Anxiety & Sleep: Can Lack of Sleep Cause Anxiety?

A variety of factors can contribute to anxiety, including your sleep patterns. In fact, research has shown that anxiety contributes to sleep issues, and sleep issues contribute to anxiety.

It can be a vicious cycle.

Some people also experience a specific form of anxiety called sleep anxiety, characterized by fear or a sense of doom about going to sleep.

Keep reading to learn about sleep anxiety and how anxiety can hinder your ability to fall asleep, stay asleep, or maintain normal sleep patterns. We’ll also look at symptoms you may experience if you have a clinical anxiety disorder, including insomnia anxiety.

Then, discover actionable tips and techniques for how to sleep with anxiety and how to prevent it from affecting your sleep and overall health.

Almost everyone has felt on edge after a poor night's sleep. Increasingly, researchers are discovering that insufficient sleep not only leads to short-term irritability but also heightens the risk of developing anxiety disorders in the long term.

Some research suggests that people with sleep issues such as insomnia may have an elevated risk of developing anxiety.

In addition, another study found that poor-quality sleep amplifies reactions in parts of the brain associated with anxiety, such as the amygdala and anterior insula.

These reactions were strongest in people with high levels of anxiety, suggesting that those who are already prone to anxiety may experience the most significant increase in symptoms if their sleep is affected.

Put simply, sleep deprivation doesn’t just affect your mood; it appears to cause physical brain reactions that can trigger anxiety.

Though not a diagnosable disorder like social anxiety or generalized anxiety disorder (GAD), sleep anxiety involves excessive worry about falling asleep or staying asleep throughout the night. Other symptoms include feeling anxious before bed or dreading nighttime during the day.

In short, anxiety frequently coexists with insomnia, although different anxiety disorders can impact sleep quality and behaviors in various ways.

There’s also a phobia called somniphobia, which is an extreme fear of all things sleep-related.

Common Anxiety Symptoms

Anxiety disorders can cause a range of symptoms, from excessive worrying to changes in your ability to concentrate on specific tasks.

Sleep anxiety symptoms can be similar to symptoms of general anxiety disorder (GAD), one of the most common anxiety disorders, but they usually occur around bedtime or revolve around sleep. Common GAD symptoms can include:

• Feeling like you’re on edge, agitated, and restless

• Difficulty focusing and a feeling that your mind is going blank

• Excessive, difficult-to-control feelings of worry

• Feeling fatigued easily and often

• Muscle tension and stiffness

• Irritability

Other anxiety disorders can present different symptoms. For example, people with panic disorder may experience extreme, abrupt moments of fear that occur unexpectedly, which are referred to as panic attacks. This can also manifest in nocturnal panic attacks that happen around bedtime or during sleep, causing sleep disruptions.

Obsessive-compulsive disorder (OCD) can lead to unwanted, uncontrollable thoughts that contribute to certain repetitive behaviors. Those symptoms can disrupt sleep, too.

As mentioned, the relationship between sleep and anxiety isn’t one-sided. Research not only links insufficient sleep to increased anxiety but also shows anxiety itself can disrupt healthy sleep habits and keep you awake.

One reason is that both stress and anxiety can cause imbalances in certain hormones and chemicals that affect sleep, disrupting normal sleep patterns.

If you’ve been diagnosed with an anxiety disorder, you may notice that your symptoms worsen when you struggle to maintain good sleep habits.

Below, we'll delve into the various risk factors for both sleep-related anxiety and sleep disorders so you can see how they interact.

Risk Factors for Sleep Anxiety

People are more likely to develop anxiety around bedtime and during the night if they have the following sleep disorders:

• Chronic insomnia. Symptoms of insomnia include lying awake for a long time after you get into bed, spending a large percentage of the night awake, being unable to sleep, and only being able to sleep for short periods before waking. You may also feel extra tired during the day.

• Sleep apnea. This breathing disorder causes you to stop and start breathing repeatedly during sleep. One of the main symptoms is snoring, and it’s also associated with an increased risk of panic disorder.

• Restless leg syndrome. This condition is characterized by an urge to move your legs and feet, especially at night. The symptoms can lead to anxiety.

• Sleepwalking. This is when someone gets up and does things while asleep or not fully awake. It may include other activities in addition to walking.

Meanwhile, some mental health disorders are also linked with some sleep disorders, including:

• Anxiety disorders. Conditions like GAD, panic disorder, and OCD can lead to a higher likelihood of sleep anxiety and disorders like insomnia. Anxiety is also associated with sleep reactivity, which is the degree to which people develop sleep disturbances in response to stress. This two-way relationship means that anxiety can worsen your sleep, which in turn may worsen your anxiety symptoms.

• Post-traumatic stress disorder (PTSD). This is a serious mental health condition that can develop in people who’ve experienced a traumatic event. A common symptom is recurring nightmares, which can disturb your sleep and wake you up.

• Mood disorders. Depression and bipolar disorder are both associated with sleep issues.

In addition to causing or worsening anxiety, sleep deprivation can have other adverse effects on your health. These include:

• Impaired memory and mental function. When you don’t get sufficient sleep, you may find it more difficult to think clearly, process complex information, and remember specific details.

• Lack of alertness and energy. Even a mild amount of sleep deprivation can affect your reaction time and level of alertness. You may also start to feel tired and less energetic during the day.

