What Causes Anxiety At Night And How To Deal With It

By: Jon Jaehnig

Updated November 05, 2020

Medically Reviewed By: Wendy Boring-Bray, DBH, LPC

Anxiety at night is caused by the same triggers as anxiety during the day. However, the combination of anxiety and trouble sleeping can mimic other conditions and the different setting of night versus day can make you think that it's something else. So, what causes anxiety at night and what can you do about it?

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What Is Anxiety?

Anxious feelings are the body's normal alarm-response to psychological or physical threats, real or imagined, and can, therefore, be affect any person. In mild degrees, it is even considered 'serviceable to the individual.' 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. 

Anxiety At Night

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.

Symptoms Of Occasional Anxiety At Night

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.

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For most, symptoms of anxiety at night 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.

Symptoms of Anxiety Disorders at Night

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.

Dangers Of Long-Term Nocturnal Anxiety

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.

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

How Can I Address Anxiety At Night?

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%.

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  • 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.  

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What Is Enough Sleep For Me?

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)

Getting Help

Cognitive-behavioral therapy has been shown to be effective in permanently reducing anxiety symptoms and can help with anxiety at night. 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.

Anxiety At Night Can Have Lasting Negative Effects On Your Health
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You may read the full study here: Internet-Based Cognitive Behavior Therapy vs. Cognitive Behavioral Group Therapy for Social Anxiety Disorder: A Randomized Controlled Non-inferiority Trial.

BetterHelp's online therapists and counselors are professionally trained to uniquely assist you with anxiety at night, 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.

Counselor 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."


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. Help is out there; get the help you need and enjoy restful nights again. Take the first step today.

Frequently Asked Questions (FAQs)

How can I calm my anxiety at night?

When the evening comes, all you want to do is get a good night of sleep. There are many things you can do to calm nighttime anxiety. Some people find that meditation helps with anxiety. Others notice that reading a book before bedtime relaxes them. Having a nighttime routine can alleviate some of the anxiety one experiences at night. For example, after dinner, take a bath, then get into pajamas, read a book, or listen to an audiobook. You could drink a calming warm beverage like a cup of tea. Then dim the lights, and meditate. After that, you can lay down and go to sleep.

What causes panic attacks at night?

Many people suffer from panic attacks. It's difficult when they occur at night. Some individuals have panic disorder, where they feel panicked out of the blue. Some people find that their anxiety is heightened at night. That could be for many reasons. It's important to talk to a mental health professional if you are experiencing panic attacks. They can help you get to the bottom of the cause of them. One thing to keep in mind is that there may be triggers that are impacting your anxious feelings at night. Maybe you experienced a traumatic experience that took place at night. If there's a reason for your panic attack, it might be that. It could be worth it to speak to a therapist who specializes in trauma, who can help you work through these triggers and cope with panic attacks.

What causes anxiety at night?

Anxiety at night is no different than anxiety during the day. It can be caused by not knowing how to handle normal stress, by mental health challenges like an anxiety disorder, relationship trouble, physical health conditions and a number of other things.

Anxiety can feel different at night because it can cause you to have trouble falling asleep and staying asleep. When you’re dealing with anxiety and it disturbs your sleep routine, it can make it feel even worse and cause you to struggle the next day at work or school.

How do I stop night time anxiety?

The best way to stop night time anxiety is to find and address the root cause of your anxiety. For example, if it’s caused by a mental health disorder such as an anxiety, depression, Bipolar Disorder, or Obsessive-Compulsive Disorder, explore your treatment options. This could include options such as therapy or possibly prescription medication.

If you’re struggling with anxiety that is not related to a mental health disorder, learning how to reduce anxiety can improve your lack of sleep. The Sleep Foundation recommends things such as:

  • Meditation
  • Exercise
  • Keeping a to-do list on paper so it’s not in your head
  • Getting up instead of lying in bed awake

If your night time anxiety is a result of sleep disorders, you should consider working with a physician or mental health professional to address it and explore your options.

Is anxiety worse at night?

Anxiety can be a bigger struggle for people at night. You may find that you’re so busy during the day that you don’t have time to worry about things. But then, when you lay down and are falling asleep, all the worries from the day or for the future can seem to hit at once. This can be true whether you are diagnosed with a mental health disorder or if you just struggle with handling stress and anxiety.

Can't sleep at night anxiety?

If you struggle with a lack of sleep, you may be wondering if anxiety could be the cause. Anxiety and depression can impact your ability to get a good night’s rest. Some people with depression and anxiety find themselves sleeping too much during the day, which can make it difficult to sleep at night. And some people struggling with them can find it difficult to shut their mind off and sleep at all.

