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Anxiety has a multitude of symptoms, not the least of which is causing problems with your sleep. When you are preoccupied with worries and fears, falling asleep and staying asleep become more difficult. It’s a vicious cycle, too, as your anxiety surrounding sleep can cause your sleep issues to get worse.
If you’re dealing with anxiety, there are ways to manage and treat your symptoms. It’s also important to pay attention to your sleep habits and take steps to prevent anxiety from depriving you of sleep. In this article, we’ll talk about the link between anxiety and sleep and how you can manage your anxiety and sleep problems. Read on to learn more.
Anxiety is often described as feelings of worry, fear, nervousness, or unease. While anxiety is normal when you're feeling afraid or stressed, it becomes a disorder when your anxiety is excessive or continuous. Anxiety is a mental health condition that can affect your daily life and energy levels significantly. Research published in the Journal of Anxiety Disorders shows that typically, you can diagnose an anxiety disorder if someone has persistent feelings for most days over the period of six months or more.
Anyone can suffer from an anxiety disorder. It's one of the most common mental health conditions diagnosed worldwide. Studies in Epidemiologic Reviews indicate that anxiety can vary in severity, with some people feeling more debilitated by the disorder than others. The worse your anxiety is, the more it can affect your day-to-day life and your sleep habits, creating a wide range of symptoms that impact overall well-being.
Although anxiety is a broad term, there are actually several different types of anxiety that can more specifically describe someone's condition:
Generalized Anxiety Disorder: Generalized anxiety disorder causes a general sense of anxiety and worry about a variety of different things in the individual's life. Research in Depression and Anxiety shows this is one of the most common anxiety disorders.
Social Anxiety Disorder: People with social anxiety disorder have a particular fear and anxiety related to social situations. Their fear may center around being embarrassed in social settings or being judged by others.
Obsessive-Compulsive Disorder: OCD causes someone to obsess over an issue and induce compulsion to control the source of their anxiety. Studies in Clinical Psychology Review show compulsions are often repeated over and over again and can cause significant impact on daily functioning.
Panic Disorder: Panic disorder is defined by panic attacks, which are short episodes of intense fear that can sometimes manifest physical symptoms.
Phobias: Phobias are intense fears caused by a particular trigger. For example, someone with acrophobia has a fear of heights.
Post-Traumatic Stress Disorder: PTSD is a disorder caused by a traumatic event or situation. Individuals with PTSD may experience triggers that cause them to relive the situation and have anxiety about it.
Identifying your type of anxiety disorder may help you and your healthcare provider develop an appropriate treatment plan for managing symptoms.
Anxiety can count sleep disorders such as insomnia among its common symptoms. Research in Sleep Medicine Reviews demonstrates that insomnia can be even worse for those with anxiety, as they may worry about their ability to fall asleep at night, making it more difficult to fall asleep and stay that way.
Sleep disturbances can be brought on by anxiety and vice versa, creating a cyclical pattern. The types of anxiety that most commonly have insomnia as a symptom include generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Studies in Current Psychiatry Reports show that negative thoughts surrounding bedtime can cause sleep deprivation and poor sleep hygiene, leading to further health complications.
Typically, anxiety will make it difficult to fall asleep, but waking up throughout the night can also happen. People with anxiety may experience racing thoughts when they wake up in the middle of the night, making it difficult for them to fall back asleep. Not only does this deprive you of sleep hours, but it also interrupts the sleep cycle, preventing those with anxiety from getting the full benefits of restorative sleep. For specific strategies on managing nighttime awakenings, explore our guide on how to stop waking up in the middle of the night.
Chronic anxiety extends far beyond temporary worry, creating persistent changes in both physical and mental functioning. Research published in Nature Reviews Neuroscience demonstrates that chronic anxiety activates the body's stress response system continuously, leading to elevated cortisol levels and sustained sympathetic nervous system activation.
This persistent state of arousal affects multiple body systems. The cardiovascular system experiences increased heart rate and blood pressure, while the digestive system may become disrupted, leading to gastrointestinal issues. Studies in Psychoneuroendocrinology show that chronic anxiety can also suppress immune function, making individuals more susceptible to infections and slower healing.
