Relationship Anxiety and Poor Sleep - a Negative Feedback Loop

Relationship anxiety is gut wrenching. It keeps you awake, preventing sleep from acting as a soothing relief. You might be anxious about having upset a loved one, on edge waiting for a response to a text, or wondering if you have been forgotten by your partner. Being uncertain leads to imagining the worst possible scenarios. These are part of the catastrophizing and Repetitive Negative Thought patterns that stop you from sleeping, wear you out, and stir up more anxiety. Sleep is fitful and unrefreshing if you manage to sleep at all, offering no respite. In fact you get anxious about not being able to sleep which just magnifies the negative feedback loop between relationship anxiety and poor sleep.

Relationship Anxiety and Poor Sleep – linked to loneliness

Cora a 36-year-old piano teacher, thrived on good planning and structure in her daily life. She set out her travel routes and journey times to meet students in their homes, methodically. Her partner Kyle, a 38-year-old financial advisor spent most of his time entertaining and socializing with clients. His schedules therefore were unpredictable and subject to instant change.

While attracted to Kyle’s exuberance and his ability to get on with a vast array of people, Cora suffered intense relationship anxiety and poor sleep when he was out of reach. Her relationship anxiety ratcheted up when he didn’t keep her abreast of his every move, leaving her hanging. Often she was lonely and it took her back to her days as a child, coming home to an empty house when her parents were at work, feeling alone and unmoored.

A presentation at The American Academy of Sleep Medicine 2024, described loneliness as a significant factor in poor sleep, which in turn exacerbates loneliness. The authors noted that younger people were more likely to reduce their sense of loneliness if they managed to get good enough and sufficient sleep.

But young Cora was often awake at night, wondering if her parents would squabble and say hateful things to one another, thinking she was asleep. She dared not fall asleep in case one of them left, or got hurt. She had to stay vigilant to make sure her family was intact. For Cora, relationship anxiety and poor sleep was mediated by an intense sense of loneliness and unpredictability.

Relationship Anxiety and Poor Sleep – Repetitive Negative Thinking disrupts circadian rhythms

Cora’s relationship anxiety and poor sleep led to a cycle of Repetitive Negative Thinking, (RNT). She would imagine all sorts of catastrophic scenarios where she starved because there was no food in the house. She envisioned being rejected by her class mates for smelling because she was dirty and wore unwashed clothes, and or scenes where her parents were so busy with work and family of origin, that she would end up homeless and unwanted. These repetitive negative thoughts spiraled, overwhelming the young girl. When Kyle’s uncertain work schedule stirred up anxiety, the same sequence of RNT set up a familiar pattern for adult life – of dire outcomes that led to panic attacks and severe mistrust of the romantic relationship.

A study reported in the Journal of Behavior Therapy and Experimental Psychiatry, 2017, reported that Repetitive Negative Thinking interferes with the normal circadian rhythms that promote sleep-wake cycles. The negative thoughts took up so much of Cora’s attention, that she couldn’t switch off. If she did fall asleep it was for short periods, leading back to the negative thinking – reinforcing the loop where there was no possibility for rest, and disengagement from the relationship anxiety.

Relationship Anxiety and Poor Sleep – napping makes it worse

When Kyle was away for a weekend with clients, or late home from a meeting, Cora texted him incessantly. She needed to be in touch to make sure he was still there – as if she were the little girl desperately trying to reach unavailable parents who were out doing their thing, forgetting her – throwing her into a massively scary state. When he took his time responding or complained that she was overdoing it, she wasn’t able to sit still. Staying on high alert, she did chores around the house, had tiny bouts of sleep, overwhelmed by the RNT that filled the hole Kyle had left.

She found herself nodding off and having unplanned naps during the day when she was not teaching. She woke up disoriented, slipping in and out of the fears little Cora had, and those that adult Cora felt. Vivid images of feeling alone and scared, with no way of reaching her parents when she was little washed over her. These images were then overlaid with more recent ones of trying to reach Kyle when he was at work or at his brother’s place – while facing the abject fear of being forgotten when her text was unread, and her voice message unheard for what seemed like an eternity. For little Cora, time had no meaning, where a minute might as well have been a lifetime. That same sense of shaplelss time recurred now in adulthood, reinforcing memories of fear.

