How to Calm Nighttime Anxiety When You’re Trying to Sleep

Anxiety and trouble with sleep go hand in hand. Indeed, one of the most stressful experiences is lying awake, night after night, struggling to fall or stay asleep. For many people, trouble with sleep is both the cause and consequence of nighttime anxiety. Feeling anxious makes it harder to fall asleep. However, we all know the importance of getting enough sleep. So not falling asleep can make us even more anxious. In some people it can even trigger panic attacks. 

Insomnia and sleep problems are very common. In fact, it’s estimated that 1/3 of adults in the U.S. get less than the recommended 7-9 hours of sleep a night. About 30% of adults also struggle to fall or stay asleep. Consequently, if you struggle to get a good night’s sleep, you’re not alone. However, it can certainly feel like you’re alone when you’re tossing, turning, and then battling sleep deprivation the next day.

In this post, I’ll talk about the relationship between sleep and nighttime anxiety. I’ll discuss nocturnal panic attacks and night terrors. And I’ll close by discussing short-term and long-term strategies you can take to improve your sleep. It’s important to note, however, that I am not a medical professional. If you are struggling with insomnia or other health problems, seek professional help from a healthcare provider.

Experiencing Nighttime Anxiety

I’ve struggled with nighttime anxiety for many years. There are usually a couple of times each year where I cannot fall asleep until 4am for days at a time. The initial cause is often a change to my routine or racing thoughts. However, the sleepless nights tend to persist because of anxiety. I hate these periods of sleeplessness. So I get very anxious about them returning. As soon as I have a sleepless night, I become anxious that it will happen again. This, of course, just makes sleep less likely. 

Usually after a few days to a week, I find something to snap me out of it. I go over the strategies I’ve used below. However, many people struggle with anxiety and sleep for a very long time. Breaking that cycle can be especially difficult, though certainly not impossible. 

Nighttime Anxiety and Sleeping 

Anxiety disorders are the most common mental health conditions in the U.S. Indeed, over 19% of U.S. adults have some kind of anxiety disorder. Common emotional symptoms of anxiety include irritability, feelings of dread, restlessness, fear and a sense of danger. Anxiety can also come with physical symptoms like a racing heart, heart palpitations, chest pain, increasing blood pressure, sweating, twitching, stomach upset, headaches, and, what we’re here to talk about, sleep issues.

There are many potential causes of anxiety disorders, from experiencing a traumatic event to genetic predispositions to health conditions like thyroid problems. We can also experience anxiety without having a diagnosed anxiety disorder. Anxiety tends to become diagnosable once you experience it regularly and/or it interferes with your daily activities. 

However, one of the tricky parts about the relationship between sleep and anxiety is that anxiety can cause lack of sleep. Lack of sleep can also increase anxiety. As a result, the relationship between sleep and anxiety can become a vicious cycle. What may have started as occasional anxiety can become persistent and affect your daily life.

You might have anxious thoughts around an upcoming work presentation. This could cause you to get a lack of sleep. Your lack of sleep could lead to irritability and more stress, making you now sleepless because of your work presentation and stress about sleeping, and so on. Sleep anxiety highlights the importance of having tools to manage anxiety. I’ll get to those below.

What Are Nocturnal Panic Attacks?

Before diving into those tools, I want to discuss a couple of other ways that anxiety can manifest in our sleep. One of those is through nighttime panic attacks. Almost 5% of the U.S. population experiences a panic disorder at some point. Individuals with a panic disorder experience episodes of intense fear that frequently overwhelms their nervous system. 

Common symptoms of a panic episode include heart palpitations, an elevated heart rate, chest pain, sweating, shortness of breath, dizziness and nausea or stomach upset. They’re similar to the symptoms mentioned above for anxiety. However, they are generally experienced more intensely. Plus, an anxiety attack may be brought on by a stressful event, but it doesn’t have to be. 

We’re generally more familiar with daytime panic attacks. If you watched Ted Lasso, for example, he experienced panic attacks in the latest season. However, panic attacks can also happen when we’re lying awake at night. These nocturnal attacks might be brought on by anxiety around sleeplessness or racing thoughts or there might not be a trigger. Either way, they often lead to more sleeplessness as it can take a long time for our nervous system to calm down.

Plus, the “Mind After Midnight” hypothesis argues that we are not as good at regulating our emotions when we’re up late. While it’s early days in this research, there’s some evidence to suggest that our brains are not as well equipped to be rational in the middle of the night, which probably resonates with many of us. All of this means that it can be especially hard to manage our emotions, including after a panic attack, when it’s the middle of the night.

