Mental Health Tips
March 22, 2024

Why Do I Get Anxiety at Night and What Can I Do About It?

Written by
Two Chairs Content Team
Reviewed by
Nick Forand, PhD, ABPP
Updated on
Bed in dimly lit bedroom featuring green and white pillows, a bedside lamp, and a plant

Experiencing anxiety at night is a common concern that many people face. But why is anxiety worse at night for some people? As the world quiets down, our thoughts and worries often take center stage, making it challenging to find restful sleep. If you don’t sleep well you may feel worse in the morning, causing undue stress that weighs you down throughout the day. 

If you find yourself asking, “Why do I get anxiety at night?” — this article is for you. We’ll discuss common causes of night-time anxiety and provide a variety of helpful strategies to help you cope as bedtime approaches.

The relationship between anxiety and sleep

Studies have shown that sleep disturbances, particularly insomnia, are common in people with anxiety. Different types of anxiety disorders impact people and their sleep in varying ways, with some individuals experiencing more severe disruptions than others​​. People with anxiety disorders tend to exhibit heightened sleep reactivity, making them more susceptible to sleep disturbances during times of stress. 

People with generalized anxiety disorder, for instance, may experience chronic and excessive worry about various aspects of their lives. This ongoing state of worry can significantly affect their ability to relax and sleep at night. 

On the other hand, circumstantial or situational anxiety,which occurs in response to specific events or conditions, might lead to temporary sleep disturbances. This type of anxiety often resolves once the triggering event or condition is no longer present.

It's important to note that the relationship between sleep and anxiety is bidirectional: Anxiety can disrupt sleep, leading to a sleep debt that worsens anxiety symptoms, thereby creating a loop of insomnia, stress, and worry. This cycle highlights the importance of addressing both sleep and anxiety to break this negative pattern and improve overall mental and physical well-being.

Why do I get anxiety at night?

Often, there’s no single reason you’re experiencing anxiety at night time — it can have many causes and impact people differently. These factors can range from stress in your personal life and work to genetic predispositions and mental health disorders. The source of your night anxiety can come from any part of your day, or it may be in response to a particular event that’s leading to stress. 

Understanding the causes of your anxiety is important in developing effective strategies for management and treatment. Let’s look at some common causes of anxiety at bedtime.


Stress and anxiety often go hand in hand, particularly when it comes to their impact on sleep. Cortisol, a primary stress hormone produced in the adrenal glands, follows a 24-hour rhythm in the body. Normally, cortisol levels peak in the morning to promote wakefulness and gradually decline throughout the day, reaching their lowest at night — which is what helps us fall asleep.

Chronic stress disrupts this natural rhythm of cortisol. When under prolonged stress, something called the hypothalamic-pituitary-adrenal axis, which regulates cortisol production, becomes overactive. This leads to elevated cortisol levels that can persist into the evening, interfering with the body's ability to transition into sleep​​. 

Traumatic experiences

After a traumatic experience, such as experiencing an assault, witnessing violence, or being involved in a serious accident, it is normal to experience heightened anxiety for a period of time. For some, these experiences can lead to significant changes in mood, sleep, and arousal common in posttraumatic stress disorder (PTSD) that persist long after the event.

In fact, as many as 70–90% of PTSD patients report suffering from regular sleep disturbances. Traumatic experiences can disrupt sleep architecture, particularly REM sleep, which is essential for processing emotions and memories. This disruption can often lead to nightmares and distressing dreams related to the traumatic event, contributing to a heightened state of arousal and sleep disturbances, a common symptom of PTSD.  Post-trauma, hyperactivation of brain regions, like the amygdala and insula, which process fear and anxiety, can also occur. This heightened brain activity contributes to increased arousal, interfering with sleep.

Major life transitions

Major life transitions like moving, changing jobs, or significant relationship changes can impact anxiety levels and sleep patterns. Research indicates that fluctuations in stressful life events, especially during adolescence, are associated with changes in symptoms of anxiety and depression, as well as sleep duration and quality​​. 

