Waking Up With Anxiety in the Middle of the Night

You might experience anxiety at night, which might be because of symptoms like nocturnal panic attacks or a racing heartbeat. Anxiety can disrupt your sleep and make it difficult to drift back to sleep. That's because anxiety and sleep are closely linked.

Anxiety can worsen a sleep disorder, such as insomnia, but difficulty sleeping can also worsen anxiety. In either case, taking steps like getting up to relax until you're asleep or exercising earlier in the day could help you go back to sleep and improve your overall health.

Causes of Anxiety at Night

Stressful life events and anxiety can make your mind more active than usual and trigger a heightened mental and emotional state called hyperarousal. As a result, your fight-or-flight response—or how your body automatically reacts to stressful events—can be thrown off balance.

Usually, when you wake up in the morning, your brain releases more noradrenaline (also called norepinephrine). This hormone is involved in your fight-or-flight response and is linked to certain brain functions that keep you awake.

Other than a disrupted fight-or-flight response, you may have anxiety at night due to the following:

• Daytime stress: Being stressed during the day is associated with disrupted sleep at night. That's more likely for people whose sleep is particularly vulnerable to stress.
• Mental health disorders related to anxiety or stress: Disorders like generalized anxiety disorder and posttraumatic stress disorder can also provoke or worsen sleep difficulties.
• Sleep deprivation: Losing sleep during the night can cause an unusual increase in noradrenaline levels. In turn, you might suddenly wake up with anxiety at night and find it difficult to fall back asleep.
  

Symptoms of Anxiety

Anxiety symptoms may vary according to the disorder. However, general symptoms can include:

• Difficulty concentrating or controlling feelings of worry
• Easy fatigue
• Feelings of doom
• Irrational worries
• Irritability
• Restlessness or feeling wound up and on edge
• Sleep problems
• Tense muscles
• Trembling or shaking

It's also possible to experience panic attacks that happen at night—also called nocturnal panic attacks. These panic attacks can jolt you awake. Typical signs of a panic attack can include:

• Chills or hot flashes
• Dizziness, feeling faint
• Elevated, racing heartbeat
  
• Feelings of fear and loss of control
• Nausea or abdominal pain
  
• Numb or tingling sensations in the body
• Racing, unwanted worries (intrusive thoughts)
• Shortness of breath, chest pain, or difficulty breathing
  
• Sweating
  

Side Effects

Since anxiety and sleep are so closely related, a potentially never-ending cycle can emerge. Waking up with stress, worry, and anxiety can make it harder to fall back asleep. This inability to relax the mind and drift off, in turn, causes even more anxiety.

Having anxiety, a stress disorder like PTSD, or a sleep disorder can disrupt your rapid-eye movement (REM) sleep. The REM sleep stage can help you process your emotions and adapt to fearful or stressful events by reducing your emotional responses when recalling the events. If anxiety causes you to lose out on REM sleep, you may spend less time recovering from emotional events.

How To Avoid Anxiety at Night

Reducing anxiety can improve your sleep. Several strategies can help manage anxiety and stress:

• Anxiety redirection: Being more engaged in your community, such as volunteering or simply lending your neighbor a hand, can help take your mind off your stress and anxiety.
• Exercise: Studies show that physical activity can reduce symptoms of anxiety disorders. Regular exercise in the mornings and afternoons can also improve sleep.
  
• Meditation: Deep breathing and progressive muscle relaxation (PMR)—when you tense one area of your body at a time—can help you relax.
  
• Professional assistance: If you have an anxiety or stress disorder or suspect you do, it's worth talking to a psychiatrist or therapist. They can provide treatments, such as medications and therapy.
• Relaxing activities: Unwind from the day and get ready for sleep with a bedtime routine of relaxing activities. Try listening to music, reading, journaling, or taking a bath.
  
• Task management: It might help to write down what you must do during the day. Break down those extra stressful tasks into smaller, more manageable steps. Try to prioritize your time with the important stuff.

How To Calm Anxiety At Night

Some techniques can help you reset and go back to sleep. Try these tips:

• Change your environment, if possible: Make your sleeping area as comfortable as possible to help facilitate sleep. Your environment should generally be cool, dark, and quiet, with supportive pillows and mattresses.
• Don't clock-watch: If you have difficulty sleeping, don't check the clock. Knowing what time it is may only add to your worries if you've woken up with anxiety. This can contribute to the vicious cycle of anxiety and sleep.
• Establish a screen-free bed: If you are trying to go back to sleep, avoid checking your phone in bed, don't watch TV, and keep your laptop packed up.
• Get up and do something relaxing: If you can't fall back asleep and 15 minutes have passed, go into another room for a moment. Sit in a comfortable chair and read or do some breathing exercises. After relaxing, try going to bed again.
• Reduce certain types of lighting: If you can't keep your room dark, reduce blue or white lights. Dim yellow and orange or red lights won't interrupt your sleep as much.
• Write about future tasks: If something is coming up that's making your mind race, writing down what you have to do may help you sleep. One small study found that participants who wrote down their to-do lists fell asleep faster than those who wrote about what they'd completed.

When To See a Healthcare Provider

Since sleep difficulties can worsen anxiety and interfere with your sleep, it's important to know when to get help. Anxiety disorders are very common; about 30% of adults experience them at some point.

Talk to a healthcare provider for diagnosis and treatment if you have anxiety and sleep loss. They can provide ways to manage your condition, such as therapy or medication.

A Quick Review

Anxiety upon waking up can make falling back asleep difficult, and as you toss and turn, the worries and fears may only worsen. Whether from a mental health disorder or periodic stress, managing anxiety—and learning ways to fall back asleep—can be a critical part of maintaining your overall health. Keep an eye on how much rest you're getting, and if you suspect you have a mental health disorder, seek help from a healthcare provider.