Can Anxiety Really Keep Me Up All Night?

Insomnia is one of the beasts of anxiety. Sleeplessness leaves one feeling wasted, fatigued, desperate, and hopeless. Restoring someone’s ability to sleep can pro-vide immediate, immeasurable relief. The insomnia of anxiety goes beyond counting sheep. Patients ruminate for hours—staying up all night, staring at the ceiling, or reading for hours without sedative effect. Standard methods of sleep hygiene fail, and often patients may resort to walking long distances to contain their anxiety, in effect becoming lost souls wandering the night.

Some become anxious about sleep as a way of fearfully remembering traumas that happened at night; others are simply afraid to lose control of the vigilance over their surroundings they maintain while awake. Women who have been victims of sexual harassment or assault,anyone who has been robbed, or victims of other violence can speak to the sleepless nights endured for weeks to months afterwards. Acute loss, whether of a relationship, a job, or one’s health can trigger profound insomnia.

Nightmares from anxiety can turn an other-wise better night of sleep into a wash. For example, someone may report feeling very tired; but once he gets into bed, he cannot sleep. It becomes important to rule out other causes of insomnia, such as major depression, hypomania/mania, and/or substance abuse. Panic about life events keeps people up at night, and this insomnia encourages or causes patients to seek medical attention.

Rick’s comments:

Because I am coping with OCD, I have to be very careful when I go to bed to not begin thinking of unresolved events from the day, longer term concerns, or issues from my past (sometimes 20 years past) that disturb or sadden or anger me. I am capable of staying with these thoughts for hours, replaying them again and again; I sometimes find I have let half the night go by without getting a wink of sleep.

Even when I have slept, it’s not unusual for me to wake up with a thought or a song in my head that seems to take hold and last for hours. (When the song is “Copacabana” by Barry Manilow, my day is pretty well shot!) OCD, of course, does not take the daytime hours off, and I have to be equally careful to try not to ruminate during the day, as best I can.