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Why do I get anxiety at night?

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Updated on January 11, 2021

It’s not unusual to experience anxiety at night. For many people, getting to sleep and staying asleep is not easy.

In bed at night, your environment may be calm, but you may feel that your mind is racing and your thoughts can’t be stopped. Perhaps you’re thinking about your morning to-do list or maybe you’re focused on other worries about the day ahead.

This anxiety could keep you from getting enough sleep.

Anxiety and lack of sleep

There are documented links between anxiety and lack of quality sleep.

A 2013 study found that people prone to anxiety are very sensitive to the effects of lack of sleep, and that insufficient sleep can trigger symptoms of anxiety. And a 2019 study found that intolerance of uncertainty and anxiety sensitivity were both correlated with insomnia severity and poor sleep quality.

Additionally, if you’re unable to fall or stay asleep, you may start to worry that you won’t get enough sleep before it’s time to wake up. This can make falling asleep even more difficult and it may make you feel more anxious.

The symptoms of anxiety at night

No matter the time of day you experience anxiety, the symptoms are usually pretty similar. These can include:

  • A sense of impending doom, danger, or panic
  • Nervousness or irritability
  • Difficulty concentrating
  • An increased heart rate and rapid breathing
  • Sweating
  • Fatigue or weakness
  • Gastrointestinal problems

If anxiety is making it hard for you to sleep, you may also have symptoms of insomnia, such as:

  • Nonrestorative sleep (sleep that doesn’t leave you feeling refreshed)
  • Low energy
  • Difficulty concentrating
  • Irritability
  • Difficulty at work or school

Panic attack at night

A panic attack is a sudden surge of intense fear or discomfort that spikes within minutes. During this time, four or more of the following symptoms occur:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating, shaking, dizziness, or lightheadedness
  • Shortness of breath or feeling like you’re choking
  • Chest pain or discomfort
  • Nausea or stomach issues
  • Chills or heat sensations
  • Numbness or tingling sensations

In addition, you may experience:

  • Derealization (feelings of unreality) or depersonalization (being detached from yourself)
  • Fear of losing control or dying

If you deal with panic attacks, you may have them at night as well as during the day.

Although a nighttime panic attack typically lasts only a few minutes, it may take more time for you to settle down and get back to sleep.

Tell your doctor if you experience nighttime panic attacks. They may have suggestions to help you deal with panic attacks at night or strategies for getting back to sleep.

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Treating nighttime anxiety

If you’re dealing with anxiety at night, your doctor may recommend medication, cognitive behavioral therapy, or both.

To augment your doctor’s recommendation, experts at Harvard Medical School suggests there are ways to relieve anxiety at night and get more restorative sleep, such as:

  • Going to bed and getting up at the same time every day
  • Getting 30 minutes of sunshine a day
  • Exercising regularly — afternoons are best (do not exercise too close to bedtime)
  • Napping for no more than an hour each day and avoiding napping after 3 p.m.
  • Avoiding drinking or eating large amounts for several hours before bedtime
  • Avoiding alcohol and tobacco
  • Keeping your bedroom dark, quiet, and cool

In addition, the experts recommend:

  • Making sure you have a comfortable mattress
  • Removing distractions like TVs and computers from your bedroom
  • Developing a calming routine prior to bedtime, such as deep breathing exercises, listening to music, reading, or relaxing in a hot bath
  • Using your bed for sleep and sex only


Anxiety can keep you up at night. Having trouble falling or staying asleep can also cause anxiety. Each can make the other worse.

If you’ve already been diagnosed as having anxiety, tell your doctor about your sleep problems. If you’re having sleep problems but don’t know why, talk to your doctor about your symptoms.

Your doctor may suggest cognitive behavioral therapy, prescription medication, or both. They also may review other ways to improve your sleep by properly setting up your bedroom and developing a pre-bedtime routine.