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How to Sleep with Anxiety: 14 Science-Backed Tips To Help

Anxious thoughts keeping you awake? Try relaxation techniques, a brain dump, and improving your sleep hygiene to help you fall asleep.
Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
Our Editorial Standards
We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists. Learn more.
Updated Regularly
We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.
Published
2023-01-20
Updated
20 MINS
Woman meditating in bedroom to reduce anxiety before bed

Falling asleep can be hard to do at the best of times. But when you have anxiety, you probably find yourself wide awake in bed longer than most. 

Sleep loss and anxiety can often become a vicious circle, too, as anxious thoughts keep you awake, but watching the clock and seeing how little sleep you’re getting only makes you more stressed. And sleep deprivation itself can make anxiety worse.

Luckily, there are ways you can break the cycle to calm anxious thoughts and get the restful sleep you need to feel your best. 

Below, we’ll dive into why anxiety disrupts your sleep and, more importantly, what you can do to fall asleep in the first place and fall back to sleep if you wake up during the night. We’ll also cover how the RISE app can help you get a good night’s rest, even with anxious thoughts. 

What is Anxiety?

Anxiety is the feeling of worry, nervousness, and unease. While feeling anxious some of the time is a natural response to stress, some of us feel severe anxiety, feel anxious all of the time, or these anxious feelings start impacting our work, health, and relationships. 

Anxiety disorders include: 

  • Generalized anxiety disorder 
  • Panic disorder
  • Post-traumatic stress disorder
  • Obsessive-compulsive disorder 
  • Social anxiety disorder

You may also experience sleep anxiety, where you feel anxious specifically about going to sleep — perhaps because you regularly struggle to fall asleep, have nightmares, or worry about what your sleep tracker will tell you in the morning. 

What Are the Symptoms of Anxiety?

The symptoms of anxiety are different for everyone and vary depending on which type of anxiety disorder you have. 

Common symptoms of anxiety include: 

  • Feelings of worry, fear, nervousness, or restlessness
  • Having trouble sleeping  
  • Having trouble concentrating or having brain fog
  • Being easily fatigued, which is made worse if anxiety causes sleep loss  
  • Irritability
  • Muscle tension
  • Nightmares  
  • Panic attacks 

Why is it So Hard to Sleep with Anxiety?

Sleep has a huge impact on mental health, but how you’re feeling mentally also affects how easy it is to fall and stay asleep. 

When you’re anxious, your body’s on high alert. Anxiety causes your sympathetic nervous system to engage and your heart rate and blood pressure to increase. This primes your body to face danger. But more often than not, we’re simply laying in bed, not in any danger at all. 

Here’s why it’s hard to get enough sleep when you’re feeling anxious or suffering from an anxiety disorder. 

Anxiety and Sleep Loss is a Vicious Circle 

Sleep and anxiety are closely linked. When your body’s in fight-or-flight mode, it’s hard to drift off, resulting in sleep loss. But when you’re sleep deprived, your amygdala — the part of your brain responsible for emotional processing — is fired up, which can cause anxiety. This creates a vicious circle that leads to more anxiety and more sleep loss. 

A 2020 paper found those with anxiety disorders often have sleep disturbances, including interrupted or shortened sleep, increased lighter stages of sleep, and less deep sleep. Deep sleep is not only vital for health and energy, it’s been found to help calm anxiety.

Beyond your overactive amygdala, your prefrontal cortex, which controls your amygdala and reactions to stress, takes a hit, too. Increased amygdala reactivity and decreased prefrontal control have been found after five nights of four hours of sleep — a sleep schedule some of us have during the workweek.

Indeed, it’s this overactive amygdala from sleep deprivation many of us are familiar with when we witness or exhibit ourselves outsized or inappropriate emotional responses to disruptive experiences during the day. For example, research shows that just one night of sleep deprivation triggers a 60% increase in the reactivity of your amygdala in response to negative pictures.

Sleep expert Matthew Walker describes the amygdala as the emotional gas pedal and your prefrontal cortex as the brake in his book Why We Sleep. To have control over your anxiety and emotions you need to get enough sleep.