What Are Night Terrors?

Another way that anxiety manifests with sleep is through night terrors. Night terrors aren’t just any old nightmare. When people experience night terrors, they may scream, shout, thrash, jerk, or sit up. Night terrors are sometimes considered a form of sleepwalking because they usually involve movement while asleep. 

Night terrors can happen after stressful situations. There are lots of theories about why we dream. However, the most well-supported theory is that our brain is trying to process memories from our day. This is potentially why, if you’ve spent all day worrying about an upcoming presentation, you have a dream that you’re late to it or worse… show up with no pants. Usually I can trace back most of the weird elements of my dreams to something I did, watched, or thought about during the day. 

Consequently, if you’re under a lot of stress or experience a frightening event during your day (or even while watching TV), it could lead to a night terror. Unsurprisingly, waking up from a night terror is a jarring event. Night terrors can also lead to many of the symptoms of anxiety and panic attacks mentioned above. So falling asleep after a night terror is often easier said than done.

Short-Term Strategies to Combat Nighttime Anxiety

As illustrated above, there are many ways that sleep and anxiety can interact and make each other worse. So what do you do when you’re in an anxiety spiral? Unfortunately, there are no silver bullets. However, there are a large number of strategies you can try in the short-term if you’re in the midst of anxious feelings to help process them and regulate your nervous system so it’s easier to relax and fall asleep.

Even more powerful, there are strategies you can use in the long-term to help prevent anxiety and lessen its effects when you do experience them. I’ll get to those in the next section.

Progressive Muscle Relaxation

To help calm you down in the present moment, a helpful strategy is to use progressive muscle relaxation. With this technique, you focus on relaxing each body part one at a time, starting with the feet and moving up or starting with the head and moving down. Some people find it helpful to tense that body part and then relax it. Doing so can help signal to your body what it feels like to relax.

5, 4, 3, 2, 1 Techinque for Nighttime Anxiety

Another strategy to calm your nervous system is the 5, 4, 3, 2, 1 technique. With this, you notice 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. You could order the senses differently if you prefer. However, the key is that you are bringing your attention to the present moment and so interrupting an anxious thought spiral. Tuning into your senses can also be very calming.

Meditation and White Noise for Nighttime Anxiety

Additionally, you might use a meditation app or white noise machine to help calm anxious thoughts. I love using the Calm app. I use their nighttime meditations frequently. They also have relaxing soundscapes you can listen to. My favorite is the nighttime thunderstorm soundscape.

Relaxing Imagery for Nighttime Anxiety

One of my other favorite relaxation techniques is to use relaxing imagery. It may sound silly, but my favorite technique is to imagine petting a dog of a specific kind of breed. I’ll then imagine petting a dog of a different kind of breed, and so on. It’s like counting sheep… but better. You might imagine cuddling with your pets, lying on a beach, or floating in the water, anything that feels relaxing.

Another technique I have used recently, to great success, is “boxing up” my persistent thoughts. For example, recently I was ruminating on a lecture I gave. The lecture was a positive experience, but I kept thinking about things I could say in my next lecture. 

I zoomed out and imagined that the classroom I was envisioning was a picture. In my imagination, I folded that picture up, put it in a box, wrapped the box up, wound a ribbon around it, and set it aside mentally to “open” and think about tomorrow. It sounds cheesy, but the visualization was very successful for allowing me to move past persistent thoughts.

Similarly, you might listen to or tell yourself a sleep story. A sleep story is a relaxing story, much like the Goodnight Moon books of our childhood.

Get Up and Do Something Else

Finally, sometimes the best answer for relaxation is to get up and do something else. Indeed, sleep experts argue that you should get up if you’ve been lying awake in bed for 20-30 minutes. If you wait longer, you may start associating your bed with anxiety and wakefulness, which is not good for sleep. So get up, do some light stretching, read a book, journal, write out your to-do list that’s swirling around your head, anything that’s calming and quiet. 

Avoid using screens or turning on lots of lights. Exposure to blue light can signal to your brain that it’s the morning and time to wake up, the opposite of what you want.

Long-Term Strategies to Combat Nighttime Anxiety

Each of the strategies above can be used as a good first step when you notice periods of sleeplessness and anxiety. However, in the long term, you ideally want to cultivate good sleep hygiene so that you can avoid those periods of wakefulness in the first place. 

