Welcome, everybody! Today’s episode is going to focus on a single topic. I have gotten a lot of questions recently about nighttime anxiety and nocturnal panic, so today we are going to focus on things that you can do to help you get a little bit better sleep and some relief from that nasty anxiety that can pop up during the night.
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Check your sleep hygiene
Try to keep a consistent sleep and wake time. It might suck when you are not getting great sleep, but it will help to force your body into a regular rhythm.
Avoid non-sleep activities in bed, such as working on your laptop or checking social media. Your bed should be about sleep, not work. A great example of this is having a ‘no phones in the bedroom’, so if possible please try to do that!
Keep a consistent pre-sleep routine – what you do as you wind down to go to sleep.
Your pre-sleep routine
Let’s talk a little more about your pre-sleep routine. There are a few elements to take into consideration here. We have a tendency to fall into a thinking trap called “emotional reasoning”.
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Emotional reasoning is the tendency to assume that since you feel a certain way, it must be true. For example, I feel like something is wrong, therefore I need to be on guard and look for danger. This comes into play with anxiety because if your body is elevated and you are feeling anxiety symptoms, your brain is going to take that as a sign that you are in danger or need to be anxious for some reason.
One of the things that you can do to work around this emotional reasoning is to make sure you integrate relaxation into your pre-sleep routing. This can be done a number of ways such as carrying out breathing exercises, using an app like headspace, doing a guided relaxation on youtube, stretching while listening to some calming music, or even something like working on a puzzle. If you want to read that is okay too, but make sure you pay attention to what sort of content you are reading. For me, if I read non-fiction business or motivational books, I get too wound up and start trying to brainstorm while lying in bed. Instead, if I read something like a fantasy book, it helps me to have cool things that are totally separate from the stress of everyday life to focus on.
Ideally, you want to be starting to disconnect from the world and focusing on transitioning into sleep 30 minutes to an hour before you actually go to bed. One problem that pops up a lot is having just too many thoughts in your head when you lie down to try to sleep. Rather than relaxing and drifting off, you worry about the next day, think of all the unresolved tasks in your life, and try to work out problems in your brain rather than just fading off into restful sleep.
Try journaling before bed
You don’t have to do any sort of formal journal format for this. Simply write down your concerns, worries, plans, to-dos, and anything else that is swirling around in your head. Getting it on paper is not going to completely remove the concerns, but it is externalizing them.
The way our brains work is we have this function called working memory. This is basically the temporary staging area where you hold information and work with it. When you take all of these worries and thoughts into bed with you, it’s almost like your brain is rehearsing the information so that you don’t lose it. When you write out your concerns, it can help to ease the burden on your working memory because you know the information exists out there. I know it might sound counter-intuitive to focus on the things that stress you out when they may seem unpleasant. And it’s not like you are truly going to forget the worries that you have all day. But try it out. You might be surprised how well this works.
In my opinion this journaling process is best done at the beginning of your nighttime routine. It can be a little agitating to bring all this stuff up, so I don’t want you to go from writing straight into bed. Doing it at the beginning of your routine allows you to give yourself permission to leave it on the paper, relax and prepare for rest.
Focus on disconnecting from the world
During this period of time, you will want to avoid devices as much as possible. You might be using your phone for headspace or youtube to relax, but definitely be sure to avoid the television or social media. You want this to be your time. The world will be there tomorrow. Obviously, having a physical space that is relaxing can be helpful. If you are trying to chill and you are surrounded by envelopes full on unpaid bills, clutter, and reminders of things that piss you off, it might be a bit of an uphill battle. Even if you don’t have a lot of space, try to make a few little spots that can be your personal oases.
Think about your inputs
You are also going to want to pay attention to what sort of inputs your body is getting. If you are on medication, it might be worth talking with your doctor about what sort of adjustments could be helpful. For instance, if your medication begins to wear off during your sleep, perhaps there is a time-release option that will give you a steady dose throughout the night. Or maybe you could break your normal dose into multiple smaller doses.
