Why am i anxious at night

Anxiety at Night: Causes, Symptoms, and Treatments

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Anxiety is a normal human emotion characterized by feelings of nervousness and worry. You may find yourself experiencing anxiety during stressful situations, such as a first date or job interview.

Sometimes, though, anxiety may linger around for longer than usual. When this happens, it can interfere with your daily — and nightly — life.

One of the most common times when people experience anxiety is at night. Many clinical trials have found that sleep deprivation can be a trigger for anxiety. Historically, research also suggests anxiety disorders are associated with reduced sleep quality.

Treating your nighttime anxiety and addressing your sleep issues are important steps in improving your quality of life.

There are many symptoms of anxiety. Everyone experiences anxiety differently. Symptoms can happen anytime of the day, morning, or 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 manifestations. 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

In some cases, you may even wake up from a nocturnal panic attack. Nocturnal (nighttime) panic attacks have the same signs and symptoms of regular panic attacks, only they occur while you’re asleep.

If you experience a nocturnal panic attack, it may be hard to calm down and fall back asleep.

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.

According to the Anxiety and Depression Association of America (ADAA), over 50 percent of adults say their anxiety levels affect their ability to get to sleep at night.

There’s very little scientific research on nighttime anxiety. Still, there are many reasons why your anxiety may be worse at night.

You may feel that your mind is racing, and you can’t 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.

Anxiety and sleep research

There is, however, plenty of research on how anxiety can affect sleep and vice versa.

According to the ADAA, research shows that sleep disorders occur in almost all psychiatric disorders.

In a small 2015 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 your doctor may choose to use a variety of different treatment options.

Treat underlying conditions

There are some medical conditions that can cause symptoms of anxiety. They include:

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

If any of these conditions are causing your nighttime anxiety, your doctor will want to treat them first.


There are many forms of psychotherapy that can treat anxiety. One of the most well-established methods is cognitive behavioral therapy (CBT). CBT is a form of psychotherapy that encourages changing your thought patterns to improve your behavior and mood.

According to the ADAA, it can take 12 to 16 weeks to begin seeing results with CBT.


In many cases, treating anxiety requires a dual approach. Both psychotherapy and medication may be used in conjunction to produce the best results.

There are various types of medications your doctor may prescribe for your anxiety. They can discuss a medication’s pros and cons, availability, and more with you.

The most common drugs prescribed for acute anxiety attacks are benzodiazepines. The most common drugs prescribed for long-term cases of anxiety are antidepressants.

Alternative medicine

For some people, alternative medicine is another treatment option for anxiety.

The research on herbal and botanical medicine for anxiety is much more limited than traditional medicine. However, a systematic review from 2010 did find that both nutritional and herbal supplementation may be worthwhile therapies for anxiety.

There’s strong evidence for the effectiveness of supplements containing passionflower, kava, L-lysine, and L-arginine.

Keep in mind that the U.S. Food and Drug Administration doesn’t regulate the quality or purity of supplements like they do for drugs. Talk to your doctor before trying supplements to make sure no interactions will occur.

Find passionflower, kava, L-lysine, and L-arginine supplements online.

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


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

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


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

Grounding techniques include both 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 take away 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 quality of sleep.

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.

Strenuous exercise raises your body temperature and heart rate, so working out before bed can disrupt the falling asleep process. 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.

Besides, exercise isn’t only good for improving sleep. It can also help relieve your anxiety symptoms.

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 night.

Avoid stimulants before bed

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

Alcohol and caffeine can both have a negative effect on sleep, so be sure to avoid these before you hit the hay.

Turn off electronics

When you finally crawl into bed, ditch the 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, and you may find it hard to complete your normal 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.

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

Whether your doctor makes a diagnosis of 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

Why Do I Get Anxiety at Night?

If you wake up at night or have trouble falling asleep, you aren’t alone in your misery. You might be experiencing nighttime anxiety, a condition that affects people from all walks of life.

Anxiety is an emotion characterized by feelings of tension and nervousness. Rooted in the fight-or-flight response to fear, anxiety is a physiological reaction to perceived danger. According to the Anxiety and Depression Association of America, anxiety is our body’s way of telling us something isn’t right.

