Anxiety plays a part in many illnesses, and the effects of anxiety follow patients through their daily lives. More than 16 million people deal with some type of anxiety disorder, including social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder and post-traumatic stress disorder.
Being a sleep specialist, I see anxiety most when it involves a patient’s sleep, but anxiety doesn’t stop after patients wake up in the morning. Anxiety has a huge impact on everyday life.
Patients with anxiety report being unable to complete tasks. They often drink or use drugs, feel isolated and stop participating in life. Emotionally, patients with anxiety can be nervous and fearful. Physically, they often experience palpitations, difficulty breathing, dizziness, sweating, restlessness and an inability to concentrate.
My patients with insomnia often have difficulty turning off their thoughts at bedtime, unable to stop worrying. These patients experience sleep panic attacks, and patients with PTSD often talk about their recurring nightmares.
Anywhere from 50% to 70% of patients with generalized anxiety disorder have difficulty sleeping. Because patients with anxiety often have disturbed sleep, they start having anxiety about their lack of sleep.
Polysomnograms of patients with anxiety show prolonged sleep onset, decreased sleep efficiency, and decreased deep (slow wave) sleep. Although patients do not usually complain of daytime sleepiness, they often complain of daytime fatigue.
Prescribing antidepressants and benzodiazepines is standard treatment. However, cognitive behavioral strategies are recommended to help patients manage their anxiety. Have the name of a trusted professional ready for recommending to patients diagnosed with anxiety.
Encourage patients to find pleasurable hobbies to engage in, participate in regular exercise, and focus on positive emotions. Meditation and yoga may also be helpful.
Treating sleep disorders in patients’ with anxiety may help ease patients’ worries. How do you treat your patients who have panic disorders? Are you doing anything differently?
Sharon M. O’Brien, MPAS, PA-C, is a practicing clinician with an interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.