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Anxiety At Night: Symptoms, Causes & Ways To Calm 2024

Mitchelle Morgan

Updated on - Written by
Medically reviewed by Kathy Shattler, MS, RDN

anxiety at night
Anxiety may get worse at night.

Are you tired of tossing and turning at night due to anxiety? Do you experience symptoms such as racing thoughts, rapid heartbeat, or tense muscles when trying to fall asleep? You’re not alone because anxiety may be worse at night.

Anxiety at night is a widespread problem[1] reported by 36.7% of respondents in a recent poll. Many individuals suffer from this disorder, and several things, such as anxiety disorders, panic attacks, anxiety night sweats, other mental health issues, and sleep issues, can contribute to it. But don’t worry; there are productive techniques to relax your thoughts and encourage sound sleep before this vicious cycle takes hold.

In this article, we’ll explore the symptoms and causes of anxiety at night and provide what helps when anxiety worsens at night, including some natural remedies for anxiety.

Can Anxiety Get Worse At Night?

Yes, your anxiety can get worse at night. Due to racing thoughts, tense muscles, or other physical symptoms, it may be difficult to fall or remain asleep. Furthermore, the night’s silence might intensify anxious thoughts and sensations. The nighttime is also when anxiety disorders and nocturnal panic attacks are more prone to happen. Deep breathing and meditation are two relaxing methods that can help reduce the symptoms of anxiety and enhance the quality of your sleep. You might also benefit from getting help from a mental health expert.

Symptoms Of Anxiety At Night

Here are some symptoms of nocturnal anxiety[2] you may experience at night, based on multiple systematic reviews, scientific research, and clinical observations:

  • Difficulty staying or falling asleep.
  • Your mind is constantly racing with thoughts.
  • Rapid heartbeat or palpitations.
  • Sweating or chills.
  • Shortness of breath or chest tightness.
  • Trembling or shaking.
  • Nausea or stomach discomfort.
  • Tense muscles.
  • Increased feelings of fear or worry.
  • Panic attacks.
  • Sleep bruxism.[3] This is the unconscious grinding of teeth and clenching of your jaws.
  • Awakening abruptly from sleep with feelings of panic or dread.
  • Feeling tired or irritable during the day due to restless sleep.

The severity and frequency of anxiety at night can vary among different people, and you may not experience all the symptoms. If you frequently encounter any of these signs or have 1-year-old separation anxiety at night, we advise you to consult a physician or a mental health expert. 

What Causes Nighttime Anxiety? 

If you constantly ask, “Why do I get anxiety at night?” Here are the possible answers for what links anxiety and sleep:

  • Disruption of circadian rhythms: If you disrupt your body’s natural sleep-wake cycle[4] by changing your sleep and waking time, it may lead to nighttime anxiety.
  • Sleep disorders: If you have a sleep disorder, such as insomnia[5] or sleep apnea,[6] it may increase the likelihood of experiencing frequent mental distress affecting a person’s mood and elevating anxiety at night.
  • Inadequate sleep: Sleep deprivation and poor sleeping habits[7] can also trigger anxiety at night.
  • Mental health conditions: Anxiety disorder, panic disorder, bipolar disorder, and depression can all cause night anxiety.
  • Physical symptoms: Physical symptoms like a racing heartbeat or breathing difficulties can trigger anxiety at night.
  • Environmental factors: Environmental factors like noise, light, allergens, or temperature changes are triggers that could lead to nighttime anxiety.

It is worth noting that sometimes, there may be no apparent causes for nighttime anxiety. However, identifying the underlying cause of your nighttime anxiety is helpful in developing an effective treatment plan.

Therefore, seeking the advice of a mental health professional is recommended if you experience anxiety at night.

How To Calm Anxiety At Night

Experiencing anxiety at night can be challenging and disruptive to your daily routine. However, several ways exist to calm anxiety at night and promote restful sleep.

All of the strategies we’ll highlight here cater to easing stress and anxiety, which leads to nighttime anxiety attacks, so they may all reduce day and nighttime anxiety in one go.

Here are some to try:

Practicing Deep Breathing

Taking slow, deep breaths[8] can help calm your nervous system and promote relaxation. Deep breathing exercises can help ease nighttime anxiety by slowing down your heart rate and reducing the levels of stress hormones in your body.

This technique increases the amount of oxygen in your bloodstream, which helps to relax tense muscles and calm your mind. Focusing on your breath also helps to distract you from anxious thoughts and encourages a state of relaxation.

