Anxiety and Sleep

Anxiety and sleep problems often go hand in hand, creating a cycle where worry keeps you awake and poor rest heightens stress. Over time, this pattern can interfere with daily functioning, affect mood and concentration, and even contribute to long-term health issues.

Understanding the connection between anxiety and sleep is an important step toward breaking the cycle and finding strategies that support both mental health and restorative rest.

What Is Anxiety?

Anxiety disorders are the most common type of mental illness, affecting around 20% of American adults Trusted Source NIH News in Health The NIH, a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency — making important discoveries that improve health and save lives. View Source . They’re characterized primarily by a feeling of worry and unease. And while it’s normal to experience anxiety occasionally in response to fearful or stressful situations, in anxiety disorders Trusted Source National Institute of Mental Health (NIMH) The NIMH is the lead federal agency for research on mental disorders. View Source , this distress becomes excessive.

The symptoms of anxiety disorders can affect people both emotionally and physically. People with anxiety may experience:

• Extreme nervousness
• Poor concentration
• Irritability and restlessness
• Fear or sense of impending doom
• Tense muscles
• Rapid breathing and heartbeat
• Night sweats
• Trembling
• Gastrointestinal distress
• Fatigue

Not all people with anxiety disorders have the same degree of symptoms or impact from anxiety on their everyday life. In one large survey, around 43% of adults Trusted Source National Institute of Mental Health (NIMH) The NIMH is the lead federal agency for research on mental disorders. View Source described having mild impairment of their life from anxiety. Around 33% said it was moderate, and nearly 23% said it was severe.

Types of Anxiety Disorders

Anxiety is a core element of a number of specific disorders, although not all are categorized strictly as anxiety disorders.

• Generalized Anxiety Disorder (GAD): People with GAD have significant, looming worries about many different things that can cause an overarching sense of anxiety.
• Panic Disorder: Extremely intense episodes of fear, known as panic attacks, that usually last for a few minutes at a time are the defining feature of Panic Disorder.
• Social Anxiety Disorder: This disorder involves an extreme fear of social settings and potential embarrassment in front of other people.
• Specific Phobias: Specific phobias are intense fears caused by particular triggers. Some of the most common specific phobias include agoraphobia (a fear of open or enclosed spaces, being in a crowd, or being outside or home alone) and separation anxiety.
• Obsessive-Compulsive Disorder (OCD): In OCD, a person obsesses about an issue in a negative way such that it provokes anxiety, and this causes a compulsion, which is their attempt to control or eliminate that anxiety. Compulsions are repeated ritually and can directly impact everyday activities.
• Post-Traumatic Stress Disorder (PTSD): This condition can arise after a person is exposed to a painful or disturbing situation. People with PTSD may relive the stressful event, feel on-edge, and have potentially debilitating anxiety.

Say Goodbye to Insomnia

Sign up to receive emails about how to improve your sleep,
as well as our comprehensive Better Sleep Guidebook.

Can Anxiety Cause Sleep Loss?

Serious sleep disturbances, including insomnia, have long been recognized as a common symptom of anxiety disorders. People who are plagued with worry often ruminate about their concerns in bed, and this anxiety at night can keep them from falling asleep.

In fact, a state of mental hyperarousal, frequently marked by worry, has been identified as a key factor behind insomnia. People with anxiety disorders are inclined to have higher sleep reactivity, which means they are much more likely to have sleeping problems when facing stress.

Sleeping difficulties have been found for people with various types of anxiety including generalized anxiety disorder, OCD, and PTSD. In several studies, over 90% of people with PTSD associated with military combat Trusted Source National Center for PTSD The mission of the National Center for PTSD is to advance the clinical care and social welfare of America's Veterans and others who have experienced trauma, or who suffer from PTSD, through research, education, and training in the science, diagnosis, and treatment of PTSD and stress-related disorders. View Source have reported symptoms of insomnia.

Anxiety disorders can also occur alongside other mental health problems like depression. According to the Anxiety and Depression Association of America (ADAA) Trusted Source Anxiety and Depression Association of America (ADAA) ADAA's mission focuses on improving quality of life for those with anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research. View Source , nearly 50% of people with depression are also diagnosed with an anxiety disorder.