Why Does Anxiety Increase at Night?

For some people, simple scenarios with uncertain outcomes such as a pending exam or an overwhelming to-do list can elicit these worried thoughts. Their brains and bodies believe there is a present danger, even though that might not be the case. According to Amanda Levinson, a licensed mental health counselor from the Neurofeedback & Counseling Center of Pennsylvania, “your anxious thoughts may occur (at night) because your brain has nothing else to do while you are falling asleep.”

As people stew about these stress-inducing situations, they become more and more anxious. Sleep deprivation doesn’t help.

“When you’re not sleeping, your brain can release more stress hormones, which causes more anxiety,” says Levison. A vicious cycle ensues, tempting you to fixate and imagine negative outcomes.

Caffeine acts as a stimulant that keeps some people awake and can lead to anxiety. Perhaps you have consumed too much chocolate or you drank coffee too late in the day. The Sleep Foundation recommends cutting off caffeine intake at least six hours before bedtime to minimize sleep interference.

Although exercise is beneficial to combat anxiety, vigorous workouts within an hour of bedtime doesn’t allow for the body’s core temperature to cool (something we need in preparation for slumber). This may delay sleep, affect sleep quality, and provoke more nighttime awakenings.

Symptoms of Anxiety at Night

Colleen Wenner, founder and clinical director of New Heights Counseling & Consulting in Fort Walton Beach, Florida, says, “The main symptom of anxiety at night is difficulty falling asleep. People who suffer from (it) may toss and turn…and may also wake up frequently and feel restless.”

Other symptoms can include:

  • headaches

  • nausea

  • stomach problems

  • increased sweating

  • insomnia

Increased activity in your nervous system can lead to panic attacks. Nocturnal panic attacks are episodes of sudden and intense anxiety caused by surges of adrenaline with no obvious stressor, and they can waken you from sleep.

Symptoms of nocturnal panic attacks can include:

Causes of Anxiety at Night

Bouts with anxiety, day or night, are normal for all human beings. According to Shelby Harris, PsyD, clinical associate professor in the departments of Neurology and Psychiatry at Albert Einstein College of Medicine, New York City, and author of The Women’s Guide to Overcoming Insomnia, “anxiety and awakenings at night can be due to a whole host of things. An anxiety disorder such as generalized anxiety, perimenopause hormonal shifts, and anxiety that isn’t necessarily a disorder and just due to a stressful time in life can all play a part.

But if you have Generalized Anxiety Disorder (GAD) or if you think you might, consider speaking to a professional who can help you determine if this mental health issue, associated with nighttime waking, is part of your equation. There are also a number of mental health disorders such as Obsessive-Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD) that can cause nighttime anxiety.

Impact of Anxiety at Night

Nighttime anxiety can affect your quality of life and lead to depression and other mental health issues. According to Dr. Harris, “after a few bad nights of sleep, we might start to nap more, go to bed earlier, awaken later to compensate, or rely on more caffeine during the day or alcohol at night. These behaviors worsen sleep and continue the cycle.”

Exhaustion during the day can affect your ability to perform necessary chores, manifest as poor work performance, and can even lead to car accidents. According to Oxford University Press, a new study indicates that people who have slept for fewer than seven of the past 24 hours have higher odds of being involved in and responsible for car crashes.

In high doses, stress hormones can wreak havoc on our bodies. Cortisol, the primary stress hormone, is released in response to fear as part of the fight-or-flight mechanism. According to the Mayo Clinic, “The long-term activation of the stress response system and the overexposure to cortisol puts you at increased risk of many health problems…Cortisol alters immune system responses and suppresses the digestive system, the reproductive system and growth processes.”

Irritability is another unpleasant side effect of sleep deprivation brought on by nighttime anxiety. It's more difficult to deal with co-workers, family members, and to have a thriving social life when you are easily annoyed.