Before Bed is Prime Worry Time 

It’s hard to calm anxiety at night. You might feel anxious all day, but those feelings of unease really kick in when you climb into bed. Or perhaps you don’t even notice your anxiety until you’re staring wide awake at the ceiling. 

This often comes down to the fact that you don’t have any tasks to do or any distractions, so your mind begins to drift to anxious thoughts. Before bed may be the only time of day you’re not working, socializing, watching TV, or doing chores, this makes it easy to ruminate.

Rumination happens when you repeatedly go over your problems again and again, or get stuck with the same anxious thoughts. Rumination can not only keep you awake, research shows it can make health issues and pain worse. 

More studies need to be done into how to overcome rumination, but distraction by socializing or doing physical activity, mindfulness therapies, cognitive therapy, and interpersonal therapy may help. 

Rumination-Focused Cognitive Behavioral Therapy (RFCBT) is another option. It’s a form of therapy that’s designed to help you shift your thinking from unhelpful rumination to helpful processing of your stress. You’re taught the warning signs of unhelpful rumination and how to use methods like distraction to break this cycle of thinking.

Of course, you can’t do some distractions — like socializing or exercise — if you find yourself ruminating in bed. This is where good sleep hygiene comes in. Sleep hygiene is the set of behaviors you can do to help you feel sleepy at bedtime, fall asleep faster, and wake up less often throughout the night (another prime worry time).

You can learn more about sleep hygiene here, and we’ll dive into what exactly to do soon.

You Get Anxious About Sleep Itself 

You might feel anxious before bed because you’re experiencing sleep anxiety as you begin to worry about getting enough sleep, hitting targets on your sleep tracker, or begin dreading waking up during the night. 

If you do wake up in the night, checking the time and seeing how little sleep you’re getting can trigger anxiety — which makes it hard to fall back to sleep. 

Anxiety can also cause nightmares, which can wake you up in an anxious state or cause anxiety before bed as you begin to anticipate them. 

You can learn more about the connection between anxiety and sleep here. 

You May Have a High Level of Sleep Reactivity 

Stress and anxiety are, unfortunately, unavoidable parts of life, but they affect us all differently. How much stress and anxiety affect your sleep depends on your sleep reactivity. The higher your sleep reactivity, the more stress can keep you up or wake you up in the night. 

And if you have high sleep reactivity, you may find it hard to drift off, giving you more time awake in bed to ruminate

Your sleep reactivity comes down to genetics, family history of insomnia, gender (women tend to report higher levels of sleep reactivity than men), and environmental stress exposure, but it’s still not known exactly how it works. 

You can find out your sleep reactivity by taking the Ford Insomnia Response to Stress Test (FIRST). 

Having a high level of sleep reactivity puts you at a higher risk of developing insomnia — making it even more important to stay on top of stress, anxious thoughts, and sleep hygiene. 

And research shows once you’ve been exposed to stress and developed insomnia, your sleep reactivity may become sensitized, increase, and not return to pre-insomnia levels, even when you stop suffering from insomnia.   

Having a high level of sleep reactivity also makes you more vulnerable to developing circadian rhythm sleep disorders such as shift work disorder — when you struggle to sleep and feel excessive tiredness when working nights or rotating shifts. 

Research suggests those with high sleep reactivity are more sensitive to circadian challenges, so if you sleep in late at the weekend and mess up your body clock, you may be tanking your energy levels, sleep, and mental health all at the same time. 

Your Circadian Rhythm May Also Be to Blame 

It’s not all about sleep, though. Your circadian rhythm also plays a part in how anxious you feel. Your circadian rhythm is your body’s internal clock. It runs on a roughly 24-hour cycle and dictates everything from your sleep-wake cycle to your hormone production. 

But with late nights on the weekends, early mornings in the week, or night shifts, it’s easy to be out of sync with your circadian rhythm.

Research shows circadian rhythm disruption can lead to depression and anxiety. And a 2019 study found having more depressive and anxiety symptoms were associated with larger disturbances to your circadian rhythm and sleep. 

How Do You Fall Asleep with Anxiety?

Whether you battle with anxiety all day long or only feel anxious thoughts creep up when you’re lying quietly in bed, here’s how you can calm your mind to fall asleep or go back to sleep.

