Sleep and Anxiety: Relations, Effects, and Treatment

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Sleep and anxiety are related because they affect each other. Anxiety can prevent falling asleep, and sleep problems can cause or worsen anxiety symptoms. Anxiety is a disorder in which an individual experiences intense feelings of worry or fear. Anxiety can cause sleeplessness because these emotions can make it hard for the individual to fall asleep.

Anxiety affects sleep quality by delaying sleep onset or causing more disturbed sleep. Experts say many anxiety disorders are commonly associated with worse sleep quality.

Poor sleep quality is harmful because it can worsen mental and physical health. Causes of anxiety may include traumatic life events, inherited traits, other mental health issues, stress, and sleep disorders, such as insomnia or sleep apnea. Just as anxiety can cause sleep disorders, these disorders can cause anxiety, creating a problematic cycle.

There are several ways to treat anxiety, including seeking professional help and taking preventative measures. Mental healthcare professionals can provide therapy or medications, while the individual can take preventive steps by leading a healthy lifestyle and practicing good sleep hygiene.

What Causes Anxiety that Affects Sleep?

Causes of anxiety that can affect sleep include traumatic life events, stress, inherited factors, other mental health issues, and sleep disorders. Anxiety is a disorder that causes someone to experience intense feelings of panic, fear, or worry. When someone experiences nighttime anxiety, it can be harder for them to relax, which is necessary to fall asleep. Furthermore, not sleeping well can result in anxiety.

Traumatic life events and stress can trigger intense emotions. Examples of traumatic events include the death of a loved one or a car accident. Stress from work or personal relationships could also develop into anxiety. Inherited factors mean that certain individuals may be more prone to developing anxiety disorders. Other mental health issues like depression can make someone more susceptible to anxiousness. Sleep disorders that negatively impact how well-rested you feel can lead to anxiety.

What Type of Anxiety Affects Sleep?

Different types of anxiety can affect sleep. These types include generalized anxiety disorder (GAD), panic disorder, phobias, and separation anxiety. Other mental health conditions can cause anxiety that impairs sleep, such as post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD).

Generalized anxiety disorder refers to a persistent worry about multiple everyday things, and these emotions can keep the person up at night. Panic disorder is when some experiences sudden panic attacks, and if this happens at bedtime, the individual won’t be able to fall asleep. A phobia is an extreme fear of a particular person, object, activity, situation, or animal. Some people have a phobia of sleep, specifically, which is known as somniphobia. PTSD is triggered by a traumatic event and can cause more disturbed sleep. OCD is a condition in which someone experiences certain obsessions or compulsions, which can result in insomnia symptoms.

What are the Effects of Anxiety on Sleep Quality?

The effects of anxiety on sleep quality include shorter sleep times and more fragmented rest. Sleep quality is a measure referring to how well-rested you feel in the morning. Poor sleep quality can have detrimental ramifications on your physical and mental well-being. Symptoms of poor sleep quality include negative emotions like irritability, difficulty concentrating and remembering things, less physical energy, and an increased likelihood of illness. Anxiety is also a potential side effect of inadequate rest. 

Who is Prone to Sleep Problems Due to Anxiety?

People prone to sleep problems and anxiety include those who are sleep-deprived, have chronic insomnia, and those with other psychiatric disorders. In many cases, the sleep problems fuel anxiety symptoms, perpetuating the vicious cycle. Other risk factors for anxiety include trauma, stress, illness, personality type, genetics, drugs, and alcohol.

How do People with Anxiety Feel before Sleeping?

People with anxiety can experience nervousness, tension, panic, and restlessness before sleeping. These emotions can make it hard for them to fall or stay asleep, resulting in worse sleep quality. Anxiousness can also cause physical symptoms such as increased heart rate, rapid breathing, sweating, trembling, weakness, and gastrointestinal problems.

Illustration of Anxious Child Awaken in Bed

What Sleep Disorders can Trigger Anxiety before Sleep?

The sleep disorders that can trigger anxiety before sleep are listed below. 

  1. Insomnia
  2. Narcolepsy
  3. Restless Legs Syndrome
  4. Sleep Apnea
  5. Sleepwalking

Sleep disorders can be harmful to your physical and mental well-being. Short-term effects of inadequate rest include poor cognitive abilities, exhibiting more negative emotions, and less physical energy. Long-term effects of bad sleep include hypertension, heart attack, stroke, diabetes, obesity, and memory problems.

1. Insomnia

Insomnia is a sleep disorder in which a person has difficulty falling or staying asleep. Insomnia is both a symptom and a cause of anxiety. Insomnia affects sleep quality by causing delayed sleep onset or disturbed rest. The dangers of insomnia include medical complications like diabetes, obesity, and heart disease. Insomnia also increases your risk of accidents.

