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Sleep and Anxiety: The Connection

Written by Evolve's Behavioral Health Content Team

Sleep and Anxiety: The Connection

If you’ve heard it once, you’ve heard it a thousand times.

Overall wellness starts with three basic things:

  1. Healthy food.
  2. Plenty of sleep.
  3. Regular activity.

You know what good food means: whole grains, plenty of fruits and vegetables, lean protein. And cut back on the sugar and processed foods. That’s how you avoid obesity, heart disease, and a host of other common physical ailments.

You’ve got that down – or know what you need to do to get it down.

You also know what plenty of sleep means: for adults, at least seven hours a night, preferably seven and a half or eight. For kids and teens, around nine or ten hours is ideal. You need a good night’s sleep because that’s when your body and brain resets and recharges, and you know exactly how it feels when your sleep dips to five hours or less a night: in a nutshell, you have a bad day. That’s why you do your best to get good sleep every night.

You’ve got that down, too – or at least know what you need to do.

As far as regular activity, you know what we mean is exercise. The experts advise around three hours of mild to moderate activity per week, with about an hour or an hour and half of harder, higher-intensity exercise mixed in. You know that’s how you keep your body and mind strong – so you try to get as much exercise as you can.

Which means you have that covered, too. And you know that if you can’t get actual gym-time in – because life – you need to be active outdoors and keep your body moving.

A new study published this month shows that one of these three things plays a larger role in our day-to-day mental health than we might think.

Sleep Rewires the Brain

You’ve probably heard that before.

It’s a clinical fact.

A study published this month in Nature Human Behavior called Overanxious and Underslept underscores this common knowledge. Study authors write:

“A lack of sleep amplifies anxiety in a dose-response manner.”

In the case of sleep, this means the more sleep you get, the less anxious you feel the next day. This is important because sleep disruption is a common symptom of almost all anxiety disorders, including post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and social anxiety disorder (SAD). Researchers theorize that if we know more about how and why sleep affects anxiety, we’ll be better suited to help people who live with anxiety disorders.

That’s where the new study comes in: researchers have identified the type of sleep that has the greatest impact on anxiety. Most people know there are different stages of sleep, and that every night we go through those stages several times, in what are called sleep cycles. One cycle of sleep includes several non-REM stages – REM is the part of sleep when we dream – and one stage of REM sleep.

For a quick read on sleep cycles from Harvard University, click here.

Now let’s have a look at what the researchers found:

  1. Non-REM sleep – called NREM – has the greatest anxiolytic effect, as compared to all other stages of sleep. Anxiolytic means anxiety-reducing.
  2. The anxiolytic effect of NREM sleep is associated with decreased activity in our medial prefrontal cortex (the part of our brain responsible for executive function, rational decision-making, and logical thinking) and increased activity in our limbic region (the area of our brain related to emotion and basic drives like food or sex).
  3. Small night-to-night reductions in NREM sleep accumulate and predict day-to-day increases in anxiety.

Get to Bed Early

That third point is the one most relevant to the general public: it tells us that losing even a little sleep can make us more anxious the next day.

Most of us think that if we get six hours of sleep instead of our regular seven or seven-and-a-half, we’ll be fine. Even if it happens two or three nights in a row. This study shows something completely different: when we reduce the amount of deep, NREM sleep we get for just one night, we feel the consequences the very next day. This happens because during deep sleep, our medial prefrontal cortex turns off and recharges. When we wake up after a solid night of rest with enough deep, NREM sleep, our prefrontal cortex is ready to spring into action and perform one of its primary functions: emotional regulation.

But when we wake up without recharging our medial prefrontal cortex, that regulatory ability decreases, and our levels of emotional, psychological, and physical reactivity increase.

The result?

Increased anxiety.

Therefore, it’s important for us to get quality sleep every night. And if we’re the parents of teenagers, we know it’s critical for them to get their NREM sleep every night, too. Their brains are developing at an astronomical pace, and adolescence is the period when the first symptoms of many anxiety, mood, and emotional disorder first show up.

Could proper sleep hygiene alleviate some of these disorders?

Study author Eti Ben Simon, interviewed in Science Daily, thinks so:

“The findings suggest that the decimation of sleep throughout most industrialized nations and the marked escalation in anxiety disorders in these same countries is perhaps not coincidental, but causally related. The best bridge between despair and hope is a good night of sleep.”

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