Sleep Anxiety: What To Actually Do About It (Part 2)

In Part 2 of this sleep anxiety series, Amanda gets practical. She breaks down exactly what to do when you can't fall asleep, what to do when you wake up in the middle of the night, and offers a full toolkit of cognitive, environmental, and somatic practices that shift the conditions for sleep over time. If Part 1 was the understanding, this is the application.

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3 Takeaways:

1. You can't force sleep, but you can build better conditions for it. 
2. The middle-of-the-night wake-up needs a different response than lying there fighting it. Sit up, name the state, meet the sensation, reach for breathwork over your phone, and get up if you're still activated after 20-30 minutes. Every regulated response starts to undo the old pattern.
3. Your daytime is the preparation for your nighttime. Morning sunlight, consistent wake time, movement, processing stress before it accumulates — none of this feels like sleep hygiene but all of it is.

CLICK HERE for the full show notes, resources, and 3 tangible takeaways!

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Transcript

SPEAKER_00 0:00

Welcome to Regulate and Rewire, an anxiety and depression podcast where we discuss the things I wish someone would have taught me earlier in my healing journey. I'm your host, Amanda Armstrong, and I'll be sharing my steps, my missteps, client experiences, and tangible research-based tools to help you regulate your nervous system, rewire your mind, and reclaim your life. Thanks for being here. Now let's dive in. Hey friend, welcome back. This is part two of our sleep anxiety series. If you haven't listened to part one, I do recommend starting there. That gives a little bit of the background of the science and the why we sometimes struggle with these two different distinct types of sleep anxiety. And I'm going to organize today's conversation around these two different experiences that we named last week. So what to do when you can't fall asleep, and then what to do when you wake up in the middle of the night. And then I'm going to close our conversation with a broader toolkit of habits and somatic practices that I think can support you in both instances. So getting into it by first talking about what to do when you can't fall asleep. When it's like somebody turned the volume up on your brain or got the juice flowing in your body the minute that your head hit the pillow. And first, I want to make one point. If you want to get better sleep, the thing you should make the most priority out of is to stop doing things that inhibit sleep. So if you want to get better sleep, do less of the things that inhibit sleep. And some of the most common culprits of things that we know inhibit quality and quantity of sleep is scrolling on your phone or watching screens right before bed, caffeine in the afternoon or early evening, eating large meals within two to three hours of sleep, alcohol, it might help you fall asleep, but it fragments your sleep quality. One of the things we talked about last week. Having irregular sleep and wake times. So waking up or going to sleep at inconsistent times, high intensity exercise too close to bed, keeping your room too warm or too bright, or leaving your nervous system in an activated state. So having unresolved stress, racing thoughts, no wind down routine. And that is just a quick checklist if you're like, oops, oops, oops, oops, oops, within the first two minutes of today's conversation, that gives you maybe, maybe something to focus on. But it's this last one I mentioned where a lot of your work comes in because most people address the surface level habits around sleep, but never actually how to downregulate their nervous system in their everyday life or how to properly down-regulate their nervous system before bed, which means that your body is physically in the wrong state when your head hits the pillow for deep restorative sleep. All right. Now here are a few other things to think about or things that could help if you struggle to fall asleep at night. Number one, can you stop reinforcing an old negative, unhelpful association? So if you have spent enough nights lying awake anxious in bed, your nervous system, your brain has started to create this pattern that bed equals threat, bed equals stress, anxiety. And then every night that you lie there for hours spiraling, you are just reinforcing that association. You are running another repetition of that pattern. And this, like we talked about last week, is called conditioned arousal. And the only way out is to stop adding reps to that cycle, which means, and I know that some people resist this. I know this might feel counterintuitive, but when you are spiraling out in bed, get out of bed. Get out of bed. If you haven't been able to fall asleep in 30-ish minutes, get up. Now I don't mean get up and go watch TV, get up and go turn on a bright light and get a snack in the kitchen. We'll talk more about what to do when you do get up. But we want our bed to be the place that we sleep. And so when you are laying in bed and getting increasingly, I think this maybe is the thing to remember here, when you are getting increasingly activated the longer you stay in bed, it's time to get out. So that we are not continuing to teach our nervous system this correlation over time. Another thing to focus on is to get in bed when you are actually sleepy. This is where that wind-down routine comes in. You've got