Medically reviewed by Gerhard Whitworth, RN — Written by Eleesha Lockett

Why does it happen at night?

Anxiety is a normal human emotion characterized by feelings of nervousness and worry. You may find yourself experiencing anxiety during stressful situations, such as a first date or job interview.

Sometimes, though, anxiety may linger around for longer than usual. When this happens, it can interfere with your daily — and nightly — life.

One of the most common times when people experience anxiety is at night. Many clinical trialshave found that sleep deprivation can be a trigger for anxiety. Historically, research also suggests anxiety disorders are associated with reduced sleep quality.

Treating your nighttime anxiety and addressing your sleep issues are important steps in improving your quality of life.


There are many symptoms of anxiety. Everyone experiences anxiety differently. Symptoms can happen anytime of the day, morning, or night. Common symptoms of anxiety include:

  • feelings of nervousness, restlessness, or worry
  • trouble concentrating
  • trouble falling asleep or staying asleep
  • gastrointestinal problems

Another symptom a person with anxiety may also experience is a panic attack. A panic attack is an episode of extreme and intense fear, often accompanied by physical manifestations. The common symptoms of a panic attack include:

  • a sense of impending doom
  • increased heart rate and chest pains
  • shortness of breath and throat tightness
  • sweating, chills, and hot flashes
  • dizziness or lightheadedness
  • a feeling of detachment, or like nothing is real

In some cases, you may even wake up from a nocturnal panic attack. Nocturnal (nighttime) panic attacks have the same signs and symptoms of regular panic attacks, only they occur while you’re asleep.

If you experience a nocturnal panic attack, it may be hard to calm down and fall back asleep.


Sleep issues and anxiety seem to accompany one another. Lack of sleep can be an anxiety trigger, while anxiety can also lead to a lack of sleep.

According to the Anxiety and Depression Association of America (ADAA), over 50 percent of adults say their anxiety levels affect their ability to get to sleep at night.

There’s very little scientific research on nighttime anxiety. Still, there are many reasons why your anxiety may be worse at night.

You may feel that your mind is racing, and you can’t stop your thoughts. You may be focused on the worries of the day or anticipating things on your to-do list for the next day.

This perceived “stress” can cause the body to experience an adrenaline rush, which makes it incredibly difficult to get to sleep.

Anxiety and sleep research

There is, however, plenty of research on how anxiety can affect sleep and vice versa.

According to the ADAA, research shows that sleep disorders occur in almost all psychiatric disorders.

In a small 2015 study, researchers examined the relationship between cognitive behavioral therapy (CBT) and sleep quality in people with anxiety. Researchers found that both sleep quality and sleep latency (the time it takes to fall asleep) improved in participants who responded to CBT.

The researchers believe that targeting sleep problems during anxiety treatment might be beneficial for those who have trouble sleeping.


It’s important to remember that it can take time to find the right treatment approach for your anxiety. Because of this, you and your doctor may choose to use a variety of different treatment options.

Treat underlying conditions

There are some medical conditions that can cause symptoms of anxiety. They include:

If any of these conditions are causing your nighttime anxiety, your doctor will want to treat them first.


There are many forms of psychotherapy that can treat anxiety. One of the most well-established methods is cognitive behavioral therapy (CBT). CBT is a form of psychotherapy that encourages changing your thought patterns to improve your behavior and mood.

According to the ADAA, it can take 12 to 16 weeks to begin seeing results with CBT.


In many cases, treating anxiety requires a dual approach. Both psychotherapy and medication may be used in conjunction to produce the best results.

There are various types of medications your doctor may prescribe for your anxiety. They can discuss a medication’s pros and cons, availability, and more with you.

The most common drugs prescribed for acute anxiety attacks are benzodiazepines. The most common drugs prescribed for long-term cases of anxiety are antidepressants.

Alternative medicine

For some people, alternative medicine is another treatment option for anxiety.

The research on herbal and botanical medicine for anxiety is much more limited than traditional medicine. However, a systematic review from 2010 did find that both nutritional and herbal supplementation may be worthwhile therapies for anxiety.

