Nighttime anxiety can be triggered by various factors, such as worries about work, family, or money, as well as stress from insomnia. Many people with anxiety disorders experience sleepless nights filled with restlessness and fear. There is a complex two-way vicious cycle between anxiety and sleep, but there are ways to help cope with anxiety, improve sleep quality, and lead a normal and fulfilling life.
At a Glance
If you find yourself lying in bed tossing and turning with worries, you are not alone. Nighttime anxiety is a common problem that makes it harder to fall asleep and stay asleep. Fortunately, there are steps you can take to calm worried thoughts and avoid nighttime anxiety. Read on to gain insight into why anxiety often intensifies at night and how you can cope.
What Causes Nighttime Anxiety?
There is no simple explanation for why some people’s anxiety worsens at night. Instead, it is likely the result of multiple factors.
One explanation is that when the lights go out and it’s quiet, there are fewer distractions, giving people more opportunity to worry and ruminate about their career, finances, or relationships. Difficulty falling asleep can also trigger a new set of worries, such as how poorly you’ll feel the next day.
Other reasons for intensified nighttime anxiety may include:
- Consuming too much caffeine during the day or close to bedtime, which can make some people feel jittery and more anxious.
- Experiencing recent trauma or having pre-existing post-traumatic stress disorder.
- Health anxiety, where you pay more attention to physical aches and discomforts while trying to fall asleep.
- Having certain medical conditions; for example, one study linked nighttime anxiety to menopause.
- Worries or fears about the next day.
Symptoms of Nighttime Anxiety
Everyone experiences anxiety differently, and symptoms can vary. Symptoms of nighttime anxiety may be similar to those during the day or unique to the night.
- Pain
- Difficulty breathing
- Heart palpitations
- Feeling nervous or restless
- Racing or out-of-control thoughts
- Difficulty falling asleep and/or staying asleep
- Nightmares
- Gastrointestinal problems
- Panic attacks and nighttime panic attacks
How Nighttime Anxiety Affects Your Sleep and Health
Nighttime anxiety can occupy your free time, drain energy, and lead to sleep problems and difficulty falling asleep. Anxiety triggers the stress response, keeping the body and mind too alert to sleep. Lack of sleep impairs physical function, quality of life, and health, and can also trigger nighttime anxiety, creating a vicious cycle. Nighttime panic attacks can wake you up suddenly, leading to persistent fatigue. Sleep anxiety—the anxiety of being unable to fall asleep—exacerbates emotions and increases pressure to fall asleep. Studies show that 24% to 36% of people with insomnia also have anxiety disorders.
How to Cope with Anxiety at Night
Thankfully, there are steps you can take to help reduce nighttime anxiety, allowing you to have a relaxing evening and restful sleep. Even if you have an anxiety disorder, using these strategies can help you better control symptoms and sleep better despite anxiety.
Set Goals
This helps achieve desired outcomes. Remind yourself daily of the experience you want, such as enjoying a peaceful night, to increase the likelihood of achieving it. At specific moments, like on the way home from work, decide to let go of work stress and enjoy the evening. Make it a habit to set personal goals and clarify how you want to feel in the evening.
Increasing focus and living in the moment can enhance enjoyment of the night. Practices like mindfulness meditation help reduce reactivity to every thought, but if they feel difficult or time-consuming, try to perceive life more vividly—such as listening intently, savoring food, or appreciating the beauty of nature. Using anxiety-relieving apps is also a way to incorporate focus on the present.
Allow Extra Transition Time
Transition time refers to the time needed between tasks. Many of us underestimate the transition time required. For example, your evening may include many different tasks that need to be completed before bed.
No matter how much time you allocate for each task, consider adding a little extra time as a buffer in case tasks take longer than expected. This helps you avoid feeling overly stressed and rushing through too many things before bed.
Prepare for the Next Day
Many people feel anxious at the thought of all they have to do the next day. Preparation is one of the best ways to avoid this anxiety. Prepare as much as possible in advance, such as choosing what to wear, packing lunch and bags, and setting the alarm. Spending a little time preparing can help control evening anxiety.
Make Room for Relaxation
Once all evening tasks are done and you’re prepared for the next day, you really need to set aside time each night to relax, release stress, and recharge. Here are some suggestions:
- Practice a relaxation technique such as deep breathing, journaling, or yoga.
- Read a book.
- Take a warm bath or drink a cup of tea to relax.
No matter what brings you peace, set aside at least 10 minutes each night for rest. This can make you feel calmer and may be the cue you need for a good night’s rest.
Establish a Bedtime Routine
Establishing a bedtime routine allows you to focus on actively doing something for yourself rather than falling into anxious rumination. Your bedtime routine might include activities such as bathing, brushing teeth, changing into pajamas, reading an inspirational book, praying, practicing meditation, or listening to music.
You should develop a bedtime routine to help you rest better. Avoid any overly stimulating activities, such as scrolling through social media or watching TV.
Instead, make your bedtime routine peaceful and quiet to help you drift off to sleep. This signals to your brain that it’s time to rest, allowing you to fall asleep peacefully.
Treatments for Nighttime Anxiety
While self-help strategies can go a long way, you may also find it useful to make an appointment with a healthcare professional, who can rule out any medical or sleep issues causing your nighttime anxiety. In addition to maintaining good sleep habits, treatment options typically include psychotherapy, medication, or a combination of both.
Psychotherapy
Research shows that psychotherapy, including cognitive-behavioral therapy and exposure therapy, may help treat anxiety disorders.
- Cognitive-Behavioral Therapy (CBT): One study found that CBT improved sleep quality and sleep latency (the time it takes to fall asleep) in people with anxiety disorders.
- Exposure Therapy: This therapy can help reduce your fear of experiencing anxiety at night and/or insomnia due to anxiety.
Medication
Various medications can be used to treat anxiety disorders, including:
- Benzodiazepines (sometimes called “benzos”): The most widely used class of sedative medications, typically used for short-term treatment of severe or refractory anxiety disorders.
- Selective Serotonin Reuptake Inhibitors (SSRIs): Currently considered first-line medications for treating most types of anxiety disorders.
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): An option for people who do not respond to SSRIs.
If your anxiety seriously affects your daily life, seek professional help. Make an appointment with a doctor or contact a mental health professional. Anxiety disorders are treatable, and psychotherapy, medication, or a combination of both can help you control anxiety in a healthy way.