to give yourself the chance to feel sleepy. This is where waking up at a consistent time in the morning matters, so that your morning cortisol awakening response can happen so that your body starts to naturally release melatonin at the appropriate time to help you get sleepy. What this also means is that you don't want to blow through your sleepy cues. So if you are getting close to eight o'clock, nine o'clock, 10 o'clock, and you're starting to feel sleepy, but you just want to finish this one more thing, or you just want to don't do it, don't do it. Because if you push past that sleepiness, your system will again put some adrenaline into your system. It's the same reason why kids are so unmanageable when they are overtired, because the thing that they need is to sleep, but their body has physiologically done something to keep them from sleeping because they passed their sleepy wake window. So only get in bed or try your best to get in bed when you're actually sleepy. Because we want your nervous system to relearn that bed is the place that your body goes when it's already moving towards sleep. Right? This also is going to help with that negative association between bed. This isn't the place we go to lie there, wait, and worry. Bed is for sleep. Bed is not for scrolling. It is not for watching things that leave you activated. It is not for lying there and rehearsing tomorrow. Bed is for sleep, bed is for sleep, bed is for sleep. Now, another thing that you can do if you are somebody who has a hard time falling asleep at night is to build a consistent pre-bed sequence, just like we do for kids, just like we talked about last week. What are some of the same things in the same order every night? When the sun goes down, dim the lights. When are you gonna get off screens? Is there gentle movement, breath work that you can do? We had talked about possibly showering to get that temperature, that core temperature drop. The reason this is important for somebody who struggles to go to bed at night is that over time this sequence itself becomes a safety signal. This structure, oh, this is the thing that we do before we go to bed. It allows your nervous system to start responding to the routine before you ever get into bed. The next suggestion I'll offer here is to make the bedroom feel safe outside of just sleep. So is your bedroom a place where you can just sit and relax? A place where you might read during the day, where you can rest, nothing high stakes. So, what we want to do when we have this negative association, when we are regularly getting in bed and feeling anxious, getting in bed and our thoughts are spiraling, is to just reassociate that entire environment with safety, with relaxation. Clutter, clutter, clutter, clutter, especially for women in the bedroom, is another contributor to our room feeling like a chore, our room not being a place that we can downregulate. So are there ways that you can simplify? Are there ways that you can maybe let the rest of the house be messy, but create a more settling environment in your room? What this can also do is it can create other neural associations with that physical space. So it stops just being purely about that high-pressure sleep context. Um, another, another thing to noodle about, if you're struggling to fall asleep at night, can you change the goal? And I think this one's really, really underrated. So instead of thinking like, I have to fall asleep, can we shift our thought into I am resting? Instead of thinking, if I don't fall asleep, tomorrow's gonna be ruined. You can try thinking, this is uncomfortable, but there are ways that I can rest even if I'm awake. And this is something in preparing for this episode, it put in my mind. And I actually was having a really, really hard time falling asleep just a few nights ago. And I had that thought and I said, I wish I could fall asleep right now, but I can rest even if I'm awake. And what would feel really restful for me right now? And I started to breathe a little bit different, I settled my system. It still took me longer than I wanted to go to sleep, but I wasn't spiraling out about it as much as I sometimes do. So with this, every time you get into bed and your system has that association and it kind of braces for the battle, the battle to sleep. When this happens, you are reiterating that there's that threat. But every time you get into bed with this genuine permission to just rest, and maybe it's okay if you don't fall asleep right away, or it's okay that you don't fall asleep as fast as you want to, but this is just a place to practice being restful. We kind of chip away at that intense association. And what we're what we're trying to get at again is sleep that comes as a byproduct of regulation, that comes as a physiological byproduct of doing the things that we need to do so that it has enough of these inputs, this enough sense of safety to really, really rest. So your job is to create conditions for good sleep, not to try to force the outcome of good sleep. And the honest reality is that reversing this conditioned arousal response, it takes time. It takes time and it takes consistency. And there's no single night that fixes it. There's oftentimes no single thing that fixes it. But when it comes to reversing conditioning, we know that we want to reduce the reps of the old pattern and increase the reps of a new one. Another thing to try if you struggle to fall asleep at the beginning parts of the night is some kind of cognitive offloading before