Anxiety and problems sleeping after a stressful year

[Rebecca88R]

Hello,

Just sharing really. I feel like I shouldn't have anything to feel bad about but things have really got on top of me recently.

I went back to work full time last autumn after having twins. Full time wasn't ideal but was the best option given the family's finances and the opportunities available at the time. I enjoyed being back at work at first, and although I felt I was rushing around a lot juggling children, commuting and work, I generally enjoyed it. Then I had a really stressful period over the summer with deadlines and staff shortages in my team. I pushed hard, got the work done but felt totally burned out afterwards.

I then spent a couple of months feeling really down and demotivated, and alarm bells were ringing as it was the first time in my life where I really struggled to drag myself out of bed in the morning and everything just felt relentless. I decided I needed to find a job that didn't take so much out of me and a couple of weeks before Christmas one came up which I got. However...I had a couple of bad nights sleep due to anxiety in the run up to the final interview, and this has carried on since for a couple of weeks. Most nights I've managed 4 hours sleep, some 6, some none. I've been waking up in the small hours in a panic and not going back to sleep, and now it has turned into so much anxiety at bedtime that it takes me hours to get to sleep at all. I'm just exhausted, I've got a week off work and am really worried about going back to work next week still feeling like this.

Due to Christmas I've not been able to speak to a GP yet and the out of hours one just told me to "read some resources about anxiety" before hanging up on me. I've done all sorts of guided meditation and breathing - it works to a point but the second I roll over to go to sleep my heart starts pounding again and I'm back to square one.

I guess I'm fearful about what's next...not knowing whether this is a one off blip that will fizzle out at some point, or whether this is just the beginning...I don't know if I should be exploring medication at this point as I can't see a way out under my own steam. I just feel really low, and I know some of that is due to the lack of sleep, but I feel like I'm stuck in this horrible cycle.

Ok the bright side I appreciate my children even more - it's nice to feel needed.

Any similar experiences appreciated if you would share.

I have night time anxiety attacks. Propronal helps. Ask the doc for some. Also maybe a low dose diazepam for a night or two to break the fear of going to sleep/ waking in a panic. It's horrible. I hope it passes soon.

It sounds like this is a short term problem? In which case resetting your sleep habits shouldn't be too difficult.

First question - what's your routine leading up to bedtime?

What's your sleep environment like? Eg screens, noise, clutter, etc.

What do you do when your heart starts racing? Eg do you re-focus your attention on slow deep breathing? Or do you start telling yourself it's all hopeless and you'll never get to sleep?

Instead of trying to fight panic it can be better to just accept it's happening and focus on breathing through it.

To me, it sounds like you had a blip and now you've gotten yourself into a spiral of panicking about panicking which has created a habit.

Beta blockers in the short term to break the cycle.
Longer term, review sleep hygiene, exercise habits and caffeine intake. Meditation/mindfulness will help.
Wishing you a better 2024. 🙂

On the waking up panicking part... I have a few audio books / podcast episodes that are calm/boring and where I've listened to them before so I know what happens.

When I wake up in a panic, after settling myself from the initial panic, I set one of the calm/boring episodes to play for half an hour and just focus on my breathing and keeping my attention on the person speaking rather than letting my brain get sucked into anxious rumination (because that keeps you on edge and awake).

It doesn't work if it's an interesting book/episode or something I've not listened to before - because then it makes me more awake wanting to know what happens next.

It's just to have something that won't provoke any kind of emotional response (positive or negative) and to stop anxious thoughts spinning.

Once you let yourself lie there thinking about things it wakes you up because your brain needs to be alert to think through worried and plans, so it's important to find ways to stop that and let you brain rest enough to fall asleep.

Even when it feels like you're not sleepy, if you can keep your breathing slow and steady and stop your mind running off into thoughts, most of the time you should be able to fall back to sleep within half an hour or so.

Knowing that you will fall asleep eventually can help - rather than panicking that you're not currently asleep right this instant.

Some evidence based resources that the NHS might use with you if you were having CBT for this:

https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Sleep

I know it's frustrating when you're asking for help and someone tells you to go and read stuff - it feels a bit dismissive when you want a solution. But these take you through things step by step and give you practical things you can do to improve the situation.

@pavementmutation thank you - that's all really helpful.

In term of sleep environment etc, I'm quite consistent at all that. My children all have very predictable bedtime routines and I do the same for myself! Shower before bed, a bit of reading lights off by 10pm, up at 6am even on weekends (my body clock is quite regular). Our room is quiet, lights are dim, not too hot. Up until a few weeks ago I would've asleep within 15 minutes. However...I snore, and have recently been stressing about keeping my husband awake, so he has been sleeping in the spare room. My mum has visited over Christmas and is staying in the spare room so knowing that isn't an option has added to the stress. I've actually spent all night on the sofa the past few nights too as I find it easier to fall asleep there - there's less pressure as it's not where I'm "supposed to" go to sleep! So my usual sleep habits have been thrown off which probably isn't helping, although the sleep I'm getting on the sofa is saving me right now.

I am quite bad at focusing on breathing through the feeling. I'll do a few breaths and then get distracted/start thinking again, or I'll get impatient or frustrated that it isn't working right away. Serves me right for not practicing it more when I was feeling more well! I've had CBT before for other anxiety related issues which helped reframe a lot of unhelpful thoughts, but the panic/heart racing situation is a lot rarer for me, and so I'm definitely not skilled at bringing myself down from more intense feelings with breathing.

I'll have a think about the podcasts - I think definitely focusing on something should help. I had been listening to various guided meditations on Headspace but I think because I know they are designed to help me sleep/relax it can sometimes add to the pressure rather than serve as a distraction.

In short - you're right, I've just got myself into a weird habit I think - I'm totally overthinking it and thinking of the worst case scenarios. The pressure of "needing enough sleep to enjoy Christmas" hasn't helped. I'm frustrated with myself too because I solved the main problem in life causing me too much stress - getting the new job! So I should be feeling better.

Thank you for the perspective, if I have trouble tonight I'll re-read these posts as a sanity check 😊

I understand what you mean about feeling under pressure to sleep. It might just be that all the upheaval and change of routine of Christmas after recent stresses has knocked things further off kilter and they would naturally reset.

In terms of breathing, if it doesn't come easily there are two things you could use to focus. The first is to have one or both hands gently placed on your stomach and focus on breathing so that your stomach slowly expands and relaxes (if you are breathing deeply your stomach should fill out, anxious breathing tends to stay high up in your chest). The other is to count - in for 7, hold for 4, out for 10, repeat.

It does sound like you're doing lots of the right things. I hope tonight and the next few nights start to get easier.

And congratulations on landing the new job, by the way!

Sorry to hear. Headspace (a meditation app) has some great wind-downs and sleep stories which help get you back to sleep. They usually have 30 day free trials.