What Causes Heightened Anxiety At Night?

Medically reviewed by Majesty Purvis, LCMHC
Updated May 24, 2023by BetterHelp Editorial Team

Anxiety At Night Can Have Lasting Negative Effects On Your Health

Nocturnal stress is caused by the same triggers as during the day. However, the combination of nervousness and trouble sleeping can mimic other conditions which can make you think that it's something else. If you're concerned that mental health is impacting your sleep, continue reading this article to learn more and reach out to BetterHelp to work one-on-one with a qualified sleep therapist. 

Is Anxiety Keeping You Up All Night?

Anxiety can be triggered by normal stress-inducing events and have distinct symptoms. It can also manifest as generalized anxiety. Some people are just more prone to anxiety than others, based on hereditary factors and temperament. However, most people are familiar with these general anxiety symptoms. Anxiety can make you feel like you’re all alone. However, almost twenty percent of the population suffers from anxiety. This means that there is a lot known about how to effectively treat anxiety.

At night, your brain and subconscious mind continue to process and deal with challenges experienced during the day. If the challenge is severe, it could lead to insomnia or other sleep disturbances. In extreme cases, you could wake up from a panic attack, experience night terrors, or have sleep paralysis. Many people also experience “stress dreams.” These dreams usually involve everyday actions in which things go terribly wrong. Stress dreams aren’t as vivid or jarring as night terrors but can still disturb sleep.

Insomnia or sleep disturbances such as nightmares or night terrors are diagnostic markers for normal anxiety, as well as anxiety disorders. During a time of great stress, a person’s hormonal system is affected, so it can become common for people who are going through this to wake up at night or feel extreme anxiety. It can even battle to get back to sleep. Whatever is causing anxiety during the day, is likely to show up at night too.

It is important to note the distinction between occasional nocturnal anxiety, and nocturnal anxiety due to an anxiety disorder. The former can be addressed and solved with a few lifestyle changes, supplemented with therapy and counseling. The latter, however, can only be diagnosed by a medical doctor or psychiatrist and is best treated with medication and lifestyle changes.


Knowing the difference between occasional anxiety and something else can be important for getting the help that you need. While most people with anxiety share some common symptoms, the complete set of symptoms is different for everybody. Below are some common symptoms of occasional anxiety (experienced by everyone).

  • Occasional worry about circumstances like a break-up, stress at work, conflict, or a child’s illness.
  • Embarrassed or feeling self-conscious when facing an uncomfortable social situation.
  • Experiencing physical symptoms such as the jitters, mild sweating, or even dizziness over a pending big exam, a business deal, or an event like getting married.
  • Sadness, insomnia, and anxiety or worry immediately following a traumatic event.
  • Realistic and appropriate fear of a threatening situation, person or object.
  • The normal need for assurance of a safety, security, and good health.

For most, symptoms of nighttime anxiety will disappear once the stressors are gone, alleviated, or managed. In the case of a great life upheaval or trauma, anxiety symptoms can last for months. If they last longer, it may be time to visit a medical professional, as you may be suffering from an anxiety disorder.

Anxiety disorders are a group of mental disorders characterized by distinct symptoms. Mental disorders can only be diagnosed and treated by a professional doctor or licensed therapist. You don’t need to have all of these symptoms to have an anxiety disorder. If you have a lot of them or some of them fit you really well, it’s best to talk to a licensed therapist or your doctor.

  • Worrying constantly, chronically, and without logic or reason so that it affects relationships, causes emotional and physical distress, and interferes with your normal functioning every day. People will also experience impaired concentration due to worrying.
  • Avoiding social interaction and common social situations for fear of embarrassment, humiliation, or judgment.
  • Repeated, random panic attacks, feelings of impending doom and terror coupled with constant worrying over and fear of another panic attack.
  • Persistent nightmares, night terrors, or flashbacks of a traumatic event months or even years after the event.
  • Irrational fear, sometimes resulting in avoidance of a harmless to mildly threatening object, situation, or person.
  • Irrational fears of perceived threats that result in compulsive behavior such as chronic handwashing, continuously checking that a place is locked for the night, etc.

As stated above, if you experience any or all of the above symptoms, please seek out professional help.

Associated Risks

Continuous sleep deprivation or insomnia due to anxiety can lead to more problems. Our hormone and autonomic nervous systems are especially vulnerable to prolonged or repeated stress- the latter of which, if left untreated, can even lead to “a dysfunctional arousal state and pathological anxiety states.” For this reason, it’s very important to manage stress and nip its effects in the bud. If not, it could cause chronic insomnia and even sleep deprivation- both of which will usher in a host of health problems. That’s bad news and is best avoided.

Anxiety At Night Can Have Lasting Negative Effects On Your Health

In the United States, insomnia is the most common specific sleep disorder. Approximately 30% of adults report short-term problems with sleeping, while 10% experience chronic insomnia. Not all people who have anxiety develop insomnia, and not all people who develop insomnia have anxiety. However, if you do experience insomnia, you should be careful of its harmful effects. For example, not getting adequate sleep can give rise to an array of health problems such as:

  • Increased risk of Type 2 Diabetes
  • Delayed wound healing
  • Reduced growth hormones
  • Deficits in working memory and attention
  • Depression
  • Uncontrollable or unwanted weight gain or weight loss

Start Feeling Better

The sooner you address the anxiety that keeps you awake at night, as well as any other excessive symptoms, the better. Humans are creatures of habit, and it is possible, even probable, to get into the habit of feeling anxious. It’s never good to suppress any feelings, and truly facing anxiety and its causes is of paramount importance in order to avoid a negative response to stress.

