What Causes Anxiety At Night And How Can I Get A Good Night’s Sleep?

Anxiety can significantly impact your mental and emotional health. Anxiety symptoms can be particularly problematic if you’re experiencing them before bedtime when unwinding from the day, or later at night. 

There are several reasons you may be experiencing elevated anxiety levels at night, and there are also numerous ways you can address your symptoms. If you’re experiencing symptoms of an anxiety disorder, professional mental health treatment may be especially valuable.

This article explores how sleep and anxiety are connected, what you can do about nighttime anxiety, and how to help yourself fall alseep at night to prevent sleep deprivation. We’ll also highlight resources for individuals who would like mental health support while addressing any sleep conditions or issues related to problems falling asleep. 

The connection between mental health and sleep

The connection between mental health and sleep is profound, as various health conditions like sleep apnea and post-traumatic stress disorder (PTSD) can significantly impact one's ability to fall and stay asleep. Cognitive Behavioral Therapy (CBT) is an effective approach for addressing sleep anxiety and improving overall sleep quality. By focusing on these aspects, individuals can better manage their mental health and foster a more restful sleep environment.

What are anxiety disorders?

Anxiety disorders are the most common type of mental illness in the US. Almost 20% of the population lives with an anxiety disorder. While many people experience anxiety to some degree, an anxiety disorder is marked by serious and consistent symptoms that impact an individual’s ability to function. 

There are several anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, and social anxiety disorder, among others. While anxiety has many common characteristics, an individual’s specific symptoms may depend on a host of factors, including their personal history, external influences, and the existence of other mental illnesses. 

Below are a few common symptoms of generalized anxiety disorder: 

• Feel anxious, irritable, nervous, or restless

• Difficulty focusing

• Shallow or rapid breathing

• Increased heart rate

• Gastrointestinal distress

• Sleep disruptions

• A sense of impending doom 

What causes anxiety at night?

Anxiety and sleep disturbances often go hand in hand: A lack of sleep can exacerbate symptoms, and increased anxiety can disrupt sleep. Below are a few of the most common causes of anxiety at night. 

Prolonged stress 

The autonomic nervous system is often vulnerable to prolonged or repeated stress. Repeated stress can lead to “dysfunctional arousal and a pathological anxiety state,’ according to a study published in the journal Dialogues in Clinical Neuroscience. This heightened state can persist throughout the day and carry over into the evening. 

Because you may not be as active at night, your brain has the chance to ruminate on worries from the day. Without the distractions of the day, you may experience increased nervousness and tension, especially when you have an upcoming event or current life challenges on which to focus. Ruminations or racing thoughts can lead to worsened anxiety symptoms for which you might not have an outlet due to the late hour. 

Panic disorder 

If you experience panic attacks, your anxiety may be related to episodes of panic you experience in the middle of the night. Nocturnal panic attacks are common in those who live with panic disorder (approximately 70% of individuals with panic disorder experience nocturnal panic attacks), though they can occur to anyone. A panic attack at a late hour, or the fear of having one, can lead to severe symptoms.  

Caffeine 

Another common source of late-night anxiety is caffeine. Caffeine is a stimulant that affects the nervous system and can lead to mental and physical effects that may cause stress. Drinking caffeinated beverages in the evening or late afternoon may exacerbate your symptoms and impact your sleep patterns. 

Strenuous exercise 

Experts also suggest avoiding strenuous exercise at night, which can increase anxiety levels in the short term and make sleep more elusive. However, exercising during the day and low-intensity workouts at night can reduce anxiety and promote restful sleep.

Stressful dreams   

Many people also experience stressful dreams. These may involve everyday actions—such as performing your job, running errands, etc.—in which the situation goes wrong. Stress-related dreams can mirror symptoms that you experience during the day and may further disrupt your sleep patterns. 

Insomnia 

How to manage symptoms for more restful sleep

The following tips may help you cope with anxiety at night and get more restful sleep. Some of these strategies may work better than others, so consider identifying the tools that help control your specific symptoms. 

