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Reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
It’s an experience just about everyone has had — after switching off the lights and tucking into bed, our mind races through one worry after another, making it nearly impossible to relax and drift off to sleep.
When anxiety occurs at night, it can be a serious annoyance that takes its toll on your ability to sleep, as well as your ability to focus the next day.
A range of factors can cause or contribute to nighttime anxiety, from worries about your health, life or the coming day to things like your daytime caffeine consumption.
Just like other types of anxiety, nighttime anxiety is treatable with the right combination of good habits, therapy and, if required, anti-anxiety medication.
Below, we’ve explained why anxiety often occurs at night, as well as the specific symptoms you may experience if you’re prone to nighttime anxiety.
We’ve also shared practical, science-based treatments that you can use to take control of your thoughts and prevent night anxiety/ anxiety dreams from interfering with your sleep and quality of life.
A range of factors may cause or contribute to anxiety, including genetic factors, levels of certain chemicals in your brain, stress and your environment.
Researchers believe that certain traits and events may increase your risk of developing anxiety at some point in life. Common risk factors for anxiety include:
Exposure to stressful or negative events during your early childhood or adulthood
Certain childhood personality traits, such as shyness or inhibition
A family history of anxiety or other mental illnesses
Physical health issues, such as heart arrhythmias or thyroid problems
Unlike generalized anxiety disorder, panic disorder and other types of anxiety, feeling anxious at night isn’t recognized by the medical community as a specific class of anxiety.
With this said, several factors may make you feel more anxious at night, or make your anxiety symptoms more noticeable. These may include:
Fears or concerns about the upcoming day, such as worries about your schedule, an important event or a demanding workload.
Worries about not being able to fall asleep, or the effects that lack of sleep might have on your health and physical function the next day.
Caffeine consumption during the day, particularly if you’ve consumed a lot of caffeine during the afternoon or evening.
Health anxiety (also referred to as hypochondria, a type of obsessive concern about suffering from a medical condition).
Some anxiety disorders, such as post-traumatic stress disorder (PTSD), are closely associated with nighttime anxiety and insomnia.
Anxiety may cause you to experience a variety of symptoms, including:
Feelings of restlessness, or that you’re constantly on-edge
Worries and concerns that are difficult to control
Difficulty concentrating and a feeling that your mind is blank
Sleep problems, including insomnia and/or poor-quality sleep
Irritability, annoyance and fatigue
When anxiety occurs at night, it can have a serious impact on your ability to fall asleep and stay asleep.
You may find yourself worrying about certain things in bed, or that your mind races from one thought to another.
Some forms of night anxiety may cause nocturnal panic attacks — sudden, unexpected attacks that involve fear, trembling, heart palpitations, sweating and other symptoms.
When nighttime anxiety begins to interfere with your sleep, it can cause or contribute to chronic insomnia. This may cause the following symptoms:
Lying awake in bed without being able to sleep
Only falling asleep for short periods of time
Feeling like you haven’t slept during the night
Waking up at an unusually early time
When anxiety-related insomnia is severe, it can cause you to feel tired during the daytime. You may find it difficult to pay attention to specific things, remember information or find that you feel depressed or easily annoyed.
Over the long term, failing to get enough sleep can increase your risk of developing issues such as heart disease, high blood pressure, type 2 diabetes, kidney disease and obesity.
Whether it occurs during the day, at night or in only specific settings, anxiety is treatable, either through the use of medication, therapy, changes to your habits and lifestyle or a combination of different approaches.
Treating anxiety can take time. Based on your symptoms and needs, your healthcare provider may suggest one or several methods to help you treat your nighttime anxiety.
Several medications are available to treat anxiety. Your healthcare provider may suggest using medication if you have anxiety symptoms that interfere with your ability to sleep or have a large impact on your quality of life.
Common medications for anxiety include benzodiazepines, which are often used as short-term anxiety treatments, and antidepressants, which are typically used as long-term treatments.
In some cases, your healthcare provider may suggest using beta-blockers to treat the physical symptoms of anxiety.
