Can't Sleep Because Of Anxiety? Box Breathing Could Be The Answer

Trying to get a good night’s sleep when you’re feeling stressed is not for the faint-hearted. It’s ironic considering the best thing we can do when we’re feeling overwhelmed is rest – but switching your mind off when you’re experiencing stress isn’t easy.

“Under stress, people often describe not being able to switch off their racing minds. You may find that you fall asleep OK, but then wake up in the early hours of the morning, wide awake,” Bensons for Beds’ resident sleep expert, Dr. Sophie Bostock, says.

But don’t stress (ha), feeling anxious doesn’t have to keep you up at night. Some people seem to sleep soundly no matter what is going on in their lives but let’s be real, some of us need a bit of extra help.

Sleep reactivity is the name given to describe the extent to which stress disrupts sleep, a difficulty falling or staying asleep.

So let’s break it down.

What is stress?

“In our bodies, the term ‘stress’ or ‘stressor’ can refer to anything which provokes our ’fight or flight stress response. The stress response evolved to help our ancestors fight or flee from danger,” Bostock says.

When the brain detects a threat, the body releases adrenaline, which speeds up the heartbeat, increases blood pressure, and triggers the release of the stress hormone, cortisol. Cortisol stimulates the release of glucose into the bloodstream to fuel the body for action.

Stress also influences the way we think and feel. We focus our attention on the threat; it takes over our brains making it harder to step back and see the big picture.

“The emotional centres of the brain become more sensitive to negative events when we’re already feeling stressed. We also tend to become more anxious, irritable, and prone to low moods,” Bostock adds.

What are some of the signs of stress?

“The way that we react to stress is individual, and will depend on whether it’s acute or chronic,” Bostock explains.

Most of us are familiar with the signs of acute stress, which are characterised by the ‘fight or flight stress response.’ This might be how you feel before public speaking, or if you narrowly avoid an accident on the road. Signs of acute stress include:

  • Sweating
  • Racing heartbeat
  • Tense muscles
  • Stomach upset, indigestion, or heartburn
  • Altered appetite
  • Rapid breathing
  • Narrowing of attention and focus toward the threat

When you are stressed for a long time, some of these physical signs are less obvious, and you might not consciously ‘feel’ stressed. It could be that the brain and body have simply learned a pattern of increased arousal (so-called ‘hyperarousal’) because you’ve been under stress for so long.

Chronic exposure to stress hormones takes its toll on the body. Signs and symptoms of chronic stress can include:

  • Weight gain or weight loss
  • High blood pressure
  • Changes to the menstrual cycle
  • Sexual dysfunction
  • Constipation or diarrhoea
  • Rashes or itchy skin
  • Infections or illness
  • Changes in mood – greater impatience, irritability, anxiety or depression
  • Difficulty making decisions
  • A feeling of being overwhelmed
  • A worsening of physical or mental health conditions
  • Difficulty sleeping, either falling asleep or waking up during the night

How does stress and anxiety affect our sleep?

We tend to produce more of the hormone, cortisol when we’re experiencing stress. Cortisol is a useful hormone for fuelling action, but before bed, it increases our levels of arousal, at a time when we need to relax.

“Stress, therefore, leads to a state of hyperarousal, where your brain and body are more alert than normal. It takes us longer to fall asleep, and because sleep is lighter, we’re more likely to be woken by noise, movement or changes in temperature,” she explains.

Bostock continues: “Stress can also cause us to change behaviour in ways that are unhelpful for sleep, such as doing less exercise, relying on alcohol to relax, working late or taking long naps to recover.”

How can we ease stress for a good night’s sleep?

“Relaxation is a skill – the more often you practice, the more quickly and deeply you will be able to relax,” Bostock says. You should try practicing relaxing fora few minutes during the day, as well as part of your wind down before bed.

Here are three ways you can reduce stress before you sleep.

“When we’re in danger, our breathing tends to either get faster, as we prepare to fight or flee from a threat, or occasionally, it might pause completely: as we freeze, while we make up our minds,” Bostock shares.

Maintaining a slow, steady breathing rate, therefore helps to signal to the brain that we’re not under threat, and helps to drive the relaxation response.

There are many different breathing techniques you can try, and it’s worth experimenting with a few different exercises, until you find an approach which has a calming effect on you.

Box breathing involves breathing in for a count of 4, holding that breath for a count of 4, breathing all the way out for a count of 4, and holding for a count of 4. Set a timer for 5 minutes and aim to maintain this pattern. Over time you can build up to 20 minutes or more.

“If you’re lying down it can be helpful to keep one hand on your belly and one hand on your chest,” Bostock adds.

“Focus on making your belly fall, rather than your chest. This means you are more likely to be using your diaphragm to pull the air all the way, deep into your lungs, which provokes the relaxation response,” she says.

If you want some mental focus before sleep, Bostock suggests trying some positive imagery. “Close your eyes and picture an event or place that makes you feel relaxed. This might be a beautiful beach, mountain, lake, forest, or an imaginary place,” she adds.

“Imagine that you’re the movie director of your perfect scene. Ask yourself: what you can see… what you can feel… what you can smell… what you can touch?” she adds.

You’re not trying to sleep, which is important you’re just going to enjoy visualising a happy place where you can feel calm and comfortable. “The more often you can return to this safe place in your mind, the more easily you’ll be able to relax and unwind, and eventually, it could help you to fall asleep,” she adds.

If you have an active busy mind before bed try to get into the habit of writing down some of your inner dialogue in advance of bedtime. “Put aside 10-20 minutes for this exercise, perhaps at the end of the work day, or after dinner. Ideally not right before bed since this exercise will get you thinking,” Bostock says.

Sit down somewhere you won’t be disturbed and grab a notebook. Write a few bullet points about what has happened today.

  • What went well? How did that make you feel?
  • Has anything troubled you? Why was it difficult?
  • What could you do differently next time?

“The aim is to stop unnecessary thoughts whirring around your head,” Bostock shares.

If similar thoughts pop into your head when you’ve switched the light off, tell yourself that they’re on the page and you don’t need to think about them anymore.

“If any urgent thoughts do come up in bed, keep your notebook and a pencil by your bed so that you can write them down, and then let them go,” she adds.