The following are tips for dealing with stress, which is the #1 cause of anxiety. Do note that only persistence with the following will result in long-term benefits. Over time, these will become good habits and serve as valuable tools to stay in control of anxiety, instead of remaining under anxiety’s debilitating influence.

  • Exercise – This is one of the most effective way to quickly lower stress hormones in the body and set off a cascade of biological processes that promote both physical and mental health. We’re built to move, not sit for hours in front of a computer or TV. Studies have shown that even walking for only 15 min a day can reduce all-cause mortality by 14%.
  • Develop a Nighttime Routine – For night anxiety that results in sleep problems, limit strenuous exercise to the morning or early afternoon and also consider mentally soothing exercises like yoga, Tai Chi, and Qi Gong. Some people find that reading a book helps – but that’s not the same as reading on your phone. Electronic devices give off a harsh, artificial light that can trick your body into staying up longer. Other things that might help you fall asleep include caffeine-free herbal teas. You may want to cut out caffeine afternoon as well.
  • Meditation – This is scientifically-proven to reduce stress and anxiety. It calms the mind and improves brain function- if practiced daily. Consider learning a specific technique, such as Transcendental Meditation (TM), which has over 40 years of studies proving its efficacy in managing stress and anxiety disorders. “No other stress management technique has anywhere close to TM’s amount of hard data in support of its claims to reduce stress,” says Norman Rosenthal, MD, of the U.S. National Institutes of Mental Health.
  • Diet – Avoid large and late suppers and stimulants like coffee or chocolate. Also, lower sugar intake and replace with fruit. Avoid fast food and processed foods. If necessary, visit a dietician for specific dietary advice. Many people also turn to alcohol to help them sleep. Alcohol can help you fall asleep, but it makes it harder for you to stay asleep. It’s better to toss and turn for a bit longer and stay asleep all night than to fall asleep sooner and wake up too early.
  • Play Music – The link between emotions and music is a strong one. MindLab International with Dr. David Lewis-Hodgson has tested this particular ambient music track for anxiety, with a 65% reduction in participant symptoms. Listen to this or other soothing music before going to bed.
  • Supplementation- Vitamin B12 has been proven beneficial for neurological functioning and is effective in treating mild anxiety. Vitamin deficiencies will manifest as irritability, memory impairment, depression, psychosis and heart irregularities. You can also consider taking a natural sleep supplement, such as chamomile tea, melatonin, valerian, St John’s Wort or kava-kava, before bedtime. Discuss any supplements with your doctor beforehand to avoid any negative side effects.
  • Seek Help – A licensed therapist can help you figure out the underlying cause behind your anxiety – to address that cause directly – so that you are able to gain restful and peaceful sleep every night.

Sleep Recommendations

As you work on dealing with nighttime anxiety, it is important to track your sleep and know how much sleep you need to be healthy. As we age, we need less sleep, but sleep doesn’t become less important as we age. Be sure to get enough hours of shut-eye for your age group:

  • Adult: 7 – 9 hours
  • Teenager: 8 – 10 hours
  • Child 6 – 12 years: 9- 12 hours
  • Child 3 – 5 years: 10 – 13 hours (including naps)
  • Child 1 – 2 years: 11 – 14 hours (including naps)
  • Infants 4 -12 months: 12 – 16 hours (including naps)

Help Is Available

Cognitive-behavioral therapy has been shown to be effective in permanently reducing anxiety symptoms and can help with nighttime anxiety. If your symptoms are related to a traumatic event or series of events, therapy or counseling is strongly recommended.

Most often, treating the cause of the anxiety will solve sleep or nighttime issues. Be sure to exclude any physiological causes of anxiety or insomnia, and consider getting help. Even if diagnosed with an anxiety disorder, therapy will be very helpful in managing symptoms. Therapy or counseling can help you determine the reasons behind high anxiety levels. Research shows that online therapy can be a powerful tool in reducing anxiety symptoms.

BetterHelp’s online therapists and counselors are professionally trained to uniquely assist you with nighttime anxiety, or anxiety in general, and they could be all you need to regain your healthy sleep patterns. If meeting with a counselor or therapist over the internet seems strange to you, consider reading the following reviews from real BetterHelp users.

BetterHelp Therapist Reviews

“I tried a few counselors and almost gave up until I found Colleen. I love her! She’s easy to talk to, really gets me and best of all she makes me feel like I’m talking to a friend. She’s given me some great tips and I’m sleeping better already most nights.”

“Dr. Broz had made a significant impact on my life. After just one session with her I was able to get more sleep and handle issues with my husband and young kids better. She’s empathic and very easy to talk to. I would recommend her to anyone looking for help with stress, sleep issues, anger or relationship advice. Thanks Sandra for everything you do for me and all your patients.”

Final Thoughts

Stress and anxiety aren’t often related, but they often go together. If you’ve tried everything and there’s no other explanation for your late nights, anxiety could be keeping you up. That doesn’t mean that you have to put up with it.

Is anxiety keeping you up all night? BetterHelp is here for you. Take the first step today.

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