How to fall asleep with anxiety

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Anxiety is a natural emotion people feel when stressed or under pressure. It acts as an alarm bell for something being wrong and makes a person feel nervous or worried. In moderate amounts, anxiety can help a person cope with stressful and difficult situations.

However, when a person experiences anxiety often or disproportionately and it interferes with their daily life, it may indicate an anxiety disorder. Anxiety disorders are a group of mental health conditions that include:

• generalized anxiety disorder
• specific phobias
• social anxiety

Symptoms

Anxiety disorders can affect every person differently, but common symptoms include:

• sweating
• restlessness
• shortness of breath
• excessive worrying
• feelings of dread
• avoiding certain situations
• difficulty enjoying free time

Learn more about anxiety disorders here.

Sleep is crucial for the body to be able to function properly.

Doctors refer to an ongoing difficulty falling or staying asleep as insomnia. Research suggests there is a strong link between insomnia and anxiety, with 70–90% of people with anxiety reporting insomnia.

A person experiencing anxiety is more susceptible to worrying, experiencing intrusive thoughts, and ruminating. When a person is lying in bed trying to sleep, they may have few distractions from these worrying thoughts.

These feelings of anxiety may stimulate the brain and body into a state of hyperarousal, as if it is facing a threat, making it difficult for the person to fall asleep. In fact, research suggests that this state of hyperarousal is a key contributor to insomnia.

Not only can anxiety make it more difficult for a person to sleep, but poor sleep can worsen a person’s anxiety, creating a negative cycle.

A 2019 study states that there is a link between poor sleep and elevated levels of the stress hormone cortisol, as well as decreased testosterone levels. Both of these hormones are also associated with mental health conditions such as anxiety, which may explain why poor sleep can lead to the worsening of a person’s mental health.

Additionally, chronic sleep deprivation connects to increased inflammation in the body, which may also influence mental health.

Learn more about the link between stress and sleep here.

One way a person can aim to improve their sleep is to focus on reducing their stress levels throughout the day.

Methods of doing this include:

• Regular exercise: Research suggests that regular aerobic exercise may reduce anxiety levels.
• Relaxation exercises: Meditation, breathing exercises, and progressive muscle relaxation exercises may help reduce stress.
• Talking with trusted people: Discussing problems with loved ones may help put a person’s mind at ease.

Sleep hygiene

People can also make gradual changes to their nighttime routine to help calm their bodies and make their environment more suitable for a good night’s sleep.

Some sleep hygiene changes a person may wish to make include:

• aiming to wake up at the same time every day, even on weekends or when they believe they did not get optimal sleep
• avoiding stimulants such as caffeine, nicotine, and sugary snacks for at least 4 hours before sleep
• avoiding looking at TV, computer, and phone screens before trying to fall asleep
• making the bedroom as comfortable as possible by trying to keep the room dark, cool, and quiet
• using an eye mask and listening to white noise to block out background noise if needed
• avoiding checking the time, as this may make a person feel stressed about how much sleep they are going to get and make them feel more anxious
• waiting until their body feels tired before trying to sleep where possible, as trying to force sleep can start to feel stressful and worsen a person’s anxiety
• avoiding naps
• getting out of bed if they cannot sleep within 20–30 minutes of going to bed and doing a quiet or boring activity until they feel tired enough to sleep

It may also be helpful to keep a diary to track sleep patterns and help highlight things that seem to improve or negatively impact sleep.

Treatment will vary from person to person depending on the type of anxiety a person experiences and their preferences. It may include therapy, medication, or a combination of both. A mental health professional will discuss a person’s history and symptoms to find the best option for them.

Therapy

Common types of therapy for anxiety include:

• cognitive behavioral therapy (CBT)
• acceptance and commitment therapy
• exposure therapy and virtual reality exposure therapy

There is also a form of CBT specifically for insomnia that may help a person manage anxiety and sleep issues.

Medication

Some medications a doctor may prescribe to treat anxiety include:

• antidepressants
• antianxiety medications, such as benzodiazepines
• beta-blockers

Learn more about anxiety treatments here.

Below are answers to some of the most common questions about falling asleep with anxiety.

Why does anxiety get worse at night?

People can become anxious at night due to the same causes that make them anxious during the day. However, at night there can be fewer distractions, and a person may feel more alone with their thoughts.

They may also begin to worry about the coming day or get anxious about how many hours of sleep they will get. Research suggests that excessive cognitive activity before bed, such as overthinking and worrying, contributes to trouble sleeping.

How can a person quickly calm anxiety at night?

If a person is experiencing ongoing intrusive thinking at night, they may find it helpful to get out of bed and do a calming activity such as:

• reading a book
• having a warm bath or shower
• making a warm drink
• listening to calming music

It may seem counterintuitive to get out of bed, but trying to force sleep while feeling very anxious may cause more anxiety and contribute to the cycle of stress and sleeplessness.

What can make anxiety worse?

Triggers vary from person to person, but certain factors are more likely to worsen anxiety, including:

• caffeine and sugar
• certain medications
• ongoing conflicts or stress in areas of a person’s life such as relationships, work, health, or finances
• specific situations such as public speaking or attending important social events

Anxiety can negatively impact a person’s sleep.

People may aim to improve their sleep by trying to reduce their stress levels throughout the day, practicing good sleep hygiene, and talking with a doctor about their anxiety. With treatment and support, a person may reduce the impact of anxiety on their sleep.