Do I Have Sleep Anxiety?

Sleep anxiety involves fear or worries about being able to fall or stay asleep. Such worry can then interfere with a person’s ability to get adequate rest.

Sleep anxiety is complex, and people may experience it in various ways. It can make falling asleep harder or make staying asleep more challenging. It can also lead to feelings of anxiety about whether you’ll be able to get the sleep you need.

While people are aware of the importance of sleep, they are also conscious of the fact that they often don’t get the recommended amount of rest. For some, just the thought of climbing into bed each night can be anxiety-provoking. Where many people nod off quickly and easily, others find themselves tossing and turning as thoughts race through their minds and the pressure builds to catch a few elusive Zzzzs as the hours tick past.

This article explores the signs of sleep anxiety and the impact it can have on your life and health. It also discusses the causes and potential treatments for sleep anxiety.

Symptoms of Sleep Anxiety

While some may find going to sleep an easy and natural process, those with sleep anxiety often see it with fear and apprehension. Symptoms that people with sleep anxiety often experience include:

• Fretting about tasks that need to be completed the next day
• Worrying about things they didn’t get done the day before
• Stressing about whether they will be able to fall asleep
• Repeatedly checking the time and feeling distressed by how long it is taking to fall asleep
• Ruminating about why they cannot sleep
• Feeling fearful about going to bed and not being able to sleep

Identifying Sleep Anxiety

If you are struggling with persistent feelings of anxiety and difficulty sleeping, it is important to discuss your symptoms with your doctor. Anxiety can be serious and can grow worse over time.2 Sleep deprivation can also take a significant toll on your mind and body.

To make a diagnosis, your doctor will ask questions about the symptoms you have been experiencing. Be open and honest about your struggles with sleep and the effect it is having on your ability to function in your daily life.

Your doctor will also want to know more about how long your symptoms have occurred, your medical history, and any other medications or supplements you are currently taking.

Certain medications or supplements may contribute to anxiety symptoms or sleep disturbances. Your doctor may also perform a physical exam and conduct lab tests to rule out any medical conditions that might be causing your symptoms.

Why Do I Get Anxiety When I Try to Sleep?

In many cases, sleep anxiety represents a form of performance anxiety. Performance anxiety is a type of anxiety focused on a person’s ability to perform a certain task. While we often associate this type of anxiety with worries about public speaking, athletic performance, or test-taking, it can also emerge when you’re anxious about being able to do what seems to come so naturally to other people. In the case of sleep anxiety, this fear centers on your ability to “perform” sleep.

When you find it difficult to fall asleep, it means you also have more time to focus on your fears and worries. As you lie awake, free from the usual daytime distractions, your mind may drift toward rumination and worry, including fretting over the fact that you’re not sleeping. Unfortunately, these concerns then make it even more difficult to drift off.

This nightly battle can then lead to what is known as anticipatory anxiety, or feeling anxious about things that haven’t happened yet. You might find yourself dreading going to bed each night. Over time, this not only contributes to sleep deprivation but can also play a part in the development of worsening anxiety.

Risk Factors for Sleep Anxiety

Sleep anxiety is sometimes connected to different types of mental health conditions. People who experience these conditions are sometimes more likely to struggle with sleep, which can increase their risk of developing sleep anxiety.

• Generalized anxiety disorder: This condition is marked by persistent fears about a variety of activities or topics. Such worries are excessive and persistent and affect a person’s ability to function normally. These worries can sometimes center on sleep.
• Insomnia: This type of sleep disorder makes it more difficult to fall or stay asleep and impacts overall sleep quality. Insomnia can contribute to health problems, including anxiety, depression, and cardiovascular disease, affecting around 10% to 30% of people worldwide.4
• Panic disorder: This is a condition characterized by recurrent, intense, and sudden panic attacks. In some cases, people may experience nocturnal panic attacks, a type of sleep anxiety that can cause people to wake up due to symptoms of a panic attack.
• Post-traumatic stress disorder: Trauma can also contribute to sleep disturbances. Research suggests that people who have PTSD are very likely to experience recurrent nightmares that interfere with their ability to sleep.5 Fear of having a nightmare while asleep can also contribute to sleep anxiety.
• Other sleep disorders: Having another type of sleep disorder can also contribute to symptoms of sleep anxiety. Other types of sleep disorders that can contribute to anxiety include restless legs syndrome (RLS), sleep apnea, and narcolepsy.6