If you believe that anxiety is keeping you up at night, it’s best to take steps to address it quickly. A lack of sleep can lead to challenges with your mental health and physical health. There has been a connection between sleep disorders and health issues such as high blood pressure and heart attack.

What is the best sleeping position for anxiety?

Some people believe that it’s best to sleep on your back if you struggle with anxiety. They find that if you’re dealing with depression and anxiety, you may be more likely to sleep curled up tight on your side. This can cause your muscles to be tight, which can naturally happen when you’re dealing with anxiety and depression. By sleeping on your back with your arms and legs outstretched, they believe it can help your muscles to lengthen and relax.

If you struggle with an anxiety disorder or sleep disorders, you may also find it helpful to do things like avoiding caffeine late in the day, taking a warm bath before bed, using essential oils to help you relax, and practicing deep breathing as you try to fall asleep. These can help to reduce anxiety so you can get good sleep.

How do I shut my brain off for anxiety?

If you’re struggling with sleep problems or sleep disorders due to anxiety and stress, you may think that you need to figure out how to address the lack of sleep. This can cause people to do things like taking medication to help them sleep. However, doing this is not addressing the root cause of the problem.

When you address your anxiety, it can help you to overcome the trouble you have at night which can result in good sleep on a regular basis. There are several different treatment options that can help you gain control of anxiety, depression, and stress. Here are a few to consider:

  • Talking to a mental health professional to explore therapy options
  • Learning how to meditate
  • Practice deep breathing
  • Exercise during the day. Get outside to get fresh air and sunshine.
  • Journal before laying down at night to help get your worries out of your brain.

How can I stop thinking at night?

The Sleep Foundation recommends trying the following things to overcome your anxiety to help with falling asleep and staying asleep at night:

  • Meditate
  • Exercise during the day
  • Avoid stressful activities before bed
  • Keep a to-do list written down to get it out of your head
  • Get up and do something else if you can’t fall asleep

Doing these things can help you stop thinking so much and start falling asleep faster. You may also find it helpful to journal so you can get all your thoughts out of your head before trying to go to bed.

Why does my mind race at night?

For many people, anxiety and stress can pick up at night because the environment around them is quieter than in the day. You may have raced through your day moving from one activity to the next with little time to really process what was happening around you. At night, when you lay down, it’s the time every day for most people when all is quiet.

This can allow your thoughts to take over. They may jump from one problem to the next causing you to experience sleep problems.

Can anxiety come on for no reason?

While it may seem like your anxiety is coming out of nowhere, there is likely something that it’s stemming from and you just don’t know what it is yet. Working with a mental health professional like a therapist can help you get to the root cause of issues such as anxiety and depression. Learning how to identify what it is can be the first step in learning how to address it.

When you find the right treatment plan you may find relief from sleep disorders, depression, and anxiety.

What happens if anxiety is left untreated?

If anxiety is left untreated it can lead to serious mental health or physical health complications.

 An anxiety disorder can lead to regular sleep problems. Lack of sleep and sleep disorders like sleep apnea have linked to issues such as high blood pressure, heart disease and heart attack.

Anxiety and depression are often linked together. If you experience anxiety and stress on a regular basis and don’t address it, it could turn into depression.

The good news is, there are plenty of treatment options that you can explore. You can speak with your physician that can provide medical advice, diagnosis, and treatment options. Or, you could work with a mental health professional such as a licensed therapist.

How do you kick anxiety?

The best way to kick anxiety can be to identify where it’s coming from. When it seems like depression and anxiety is coming from nothing it can be hard to know what the right steps are to take. You may benefit from talking to a mental health professional who can help determine if you’re struggling with an anxiety disorder or if it’s the stress and anxiety of normal life. They can also help you identify treatment plans to overcome it.

Why I wake up at 3am every night?

There are many reasons why you could be waking up at the same time every night. It could be caused by a sleep disorder that has thrown off your natural sleep-wake cycle, or it could be caused by anxiety, depression, or a number of other mental health or physical health conditions. If you wake up and are struggling to fall back to sleep on a regular basis, it may be in your best benefit to speak with a therapist or your primary care doctor to start exploring the possible causes and what treatment options are available.

What is the best medicine for anxiety and insomnia?

There are different kinds of medications that you can take to address sleep disorders like insomnia and anxiety disorders such as Generalized Anxiety Disorder. It’s best to work with your doctor or mental health professional like a psychiatrist to determine which options are the best for you.

