Everyone experiences anxiety on occasion. In fact, experts believe that anxiety is an important way for the body to stay alert, focused, and prepared to respond to a stressful situation. But anxiety can also be accompanied by racing thoughts and physical symptoms that may get worse at night and make it difficult to sleep.

While anxiety is often a temporary experience, when it persists or gets worse Trusted Source National Institute of Mental Health (NIMH) The NIMH is the lead federal agency for research on mental disorders. See Full Reference over time it can develop into an anxiety disorder. We delve into the causes of nighttime anxiety, how to calm anxiety at night, and when to talk to a doctor about persistent anxiety and sleep problems.

What Causes Anxiety at Night? 

Whether it occurs at night or during the day, anxiety is caused by the body’s response Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference to a potential threat. Researchers have found a wide variety of factors that can trigger or increase a person’s anxiety.

  • Lack of sleep: People who do not usually get the recommended amount of sleep have been found to experience more mental distress Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference , which can include stress and anxiety. Studies also show that when a person gets less sleep than they are accustomed to, they have heightened anxiety the next day Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference .
  • Life stressors: Stressful life events, like work troubles, illness, or the death of a family member, can cause a person to feel temporarily distressed and anxious. In some people, anxiety disorders may begin after a particularly difficult life stressor Trusted Source SpringerLink SpringerLink provides researchers with access to millions of scientific documents from journals, books, series, protocols, reference works, and proceedings. See Full Reference .
  • Traumatic experiences: People often feel anxious in the weeks after a traumatic event Trusted Source National Institute of Mental Health (NIMH) The NIMH is the lead federal agency for research on mental disorders. See Full Reference , like a natural disaster, act of violence, or car crash. Childhood trauma can also make a person more likely to experience panic attacks Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. See Full Reference or excessive worry Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. See Full Reference as an adult.
  • Genetics: Research has found that multiple genes may make a person more likely to develop an anxiety disorder. A person who is genetically predisposed to anxiety may develop a disorder after experiencing trauma or significant life stressors.
  • Medication side effects: Certain medications can produce side effects that include anxiety. For example, starting or increasing the dosage of steroids, amphetamines, or antihistamines has been associated with anxiety and panic-like symptoms. Similarly, substances like caffeine and nicotine can trigger anxiety.

Why Is Anxiety Worse at Night?

Anxiety can get worse at night as people find themselves focusing more on their worries once they are lying in bed without the distractions of the day. For example, sometimes people with insomnia may begin to develop worries about whether or not they will be able to fall asleep. These worries may then exacerbate insomnia and make falling asleep even more difficult.

Additionally, several other conditions can flare up at night, causing anxiety. For example, people with nightmare disorder often feel distressed after waking up from a nightmare. Post-traumatic stress disorder (PTSD) also involves nightmares and disrupted sleep. And nocturnal panic attacks can cause a person to wake up during the night feeling anxious and like something bad is about to happen.

Symptoms of Anxiety at Night 

The symptoms and severity of anxiety vary widely. A person experiencing anxiety may notice symptoms at night such as:

  • Worry or fear about the future 
  • Restlessness 
  • Headaches, stomachaches, or other pains 
  • Tense muscles, increased heart rate, or sweating
  • Shortness of breath or chest discomfort 
  • Dizziness 
  • Trembling, chills or tingling sensations 
  • Flashbacks of a traumatic event or nightmares

How Anxiety Impacts Sleep 

Anxiety and worry can interfere with a person’s ability to fall or stay asleep. One reason for these effects is that anxiety can trigger the body’s stress response Trusted Source American Psychological Association (APA) APA is the leading scientific and professional organization representing psychology in the United States, with more than 121,000 researchers, educators, clinicians, consultants and students as its members. See Full Reference . This stress response sets off a cascade of effects Trusted Source American Psychological Association (APA) APA is the leading scientific and professional organization representing psychology in the United States, with more than 121,000 researchers, educators, clinicians, consultants and students as its members. See Full Reference throughout the body that can leave a person feeling too wound up or agitated to fall asleep. 

Additionally, anxiety can continue to affect the body after a person falls asleep and change how they move through the stages of sleep. For example, more anxious people have been found to spend less time Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference in the rapid eye movement (REM) stage of sleep. Anxiety is also associated with less time spent in deep sleep, which is thought to be important for restoring the body and mind.

How to Calm Anxiety at Night 

People who have anxiety at night can try multiple techniques to relieve stress and help reduce anxiety.

  • Breathing exercises: Practicing slow, deep breathing may help people manage excessive worry and combat insomnia. Breathing exercises may promote sleep by reducing arousal in the nervous system and increasing relaxation.
  • Progressive muscle relaxation: Learning to tense and relaxing muscles in the body one group at a time is another technique that promotes relaxation. This technique is commonly used to treat panic attacks, excessive worry, and insomnia. Breathing exercises and progressive muscle relaxation can also be used together.
  • Writing: If a person’s nighttime anxiety stems from worrying about tasks they must complete in the future, research suggests that writing before bed may help. Specifically, people who write a detailed to-do list outlining tasks they need to complete have been found to fall asleep faster.
  • Exercise: Engaging in regular exercise has been found to reduce anxiety, both in people who have anxiety disorders and those who do not. Physical activity may also help improve sleep in people with insomnia, particularly older adults.
  • Therapy for anxiety: When anxiety begins to interfere with a person’s sleep or waking life, seeking professional treatment may help. Mental health professionals can offer support and a variety of tools for coping with anxiety.
  • Therapy for insomnia: Cognitive behavioral therapy for insomnia (CBT-I) is a type of therapy that is usually the first treatment recommended for people with insomnia, including people whose insomnia is linked to anxiety at night.
  • Support groups: Sometimes a support group is helpful when a person is dealing with anxiety. Support groups may be available in-person or online, and are sometimes overseen by a mental health professional.

Talking to Your Doctor About Nighttime Anxiety

Reach out to your doctor if you suspect that your nighttime anxiety is more than just occasional worry. Experts encourage people to bring up their mental health concerns with their primary care provider Trusted Source National Institute of Mental Health (NIMH) The NIMH is the lead federal agency for research on mental disorders. See Full Reference , who can refer to a specialist if necessary and discuss medications and other treatment options. 

Be honest with your doctor about your symptoms, providing details about how long they have been happening and how severe they feel. Even if your nighttime anxiety does not feel severe, talk to your doctor if your sleep is disrupted enough that it impacts your daytime activity. A doctor can help you determine if a sleep disorder or underlying health problem may be causing your symptoms. 

Keeping a sleep diary for a week or two prior to your doctor’s visit may help them better understand what you are experiencing. To keep a sleep diary, write down when you fall asleep, when you wake up, when you nap, when you feel tired, and when you exercise or ingest caffeine or alcohol during the day.

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