Difficulty Sleeping? Anxiety Could Be Keeping You Up

Medically reviewed by Julie Dodson, MA
Updated June 18, 2024by BetterHelp Editorial Team

There are a variety of sleep issues an individual may experience, and they can all be frustrating. For example, it might take you hours to fall asleep, or you may toss and turn in a night of restless sleep. Sleep anxiety may be one of the many different causes that can affect your quality of sleep. If you’ve been having difficulty falling asleep due to symptoms of anxiety, read on to find out how the two might be connected and learn what you can do to manage sleep anxiety.

Is anxiety affecting your well-being?

Symptoms of anxiety disorder

Though they are typically treatable, anxiety disorders can be distressing and even debilitating mental health conditions to experience. Around 5.7% of American adults live with generalized anxiety disorder (GAD). Common symptoms include:

  • Persistent, excessive worry
  • Trouble controlling worry
  • Difficulty sleeping
  • Muscle aches
  • Trembling
  • Nausea
  • Irritability
  • Fatigue
  • Being easily startled
  • Difficulty relaxing
  • Panic attacks

Under the anxiety disorder umbrella are multiple more specialized mental health conditions, such as panic disorder and social anxiety disorder. Although there is no way to be diagnosed with “sleep anxiety,” anxiety and sleep patterns may influence each other, potentially leading to sleep disorders that further disrupt sleep. Nocturnal panic attacks can sometimes occur as a sudden nighttime episode of extreme fear.

Why it can be important to address sleep issues

Trouble sleeping can translate to immediate negative effects the next day. According to a 2000 study, going without sleep for just 17 to 19 hours can impair cognitive performance to a degree comparable to having a blood alcohol level of 0.05%. Over time, consistently poor or insufficient sleep can lead to an increased risk of serious health problems like high blood pressure, stroke, diabetes, and depression. For these reasons, it can be important to be proactive about addressing a possible sleep disorder. 


The connection between sleep problems and anxiety disorders

Research suggests that “some form of sleep disruption is present in nearly all psychiatric disorders.” In addition, those with insomnia are more likely to develop an anxiety disorder, while those with an anxiety disorder are less likely to experience a restful night’s sleep.

In other words, getting too little sleep and anxiety disorders have a bidirectional relationship, as the presence of one can bring about or exacerbate the other.

There are various ways in which anxiety might negatively impact your sleep. A common one is that your mind is racing with worry and anxious thoughts, making it difficult for you to relax and fall asleep. Another is that certain symptoms of anxiety can make it harder for your body and mind to relax and drift off into a nourishing sleep. Physical symptoms of anxiety may include nausea or gastrointestinal issues; it may also affect your emotional health, causing irritation and restlessness.

Tips to fall asleep when you’re anxious

Having trouble with your sleep schedule due to anxiety can cause additional stress, potentially resulting in a frustrating loop where sleep becomes increasingly elusive. The next time you’re experiencing poor sleep quality, consider the following tips to help treat anxiety.

Journal before going to sleep

If you feel anxious, writing in a journal before bed can be a good way to get the things that are causing you stress off your mind so you can more easily fall asleep. It can offer you the opportunity to process the events of the day and plan for the next so that you can be prepared for a restful sleep once your head hits the pillow. Research supports the efficacy of journaling for anxiety, with one study indicating that participants who engaged in journaling consistently over the course of 12 weeks experienced “decreased mental distress and increased well-being relative to baseline” along with greater resilience.

Is anxiety affecting your well-being?

Avoid caffeine and alcohol late in the day

Many people consume caffeine at the start of the day to help them perk up, especially if they’re feeling tired after not sleeping well. However, ingesting caffeine too late in the day can make it harder to fall asleep that night since it can contribute to the wired, jittery feeling many people with sleep anxiety might experience. Alcohol can also have a negative effect on sleep. While it may sometimes help you fall asleep faster, it can prevent you from entering the deepest REM cycles you need to wake up feeling rested. Practicing good sleep hygiene can help you with falling asleep and staying asleep.

Try a weighted blanket

When you’re experiencing anxiety, your body’s fight-or-flight response is activated. Your autonomic nervous system is geared up to face a threat, which can make settling down to sleep difficult. That’s why some people find sleeping with a weighted blanket to be useful. It can assist in putting your autonomic nervous system into “rest” mode, providing a sense of calm by helping bring your heart rate and breathing back to normal levels.

Exercise during the day

Extensive scientific evidence suggests that exercising can help alleviate symptoms of anxiety. It can boost mood, provide an outlet for excess anxious energy, and release tension from your muscles. As one study notes, physical activity can also benefit those who experience anxiety by increasing blood circulation to the brain, thereby decreasing psychological reactivity to stress. 

Practice mindfulness

People who experience anxiety are often caught worrying about the past or the future. Mindfulness meditation helps you learn to be in the present moment instead, which can help decrease feelings of anxiety. Deep breathing, in particular, has been shown to significantly decrease subjective anxiety for both young and older adults.

Another study found that daily meditation may be as effective as Lexapro, a common anti-anxiety medication, in reducing anxiety symptoms. However, it is important to consult your healthcare provider before starting, stopping, or changing medications. 

How therapy can help

If you’re experiencing symptoms of a clinical anxiety disorder like GAD, it’s typically recommended that you connect with a therapist for evaluation and treatment advice. GAD is often treatable through cognitive behavioral therapy (CBT), sometimes in tandem with medication. The aim of CBT is to help you learn to recognize and shift distorted thought patterns that are contributing to distress. A therapist can also teach you useful coping mechanisms for managing symptoms, including trouble sleeping. 

If the prospect of meeting with a therapist in person increases your anxiety, you might consider connecting with a provider online instead. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist with whom you can meet via phone, video call, and in-app messaging from the comfort of your home or anywhere you have an internet connection.

Research suggests that online CBT can be an effective treatment option for those experiencing symptoms of anxiety, just as in-person CBT is, so you can feel comfortable in choosing either option in most cases.


Trouble sleeping is a common symptom of anxiety disorders like generalized anxiety disorder. There are various strategies you can try to help yourself fall asleep when anxiety is keeping you up, such as meditating, journaling, and sleeping with a weighted blanket. Meeting with a therapist is also recommended for those who are experiencing symptoms of an anxiety disorder.
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