Sleep Performance Anxiety
Excessive worry about getting "enough" sleep and pressure to perform well during sleep, paradoxically preventing sleep.
- Obsessive focus on sleep duration or quality
- Worry about consequences of poor sleep
- Frustration with sleep efforts
- Clock-watching and panic about remaining sleep time
- Heightened awareness of sleep quality
The more you try to force sleep, the more elusive it becomes. This performance-based approach creates anxiety that actively prevents sleep. We help you shift from controlling sleep to allowing sleep through cognitive restructuring and paradoxical interventions.
Racing Thoughts & Mental Overactivity
Unable to "turn off" your mind at bedtime, with thoughts spiraling about work, relationships, finances, or unfinished tasks.
- Mind racing with unrelated thoughts at bedtime
- Problem-solving or planning in bed
- Difficulty redirecting attention away from thoughts
- Rumination on past events or future worries
- Mental restlessness despite physical fatigue
Racing thoughts activate your nervous system when you need it to calm down. We teach cognitive techniques to declutter your mind, combined with mindfulness practices that increase your ability to observe thoughts without engaging with them.
Sleep Anticipation Anxiety
Anxiety and dread that builds as bedtime approaches, often starting hours before sleep with worry about whether sleep will happen.
- Anxiety increasing as evening approaches
- Dread at the thought of bedtime
- Avoidance of the bedroom
- Staying up late to delay confronting bedtime
- Catastrophic thinking about tomorrow without sleep
Anticipatory anxiety creates a conditioned fear response to bedtime itself. We use graduated exposure, cognitive restructuring, and behavioral activation to reduce anticipatory anxiety and rebuild a neutral or positive association with sleep.
Stress-Induced Insomnia
Sleep disruption triggered by acute or chronic life stress, such as work pressure, relationship conflict, health concerns, or major life transitions.
- Sleep problems triggered by specific stressors
- Difficulty relaxing despite recognizing need for sleep
- Sleep returning to normal when stress resolves temporarily
- Increased stress amplifying sleep problems
- Tension and physical restlessness in bed
Stress naturally disrupts sleep, but when that disruption becomes chronic, it can persist even after the original stressor resolves. We develop comprehensive stress management strategies and sleep-specific cognitive-behavioral techniques to restore sleep resilience.
Hyperarousal & Nervous System Dysregulation
A persistent state of physical and mental activation where your nervous system remains in "high alert" mode, preventing the downshift necessary for sleep.
- Physical tension and inability to relax
- Racing heart or shallow breathing at bedtime
- Feeling "wired" despite being tired
- Heightened startle response or sensitivity to stimuli
- Chronic tension even during the day
Hyperarousal creates a physiological barrier to sleep. We combine mindfulness, progressive relaxation, autonomic nervous system regulation techniques, and sometimes medication consultation to calm your nervous system for sleep.
Health Anxiety Related to Sleep
Worry about negative health consequences of poor sleep, or fear that sleep problems indicate a serious medical condition.
- Catastrophic thinking about sleep loss consequences
- Fear sleep deprivation will cause illness or damage
- Reassurance-seeking about sleep and health
- Hypervigilance to bodily sensations during sleep
- Excessive health research related to insomnia
Health anxiety about sleep amplifies worry and prevents the relaxation needed for sleep. We use cognitive restructuring, psychoeducation about sleep's actual health impact, and anxiety management techniques to reduce health-related sleep worries.
