Ever notice how a stressful day can leave you tossing and turning at night?

I ask because, as we look ahead to International Stress Awareness Day on November 6, and those of us in the US “fall back” with the end of Daylight Saving Time on November 3, it’s the perfect time to reflect on two things that affect quality of life for every single person, every single day: stress and sleep.

Believe it or not, stress and sleep are deeply interconnected. Stress exacerbates poor sleep, and poor sleep exacerbates stress. They impact each other directly, and — in combination — they can cause or compound mental and physical health issues too.

Of course, this synergistic relationship also means that effective stress management can lead to better sleep quality, and vice versa. More on this later.

First, let’s examine the relationship between stress and poor sleep.

statistics on stress & poor sleep

The 2024 Stress in America survey found “the overall average reported level of stress this year was 5 out of 10“ thanks to a wide range of external stressors. This is to say nothing of the unique intersectional stressors we each face on an individual level.

I doubt anyone reading this right now needs statistics to understand what I’m getting at. You already probably understand that stress is a pervasive problem in daily life.

Poor sleep is also mentioned fairly often by clients in my practice, but is frequently overlooked as a potential source (and outcome) of stress itself. On its own, poor sleep is just as problematic and widespread. What’s most concerning to me as a therapist is the fact that poor sleep can increase the risk for “frequent mental distress” by nearly threefold. This is a statistic not to be taken lightly.

The average person losing a little sleep for a few nights may feel a little tired temporarily, but adults who are already struggling with high or chronic stress tend to feel the impact more. Negative physical consequences include increased risk for diabetes, heart disease, weight dysregulation, and accidental injury. Negative emotional consequences include feeling mentally sluggish or lethargic, increased irritability or anger, poor concentration, low mood and loss of motivation — all of which lead to further stress during waking hours.

Obviously it’s bad enough when we have issues with just stress OR sleep. But it feels much worse when we struggle with both.

what’s the science here?

Stress has adverse effects on sleep quality and duration. When stressed, our bodies release cortisol and adrenaline which work to keep us alert, impairing our ability to both fall asleep and stay asleep. Additionally, we become more prone to anxious ruminations or racing thoughts, which further delay sleep onset.

Sleep reactivity is something to consider as well. This is the ‘ease’ with which sleep can be disrupted by stress. As a function of both individual and environmental factors, this is worth noting when thinking about your relationship with sleep.

That said, the fact remains that poor sleep has noticeable impacts on both stress and mood. Sufficient sleep helps regulate cortisol and inflammation, aiding in emotional regulation and stress recovery. Without sufficient rest, our stress hormones remain dysregulated and may even increase, creating a feedback loop of adverse effects.

Even small disruptions in your circadian patterns (i.e. by going to bed late or sleeping in) can disrupt this regulatory process. Interestingly though, studies have found that ruminations alone are more harmful to sleep quality than just high levels of stress in general. This implies it is really the mental and emotional impacts of stress (i.e. anxiety) that cause the most harm. Which leads to my main point…

Stress & Sleep have direct impacts on Anxiety & Mental Health

Broadly speaking, stress is the most common trigger for anxiety that I encounter in my practice. Whether acute or chronic, all stress can cause significant sleep disruptions. Simply worrying that you’ll have trouble falling asleep can become a self-fulfilling prophecy. And when we’re sleep deprived, we’re more likely to experience anxiety in response to stressors.

So how can we make sure this doesn’t become a bigger problem?

So, what can we do to manage stress and get better sleep?

Spoiler alert: you can do quite a lot…

1. make some Lifestyle Changes

• Exercise regularly: Healthy movement can help dispel physical symptoms of anxiety. As a bonus, exercise has also been shown to boost mood and support overall emotional regulation. Doing so regularly turns this one-time action into a beneficial habit.

• Eat healthily: Be mindful about consuming nutritious, well-balanced foods. Avoid substances known to worsen sleep, such as caffeine, alcohol, and nicotine. Don’t eat too close to bedtime to avoid sleep disruptions due to (in)digestion.

• Practice good sleep hygiene: Keep a consistent sleep schedule, even on weekends, to reinforce your body’s natural circadian rhythm (i.e. sleep-wake cycle). Develop a “wind down routine” to ease your transition into bedtime. Ensure your room is sufficiently dark, quiet, and cool.

2. make some mental changes

• Mind-body tools for stress management:

  • Breathing exercises: Techniques like box breathing and diaphragmatic breathing can help calm your heart rate, lower blood pressure, and slow racing thoughts. In my practice, I favor an exercise that additionally integrates counting.

  • Body scans & progressive muscle relaxation: Tense and relax different muscle groups to increase awareness/grounding and release physical tension. Think of it as an active, literal form of ‘letting go’ of anxious energy.

  • Meditation: This can help focus your attention away from the stream-of-consciousness narratives present in ruminations. There are many types to choose from: mindfulness meditations, focused/guided visual meditations, loving-kindness meditations, walking meditations, etc. Take your pick!

  • Yoga or tai chi: Yoga can be quite active depending on the school of practice, but yin and restorative postures are great for cultivating more relaxing movement. Tai chi is gentle as well, utilizing calm, flowing movements and deep breathing. Combine breathwork with these mindful movements to build flexibility, strength, and balance while promoting relaxation and stress reduction.

  • Music: Listen to soothing songs. Or, if you're feeling too energized for slow music, start with “mood matching.” First, pick your favorite uptempo tunes to allow the playlist to meet your stress where it’s at; as time goes on, you can gradually shift toward more calming music.

• Cognitive tools:

  • Get your worries out before bedtime: Address anxieties early to prevent them from keeping you up. Plan for the next day and write out your to-do list long before bedtime. For more larger, abstract worries, I recommend journaling or scheduling “worry time” — again, done well in advance of your head hitting the pillow.

  • Challenge negative thoughts: Ruminations tend to bring negative thoughts and judgments, but are these thoughts truly reasonable? Realistic? Helpful? Productive? Appropriate? If the answer to any of these is “no,” it may be time to reassess your narrative and consider cognitive-behavioral techniques to manage negative thinking.

  • Practice positive thinking: Cultivate gratitude by identifying things you appreciate, especially when confronting challenges. This can help ground you in the present and promote a more positive outlook, building a foundation for even more forward thinking down the road. It’s a matter of seeking it out with conscious intention.

These tips are in no way comprehensive, and any combination of tools can help promote healthier stress management and sleep practices. However, if you frequently struggle with ruminations, delayed sleep onset, frequent wakings, nightmares, or night terrors, you may benefit from further discussion with a health professional.

If you’re not sure where to start, I offer a complimentary 10-minute phone consultation — and encourage all prospective clients to take advantage of it! While I cannot diagnose sleep disorders, I AM trained to work collaboratively with clients to create a personalized care plan that supports their specific, unique needs. Stress management and anxiety-related sleep disturbances are just two of many issues I love working with in the virtual therapy space.

I’ll close by reiterating that it's never too late to prioritize your mental health and take steps toward thriving — especially as many of us have just gained an extra hour. Maybe consider taking just a few minutes of that time to reflect on your stress levels and sleep patterns. Are there any changes there that you’d like to make?