Anxiety at Night: Causes, Symptoms, and Treatments (2024)

Experiencing anxiety when you lie down to sleep at night can occur due to stress, an anxiety disorder, or other health conditions. Depending on the cause, treatment may be medication, lifestyle, or therapy based.

Anxiety is a typical human emotion characterized by feelings of nervousness and worry. Anxiety occurs when stress lingers for a long time, sometimes without an obvious cause.

You may be anxious due to stressful situations, such as a first date or a job interview. But when this sense of worry doesn’t go away and even keeps you up at night, you may have an anxiety disorder.

Read on to learn the possible causes of nighttime anxiety and how to relieve it.

Anxiety can interfere with your daily — and nightly — life.

Research shows sleep deprivation can trigger anxiety. Research also shows that the risk of poor sleep is higher in people living with mental health conditions like anxiety.

For this reason, treating your nighttime anxiety and addressing your sleep issues are both important steps in improving your quality of life.

There are many symptoms of anxiety. Everyone experiences anxiety differently. Symptoms can happen any time of the day, in the morning, or at night. Common symptoms of anxiety include:

  • feelings of nervousness, restlessness, or worry
  • trouble concentrating
  • trouble falling asleep or staying asleep
  • gastrointestinal problems

Another symptom a person with anxiety may also experience is a panic attack. A panic attack is an episode of extreme and intense fear, often accompanied by physical symptoms. The common symptoms of a panic attack include:

  • a sense of impending doom
  • increased heart rate and chest pains
  • shortness of breath and throat tightness
  • sweating, chills, and hot flashes
  • dizziness or lightheadedness
  • a feeling of detachment, or like nothing is real

Symptoms at night

Sometimes, you may even wake up from a nocturnal panic attack. Nocturnal (nighttime) panic attacks have the same signs and symptoms as regular panic attacks, but they occur while you’re asleep.

Research shows that about 20% to 45% of people living with panic disorder experience frequent nighttime panic attacks. If you experience a nocturnal panic attack, it may be hard to calm down and fall back asleep.

For some people, nighttime anxiety can lead to insomnia. Insomnia is defined as persistent trouble falling or staying asleep. Chronic insomnia can have negative health effects, including an increased risk of:

  • health conditions, such as high blood pressure and a weakened immune system
  • mental health conditions, such as depression
  • accidents

There are many reasons why you might have an anxiety disorder. Often, people may have a genetic susceptibility to anxiety, and this can interact with stressful life situations or experiences.

Other factors contributing to developing anxiety include prescription medications or herbal supplements, substance use disorder, or a history of trauma.

Anxiety can also be triggered by medical conditions. They include:

  • heart disease
  • hyperthyroidism
  • diabetes
  • chronic pain
  • irritable bowel syndrome
  • certain brain tumors

Anxiety and sleep

Sleep issues and anxiety seem to accompany one another. Lack of sleep can be an anxiety trigger, while anxiety can also lead to a lack of sleep.

You may feel your mind racing and may not be able to stop your thoughts. You may be focused on the worries of the day or anticipating things on your to-do list for the next day. This perceived “stress” can cause the body to experience an adrenaline rush, which makes it incredibly difficult to get to sleep.

Population surveys show that 24% to 36% of people who have difficulties sleeping at night have an anxiety disorder. In one self-reported survey, researchers also found that people living with panic disorder are three times more likely to have issues with sleep than people who don’t live with the condition.

In a small 2016 study, researchers examined the relationship between cognitive behavioral therapy (CBT) and sleep quality in people with anxiety. Researchers found that both sleep quality and sleep latency (the time it takes to fall asleep) improved in participants who responded to CBT.

The researchers believe that targeting sleep problems during anxiety treatment might be beneficial for those who have trouble sleeping.

It’s important to remember that it can take time to find the right treatment approach for your anxiety. Because of this, you and a doctor may choose to use various treatment options.

They include:

  • treating any underlying conditions
  • trying psychotherapy such as CBT
  • taking antianxiety medications such as benzodiazepines or antidepressants
  • trying herbal supplements such as saffron, kava, ginseng, or lavender, which may help reduce anxiety, according to research

Remember that the Food and Drug Administration (FDA) doesn’t regulate the quality or purity of supplements as they do for drugs. Talk with a doctor before trying supplements to ensure no interactions will occur.

Here are some lifestyle tips that may help you relax and ease your anxiety at night:

Meditation

Meditation is the practice of mindfulness. Research suggests that even one session of meditation can be beneficial in reducing your anxiety. Even more benefits may be seen over the long term.