bed. So if your brain is running through your to-do list or cycling through worries the moment you lie down, it is gonna hold on to that information for you. Is there a way that you can give it a place to rest? Maybe you keep a notebook by your bed and do a brief brain dump before you go to sleep, not to solve anything, but just to get it out of your head. Once it's on paper, oftentimes our brain can let go of doing its job. Something that has been really helpful for me, I try to get off my phone at least a half hour before bed, if not more. One of the last things I do before I plug my phone into the charger is I look at my schedule for the next day. This might be the opposite of what some of you want to do. For some of you, this might create that spiral of anticipation for the next day. But for me, it just helps me hey, today is done. What does tomorrow look like? Because I want to be aware of it right now so that in 30 minutes, 60 minutes when my head hits the pillow, I'm not wondering what I am doing tomorrow, what needs to be done tomorrow. I look at what's on my schedule for tomorrow, I take note of the priorities, I maybe add a little to-do list to the top of tomorrow. And then I've I've offloaded it. My brain is done. So taking a minute to pause and reflect on some of the things that I just shared, is there one or a couple of those that feel like they might be helpful for you? If so, take note. Now let's shift into talking about what to do when you wake up in the middle of the night and can't seem to go back to sleep. Because for me, when I've experienced this, and what we hear from from many of our clients is this is when you feel the most helpless. Because a lot of times it catches you off guard. You were asleep and now you're not. You were resting and now it's 2 a.m. and you are feeling wired and you have to be up in a few hours. So the first and most important thing that I want to say is this you didn't wake up because you were anxious. You woke up, and then your brain tried to make sense of the state that it found itself in. Now, where this gets fuzzy and gray is it might be because of anxiety that you are waking up. It might be because of chronic stress that's messing with your cortisols. It could be the blood sugar that we talked about last time. It could be because you did not discharge enough or complete enough of your stress cycles. So there is definitely a correlation with anxiety and waking up. But from a more biological read, you woke up. Something woke you up, likely physiologically. It was maybe a sound. It was your blood sugar. It was a funky cortisol curve. You woke up when you didn't want to wake up, when you didn't expect to wake up. You woke up because maybe there was adrenaline pumped into your system for some other reason. And when we have this activated body-based experience, our brain's job is to make meaning of it. And that meaning that it tries to make of it is what oftentimes results in the restlessness and in the thought spiraling, which then feeds further activation into our system. And this distinction matters because it means that the spiral of thoughts isn't the cause, it is the response. And you can work with a response. So your only job in that moment is to try to bring the intensity down. We're not trying to eliminate it. We're not trying to fix it. We're not trying to outthink our overthinking in the moment where our prefrontal cortex is offline because it's the middle of the night. We are doing whatever we can to settle the body, to settle the nervous system enough and hope that it can find its way back to rest. And what I want to talk through now are a couple tangible things that you can do, a couple ways that this might look. So, number one could be to change your position. Could you sit up? And I know that that might to some of you sound way too simple of a suggestion, but movement, shifting position can interrupt this pattern. Lying flat and spiraling is a loop. Breaking that physical position breaks that thought loop. And you do not have to get out of bed. Just change something about your body position. Sit up, do some breath work there, see if your eyes can get heavy, maybe lay back down. The other thing you can do is name your state. You can do that out loud or just in your own head. My body's activated right now. That's it. Not why is this happening again? Why is this? Is there something wrong with me? Just on repeat, my body's activated right now. My body's activated right now. And this act of orienting can give your prefrontal cortex a way to come back online, or it can give it something accurate to hold on to instead of spiraling out into the catastrophic stories that I don't know about you, but I come up with at 2 a.m. Everything feels so important at 2 a.m. And it's uh definitely not by 8 a.m. the next morning. Some other things you can do to help to settle this response is a hand on your chest. So especially if your your chest is tight, can we meet that sensation rather than fighting it? Can you place your hands on your sternum, apply gentle pressure, just making contact with your body in some way can be regulating. Something I'll sometimes do is make really soft, gentle fists as I inhale and then exhale, releasing my fists. Kind of that physical release sometimes gets my brain to release as well. And if you do want to try some breathing, uh, two of my favorite practices are a physiological sigh. So it's a double inhale through your nose with a long exhale out of your mouth. Your first inhale