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Managing the Negative Effects of Anxiety on Sleep

10/11/2022

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth ​
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Do you lay in bed tossing and turning? Do you check the clock and calculate the number of hours of sleep you’d get if you fell asleep right now? Or think about your list of to-do’s for tomorrow? If so, you’re not alone. So let’s talk about how to manage the negative effects of anxiety on sleep. 

Anxiety, and associated worry thoughts, have a significant impact on our ability to sleep. And with the high demand world we live in, it’s no wonder that so many people struggle with sleep problems. 

The tough thing about anxiety and sleep is that it can be difficult to know which comes first. Do we not sleep because we are anxious? Or are we anxious because we can’t sleep? It’s likely both. Stress and anxiety can cause or worsen sleep difficulties and lack of sleep can make us anxious.

​So, how can we manage our worry thoughts to help us get better sleep?

​https://youtu.be/8KEbCRXZUqE


How to Get Better Sleep

Worry and anxiety are a normal part of life, but also among the strongest factors that impact sleep. If you are finding worries are preventing you from sleeping, here are some tips to help you sleep better:
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  1. Keep a “worry log” – if you can’t sleep, get out of bed, write down your worries, and ask yourself 3 key questions: what is the evidence for this worry? What is the problem to be solved? What can I do right now?​
  2. Implement relaxation strategies such as diaphragmatic breathing, visual imagery, and progressive muscle relaxation – these can help with sleep onset and maintenance. This also means reducing stressful or anxiety-provoking activities close to bedtime.
  3. Move your body. Exercise helps to not only manage anxiety but to improve sleep; however, exercise can keep you awake if done in the evening – as a general rule, it’s good to avoid exercise in the 2-3 hours before bedtime.
  4. Have a good bedtime routine. For example; have some decaf tea, listen to relaxing music,  or have a warm bath. Make a clear distinction between daytime activities which require alertness – and bedtime activities which should induce relaxation. This includes reducing or eliminating screen time before bed. 
  5. Don’t stay in bed if you can’t sleep, as this can lead to our bed becoming associated with a state of wakefulness. If you can’t fall asleep within 15-20 minutes, get out of bed and do not get back into bed until you are sleepy (not just tired).

Final Thoughts

Still not able to effectively manage the negative effects of worry on your sleep? Cognitive-behavioural treatment (CBT) is the most effective treatment for sleep problems, as well as associated mood and worry or anxiety issues. If worry thoughts persist and continue to have a significant impact on sleep, consider seeing a registered mental health provider. It may also be helpful to talk to your family physician to ensure there are no other underlying issues that may be impacting your sleep.

https://youtu.be/CIOhCas5KUc

I'm medically obese - and totally love my body. Is that okay?

13/10/2022

 
The question:

I’m medically obese – but totally happy with my body (I swear). Family and friends tell me there has to be something psychologically wrong with me, if I can be truly happy with my body being this large. What’s your perspective?

The answer:

​First, there is nothing “psychologically wrong” with you for truly accepting your body as it is. You sound like a confident person whose self-esteem is not impacted by your physical appearance. The reality is there are a range of physical attributes (e.g., weight, height, facial features, acne, scarring), health conditions (e.g., cancer, HIV) and physical disabilities (e.g., paraplegia, amputations) which could impact self-esteem and confidence.
 
Unfortunately, the stigma in our society surrounding weight issues is undeniable: I think most people view weight as something that is very much within one’s control. The reality is that there is a significant margin of control we can have over our weight through healthy diet and exercise, but some people have a stronger genetic component to their weight, and these individuals can have tremendous difficulty losing weight.
 
You say you are “medically obese”: a body mass index (or BMI) is the measurement that is used to define individuals’ weight classification, and involves a ratio between height and weight. Individuals are classified as being “obese” when the BMI exceed 30 kg/m2. By definition, obesity is a medical condition where body fat has accumulated to the point that there may be an adverse impact on health.
 
I wonder if the concern coming from your family and friends is related to your physical health, not your psychological well-being.
 
There is ample evidence that obesity increases the likelihood of developing a range of serious health conditions, including: heart disease, diabetes, sleep apnea, osteoarthritis, and certain types of cancer. Overall life expectancy is also reduced.
 
When your family or friends express their concerns to you, you may want to ask them what specifically they are concerned about, as I suspect it has much more to do with these health risks. I also wonder if it may be scary for you to acknowledge the possible negative health effects your weight is having.
 
Stating your happiness and acceptance of your body/weight to others may possibly be a way for you to avoid facing some of the other negative impacts that exist, as those may be daunting to both face and start to take some action toward.
 
I would suggest a conversation with either a loved one that you trust, or ideally a health professional: a physician, nutritionist, or dietitian can provide you with useful information on making some changes to your lifestyle – if that is something you feel you want to do.
 
Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail.

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