1. Try Tried-and-Tested Relaxation Techniques  

It can be hard to calm anxious thoughts when you’re in the throes of anxiety, but certain techniques can help you relax before bed. Relaxation techniques can help you fall asleep when you first get into bed and drift back off if you wake up during the night. 

A 2021 study found progressive muscle relaxation, guided imagery, and breathing exercises like deep breathing all increased how relaxed participants felt.  

Music relaxation at bedtime has also been shown to help those with post-traumatic stress disorder (PTSD) and insomnia. It improved sleep efficiency, the measure of how long you spend in bed actually sleeping, taking into account the time it takes you to fall asleep and how long you spend awake during the night. The higher your sleep efficiency, the more time you spend asleep. 

The RISE app has audio guides that guide you through four science-backed relaxation techniques for better sleep.

RISE users on iOS 1.202 and above can click here to go right to their relaxation audio guide homepage and get started.

2. Do a Brain Dump 

Journaling before bed can help you get a better night’s sleep, but writing down your to-do list may have the biggest difference of all. Research found people who wrote a to-do list before bed fell asleep faster than those who wrote down the tasks they had already completed. 

The paper concluded, “Rather than journal about the day’s completed tasks or process tomorrow’s to-do list in one’s mind, the current experiment suggests that individuals spend five minutes near bedtime thoroughly writing a to-do list.”

Writing down everything you have to do can help your brain stop ruminating on them. Use RISE’s brain dump feature to write out your to-dos and get a reminder of them the next morning, so you can fall asleep safe in the knowledge they won’t be forgotten about. 

RISE users on iOS 1.202 and above can click here to set up their Brain Dump Habit notification

3. Do a Relaxing Bedtime Routine 

Slow your brain down and prime it for sleep with a relaxing wind-down routine. Doing a bedtime routine about one to two hours before bed is one of the key behaviors of good sleep hygiene.

Avoid doing anything stressful or stimulating before bed like working, watching the news, or scrolling through social media. Instead, do calming activities like: 

  • Mindfulness meditation 
  • Yoga
  • Journaling
  • Reading
  • Listening to music
  • Taking a warm shower or bath (this can also help drop your body temperature to help you fall asleep) 

Be sure to do your bedtime routine in a dimly lit environment to stop bright light from keeping you up. 

Doing the same routine at the same time can also be a helpful signal to your brain that it’s time to start slowing down and switching off. The routine can also help to preoccupy your mind if you find yourself getting anxious in the run-up to bedtime. 

4. Don’t Lay Awake in Bed 

If you’ve been clock-watching for more than 20 minutes, try getting out of bed and doing a relaxing activity until you feel tired. Avoid bright lights, screens, and anything too stimulating. 

Doing something distracting like reading can stop your mind from worrying, and getting out of bed when you’re struggling to sleep will stop your brain from associating your bed with a stressful place. You’ll hopefully start to feel sleepy again soon and can climb back into bed more relaxed. 

You can also do this if you find yourself awake during the night and nighttime anxiety is stopping you from falling back to sleep.

We’ve covered other methods to help you fall back asleep here.

Bonus tip: Try to avoid checking the time if you can’t fall asleep or if you wake up during the night. If you have an alarm set, it doesn’t really matter what time it is, but knowing the time will only increase your anxiety.

5. Exercise (But Not Too Close to Bedtime) 

Hitting the gym or lacing up for a run can help with both anxiety and sleep. Moderate aerobic exercise has been shown to help insomniacs fall asleep faster, wake up less often during the night, and feel more rested in the morning. And low-to-moderate-intensity exercise can improve overall mood, anxiety, and depression.

But doing intense exercise within an hour of bedtime may increase how long it takes you to fall asleep. Exercise releases the stress hormone cortisol and you’re probably exercising in bright light, too, so aim to work out earlier in the day. You can find out more about the best time to work out here.

Bonus tip: Try working out in nature — run around your local park, plan a day trip to the nearest hiking spot, or do jumping jacks in your backyard. Spending time in nature has been shown to decrease stress and boost your mood

For a real win-win, work out outside in the morning to get the sleep-boosting benefits of early morning sunlight exposure, too.

6. Drink Caffeine Wisely 

RISE app screenshot telling you what times to limit caffeine
The RISE app can tell you when to have your final coffee of the day.