How to Treat Nighttime Anxiety

If you experience chronic nighttime waking, it’s important to keep up with your annual physical or consult a physician to rule out other medical issues that can mimic anxiety. It’s possible that once you are treated for your underlying condition, nighttime waking will abate on its own. Some conditions with similar symptoms:

  • heart problems

  • asthma

  • diabetes

  • hyperthyroidism

  • sleep apnea

  • gastrointestinal diseases

  • chronic pain

  • inflammatory disorders

  • neurological disorders

Everyone is different, and experimenting with various interventions is vital before figuring out what reduces your anxiety. Some people seek a doctor first while others experiment with alternative treatments. Either way, many of these approaches are effective.


Antidepressants and benzodiazepines are common drugs that your doctor might prescribe to treat your anxiety.

Cognitive Behavioral Therapy

CBT is a type of talk therapy performed with a mental health counselor and treatment usually involves efforts to change thinking patterns.

Neurofeedback Therapy

This is a kind of biofeedback, a mind-body technique, which teaches self-control of brain functions to subjects by measuring brain waves and providing a feedback signal. Medication isn’t involved, and it's a non-invasive procedure using electronic instruments.

Hormone Replacement Therapy

This medication contains can help balance female hormones in menopausal women.


You can purchase melatonin pills or gummies over the counter at your local pharmacy to take before bedtime. These tablets add to your body's natural supply of the hormone, which can help improve the quality of your sleep. Check with your doctor before taking any supplements to avoid any drug interactions.


Acupuncture involves the insertion of very thin needles through your skin at strategic points on your body. It is used to treat pain and manage stress.


This method helps to shift the patient’s perspective. Eli Billiuos, certified hypnotist at NYC Hypnosis Center, identifies and reframes the sensitizing event by giving suggestions for mood enhancement to reduce stress, manage anxiety, and prevent catastrophic thoughts. This new perspective can reduce or eliminate anxiety.

Get it Off Your Chest

Sometimes speaking to an acquaintance or family member who can empathize with you is a beneficial way to address stressors and bring you comfort. Journaling and making to-do lists are other methods that might help you to release thoughts out of your head.

Digital Detox

Exposure to blue light from screens disrupts melatonin production. Keeping devices in another room and following a wind-down routine like reading a book before bed can promote healthier sleep. Michelle Caldwell, associate clinical counselor at online education company Theara, explains that relaxation apps such as Headspace or sleep podcasts like Sleep With Me have specific mediations designed to help you fall back to sleep when experiencing nighttime anxiety. It's probably better to listen on Alexa to avoid blue light.

Be Comfortable and Cool

Your bedroom is your sanctuary. Keep it distraction free (don’t work in bed) and keep it as cool as possible. Before falling asleep, try meditating or yoga to train your body to let go in this relaxation space.

By educating yourself and adopting minor lifestyle changes, nighttime anxiety can resolve on its own. If it continues to disrupt your sleep or if it affects you daily, it’s probably time to touch base with a physician.

Notes: This article was originally published October 7, 2022 and most recently updated October 19, 2022.

Holly Rizzuto PalkerWriter

Holly Rizzuto Palker's work has appeared in Parents, The New York Daily News, The Independent, Rachael Ray In Season, YourTeen Magazine, Kveller, and more.

Night awakenings: causes, causes for concern, ways to deal with

December 14, 2015 Health

You fall asleep without problems, but wake up in the middle of the night and toss and turn in an attempt to get back to sleep. What causes nighttime awakenings and how to deal with them?

Iya Zorina

Author of Lifehacker, athlete, Candidate Master of Sports

The usual story is that you haven't had enough sleep for three days and this time you decided to go to bed early. You go to bed at ten o'clock in the evening, hoping to get a good night's sleep, but suddenly you wake up at two in the morning. Sleep in one eye, you lie and stare at the ceiling, trying to fall asleep again. It takes two hours before you fall asleep again, and then almost immediately the alarm goes off and you're sleep deprived again and feel disgusting. nine0003

Causes of night awakenings

There are many reasons, both external and internal, for which a person may suffer from sudden night awakenings.

Common external causes include street noise, partner snoring, too much light in the bedroom, inappropriate temperature (too warm or too cold), pets nestling in your bed, an uncomfortable mattress, or a baby who wakes up and comes to your home. room.

