Life alongside the war is full of tension and anxiety, and it affects the sleep patterns of many people. While some experience difficulty falling asleep and insomnia, others report nightmares and particularly vivid dreams. For more about the reasons for this and the classic and innovative ways of coping with sleeplessness, join researcher Rotem Siso, and learn more about the phenomenon in this blog.

Sleeplessness (professionally known as insomnia) and anxiety disorders interact and are known to feed into each other. People suffering from anxiety often find themselves struggling to quiet the thoughts echoing through their minds at nighttime, and cannot fall asleep. On the flip-side, chronic sleeplessness may amplify feelings of anxiety – and the thought of yet another sleepless night, in and of itself, may intensify the symptoms. In actuality, sleeplessness is a central component of anxiety to such a degree that it is counted among the official criteria required for diagnosing anxiety disorders and depression.

The effect of stress and anxiety on sleep usually occurs due to changes in the normal secretion of the stress hormone – cortisol.
Cortisol is a steroid hormone secreted from the adrenal gland in pulses that vary throughout the day: its level decreases around the evening hours and reaches its lowest point around midnight – allowing one to fall asleep more easily. Its level then increases, reaching its peak around 8:00 AM – where it plays a key role in waking up from sleep. Therefore, anxiety-inducing situations, such as emergencies and wartime – which lead to increased cortisol secretion over longer periods of time, including during the evening hours and at nighttime – have a particular effect on the ability to fall asleep and to sleep uninterrupted. Thus, one of the earlier studies demonstrated that people suffering from sleeplessness have substantially higher levels of cortisol than people who have no trouble sleeping, with a particular emphasis on the evening hours and nighttime.

Reality or Dream?

Sleeplessness is not the only phenomenon that the war had brought with it. In recent weeks, reports of highly vivid dreams, which are sometimes confused with reality, have been accumulating on social media. One of the hypotheses regarding this is that in states of stress and anxiety, one of the phases of sleep – REM sleep – is prolonged.
REM sleep (Rapid Eye Movement sleep) is a phase of the sleep cycle where substantial brainwave activity, similar to the brain activity when one is awake, is present.  Most dreaming occurs during this phase, and when a person is woken up from REM sleep, they will usually remember their dream in a clear and detailed manner, as though it had happened in reality.
Studies have shown that REM sleep and dreams play an important role in processing stressful or difficult events that have occurred. Thus, for example, patients who were involved in road accidents but slept afterward and experienced dreams (that is to say, experienced REM sleep) were less likely to develop post-traumatic stress disorder (PTSD).
It is no surprise that during such an emotionally busy period, REM sleep takes up a more substantial role, and dreams may be experienced as particularly vivid – as a mechanism for coping with the situation.

Let Me Sleep in Peace

Proper sleep is important for day-to-day functioning, mood, and quality of life.
Classically, Cognitive-Behavioral Therapy (CBT) has been proven to improve sleeplessness, as have some pharmacological interventions, including antidepressants and anti-anxiety medications of the SSRI family.
More innovative methods for contending with severe sleeplessness that is resistant to classic treatments have been studied in recent years. One technique that demonstrated promising results in treating anxiety and sleeplessness in a study from 2018 is rTMS (Repetitive Transcranial Magnetic Stimulation). Under this treatment, the brain is externally stimulated by non-invasive means that encourage the activation of sleep-inducing GABA receptors in the brain.

One way or another, the good news is that usually, when the stressogenic situation resolves, sleep is also expected to improve. In the meantime, one may try to maintain a regular daily routine which aids in the secretion of sleep-encouraging hormones, maintain moderate physical exercise, and avoid anxiety-inducing content before going to bed.

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