From a cognitive perspective, chronic anxiety impairs concentration, memory formation, and decision-making abilities. The brain's prefrontal cortex, responsible for executive function, becomes less efficient when constantly managing anxiety responses. This creates a cycle where anxiety-related cognitive impairment leads to decreased performance and increased worry about capabilities.
One of the most debilitating aspects of anxiety disorders is their impact on sleep quality and resulting fatigue. Research in Sleep Medicine shows that anxiety doesn't just make it harder to fall asleep—it fundamentally alters sleep architecture, reducing time spent in deep, restorative sleep stages.
Sleep difficulties associated with anxiety often result in non-restorative sleep, where individuals may sleep for adequate hours but wake up feeling unrefreshed. This occurs because anxiety-related hyperarousal prevents the nervous system from fully relaxing during sleep. Studies in Clinical Sleep Medicine demonstrate that this leads to increased light sleep and frequent micro-awakenings that fragment sleep quality.
The resulting fatigue compounds anxiety symptoms, creating a vicious cycle. When we're tired, our emotional regulation becomes impaired, making us more susceptible to anxious thoughts and less capable of implementing coping strategies effectively. If you're experiencing this pattern, our detailed guide on why you sleep but don't feel rested provides comprehensive insights and solutions.
There is no single specific cause of anxiety, as research indicates it's a complex condition with multiple contributing factors. Studies in Molecular Psychiatry suggest that anxiety disorders result from an interaction between genetic predisposition, environmental factors, and neurobiological changes.
Genetics play a significant role, with anxiety disorders often running in families. However, having a genetic predisposition doesn't guarantee someone will develop an anxiety disorder. Environmental factors such as trauma, chronic stress, major life changes, and certain medical conditions can trigger anxiety disorders in susceptible individuals.
Neurobiologically, anxiety involves dysregulation in neurotransmitter systems, particularly gamma-aminobutyric acid (GABA), serotonin, and norepinephrine. Research in Neuropsychopharmacology shows that imbalances in these systems affect both mood regulation and sleep-wake cycles.
Symptoms of anxiety can manifest in both emotional and physical ways, often overlapping with other medical conditions. Research in General Hospital Psychiatry identifies the following as primary anxiety symptoms:
Emotional Symptoms:
Physical Symptoms:
Studies in Psychosomatic Medicine show that these symptoms can significantly impact quality of life and often require intervention from a healthcare provider to properly diagnose and treat.
Beyond traditional treatments, several natural approaches can help calm an overactive nervous system and reduce anxiety symptoms. Research in Evidence-Based Complementary and Alternative Medicine demonstrates the effectiveness of various natural interventions.
Deep Breathing Techniques: Diaphragmatic breathing activates the parasympathetic nervous system, counteracting anxiety's fight-or-flight response. Studies in Applied Psychology: Health and Well-Being show that regular practice can significantly reduce anxiety levels.
Progressive Muscle Relaxation: This technique involves systematically tensing and releasing muscle groups, helping reduce physical tension associated with anxiety. Research in Behaviour Research and Therapy confirms its effectiveness for anxiety management.
Mindfulness and Meditation: Regular mindfulness practice helps break the cycle of anxious thoughts by training attention to stay present. Studies in JAMA Psychiatry demonstrate significant anxiety reduction with consistent meditation practice. For guidance on implementing these techniques before bed, explore our article on CBT-I, hypnosis, and meditation for sleep improvement.
Nature Exposure: Spending time in natural environments has been shown to reduce cortisol levels and anxiety symptoms. Research in Environmental Science & Technology indicates that even brief nature exposure can have measurable calming effects.
Several lifestyle factors significantly impact both anxiety levels and sleep quality. Understanding and modifying these factors can provide substantial relief for anxiety-related sleep difficulties.
Physical Activity: Regular exercise acts as a natural anxiety reducer by releasing endorphins and reducing stress hormones. Research in Depression and Anxiety shows that moderate physical activity can be as effective as medication for some individuals with anxiety disorders. However, timing matters—exercising too close to bedtime can interfere with sleep. Learn more about exercising before sleep and its effects on sleep quality.