with your nose is a full breath in, your second breath is just a sip, and then a long exhale. It sounds like this. So long full inhale. Sip. Long exhale. The other thing, more simply, is just extended exhales. So your exhale, the exhale part of your breath, activates the parasympathetic nervous system branch. Your inhale activates the sympathetic. So when you exhale longer than you inhale, it is pulling on your relaxation response. So you can try inhaling for a few counts and then just exhale a little longer out your nose or your mouth and try to do this for a few breaths, a few minutes. You are not looking for some dramatic shift or solution. You're just trying to sense that there's a gradual softening happening in your system. When you wake up in the middle of the night, do not, do not, do not, do not, do not grab your phone. And I want to be really specific about why, because it's not just about the blue light. Although even a second of like one second, if you're like, I'm just gonna check the time really quick. One second of that light into your eyes communicates to your system and it's time to be awake. But also your phone is an unpredictable content device, whether it's social media or whether it's, oh, look, I have a missed call or somebody text me after I fell asleep. You do not want anything else that is going to pull you into more arousal. At 2 a.m. when your system is already activated, your phone is like pouring gasoline on a fire. If you do need to get out of bed and fill your time with something, what is something that you can occupy yourself with that is not stimulating for your nervous system? Could be a book, quiet music, some breath work, just going and sitting on the couch and seeing if you can be there until you're tired. The other thing with this, and this could be maybe if you're having a hard time falling asleep or the middle of the night, wake up, but it's something that is often called the 20-minute rule. So if you have been lying awake in bed for more than 20, maybe 30 minutes, get up. Get up. Do something calm. Do something in very, very dimmed light. It could be gentle stretching, drinking something warm, just sitting quietly until you start to feel sleepy again. And I know that that can feel counterintuitive. It is counterintuitive to get out of bed when you're trying to sleep, but it works because every time you lie in bed awake and activated, what are we doing? We are running another rep. We are strengthening that cycle that says bed is for anxiety. So getting up helps to break that association. And then just reiterating, reiterating what I talked about last week, which is don't try to solve anything. 2 a.m. prefrontal cortex, bloop, it is less online. Your thoughts are gonna feel urgent, giving yourself this context of, hey, my brain is spiraling because it's trying to find a reason we woke up. We're here, we're safe, it's dark, take a breath. We can worry about that tomorrow. We can worry about that tomorrow. Now, before we close, I want to give you kind of a broader toolkit. So beyond the moment-to-moment responses, there are, I want to reiterate, we talked, we touched on them briefly, but I want to reiterate the habits and the practices that shift our conditioning over time, that can reduce what's filling our stress bucket, that play into our physiology that supports circadian rhythms, that supports quality sleep. And the first one I'm gonna talk about is caffeine and alcohol. So caffeine has a half-life of five to seven hours for most people, which means that if you are having caffeine after, let's say, about 12 o'clock, it is likely still in your system at bedtime. And so caffeine after about 12 is disrupting for sleep for more people than I think realize it. And then there's alcohol. While alcohol feels like it can help you fall asleep initially, it fragments your sleep significantly in the second half of the night, which is a really common driver for those two to 4 a.m. wakeups. Then, reiterating, morning sunlight and a consistent wake up time. These two things together are, I think, the most powerful regulators for your circadian rhythm. Light exposure in the first hour of your morning anchors what we call your sleep wake cycle. So it is what sets the time for your melatonin release at night is the light exposure in the morning. So can you have a consistent wake up time even on the weekends? And this is something that's really going to protect. What we call your sleep drive. We want high sleep drive in the evening. And so I know this isn't like a glamorous intervention, but get outside within the first hour of being awake with naked eyes. You can have, you can have uh like glasses or contacts in, but you don't want to be wearing sunglasses. You actually want the sunlight kind of directly into those eyeballs. I shouldn't have to say this, but I will. Don't stare directly at the sun. That will cause, that will cause damage to your eyes. But getting out in the morning, or if you're somebody who wakes up before the sun is up, when you wake up, put on bright overhead lights. And then as soon as the sun is up, can you go outside for 10 or so minutes? Another thing that can increase our sleep drive in the evenings is movement during the day. So exercise for a couple of reasons. Exercise is one of the most effective ways that we can discharge accumulated stress. It also is a big cortisol regulator for folks. And our movement doesn't have to be intense. It could be daily walks. The other thing to note here is that