The internal causes of sleep are also varied and depend on many parameters. nine0003

Sex and age

The older a person gets, the more often he suffers from interrupted night sleep. Elderly people often take a nap during the day and wake up in the middle of the night.

Young women experience nocturnal awakenings associated with the menstrual cycle: just before the onset of menstruation.

Pregnant women wake up at night for a variety of reasons: swollen legs, back pain, frequent urination, heartburn, and fetal movements.

Night awakenings can torment women at the onset of menopause due to fever, palpitations, sweating, stress and anxiety. nine0003

Diseases and medicines


Talk to your doctor if you have sleep apnea (breathing stops), especially if you snore or wake up unrested in the morning.

Chronic pain, such as arthritis or fibromyalgia, is also a frequent cause of nocturnal awakenings.

Although everyone wakes up sometimes to go to the toilet, if you wake up because of frequent urination, it is worth paying attention to this and consulting with your doctor. nine0003

Diabetes, diseases of the thyroid gland, kidneys, lungs, cardiovascular system can also cause nocturnal awakenings.

Drugs such as beta-blockers and diuretics have a bad effect on sleep.

Psychic causes

Stress, depression and anxiety disorders are often accompanied by insomnia and sudden nocturnal awakenings.

When to start worrying

If you wake up periodically in the middle of the night, this is not necessarily a sign of illness or disorder. To understand when to start worrying, doctors advise applying the rule of three. nine0003

If sudden awakenings occur three times a week, last at least 30 minutes, and recur for 30 days, it is worth visiting a doctor.

What to do if you wake up at night

There are several ways to help you deal with nighttime awakenings on your own.

1. Do not spend more time in bed. Some people think that the more time they spend in bed (either going to bed earlier than usual or sleeping longer), the more time they will sleep. nine0003

This is actually the worst thing to do if you have insomnia. Instead, on the contrary, spend less time in bed. For example, go to bed an hour later than usual and wake up at the same time as always. It may seem counterintuitive, but it really works. Here are some more ways to deal with insomnia.

2. Don't doze off. If you sleep during the day, it takes hours from your night's sleep. But if you really feel like it, you can take a nap no more than 20 minutes before 14:00 - this time is enough to rest and gain strength. nine0003

3. Limit your intake of alcohol and nicotine, liquids and heavy meals, and refrain from physical activity at least three hours before bedtime. All this can provoke a sudden nighttime awakening.

4. Avoid caffeine eight hours before bed . Caffeine not only prevents you from falling asleep, but it can also cause you to wake up at night.

5. Stay out of bed if you cannot sleep. Get up, walk around the room, do something quiet and calm in dim lighting (do not turn on your smartphone or computer). Here is a list of things to do if you can't sleep. Go back to bed only when you feel sleepy. nine0003

6. Don't look at your watch. When you count how many hours are left before the alarm goes off, you get nervous and worried, which, in turn, makes it even more difficult for you to fall asleep.


7. Learn to control stress and anxiety . Try some relaxation exercises before heading to bed. For example, take up meditation. Avoid stressful conversations and situations a few hours before bedtime.

8. Keep your bedroom dark, quiet and cool. nine0058 Make sure nothing wakes you up in the middle of the night. If noise can bother you, buy earplugs or find a quiet, monotonous noise source. If the light interferes, good blackout curtains or a blindfold will help.

How do you deal with nighttime awakenings?

Why am I worried at night?

We'll be honest with you: our collective mental health wasn't all that great last year. According to the American Anxiety and Depression Association, anxiety disorders affect more than 40 million adults in the US, and for many, symptoms only worsen at night. Running thoughts and feelings of worry, panic, and fear can prevent your body from resting, relaxing, and falling into deep sleep. nine0003

Fortunately, there are many ways to deal with night anxiety. Some people have great success using the best meditation apps or crystals for anxiety to calm down or develop a solid nighttime routine.

But while figuring out how to get better sleep is important, it's also important to understand Why you might get restless at night so you can find the root of the problem.

What makes you anxious at night?

People with anxiety often have difficulty sleeping. Part of the problem is that these two factors can create a vicious cycle: sleep deprivation can make you anxious, and then you start to feel restless. nine0091 about your lack of sleep.

