Sleep and Anxiety: How Worry Can Keep You Awake
Anxiety is not very good at respecting bedtime. The moment the lights go out, a quiet mind has room to rehearse tomorrow’s problems. And when sleep is poor, anxiety usually gets louder the next day. Breaking that loop is possible.
Key takeaways
- Anxiety and poor sleep reinforce each other.
- Move worry earlier in the day with a simple routine.
- If anxiety is constant or overwhelming, talk to a health professional.
Why anxious minds stay awake
Anxiety keeps the body’s alert system switched on, with a faster heart rate and tense muscles, the opposite of what sleep needs. Add the fear of not sleeping and you get a self-feeding cycle: the more you try to sleep, the more awake you feel.
Strategies that help
- Worry time. Set aside ten minutes in the early evening to write down worries and one next step for each.
- A written to-do list. A small 2018 study found that writing a specific to-do list before bed helped people fall asleep faster.
- Slow breathing. Breathe in gently, then breathe out for longer than you breathe in, for a few minutes.
- Wind-down routine. Dim lights, no work email and a calming activity.
If you wake and start spiralling
Resist the urge to check the time. Get up if you have been awake for a while, sit in low light and read or listen to something calm. Return to bed when you feel sleepy. Our guide to falling asleep faster explains why this works.
Caffeine and alcohol
Both can fuel anxiety symptoms and disturb sleep. Try cutting caffeine after midday for two weeks and see how you feel. Alcohol may feel calming but often worsens anxiety the next day.
When to get help
If anxiety is intense, constant, or comes with panic attacks, avoidance or low mood, speak to a doctor or therapist. Cognitive behavioral therapy helps both anxiety and insomnia. If you feel unable to cope, or have thoughts of harming yourself, seek urgent help from emergency services or a crisis line.
Frequently asked questions
Why does my anxiety get worse at night?
With fewer distractions, worries get louder, and tiredness lowers your ability to cope. Writing worries down earlier can help.
Does melatonin help anxiety-related insomnia?
It is not an anxiety treatment. Speak to a doctor before using it.
References and further reading: Scullin et al., 2018, Journal of Experimental Psychology: General (bedtime writing); American Academy of Sleep Medicine guidance on CBT-I.