Rush of Anxiety when Falling Asleep: Sleep Anxiety, Nighttime Panic Attacks, and Tips for Improving Sleep
Written by Colter Bloxom, LPC
Colter is a licensed psychotherapist and the owner and founder of Thrive Therapy. He specializes in the treatment of anxiety, OCD, pornography addiction, identity issues, and more.
If you’ve ever found yourself wide awake at night, with your heart racing and thoughts spiraling, then you know how cruel anxiety can feel when all you want to do is get some sleep. At night, there’s often no distraction from your thoughts. As the world quiets down, your mind gets louder and louder.
Many people who live with an anxiety disorder find that their anxiety gets a lot worse at night when they’re trying to fall asleep. Nighttime anxiety is frustrating and can even cause despair.
When anxiety prevents you from getting the rest you need, you can be left battling both anxiety and sleep deprivation, which can get locked in a vicious Catch-22. The more anxious you feel, the less you’re able to sleep — but the more sleep-deprived you are, the more vulnerable you are to anxiety attacks.
Today, I’ll be talking about what happens when you get anxiety while falling asleep, including some options for coping and treatment that could help you get the better sleep you deserve.
Why is my anxiety worse at night?
It’s common for people with anxiety to find that their symptoms get worse at night. Up to 45% of people who live with panic disorder experience both daytime and nocturnal panic attacks. No one knows, exactly, why — but you’re not alone.
What is nighttime anxiety?
Nighttime anxiety refers to the surge of anxious feelings that come on in the evening or while you’re you’re trying to sleep. Most of us have had some worries run through our minds as we lay down to rest. But anxiety isn’t just about feeling restless or tossing and turning.
Nighttime anxiety can feel like your body and mind are in complete overdrive. You might notice physical symptoms like your heart pounding, your chest tightening, or your breathing becoming fast or shallow. Mentally, it can feel like you’re trapped in a loop of racing thoughts that you can’t escape, no matter how tired you are and how much you just want to sleep.
Some people experience panic attacks at night, which might cause you to suddenly wake up with a start or feel like you’re in physical danger (or even like you’re about to die). You might even feel like you can’t breathe. These nighttime anxiety attacks aren’t just a mental struggle — they’re an all-consuming experience.
What causes anxiety at night?
Anxiety can get worse at night for some people due to a variety of factors. Here are some common causes:
- Unprocessed daytime stress: During the day, distractions can keep your mind busy. But as soon as you lie down, all the worries you’ve shoved aside can come flooding back. Your brain might see the quiet as the perfect opportunity to remind you of everything you haven’t dealt with yet, which could make your anxiety worse.
- Sleep deprivation: Lack of sleep doesn’t just make you tired; it can also heighten your body’s stress response and make it harder to calm down when anxiety strikes. This means that sleep deprivation and nighttime anxiety can get locked in a vicious cycle.
- Doom scrolling: The blue light from screens can disrupt your body’s production of melatonin, a hormone that helps regulate sleep. So when you use your phone in bed, that can make you feel more anxious. Scrolling through stressful news or social media can also ramp up feelings of anxiety.
- Inconsistent sleep schedule: Inconsistent bedtimes can throw off your circadian rhythm, which makes it harder to wind down at night. This can sometimes contribute to nighttime anxiety.
- Biological factors: Cortisol, our bodies’ primary stress hormone, naturally fluctuates throughout the day. For some people, cortisol spikes in the evening or early morning, which could trigger anxious feelings.
- Nightmares: If you experience nightmares, then it’s understandable to be anxious going to sleep. This is common for people who live with post-traumatic stress disorder (PTSD) and related nightmares.
- Somniphobia: This is an actual phobic fear of sleep itself. People with somniphobia are usually afraid of having nightmares, sleep paralysis, or even dying in their sleep. It can happen for a lot of different reasons, and having panic or anxiety attacks at night can make you feel even more afraid of sleep.
- Underlying mental health conditions: If you live with an underlying mental health condition, like generalized anxiety disorder, panic disorder, or OCD, then it could make nighttime anxiety worse. You might also live with a sleep disorder like insomnia, which can trap you in its own cycle.
What it feels like when you're too anxious to sleep
When you’re having nighttime anxiety, you’re not just lying awake or tossing and turning. Often, it’s a full-body and emotional experience.
Some signs that you might be experiencing nighttime anxiety include:
- Physical tension: Your muscles may feel tight or achy, as though your body is bracing for an unknown threat. You might feel jittery, with your heart racing or your breathing shallow and quick.