Cora’s fear experience is supported by research published in the journal Cognitive, Affective, & Behavioral neuroscience, 2022, which reported that a two-hour daytime nap was not restorative, but rather reinforced fear memories that were present just before sleep.

Without regular good sleep, Cora’s nervous system didn’t get a chance to switch off from the ‘fight, flight or freeze’ responses typical of anxiety and vigilance. The neurochemicals that promote the hyper-alertness continue to be produced and Cora’s brain was not able to use REM sleep to reorganize her memories into less threatening ones. REM sleep helps store memories while processing them, and without the natural cycle of REM sleep Cora was stuck in the scared, anxious mode, unable to detoxify her childhood memories that now dictated her adult life. Insecurity was the only lens she had to experience the world.

Relationship Anxiety and Poor Sleep – linked to mental health issues

Without restorative night time sleep, and daytime naps only enhancing Cora’s fears about being forgotten, abandoned and unwanted, she developed a mood disorder originating in her childhood that got worse as she got older. Anxiety with paranoia, bouts of depression overlaid with anxiety made it almost impossible for her to get relief. When her paranoia was elevated, she had psychotic episodes, where her reality and objective reality were far apart. Kyle might be driving home after a work event, but she would insist he was going to a bar first, because he didn’t want to be home with her.

Cora’s childhood experience of consistently poor sleep made her more than twice as likely to develop psychotic disorders, and nearly four times as likely to experience psychotic episodes in early adulthood, according to JAMA Psychiatry, 2024. Researchers in the Avon Longitudinal Study of Parents and Children, tracked children from 6 months to 7 years and then again at 24 years of age, to come up with this finding.

The journal Nature Reviews Neuroscience, 2024 reports that ‘Disrupted REM sleep, common in sleep disorders, may prevent this necessary processing, increasing the risk of mental health issues.’ Unfortunately, Cora’s early experience of neglect led to sleep problems that made her prone to mental health disorders.

In addition, Cora’s sleep pattern is misaligned to her chronotype (morning person, evening or late night person). She is a morning person, but goes to bed late due to relationship anxiety and the need to stay hyper vigilant. The journal, Psychiatry Research, 2024 report that mental health issues are more prevalent in those whose chronotype is misaligned with their sleep times. Cora being a morning person, is more prone to mental health problems because she goes to bed late – a misalignment with her chronotype.

Relation Anxiety and Poor Sleep – finding a path to secure attachment

What will not work

Let’s start with what won’t work in Cora’s case, and get past all the self-help stuff that she may find on an internet search. Because she has massive anxiety based on childhood trauma, sleep hygiene won’t do the trick. Nor will avoiding eating and or drinking certain things before bed. Neither will lighting changes, or avoiding screen time or reading help her settle into a good night’s sleep.

Here’s what will work based on the need to reduce the ‘fight or flight’ neurotransmitters that are coursing in her system, preventing sleep:

Putting the anxiety and fear about Kyle outside of her by writing it all down, will go a long way to easing the stress. Once it is out there in writing she can see it and talk herself through it. She isn’t caught up in the Repetitive Negative Thought Cycle that keeps the ‘fight or flight’ adrenalin going.
Sketching and or drawing out the images that go along with the RNT can help to make them visible and less powerful. Cora can then see the difference between the images and thoughts that are created when relationship anxiety and poor sleep coincide to that when her judgement is more rational.
Cora can imagine and create fantasies of being in charge, and recalling the many and frequent moments when Kyle came home, was affectionate and when they cuddled together.
Keeping a log of interactions with Kyle (two-ways) with a time line, can offer a reality check to adult Cora that what may seem like hours, was actually a few minutes.
These more comforting images are what she needs to relax and allow herself to surrender to sleep. She is giving herself what she never had as a child – a reassuring comforting voice, making her feel safe and secure enough to enter the important restorative state of good sleep.

Relationship Anxiety and Poor Sleep – a Negative Feedback Loop