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8 Tips For Health Anxiety-Related Sleep Problems

Hands up whose clients are struggling to sleep at the moment? For those with pre-existing or developing health anxiety, sleep disturbance may be greater during the current Covid-19 outbreak, and concerns over the effects of poor sleep on immunity can create a vicious circle. Insomnia Clinic founder Kathryn Pinkham is currently offering her online sleep programme free to NHS workers – and here shares 8 tips for improving the sleep of clients with health anxiety.


For some people, the threat of illness is a particular trigger for sleep anxiety, as the belief that we need to get more sleep to fight illness kicks in. And of course, this is true to a certain extent. Good quality sleep can help us to develop a stronger immune system.

However, during the current coronavirus crisis it may be important to remind clients with health anxiety that it is quality of sleep, and not quantity of sleep, that really counts. You could also try reminding your anxious client that humans are designed to cope with periods of sleep loss – otherwise, babies would be born with the ability to sleep through.

Unpredictability, lack of control, and a sense of threat, all contribute to anxiety. In addition, specific reactions to an infectious disease outbreak can include:

  • Fear and worry about health and the health of loved ones
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

All are likely to lead to changes in sleep (as well as eating) patterns, and difficulty in sleeping (as well as concentrating).

8 tips to improve sleep during the pandemic:

1 Limit exposure to news and social media
Checking news feeds is normal reassurance-seeking behaviour. When our normal structures have fallen away and the situation is unfolding minute by minute, it is easy to while away hours staring at the news.

Instead, your client could decide how much time per day they are going to allow themselves for news updates – say 15 minutes of news in the morning, and 15 minutes in the afternoon. It may also help your client to select a couple of trusted news sources, and only look at these.

2 Stick to the government guidelines
Educating ourselves on the latest guidelines is important so we can all protect ourselves and those around us. Knowing they are doing this may help clients with health anxiety to feel more secure.

3 Establish a worry window
Worrying is inevitable at this time. You could suggest that clients allocate a 20-minute window of time, each day, to write down everything they are worried about. This is a great way of saying to our minds that we are not ignoring our worries, but rather acknowledging them at a time that is suitable. I have also noticed that clients tend to find using pen and paper more effective in ‘emptying’ their mind than a digital device.

Once the 20 minutes is up, clients can be encouraged to move on and do something they enjoy – making a note of any thoughts or worries that pop up, and setting them aside for the next worry window.

This technique teaches our minds to be more proactive about when we worry, so that the worries are not constantly intruding.

4 Problem solve
Having noted down their list of worries, clients are now in a better position to problem solve. What are they in control of? What plans can they make? Suggest they come up with an action plan – and stick to it. If they find their mind wandering again, they can remind themselves they have made a plan, then let the thought go.

5 Label ‘what if’ worries as hypothetical
This type of worry is really common among clients with health anxiety. Our mind wanders off into all of the possible worst-case scenarios.

Clients may indulge in ‘what if’ worries because they feel as though they are ‘covering all bases’, somehow preparing themselves for the worst. In reality, they are just making themselves imagine a situation that they don’t want to happen, and that negatively affects how they feel.

Clients can be encouraged to acknowledge and write down these worries – but to label them as hypothetical. They have not yet happened, and there is no guarantee they will. They shouldn’t be treated as facts.

6 Practice mindfulness
An excellent approach to ‘what if’ worries is observing that we are not what we think. Our thoughts are simply opinions we have of ourselves, others and the world – based on our experience but not facts. Noticing the presence of the thought without engaging in it can significantly reduce stress levels.

For example, a client’s thought may be ‘what if… I get coronavirus’. Help them to observe this thought, acknowledge this is normal and be kind to themselves about having it – but then let it go. If they have made a plan to avoid getting it as far as they can, then there is no point them dwelling on this.

7 Get outside
Many clients with health anxiety, who are not considered at increased risk from Covid-19, will still be avoiding going out at all – even for their daily allowance of exercise. Lack of fresh air and exercise worsens mood and sleep patterns.  We also need daylight to regulate and keep our body clocks in sync. As a minimum, suggest clients make sure all curtains and blinds are fully open during the day.

8 Keep to your normal bedtime
When self-isolating, it may be tempting to go to bed early, sleep late, or nap during the day – especially as the weather gets warmer. But a strong sleep drive is essential for sleeping. Where possible, clients should be encouraged to save their bedroom for sleeping, use other rooms for leisure or work, and stick to their usual bedtime. Setting an alarm and getting up every day at their normal hour will help to maintain their normal appetite for sleep – and prevent anxious hours lying wide awake at night-time.

Kathryn Pinkham is currently offering a Sleep Well Live Better Programme for anyone struggling with poor sleep and sleep anxiety. This step by step, NHS-recommended programme of treatment is supported by a private Facebook group and facilitated by Kathryn. The course has been proven to help up to 85 per cent of participants with their sleep in under four weeks – and she is currently offering it free for NHS workers. 


Kathryn Pinkham

Kathryn Pinkham is the founder of The Insomnia Clinic, one of the UK’s only specialist insomnia services. The Insomnia Clinic trains and provides a network of qualified insomnia specialists who are experts at working with people who suffer with poor sleep. The Insomnia Clinic offers face-to-face sessions at over 15 locations across the UK, and Skype sessions for those who are unable to travel. The Insomnia Clinic offers treatment to both individuals and also companies who want to reduce absenteeism in the workplace. The approach is Cognitive Behavioural Therapy for insomnia (CBT-i), the recommended treatment for poor sleep, to help people to change and improve sleep patterns and manage anxiety around sleep.

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