Sleep Anxiety: Signs, Symptoms, And Causes

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated October 18, 2024by BetterHelp Editorial Team

Sleep can be essential for both physical and mental well-being. However, for some people, achieving a good night's sleep can be challenging due to a condition known as sleep anxiety. This type of anxiety can make it difficult to fall asleep and stay asleep, often leading to poor sleep quality and various health concerns. It may be addressed with relaxation techniques, healthy sleep hygiene practices, and therapy.

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Overcome sleep anxiety with online therapy

What is sleep anxiety?

Sleep anxiety can be seen as a type of anxiety disorder involving intense worry or fear about falling asleep or staying asleep. Although it’s not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the term “sleep anxiety” is often used colloquially.

This condition generally stems from a fear of not getting enough rest, which can create a vicious cycle of anxiety and insomnia. People with sleep anxiety might dread going to bed, knowing that their worries will likely keep them awake. Over time, this can lead to chronic sleep disorders and significantly impact one’s mental and physical health.

Sleep anxiety usually manifests through various symptoms, both psychological and physical. Understanding the following signs can help individuals identify and address this challenge.

  1. Difficulty falling asleep: Persistent worries about not being able to sleep, which can make the process of falling asleep much longer and more stressful
  2. Trouble staying asleep: Frequent awakenings during the night, often accompanied by a sense of anxiety or panic
  3. Poor sleep quality: Even when asleep, sleep may not be restful, potentially leading to tiredness and fatigue during the day
  4. Nocturnal panic attacks: Sudden episodes of intense fear or panic occurring during the night, which can wake a person abruptly
  5. Physical symptoms: Racing heart, sweating, trembling, or shortness of breath when trying to fall asleep or when waking up in the middle of the night
  6. Mental symptoms: Excessive worries about sleep, persistent thoughts about the consequences of not sleeping well, and general anxiety symptoms
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Examining sleep and anxiety disorders

Sleep problems, especially insomnia, tend to be common in people with anxiety disorders and other mental health challenges. Symptoms like insomnia and nightmares are frequently included in the definitions of some anxiety disorders, such as generalized anxiety disorder (GAD), as well as post-traumatic stress disorder (PTSD). 

Studies using polysomnography, a type of sleep study, have shown certain changes in sleep patterns in people with anxiety disorders. For example, people with GAD may have trouble staying asleep, while those with panic disorder may struggle with both falling asleep and staying asleep. 

Additional causes

Several factors can contribute to the development of sleep anxiety:

  1. Stress and daily life pressures: High levels of stress from work, school, or an individual’s personal life can trigger anxiety that extends into the nighttime.
  2. Traumatic experiences: Past traumas or stressful events can contribute to nocturnal panic and anxiety symptoms related to sleep.
  3. Poor sleep habits: Irregular sleep schedules, excessive screen time before bed, or an uncomfortable sleeping environment can exacerbate sleep anxiety.
  4. Physical health issues: Conditions like sleep apnea, which can disrupt normal breathing during sleep, may lead to anxiety about sleeping.
  5. Substance use: Consumption of caffeine, alcohol, or certain medications can interfere with sleep and contribute to anxiety.
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Overcome sleep anxiety with online therapy

Treatment and therapy options

Treating sleep anxiety typically involves a combination of therapy and lifestyle changes, sometimes alongside medication. Cognitive behavioral therapy (CBT) is viewed as one of the most effective treatments for sleep anxiety, as it typically helps individuals identify and change negative thought patterns and behaviors related to sleep. Relaxation techniques, such as deep breathing, progressive muscle relaxation, and mindfulness meditation, can also reduce anxiety and promote better sleep.

Practicing good sleep hygiene by establishing a regular sleep schedule, creating a restful environment, and avoiding stimulants before bed can improve sleep quality as well. 

In some cases, doctors may prescribe medication to manage anxiety symptoms or sleep disorders. Be sure to talk to your prescribing provider if you experience any side effects, as well as before starting, stopping, or changing the way you take any form of medication. 

Additionally, online therapy can offer a convenient and cost-effective way to receive mental health support, which can be particularly beneficial for those who find it challenging to attend in-person sessions. The flexibility of online therapy can help individuals overcome sleep anxiety by providing timely and tailored support.

Research suggests that online therapy can be highly effective in treating insomnia, which may result from sleep anxiety. According to a 2024 study, “Remote cognitive behavioral therapy for insomnia is effective in improving sleep quality, depression, anxiety, fatigue and mental health in insomnia patients.”

Takeaway

Sleep anxiety is a common but treatable condition that can significantly impact one's life. By understanding the signs, symptoms, and causes, individuals can seek appropriate help and adopt strategies to manage anxiety and enhance sleep quality. Improved sleep hygiene, relaxation strategies, and in-person or online therapy can be beneficial. Addressing sleep anxiety may not only help people get a good night's sleep, but it can also promote a better quality of life.
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