Many people feel more anxious at night. Your options for managing nighttime anxiety include relaxation techniques, lifestyle changes, medication, and talk therapy.
As you lie in bed trying to sleep, you may find yourself feeling anxious. For many, the quiet period before sleep allows for racing thoughts and amplifies the worries of the day.
It is common to feel slightly anxious at night from time to time. However, some people may feel anxious at night regularly or find that anxiety gets in the way of their sleep.
Experiencing high levels of anxiety at night may be a sign of an anxiety disorder. Anxiety disorders are mental health conditions that people usually treat with a combination of medication, lifestyle changes, and talk therapy.
What causes anxiety at night?
Anxiety describes a state of being hyper-alert to perceived threats. At night, when the room is dark and quiet, your brain and body can be even more alert to these perceptions. You may notice worries about intruders or noises that you can hear. The stillness of the night may cause you to worry about your to-do list and things that may not go to plan in the days ahead.
expecting the worst to happen and looking out for danger or threats
feeling dread
a racing or pounding heart
shortness of breath
headaches, tiredness, or difficulty sleeping
an upset tummy, frequent urination, or diarrhea
twitches, tremors, and sweating
You may notice some of these symptoms if you’re feeling anxious at night.
Some people may also experience nocturnal panic attacks. Research from 2022 suggests that the majority of people with panic disorder have panic attacks at night. NAMI notes that panic attacks — including those that happen at night — can cause:
dizziness
chest pain
shortness of breath
heart palpitations
sudden feelings of terror
How anxiety can affect sleep
Research from 2022 suggests that sleep problems affect around 50% of people with anxiety. Nighttime anxiety can make it more difficult to get a good night’s sleep. Anxiety causes your body to go into a stress mode where it releases stress hormones like cortisol. This stress mode may prevent you from sleeping or getting good-quality sleep.
Nighttime anxiety can affect your sleep negatively. However, 2021 research suggests that sleep deprivation can also increase anxiety levels. This can create a problematic cycle if you have nighttime anxiety. Your anxiety may be getting in the way of your sleep but sleep deprivation may then worsen your anxiety.
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There are lots of treatment options available to help with nighttime anxiety.
Your doctor may suggest medications, including:
selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft) and fluoxetine (Prozac)
serotonin norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor)
benzodiazepines like lorazepam (Ativan), which are usually short-term options
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Natural remedies for anxiety at night
Optimizing your sleep and lifestyle can also help you improve anxiety at night. According to the National Sleep Foundation, you can improve your sleep and your mental health by:
getting regular exercise
eating meals at regular times every day
spending some time in natural light during the day
avoiding nicotine, caffeine, alcohol, and heavy meals close to bedtime
creating a routine to relax and wind down at the end of the day
putting devices away at least an hour before bedtime and sleeping in a cool, dark, and quiet room
Talk therapy can also help you manage and improve anxiety symptoms. A form of therapy called cognitive behavioral therapy for insomnia (CBT-I) aims to help you improve your sleep and anxious thoughts at night.
listening to some hypnosis or a hypnotherapy recording
relaxation techniques, such as breathing exercises or progressive muscle relaxation
meditation
listening to music
Contacting a doctor
Even though it is natural for us all to feel anxious sometimes, contact your doctor if you’re experiencing anxiety at night regularly or if it is affecting your sleep quality.
Anxiety is treatable. A doctor can help you put a plan in place to help manage your anxiety and get a good night’s sleep again.
Summary
Most people will experience anxiety at night sometimes. However, if it is stopping you from sleeping well or affecting your quality of life, there are things you can do to manage nighttime anxiety.
Your doctor may suggest taking medication or seeking talk therapy. Making some lifestyle changes like getting regular exercise can also help improve your sleep and mental well-being.