These medications, which are typically used to treat high blood pressure, can be used as-needed to treat anxiety when it develops.
Our full guide to anxiety medications goes into more detail about how these medications work, their effects, side effects and more.
Almost all anxiety disorders improve through psychotherapy, either on its own or in combination with medication.
As part of therapy, you’ll work with a mental health professional to identify the specific thoughts and distortions that are causing you to feel anxious.
You’ll also learn techniques for challenging these thoughts and improving the way you deal with anxiety.
Several different forms of psychotherapy are used to treat anxiety, including cognitive behavioral therapy (CBT) and exposure therapy.
Our guide to therapy for anxiety goes into more detail about how therapy can fit into an anxiety treatment plan.
Caffeine is a handy natural stimulant that has numerous benefits, from reducing tiredness early in the morning to improving certain aspects of your mental function.
However, because of its approximately five-hour half-life, the effects of caffeine can stick around for hours after you drink a cup of coffee, energy drink or other caffeinated beverage.
In a study published in the Journal of Clinical Sleep Medicine, researchers found that a 400mg dose of caffeine (the equivalent of two to three energy drinks) produced a noticeable reduction in sleep even when it was taken six hours before bedtime.
While this is a large dose of caffeine, the findings of the study are clear — caffeine stays in your body for a long period of time, and it’s a major sleep disrupter.
If you’re a coffee drinker, there’s no need to avoid caffeine completely. However, for good sleep, it’s best to limit your caffeine intake and avoid drinking caffeinated beverages in the afternoon or evening.
Using your phone, computer or other electronic devices at night can worsen anxiety and delay sleep in several ways.
First, scrolling through news or social media on your phone keeps your brain stimulated, which can make relaxing more difficult.
Second, the blue light that’s emitted from many devices can affect your circadian rhythm, preventing you from feeling tired.
For less anxiety and better sleep, try switching your phone to silent mode and living a tech-free life for at least an hour before you go to sleep.
Not only will you have less on your mind as you get into bed, but you’ll also have more time for relaxing, pre-sleep activities such as reading a book, taking a warm bath or listening to relaxing, peaceful music.
Simple changes to your habits can make dealing with nighttime anxiety and falling asleep much easier. Try the following steps to relax, unwind and improve your sleep:
Drink a cup of sleep-friendly tea. If you find it difficult to fall asleep, drinking a cup of caffeine-free tea may help.
Prepare for the next day early. It’s easy to worry about what you’ll do after you wake up. To reduce uncertainty, try writing down your priorities for the next day, setting your alarm clock and taking other steps to establish the next day before you sleep.
Maintain a consistent sleep routine. Simple things such as setting a regular bedtime and waking up at the time each morning may help you to reduce nighttime anxiety and fall asleep easier.
Switch sleeping positions. Currently, there’s no research on how sleeping positions affect anxiety. However, you may find that a certain position offers better comfort and allows you to fall asleep easier than others.
Try to exercise every day. Exercise reduces your production of stress hormones that can fuel anxiety and keep you awake. It also stimulates the release of endorphins that reduce tension and promote relaxation. For optimal results, try to meet the Physical Activity Guidelines for Americans by getting at least 150 minutes of moderate-intensity aerobic exercise (for example, light jogging or cycling in your neighborhood) and at least two muscle-building workouts per week.
Try meditating. Research suggests that meditation and mindfulness can help to reduce anxiety and depression. If you’re prone to late-night anxiety, try to meditate before you go to sleep to improve relaxation and produce a sense of calm.
From fears about tomorrow to worries about your health or ability to fall asleep, a large variety of different things can cause you to experience nighttime anxiety.
Anxiety at night can take a major toll on your mental and physical well-being, making it important to seek out treatment if you’re struggling to enjoy restful nights.
If you’re worried that you may have an anxiety disorder, you can connect with a licensed mental health provider using our anxiety treatment online service.
You can also learn more about treating anxiety, including anxiety that occurs during the evening or night, in our full guide to how to calm anxiety.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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