Study Makes Nocturnal Anxiety The Gateway To Bigger Problems

Going to bed and remembering appointments, pending tasks and problems to solve, to the point of losing sleep or taking a long time to sleep, can be a sign of nighttime anxiety. According to Álvaro Cabral Araújo, a researcher and collaborator at the Institute of Psychiatry at the Hospital das Clínicas of the Faculty of Medicine at USP, nighttime anxiety is “that perception that you reach the end of the day and your thoughts become more accelerated, worries arise and the individual may perceive discomforts such as tightness in the chest, palpitations, faster breathing, this within the context of an anxiety condition that can worsen close to bedtime”.

A survey carried out by the Academia Brasileira do Sono during November 2020 and April 2021 revealed that 70% of Brazilians were not satisfied with the quality of their sleep and that the habit of thinking about everyday issues when going to bed increased by 5.1 %, going from 28.3% to 33.4% of the total respondents. The covid-19 pandemic, the context in which the research was carried out, only aggravated a problem that was already worrying.

brain functions
Nocturnal anxiety not only harms the sleep nights in which it is felt. In the long term, it can lead to damage to brain functions, as explained by Lucas Baviera, a psychologist, specialist in Psychoanalytic Psychotherapy and Master in Clinical Psychology at the Institute of Psychology at USP: “With regard to sleep impairment, we can list mainly the issue learning ability, retaining new information, attention span and memory capacity. Even information already retained that is in memory can be impaired, as sleep loses quality”.

Closely associated with insomnia, nocturnal anxiety is common among people who live with an anxiety disorder and the relationship can be interpreted as cyclical: “It is a feedback system, because then the person is worried about sleeping, because he needs to sleep, because he will wake up very upset the next day if you don’t sleep well. These are all factors that increase anxiety and, increasing her anxiety, it becomes less conducive to having this inviting sleep environment”, adds the psychologist.

Although there is this deep connection, it is possible to identify the difference between pre-sleep anxiety and other sleep disorders: “An important sign, which can mark this difference, is that nighttime anxiety will concern worries, other sleep disorders will not. necessarily involve concerns. We can think, for example, of the insomnia of the person who wakes up in the middle of the night wanting to do something. The person may be wanting to expend energy, wanting to be productive or something. Nocturnal anxiety concerns concerns and fears, whether they are based on something concrete in the person’s life or something unconscious”, says Baviera.

possible treatments
Treatment for pre-sleep anxiety, as well as for anxiety and insomnia, can be done through psychotherapy and pharmacotherapy. Araújo highlights the action of anxiolytics, but warns that they should be consumed for a limited time and only with a medical prescription: “Ideally, they should not be applied for a very long period of time, especially due to the risk of dependence. The biggest problem is that the person may need increasingly larger doses of the same medicine and, when you try to take the medicine, you have a worse quality of sleep”. Care regarding these issues is essential, but psychiatric treatment should not be refused for fear of dependence. Araújo reiterates that there is a range of drugs that do not generate addiction and that are the most regularly prescribed.


In Bavaria’s view, psychoanalysis is an essential way out: “When we talk about psychoanalytic follow-up, we also pay attention to the things that need to be said, this person probably has some things that he is having difficulty saying and that it would be nice to say to an appropriate person.”

Other ways to mitigate episodes of nocturnal anxiety can be done on a daily basis, avoiding some excesses and changing some habits: maintaining a constant sleep routine, doing regular physical activity up to three hours before bedtime, going to bed only when feel sleepy and avoid caffeine, alcohol and tobacco at night.