Narrative Review. This page provides the verified citation, abstract, and full-text PDF for the journal article.

Clinical boundary: Sleep disturbance can reflect medical, respiratory, neurological, circadian, medication, substance, mood, or trauma-related conditions. Sleep restriction and medication decisions require appropriate individualized assessment.

Publication Details

Author: Christian Jonathan Haverkampf
Journal: The Journal of Psychiatry Psychotherapy and Communication
Publication date: 2022-12-31
Volume, issue, pages: 11(4), 101–110
Article type: Narrative Review

Recommended citation: Haverkampf, C. J. (2022). Anxiety and Sleep: A Bidirectional Clinical Relationship. The Journal of Psychiatry Psychotherapy and Communication, 11(4), 101–110.

Abstract

Anxiety and disturbed sleep commonly reinforce one another. Worry, threat monitoring, bodily arousal, nightmares, and avoidance can delay or fragment sleep; insufficient or irregular sleep can heighten emotional reactivity, concentration problems, bodily sensations, and perceived inability to cope. This narrative clinical review examines that bidirectional relationship without assuming that either problem is always primary. Assessment should distinguish insomnia disorder from curtailed sleep opportunity, circadian disturbance, obstructive sleep apnea, restless legs syndrome, parasomnia, medication or substance effects, mood episodes, trauma-related sleep disturbance, and anxiety about sleep itself. A targeted history, medication review, two-week sleep diary, and disorder-specific measures can clarify the pattern and indicate when further sleep or medical evaluation is needed. Cognitive behavioral therapy for insomnia is first-line care for chronic insomnia in adults and can be coordinated with evidence-based treatment for an anxiety disorder. Stimulus control, carefully prescribed sleep restriction or compression, cognitive and behavioral work, and relapse planning are more effective than generic sleep-hygiene advice alone. Medication requires individualized review of benefit, interactions, dependence, respiratory risk, pregnancy, and next-day impairment. Household responses also matter: a partner can support agreed changes without becoming a monitor or guarantor of sleep. A communication-focused formulation can help patients and clinicians clarify nocturnal sensations, predictions, reassurance requests, and practical constraints. The aim is flexible sleep behavior, less conditioned arousal, safe treatment, and restored daytime function rather than forced or perfect sleep.

Keywords

anxiety; insomnia; sleep; hyperarousal; CBT-I; exposure; circadian rhythm; psychotherapy

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Website copy first made available on 26 August 2026. The journal citation retains the article’s issue date.

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