisting the urge to glance at the clock may not be as easy for every insomnia sufferer as it sounds. But take it from one who’s been there: it cuts down on anxiety about sleep.

Do you watch the clock at night? Do you think it affects your sleep in any way?

Sleep Deprivation and Anxiety: New Findings

Researchers at UC Berkeley have shown that sleep deprivation amplifies anxiety in people prone to worry. In a study written up in Science Daily, the researchers found that a single sleepless night greatly ramped up neural activity in two brain regions associated with the processing of emotion.

Stress and negative emotion felt strongly after sleep deprivationIt’s a vicious circle, as many people with chronic insomnia will attest. Stress and worry lead to bad nights, and the resulting sleep loss seems to magnify the worries, which in turn leads to worse nights and soaring anxiety, and on and on. Once the cycle is set in motion, it can feel impossible to stop.

Researchers at UC Berkeley have shown that sleep deprivation amplifies anxiety in people prone to worry. In a study written up in Science Daily, the researchers found that a single sleepless night greatly ramped up neural activity in two brain regions associated with the processing of emotion: the amygdala and the insular cortex. Excess activity in these two regions is common in people that have generalized anxiety disorder, panic attacks, and PTSD.

Study Particulars

Eighteen healthy young adults were the subjects in this experiment. They spent two nights in UC Berkeley’s Sleep and Neuroimaging Laboratory. They got a good night’s sleep on the first night. The second night, they stayed awake.

After both nights, they watched a slide show containing neutral and highly disturbing images, during which time their brains were scanned using functional MRI. Before each image, a visual cue was presented to create anticipation for the image that would follow. A yellow circle indicated that a neutral image such as a bicycle was going to appear. A red minus sign portended a disturbing image such as the body of a burn victim. And a white question mark signaled that either a neutral or a shocking image would flash upon the screen.

An Emotional Roller Coaster

The red minus sign and the white question mark triggered enormous anticipatory anxiety in the subjects when they were sleep deprived, as shown by the excessive neural activity occurring in the emotion centers of their brains. And in sleep-deprived subjects who were naturally prone to anxiety, the activity in the amygdala and insular cortex was sky high.

The subjects in this experiment were not insomnia sufferers. But if sleep deprivation magnifies anxiety in healthy, normal sleepers, it’s bound to boost anxiety in us. I for one am as familiar with this pattern as with the back of my hand. Bad nights heighten whatever anxiety I may be feeling, in turn begetting more bad nights and even greater anxiety.

No wonder insomniacs sometimes feel like we’re on an emotional roller coaster and powerless to make it stop.

How does insomnia affect you emotionally?

Who Says Sleep Declines with Age?

Older adults tend to sleep less than younger adults, with total sleep time declining by about 10 minutes per decade.

But the assumption that sleep problems generally increase with age does not always hold true, according to two studies recently published in the journal Sleep.

sleep-agingI used to be the only insomniac among my champion sleeper peers. Now several of my friends report experiencing insomnia. I guess that’s not surprising: we’re the baby boom generation, and sleep problems tend to increase with age. Or do they?

Older adults do tend to sleep less than younger adults, with total sleep time declining by about 10 minutes per decade. But the assumption that sleep problems generally increase with age does not always hold true, according to two studies recently published in the journal Sleep.

Study Results

Investigators in the first study analyzed complaints of sleep disturbance and tiredness in over 150,000 Americans age 18 and above. What they found was surprising:

  • The youngest group (18- to 24-year-olds) had the highest rate of reported sleep disturbance, and the oldest group (70- to 74-year-old males, and females age 80 and above) had the lowest rate.
  • The 18- to 24-year-olds and adults age 70 and older reported the highest rates of tiredness, while adults age 65 to 69 reporting the lowest rate of tiredness.
  • Overall, the investigators concluded, “both sleep disturbance and tiredness complaints generally declined across the life span.”

In the second study, researchers took data from over 84,000 people in England and Finland and looked to see how sleep lost over worry changed with age. These findings, too, suggest that sleep quality doesn’t necessarily decline with age:

  • Sleep loss over worry was highest among 34- to 55-year-olds.
  • There was a decline in sleep loss over worry between the ages of 56 and 65 (in women, however, the decline began somewhat later than in men).
  • Sleep loss over worry was the lowest in old age.

Sleep Complaints, Health, and Stress

How can we explain why people in the oldest age groups reported better quality sleep than younger people? One factor that may be involved is overall health. People develop more health problems as they age, and many of these problems have a negative impact on sleep and on mortality. People who survive into the oldest age groups may be particularly resilient to age-related health problems and thus may not experience the associated problems with sleep.

Stress is clearly a factor in the sleep loss over worry reported by the younger groups: people in their 20s and 30s are completing college degrees, entering the job market, and bearing and rearing children. Baby boomers well along in middle age are contending with a few stressors too: we’re developing health problems; losing jobs to a younger, cheaper workforce; caring for sick parents; and even parenting grandchildren. Maybe it’s only the luckiest among us that will slide into old age with a clean bill of health and sound, restorative sleep.

Anyway, when I talk about insomnia these days, I’m not the Lonely Hearts Club Band member I used to be. Now I’ve got plenty of company.

If you’ve got a sleep problem, when did it begin? Was it related to stress or something else?

Age and Sleep Disturbances

Sleep Lost over Worry