Have you had caffeine? If you are the type to have coffee, soda, or energy drinks during the day, you need to be careful with that. Caffeine is a stimulant. That means it mimics the effect of anxiety in your body and can give you a headstart when you are starting to feel anxious. It also makes sleep more difficult. Many people, myself included, use caffeine in the mornings and during the day to help with energy. However, if you consume caffeine in the afternoon, it can interfere with your sleep in the evening. Watch out for that and be honest with yourself. Even if you have a tolerance to caffeine and are used to drinking a lot, it’s still going to interfere. It’s just biology.
Also consider what food you are eating and when, as well as alcohol consumption etc. There are so many possible variables here, but just consider what is happening in your body while you are trying to sleep. Keeping a log of these things can be helpful.
It’s always helpful to rule out physical issues with your doctor as well. Say you have sleep apnea and you have short periods of breathing interruption while sleeping. That could definitely trigger panic since you are literally unable to breathe in those moments, even if it’s not immediately dangerous. A sleep study could determine whether that is part of the equation. They could also help you determine the appropriateness of supplements like melatonin, CBD, or vitamins.
Nocturnal Panic Attacks
Let’s talk a little more about when you are getting to sleep okay and then you wake up with a panic attack. It’s super unpleasant, but as always it’s important to remember that panic attacks, even at night, are not physically dangerous to you. Rather than fighting against the panic and trying to sleep through it, it seems to be more useful to accept that the panic is happening and take a break from sleep. It’s unlikely that you are going to power through and get back to sleep, so don’t try. I’d suggest getting out of bed when they happen. Grab a glass of water and let the temporary shittiness subside a bit.
It can be really tempting to focus a whole lot on the “why” of panic attacks. Trying to figure out what was going on that made it happen. That’s not always very useful, though. Very often, it’s not even really possible to determine why a panic attack happened. So instead of trying to figure out why it happened, focus on trying to let it pass and recover as well as possible. Accept that this is part of your journey right now and you can handle it.
Take a break
The last thing you need to do when you wake up from a panic attack is to go to social media and post about it. Stay disconnected from the world. But definitely give yourself a break though. Take 10-15 minutes to grab some water, do some deep breathing, and engage in a relaxing activity like a crossword puzzle, doodling, crocheting, etc. Then try to go back to bed again. Even if you have to take multiple breaks like this, it will likely still equate to more sleep and less frustration in the long run. When you just try to push harder to get to sleep, you end up staying awake for hours and you get more and more frustrated.
It can definitely be frustrating to experience nocturnal panic attacks. It can also be hard to think straight when it happens in the middle of the night. One thing that you can do to set your sleepy anxiety-riddled self up for success is to write a little note to yourself. Write down whatever you need to hear. That you’ve been through this before, that you are not in danger, and that you are safe. You can also write down a little coping guide with suggestions for what to do. It might say get out of bed, get a cold glass of water, and go read on the couch for 10 minutes or listen to your favorite guided meditation.
If you are having a hard time relaxing after a panic attack, maybe it would be helpful to shift your focus away from trying to relax and instead actively focus on something that is incompatible with anxiety such as gratitude. You could write down or meditate on three things that you are grateful for. Personally, I like to re-visit memories that made me feel extremely grateful and use those as a meditation focus.
When you are actually lying in bed with your eyes closed, it can help to engage in visualization. Imagine a scene that is relaxing for you. Maybe it’s walking through the woods or sitting on the beach. Whatever it is, rather than trying to force negative thoughts out of your brain, try to focus on your relaxing visualization. It’s worth mentioning that if you are in a place where you can pretty reliably predict that your sleep is going to be interrupted due to anxiety, give yourself more time to sleep. It may be inconvenient and frustrating, but if you are feeling sleep deprived and out of it, it probably won’t help your anxiety at all the next day. Give yourself time to get enough sleep even with the interruptions. And that’s about all I have for you so…
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