timing matters somewhat. Very intense exercise close to bedtime can be disruptive for sleep. So if you're going to do more intense exercise, the earlier in the day possible tends to serve you better for sleep. But you want to move during the day and you want to move pretty consistently throughout the day. So this is if you work a sedentary job, can you get up? Can you take walking breaks? Can you go walk on your lunch, go to the bathroom? Even if you're just getting up for a couple minutes every hour, moving throughout the day, and then having a little bit more of a structured exercise time can be helpful for sleep. Then reiterating what I've mentioned, keeping the bedroom cool, dark, and quiet. Cool, dark, and quiet. Your core body temperature needs to drop to initiate and maintain sleep. And cold rooms support that. We want a cold room. If you're hot, you're gonna have worse quality of sleep. If there's lights in your room, you're gonna have worse quality of sleep. If there's sudden noises, so maybe you need a white noise machine to kind of take the edge off of any and all sensory burden for our nervous system. We talked already about a couple of the breath practices. So the physiological psi is one of the fastest ways to downregulate your nervous system because it works on impacting your CO2 levels and stimulates your vagus nerve. So that double inhale through your nose with that long exhale. Do that two or three times. An extended exhale breath, breathing in, extending your exhale out longer than your inhale. Another practice that's one of my favorites to do when I just know I'm taking a lot of charge into my evening is something called legs up the wall. And it's exactly as it sounds. Go put your butt where the floor and your wall meet, and then put your legs up. This is a really passive but restorative position that directly activates our parasympathetic nervous system, our relaxation response. Because what's happening is it shifts blood flow. The using gravity, the blood from our legs pulls back up to our heart. Our heart doesn't have to work as hard to pump. Our heart rate slows down, which naturally tells our breath rate to slow down. Doing legs up the wall for five, 10 minutes, just breathing naturally, is a really, really supportive practice if you struggle to get to sleep or stay asleep. Now, before we wrap up, I will share one more somatic practice and a health tech tool that I have been using and really loving. So the somatic practice is called orienting. So this is a practice that helps to tell your nervous system it is safe in the present moment. You are actively resourcing for cues that put you in the present moment and communicate a sense of presence and safety. So what this might look like is sitting in bed, slowly scanning the room around you, slowly rotating your head, letting your eyes follow, and just taking in what is actually in your room. You can touch the sheets, the mattress, naming what you feel, noticing temperature or texture. So this in some ways can be a mental exercise for presence, for mindfulness, but it's also a body-based signal or body-based signals that we're tapping into. Ones that say, I am here, I am okay, look, there's no danger present, pleasurable or neutral noticing our sensations, read as safety to our nervous system. And your nervous system responds to present moment sensory input more than it responds to logic. And so a lot of times, especially when the thoughts have started to race, what we need to do is we need to anchor in to a more sensory state, anchor out of our mind into the body and orienting, taking things in visually, taking things in with touch, noticing three sounds you can hear. Is there anything you can smell? And allowing yourself to move through those senses, orienting you to safety, to neutrality in the space that you're in. Then maybe layer in some breath work to help you settle into more rest. And the last tool I'll tell you about is something called an ohm breathing lamp. So this is a bedside lamp that has a small stone-like feature on top. When you pick it up, it has these sensors on the bottom of that stone that lay in your palm. And those sensors read things about your current biodata. It reads your heart rate, your blood pressure, and it guides you into something called resonance breathing. So resonance breathing is a slow-paced breathing practice that has specifically been studied for its effects on the nervous system. So it has this ability to stimulate your vagus nerve, it can increase your heart rate variability, and it has become one of my most consistent nighttime tools. And what it does is when you pick this stone up off the lamp, it begins to vibrate gently in your hand, as well as there's a soft light on the lamp that cues you when to inhale and when to exhale. And then it's using those sensors in the stone to read your personal data and it's adjusting how it's coaching and guiding your inhale and exhale to bring your heart rate, your blood pressure, and your breath all into alignment. So I got an early testing unit from Ohm about six months ago and love it. Not only because I think it's the most functional bedside lamp, where it has a dimmable light. It also has a sound machine feature that we use regularly. But this practice is so simple, it's so repetitive, and it's so effective for helping me prepare to get a good night's sleep. And it's something I come to often, even throughout my day, my busy days of being a mom and a business owner. And I love that there are no