These transitions can trigger a cascade of emotional responses, heightening anxiety, which in turn affects sleep regularity and overall sleep health. Managing your anxiety during these periods can help stabilize sleep patterns and reduce the feeling that anxiety is worse at night. 

Substance abuse

Substance abuse can impact sleep and exacerbate anxiety disorders. Individuals engaging in substance use may find themselves trapped in a vicious cycle where substances are initially used as a coping mechanism for anxiety. 

Studies have shown that substance abuse can amplify anxiety symptoms, leading to heightened feelings of unease and restlessness at night. Substances may also alter brain chemistry, ultimately worsening anxiety. 

Brain chemistry

Our brain chemistry can have an impact on how we feel in our day-to-day, as well as how well we sleep. There are certain neurotransmitters in the brain, like serotonin, GABA, and norepinephrine, and changes in how these chemicals function in the brain are associated with sleep problems: 

  • Serotonin is linked to mood and sleep, but if that system is out of balance, we might feel anxious and have trouble sleeping. 
  • GABA is a substance that helps us relax and sleep, but changes in GABA functioning can make us feel more anxious and find it hard to sleep. 
  • Norepinephrine keeps us alert, but changes in its levels it can make it hard to fall asleep.

This can create a cycle where feeling anxious makes it hard to sleep, and not sleeping well makes us feel even more anxious. 

How to reduce anxiety at night

You might want to learn how to get rid of bad anxiety at night, but anxiety is actually a normal emotion. It can be more helpful to think about managing your anxiety so it stays at a healthier level. Anxiety management can happen in a couple of ways: treating an underlying anxiety disorder through therapy and finding ways to help manage symptoms through different behavioral strategies. 

If your night-time anxiety is severe enough to disrupt your everyday life, therapy can be especially beneficial.

Talk to a therapist

Therapy can provide evidence-based solutions to help you learn coping skills and manage your anxiety. This includes proven techniques for challenging negative thought patterns, regulating your emotions, and facing anxiety-provoking situations. 

Working with a therapist can provide several benefits to help you with anxiety, including:

  • Providing targeted, evidence-based strategies to help with anxiety symptoms
  • Teaching you about the causes of anxiety and how to address them
  • Giving you a space to voice your concerns to an empathetic listener
  • Offering structured methods to help change the way you think, feel, and behave

Taken together, these benefits can be life-changing. With therapy alone, many people see substantial reductions in night-time anxiety symptoms. Read our blog to learn more about when to seek help

Practice deep breathing

Deep breathing exercises can be a simple and effective method of calming an overactive mind. Research has shown that even brief breathing exercises can reduce anxiety and may help you fall asleep faster and sleep better as a result.

Try this simple practice at night — square breathing — if you’re experiencing anxiety:

  1. Slowly inhale through your nose to the count of four
  2. Hold your breath for four seconds
  3. Slowly exhale through your mouth to the count of four
  4. Hold your lungs empty for four seconds

Repeat this cycle until you feel your anxiety symptoms begin to diminish.

Stick to a sleep schedule

A regular sleep schedule can prime your body and brain for bedtime. Your body has a natural sleep-wake cycle called your circadian rhythm, which regulates the hormones associated with sleep and wakefulness. 

But circadian rhythms can be disrupted, either through staying up too late, changing when you wake up, or starting activities that promote wakefulness before bed. By developing a set routine for when you go to sleep and when you wake up, you can maintain your circadian rhythm and hopefully have an easier time falling asleep.

Start journaling before bed

If you’re experiencing anxiety at night, symptoms may be the result of uncompleted plans or thoughts that you feel like you need to remember. The concern then becomes the conflict between sticking to your plan to go to sleep, getting up to work on a project, or making a note before you forget.

Starting a nightly journal can significantly alleviate this tension, letting you get all your thoughts onto paper before settling down for the night.

Therapy tailored to you

While there are things you can do to stave off anxiety at night, talking to a professional therapist can be a very effective and long-term solution. By engaging with therapy, you're taking a proactive step toward reclaiming your peace of mind and restoring the natural balance of your life.

At Two Chairs, our team has decades of experience helping people manage anxiety and take charge of their life. Start treatment today by booking an appointment online to get connected with the right therapist for you.

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