Meditating right before you tuck in for the night can be a great way to turn down nighttime anxiety.

Deep breathing

Deep breathing is a great way to reduce anxiety and stress. Breathing deeply can slow your heart rate and improve your blood pressure.

If you’re experiencing a panic attack at night, try deep breathing to ease the attack.

Grounding

Anxiety can cause episodes of dissociation. Grounding is one way to keep yourself present in the moment.

Grounding techniques include cognitive and sensory awareness, such as touching an object or saying today’s date out loud. Doing this at night before bed can help bring you back to the present moment so you can sleep.

To-do list

If one of your anxiety triggers involves worrying about your daily activities, you may notice your anxiety spikes more at night. Creating a to-do list for the day or week may help relieve some of that anxiety.

Healthy sleep habits

One of the most important ways to ease anxiety at night is through healthy sleep habits. Making sure you’re happy and comfortable in your own bedroom will help improve your sleep quality.

There are many ways to establish good sleep habits to ensure you’re sleeping better and for longer:

Exercise daily

Exercise can help improve both sleep quality and duration. If you experience nighttime anxiety, morning exercise may help you sleep longer at night, while afternoon workouts also have sleep benefits.

Research also shows that exercise can actually directly influence your anxiety levels for the better.

Strenuous exercise also raises your body temperature and heart rate, so working out before bed can disrupt the process of falling asleep. However, regular exercise is better for sleep than not exercising at all, and finding a routine that works for you is the most important thing.

Develop a sleep schedule

Establishing a sleep schedule can help keep your circadian clock in check. When you keep your wake and sleep cycles around the same time each day, you may find it easier to fall asleep at night.

Avoid stimulants before bed

Stimulants like caffeine can worsen anxiety symptoms. In addition, because stimulants increase body activity, taking them before bed can make it more difficult to fall asleep.

Though it isn’t a stimulant, alcohol can also disrupt sleep, so be sure to avoid it before you hit the hay.

Turn off electronics

When you finally crawl into bed, you may want to consider avoiding electronics. A 2017 study found that in almost 350 adult participants, the use of electronics after bedtime was related exclusively to the amount of time it took to fall asleep.

This is because artificial blue light from electronics is thought to suppress the sleep hormone melatonin, making it harder to fall (and stay) asleep.

Create comfort

Pillows and mattresses should be comfortable and supportive for your body and sleeping style. Your bedroom is your own, so making it a comfortable, safe space to sleep can make all the difference for your nighttime anxiety.

Constant anxiety that makes it difficult to sleep at night can affect your daily quality of life. Your work or school performance may worsen, making it hard to complete your typical daily tasks.

If anxiety and lack of sleep are affecting your life in this way, it’s important to reach out to a doctor or mental health specialist for help.

Whether the doctor diagnoses anxiety, insomnia, or both, reaching out is the first step in the treatment process.

There are many reasons why your anxiety may be worse at night. Daily stressors, poor sleep habits, and other health conditions can lead to increased anxiety and panic attacks at night.

However, there are many treatments available that can help ease your anxiety and improve your quality of sleep. If you’re concerned that your nighttime anxiety and lack of sleep are affecting your life, it’s never too late to take advantage of the mental health resources available to you.

These online resources can help you find a mental health professional near you:

Anxiety at Night: Causes, Symptoms, and Treatments (2024)

FAQs

Why do I get so much anxiety at night? ›

The bottom line. There are many reasons why your anxiety may be worse at night. Daily stressors, poor sleep habits, and other health conditions can lead to increased anxiety and panic attacks at night. However, there are many treatments available that can help ease your anxiety and improve your quality of sleep.

How to stop worrying at night? ›

How to fall asleep when worries keep you up at night
  1. Set a designated worry time. Schedule some time toward the end of the day, but not too close to bedtime, to think about all the things that are causing you stress. ...
  2. Try meditation. ...
  3. Get out of bed. ...
  4. Stick to slumber in bed. ...
  5. Don't check the time.
Mar 15, 2023

How to cope with sleep anxiety? ›

How Do You Overcome Sleep Anxiety?
  1. Creating a healthy sleep schedule.
  2. Engaging in regular exercise.
  3. Keeping your sleeping area dark, cool, quiet, and comfortable.
  4. Trying relaxation techniques like reading, meditating, and staying away from screens close to bedtime.
  5. Avoiding caffeine, alcohol, and heavy meals before bedtime.
Nov 7, 2023

How to stop feeling paranoid at night? ›

Next, when paranoia occurs, focus on breathing or try breathing exercises. Slowing down your breath may signal to your brain that it's okay to calm down and relax. You can also try meditation or journaling to externalize your thoughts. Taking a warm bath before bedtime may also help reduce paranoia.

