Sleep Difficulties

Adequate sleep contributes to healthy development and is vital to emotional and physical well-being. Unfortunately, difficulties with sleep are widespread in today's society and chronically insufficient sleep has been associated with declines in functioning, including impairments in attention, academic performance, social interactions and emotion regulation.

Sleep problems are especially prevalent among individuals with anxiety and mood disorders. Research examining specific sleep complaints suggests that 90% of children and adolescents with clinical anxiety experience at least one sleep problem and a majority experience several sleep-related deficits. As inadequate sleep can limit our brain's ability to manage stress and extinguish fear, sleep-specific interventions within anxiety disorder treatment can help to optimize outcome.

A number of sleep-related difficulties can arise in individuals with anxiety and associated presentations. These include:

• Inadequate/Insufficient sleep
• Difficulty sleeping alone
• Tantrums surrounding sleep or bedtime resistance
• Nighttime fears
• Racing or anxious thoughts
• Muscle tension, physical discomfort (e.g. pain), or physiological arousal (e.g. racing heart) at night
• Difficulty with falling asleep
• Difficulty staying asleep
• Difficulty with waking up in the morning
• Nightmares

Assessment of Sleep-Related Difficulties

It is important to specifically assess for sleep-related difficulties in individuals presenting with anxiety and related disorders in order to promote treatment gains. At CUCARD, clinical interview, self and parent-reported questionnaires, and sleep logs may all be used to comprehensively evaluate potential sleep problems that can contribute to maintaining anxiety, related symptoms and daily impairments.

Treatment of Sleep-Related Difficulties

At CUCARD, treatment for anxiety, mood and behavior-related sleep deficits is based on research informed cognitive-behavioral therapy (CBT). CBT helps individuals to identify and modify behaviors and thoughts that perpetuate sleeping problems and teaches specific skills for coping with and improving sleep and related difficulties.

Individuals who participate in CBT for sleep-related difficulties can learn to:

• Understand the relationship between sleep and anxiety
• Develop a healthy sleep schedule and bedtime routine
• Implement healthy practices, habits, and environmental factors important for reducing nighttime anxiety and getting adequate sleep 
• Use relaxation techniques to calm nighttime anxious arousal 
• Identify their anxious thoughts and develop coping thoughts that are more adaptive
• Reduce difficulties with falling asleep
• Use effective parenting strategies for helping their child to sleep alone