You may also find that there are other treatment options that can help you. Or, you may find a combination of treatments to work the best.

Why can't I sleep throughout the night?

If you’re struggling to sleep through the night, it could be due to a mental health challenge such as an anxiety disorder. You may find that anxiety, depression, or daily stress causes your mind to run at night when the rest of the world seems to be quiet. Your lack of sleep could also be caused by a sleep disorder.

If you’ve been unable to identify where the struggle is coming from, seek the help of a medical or mental health professional to explore possible explanations and how to address them.

Does CBD help anxiety?

There is still a lot of research to be done when it comes to the impact of CBD on anxiety. Some research has found promising results that it could be beneficial. But it’s best to speak with your doctor or psychiatrist to explore what the best treatment options are for your specific situation.

How do you calm down anxiety?

Anxiety and stress can weigh on a person. For some people, they are coping with both depression and anxiety. For others, they are managing a high level of anxious thoughts. People who deal with generalized anxiety find themselves worrying a lot. The last thing you want to do is make anxiety worse. It can be a difficult condition to live with, but there are things you can do to help yourself and reduce anxiety. Different techniques work for generalized anxiety. Some people find that ice-diving helps panic attacks. You can take a bowl of ice and stick your nose in it for 30 seconds. The shock of the cold to your system can alleviate a panic attack. Some individuals find that naming five things you see, hear, taste, feel, and smell can calm anxiety. These are grounding exercises that you can try when you are experiencing high levels of anxiety. Dealing with nighttime anxiety can be tricky, but there's hope.

What helps night time anxiety?

Some people find that their anxiety is worse at night. One thing that can help nighttime anxiety is knowing the cause. There are techniques you can use to ease anxiety, and you can learn them. One thing you can try is identifying the times at night that you feel anxious. Understanding if there's a pattern can help you work through these anxious thoughts and feelings. It makes anxiety worse when the cause is unknown. Once you know when you're anxious, you can start learning techniques to deal with your anxiety. It also depends on what your symptoms are. If you are having a racing heart, learning breathing techniques can help slow your heart rate. You might consider investing in a weighted blanket. These can help people with anxiety feel safe. Talk to a mental health professional and discuss your anxiety symptoms. They can suggest techniques to manage your nighttime anxiety best.

How long can anxiety last?

There is no concrete answer to how long anxiety lasts. There's no way to know because it differs from person to person. When you're suffering from anxiety it may feel like it's going to last forever. The good news is that's not true. Anxiety is different for each person, but one thing we do know is that it does get better with treatment. There are a variety of symptoms of anxiety. Some people may experience shaking or sweating, while others ruminate on their problems. There is, however, a rough time frame for how long panic attacks can last. A panic attack typically lasts 20-30 minutes. Remember, when you are experiencing a panic attack, it will end. It generally peaks around the 10-15-minute mark, and then anxiety will decrease after that. For generalized anxiety, it can linger for days. That's why it's crucial to speak to a therapist about your symptoms so you can learn coping strategies to manage your anxious thoughts.

Why do I feel like I'm dying when I'm falling asleep?

If you feel uncomfortable before you fall asleep at night, it may be because you have a sleep disorder, or it could be an extreme amount of anxiety. It's important to discuss your symptoms with your healthcare provider. Some people experience intense panic attacks while they are trying to sleep, and it can feel like you are dying. These attacks require medication attention, and you should speak to a therapist, or a psychiatrist. You don't have to suffer from panic alone. Some skilled professionals see these symptoms every day and can support you.

Can anxiety wake you up at night?

Anxiety can wake you up at night for many reasons. You might wake up with night sweats from a bad dream. You may be anxious about something that happened during the day. You may find that you're going through a particularly difficult time in life, and you can't seem to stop thinking about it. These thoughts make you wake up suddenly during the night. For people who cope with depression and anxiety, these two emotions could be draining you. As a result, you could also wake up in a panic attack. It's essential to understand the cause of your anxiety, and if it's situational or a chronic condition. These are things you can discuss in therapy.

How can I relax my mind to sleep?

One way to relax your mind is to meditate. Meditation is a proven relaxation method where you can let your mind rest. You don't have to change the thoughts in your brain. Allow your mind to flow freely; let the feelings be there. There's no pressure to do or act. Releasing your mind will allow your thoughts to slow down, and you will find yourself drifting off to sleep. Another thing you can try is writing in a journal before bed. That way, you can get the thoughts out of your mind and on paper. It will make for a more restful sleep. You can discuss relaxation techniques with your therapist, and see which ones work for you.

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