Establishing Healthy Sleep Habits

Establishing healthy sleep habits[9] can help ease nighttime anxiety by creating a consistent and calming routine before bed. Good sleep hygiene can include avoiding caffeine and electronics before bedtime, using relaxation techniques such as deep breathing, keeping a sleep diary, and creating a comfortable sleep environment.

You should also strive to sleep for at least seven hours, have fewer distractions, and have a light snack instead of a fatty meal if you must eat before sleeping.

Trying Relaxation Exercises

Research suggests that relaxation exercises, such as progressive muscle relaxation[10] and meditation,[11] can help eliminate nighttime anxiety by promoting peace and reducing tension in the body. 

These exercises can slow down the nervous system, calm racing thoughts, and promote relaxation and tranquillity, making it easier to fall asleep and stay asleep throughout the night.

Nighttime Anxiety Treatments

The points we just went through are strategies to ease occasional anxiety attacks. Here are some treatments you can use to reduce long-term chronic anxiety when you feel anxious most of the time. 

Furthermore, these may help panic attacks, especially nocturnal panic attacks, when these are sources of your nighttime anxiety.

Addressing Any Underlying Medical Conditions

If you have a medical condition contributing to your anxiety, such as hyperthyroidism[12] or chronic long-term insomnia, seek treatment from a medical professional. Treating hyperthyroidism anxiety at night and other conditions like sleep apnea may require medical intervention or lifestyle changes. 

Addressing them can improve physical and mental health, leading to better sleep and reduced anxiety.

Seeking Support From A Mental Health Professional

A therapist or counselor can help you develop long-term coping strategies for managing anxiety. A recent meta-analysis of studies suggested cognitive-behavioral therapy[13] or mindfulness-based interventions that address any underlying mental health conditions contributing to anxiety. These conditions include anxiety disorders,[14] depression, bipolar disorder, or post-traumatic stress disorder.[15]

Additionally, a mental health professional can support and guide you in developing coping mechanisms to manage nighttime anxiety. They can also suggest lifestyle changes or support groups to help you better heal the anxiety symptoms.

Working with a mental health professional can provide a safe space to explore and understand the anxiety’s root causes, ultimately leading to more effective and sustainable management of nighttime anxiety.

Consider Medication

Taking medication,[16] such as anti-anxiety, anti-depressants, or sleep aids, can help ease nighttime anxiety. These medications work by calming the nervous system, affecting the brain’s neurotransmitters, and promoting relaxation.

However, it’s important to talk to a doctor or mental health professional before starting any medication to ensure it’s the right option for you and to avoid any potential side effects or interactions with other medicines.

Please note that some medications may be addictive, so you should only use them under careful supervision. It’s also important to note that some sleep anxiety medications are seasonal treatments, not long-term solutions for managing anxiety.

You should often use medication with other therapies, such as cognitive-behavioral therapy, to address the underlying causes of anxiety.

When To Seek Medical Help

As a general rule of thumb, if you feel anxious and experience sleep problems due to nighttime anxiety or if it disrupts your sleep or daily activities, it may be time to seek medical help. It’s vital to seek help if your chronic anxiety is accompanied by symptoms such as rapid heart rate, chest pain, or difficulty breathing, as these can be signs of a more serious condition.

Also, seek aid if you have tried self-help techniques that haven’t worked or have underlying medical issues such as high blood pressure or mental health problems. A qualified healthcare professional can assess your symptoms, diagnose, and offer appropriate treatment options.

Remember, seeking help for nighttime chronic anxiety is not a sign of weakness, and getting treatment can greatly improve your quality of life and even help prevent chronic diseases.

The Bottom Line

Night anxiety can be debilitating and distressing since you struggle to fall and stay asleep. And the effect is that your life’s quality during the day deteriorates as you struggle to stay alert during important tasks.

The good news is that various ways to manage each anxiety trigger exist. Effective home-based treatments for calming anxiety at night naturally include deep breathing, getting a good night’s sleep, and relaxation exercises. 

Then the medical solutions may be addressing any underlying medical conditions, seeking support from a mental health professional, and considering sleep medicine to help with falling and staying asleep.

It’s essential to take action if you are experiencing sleep anxiety. If self-help methods don’t alleviate your symptoms, or if you’re having trouble coping, don’t hesitate to seek professional help. With the right support and treatment, overcoming nighttime anxiety and enjoying restful and peaceful nights is possible.