Can Lack of Sleep Cause Anxiety?

Distress about falling asleep can create a sleep anxiety that reinforces a person’s sense of dread. These negative thoughts about going to bed, a type of anticipatory anxiety, can create challenges to healthy sleep schedules and routines. Research indicates that anxiety and pre-sleep rumination may affect vivid dreaming during rapid eye movement (REM) sleep. Anxiety can provoke nightmares and disturbing dreams that create a higher likelihood of sleep disruptions and may reinforce fear around going to sleep.

At the same time, strong evidence indicates that sleep deprivation can instigate or worsen anxiety disorders. Researchers have found that people who are prone to anxiety are especially sensitive to the effects of insufficient sleep on mood and emotional health. The bidirectional relationship means that anxiety and sleep deprivation can be self-reinforcing; worrying causes poor sleep, while further sleep difficulties cause greater anxiety.

People with obstructive sleep apnea (OSA), a sleep disorder that causes repeated lapses in breathing and interrupted sleep, have been found to have higher rates of mental health problems, including depression, anxiety, and panic disorder.

How to Sleep With Anxiety

Although the impacts of anxiety disorders can be substantial, they are one of the most treatable mental health disorders. Any person who has persistent or significant anxiety and/or sleeping problems should talk with a doctor who can best assess their situation and discuss the benefits and downsides of the potential treatment options in their case.

Cognitive Behavioral Therapy (CBT) for Insomnia

Cognitive behavioral therapy (CBT) is a common treatment for anxiety disorders. It’s a type of talk therapy that works to reorient negative thinking, and it has had success in decreasing anxiety. Studies have found that CBT can often reduce anxiety even in people who have insomnia Trusted Source Behavioral Sleep Medicine View Source .

Addressing anxiety can pave the way for better sleep, but severe cases of insomnia may persist after CBT for anxiety. CBT for insomnia (CBT-I) may be a useful next step in these cases.

Anti-Anxiety Medications

Several different types of medications are approved to treat anxiety disorders including anti-anxiety drugs, antidepressants, and beta-blockers. These medications are intended to mitigate symptoms rather than cure the underlying anxiety.

Sleep Hygiene

Because of the multifaceted relationship between anxiety and sleep, getting better rest may help combat feelings of anxiety. Building healthy sleep habits and a consistent routine can make going to bed a more pleasant experience. Steps including making your bed more comfortable, eliminating sources of sleep disruption like light and noise, and avoiding caffeine and alcohol in the evening can help enhance your sleep.

Relaxation Techniques

Trying relaxation techniques can help identify ways to get rid of anxiety and make it easier to fall asleep quickly and peacefully. Relaxation exercises may be a component of CBT and can break the cycle of worry and rumination.

You may also want to try scheduling times to actively worry, as this may eliminate worrying time as you lay down for sleep. Deep breathing, mindfulness meditation, and guided imagery are just a few approaches to relaxation that can help put your mind at-ease before bed or if you wake up during the night.

When to See a Doctor

Occasional nights of worry and poor sleep are common, but persistent problems may signal something more serious. If anxiety or sleep difficulties last for weeks or begin to interfere with your daily functioning, it’s a good idea to seek professional help. Warning signs include:

• Struggling to fall or stay asleep at least three nights per week
• Experiencing significant daytime fatigue, trouble concentrating, or irritability
• Ongoing or excessive worry that feels difficult to control
• Panic attacks, frequent nightmares, or heightened anxiety at night
• Dependence on alcohol, medications, or sleep aids to fall asleep

A doctor or sleep specialist can help determine whether you are experiencing an anxiety disorder, a sleep disorder, or both. Treatment may involve therapy, lifestyle changes, or medication. Addressing these issues early can break the cycle of anxiety and sleep problems and improve overall well-being.

Still have questions? Ask our community!

Join our Sleep Care Community — a trusted hub of sleep health professionals, product specialists, and people just like you. Whether you need expert sleep advice for your insomnia or you’re searching for the perfect mattress, we’ve got you covered. Get personalized guidance from the experts who know sleep best.