Patricia is 27 years old, she is finishing her studies, and she goes to school psychology consultation showing symptoms of night anxiety that only happens to her at night. She wakes up suddenly, overcome by hopelessness and discouragement due to the problems of insomnia, tiredness and fatigability that they cause her. Patricia says that, due to the proximity of the final exams plus the workload and practices, she feels with morning anxiety but it gets noticeably worse at night and he says «I think that I'm not getting out of this”, verbalizing very negative thoughts.
Does night anxiety exist?
Yes there is night anxiety. It is about Patients with morning anxietywhich can last all day, except for the moment of waking up. This anxiety then worsens significantly during the day until it reaches the night, when it is felt in a profound way.
The symptoms are typical of anxiety as:
- Tachycardia
- Sweating
- Dyspnoea
- Concern
- Waking up with anxiety in the middle of the night. That is, a night panic attackwhich is not very different from a daytime one, and which does not occur in isolation.
In any case, the anxiety attack Nocturnal They occur in a small percentage of people who suffer from anxiety. Among those who have daytime panic attacks, only 10% also have nocturnal ones.
This anxiety usually occurs during the non-REM phase of sleep, but is not associated with night terrors or nightmares that could wake us up. In addition, it is possible that the next day you will not remember that you had the anxiety attack.
Nocturnal anxiety attacks are caused by single, isolated events, such as witnessing a traffic accident.
Common reasons for nighttime anxiety
- Psychological and work stress. Many people suffer from anxiety after work due to accumulated stress. It generates anxious thoughts that increase tension during work and cause nighttime anxiety.
- Restless legs syndrome. Afternoon discomfort that occurs with leg pain and causes insomnia and anxiety.
- Associate events with the night. If arguments with your partner or family members occur more frequently at night, when you go to bed you will have a high level of anxiety and negative thoughts associated with these arguments, even though they have been resolved. The body becomes tense and you cannot achieve sufficient relaxation to be able to sleep.
- Psychophysiological responses. If we go to bed focused on our bodily sensations, we tend to suffer more discomfort, pain and fatigue, which in turn generates even more anxiety.
- Diet. Certain changes in brain chemistry cause us to crave sugars at night. They cause us to be unable to sleep or to wake up suddenly to satisfy our hunger. emotional anxiety.
- Stress. Nighttime anxiety can occur due to high levels of daytime stress due to family, financial, academic, or even no apparent reason.
- Intrusive thoughts. Lack of distraction at night, once in bed, facilitates the emergence of negative thoughts about everyday or future problems.
How to calm anxiety at night?
First of all, you have to want to change. If so, there are some very easy preventive changes you can make:
- Keep yourself mentally busy. Even if we are tired after a day of work, we must do activities that allow us to “disconnect” so that we do not get lost in our own negative catastrophic thoughts and thus reduce anxiety.
- Aerobic exercise. Works great for overcome anxietyIf you find it too difficult, try starting with a small one and the anxiety will decrease.
- Have routines. That doesn't mean we should always stay in our comfort zone. Also, remember that the magical things in life happen outside of it. Find a routine that makes you feel good and brings out the best in you: reading, drawing, painting, blogging, dancing, yoga… Try to find ones that help you disconnect from work.
- Objectives and goals. Be very clear about your short, medium and long term goals because they will allow you to establish the objectives necessary to reach each one of them. It is equally important that, every night, you go to bed reviewing whether you have met your objectives and, if so, what the next one is. In this way, you will focus on it and make that phrase “Go to bed with a goal and wake up with a purpose”, and it will reduce your anxiety.
- Be self-aware. Above all, your feelings. So, if you start to have nighttime anxiety, don't fight it, accept it – it's not the same as resigning yourself to it. Recognise what the triggering factor was. Remember that when you start to fight anxiety – nobody wants to have it, obviously – it not only doesn't improve but it gets worse.
