What are some strategies to help people sleep?
In general, it's very important to avoid stimulating behaviors before bedtime and to emphasize good sleep hygiene. These behaviors are going to vary from person to person but in general it means avoiding caffeine after 5 p.m., and not just coffee but also tea and caffeinated soda. It means not smoking shortly before bedtime because nicotine is a stimulant. It means not going to bed and lying awake for a long time. Instead, it's better to get up after a short while, go to a different part of the house, do something relaxing and then try to go back to sleep.
You may find it very relaxing to have a phone conversation with a particular person before going to bed. That person might be able to provide some reassurance and help the sleeper feel calmer. On the other hand, it wouldn't be a good idea to have a phone conversation with someone with whom you're having a disagreement.
What medications can help with sleep problems associated with anxiety?
There are several medications for insomnia. In the past, psychiatrists typically used drugs of the benzodiazepine class, such as Valium and Librium, to help people with sleep. There's agreement among psychiatrists that in the short term that a benzodiazepine is useful. However, there isn't yet a consensus that long-term treatment with benzodiazepines is helpful.
There are newer medications that act a little bit differently from the old-time benzodiazepines, and seem to have a shorter duration of action. So you can get help with sleep, but then not feel very tired, hung over or drugged the next day.
Why do worries often surface at night?
“The question of why worries often surface at night is an interesting one, and I have to say at the outset that I don't have the answer to that,” says Ross. “In this modern day, when we're all trying to do so many things and balance so many activities in our lives, I think there's a tendency to use the bedroom as a place to accomplish things other than sleep.”
Historically, Freud and other psychoanalytic thinkers thought that there was something about dreaming that enabled a person to work out certain internal conflicts. So it's probably worth saying that it may be that conflicts are worked out at night in our sleep.