I get anxious at night

Anxiety at Night: Causes, Symptoms, and Treatments

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:

American Psychiatric Association’s Find a Psychiatrist
American Psychological Association’s Psychologist Locator
Anxiety and Depression Association of America’s Find a Therapist