2. Narcolepsy

Narcolepsy is a sleep disorder in which a person has extreme daytime drowsiness and sudden urges to fall asleep. Narcolepsy may trigger anxiety symptoms. Narcolepsy can affect sleep quality by making it difficult to stay asleep at night. Narcolepsy can be dangerous because someone could experience a sudden sleep attack while on the road or operating machinery.

3. Restless Legs Syndrome

Restless legs syndrome (RLS) is a sleep disorder characterized by a persistent need to move your legs, especially at night. Experts say that restless legs syndrome can sometimes be triggered by anxiety or stress. Restless legs syndrome affects sleep quality by making it harder to doze off, resulting in shorter sleep durations. The dangers of restless legs syndrome are the same as insomnia because it’s a byproduct of RLS. These dangers include diabetes, obesity, heart disease, and increased accident risk.

4. Sleep Apnea

Sleep apnea is a sleep disorder in which a person’s breathing periodically starts and stops while asleep. There are two types of sleep apnea, obstructive and central. Obstructive results from a blockage in the upper airway, whereas central sleep apnea is caused by the brain not sending the right signals to the breathing muscles. Sleep apnea can bring about or worsen anxiety. Sleep apnea affects sleep quality by causing more disturbed rest because the individual often will wake up gasping for air. The dangers of sleep apnea include sleep deprivation, diabetes, medication and surgery complications, and liver problems.

5. Sleepwalking

Sleepwalking is a sleep disorder that causes a person to get up and walk while asleep. The formal name for sleepwalking is somnambulism. Cleveland Clinic reports that anxiety, stress, and other mental health factors may lead to nighttime disturbances like sleepwalking. A 2013 study from the American Academy of Sleep Medicine found that sleepwalking led to complications associated with poor sleep quality, such as daytime drowsiness, fatigue, and insomnia. They added that sleepwalking also caused depression and anxiety symptoms. People who sleepwalk run the risk of hurting themselves.

Does Anxiety Cause Sleep Disorders?

Yes, anxiety can cause sleep disorders. Anxiety can cause insomnia, and experts say it may trigger restless legs syndrome.

How to Sleep with Anxiety

There are ways to help yourself sleep with anxiety. Tips to increase sleep quality if you’re experiencing anxiety include relaxation exercises, good sleep hygiene, therapy, and medication. 

Relaxation exercises can help your mind calm down and focus your attention away from what’s troubling you. The examples of relaxation exercises are written below.

  • Meditation
  • Yoga
  • Warm bath
  • Reading
  • Deep breathing

Good sleep hygiene is often recommended to improve sleep quality, which should help alleviate anxiety in the process. The examples of good sleep hygiene are written below.

  • Keeping a consistent sleep schedule
  • Comfortable bedroom
  • Avoiding electronics before bed
  • Cutting back on caffeine and alcohol
  • Regular exercise
  • Not eating large meals late at night

Seeking professional help for anxiety through therapy or medication is also an option. Healthcare professionals will usually try therapy before resorting to medical intervention to improve anxiety and sleep.

What Therapies can Help with Anxiety and Sleep?

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that could help with anxiety and sleep. CBT helps an individual learn how to change their behavior. A specific form of CBT is designed to help treat insomnia and can take 6-12 weeks for results to show.

CBT can teach someone how to avoid behaviors and environments that trigger anxiety or insomnia. They can learn about the relationship between sleep, anxiety, the brain, and the body. They may also learn how to change any negative thoughts or emotions associated with rest. Sleep therapies like CBT may incorporate specific techniques like relaxation training and sleep hygiene.

What Medications can Help with Sleep with Anxiety?

Benzodiazepines are a type of medication that’s often prescribed to treat anxiety. Benzodiazepines are sedatives that help relax the muscles and mind. Xanax and Valium are examples of better-known Benzodiazepines. Doctors may prescribe these medications to treat panic disorder, generalized anxiety disorder, and social anxiety disorder.

Medications for sleeping can also alleviate anxiety by improving your rest. A physician may prescribe sleeping pills to treat insomnia, but these are supposed to provide a temporary solution. Some people may opt to use natural sleep aids like melatonin or chamomile tea instead of prescribed or over-the-counter medications.


Jill Zwarensteyn is the Editor for Sleep Advisor and a Certified Sleep Science Coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.

Based in Los Angeles, she is an experienced writer and journalist who enjoys spending her free time at the beach, hiking, reading, or exploring new places around town.

She’s also an avid traveler who has a personal goal of being able to successfully sleep on an airplane someday.

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