Treatment for Sleep Anxiety

While sleep anxiety can be understandably upsetting and disruptive, there are effective treatments that can help. The right approach for you depends on what is causing your symptoms, but will often involve interventions aimed at reducing anxiety and insomnia.

Anxiety Treatments

Psychotherapy is the first-line treatment for anxiety. Cognitive-behavioral therapy (CBT) and exposure therapy are two types that can be particularly effective.

However, certain medications may also be prescribed to help manage both acute and long-term anxiety. Benzodiazepines are sometimes prescribed to manage immediate symptoms of anxiety, while antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can be a longer-term treatment.

Sleep Treatments

In addition to addressing underlying conditions that may contribute to anxiety, treatments for insomnia often focus on psychotherapy and lifestyle modifications. Cognitive-behavioral therapy for insomnia (CBT-I) focuses on adjusting thoughts to promote sleep, practicing relaxation strategies, and using other strategies to improve sleep.

Medications are sometimes prescribed to treat insomnia and may include prescription sleeping pills, OTC sleeping pills, melatonin, and natural remedies. While these medications can help people get more sleep in the short term, they can have side effects and don’t address the underlying factors that are contributing to sleep anxiety.

How Do I Overcome Sleep Anxiety?

While sleep anxiety is distressing, making certain lifestyle changes and utilizing effective sleep strategies can help you feel less anxious and better rested.

Practice Good Sleep Habits

Tweaking your sleep habits can significantly improve sleep, which may help you to feel less anxious about falling and staying asleep. Helpful strategies include:

• Avoiding daytime naps
• Creating a comfortable sleep environment
• Going to bed at the same time each night and waking at the same time each morning
• Remove electronic devices from the bedroom and avoid using your phone or tablet for an hour before bedtime
• Avoid large meals, excessive caffeine, and alcohol in the evening

Stay Physically Active

Regular exercise can help improve sleep and combat feelings of anxiety. One study found exercise can help improve sleep quality.7

Research has also shown that exercise can be helpful in reducing symptoms of anxiety. Not only can it relieve symptoms of anxiety, but it may also be protective against future anxiety.8

Utilize Relaxation Techniques

Relaxation techniques can help combat stress and take some of the pressure off you might be putting on yourself each night. Strategies that can be helpful include:

• Deep breathing: Improper breathing, such as taking shallow, rapid breaths, can often make anxiety worse. Deep breathing techniques can help induce a relaxation response that will relieve anxiety, improve relaxation, and make it easier to get a good night’s rest.9
• Progressive muscle relation: This technique involves tensing and then relaxing muscles of the body, typically starting at the top of the body and moving down. By practicing this technique, you can learn how to rapidly induce a wave of relaxation that passes through the body. It can give you greater control over your body’s response to anxiety, and research has shown that it can also help improve sleep quality.10
• Guided imagery: When you find yourself lying awake and worrying, using guided imagery may help ease feelings of anxiety and help induce sleep. This approach involves using visualizing techniques, such as picturing a restful scene, to help calm your mind and body. Research suggests that the use of guided imagery may help improve sleep quality.11

A Word From Verywell

Sleep and anxiety have a bidirectional relationship. Anxiety can make it difficult to sleep, but poor sleep can also lead to increased feelings of anxiety.

When you find yourself getting anxious and stressed, remember that it may take time to get your sleep back on track. Celebrate the small victories, focus on establishing healthy sleep habits, and turn to effective relaxation techniques when you find yourself struggling.