- Racing thoughts: These aren’t just fleeting worries; they’re persistent, repetitive thoughts that refuse to let go. You might fixate on things that feel trivial during the day but seem catastrophic at night.
- Sense of dread: Bedtime might fill you with a sense of unease, as though something bad is about to happen. For some, this dread makes it hard to even lie down in bed. You might even feel afraid that you could die in your sleep.
- Panic-like symptoms: Some people experience panic attacks at night. For example, you might wake up in a cold sweat, feel like you can’t sweat, or have intense chest pain that feels like a heart attack. These episodes can make you scared to fall back asleep.
- Emotional exhaustion: Night after night of anxiety can make you feel defeated. You might worry that you’ll never get a good night’s sleep again. This can cause you to feel exhausted, both physically and mentally, while you’re awake.
If you live with somniphobia, then these feelings could feel even more intense as nighttime approaches.
How can you differentiate between general anxiety and sleep anxiety?
Nighttime anxiety could be due to generalized anxiety, or somniphobia, which is the anxiety/fear of sleep itself.
While general anxiety can appear at any time of day, sleep anxiety tends to intensify as bedtime approaches. If you notice that your worries center around sleep itself or you dread the thought of trying to fall asleep, it’s likely that sleep anxiety or phobia is a significant factor.
If you’re mostly worrying about things that happened during your day, then you might have generalized anxiety disorder that’s playing into nighttime anxiety. Paying attention to when and how your anxiety comes up can help you identify patterns and address them effectively.
Strategies to help you overcome anxiety at night
If nighttime anxiety feels like it’s taking over your life, know that there are strategies you can use to take back control. These approaches focus on calming your mind and body, breaking the cycle of stress and sleeplessness, and finally getting the rest you deserve.
Relaxation strategies
Relaxing isn’t about going to a spa. It’s literally about calming your nervous system to counter the stress response. Deep breathing exercises can help slow your heart rate and bring your body out of "fight or flight" mode. Try inhaling for a count of four, holding your breath for four, and exhaling for six, slowly.
Progressive muscle relaxation, which is a research-backed technique, can also help. Start at your toes and work your way up. Tense each muscle group — for example, first your toes, then your ankles, then your calves, and so on — for a few seconds, then release completely. This can help your body release physical tension and send signals to your brain that it’s time to relax.
Mindfulness
Mindfulness practices, like grounding exercises, can help you stay present and avoid spiraling into anxious thoughts. Mindfulness is related, but slightly different from, relaxation. It’s more about connecting yourself to the present moment.
The 5-4-3-2-1 method is a great tool: name five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste (like taking a sip of water or chewing gum). This simple exercise can help bring your focus back to the present moment.
Sleep hygiene
Sleep hygiene refers to practices that help set your body up for a successful night’s sleep. There are so many things to pay attention to that can help you rest. For example, go to sleep and wake up around the same time every day, even on weekends. Set up a bedtime routine and a morning routine to help get your body into a rhythm. Make sure your sleep environment is as dark, cool (around 65 degrees is best), and quiet as possible.
Physical activity
Getting exercise isn’t just about improving your physical health. Research consistently shows that regular physical activity can reduce your overall stress levels and improve your sleep quality. You don’t need to get a gym membership if that’s not your thing. Even a short walk during the day with your dog or a friend can make a difference. Just be mindful of when you exercise — late-night workouts can sometimes make it harder to wind down.
Get mental health treatment
The truth is that if you’re reading this article, then you may have already tried all of these tips. They may have worked some, but you might still have a hard time resting — truly resting — because of anxiety. If this is true for you, then you could benefit from getting professional help.
Therapy can help you explore the underlying causes of your anxiety and equip you with tools to break free from the cycle. Anxiety isn’t “just in your head,” and it’s often not something we can just think our way out of on our own.
Get better sleep and treat anxiety with Thrive's mental health IOP
If you live with severe anxiety, then you may be looking for more support than a once-a-week therapy session. Our intensive outpatient program (IOP) in Arizona is a nine-hour-per-week program that lasts for 12 weeks. You’ll come in 3 days per week to receive the best in evidence-based treatment (including cognitive behavioral therapy and dialectical behavior therapy) for anxiety symptoms.
Being sleep-deprived due to anxiety is not something you need to just accept. You deserve to rest. Reclaim your nights with our innovative IOP for anxiety.