Exercise

Physical activity is one of the most effective ways to lower stress hormones in the body and set off a cascade of biological processes promoting physical and mental health.  Exercise can be an effective method of managing anxiety and insomnia. However, as strenuous exercise may increase symptoms, sticking to low-intensity physical activity may be beneficial within an hour of bedtime. Yoga is one low-intensity exercise you can do at night that has been proven to reduce anxiety and depression.

Develop a routine

For trouble sleeping, consider developing a consistent regimen that prepares you for sleep and helps you get on a regular schedule. Your bedtime routine can include activities like reading, tending to personal hygiene, yoga, breathing exercises, and avoiding your phone for an hour before sleep.  

Meditate

Mindfulness meditation has been proven effective at reducing stress, and you can partake in it before bed. Meditation can quiet your mind and improve brain function, particularly when practiced regularly. You can practice several different techniques, such as transcendental meditation, mindfulness, and progressive muscle relaxation. Consider trying the following sleep meditation: 

• Lay down in a comfortable position.

• Pay attention to your body, starting at your toes.

• Imagine your toes filling up with sleepy sand or progressively relaxing. Let go of any tension in your muscles you might be holding from your day.

• Move to your ankles, legs, and knees, repeating the muscle relaxation and imagination exercise.

• Repeat the exercise for every body part until you reach the top of your head. 

Maintain a balanced diet

Nutrition can play a significant role in your sleep patterns. Try to avoid large and late suppers, along with stimulants like coffee or chocolate. A diet rich in vegetables, fruits, lean protein, nuts, legumes, and healthy fats can help reduce stress and promote restful sleep.  

Play music

Research shows that listening to music can lead to better sleep, particularly when the music has a lower register and rhythm. Consider putting on relaxing music before bed or using a machine that plays soothing sounds. 

Consider supplements

Several vitamins and minerals are thought to have relaxing effects. Vitamin B12 has been proven beneficial for mild symptoms. Before bed, you can also consider taking a natural sleep supplement, such as chamomile tea, melatonin, valerian, St. John’s wort, or kava-kava. Discuss any supplements with your doctor beforehand to avoid adverse side effects, as many supplements can interact with substances and medication. 

Get the recommended amount of sleep for your age group

As you deal with nighttime anxiety, consider tracking your sleep and remaining aware of how much sleep is suggested for your age group. As you age, you may need less sleep. However, sleep doesn’t become less important. The following are guidelines for sleep duration from the Centers for Disease Control:

• Adults: Seven to nine hours of sleep 

• Teenagers: Eight to ten hours of sleep 

• Children 6 – 12 years: Nine to 12 hours of sleep 

• Children 3 – 5 years: Ten to 13 hours of sleep

• Toddlers 1 – 2 years: 11 to 14 hours of sleep, including naps

• Infants 4 -- 12 months: 12 to 16 hours of sleep, including naps

Managing anxiety with professional guidance

If you’re struggling to fall asleep, stay asleep, or get rest, you’re not alone. Speaking with a licensed therapist may be beneficial as you navigate your symptoms. If you experience anxiety in social situations or when thinking of adding another appointment to your plate, you might also consider online therapy. 

Online therapy for anxiety

Studies show online therapy can help individuals manage anxiety symptoms and sleep better. For example, in a study on the efficacy of online cognitive-behavioral therapy for insomnia and anxiety, participants experienced significant improvements in the quality of their sleep and reductions in symptoms of anxiety. Cognitive-behavioral therapy is a widely accepted form of treatment that helps individuals reframe unwanted thought patterns, including those that may lead to late-hour symptoms. 

Online therapy can help you address symptoms and better understand why they may arise during specific times. With a platform like BetterHelp, you can reference your messages and notes through an online journal, which allows you to track your progress and monitor the times of day you feel heightened symptoms. Your therapist can also connect you with helpful resources, such as at-home exercises and worksheets targeted to your unique symptoms.