Insomnia is the medical term for difficulty sleeping, which can include:

  • difficulty falling asleep
  • trouble staying asleep
  • waking up too early
  • waking up feeling tired

Anxiety is your body’s natural response to stress, where you feel apprehension or fear about what’s going to happen next. You may have an anxiety disorder if your feelings of anxiety:

  • are extreme
  • last for 6 months or longer
  • are interfering with your daily life and relationships

According to Mental Health America nearly two-thirds of Americans state that stress causes them to lose sleep. They also note that poor sleep habits have been linked to problems like depression and anxiety.

According to Harvard Health Publishing, sleep problems affect more than 50 percent of adults with generalized anxiety disorder.

Does anxiety cause insomnia or does insomnia cause anxiety?

This question typically depends on which came first.

Sleep deprivation can elevate the risk for anxiety disorders. Insomnia can also worsen the symptoms of anxiety disorders or prevent recovery.

Anxiety can also contribute to disrupted sleep, often in the form of insomnia or nightmares.

The relationship between sleep and mental health

The relationship between mental health and sleep isn’t entirely understood yet. But according to Harvard Health Publishing, neurochemistry studies and neuroimaging suggests:

  • an adequate night’s sleep helps nurture both mental and emotional resilience
  • chronic sleep disruptions might generate negative thinking and emotional sensibility

It’s also implied that treating insomnia may help alleviate the symptoms associated with an anxiety disorder and vice versa.

If you think that you might have insomnia, talk to your doctor. Along with a physical exam, your doctor might recommend that you keep a sleep diary for a couple of weeks.

If your doctor thinks that a sleep disorder such as insomnia is a probability, they might recommend that you see a sleep specialist.

A sleep specialist might suggest a polysomnogram (PSG), also referred to as a sleep study. During the sleep study, various physical activities you go through during sleep are electronically monitored and then interpreted.

Although there are over-the-counter sleep aids and prescription medications for insomnia, many doctors will start treating insomnia with cognitive behavioral therapy for insomnia (CBT-I).

The Mayo Clinic has determined that CBT-I is, typically, either equally or more effective than medication.

CBT-I is used to help you understand, recognize, and change your attitudes that impact your ability to sleep and stay asleep.

Along with helping you control or eliminate worries or negative thoughts that keep you awake, CBT-I addresses the cycle that has you so worried about getting to sleep that you’re unable to fall asleep.

There are several strategies for helping you avoid behaviors that get in the way of good sleep. You can develop good sleep habits by practicing some of the below:

  • Relaxation techniques such as breathing exercises and progressive muscle relaxation can help reduce anxiety at bedtime. Other relaxation techniques include taking a warm bath or meditating prior to going to bed.
  • Controlling stimuli such as using the bedroom for sleep only and not allowing other stimuli such as electronics in. This will help you dissociate your bed as a place of busy activity.
  • Setting a consistent bedtime and wake-up time can help you train yourself for consistent sleep.
  • Avoiding naps and similar sleep restrictions can make you feel more tired at bedtime which can help improve insomnia for some people.
  • Avoiding stimulants such as caffeine and nicotine close to bedtime can help you be physically ready for sleep. Your doctor might also recommend avoiding alcohol close to bedtime.

Your doctor may suggest other strategies tailored to your sleep environment and lifestyle that will help you learn and develop habits that will promote healthy sleep.

Which comes first: anxiety or insomnia? Either one.

According to the Anxiety and Depression Association of America, anxiety causes sleeping problems, and sleep deprivation can cause an anxiety disorder.

If you think that you’re experiencing anxiety, insomnia, or both, talk with your doctor. A thorough diagnosis will help direct your treatment.