Sleep anxiety symptoms, causes, and strategies

An estimated 24% to 36% of people with insomnia also experience some type of anxiety disorder. Sleep is an essential component of good health, and it’s important to make sure you get the rest your body needs each day. However, for some people, nighttime brings a rush of anxiety, making it difficult to get the rest they need. 

Navigating anxiety and sleep can be frustrating. But one of the first steps to reducing sleep anxiety symptoms and achieving healthy rest each night is learning more about the relationship between anxiety and sleep.

What do sleep anxiety symptoms feel like?

Many people struggle with falling asleep each night. It’s important to note that the symptoms of sleep anxiety are often different from general poor sleep. Overall, sleep anxiety symptoms can feel like a mixture of sleep-related symptoms and anxiety symptoms.

Some symptoms of sleep anxiety you may experience include:

• Feeling overwhelmed or helpless
• Nervousness
• Restlessness
• A sense of impending doom
• Fear of falling asleep (somniphobia)
• Nocturnal panic attacks
• Digestive issues
• Elevated heart rate
• Sweating
• Tense muscles
• An inability to relax or unwind
• Trembling
• Rapid breathing

The symptoms of anxiety and sleep deprivation can vary, and some people may experience symptoms associated with both conditions. A health professional can help you determine the root of your sleep-related anxiety and rule out conditions like panic disorder and sleep apnea.

How does sleep deprivation affect anxiety?

Anxiety can make it difficult to fall asleep and stay asleep, especially during the height of your worries. A lack of sleep can also have a notable impact on anxiety.

Sleep loss can occur in a variety of ways. Some people may have difficulty falling asleep. Others may wake periodically throughout the night. One 2023 study found that, regardless of how sleep was lost, people experiencing sleep deprivation had increased anxiety symptoms. 

As a result, anxiety and sleep problems can have a cyclical relationship. Anxiety can cause poor sleep habits, which can, in turn, increase the frequency and severity of anxiety symptoms. 

Why do you get anxiety at night?

Have you ever experienced a rush of anxiety when falling asleep that disrupts your rest? If so, you’re not alone. Nighttime anxiety can stem from several different causes. 

Some of the most common causes of sleep anxiety include:

• Additional health conditions: Other conditions, like post-traumatic stress disorder (PTSD) and panic disorder, can make it difficult to fall asleep at night. Hormonal issues may also impact how well your brain can prepare for sleep.
• Sleep patterns and routines: Your body has a natural sleep-wake cycle balanced by specific brain chemicals. One study found that night-shift workers may experience circadian desynchronization, which can lead to anxiety and sleep problems.
• Perfectionism: If you struggle with falling asleep, you may have found yourself watching the clock, stressed about the amount of rest you’ll receive. Worrying about receiving the perfect amount of sleep each night can cause anxiety before bed.

Do certain types of anxiety disorders have a greater impact on sleep?

Anxiety can affect you at any time of the day. But for some people, their type of anxiety is more closely associated with bedtime behaviors, such as turning off the lights or being away from loved ones. This can have a different impact on sleep health compared to other types of anxiety.

Some types of anxiety disorders that may have a greater impact on sleep include:

• Generalized anxiety disorder (GAD)
• Social anxiety disorder
• Post-traumatic stress disorder
• Obsessive-compulsive disorder (OCD)
• Phobias (such as fear of the dark or fear of sleep)
• Separation anxiety disorder

Five ways to manage nighttime stress and anxiety for better sleep

Sleep anxiety can make it difficult to receive the rest you need to succeed each day. Fortunately, there are easy steps you can implement at home to help balance anxiety and sleep.

1. Create a consistent routine

Circadian rhythm is the body’s natural clock that helps you know when to wake up and go to sleep. By establishing a consistent routine with similar wake-up times and bedtimes each day, you can regulate this internal clock.

You can also create a routine with relaxation techniques before bed, helping prepare your body to get the rest it needs. This includes activities like listening to music, reading, or doing gentle stretches.

2. Limit screen time

As a part of your body’s circadian rhythm, your brain uses melatonin when it comes time for bed. However, light — especially blue light from screens — can suppress the production of melatonin. This can make it difficult to fall asleep at night. For healthier sleep habits, try limiting screens 30 to 60 minutes before bedtime.

3. Avoid caffeine and sugar before bed

Caffeine and sugar can increase alertness and provide a boost of energy. While this can be helpful when starting your day, drinking caffeinated drinks or eating sugary foods later in the afternoon or evening can increase anxiety symptoms before bed and make it difficult to sleep. Save caffeine and sugar for earlier in the day so they don’t affect your sleep. 

4. Practice journaling 

Journaling provides a quiet moment to think about your day and examine your thoughts. Not only can this be a beneficial way of relaxing your body before bed, but it also offers an opportunity to confront any situations or thoughts you may feel anxious about.

5. Improve your sleep environment 

To get a good night’s sleep, it’s important to make sure you have the conditions you need to encourage sleep. Before going to bed, make sure your bedroom is dark, quiet, and comfortable. 

Break the cycle of sleep anxiety with treatment

If you find yourself struggling to fall asleep at night because of anxiety, a healthcare provider can diagnose a sleep or anxiety disorder based on your medical history, physical exams, and sleep studies.

Sleep anxiety can be complex. If you’re experiencing this confusing cycle, you may not know if your anxiety is causing sleep issues, or vice versa. Because of this, treating both concerns at the same time using an integrated treatment approach is essential.

Know that it is possible to manage your sleep anxiety with the right treatment, but it may take time. Be patient with your professionally-guided treatment and don’t give up! 

Talk therapy

There are many types of treatments that may help with sleep anxiety. One of the most common is cognitive-behavioral therapy (CBT).

Cognitive-behavioral therapy is a type of talk therapy focused on helping you understand how your thoughts are related to your actions. This type of therapy for anxiety can help you identify and replace unhelpful thoughts.

CBT provides you with the tools you need to manage the symptoms of most types of anxiety concerns, including sleep anxiety. This includes healthy coping mechanisms and stress-reduction techniques. One 2015 study showed that individuals receiving CBT for anxiety often experienced improved sleep quality. 

Self-care techniques

Holistic methods can also help reduce your stress at bedtime. Meditation, deep breathing exercises, gentle stretching—all of these are activities that can help you manage your anxiety and get better sleep. Some studies have also shown that art therapy and other creative outlets can provide beneficial results in reducing the symptoms of anxiety and improving sleep quality.

Sometimes, you may not see the results you need with holistic methods or talk therapy. Although this can be frustrating, you’re not alone. If your sleep anxiety doesn’t seem to improve with therapy alone, a mental health professional may also prescribe medication. 

Medication

Medications for sleep anxiety help address both insomnia and anxiety at once. These medications work to relax both your body and mind, helping reduce any lingering symptoms of anxiety that may persist until bedtime. You can talk with your provider about whether medication may be the right option for you. 

Find care with Rula

Healthy, restful sleep is an essential component of your mental and physical health. However, anxiety and sleeping problems often have a cyclical relationship, with each one worsening the other. If you or someone you love struggles with anxiety and sleep, reaching out to a healthcare professional can help.

At Rula, our therapist-matching platform allows you to connect with a therapist who understands your concerns about anxiety and sleep and accepts your insurance. After finding the right therapist for you, you can schedule your first meeting for as soon as tomorrow.

Find a therapist with Rula