Skip to main content
Medically Approved

How to get rid of bad anxiety at night

twitter share buttonfacebook share buttonlinkedin share buttonemail article button
Anxiety symptomsCausesHow to prevent anxiety before bedTreatment options for anxietySummary
Anxiety is a common mental health condition that can cause several symptoms, such as difficulty falling asleep at night. This can often make anxiety worse.
Medically reviewed by Ifeanyi Olele, DO, MBA, MS
Updated on

Anxiety is a common mental health condition that can cause feelings of fear and overwhelm. For many people with anxiety, their symptoms may heighten at night or as they try to fall asleep. This can often result in poor sleep quality and not getting enough hours of sleep.

The Centers for Disease Control and Prevention (CDC) recommends adults get at least 7 hours of sleep a day.

A 2021 study found that people with anxiety often find it more difficult to fall asleep. This can cause you to experience more anxiety the next day, creating a cycle. This is why it’s important to learn how to manage anxiety before bed so you can set yourself up for the best day ahead.

What anxiety symptoms might you experience at night?

Female laying down on her at night and in an anxious state.
Maskot/Getty Images

If you experience anxiety at night, this may show up in different ways but is most commonly characterized by restlessness, worrisome thoughts, and trouble falling and staying asleep.

You may also experience physical symptoms, such as:

  • rapid heartbeat
  • dizziness
  • shortness of breath
  • gastrointestinal problems

Anxiety can sometimes prompt a panic attack, characterized by intense feelings of worry and physical symptoms such as chest pain, sweating, and dizziness. When a panic attack occurs at night, this is known as a nocturnal panic attack, where symptoms intensify and can make it difficult to fall asleep.

It is important to speak with the doctor if persistent nocturnal panic attacks occur, as this can lead to insomnia, which may also result in depression, high blood pressure, and a weakened immune system.

Man on phone in bed

100% online care

Treatment plans in 15 minutes or less for 40+ conditions.

Start consult now


What causes anxiety is not entirely known. The National Library of Medicine mentions risk factors, including the following:

  • traumatic events in early childhood or adulthood
  • family history of anxiety or mental health conditions
  • physical health issues, such as arrhythmia

The causes of nighttime anxiety may not be markedly different from daytime anxiety, but it may be harder to manage. As there are fewer distractions from worrisome thoughts at night, you may find it difficult to keep them at bay. 

You may focus so intently on a negative experience from the day or an item on your to-do list that you are unable to sleep. Worrying about your lack of sleep can also cause a spike in adrenaline. The increased presence of this stress hormone in the body can make it even more difficult to wind down for sleep. 

How to prevent anxiety before bed

Certain lifestyle strategies can help improve your anxiety at night. Experts at Harvard Medical School say maintaining good sleep hygiene is essential for those experiencing nighttime anxiety. 

The following measures may help:

  • Maintaining a good sleep schedule: This includes going to bed at roughly the same time every night, including on weekends.
  • Getting enough sunlight: It can be important to ensure you are getting enough sunlight during the day to help establish your circadian rhythm.
  • Physical exercise: Studies show that exercising during the day can also improve sleep and mood. 
  • Avoiding alcohol and caffeine: Avoiding caffeine, especially within 2 hours of going to bed, is recommended for good sleep hygiene. Alcohol can also greatly affect sleep, so you may want to avoid this in the hours before bed.
  • Engaging in relaxing activities: To prepare your body for sleep, engaging in relaxing activities, such as reading or meditating may be helpful.
  • Getting out of bed if you can’t sleep: If you do wake up in the middle of the night, don’t lie in bed with your worrisome thoughts. Instead, get out of bed and find a quiet, relaxing activity to do until you feel sleepy.
Pill bottle with text 'Starts at $4'

Free prescription coupons

Seriously … free. Explore prices that beat the competition 70% of the time.

Get free card

Treatment options for anxiety

The main treatment methods for anxiety include psychotherapy, prescription medication, or a combination of both.

A 2015 study on the effectiveness of cognitive behavioral therapy (CBT) found it to be an effective treatment for anxiety and sleep issues. CBT breaks negative patterns by isolating overwhelming thoughts, feelings, and sensations and organizing them into smaller parts that are easier to manage.

Another method for treating anxiety is through taking prescription medication. Common examples include selective serotonin reuptake inhibitors (SSRIs), such as escitalopram (Lexapro) and sertraline (Zoloft).

A doctor may also prescribe serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor) and duloxetine (Cymbalta).

If you need help covering the cost of medications, the Optum Perks free Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.


Many people with anxiety may experience difficulty falling asleep at night. Consider speaking with a healthcare professional if you regularly experience anxiety before bed. They can work with you to create a suitable treatment plan and suggest any medication that may help.

Incorporating lifestyle strategies to improve your sleep hygiene, such as regular exercise and relaxation techniques, can also be beneficial.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

Article resources