Caffeine is great when you need a pick-me-up first thing in the morning, but consuming too much of it can not only keep you up past bedtime, it’s been shown to increase anxiety

Stimulants like caffeine can also cut into your sleep time, making you more vulnerable to anxiety in the first place. 

Try cutting down on the amount of caffeine you have — or cutting it out altogether if you find you’re sensitive to it. Caffeine can linger in your system for 12+ hours, too, so aim to have your last coffee by the early afternoon. 

RISE can tell you the exact time you should stop drinking coffee each day based on your circadian rhythm. 

You can learn more about when you should stop drinking coffee and how much caffeine is too much here. 

RISE users on iOS 1.202 and above can click here to set up their limit caffeine reminder.

7. Avoid Sleep Aids 

It can be tempting to reach for sleep aids to help you drift off if you’re suffering from poor sleep, but both over-the-counter and prescription sleeping pills can be addictive and can come with unpleasant side effects. 

Plus, the sleep you do get is manufactured and not the natural healthy sleep you need to feel your best. Sleep aids can also cause a hangover effect, making you feel groggy the next day.

Even melatonin supplements, the manufactured version of your natural sleep hormone, can sometimes cause anxiety as a side effect. 

To learn more, you can dive into the safety of sleep aids here. 

8. Avoid Alcohol Before Bed 

Alcohol is a common sleep aid, but you should avoid it before bed. While it can help you feel sleepy and forget about your worries, it can cause fragmented sleep (when you wake up during the night) and insomnia. 

As a general rule, avoid drinking three to four hours before bed. RISE can tell you the exact time to have your last alcoholic drink.

Find out how long before bed should you stop drinking alcohol here. 

RISE users on iOS 1.202 and above can click here to set up their avoid late alcohol reminder.

9. Get Natural Light First Thing 

When you’re suffering from anxiety or depression, you may not feel like heading out for a walk, an outdoor workout, or even leaving the house at all. But daylight, especially first thing, can dramatically help your sleep. 

Aim to get at least 10 minutes of natural light as soon as possible after waking up. This will reset your circadian rhythm, helping you feel sleepy at the right time later that day. Extend that to 30 minutes if it’s overcast or if you’re getting light through a window. 

Try to get some sunlight throughout the day, too. Take your workout outside, go for a long walk, or try to work by a window. 

10. Limit Light in the Evenings

RISE app screenshot telling you when to get and avoid bright light
The RISE app can tell you when to get and avoid bright light.

Light suppresses melatonin, making it harder to fall asleep. About 90 minutes before bed, dim the lights and avoid screens. If you do watch TV or scroll on your phone, put on blue-light blocking glasses to stop screens from sabotaging your sleep. 

You should also be careful with light exposure if you wake up during the night. Use a phone flashlight, instead of bright overhead lighting, if you need to get up and use the bathroom. 

And if you get out of bed to do a relaxing activity when you can’t sleep, dim the lights as low as possible and avoid screens. 

RISE can remind you when to get and avoid bright light, and when to reach for blue-light blocking glasses each day. 

​​RISE users on iOS 1.202 and above can click here to set up their get bright light reminder.

11. Go to Bed at the Right Time for You 

Even when anxious thoughts aren’t keeping you up, if you go to bed at the wrong time for your body clock, you may find yourself lying awake for hours, which could be a source of anxiety itself. 

Check the RISE app for your Melatonin Window. This is what we call the roughly one-hour window of time when your body’s rate of melatonin production is at its highest. If you go to bed during this window, you’ll have an easier time falling and staying asleep. 

Going to sleep at the right time for you, and therefore falling asleep more easily, will also give you a better chance of meeting your sleep need, the genetically determined amount of sleep you need, each night. 

Identifying a bedtime like this can also help you avoid the temptation to stay up with one more Netflix episode if you experience anxiety before bed.

RISE users on iOS 1.202 and above can click here to view their sleep need.

RISE users on iOS 1.202 and above can click here to set up a reminder to check their Melatonin Window.

12. Live in Sync with Your Circadian Rhythm 

RISE app screenshot showing your energy peak and dip times
The RISE app can predict your circadian rhythm each day.