Nutrition and Diet: A balanced diet rich in nutrients supports both mental health and sleep quality. Studies in Nutritional Neuroscience demonstrate that certain nutrients, including omega-3 fatty acids, magnesium, and B vitamins, can help reduce anxiety symptoms and improve sleep. For specific guidance on foods that promote better sleep, check out our comprehensive guide on nutrition and sleep.
Caffeine and Stimulants: These substances can exacerbate anxiety symptoms and interfere with sleep. Research in Sleep Medicine Reviews shows that limiting caffeine, especially in the afternoon and evening, can significantly improve both anxiety and sleep quality.
When anxiety significantly impacts daily functioning and sleep quality, professional treatment may be necessary. A healthcare provider can help determine the most appropriate approach based on individual symptoms and circumstances.
Cognitive Behavioral Therapy (CBT): This evidence-based therapy helps individuals identify and change negative thought patterns that contribute to anxiety. Research in Clinical Psychology Review demonstrates that CBT is highly effective for treating anxiety disorders and associated sleep problems.
Cognitive Behavioral Therapy for Insomnia (CBT-I): Specifically designed for sleep issues, CBT-I addresses the thoughts and behaviors that interfere with sleep. Studies in Sleep Medicine Reviews show it's particularly effective for anxiety-related insomnia. Learn more about CBT-I for anxiety and insomnia and how this approach can transform your sleep.
Medication Management: When necessary, various medications can help manage anxiety symptoms. These may include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines for short-term use, or other anti-anxiety medications. A healthcare provider can determine the most appropriate medication and monitor for side effects.
Optimizing sleep hygiene is crucial for managing anxiety-related sleep difficulties. Research in Sleep Health emphasizes the importance of consistent sleep practices for both anxiety and sleep improvement.
Create a Comfortable Sleep Environment: Make your sleep environment a peaceful respite where you can relax and let go of anxiety. Use comfortable bedding, maintain a cool temperature (60-67°F), ensure the room is dark enough for sleep, and minimize noise. Consider using blackout curtains, white noise machines, or calming aromatherapy.
Establish a Consistent Sleep Routine: When you wind down for the night, stick to a consistent sleep routine filled with relaxing activities. This might include drinking herbal tea, taking a warm bath, gentle stretching, or reading something calming. Studies in Behavioral Sleep Medicine show that consistent routines signal to your body that it's time to sleep. For additional strategies, explore our comprehensive guide with 11 ways to sleep better.
Avoid Stimulants Near Bedtime: Caffeine and alcohol near bedtime can disrupt sleep and increase anxiety. Caffeine is a stimulant that may cause increased anxiety around bedtime. Try to limit caffeine to morning or early afternoon. For alcohol, stop drinking at least 4 hours before bed. Learn more about alcohol and sleep in our detailed guide.
Practice Relaxation Techniques: Incorporate meditation, breathing exercises, and progressive muscle relaxation into your bedtime routine. These techniques can help calm anxious thoughts and prepare your body for sleep. For specific guidance on managing bedtime anxiety, read our article on how to get rid of sleep anxiety.
Modern technology can both help and hinder anxiety-related sleep issues. Research in Sleep Medicine shows that blue light from screens can suppress melatonin production and increase alertness, making it harder to fall asleep.
Screen Management: Dim screens or use night mode settings in the evening. Avoid scrolling through social media or reading stressful content before bed, as this can increase anxiety levels. Consider implementing a "digital sunset" by turning off all screens 1-2 hours before bedtime. For comprehensive guidance, explore our article on using technology in the bedroom safely.
Sleep-Promoting Technology: While limiting screen time is important, some technology can aid sleep. White noise machines, sleep tracking apps, or guided meditation apps can be helpful tools when used appropriately. Learn more about white noise and sleep in our detailed guide.
While self-help strategies can be effective for mild anxiety and sleep issues, it's important to recognize when professional help is needed. Research in Primary Care Companion for CNS Disorders suggests seeking help from a healthcare provider when:
A healthcare provider can conduct a thorough evaluation, rule out other medical conditions that might be contributing to symptoms, and develop an appropriate treatment plan tailored to individual needs. For guidance on overcoming both anxiety and insomnia together, explore our comprehensive resource on therapy to overcome insomnia and anxiety for good.