Luckily there are a number of lifestyle changes you can make that promote good sleep hygiene and can reduce stress and anxiety. While they often take time to make a difference in your sleep and anxiety, they are tools that are often very powerful in the long run.

Develop a Sleep Ritual

A sleep ritual helps relax you into the evening. You might read for an hour before bed, put away devices, do a meditation, practice yoga, or anything else that’s relaxing. Establishing a consistent routine will make it so that your body increasingly recognizes when it’s time to wind down for bed.

Maintain a Consistent Sleep Schedule

Similarly, researchers find that it’s much easier to fall asleep if we maintain a consistent sleep schedule. That means we go to bed and wake up at similar times each day. Even if you have a bad night of sleep, strive to maintain your normal waking hours so as not to throw your schedule off. We also get the most out of our hours of sleep if we maintain a consistent schedule.

Limit Caffeine and Alcohol to Prevent Nighttime Anxiety

Moreover, poor sleep can be the result of too much caffeine or alcohol. Make sure to limit your intake to moderate amounts. Even just drinking to the point of light tipsiness can lead to way worse sleep quality. You may also find that limiting your caffeine consumption to the morning helps. 

Reduce Distractions

Similarly, too many distractions in our sleep environment and daily life can negatively impact sleep. In terms of your sleep environment, you might invest in blackout curtains, ear plugs, eye masks, or anything else to reduce light and noise distractions.

Plus, racing thoughts can result from too many distractions in your daily life. You might find it helpful to time block your work day and even leisure hours so that you focus your attention on one thing at a time for at least part of the day. Also, silencing or putting away your phone and closing out of your email applications until a specified time of day can reduce the constant distraction noise we’re exposed to all day.

With fewer distractions, many people find it easier to be productive and calm their minds.

Develop a Meditation and/or Journaling Practice

Meditation and journaling are both incredible tools for managing stress. Researchers find that meditation is associated with improved sleep quality. Others have found that meditation reduces instances of insomina and lowers the risk of depression.

Journaling can also help people fall asleep. However, researchers find that the benefits are greatest if you spend a few minutes writing a to-do list for the next day rather than going over what you did during your day.

Plus, journaling your worries can help put them in perspective. Often, journalers find that their anxious thoughts are soothed after writing them down. And research backs that up.

Meditation and journaling can have immediate benefits for your mental health. However, the bigger effects may take longer to manifest. If you can keep up with a semi-regular practice over weeks or even months, you may notice that you have fewer sleepless nights over time.

Seek Therapy to Address Nighttime Anxiety

Additionally, many people find therapy extremely useful for helping with stress, anxiety, and sleep issues. In particular, cognitive behavioral therapy is a form of therapy where individuals work with their therapists to come up with more positive ways of responding to problems. CBT has been found to be as effective at treating anxiety and depression as other forms of therapy and some medications.

Consequently, seeking therapy like cognitive-behavioral therapy can help people with nighttime anxiety better handle anxious thoughts.

Receive Medical Treatment for Persistent Nighttime Anxiety

If your sleep issues are persistent, it’s important to explore treatment options with your primary care doctor. A medical professional can help evaluate you for potential medical conditions that may be affecting your sleep, like sleep apnea. 

Plus, in some cases you may find that prescription medications or supplements like melatonin are necessary for sleep and/or anxiety. Indeed, the right treatment options can help you get your circadian rhythm back on track. You may find a treatment option that you pursue just in the short term or in the long term. Either way, they can make a big difference for your sleep and quality of life. Consequently, I highly encourage you to seek the advice of a professional if your sleep issues are persistent.

Final Thoughts on Nighttime Anxiety

Anxiety and sleep loss frequently go hand in hand. Whether we’re experiencing racing thoughts, unease, panic attacks, or night terrors, it’s hard to fall into a deep sleep when we’re anxious. And the less sleep we get, the more anxious we’re likely to feel. 

However, I find that it helps me to remember I am not alone when I am struggling to fall asleep. Anxiety and difficulty sleeping are very common. When you experience anxiety while sleeping, there are a number of tactics you can take to calm your nervous system in the moment. In the long term, you may also find it helpful to adopt strategies that improve your sleep hygiene.

I hope you found this article helpful. If you did, please consider liking, subscribing, or sharing with others. It’s always a big help! Interested in related content? Check out my posts on tips for sleeping (with free sleep journal!), how to set boundaries, the relationship between mental health and eating disorders, and more in the health section of this blog.