• An increased risk of chronic health problems. Research shows that sleep deprivation can increase blood pressure and heart rate, raising the risk of cardiovascular events like heart attack and stroke. Over the long term, lack of sleep may increase the risk of dealing with chronic health issues like diabetes.

• A higher risk of injuries and accidents. Sleep deprivation affects your alertness and concentration, increasing your risk of injuries and accidents.

• Quality of life. Lack of sleep can make you feel less inclined to spend time with your friends and family, exercise, or do other things that normally bring you pleasure and satisfaction.

There’s good news: Both anxiety and insomnia are treatable. Try the techniques and treatment options listed below to improve your sleep habits, control your anxiety, and improve your physical and mental health.

1. Ask Your Provider to Do a Sleep Study

If you think you may have a sleep disorder, ask your provider what’s involved in getting an official diagnosis. They may ask you to participate in a sleep study to help them determine the cause of your sleep disturbances and create a more tailored treatment plan.

2. Seek Treatment for Anxiety

You can often treat anxiety disorders with medication and psychotherapy, either alone or in combination.

Numerous studies show that cognitive behavior therapy for insomnia (CBT-I) — a form of talk therapy — may effectively treat insomnia in people who also have anxiety or depression.

Whether you explore this option or something else, you can seek help by discussing your symptoms with your primary care provider. They may refer you to a specialized mental health provider, like a psychiatrist or psychotherapist, for further treatment.

Your provider may also decide that you’re a good fit for anti-anxiety medications or antidepressants.

2. Use an Over-the-Counter Sleep Aid

Your body releases hormones, like melatonin, to make you feel sleepy. Melatonin is secreted by your pineal gland — a tiny, pea-shaped gland inside your brain — in response to darkness.

It helps synchronize your mind and body by regulating your circadian rhythm, an internal clock that controls feelings of alertness and tiredness on a 24-hour cycle.

Simply put, your circadian rhythm makes you tired around bedtime. But if you need an extra boost, you can try melatonin, which is available over the counter as a natural sleep aid.

Taking a melatonin supplement can be an easy, effective way to help your mind and body drift into restful slumber. Talk to your healthcare provider to find out if this might be a suitable option for you.

3. Try Sleep Medicine

If you have severe insomnia, your healthcare provider may prescribe medication to help you fall asleep faster and stay asleep throughout the night.

Several prescription sleeping pills can treat insomnia, including Lunesta^® (eszopiclone), Ambien^® (zolpidem), Silenor^® (doxepin), and others.

While these medications effectively promote sleep, they can also cause side effects. Research findings on their impact on rapid eye movement (REM) sleep and deep, slow-wave sleep are mixed.

If your healthcare provider prescribes any type of sleep medication, follow their instructions exactly.

4. Practice Good Sleep Hygiene

Sleep hygiene is a term for good sleep habits that can help you get a better night’s sleep.

The CDC recommends the following techniques to maintain good sleep hygiene:

• Stick to a consistent sleep schedule. Try to go to bed and wake up at the same time every day. This helps your body maintain a circadian rhythm and reduces your risk of lying awake at night.

• Stay physically active. Regular exercise can make it easier to relax and fall asleep at night. Research also shows that working out is a great way to relieve the symptoms of anxiety and depression.

• Limit your caffeine intake. Caffeine, a stimulant with a long half-life, can stay in your body for hours after you finish a cup of coffee. Aim to limit your caffeine intake near bedtime, or even try avoiding caffeine entirely after midday.

• Remove screens from your bedroom. Devices affect your sleep in multiple ways. They can keep your brain stimulated by bombarding you with content, and they emit a form of artificial blue light that can affect your natural sleep cycle.

• Keep your bedroom dark, quiet, and comfortable temperature-wise. A dark, quiet, and comfortable environment makes falling and staying asleep easier.

• Try relaxation techniques before bed. Mindfulness practices like deep breathing can help slow down any racing thoughts or lingering worries from the day.

• Avoid large meals or alcohol before bed. Although alcohol can make falling asleep easier, behavioral studies suggest that alcohol can contribute to sleep problems over the long term.

5. Aim for Seven to Nine Hours of Sleep per Night

According to the CDC, adults should get between seven and nine hours of sleep per night. If you usually sleep less than seven hours a night, try going to bed earlier or moving your wake-up time slightly later.

Whether you think you have sleep anxiety specifically or if your general anxiety symptoms are affecting your sleep at night, it can take a toll on your daily life.

Here’s what to remember about sleep and anxiety and how to take action:

• Research shows that poor sleep can increase anxiety levels, and higher anxiety levels can lead to poor sleep. Some mental health disorders are also linked with sleep disorders and vice versa.

• If you’re dealing with anxiety or sleep disturbances, it’s best to talk to a sleep specialist, a primary healthcare provider, or a mental health professional.

• Treatment and prevention options include over-the-counter supplements like melatonin, improved sleep hygiene, psychotherapy, and, if necessary, prescription sleep medicines or medications that address your anxiety.

With treatment, it’s possible to gain control over your anxiety and your sleep habits to improve your well-being and quality of life.

If you think you may have an anxiety disorder and want to explore medication options to manage symptoms, you can connect with a licensed psychiatry provider online using our psychiatric evaluation service.