For those struggling with anxiety-related sleep difficulties, Sleep Reset offers a comprehensive, science-backed approach to improving sleep without relying on medications. Our program recognizes the complex relationship between anxiety and sleep, providing personalized strategies that address both issues simultaneously.
Sleep Reset's approach combines evidence-based sleep techniques with ongoing support from dedicated sleep coaches. The program focuses on identifying and addressing the specific factors that contribute to your sleep difficulties, whether they're related to anxiety, poor sleep hygiene, or other underlying issues.
Unlike approaches that rely on sleep medications, which can create dependency and don't address root causes, Sleep Reset teaches sustainable skills for long-term sleep improvement. The program includes sleep tracking, personalized recommendations, and regular check-ins with your sleep coach to ensure continued progress.
Don't let anxiety-related sleep difficulties continue to impact your quality of life. Quality sleep is essential for emotional regulation, stress management, and overall mental health. When anxiety interferes with sleep, it creates a cycle that can be difficult to break without proper intervention.
Sleep Reset's evidence-based program can help you develop the skills and strategies needed to improve both your sleep quality and anxiety management. By addressing sleep issues, many people find that their anxiety symptoms also improve, as better sleep enhances emotional resilience and stress-coping abilities.
Take the first step toward better sleep and improved anxiety management by exploring how Sleep Reset can help you break the cycle of anxiety and poor sleep.
Anxiety tiredness refers to the persistent fatigue and exhaustion that results from chronic anxiety and its impact on sleep quality. Unlike normal tiredness from physical exertion, anxiety tiredness stems from the body's continuous stress response and disrupted sleep patterns. Research in Psychosomatic Medicine shows that anxiety activates the sympathetic nervous system, leading to increased energy expenditure even during rest. Additionally, anxiety often prevents deep, restorative sleep, leaving individuals feeling unrefreshed despite spending adequate time in bed. This type of fatigue is characterized by feeling mentally and physically drained, having difficulty concentrating, and experiencing low energy levels throughout the day, even after what should be sufficient sleep.
Sleep and anxiety have a bidirectional relationship, meaning each can significantly impact the other. Studies in Sleep Medicine Reviews demonstrate that anxiety can cause sleep disturbances by increasing arousal and making it difficult to fall asleep or stay asleep. Racing thoughts, worry, and physical tension associated with anxiety interfere with the natural relaxation needed for sleep onset. Conversely, poor sleep quality can worsen anxiety symptoms by impairing emotional regulation and stress resilience. Sleep deprivation affects the brain's ability to process emotions effectively, making individuals more susceptible to anxious thoughts and less capable of managing stress. This creates a vicious cycle where anxiety disrupts sleep, and poor sleep increases anxiety, making both conditions more difficult to manage without proper intervention.
Yes, anxiety disorders commonly cause both fatigue and sleep problems as core symptoms of the condition. Research published in the Journal of Clinical Sleep Medicine shows that up to 90% of people with anxiety disorders experience some form of sleep difficulty. These sleep problems can include difficulty falling asleep (sleep onset insomnia), frequent awakenings during the night (sleep maintenance insomnia), early morning awakening, and non-restorative sleep. The fatigue associated with anxiety disorders results from multiple factors: the energy expenditure of maintaining a constant state of worry and hypervigilance, disrupted sleep architecture that prevents restorative deep sleep, and the physical tension that anxiety creates in the body. This fatigue is often described as feeling mentally and physically drained, having difficulty concentrating, and experiencing persistent low energy levels that don't improve with rest. A healthcare provider can help determine if fatigue and sleep problems are related to an anxiety disorder and develop an appropriate treatment plan to address both issues.
Dr. Shiyan Ooi
Dr. Shiyan Ooi is a medical doctor with over a decade of experience treating patients with chronic conditions. She graduated from the University of Manchester with a Bachelor of Medicine and Surgery (MBChB UK) and spent several years working at the National Health Service (NHS) in the United Kingdom, several Singapore government hospitals, and private functional medicine hospitals. Dr. Ooi specializes in root cause analysis, addressing hormonal, gut health, and lifestyle factors to treat chronic conditions. Drawing from her own experiences, she is dedicated to empowering others to optimize their health. She loves traveling, exploring nature, and spending quality time with family and friends.