Does nighttime anxiety go away? ›

If you're anxious about sleeping at night, don't worry: You can learn to sleep well again. And once you're sleeping better, you may find that your sleep anxiety will go away.

What is the best sleeping tablet for anxiety? ›

Benzodiazepines: Doctors prescribe benzodiazepines to treat insomnia or anxiety that is disabling, severe, and causing extreme distress. Diazepam (Valium), alprazolam (Xanax), and triazolam (Halcion) are examples of benzodiazepines.

How do I overcome my fear of anxiety at night? ›

How can I prevent sleep anxiety?
  1. Avoid drinking lots of fluids before bed, especially alcohol.
  2. Do relaxing activities before bed, like meditation or listening to soft, peaceful music.
  3. Don't consume caffeine in the late afternoon or evening.
  4. Go to bed and wake up at the same time each day.

How to stop anxiety quickly? ›

Do
  1. try talking about your feelings to a friend, family member, health professional or counsellor. ...
  2. use calming breathing exercises.
  3. exercise – activities such as running, walking, swimming and yoga can help you relax.
  4. find out how to get to sleep if you're struggling to sleep.

What medication is good for racing thoughts at night? ›

Antidepressants: Certain antidepressants can be effective in treating anxiety and racing thoughts. Selective serotonin reuptake inhibitors (SSRIs) are commonly used. Antihistamines: Some over-the-counter antihistamines, such as diphenhydramine (Benadryl®), can have a sedating effect and may be used to help with sleep.

How to stop overthinking at night? ›

There are many other useful techniques — from meditation to journaling to wind-down time to relaxation techniques such as breathing to slow your thoughts and Yoga Nidra to keeping a pad of paper bedside (to be used very sparingly) for jotting down things you want to remember tomorrow to worry exposure.

What does sleep anxiety feel like? ›

Your mind races with thoughts about work, relationships, health, and family. You feel fidgety and agitated, unable to get comfortable, restlessly tossing and turning. Your body tenses up, jaw clenching, muscles stiff with stress you don't even realize you're holding.

What foods are good for insomnia and anxiety? ›

Nuts and seeds, fish, and avocados are some healthy foods that are rich in magnesium. The unsaturated fats found in these foods contribute to the production of serotonin. They also contain plenty of vitamin B5, the lack of which can contribute to insomnia and disrupted sleep.

Why is my anxiety worse at night? ›

Anxiety can get worse at night as people find themselves focusing more on their worries once they are lying in bed without the distractions of the day. For example, sometimes people with insomnia may begin to develop worries about whether or not they will be able to fall asleep.

Why is my anxiety getting worse? ›

A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances. Personality. People with certain personality types are more prone to anxiety disorders than others are.

Why do I get anxiety for no reason? ›

Health conditions like heart disease, diabetes, or hormonal imbalances can all contribute to feelings of anxiety. Even something as simple as not getting enough sleep can leave you feeling on edge. It's always worth checking in with your doctor if you're frequently anxious and can't figure out why.

Why do I keep waking up at 3am with anxiety? ›

Stress may be the first thing to consider if 3 a.m. awakenings are a new thing. When you feel stressed, your body activates your sympathetic nervous system, and you may jolt awake in the middle of the night. You may experience an increased heart rate and blood pressure.

Why do I get overthinking anxiety at night? ›

Stress and anxiety can cause racing thoughts at night that prevent you from getting the sleep you need. By identifying your stress, scheduling time to attend to your worries, and establishing a healthy bedtime routine, you may be able to avoid racing thoughts and sleep more soundly.

What is somniphobia? ›

Somniphobia is the extreme fear of sleep. People with somniphobia may worry or obsess throughout the day about how they can avoid sleep. They may be afraid of what happens when they do fall asleep, such as having a nightmare or sleepwalking.

Why is my brain overactive at night? ›

Racing thoughts at night can also be attributed to mental health disorders, especially anxiety disorders. Experiencing racing thoughts at night might be something experienced frequently, or intermittently by people with a mental health condition, and can be exacerbated by difficult life circumstances.

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