If your anxiety keeps you up at night, you’re in good company. About half of people with anxiety disorders experience sleep problems, especially insomnia, or difficulty falling asleep and staying asleep.
Why that happens: “When you’re anxious, your body activates its stress response systems to prepare you to deal with the cause of the stress,” says Chester Wu, MD, a psychiatrist and sleep medicine physician in Houston and a medical reviewer for Everyday Health. This causes a spike in levels of cortisol (a stress hormone) in the body, which can lead to increased alertness, racing heart rate, and other symptoms that could keep you awake.
This can be especially problematic if it happens often. “Unfortunately, nighttime is rarely the time when we’re able to address our problems constructively,” says Dr. Wu. What’s more, sleep loss due to anxiety can lead to other health issues. When you lose sleep for any reason, you can experience symptoms like trouble learning and focusing, slow reaction times, emotional lability, and loss of productivity. Over time, sleep deprivation is linked to chronic health conditions like heart or kidney disease, diabetes, stroke, obesity, and depression.
To manage your anxiety and get better sleep, it helps to find ways to calm your mind and body both during the day and before bed. “It’s important to do things that relax you before bed, as well as avoid things that might (unwittingly) exacerbate pre-sleep anxiety and arousal,” Wu says.
These five tips can help you manage anxiety symptoms at bedtime and get better sleep in the long run.
If your anxiety is making it hard for you to fall asleep, tell your healthcare provider or a mental health professional about the symptoms you’re having, says Alice Feller, MD, a psychiatrist in Berkeley, California, and the author of American Madness: Fighting for Patients in a Broken Mental Health System. They could offer you several treatment options, such as talk therapy or medication in some cases.
Cognitive behavioral therapy (CBT), a common type of talk therapy, is an especially effective treatment option for both anxiety and insomnia, research shows. Guided by a mental health care provider, CBT can help you identify unhelpful thought and behavior patterns that make anxiety or sleep problems worse and replace them with more helpful ones.
2. Avoid Caffeine or Alcohol Before Bed
Some people turn to caffeine to help them focus, but many people with anxiety find that overdoing it on caffeine worsens their symptoms. Not only can too much caffeine ramp up anxiety, but it can also keep you awake if you have it too close to bedtime.
“If you drink coffee, Coke, or another stimulating drink, stop your intake well before bedtime,” says Dr. Feller. “This allows your body to metabolize the caffeine so it won’t keep you awake.”
The same goes for alcohol, which can cause or worsen anxiety. “Alcohol may seem like a soothing way to self-medicate late-night anxiety, but it’s actually doing more harm than good,” says Wu. “It can act as a stimulant right after you drink it and in low doses, and it will also fragment your sleep once you fall asleep.” Wu recommends avoiding alcoholic beverages at least three to four hours before bed.
3. Pay Attention to Sleep Hygiene
Whether or not you have an anxiety disorder, your sleep habits — sometimes called sleep hygiene — can have a big say in how well you sleep. Good sleep hygiene can help you get better shut-eye more consistently over time, research shows.
If your sleep hygiene is lacking, some tips that can help include:
Go to bed and wake up at the same time each day. This can help regulate your body’s sleep-wake cycle.
Aim for 7 to 8 hours of sleep each night.
Make your sleep space dark, cool, and quiet. “Make sure that you’re comfortable in bed,” adds Feller. (An uncomfortable mattress can keep you up, too.)
Try to avoid using electronic devices an hour before bed. The screens of these devices emit blue light, which can suppress your body’s production of melatonin (a hormone that helps you feel sleepy) and keep you from falling asleep.
If you go to bed and don’t fall asleep within 20 minutes, leave your bedroom and do a relaxing activity, such as reading or listening to calming music. When you feel tired again, go back to bed.
4. Try Deep Breathing or Other Relaxation Techniques Before Bedtime
“Breathing exercises are some of the best ways to calm anxiety at night to get better sleep,” says Wu. “They’re a powerful form of mental distraction — by focusing on controlled breathing, you can divert your attention from anxious thoughts.”
They also activate the calming aspect of your nervous system (the parasympathetic nervous system), which helps lower your heart rate, decrease muscle tension, and promote relaxation, Wu adds.
One way to try deep breathing: Find a comfortable place to sit or lie down. Start by taking a normal breath, followed by a deep breath in through your nose and out through your mouth or nose (whichever feels more natural to you). When you breathe in, let your chest and lower belly rise and your abdominal area expand completely. Repeat as many times as you’d like.
Another relaxation exercise you could try is called progressive muscle relaxation. Like deep breathing, this technique can help you calm your mind and body by focusing your attention away from your anxiety and onto slowly tensing and relaxing each muscle group in your body. One example to try: Start by tensing the muscles in your toes for about 5 seconds, and then relaxing for 30 seconds. Then, repeat this exercise with each muscle group as you work your way up your body until you reach your head and neck.
5. Set a ‘Worry Time’ Before Going to Bed
This may sound odd, but research suggests that putting your worry on a schedule can help you push aside those concerns when you don’t want to think about them. For instance, if you practice training your brain to worry for 15 minutes prior to bedtime, you may gradually find it easier to brush off those worries while trying to fall asleep.
For people with anxiety disorders, this may be easier said than done. But daily practice can help you get better at it over time.
How to try it: Each night, try setting aside 10 to 15 minutes to write down things you’re worried about and try to find solutions for each one. Doing this regularly can help slow down any racing thoughts you’re having while you try to go to sleep.
The Takeaway
Nearly half of people with anxiety have sleep problems. If anxiety constantly keeps you awake at night, tell your doctor, and they can recommend treatment options for you. Proven strategies for better sleep, such as relaxation techniques, avoiding caffeine late in the day, and maintaining good sleep hygiene, can also make a big difference.
