Do you ever wake up in the morning or middle of the night from a stress-provoking dream? If so, anxiety could be to blame.

“Stress and anxiety can keep the body in a hyperarousal state, causing you to wake more easily and have difficulty quieting your mind afterward,” says Susan M. Mucha, M.D., a Piedmont sleep medicine physician.

“Like any major life event – such as a death in the family, trauma or new job or responsibilities, the COVID-19 pandemic has impacted our day-to-day lives and psyches, which can lead to the presence or worsening of anxiety and depression, and subsequently, insomnia,” says Dr. Mucha. “COVID-19 has created new fears, stresses and anxieties for many people, like the fear of contracting the illness and inadvertently passing it to others; the financial strain of losing a job or income; and, for many, the extra responsibility of teaching school lessons to their own children.”

She says all of these stressors can drive insomnia – both sleep initiation insomnia (falling asleep) and sleep maintenance insomnia (sleep disruption or inability to stay asleep).

Symptoms of stress dreams

“People with stress-related dreams and insomnia could present with symptoms such as fatigue. They are so tired, but when they try to go to sleep at night, they have poor, disrupted sleep. Then, feelings of sadness can develop as they feel they no longer have the energy or desire to do the things they used to do during the day,” says Dr. Mucha.

How harmful is lack of sleep?

Dr. Mucha notes that not only can sleep deprivation related to stress, anxiety and depression cause fatigue the next day, but it can also play a role in physical, mental, and emotional pain.

“I often ask my patients to consider this: When you are tired, does everything hurt more? It is true of physical, mental and emotional pain, translating into feeling more anxious, sad, or depressed, making for a nonproductive or painful day,” she explains. “Then, at bedtime, these worries or sad feelings can worsen and keep a person from falling asleep – and the vicious cycle continues.”

In addition, chronic sleep deprivation has been associated with a number of increased health risks, including issues related to the immune system, cardiovascular system and endocrine system.

What to do if COVID-19 stress is affecting your sleep  

First, start with lifestyle modifications to support good sleep. Dr. Mucha recommends winding down at least an hour before bedtime so the brain can relax before lights-out.

“If you have worries on your mind, schedule 15 minutes in the evening to sit and write them down, so you can put them aside at bedtime, focusing on relaxation and sleep instead,” she recommends. “Near bedtime, avoid screen time and indulging in stimulating activities or substances, like caffeine, cigarettes, or alcohol.”

She suggests a routine that includes stretching, meditation, reading or listening to calming music. Consider taking a bath or shower at the start or end of this relaxation period.

If these methods don’t help, or if you have ongoing stress dreams or trouble falling or staying asleep, contact your healthcare provider.

“It’s also important to keep in mind that frequently waking during the night can also be a symptom of an underlying medical disorder, such as obstructive sleep apnea,” she says.  

Seek social support

“The social isolation of this pandemic, as well as the health and economic impact of COVID-19, has been associated with an increase in anxiety, depression, post-traumatic stress disorder, insomnia, and risk of suicidal ideation,” says Dr. Mucha. “Even prior to the pandemic, insomnia was the most prevalent sleep disorder, affecting millions. But now we are seeing an increase in the number of patients in the sleep clinic who present with insomnia, often having never experienced a significant number of sleep disturbances in the past.”

Dr. Mucha encourages people to connect with others, either virtually or from a safe distance.

“We are all going through something. Reach out to family, friends, co-workers and neighbors to ask for or offer support,” she says.

If you need more help, try one of these resources:

• National Suicide Prevention Lifeline, available 24/7: 1-800-273-8255
• Georgia COVID-19 Emotional Support Line: 1-866-399-8938
• Red Cross Disaster Distress Helpline: 1-800-985-5990
• Crisis Text Line: Text Hello to 741741