Treatment for nighttime anxiety
- Psychoeducation. When we suffer from nighttime anxiety, a secondary fear appears, which is that of going to bed due to the possibility of anxiety appearing or even catastrophic thoughts about physical disorders that could appear associated with the moment of sleeping. Therefore, it is important to educate the patient in What anxiety is and what it is notwhat it can and cannot produce. This is how we help you cope with your experience. It is important that you become aware that mind and body are indivisible and, therefore, we are one and that when we talk about health is both physical and emotional or psychological.
- Cognitive-behavioral psychotherapy. It is the one that has been shown to be most efficient for this disorder. Thus, with different techniques, work is done on a cognitive level from catastrophic thoughts, cognitive distortions… while at a more physiological level, breathing techniques, relaxation, habituation, interoceptive exposure are used and, in addition, guidelines are worked on that range from correct sleep hygiene, avoiding stimulants in the hours before sleep, a healthy and light diet… At an emotional level, the following are treated: emotional skills to cope with the various situations of everyday life.
- Third generation therapies These types of techniques have also proven useful, including Virtual Reality, Mindfulness and Acceptance and Commitment Therapy, which allows us to reduce anxiety levels while awake and whose effects extend to sleeping hours.
- Pharmacological treatment. There is a tendency to over-medicate the mind, especially with anxiolytics and antidepressants. They improve the symptoms but do not solve the underlying problem.
- Relapse prevention. Recognize the warning signs so that when one of them appears, you can handle it with the tools that the doctor has already given you. psychologist in therapy.
Guidelines to reduce nighttime anxiety
- Get out of bed. Our bed is a comfortable, safe, calm place, which is what allows us to sleep. If you suddenly have a nocturnal anxiety attackDon't keep tossing and turning in bed, it will only increase your anxiety. Get up, take a walk around the house, lie down on the sofa, put on the television for a while or immerse yourself in the book you are reading. Within half an hour, you should be able to go back to bed.
- Distractions. Get out of bed and distract yourself by painting, reading, watching a movie, etc., whatever you prefer, but without using any kind of technological device – mobile phone, iPad, computer – because then you activate your brain. You have to remember that trying to distract yourself at night sometimes causes more anxiety. If after about 10 minutes you have not calmed down, you will have to try another way.
- Diary of anxieties. Write down how many crises you have and what the triggers are: insomnia or a lot of recurring thoughts about work that you can't get out of your mind. In this diary you should write down:
What you were doing, where you were, and whether you were alone or with someone.
Any trigger you can think of.
Your most common thoughts when you have anxiety.
What was the last thing you thought about before falling asleep?
What do you do to calm down?
Explain if your current thoughts are irrational.
Rate your anxiety level, from zero to ten.
- Listen to relaxing music. Soft relaxing sounds such as falling rainwater or waves help you relax. These are not the only types of music. Many people find Zen or oriental music helpful. In any case, forget about electric music and loud sounds, as they will increase your anxiety and prevent you from sleeping.
- Guided visualization. After applying the breathing and relaxation techniques that your psychologist has taught you in consultation, you can also practice this technique that helps you prepare your mind and body for sleep. There are many audios with guided visualisations on the internet – make sure that the website you enter is secure – or ask your psychologist for one.
- Limit caffeine and alcohol consumption. Alcohol, caffeine in coffee and theine in tea increase anxiety and make you irritated and restless, and when consumed excessively, can even lead to panic attacks. It is necessary to limit or eliminate the consumption of these drinks.
- Proper sleep hygiene. You should prepare to go to sleep an hour before going to bed, which means turning off the television, computer, mobile phone, tablet, because all of them activate the mind and interfere with the production of melatonin. Always go to bed at a fixed time, so that it becomes a routine, and this way you will avoid anxiety. You should try to do it every night, or almost every night.
- Consult a psychologist that helps you identify what causes your nighttime anxiety and gives you the necessary guidelines to resolve it, accompanying you throughout the process. online therapy with video conferencing It is also useful in these cases. Make an appointment in .
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