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  • Anissa Bell, LMFT

Clarity on Sleep Anxiety: What’s really in your bed?

Updated: Jul 29



It’s all about the bed…but maybe not in the way you think!

According to the National Sleep Foundation, it is estimated that 30 percent of the general population complain of sleep disruption and 10 percent have symptoms of functional impairment that meet the criteria for an insomnia diagnosis. Consumers spend billions of dollars a year investing in their sleep in the form of mattresses, memory foam pillows, climate beds, deep sleep headbands, luxury bedding, weighted blankets, room-darkening blinds, white noise machines, aromatherapy, and various other products designed to improve quality and quantity of sleep. Sleep aids generated almost 70 billion dollars in revenue as of 2017, and are estimated to increase to almost 102 billion in revenue as of 2023. With this fast-growing market of various sleep aids to choose from, are these products really the key to a good night’s slumber? Well, yes and no. Many factors can improve the quality and quantity of our sleep hours. Consider these recommendations to create an ideal sleep environment:

· Make sure your bedroom is a comfortable temperature (bedding should be appropriate for room temperature).

· Try to eliminate sources of light from windows, doors, and electronic equipment.· Use a sleeping mask If you are unable to eliminate sources of light

.· Keep your bedroom quiet. Consider turning on a fan or using a white noise machine if you are unable to eliminate sources of noise that are causing disruption

.· Ensure you have a comfortable mattress and pillow for proper support to avoid any physical issues that may impair sleep.

While it is certainly important to have a comfortable bed and bedroom environment, it is equally important to take a deeper look into what the bed and bedroom is really all about. When you are spending time putting 300-thread-count sheets and a down comforter on your support coil mattress and zero gravity pillow, think about what you are really putting on – and in - that bed. Is there stress from worrying in bed? Are there food cravings from snacking in bed? Is there problem-solving going on related to emails you just answered in bed? What else is happening in that space other than sleep?

The bed should really be a place for sleeping and nothing else (sex is the exception to this). If you are not sleeping in your bed, you should be out there. This has become an increasingly difficult concept for people. With the ease of access to portable entertainment in the form of Smart Phones, iPads, Kindles, laptops, and of course, television, we have invited a lot of extra stimulation into our bed that is not serving us well. According to the National Sleep Foundation, the blue light emitted from screens is impacting sleep in a big way in that it can delay the release of sleep-inducing melatonin, increase alertness, and reset the body’s internal clock and circadian rhythm. This excess stimulation to the body and brain causes disruption in our sleep pattern, and additionally, using these devices in bed attaches this stimulation to the bed itself. Our beds should be a protected space with the idea of leaving activating and stressful activities out of it as much as possible, so that the brain connects the bed to sleep rather than wakefulness.

To further explain this idea, let’s focus briefly on classical conditioning psychology. Without going deep into the roots of classical conditioning, the basic concept is that your brain associates a specific stimulus/cue with an automatic response. For the purpose of sleep, we want the cue to be laying down in bed and the automatic response to be sleep. To conditionour brain to have this response, the association of “bed = sleep” must be strong and consistent. When in the bed, you should be sleeping. If you are doing other activities such as eating, watching TV, answering work emails, worrying, fighting with your spouse, paying bills, etc., those activities are now attached to your bed. All of that activation and/or stress has now been poured into the bed, and your brain now associates THOSE activities with the mattress, rather than just sleep. If you are trying to “condition” your brain, there is no clear and consistent association between bed and sleep when other activities are going on. Now when you get into bed your body is confused about what to do here. Is it time to eat? Work? Process information? Problem solve? Or sleep? The brain should be conditioned to know that the cue of lying in bed clearly means sleep, without questioning any other possible activities.

Here are some changes you can make right now to re-condition your brain:


1) Only use the bed for sleep and sex. This is the core of maintaining a healthy sleep environment, so follow this goal as strictly as possible.

2) If a transition activity is absolutely necessary as a trade out for devices in bed, try reading an actual book in bed for a few minutes. An audio book is also acceptable, but avoid reading a book on a screen before bedtime.

3) Keep a pad and pen close to your bed, in the bathroom or just outside of your bedroom, should you need to write down tasks or worries that are keeping you awake. Avoid writing those worries down while you are in bed, as they will now be attached to that protected space. If these thoughts are prevalent enough to keep you awake, you can get up and walk over to the pad and pen to write them down.

4) If you have been considering changing something about your bed, this is a great time to change your sleep habits. Get rid of your old mattress or sheets and all of the anxiety attached to it, start fresh with something new about your bed, and begin conditioning your brain in this healthy way. The brain can begin to connect a new mattress or pillow as a “new place” that is associated with sleep and this environmental change can help strengthen the re-association that your bed is the cue for sleep.

5) Don’t stay in bed if you really cannot sleep. Again, the bed should be a place that your brain connects to sleep. If you are fully awake struggling with insomnia, it is time to get out of bed and try it again once you are feeling sleepy. This can be extremely difficult, but try to look ahead to the longer-term goal of having consistent quality sleep rather than the short-term pain of getting out of bed.

6) Sometimes unhealthy connections that contribute to insomnia can also carry over into the bedroom, so do your best to keep the bedroom as stress-free as possible.Our beliefs about sleep and behavior during bedtime routines are very powerful and are often the root cause of chronic insomnia. The good news is that these unhelpful beliefs and behaviors can be changed in order to improve sleep. Sometimes this can be done on your own by making these small changes. Severe chronic insomnia may require the help of a cognitive behavioral sleep therapist to take a more in-depth look at sleep patterns and develop an individualized plan to treat the insomnia.

What really matters is that you get the appropriate tools for sound sleep. For some, this may be as simple as a purchasing a new mattress or choosing just the right pillow. However, for many, resolving insomnia requires a more intensive look at what is really in the bed. Take some time to survey your bedtime routine and remove any activities that are interfering with getting the quality and quantity of sleep you want!


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Clarity Therapy Associates

(858) 400-4646

12526 High Bluff Drive, Suite 300, San Diego CA 92130

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