screens involved. It is a device that's beautiful, it's functional, it's sitting in my environment. Anytime I see it, is this cue calls me into this practice, giving me this moment to pause and settle? And what again makes this so different from doing breath work on your own is that it does, it finds your unique resonance frequency in real time and guides you there. I have been pitched so many different vagus stimulating devices, vagal toning, nervous system regulation. This is the only one of all of the health tech devices that I have tried that I consistently use on a regular basis. It's one that I have reached for at 2 a.m. when I've had a hard time sleeping and it's lulled me back into quality rest. I have fallen asleep with the stone in my hand more than once. Again, it's currently available for pre-order, I believe for $50 off. I will drop a link to their website in the show notes and you can check it out. This is one of the few health devices that I can put a 100% stamp of approval. I've tested it. I love it. My family loves it. So that is something I'd recommend, especially if you are struggling to sleep, or if you're just looking for a consistent, simple daily nervous system regulation practice, the ohm breathing lamp is a wonderful, wonderful option. So I want to close and wrap up this conversation today with the bigger picture. Anxiety disrupts sleep. Sleep deprivation increases anxiety. Both are true simultaneously and they feed each other bidirectionally. Our poor sleep elevates cortisol, it increases amygdala reactivity, it reduces prefrontal function, it shrinks our window of tolerance. All of these things are going to create a physiological situation where you are more anxious after a bad night of sleep. And that elevated anxiety then feeds into the next night's disruption. So this is why sleep is one of the most powerful levers that we can pull in nervous system regulation and nervous system healing, and one of the most underestimated, in my opinion. We need to take our sleep seriously if we want to be well. We need to invest in tools. We need to consistently step into practices that help us to sleep better. Sleep is the primary brain health and nervous system recovery process. It is when your brain consolidates learning. It's when your lymphatic system clears out metabolic waste. It's when your cortisol resets. Emotional processing happens as you sleep. And you do, you genuinely limit your ability to heal your nervous system, to recover, to be mentally well when you are not getting adequate sleep. This is one of these things that I cannot emphasize or re-emphasize enough. It's not optional. And I also want to add that caveat that this is coming from a mom with really young children. My sleep is regularly disrupted for things outside of my control. But understanding the science holds me accountable to consistently controlling my controllables, to consistently putting my phone away earlier so that I can get to bed when I can get to bed. For allowing myself to, if the best night's sleep I'm going to get is actually in my kids' bed because it's going to keep them asleep longer. That's what I do. Make the adaptations, take your sleep seriously because it is one of the most foundational anchors to your wellness. Now, part three of this series comes next week, and it is going to be a standalone wind down practice, about 10 minutes. Hopefully, something that you can try sometime that week, see if it helps helpful for you, and maybe build that into your windown or bedtime prep process. Okay, here's the wrap-up for today. Number one, you cannot force your sleep. But what we can do is build strong conditions for it. So that can be the habits that you have throughout your day, be it morning sunlight, consistent wake-up times, movement, keeping yourself well, getting off screens, having that wind down routine, and then a cold, dark, quiet room where possible. Number two, when it comes to the middle of the night wakeups, those need a different response than just lying there and trying to fight it. So, what are the things you can do in the middle of the night? You can sit up, you can name your state, meeting that sensation rather than resisting it. Changing your mindset around I have to sleep now, I have to sleep now, I have to sleep now, or else I am here to rest. I can rest even if I can't fall asleep. What would make this feel or look more restful for me? You can also reach for breath work practices over a phone. Again, why I love the own breathing lamp is even if both things are on my nightstand, my phone or the breathing lamp, it gives me the option. It gives me the choice. I can choose something that's going to further disrupt my sleep, or I can reach for that stone, place it in my hand, and do a breathing session to help settle my system. And if you can't fall asleep after those 20 to 30 minutes, get out of bed, do something low stimulating so that we can keep a more positive association between sleep, bed, and rest. And then the third is your daytime is the preparation for your nighttime. Morning sunlight, consistent wake up, movement, processing stress before it accumulates, stabilizing blood sugar. And I know this is repetitive to things I just said. I want to reiterate it. Your daytime is the preparation for your nighttime. All right, friends. As always, if any of this resonates, if you have any follow up questions, I would love, love to hear from you. And until next week, I am sending so much hope, healing, and restful sleep your way.