You may experience anxiety at night for a number of reasons:

1. Mental hyperexcitation.

It's no surprise that so many people with anxiety also suffer from sleep disorders or simply find it harder to fall asleep and stay asleep. According to the Cleveland Clinic, sleep disorders affect more than 50 percent of patients with generalized anxiety disorder.

Sleep problems can be caused by:

  • Racing thoughts
  • Stress and anxiety
  • Looking forward to the next day

These “stressors” can cause an adrenaline rush that makes it harder to fall asleep. Even worse, anxiety can make you think about your fears and concerns at night when you're trying to sleep. Stress-related cognitive-emotional reactivity, a state of mental hyperarousal, appears to be a key component of insomnia.

2. Anxiety due to not falling asleep. nine0013

You cannot sleep because you are worried about something. You look at your watch. It's 3 am now. You have now stressed that you are still awake and should be up in a few hours.

sleep crystals under the pillow

For many, this scenario plays out every night of the week. Eventually, they develop sleep-waiting anxiety. In other words, they can't wait to go to bed. because they are worried that they will have anxiety about sleep. It is literally worry about worry. nine0003

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Anticipatory anxiety can create a vicious circle. You worry so much that you will have anxiety, and it becomes a self-fulfilling prophecy.

3. Lack of sleep.

Lack of sleep can also cause anxiety. A study published in the Journal of Sleep Research shows that anxiety can affect deep and REM sleep states. Anxiety can also cause nightmares or disturbing dreams that reinforce negative associations with sleep. nine0003

There is also evidence - such as this study in the Journal of Neurology - that anxious people are more sensitive to the effects of sleep deprivation. Lack of sleep can exacerbate anxiety symptoms.

(Image credit: Getty)

  • Therapy vs Counseling : What's the difference?

How to deal with anxiety at night

Anxiety is one of the most common mental health problems in the country, but it is also highly treatable. Many people respond very well to treatment and therapy. If you suffer from anxiety at night, talk to your doctor or therapist. There is help there. There is no reason to be ashamed and suffer. nine0003

1. Cognitive behavioral therapy

Cognitive behavioral therapy or CBT is a common and effective treatment for anxiety disorders. With CBT, the goal is to change thought patterns and turn negative thoughts into positive ones. American Psychological Association. While CBT is effective, it can take 16 weeks or more to see results.

2. Treatment of underlying diseases

Sometimes nighttime restlessness or restlessness in general is caused by an underlying disease. Diabetes, heart disease, chronic pain, irritable bowel syndrome (IBS), and even hyperthyroidism have been linked to anxiety. nine0003

If an underlying condition is causing your anxiety, treating that condition is the first step to getting rid of nighttime restlessness.

3. mindfulness meditation

Mindfulness can help calm and calm the mind, allowing you to fall into a deep sleep, he says. Sleep Health Association. This can be especially helpful if you're worried about not being able to sleep.

Mindfulness meditation can help you become more aware of your thoughts and let them go instead of thinking. With practice, you will learn to let disturbing thoughts, such as the fear of not being able to sleep, fly away like clouds in the sky. nine0003

If you don't know where to start, try downloading a meditation tool like the Calm App that can take you through your first mindfulness session, or start a beginner diary to get all those bad thoughts out of your brain onto a page.

gender studies - useless degree

(Image credit: Getty)

4. Set sleep mode.

Establishing and following a healthy sleep routine can help manage nighttime anxiety. nine0003

  • Go to bed at the same time every night
  • Wake up at the same time every morning
  • Create a comfortable and soothing sleeping environment
  • Make sure your bedroom is cool (65 degrees Fahrenheit is optimal for sleep).
  • Put your phone away and get rid of distractions

5. Stay active.

Exercise can help you sleep better and longer, especially if you set the perfect early or late afternoon workout schedule. nine0003

If you use all this accumulated energy, it will help you feel more tired before going to bed. Exercise alone can also help with anxiety symptoms. It distracts your mind, boosts your serotonin levels, and helps relieve muscle tension.

Anxiety at night is common, but you don't have to put up with it.

Learn more