What Causes Anxiety At Night And How To Deal With It

By: Jon Jaehnig

Updated June 17, 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. Less than half of those people get the help they need, but you can be part of that percentage.

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.

Types of Nocturnal Anxiety

It is important to note the distinction between normal 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 Normal Anxiety at Night

Knowing the difference between normal 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 normal anxiety, but remember you may not experience all of these to have normal anxiety.

  • 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.

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 psychiatrist. Once again, 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 healthcare provider.

  • 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 (even at night), 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 hand-washing, continuously checking that a place is locked for the night, etc.

As stated above, if you experience any or all of the above symptoms, 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 need to be careful of its harmful effects.

Why is this bad? Not getting adequate sleep can give rise to an array of health problems.

  • 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 maladaptive 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 Chi Qong. 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 probably better to toss and turn for a bit longer and stay asleep all night than to fall asleep sooner and wake up 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 proven 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. 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.

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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, adjacent 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 power 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."

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.

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.


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.

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