There’s strong evidence for the effectiveness of supplements containing passionflower, kava, L-lysine, and L-arginine.

Keep in mind that the U.S. Food and Drug Administration doesn’t regulate the quality or purity of supplements like they do for drugs. Talk to your doctor before trying supplements to make sure no interactions will occur.

Find passionflowerkavaL-lysine, and L-arginine supplements online.

Lifestyle tips

Here are some lifestyle tips that may help you relax and ease your anxiety at night:


Meditation is the practice of mindfulness. Evidence suggests that even one session of meditation can be beneficial in reducing your anxiety. Even more benefits may be seen long term.

Meditating right before you tuck in for the night can be a great way to turn down the nighttime anxiety.

Deep breathing

Deep breathing is a great way to reduce anxiety and stress. Breathing deeply can slow your heart rate and improve your blood pressure.

If you’re experiencing a panic attack at night, try deep breathing to ease the attack.


Anxiety can cause episodes of dissociation. Grounding is one way to keep yourself present in the moment.

Grounding techniques include both cognitive and sensory awareness, such as touching an object or saying today’s date out loud. Doing this at night before bed can help bring you back to the present moment so you can sleep.

To-do list

If one of your anxiety triggers involves worrying about your daily activities, you may notice your anxiety spikes more at night. Creating a to-do list for the day or week may help take away some of that anxiety.

Healthy sleep habits

One of the most important ways to ease anxiety at night is through healthy sleep habits. Making sure you’re happy and comfortable in your own bedroom will help improve your quality of sleep.

There are many ways to establish good sleep habits to ensure you’re sleeping better and for longer:

Exercise daily

Exercise can help improve both sleep quality and duration. If you experience nighttime anxiety, exercising during the early or late afternoon may help you feel sleepier before bed.

Besides, exercise isn’t only good for improving sleep. It can also help relieve your anxiety symptoms.

Develop a sleep schedule

Establishing a sleep schedule can help keep your circadian clock in check. When you keep your wake and sleep cycles around the same time each day, you may find it easier to fall asleep night.

Avoid stimulants before bed

Stimulants can worsen anxiety symptoms. In addition, because stimulants increase body activity, taking them before bed can make it more difficult to fall asleep.

The National Sleep Foundation warns that alcohol, cigarettes, and caffeine can all have a negative effect on sleep, so be sure to avoid these before you hit the hay.

Turn off electronics

When you finally crawl into bed, ditch the electronics. A 2017 study found that in almost 350 adult participants, the use of electronics after bedtime was related exclusively to the amount of time it took to fall asleep.

This is because artificial blue light from electronics is thought to suppress the sleep hormone melatonin, making it harder to fall (and stay) asleep.

Create comfort

Pillows and mattresses should be comfortable and supportive for your body and sleeping style. Your bedroom is your own, so making it a comfortable, safe space to sleep can make all the difference for your nighttime anxiety.

When to see a doctor

Constant anxiety that makes it difficult to sleep at night can affect your daily quality of life. Your work or school performance may worsen, and you may find it hard to complete your normal daily tasks.

If anxiety and lack of sleep are affecting your life in this way, it’s important to reach out to a doctor or mental health specialist for help.

For some people, nighttime anxiety can lead to insomnia. Insomnia is defined as persistent trouble falling or staying asleep. Chronic insomnia can have negative health effects, including an increased risk of:

  • health conditions, such as high blood pressure and a weakened immune system
  • mental health conditions, such as depression
  • accidents

Whether your doctor makes a diagnosis of anxiety, insomnia, or both, reaching out is the first step in the treatment process.

The bottom line

There are many reasons why your anxiety may be worse at night. Daily stressors, poor sleep habits, and other health conditions can lead to increased anxiety and panic attacks at night.

However, there are many treatments available that can help ease your anxiety and improve your quality of sleep. If you’re concerned that your nighttime anxiety and lack of sleep are affecting your life, it’s never too late to take advantage of the mental health resources available to you.

These online resources can help you find a mental health professional near you:

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Originally published on Healthline.

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