Being out of sync with your circadian rhythm can lead to depression, anxiety, and poor mental and physical health, and syncing back up can help. 

As leading circadian rhythm expert Satchin Panda says in The Circadian Code, “having a robust circadian clock is both a protection against and a path out of anxiety and depression.” 

How exactly can you live in sync? 

  • Keep a consistent sleep pattern, even on your days off
  • Eating during the day and at roughly the same times 
  • Get morning daylight and avoid light in the run-up to bedtime 

The RISE app can predict your circadian rhythm each day, so you can see when your body wants to wake up, wind down for bed, and sleep. RISE can also remind you when to get and avoid light and when to avoid large meals close to bedtime. 

RISE users on iOS 1.202 and above can click here to see their circadian rhythm on the Energy screen.

13. Consider CBD and Cannabis

CBD and cannabis are often recommended for those with anxiety and sleep problems. And they may be useful in some cases.

Cannabis has been shown to: 

  • Decrease how long it takes to fall asleep 
  • Reduce how long you’re awake during the night 
  • Reduce nightmares 
  • Reduce anxiety 

But more research needs to be done to be sure, and some research suggests high doses of THC (the part of cannabis that gets you high) in those who regularly use it can increase how long it takes you to fall asleep and how often you wake up during the night. 

When it comes to CBD, research shows it can improve anxiety, including general anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Higher doses of CBD in cannabis have been associated with higher sleep efficiency.

While a lot of research shows cannabis and CBD may improve sleep, most of what we know about how the substances affect sleep actually comes from studies on how they affect anxiety, with sleep as a secondary outcome. So, while they show promise, we recommended trying tried-and-true sleep hygiene habits before turning to CBD or cannabis.

Want to dive deeper? We’ve covered whether cannabis helps with sleep and whether CBD helps with sleep here.

14. Speak to a Doctor or Therapist 

Anxiety can easily affect your sleep, and a lack of sleep can affect everything else in life, including your mood, energy levels, productivity, and mental and physical well-being. So, anxiety is worth getting to the bottom of. 

While relaxation techniques and good sleep hygiene can help you fall asleep, you may need more help reducing your anxiety, depending on how severe it is. 

Consider speaking with your healthcare provider, a therapist, or a mental health professional. They can recommend treatment options like cognitive behavioral therapy (CBT), for example, which has been shown to improve anxiety and insomnia

They can also help to get to the bottom of why you’re feeling anxiety in the first place, helping you sleep better long term. 

Get a Peaceful Night’s Sleep, Even with Anxiety  

Battling with anxiety throughout the day is hard enough, but it can feel even harder when you’re lying awake alone in bed. This is especially true when sleep loss can make you feel more anxious, and it’s easy to get anxiety around your sleep. 

Try relaxation techniques like progressive muscle relaxation, doing a brain dump, and good sleep habits like getting bright light and avoiding caffeine at the right times. 

The RISE app can help by telling you the ideal times to do 20+ sleep hygiene habits each day based on your circadian rhythm. These habits will help you fall asleep faster and wake up less often during the night. And when you need an extra helping hand calming anxiety, turn to RISE’s guided relaxation techniques to help you drift off and get a good night’s sleep. 

Summary FAQs

How can I fall asleep with anxiety?

You can fall asleep with anxiety by doing relaxation techniques like progressive muscle relaxation, doing a brain dump before bed, getting out of bed and doing a relaxing low-lit activity when you can’t sleep, and maintaining excellent sleep hygiene throughout the day.

Why does anxiety get worse at night?

Anxiety can get worse at night as you don’t have any distractions, so it’s easy to ruminate and begin feeling worried and anxious. You may also feel more anxiety at night as you worry about how long it’ll take you to fall asleep or how little sleep you’re getting that night.

Sleep anxiety symptoms

Sleep anxiety symptoms include feeling worried, stressed, or uneasy; having trouble falling asleep or going back to sleep; restlessness, and irritability.

Sleep anxiety medication

Sleep anxiety medications include antidepressants, benzodiazepines, and z drugs. These medications are designed for short-term use, however, and can come with side effects. More natural sleep anxiety medication includes melatonin and CBD, but the most risk-free treatment is improving sleep hygiene and trying relaxation techniques to calm anxiety and help you fall asleep.

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