2020 has been a stressful year for people in the U.S. According to results from the American Psychological Association’s Stress in America 2020 survey, general stress levels are significantly above average compared to years past. In xfact, this year’s respondents reported the highest average stress levels since the survey was first launched in 2007 – 5.4 out of 10, an increase of 0.5 since last year. These figures can largely be attributed to COVID-19 and its implications on finances, parenting, and other aspects of daily life.
Stress and anxiety often lead to insomnia and sleep problems. By the same token, lack of proper rest can contribute to stress. And because stress and sleep problems share such a reciprocal relationship, addressing one of these issues can often lead to improvements for the other.
The network known as the hypothalamic-pituitary-adrenal (HPA) axis regulates your body’s hormonal response to stressful situations. The hypothalamus – a cluster of nuclei located in the brain – will instruct the pituitary gland to release a hormone, and then the pituitary gland will signal the adrenal glands to produce steroid hormones called glucocorticoids. Two of these glucocorticoids are cortisol and adrenaline, which are also known as stress hormones.
The body naturally produces cortisol throughout the day, with levels spiking immediately after we wake up and gradually decreasing throughout the day. This added cortisol regulated by the HPA is the reason why you often feel hyper-alert during stressful situations, but this can cause you to “crash” once the stress subsides.
Stress can take many forms, but these feelings generally fall into one of three categories:
While moderate amounts of acute stress pose very little risk to your health, chronic stress can have a major impact on your body. These effects can be felt in various ways and throughout different bodily systems, including:
The HPA axis is directly linked to how you sleep. HPA axis activity shuts down when you first fall asleep, but the axis – along with the nervous system – will commence hormone secretion during the final stages of your sleep cycle that align with circadian rhythms and help you wake up.
One of these hormones, the adrenocorticotropic hormone (ACTH), regulates the amount of rapid eye movement (REM) sleep you experience each night and time you wake up in the morning. ACTH in turn stimulates the release of cortisol and other glucocorticoids that help you feel refreshed, well-rested, and alert as your rise for the day. Since HPA axis activity plays such an important role in our sleep cycle, this means stressful situations and stressors can easily produce sleep-related problems.
Insomnia is a common sleep disorder derived from stress. Insomnia is defined as persistent difficulty with sleep onset, maintenance, consolidation, or overall quality. It occurs despite adequate time allotted for sleep on a given night and a comfortable place to sleep, and people with insomnia experience excessive daytime sleepiness, fatigue, irritability and other impairments when they are awake. Current estimates suggest 10-30% of adults live with insomnia.
A person may be diagnosed with chronic insomnia if their symptoms occur at least three times per week for at least three months. Persistent stressors can heavily contribute to chronic insomnia. These stressors may include:
Not everyone develops chronic insomnia due to constant stress, but those with anxiety disorder are at higher risk of experiencing insomnia symptoms. Additionally, changes to one’s sleep schedule that occur due to life events or changes can also lead to insomnia. Once chronic insomnia takes hold, people often feel anxious about sleeping and other aspects of their lives. This increases day-to-day stress, which in turn exacerbates insomnia symptoms.
Other daytime impairments related to insomnia that can bring about or contribute to stress include:
If someone experiences insomnia symptoms for fewer than three months, then this condition is referred to as short-term insomnia. Just as chronic stress can precipitate chronic insomnia, acute stressors can bring about short-term insomnia symptoms. These stressors may include:
Acute stress may also occur if you’ve made significant changes to your bedroom or sleep area. For example, new parents may experience insomnia symptoms when sharing their bedroom with their baby for the first time, even if the child is not audibly disruptive. Children may also have sleep problems immediately after they begin sharing their room with a sibling. Visiting or moving to a new location can lead to short-term insomnia, as well.
Short-term insomnia symptoms may begin to dissipate once the stressful situation ends and acute stress subsides. However, some people fall into a vicious pattern of sleep loss and daytime anxiety about sleep that eventually snowballs into chronic insomnia.
In addition to insomnia, chronic stress can lead to sleep apnea. This sleep disorder is characterized by a recurring collapse of the upper airway during sleep, which can cause heavy snoring and choking episodes along with excessive daytime sleepiness and other daytime impairments. Hypertension, heart disease, diabetes, and other medical conditions that can often be attributed to stress are predisposing factors for sleep apnea. Obesity is also considered a major risk factor. And like insomnia, sleep apnea can exacerbate stress by disrupting your sleep and wearing you down during the day.
Getting enough sleep on a nightly basis can alleviate stress quite effectively. Unfortunately, a good night’s rest can be elusive if you’re stressed out – especially if sleep problems are a major source of your day-to-day anxieties.
There are other measures you can take to relieve stress. These include regularly exercising and maintaining a healthy support network of friends and family. However, keeping stress at bay often demands adequate sleep. National Sleep Foundation guidelines advise that healthy adults should sleep between seven and nine hours each night.
Stress management is key to a good night’s sleep, and how well you manage stress can depend on your day-to-day lifestyle. In addition to following a balanced diet and exercising throughout the week, you can alleviate stress through controlled breathing and other relaxation techniques. A healthy work-life balance is also important, as is your ability to productively “release” stress during situations that cause stress, and not at other moments.
Stewing in bed when you are too stressed to sleep can be counterproductive. If you haven’t nodded within 15 minutes of going to bed, try getting up and relocating to another area of your residence for a relaxing activity such as reading, meditating, or listening to calming music; avoid watching TV or other activities that involve blue light devices.
Some people also experience anxiety when they wake up in the middle of the night and see the time on their bedside clock. Avoid looking at your clock if you wake up – cover the display if necessary.
Some people find stress relief through cognitive behavioral stress management (CBSM). This form of short-term therapy pinpoints the way your thoughts and beliefs affect how you behave and interact with the world around you. By identifying irrational or inaccurate thoughts and replacing them with more positive ones, you may be able to change your behaviors and your general outlook.
Studies have shown CBSM can be an effective measure for various groups that tend to experience undue stress, such as professional nurses, people with substance abuse disorders, and individuals living with HIV.
Incidentally, cognitive behavioral therapy has also proven effective for alleviating insomnia symptoms. Known as CBT-i for short, this type of therapy helps people overcome misconceptions or negative beliefs about sleep in order to get more rest and overcome their insomnia. CBT-i emphasizes sleep restriction and the importance of getting out of bed on sleepless nights, as well as proper sleep hygiene and relaxation techniques.
In addition to following sleep hygiene guidelines and pursuing CBSM therapy, many people effectively manage their stress by taking the following measures:
You should see your doctor or another physician immediately if you’re experiencing suicidal thoughts, abusing drugs or alcohol, or feeling that you can’t cope with day-to-day life due to stressors. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255 (1-800-273-TALK). The lifeline also offers 24-hour live online chat on their website, as well.