+ 16 sources

Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here

  1. Morin, C.M., Bjørn Bjorvatn, Chung, F., Holzinger, B., Markku Partinen, Penzel, T., Ivers, H., Yun Kwok Wing, Ngan Yin Chan, Merikanto, I., Mota-Rolim, S.A., Tainá Macêdo, Luigi De Gennaro, Leger, D., Yves Dauvilliers, Ferri, R., Nadorff, M.R., Bolstad, C.J., Mariusz Siemiński and Benedict, C. (2021). Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study. [online] 87, pp.38–45. doi:https://doi.org/10.1016/j.sleep.2021.07.035.
  2. Smith, N.M., Albanese, B.J., Schmidt, N.B. and Capron, D.W. (2019). Intolerance of uncertainty and responsibility for harm predict nocturnal panic attacks. [online] 273, pp.82–88. doi:https://doi.org/10.1016/j.psychres.2019.01.025.
  3. Polmann, H., Henrique, F., Melo, G., Stuginski-Barbosa, J., Guerra, S., André Luís Porporatti, Dick, B.D., Flores-Mir, C. and De, G. (2019). Association between sleep bruxism and anxiety symptoms in adults: A systematic review. [online] 46(5), pp.482–491. doi:https://doi.org/10.1111/joor.12785.
  4. Xie, Z., Deng, Y., Xie, C. and Yao, Y. (2023). Changes of adrenocorticotropic hormone rhythm and cortisol circadian rhythm in patients with depression complicated with anxiety and their effects on the psychological state of patients. [online] 13. doi:https://doi.org/10.3389/fpsyt.2022.1030811.
  5. Khurshid, K.A. (2018). Comorbid Insomnia and Psychiatric Disorders: An Update. Innovations in clinical neuroscience, [online] 15(3-4), pp.28–32. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906087/
  6. Psychiatric Annals. (2016). Sleep Problems and Disorders in Patients with Anxiety Disorders | Psychiatric Annals. [online] Available at: https://journals.healio.com/doi/abs/10.3928/00485713-20160506-01
  7. Waters, F., Chiu, V., Atkinson, A. and Jan Dirk Blom (2018). Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward Psychosis With Increasing Time Awake. [online] 9. doi:https://doi.org/10.3389/fpsyt.2018.00303.
  8. Noble, D.C. and Hochman, S. (2019). Hypothesis: Pulmonary Afferent Activity Patterns During Slow, Deep Breathing Contribute to the Neural Induction of Physiological Relaxation. [online] 10. doi:https://doi.org/10.3389/fphys.2019.01176.
  9. Milojevich, H.M. and Lukowski, A.F. (2016). Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits. [online] 11(6), pp.e0156372–e0156372. doi:https://doi.org/10.1371/journal.pone.0156372.
  10. Toussaint, L., Quang Vinh Nguyen, Roettger, C., Dixon, K., Offenbächer, M., Kohls, N., Hirsch, J.K. and Sirois, F.M. (2021). Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation. [online] 2021, pp.1–8. doi:https://doi.org/10.1155/2021/5924040.
  11. Bartlett, L., Marie-Jeanne Buscot, Aidan Bindoff, Chambers, R.D. and Hassed, C. (2021). Mindfulness Is Associated With Lower Stress and Higher Work Engagement in a Large Sample of MOOC Participants. [online] 12. doi:https://doi.org/10.3389/fpsyg.2021.724126.
  12. NAZLI GÜLSOY KIRNAP, ÖZLEM TURHAN İYİDİR, YUSUF BOZKUŞ, ŞERİFE MEHLİKA IŞILDAK, ANIL, C., SEVDE NUR FIRAT, CANAN DEMİR, ASLI NAR and NESLİHAN BAŞÇIL TÜTÜNCÜ (2020). The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma. [online] TÜBİTAK Academic Journals. Available at: https://journals.tubitak.gov.tr/medical/vol50/iss4/30/
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  15. Pajuelo, A., Ramos, J. and Lazo-Porras, M. (2022). Anxiety, Depression, and Post-Traumatic Stress Disorder (PTSD) Symptomatology According to Gender in Health-Care Workers during the COVID-19 Pandemic in Peru Shortened Title: ‘Psychological Impact of the Pandemic on Women’. [online] 19(19), pp.11957–11957. doi:https://doi.org/10.3390/ijerph191911957.
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Mitchelle Morgan

Medically reviewed by:

Kathy Shattler

Mitchelle Morgan is a health and wellness writer with over 10 years of experience. She holds a Master's in Communication. Her mission is to provide readers with information that helps them live a better lifestyle. All her work is backed by scientific evidence to ensure readers get valuable and actionable content.

Medically reviewed by:

Kathy Shattler

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