Sleep Anxiety: What to Know

Written by
The Manual Team
Medically approved by
Dr Earim Chaudry
Last updated
14th February 2022

In 30 seconds

Sleep anxiety is a feeling of stress, fear, worry, or anxiety about falling or staying asleep. More generally, anxiety and sleep problems are often closely related. Studies show people with poor mental health tend to be more likely to have sleep disorders. Yet both are treatable – and just because you struggle with sleep now, it doesn’t mean you will struggle forever.

The Link Between Sleep and Stress

Sleep can be stressful. When you’re not getting the amount of sleep you need, or you are struggling to fall asleep, it’s no doubt incredibly frustrating. And that frustration can make it even more difficult to achieve a good night’s sleep.

It’s a nasty vicious cycle, and sleep anxiety sits at the centre. Sleep anxiety refers to the feelings of fear or stress about falling asleep. In the long run, it can be really detrimental to your health.

Here, we’re sharing everything you should know about sleep anxiety – from the symptoms to the possible causes, and what you can do about it.

What is Sleep Anxiety?

Sleep anxiety is the name for the feelings of stress, fear, worry, or frustration you feel when thinking about falling or being asleep. Often, it manifests itself as a fear about not being able to fall asleep. However, in some people it is a phobia of sleep itself (known as somniphobia) – a fear that maybe something bad will happen or that you will have unpleasant dreams,  while they are sleeping.

Sleep disorders and anxiety are generally very closely related. You are more likely to suffer from sleep deprivation and poor sleep if you have generalized anxiety disorder, depression, or bipolar. And, similarly, you are more likely to have mental health problems if you have trouble sleeping.

Whichever comes first, poor sleep and anxiety about your sleep can feel like an endless frustrating cycle. But there are ways to break that cycle – as we discuss below.

But first:

What are the Symptoms of Sleep Anxiety?

Sleep anxiety can affect different people in many different ways. Here are some of the symptoms you should look out for:

  • Fast heart rate and rapid breathing
  • Excessive sweating
  • Physical tension and feelings of panic, stress, or fear, either at bedtime or when thinking of sleeping
  • Feelings of restlessness or nervousness
  • Gastrointestinal discomfort
  • Unpleasant dreams (unfortunately, these can be both a symptom and a cause of sleep anxiety).
  • Panic attacks. Panic attacks are episodes of acute fear that trigger a range of different physical symptoms – such as an increased heart rate, a sense of doom, or an overwhelming sense of fear. If they occur at night, you may be anxious that they can happen again.

If you suffer from anxiety generally, you will be familiar with many of these symptoms. However, if you have sleep anxiety, they may feel more intense – as there may not be much external stimulus to distract you.

What Causes Sleep Anxiety?

There are many possible causes of sleep anxiety:

  • Generalized anxiety disorder. If you suffer from anxiety, you are more likely to experience sleep anxiety. Generalized anxiety is a condition in which you feel excessive anxiety, often without an external trigger – combined with physical symptoms such as dizziness or shortness of breath.
  • Post-traumatic stress disorder (PTSD). PTSD is a type of anxiety disorder that is caused by a really upsetting, scary, or unpleasant event, such as an accident, assault, or health problem. After these events, it is common to relive them through nightmares or flashbacks. 
  • Thyroid problems. Sometimes, when you have too much thyroid hormone in your blood, your sleep can be affected. Trouble sleeping can be accompanied by feelings of irritability, anxiety, or nervousness. 

Find out more: Overactive Thyroid Symptoms in Men.

  • Chronic insomnia. Anxiety may cause a lack of sleep, but a lack of sleep can also cause anxiety. If you regularly worry about sleep disruption, or how many hours of sleep you are going to get, this can develop into anxiety. In this respect, sleep anxiety is a type of performance anxiety.
  • Nightmares. Similarly, if you are regularly afflicted by bad dreams, you may feel nervous about or reluctant to go to bed for fear of repeating them.
  • Sleep paralysis. People that suffer from conditions such as recurrent isolated sleep paralysis (RISP) can be prone to sleep anxiety. RISP is a condition that causes you to be unable to move your body. It can be very unpleasant and, if it happens a lot, it can give you fear of going to sleep.

Sometimes, anxiety can just happen – without any discernible cause. The important thing is to know that there are things you can do about it:

How Do I Stop Anxiety While Sleeping?

There are some effective methods to treat and prevent sleep anxiety. These include psychotherapy – usually in the form of cognitive behavioural therapy (CBT) – medication, and improved sleep habits.

  • Cognitive behavioural therapy (CBT). CBT is a type of psychotherapy. It is based on the idea that you can change your behaviour by changing your thought patterns, or the way that you think. CBT-I (or CBT for people with insomnia) may be your best option, but general CBT can be an incredibly beneficial treatment option for people with anxiety.

The treatment can help you understand and avoid anxiety triggers and change the way that you think about sleep. It takes a matter of months to see results. 

  • Sleep medicine. Poor sleep is a type of medical condition – and medicinal solutions can help. Treatments such as melatonin or promethazine can help you get better sleep. But be careful with them. If you are suffering from anxiety, you may become dependent upon them to sleep.
  • Improve your sleep hygiene. Sleep hygiene is the term for your habits and routines that affect your sleep quality. Let’s explore these in detail:

What are Some Tips for Getting a Good Night’s Sleep?

  • Reduce alcohol. Alcohol may help you get to sleep more quickly, but it affects the quality of your sleep – and it has been found to make anxiety worse in the long term. Reducing the quantity of alcohol you drink may help your sleep anxiety.
  • Cut stimulants. Caffeinated drinks like tea or coffee will affect the quality of your sleep – and they too have been found to exacerbate anxiety. If you want to sleep better, avoid caffeine at least six hours before bedtime.
  • Wind down before sleep. Using devices or exercising right before you go to bed is generally not recommended – as they are likely to keep you up. Instead, try relaxation techniques like deep breathing, meditation, or mindfulness – or just read a book or have a hot bath.
  • Create a pleasant sleep environment. That means a cool, quiet, and dark space that you only use for sleep and sex.
  • Exercise regularly. Exercise can be a very effective treatment for anxiety and poor mental health in general. Try to do 150 minutes of moderate activity a week.

Key Takeaways

Sleep anxiety is the name for any feelings of stress, nervousness, or fear around sleeping. Sleep and anxiety are very closely related – and one can affect the other.

There are effective things you can do to help, however. These include psychotherapeutic practices like CBT, or improving your sleep hygiene and mental health habits more generally – by cutting alcohol and caffeine and exercising regularly.


How Does Sleep Affect Anxiety?

Sleep is known to have an impact on anxiety and your mental health generally. People who have trouble sleeping are more likely to have anxiety disorders, while those with anxiety are more likely to suffer from poor sleep. It can feel like a difficult cycle to break.

What is the Best Way to Sleep?

There is no best way to sleep that will be true for everyone. However, aiming for at least 7 hours of sleep a night is important. Cutting down on stimulants and alcohol will help, as well as ensuring that the place where you sleep is cool, dark, and quiet.

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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