The relationship between stress and sleep is reciprocal. When stress levels are high, it can cause difficulty in sleeping. Similarly, when sleep quality is poor or insufficient, it can lead to maladaptive changes in the body’s stress response. To break free from this frustrating cycle, it is crucial to understand the connection between stress and sleep.
Chronic stress disrupts the sleep-wake cycle, causing difficulty in falling asleep and poor sleep quality. It reduces deep sleep and REM sleep and affects the emotional content of dreams. High cortisol levels are linked to insomnia and night-time awakenings. Stressful events can also trigger short-term insomnia as a natural response to a potential threat.
What is Stress?
Stress is the body’s response, both physically and mentally, to a perceived threat. When faced with a stressful situation, the brain triggers the fight-or-flight response, which causes the release of hormones like adrenaline. These hormones raise blood pressure, muscle tension, breathing and heart rate, and blood sugar, as well as increase alertness, decrease pain sensitivity, and slow digestion. All of these changes are meant to help a person deal with the challenge or flee to safety.
The second part of the stress response involves a series of hormones, including cortisol, which is released in high amounts during times of stress. Cortisol directs energy away from processes that are not urgent, such as wound healing and immune system functioning, to help the body prepare to fight an immediate attacker.
From an evolutionary perspective, stress is a useful tool. The rapid stress response aids in avoiding threats and accidents. However, exposure to prolonged and repeated stressors, such as relationship issues or financial worries, can result in chronic stress, which can have a significant impact on health. It is essential to recognise and address common stress triggers and sources in daily life.
Which Sleep Disorders Can Stress Affect?
Sleep disorders can cause problems with sleep quality, quantity, or timing, or lead to unusual behaviours during sleep. Stress is closely related to two of the most common sleep disorders: insomnia and sleep apnoea.
Insomnia
Insomnia is a sleep disorder that involves difficulty falling asleep, staying asleep, or waking up too early. Stress is a significant risk factor for insomnia. People with insomnia may feel unrefreshed upon waking and experience daytime sleepiness. Approximately 50% of all adults have symptoms of insomnia at some point in their lives.
Sleep Apnoea
Sleep apnoea occurs when the upper airway is blocked during sleep, causing partial or complete lapses in breathing. People with sleep apnoea are more likely to have high-stress levels. Sleep apnoea is closely related to post-traumatic stress disorder (PTSD), characterised by permanently high-stress levels following a traumatic event. Treating sleep apnoea can help ease PTSD symptoms.
How to Break the Stress-Sleep Cycle?
Stress and sleep quality are interconnected, and reducing stress can positively impact the quality of sleep, and vice versa. If you are experiencing stress-induced sleep problems, there are several tips you can try to improve your sleep quality. However, since everyone is different, what works for one person may not work for another. Therefore, it may be necessary to experiment with different approaches and consult a medical professional to find a solution that suits your specific needs.
To improve your sleep hygiene during stressful times, you can try the following techniques:
- Refrain from checking the time if you wake up during the night.
- Schedule worry time earlier in the day to allow yourself to write down or talk through your concerns, and shift negative feelings away from bedtime.
- Avoid consuming caffeine later in the day, as it can make it harder to fall asleep. Limit your caffeine intake to the morning and early afternoon.
- Avoid alcohol and tobacco within four hours of bedtime, as they can negatively impact sleep quality.
- Stick to a consistent sleep schedule by waking up and going to bed at the same time every day. Choose a bedtime and wake-up time that fits your natural inclinations, depending on whether you are a morning person or a night owl.
- Manage your exposure to light. Regular exposure to sunlight during the day, especially in the morning, can help regulate your internal sleep-wake clock. Conversely, avoid bright artificial lights in the evening close to bedtime, as they can make it harder to fall asleep.
- Stay active by exercising regularly. Regular exercise can help reduce stress, improve mood, and enhance sleep quality and duration. Exercising in daylight generally provides the most benefits for sleep. While evening exercise can still positively affect sleep for many people, it is best to avoid vigorous workouts an hour or less before bedtime.
What Treatments Are Available for Stress Management and Sleep Improvement?
If you are experiencing stress and sleep problems, you may consider seeking treatment. Your primary care physician may suggest their own treatment plan or refer you to a mental health specialist. Some of the most effective treatments for stress management and sleep improvement include counselling, medication, and support groups.
Counselling
Counselling is a helpful option to manage stress and improve thoughts related to sleep. Cognitive behavioural therapy for insomnia (CBT-I) is considered a primary treatment for insomnia and should be performed under the guidance of a qualified healthcare professional.
Medications
While many physicians now avoid treating insomnia with sleep medications due to concerns over their side effects and effectiveness, medication may still be appropriate in some cases, especially for those experiencing both insomnia and mental health issues like anxiety or depression. However, it is always advisable to consult a healthcare professional before starting treatment with any sleep aid.
Support Groups
Support groups can offer a forum for conversation, discussion, and shared experiences. They also help buffer against feelings of loneliness and isolation. Peer support groups are an excellent option for people who are looking to connect with others who are dealing with the same issues.
